Assembly Standing Committee on Emergency Management

Good afternoon, this is Assembly Member Freddie Rodriguez and our first meeting of emergency management. Welcome to today's hearing. Let's turn this agenda over and remind everyone of today's ground rules. At today's hearing, we'll take public comments from those in the room. Members of the public may also submit testimony to the Committee at AEM.Assembly.ca.gov. But first, let's establish a quorum. Committee secretary, please take the roll.

[Roll Call]

And we do have a quorum so that the next order of business is a consent calendar. The following bills are on consent AB 1792. Rodriguez the motion is do pass to the Committee on Appropriations, AB 1863. Ramos. The motion is due past the Committee on Public Safety Safety, AB 2101. Rodriguez the motion do pass, the Committee on Health, AB 2348 Rodriguez. The motion do pass. Committee on Health, AB 2469. The motion is do pass. Committee on Appropriations, AB 2594. The motion do pass.

Committee on appropriations, AB 2776 Rodriguez. The motion of do pass, Committee on Natural Resources and AB 2983. Rodriguez the motion do pass, Committee on insurance, do I have a motion? A second on the consent calendar, second of a motion, a second. Secretary

[Roll Call]

Consent calories out. So now we have two items remaining on our agenda. AB 2973 see Mister Hart here. Are you ready? And you may begin. Just quickly. Before we begin, I just want to make sure you do accept the proposed Committee amendments on the Bill. Okay. Thank you.

Good afternoon, chair.

Despite the enactment of the EMS act and relevant case law, confusion persists regarding the roles, responsibilities and statutory authorities of relevant stakeholders.

This bill reaffirms existing law that a county can assign its EMS responsibility to a new or existing County Department, contract with cities and or fire districts, contract with a private ambulance provider, or employ a combination of these four options after a competitive process, it's important to note that the Statewide Emergency Medical Services Authority has the final authority to approve or reject an EMS plan, creating another check and balance in the process.

AB 2973 will enhance the accessibility of emergency medical services in California while promoting accountability, transparency and coordination among all stakeholders involved in providing EMS services. Recent amendments to the bill remove language that clarified the role of the Board of Supervisors over the conduct of the LEMSA medical director. I've been working closely with the opposition and commit to continuing discussions should this bill move to the Assembly Health Committee.

Speaking in support of the bill with me today is Santa Barbara Fire Chief Mark Hartwig and Andrew Schouten, Chief Counsel for the County Fire Chiefs Association.

Okay, thank you. Proceed.

Mr. Chair, members of the board, Santa Barbara county fire Chiefs is interested in this for a lot of reasons, but I wanted to just tell you our experience, if I could. We got together, a 15 year agreement was about to expire. We got together with cities, fire districts and labor groups within the county and said, can we design a system that serves our needs even better than what we have right now? We came to the conclusion that we could.

We spent about five years designing this system, making sure that we collaborated and cooperated closely with the county who was responsible for it, and we brought forth a plan. And quite frankly, the plan has been held up for quite a while because there's just a lot of confusion as to what the county can do now that the service is available, what are the options available to the county?

So, interestingly enough, we designed a system that we thought we might get a private provider to even bid on that would meet all of our needs, better cities, fire districts, and the county fire department and the current provider decided, for business reasons, probably not to. And so we're here today.

We work with Assemblymember Hart to really write a bill that codifies, for the most part, and I'll pass it over to the attorney who helped us, the county fire chiefs, but really codifies some very complex case law, complex government code, and also the EMS act.

Okay, thank you. Proceed, sir.

Hi. Good afternoon, Chair Rodriguez, members of the Committee. Thank you for the opportunity to come here and testify in support of AB 2973. My name is Andrew Schouten, and I am an attorney in the firm of Wright, L'Estrange & Ergastolo in San Diego. My practice focuses on antitrust, unfair competition, government contracting, and EMS law. You might be asking yourself, why is an attorney talking to you about EMS?

Well, I've been practicing in this space for eight years now, and I represent about 45 different county, city, fire district, special district, providers of ambulance and EMS, as well as fire agency associations. So I've come to understand the EMS act pretty well. And one thing I can tell you is it's a remarkable piece of legislation. It was groundbreaking when it came in, and it is broad, and it covers a number of aspects of EMS, but not everything.

There are a number of statutes outside of the EMS act that actually provide authority to the counties to regulate services, and there's been judicial decisions based on those. But because the EMS act is broad, it creates this silo effect where people don't look past it, even though there's good law and good statutes outside of it.

And so that's one of the reasons for this bill, is to put into the EMS act a number of these authorities and codify judicial decisions interpreting those statutes in the Government Code, the Health and Safety Code, the Vehicle Code, and the Welfare Institutions Code, and bring them into the EMS act, because we know it has a siloing effect so that people will pay attention to it. And there's a couple of really good reasons for this.

The first is these four options that are discussed in the bill in terms of what the county Board of Supervisors or the board of a JPA can do. It's important to specify that these are policy decisions to be made by policymakers. They are not medical decisions by medical professionals.

Another important thing is a lot of these powers that exist outside of the EMS act can be used to further and supplement the powers and functions of both the counties and the LEMSAs under the EMS act. For example, permitting and licensing ordinances, the EMS act is silent on permits and licenses, but permits and licenses are fundamental to how local governments regulate public transportation on highways.

And so by calling out that these other powers can be used to support the county functions and LEMSA functions, it clears up a lot of ambiguity because that stuff just isn't specified in the EMS act. Finally, I wanted to note that we were very careful in drafting this bill and wanted to make sure that we preserved the existing authority under the EMS act of the state EMS authority, the medical control authority of the LEMSAs, and the rights of other local government entities.

And so with that, I'd be happy to answer questions with my panel members.

Okay, thank you very much. Is there anybody else in the room in support of AB 2973?

Good afternoon, Chair Rodriguez, members of the Committee. My name is Chris Mailes. I am the Fire Chief for the City of Santa Barbara Fire Department.

I'm also the President of the Santa Barbara County Fire Chiefs Association, which represents the communities of Guadalupe, Santa Maria, Lompoc, Santa Barbara County, Montecito Fire Protection District and Carpinteria Summerland Fire Protection District. Collectively, all of our departments and the communities we serve are strongly in favor of this. Thank you.

Kelly Brooks on behalf of the Board of Supervisors of Santa Barbara County, in support.

Julian Avoris on behalf of the League of California Cities, in support.

Ethan Nagler on behalf of the cities of Merced and Santa Rosa, in support.

Sarah Dukett on behalf of the Rural County Representatives of California. We're a bit of an in betweener. We raised a number of concerns, but your Committee amendments today addressed our concerns, so we'll be re evaluating our position and hopefully supporting. Just want to thank the Chair and the author for working with us.

David Neels, fire chief, Montecito Fire Protection District. Thank you.

Anyone else in support? Seeing none. Anyone opposition?

Jared Moss on behalf of the 911 ambulance providers--

Hold on. Let's do the testimony, then you can come up.

Hi, everyone. I'm Darby Kernan. I represent the Emergency Medical Services Administrators Association of California. We represent the interests of all the 34 local emergency medical services agencies covering all 58 counties. We do appreciate all of the amendments and the time all of your staff and members took this week, last week to meet with us on this bill. We are still strongly in opposition of this bill, even though the amendments do clean up a lot of the problems that were in the drafting of the bill.

The bill moves the current 40 year EMS system away from a clear and transparent process run with a focus on the EMS system and using professional medical judgment into now moving it to a completely political situation. The bill removes and makes all of the contracting authority based on the Board of Supervisors decision. I used to work for the California State Association of Counties for seven years, representing all 58 county Board of Supervisors.

I think Board of Supervisors are amazing at the work they do in counties, but they're not executing the behavioral health contracts. They are not executing the contracts for all of the various agencies that they are running. They are the administrative body. They are not medical experts and should not be making these decisions.

A couple of the key things I'd like to point out in this is, while the bill is based on the Board of Supervisors in Santa Barbara County that want the contract with fire, that is kind of the goal of what happened, and it has been litigated, that now with the amendments, the process for public agencies is going to be completely different than for private agencies.

And I think when you're moving it so public agencies do not have to go through a public process or a competitive process, but private entities do. I think you have some real problems with that. And then I just want to point out, I worked at CSAC during the pandemic, and during the pandemic, we had Board of Supervisors getting recalled. We had a lot of political upraising because public health was making really tough decisions, and elected officials did not like those decisions.

And even in some counties, like Shasta County, we saw every Board of Supervisor recalled. And if we're going to take our emergency response system and throw it into a political system for all 58 counties now, not just Santa Barbara, because they don't like the way the system works today, then you are putting at risk that decisions for who is getting a response to 911 calls are only in specific districts or where voters are more encompassed.

Like you are taking this competitive process that is based, independent scoring is done, people outside the county are used who are experts in the EMS system. That is the contracting process today. And if you get the points, you get the contract. If you don't get the points, you don't get the contract, and then you have recourse through a public process to appeal and protest and eventually end up in litigation that is going to get thrown out.

And now you are having the Board of Supervisors make this decision, and we are not asking you to vote no on this bill today. We're just asking you not to vote on this bill today because it is changing our EMS system into a political nightmare. Thank you.

Chairman and Members. Bob Giroux, on behalf of the Urban Counties, we too submitted a letter of concern. We don't feel that Assemblymember Hart's bill is a General solution. It's too broad. We look forward to working with the author. I've had good conversations with him, and as the bill moves along, we'd like to ensure that it's not a one size fits all process. Thank you.

Okay, were you going to speak in opposition?

Thank you everyone. My name is Nicole Smith and I'm a labor representative for United EMS Workers AFSCME Local 4911. We represent emts, paramedics, critical care transport, paramedics and critical care nurses and all the support staff in private industry EMS. We regretfully oppose AB 2973, which unravels centralized, established and integrated county wide ambulance system that have been in place for over four decades.

Unfortunately, AB 2973 will create a system that gives sole authority to county supervisors instead of allowing the LEMSA to ensure that equatable, integrated, efficient and sustainable emergency services are being provided on a regional level. Our members have seen firsthand how politicized county run process for bidding on emergency service contracts can negatively impact the workforce and EMS services delivered to the community.

Counties or single municipalities will bid for an emergency services contract and then subcontract that labor back to the workforce that is currently in practice in Contra Costa County today. This has resulted in a system delivery model that increases charges to patients and suppresses the wages and benefits for private emts and paramedics as private ambulances services would need to renegotiate or even terminate fractured county contracts due to reduction in service territory.

This reduction in service territory would then fracture coordinated EMS response and deprived rural and unincorporated areas of a dedicated ambulance provider. The EMS act helped coordinate county medical control and oversight to protect patients and ensure all Californians have access to high quality emergency medical care regardless of their city of residence or socioeconomic status. AB 2973 would erode equal access to emergency medical care and negatively impact the wages and benefits of all emts, paramedics and RNs. Thank you.

Thank you. Anyone else in the room opposition, please come forward. State your name and position.

Thank you Chair, Members. Janice O'Malley with American Federation of State, County and Municipal Employees, in regrettable opposition. Thank you to the author for working with us diligently and appreciate the time. Thank you.

Hi Chair, Members. Jared Moss on behalf of the 911 Ambulance Providers Medi-Cal Alliance, in opposition.

Good afternoon Mr. Chair and Members. Karen Lange on behalf of the Kern County Board of Supervisors, in opposition. We anticipate their letter was sent on Friday, I apologize. And Solano county is expressing concern. They are the only county with a single county JPA, and I do believe the version that's being adopted may not address their concerns. So I anticipate needing to continue advocate in opposition for them as well. Thank you.

Good afternoon, Mr. Chair, Members. Sean Henschel, on behalf of American Medical Response, standing with our AFSCME workforce, in opposition. Thank you.

Good afternoon, Mr. Chairman and Members. My name is David Magnino and I'm a private licensed paramedic here in the State of California. And I believe that you need to let the regulatory process that is currently underway run its course. And so I'm opposed to this bill.

Thank you. Anyone else in opposition? Seeing none. We'll bring it to the Members. Any questions, comments? Anybody? Assembly Member Hart? I mean-- Sorry.

My neighbor. That's okay, Assemblymember Gabriel.

I thought I'd liven it up.

I have some experience after carrying a bill like this that's now in the Senate, moved through the Assembly with a bill dealing with this issue. It's a complicated issue, and because it's a complicated issue, many things need to be worked out. And I would just encourage us--

We have the chair with an aye recommendation on this, and I think that at this point in time, a no vote says we shouldn't continue these discussions, an aye vote says that discussion should continue. There are so many places where this bill can be stopped if it can't get worked out properly. As I can tell you from, I'm in a two year process with the other bill, so I would just encourage the Members, unless you have a compelling reason to stop it.

I think that we have a Member who is certainly committed, as the testimony, even from the opposition said, committed to talking with them, trying to work these issues out. So that would, I would certainly encourage us to move this bill out of this Committee. Thank you.

You're welcome. Anybody else? Assemblymember Calderon, question?

Yes, thank you, chair. Well, I greatly appreciate, and first of all, I have a lot of respect for you. I think, you know, this is my colleague, and I appreciate the intent and what you're trying to do with this bill. But I do have some grave concerns about the type of precedent this legislation could, you know, could set. And I would have really liked to see the bill just narrow down a little bit. And so I'm respectfully not going to be supporting it today.

However, as it continues to go through the process, and you work to refine it. I will definitely revisit that my vote when it comes to the floor.

Thank you. Thank you. Assemblymember Borner, you had a question.

Boerner. I'm sorry.

Boerner.

Fine. Thank you for bringing this forward. I know it's in San Diego county. We have a very complex network of how EMS services are provided. It's different in every city. It's different in unincorporated counties. Could you maybe respond to some of the opposition's concerns and how you intend to address it? Because I do think there's a concern if the process-- I mean, I think, I disagree. I was on the Encinitas Planning Commission. I don't have a background in planning, and I learned planning in three months.

I think when we're elected officials, we learn the important aspects of our job in every way, at least good public officials do, which I think are most. So I do think even if you're not an expert in the healthcare area and EMS services, when you have that role, you become one and you rely on your staff to understand how to do that. But I do think you want a fair and objective process, and it should include public entities as well as private.

So can you maybe respond to some of those concerns that the opposition had? And then I have one more question.

Yeah, I think I would just simply say that this is a work in progress, and I am committed to continue to work with the opposition. And I appreciate the comments from some of those folks about our willingness to do that. I appreciate the amendments that Chair Rodriguez offered to the bill. I think that clarifies many of the things that the opposition raised. This is a dynamic process. Folks are coming prepared to say one thing, and we have these amendments that are happening in real time.

So I think many of those concerns are being addressed by these amendments. And I think there's probably a fundamental philosophical difference that what somebody calls a political process, another person would call democracy and elected officials exercising their appropriate role. And it doesn't fundamentally change that role. The Board of Supervisors have that authority today.

What's confusing is the court cases that are informing the code sections of the law, the EMS act, and the idea here is to combine those so that it is in one place and it takes some of the ambiguity of the process out so that it's clear what board supervisors can and can't do. That's the intent of the legislation, is to clean this up and to make this a better functioning process.

Okay. So I appreciate that. I do think, you know, when we, when we would go look at things, when I was on the council or when I look at what my Board of Supervisors do, they do have a competitive bidding process that can include public and private. And that's my understanding of the intent of your legislation is not just to give favor to maybe the private industry, but also have an equal footing for public.

And as long as that process itself is the same for both, you don't want a differential process for a private indices versus a public entity. That would be important, I think from my perspective going forward. And the second thing is, could you clarify how this works if it's a joint powered authority, if one county is part of the JPA, would it be awarded an EMS contract as part of something else? So if you have a multi-county JPA, we don't have that in San Diego. county.

So that was new when I read the bill analysis and some of the opposition letters. Could you clarify how that would work?

Yeah, my understanding is the amendments that we're taking today don't change those relationships. So if you're in a JPA, you'll stay in that situation. And this is neutral as to how the structure is that local governments have created to manage their EMS services.

So with that, I think I share your comments. I know you're a hard worker, you're a very fair Assembly Member, and I know you're going to keep working on this up. So you have my aye vote today. And with that I'd like to make the motion.

There's a motion and second, I just had a couple comments I wanted to make as I'll be supporting the bill as well. But obviously this is a very complex issue as we can all attest to it. We've heard the both sides of supporters and opposition on this. Obviously we talk about what's been in statute 40 years ago. That's 40 years ago. Unfortunately, things have changed, right.

I think we need to evaluate some of these policies moving forward as to how do we make sure that we get the appropriate coverage, the response in our counties and our cities where we're working at. Obviously one thing I find a little difficult was when I met with the opposition, I think on Thursday last week, and they didn't offer me anything, anything. I was more than willing to extend the olive branch to tell me how can we get this bill in a better place?

And when you tell me no, there's nothing we can do, that's a little concerning to me, right? Because we're all in a place where we need to work together, we need to collaborate, kind of give and take on both sides, but what they didn't offer anything that's kind of a challenge, puts me in a very awkward spot to see that this is a very important issue that we need to see how we can work together to make sure once again that our resources are used the way they should be. And with that, I do have the motion, I do have an aye reco.

And I know there's a motion and a second, and I trust that you continue to work with opposition. Hopefully they can come up with some other ideas and suggestions moving this bill forward. If it gets out and gets-- Obviously, there's another Committee that's going to go to. I believe it's Health that's going to go to. So there's another take after we can look at it. And hopefully there are some other things working with the opposition moving forward.

So with that, I do have aye reco, there's motion first and a second. And secretary, call the roll. And this would be due pass as amended to Committee on Health. So secretary, please call the roll.

AB 2973. The motion is due pass as amended to a Committee on Health. [Roll call]

Okay, so that motion is out. We have six ayes. We'll keep the roll open for missing Members. Thank you.

Thank you, Mr. Chair.

All right. Thank you, Mister Rodriguez. You may proceed with AB 1786. You may proceed with AB 1786.

Thank you, Members. This bill would establish the California Individual Assistance act, administered by the Department of Social Services, and the California Local Assistance act, administered by the Strategic Growth Council. The purpose of this bill is to provide timely and direct assistance to individuals and communities that have suffered harm due to disaster related climate change, but may not be eligible for or warrant federal assistance, disaster assistance. This bill provides local governments, community based organizations, and individuals with the assistance they need to quickly recover from a disaster.

All too often, FEMA and Cal OEs have been unable to provide assistance to the most vulnerable communities, where disaster survivors have very few paths to recovery. This is because critical aid from FEMA remains out of reach for families and individuals who have suffered a disaster if the local disasters not meet the criteria for federal assistance. In fact, FEMA recommends states establish their own individual assistance programs due to the limitations on federal disaster assistance.

For example, after the community of Pajaro was flooded, I visited the evacuation shelter in Watsonville. There were too many displaced families with unmet needs and this has been the case throughout the state in recent disasters. Whether it's the earthquake in Ferndale, floods in Planada Tulare in San Diego, or snow near Big Bear, state and federal assistance wasn't available. We need to do better. This Bill would help.

It has leveraged 500 million annually from the Greenhouse Gas Reduction Fund to help communities and individuals recover from climate driven disasters. Witnesses here in support with me are David Knight, Executive Director of CalCAPA. Noe Paramo, legislative advocate for the California Rural Systems League foundation, and welcome. My first go ahead.

Good afternoon, Madam Vice Chair, Members of the Committee. My name is Noe Paramo. I'm with California Rural Legal Assistance Foundation. Thank you to Assemblymember Rodriguez for presenting AB 1786 and to the Committee for the Opportunity to testify in support of the bill, which creates and establishes two natural disaster relief programs to help California's residents and families impacted by natural disasters arising from climate change.

The bill establishes the California Individual Assistance Act program to fund needed direct financial assistance to impacted individuals and families who are ineligible for federal or state assistance due to their immigration status.

Climate change impacts all, regardless of immigration status, evidenced by the storms of 2022 and 2023 that resulted in federal and state disaster declarations in more than 20 California counties, including, as was referenced by Assemblymember Rodriguez, Monterey Pajaro the Committee was flooded Merced County Planada the Committee was flooded. I'm from Tulare County, originally from the small town of Woodlake, and the flooding there came right up to my mother's and my home. Fortunately, that did not happen. She didn't have to be evacuated, but her neighbors did.

This resulted in these families being displaced, as I said, from their homes and endured job loss. Secondly, the bill establishes the California Local Assistance program to help the local communities rebuild and support badly needed infrastructure and lifelines for prevention and recovery from damages. The bill also recognizes that local governments need to be responsive and in partnership with the state and local community based organizations.

Specifically, AB 1786 will partner with trusted community based organizations as providers with experience and capacity to deliver culturally competent emergency response and recovery services to address the needs of immigrant and farmworker communities for an equitable resilience and adaptation from the impacts of climate change such as storms, flooding, excess heat, freezes, wildfire, smoke, and drought.

CBO's have demonstrated through the Storm Assistance for Immigrants Program administered by the California Department of Social Services successfully have implemented these service delivery models customized locally to meet the needs of these communities. As a CBO partner, CRA foundation has received positive outcomes in providing direct financial assistance, outreach and education, and navigation services to these communities. However, to date, communities still continue to contact us and other CBO's in need of services. More than 60,000 individuals have been helped by the Storm Assistance for Immigrant program.

More than $80 million have been provided for direct financial assistance. But it's not enough. We need more assistance for this CRA foundation supports the bill. We look forward to your support and your consideration, and we look forward to working with the Legislature, this Committee, Chairman Rodriguez and the Administration. Thank you very much.

Thank you. Good afternoon, Chairman Rodriguez and to the entire Committee with emergency management. Thank you for the time to speak today. My name is David Knight. I'm the Executive Director of the California Community Action Partnership Association. I'm honored to be here as a representative of the 60 community action agencies who provide opportunities in all 58 California counties.

We are here today in support of AB 1786, the California Individual Assistance Act, California Local Assistance Act. CalCAPA is thankful to Assemblymember Rodriguez for his efforts to this much needed solution forward. As Californians and leaders in the mitigation of poverty, we understand greatly in first town how devastating a natural disaster can be to a community. We know community members seeking support and resources during disasters rely heavily on previously known community based organizations, and that means especially community action agencies and our partners.

Community based organizations role in disaster response is critical. First, CBO's are trusted messengers. Second, they are already in the community, so they are ready to respond timely in emergency situations when we often have funds set and ready for reimbursement of medical, fire, police, as well as midterm solutions for possible recovery opportunities.

What we lack is the ability to have immediate resources for both recovery opportunities, such as housing or relocation payments, as well as the funding for costs currently absorbed by CBO's who employ the people on the ground that deliver the immediate relief. One such demonstration of this is just during the last year's late 2022 and early 2023 flooding. I don't have to remind many of you of the flooding that occurred.

We've heard about that already, but that what caused over $100 billion in homes to become damaged, the Community Action Board of Santa Cruz County, along with its partners in the recovery, were there on site.

Immediately after, before formal recovery began, these community based organizations offered critical interpretation and case management support to the Pateko community, speaking during the emergency, then at shelters, before our state resources were even deployed this legislation will assure that what happened in this valley, where there has been no reimbursement to support agencies from local government entities, does not happen again. It's a stark reminder that many local cbos are often called upon first to organize resources in emergency.

While they are often the first to arrive, they are for sure the ones still in the community way after the emergency and waters have rescinded. The Community Action Board of Santa Cruz County was responsible through the storm, assistance for immigrants and creation of a program that distributed almost $10 million in economic recovery funding for those impacted by the floods. This is extremely critical in that most of the victims have yet to return to full time employment in over a year.

CalCAPA applies this bill's recognition of the importance of leveraging the capabilities of community based organizations to deliver culturally competent emergency response and recovery services to displaced residents. As evidenced by the services provided after the floods last year, local community based organizations are capable of assembling and quickly responding to community needs during the recovery period. Local emergencies should have local solutions, and the California Individual Assistance act provides much needed financial support to locally based solutions that will be called upon at the next disaster.

Thank you again to Assemblymember Rodriguez and to the Committee on Emergency management for your time today and for your services to the great people of California.

Thank you, gentlemen. Do we have anyone in support in the room? All right. And confirming we don't have any witnesses in opposition. Do we have anyone in the room opposing? We're going to take this back to the Committee. All right. Mister Rodriguez, would you like to close?

Thank you very much. Thank you very much. And I respectfully ask for an aye vote. Thank you.

All right. We have a motion and a second for AB 1786.

AB 1786, the motion is due pass to the Committee on Human Services. [Roll Call]

Great. That's six votes and it passes.

Roll open for, I think, a missing Member too. So hopefully in the next five minutes we'll leave the roll open. Thank you, everybody. And. Yes.. Which one was it? The consent?

We'll open the roll for the consent calendar. Yeah, do the roll call.

[Roll Call]

[Roll Call]

We'll still leave the row open for a few more minutes, okay? So with that, this meeting is adjourned. Thank you very much for participating, everyone. Thanks.