Assembly Standing Committee on Business and Professions

All right? Good morning. Welcome to this morning's Assembly Business and Professions Committee hearing. Phil. As long as you don't keep on walking out the exit. Perfect. We have a binder. It's a good sign. We have 12 bills on today's agenda.

Please note that AB 481, Koreo, AB 913, Petrie Norris, and AB 124 Holden have been removed from today's hearing agenda and will remain eligible to be heard on another date. We also have the following four bills on consent.

AB 602 by Assemblymember Pellerin, AB 623 by Assemblymember Chen, AB 936 by Assembly Member Wood, and AB 1610 by Assembly Member Joan Sawyer.

For each bill being presented today, we will be allowing primary witnesses here in the room today to speak for up to two minutes each, with up to two primary witnesses per side. Any additional witnesses will be limited to name position on the bill and the organization they represent, if any.

For those wishing to provide further comments, we are accepting written testimony through the position letter portal on the committee's website. With that, we're going to begin today's hearing as a Subcommittee. And I see Assemblymember Hart with agenda item number five, AB 687.

If you would like to present, sir, you are more than welcome. This bill enjoys support from both sides. That's a great bill. Just hit the. It might take a second, or do I need to hit my. There we go.

Thank you, Chairman and members, I'm pleased to present AB 687, a measure to help cities and counties better track and regulate cannabis activity. Proposition 64, passed by the voters in 2016, established the state's cannabis track and trace system.

This software tracks commercial cannabis activity from seed to sale and can provide key data for enforcement and deterrence of illegal sales and cultivation. Local governments, who are often on the front lines of enforcement, unfortunately do not have access to this critical data set.

They must either replicate cannabis data directly from licensees or regulate with limited information, making regulating cannabis costly and inefficient. AB 687 will direct the Department of Cannabis Control to provide local governments access to the state's track and trace data in real time.

The measure ensures the data is shared with public agencies that can aggregate, analyze, and provide necessary support for law enforcement to tackle illegal cannabis grows.

Speaking in support of the bill with me today are Greg Turner, representing the California Cannabis Authority, and Elizabeth Espinoza, representing the County of Santa Barbara.

Great. Ready when you are. Two minutes for witness. Thanks.

Thank you. Mr. Chairman and members, my name is Greg Turner. I'm the Executive Director and counsel of the California Cannabis Authority. Thank you for the opportunity to testify, and thank you Assemblymen Hart, for carrying the bill. CCA is a joint powers authority.

We were created by California counties for the purpose of providing tools to local governments to be able to be more effective and more efficient in their regulatory and tax programs. We do that predominantly through a data analytics platform where we take in cannabis related transactional data and then provide that sift through that raw data, and then provide that in a way to local governments, which is prioritized.

It's analyzed and prioritized for them so that they can focus their resources on those actors that are furthest outside the parameters of either state or local regulations. So we provide that in a cloud based secure system, and it is provided to local governments that have a user level access to the data for jurisdictionally specific information to them.

AB 687 would allow us to get access to delivery related zip code information, which is really important from both the Tax Administration and a regulatory perspective, as well as a larger data set of track and trace data. So with that, I'm happy to answer any questions, but I'll keep it short.

Thank you.

Thank you. Good morning, Mr. Chairman and members. Elizabeth Espinosa here this morning on behalf of the Board of Supervisors in the County of Santa Barbara. For context, the County of Santa Barbara has issued more active cannabis cultivation licenses than any other jurisdiction in the state, representing more than 20% of those that have been issued in the state.

As such, it's critical for our county to have access to timely, accurate, and location specific data about local commercial cannabis activities.

In the interest of time, I'll finish by thanking Assemblymember Hart for his leadership on this measure that will facilitate local government real time access to track and trace data that is exceptionally important for effective and efficient local cannabis regulation, as well as helping more fully inform cannabis policy at the local level.

I thank the committee for your positive consideration of this measure and urge you to support SB 687. Thank you.

Thank you very much. Now I'll turn it over to any primary witnesses in opposition. Are there any primary witnesses in opposition in the hearing room? Seeing none. Now we'll turn it over to the public for add ons. Anybody want to add on to the bill in support of AB 687?

Anybody here to add on in support? Seeing none. Anybody who wants to add on in opposition to AB 687? Seeing none. We're going to bring it back to colleagues for any questions or comments on the bill.

Colleagues, any questions? The coffee hasn't kicked in yet. Just give them a little time, but with that, I'll turn it over to Assemblymember Hart. Would you like to close?

And I would simply, respectfully request an aye vote. Thank you.

Thank you, sir. Thank you for bringing this bill forward. Although I believe some guardrails would be useful to ensure that the California Cannabis Authority and other local agencies don't have unfettered access to track and trace data for cities and counties that they don't represent, I will be happy to support the bill today when we have a quorum.

So as soon as that happens, I'm sure we'll get a motion in a second and we'll vote on the bill. Thank you very much.

With that, we're going to move on to agenda item number two, AB 420, by Assemblymember Aguiar-Curry. I'm guessing that's not by accident the bill number. Well done to your interns for standing in line. No, you wouldn't. Assemblymember, we're ready when you are.

So nice to see everybody has a sense of humor this morning. It's going to be a long day, gang. Thank you, Chairman Berman and members. And I'd also like to thank the committee staff for all their work on this.

This bill clarifies that the medicinal and adult use cannabis Regulation and Safety act does not prohibit a cannabis licensee from manufacturing, distributing, or selling products that contain industrial hemp or hemp derived compounds or extracts.

Hemp and Marijuana are both Members of the cannabis family, but hemp is a typically non intoxicating and has higher levels of CBD. Given the similarities, many of the products made using hemp and cannabis are manufactured using the similar processes, and the products are similar, too.

For example, CBD products can be made from hemp or cannabis and are very popular among consumers. CBD is non intoxicating or habit forming and provides relief from pain, inflammation, anxiety, insomnia, and other conditions.

CBD products derived from hemp are widely available online in grocery stores, gas stations, gyms, and other common retail locations. However, CBD is also used in many cannabis products, but cannabis manufacturers, distributors, and retailers can only work with cannabis derived CBD.

Cannabis derived CBD is much more expensive because it is subject to stricter regulation and cannabis typically has a lower CBD content. This puts cannabis licensees at a disadvantage when selling their products.

This restriction contributes to the struggle of cannabis licensees to stay afloat as they compete with the illegal market. AB 420 will enhance the viability of legal cannabis licensees in the marketplace by authorizing licensees to manufacture, distribute, and sell hemp and hemp derived CBD and other products in compliance with current law.

We look forward to working with stakeholders, state agencies and committee staff as we address concerns about the best way to implement these changes.

With me today are Pamela Epstein, representing the California Cannabis Industry Association, and Karen Woodson from Kiva Confections.

Great. Ready whenever you all are. Two minutes per witness and support.

Good morning, Mr. Chairman and members. Thank you to the assemblywoman for her work on this issue. My name is Pamela Epstein. I am the chief legal and regulatory officer for Eden Enterprises.

Eden holds cannabis licenses for retail, distribution and manufacturing. I'm here on behalf of the California Cannabis Industry Association as our Board President. CCIA represents several hundred licensed cannabis businesses and ancillary companies across California.

CCIA and several other cannabis trade associations have consistently supported the integration of hemp cannabinoids into the cannabis supply chain by licensees specifically to incorporate hemp cannabinoids like CBD in manufactured cannabis goods, to manufacture hemp products within their facilities, and to sell hemp products within licensed dispensaries.

Existing cannabis laws are well suited to accommodate hemp products, and the legal industry would benefit significantly from the opportunity to expand product offering. California's legal cannabis market is struggling. Operators are being pushed to the brink of their existence.

At the same time, the illicit market continues to gain market share. Proposition 64 was intended to create opportunities for legal operators while working to subvert the illicit market. Unfortunately, we are far from achieving that reality.

The industry continues to be challenged by a lack of access to retail, excessively high and complex taxes, and costly regulatory requirements. Licensed dispensaries are also seeing the sales of intoxicating hemp products eat into their bottom line, estimating losses of around 30%.

Often, these products are designed to be attractive to children and are manufactured using heavy metals and residual solvents without final form product testing.

Unfortunately, the lack of enforcement and the ease of accessibility of these hemp products harms not only regulated businesses, but deprives the State of generated tax revenue promised by Prop. 64. 17 Regulated cannabis states already provide authorization for the integration of hemp cannabinoids into their cannabis supply chain.

Metric, our state's track and trace system is familiar with the technical integration needs. In fact, nine of those 17 states, use metric to meet their track and trace requirements.

And if you could wrap up when you get a second, that'd be great.

Absolutely. The MAUCRSA is already set up to manage dual use facilities with CGMP. Manufacturers manufacture these products, CBD only, and for these reasons, CCIA is proud to support AB 420 and urge your aye vote today. Thank you.

Thank you very much.

Good morning, Committee Members, and thank you, Assemblywomen, for the leadership and courage that brings us here today. My name is Karen Woodson with Kiva Confections and I am also here on behalf of the California Cannabis Manufacturers Association.

My remarks will be brief, I promise. I am here to testify that manufacturers like Kiva would benefit greatly from the option to use hemp derived cannabinoids. A significant number of Kiva's product use minor cannabinoids like CBN and CBD to create a tailored experience for our consumer.

But it's a costly to source these minor cannabinoids from the closed looped cannabis market. And those costs are rising as we start to see contraction in the cultivation sector. According to Kiva's own innovation team, a product made with hemp cannabinoids would, on average cost around $20.

But that same product, sourced from cannabis derived cannabinoids, costs the consumer $24. That 20% savings could be passed on to consumers and help make our products a bit more competitive against illicit sales.

In addition to the integration matter, we also support efforts to increase enforcement against the proliferation of intoxicating hemp markets or hemp products that we're seeing on the market today. AB 420 represents an absolute step in the right direction and I strongly urge your support today. Thank you.

Thank you very much. Now let's turn over to any primary witnesses in opposition. Are there any primary witnesses in opposition to the bill in the hearing room today? Seeing none, let's change it over to the members of the public. Anybody wants to add on in support of AB 420 this morning?

Anybody wants to add on support? Seeing none. Anyone who wants to add on in opposition? Seeing none. We're going to bring it back to colleagues for questions or comments. Any questions or comments from colleagues? Seeing none. We're still a Subcommittee, so we don't have motions or seconds yet, but assemblymember would you like to close?

Simply ask for your aye vote. Thank you very much for AB 420.

Thank you very much. Thank you for what is turning out to be years of leadership on this topic. I understand there's still a bit of a long road to go and this bill is currently more of a vehicle for those further discussions.

I'll be supporting the bill today to allow those discussions to continue and look forward to seeing the bill fleshed out more as it moves through the process and appreciate all your leadership.

And when we get the chance, I'm sure we'll have a motion in a second. Thank you. Thanks.

So next up we have agenda item number eight, AB 1244 by Assemblymember Holden. And for those who might be curious, we go in file order, and so we have to. So we stick with that. Assemblymember Holden, ready whenever you are.

Thank you. And good morning, Mr. Chair and committee.

Today I'm presenting AB 1244. Bill that would require qualified manager under the Private Investigator Act and the Private Security Services Act to hold a current and valid qualified manager certificate issued by the Director of consumer affairs.

According to the Bureau of Security Investigative Services, there have been a number of instances where the bureau has cited multiple companies because of the behavior of a single qualified manager who moves from company to company. through the administrative process.

Through the administrative process, the bureau can discipline the company, but not the qualified manager individually. So the person responsible for the conduct that led to formal discipline of the company is able to move on to another company without a record of the discipline.

I want to address the closing statement that was made in the analysis regarding the need for the bill. Existing law allows someone with a qualified manager designation to be associated to multiple licenses.

While existing law establishes responsibility and liability for qualified managers, disciplinary action cannot be taken on qualified managers individually because the designation is a lifetime designation and not subject to discipline.

This results in situations where the bureau cites or revokes company license and the qualified manager is still free to associate to another existing license without a record of discipline. And unwittingly, consumer does not have any way to discover that a qualified manager may have had disciplinary or performance issues.

My office has also had conversations with the California Association of Licensed Investigators. They have highlighted some areas of concern regarding the bill. As BSIS and Cali continue to talk, I'm confident that a mutual, agreeable resolution will be reached. Joining me.

Kelly Jensen, representing the California Association of Licensed Security Agencies, Guards and Associates. I ask for your aye vote.

Thank you. Assemblymember, two minutes, please. Go ahead.

Thank you, Mr. Chairman.

Kelly Jensen, representing the California Association of Licensed Security Guards and Agencies. This is the trilogy of bills that we have worked with Mr. Holden on over the years that has added additional training requirements, additional reporting requirements, and now additional requirements for qualified managers.

We're very proud of that. The security guard industry is regulated in such a way in California. We are the top of the heap as it relates to regulation in the nation. Very proud of that.

With the amount of security guards in California, it's very important that we have those regulatory statutes in place. So we ask for an aye vote. Thank you.

Thank you very much. Any primary witnesses in opposition to the bill want to present. Two minutes per primary witness in opposition. Please go ahead. And you can sit in the front if you want, or stand at the mic, whatever your preference.

I can stand here?

Yeah.

All right. Thank you. Good morning. Good morning, Chair. Good morning, members. Thank you for allowing me to testify. My name is Francie Taylor. I'm a past President and current government affairs chair of the California Association of Licensed Investigators, although we really support the consumer protection that we know exists and what was stated here earlier.

But this bill would create a double licensure for many of our members. The way our scheme is set up is that I am a QM of my own agency, so I supervise myself. And this bill would, as written, would require me to pay two fees, one for a qualified manager and one for myself.

We understand that there's a need and there's some problems and those need to be corrected. And we also understand that our situation is not the intent of the bill. And we're working with the regulatory agencies and the author and so forth. We believe there'll be a resolution. Thank you.

Thank you very much.

Good morning. My name is Frank Huntington. I'm honored to be the President of the California Association of Licensed Investigators. What she said. No. We look forward to working with the assemblymen and the bureau.

Kelly has always had an outstanding relationship with the Bureau of Security Investigative Services. We are actively working with them to resolve this issue, and I'm very confident we can come up with a good resolution. Thank you.

Thank you very much. Any witnesses in the public who want to add on in support of the bill? Seeing none. Any witnesses in the public who want to add on in opposition to the bill? Seeing none. I'll bring it back to colleagues for questions or comments. No questions. No comments. Would you like to close the Assemblymember Holden?

When you have a quorum, I respectfully ask for your aye vote.

Thank you, sir.

And thank you for your continued work in this area to ensure our communities are protected by experienced and trained professionals. As has been discussed, I'm aware opposition has approached your office to share concerns with the Bill. Appreciate your openness and willingness in having conversations to try to work out any concerns that folks have. And with that, I'll be happy to support the Bill when we have a quorum. Thank you, Assembly Member. All right, Assembly Member Friedman, you've got agenda item 10, AB 1399.

Good morning, Chair and Committee Members. I want to thank you and your Committee staff for all of your hard work on this Bill. And I'm accepting the suggested Committee amendments raised in the analysis. California regulations require veterinarians to conduct new in-person examinations each time that an animal, even a regular long-time patient of the vet, has a new concern, even minor and extremely common ailments and problems such as skin issues or fleas, or for routine prescriptions.

This is because, believe it or not, current law requires the establishment of a Veterinarian Client Patient Relationship, or VCPR, for every new medical condition of a pet. AB 1399 would allow for a Veterinarian Client Patient Relationship to be established through either an in-person or real-time video communication creating a lifeline to veterinary care for pet owners who face financial, geographic, or logistical obstacles to bring their pet into a vet physically.

As we've seen in the human healthcare field, telehealth can help bridge gaps in care created by workforce shortages or other barriers to healthcare access. Amidst the ongoing veterinary workforce shortage, research shows that 75 million pets in the U.S. could be without veterinary care by 2030 if we do not update our approach to providing these services.

Unfortunately, based on data from the Centers for Disease Control, the U.S. Census Bureau, Esri, and the American Veterinary Medical Association, the State of California has a failing veterinary care accessibility score of 47 out of 100. The Bill would also establish parameters for the practice of veterinary telehealth to ensure that it's safe and effective when it's used in the treatment of animals.

These parameters include the veterinarian must be licensed by the State of California, employ sound professional judgment to determine whether using veterinary telehealth is an appropriate method for delivering medical advice, diagnosis, and treatment to the patient in that instance, provide quality of care consistent with prevailing veterinary medical best practices and be able to refer the client to a local veterinarian who may be able to see the patient in person upon request of the client.

To be clear, telehealth is an effective tool in treating animals, but it will not replace clinic visits, and we're not suggesting that it does. The Bill is only permissive. It will allow your licensed California veterinarian who want to utilize telehealth to do it, but it's also not requiring it for any vet. A vet could simply say, I don't want this to be part of my practice. Telehealth is a proven, safe means for delivering care, and with this Bill will prevent thousands of animals from needlessly suffering.

I'd also like to acknowledge that we have had good conversations with the opposition last week, and we will continue to work with them to address their concerns. I'm a lifelong pet owner and I bring my pet regularly to the vet and I'm not going to stop doing that. But there are times where I wish I could just jump on a Zoom and say, hey, take a look at this rash.

Do I need to bring Finley in or can I just put some vaseline on it or something? I know they're all going, no, not Vaseline. And as a horse owner, this is even more important because for me to get a visit from my horse vet, it's very expensive and requires them to travel, for my vet, up to sometimes 50 miles to get to the horse.

And I can tell you as a horse owner, many, many horse owners don't call the vet at all because the adage is, if they're still around, if it's still bothering them in a few days, then I'll call the vet. If I could just jump on that Zoom sometimes the vet could say, no, I need to come out right now or no, this is fine, this is going to pass. So with that, I would respectfully ask for an Aye vote we do have witnesses here.

Why don't you introduce yourselves and your testimony? Okay.

Great. Two minutes per witness. Thanks.

Thank you. Good morning, Chair Berman and Members of the Committee. Brittany Bennesi, on behalf of the American Society for the Prevention of Cruelty to Animals. As Assembly Member, Friedman said, every year thousands of animals needlessly suffer, experience premature death, or relinquish to shelters due to a lack of access to veterinary care in the state. This month, the ASPCA released survey data illustrating the crisis described and the vital opportunity that expanding the use of veterinary telehealth offers.

Approximately one quarter of our survey's respondents reported wanting or needing veterinary care in the last two years and being unable to obtain it. Nearly 70% of those indicated that they had an interest in using veterinary telehealth if it were an option, and two out of three said that their pet would see a vet more often if it were available.

With California's unreasonably stringent regulations explicitly prohibiting the use of veterinary telehealth to establish a veterinary and client patient relationship, it is clear we are leaving a key tool out of the veterinary care toolbox, a tool that is available and being safely deployed in other states, and this tool is safe and effective. During the pandemic, governments relaxed long-standing state and federal regulations restricting telehealth, and according to the Veterinary Virtual Care Association, no U.S. or Canadian jurisdiction has reported harm to a pet as a result.

Whether you live in a veterinary desert, be that rural, urban, or simply underserved, have mobility challenges or lack transportation, or simply have a pet who gets stressed out going to the vet, expanding the use of telehealth in California will improve the access to veterinary care for your animal, and California's well trained, licensed professionals should be trusted to make that determination. We are grateful to Assembly Member Friedman and Assembly Member Lowenthal for recognizing this opportunity.

AB 1399 will empower California veterinarians who want to to offer medically applicable and appropriate veterinary care via telehealth, reducing pressures on the veterinary workforce crisis and expanding access to care for California pet owners and their beloved animals. I respectfully ask for your Aye vote.

Thank you very much.

Good morning Mr. Chair and Members. My name is Christie Long and I've been practicing small animal veterinarian since 2007. I'm a member of the American Veterinary Medical Association, the California Veterinary Medical Association, and the Southern California Veterinary Medical Association. Currently, I serve as Vice President of Medicine for Modern Animal, a small animal general veterinary practice company that I helped to found.

We are based in Los Angeles and have six practices there as well as two in the Bay Area, with a third opening in Berkeley on Thursday. We serve 26,000 humans and 22,000 patients across our clinics, which offer full-service practice, including preventive care, diagnostic testing, surgery, and dentistry for cats and dogs of all ages. I started Modern Animal because I know the difficulties associated with delivery of quality veterinary care in America, both for the veterinarian and for the consumer.

My field has not kept pace with the growth in pet ownership, and we're under tremendous strain as a workforce to ensure access to care at Modern Animal, we've opened the doors for our practice in West Hollywood. About three weeks into the COVID-19 pandemic, stay-at-home order. Nearly instantly, we were inundated with patients. Within two months, we had no available appointments for weeks.

During this time, the California Veterinary Medical Board relaxed its previously stated interpretation of how a VCPR could be established in the interest of reducing potentially unnecessary interactions that could lead to more COVID cases. Prior to the pandemic, the VCPR pertained to a specific diagnosis, which meant that electronic communication such as telemedicine could not be used to diagnose new conditions or prescribe medications related to them.

During the year and a half where this restriction was waived, we were able to reduce the number of visits to the clinic that a patient and its owner had to make, providing more availability to patients that actually needed to come in. Our veterinarians made these decisions in cases when it was appropriate, based on assessment over video, using their skills and knowledge to do so.

This was game-changing for our clients, who deeply valued the ability to discuss their pet's issues over chat or video, and only come into our clinic when absolutely necessary. Many of our clients had never cared for a pet on their own, and they were doing so in the COVID vacuum. We did not have any substantial substandard patient outcomes related to utilizing this new temporary authority.

Indeed, one case that is worth relating is that of a client who lost his job near the start of the pandemic and subsequently his apartment. He found himself living in his car along with his beloved dog. To date, he has sent more than 7,500 chat messages and engaged in 34 video calls, interacting with our virtual team a total of 353 times.

Thank you. And if you could wrap up, that'd be great.

Yeah, absolutely.

Thanks.

Our doctors are able to assess patients on video in a considerably more relaxed setting that typically occurs in our clinics, lowering patient stress and likely resulting in a more accurate assessment of the patient's status. Unfortunately, as the pandemic is winding down, the California Veterinary Medical Board reverted the pre-pandemic rules, and we now can only establish a VCPR on a new problem in person.

Thank you. Thank you very much. Thank you. So are there any additional witnesses who want to add on? I apologize, everyone. My bad. Primary witnesses in opposition. Would you like to come up? Two minutes per primary witness in opposition, then we'll get to the add-ons.

On? Ok. Good morning, Mr. Chairman and Members. My name is Dan Baxter and I'm the Executive Director of the California Veterinary Medical Association, speaking in opposition to this Bill.

I want to thank you for your consideration today with additional thanks to assemblymember Friedman for having met with us last week to discuss the Bill. To begin with, I want to make it crystal clear that the CVMA wholeheartedly supports the reasonable use of veterinary telemedicine. And indeed, we've worked hard over the years to educate practitioners on the full parameters of telemedicine's permissible use under the law.

As to AB 1399 itself, the CVMA is opposed to this Bill because, as drafted, it would create a new and dangerous clinical framework whereby an animal would never have to be seen in person by a veterinarian in order for treatment to be rendered. California law states that before treating an animal or prescribing a drug for such treatment, veterinarians must establish the VCPR.

That means an in-person physical exam whereby the veterinarian gathers information from the animal by the use of sight, sound, touch, smell, lab tests, et cetera. AB 1399 would alter the VCPR by allowing it to be established solely via telemedicine modalities, thus immediately depriving practitioners of the critically important information that only a physical exam can provide. Without that information, a veterinarian is utilizing guesswork to assess and treat an animal that they've never before seen or touched.

Now, the CVMA has heard the argument made that if telemedicine is okay for my young child, shouldn't it be okay for my pet? For two reasons, that's not a sound comparison. First, the vast majority of babies and young children in California have been personally treated by a pediatrician in their early years of life. Accordingly, there is an established relationship with a doctor who has a baseline about that child.

Second, the entire comparison is faulty because telemedicine and human applications. Humans are conditioned to express pain, especially babies and young children. Animals, by contrast, are conditioned to hide pain. Also, as one final note, that COVID framework that existed over these past 18 months still did not allow a VCPR to be created in the first instance, absent a physical exam. That situation has never existed, even in Covid times. For these and other reasons, we oppose the Bill.

We do look forward to working with Assemblymember Friedman and Assembly Member Lowen going forward towards a further dialogue. Thank you.

Thank you very much. Any additional primary witnesses in opposition? Go ahead.

Mr. Chairman, Christina De Caro, representing the California Veterinary Medical Association. I'm reading the testimony of, unfortunately, Dr. Jennifer Hawkins, who is en route from the airport and was delayed. Thank you very much for the indulgence. I am Dr. Jennifer Hawkins, the Executive Director of the Southern California Veterinary Medical Association and a small animal veterinarian in Orange County opposed to the Bill.

Unfortunately, the sponsors may have told some of you that the veterinary community is opposed to the Bill because of the, quote, generational divide, suggesting that members of the veterinary community are of advanced age and out of touch with technology, and nothing could be further from the truth. In fact, technology and communicating with our clients is the mainstay of our business. The reason that I oppose the Bill and many of my colleagues oppose the Bill is because it's not sound veterinary practice.

It also clears a path so that veterinary medicine app subscriptions can thrive. For example, on one app you can pay $140 a year and receive unlimited veterinary care from a person who has never met your pet and is based out of state. Veterinary medicine works well when we've established a relationship with pets in person. We know and understand the conditions that they are battling. From there, veterinary telemedicine works great for checkups and triaging cases.

If a client calls my office and says they think their cat has a urinary tract infection, we triage this over the phone with them. If they describe certain behaviors, such as straining in the litter box, we tell them to come in because it could be sterile cystitis or a life-threatening urethral obstruction. I had a client who ran out of arthritis medicine and thought the dog's reluctance to rise was attributed to that.

In fact, the dog was weak from blood loss and from a bleeding tumor of the spleen. It has been said that the Bill merely gives me the flexibility to use telemedicine or not for an initial appointment. And I'm likely going to pass, and I'm guessing many of my colleagues will, too. The liability for me is too great. If I guess and things go wrong and the owner sues me. For these and other reasons, I urge your No vote today on AB 1399.

And again, thank you for the consideration.

Of course. Thank you very much. Any additional witnesses of the public who want to add on in support of the Bill, please provide your name, organization you're with, if any, and position on the Bill.

Good morning. Chair and Members. Juliana Tetlo, representing San Diego Humane Society, in very strong support.

Thank you.

Good morning, Mr. Chair and Members. Cassie Gilson with Axiom Advisors on behalf of the Virtual Veterinary Care Association, in strong support.

Thank you.

Good morning. Jennifer Fairing, offering the strong support of the Best Friends Animal Society. Thank you.

Thank you.

Good morning. Lizzie Cootsona with Shaw Yoder Antwih Schmelzer and Lange, on behalf of the Humane Society of the United States and Cal Animals in support.

Thank you very much.

Good morning. Barbara Schmitz. I work for the San Francisco SPCA. Today is the 155th anniversary of our founding. We're in strong support of this Bill as well.

Thank you. Happy anniversary. Any additional witnesses in opposition who want to add on in opposition to the Bill? Seeing none. I'll bring it back to colleagues who we still don't have a quorum. Questions or comments from colleagues? Any questions or comments? Seeing none. Assembly Member Friedman, would you like to close?

Sure. I'd like to just respond to a few of the things that I heard. And first of all, we are absolutely committed to continuing to try to address the concerns from the Veterinary Association, particularly with regard to the subscriptions and the apps.

I would say that what we heard, the read testimony from the vet talking about the triage over the phone, think of how much more effective that could be if that was a Zoom triage, which is what this Bill would allow. It would allow for those vets to get onto a Zoom and now have a visual instead of having to listen to a telephone interpretation to actually be able to see the animal and then to be able to make the determination if that animal needs to be brought in exactly how they described that phone visit happening.

And the sad reality is that there are a lot of people out there, and we all know this, who just are not capable of bringing their animal into the vet all the time, whether it's an old lady who's got a cat who doesn't have a ride or who can't afford to get an Uber to go to a vet who is going to wait.

They're going to wait to get care for their precious animal because of the barriers that they might have physically, financially, time-wise, due to their mobility, due to an illness. And this gives the vet the flexibility of being able to then say, this is routine. Here's what you need to do, or, no, this animal, you really do need to bring the animal in now.

Now, I agree that it's suboptimal to do telehealth, probably for people as well and for animals, but we shouldn't let, and I hate to use one of these phrases, we shouldn't let the perfect be the enemy of the good. And we do know that there are animals that are just going without routine care or going without care, even in what could be an emergency situation because of access issues.

If these vets don't want to use the telehealth because they think it's not good enough, there's nothing in the Bill that forces them to. It's simply permissive in certain situations. And it may be that some vets say to their patients, listen, I know you're ill, and in this case, we're going to use telehealth right now. They're not allowed to do that under our laws.

Absolutely.

Thank you very much. I would request an Aye vote.

Thank you, Assembly Member Friedman. I'm happy to support this Bill today with the Committee amendments. I'm optimistic that with more conversations between stakeholders this year, the author can potentially find a way to resolve opposition to the Bill. As we've seen happen in other states. I will be happy to support this Bill when we have a quorum.

Thank you.

Thank you very much. Thanks, everybody. I'm going to hand the gavel over to Vice Chair Flora to go race over to the Capitol. Vice Chair Flora, Chair Flora.

Mr. Chen, you ready? And if it's all right with you, we'll start with AB 351.

Thank you, Mr. Chair, for your time and allowing me to present AB 351. I'm grateful to the Chair and the Committee for taking up this piece of legislation.

There is no current authority delegated to the Department to provide a process for commercial license transfers because of the omission of the words transfer or assign from the list of activities the Department is authorized to conduct. Currently, licensees must engage in business practices to facilitate a change in licensing. If, however, all current owners transfer their ownership, they cannot operate until a new application has been submitted and approved by the Department.

In many cases, this can be a lengthy and unpredictable process because of lack of guidance provided by the Department through no fault of their own, because cannabis businesses cannot receive the benefits of bankruptcy court receiverships or the alternative option available to address the needs of insolvency for this rapidly expanding industry, unfortunately, there is no formal mechanism to reassign the license to a court-appointed receiver. Other states, like Oregon and Washington, already permit the direct transfer of cannabis licenses.

This Bill would allow us to follow suit by allowing the Department to create a process to transfer licenses for commercial cannabis activity. And before I pass it off to our witness, I just want to note that we have had some late but incredibly productive conversations with the League of California Cities to clarify local control protections, and we will be continuing to have these active discussions ongoing.

Here to testify, we have Karen Woodson, Senior Director for the compliance and licensing at Kiva, one of the sponsors of this piece of legislation.

Thank you very much. Two minutes.

Great. Hello again, Members of the Committee and distinguished staff. Again, thank you, Assemblyman Chen, for the leadership that brings us here today. My name is Karen Woodson for Kiva Confections and our distribution arm, Kiva Sales and Service. And I'm also here on behalf of the California Cannabis Manufacturers Association to urge support for 351. Current statute emits explicit language authorizing the Department to transfer or assign licenses, and as a result, Department regulations specify that cannabis licenses are, quote, not transferable.

This Bill provides express authority for the Department to create the process to support the transfer and assignment of state licenses. While licensees cannot transfer their licenses, they can sell ownership stake in their licensed business entity. And as you can imagine, that's a complex and risky transaction. To ensure continuity of operations, at least one owner must remain in control and direction of the license while all the new owners obtain approval from the Department.

It's an onerous process, subject to an indefinite timeline because the Department has no reasonable schedule for processing owner modifications. Historically, those transactions have required six months or more. If all current owners transfer their license, then the business must submit a new application, go back to the application line, even when the owners are known entities or current license holders, in addition to forcing a stop in the operations and, by extension, tax revenues.

The timeline for approval likewise is uncertain because the Department again has no expected timeline for which to process new applications. And finally, because cannabis businesses do not enjoy the benefits of bankruptcy court, receiverships are the alternative option available to address the needs of insolvency for a rapidly expanding industry. Unfortunately, there is no formal mechanism and statute that authorizes the Department to reassign the license, for example, to a court-appointed receiver. It's a lose-lose situation.

Ideally, state licenses should be transferable for a fee, subject to local authorization and ownership approval by the Department. This is certainly the case in other states, among several California cities and counties, and in other industries like alcohol. AB 351 will help streamline license transfers and offer better transparency to what's already occurring in the cannabis market. And I urge your Aye vote today. Thank you.

Thank you very much. Anyone else in support of AB 351? Name and organization, please.

Good morning, Mr. Chairman, Members. Amy Jenkins on behalf of the California Cannabis Industry Association, in strong support. Thank you.

Thank you. Anyone else in support? Seeing none. Anyone in opposition to AB 351? Seeing none. Bring it back to the Committee. Any questions from the Committee? Seeing none. Mr. Chen, would you like to close?

Thank you, Mr. Chair. I respectfully ask for your Aye vote.

Thank you very much. When we have a quorum, we will bring that measure up. Thank you. Ms. Irwin, would you like to present?

Mr. Vice Chair and members. I would like to begin by accepting the Committee Amendments and thanking the committee staff for their hard work on this bill. I'm here to present AB 1207.

When Proposition 64 was passed in 2016, there was a distinct promise to California voters that legalization of recreational cannabis would not come at the expense of our children. But in reality, the very opposite has occurred.

Poison Control Center calls due to pediatric cannabis exposures have skyrocketed since 2016, and they will only continue to increase as time passes. In 2021, California had 793 exposure calls to Poison Control Centers for children five years and under.

Every week, it seems like we read another news article with the same story. Children at school are often transported to the emergency room because they and their peers have consumed cannabis products that they have confused with traditional foods due to packaging that is attractive to children.

While the illicit cannabis market, no doubt, is responsible for a number of these exposures, a simple look at California's legal cannabis products shows that they are not without blame.

We cannot continue to allow California's legal cannabis market to manufacture, package, and advertise products with features that are attractive to children. AB 1207 addresses the ever increasing pediatric cannabis exposures by codifying and strengthening regulations on what makes a product attractive to children.

It also codifies regulations that prevent cannabis vape products from containing additional flavoring. Lastly, it explicitly adds to the statute prohibitions on the manufacture, sale, and advertising of cannabis products that are attractive to children.

The Committee Amendments that are accepted today are the results of discussions my staff and I have had with Committee Members and staff to address a number of opposition concerns. And I do also want to point out that there have been a number of opposition letters that have come in recently that are addressing the bill before the Committee Amendments.

With me today in support of this bill are Adwan Akiya Anu. Did I get that right? And Lynn Silver.

Thank you very much. 2 minutes per witness, please.

Hello, thank you, Chair and members. My name is Adawa.

Can you turn your mic on, please?

Better.

Awesome. Thank you so much, Chair and members, for having me. My name is Adwan Akiya Anu with Youth Forward. Youth Forward is a Sacramento based nonprofit organization that works on youth substance use prevention and mental health here in Sacramento.

Perfect.

We also support a network of about 350 youth serving organizations around the state that organize on cannabis policy and youth prevention. Here in Sacramento, we have staff that are working in our local high schools, and we're seeing a widespread use of flavored candy, edibles, and candied vape products.

Vape concentrates are legal products with dangerously high levels of THC being used by youth and young adults. It is very clear to us that the cannabis industry is targeting young people as consumers, with products and marketing designed to appeal to kids.

Last week, I visited a local dispensary here in Sacramento, and I was overwhelmed by the amount of visual imagery, graphics, and cartoons on inhalation products as a young adult, but an adult nonetheless, I thought to myself, if I was genuinely interested in consuming and accessing cannabis, I would not need this much cartoon imagery and graphics to appeal me.

I would just go out and get it. For that reason, we believe strongly that the legislature must take the step of regulating the industry and require the industry to stop these practices and protect our youth. Thank you.

Thank you very much. Next witness.

Thank you. Mr. Chair.

Your mic, please.

Thank you, Mr. Chair and Mr. Vice Chair. My name is Dr. Lynn Silver. I'm a pediatrician at the Public Health Institute and full clinical professor at UCSF. I serve on the Department of Healthcare Services, Prop 64 Advisory Group and work with Cannabis policy research and with jurisdictions across California and the country.

Last week, JUUL settled for $462,000,000 to pay for its marketing of fruit flavored vapes to kids. In 2021, this house wisely prohibited flavored tobacco products that were hooking kids. California voters overwhelmingly backed that decision.

No matter how you feel about cannabis, why permit our legal or illegal cannabis industry to market thousands of products that are blatantly appealing to children? The images before you are all from legal California cannabis retailers, all but two taken this month.

We are seeing too grave and predictable consequences. For example, at Rady Children's Hospital in San Diego, THC ingestions have increased exponentially. The average age is three years old. Six in 10 of these children have been hospitalized, one in 10 to the intensive care unit.

Some require ventilators. Fruity candies cause 73% of these ingestions nationally. Sometimes, though rarely, children die. In California, cannabis poison control reports for minors increased 13 fold, as the member noted.

That's why Cal, PTA, and the Academy of Pediatrics have joined us in supporting this bill. The second grave consequence, just as with JUUL, is the growing use of slickly marketed products by preteens and teens.

These odorless products, often high potency vapes, are marketed with fruity flavors or imaginative names that imply healthfulness or recall favorite treats, and are increasingly used before and at school, interfering with learning.

Starting use as a teen doubles risk of dependency and is the most vulnerable age for psychosis often triggered by cannabis use, especially of potent vapes and dabs. As our surgeon general warned, cannabis interferes with the developing brain and with cognitive performance.

Frequent use is significantly associated with increased suicide risk and lower high school graduation.

So much. If we can have you wrap up your thought.

It is time to fix this. This bill will end cannabis mimicry of popular products marketed to kids. It won't stop edibles from being tasty, but we can at least end some of the most concerning tactics that are hooking kids or causing accidental poisoning. Thank you.

Thank you so much. Anyone else in support of AB 1207? Name an organization, please.

Good morning. Elizabeth Espinosa, here today on behalf of the County Health Executives of California, representing the local health departments in support. Thank you.

Thank you.

Hello. Kelsey Fernandez with Marin Healthy Youth partnerships in support. Thank you.

Good morning. My name is John Gaffney. I live in Folsom and support AB 1207 as our teen who played soccer for Sacramento Republic's Academy.

Thank you so much, sir. Name and organization.

I'm a parent of a son who had cannabis induced psychosis. My name is John Gaffney.

Thank you so much.

If I can just. Quick statement, really short, sir.

We've already had 2 minutes. We had to keep the committee.

I have Dizzy brand right here. This is what caused my son.

Thank you so much.

Lori Dubin. Good morning from Marin Residents for Public Health Cannabis Policies. I'm the co-founder. I am strongly in favor of AB 127. I have images that. If I can give to the Clerk.

You can give to the sergeants. Thank you. Anyone else in support? Name an organization, please. Seeing none. Anyone in opposition? Davy 127, you have 2 minutes per witness, please.

Good morning, Mr. Chairman and Committee Members. Amy O'Gorman Jenkins, on behalf of the California Cannabis Industry Association, I want to begin by expressing our organization's sincere appreciation to the Chair and to Mr. Sumner for working to address numerous concerns that were highlighted in our opposition letter.

I also want to express our gratitude to the author for accepting these amendments as proposed to be amended. This is a much improved bill. Unfortunately, CCIA must continue to respectfully oppose.

While we share the author's goal of deterring youth access, we continue to find some of the elements in this bill problematic. For instance, we find the prohibition from using fictional or human characters in our advertisements unnecessary.

Numerous legal cannabis businesses use images of humans in sophisticated ways specifically to communicate important information about proper use. We also maintain that the changes as proposed will only punish good actors while bolstering an unlicensed cannabis market. That notoriously sells and markets to children.

While proponents of this bill consistently cite an uptick in emergency room visits and youth use, they have failed to demonstrate that these incidents are associated with legal products. In fact, we believe that the majority of these incidents are associated with illicit cannabis or intoxicating hemp products easily purchased online.

Access to legal cannabis is already fiercely age gated. A study published in 2022 in the peer reviewed Journal of Safety Research found that 100% of licensed California cannabis retailers check IDs to avoid selling to underage customers.

If youth are gaining access to cannabis products, that is not a product problem, it is an enforcement problem. I also want to make a point pertaining to the examples of the violations that were distributed to Committee Member offices before today.

Upon a review of the products presented, CCIA identified only one that is manufactured by a legal operator, and we reported that operator to the DCC.

Unfortunately, we've identified dozens of illegal cannabis products and intoxicating hemp products for purchase from headshots and online that are easily and absolutely intended for youth. We are not the problem, but we are committed to being part of the solution.

In closing, we wish to reiterate our appreciation for the work that has been done here to make AB 127 a better Bill. We look forward to working with this Committee to support a well functioning, safe, regulated cannabis market in California. Thank you.

Thank you. Next witness, 2 minutes.

Pamela Lopez with K Street consulting on behalf of California Normal, this state's cannabis consumer and human rights advocacy organization. We also appreciate the committee and the author's work on this bill.

Unfortunately, we remain opposed. We agree that preventing youth cannabis consumption is a priority. I think it would be worthwhile in the discussion over this bill to differentiate between accidental consumption of cannabis by a three-year-old and teenagers who are intentionally seeking out and using cannabis.

And it is absolutely worthwhile to have a discussion about how do we help youth and teenagers not fall into a pattern of drug abuse. We fund those programs in part with taxes that are generated by licensed and legal cannabis companies in the State of California.

Steezy alone estimates that in one year they will pay $20 million less in taxes. $20 million less in taxes in one year to support the childcare, law enforcement, and anti-youth cannabis consumption programs that their taxes support.

This bill is prohibition all over again. And from California Normal's perspective, the voters have already opined that we have a right to access safe, legal and licensed cannabis products. If legal companies are not producing vape pens that we want to access.

If they are forced to produce only vape pens that taste gross, consumers will simply go back to the illegal and illicit economy, which already provides two thirds of all cannabis sales that occur to this day in the state.

So there's an adult conversation that has to be had here about what do adults in California have the right to do? And we do have the right to access safe, legal and licensed cannabis. And we are happy to participate in a legal system to pay our taxes to make sure that young people don't develop drug addiction problems. Thank you.

Thank you. Anyone else in opposition to AB 1207? Name and organization, please.

George Miller, on behalf of Weed Maps, in opposition.

Pamela Epstein on behalf of Eden Enterprises, in opposition

Alicia Priego on behalf of the California cannabis Manufacturers Association and also the California Distribution Association. And align our comments with CCIA.

Karen Woodson with Kiva Confections opposed.

Thank you very much. And we're going to take a moment and establish a quorum, and then we will go back to the Committee Members. Madam Secretary, please call quorum.

[Roll Call]

Thank you. We have a quorum, and we'll bring it back for questions from the committee on AB 1207. Any questions from the committee? Seeing none. So, would you like to close?

Yes. Look, we absolutely do need to support the legal market by means, and I do agree with Ms. Jenkins, like means, like additional enforcement. But we absolutely do not need to support the legal marketing by having packaging that's attractive to young people.

We need to make sure that the legal market does not contribute to pediatric overdoses in the future. So we think this is a common sense bill and certainly appreciate, again, the amendments that were made in response to the initial objections of the industry.

And with that, I respectfully ask for your aye vote.

Thank you so much. Madam Secretary, please call the roll. We need a motion a second. I'm sorry, Madam Secretary, please call the roll. Mr. Lowenthal had a question for you, so I'm going to absolutely grant that, so go for it.

I actually just want to make a comment, if that's okay, Chair. You know, I need to be candid with those speaking in opposition. The industry is asking for legislators and regulators to provide relief to the regulated market, and we're working as hard as we can to contemplate those issues.

And at the same time, we're also residents, stakeholders, parents, and we expect at the same time, those things to be considered and to talk about how you're already struggling on the one hand and need this support and are concerned about the effect of sales and not considering these things for me, it doesn't work.

This isn't just an enforcement problem, at all. This is far greater than that. And I'm looking at these advertisements for McFlurry cocoa pebbles.

I mean, I'm a parent of three young kids, and I totally and completely support the legal industry of cannabis in this state. And there's no way in good conscience I can support these being out there, because I absolutely know the impact that this makes on my kids.

I don't even think this is good for the actual products themselves, cereal, sugary foods and so forth, and the impact that's making on children, much less being hidden behind cannabis or alcohol or anything like that.

In the course of this debate, I've totally and completely, really become much, much more interested in this. I would like to ask if you would consider adding me on as a co-author.

And I very much will ask the industry to reconsider this as time is going on, because it's deflating for us if you can't get behind this, and you also want us to get behind much, much bigger fish, right? So please consider that.

Thank you very much. I do feel. I do feel a little bit obligated if we're going to go back to questions from the committee. We did bring that up, so I'm more than happy to go back to questions from the committee, but I will give opposition or the supporters a chance to respond to these questions if we're going to do this again. So, Mr. Lee, do you have a question?

I just have a quick comment as well. And I just want to say I appreciate the author bringing the bill forward. And we had a conversation about this. I understand the intent of the bill is much more to talk about, and what Senator Lowenthal, I'll talk about is mimicry of childlike products and attractiveness.

I do have some concerns. I look at the language about the use of just vegetables, plants, robots. I mean, I don't think particularly artistry itself conveys attractiveness to children.

So as you move forward with the bill and keep looking at it, I'm sure in the other houses you keep fine tuning it. But I think the issue you're trying to do is mimicry of other products rather than just the use of animals or the use of art and color itself.

So I would also be flagged that for you as something you look at and you keep going forward. So I want to just say that.

Thank you and we will continue to work on the bill.

Thank you very much. And what opposition like to respond to them?

I would. Mr. Chairman, thank you. As I previously indicated, the legal products that we did identify on a prior flyer, and I've not seen this one, I personally called and reported it to the DCC.

We do not have a policy of tolerance for operators that are violating our laws, including the youth component. I can't speak to, again, the graphics that are stated or that are included in what was just distributed.

But I also do want to add that in the future it would be helpful to take a picture of the front and the back of the graphic because there's a lot of required pertinent information which would help me verify if these products are in fact legal or counterfeit.

That information includes a package UID, the license, the packaging date, distributor information, and associated testing and licensing numbers. So that would certainly help us verify.

And as I said, I, as the industry lobbyist, have no intention of defending products that are violating our laws intended to deter youth access. And I will continue to do that.

And I called that manufacturer personally and told them that I complained, and we will continue to do that. But I would like to see some of the graphics going forward so that we can verify the validity that those products are, in fact, legal.

Thank you so much.

And I would just add, respectfully, Assemblymember California Normal, again, with great respect, is a consumer advocacy organization.

We actually do not represent industry, and one of our primary concerns is making sure that consumers have access to products that have gone through the process of licensure, because we know that they will be safe for adult consumers.

We agree with all of the comments of Ms. Jenkins. I'm a parent of two small children as well.

We do not want products to be appealing to or marketed toward children. The safety and labeling locks, we've done tons of work around that to make sure that little kids aren't getting into stuff as well. And we agree with you that youth cannabis use is a priority, which is why we support programs to address it.

Thank you so much. And looks like one of the supporters has a comment as well.

First, I just wanted to clarify, most of these pictures were taken at the cookies burner on hate dispensary in San Francisco, which is a legally licensed dispensary in San Francisco. All of these were legal products. And I have visited many dispensaries across the state and seen similar patterns. I appreciate the comments of the Members of the panel. This is a problem of the legal market, the illegal market, and the hemp market. And we have to address it effectively, sector by sector, to protect our children.

Thank you.

Thank you so much. All right, we have a second. And we have a first and a second. Madam Secretary, please call the roll.

[Roll Call]

We'll leave that bill open for absent members to add on, and it looks like Mr. Jones-Sawyer. Mr. Jones-Sawyer presenting AB 1565.

Good morning, Chair and members. I am here to present AB 1565, which would establish ongoing funding to support local cannabis equity applicants and licensees beginning in fiscal year 2028 to 2029. In November 2016, California voters approved Proposition 64, which legalized adult recreational use of cannabis and established a taxation structure. Historically, support for equity applicants and license holders have been lacking, as additional jurisdictions are creating equity license programs to help those disproportionately affected by the war on drugs to enter the industry.

It is imperative that the state provide more resources to get these businesses up and running. The cannabis business has a high financial bar of entry, with the average upfront cost of operating a dispensary ranging from 80,000 to 250,000. When justice involved, California see this industry boom based on the very product that resulted in their incarceration, and create generational wealth for those who do not look like them, or what do we expect them to think?

If we want to talk about equity, we cannot allow disadvantaged communities that have already suffered due to the unjust criminalization of cannabis to now miss out on the profits of its legalization. By failing to provide further support for equity licenses and applicants, these businesses are pushed into the illegal market. Ultimately, we also fail to keep the promise of Prop 64 in helping begin to undo the damage of cannabis criminalization.

That is why AB 1565 provides an upfront support to help reduce barriers to entry, further combating the illegal market and ensuring equity for applicants and licensees. With me to speak in support of the bill is Pamela Lopez on behalf of California NORML, and Amy Jenkins, on behalf of the California Cannabis Industry Association, I respectfully ask for your aye vote.

Thank you so much. First Witness

Pamela Lopez, K Street Consulting on behalf of California NORML. Polls and surveys have shown that Californians, including California NORML members, want to support equity businesses. Our poll data shows that this is because the cannabis economy creates a unique opportunity for a small step toward reparations following the war on drugs. Those reparations are still due to communities of color.

California NORML analyzed data from the California Attorney General and found that statewide in 2018, Black Americans were arrested 4.1 times as often as Whites for arrests that had to do with cannabis. Those disparities have continued in subsequent years. The biggest barrier by far to equity players entering the legal cannabis industry in California has been a lack of funding.

Although it is fantastic that we have passed legislation to provide tax breaks for some equity operators, the hardest thing is getting into the market and opening businesses in the first place. Prop 64 directed cannabis tax monies towards social toward communities impacted by the drug war, and AB 1565 helps to make good on the promise of promoting equity and taking a small step toward correcting the wrongs of the war on drugs for communities of color. Thank you.

Thank you.

Mr. Chairman and members, Amy Jenkins on behalf of the California Cannabis Industry Association, in strong support of AB 1565, California made a commitment to end decades of failed prohibitionist policies and do right by communities most affected by the war on drugs with a passage of Prop 64. Yet despite ongoing investments to support and expand these opportunities for social equity operators, significant barriers remain.

In 2021, CCIA was proud to publish the California Cannabis Equity Accountability Report, which analyzed the success and pitfalls of ongoing local equity programs throughout the state. Among other findings, CCIA found that additional jurisdictions established local equity programs, or as they established local equity programs, ongoing and guaranteed streams of funds to support equity applicants and licensees would be critical to the long term viability of these programs.

AB 1565 provides front-end support to current and prospective social equity licensees by guaranteeing 15 million from the California Cannabis Tax Fund will go towards supporting these programs in 2028 and onward. With almost two-thirds of the state's cannabis industry operating in the illicit market, more equity programs coming online each year will provide more pathways to support operators transitioning to licensure. This is essential and we strongly support this bill and we urge your aye vote today. Thank you.

Thank you very much. Anyone else in support of AB 1565? Name an organization, please. Seeing none. Anyone in opposition to AB 161565? Seeing none. Bring it back to the committee. Any questions from the committee, Mr. Lowenthal? Right on. Seeing none, Assemblymember, would like to close?

I respectfully ask for your aye vote.

Thank you very much, Madam Secretary. Please call the roll.

[Roll Call]

The bill is out. We'll leave it open for absent members.

Thank you very much.

Looks like we have one more bill on file. AB 1286 by Mr. Haney. Yes.

Members, we're going to start with the consent calendar and just kind of roll through the file and wait for Mr. Haney. And then we're going to need motions and seconds on everything. Second.

On the consent calendar. Berman? Flora?

Aye.

Flora, Aye. Alanis? Alvarez? Bonta? Chen? Chen, aye. Dixon? Dixon, aye. Gipson?Gipson, aye. Grayson? Grayson, aye. Irwin? Irwin, aye. Jackson? Jackson, aye. Lee? Lee, aye. Lowenthal? McCarty? Mckinnor? Mckinnor, aye. Nguyen? Nguyen, aye, Patterson? Patterson, aye. Ting?

That bills out. We'll leave it up for absent Members and we'll start at the top of the file.

On the consent calendar, Lowenthal, Aye.

351 Chin, AB 351 Chin. We need a motion and a second, Mr. Gibson. Second by Jackson. Madam Secretary, please call the roll.

AB 351 Chen. The motion is do passed to the Committee on Appropriations. Berman? Flora? Aye. Flora, aye. Alanis? Alvarez? Bonta? Chen? Chen, aye. Dixon? Dixon, aye. Gipson? Gipson, aye. Grayson? Grayson, aye. Irwin? Irwin, aye. Jackson? Jackson, aye. Lee? Lee, aye. Lowenthal?

Lowenthal, aye. Mccarty? Mckinnor? Mckinnor, aye. Nguyen? Nguyen, aye. Patterson? Patterson, aye. Ting?

Aye.

That Bill is out. We'll leave it open for absent Members. Moving on to file item AB 420. We need a motion and a second. Mr. Chin makes motion AB 420, Mr. Gipson seconds it. Madam Secretary, please call the roll.

AB 420. Aguiar Curry. The motion is do passed to the Committee on Appropriations. Berman? Flora? Flora, aye. Alanis? Alvarez? Bonta? Chen? Chen, aye. Dixon? Dixon, aye. Gipson? Gipson, aye. Grayson? Grayson, aye. Irwin? Irwin, aye. Jackson? Jackson, aye. Lee? Lee, aye. Lowenthal? Lowenthal, aye. Mccarty? Mckinnor? Mckinnor, aye. Nguyen? Nguyen aye. Patterson? Patterson, aye. Ting?

The Bill is out. We'll leave it open for absent Members. I think we're moving on to file item number five, AB 687. Mr. Hart, need a motion and a second. Mr. Gipson, Mr. Gipson makes motion, Lowenthal seconds it. Madam Secretary, please call the roll.

AB 687 Hart the motion is do passed to the Committee on Appropriations. Berman? Flora? Flora, aye. Alanis? Alvarez? Bonta? Chen? Chen, aye. Dixon? Dixon, aye. Gipson? Gipson, aye. Grayson? Grayson, aye. Irwin? Irwin, aye. Jackson? Jackson, aye. Lee? Lee, aye. Lowenthal? Lowenthal, aye. McCarty? Mckinnor? Mckinnor, aye. Nguyen? Patterson? Patterson, aye. Ting?

The Bill is out. We'll leave it open for absent Members. Think we'll go to file item seven. AB 1207 Irwin. Do we have everybody on that one? Okay, AB 1207 Irwin. Madam Secretary, please call the absent Members.

AB 1207. Irwin. The motion was do pass as amended to the Committee on Appropriations. Berman? Flora? Excuse me, Alanis, Alvarez, Bonta, Mccarty, Patterson, Patterson not voting, Ting.

We'll hold that one until in ad. Absent Members to add on. Moving on to file item number eight. AB 1244 Holden. Mr. Gipson moves the Bill, Mr. Grayson seconds it. Madam Secretary, please call the roll.

AB 1244 Holden the motion is do passed to the Committee on Appropriations. Berman? Flora? Flora, aye. Alanis? Alvarez? Bonta? Chen? Chen, aye. Dixon? Dixon, aye. Gipson? Gipson, aye. Grayson? Grayson, aye. Irwin? Irwin, aye. Jackson?Jackson, aye. Lee? Lee, aye. Lowenthal? Lowenthal, aye. McCarty? Mckinnor? Mckinnor, aye. Nguyen? Nguyen, aye. Patterson? Patterson, aye. Ting?

That bill is out. We'll leave it open for absent Members. Move to file item number 10. AB 1399 Friedman. Madam Secretary, the motion a second.

Move the Bill.

Mr. Gibson, Tina, and Madam Secretary, please call the roll.

Call the role AB 1399 Friedman. The motion is do pass as amended to the Committee on Appropriations. Berman? Flora? Flora, aye. Alanis? Alvarez? Bonta? Chen? Chen, aye. Dixon? Dixon, aye. Gipson? Gipson aye. Grayson? Grayson, aye. Irwin? Irwin, aye. Jackson? Jackson, aye. Lee? Lee, aye. Lowenthal? Lowenthal, aye. McCarty? Mckinnor? Mckinnor, aye. Nguyen? Nguyen, aye. Patterson? Patterson, aye. Ting? Alanis, aye.

Thank you very much. That Bill is out. We'll leave it open for absent Members. And moving on to file item 11, AB 1565 Joan Sawyer. Madam Secretary, please call the absent Members.

AB 1565 the motion is due passed to the committee on appropriations. Berman? Alanis? Alanis, no. Alvarez? Bonta? McCarty? Ting? AB 1565 Alanis, no to aye.

Thank you very much. We'll leave that Bill open for absent members to add on. And I see Mr. Haney in the room. Assemblymember ready when you are, presenting AB 1286.

Thank you, Mr. Chair and members, I want to start by accepting the Committee amendments today. These amendments include clarifying the unsafe conditions that constitute a pharmacy closure to prevent frivolous and unnecessary closures and reaffirm the ability to waive pharmacy staffing requirements due to unforeseen circumstances or workload volume. I appreciate the Committee's feedback, and thank you for working with my office on the language. AB 1286 is a patient safety bill that establishes first in the nation protections from life-threatening medication errors at understaffed and unsafe pharmacies.

Specifically, the Bill Requires mandatory reporting of all medication errors to a third-party entity approved by the California State Board of Pharmacy. It also addresses the inadequate staffing and unsafe working conditions in many community chain pharmacies that can lead to medication errors. Chain pharmacies and the pharmacists who work for them, are instrumental in delivering care to Californians. However, recent news reports have highlighted alarming medication errors in this setting, including errors that have led to hospitalization or death.

In 2021, the Board of Pharmacy released survey results in response to these alarming medication errors. Amongst other things, the survey results showed that a startling 91% of pharmacists working in community chain pharmacies indicated they did not believe staffing in their work site is appropriate to ensure adequate patient care.

Additionally, there have been reports of unsanitary conditions in community chain pharmacies, including rodent infestations, insufficient staffing, unsanitary conditions, or lack of autonomy to make clinical decisions in the best interests of the patient, not profits, can lead to an increase in medication errors and while significant time and research has been dedicated to evaluating medication errors occurring in inpatient settings like hospitals, similar research and information sharing does not exist in the community pharmacy setting.

Because of this, medication errors are widely underreported and unknown while having detrimental effects on patients. Unfortunately, there is no requirement under current law for pharmacies to report medication errors or to consider the pharmacy working conditions that lead to medication errors. To address this, AB 1286 will require mandatory reporting of medication errors to allow for robust evaluation and give licensed pharmacy staff autonomy over their working conditions so they can better provide safe patient care and services for all Californians.

Here to testify with me today in support is the Pharmacy Board President, Seung Oh and Dr. Chris Atkins, licensed pharmacist, and Anne Sotoger Grin from the board for technical questions. Thank you Mr. Chair and welcome back.

Thank you. Two minutes each per witness in support. Ready when you are.

Good morning Chairperson Berman, Vice Chair Flora, members of the Committee, on behalf of the California State Board of Pharmacy, I sincerely thank Assemblymember Haney for authoring this important public health measure and the Committee and its staff for its consideration of this measure today. My name is Seung Oh, President of the board. By statute, the board is a consumer protection agency charged with regulating the practice of pharmacy, explicitly stated in pharmacy law. Whenever the protection of the public is inconsistent with other interests ought to be promoted.

The protection of the public shall be paramount. Consistent with the legislative mandate, the board is sponsoring AB 1286, one of the most significant patient safety measures ever sponsored by the board. As a practicing pharmacist, I took an oath to devote myself to a lifetime of service to others through the profession of pharmacy. Regrettably, I have both personal experience, knowledge o,f as well as have heard public testimony, regarding unsafe conditions within many pharmacies that are placing patients at risk.

As has been reported in the media, discussed nationally, witnessed and experienced by patients, and demonstrated through the board's workforce surveys. Current workplace challenges, most notably in community chain pharmacies, are placing patients at risk.

As time is limited, I'll focus my testimony on key findings from the board survey of the survey responses from community chain pharmacists, 78% said they do not believe they have sufficient time to provide adequate screening prior to administration of immunizations, 83% said they do not believe they have sufficient time to provide appropriate patient consultation and 91% said they do not believe staffing in their primary worksite is appropriate to ensure adequate patient care. These responses paint a picture right for consumer harm the urgency of this issue cannot be overstated.

It is clear staffing decisions need to be made at the store level by individuals responsible for operational compliance, and pharmacists require autonomy to make independent clinical decisions in the best interests of patients. Good public policy and the board's consumer protection mandate demand that the board take action to prevent future medication error. I thank you for your time, your consideration of AB 1286, and your assistance helping the board protect California consumers.

Thank you very much.

Good afternoon, Committee Members. My name is Dr. Christopher Adkins and I am here today to testify in strong support of Assembly Bill 1286. I'm a licensed pharmacist and recently left my position at Vons Pharmacy due largely to the horrendous working conditions, chronic understaffing, and lack of autonomy that put my patients at risk every single day. I joined the pharmacy profession after years of extensive education and training to be able to help patients receive critical medication, clinical care, and advocate for those patients.

Unfortunately, after three years in the change setting, I made the tough decision, as many of my colleagues have to leave. If Assembly Bill 1286 had been law, I wonder how that might have influenced our decision. Just to give you a little insight into my role as a pharmacist, we are tasked with ensuring the safety and accuracy of every prescription that comes through our pharmacy. In addition to that already daunting task, we also act as the most accessible healthcare provider in most communities.

No appointment needed, just walk in and ask any question you want. But mostly we uphold the oath that we took as a pharmacist, and I quote the first line, I promise to devote myself to a lifetime of service to others through the profession of pharmacy, end quote. When we have to work for employers that have taken no such oath and whose only obligation is to their shareholders, it creates a juxtaposition in the goals of the work that we do.

Patient safety has been put at risk because pharmacists and pharmacy technicians are overworked and understaffed. We no longer have time to perform high-quality consultations that we are required by law to provide. We are no longer able to devote adequate time to the patients in most need. We can barely even answer the phone anymore to help patients, doctors or transfer prescriptions. We are also legally responsible for everything that happens in the pharmacy and that is performed under our license.

Without the authorities provided by this Bill, pharmacists can't truly be a pharmacist in charge. They can merely be a pharmacist in liability. I have seen errors where patients receive the wrong vaccine because companies care more about profits than safety. I have caught misfilled medications that have happened simply because we are doing too many things at once. I have heard numerous patient complaints that we can't pick up the phone or to refill their medications or transfer their prescriptions.

And they're right Assembly Bill 1286 gives pharmacists the protections we need to put our patients first. The Bill allows for a pharmacist in charge to temporarily close the pharmacy when working conditions are deemed unsafe. I personally have had a medical emergency alone in the pharmacy and was told to wait 2 hours for another pharmacist to come and cover me

And if you could wrap up, that'd be great.

Additionally, the Bill ensures that pharmacists are not left alone to work 12 hour shifts by themselves, as multitasking alone can reduce the quality of care and create an unsafe work environment. Lastly, the Bill requires mandatory medication error reporting to the state so the state can gather aggregated data on medication errors and assess trends to ensure that no patient will ever suffer a medication error due to workforce conditions.

It is for these reasons and more that I ask for your strong support and yes, vote on Assembly Bill 1286. Thank you.

Thank you very much. Now we'll turn it over to primary witnesses in opposition. Do we have any primary witnesses in opposition to the Bill? You'll have two minutes each.

First, the Bill inappropriately places the authority on the pharmacist in charge to make the decision in its entirety to close the pharmacy on a moment's notice. This is overly broad language that allows for the pharmacist to shut the doors of a pharmacy if they are uncomfortable with staffing or sanitary conditions of the pharmacy.

Our primary concern is the abruptness with being able to close a pharmacy would limit patient access and have limit implications on patient safety as many patients are planning their day to arrive to the pharmacy. And having the pharmacy be closed without notice would provide very difficult circumstances for many patients that would not have the ability to come back when it does open back up again.

We as a company have several processes in place to make sure that we can have our pharmacy staffed appropriately, that there are mechanisms for the staff to reach out to their leadership to ensure that those decisions can be made appropriately and with appropriate support. Secondly, AB 1286 establishes the pharmacy-mandated staffing floor for all pharmacies in California, regardless of volume or location, and without taking into account any unintended situations where pharmacy personnel call in sick, must leave early for family emergency, or abruptly quit.

This required staffing floor will be impossible for many of our pharmacies in California. Safeway and Albertsons has many pharmacies in the state that are providing patient services at a loss. We keep our pharmacies open as a customer service and to assure patient access to pharmacy services in rural areas or other areas of the state with limited access. Safeway and Albertsons makes the decision about staffing based on the volume of medications dispensed throughout the day.

In addition, there's already regulations that do require that an available individual is present to help the pharmacist when they do need that help. For many reasons, two of which I've covered, we do stand in opposition to this Bill and ask for the Committee to vote No.

Thank you very much.

Morning. Jennifer Snyder on behalf of the California Community Pharmacy Coalition. I want to first acknowledge the Chair and the Committee's work on amendments to the Bill, and they do improve it. But unfortunately, we're still strongly opposed to the Bill. And Rob Geddes did a very nice job of referring to the two major concerns we have more specifically related to the ability for a pharmacist in charge or a pharmacist on duty to close a pharmacy. But I want to add just a couple additional points.

One, we do appreciate and recognize the concerns of the supporters of the Bill relative to workforce issues. But I think it's really important to note that California has the most restrictive technician-to-pharmacist ratio in the nation. We have a requirement in California that a pharmacist can only supervise one pharmacy technician. There's no other state that has this. 24 other states in the nation have unlimited ratios. Most others have one to three or one to four.

So in most of our pharmacies, they are limited to the number of support staff that can actually help a pharmacist do their job. And so we have for the last decade, been trying to work towards changing that pharmacy ratio. And we would really, really implore the proponents and the supporters of the Bill to look at that larger issue and really try to address the underlining issue that we believe is causing the problem in the first place.

The bill's provisions more specifically authorize a pharmacist in charge to make staffing decisions for that pharmacy. But our state statute restricts really what they can do within that authority. And then again, it requires then that the pharmacy close down, which, again, is a huge concern with respect to patient access, especially in rural areas where a patient, in particular, is not able to access their medications when they're planning to access those medications. Lastly, the Bill, which we actually do support, authorizes pharmacy technicians to do vaccinations.

We're very supportive of that provision, but it narrows the ability for that pharmacy technician to only be able to work within the vaccinations and a limited amount of tests during the day. And so the Bill, on one hand, will allow for two pharmacy technicians to one pharmacist, but limits the ability for that second pharmacy technician to help out in the larger pharmacy setting.

So again, back to our limits, create the concerns, and we need to look at a better picture in a different way in how we handle this situation. So, unfortunately, we must still oppose 1286. Hope we can continue to find a solution to this issue in California. Thank you.

Thank you very much. Any members of the public who want to add on in support of the Bill to add on name organization you're with, if any, and position.

Good morning, Mr. Chair and Members. Missy Johnson here on behalf of the California Pharmacists Association with a support if amended position. We look forward to working with the author and the sponsors on our concerns. Thank you.

Thank you.

Jassy Grewal, UFCW Western States Council in strong support. Thank you.

Thank you. Any additional witnesses in support? Seeing none. Any witnesses in opposition who want to add onto the Bill?

Good morning, Chair Members. George Soares of the California Medical Association, respectfully in opposed, unless amended position, quite sure we can get to neutral and continue to work with the author's office, and they have already worked with us in the Committee. So thank you.

Thank you very much. Appreciate that. Bring it back to colleagues. Questions or comments on the Bill? Please go ahead, Senator Patterson.

Thank you. Question for sponsor of the Bill. Just can I learn a thing or two? I've been involved in situations where regulators, and I've seen it many times in my career, use their legislative authority to create regulations, promulgate regulations, sometimes beyond the scope of probably the legislative intent. But in this scenario, where the Board of Pharmacy was put together, an ad hoc group, and identified this as being a problem, why couldn't they develop a regulatory process where this could have been part of a public process?

Thank you very much for that question. Anne Sodergten with the California State Board of Pharmacy staff. So the board did use a very public process actually in developing this. Everything that the board does, all of their both Committee and Board Meetings are public, providing an opportunity for engagement. The workforce survey was the jumping-off point, that along with media reports, and so there was a public process, it was a year-long process that the board used in developing this proposal.

Do you not have the authority to promulgate regulations along these lines?

I believe that we are seeking statute because we believe that that's the best way to effectuate the changes that are sought. The Board's regulatory authority is a little bit limited.

Thank you.

Thank you, Assembly Member Nguyen.

Thank you, Mr. Chair. First, I want to thank you. I want to thank you for what you all do, because you do provide that sense of if anybody is ill, right. That what you do when you provide. I visited the pharmacist many times and really appreciate the fact that I was able to sit and consult with them about my medication. COVID really did a number on all of us, on all of our industries.

And what I'm hearing is that the lack of staffing is one of the areas in which it really just made all of us in all of our industry, tired, worn out, just burnout overall. My concern, though, is as somebody who's worked in the low-income communities and worked with communities of colors, especially limited English-speaking communities. Many of us, and I say us because I come from that community.

I grew up, I'm a MediCal baby and we had one place to go to to get our medication. And I'm thinking about the parents and the families and the grandparents who don't have transportation already as it is, and they're going to a pharmacist to pick up their medication only to find out that it's closed and not sure when it's going to reopen again. I'm thinking about the folks who need that medication. Where will they go to get the medication if this pharmacist closed down?

I'm thinking about the community members who have nowhere else to go. I'm thinking about the fact that this is the one place they went to all the time to ensure that they had developed this relationship with their pharmacist and trust that pharmacist and getting their medication and asking all the questions. But when this shuts down without any notice, where will they go? How will they get the treatment that they need?

Many of them don't have a health place that they go to, like a Kaiser, where the pharmacist is right there on site. Right? And they rely on these pharmacies to be able to get their medication. I hope that you have thought about that. And I'm hearing a lot about these surveys that you did. And I don't know about all of you, but I usually do surveys when I have a complaint about something. Right? And not necessarily something good. And I'm going to change that now.

So now when I have something good, say I'm going to start doing these surveys. But I'm curious to know that these folks that completed the surveys, when they completed the surveys and they complained about the cleanliness, the lack of, the inaccuracy of the medication, did they also know that this would shut down a pharmacy and they wouldn't be able to get their medication that they needed? Right? I am all about regulation.

I'm all about making sure that these communities receive the right care, the right treatment, the right medication, all of that. And I want to thank you for that because so often communities of colors and low-income communities are the one that get the grunt of this. So I'm all about that. But I want to ask you if you would take a look at this and think about maybe it's the staffing, right?

As our opposition said, that is needed because we saw that happen during COVID. Restaurants shut down, supermarkets shut down. And what happened? There were food deserts. Folks had to go to food banks to get their food. Folks had to find other ways to do it. In this situation here, I'm asking you that maybe we take a look at other areas in which we can make this work for those communities. Thank you.

Other folks may have ways of weighing in. I want to thank you for those comments and say that the intention of this Bill is absolutely to increase access and safe access. The Committee amendments, I think, helped us clarify the very rare instances when there's unsafe and unhealthy conditions where a closure would happen and then it would immediately reopen. But I do want to say and give my commitment to continue to work on that issue of closures.

This is not intended to reduce access, but I also want to say, and I'd imagine this is something we'd agree with, a pharmacy that is unsafe to the point of having a rodent infestation or a significant risk, as you heard of medication error is probably one that needs to be closed for some amount of time to fix that issue before it reopens, even just for an hour or 2 hours. If it's forced to stay open, that can create serious issues for patient safety.

But I understand the concerns that have been raised, particularly on this issue of closure and in areas where there isn't as much access. And so I'm definitely committed to looking more at that and refining it, defining it, and reducing that situation even further. I do want to say, and there was a point about liability. Right now, pharmacists in charge do have liability. They're the professionals, and they should be able to make some of these decisions to protect patients.

And right now, they're being restricted from their ability to do that. The decisions are being made by others, and we want to make sure that the professionals, the medical professionals, are the ones who are making these decisions. Yeah.

Please. Briefly.

Yes.

So, to the point of closing pharmacies, we absolutely don't want to close pharmacies. That's the last thing any pharmacist wants to do. And the circumstances that we would close a pharmacy under are extremely extenuating. Like literally having a medical emergency where I had an asthma attack and was told to keep the pharmacy open. I did nothing in the pharmacy but stand there and stare at a rescue inhaler for 2 hours. I didn't help anyone while I was there, and I was also robbed at one point.

And after the robbery, I dispensed a medication to a patient that was waiting in the waiting room that didn't even know we were robbed. The circumstances under which we would close a pharmacy aren't just because we're working too hard, because we're always working too hard. It's not just because we don't have proper staffing, because we never have proper staffing. It's very extreme circumstances at which we deem that patient safety is at risk.

And that is more of a con than the pro of keeping the pharmacy open for the other patients would be. That's the clinical decision-making that we have to do as a pharmacy and to speak to increasing staffing ability. I would love to do that. Maybe increasing staffing or technician ratio would help, but there are no technicians now because the job is so hard. They all have left to do something else. There is a technician shortage, but no pharmacist shortage. Not yet, anyway.

But the schools are decreasing their admissions. A lot of them are down to 30% of their class size, and those classes graduate in about three to four years. So in three to four years, there will be a pharmacist shortage. There will be stores closing because there are no pharmacists to work, not because they want to close the pharmacies. Thank you.

Thank you. I've got Assembly Member Grayson.

Thank you, Mr. Chair. And a lot to discuss here. I first want to preface by saying I have immense respect for the author and also for the Chair of this Committee. Thank them for their hard work in working together, collaborating, coming up with amendments. So I appreciate that. One question, just for clarification. You said there was a study that was done. The Board put out a study. When did you put out that study?

Yeah. So following the Board's sunset review oversight, one of the issues that was raised that the Legislature asked the Board to look at was workforce and medication errors. And so the board did develop a workforce survey and released that to its licensees. And it's based on that. Those are the statistics that were cited were from that workforce survey in 2021.

Thank you so much. So the answer was 2021 when the study went out?

Yes.

Okay. So that was for many of us. I think we remember that was in the midst of COVID I'm not sure if we could find a hospital, an emergency room. I don't think we could find a business that would state that they were adequately staffed. I think stress levels at that time were at an all-time high. I think that if you were to have surveyed any business, you would have found out that employees would have said, I'm at an all-time stress level.

We don't have enough staff. So I'm not sure if the study came back as pure as we want to hold it. It might be a bit skewed because of COVID Would be interested to see if we get the exact same results. Now that we're saying we're out of COVID I do share sentiments with my colleague. I am very concerned about pharmaceutical deserts, especially in the author's own district, where chain pharmacies are literally closing their doors and entire stores almost completely.

So that is a concern of mine. I do believe the author is working very hard to make sure that we do not compromise access as well as the Chair as well. I'm not sure how the Bill addresses the workforce challenge. By admission of one of the testimonies that we heard today from a proponent, we are in a place and a challenge where there's workforce issues and access to future technicians or pharmacists. So I do have a question.

Do pharmacies have to be licensed in order to open?

Yes.

So what is the role of the Board of Pharmacy once you license a pharmacy? Do you just give them a license and then say, go off into the wild, wild west and open a store and that's it? Or is there any type of engagement or interaction after they receive their license, like an inspection or other services that you might provide of a pharmacy?

Yes. So the Board regulates once they issue the license. Right? And so we do inspections. We do routine inspections. So where we're going out for no reason other than to assess the operations. We're also performing inspections depending on the type of license as a requirement. We are also going out and conducting inspections in response to consumer complaints and information received from other regulatory agencies.

Interesting. So you are out there doing inspections. How often does a pharmacy receive, how often would they be inspected? Once a year. Once every five years.

So it will depend because complaints are site-specific driven generally. So we may be going to a single pharmacy multiple times, depending on the type of case or triggering event with respect to routine investigations, where we're going out for no other purpose other than to assess, it's once every four years.

Once every four years. So you do have a system set up for consumers to call and complain about a pharmacy. Is it possible that the Board of Pharmacy could also set up the same system for an employee that is working at a pharmacy that is a bad actor, that's not operating in the way they should, that an employee could call and make a complaint?

Yes. So the Board would investigate a complaint received from an employee as well, and the Board has pursued action. I think one of the challenges as a regulator sometimes is when we do a complaint investigation, it's kind of reactive. It's in response to something that's already happened. So whether it's a medication error or insanitary conditions, those are things that have been reported to the Board, and so the condition already exists.

Okay. So the point is that an employee could call if something wasn't right at the pharmacy, and it is the responsibility of the Board of Pharmacy to go and inspect that and determine whether that pharmacy needs to have a right to cure or whether it needs to be closed down temporarily or even permanently lose its license.

Yeah. So the Board would be assessing for the requirements of the law. So it can't generally take any kind of enforcement action if there's not a provision in the law that establishes as the condition being a violation of probation, should we find that it exists. I did not explain that very well, but hopefully you're getting what I'm trying to articulate.

I think I'm getting there. So this is one of the good parts of this Bill would be that it could list a certain, or it could provide a list of violations that would definitely give you the ability to enforce and take action against a pharmacy.

Yes.

And not necessarily an employee making a unilateral decision to close a pharmacy on the spot. Obviously, if there's a fire in the pharmacy, we definitely want that employee to exercise protection. I think where I'm going is, under this Bill, would it be possible for an employee if the refrigerator, for whatever reason, the refrigerator that was housing insulin, because insulin has to be refrigerated?

If that refrigerator quit working and insulin was now not at the right temperature, could the pharmacist at that point close the pharmacy because insulin wasn't being refrigerated with this Bill? Well, I don't know if I'm just asking with this Bill. I'm asking the sponsor.

I would just speak to. That happens in the pharmacy.

I'm actually asking the.

I'm sorry.

Yeah, I'm actually asking the sponsor.

Hi. So, as I understand your question, I believe the answer would be no. However, it would be the Board's expectation that the insulin that has not been maintained at the proper storage would not be dispensed to a patient.

Thank you. Go ahead.

Yeah, I think the language we got with amendments helped to clarify that, but what you're saying, it probably needs further clarification.

Thank you.

That if there's one particular issue with one type of medicine that shouldn't leave the entire pharmacy to close, that should lead that medicine not to be used.

Hence is why I have immense respect for the author.

So that aspect of it I think we could further clarify and I think is important. That would be an unsafe, unsanitary, unhealthy condition as it relates to that medicine, but shouldn't lead to an entire pharmacy closure.

With that. Thank you very much. So with that, I will definitely go ahead and make sure that you are able to continue to work on the Bill today, as hopefully we move it out of the Committee. And I want to again thank the Chair and the author for the Bill and your willingness to collaborate and continue to improve and make it better.

And also, we're definitely committed to continue to work with the opposition. And on this issue of closure, I'm hearing the concern about that, and really, we'll commit to working on that moving forward.

So I'll support the Bill to get it out today.

Vice Chair Flora.

I just was curious if the opposition had anyone to respond to some of the Assembly Member's questions, or just your comments on those questions as well.

Yes. Thank you, Assembly Member Flora. Yeah, just a couple of points on the topic of closure. I agree with Assembly Member Haney that as written today, the instance that Assembly Member Grayson outlined could allow a pharmacist to make the decision to close the pharmacy. And that's one of the concerns that we had, is based on the decisions or the language as written. It is overly broad and allows for the pharmacists to make those decisions which would be concerning and limit access to care. During the process, we did offer amendments to the language prior to it becoming a legislative proposal.

And our neighbors to the north actually have solved this in a little different way. Rather than going to the extent of closing down the pharmacy in its entirety, they wrote their language that's similar. To accomplish the same event here is to temporarily suspend a service or services and not lead the pharmacist down the decision to close the pharmacy in its entirety.

So would line up more with, I think, what Assembly Member's intent is here to make sure that access remains in place and that the offending issue is resolved and does not impact patient safety. And so that's one concern. I'll yield to Jennifer here as well.

Please.

Thank you. I would only add that I think the Assembly Member Grayson's points about this really is the role of the Board of Pharmacy as the enforcer, and that really should be in their hands to make those decisions, whether or not a pharmacy should stay open or not. So we'd hope that the author would be looking at different ways that they can provide those tools to the Board of Pharmacy rather than put it in the hands of an employee of a pharmacy company.

Thank you very much.

Yes, thank you. I just wanted to clarify, does this Bill also require an additional staff member technician? Is this a requirement of the Bill?

So the Bill does seek to establish a minimum floor, a minimum staffing floor. It does not need to be a pharmacy technician. It can be an unlicensed, a nonlicensed individual that also has authority.

So that doesn't currently exist. I mean, I go to a pharmacy regularly and there are three or four people in there. So what circumstances would this enable further? That's not enough?

So I think the challenge right now is that not all pharmacies have more than just the pharmacist present.

Okay. I'm just trying to understand that issue. And there's been such an enormous growth of online pharmacies, so I'm just trying to understand the need for additional humans at the pharmacy. Like I say, when I go to all number of different pharmacies and there seems to be plenty of people there. Talk to me about this cleanliness issue. I mean, you work with, maybe if it's a grocery store, like Vons or Albertsons or also independent pharmacists. So independent pharmacies would be subject to this as well.

And so if there's a cleanliness issue, wouldn't you deal with the store management? I mean, do we need a whole new law to make sure everybody has a clean pharmacy and sweeps their floors and checks for rodents? I mean, wouldn't the management of the facility, the management of the pharmacy, the management of the store, isn't that part of the process to make sure, I mean, there's food being served 20 feet away? How significant and serious is this cleanliness issue?

Sorry, I'm talking way too much. So I think I would say that through investigations that the board has conducted, we have found that there are opportunities where pharmacy personnel have tried to elevate the issue and secure the necessary changes to remedy the issue, whether it's a dirty pharmacy or a pest infestation. And so through the course of it, what we have found is that not in every case, right. Every case is different.

But there are times where the evidence has demonstrated that pharmacy personnel have actually tried to work within the management of the pharmacy to remedy the condition, and it has not been. And so we're kind of sometimes their last resort.

So we need a state law to fix that. Seems pretty dramatic. Okay, thank you very much.

Thank you very much. Any additional questions or comments from colleagues? Still looking for a motion and a second.

So moved.

Have a motion. Have a second. Any additional questions? Comments? Seeing none. Mr. Haney, would you like to close.

Hear the comments, particularly around the closures. We'll absolutely continue to work on that and clarify that language and really appreciate the Chair and the staff for these amendments. And this is addressing a very important issue around patient safety and would respectfully ask for an Aye vote.

Thank you, Mr. Haney. I want to thank you. I was worried that today's hearing was going to be too short, so I appreciate you bringing this Bill forward and for accepting the Committee's amendments, which are intended to help strike a balance between protecting pharmacy staff and patient safety with ensuring pharmacies can effectively continue to provide services in our communities.

I know you've heard the questions and concerns and conversation from colleagues, but I have all the faith in the world you'll continue to work with the opposition and address concerns that have been raised. And so I'm happy to support the Bill with the amendments today. Madam Secretary, please call a vote.

AB 1286 Haney. The motion is do pass as amended, to the Committee on Appropriations. [Roll call].

That Bill is out. We'll leave the roll open for absent Members. Thank you very much. So I think that's all the bills. We're going to run through the agenda so that folks who weren't able to be here can add on to votes they might have missed. Do we have any? You did all the. Madam Secretary, please run through the agenda.

[Roll Call]

That Bill is out. We'll leave the roll open for absent Members.

[Roll Call]

It might have already been out. We'll leave the roll open for absent Members.

[Roll Call]

Thank you.