Senate Standing Committee on Business, Professions and Economic Development

You on business, professions and economic development will come to order. Good morning. As you know, the Senate continues to welcome the public in person and via the Teleconference service. For individuals wishing to provide public comment, the participant number is 877-226-8216 and the access code is 6217161-621-7161. We're holding our Committee hearing in our 1021 O street location. I ask all Members of the Committee to report to room 2100 so we can establish a quorum. We have 13 bills on today's agenda.

There are five measures proposed for consent. File item number three, AB 307. File item number six, AB 878. File item number nine, AB 1130. File item number 12, AB 1557. And file item 13, AB 1731. We'll take up the consent calendar after we are able to establish a quorum, and in the interim, we will meet as a Subcommitee and begin the agenda with item number seven, AB 993. Assembly Member Rubio Cannabis Task Force. Please proceed when ready.

Good morning, Mr. Chair and Senators. And thank you for giving me the opportunity to present AB 993. AB 993 seeks to add the Civil Rights Department and the Department of Industrial Relations to the membership of an existing task force on state and local regulation of commercial cannabis activity. The goal in doing so is to address the recent reports on labor trafficking that is ongoing within the cannabis industry.

The Department of Cannabis Control, the DCC, has the power to take action against both licensees and unlicensed persons for violations of the Medicinal and Adult Use Cannabis Regulation and Safety Act. However, the DCC alone is not the appropriate agency to coordinate enforcement of labor trafficking. The DCC has stated the Department of Industrial Relations is the appropriate entity to resolve issues such as wage theft or workplace violations.

And as this Committee knows, the Civil Rights Department is better equipped to take action against perpetrators of these violations. By adding these two state entities to the task force, California can better be equipped, through enhanced communication, to deal with all forms of human trafficking within the cannabis industry. This measure is author sponsored, has no opposition, and we are committed to working in close coordination with the respective departments to ensure successful implementation.

Thank you, ma'am. Let's now move to witnesses in room 2100 who would like to testify in support of AB 993. Seeing none. Any opposition witnesses to AB 993, lead or otherwise. Seeing none. Let's move to witnesses waiting to testify via the Teleconference service. Moderator, if you please, prompt any individuals waiting to testify in support or opposition to AB 993. We will begin with them.

Ladies and gentlemen, if you wish to comment on this legislation, please press one then zero. Mr. Chair, no one has signaled that they wish to speak.

Thank you. So let's bring the matter back to my colleagues on the dais. Colleagues, any questions or comments? Senator Archuleta?

Yes. Thank you, Assembly Member for bringing this forward. Obviously, there's a necessity for this because people are being abused in this newly developed industry. And as the industry develops, we'll find that people taking advantage of people, especially those underserved in some of these areas, is critical. And I'm so glad that we're going to have this oversight to see that people are treated with dignity and honor in the fact that they're working and trying to make a living for themselves and their family.

And I think this is a great way to do it, and hopefully in conjunction with law enforcement as well. So then these things don't go unanswered day after day, and that we have punitive results at the end that will cause them to change their ways and listen, that we in California are not going to mistreat our workers. So at the appropriate time, I'll be moving the Bill.

Thank you, Senator Archuleta, when we get there. Senator Alvarado-Gil.

I will say Senator Archuleta said everything that I need to say. So thank you so much, Assembly Member Rubio.

Okay, would you like to close?

Thank you. And I respectfully ask for an aye vote at the appropriate time.

Thank you very much. Thank you, ma'am. We'll move back to item number one, Assembly Bill 232, Assembly Member Aguiar-Curry. Please proceed when ready.

All right. Thank you, Mr. Chair and Members. First, I would like to thank the Committee staff for their continued work with our office. I'm happy to accept the Committee's recommended amendments upon approval of the Board of Behavioral Sciences. Today, people physically located in California must be treated by a therapist who is licensed by the Board of Behavioral Sciences, with no exceptions.

However, when someone travels to California from out of state or is in the process of moving, they may rely on a therapist in their licensed therapist in their home state. AB 232 would grant a 30 day temporary practice allowance to qualifying out of state therapists so they can provide therapy via telehealth to their existing clients.

This bill will help consumers maintain continuity of mental health care and access their therapists during a time of need, even if they are traveling or in the process of relocating. This bill emerges from the Assembly with no no votes and no opposition. And I'm joined by two witnesses today Steven Sodergren, Executive Officer of the Board of Behavioral Sciences, and Rosanne Helms, Legislative Manager for the Board of Behavioral Sciences.

Good morning.

Please proceed.

Good morning, Chair and Senators. Thank you. I'm Steve Sodergren. I'm the Executive Officer of the Board of Behavioral Sciences. And thank you for your time today to hear us on this bill. Several other states have temporary practice allowances for out of state licensees so that visiting or relocating clients can obtain mental health services via telehealth from their current therapist for a limited time period.

The Board carefully considered the features of other states laws when drafting this proposal and built several safeguards to ensure the allowance will not be abused. It limits the allowed practice for a period of 30 consecutive days. It requires the client to be a current client of the therapist. It requires the therapist to inform the client of the limited time frame of the services, and it also requires the therapist to inform the Board of their name, license information, and contact information.

The Board believes this proposal strikes a careful balance between both public protection and the mental health continuity of care of individuals who are traveling to the state temporarily or may be relocating to the state. We are here today to answer any questions, and we'd like to thank you and the stakeholders for their participation in this effort and their ongoing contributions. We respectfully request an aye vote.

Thank you, sir. Next, please.

I'm just here with Steve to answer any questions you might have.

Thank you for joining us. Any other support witnesses here in room 2100 who would like to testify? Seeing none, let's move to any opposition witnesses, lead or otherwise. Any opposition witnesses to AB 232? Okay, let's move to witnesses waiting to testify via the teleconference service. Moderator, if you would please prompt them, support or opposition, and we will take their testimony.

Thank you, Mr. Chair. For those who wish to speak in support or opposition, please press one, then zero. And we have at least one person who signaled that they wish to speak. Just a moment. And we'll now go to line 10. Your line is now open.

Taylor Jackson with California Health Plus Advocates, representing California's almost 1500 community health centers, in support.

Mr. Chair, we have one additional person. Just a moment. We're now going to go to line 13.

Hello. My name is Sumaya Nahar with the California Association of Marriage and Family Therapists in support of AB 232. Thank you.

Next, please.

Mr. Chair, we have no one else.

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

Thank you. Assembly Member, my question is, the relationship between the therapist and the patient is critical. No doubt. As soon as the patient comes into California, notifies their therapist. What's the process time for the therapist to obtain this temporary license. And what does it take? Because it's only good for 30 days, but if it takes three months to get it, that's patient is without service.

Correct. It would not take three months. So what we would do is they would be directed to a link on our website, and so, usually they contact us anyways to ask if they can treat the therapist. So there'll be a link on our website that allows them to sign up via our online licensing system. It would be instantaneous, so they would basically enter their information. It would generate an authorization to practice for 30 consecutive days, and it would explain to them what they needed to do, what they needed to inform their client.

So the communication between you and the therapist wouldn't take forever, and the license can be issued quickly.

Right. And they would go right on our website. They'd fill out a form, and it would give them instructions about how long they could practice.

And my concern is the trauma of moving, and for whatever reason, could be a divorce, could be God knows what. But that continuity that you mentioned, Assembly Member, must not be broken. And that's the reason for my question.

Yeah. They could do it the same day and be ready to go.

Very good. Thank you, Mr. Chair.

Senator Alvarado-Gil.

Assembly Member, thank you so much for bringing forward a real solution to helping close the gap for behavioral health and services. I'm a big supporter of telehealth and telehealth medicine. One question I have here is the conversation with insurance plans. So would this be a self-pay type of situation where the client or the patient would need to come up with their own way to cover the charges, or is this something that the insurance companies have been more amenable to looking at as a covered benefit?

I'm going to have my expert witness.

That sounds great.

That's an interesting question. The therapist would need to work out the coverage with their insurance because they decide that based on their own rules. Many other states have this temporary practice allowance, so we could take a look at how that's worked for them or see if they know.

Yes, because I think that that would be something that would help bolster this bill into something very great, is to give that ability for the client or the patient to be able to make that decision to have continuum of care without the burden of excess cost, which could be a hindrance.

Thank you.

Thank you.

Senator Eggman.

How often does this happen?

Well, we consistently get calls and emails from therapists that are asking if they can practice in the State of California. And with the continuity of care, it's really frustrating to have to tell them that there's no way, you have to become licensed. We do have a more expedited licensure process for people that have a license in another state, but still, that could take months, a couple of months to get that. So this would be very nice to be able to say, hey, well, here's a solution for you. You can do this for now, and then maybe seek licensure.

Okay. Thank you.

Yes, sir.

Follow up question. Patient relationship very important, I understand. Is it with only one, two, five? How many patients can the therapist have in the various parts of the state at one time?

We just left it at 30 consecutive calendar days per year. Because sometimes a therapist might be treating a family and the family might be traveling, or it might be a couple. Maybe they have two independent clients that happen to just both be traveling to California. That would be allowable. We don't want it to be throughout the year. It's just a 30 day per person. If they want to treat clients in California continuously throughout the year, then we have a different licensure process for them to actually get.

So there isn't a specific number, but you're taking a look at that to monitor that. It's not excessive.

Right. We're going to have a staffer that's looking at that how this goes in our office. And then at the same time we have a separate process for licensures for people that want to see clients throughout continually.

Good, thank you. And I'd like to comment my colleague on the question about the payment. Maybe we should CC the insurance in that questionnaire some way so that there isn't a break financially if it's insured by Blue Cross or someone. I think that's a great question. Thank you.

Assembly Member, would you like to close?

Thank you for the conversation and thank you for bringing a couple of items up that maybe we had not thought of, but we'll work on it still, so thank you very much, and I respectfully ask for your aye vote.

When we achieve a quorum. We will do that. I don't know if someone wants to make a motion. Senator Alvarado-Gil moves the bill. We'll vote when we get a quorum.

Great, thank you very much.

Thank you. I see Assembly Member Low here. So let's move to item number eight, AB 1070, physician assistance. Proceed when ready, sir.

Good morning, Mr. Chair, Committee Members. Happy pride. Thank you for allowing me to present Assembly Bill 1070, which helps to lift the current supervision requirements of the ratios for physician assistance. And I want to thank the Committee staff for helping to allow us to identify some technical amends to hopefully be taken appropriations, and I respectfully ask for aye vote when you've established the quorum.

Okay, witnesses in support here in room 2100.

Mr. Chair Members, Charles Wright, on behalf of Signify Health, the sponsors of AB 1070. Licensed clinicians, physicians, nurse practitioners, and physicians assistants conduct millions of in home health evaluations annually for Medicare Advantage and Medicaid MCO recipients in all 50 states. The number of in home evaluations in California is in the tens of thousands annually for some of the most vulnerable and aging Americans.

Clinicians spend on average 50 minutes either sitting face to face or via video conferencing with recipients to review current and past health conditions, perform diagnostic tests when appropriate, examine the home for safety hazards, and discuss social detriments of health. They also perform an extensive medication review. Being in the home means clinicians can accurately evaluate all medications on site and identify any adherence concerns that can be reported to the beneficiary's primary care physician and plan.

In the instance of signifies experience, 43% of those evaluated have social risk factors that may affect their overall health. When these factors are identified, it gives opportunity for those needs to be met by arranging different available solutions. To be clear, clinicians do not provide treatment nor issue prescriptions during a visit. The COVID-19 pandemic has a profound impact on workforce availability that remains a challenge today.

Highly trained and credentialed physicians assistants are well qualified to perform these in-home evaluations, but are at times constrained by current law in the ability to provide more Californians with their services. Currently, California allows a physician to oversee a maximum of four physician assistants that provide in home evaluations. AB 1070 will lift that limitation and instead allow each physician to determine how many physician assistants they may supervise at once. This change will allow these evaluations to be provided to a greater number of Californians.

Nothing in AB 1070 compromises or otherwise impedes or delays patient care, nor does it change current scope of practice laws for physician's assistance. For these reasons, I respectfully ask for your aye vote on 1070. Thank you, Mr. Chair, Members.

Any other witnesses in support here in the hearing room 2100? Seeing none. Let's move to any witnesses in opposition, lead or otherwise opposition witnesses.

Mr. Chair, Members, Paul Yoder, on behalf of the California State Association of Psychiatrists. I think the Bill needs some clarification. CSAP's current position is Opposed Unless Amended. Had a very productive conversation with the sponsors. Look forward to working with the author and his staff. Do believe there's a path to get there. Do want to let the Members know, though there are probably other specialties within the House of Medicine who will eventually have the same concerns as voiced by CSAP.

So we're going to have that conversation with the author and his sponsors. Not asking you to hold the Bill today. Thank you.

Thank you. Any other opposition witnesses? Seeing none.Then let's move to the teleconference service moderator, if you would please prompt any individuals waiting on the teleconference line to testify in support or opposition, we will begin with them.

Thank you. Mr. Chair. For those who wish to speak in support or opposition, please press one, then zero at this time. Press one, then zero. Thank. Thank you. And we have at least one person who signaled that they wish to speak. Just a moment, please.

And we will now go to Line 14. Your line is now open.

Thank you. Mr. Chairman, Aaron Bone with the Medical Board of California. The board regrets that it is opposed to AB 1070. We believe that the language in the Bill is currently vague and does not sufficiently define what is intended to happen during a home health evaluation. The board is concerned also that eliminating the physician to PA ratio could lead to inappropriate supervision or result effectively in no supervision under the current version.

Further, the unclear terminology, we fear, could lead to confusion amongst consumers, clinicians and regulators about what activities are authorized during these patient encounters. The board values the work that PAs provide to consumers, but believe that appropriate supervision is still necessary. Board is opposed to AB 1070. Thank you.

Thank you. Next, please.

Mr. Chair, there is no one else who signaled they wish to speak.

That's fine. Now let's bring the matter back to the dais and my colleagues. But before I turn to them, it's my understanding that this is the Assembly Member's birthday today. So, colleagues, we should be kind to him. Any questions or comments? Senator Eggman.

Thank you. Happy pride and birthday. So it sounds like there's an opposition that's popped up. And so I'm assuming that you're going to continue to be in dialogue with them going forward.

That's absolutely right. As you've heard it, and consistent with that, to help address and clarify specifically to address the concerns moving forward.

Okay. And I'd like to move the Bill when the time is appropriate.

Thank you. Senator, any other questions? Senator Alvarado-Gil.

And if I might, through the chair, ask Mr. Wright also to join to additionally clarify specifically. But this is to address the in-home evaluations and increasing assets specifically. It does not remove the supervision, but helps to allow the increased access specifically. And ask Mr. Wright also to clarify as well.

Yeah. My understanding is that you can have a pool of physicians assistants, but you can only supervise four at a time.

At a time per physician. Okay. So by removing this cap, what is the intent that they can supervise five or six or 10, 15 or how do you see that?

The intent is to allow the physicians under their own jurisdiction and their own knowledge of physicians assistance to be able to supervise more than four. It does not set a cap on it. So the belief is that four is too low of a number. The more physicians assistance that are available to be out in the world working and helping clients, it gives greater access to healthcare.

Okay. So there's no cap to this, which I think that should be my concern, kind of moving forward, because I think that different physicians have different capacities, right? But going from removing a cap of four, which I understand there's been some work here done also through Senate bills in 2019, and we wanted to kind of make this so that we have the healthcare workforce. As our population is aging, we want to have the right trained workforce, right? So any comments or any conversations around a cap?

Sure. Very well received, Senator. With respect to helping ensure that we do not have subpar treatment while increasing access, that's certainly not the intent. So I'd love to partner with you and to keep you informed on the specific definition accordingly to help clarify and address those concerns.

Okay. And has the opposition have they mentioned any type of cap or anything that they're looking for?

We are in continued conversation with them, and we'll continue to do so. We've been in conversation with this Committee as well as Appropriations Committee to further clarify, to address some of these concerns and hopefully to remove that opposition.

All right, thank you.

Thank you.

Thank you. Senator Archuleta.

Yes. Happy birthday. Congratulations. My questions are pretty much on the same line about the caps, but it's who brought this forward that we could do more than four. My God, we can do as many as 10 or I mean, the discussion must have been around sometime about the workload, because that's going to be the issue. Quality care, excessive amount of time and effort that it takes to give the general public exactly what they're asking for. More of the best.

How do we maintain that more of the best without exceeding a number? That's ridiculous if you're going to put a number on it, and if you don't, then you have to self-police yourselves, and then you're trying to capture one versus the other. So that cap idea may not be that bad, if you've discussed it.

Yes. Senator, as previously heard, we've been in conversation with the Specialties specifically to help address some of these concerns. As you well know, this Committee and the State of California has been focused over the past decade plus to increase access, but also not to denigrate the quality of care as well. We've been focused on specifically helping the rural and underserved communities, but to help ensure that we're doing so in appropriate way.

So I think this is a valid conversation to address and something that I take very seriously as well, should this continue to move forward.

Okay. Assembly Member, would you like to close?

I respectfully ask for aye vote.

Okay. Looks like we have a quorum, so let's first establish a quorum.

[Roll call]

We have a quorum. Now let's call the roll on number eight, AB 1070 Low.

Motion is due pass to Senate Appropriations. [Roll call]

Alvarado-Gil, aye.

Bill has seven votes. We'll hold the roll open for absent members. Let's return to... Let's do the consent calendar. There are five measures proposed for consent. File item number three, AB 307. File item number six, AB 878. File item number nine, AB 1130. File item number 12, AB 1557. And file item number 13, AB 1731. Is there a motion? Moved by Senator Archuleta. Please call the roll.

Roth. Aye. Roth, aye. Nguyen. Alvarado-Gil. Aye. Alvarado-Gil, aye. Archuleta. Aye. Archuleta, aye. Ashby. Ashby, aye. Becker. Aye. Becker, aye. Dodd. Eggman. Eggman, aye. Glazer. Niello. Aye. Niello, aye. Smallwood-Cuevas. Wahab. Wilk.

Consent calendar has seven votes. We'll hold the roll open for absent members. Now turning to file item number one, AB 232, temporary practice allowances. Bill was moved by Senator Alvarado-Gil. Motion do pass as amended to Senate Appropriations. Please call the roll.

Roth. Aye. Roth, aye. Nguyen. Alvarado-Gil. Aye. Alvarado-Gil, aye. Archuleta. Aye. Archuleta, aye. Ashby. Ashby, aye. Becker. Aye. Becker, aye. Dodd. Eggman. Eggman, aye. Glazer. Niello. Aye. Niello, aye. Smallwood-Cuevas. Wahab. Wilk.

Bill has seven votes. We'll hold the roll open for absent members. Next, let's move to item number seven, AB 993.

Motion is do pass to Senate Appropriations. Roth. Roth, aye. Roth, aye. Nguyen. Alvarado-Gil. Aye. Alvarado-Gil, aye. Archuleta. Aye. Archuleta, aye. Ashby. Ashby, aye. Becker. Aye. Becker, aye. Dodd. Eggman. Eggman, aye. Glazer. Niello. Aye. Niello, aye. Smallwood-Cuevas. Wahab. Wilk.

Bill has seven votes. We'll hold the roll open for absent members. I see Dr. Wood is here. So we'll take item number two, AB 242, clinical access hospitals employment.

Senators, Mr. Chair and Members. AB 242 eliminates the five year sunset on a prior bill of mine, AB 2024. Another similar pilot by then Assembly Member Wes Chesbro from 2004 to 2011. This bill permits federally certified critical access hospitals to employ physicians and be able to bill for their professional services. Critical access hospitals are often referred to as frontier hospitals because most of them are located in remote and rural areas. There are 34 such hospitals in the state, and they all have 25 or fewer beds.

While these hospitals are small, they provide critical services and value to their communities. Without these hospitals, people would need to drive many miles before reaching another hospital. One of the issues I continue to hear throughout my district is how difficult it is to recruit physicians. 6 of the 34 hospitals are in my district. Having been a healthcare provider myself, I understand the concerns of the medical community about whether allowing hospitals to employ physicians will change the nature of the physician's clinical decision.

But the opportunity for these hospitals to hire physicians has now been piloted two times with no negative feedback. The opposition has requested a sunset remain in place. While I remain open to their concerns, pending the results of the report called for in my earlier legislation, today I believe that two pilots is adequate to determine if there are any concerns allowing the hospitals to hire physicians.

It's important to point out that a continued sunset creates uncertainty to physicians who may be seeking employment and whether the length of employment could end abruptly by the sunset. This is what happened with the end of the original pilot by Mr. Chesbro. AB 242 is a modest bill and provides a limited exemption for those hospitals most at risk of closing their doors if they cannot address their physician staffing needs. In support of the measure today, I have Ted Owens, the Executive Director of Governance and Business Development with the Tahoe Forest Healthcare District. I respectfully ask for your aye vote.

Thank you, sir. Mr. Owens. You can go wherever you'd like, sir.

Good morning, Chair Roth and Committee Members. I'm Ted Owens, Executive Director of Governance and Business Development for the Tahoe Forest Health System, which includes the Tahoe Forest Hospital, located in Truckee, California. I am here to support AB 242. The Tahoe Forest Health System is a critical access hospital based out of Truckee serves the North Lake Tahoe area, and under the provisions of AB 2024, Tahoe Forest engaged in physician direct employment.

And today, with few exceptions, Tahoe Forest employs the majority of the physicians in our region. It has proven to be a great benefit for our organization, as well as for providers. This is particularly true in a rural setting for the following reasons, it has stopped physician turnover in our region. Very beneficial. Direct employment has produced exceptionally strong retention. We have only lost one provider for reasons of moving closer to family who is now engaged in discussions with us to come back to Tahoe Forest.

It is far easier to recruit established physicians by eliminating the challenges of expensive clinic space, business office staff, insurance, and regulatory compliance. It has enabled Tahoe Forest to recruit young physicians coming out of residency and or fellowship by provision of a strong employment package so they may pay down their student debt as well as establish a career in a community. Our recruitment efforts have taught us that young physicians want employment and not establishment of standalone clinical office business.

It does not financially make sense for them. This is a valuable tool for very rural hospitals to retain and recruit in regions where the loss of a single provider can be devastating to the survival of a small hospital, not to mention the impact on the community that it serves. In addition, I want to share with you that should AB 20 or 242 fail, this would be a unique situation.

Tahoe Forest Hospital was engaged in litigation with the Federal Government, both with the IRS and the Social Security Administration, over our contracted services for the 2014 year, utilizing, as is commonly known, a professional services agreement with providers. The federal agencies ultimately determined that physicians must be employees, regardless of California's long standing corporate practice of medicine laws. We escaped by technicality as a government entity, any cost to the district other than the litigation.

However, they did find and assured us that they trump the corporate practice of medicine in California. We need to be aware of this. And I provided our background information to the author, to Assembly Member Wood. I'm happy to answer any questions. Tahoe Forest Health System is here today in strong support of AB 242.

Thank you, sir. Appreciate you coming. Any other support witnesses in the room? Please step forward. Name, position, affiliation.

Good morning, Mr. Chair and Members. Connie Delgado on behalf of the 33 Members of the District Hospital Leadership Forum in support.

Thank you for coming. Next, please.

Yeah. Thank you, Mr. Chair and Members. Sarah Bridge on behalf of the Association of California Healthcare Districts, here in proud support.

Thank you.

Good morning, Chair and Members of the Committee. Ronnie Bridigo here with the California Hospital Association in support. Thank you.

Thank you. Any other support witnesses here in the room? Please step forward. Now let's turn to opposition witnesses. Lead first, and then any others.

Mr. Chair, Members of the Committee, Brandon Marchy with the California Medical Association here in respectful opposition. Actually an opposed unless amended position on the bill. As Chairman Wood mentioned in his speech a couple of years ago, we did work with him to figure this issue out, eventually go neutral on that bill with the intent that the report would be out before the program was allowed to sunset. That report is not out.

While we have seen some rough numbers, we also don't know what that analysis looks like. And that report, to our knowledge, again, that analysis is not out. So I want to point that out very clearly. To our knowledge, does not contain an analysis of if the provisions of the bill or if the pilot program had any impact on clinical decision making. Because of that, we are requesting an amendment to just extend that sunset for five years, as opposed to indefinitely. But again, happy to answer any questions. Respectfully opposed. Thank you.

Thank you. Any other opposition witnesses here in the hearing room? Seeing none. Let's move to the teleconference service. Moderator, if you would please prompt any individuals waiting on the line to testify either in support or opposition, we will take testimony from them.

Thank you, Mr. Chair, for anyone who wishes to speak in support or opposition, please press one then zero at this time.

Mr. Chair, no one has signaled that they wish to speak.

That's fine. Let's bring the matter back now to the dais and my colleagues for any questions or comments. Colleagues, questions or comments. Okay. First Senator Eggman, followed by Senator Alvarado-Gil.

Thank you for bringing this forward and continuing to represent your district. Can you talk a little bit about the opposition, and do we have any, I know we heard from a witness that everything's going fine. Do we have any other indicators? Because as far as I know, there's been no problems that have surfaced from this, no actual data, no exposes, no articles, no reports of any kind. And do we have any timetable for that analysis to be done?

Honestly, I don't know exactly when the analysis is going to be done. We have not had any, there's nothing that I am aware of, that would indicate that this is a problem. Actually, I think the problem is the continued sunsets. And as our witness said, if you are actually going to be committing to moving into a sometimes pretty remote area to practice, you want to know that that job's going to be there and not disappear in three or four years.

So I would point out that this is not a unique situation, and this situation happens in many other states in the United States. And so I don't know what the number is, but it's a very large number. California may be one of the only states, or I think it is one of the only states, that still has a corporate bar associated with it. And so it's been piloted once, it's now been piloted twice. We don't have any evidence that there is a problem. There is a report coming, that is correct, but how many times do we pilot this and create continued uncertainty for physicians?

I would move the bill.

Thank you, Senator. Senator Alvarado-Gil.

Thank you, Assembly Member Wood, for always championing the healthcare sector and bringing in solutions for our rural communities. I have six of the critical access hospitals in my Senate district, so I will be supporting your bill and look forward to it working hand in hand with Senate Bill 784, that was also authored by my colleague here, Becker.

I think that these are real solutions that are going to help our rural communities and I'd like to see those two bills work together in concert, and look forward to continuing to support more ways to support our hospitals. Thank you.

Senator Becker.

Yeah, I'll just add in, I've been working in this space, appreciate your efforts, and have heard from many hospitals that, again, on this limited set that we are talking about, the importance of being. Able to do this. So I appreciate your efforts.

Let me just ask one I'm just curious, where would the complaints be lodged? If there were complaints about interference with the provision of medical services, would it be the medical staff organization at the hospital in question. Would it be the medical board? Would it be a combination of those?

I think it would be a combination of both. And I would have to guess that the California Medical Association would become aware of those, and as far as I'm aware, they're not aware of any. So I think this is just a continued, you know, we don't like the policy, so let's just continue to extend it within the sunset.

Interesting. Certainly the hospitals that are involved should know.

They should know.

Okay, colleagues, any other questions, comments? Yes, ma'am.

Can you just remind me what the limit is on your bill? It's rural or how you limited it?

Yeah, these are critical access hospitals. So by definition, federal definition, these are 25 beds or less.

Okay.

There are 34 in California.

Got it.

I know somebody else who has six.

Seeing no other hands up. Assembly member?

Move the bill.

Well, it's been moved by Senator Eggman, but you may close.

Thank you for the questions and very much appreciate the dialogue, and I respectfully ask for an aye vote.

And the motion is do pass to the Senate Health Committee. Please call the roll.

Roth. Aye. Roth, aye. Nguyen. Alvarado-Gil. Aye. Alvarado-Gil, aye. Archuleta. Aye. Archuleta, aye. Ashby. Ashby, aye. Becker. Aye. Becker, aye. Dodd. Eggman. Eggman, aye. Glazer. Niello. Aye. Niello, aye. Smallwood-Cuevas. Aye. Smallwood-Cuevas, aye. Wahab. Wilk.

Bill has eight votes. We'll hold the roll open for absent members. Thank you, sir.

Thank you very much.

Assembly Member Valencia, you've been very, very patient. We'll start with item number four, AB 342, architects and real estate appraisers.

Although I'm the rookie, I know where I should be in the Committee room. Giving them a hard time. Buenos dias, Mr. Chair and Senators, I want to start by thanking the committee team for diligently working on AB 342. I'd also like to give a quick shout out to our legislative intern, Kobi Grossman, for also assisting with this bill. This bill will promote DEI, diversity, inclusion, and equity efforts in historically homogeneous professions.

AB 342 will give the California Architects Board and the Bureau of Real Estate Appraisers the authority to request demographic information on race, ethnicity, and gender expression of its licensees. A change in statute is necessary to grant these licensing bodies the authority to ask for and collect diversity data. By allowing, yet not mandating, this collection, we can gain a better understanding of the state of diversity of these professions and develop targeted strategies to promote greater inclusivity and equity.

The collection of this aggregated data will be published in the California Department of Consumer Affairs. This bill creates parity with other professional licensing boards who are already collecting this type of information. AB 342 is an industry sponsored bill, and with me I have Mr. Scott Terrell and Mr. Mike Below as testimony. Thank you.

Gentlemen, please proceed.

Chair and Members. Scott Terrell on behalf of the American Institute of Architects, an association of over 11,000 architects and design professionals in California, and the sponsor of AB 342. As the largest representative of the architectural profession in California, we have made it a priority to champion a culture of equity, diversity, and inclusion, as we believe that when our members' cultural, demographic, and ethnographic makeup more closely mirror the communities we serve, we will be more effective and better suited for long term growth. Additionally, when designing livable and sustainable communities, it's vital that there are cultural competencies of the communities that we are serving.

The collection of this demographic information is essential to these efforts, as it will allow for research to be done to understand attrition and recruitment patterns. From there, the industry can better develop strategies to address any patterns that create barriers to entry. And for these reasons, we respectfully ask for an aye vote. Thank you.

Thank you. Next, please.

Mr. Chair and Members, Mike Belote for the California Government Relations Committee of the Appraisal Institute, a national body of real estate appraisers. This issue is of special importance to appraisers because of the national focus in the last few years on appraisal bias. There have been reported incidents of appraisals being affected by the demographics of the seller or buyer, and that's wrong.

The appraiser is supposed to come to an opinion of value at a moment of time on the real estate, regardless of who owns it or who's buying it. This bill doesn't directly relate to appraisal bias. As a matter of fact, we supported a bill requiring continuing education on the subject. But it does speak to the need to grow the profession and diversify the profession. And there's no better way to do it than figure out where you are when you begin. And so we strongly support the bill and would ask for an aye vote.

Thank you, sir. Are there any other individuals in room 2100 who wish to testify in support of the measure? Name, affiliation and position, please.

Mr. Chair and Members. Amy Costa, I'm representing the International Interior Design Association of Northern and Southern California in strong support.

Thank you. Anyone else? Let's turn to witnesses in opposition. First, lead witnesses, followed by others. Any witnesses in opposition in the hearing room who wish to testify? Seeing none. Let's turn to the teleconference service. Moderator, if you would please prompt any individuals wishing to testify either in support or in opposition to the measure, we will take their testimony now.

Thank you, Mr. Chair. Anyone wishing to speak in support or opposition, please press one, then zero. We have no one.

Thank you, sir. Bring it back to the dais. First, Senator Ashby, followed by Senator Archuleta, Senator Smallwood-Cuevas, and Senator Eggman.

Thank you, Chairman Roth. The pattern for building out housing is long and very involved and involves a lot of different entities. And of course, architects play a part in that. And I was really happy to hear Mr. Belote talk about how this would start to impact some of that industry, given this country's ugly history with redlining and making lending decisions based on people's ethnicity, race, gender. It wasn't that long ago that a woman couldn't even qualify for a loan in this state without permission from a man. I think this is a good step in the right direction and be happy to move the bill.

Thank you.

Senator Archuleta.

Yes, thank you, Assembly Member bring this forward. I think it's a bill that's desperately needed, no doubt. And I will support the bill, 150%. My question is, once you get all the data together, and you realize there's inequities, not enough Latinos, women, blacks, I mean, there isn't the diversity that you're looking for. Now, what is the Association going to do about it? To promote people coming into the industry, educationally and however supportive, whatever it's going to take to change those numbers. What is the game plan in the future?

In conversation with the industry, it's my understanding that the first step is to collect the data and then thereafter generate strategies to expand these types of professions to a broader demographic. Any maybe...

And I appreciate that. I'm just wondering also how you're going to do it.

Senator Archuleta, at least with respect to real estate appraisers, this is a national conversation. There's all kinds of efforts in terms of outreach to underrepresented communities to talk to them about the profession of real estate appraising. So a lot is being done about it, but you have to start with the data. I would also say that the profession, both here in California and nationally, is looking at barriers to entry which may disproportionately affect underrepresented people, like experience requirements. And there is work being done on that too. In fact, the Bureau of Real Estate Appraisers has regulations out now modifying the experience requirements, which could address a barrier to entry and allow more people in.

I was hoping you would tell me there's scholarships out there. There's going to be an outreach program going out there. There's going to get people who look like the people in the neighborhoods to enhance the abilities and just to bring people together. And that's what I'm looking for. The bill is a great bill. I'm supporting it. I'm just taking it to the next level.

Fair enough. I should have come with better prepared in terms of those programs. I will get to you and your office with the list of what they're doing.

Very good. Thank you.

Senator Smallwood-Cuevas.

Well, Senator Archuleta had, I think, asked the question that I wanted to ask, but I wanted to just thank the author for bringing this important bill. And one of the challenges that we have in Southern California is the ability for black and brown homeowners to actually hold on and keep and utilize their equity. So this is a first step in helping to really appraise their properties in a way that doesn't continue to further the bias and starts with the industry and the sector, for sure.

I guess my question for you in this process is, and maybe this is for the witnesses. There have been a number of lawsuits that have been filed against appraisers in particular. And I wonder that, does this bill in any way address some of the harm that has already occurred with those families? Does collecting this data is this a step toward helping to repair some of the harm that has been done to black and brown and homeowners, particularly those that have been in red lined areas. In working with the different organizations, do you see this is the beginning of that process?

And is there a sense that this information will be utilized in a way that will help support clarifying what has been done? And how do we make those improvements to ensure that those homeowners who were wrongly appraised, for example, that they see some relief?

I appreciate the question and comment, and we've had candid conversations with the industry, and I do believe, based on those conversations, nobody is denying that dynamic. And I think this is the first step in addressing those shortcomings that have been taking place for a long, long time for marginalized communities. So it's my intent with this bill to take that first step and then continue to grow that process.

Well, I thank you so much, and I look forward to voting in support of this bill.

Thank you.

Well, seeing no other hands raised, Senate Member Valencia, would you like to close?

I appreciate your time and respectfully ask for a yes vote.

And we have a motion on the bill by Senator Ashby. The motion is do pass to Senate Judiciary. Please call the roll.

Roth. Aye. Roth, aye. Nguyen. Alvarado-Gil. Aye. Alvarado-Gil, aye. Archuleta. Aye. Archuleta, aye. Ashby. Ashby, aye. Becker. Aye. Becker, aye. Dodd. Eggman. Aye. Eggman, aye. Glazer. Aye. Glazer, aye. Niello. Aye. Niello, aye. Smallwood-Cuevas. Aye. Smallwood-Cuevas, aye. Wahab. Wilk.

Bill...

Aye. Nguyen, aye.

Bill has 10 votes. We'll hold roll open for absent members. Since you're on a roll, sir, item number five, AB 470, continuing medical education physicians and surgeons.

Wonderful. Thank you, Mr. Chair and Senators. I am very proud to present this bill, AB 470, which is a Latino Caucus priority bill. And the hope of this bill is to extend cultural medical equity. I'd like to start by again thanking the committee for their work on this, and then Katie Guthrie, who's our legislative aid, who has worked on this bill as well. AB 470 reaffirms the importance of increasing linguistic and culturally competent education through the continuing medical education courses.

The bill modifies existing law that provides parameters on how physicians may fulfill their 50 hour CME requirements. AB 470 will improve physician patient communication by encouraging the development of new CME courses at accredited institutions. An advisory group will inform associations that accredited CME courses of federal and state threshold language requirements in order to update CME standards to ensure that they meet the needs of California's changing demographics. Data suggests that there are linguistic inequities in our healthcare system.

According to a report by UCLA's Latino Policy and Politics Initiative, 44% of Californians speak a language other than English at home. In the healthcare workforce, there are only 62.1 Spanish speaking physicians per 100,000 Spanish speaking patients. This current ratio of physicians to patients that speak a language other than English does not meet the emerging need. Language barriers between physicians and patients can lead to barriers in receiving quality and culturally competent health care.

As California becomes more of a minority majority state, we need to ensure that communities of color are receiving culturally competent care with me. To provide testimony. I have Dr. Shapiro with AltaMed.

Doctor, please proceed.

It's an honor and a pleasure to be with all of you. Good morning, Chair and Members. My name is Dr. Ilan Shapiro. I am here to speak in support of AB 470 on behalf of AltaMed Health Services. AltaMed is a proud co-sponsor of the bill in partnership with the California Medical Association. We thank the Assembly Member, Avelino Valencia and the Latino Legislative Caucus for their leadership on this important issue.

I serve as a practicing physician and hold this position as the Chief Health Correspondent and Medical Affairs Officer for AltaMed. AltaMed is one of the largest fair, qualified health centers in the country, providing culturally and linguistically competent care for more than 500,000 patients at more than 50 sites from LA to Orange County. You can imagine the diversity of languages that we take care of. It goes from Spanish, Vietnamese, Mandarin, Korean, and we try to be there for our patients.

And those services include pediatrics, making sure that they have a family practitioner, someone that actually is an internal medicine doctor, dental, behavioral, and also our amazing promotoras and other community things that we do to make sure that we encourage our community to know the information and go forward with healthcare and wellness needs that they have. We do not only provide healthcare to working families, but also we are employing from our own community, and actually, that's way that we connect with the patients that we serve.

We employ approximately 4000 individuals in the state. That includes 400 providers. That's an important number. AltaMed exemplifies what it means to be trusted community partner. We started in the East LA Barrio Free Clinic in 1969, and we moved forward giving access to critical services to communities in South California. With over 50 years serving our community, advocating for Latino, immigrant, multiethnic working families. We understand our communities well.

We have been there in the side on the most most difficult times, from birth to the problems that we have seen the past three years during the pandemic, advocating for access and resources that are meant for our communities. We saw the disparities in our communities, where we were the last ones to receive testing, vaccines, and other things around our community.

After we learned that the Latinos were dying in an unprecedented pace during the pandemic, we launched a culturally competent, amazing campaign called Ándale! ¿Qué Esperas?, where we brought the language, the cultural aspect of it, and actually merged it inside of our communities to see El Chavo Del Ocho, someone that actually is a very well known character in the Hispanic community and also bring the same efforts with other communities to make sure that we were talking and being present with them in a linguistically and culturally competent way.

Our success was due to having a culturally and linguistically competent workforce from the communities that we were serving and with the tools that we needed to actually deploy that in our communities. AB 470 is an important step in increasing access to high quality, linguistic competent care. Since COVID-19 pandemic, health disparities and culturally and linguistically held workforce shortages has exaggerated.

About one in every five healthcare workers left their jobs during this time. We were hearing about the shortage of physicians that actually speak the same language of the community that we're serving, that actually is taking a big hit in the people that we are serving. Adding to this, Spanish speaking physicians are the most common underrepresented in our state, despite the need for culturally linguistic competent workforce. This sadly creates a disparity.

And when a patient comes to a clinic needing help and there's barriers there. We're talking about diabetes, we are talking about cancer, we're talking about vaccines, about their kids. This actually creates multiple barriers where care is put on the side, and communication actually plays an amazing important role of the things that we are doing. And that actually, when we have that disparity, that gap, we worsen the quality of care and increase one thing that we want to avoid.

It's that emergency visits, that care that could be given at that moment if we had the tools to communicate in a linguistically concordant way with that patient. Finally, I have firsthand experience on how important it is for my patients to speak to a doctor in their own language. I cannot stop counting the stories of mothers that come to me in urgent care with a horrible night fevers. And they see someone that actually understand their culture, their language.

And most importantly, they know that if that doctor, even though that he speaks Spanish, they will have other tools in their team to actually communicate with them and make sure that that little one, Maria, will be taken care of with their fevers, with their problems, and make it better. You cannot imagine the relief when they hear the language, the smile, and most importantly, the way that they connect again back to healthcare. And that's something that my abuela, my grandmother, did not have.

I needed to translate for her. I needed to be there. There were no tools in order for her to actually communicate appropriately with the physician, or the physician actually to get the tools in order on a busy day. To understand what was happening. With this bill, we will be given the tools for physicians and healthcare providers to close that language gap. This bill will expand access to quality of foreign language courses and will be offered in to physicians.

In addition to their preexisting CMEs that we were referring to. AB 470 will allow healthcare professionals to better understand and communicate with our patients and effectively interact with them. For these reasons, I ask for aye vote on this important measure. Thank you very much.

Thank you, Doctor. Thanks for visiting with us. Any other witnesses in support of this measure in the room, please step forward. Name, affiliation, position only, please.

George Soares of the California Medical Association. As proud co sponsors. Thank you.

Thank you. Next please.

Thank you, Chair and Members. Tim Madden representing the California Rheumatology Alliance in support.

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

Thank you, Mr. Chair. For those who wish to speak in support or opposition, please press one or zero, 1 and 0, at this time. We're going to first go to line 18. Your line is now open.

Thank you. MJ Diaz on behalf of Kaiser Permanente in support.

Thank you. Next please.

Line 14. Your line is now open.

Aaron Bone with the Medical Board of California in support. Thank you.

Next.

Line 11. Your line is now open.

Good afternoon, Chair and Members. Dennis Cuevas-Romero with the California Health Plus Advocates in strong support.

Thank you. Next please.

Mr. Chair, there is no one else.

Let's now bring the discussion back to my colleagues on the dais. Colleagues, questions or comments? Senator Eggman has moved the bill. Assembly Member, I would say you're really on a roll. Would you like to close?

I would. In my opinion, no more needs to be said. It's just going to allow folks to have better access to folks who understand them. Respectfully ask for an aye vote. Thank you.

Okay. Moved by Senator Eggman. The motion is do passed to Senate Appropriations. Please call the roll.

Roth. Aye. Roth, aye. Nguyen. Aye. Nguyen, aye. Alvarado-Gil. Aye. Alvarado-Gil, aye. Archuleta. Aye. Archuleta, aye. Ashby. Ashby, aye. Becker. Aye. Becker, aye. Dodd. Eggman. Eggman, aye. Glazer. Glazer, aye. Niello. Aye. Niello, aye. Smallwood-Cuevas. Smallwood-Cuevas, aye. Wahab. Wilk. Aye. Wilk, aye.

Bill has 11 votes. We'll hold the roll open for absent Members. Thank you, sir. Chair Berman, come on down. Item number 10, Assembly Bill 1341. Public health, COVID testing and dispensing sites, et cetera.

Thank you. Chair Roth and colleague our senators. AB 1341 is a Bill to ensure that vulnerable communities retain access to life saving medications for the treatment of COVID-19.

Evidence repeatedly shows that antiviral therapeutics like Paxlovid dramatically reduce the risk of hospitalization or death from COVID-19, especially for higher risk patients like seniors. However, reports indicated that these therapies have been underutilized, particularly in low income communities and communities of color.

Recognizing this critical access gap. Last year, the Federal Department of Health and Human Services issued a declaration. Allowing for pharmacists to independently order and administer COVID 19 therapeutic.

In compliance with FDA authorization, this authority is set to expire as the federal stockpile of medications established during the Emergency Use Authorization is expected to be exhausted later this summer. AB 1341 will extend the current authority of local pharmacists to provide therapeutic treatments for COVID-19 without a prescription until 2025. Respectfully ask for I vote.

Thank you, sir. Any witnesses in support here in the room, please step forward.

Thank you, Mr. Chair and Members. Joe Saenz on behalf of the County. Health Executives Association, representing local health departments and support.

Thank you, Mr. Saenz. Next, please.

Good morning. Jennifer Snyder. On behalf of the California Community Pharmacy Coalition. Very pleased that Senator Berman is willing to author this Bill and move this forward. Our pharmacies have been an integral part of providing not just testing, but now treatment through federal waivers. And we want that to continue at least for another period of time, until the Bill sunsets. So we really appreciate his authorship. Thank you.

Thank you for coming down to testify. Any other witnesses in support? Let's turn to witnesses in opposition. Any opposition witnesses in the room? Room 2100, lead or otherwise. Seeing none, let's move to the teleconference service. Moderator, if you would please prompt anyone waiting on the teleconference service to testify either in support or opposition, we will take their testimony now.

Thank you, Mr. Chair. For those who wish to speak in support or opposition, please press one, then zero. At this time, press one, then zero.

Mr. Chair, there is no one.

Good. Let's bring the matter back to the dais and my colleagues. Colleagues, any questions? Comments? Senator Glazer moves the Bill. Seen no hands. Chair Berman. You may close.

Respectfully ask for your I vote. Thank you very much.

Okay. The Bill has been moved by Senator Glazer. The motion is do passed to Senate Appropriations. Please call the roll.

[Roll Call]

Bill has 11 votes. We'll hold the roll open for absent Members. Thank you, sir. Is this Assembly Member Garcia? Item number 11, AB 1395. Welcome.

Hello. Good afternoon. Good afternoon. Or still good morning. AB 1395 would require the Medical Board of California to issue the Mexico Pilot Program license to an applicant who is otherwise ineligible for the license without an ITIN or Social Security number. Currently, doctors from Mexico are eligible to work in the United States through the Doctors and Dentists program, but cannot do so because they do not have the needed documentation. This corrects that problem. Respectfully ask for your aye vote. We do have one witness. He has been told to be brief and.

Please proceed, sir. Thank you for being

By the Chairman's fingers how quick he wants us to be. In the year 2002, this Committee passed the initial Bill creating this program. It took us 15-16 years to finally get this going. We asked for 100 doctors. We got 30.

We have 22 in the state. Now, we were very lucky that the IRS issued an ITIN for most of those doctors who had never worked in the United States, which is a requirement for the ITIN. The other four are dual citizens. They already had a Social Security number. The remaining six to eight that we are expecting in the next three to four months, none are dual. They all will require an ITIN.

We don't want to take a chance with the treasury saying no, so we need this legislation to go through. The analysis that the Committee has done is excellent. It addresses all of the pertinent issues. The medical board most important entity involved in this process has given its thumbs up. If you have any questions, I would be more than happy to address them. But I do want to point out you've had a lot of bills on this issue. We go to the heart of the problem.

Think about it. In the year 2000, we drafted this Bill. It took us too long to implement it, but we address cultural, linguistic competency. These doctors cannot remain in California. We don't want to take them from Mexico because they'd have to pass the US. MLEs to remain here permanently. It's a loan program. We borrow them for three years and place them in areas where they're most desperately needed.

We will be coming to you with a Bill in the next year that will ask for 150 of these doctors. It'll be five, three year cycles. So we hope this Committee will see the importance of this legislation. We thank the Committee staff immensely for their working with us and the medical board. And we ask an aye vote on your part.

Thank you, sir. Good to see you again. But before you leave, identify yourself for our record.

Arnoldo Torres representing the Central Coast Health Network.

Thank you for your service. Any other witnesses?

I would move the Bill.

Senator Eggman just moved the Bill. Any other witnesses in support? Please step forward. Name?

Dr. Lance Shapiro from AltaMed Health Services in support of this Bill.

Thank you, Doctor. Any other witnesses in support? Seeing none. Let's move to witnesses in opposition, lead or otherwise, seeing no opposition witnesses. Let's move to the teleconference service. Moderator, if you would prompt, please. Prompt any individuals waiting to testify either in support or opposition. We will take the testimony now.

For those wishing to speak in support or opposition, please press one, then zero. Press one, then zero. Mr. Chair, we have no one who signaled that they wish to speak.

Perfect. Let's bring the matter back to the--

Mr. Chair, pardon me, I apologize. We do have one person. I'm sorry,

Even more perfect. Please proceed.

We're going to go to line 14.

Thank you, Mr. Chairman. Aaron Bone, with the Medical Board of California in support.

Thank you. Next, please. There is no one. Now we'll turn to my colleagues on the deus questions, comments for Senator Archuleta. Thank you, Mr. Chair. You know, we heard earlier the desperate need of physicians and nurses coming into the Latino community. Spanish speaking. How many physicians do we have in the wings waiting for this Bill to be enacted?

The pilot program allowed Arnold Torres representing CCHN.

Thank you, sir.

The legislation allowed us to bring in 30 we have six that require this legislation in order to be able to enter California and work. So we have six, we have 22 already working here. And they've provided over 100,000 medical encounters to over 35,000 patients since they began, which was August of 21. Again, remember, a lot of these doctors did not come in at the same time. They've been staggered since August 21.

But the access that they're providing is almost equal to what a Doctor in a health center is required to do by the Federal Government, which is four encounters per hour for internal medicine. Three encounters per hour. When you look at the data that we have, we're very close. These doctors are acclimating themselves very well to the system of care in this state. And their productivity is phenomenal in primarily rural and farm worker communities where they're most desperately needed.

Great. Thank you for bringing the Bill forward and I will definitely support it. Seeing no other hands. Senate Member Garcia, would you like to close? Thank you for your attention on the Bill and respectfully ask for a high vote. Bill has been moved by Senator Eggman. The motion is do passed to Senate Appropriations. Please call the roll.

Roth. Aye. Roth. Aye. Nguyen. Aye. Nguyen. Aye. Alvarado-Gil. Aye. Alvarado-Gil. Aye. Archuleta. Aye. Archuleta. Aye. Ashby. Aye. Ashby. Aye. Becker. Dodd. Aye. Dodd. Aye. Eggman. Aye. Eggman. Aye. Glazer. Aye. Glazer. Aye. Niello. Aye. Niello. Aye. Smallwood-Cuevas. Aye. Smallwood-Cuevas. Aye. Wahab. Wilk. Aye. Wilk. Aye.

Bill has 11 votes. We'll hold the roll open for absent Members. Thank you, sir.

I guess we lost Becker.

Let's start at the top and roll through them then. When is she going to get back? We'll go ahead and open the roll starting with the consent calendar. Members, for opening the roll on the consent calendar, the current vote is 7-0. Chair voting aye.

Nguyen. Aye. Nguyen. Aye. Dodd. Aye. Dodd. Aye. Glazer. Aye. Glazer. Aye. Smallwood-Cuevas. Aye. Smallwood-Cuevas. Aye. Wahab. Wilk. Aye. Wilk. Aye.

We have 12 votes. We'll hold the roll open for absent Members. File item number one. AB 232. Current vote is seven to zero. Chair voting aye.

Nguyen. Aye. Nguyen. Aye. Dodd. Aye. Dodd. Aye. Glazer. Aye. Glazer. Aye. Smallwood-Cuevas. Aye. Smallwood-Cuevas. Aye. Wahab. Wilk. Aye. Wilk. Aye.

Current vote 12-0. Hold the roll open for absent Members. Next item. Item number two. Assembly Bill 242. Current vote is eight to zero. Chair voting aye.

Nguyen. Aye. Nguyen. Aye. Dodd. Aye. Dodd. Aye. Glazer. Aye. Glazer. Aye. Wahab. Wilk. Aye. Wilk. Aye.

Current vote 12-0. Holden all open for absent Members. File item number four. AB 342. Current vote 10-0. Chair voting aye.

Dodd. Aye. Dodd. Aye. Wahab. Wilk. Aye. Wilk. Aye.

Current vote 12-0. Will hold the roll open for absent Members. File item number five. Let me see five. AB 470 current vote 11-0. Chair voting aye.

Dodd. Aye. Dodd. Aye Wahab.

Current vote 12-0. Will hold the roll open for absent Members. Next item. File item number seven. Assembly Bill 993. Current vote is 7-0. Chair voting aye.

Nguyen. Aye. Nguyen. Aye. Dodd. Aye. Dodd. Aye. Glazer. Aye. Glazer. Aye. Smallwood-Cuevas. Aye. Smallwood-Cuevas. Aye. Wahab. Wilk. Aye. Wilk. Aye.

Current vote 12-0. Hold the roll open for absent Members. Next item. Item number eight, AB 1070. Current vote 7-0. Chair voting aye.

Nguyen. Dodd. Aye. Dodd. Aye. Glazer. Smallwood-Cuevas. Aye. Smallwood-Cuevas. Aye. Wahab. Wilk.

Current vote 9-0. Hold the roll open for absent Members. File item number 10. Assembly Bill 1341. Current vote is 11 to zero. Chair voting aye.

Dodd. Aye. Dodd. Aye. Wahab.

Current vote 12-0. Hold the roll open for absent Members. File item number 11. AB 1395. Current vote 11-0. Chair voting aye.

Becker. Aye. Becker. Aye. Wahab.

Current vote 12-0. Will hold the roll open for absent Members. Thank you, Mr. Chair. No problem. Thanks for doing all the heavy lifting. We're back on the record. We're going to open the roll. We're going to start with a consent calendar. Consent calendar. The vote current vote is 12-0. Chair voting aye. Please call the roll.

Wahab. Aye. Wahab. Aye.

Vote is 13-0. Consent calendar is out. File item number one. Assembly Bill 232. The current vote is 12-0. Chair voting aye.

Wahab. Aye. Whab. Aye.

Matter is out. File item number two. Assembly Bill 242 Assembly Member Wood. Current vote is 12-0. Chair voting aye.

Wahab. Aye. Whab. Aye.

Current vote is matter is out. File item number four AB 342. Current vote is 12-0. Chair voting aye.

Wahab. Aye. Whab. Aye.

Vote is matter is out. File item number five. Assembly Bill 470. Current vote is 12-0.

Wahab. Aye. Whab. Aye.

Vote is matter is out. File item number seven. Assembly Bill 993. Current vote 12-0. Chair voting aye.

Wahab. Aye. Whab. Aye.

13-0. That matter is out. File item number eight. Assembly Bill 1070. Current vote is nine to zero. Chair voting aye. Please color roll.

Nguyen. Glazer. Wahab. Aye. Wahab. Aye. Wilk.

Vote is 10-0. That matter is out. File item number 10. Assembly Bill 1341. And the current vote, once I find it is 12-0. Chair voting aye.

Wahab. Aye. Whab. Aye.

Vote is matter is out. And our last item, file item number 11. Assembly Bill 1395. Current vote, 12-0. Chair voting, aye.

Wahab. Aye. Whab. Aye.

13-0. That matter is out. And this concludes today's hearing of the Senate Business, Professions, and Economic Development Committee. Thanks to all who testified or participated, we are adjourned.