Senate Standing Committee on Business, Professions and Economic Development

Good morning, everybody. Welcome to this morning's sunset review oversight hearing, which is being held jointly by the Assembly Business and Professions Committee and the Senate Committee on Business, Professions and Economic Development. Today we'll be hearing from five entities responsible for overseeing the regulation of occupations within the Department of Consumer affairs: the California State Athletic Commission; the Court Reporters Board of California; the Dental Board of California; the Board for Professional Engineers, Land Surveyors and Geologists; and the Board of Vocational Nursing and Psychiatric Technicians.

For each portion of today's hearing, we will begin by hearing from representatives of the entity under review. Next, we will open the discussion up for questions from Committee Members. Finally, we will invite other interested stakeholders here in the room to provide public comment. We ask that speakers limit their remarks to two minutes per organization.

I am looking forward to today's hearing, where I anticipate we will have a productive dialogue with the regulatory entities about how they are working to protect the public, and how we in the Legislature can further empower them in the work they do. And I take the challenge seriously. The bar that Chair Ashby set yesterday of how to move a sunset review hearing along efficiently. And so that will be my responsibility today.

But before we begin, I'll turn it over to my Senate counterpart, Chair Ashby, for any introductory remarks.

Thank you so much. Thank you. There you go. Thank you. I just want to thank everybody for being here today. It's an early morning right after changing times, and we all know how that goes. We're all tired, but I appreciate you being here and I appreciate the Chair. We have a lot of important topics. Wonderful staff.

I'm new to BPED, but the one thing I have learned in my first couple of weeks here is that I have an excellent Co-Chair over here from the Assembly and that we both have extraordinary staff and these topics are hard and tough to grapple with. And so thank you for engaging in the process and thank you to our staff for your years and years of hard work.

Thank you, Chair Ashby. Today's hearing will begin with representatives of the California State Athletic Commission. I would like to recognize that Assembly Member Mike Gipson is joining us for the discussion of CSAC. On behalf of the Assembly Committee on Arts, Entertainment, Sports and Tourism. Chair Gipson, would you like to make any opening remarks before we hear from the representatives from CSAC?

Sure, sure. Thank you very much, Mr. Chairman. And to our Senate counterparts, thank you very much for one allowing me to be part of this as the Chair of Arts and Entertainment and Sports and Tourism. The State Athletic Commission, the work that they do is very important to all of us, and especially to my Committee, to engage in professional and amateur boxing, kickboxing and also mixed martial arts.

Without this Commission and the work that it does, we can't really be as important and viable as we want it to be. We know that. Prior to me being appointed by the Speaker, there was some outstanding or an outstanding bills and direction that was given by the Arts and Entertainment. Really would like to see what has come out of that.

So as you come and talk about the Athletic Commission, if you can, please elaborate on the work that was done last year before the change took place. Because, again, you're part of our economy. You're part of what makes California great. People come from all around the world to see and experience our sports, our entertainment, things of that nature. And this Commission is very vitally important. So I'm happy to be here and look forward to the robust conversation as we move forward.

So thank you very much, Mr. Chairman.

Thank you, Chair Gipson. With that, we'll begin with our first panel, and I believe we have Peter Villegas, Scott Wetch and Andy Foster here representing the Commission. Ready when you are.

Good morning, Chair Berman, Chair Ashby and Committee Members, thank you for having us. My name is Peter Villegas and I serve as Chair of the California State Athletic Commission. This Commission regulates all professional combat sports in California and has oversight over all amateur combat sports throughout the State of California. With me today are Commissioner Scott Wetch, the appointee of the Senate, and the Executive Director, Andy Foster, of the Commission. I'd like Mr. Wetch just to make some remarks.

Mr. Chairman and Madam Chair, thank you. And Committee Members, thank you. I am here today proudly representing as an appointee of the Senate to CSAC. And this is my 37th year working in and around state government, and I've served on a number of boards. And I have to say during my short tenure, Mr. Chairman, I've been extremely impressed with the dedication and the professionalism of both the executive staff and the field staff.

I've had the opportunity to attend both small regional events as well as large events being telecast internationally, and the attention to detail in protecting the welfare and health and safety of the fighters has been impressive, to say the least. And I'll be deferring to the Chair, but I'll be here to answer any questions that I may be assistance with. Thank you.

Thank you. I'd be remiss if to not also highlight that although Andy Foster is Executive Director of CSAC, he is globally recognized as the best Commission leader in the country representing the State of California. Since the Commission last appeared before this Committee, the world had experienced a global pandemic. The Commission was greatly impacted by the halt of sporting events in California, but with the assistance of the Department of Consumer affairs, quickly wrote emergency regulations to begin regulating events using a COVID bubble.

With the pandemic behind us, we have returned to the high volume of events in California that we are known for, once again becoming the busiest athletic commission in the country and in North America. I have reviewed the sunset background paper prepared by legislative staff and want to commend the hard work of Chief Consultant Sarah Mason in the Senate and Consultant Vincent Chee in the Assembly.

The background paper is very well written, accurate, and highlights a number of current issues facing the Commission, including the need for clarification that, in the event a Commission assigned ringside physician determines a fighter or participant needs to be transported to a trauma hospital, that the assigned ambulance take them immediately. Sometimes the ambulances are contracted with the county. We need to have oversight to be able to make sure that the fighter is taken care of.

I look forward to answering any questions on the items in the background paper or anything else you'd like to discuss today. Thank you.

Thank you very much. Mr. Foster, I don't know if you want to make any comments or here for technical expertise.

Yes, sir, I'm just here.

Perfect.

Thank you, sir.

Thank you. Appreciate it. Open it up to colleagues for questions or comments. Senator.

Yes, I'd like to comment and obviously compliment the Commission. I've had the occasion to go to a couple of fights and I was at ringside and I was really impressed by the on-hands, I guess, of your personnel that are there, with the clocks and watching this and running here and running there and just totally involved in the fight, and the doctor that would go over.

And so I felt very proud of the Commission, the State of California, and the involvement of the Commission, the staff and so on. So I just wanted to point that out and I look forward to your success even further. So continue the safety as your number one item for all the boxers and everyone involved. And please always keep that in mind. Thank you.

Thank you, Senator Archuleta. Senator Roth.

Thank you, Mr. Chair. I'm just curious, why would an ambulance provider, public or private, not carry, transport an injured fighter to a healthcare facility, ever? Why do you need control?

Sometimes the ambulances are, oftentimes the ambulances have contracts with the county. And so when an event is in a respective county, they look to make sure that the county approves of that transportation. The promoter is responsible for hiring the ambulance company, not the Commission, the promoter. And sometimes the ambulance company that they hire are not contracted with that respective county that the fight is in.

So are these ambulance providers, not when they're at your facility, they're not part of the emergency management service that a county or a local jurisdiction is responsible for operating? I'm confused. I mean, if you dialed 911, would somebody respond to your fighter? And is that the difference?

Sir, that's in a nutshell, the issue is what's been happening on several occasions is the ringside physician said, "this fighter is hurt, he needs to go to the hospital now." And the ambulance company will call dispatch and wait for approval from the fire department or from local EMS. And we ran into that situation last year with catastrophic consequences.

Is it, who's going to pay? Is that what we're dealing with with healthcare providers and ambulance services?

I think that's a piece of it, but it's already been paid. I think it's mainly just jurisdictional. Who's going to make the call? And the state Athletic Commission is saying, "go." And the ambulance provider is saying, "well, we need to get approval. We need to get dispatch to allow us."

I'm a big supporter of our healthcare providers and our ambulance service folks and proud of what they do in the state, but I'm just one of 120 around here. But I'll tell you this, somebody ought to fix this.

Well, that's what we're hoping that we can.

But we shouldn't have to do it through a sunset review process in the Business and Professions Committee sandbox.

Right. Well, we welcome the opportunity to discuss further, make sure this is done right. If an event happens in Riverside County, Riverside County has a contract with the ambulance company. If the promoter hires an outside ambulance company that's not contracted with Riverside County, they're hesitant to transport that fighter. And we want to have the authority to do that.

Why would you hire a company that's outside the county?

We do not do the hiring. The promoter has a responsibility to have two ambulances on site for every event. So the promoter is paying for the ambulance services.

Well, I don't want to belabor this, but just one more question. So at an event, if a fighter is seriously injured, can you pick up and dial 911 and get an ambulance there?

We could, sir, and that's been the suggested solution, but that sort of defeats the purpose of having ambulances on site because the idea is to use the ambulance that we already have there and the medical staff we already have there to take them to the hospital. But that's been the solution is, and in fact, that is what happened last year, is they call 911 and switch from the ambulance.

Well, I just make a suggestion. I'm not an expert on this, even though I've been on the Health Committee a while, but I am certainly not an expert. But I would suggest that somebody sit down with the emergency management folks and figure out if your solution is the best solution under this circumstance, because it sort of conflicts with, I think, the way the counties and the state organize the emergency management response system.

Your system is sort of an outlier, and that may be the source of the problem. Thank you.

Thank you, Senator. And the good news is, everyone recognizes this is a huge problem that needs to be fixed. And as we know, in our job, that's 90% of the battle. So confident we'll find the right solution. Chair Gipson.

Thank you very much. I just have one question. I would like to hear about the changes and the new processes that has been put in place or in motion from the last sunset review, for one example, is the implementation of the new retirement benefits for mixed martial arts. Can you elaborate on that for me, please?

Hello, Mr. Chairman. That was the Bill last year. That was Mr. Haney's Bill. And we've actually began collecting money. We've transferred the funds. We're about to get a Department of Finance code. It's going into the account, and we are collecting money for the MMA fighters at this time.

So it's in process. And the benefit is that you're collecting money. What's the process to collect the money?

It's a dollar a ticket, sir.

It's attached to the ticket sale?

Yes, sir. So when the promoter turns in their gate report, if they sold, like we just sold, UFC did, like, 16,000 tickets, they added 16,000 that was allocated to that fund.

Okay. That's done at every game?

Every mixed martial arts event, sir. And for boxing, it's 88 cents a ticket. As you probably saw, one of the requests we requested was to change that to a dollar as well, so that the boxing and the mixed martial arts are the same. But yes, at every event, sir.

Thank you very much.

I'd like to also highlight that California leads the country in this. Again, we are the only Commission that has a retirement fund for MMA fighters and a pension fund for boxers in the country. We're the only ones where the participants in California benefit from that.

And I think certainly those who are playing appreciate that, because retirement is absolutely important, especially that's something that I'm not sure that none of us on this panel receive after 12 years of being in office. It's most unfortunate, but that's another day for another story, another Committee. Certainly we want to be on that Committee, right?

Certainly those who put their blood and sweat into a career such as martial arts, at the end of their time should be able to retire and have something set aside for them. And so I appreciate you even moving the 88 cents to a dollar, making it consistent for the industry. So thank you very much for your response.

Thank you. And just for note, in 2023, the Commission was able to locate and pay 39 retired boxers, totaling over $581,000.

For their participation in California.

Awesome.

That's great. Any additional questions before I go to my Co-Chair? Chair Ashby.

Thank you. Ok, I just have one question and one comment. Let's start with the comment first, on the ambulance issue coming from the local, and I'm sure I'm not the only one up here, I understand the scope issue there, with counties having various contracts in place for who can provide ambulatory service.

So we'll take a look at that on the Senate BNP side and try to figure out if there's a way we can address that issue moving forward, at least for your industry, although it does appear to be a larger issue as well.

And then my question for you, and not sure which one of you this is best for, maybe Mr. Foster, so, tasking you with the ongoing administration of the existing pension fund that we're talking about here and now, also the mixed martial arts retirement benefit fund, it seems like a pretty large task.

And I am wondering, given the day to day work that you are already required to do all across the state to ensure that things are fair and that the fights are as safe as possible, is this the best way to provide assistance to the individuals who benefit from those funds?

Madam Chair, that's almost like a policy question, if it's the best way. It's providing funds. It's something. It's better than nothing. And regarding our workload, which I think is what you were getting at, it's significant. But at this stage of the game of the newly created fund, we're literally just collecting money. Okay. This conversation will certainly happen as the fund matures and fighters start getting towards vesting. But that's several years in the future, if not 6, 7, 8 years in the future.

Right now, we're just collecting money, which is minimal workload increase.

Okay.

And I would add as being the only Commission that does this, there's no one we can really refer to in our industry. So we're really creating, developing the correct process. But welcome all thoughts and ideas.

Yeah, I think that's sort of the point. Want to set you up for success in the long term. Yeah. All right. Thank you.

Please, Senator.

Obviously, we all applaud the fact that there is a pension or retirement. Is that a number of years or number of fights? How is that implemented?

Yes, Senator Archuleta. The boxers require 75 rounds to the vest because they fight in , 6, 8, 10s and 12s. The mixed martial arts fighters have 39 rounds because most of them are 3, but some of them are 5 rounds. So you see they're a little bit different. But if you fight the 75 rounds in California, you will vest without, like, a break. There are a few little rules, but essentially it's 75 rounds and in mixed martial arts it's 39 rounds and you will vest.

After that time period, do they reach a certain age and then they'll start receiving it at 62 or whatever?

Well, at 50 years old, sir, they can make the claim and it's a one-time claim. It's a one-time benefit.

And is it a lump sum payment or is it payment over years?

It's a lump sum payment, sir.

I see. Okay. Thank you.

Thank you, Senator Archuleta, seeing no other questions. Well, thank you for the questions. Thank you for the answers. I think, following up on Chair Ashby's point, if, as you're implementing these new programs, if you identify areas where maybe code is impeding your ability to implement them to the best of your ability, let us know. Don't hesitate to reach back out to the committees to let us know if tweaks need to be made all the time.

Tweaks need to be made, especially to new programs that we prop up. I have a quick question on kind of fluidity and revenues and expenditures, Issue 5 of the background paper. Has the Commission, because of COVID things have changed and there aren't as many in-person events and not as many people are attending them in person. Has the Committee considered revenue sources other than the gate and broadcast fees to make sure that you have the resources that you need to make sure that boxers and fighters are safe here in California?

The Commission. The Commission continuously requests appropriate appropriations, as the legislators noted, multiple times. The stable expenditures of the office staff, rent, and are only about half of the total expenditures. If the Commission has a high-volume year, expenditures as well as revenue will be higher. Budgeting is a challenge, but we are always looking for ideas and strategies. I think one that we thought of was the license plate, establishing a license plate, so people can pay for a license plate recognizing our industry.

And that's one idea, but we have multiple others. Are there others, Andy, that we've.

Yes sir, another idea that we've had, it's going to sound a little crazy, but the NBAs did it, the NFL did it, Major League Baseball did it. We're looking at the idea of perhaps putting a logo or some kind of sponsorship on our referees' uniform. It's doable. It's possible. But that's new. So that's one idea. And that would generate significant revenue.

As long as the fighters can't sponsor those logos, of course. Yeah. Kidding. Don't want biased referees.

But the background paper did bring up the very important, to your point about the revenues of the Commission. Revenues fluctuate just wildly. This Commission gets 88% of its revenue from events. So if the Commission has events, we get money. And then we need the money to expend. During the COVID year, we only had expenditures of about half of our appropriation because the fixed costs were about half. Does that make sense? So, it's continually been a challenge.

Thank you, Mr. Foster. Mr. Wetch.

Yeah. Mr. Chairman, in regard to not the funding of the Commission itself, but of the benefit plans for the fighters, we have also considered looking at the model of the 50/50 Raffle, which is authorized in other major sporting events. The only difference here is that instead of having it just be a random charity, it would be dedicated to the health and welfare of the fighters.

Very interesting idea. Great. I think those are all my questions. Any additional questions from colleagues? Appreciate you. So let's go to members of the public who would like to speak to the California State Athletic Commission. Any Members of the public who want to come and make comments or do some training, anything? No? Seeing none. Okay.

Then I think that's all we have. I should say Assemblymember Haney has talked to me about both how much fun he had and how informative it was going to events. So it might be something that I'll follow up with y'all on to get an opportunity to do and help get a better understanding of how fast things are moving and the complicated nature of the work that you're doing and your teams are doing to make sure everyone stays safe.

So appreciate everything that y'all do. Thank you for coming today.

Thank you, Mr. Chair, Committee Members.

Okay, next on the agenda, we'll be hearing from the Court Reporters Board of California. I believe we have the Board's Executive Officer, Yvonne Fenner, in the room with us today, and Board Chair Denise Tugade will be joining via Webex. Hopefully. Maybe.

Mr. Chair, I'm here.

All right. Perfect. Love it when things work. Please begin with your opening remarks whenever you're ready.

You. Thank you Chair and Members, the Court Reporters Board of California licenses certified shorthand reporters CSRs, more commonly known as court reporters, and overseas California's schools of court reporting.

There are currently approximately 5,584 active licensees and we have 213 registered court reporting firms. The world of court reporting has undergone dramatic changes since we were last before you in 2019. During the pandemic, court reporters quickly offered remote reporting, allowing depositions and some trials to proceed.

The virtual platform for depositions, with its cost savings to litigants, is here to stay. Taking advantage of improvements in remote technology, the board was also able to pivot to online skilled licensing, something they had been pursuing since 2018 and thus had almost everything in place.

This allowed the board to continue licensing without interruption despite pandemic restrictions. On January 1, 2022 via SB 241 by Senator Umberg, the board was authorized and directed by the Legislature to register non CSR owned firms that offer court reporting services, in California.

The board began registering firms that offer court reporting services in July of 2022. To date, as I mentioned, the board has registered 215 firms, which includes both licensee owned and nonlicensee owned firms.

Nonlicensee owned firms are required to register with the board. Registration for licensee owned firms is optional. We are in the middle of a technology modernization project that is funded by the Technology Modernization Fund, the TMF through CDT.

This will bring CRB fully off of the legacy systems completely online for consumers and licensees while aiming for paperless communications. As a result of AB 156, which was signed by the Governor and chaptered on September 7, 2022 the board was allowed to license voice writers, an initiative the board has been pursuing since 2018.

Voice writing is an alternative method of court reporting using voice technology rather than a stenotype machine. Both methods create shorthand notes of the proceeding simply via different types of equipment.

The board was able to adapt the license application, set up proctoring instructions, and begin administering the license exam to qualified voice writing candidates. In time for the November 2022 exam cycle, staff has completed regulations to update curriculum requirements to include voice writing.

Voice writing is a major change to the court reporting industry in California. The training program is significantly shorter than training steno writers and enjoys a higher completion percentage.

Court reporting schools will benefit from offering a voice writing training program as it more closely aligns with vocational education goals asked of them by their accrediting bodies. A robust workforce allows the consumer to not only be assured of having a court reporter available to create an impartial record of their proceeding, but also keeps the marketplace competitive. Thank you, Chair and members.

Thank you very much. And Ms. Fenner.

Good morning, Chair and members. My name is Yvonne Fenner. I'm the executive officer for the Court Reporters Board, and I'm here just to answer technical questions and assist Chair Tugade with anything that she needs from staff.

Wonderful. Thank you very much. I'd like to turn it over to colleagues for any questions or comments. Any questions or comments for the Court Reporters Board from colleagues.

Good morning. Thanks for being here. Just a comment and maybe a question at the same time. Last year I was asked to visit a court in Victorville. I represent the Victorville area in San Bernardino. County. I think we all know we're going through a shortage of this profession. I asked, what is it that is the block to see how people are more interested in trying to serve at that capacity.

They tell me that they're trying to provide as much aid as necessary, whether it's through grants or even sign up bonuses and guaranteeing that they'll get a job once they go through the program. What is it, in your view, that is creating such a big shortage throughout the state?

Thank you so much for the question, assemblymember. Workforce has been one of the greatest challenges that we've seen, and as I've mentioned, it's a really long standing issue that we've been looking at since well before 2018, and we have looked at many different ways to attack this issue, whether that's encouraging new forms of court reporting through voice writing that includes more folks into the profession at a faster rate, registering firms like I mentioned.

But we've also seen investments from the Legislature, which we're very grateful for, to encourage hiring at the courts. We've definitely prioritized that it's a long standing issue, and I know there's a long historical precedent as well, that I'm happy to turn over to Ms. Fenner to speak to.

So as a longtime court reporter, I would just put it into perspective a little bit. Many years ago, when I first started training as a court reporter, I had to wait just to get into the training program. By the time I finished the program, there were so many reporters that there was a glut, if you will. So I had a real hard time finding work.

So I've seen the cycles over the years go up and down, and it's definitely been complicated by the universal labor problems that we have all experienced after COVID.

So this one's, I think, a little bit more pervasive than we've experienced in the past. The good news is, thanks to the Legislature's forward thinking. We have been licensing voice writers, and that program fits very well with vocational training, adult education.

And what we're seeing in the schools right now are waiting lists to get into the programs. We see different schools also hiring additional teachers to try and help handle this demand for the program and training right now.

And we've seen that trickle over into the number of statistics for the people that are coming to take the license exam. So three years ago, we maybe had less than 20 people, first time takers for the license exam. In November, we had 59, 1st time.

We have 54 for the current cycle. So you can see that it's definitely driving up and we will have for workforce. Now it's going to take some time, and the board has recognized that.

So we're still exploring reciprocity with the national license. We're promoting remote reporting as much as we can because we feel that that would open up a lot of possibilities to, there are reporters, they're just not necessarily next to the courtroom or next to the conference room where the deposition is being held. So we do have some challenges, but I think we're working hard on solving them.

Thank you so much, Creo. Senator Roth, are you asking on this issue or different issue? Court reporters workforce?

Yes.

Perfect.

As a longtime former attorney, I was a customer of the court before I came up here. And we depend on court reporters in our courtrooms for a variety of reasons, but certainly to make sure, as you well know, as a court reporter and as you know, Madam Executive Director, we depend on court reporters to make sure that the record is accurately transcribed.

So when we have an issue that we want to take up to the appellate court, the appellate court and the justices who aren't in the courtroom when we try our case are able to find out exactly what happened and decide the issue for us.

As you know, they're mandated. Courtrooms are mandated to have reporters, some of them the criminal courts, the juvenile courts. But there are courts that deal with our most vulnerable.

My understanding is that are not mandated to have court reporters, such as the family law court, which is a problem because they're dealing with our most vulnerable at times that are the most vulnerable they probably will ever have in their life.

They're critical decisions being made, and without a court record, it's almost impossible to appeal what goes on in that court. And there may be others. I don't know. I don't know whether probate is mandated.

What are we doing to make sure that one, we know what the workload and workforce shortage is in our non mandated courtrooms, and what are we going to do about it? Let's start with the first question.

Do we know, even with this new workforce effort, with voice writing, which I've long supported since I came out of the military, and that's basically all we had when we deployed people doing stenomask reporting, do we know what our non mandated courtroom workforce shortages, anyone, any takers?

Thank you for the question, Senator Roth, and I'll turn to Miss Fenner on that if we do have numbers.

Thank you, Madam Chair. We definitely do not have those numbers. Those are kept by the Judicial Council. The board does not track where people work. And so the shortages that we know of, the information comes from judicial counsel.

Now, we know that most of the courts have stopped providing court reporters, official court reporters, in civil matters, and they've added the family courts, the family law courts, as you said. And that is definitely of concern to the board because those are, as you said, the very most vulnerable people, it's the lowest point of their life.

And not only do they have money and possessions at stake, but often it's custody of the children. And so these are very important matters. And the record is critical. So the board has a vested interest in making sure that those courts are covered. However, the actual hiring is outside of our control.

And as a formal attorney who practiced in the civil side of the courtroom, those who could pay got a court reporter, and those who couldn't pay didn't. Less critical in the civil side, more critical in the mandated courts. And I think we also can't control where these court reporters go, these new ones who are in training, because they have choices.

They could take depositions for someone like me, who had clients who could pay significant amounts of money for the court reporter's time and the preparation of the record, where those court reporters could choose to go to a courtroom and sit, where the compensation perhaps was less lucrative. Just a comment. We've been debating electronic reporting in this Legislature for some time, and there are deficits there, of course.

But I think at some point, whether it's on a temporary basis or otherwise, we're going to have to face the fact that we're unable to staff our mandated courtrooms, particularly in family law, and grapple with this electronic reporting once again, perhaps even on a temporary basis, until the workforce shortage subsides.

And we convince court reporters who are coming out of training to take a swing at the courtroom reporting, hopefully in family law court. Thank you, Mr. Chair.

Thank you, Senator Roth. And just to drill down on that a little bit more, my understanding is that judicial council has requested things like a workforce survey, for example, which I think might answer some of the answers that Senator Roth is looking for. Is that something that has been discussed? I know workforce survey and also helping applicants out with the exam are the two main issues that they highlighted.

I don't know if that's something that has been or is being discussed.

Yes. Chair Berman, we, executive officer Yvonne Fenner and I have met with judicial counsel regarding that request. And before I go to that, I'll just respond quickly to Senator Roth's last statement. What we found is that there's a difference between the shortage of court reporters and the shortage of court reporters who are working in the courts.

And so, for example, what used to be one or two court reporters for a day in a court has now turned into five court reporters who are now having to contract each for one case, two cases. And so there's an efficiency loss there.

And so part of the question is how do we return back to that original system or something closer to it? And so that is part of the discussion we've had with judicial council.

I will say we are in the process of looking at much of what judicial council has requested, looking at how we can better have reciprocity with other tests with other states, and then also looking at how we can try to bring our testing in line with other tests that are out there.

In terms of how we can help test takers pass the test however, the board has had extensive discussions on that issue and have determined that that's really a conflict of interest because the board does issue the test. And so if we're both issuing the test and then helping applicants to pass it, that could constitute an issue there.

And so we have left that role to both the schools and the trade associations. That said, again, we are looking at ways to make that test align better with existing tests in other states and nationally.

Senator Roth.

Just a follow up. Whether we are talking about reciprocity or test taking assistance or anything else, these efforts are going to take time, new students and pipelines. The courts, of course, raise the issue because without a court reporter, there's no effective appeal, and we're dealing with people who don't have the money to pay for a court reporter.

I guess my comment and the reason I raised it is I think there's a certain sense of urgency that we need to all adopt here to create at least a temporary solution to this problem for those people who are stuck in these courts and do not have a court reporter to make a record.

Just my comment. It's not the board's responsibility. You have your sandbox, and you're performing very well in it, and I'm thankful for that as a former customer of yours.

But I do think as a group and as a Legislature, we need to adopt a sense of urgency with this. And it's caught up in the politics, and nobody understands politics better than those of us who sit up at the DEUs. But I think at some point, we need to put politics aside and work a temporary solution to this.

So for those in the room and those listening to this, I think we ought to put our shoulder to the wheel and fix this problem again, at least on a temporary basis. Thank you, Mr. Chair.

Thank you, Senator. Senator Pellerin.

Thank you. I'm reading here that some of the failure rates are 70% to 80%, and in one year, it was 94.5. So my question, why do you think it's so hard for folks to pass this test?

I would encourage you to take a look at the first time pass rate. So the overall pass rate is skewed in the sense that once the candidate leaves school, we don't know if they continue to practice or what effort they actually put into getting better at the skill.

So for comparison purposes, we always use the first time pass rate. Before we went online in 2020, the pass rate was all over the board, and it was as low, as you said, in the teens as a percentage rate.

Once we moved the skills test online, we saw an amazing side effect in that the passage rates started to smooth out. It's been 50 to almost 60% passage rate since we moved the skills test online. So that's stabilized.

In addition to that, once we started licensing voice writers, we've seen that pass rate increase as we expected. And the most current pass rates are in the 60 to almost 70% pass rate. So we are seeing that.

Okay. And then just another question. How is AI impacting your industry? Is that what the voice recorders are that you're talking about? Actually, AI is a whole level above that. Okay.

Actually, AI is a whole level above that. So the voice recorders, the digital monitors, they basically come in with tape recording equipment, and that has its own problems, as well as the transcription from those recordings. Separate problem.

If you want to talk about AI, I would just say that it's pretty amazing how court reporter, as an industry, have always embraced technology, and so we are on the cutting edge of it. You'll find AI already built into all of the translation software programs that court reporters are using. Where it gets to be tricky.

And this is a preview of coming attractions for all of the legislators. We have software that will offer a translation. It will say, this is what we think it heard. Now, that can be one word. It can be the entire proceeding.

In a state as diverse as California, we have some special problems with the people that are testifying in court and in depositions. They come from so many different ethnicities. They may be first generation Americans.

The accents are very strong, and it doesn't even have to be people that are born outside of the country. We have regional dialects that are very strong, and the AI is not able to make the differentiation and make the correct guess, if you will, at what that word is.

So we are always going to need that human element. We're going to need a court reporter as a neutral third party that can say, I'm impartial. This is what happened. And I certified this is what happened here.

You are litigant. You can take this to the appeals court. Not in a case right now. I think that the Legislature needs to act, but as it develops, I think that you will see this issue coming back before you.

Thank you, Chair Ashby.

Thank you so much. First, I just want to say good morning to Ms. Tugare. It's nice to see you. I have a couple of questions for you guys. One is, what are some of the ideas from the board's perspective to increase court reporting educational programs? There appear to be job opportunities. So I'm just wondering why there aren't more programs. Let me give you an example.

In California, we have more than 100 schools that offer cosmetology programs, but only that, I know of about eight schools that offer training for court reporters. Do you guys have some suggestions on pathways?

Thank you, Ashby. So, actually, much of the training can happen online and happens outside of California. So those eight schools are just those that are located in California.

That said, we are working with the California community colleges and would love to work more extensively with the chancellor's office to get more programs into our community colleges, because, as we've said, this is an incredibly dynamic profession, a lucrative one, one that can lead to really great jobs.

And so I know Ms. Fenner and other staff with the board have done great work to do outreach at different workforce and job fairs, but certainly looking to expand our reach with the creation of schools. Certainly. Ms. Fenner, do you want to add anything?

I would just add to that we court reporters have the best job that no one's ever heard of. Most people never come in contact with the legal system, and if they do. It's a one time thing, so they don't even know court reporters are out there.

It's a wonderful career. It's open to. We have a large number of minorities, a large number of women that are able to support their families single handedly through this profession.

So it's really key that we get the word out. What's really exciting now is I think we are in a time of more acceptance for vocational training. There was a time where, you had to go to college. Vocations really didn't have a place. So that attitude has changed.

And so we are hopeful that the Legislature will help us get into the chancellor's office, get into the different higher education oversight agencies that give funding for adult education. It's often a second career.

It's not everyone coming out of high school. It's a second career. People have finished their degree and find out they don't want to teach English, but they have the English background that will make them perfect court reporters.

I wasn't planning on telling this story, but I think I will. One of the roles of this Committee that the Chairman and I both agree upon is there's this economic development piece, right?

Yes, there's the sunset parts and all these things that we do. But in this state, we're always looking for opportunities for good, high wage jobs for people, and this is one of them. And we need to find ways to sing it from the rooftops. And I love the idea of it being considered more vocational and focusing on how the community colleges can help us push people to this career and introduce it to them.

This is the story I want to tell people in the City of Sacramento. The city attorney is the first Latina female to hold that position. She is a lawyer because while being raised by a single mom in LA, her mother was a court reporter, and she and her little sister sat in the back of the room after school because she had a very nice judge.

And so Susannah Alcala Wood and her sister sat in the back of those chambers every day and watched. Their mom, Susanna was so moved that she ended up becoming a lawyer and now runs the City of Sacramento's legal Department, which oversees about 35 attorneys.

So I do believe that being a court reporter is quite the noble profession and can really lead people into other careers as well. So I thank you for the work that you're doing and look forward to the opportunity to help get more people in this profession. Do you have one last question for you.

And this one, I just kind of want to get on the record so that we can include it if we need to. In anything further, has the board received any complaints about electronic recordings? I know it's a topic adjacent that comes up a lot here, or the other transcript issues that are not within their jurisdiction. And if so, does the board refer these complaints to any other agency?

I'll jump into that one, Madam Tugade, if you don't mind, just because it's technical and deals with the complaints. So we don't actually have jurisdiction over work that people that are not court reporters are doing.

So, for instance, we do have people that will call and say, I got a transcript from an electronic recording, and I don't think it's accurate. We don't have the ability to do anything about that because they're not licensed court reporters. We don't have the ability.

Right now, if we have a complaint about accuracy of the transcript, we can go to the court and say, send us the notes for this proceeding. If it's a deposition, we can go to the court reporter and say, send us your notes for this proceeding. We can look at the final transcript.

We can look at the original notes that are the basis of the generation of that transcript and say, yes, this is accurate or no, there was a problem.

With an audio recording, we don't have the audio recording. We don't know the authenticity of the audio recording. We don't know if it's been manipulated in any way or altered. And that person that transcribes it doesn't have that information. So we know that there are complaints, but we aren't able to act on them.

All right. Thank you very much.

Thank you, Chair Ashby. Let me just first kind of quadruple down on the PSA. That court reporting is a wonderful profession, a very good paying profession, and more people should be going into. So definitely let us know anything that we can do to help in terms of encouraging more people.

It's encouraging to hear that the numbers of applicants and folks taking the test are increasing over the last couple of years. So hopefully that continues to progress. One question.

A lot of the important questions have been asked and answered regarding the Transcript Reimbursement Fund. I think this is a critical program, but it seems that the current way we're funding may be a bit complicated.

Are there challenges for the board to work through fiscal issues and develop a budget when there is pressure to keep the TRF funded? In the board's opinion, could it be possible to separate out the revenue needed to fund the TRF into its own fee assessment so we can have a more reliable picture of what's brought in and what's spent on the program.

Thank you, Mr. Chair. The TRF is one of the most critical programs that we do have. When we speak about the urgency for indigent, you know, I wanted to make sure to add how much the board feels that urgency.

And just to add that this is one of the ways that we make sure that our most in need Californians are getting those services and that they are getting the same exact services that someone who can afford to pay for those services can get.

And so we want to make sure that poor people are not getting some sort of lesser option in the course of urgency. But in terms of how we fund the TRF, unfortunately, it is complicated. And part of that is that the number of licensees changes every year.

And so in order to, for example, set an exact amount for the TRF to be funded at, it will require us to know exactly how many licensees we have every year and then change that set amount per licensee, for example, or to come up with some other source. We have received General Fund infusions in the past for which we've been very grateful, and it has really helped keep the PRS sustainable.

However, at this time, it doesn't seem that there is a way to change the current format of the Fund, but would be open to ideas from the Legislature.

I would just add that we've had the TRF built into our budgeting process for so long, and it sort of takes priority. So that's our main source of funding. So first it's staff, then it's the TRF, so that we can actually implement everything.

If anybody has an idea on a way of assessing that, we would definitely be open to it. I think our Chair touched on the fact that with that moving target, with the number of licensees changing, I'm not sure how we would factor that in, but we're totally open to it.

Great. Thank you very much. And Senator Roth had a good suggestion on his way out of reaching out even lower than community college, maybe to the high school level, maybe the California School Board Association, to make sure that they know about these really good opportunities that could exist for future court reporters.

We've been in contact with the guidance counselors, for example, because they don't even know about the industry, that it's a viable career.

Exactly right. That's great. So with that, we're going to go to the members of the public, any members of the public who want to come and testify for up to two minutes per organization on the court reporter board. I don't see anybody leaping up now. I do.

Okay. And I think just pull the microphone up. I'm assuming it's on. If it's not, we'll figure it out. Hold on 1 second. Is the mic? Yeah. Yeah.

Thank you. Good morning, Chairs and Members, Ignacio Hernandez, on behalf of the California Court Reporters Association in support of the CRB in the extension of the sunset, but also want to address a couple of issues that I think go to the entire discussion on workforce. A couple of are within the purview of the CRB right now, and some suggestions on things that can be done.

Number one, there are two issues that come up right now, immediately, that we are concerned at the CRB that could have an impact on the number of licensees in California. And that is the CRB is moving to withdraw the authority of an applicant to review his or her online exam to see where they have made some of the mistakes, and also withdrawn the opportunity to appeal the failure of, if somebody fails an exam, withdrawn the ability to appeal the results.

Those two things we are very concerned about, because that actually could lower the number of folks who pass. There are a number of licensees who they had to take it multiple times, and being able to review the dictation portion of it and also to appeal is what led them to the pathway to actually get their license.

So we are asking the CRB to reverse that, put a hold on those changes, and we should look at that very closely and find a way to be able to continue to allow for review and appeal. On the workforce piece, I really appreciate all the discussion. I could speak for 2 hours on that, but I won't. But I will mention a couple of things.

One is the LAO just released a letter at the request of the chair of the Senate Judiciary Committee, specifically on court reporters and the need for court reporters.

And I know members of my client, CCRA, participated and provided a number of very specific things that courts can do today to increase the availability of court reporters in courtrooms, in family law courts. It's just a matter of daily management and a number of other things of coordination.

So happy to share some of those in writing with the Chairs and with the Committee Members. So there are things that can be done. Now, we spent hours talking to the LAO and being interviewed for that letter is online if anyone wants to take a look at that.

And that's two minutes. So if you can wrap up and then submit any additional comments via writing, would be great.

Workforce development, we are working on a project similar to what I worked on with the interpreters, which would allow for some payment of COVID some of the cost of training and cost of the exam, and with a guaranteed job already available.

So folks go through the training knowing they'll have a job at the end. We're working on that right now and happy to share some of that information with everyone. Thank you very much.

Mr. Chair. Madam Chair. Cory Jasperson, on behalf of the Judicial Council. Yvonne, how are you? And chair of the Court Reporters Board want to thank the Committee staff for the excellent write up that covered all the issues. We support the staff recommendations, especially those recommendations related to a workforce study.

We think that'd be really important to get some basic information about the existing workforce. Any kind of assistance with newer passers would be very beneficial as well. Also the reciprocity with the national test.

I would point out that the Judicial Council has a successful near passer program for court interpreters. The council licenses and certifies court interpreters, but we also identify near passers.

We have a contract with the National Center for State Courts that is then able to provide individualized, intensive training, peer tutoring, one on one, small group tutoring, specialized resources to help those court interpreters when they set for the exam the next time so they can be successful.

As the Supreme Court noted in their 2018 Jameson Viva Desto ruling, quote, the absence of a verbatim record of trial court proceedings will often have a devastating effect on a litigant's ability to have an appeal decided on the merits. The steady decline in the number of court reporters threatens access to justice.

This is a real crisis in the courts, especially for Californians that cannot afford to pay thousands of dollars for their own private court reporter when a court provided reporter is not available.

In the quarter July to September 2023 alone, 133,000 proceedings occurred without a verbatim record in family, probate and unlimited civil the last three years. While we're excited about the increase of voice writers that are being licensed, we had 68 new CSRs last year, 35 the year before and 39 the year before that.

The current shortfall of court reporters is 650. The LAO report last week had, I think 671 as the number. So the number of new court reporters coming in is not addressing the existing shortfall. Los Angeles has 105 vacancies today.

And that's two minutes. So if you wrap up and then submit any additional comments and writing, that'd be great.

Definitely. Thank you, Mr. Chair. We definitely want to work with all stakeholders. This is an important issue, and we ask for your support.

Thank you very much.

Chairs and Members, Mike Belote. Our firm has a number of clients who are vitally interested in the court reporter issue, including the California Judges Association, the Civil Defense Bar, and we also represent a coalition of national court reporting firms. The problem is bigger than just the courts. It's the most acute in the courts.

But we are also having trouble staffing depositions with CSRs, who are the gold standard, and our members, our civil defense members, given their druthers, would have a live CSR on site. Whether the answer is voice writing, opening more schools or something else, technology, whatever it is, we think the problem is both in the courts and in having people available for depositions.

We look forward to working with the board and their efforts on workforce, with the schools, and with you, because the problem is large and growing, we think. Thank you.

Thank you.

Chair Berman and Vice Chair Ashby Coby Pizzotti. I'm a Washington Unified School District trustee, and I think you hit on some very key points when you said, please bring this issue to the California School Boards Association.

I think that's a very critical component because a pathway in the schools is the right way to go about bringing in new ideas and getting children to see that there are actually good pathways, good paying jobs out there for them that don't require a four year degree.

I also happen to see this profession growing up as my father was a court reporter and he started a firm in 1974, Pizzadi and Jarnegan, an associate. So I just wanted to say I've had the experience of seeing this profession grow and blossom and see all the ups and downs that it's had. But I really wish that the board please go out and talk to CSBA. Thank you.

Thank you very much. Seeing no additional comments from the public. Want to bring it back for last questions, if any, from colleagues on the Committee. Member Carrillo.

Yeah, on that last speaker bringing it up to CSBA, I think that that would be a great path because in my view, what we are experiencing is growth and interest in CTE, career, technical education. And I think I would like to explore that myself with my schools and contact CSBA. Like to hear from you. Do you see that's a path viable?

Definitely. That's definitely something that we can pursue, and it's appropriate for it to begin as early as high school. I agree.

Thank you very much. Thank you for testifying today. With that, we're going to move on to the next board. Thank you, everybody.

Thank you.

So next we'll be hearing from the Dental Board of California. I understand. Dr. Alan Fensenfeld, board President, and Tracy Montez, the board's executive officer, are here with us today. Please begin with your opening remarks whenever you are ready.

Good morning. Good morning. Chairs Ashby and Berman and Committee Members. I am Dr. Alan Felsenfeld and I'm proud to be serving in my third term as the President of the Dental Board of California. Sitting to my left is Dr. Tracy Montez, our Executive officer.

Our board licenses and monitors and regulates approximately 104,000 dental professionals, specifically 43,000 dentists, 46,000 registered dental assistants and 2,300 registered dental assistants and expanded functions. The board also sets the duties and functions of unlicensed dental assistants to protect the public and we issue many types of permits such as a General Anesthesia or moderate sedation permit for qualified dentists, as well as permits for dental sedation or orthodontic assistance. In carrying out this complex work, the board's highest priority is the protection of the public.

This work is performed with an appropriate budget of approximately 19 million dollars, and 84 authorized positions distributed across administrative, customer service, licensing, complaint intake, enforcement and discipline units. The board itself is composed of 15 members and thanks to Governor Newsom for his recent appointments, one of whom is sitting in the back of the room right now I might add, that we are now only with two vacancies. As of 2011 the board also has a dental assisting council consisting of seven members.

Board members, council members and board staff work together to carry out the board's mission to protect and promote the health and safety of consumers of the State of California. I would like to take a few moments to highlight some of the accomplishments that we've had during the past five years. For personnel, our board has hired a new Executive Officer in November 2022 and a new Assistant Executive Officer in December of 2022.

Our vacancy rate, which was hovering around 25% for many years, has been reduced to about a 7% rate, which is very good for a government agency. As of April 1, all positions in the enforcement division will be filled. That includes both sworn and nonsworn investigators. In addition, mandated training, in addition to mandated training, excuse me, board members and management participated in the diversity, equity and inclusion training. With respect to licensing of our members, complete applications are being processed within 30 days.

No backlogs exist and that is very good. The 90 days is the standard target.

Continuing education audits have been resumed after being delayed due to staff vacancies, and finally, the Access to Care Committee has been reinstituted to more closely examine workforce shortage reported for the dental assisting profession, as well as serving the underserved with respect to enforcement, which I feel is probably one of the most important responsibilities we have. Since early 2023, the board has been the subject of the Department of Consumer Affairs Enlightened Enforcement Project, working with DCA subject matter experts and board staff to review, update and improve board enforcement processes.

Inspections, which are complaint driven, are under 30 inspections to be performed across both northern and Southern California. And in both 2021 and 2023, the board sworn officers investigated unlicensed activity in Southern California, resulting in both misdemeanor and felony arrests. With respect to legislation, 25 bills over the past few years have impacted the board.

For example, SB 501, which you're aware of, was a comprehensive update to the Dental Practice act covering anesthesia and sedation, especially for pediatric patients. And AB 526 when we needed help, authorized dentists to administer COVID-19 and influenza vaccinations, provided they comply with specific requirements. Before concluding, I would like to end with the board's outreach efforts. Since the COVID-19 pandemic State of Emergency concluded, the board has attended some rescue and some resource affairs and professional Association meetings.

The board reinstituted its newsletter, producing both May and November issues and these are posted online. The board is now on social media X, formerly Twitter. The board is also completing a comprehensive update of its website to make it more user friendly. This should be completed by the end of this month. And finally, the board will be presenting the findings of its supplemental diversity, equity and inclusion survey at its August board meeting for integrating into its current strategic plan.

The board welcomes the opportunity to continue to work with DCA, our stakeholders, the legislators and the public to carry out the mission of the board, and we will be happy to answer any questions you may have now.

Thank you. Go ahead.

Thank you. I'm just here for support.

All right. Everyone needs a little support. Open up to colleagues for any questions or comments. Starting. Yeah, something over Carillo.

Good morning and thank you for being here. Some areas in the state don't have access to dentist services. The lack of access not only in the dental care, but also in healthcare. And also I noticed that in some areas there is no dentists practicing that simulate the population that they serve. We heard on the previous panel how diverse California is and the importance of having access, in that case, for co reporting. The same, I believe, is for healthcare.

And those are conversations that I've had with CMA, the doctors Association too, to be able to have a diverse profession, professionals that serve the communities they represent. And my experience, I've kind of seen the same thing in the dental profession, that there is not a diverse number of dentists that represent the areas that they serve. Is there something that has been done to try to get this kind of diverse professionals throughout the state.

And I'm sure there's also a lack of professionals, dentists coming into the state. Is there an opportunity to look at other programs where you could attract dentists to come and serve in California that simulate the population?

Yes, we certainly are aware of workforce shortages, and our data is actually showing that it's not as bad as reported. What we're finding is it's more the ability to hire. Having said that, though, our board is working with the Health Care and Access Information center to gather data through various surveys to look at potential workforce shortages. And our data thus far is showing some deficiencies in the Los Angeles County regions and Stanislaus County regions.

And so, in fact, I'm going to a meeting tomorrow with them and so working with them closely to look at mentorship programs, things like that, especially with regard to our dental auxiliaries. And then as far as the dentists are, we do have various pathways, used to be five, It's more four now, different pathways to come into the state, licensed by credential, licensed by residency and so forth. So we are looking at ways to facilitate access into California and reaching out to other underserved areas.

As Dr. Felsenfeld mentioned in our introduction, we have reinstated our Access to Care Committee. And so we are charged with, again, trying to bring in various pieces of information and working with other stakeholder groups to really get a good picture of the workforce shortage and diversity. Much of the data that we collect through our surveys is volunteer reported. And so we need to kind of dig down and really get a sense of the true picture of California beyond just the volunteer data.

But it is on our radar and we're working with various organizations to do outreach and again, to look at any kind of barriers or concerns with underserved.

I might also add, sir, this year, while it's not a rapid response, this year we opened a new dental school, number six, in California. So the more dentists that we produce, the more likely they're going to want to stay in California, that's been the trend, and more likely that they'll be able to find their jobs where the jobs are. That's going to take a few years, obviously, to come to fruition.

Have there been any discussions on having these new professionals going through the accreditation program and getting their licenses to have them serving California as opposed to training them in California and then they go to other states? Have you had any thoughts or discussions on making that part of a requirement per se for them to stay and serve in the unserved communities.

We did have a grant program many years ago where students were awarded money for their education by going and participating in underserved communities. However, we have since depleted that grant money. But once upon a time there was something set up for that.

Sounds like a budget request opportunity Assembly Member Carrillo. Assembly Member Soria.

Thank you and good morning. I just want to follow up on what Assembly Member Carrillo brought up because I think the issue of access is extremely critical to communities, rural communities that we represent. And so I understand your point that we're working on it. What does it mean to be working on it? That's great that you guys are working on it, but I'd like more detail.

Well, as I mentioned, we're working with our stakeholders to identify the data in terms of where there's actual workforce shortages, because again, right now the data is not trending, that it is as widespread as reported. However, that data is voluntary. So that's why our Access to Care Committee is going to be working to get a more formal survey out to try and get a sense of where these individuals when they graduate, where they go practice.

We don't collect that data, so that's why we have to work on it, because we don't have the immediate data at hand. We also, again, like I said, we have the various pathways. We're working on a legislative Bill with one of our stakeholder associations to look at a perceptorship potential pathway for our dental assistance, which will again, hopefully increase the influx of individuals into the profession.

And so again, looking at our pathways, looking at our data that we have and trying to find a better match so that we can reach out to those underserved communities. Comment came up earlier about how to help with economic development, one of the nice things about the dental auxiliary is we have our dental assistants who many of them then go on to be RDAs and then registered dental hygienist and even in some cases, dentist. And so we do have pathways to get individuals licensed.

The next step is then to get them into these communities.

So I think in your comments earlier, you mentioned that there was two counties, Stanislaus, and what was the other county?

Los Angeles County, which is a large county.

And those are the two counties where there are shortages?

Primarily of our dental auxiliaries.

Okay. Yeah, I think it just seems like I don't understand why we wouldn't be able to have that data more readily available since you guys give the licenses. And how do we not have that data?

Well, that data is collected upon renewal, so we have to be very careful about the data that we collect upon licensure unless it is directly related to the qualifications of the licensee. So we tend to stay away from demographic type of data upon licensure because that can be problematic in terms of licensing decisions. It's a perceptual issue. So legally, we have to be very sensitive of the data that is collected upon licensure. However, during renewal, we do have a survey that is completed, we are mandated,

There's actually two surveys that our licensees complete, and that's the data that we're starting to look at now. Again, this is a separate state agency that collects the most robust data, and they have just started doing this over the last couple of years and putting it up on a dashboard. And so we're working with them and their data to get a better sense, again of the needs of the underserved population. I have to, again, really reinforce this, though.

It's voluntary data, so it's up to the licensee and it's within all of our boards in the Department to go through the survey and answer the various demographic, educational, training questions and so forth.

How about the data without the demographic piece, like, just the numbers? I know in my area we have a lack of all of the above when it comes to dental healthcare services.

Right. So we do collect data as far as counties, and we do report that at our quarterly Board Meetings, so we do know. It's just there isn't a standard per se that says for every 100,000 Californians, you should have x amount of dentists. So we report how many dentists and dental assistants, but we don't have a standard to say, 'Yes, there is an extreme shortage'.

So how do we create a standard? Because I know that we have one for doctors, right. We say the ratio per week, even like hospitals. Right, they regulate and say we need this many nurses per whatever patient. So I'm just curious.

I'm not aware of a population ratio that certainly we can look into that and report back to you. Yes, there's hospital patient ratios, but as far as population ratios, I'm not aware of that standard. I'm not sure how we would go about that, but I'm certainly happy to do the research and report back.

Right. Thank you.

Thank you. Council Member Dixon.

Hi.

I apologize. I've been in another Committee, so missed a lot of the earlier discussion, but I did meet with some folks in the lead up to this hearing, so I just had a couple of clarifying questions regarding dental assistants. The question was asked of me if the dental board could increase by one seat an additional Member on the dental board to include assistants. So question number one, I don't know the process. If the board recommends or we are to recommend, that's question number one.

Number two, I did learn in my discussion with dental assistants, and forgive me, I don't have my notes in front of me, but there are thousands of dental assistants, licensed dental assistants practicing in the State of California. That's terrific. I also learned, so correct this information if I'm wrong, that there are thousands of people performing the role of dental assistant in dental offices who are not licensed. So answer those two questions, please.

How are the board positions determined and allocated amongst the ancillary Members of the profession? And number two, clarify the situation about dental assistant licensing.

The short answer to the first question is that's done by statute. Who's on the dental board? We are mandated certain seats, and we are actually looking at the possibility of increasing that. It's going to have to come from you guys, of course. But that is something we've been considering and talking about as well, increasing the number of dental assistants on the board. As far as the second part of the question and please ask it again. I'm sorry.

Well, as I say, I don't have the data in front of me, but there's the basic issue. There's thousands of people performing the role of dental assistants who are not licensed.

Unlicensed dental assistants, thank you. We take great pride in wanting to see our dental assistants licensed to do their jobs, but it's not a mandate that you do that to be a dental assistant. You can do on the job training and learn how to do that in a dental office. So if you want to be a dental assistant, you go to your dentist, he can, or she can teach you how to be a dental assistant. But there are certain things you cannot do.

There are certain skill sets that you have to have. There are certain legal implications. So when you get licensed, you can do more than just general take the patient and take their blood pressure types of things. You can do other things with the patient and with the dentist you're working with. So it's okay to be unlicensed. And we do control the legislation. We do not the legislation. We control the rules of what they can do and what they can't do. We have that capacity.

How is that enforced?

Say that again.

How is it enforced?

Everything that is enforced is enforced by complaints. We don't go running into dental offices and say, let's take a look at what you're doing. But if we get a complaint, we do investigate that. And we do see, there was not dental assistant, there was just a big arrest in Southern California for unlicensed dentistry, dentists practicing. So we are absolutely investigating. If we get a complaint about that.

Does the board receive any complaints about unlicensed dental assistants?

I don't know the answer to that.

Rarely. Rarely. And if I may elaborate a little bit, there's about, again, 46,000 licensed registered dental assistants. We don't know how many unlicensed dental assistants, because we don't track that. We merely, or I should say the Legislature, has set their duties in statute. And again, there are prerequisites, of course, but again, we don't track that. The dentist has the ultimate authority over unlicensed dental assistants and registered dental assistants in terms of the duties that are performed within the identified scope.

And so if we get complaints, it's usually against the dentist, not necessarily the actual unlicensed or licensed dental assistant.

Okay. Thank you very much.

You're welcome.

Thank you. Any additional questions from colleagues? Senator Smallwood-Cuevas.

Thank you, Mr. Chair. My question has to do with the vacancy rates and particularly around the dental assisting work. Can you hear my? Turn my volume up. Can you hear me? Is that better? Thanks. Thank you. I had the opportunity to visit Chowchilla, our women's prison, and inside of that prison, women are helping to build some of the dental trays and guards and some of the custom dentures. And I know that there is places where many of these women have come from.

There is a shortage of dental assistants. So I'm wondering, does the board sort of monitor and work with CALPIA around providing some training program that might address our shortage by certifying and training these women who are already doing fairly high level, sophisticated work inside? And then I also wanted to know more about your licensing, the licensure process as it relates to formerly incarcerated people and what the board is doing to address the vacancies with underrepresented populations.

To add to some earlier conversation on workforce shortages. So the board does not provide training programs. We regulate. We leave the training programs to our schools and our associations, and we encourage them to work closely with programs like that to show them how to move through the licensure process. And again, we do have some legislation out there that we anticipate will add an additional pathway to our dental auxiliary program.

Again, I'm going to use the example of getting into dental assisting the unlicensed part, moving into a registered dental assistant, hygiene and then a dentist we actually have a board Member, that that's her path. And so we really are trying to do as much outreach as we can with different community organizations to show them how to get individuals licensed. I know it sounds like a very small thing, but just even updating our website, we have so many people that really look to our website.

How do you get licensed? We want to make it as easy as possible. The other thing that we're doing is we are reaching out to our applicants, for example, that may be having difficulty getting licensed. They turn in what we call an deficient application. It doesn't have necessarily all the training certificates. It's confusing. We work with them to help them get through the process. So we have lots of outreach, lots of materials. We're happy to connect with any organizations that need assistance.

But again, we don't do the training per se. We do the licensing part of that.

And I guess just to follow up on my clarification, what sort of data are you collecting to look at opportunities to address the vacancy rates? I understand that you aren't doing the direct recruitment, but how are you informing the field, the sector on ways to be able to address the shortage? And I'm particularly because you are a state board and the state has a relationship with the women's prison.

I'm just curious how even in that example, are you doing any effort to look at the trend of who those sort of dental workers are inside of our prisons and how might we build some connections between the folks who are doing the recruitment? What data do you have? Do you collect that? What trends are you seeing?

We don't collect that data. Again, the data that we tend to collect is related to the profession, the qualifications to the profession. So we don't necessarily collect direct demographic data. We do have some data on where individuals go to schools and so forth. Again, happy to work with the state agency to see what we can do.

But it's typically, again, demographic data is separate than initial licensure data, but we will work with organizations when they indicate that they have shortages, go out to resource fairs, make presentations, work with the schools, let them know of what we're hearing. And often, again, our associations and our stakeholder groups are very good at doing that kind of research, outreach as well.

I look forward to working with you on that. I'm authoring a Bill right now, 1067 in Healing Arts, working with the Healing Arts boards to expedite licensure for folks who are going to do the work in underserved communities. And so I think there are ways for us to make the connections at the board level to deal with the vacancies and at the same time help the state deal with our problem, which is to address poverty and the lack of representation in some of these sectors.

So I look forward to working with you on that.

Thank you for that.

Thank you. And this is not underserved. I would like to say, with regard to the military, we have expedited 156 licensees, and we also have, with regard to AB 107, expedited military for temporary. We're doing that, too. So if we're told to expedite, we are on it.

Thank you, Senator. Senator Carrillo.

Just following up on the previous comments, fully understanding that you don't collect data for various reasons, and going back to dentists that serve underserved communities, have you thought of looking into foreign dental schools being able to practice here, their students. Quite frankly, California, again, is very diverse, the population is to be represented.

And if dental schools from Latin America are able to those students be able to go through some certification process to be able to serve our communities here in California, being sensitive, again, because you don't collect that data, would that be something that would be a path to represent the population that we have in California?

We at present have a foreign dental school in Mexico which unfortunately is going to lose their ability to give us dentists to be licensed because of accreditation reasons. Let me explain. Perhaps you're not aware of it. This has been an ongoing problem for many, many years. This is not a new issue.

Our last sunset Bill, AB 1519, in 2019, transferred the approval of dental schools to allow students who graduate from them to come and take our licensing pathways to go out and practice wherever they want, not mandating it, but wherever they want. That Bill transferred the approval process from the Dental Board to the American Dental Association Commission on Dental Accreditation, the CODA, as it's called, which is the US Department of Education recognized accreditation body for dental education programs.

Now, prior to them having international programs, which have only been around for a few years, this board received applications. Our board received applications from a school in Mexico and one in Moldova for approval so that they can accept students and then send them back to California for licensing to do whatever, or to send them back, well, to send them back. At that time, CODA did not have international accreditation.

So our mechanism was to take three or four board members and outside people and send them in there using whatever criteria they could find from CODA that was released and available and went out and looked at these programs and approved them. The Dental Board does not have the expertise to do accreditation, which is a rigorous process. I am a site visitor for CODA for oral and maxillofacial surgery programs. It is a big thing to do these things, and a dental school is even more impressive.

So it's usually a large group of trained examiners who will go in and look at it could be 10 or 12 people coming in, looking at the curriculum, the different forms of the curriculum, parts of the curriculum, and also looking at educational processes to be sure that the people coming out of there live at the same level that the people coming out of our 66 dental schools do. There are alternate means for internationally educated dentists to come up and practice if they wish to do so.

There's a two year, it costs two years. I get that. There's a two year program in five of the six dental schools. If they wish to come and practice in our state from anywhere, they take the exam, they qualify this, and then they do two years. And when they're all done, they have the same DDS degree coming from, let's say UCLA, where I was from, and I have that. It's the same degree. So then they are free to go wherever they wish.

It is unreasonable to think that these international dental programs should have a pathway for approval that is lesser or diminished from that which the other schools have to go through. Our board took an opposed position to 1552 last year and is supportive of the process that exists today. With CODA being the accrediting body for all schools that send people to California.

That's the best way that we can hope that they'll get the good quality care they need and we don't have to worry about the lesser accreditation pathways. That's why CODA exists.

Thank you for that clarification, for addressing that. I'm not familiar with CODA or these other schools, merely just trying to find a way to get our populations to be served.

We understand that.

And we do have, as just an illustration, we have the standards. The CODA has already accredited a school in Turkey and a school in Saudi Arabia, which means, in theory, if we want to send American students there, they can be trained there, come back here, and then they are eligible like any other dental student coming out of any of one of our schools.

Thank you for that.

Well, thank you very much.

You're welcome.

Senator Roth.

You mentioned the school in Mexico. I thought I read in our background paper that that school previously approved by the California Dental Board is currently winding its way through the national accreditation process, is that not correct?

We don't know.

I don't know for sure, as I understand it, and its anecdote, I don't really want to put that into the record, but I don't know if they are at this point.

We have asked CODA and Moldova, and we have not received. I'm sorry, Mexico I mean. We have asked them and they have not confirmed that they are in the approval or the process of being approved. CODA cannot release information on any of the schools that may have initiated the process until it becomes public. And we have not received confirmation when we've worked with our stakeholders on Mexico.

Okay.

Well, that answers the question. Thank you.

Thank you. Any additional questions or comments from colleagues on the committees? Ashby is good. One question. I'm curious to hear the board's perspective on the proposal that's discussed in the background paper around allowing licensees to take some of their continuing education in courses in mental health and wellness. I feel strongly that burnout is a serious problem in all the health professions.

And as we're constantly debating how we can increase our healthcare workforce, which is so important, we certainly don't want to risk losing the professionals we already have because of challenges to their mental well being. Has the board taken a position on the concept of mental health and wellness courses, counting towards continuing education requirements? And are you open to working with the Legislature to pursue a proposal along those lines?

The board has not formally taken a position yet, but we are hoping to do so at the May board meeting.

We have talked with our stakeholders, and Dr. Felsenfeld and I agree that mental health is extremely important, and we feel that it would be useful to have it clarified in our continuing education, because, as you know, our continuing education is broken up in terms of CE that is directly related to treatment services, those that are courses that are less, not as beneficial to the professional, and then those that are completely beneficial to the individual, but not to dental services.

So we want to make sure that it is considered as beneficial to the treatment of patients because we know that it's so important to think about our mental health, and that's consistent with the governor's initiative on mental health. So we would be more than happy to work with you on that potential legislative proposal. Thank you.

Fantastic. Thank you very much. And chair Ashby.

Sorry I lied to you when I said I didn't have any questions. I apologize.

All right.

This one's multilayered a little bit. Your program is obviously quite large, your responsibilities. So this is just me sort of digging into the weeds. Does it still make sense for so much of your operations to include managing these committees of licensees or interested parties or other individuals? What's the value add, for example, of having the layer of a state maintained diversion evaluation Committee? And are there other ways we can assist dental professionals who are facing very real substance abuse challenges?

We believe that our diversion program is actually working very well. So our diversion Committee consists of several Members and a program manager in the board, and we work our program manager with Maximus, that is the contracted vendor, to provide monitoring and oversight. So there's very specific criteria for individuals that enter into the program and how they're monitored and how the process is terminated. Part of the monitoring involves drug testing and regular contact to ensure that they are meeting their probationary requirements.

And so if there is any violations, it's reported to the board so that we can take the appropriate disciplinary action. So with regard to the Diversion Evaluation Committee, I would say it's very useful and very successful. And we have a Committed Committee that works closely with our program manager.

Thank you very much. With that, we're going to open it up to Members of the public who have comments. Just a reminder, two minutes per organization and we've got two more boards to get through, so we're going to keep it at a tight two minutes. Please go ahead.

All right.

Good morning, Members of the Committee and Chair Berman and Chair Ashby. My name is Mary McCune and I'm with the California Dental Association. We're pleased to support the legislative proposals brought forward from the Dental Board to this Committee and look forward to continued conversations around a lot of these around pathways to licensure for out of state dentists, for the mental health continuing education, and cleaning up the dental anesthesia permitting structure.

We're also in strong support with limiting the foreign dental school approval to really the entity that's most appropriate for that, which is CODA. CODA regulates the seven dental schools here, six soon to be seven, and the 66 others throughout the country. This ensures both equality in dental school education throughout the country and patient safety. We're also enthusiastic about the potential for the sunset bill to expand licensure for dental assistance through the preceptorship pathway.

And we are looking forward to looking at that and other things to bring a more culturally and linguistically diverse workforce from dental assisting all the way through dentists. And lastly, we're also in strong support of the existing structure of the dental assisting council. I know that there were talks about board composition changes.

We really think that the dental assisting council allows for a more robust discussion using several different levels of expertise and permits within that workforce, to have those discussions within the regulatory body of the Dental Board, rather than combining that into one additional person on the dental board. And for those reasons that we're in strong support of the Dental Board's continued regulatory authority. Thank you.

Thank you.

First, we'd like to note that we're very pleased with the work that Dr. Tracy Montes has done as executive officer of the dental board. We have found her to be approachable and eager to work collaboratively with all stakeholders.

There are three issues in particular we want to bring to your attention. One has already been addressed is the representation on the board. There is one dental assistant on the board representing approximately 75,000 dental assistants, yet there's eight dentists representing approximately 35,000 dentists.

You can see that inequity and there is also still a hygienist on the dental board. Even though the Dental Board does not regulate hygienists any longer, they have their own board. So we would respectfully request that you consider this inequity and change that hygiene position to a dental assistant. Second, the unlicensed dental assistants.

Although we support an entry level worker for the dental office who may eventually become licensed through a work pathway, the unlicensed dental assistant continues to be a concern as the Dental Board has no authority over these individuals who typically have no background in dentistry, yet they have direct patient treatment responsibilities.

Many RDA applicants have been denied licensure for various criminal acts, yet they can continue to provide treatment to patients. As an unlicensed dental assistant, we request the Dental Board be directed to research and develop a tracking system for these unlicensed individuals, at minimum requiring registration with the Dental Board in the form of background checks.

This would allow for potential screening and tracking for patient protection. And lastly, the regulatory language update. A thorough review of the regulatory language regarding dental assisting practice and education started in 2014 and has yet to be completed. Dr. Montez has informed us that they have started over with a review of the articles of Chapter three and we are encouraged by this news.

Thank you.

We request, however, that this Committee emphasize to the board the need to complete this project with attention to detail, but also in a timely manner to rectify these issues. Thank you very much for your time.

Thanks.

Good morning Chair Ashby and Chair Berman. Gary Cooper, representing the California Association of Oral and Maxillofacial Surgeons. We certainly recommend that the dental board be reinstated and be renewed. Just talking a couple of issues.

Number one is the first issue that's raised in the background report. We believe that the elective facial cosmetic surgery Credentialing Committee should be maintained.

We know that it has been suggested by the Dental Board to sunset that we believe, for the safety of the public and for the professionalism of the profession, that it should be maintained and kept in statute.

The second issue is item number nine, dealing with SB 501 and General Anesthesia. As you all know, we were very proud to be the sponsors of SB 501 in 2017 and 18, and we're very happy that it has become the law of the land.

And so we did introduce in 2021 a bill to make that SB 501 statutes and provisions will apply to adults. We certainly believe that today, and we believed it then and we believe it now. We believe that just because someone turns 13 years old, they shouldn't be forced to have less safety in a dental office than people who are under 13. So at some point, we are certainly recommending that the provisions of SB 501 be added to the adult population. Thank you very much.

Thank you very much.

Good morning, Chair Ashby and Chair Berman and Members of the Committee. My name is Juanita Chavez, and I'm speaking on behalf of Dolores Huerta Foundation and its founder, my mother, Dolores Huerta.

And I'm here to talk about the issue of the shortage of dentists in rural and underserved communities. As Dr. Felsenfeld mentioned, once they are graduated, dentists will go to where the work is, where the jobs are.

But what we find from the Dental Board's own data is that dentists will tend to go to urban areas. So we have data from the board that shows, and they said they don't collect data.

So I'm not really sure how they came up with this data, but San Francisco has one dentist for every 710 residents, Orange County one dentist for every 774 residents, whereas Yuba County has one dentist for every 11,753 residents. Sierra county has no dentists in their county. Alpine, zero dentists.

So we want to refute the idea that dentists are graduating and going to where the jobs are, because really they're not going to these areas that are so needing them, and even in the urban areas.

I've submitted letters from three organizations in the Los Angeles area, an urban area, but they work in low income communities, and they've stated how challenging and difficult it is to attract and hire dentists to serve these communities.

So we are supporting AB 2920 authored by Gomez Rayes, because the prior accreditation of foreign dental schools under AB 1116, Keely in 1998 successfully increased access to dentists in underserved areas and should continue.

Over 300 dentists successfully graduated and became licensed under AB 1116, and many dedicated their practices to providing dental care in these underserved communities. AB 2920 would ensure that this pipeline of quality dental professionals continues to benefit these communities.

Foreign dental schools accredited under AB 1116 underwent rigorous and meticulous review by the dental board before receiving accreditation.

That's two minutes. We could wrap up. That'd be great. Okay, thanks.

So we know that AB 1519, Lowe's requirement pretty much took away. That entirely ended this program. And we know that CODA is taking 10 to 12 years to accreditate for their schools to become accredited. So we just like to say that we want to support AB 2920 and that the Dental Board continue to have that. Thank you for responsibility.

Thank you.

Good morning, everyone. My name is Ana Maria Quintana. I'm vice mayor for the City of Bell. I come before you to also recommend that the dental board be renewed, relicensed. That being said, I do want to ask the Members of the board to support having the Dental Board reinstate the approval process for dental schools.

Foreign dental schools specifically. My community is 49% foreign born. Language is very, very limited, and studies have shown that having culturally competent healthcare providers just improves the quality of services.

The reason why I challenge the Dental Board's authority to not do this is because when you think about CODA, CODA undertook the process of accrediting foreign dental schools at the request of the State of California. The purpose of the dental board is exactly that.

To renew, to regulate the profession. If we as a state find that there is a shortage of culturally competent attorney, sorry, dentists, I'm an attorney, so slip of the tongue here, we have a duty to fix that need.

The reason why I think the Dental Board is also capable of doing that, and it's kind of essential that the Dental Board take on that task, is that the CODA approval process takes 10 to 12 years in a foreign context. Studies have shown, and the record shows, that when they started this process was in 2007, when the dental board made that request.

And as of date, and Dr. Montez is correct, and there are two schools, but that took 10 to 12 years to ask members of our communities, rural communities, underserved communities, to wait 10 to 12 years to have a school, to create a pipeline that services our communities. I think it's uncalled for. The approval process for the Dental Board was two to three years.

So to finish the recommendation, I would echo Senator Roth's words, is to leave the politics aside and come up with a solution in which we can provide services for our communities. It is mean the pandemic as a whole highlighted the inequities that exist. So we have the resources and if we're not, we have a duty to provide them.

Thank you very much. Very quickly, because you're.

Really quickly, since we did talk about earlier about resources, reinstating the Dental Board's authority to approve foreign dental schools would not be a burden on the state because the cost entirely would be borne by the applicant.

Thank you very much. Thanks. Any additional comments? Got a couple down here from Members of the Committee, Dr. Eggman. And then we'll go to Senator Roth.

Thank you very much. Thank you. Can you respond to some of those comments? Just mean we know. We've covered deeply both issues around access in every one of these oversight hearings we do. Right. And so we know the ability to provide dental care and we know all the impacts on that for education and schools.

So can you speak to this a little bit? And then even where did the dentists that were approved go? Can they come back?

It's difficult to track where all of them go. I can talk to you anecally, I've spent most of my career teaching at UCLA and I was dealing with the dentists from foreign countries who took the two year program and they did not go into their catchment area, as it were, from where they were. From where the people are. Those are those people.

Excuse me, Mr. Chair, I don't think when people are talking with data that we should go back to anecdotes.

I would agree with you completely. I think the point is the accreditation or the approval process that was done by the board back then was not nearly as rigorous as it is when it's done by CODA. So we're giving them a lesser accreditation or approval process than would be necessary for the six now to be seven dental schools in California have to go through. I can't see the equity there.

We have doctors, though, from other countries who have gone to medical schools in other places. Correct?

We do, but they've been licensed through various.

And so. And CODA can't set up a similar process.

Likely not, but we can't speak for CODA.

I want to clarify, too. CODA wasn't set up as a result of California. Again, the US Department of Education has designated CODA as the accreditation for dental schools in the United States. And it's a choice whether or not schools choose to be CODA approved. There's CODA approved schools in Canada. They're across California, across the United States. Again, we have two.

The amount of time if it's in us in the United States, it's going to be less because a lot of our teaching and our schools are very similar in standards and so forth. It does take longer for international schools because there are more things, there's the time, the distance, things like that.

But really it comes down to completing the application, setting up the appointment, providing the materials. It's a process that's iterative. It goes back and forth.

So when you say 10 to 12 years in speaking with CODA, they will not give you a specified time frame. I tried to do that and they said no because there's so many variables that are involved. But the fact is that there are schools that have gotten approved through CODA and we recognize them as authority. And as Dr. Felsenfeld said, it's the standards for health and safety and patient protection.

That's what we have to keep in mind, is that if we were to go back to the Dental Board doing this, we don't have the expertise to fully ensure that all of those standards are met. That's why we leave it to professionals who do accreditation. Thank you.

While that was in effect, while you were overseeing it, what problems arose?

It's hard to answer that question. Problems would come with poor patient care or patient complaints. If the number 300 is accurate, and I'm not sure that that's really true. There's still 43,000 dentists in this state. It's a very small portion of the dentists have come through these pathways that previously existed.

So it's going to be hard to determine how badly or how well they're performing. The data would not support that.

And we don't provide that data. Like we don't say this person graduated from this school and now they have disciplinary action. Once you've graduated and become licensed, that's it. We're not looking at the background. We're looking at you met the requirements, you're out practicing, and if there is an issue, it would come through a complaint and the disciplinary process.

I hear what you're saying, and it sounds like we're talking a lot about anec.es, because somebody who represents a rural area, we know the problems that result from lack of access. So this is a pathway to access. And you're saying, anec.ally, we're not sure if it worked. We're not sure if it didn't work, but we offer nothing in its place.

Well, it worked in that it gave an opportunity for individuals to go through that school and to graduate, but to continue to allow that is problematic from the board's perspective because we don't have the ability to offer accreditation. It was a temporary fix for a request.

And once the approval was made for those two schools during the time that that was happening, then CODA was established. So coda was not. We did, the board did approve those schools.

But now we have CODA, and given that we don't have the expertise, that's the situation. But we don't track licensees to see how they do or don't. Again, they've met the bar, they've become licensed, and then they're out to do their practice. And I grew up in a rural area.

Just a comment and then a couple of requests, maybe. Our material indicates that in 2019, when the sunset bill transferred the responsibility for approval from the Dental Board to CODA, the school in Mexico, did not oppose because they were currently involved or then involved in the OoDA accreditation process.

Just to clarify the original question that I asked. So I guess one request is to see if we can get the status on that CODA accreditation package from the school in Mexico.

Two, I assume that you keep track of your dentists by practice location, and at least if you're like lawyers, they have a database that tracks where we received our law degree. So I'd like you all to see if you can tell us where the dentists who graduated from the school in Mexico have practiced or are currently practicing. Two, request number two.

And then request number know. Years ago, we did a program for physicians to try to encourage physicians to serve in medically underserved areas, physicians from Mexico.

Took us a long time to get that program up and running, thanks to my colleagues, perhaps the one to my right, and others from the Central Valley.

The program seems to be moving now, so I'd like for you to take a look at whether that sort of program could also work for dentists and what it would take to implement that program in our dental underserved areas of the state. Three requests.

Happy to do so. I know that's the Mexico pilot project.

Exactly. Thank you very much. Thank you, Mr. Chair.

Thank you. Any additional questions, comments from colleagues? Seeing none. Thank you very much. Appreciate the very robust and important conversations we're going to move on to the board for professional engineers, land surveyors and geologists.

The next item on our agenda is the board for professional engineers, land surveyors and geologists. We should have Michael Hartley, Christina Wong, and Rick Moore here with us today. And I understand Nancy Eisler is not able to attend, but whenever the folks are who are here, please go ahead.

We're ready for your presentation.

And maybe just hit the button on the mic. There you go.

How about now?

Perfect.

All right. Good morning, Chairs and Members of the committees and staff. My name is Michael Hartley. I am the Professional Land Surveyor member on the Board and the current President. With me today are Christina Wong, who is a public member and is also the Vice President, and Ric Moore, our Executive Officer.

We appreciate this opportunity to provide an update to the committees on the activities of the Board during the last five years, as well as present our ideas and thoughts on this sunset review. I'll be speaking on the history of the board, its current makeup, and an introduction of the Board's online Connect system. Our Executive Officer, Ric Moore will follow with more detail on the Connect system, address some of the issues presented by the background paper, and Christina Wong will wrap things up.

The origins of the Board date back to 1891, when land surveyors were first regulated in California and the nation. Regulation of professional engineers began in 1929 following the early morning collapse of the St. Francis Dam, which caused a disastrous flood along the Santa Clara river as it coursed through Los Angeles and Ventura counties. The event claimed the lives of over 400 individuals, destroying many homes and farms.

It is still considered one of the worst American civil engineering disasters of the 20th century and the third greatest loss of life in California history. Afterwards, other branches of engineers were added through the ensuing years, and the responsibilities of the former Board of Geologists and Geophysicists was merged with our board by the Legislature as a result of the budget crisis from 2009.

Today, the Board does several things, regulates almost 190,000 individuals, the majority of which are located in California, with some dispersed throughout the United States and around the world. The Board issues an average of 500 new certificates and licenses annually, develops and administers over 4800 state exams annually, processes a volume of over 6500 applications on an annual basis, primarily through the board's recently implemented online Connect system.

The Board is mandated to safeguard the life, health, property, and public welfare by regulating the practices of professional engineering, land surveying, geology, and geophysics. The Board qualifies and licenses individuals, establishes regulations, enforces laws and regulations, and the Board helps the public make informed decisions. There are 15 Board members consisting of five professional engineers, one licensed land surveyor, that would be me, one professional geologist, and eight public members. All appointments to the Board are for a term of four years, and there are currently two vacancies.

Interestingly, the Board has experienced considerable turnover and only one third of the current members on the Board were a part of the last sunset review. As a result of an extensive, multiyear business modernization effort, the Board responded to the unique challenges faced during the pandemic by launching the first of many phases of the connect system in September of 2020. The primary goal was, and still is, to provide a more efficient and consistent service to the people who need to conduct business with the Board.

As a licensee myself, I can say that I've used the Connect system to renew my license. It was very intuitive and really made the renewal process painless. While development of the Connect system continues to evolve from the initial 2020 success, the Board recognizes that more effort is needed towards achieving the original goal and is committed to proactively addressing feedback provided by its users. I'd like to ask Executive Officer Ric to provide some additional detail.

Good morning. So when the Board transitioned from the former, download the application, complete that by hand, mail that in with all the information from your references to a completely online system that could be accessed 24/7 anywhere in the whole entire post-pandemic world. We underestimated the popularity of that and some of the reasons that we had, that we're currently experiencing that is hindering us from reaching our ultimate goal for providing the best service is kind of a too much of a good thing type of situation.

We do a customer satisfaction survey as responses from our users on this system, and while we receive a respectable 4.5 out of five rating on that, when we drill a little bit deeper into those responses and the feedback, the users of the system that are submitting initial applications for licensures have a lesser satisfaction rate. We believe that's primarily due to the much larger volume of applications that we are now receiving.

Literally, our staff could stop work at the end of the day and come in the next morning and there's another 150 applications in the pipeline. So it's kind of an interesting situation. More particularly with the engineering and civil engineering applications, we've seen an almost 70% increase in the number of applications that are coming in, and some of those are not as complete as they would have been in the past, and that has led to us reevaluating how we need to address those situations.

We have noticed that the peak of that volume has passed us and we're starting to trend down to a little bit more of the levels we anticipated. So what we've done is we've kind of rededicated our staff internally to try to address that situation, and we are slowly chipping away at the backlog is which we refer to it, and we're hoping by the end of summer, early fall that we will be down to the more manageable levels we expect to.

Another result of going online with the system again is we also had complaints to middles go through the new Connect system again, complaints 24/7 from anywhere in the world. We're receiving far more complaints than we ever used to in the old method. Many of those are not within the Board's jurisdiction. Many of them are not submitting complete information that allows us to actually commence the investigation.

So our board is working to improve the communication at the complaint submittal level to try to address that and help mitigate that because that has affected our timelines down the line with our investigations. We've also noticed that switching over to our fund condition, our revenues have sporadically remained pretty consistent through the year since the last sunset. However, our expenditures have increased primarily due to state salary expenses and state administration cost.

So that has resulted in fund condition that is reaching the limits of what our revenue is allowing us to do. So what we've already done is we've commenced a fund condition or a budget analysis and a fee schedule analysis internally with our office with DCA budgets, and we're very much underneath our statutory limits for our fees.

So if we need to adjust those fees, which we hope to present to our board later this summer, we would expect to be going that through the rulemaking process and we would expect that would be a target date of probably January 2026 if the fees did change. Okay, with that, I would like to pass it on to Ms. Wong. As a public member, we thought it'd be appropriate for her to briefly address some of the public communications information.

Good morning. The Board primarily communicates with consumers, applicants, licensees and stakeholders through multiple avenues involving electronic communications, board meetings, online publications and social media posts, both virtually and in person. While the board has maintained a policy of holding public board meetings at various locations throughout the state, it is recognized that a hybrid accessibility approach by adding the virtual meeting option, encourages many members of the public across all demographics to participate in the meetings.

Much of the Board's licensing and enforcement outreach is performed by licensed staff members and the Executive Officer through both virtual and in person workshops. The Board initiates communication with applicants, licensees and representatives of educational programs throughout the state on a regular basis. The Board's most recent strategic plan delineates the outreach objectives in relating to diversity, equity and inclusion. Board staff are identifying ways to expand on the delivery of awareness and education about our mission and licensing to underserved populations. Thank you.

Thank you very much. With that, I'll open it up to colleagues for questions or comments. I've got a couple, I'll get started, and then if other folks have any, feel free to jump in. So I know a big issue of concern has been unlicensed activity. How many complaints received by the board are related to unlicensed activity? And relatedly, what portion of investigations conclude that unlicensed activity is indeed occurring? And then I might ask a follow up question or two, but let's start there.

Yes, unlicensed activity has long been a concern for our board. That's probably one of the areas that we more commonly collaborate with our professional societies. It's a concern for them, it's a concern for us from the consumer point of view. I don't have exact numbers, but I would say the unlicensed, most of our complaints are related to land surveying and civil engineering. I would say the unlicensed aspects of that are probably easily 25% to 30% of those complaints. Our licensees are very susceptible--

The practices that they do are very susceptible to advancements in technology. It's kind of a two edged sword with our licensees. It's a good thing. It helps them do the work that they do that's very valuable to the consumers. On the other hand, sometimes it makes it much easier for unlicensed people to do that work too. And that's where collectively we're all struggling with that.

And for unlicensed folks to do that activity poorly?

I would say poorly, yes. In many ways, they don't really understand what they don't understand.

Right. How does the board's enforcement unit compare to comparable licensing entities? Have you looked at others' best practices?

I would say, well, I know that our enforcement staff regularly communicates with other enforcement staff within the Department of Consumer Affairs here in California, but we also, on a national level, our enforcement manager is part of a enforcement committee with other engineering surveying boards across the nation and regularly communicates. We do probably have a higher volume of complaints, but we tend to have a higher volume of licensees too.

Sure.

I would say in California we do have a better process for handling unlicensed in terms of we can issue an administrative citation and a fine, where many states, all they can do is issue a cease and desist and unlicensed people can ignore them. But it is something that we're very active in both within the state and nationally.

Thank you. I might come back to a couple of questions, but want to go to Senator Becker.

Yeah. Just had a question about the complaint portal. You talk about it in the document and I think you referred to it in the Connect. When you talk about the transition to Connect in 2020 and then there was some additional back office added to the complaint portal. How do people access the complaint portal? And has that process been clear?

We have a link on our website for consumers and licensees, anyone to submit a complaint, it can be submitted anonymous. We don't like to say it's an easy way to submit a complaint, but we have made it easier for them to do that. And it's all done purely online without any interaction with our staff. And then where the slowdown is, is in the intake, because many of the complaints don't come in with supporting documentation or they don't pertain to the jurisdiction of our board.

And so the intake process is where we're slowing down and it's passing on to our investigation. But what we're trying to do now is try to improve the communication at that complaint, when they're completing the complaint, at that time when they're submitting it, to try to reinforce what information we need to do to begin a successful investigation, if that helps.

Yeah, that is helpful. And if people kind of Google, they find the board and they find that. You've checked that out?

We found that it's actually very easier to find our board and our online complaint by Googling than it used to. Yes.

Okay. Yeah. Thank you.

Thank you, Senator. Chair Ashby?

Thank you very much. Thank you for being here. Sorry, I've been in and out. I'm taking care of a couple of other things, too. I just have one question for you. What is the extent of land survey or unlicensed activity? Is it prevalent enough to dedicate full time investigative staff to enforce one of the three practice acts administered by the board? As the background paper suggests, industry is willing to pay for it.

I would say the land survey and licensure part of our mission is probably the one most susceptible to unlicensed practice because, as I mentioned, the technology, anyone has a phone with GPS that is reading satellites on a daily basis and using those directions, and assumes that land squares are utilizing the exact same equipment, they're using the same satellites, but they're using equipment that instead of getting you within a 10th of a mile of where you need to be for an address, they're getting you within 5 where you need to be.

And they don't understand when you're a surveyor and you have a property to come over with their IPhone and say, I don't understand, this is where my property corner is, and the licensees are. No, that's not exactly the way it's done. There's also technology that counties and cities and local public agencies are using with online mapping systems that show tax assessment parcels overlaid with aerial photography. And many consumers assume that that information is as accurate what a surveyor would do.

And it has opened the door for organization, I wouldn't say organizations for companies and individuals to offer services to the consumers in an effort to sidestep paying for a surveyor. And that has been very problematic for both us and the licensees.

Yeah, I think that that covered a lot of what I was going to ask. Also, let's open it up to members of the public for any comments. Just a reminder, two minutes per organization, and we're still hoping to get one more board in before about noon, so we're going to be a little tight on that. Two minutes.

Good morning. Morning, Committee Members and Chairs. My name is Alan Escarda. I'm a licensed professional engineer. I'm also a member of the Professional Engineers in California Government, commonly known as PECG.

I'm Chair of their committee that follows the board, and as such, I've attended 90% of their hearings over the last four years. So I can personally attest to the board and its staff's professionalism, their competency, and their dedication. So what I'd like to do is make three comments on the sunset report.

First and foremost is PEC strongly supports the renewal of the board for all the things that they do, enforcement exams. It's very essential to protecting the health and safety of the public. The other two issues are on the licensing issues in the report.

First one is continuing education. License issue number four on page 40. Take supports continuing education, just not legislatively mandated board imposed programs that have fees, assessments and additional time requirements. As an engineer, worked for the state for nearly 30 years.

We had training programs second to none, and we had various other certification programs and are on the job as continuing education in itself. So we would certainly support the staff recommendations for the board to find an alternative to mandatory fee based continuing education for the licensees that the board oversees.

Last is the license issue number five, the geologist work experience. It's also located on page 40. Currently, geologists have education requirements. Engineers and land surveyors don't have that same requirement for licensure.

So it has impacted some geologists and ability to apply for applications. So what we'd like to do is encourage the board to continue look at substituting work experience in lieu of academic field experience. We think that our work experience is counted toward engineers. We'd like to see the same thing for geologists.

Great.

Thank you for the opportunity.

Thank you very much.

Good morning, Chairs and Members. Tyler Munzing, on behalf of the American Council of Engineering Companies, California, representing about 25,000 of the design professionals that are licensed by the board.

Also this morning, representing the California Land Surveyors Association, which represents the over 4000 land surveyors also licensed by the board. Shortly, just wanted to mention that we obviously strongly support the board's sunset extension.

One area we would recommend the Committee to look into for additional action is, as discussed, the unlicensed practice issue, especially in the area of the discipline of land surveying.

And we offered our suggestions on this both to the Committee and to the board from ACEC back in October, from CSLA, from the landslide Association in February of this year. And both of you received that in writing previously. Just wanted to say we very much appreciate the board's attention to this issue.

Obviously, working with the board very closely and very proud of the people that work at the board, the work they've done on this as well, as was mentioned in the report, speeding up the application review process, which is moving in the right direction. And finally, for the work they do for both the engineering and land surveying industries. Thank you very much.

Thank you.

Thank you. Chairs and Members, my name is Don Schinske. I'm here on behalf of the Structural Engineers Association of California. Structural engineers in California first receive a professional engineer's license and then undergo additional testing, have additional work experience, references, and so on in order to qualify as a structural engineer, two issue points we want to raise.

One is the topic of continuing education. If you ask structural engineers whether they want it, it's yes, maybe we'll see. Depends. But point being, it's discussion that needs to be had. While the laws of physics don't change, how we apply them in engineering has changed dramatically.

What your dad learned as a structural engineer 30 years ago is not the same as what your daughter is learning as a structural engineer now. So it's a fair expectation that we at least consider the topic and decide whether there's a way to move forward.

The other topic I just want to flag is kind of a long standing one for our organization. In 1933, we had 220 school buildings fail in the Long Beach earthquake. In 1971, we had a couple of hospitals collapse, a few more that were damaged and made inoperative.

On the heels of both those, structural engineers were given the added to their title authority restricted practice. That is, only structural engineers can design schools and hospitals. Now, that's a welcome thing. We think it's a good thing.

It also doesn't represent a very coherent strategy on the behalf of the State of California. These were, I think it's safe to say, reflexive moves. And I assume when there's another earthquake, there'll be another set of reflexive moves that are made.

The question becomes, can we do a little bit better than that and follow the lead of what almost all other Pacific rim and western states have done now, which is adopt significant structure language that reserves the design of complex or high occupancy or important structures to structural engineers. Thank you very much.

Thank you very much.

Good morning, Chairman and Committee Members. Thank you for all your questions and comments. I'm the executive secretary of California Nevada civil Engineers and land surveyors. My name is Eric Angstadt.

We certainly support the board and its efforts with the sunset review process and appreciate a lot of the comments here and a focus when we've been working with the board for some time now and have presented our position as long as in conjunction with ACC California as well as the LSA.

I'm going to be brief with my comments because I have several licensees here to bring forward and let you tell you about what their experience has been.

But I want to just touch on a couple of areas and focusing exclusively on unlicensed practice, which right now I would submit to you, consistent with the board's data, where the number of licensed land surveyors in this state are slowly declining, that some of that has to do with what licensed land surveyors are seeing or occurring with unlicensed practice out there.

Every single day in my office, I see incidents of this that are provided to me by many of these licensees that I'll share with you on a weekly, sometimes daily basis. Want to just hit on some quick points that we want to focus on enforcement and subsidizing that enforcement through fees, enhanced fees by members, as well as enhanced penalties, significantly enhanced penalties, so that we provide a deterrent effect for much of this behavior. Secondly, there's been a lot of discussion about continuing education and that requirement.

We support this. We also support public education because many consumers of surveying services, whether they're public agencies, developers, contractors, or the General public, need to know what it is that land surveyors do, why it's so important, and how it affects their lives.

So that we have some appreciation for the fact that these licensees, their training and their expertise helps keep the people of the State of California safe. That's another element of this where we would be more than willing to assist the board in whatever capacity that they would like to have.

Thank you very much. Two minutes flies by.

Okay, I'm going to let go.

Perfect. Thanks.

Good morning. My name is David Ron. I'm an owner of Martin Ron and associates in downtown San Francisco. Our firm has worked on major downtown iconic projects like Salesforce Tower, Chase center at T Park.

Many more. I drove this morning from the half Moon Bay community, which is Mr. Berman's district and Mr. Becker's district. So this is personal to me. I appreciate you guys bringing up the unlicensed practice.

As a professional land surveyor, this is one of the biggest things that we see threatening our profession and harming the public. The recent Crownholm mysiteplan.com case shows just how challenging it is for the board to even punish an egregious bad actor in this situation.

So, again, I would like to just thank the board for working on that and then for the Assembly Members and the Senators for understanding and recognizing this unlicensed practice issue. And that's it. Thank you.

Thank you. Thanks for making the drive. I missed the co side.

Good morning. Thank you for having us here this morning. My name is Matt Stringer. I'm the Vice President in charge of surveys at a 400 person civil engineering and land surveying company. Primarily supports public infrastructure across California.

I personally oversee 15 licensees, and I've been a licensee for more than two decades. And I just want to lend my support to what the board has said today.

And I want to say I appreciate your questions about the enhanced enforcement against unlicensed practice and especially the thorough answers we've had here today. I think that is the biggest issue facing licensed land surveyors today. After all, if we accept unlicensed practice, we might as well not have a license. Thank you.

Thank you very much.

Good morning. My name is Jim Dickey. I'm a principal with a fairly large surveying company up in Santa Rosa, California.

We have about 40 people, and we do work throughout the state. Unlicensed practice is the biggest issue that we have going forward, and unlicensed practice affects consumers, it also affects public works projects, and that unlicensed practice can lead to bad elevations, bad grades, and hopefully it will not end up with falling down infrastructure, but it very well could in the future.

We appreciate your thoughts and concerns about these issues, and we look forward to being able to support you.

Thank you very much.

Good morning, Chairman and Committee Members. I'm Jeff Setera with Sandis civil engineers. We're 125 person firm in Northern California, five offices. I want to echo my peers.

We want to continue to work together, support the board and what it does, and pay particular attention to the unlicensed practice that's ongoing. I mean, just yesterday, I received an email solicitation for a company outside California that does construction layout to the point.

I think protecting the profession through licensing is important because of the work that we do with infrastructure. Schools, hospitals, highways, all these things need the care and responsibility that we as professionals take on.

I've certainly dedicated my career to upholding the professionalism that has been put forth in the board and its regulations, and we're going to do everything we can to support the board and your efforts. Thank you very much.

Thank you very much.

Good morning. I am G.V. Ayers. I represent the Association for Environmental and Engineering Geologists. Thank you, Chair Berman and Chair Ashby and members for the opportunity to speak. Appreciate the work of the board and we are offering our continued support for the board.

We appreciate the hard work and the commitment of Committee staff. Acknowledge that having done this before myself in the sunset process, and the stringent work of the board, the agonizing work of the board in doing this as well.

And geologists play an important role in guarding the public interest in numerous areas, including infrastructure design and construction, water sustainability and land integrity. Without getting too far into the weeds, or I guess, shall I say, into the crevices of the rock.

We submitted a letter of support from our Association President to Committee staff, and so we will be very brief here. California is geologically the most diverse state in the nation.

Thank you so much for your time. Look forward to this process. Thank you to everyone who took the time to come and testify. Any additional questions, we're going to move on to the next board. Thank you very much, everybody. Appreciate it.

AEG strongly supports the goals and objectives outlined in the board's strategic plan, and AEG continues to assist the board's goal by helping to promote the importance of licensure to geology among students and early career professionals.

Thank you so much for being here. All right, we're going to start this next board. This is the review board for vocational nursing and psychiatric technicians. Joining us today are, I think, Carel Mountain, the Board President, and Elaine Yamaguchi, the executive officer on Zoom.

Are you both on Zoom or Webex. Sorry, Webex. You're right. I need to be correct. This is what happens when Mr. Berman steps away. What else can I mess up while he's gone?

Senator Archuleta, what else can we do? All right, let's go. All right. We appreciate you being here very much. We're going to get started. Go ahead.

Thank you so much to the Committee chair Ashby. Chair Berman and Members, thank you for this opportunity to present the board's hard work over the past three years. I'm Dr. Carel Mountain. It's my honor to serve as the BVMPT board President.

When we appeared before you in 2021, the Joint Committee was very clear with us our program approval process was not acceptable. We took that very much to heart. Before 2022, an organization could send in a letter of intent that only contained the name of the organization and the general area in which they plan to open a school.

Now, thanks to the authorizations from AB 1536 and the subsequent regulations, an entity must be ready before requesting to open a new school.

This means completed curriculum and policies, items that had represented the largest parts of the process. After our 2021 hearing, staff and legal counsel worked to upend the longstanding procedures, create clear, thorough forms and craft the necessary regulations.

We reached out to stakeholders, existing programs and groups that had expressed interest in starting new programs. A series of webinars was held explaining all of the facets of the new procedures and forms and the projected time frame for the whole process approval.

In recognition of the length of time some had been waiting, we opened the first round in 2022 only to those who had been on the waiting list before January 1, 2020. The bottom line is in 2021, our waiting list was more than 50. Today we do not have a waiting list.

Since 2021, 23 new vocational nursing programs have opened. In 2024, we are on track to see 12 new programs start. At this point, I am happy to introduce our executive officer, Elaine Yamaguchi.

Thank you, Dr. Mountain. Chair Berman, Chair Ashby. Members, thank you again for your time today. I know it's getting late, but I also wanted to say how much we appreciate the support and hard work of the Committee staff, and I would like to very briefly, very briefly address the board's overall health. In 2021, it was projected that without action, the board would be insolvent by this fiscal year. But today we have nearly nine months funds in Reserve.

AB 1536 authorized us to charge the schools and programs for the work on approvals for both new and continuing programs, and this was the first time that we'd been so authorized.

We definitely appreciated the support of the Legislature and the Governor, and while this was a very minor, modest increase to our bottom line, it was a very, very important starting point. So in the meantime, we increased our other fees to their statutory ceilings to ensure the board's viability.

And our next step will be to engage in a study of the board's overall fiscal operations and revenue streams and develop a permanent structure which would be sustainable and enable us to right size all of our fees. And the board is very committed to having this discussion.

We continue to look for efficiencies and cost savings. Right now we're in the process of renewing our lease and we'll be analyzing the best use of our space and resources, hope to make some cost savings there.

The board itself is close to our full strength. We do still need one LVN Member. Our meetings have been efficient and successful. I thank and commend our board members for their engagement, their enthusiasm.

I'm especially grateful to Dr. Mountain, our Vice President, Mr. John Deerking, for their leadership as our Executive Committee for the past several years. And of course, I'd thank our leadership team and staff for their dedication, their hard work and their sense of humor. And we'd welcome your questions.

Sense of humor is important to go along with hard work. Thank you very much for your remarks. Want to open it up to colleagues for any questions or comments? Senator Archuleta?

Yes, thank you. And thank you for the work you do and the board. Some of the issues that you've had in the past that keep coming up over and over is the number of nurses and practitioners, technicians that are trying to enter the field and the bottleneck and I guess the licensing and expediting those licenses so they can get to work.

The other thing is the fact that you mentioned schools and the accreditation and where there's a pathway from the school to continuing the education that's needed and the hours that are needed and then in turn finding the employment. Would you address some of those?

Dr. Mountain, would you like to start or should I?

I'll start and then I'll turn it back over to you. I wanted to address really quickly the idea that there's a bottleneck and what's happening with helping students get the education they need. Certainly we're moving forward with helping schools to open.

We want to make sure that those schools are providing adequate education and creating safe practitioners. Another issue that we have in the State of California that has been talked about a lot is clinical placements.

You can't expect a nurse to go to work if they've never touched a patient. There was a lot of discussion about this during the pandemic when certain students weren't able to go into the clinical area. For us at the board, patient safety, consumer safety is paramount.

And making sure that education aligns to create safe practitioners to provide the care is one of our most important duties that we do. Ms. Yamaguchi, over to you.

Thank you. I don't know that there really is a bottleneck per se. I think in terms of the vast majority of folks who come after school to become licensed, and we're talking about probably 8000 a year. Those are processed very quickly, in about a week probably.

There are, of course, individuals whose application processes aren't nearly so simple. We do, of course, have a couple of equivalency programs that are basically around the traditional path.

Those do take a long time and they need to, because it shouldn't be easy to become a nurse or a psych tech. It has to be very carefully monitored before we will let somebody take the test to become a practitioner. Senator, I'm not sure if we answered all the points you raised.

Well, yes, you have. And my concern is, in the communities in LA County that I represent, there's always the need for the nurses and clinics and so on, and I keep hearing that trying to get their license and getting that on the job training that they've got to have at the hospitals and clinics and everything else, and it's hard to get in there sometimes and then to find the employment thereafter.

I just wanted to point it out that I'm glad you're aware and you're working on it, and we're trying to make sure that the curriculum is tight and it's, as you said, patient oriented, patient safety and the professional that's needed in the industry that you've always been there for. I just wanted to address those issues and I thank you for the work you do. So, big shout out for you as well.

Thank you, Senator. But you are absolutely correct. There is and always probably will be a tight amount of resources in terms of clinical site placements for nursing students. And bluntly, especially in areas like LA County, most clinical sites would rather have an RN student than an LVN student or psych tech student. It's a sorry sort of State of affairs.

Thank you. Thank you, Mr. Chair.

Thank you very much, Chair Ashby.

Thank you. This is more of a statement, but one that I feel I need to make on the record so that, you know, since I'm a new chair to the position, that I do appreciate the discussions about schools, and I look forward to partnering with you guys and the other stakeholders to ensure that qualified students have access to quality, affordable programs as well as the necessary clinical training to promote patient safety. So thank you for giving me the opportunity.

Just to let you know on the record that I'm looking forward to working with you on that.

Thank you.

Thank you. Chair Ashby, regarding issue number four in the background paper, the new federal title four changes, if the minimum number of educational program hours were deleted, what would the approval process look at instead?

That is the very question, sir. Right now, we don't know. And we're waiting, I think, on some guidelines, some direction from the federal Department of ED, among other things, on the implementation date and timeline.

But if we were to, for example, just strike the number of required hours in our statutes and our regs. What we would then be faced with is a substantial amount of well, review analysis.

And I think revisiting curriculum reforms, curriculum requirements, because short of requiring hours, we're worried about just cutting that number. We would need to install some very rigorous criteria for what the lesson plans would include, what the clinical requirements would include, how they would be correlated without citing a number. Dr. Mountain, did you want to add to that?

I just think that the importance of making sure that especially vocational nurses and psychiatric technicians, their programs go by very quickly. Most of them are 18 months or less.

And so that delineating those hours has been really helpful in maintaining curriculum rigor, which is important when you have people that are interfacing so closely and intimately with the public. And so I would hate to see the hours just disintegrate.

I know there's been discussion about revising those hours or revisiting the way the curriculum is delineated, which might be more advantageous to maintaining public safety.

Thank you both, and definitely keep us in the loop as some of those discussions continue.

Absolutely.

With that, let's open it up to members of the public for anybody who has any questions or, excuse me, any comments to make. Just a reminder, two minutes per organization/person. And feel free to just say, me too. If somebody covered what you wanted to talk about.

Mr. Chair, Vice Chair, Senator Coby Pizzotti with California Association of Psychiatric Technicians, I would again like to hearken back to your court reporting comment of this would be a great pathway. Psychtechs LVNs would be an awesome pathway to work with CSBA and the School Counselors Association to get more people coming into the programs.

Post COVID, I could say our union has lost over 1000 members just as a matter of attrition through retirement. People did not want to work in the environment. We represent 5300 of the licenses.

There's approximately 8600 licenses in the state from a decade ago. There was over 12,000 of psychtechs. So I'm just trying to illustrate the point that there's not enough people coming into this program and yet looks like Prop one is going to pass.

We're going to build capacity in the mental health arena, yet there's not a lot being done to build the capacity to treat. We're building the programs, but not the treatment itself. So we wanted to really highlight and illustrate that point.

And then to the issue of fees. The board has the ability to raise fees on licensees. They have to come to the Legislature in order to raise or create, and then they created and then raise fees on the schools. When the board made the decision to raise fees on the licensees, they did it without a single licensee member of the board present.

So there's four licensed representatives on the board, two psych techs, two LVNs. Not one of them was present when that vote was taken.

So I just wanted to make that very clear. That raised the license renewal fees from 220 to 300. I'm trying to impress the point that we would like for the schools to pay their fair share because right now it's on the backs. The burden is on the backs of the licensees.

Thank you very much.

On that note, swish tag team. Exactly. Matt Back, representing the California Association of Private Post Secondary Schools. I wasn't really going to talk about the fees, but it was interesting to hear the board chair and staff say that they are in a good financial situation.

I think I heard nine months of fiscal Reserve, our fees were significantly increased. We had new fees in the last sunset or maybe in the 2018. But anyway, there are new fees. The fees that I saw in the report are substantial and certainly alarming to us.

Put that aside. Those fees and the other issues really won't matter if we don't fix the title four issue problem that we, as California did not create. The feds have now placed in our laps this title four issue, that 133 of the 150 some odd VN programs will be title four ineligible July 1, 2024.

That means all of the students you are talking about that you want to get into this profession will not have the financial tools to attend our schools. That is obviously, again, not a problem that we created. But the way that the title four law is written, it links to your home state's minimum requirements. So California is on the hook for those minimum requirements. 133 schools are above the minimum hours.

They've all been approved by the board. They're all operating in the state. Because we were approved at those numbers, it's beneficial to the students. Our test rates are better. There's reasons we do that with employers.

So we need to find a solution to that issue again, unfortunately, within the next four months. And Ms. Yamaguchi at her last board meeting said even if they dropped everything they do and tried to approve the 103 programs before July 1, they wouldn't be able to get there. So forcing schools or telling schools to go down to the 1530 is not a viable solution by July 1.

So we obviously look forward to working with DCA, the board, all of you, to find a solution before July 1. Thank you.

Thank you very much.

Good morning, chairs and Members. Kirk Blackburn here on behalf of Concord Career colleges. Also to briefly touch upon the title four issue, I just wanted to stress that once again, Concord educates nearly 1000 students per year. Without a statutory change or some type of fix before July 1, all these students will be ineligible for federal funding.

So just wanted to stress to Committee Members how critical this issue is and also wanted to thank executive officer Yamaguchi and the BBMPT for their prompt attention to it. Without the Legislature's timely help, schools, students and ultimately the health of the public will be negatively impacted. So thanks for all your hard work identifying a timely solution. Thank you.

Thank you very much. Want to give executive officer Yamaguchi or President Mountain an opportunity to make some closing comments if they want or not. You're good. Everyone's good.

It would be redundant at best. I think the points raised by our friends in the community absolutely. Well put. Absolutely things that we go to sleep thinking about.

We will be working as hard, as hard, and we look forward to, of course, help from the Legislature and your fine community staff, our community, our board, and also not to leave out our colleagues at other boards in DCA because this regulation package will affect a number of them. So I do believe that we'll be working together with a number of the other impacted boards and the department as a whole. Dr. Mountain, anything else?

I absolutely echo what you just said, and that is our goal, to support the schools always keeping patient safety in mind. And I just want to thank Elaine for all her hard work, too, in making all of this happen and really listening to the public and to the members of the board when we have concerns.

Thank you.

Thank you both. With that, we'll wrap up the board of Vocational Nursing and Psychiatric Technicians segment of the sunset review process. That's also the last board or entity to discuss.

So I just want to really thank, thank our staff on behalf of chair Ashby and myself, the Senate staff, the Assembly staff, who put in long, long hours to understand the nuances of all these important concerns that are raised and issues that need to be addressed. And with that, today's sunset review hearing is adjourned.