Senate Floor

[Roll Call]

Members, I'm happy to tell you we have a quorum is present. So we will begin our business of the day with the Members and our guests. Beyond the rail and in the gallery. Please rise. We will be led in prayer this morning by Senator Roth, after which, please remain standing. We will be led in the Pledge of Allegiance to the flag by Senator Alvarado-Gil.

Gracious and loving God, as we come to you in prayer this day. May we be open and responsive to your spirit as we go about the business of our lives. May we see your goodness in each person we serve. As we strive to be persons of peace in moments of conflict, may we search for the guiding presence of your truth. As we enjoy the successes of our collaborative efforts. May we know the value of patience and kindness. And as we conclude the work of this week, may our hearts be filled with Thanksgiving. We ask this in your name. Amen.

Please remove your caps and join me. In saying, I pledge allegiance ...

Members, we're going to go out a little bit out of order today. We're going to start with a third reading file and then go back through our typical agenda. So without objection, Members, we're going to move to Assembly third reading file item number 114. Can I get everybody's attention? Please move to Assembly third reading file item 114. Assembly Bill 100. Senator Skinner, are you prepared? She is secretary.

Secretary, please read.

Assembly Bill 100 by Assemblymember Ting. An act relating to state budget making an appropriation, therefore, to take effect immediately, budget bill.

Senator Skinner?

Thank you, Mr. President, members, AB 100 is a budget bill junior that amends the 2022 Budget Act and makes changes necessary to implement that package. It also makes clarifying sections to one. Clarifying changes to one section of the 2021 Budget Act related to legislative priorities. Let me just highlight a couple of items. It provides 15.4 million in additional funding to Cal Recycle to assist with the cleanup and debris removal from the Mckinney fire in Siskiyou County.

And it provides funding for preschool family fees to be waived through to September 30, 2023. And with that, I ask for your aye vote.

Members, discussion or debate? Discussion or debate? Seeing none. Secretary, please call the roll.

[Roll Call]

Secretary, please call the absent members.

Allen, Blakespear, Gonzalez, Stern.

All right, ayes 36, noes, zero. The measure carries. We'll move on to file item 115. Senator Skinner, are you prepared? She is. Please read.

Assembly Bill 110 by Assemblymember Ting. An act relating to early childcare and education and making appropriation, therefore, to take effect immediately. Bill related to the budget.

Senator Skinner, the floor is yours.

Thank you so much, Mr. President, members, I am pleased to present AB 110. This early budget action trailer bill enacts the childcare and state preschool provisions. Most significantly, this bill allows us to reappropriate unspent federal relief dollars. So that we can provide an additional temporary rate supplement. For all state-subsidized care and preschool programs. It also, the bill, authorizes the Department of Social Services and the Department of Education to extend the family fee waivers for our low-income families.

So that they have pay no fees through to September 30, 2023 for all childcare and full-day preschool programs. And again, it is using these unspent federal funds. There's an urgent need to get these federal dollars out because otherwise they would be taken back by the Feds if we do not utilize them. So the family fees then return on July 1 without this action, which would cause many low-income families to not any longer afford their childcare. So with that, I ask for your aye vote.

Members, discussion or debate? Discussion or debate? Seeing none. Secretary, please call the roll.

[Roll Call]

Please call the absent members.

Alan, Blakespear, Gonzalez, Jones, aye.

Ayes 37, noes zero. The measure carries. We'll move on to file item 116. Senator Skinner is ready. Secretary, please read.

Assembly Bill 111 by Assemblymember Ting. An act relating to taxation and making an appropriation, therefore, to take effect immediately. Bill related to the budget.

Senator Skinner.

Thank you very much, Mr. President. Members, AB 111 is a budget trailer bill related to student loan forgiveness income tax exemption. Most significantly, this bill ensures that any income a California resident receives from student loan forgiveness programs after December 31, 2020, so going back, and before January 1, 2026 is excluded from state income taxes in conformity with federal law.

And while the Biden-Harris plan for student loan forgiveness is now in the courts and is not assured that we would be able to provide this to California residents, there was pandemic relief for student loans where a number of California residents did take advantage of that. And without this action, they've been expected to pay California income taxes on that relief.

And this action would cover the loan forgiveness during the pandemic and then going forward with the, I had hope, success with the courts, with the Biden-Harris loan program. In addition, it ensures that other fee waivers and pandemic relief provided to students through post-secondary institutions is also excluded from state income taxes and with that I ask for your aye vote.

Members, any discussion on this item? Any discussion? Seeing none, Secretary, please call the roll.

[Roll Call]

Please call the absent members.

Blakespear, Gonzalez, Nguyen, Stern. Stern aye. Nguyen, aye.

Just under the gun. Ayes 38. Noes zero. The measure carries. We have two more budget trailer bills remaining. We'll go to file item 117.

Secretary, please read.

Assembly Bill 112 by Assemblymember Ting. An act relating to health facilities and making an appropriation, therefore, to take effect immediately. Bill related to the budget.

Senator Skinner.

Thank you very much, Mr. President. Members, AB 112 is a trailer bill that implements the distressed hospital loan relief program. Most significantly, this bill implements a no-interest cash flow loan program for struggling hospitals, nonprofit hospitals to stay in operation. It provides for nonprofit and public hospitals to be eligible for assistance based on eligibility criteria developed by the Department of Healthcare Access and Information.

It would also require the loans to be paid back over 72 months with the possibility of extension or forgiveness if financial circumstances make repayment challenging. And because with the repayment program and this being a revolving loan, it may give the ability to have funds available if we face future distressed hospitals. It also requires all hospitals to report certain financial data quarterly to the Healthcare Access and Information Department so they can monitor and identify hospitals that are facing financial difficulty. And with that, I ask for your aye vote.

Thank you, Senator Skinner. I see microphones up from Senator Dahle, Archuleta, and Durazo. We'll start first with Senator Dahle, please.

Thank you, Mr. President. Members, I would like to just take a moment. This is an issue I've been working on for the last 10 years. In my district, the largest community is about 105,000. The City of Reading, California, is the biggest community we saw last year, or this year, a hospital be closed down in Madera, a population of about 150,000.

So I've been involved in this issue for some time with very small rural hospitals, and I want to just give you an example of what it's like if you're in parts of my district. Modoc County, for example, if you want to have a child, you have to travel, like, 140 miles to have a child. Because we do not have the services at our hospitals.

Our hospitals, in many cases, have turned into just an emergency room, and many of our patients are having to be flown to hospitals that have services. So I want to give a little background. In 2010, the general fund participated about 18 and a half billion dollars to our Medi-Cal Medicaid programs. Today, 2023, we spend 35 billion. We had 8.4 million people on assistance of Medi-Cal Medicaid in 2010. Today, we have 15,500,000, 40% of our population. Now, the legislature has taken the ability to add more people.

We've added 1.2 million undocumented to that program. And let me talk about the real problem. The real problem is hospitals are getting reimbursed $0.74 for every dollar they spend. They're losing $0.26 on every patient and every dollar they spend. On top of that, we've seen the Governor, quite frankly, did a no-bid contract with Kaiser two years ago under the pandemic, the legislature came and then ratified that deal. And their ability is that they have a better deal.

They can actually pirate and take the high-paying and people who have insurance and leaves those rural, more underserved communities without that ability to be able to do cost share. I want to talk about a fix because this is not even a Band-Aid. This is just going to get us through to the next month and a half or so until we have the actual budget. And that's what I want to talk about really here today is I want to talk about the MCO tax.

We did it under Governor Brown. I actually voted for it, was chastised by my party because it's a tax, but it helped my hospitals stay afloat in my district back then. What we need to do is we need to pass the MCO again. And we need to not put that money in the general fund where it was put under Governor Brown and under this governor as well.

That money, that tax base needs to go into a fund that actually helps raise that $0.26 up that they're losing so we can actually do health care from our plan. So I want to give you a solution that we're going to need to talk about in the next few weeks, because as many of you know, our side of the aisle doesn't get the opportunity to weigh in on these things. So this is my opportunity to give you a solution to fix this problem.

We are going to see literally more than a dozen hospitals in the case of California being almost shut down. So the last thing I want to say is many of these hospitals have had seismic standards that they have been forced to rebuild their hospitals. So some of them, not all of them, but some of them have bonded themselves to do seismic, and they have those payments for seismic. At the same time, they're losing money under Medi-Cal, Medicaid.

And that's, quite frankly, why they're not in business. So I want to bring it to your attention. I'm going to support this legislation today because it's what we need to do. But at the end of the day, this is going to get us through until we do the real budget. And we need to be talking about long-term fixes because it's literally billions of dollars to our general fund and our constituents are going to lose services if we don't do a major overhaul.

And for those reasons, I hope you take those into consideration during the regular budget process. And I respectfully ask for an aye vote on AB 112.

Thank you, Senator Dahle. Senator Archuleta, followed by Senator Durazo, Senator Rubio.

Thank you, Mr. President. I rise in strong support of AB 112 centers and community hospitals. They are the backbone of our communities. They're not just hospitals. They're meeting places, and they've been there for many, many years, and they're facing a crisis. And a good number of our hospitals, the community hospitals, are operating in the red. And one of these hospitals in my district is Beverly Hospital in Montebello. And I will tell you, it is a hospital that has been there for 70 years.

The police departments down the street, fire departments down the street, schools down the street, neighbors come from everywhere. It is the hospital for care. Beverly Hospital has 200 beds, and over 90% of their patient population have Medicare Medi-Cal patients. Beverly Hospital is the only hospital in Montebello, as I'd mentioned, but it has filed for bankruptcy. This bill, this money will keep them open long enough to be able to perhaps sell, regroup, whatever, but they will keep their doors open.

And I'm thanking everyone here in the Senate for their work. And, Madam Budget Chair, thank you so very much, Madam Protem. I thank you, Senator Caballero, that I thank you for working with my staff and making this bill happen. So please understand they are in dire situation and this bill will take them over to the top. And I urge an aye vote. Thank you.

We'll turn the floor over to Senator Durazo.

Thank you very much, Mr. President. I stand in support of AB 112. This bill requires the HCAI to verify a plan for the hospital to regain financial viability. What I would add is that this plan should be made available to the public, and it should include the well-being and the participation of the doctors, the nurses, the staff of those hospitals.

And finally, I want to thank the Senator from Bakersfield, Senator Caballero, for the series of meetings that she's been having, bringing in stakeholders to really get to the nitty-gritty of what are the issues being faced by each hospital. They're all different situations, but we need to know exactly what they need. Thank you.

Thank you, Senator Durazo. We'll go to Senator Rubio, followed by Senator Grove.

Thank you, Mr. President. And members of the Senate. Today, I also rise in strong support of AB 112. And I would thank the budget, not only the chair, but the staff that's been working really hard behind the scenes. I want to just share some of the concerns that our communities are seeing. The concern about Beverly Hospital now filing for bankruptcy is having detrimental effects on our communities. We're getting calls from families that are really concerned about where to go if they need services.

So, of course, we have nurses, doctors, support staff, service workers that are all calling also concerned about their future, their stability for their own families. And so all the community clinics are also in a state of panic. So this is really going to help bring a little bit of stability and ease as it pertains to all our community clinics that are wondering if they're going to have to take, you know, people if these hospitals close.

So, with that, I just want to thank, once again, the chair, staff, and also the Assemblymember, I'm sorry, the Senator from the Central Valley, Anna Caballero, for bringing this forward, the issue, the attention to it. And with that, I also urge an aye vote. Thank you.

Thank you, Senator Rubio. Senator Grove, the floor is yours.

Thank you, Mr. President. I rise in support of AB 112. And I want to thank my colleagues, and especially the Senator from Merced for her hard work. I know that neither of us had hospital legislation in our legislative package this year, and once we got here, we realized that there was a catastrophic situation going on. And I just applaud her for taking the lead and setting up the countless meetings that we had with all the stakeholders.

I also want to thank the Governor and his staff, specifically, Dr. Galley, for recognizing the urgent measure that we have before us and how to solve this problem. My colleague from Merced often says that we're trying to repair an airplane and replace its engine while it's still in flight so that it doesn't crash. And that's exactly what this piece of legislation felt like. AB 112 creates distressed hospital loan program to try to help the many hospitals in the state that are in danger of closing.

The hope is to avoid a situation that happened in Madera County with the closure of the Madeira Hospital, that has had ripple effects in my district. Dozens of people being transported into Fresno, several of them have died in transit. And you have 170,000 person, mostly low-income farm worker community in Madera that is without hospital services and will need to travel a long distance. Now, I know some people make comments and say it's only 42 miles.

Let me tell you, 42 miles down the 99 and across the 41 and in that traffic to take the other freeway, the 160, that connects to the hospital. It could be during traffic, a two-hour drive. And when you're having a stroke or a heart attack, it's a long time to survive in an ambulance. Kaweah was the next one.

Kaweah Hospital was the next one in my district, in Tulare county that came publicly out that said that the reason for their financial distress that they have is that they have over 70% of the population for Medi-Cal recipients, and they don't have that balance of mix between commercial plans and Medi-Cal and managed care plans.

Their predominant payment system is the Medi-Cal system that serves the population in the Central Valley. Again, predominantly farm worker families. And as my colleague from Bieber said, I'll put it in a little bit different way. Any business plan or business model that gets reimbursed $0.74 on every dollar that you spend is a pathway to bankruptcy. I don't care if you're an attorney. I don't care if you're a realtor.

I don't care if you're a small business owner, if it costs you $1 to provide the service that you provide, whether you're a doctor or a hospital, or like I said, an attorney or a realtor, any small business or any large business, and you get reimbursed $0.74 on the dollar, it's a pathway to bankruptcy. Now, I know there's other ways that they calculate this formula.

And if you get so many commercial plans, and then those plans pay additional dollars, and you get managed care systems and they pay additional dollars, it's supposed to offset the Medi-Cal reimbursement. But there are some places in California where Medi-Cal is so strong, and they're the predominant patient that's being seen and access to everybody to have health care. And you guys talk about equity.

It's not right that hospitals in my district and hospitals in my colleague's district, and when the Beverly Hospital that serves a low portion, a low socioeconomic disadvantaged population as well. I just think that we need to look at the way our hospitals are structured, not only structured for payment, but structured for the reimbursement rate. And there has to be seismic off-ramps. You set this goal that is costing hospitals billions and billions of dollars, and there has to be seismic off-ramps.

Speaking from experience, the last great earthquake that we had in this state was July 4 in Ridgecrest, California, 7.1, 4.9. A series of earthquakes after that. We had to evacuate the new seismic part of the hospital because it didn't withstand the earthquake and move everybody over into the old part of the hospital. And it didn't have all those OSHSPA, all those reinforcements that are required by the state legislation that was passed.

And that was the part of the hospital where we were able to make sure that services were continued while we were going through this earthquake cycle. Again, Kaweah is the number one Medi-Cal enrollment percent per population, this hospital has 613 licensed bed 5200 employees and has a level two trauma center in the Central Valley, which sometimes is desperately needed. Kaweah is in such a bad situation because of the California reimbursement rates that they came out publicly when Madera went down and said, we're next.

And that's a hard thing to do because you create panic within the community, you create panic within the employees, and then you create panic within the providers that need a hospital in order to practice medicine. I again applaud the author. I applaud my colleagues. I specifically give great admiration to my colleague from Merced who put this whole deal together, working with everybody, and I applaud the Governor and Dr. Galley's office for making this happen, but sometimes, I mean, nobody in this room operates a hospital that I know of.

So if you do raise your hand, a lot of times we pass legislation, and we don't know how it operates on the ground.

And so, again, we all got together, and we thought this would be a great deal, a low-cost or low-interest loan that would be accessible to get hospitals through a process so that they wouldn't close and they'd be able to make their 401K payments, they'd be able to make their bond payments, and they wouldn't go bankrupt, or they wouldn't have to close down hospitals, specifically Kaweah and Ridgecrest in my district.

Ridgecrest, a small community hospital, just a few beds, but 190 miles from anywhere, kind of like my colleague in Bieber. So it affects hospitals large and small. Again, I don't think anybody in this room operates a hospital. We all thought we had some great legislation that is moving forward, and I got a panic text from one of my hospitals. So I have a question of the author.

Senator Skinner. We'll accept a question.

Thank you.

My question is, is it understanding that the forgivable loans authored by this bill are secured for future Medi-Cal revenue reimbursement rates? Some of the hospitals that are financially distressed right now have already secured their seismic activity and their bonding because they're in such a bad situation, and they've used, in order to stay open longer, they've used their future Medi-Cal payments as a security for the bonding to keep the hospital open as long as they have. Again,

Is there a question there, Senator Grove? Is there a question? You want to let her answer that question?

Okay, Senator.

Yes.

So I'm concerned about the reimbursement of the Medi-Cal commitment that's already committed in order to be able to obtain these loans. And I wanted to know if that was something that was being considered. I know it came up last minute.

Senator Skinner.

These bills were, including, this one, were heard in the full Budget Committee on Tuesday and passed. And this very robust discussion around this particular bill occurred. And as my colleague from Bakersfield who's speaking knows, because she was part of those discussions, the administration has not defined all of the criteria yet for the loans. So since that is still underway, I cannot give you a definitive answer on that question.

Thank you, Senator Skinner. Senator Grove, on your time. Anything further?

Thank you. On my own time, again, I support strongly AB 112, and I thank, like I said, the Governor and everybody involved to make this happen.

As the language continues to be developed, I would take into consideration the comment that I just made from one of my hospitals that their future Medi-Cal reimbursements, guaranteed payment I guess if you see a Medi-Cal patient, are committed to their bonds and committed to their already outlined debts that they have in order to keep the hospital open, and they wouldn't be able to qualify for this, and it would cause a catastrophic loss in the Central Valley. Thank you.

Thank you, Senator Grove. We have Senator Niello, followed by Senator Alvarado-Gil. Senator Niello, the floor is yours.

Thank you, Mr. President. I appreciate all the comments that have been made, and one in particular pointed out that this issue is multifaceted, and that is true, and that kind of gets to the point of the details behind the analysis of future budget actions on this particular issue. But we really know why we're here.

The issue with reimbursement rates has been very well detailed, and I won't go into that specifically anymore, except to point out that the primary driver of this particular challenge is legislative action of the past. This legislature has increased the number of people covered. It has increased the array of benefits, and yet it continues to underfund it. In other words, we create all sorts of benefits for our constituents and we force medical institutions and medical providers to pay for a good portion of it.

And we are here on this issue largely because of this. We will continue to revisit this problem as long as we underfund institutions and providers. So if there's a question as what's causing this and what can we do about it, I would suggest that is relatively obvious. I do support AB 112. We need this relief for hospitals, especially those in rural areas challenge. But it's going to expand beyond the rural areas if we don't fix the underlying issue.

Thank you, Senator Niello. Senator Alvarado-Gil, followed by Senator Laird.

Thank you. One in five hospitals are at risk of closure, and I think that all of us here know the detriment of not taking action on this Bill. This is really about patient care, particularly in rural hospitals, which 19 across California have closed in 2020, 10 in 2021 and 22. More hospitals in our state are in imminent danger of closing, and many more due to some of the requirements around seismic retrofitting. I will not repeat what my colleagues have already said, other than to underscore and thank you for your advocacy for the rural hospitals. I also want to note that when we are closing hospitals, we are losing jobs. And hospitals have historically supported one in every 12 rural jobs. We now know that in the Eastern Sierras, where I represent, 14 of my hospitals have over 1600 less beds serving needy Californians. This means beds that are no longer available for those who travel into the eastern sides, come to our national parks, to our state parks, visit some of our historic communities, to vacation with their families, and to enjoy our ski resorts, our hiking parks, boating lakes. I support this Bill, and I want to also thank my colleague from Merced for her leadership on this and her mentorship on helping to lead in the Central Valley around rural hospitals. This Bill is absolutely necessary to ensure that our hospitals serving our rural population stay open and functional. And without this Bill, we will continue to see hospital closure and patient care suffer. The hospital in my colleague's district, Madeira Hospital, also serves from the eastern County of Madeira, which I represent, and we were voted in to prevent more hospital closures. And this Bill I am in full support of. Thank you so much.

Thank you, Senator Alvarado-Gil. Next up, Senator Laird, followed by Senator Caballero.

Thank you, Mr. President. Last year, many of you on this floor joined me in saving a hospital. The Watsonville Hospital, in a disadvantaged community with 625 employees, declared bankruptcy. I did a Bill in 19 days last January. It created a public hospital district. Five days later, the bankruptcy court accepted the bid from the five day old hospital district to buy the hospital. We spent six months raising $65 million, and that hospital closed on the last day of session here. And what was key to it is they had a plan. They had a plan for how they were going to have a deficit for a period of time and move to sustainability. They were transparent. We knew exactly where they stood and exactly what we were buying into. And when the hospital closed, they renegotiated the contracts. It had been a hedge fund that had owned it and had not been paying attention to business. And they renegotiated the contract so that Kaiser upped the rates, Anthem Blue cross up the rates. We still need the Federal Government to not recognize it as a rural rate for Medicare. And yes, there's a disproportionate mix with public people, but we figured out how to make it transparent and do it. And last October, for the first time in six years, that hospital posted a monthly profit. It is on the path to sustainability. And all those things were key to it. But one other thing was key to it, and that's that Assembly Member Robert Rivas and I, him 10 million in the Assembly, me 15 million in the Senate, got 25 million to that hospital to be able to make that purchase. And so the message against today's Bill is that with all the other hospitals, and I think we're going to hear about another one in a minute, they have all those same problems, but some of them are already public. Some of them have closed. Some of them aren't positioned with community support to raise money in the community. And yet that was the $25 million from the state that anchored it and made it successful. If you look at this Bill and you look at the list of hospitals and you look at how worse off some of them are to the one that we saved last year, $150,000,000 is not enough. 150,000,000 might get to a few. And you have all these other issues. And so I'm going to vote for this Bill because it is the right thing to do. And we need guardrails, and we need encouragement for all the different things we've heard on the floor, all the different things that made the Watsonville Hospital purchase successful. But this is an incredible stopgap measure, and I hope people are listening outside this floor to what we need to make this happen, what we need in the budget in June. So we have all those needs. Some of those are still unaddressed, but this is nothing but a stopgap measure that isn't even an adequate stopgap measure. But I request an aye vote.

Thank you, Senator Laird. We'll next go to Senator Caballero, followed by Senator Jones. Senator Caballero.

Thank you very much, Mr. President. I want to thank everybody who has had an opportunity to speak here today. This is obviously a really critically important issue, and many of us have been working together. It hasn't been just me. We've had innumerable meetings. This was not something, as my good friend from Bakersfield said, this isn't something we thought we were going to work on this year. But it blew up when Madeira Community Hospital closed right after Christmas. Right after Christmas, they had to give notice to their employees that they were moving into the red and that they might be laid off. And when that notice hit, people left. They needed to find a job. The doctors needed to figure out where they were going to be able to do their work. And all the rest of the staff was hoping to get out and to go somewhere else. So it's been a devastating impact on the community. 160,000 people and the hospitals located near communities,, farm worker communities, where this is their primary access. So I want to make sure that I thank the Governor and Dr. Golly for their incredible work with not only the Senate, but also the Assembly in trying to craft some solutions, because this really is just an itty bitty piece to get us through the next couple of months. What we know is that seven or eight hospitals are on the brink of closing after Madeira Hospital. And some of those have made public statements about it, but some of them are trying to hold on and trying not to have what happened to Madeira happen to them as well. And so this provides an opportunity, and every situation will be a little bit different, because some are public hospitals, some may be non for profit. The strategy is to try to help everybody. But the other part of it is that, as we have met with every single constituency group, what's really clear is we need a process for evaluating what drove that particular hospital near bankruptcy. What are the circumstances? And I won't talk about Madeira because we don't have time here, but the bottom line is, it was a set of circumstances, part of which was it was the private pay or the commercial underpayments that hurt them. In other words, it was the commercial covered individuals, which is what all of us are. Right? We're all in commercial, the cities, the counties, special districts, the school districts, they have the insurance. And those patients went somewhere else. They went to the bigger cities and the bigger hospitals, and that left just a constituency where we don't, as was recorded before, where we don't pay enough in order for the hospital to succeed. And COVID has had an incredible impact as well. So my point here is this. Look, this is the first step. It has been recommended that we create an oversight process very similar to what we do with our public education system, is we send in FIsMat and they analyze a situation, they make recommendations, and sometimes it's recommendations that boards need to be replaced, CEOs have to be replaced, spending has to be reduced. It's a powerful tool that the state has used in a different context, and it's been recommended that we use that same kind of process over the long run so we can analyze what's going on and how can we make some better decisions and some improvements. And it may be changing what the hospital is doing. As my good friend from Bakersfield said, none of us have run a hospital before. We're not in a situation where we can do that. So number one is this is short term loan. Number two, we're going to need longer term loans or grants. Number three, there's an opportunity to do a FisMat type process. And number four, the MCO tax that was discussed. All of those pieces need to come together and we need to do it quickly. We have between now and August to get this right. This part of the puzzle pieces is really important. And so I want to thank our illustrious chair for all her work on this negotiating with the Assembly and the governor's office. We can get this done, but let me put a different emphasis on some of the things that have been said. This Legislature made a commitment to try to cover as many Californians as possible, and we've been doing it in a responsible, incremental way. But we also need to change how the system works, and we need to drive people away from using the emergency room as a primary care provider and create opportunities, as many opportunities as possible to get people good, high quality health care at the lowest cost and the most efficient. And we are not there now. So this MCO tax, I think, creates an opportunity for us to make major investments in bringing new doctors on board for some of our disadvantaged communities that have a lack of healthcare services, making sure we're also providing incentives for the allied workers that work in the same system. There's an opportunity here. And so any ideas, now's the time to pop them up and make sure they're on our radar screen, because we're looking to make fundamental changes in how we provide health care to our residents. And this provides the emergency that's got us all at the table. And we're not done yet. So I want to urge you to vote aye today and participate as we move forward. And I respectfully ask for your aye vote.

Thank you, Senator Caballero, Senator Jones.

Thank you, Mr. President and members. I also will be supporting Assembly Bill 112, but just wanted to make a couple of points. First of all, I want to thank our colleagues from Bakersfield and Merced and the others that pointed out that many of us started this session this year with no intention to run bills dealing with hospitals. And that's certainly the case for me as well. I had no intention of doing that, but I did. I've introduced one Bill, and I want to thank the Senator from Santa Cruz for pointing out that there is a successful way to reorganize these hospitals and move them forward. While he was speaking about Watsonville and sharing the successes of that, I'm sitting here wondering, I wonder if the Attorney General interfered with that transaction as he did with the transaction in Madeira. The Fresno Bee ran an editorial that I wrote over the weekend asking that very question, what is the proper role of the Attorney General in these mergers of these hospitals? And I'm going to argue that that's an issue that all of us on this floor are going to have to watch over the next year as these issues come up. My Bill is on hold right now. It's a two year Bill. But I'm hopeful that there will be productive conversations amongst all of us here in the Senate and our colleagues in the Assembly that we will come up with a proper response to the Attorney General interfering with these mergers and hopefully provide this hospital care that all of our constituents need. And what everybody here on this floor is agreeing needs to happen. Thank you, Mr. President. I'll be supporting AB 112.

Thank you, Senator Jones. Any further discussion? I'll debate having, Senator Skinner, you may close.

Thank you very much, Mr. President. I appreciate the very good debate on the floor. We had a similar good discussion with many questions to the Administration during our Budget Committee hearing, and I wanted to point out that as was referenced here and was referenced in the Committee, more needs to be done, that we view this as an initial measure, an initial action to help our distressed hospitals, because we recognize that California has a hospital shortage. WE have some of the lowest beds per capita of any state in the country. South Dakota has three times more beds per capita than California does. Now, this has been a long standing problem. It's not new, but it is only getting worse, and we don't need it to get worse. Our Senate budget plan has a comprehensive approach to addressing the issues that are challenging not only our hospitals and our healthcare system. And we look very much forward to continuing that discussion with our colleagues in the Assembly and with the Administration as we prepare the Budget Act for 22-23, 2023, and act in June. Or as my colleague from Merced referenced, we still also have till August if it takes us a little longer to negotiate. But I think all of us expect that more action needs to be taken. And the thing that I find very interesting in this debate as to why our hospitals are hurting, there are so many factors. The pandemic was particularly cruel to hospitals. Now, this is ironic, because here it was, a pandemic affected everybody's health. You'd think people would have had higher health care needs. Yes, but hospitals make a lot of their revenue off of elective surgeries and off of different things that they basically get more money for. And during the pandemic that was eliminated, the hospitals themselves restricted it. But all of us, none of us wanted to voluntarily go to a hospital during the most intense aspects of that pandemic. And so hospitals across the country, and California's in particular, lost billions of dollars during the pandemic. So, yes, our payer mix does impact, but there's so many more factors that have impacted. Now, additionally, I think it was very important, the point that was made, that in our effort, which has been very important and successful, to expand Californians ability to have Medi Cal, to be able to have health care, we are, as was pointed out on the floor, trying to reduce the necessity to have to rely on the emergency room. If you have health care, then you hopefully are able to get your health care needs dealt with before it is in crisis. Emergency room health care is far more expensive than regular health care. And so the move to expand these medical rates did not, or this medical expansion and who's covered, did not necessarily cause this hospital crisis. But until we have the type of access, the number of providers, and all who will support our folks on Medi Cal, we will continue to see them relying on emergency room visits, which, of course, exacerbates the crisis. So I think all of us are clear. And as the Senate budget plan points out, we have more to do. We will do more. But as also has been referenced here, this is an important action to take to provide relief and to start to get criteria for these loans. But we don't expect it to be the last. And with that, I ask for your aye vote.

Senator Skinner has closed, all debate having ceased, secretary, please call the roll.

Allen, aye. Alvarado-Gil, aye. Archuleta, aye. Ashby, aye. Atkins. Becker, aye. Blakespear. Bradford, aye. Caballero, aye. Cortese, aye. Dahle, aye. Dodd, aye. Durazo, aye. Eggman, aye. Glazer, aye. Gonzalez. Grove, aye. Hurtado, aye. Jones, aye. Laird, aye. Limon, aye. McGuire, aye. Menjivar, aye. Min, aye. Newman, aye. Nguyen, aye. Niello, aye. Ochoa Bogh, aye. Padilla, aye. Portantino, aye. Roth, aye. Rubio, aye. Seyarto, aye. Skinner, aye. Smallwood-Cuevas, aye. Stern, aye. Umberg, aye. Wahab, aye. Wiener, aye. Wilk, aye.

Please call the absent members one more time.

Atkins, aye. Blakespear. Gonzalez.

The measure passes 38 to zero. We have one last budget item, I understand. File item 118. Senator Skinner is prepared.

Secretary, please read Assembly Bill 113 by Assembly Member Ting, an act related to employment and making appropriation, therefore, to take effect immediately. Bill related to the budget.

Thank you, Mr. President. Members, this IS the last. AB 113 is the last of our early budget actions, and it was heard, as I referenced in the Budget Committee on Tuesday. What it does is adds clarifying language to a Bill that we passed last year and that was signed into law. That was AB 2183.

AB 2183 provided two new ways, in addition to in person voting for farm workers to be able to unionize starting in 2023, mail in ballots and card checks as a condition of signing. AB 2183. The Governor in the United Farm Workers last fall agreed on clarifying language to address concerns around implementation and voting integrity so to respect that agreement and so that the Bill that was passed and signed into law last year can be implemented as intended.

This Bill is necessary, and it specifically eliminates the mail in ballot method, limits the number of union certification by the card check system to 75. The legislation in AB 113 and meaning today's and AB 2183 the Bill that it's amending expires on January 1,2028. And with that, I ask for your aye vote.

Thank you. Senator Skinner, Senator Niello, floor is yours.

Thank you, Mr. President. At the risk? No, at the intention of being redundant. You've heard me complain on this floor, criticize our budget process for having become far too policy laden in recent years, something that I'm not used to from my experience in the past. We did, but not to the extent that has been here. One point of observation, this is to clarify an agreement made between the Governor and labor unions, and also not in public.

Now, this is a budget trailer Bill, because a $10,000 allocation was stuck into the Bill, which is entirely unnecessary given the underlying intent of the action in the first place. This is pure public policy being developed without any hearing by the appropriate Committee and as I said, merely ratifying an agreement between the Governor and labor unions. As we heard in our Budget Committee the other day from agricultural employers, they have not been part of this discussion at all.

We could fix that if this Bill appropriately went through the normal policy process. And we had a public hearing where both representatives from the governor's office and labor unions who have already negotiated this could testify, as well as those that were excluded from the negotiation in the first place, the employers. I ask for no, I urge a no vote on this item.

Thank you, Senator Niello. Any further discussion or debate? Seeing none, Senator Skinner, you may close.

Thank you so much, Mr. President. Members, before I ask for your I vote. Since there was reference to that, this has not customary. From the time when my colleague from Sacramento had formerly been in our Legislature, he and I served together. And of course, at the point that we served together, there was still the two thirds requirement on budget.

And I recall many, many issues that were put in the budget as a result of that two thirds requirement that had little to nothing to do with the budget. But that's okay. Anyway, to the point of this Bill, this is important and necessary to implement a Bill that we passed and was signed into law. And with that, I ask for your aye vote.

All debate having ceased. The secretary, please call the roll.

Allen? Aye. Alvarado-Gill? Archuleta? Aye. Ashby? Aye. Atkins? Aye. Becker? Aye. Blakespear? Bradford? Aye. Caballero? Aye. Cortese? Aye. Dahle? No. Dodd? Aye. Durazo? Aye. Eggman? Aye. Glazer? Aye. Gonzalez? Grove? No. Hurtado? Aye. Jones? No. Laird? Aye. Limon? Aye. Mcguire? Aye. Menjivar? Aye. Min? Aye. Newman? Aye. Nguyen? No. Niello? No. Ochoa Bog? No. Padilla? Aye. Portantino? Aye. Roth? Aye. Rubio? Seyarto? No. Skinner? Aye. Smallwood-Cuavas? Aye. Stern? Aye. Umberg? Aye. Wahab? Aye. Wiener? Aye. Wilk? No.

Secretary, please call the absent Members.

Alvarado-Gil. Alvarado-Gill. No. Blakespear, Gonzalez, Rubio, Rubio. Aye.

Measure carries, 29 to nine. Members, we're going to now move to privileges of the floor. First up is Senator Ochoa Bogue. For purposes of introduction. Senator? Senator Ochoa Bogh.

Thank you, Mr. President and members of the Senate, I'm honored to acknowledge several realtors from the 23rd Senate District. These Members of the East Valley, California Desert, and Inland Gateway Chapters of the California Association of Realtors are helping Californians achieve the American California dream one home at a time. Please help me give them a warm welcome.

Senators, welcome to the Senate. Welcome to the California State Senate. We hope yoU've had a good, enjoyable stay here in Sacramento and the many visits that I know you have had. Okay, members, we're going to jump around a little bit. We're going to now move to Senate third reading for purposes of hearing, SCR 55, and then we're going to come back for the privileges of the floor. So, without objection, we'll go to Senate third reading, SCR 55. The Senator is prepared, if the Secretary could please read.

Senate Concurrent Resolution 55 by Senator Portantino relative to Tap Water Day.

Senator Porntino from the Majority leader's desk.

Thank you, Mr. President and Members. I rise to present SCR 55, which designates the first Thursday in May as Tap Water Day in the State of California and encourages the consumption of clean tap water as an alternative to plastic bottled water. Clean water is a human right, but many Californians do not have access to reliable tap water because we do not have enough drinking fountains around the state. Water from a public drinking fountain or a bottle filling station is far less expensive and healthier than using plastic bottles in such quantity. I'm proud to join organizations like WETAP in doing the critical advocacy to expand access to clean tap water through the installation of public water stations at schools, parks, and other areas of our cities where they are needed the most. One great recent example of this advocacy that's happened is a landmark agreement last month between Los Angeles Unified School District and UTLA, which included a commitment to making clean drinking water access for all students a priority across LAUSD, helping to advance the goals of Tap Water Day colleagues. The fight for Clean Water access has environmental, economic, and educational and public health implications, and it's up to all of us to try to allocate resources wisely and equitably as we move forward. Every community, every Californian, should have access to a drinking fountain in their neighborhood, in their schools, in their parks, so they can all drink this clean, precious resource. And so I respectfully ask for an aye vote on SCR 55. Drink on.

Thank you, Senator Portantino. Senator Dahle.

I would just like to thank the author for bringing this forward. It's been one of my things. As somebody who cares about the environment, even though I have crystal Geyser, which is the best spring water in the state, bottled in my district, I want to just thank the author for the reason being that our water systems purify water we can drink right out of the tap without having to have something in a bottle. Actually, Dr. Weber, when we were in the Assembly, we both talked about this because her grandkids wouldn't drink water out of the tap, thinking they had to have bottled water, realizing that the tap water is great water. If you travel the world, you know, you might not want to drink out of some of the taps around the world. But in America and California especially, we have high standards, and I encourage people to drink the water out of the tap and stop using plastic bottles, even though we have great bottled water, which has helped during times when we have natural disasters, but we can drink water out of the tap. It's good water. And I would encourage folks to do that. And I think this exemplifies that. So I encourage a yes vote on SCR 55.

Thank you, Senator Dahle. Seeing no further discussion. Senator Pontino, you may close.

As I said, drink on. Let's celebrate our precious resource. And I respectfully ask for an aye vote.

All debate having ceased, the secretary, please call the roll.

Allen, aye. Alvarado-Gil, aye. Archuleta, aye. Ashby, aye. Atkins. Becker, aye. Blakespear. Bradford, aye. Caballero. Cortese, aye. Dahle, aye. Dodd, aye. Durazo, aye. Eggman, aye. Glazer, aye. Gonzalez. Grove, aye. Hurtado. Jones, aye. Laird, aye. Limon. McGuire, aye. Menjivar. Min, aye. Newman, aye. Nguyen, aye. Niello, aye. Ochoa Bogh, aye. Padilla, aye. Portantino, aye. Roth, aye. Rubio, aye. Seyarto, aye. Skinner, aye. Smallwood-Cuevas, aye. Stern, aye. Umberg, aye. Wahab, aye. Wiener, aye. Wilk, aye.

Please call the absent members.

Atkins. Blakespear. Caballero, aye. Gonzalez. Hurtado, aye. Limon. Menjivar, aye.

Ayes 36, noes zero. The resolution is adopted. Members, we're going to move back to privileges of the floor for purposes of introduction. Senator Porntino at the Majority leader's desk.

Thank you. Mr. President and Members, it's my honor to introduce Evelyn Wendell from WETAP, which is a nonprofit advocacy organization that has been working throughout the State of California to bring more drinking fountains to places where they are needed. Historic agreements with the City of La Mayor Garcetti's office. Now, you see, with LA unified, WeTAP not only is advocating, but also has an app where you can find the nearest drinking fountain when you're around California.

So, Ms. Wendell brought this suggestion that we celebrate tap water to the State of California, and I'd like to present a Senate resolution to her celebrating tap Water Day. So thank you, colleagues.

Members, we're going to now move back to the traditional order of our agenda. We will begin with messages from the Governor. They will be deemed read. Messages from the Assembly will be deemed read, reports of Committee will be deemed read, and amendments adopted. We'll move next to motions, resolutions and notices. Very good. Seeing no microphones up, we're going to move to the consideration of the daily file. Second reading. File Clerk, please read Senate Bill 42.

Senate Bill 4011. Senate Bill 537. Senate Bill 585.

Second reading will be deemed read. We're going to move to governor's appointments now. We have three items up, starting at file 24. I understand that Senator Laird is going to be presenting. He's ready. Please.

Thank you very much, Mr. President. File Item 24 is the confirmation of Kelly Funk and Colette Kavanaugh. For appointment to the Board of Barbering and Cosmetology. Ms. Funk is a licensed Esthetician. Ms. Kavanaugh is a licensed electrologist. They serve on the board as representatives of their respective professions. They were approved by the Rules Committee on April 19 on a 50 vote. I respectfully ask for an imote any.

Further discussion or debate. Seeing no microphones up, Secretary, please call the roll.

Allen. Aye Alvarado, Gill aye Archuleta aye Ashby aye Atkins Becker. Aye Blakespear, Bradford aye Caballero. Aye Cortese. Aye Dahle. Aye Dodd. Aye Durazo aye Eggman aye Glazer. Aye Gonzalez Grove. Aye Artado. Aye Jones, Laird, Limon, Mcguire aye Menjivar. Aye Min. Newman aye wynn. Aye Niello aye achoa Bogue. Aye Padilla. Aye Portantino aye Roth aye Rubio. Aye serto aye Skinner. Aye smallwood, queuevas aye Stern aye Umberg. Aye Wahab. Aye Wiener. Aye Wilk. Aye.

Please call the absent Members one more time.

Atkins, Blake, Spear, Gonzalez, Jones. Jones. Aye. Limon Min. Mini.

The appointment is confirmed, 36 to zero. Move on to file item 25. Senator Laird, the floor is yours.

Thank you, Mr. President. File Item 25 is the confirmation of Danielle Munoz. For appointment to the Board of Barbering and Cosmetology. She's the Director of the Basic Needs Center. At California State University, Long Beach. And serves on the board as a public Member. She was approved by the Rules Committee on April 19 on a 50 vote. I respectfully ask for a non vote.

Any further discussion or debate on this nominee? Seeing none. Secretary, please call the roll.

Allen. Aye Alvarado, Gill aye Archuleta aye Ashby aye Atkins, Becker Aye Blake, Spear, Bradford aye Caballero aye Cortese. Aye Dahle, Dodd. Aye dorazzo aye Eggman aye Glazer aye Gonzalez Grove. Artado. Aye Jones aye Laird aye Limone, Mcguire aye Menjivar. Aye Min. Aye Newman aye wynn. Niello, Neil, Ochoabog aye Padilla. Aye Portantino. Aye Roth aye Rubio aye serto, Skinner. Aye. Smallwood Cuevas aye Stern aye Umberg. Aye Wahab. Aye Wiener. Aye wilp. Aye.

Please call the absent Members one last time.

Atkins, Blakespear, Dahle, Gonzalez Grove. Grove. I Le mone win. Aye.

The nominee is approved, 35 to zero. We'll move to the last item on appointments File item 26. Senator Laird.

Thank you very much, Mr. President, File item 26 is the confirmation of Jacob Rostovsky for appointment to the Board of Barbering and Cosmetology. He's a licensed marriage and family therapist, the Chief Executive Officer and founder of Queerworks, an LGBTQ plus mental health and homeless outreach nonprofit in the Coachella Valley. He was approved by the Rules Committee on April 19. I respectfully ask for an eyeball.

Any discussion or debate? Discussion or debate? Seeing none. Secretary, please call the roll.

Allen. Aye Alvarado, Gill. Aye Archuleta. Aye Ashby. Aye. Atkins, Becker, Blakespear. Bradford. Bradford. Aye. Caballero. Aye Cortese. Aye Dahle, Glazer. Aye Gonzalez Grove. No. Artado. Aye Jones. No. Laird. Aye limone, Mcguire. Aye Menjivar. Aye Min. Newman. Min. Aye Newman. Aye wynn. Niello. Niello. No. Ochoa Bogh. Padilla. Portantino. Aye Roth. Aye Rubio. Aye serrto. No. Skinner. Aye smallwood, Cuevas. Aye Stern. Aye Umberg. Aye Wahab. Aye Wiener. Aye Wilk.

Please call the absent Members, please.

Atkins. Becker. Becker. I Blakespear. Eggman. Eggman. I. Gonzalez, Limon. Wynn. Ochoa, bog. Padilla. Padilla. I Wilk.

All right, the nominee is confirmed 28. 25. Thank you, Senator Laird. Members, we have two different consent calendars today. Two different consent calendars. On the first consent calendar. Does any Member wish to remove anything from that consent calendar? All right, seeing none if the secretary could please read. Yeah, I'm informed that we're going to actually do both consent calendars at the same time. Does anyone have an item in the second special consent calendar they'd like removed? All right, seeing none.

If the secretary could please read Senate.

Bill 8913-5788-2912-75359504-5496-2474-878819. Assembly Concurrent Resolution 54143 and 46.

All right, Secretary, please call the roll on the two consent calendars.

Alan. Aye Alvarado, Gill. Aye Archuleta. Aye Ashby. Aye Atkins, Becker. Aye Blakespear, Bradford. Aye Caballero. Aye Cortese. Aye Dahle. Aye. Dodd. Aye deRazzo. Aye Eggman. Aye Glazer. Aye. Gonzalez Grove. Aye. Artado. Aye. Think you're on the first day consumption.

Members, we're going to. Purposes of clarification, are we going to reread the consent calendar? Okay, we're just going to have the roll call begin again. Okay? So thank you for your patience. Secretary, please call the roll.

Right. Thank you. Allen. Aye Alvarado, Gill. Aye Archuleta. Aye Ashby. Aye Atkins, Becker. Aye Blakespear, Bradford. Aye. Caballero. Aye Cortese. Aye Dahle Grove. Aye Hurtado. Aye Jones, aye Laird, aye Limon. Mcguire. Aye Menjivar. Aye Min. Aye Newman, aye WYNN. Aye Niello. Aye. Ochoa Bogh. Aye Padilla. Aye Portantino. Aye Roth, aye Rubio. Aye Seyarto. Aye Skinner. Aye. Smallwood Cuevas. Aye Stern. Aye Umberg. Aye Wahab. Aye Wiener. Aye Wilk. Aye.

Please call the absent Members.

Atkins, Blake, Spear, Gonzalez, Limon.

That's a 360 vote on file item 126. And we'll apply that to the rest of the consent calendar. 36 to zero for the balance of the consent calendar. Thank you, Members. We are going to move now to Committee announcements. I know there are a number of them on the floor. Members, do you have Committee announcements? This would be the right time for that. Senator Menjivar, I see your microphone up.

Thank you, Mr. President. Budget Subcommittee number three on health and. Human Services will meet 50 minutes after session in room 1201.

215 minutes after. Thank You, Senator Menjivar. Senator Laird.

Thank You. Mr. President. Budget Subcommittee one on Education. We'll meet in room 1100 in the swing space 15 minutes after the end of session.

After the close of session, room 1100, Senate Education sub all right, Senator Becker. THANK YOU.

Budget Subcommitee Two on resources, Environmental Protection.

And Energy will meet 15 minutes after adjournment in Room 2200. Thank you, Senator Becker. That's sub 2 15 minutes after adjournment in room 2200. Senator Padilla.

Thank You, Mr. President.

Budget Subcommitee number four on State Administration and government will convene in the legislative Office building 15 minutes following recess of the flom. Senator DERAZZO.

THANK YOU.

YES.

Senate Subcommitee Five will meet 15 minutes after adjournment in swing space, room 2100.

Very good, Senators. That completes the business of the Senate today. Senator Grove. SORRY. Desk is clear.

Sorry. It was not;

The minority leader is keeping me distracted. I APOLOGIZE, colleagues. The Senate will be in recess till 03:30 p.m. At which time an adjournment motion will be made. We will reconvene Monday at May 8 at 02:00 p.m. Please be prompt so that the majority floor leader does not chase you down.

Thank you, Senator Grove. The Senate will be in recess until 03:30 p.m. At which time the adjournment motion will be made. We will reconvene Monday, May eigth, at 02:00 p.m. Enjoy the rest of the day. Members.