Assembly Standing Committee on Business and Professions

Good morning, everyone. Just so folks know why we're waiting, we're just waiting for a colleague from across the aisle to show up. We typically don't start until we've got a bipartisan group of Members, but I know that one is on his way, so we'll be getting started soon. It it. Okay, now I'm doing a public safety announcement or a public service announcement. Any Republican colleagues on the Committee, any at all who want to show up to room 1100? That would be fantastic.

So I promise you we don't bite. We've got some coffee in the corner. Can't test to how good it is, but it's coffee. So any Republican colleagues at all? We are here. Yeah, while I'm doing public service announcements, if any authors who have bills in the Committee this morning, we have 1, 2, 3, 4, 5, 6, 7 of you. If one of the seven of you would like to show up, we will be ready to go really soon I hope. So, please come to room 1100 to present your bill.

Or if you're a Republican, come to sit on the Committee. If any random Republican wants to substitute for another Republican, I'll consider. I'll take it under advisement. I actually see that we have a Republican who has a bill up and is on the Committee. So that's a twofer. And if they say it is not Ms. Aguiar-Curry, if they show up, we can get rolling. All right.

So it turns out the rule around having a bipartisan group of colleagues is really sort of a courtesy as opposed to a rule. So we're gonna get started now that Assembly Member Aguiar-Curry is here as a Subcommitee. Subcommitee? Is that what we call it? Sure. Good morning. Welcome to this morning's Business and Professions Committee Hearing. We have 13 bills on today's agenda, including the following five bills on consent. It'd be 1902 by Assembly Member Alanis. It'd be 1988 by Assembly Member Muratsuchi.

It'd be 2166 by Assembly Member Weber, and AB 2496 and AB 3119, both by Assembly Member Low. Please note that agenda item 13, AB 2862 by Assembly Member Gipson has been pulled by the author for scheduling purposes and will be considered at a later hearing. For each measure being presented today, we'll be allowing primary witnesses here in the room to speak for up to two minutes each, with up to two primary witnesses per side.

Any additional witnesses will be limited to name position on the bill and the organization. Hello. Hello. And the organization they represent, if any. For those wishing to provide further comments, we are accepting written testimony through the position letter portal on the Committee's website. With that, we're going to begin today's hearing as a Subcommitee. Assembly Member, a majority leader, Aguiar-Curry. We would love to hear AB 2223 whenever you're ready. When you're ready.

Good morning, Chairman. At appropriate time, may I use a prop?

We love props.

You might like this one.

A little early in the morning.

It's 5:00 somewhere. Good morning, Mr. Chair and Members. I would like to accept the Committee amendments and also thank the Committee staff for their work with us on this bill. You know, I started working in this space because the 2018 farm bill unleashed a largely unregulated industry. No products were subject to thorough testing, and intoxicating products were starting to pop up in smoke shops and gas stations with no age limits or protections.

My top priority has always been to protect the health and safety of California consumers, but I also wanted to allow people to continue using non-intoxicating health and wellness products. And the discussion was focused at that time on CBD. 8045 was the strictest hemp law in the country when it was enacted. It closed loopholes from the federal farm bill by implementing THC concentration limits, prohibiting intoxicating and synthetic cannabinoids, and setting rigorous testing protocols and labeling standards.

I'm working on AB 2223 to tackle some of the issues that have come up during the implementation of AB 45. As the hemp market grows, we're seeing more intoxicating hemp products that are sold outside of dispensaries without age limits, which should be illegal. This bill is another huge undertaking that takes on three issues: cracking down on illegal hemp products with local enforcement, closing loopholes that allow intoxicating hemp products, and integrating hemp into the cannabis supply chain.

We look forward to working with stakeholders, state agencies, and Committee staff as we address concerns about the best way to implement these changes. With me today are Karen Woodson, representing the California Cannabis Industry Association, and Kristen Heidelbach with UFCW Western States Council.

Great. Anyone is two minutes each.

Great. Good morning, Chairman Berman, Members of the Committee, my name is Karen Woodson and on behalf of the California Cannabis Industry Association and the California Cannabis Manufacturers Association, I urge your support for AB 2223. The cannabis license feels less and less like a privilege and more like a burden. In addition to navigating the unrelenting sales of cannabis products and illicit channels, the proliferation of unchecked and duty free hemp products available in gas stations and smoke shops has reached a fever pitch.

Two weeks ago, Total Wine and More made widely available to consumers hemp beverages, each containing five to 10 milligrams of THC per beverage. This action has triggered deep reactions from within the cannabis industry, a mix of outrage, opportunity, and fear, but mostly outrage. As detailed in CCIA's letter, every sale of THC beverages outside dispensaries robs the state cannabis Tax Fund of roughly $6.08. Worse still, that revenue loss puts the cannabis industry at dramatic risk of a tax increase.

The Prop 64 framework is broken, and that is why so many seek opportunities outside the regulated channel. Until policymakers tackle the systemic problems baked into the state's cannabis law, we will forever be addressing threat after existential threat. AB 2223 lays important groundwork needed to reimagine how we regulate cannabinoids for intoxication, regardless of whether they come from cannabis or hemp. Following the lead of 15 other states, it expressly authorizes the use of hemp in the cannabis supply chain and permits dual use facilities.

Integration ensures legal cannabis businesses can reduce production costs without compromising quality and safety. These result in more competitive pricing at the retail level and ensure cannabis products are more accessible to consumers. The bill also clarifies the definition of hemp, prohibits the sale of products containing dangerous or chemically synthesized cannabinoids, and establishes a total THC standard for hemp products. It also strengthens existing enforcement provisions. Cannabis products are excessively regulated and overtaxed. In contrast, intoxicating hemp products are under-regulated and subject to no special taxes.

This paradox provides an opportunity for brands, policymakers, and consumers to reimagine a legal framework for cannabinoids in California and beyond. Thank you, Assemblywoman Curry, for your continued leadership on this issue. And Members of the Committee, I urge your aye vote today.

Thank you very much.

Good morning. Kristin Heidelbach here on behalf of USCW, Western States Council here in support of AB 2223. We represent thousands of workers in the cannabis industry. We want to thank Assembly Member Aguiar-Curry for her work in this space. I don't think I need to do a deep dive on the challenges that the industry is facing right now.

We have unionized, regulated cannabis businesses that not only have high taxes that they have to deal with, an untenable illicit market, but now a shadow market that has emerged that they directly compete with. UFCW cares about this legislation because we want additional guardrails in place that protect our employers who pay good living wages, they support their communities, they're good actors, and they are struggling.

So we are obviously interested in the caps and also some of the packaging that is in this bill, but also about the enforcement. We need additional enforcement against the hemp products that currently are unchecked. Happy to answer any questions. Thank you.

Thank you very much. Anybody wants to add on in support of AB 2223? Add ons in support, if you just provide your name, organization you're with, if any, and position on the bill.

Talia D'Amato, on behalf of California Normal, in support.

Thank you.

Amy Jenkins on behalf of Canacraft, March, and Ash, and Spark in strong support.

Thank you.

Good morning, Mr. Chairman. Alberto Torrico, on behalf of the Joint Labor Management Committee for Cannabis of San Diego and Imperial counties, composed of UFCW and Martinez. Thank you.

Thank you.

Mr. Chairman, Members. George Miller, on behalf of Weed Maps in support.

Thank you.

Chair, Members. Alicia Priego on behalf of the California Cannabis Manufacturers Association, in support.

Thank you.

Zoe Schreiber, on behalf of Highlands Dispensary in support.

Thank you very much. Any primary witnesses in opposition to the bill? Come on up. You have two minutes each.

Testing. All good, Mr. Chair, Members. Mark Smith, on behalf of Origins Council here with an opposed unless amended position on 2223. We represent 800 members across the full cannabis supply chain, most of whom are small, independent, licensed cannabis cultivators. As mentioned, this bill has two parts. Part one, which establishes greater clarity around the rules for the existing hemp market, and part two, which enables the integration of hemp into the cannabis supply chain.

We find ourselves in alignment on part one. Those products should be more tightly regulated. Other than repeating that we think a 1 mg cap per packaging is still too high. We disagree on part two. This bill proposes to stop synthetic hemp derived cannabinoids in the hemp market, but at the same time, it completely opens the door to those cannabinoids taking over the cannabis market. The marketplace is awash in chemically synthesized THC like compounds that you've all heard of.

Delta eight, delta nine, delta 10, thc-o-acetate, HCC, and others. These intoxicants exactly mimic the effects of THC derived from the cannabis plant. While 2223 prohibits these synthetic compounds in the hemp market, it throws the door wide open to the unlimited incorporation of these compounds into the legal cannabis market at the point of manufacturing.

The bill proposes a prohibition on synthetic THC conversions in Section 26.003 that only applies to delta nine THC, not the dozens of other intoxicating synthetic compounds that I just mentioned and the ones that are going to be created in the future. This bill should be amended to prohibit THC or a comparable cannabinoid that has been diverted from a hemp derived cannabinoid. Period.

Further, because hemp agriculture is regulated exponentially more lightly than licensed cannabis cultivation, there exists a strong market incentive to utilize these cheap synthetic hemp derived compounds in cannabis products unless guardrails are placed around this activity. So what does this mean?

It means why would I subject myself to the licensing structure to become a legal cannabis grower in the state of California when I could pay a $900 fee to CDFA, grow hemp, sell my synthetically derived THC cannabinoids into the cannabis supply chain, and not have to deal with the regulations on cannabis?

And that's over two minutes. If you could wrap up, that'd be great.

Sure. So these are our top priorities. We believe that other issues must be addressed, but we would appreciate the Committee's concerns and ask you to respectfully vote no until this bill bans all hemp derived THC intoxicants from the cannabis supply chain. Thank you.

Thank you.

Good morning, Mr. Chair, I'm Doctor Lynn Silver, and Members, pediatrician on behalf of the Public Health Institute. I'm also a professor at UCSF and a member of DHCS's Prop 64 Advisory Group. Our position is opposed unless amended. We share many concerns with the Origins Council. We thank the majority leader for seeking to address dangerous lacunae in hemp law and lack of subsequent regulation.

We strongly support the provisions prohibiting the chemical cocktail of THC being marketed by a shameless hemp industry, whether outside or inside of cannabis retailers. And we support the critical enforcement and non preemption provisions of the bill. Pediatric poisonings from hemp and cannabis are up by over 3,000%, often requiring intensive care. In California, half of 10th graders who start using cannabis now start with hemp products. These highly intoxicating products, often blatantly attractive to children, are sold in smoke and vape shops statewide.

More and more students are arriving stoned, getting stoned at school and elementary schools are seeing group poisonings requiring ambulance evacuations. We're also seeing hemp induced psychosis cases. This bill does not currently resolve the key issue of intoxicating hemp products. It still allows delta nine THC edibles like this one in amounts far above legal cannabis edibles. However, we deeply appreciate the proposed amendments, which will substantially reduce risk, and we recommend that you accept these, but also make further improvements in the bill.

We recommend specifically clarifying the 1 mg amendment as per package, although we would like to see lower than that as noted in our comments and we agree with the Origins Council on that. We would like to see that limit added to the testing requirements of 11925. We oppose the sale of untaxed and loosely regulated final form hemp products by cannabis stores outside of the cannabis manufacturing pathway.

This will cut tax revenue, it will reduce childcare slots and youth programs funded by cannabis taxes which were already cut this year, and it will undermine legal cannabis cultivators.

If you could wrap up, that'd be great.

Almost done. We recommend deleting the pass for CDPH to approve new chemical cocktails not naturally present. And we call on making the prohibition of inhalable hemp permanent and deleting the addition of inhalables to the definition. Those are currently prohibited and should not be allowed. They're just a new path for youth initiation of smoking.

Thank you very much. Thank you very much. Appreciate it. We're going to have to try to keep tight because we've got a lot of bills and a lot of people have to run everywhere. Quick, we need one more Member to establish a quorum. So Members of the B&P Committee, please come on down. Any additional folks who want to add on in opposition to the bill providing your name, organization you're with, if any, and position on the bill?

Hello, good morning. My name is Adwoa Akyiano. On behalf of Youth Forward, and our position is opposed unless amended.

Thank you very much. Seeing no additional witnesses in opposition, bring it back to colleagues. Assembly Member Pellerin.

Thank you, Chair, and thank you to the author for bringing this bill forward. Am I understanding correctly that this bill, as written, would allow a cannabis manufacturer to buy hemp, convert it to a synthetic compound like delta 10 THC, and then incorporate that synthetic compound into a legal cannabis product sold at a legal dispensary?

So the bill would allow for cannabis manufacturers, in order to compete with the hemp prices, to bring in CBD, and then convert CBD into other minor cannabinoids like CBN or CBG. The intent is not to allow for conversion into delta into delta nines or THCs. The other issue to understand is that cannabis manufacturers are already beholden to a final form for every single batch that tests for total THC.

That total THC is capped at up to 10 milligrams or 100 milligrams per serving for edibles. So the idea that our intent is to bring in delta nines or tetrahydrocannabinols, that's not the goal. That's specifically what's prevented in the bill. What is allowed in the bill is to bring in CBD from the hemp market.

That would allow my products to be cut in price by about 20%, which would allow my edibles to finally compete not only with the illicit market, but the emerging shadow market for hemp.

If I may, Assemblywoman, so we respectfully disagree on that point. The bill specifically prohibits delta nine THC. The CBD's that are brought into the cannabis supply chain are synthetically distillated into intoxicating substances and they are concentrated and then put into the cannabis supply chain at dosages that are currently allowed and are intoxicating to consumers. And what they do is they replace the need for cannabis THC in the supply chain. Right.

I'm going to use just a quick analogy here, and you are all familiar with this with gun legislation. You don't ban a Glock 17 or a Glock 19. You ban a semi automatic handgun with a magazine capacity of more than 10 rounds. The same thing applies to this bill. We should not be banning individual substances by name. We should ban the notion of intoxicating THC derived from hemp in the cannabis supply chain.

And if I understood what the sponsors and the proponents of the measure just said, we are seem to be in agreement on that. If it's CBD or CBN, great. If it's a THC distillate, we don't want those. And we propose that you shouldn't have them. You will decimate the cannabis industry. People will just stop growing cannabis and they will start growing hemp.

Okay, thank you very much.

Thank you.

We're gonna take a quick break to establish a quorum before y'all run off to other things. Madam Secretary, please call the roll.

[Roll Call]

Great. We have a quorum. We have a motion, we have a second. Additional questions? Assembly Member Pellerin, wanted to bring it back to you.

Well, I continue to have some concerns about this bill and I'm hopeful that the author will continue to work with the opposition to work out the differences to make it more palatable for us. Is that.

Thank you. Yeah. Okay.

Absolutely.

Thank you. Any additional questions or comments? Yes, Doctor Bains.

I hope I get better at this one day. Yes. No, I just wanted to reiterate some of Assembly Member Pellerin's comments as well. And I just wanted to make it very clear that the concerning part for me is the level of THC that are in the drugs on the streets today. As a physician, I'm seeing high levels of drug induced schizophrenia in our children, and that is directly linked to the THC amount in our drugs today that are hitting the streets illegally.

So I want to make sure that everybody understands that the level of THC in the illegal drug market right now is not what we had 30 years ago. It is at high, high toxic levels that are really interfering with child development and they're developing in the future as well throughout their teens. Thank you.

Thank you, Doctor Bains. Good points. Any additional questions or comments? Seeing none. Majority leader, would you like to close?

I sure would. I appreciate the comments and absolutely, we can still work on this. As you know, this is evolving. I've worked on these issues for six years. It is changing every single day. And as I present this bill to you today, it will make products and practices safer and make it harder for criminals to sell illegal products. But that does not mean our work is done. This is what is sold in Total Wine.

It's an end cap. Blood orange mango North High Tonics, 10 milligram THC, lightly carbonated. I have this and another one. They're all over the place in those stores. They are not following the rules that we initially put into. So, yes, we're trying to close the loophole. This is absolutely, as Doctor Bains said, it's out of control. We want to put some more guard rails around it. People will try to figure out other ways, but we've got to stop this. This is about safety.

This is about where this is sold. This is about keeping our small businesses going. Mind you, I want to make sure those keep going. So I want to just assure you all that I will continue to work with all the stakeholders to implement integration in a way that supports our legal hemp and cannabis industries. We further empower our regulators to attack illegal products and protects public health. I commit to all of you, and you know I will do that.

They will update the Committee as those conversations progress. And I offer my expert witnesses if you'd like to meet with them or they would like to meet with you so we can make sure everything's clear. So with that, I respectfully ask for an aye vote.

Mr. Chair, I think those were samples she was going to give out to all the Members of the Committee.

You may never get out of this meeting.

That's going to be a caucus lunch. That's going to be a caucus lunch.

But I will tell you, these are pretty powerful.

Thank you. All joking aside, thank you to the majority leader for accepting the Committee amendments today. I'd be remiss if I didn't acknowledge the half a decade of leadership that you have shown on these issues and your commitment to continuing the conversation about how to reconcile cannabis and hemp regulation. I believe everyone we've heard from today, support and opposition agrees that these conversations are going to have to continue and that this bill is still a work in progress.

Another thing I think we all agree on is that it's important that we get this right. The issues around the intoxicating hemp loophole are serious, and I applaud you, the author, for keeping your door open as we work on resolving the many outstanding questions. In the meantime, I believe the amendments taken today move that conversation forward, and I'm happy to support the bill. Madam Secretary, please call a vote.

On AB 2223, Aguiar-Curry, the motion is do pass as amended to the Committee on Judiciary. [Roll Call]

Yeah, so that that bill's on call. We'll keep the role open for absent colleagues. And next up, I see Assembly Member Villapudua, Agenda Item Number Six: AB 2228. No, ma'am. I don't trust--I don't trust my colleagues. Assembly Member Villapudua, ready when you are. Got a motion. Have a bipartisan motion and a second. Just hit the mic button. Thank you, sir.

Can you hear me now? There you go.

Beautiful.

I'm proud to present AB 228 this morning. I would like to start by thanking the Committee and staff for their work on this measure. I'm happy to accept the proposal of technical amendments that cleans up the language within the current statute. This bill attempts to address two issues. First, it would allow the repossession agency to provide the required notice of repossession to the debtor by email or by mail sent to the current address if known.

This would ensure that the notice be sent more timely and with a greater care of private and sensitive information. The second is require the price storage of the debtor belongings to be kept confidential and for that price to be set by the repossessor who is in charge of storing and maintaining it all. This is the insurer interest of the third party financial institute cannot gain access to financial information that may prevent the debtor from reclaiming their valuable properties.

With me today to help address any technical questions you may have is Joe Collins with the California Associations of Licensed Repossessors, and Dave Pontana.

Thank you. Thank you, Chairman. I'll be very quick. As the Assemblyman stated, this is a very simple bill; does two things. What we're trying to do with this bill is just strengthen the confidentiality between the repossessor and the consumer who unfortunately had their collateral repossessed, and that is by ensuring that we strengthen the confidentiality of any fees that they may have paid.

So it's just between us and them, and we strengthen the confidentiality on their address so we get it to the right address so their personal information isn't being sent to some wrong address. With me for any technical questions you may have is Joe Collins, but if not, we're good.

Thank you very much. Any additional witnesses who want to add on in support of the bill, provide a name, organization you're with, if any, and position on the bill. Seeing none, any primary witnesses in opposition to the bill? Or tweeners or--please.

Thank you, Mr. Chair and Members. Megan Allred, on behalf of American Recovery Services, in opposition to the bill as written. However, we are working with the author's office to address major concerns we have with the bill, and it's our understanding that the original intent was simply a notification measure, so we look forward to working with the sponsors in the author's office to bring the bill back to its original form. Thank you.

Thank you very much. Any additional witnesses who want to add on in opposition to the bill? Seeing none, we have a motion and a second. Bring back the colleagues for any questions or comments. Don't see any questions or comments. Assembly Member, would you like to close?

Yeah. I'd like to share my appreciation for the opposition's willingness to work with this and on the language, and I reiterate my commitment to work with them on this issue moving forward. So with that, I respectfully ask for an aye vote.

Thank you, Assembly Member Villapudua, for bringing this bill forward with the technical amendments. I'm happy to support the bill today, and happy to hear that you're going to continue the conversation with folks who have concerns.

Absolutely.

Madam Secretary, please call the vote.

On AB 2228: Villapudua, the motion is 'do pass as amended to the Committee on Judiciary.' [Roll Call].

That bill's on call. We'll leave it open for absent colleagues. Thank you very much. And as Assembly Member Lee comes up, we're gonna take a quick break in the action to do the consent calendar. Madam, can I get a motion and a second on the consent calendar? Got a lot of them. We'll go motion with Vice Chair Flora; second by Assembly Member Lowenthal.

[Roll Call]

The consent calendar is on call. We'll leave the roll open for absent colleagues. Assemblymember Lee for AB 2444. Ready when you are, sir.

Well, thank you, Mr. Chair and colleagues. Good morning. First, I would like to thank the Committee staff for their work on the Bill. With us. This Bill will ensure that basic labor law information is provided to licensed manicurists because this industry will be subject to the AB 5 employer employee determination process, starting in January 1, 2025. When AB 5 became law in 2019, manicurists were exempt temporarily until January 1, 2022. The sunset date was later bumped to 2025.

With this change coming to nail salons, this Bill seeks to provide information to manicurists and nail salon business owners. The notification will be sent to the Department of Industrial Relations so the content will be correct. And going forward, manicurists would be provided this information through the Board of Barbering and Cosmetology as part of their license and renewal process. This is a common-sense notice Bill so that people working in nail salons know that the laws around their industry are changing.

With me today in support are Lisa Fu, the Executive Director at California Healthy Nail Salon Collaborative, and Tina Bui, a nail salon owner.

Great, and you both have two minutes each.

Hi. Thank you. Good morning, Chairperson Berman and Committee Members. My name is Lisa Fu. I'm the Executive Director of the California Healthy Nail Salon Collaborative. We are a statewide organization whose mission is to mobilize the nail salon workforce to transform the health, safety and working conditions of the nail salon industry. We and Asian Americans Advancing Justice Southern California are co-sponsors of the Bill. The overarching goal is to ensure that the BBC licensed community knows and understands their rights and obligations under California labor law.

Additionally, we believe that establishment owners and licensees have a right to be informed about the change in law in January 2025, in which the ABC test for classification will become applicable to manicurists. We think that's possible by asking the BBC to utilize existing forms of communication to inform the licensees of basic labor laws, such as quarterly newsletters, their license application process, and by also calling on DIR to notify establishment owners and manicurists of the change in law.

Both agencies have a stake in ensuring labor law compliance. Licensees are more likely to perform better at work and protect the health of consumers if they are being treated properly. Also, education of labor laws leads to informed and empowered licensees and prevention of noncompliance. This is a far better route to an equitable workplace than implementing enforcement efforts after the fact. So why is this Bill necessary? One, the statewide nail salon sector is growing.

It's made up of mostly Asian refugee immigrant women. 85% identify as female, and of the 81% born outside of the US, 82% were born in Vietnam. Two, manicurists are low-wage workers with a median wage of $10.94 an hour. That's less than half the medium wage of all other workers in the state, which is over $23 an hour. We've done focus groups and interviews and found that there's confusion when talking about classification of employees. This is also likely present among other licensees as well.

This Bill represents a modest and reasonable attempt to ensure that salon owners and workers get the information they need to provide and enjoy a fair and just workplace that all workers deserve. For these reasons, we urge a yes vote on AB 2444. Thank you.

Thank you very much.

Hello, Business and Professions Committee. My name is Tina Bui and I am a salon owner and a manicurist. I have been in nail salon industry for 28 years in Santa Fe, Marin County. I enjoy doing nails because, you know, I like a detailed job. I make people happy and talking to people. I can read and write and understand enough English to work in the nail salon, but it is not enough to understand policy and legal paperwork, labor law.

So it's helpful for owners and workers to learn about labor law in their languages because not all of owners and workers can read and write English fluently. Like me, I wasn't born and grew up here. Didn't have time to go to school either. I only can have conversation with customers. But labor law and handling labor-related documents, I'm not familiar. I understand the importance of having language access. We need to have all different languages.

This issue is not for me, but for all of nail owners and nail workers and everyone in the beauty industry to have the language in English, Vietnamese, Korean and Spanish. I request Committee to support AB 2444. Thank you.

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

Leah Barros, on behalf of Chinese for Affirmative Action in support.

Good morning. My name is Faith Lee with Asian Americans Advancing Justice Southern California. We're a co-sponsor in support. Thank you.

Thank you.

Good morning. Chloe Steck with the California Immigrant Policy Center in strong support. Thank you.

Thank you.

Mariko Yoshihara, on behalf of the California Coalition for Worker Power in strong support.

Thank you.

Good morning. Hello. My name Meng Chu. I work nail salon worker. I support AB 2444. Thank you so much.

Thank you very much.

Hello. Good morning. My name is Mary Nguyễn. I am on behalf of the California Healthy Nail Salon Collaborative. I am in support of this Bill.

Thank you.

[Translation needed].

Sorry, just a quick translation. She is a nail salon worker and she is also in support of AB 2444.

Thank you very much.

Hello everyone. My name Min Ho. I support for AB 2444.

Thank you very much.

Good morning, folks. Vũ Nguyễn with the California Healthy Nail Salon Collaborative, and also a child of a nail salon worker, and I support this Bill.

Thank you.

Sydney Fang on behalf of Asian Americans and Pacific Islanders for Civic Empowerment, AAPI FORCE, in strong support of this Bill. Thank you.

Thank you. Any primary witnesses in opposition to the Bill, please come up. You've got two minutes each.

Mr. Chair and Members, Fred Jones on behalf of the Professional Beauty Federation of California. We're opposed unless amended. From our perspective, this well-intentioned Bill is to prepare one sector of our industry for Armageddon Day, which is this January 1. Our amendments would avoid Armageddon Day for this particular sector of our industry. Assembly Bill 5, which I worked closely with Assemblymember, then, Lorena Gonzalez in drafting an exception to the ABC rule in AB 5 specifically for our industry. Our industry includes hair salons, skin and nail salons.

At the last minute of AB 5, a sunset was put in on that exception only for the nail industry. That sunset date was extended four years ago with a Committee Bill, unanimous support. We would recommend you extend that sunset as a matter of equity, treat the nail sector the same as the hair and skin sector of our industry, which has an indefinite exemption to the ABC test. I say Armageddon.

The idea of trying to get 95% of these salons that utilize independent contractors to, by January 1, make them all employees and educate them of what the requirements are in an employer-employee relationship, I would argue from a practical perspective, will be impossible. The State Board of Barbering and Cosmetology has an opposed position on this Bill because the mandate required of them of this Bill is practically impossible.

Even with the amendments, recent amendments to the Bill, they still license 55,000 establishments and don't distinguish between nail, hair or skin. So every establishment will get loads of new paperwork as part of their license renewal application. So while I admire and appreciate the intent of the Bill, from a practical perspective, January 1 will be Armageddon day for the nail salon sector if the exemption is not extended. That's what we request.

Thank you very much. And one point for clarification is that the Board of Barbering and Cosmetology removed their opposition with the amendments to the Bill. But appreciate all the comments you made. I want to bring it back to, excuse me, any additional witnesses who want to add on in opposition to the Bill, please provide your name, organization you're with, if any, and position on the Bill.

David Bolag, Neighbors of the 40th Assembly District for Sane Legislation, 22-year cosmetologist in opposition to this as the opposition has spoke. Thank you.

Thank you. Thank you very much. Any additional witnesses in opposition? Seeing none, bring it back to colleagues for questions or comments on the Bill. Assemblymember Carrillo.

Just want to thank the author for bringing this legislation in front of us. As an immigrant myself, I know what it's like to come to a foreign country, having to learn the language, having to assimilate to the culture, nevertheless, working hard in search of the American Dream. I want to thank you for bringing this in front of us. And I want to thank the speakers that came up to the microphone because I know how difficult it can be and how intimidating it can be.

Thank you for bringing this in front of us. And if there hasn't been a, I'd like to move the Bill.

Got a motion. Got a second. Any additional questions or comments from colleagues? Seeing none. Assemblymember Lee, would you like to close?

Yeah, I would just like to thank the Committee, of course, for working with us on amendments to address some concerns out there. Of course, this Bill is set in a larger context of AB 5, but like it or leave it, you have to make sure that this workforce, the nail salon industry workforce, is going to be brought along on the ride. As you've heard, the majority of this workforce are Vietnam-born and women. And this industry is very unique in that sense.

So we want to make sure that the folks are armed with all the information they can to be in compliance. And this is really all that's about. It's about language and cultural competency. And I request your aye vote.

Thank you very much. Excuse me. Thank you, Assemblymember Lee, for working with the Committee on this Bill and working out some issues that were raised prior to today's hearing. And I believe any remaining issues will be discussed when this Bill is heard next in the Assembly Labor Committee. And in the meantime, I'm happy to support the Bill today. Madam Secretary, please call the vote.

AB 2444 Lee, the motion is do pass to the Committee on Labor and Employment. [Roll Call].

That Bill is on call. We'll leave the roll open for absent colleagues. Some Member Maienschein, you've got two bills, AB 2270 and AB 2581. Pick your poison, whichever you prefer.

Thank you very much, Mister chair and Members, you mean to just start with 2270? Okay. I'd like to start by accepting the Committee amendments as proposed in the analysis. According to the National Library of Medicine, understanding menopause is crucial for both the individuals experiencing it and for healthcare professionals alike.

However, despite its significance, there exists a widespread misconception surrounding menopause. This leads to a lack of understanding for those experiencing it and delays in receiving appropriate care. AB 2270 aims to address this by allowing medical and behavioral health providers to take a course in menopausal mental or physical health within their scope of practice to satisfy continuing education requirements. By increasing awareness and understanding the issues surrounding menopause, we can ensure that individuals receive the care and support they need. Thank you. And I respectfully request an aye vote.

Thank you very much. Do you have any witnesses in support of AB 2270? Come on up, you've got two minutes. You could turn on your mic.

David Bollog, representing the SFV Alliance and neighbors of the 40th Assembly District for Sane legislation. We're happy to support this legislation. Menopause is something that will affect all of us if we live long enough. It has more severe effects on us, on some of us, than others.

It's usually more harsh on our female friends and family. If I pertly witness my mother's menopause compound into other detrimental health issues she was going through, escalating into an early death for her. I am currently watching a close friend having this affect her life in a not so pleasant way. The more that could be understood by medical professionals, the better off California will be in helping people who are suffering during this stage of maturation.

The understanding should result in a better quality of life for people going through menopause. Legislation is many times incremental, many times it builds on itself. I hope that this is something that will blossom in the legislative sessions and years ahead to where we start having more encouragement of studying of this subject in the healing arts and more public recognition of the subject. Please support and vote yes on AB 2270.

Thank you very much. Anyone else in support of AB 2270? Seeing none. Anyone in opposition to 2270? Seeing none. Bring it back to the Committee. Any questions from Committee Members? Miss Bains?

Yes. No, I would like to thank the author for this important Bill. As a Doctor, I am really concerned that there isn't enough research around menopause and making sure that we treat appropriately, but also that society understands more and more about menopause itself and the impact it makes. Not only to the person, but, but the family around them as well.

Thank you very much. Any other questions from the Committee? CNN Mister Maienschein, would you like to close? Thank you very much. And I'd respectfully request an I vote. All right, second. We got motions in a second. Madam Secretary, please call the roll.

[Roll Call]

Thank you very much. And next up, you've got AB 2581.

Thank you Mister Chair and Members, I'd like to start by accepting the Committee amendments proposed in the analysis. Maternal mental health conditions are the most common complication of pregnancy and birth, impacting one in five people. 75% of people impacted by maternal mental health conditions remain untreated, increasing the risk of long term negative impacts on mothers, babies and families. Giving all healthcare and behavioral health providers training in maternal mental health is essential.

This will provide them with the tools to support patients effectively during and after pregnancy. AB 2581 expands on my Bill AB 845 from 2019 and extends the continuing education requirements for maternal mental health from physicians and surgeons to all medical and behavioral health professionals. AB 2581 would allow continuing education requirements for healthcare and health professionals to be satisfied with a course in maternal mental health.

By doing so, we empower our healthcare professionals, enabling them to understand maternal mental health and treat their patients effectively. Thank you and I respectfully request and aye vote. With me here to testify in support is Ryan Spencer from the American College of Ob-Gyns.

Thank you very much.

Thank you, Mister Chair. Ryan Spencer on behalf of the American College of Ob-Gyn's district nine in support of AB 2581. Maternal mental health conditions, including depression, anxiety and perinatal mood disorders, affect a significant number of women during the pregnancy and postpartum period. These conditions not only impact the well being of the mother, but also have profound effects on the health and development of the newborn. The barriers to effective identification and management of these conditions are multifaceted. They include lack of awareness, insufficient training, and stigma surrounding mental health issues. Enhanced training for obstetricians, gynecologists, and other healthcare providers involved in maternal care can bridge this gap.

By providing an option for providers to be educated on maternal mental health, they can be equipped with the knowledge and skills necessary to recognize the signs and symptoms of maternal mental health conditions, conduct appropriate screenings, and provide a refer for necessary treatment. Evidence suggests that early identification and intervention for maternal mental health conditions can significantly improve outcomes for both the mother and child.

Training should therefore not only focus on diagnosis but also creating an environment where women feel supportive and empowered to seek help without fear of judgment. Furthermore, ACOG advocates for multidisciplinary approach in the management of maternal mental health, involving collaboration between obstetricians, mental health professionals, pediatricians, and other relevant healthcare providers. This comprehensive strategy ensures that women receive the holistic care they need during this vulnerable period.

Helping an array of healthcare providers to better identify and manage maternal mental health conditions is a direct investment in the health and well being of mothers and their children. AB 2581 provides this pathway and I ask for your aye vote. Thank you.

Thank you very much. Any additional witnesses in support of the Bill who want to add name, organization therewith, if any imposition on the Bill?

David Bolog, SFV Alliance and Neighbors of the 40th Assembly District for Sane Legislation in support of this. Thank you so much, Mister Maienschein. This is a very important issue. A lot of times it's dismissed by doctors and family members, and I appreciate you bringing it to light.

Thank you. Any additional witnesses in support? Seeing none. Any witnesses in opposition to the Bill? Seeing none. Bring back the colleagues for questions or comments. Got a couple of questions. Going to start with Assemblymember Pellerin.

Thank you to the author. These are great bills, and we really need to be focusing on people's mental health, especially around maternal and menopause. I'm just curious, why is it optional for the course and not mandated?

It's optional because they have, for all their continuing education requirements- I am sure Ms. Bains could comment more on this- but they're allowed to choose between sort of a menu of. So it's part of how they feel it interacts with their practice.

Doctor Bains.

Yeah, no. So in the training of a physician, this is something that is largely part of our training already. The biggest issue right now is workforce. Having enough access to prenatal care and also finding somebody that's dually boarded in family medicine and psychiatry, or, like for me, having a fellowship in primary care psych. So getting people that have that extra training, those options are there.

It definitely dwindles down to having the workforce to properly address the continuing issues that are coming up in our community. Again, thank you for a great Bill. Would love to be added on as a co author on this and the menopausal Bill as well, and I thank the author for that.

Any additional questions or comments from colleagues? Seeing none. Do we have a motion? Got a lot of motions in seconds. Appreciate you all.

That's a good sign.

Never bad. Assemblymember, would you like to close?

Thank you very much, Mister Chair and Members. Thank you for the comments, and I respectfully request an aye vote.

Thank you, Assemblymember, for presenting this Bill. It's certainly important that medical and mental health care providers have adequate education and training to support the mental health needs of individuals during and post pregnancy. With your agreement to amend the Bill as outlined in the analysis, I am happy to support the Bill today. Madam Secretary, please call the vote.

On AB 2581, Maienschein, the motion is do pass as amended to the Committee on Appropriations. [Roll call]

That bill is out. Thank you very much. So we have a break in the action. We are trying to track down authors--no, his are on consent--but we do have a couple of bills that are on call, so why don't we run through the bills that have been presented so far and see if we can get some motions and seconds?

Assembly Member Chen presenting AB 3097. Ready when you are, sir.

Thank you, Mr. Vice Chair. Committee Members, thank you so much for your time and allowing me to present AB 3097. First want to thank the Committee for their hard work on this, and we're happy to take all the Committee's amendments. After a series of conversations with stakeholders, I'm happy to present this piece of legislation which serves as a title protection bill for radiologist assistance. This bill outlines the requirements and limitations for those who want to serve patients as a radiologist assistant. Our primary goal is to ensure patient safety.

Those who want to refer to themselves as a radiologist assistant must meet several criteria, namely passing the radiologist assistant exam, maintaining up-to-date registration, and working under the supervision of radiologists. We're proud to have the support of many of the rad tech and radiology organizations here in California. With that, I believe we have witness testimony. We have Leo Baca, a radiologist practitioner here to share his own experience.

Thank you very much. First witness, and two minutes apiece, please.

Mr. Chairman, Terry McHale with Aaron Read and Associates, representing the American Registry of Radiological Technologists. First of all, I want to acknowledge and thank the staff for their hard work on this. We have listened to Mr. Chi's suggestion for making this bill more artfully drawn and collaborative. He did such a great job that I almost considered wearing my hair in a hair bun today in homage for the work that he's done.

We have spoken to stakeholders to make it clear that this is not the creation of a new health care provider, but the recognition of radiological assistance who are already recognized in 31 states and federal agencies, a profession born from necessity in the 1990s to address physician shortages in the United States Department of Defense. Those shortages are exacerbated now in the mainstream, making this bill more necessary. We are pleased that we listened to and spoke with the stakeholders in the writing of the bill.

We spoke to the radiologists. We have spoken to the California Medical Association. We have heard from those who are concerned. The concerns, luckily, are not that they don't want the bill, but that they want these specialists to be able to work with their doctors also. Mr. Chi mentioned in his analysis that there is a concern of what the definition of a radiologist is, and so I think we can continue that discussion in terms of allowing other providers to work with them.

We have learned in the pandemic that we benefit from the efficiencies of qualified assistants who have matriculated in a Master's program, completed didactic and clinical education, and passed a national examination. Appreciate your patience, Mr. Chairman, and ask for an aye vote.

Thank you very much. Next witness, two minutes, please, and I'll move the bill.

Mr. Chairman and Members, my name is Leo Baca, certified radiologist assistant and U.S. Navy veteran. I currently have over 25 years as a radiologist assistant. The importance of this bill has come at a crucial time. We are living in a post-Covid era where professional staff shortages are mounting and procedural backlogs are growing.

During the pandemic, radiologist assistants were recognized in Executive Order and signed by Governor Newsom, which has since been lifted. During that timeframe, we were able to establish our role in the radiology community and make a great impact on the day to day imaging procedures. The many services we provide are and will be supervised by radiologists at all times. We radiologist assistants perform a number of procedures such as general fluoroscopy, genitourinary exams, and many needle procedures.

We also help protocol imaging exams and help staff development based on our experiences. By having a radiologist assistant perform these exams, we free up the radiologist to have them dictate those critical cases and expedite patient results to the referring physicians. Therefore, supporting AB 3097 ensures California's access and imaging services. Radiologist assistants are qualified imaging professionals with many years of experience in radiation protection and are clinically confident in performing these procedures. AB 3097 will be incredibly helpful in providing imaging services throughout California.

With Loma Linda University already here in the state and providing a reputable radiologist assistant program, the framework is in place to graduate qualified candidates to help with the ever-demanded imaging services here in California. For these reasons, we--all current radiologist assistants--are asking for an aye vote on AB 3097. Thank you again, Mr. Chairman and Members.

Thank you very much. Any other witnesses in support? Come on up. Name and organization, please.

Ryan Spencer with the California Radiological Society, in support.

Thank you.

Christy Foster Bollman with--I'm an RA--and I'm with Gurnick Academy of Medical Arts and California Society of Radiologic Technologists. Ask for your aye vote.

Thank you very much. Anyone in opposition to AB 3097? Seeing none, bring it back the Committee. Any questions for Committee Members? Seeing none, Mr. Chen, would you like to close?

Thank you, Mr. Vice Chair, and respectfully ask for an aye vote.

Thank you very much. You seconded? Madam Secretary, please call the roll.

On AB 3097: Chen, the motion is 'do pass as amended to the Committee on Appropriations.' [Roll Call].

That bill's out. We'll leave it open for absent Members to add on. We're going to just kind of go through the file and just add on for Members. We'll start with the consent calendar.

[Roll Call].

[Roll Call]

Thank you so much, Mr. Chair. Apologies. Chairing Committee hearing over in the Capitol building, and I would like to start by thanking Committee staff for their work on this bill and I'll be accepting the Committee's amendments. AB 2133 would allow registered veterinary technicians to perform cat neuters under the direct supervision of a veterinarian. California's animal shelters are overwhelmed by a constant onslaught of unwanted cats and dogs.

Since COVID, the influx of animals have become so intense that shelters have had to make difficult decisions to euthanize healthy adoptable animals to make space for new arrivals. Fortunately, spay and neuter surgeries are an effective means of limiting the unchecked pet population. These surgeries sterilize animals, preventing the birth of unwanted litters. However, California does not perform nearly enough spay and neuter surgeries to curb pet overpopulation.

The University of Florida estimates that as of 2022 there was a 2.7 million surgery shortfall across the nation. Though many factors contribute to the spay and neuter deficit, data indicates that the ongoing veterinary staffing shortage has significantly impacted surgery availability. The UC Davis Correct Shelter Medicine Program reports that a lack of practicing veterinarians has resulted in more than 40% of California's shelters being unable to provide constant spay and neuter treatments to their animals.

Furthermore, the program has shown that 80% of shelters cannot offer low cost spay and neuter services to their communities. Clearly, there's a pressing need to increase spay and neuter staffing. One way to address this shortfall is to allow RVTs with the necessary training to provide cat neuter services. RVTs are already tasked with many surgery adjacent responsibilities, including administering anesthesia and dental extractions. AB 2133 recognizes RVTs's potential by allowing them to perform cat neuters under the direct supervision of a veterinarian.

Committee amendments ensure that this privilege will be paired with robust safeguards. RVTs will be required to complete a training that has been approved by the Veterinary Medical Board and then will have to be approved by the board before they can be before they can begin performing surgery. The bill is limited to cat neuters as I recognize that increased risk presented to spay surgeries and dog neuters. Due to this risk, these surgeries should be handled by veterinarians.

With me to provide supporting testimony are Nancy Ehrlich, California Registered Veterinary Technicians Association and Doctor Richard Johnson, founder and President of All God's Creatures Teaching Hospital and Surgery Center.

Thank you very much first witness. Two minutes a piece, please, and I'll second it.

Hello, Chair and Members. My name is Nancy Ehrlich. I'm a registered veterinary technician and I'm the Regulatory Legislative Advocate for the California Registered Veterinary Technicians Association. California has a pet overpopulation crisis while simultaneously having a shortage of veterinary staff. This bill is one small step toward fixing these linked issues. Right now, there are roughly 8,000 RVTs in the state, compared to about 11,000 veterinarians. Why so few RVTs than there are veterinarians? RVTs leave the profession on an average of after seven years.

A big reason for this is that there is very little room for career advancement in the RVT profession. RVTs who have been on the job for many years are restricted to the same tasks that an entry level RVT is allowed. This bill expands the tasks allowed so that more experienced RVTs may be incentivized to continue their career in the field. It is important to note that only RVTs who have the training and who the veterinarian deems qualified would be neutering cats.

I will add that during my lengthy career and 50 years of attending Veterinary Medical Board meetings, I have never observed a case of complications from a routine male cat neuter. This bill will help the veterinary profession by giving RVTs a new lane for career advancement, while also expanding the capacity for sterilization surgeries to help solve the pet overpopulation problem. It is a win-win win all around. Thank you for your time.

Thank you very much. Next witness, please. Two minutes.

Hello, Chair and Members of the Committee, thank you for the opportunity to speak. I am Doctor Richard Johnson, founder and CEO of the Vet Tech Nursing Academy in El Cajon, California. I have taught veterinary technicians for the past 40 years at many different schools across the country. I was on the Veterinary Technician Committee for the Veterinary Medical Board for nine years and won the CVMA Doctor of the Year award for my support of veterinary technicians. I am well familiar with the technicians' education and abilities.

I'm a strong support of AB 2133 for several reasons. First and foremost, veterinary technicians are currently very capable and allowed to do the following. And these are procedures that would be required in a cat neuter situation. Induction of anesthesia. They can create a relief hole in the skin to facilitate a catheter placement, which is no different from making a small incision in the scrotum, suture, cutaneous and subcutaneous tissues.

While the scrotum is not sutured during the cat neuter procedure, the spermatic cord is ligated and the testicle removed. And the cut end of the spermatic cord can be visualized from any bleeding. It does not retract into the abdomen and entire procedure is outside the abdomen. This procedure will require standardized training and certification before the technician will be allowed to perform the procedure.

Adding feline castrations to the list of procedures that registered veterinary technicians may perform will make a significant decrease in the pet overpopulation problem that has plagued us for decades. Access to care is decreasing and in our small survey, local hospitals, the time wait for a feline castration was anywhere from two weeks to three months.

Increasing the scope of the practice of our registered veterinary technicians will increase their job satisfaction, which will help retain them in the field and decrease compassion fatigue of these extremely valuable team members.

Thank you so much for that. Appreciate that. Anyone else in support? Name and organization to AB 2133.

Hi, Nicholas Sackett for Social Compassion in Legislation. Proud sponsors of the bill, in support.

Thank you. Anyone else in support? Seeing none. Anyone in opposition to AB 2133? Come on up. Two minutes per witness.

Thank you, Mr. Vice Chair. My name is Grant Miller. I'm the Regulatory Director at the California Veterinary Medical Association. I'd like to thank you, like to thank Eddie for working on this bill. Unfortunately, the amendments don't remove the CVMA's strong opposition. But we do appreciate the thinking that went into the amendments. And also we'd like to thank Assembly Member Kalra. We have a longstanding relationship with him as well as the sponsors for engaging us early on the measurement.

We appreciate the RVT profession and the important contributions that it makes to veterinary medicine. But we feel that it's unacceptably dangerous to try to teach something as advanced as surgery as an on the job task. Especially in the case like this, where veterinarians actually aren't reporting that we're having problems getting cats neutered. I would like to yield the remainder of my time to Doctor Barbro Filliquist from the UC Davis School of Veterinary Medicine. And thank you very much.

Thank you very much. Next witness, please.

Thank you, Vice Chair Flora and Members of the Assembly Business and Professions Committee for your consideration of AB 2133. As said, I'm Doctor Barbro Filliquist and I'm a board certified surgeon and Chief of Service for the Small Animal Orthopedic Surgery Service at UC Davis School of Veterinary Medicine. My testimony today reflects my opinion on this bill and does not represent UC Davis as a whole. UC Davis officially has no position on this bill presently.

In my capacity as a surgeon at UC Davis, I'm responsible for teaching veterinary students how to remove reproductive organs of both female and male animals. These surgical procedures are among the most common ones performed by veterinarians, and all veterinary students undergo extensive training while in veterinary school to be able to safely and competently perform these procedures as a condition of licensure. The training involves education in several subjects that reach far beyond the actual surgical procedures themselves.

These subjects include anatomy, physiology, pharmacology, anesthesia, the principles of sterility, hematology, emergency medicine, and others. Neutering a cat is a complex, multi-step surgical procedure. It's not a snip snip easy task as some have contended. In fact, surgery represents one of the most advanced aspects of medical practice. To perform it safely and competently, a doctor must possess extensive knowledge not only to perform the procedure itself, but also be ready and able in an instant to recognize and react when things go wrong.

And as despite our best efforts, many things can go wrong in surgery. For instance, in the case of spaying and neutering, body tissues can tear. Unexpected anatomic findings can be discovered once the surgery commences, and the patient can physiologically crash under anesthesia. And in some instances, significant internal bleeding can occur. Response to these problems must be immediate and must draw on education in other areas of medicine that I previously mentioned.

Registered veterinary technicians as a component of their licensure have no training in performing surgery and insufficient training in the peripheral subjects to be able to address any complications that may arise. While we value registered veterinary technicians in practice, and I most certainly know that there's no way that I can do my job the way that I do it without the support and help from registered veterinary technicians.

We appreciate this, Doctor. Just ask you to finish up your thought please.

They're not equipped to be able to perform this surgery. So I respectfully ask you to vote no on this bill. And I'm available to answer any questions. Thank you.

Thank you so much for that. Anyone else in opposition to AB 2133? Name and organization please. Seeing none. Bring back the Committee. Any questions from Committee Members? Seeing none. Mr. Kalra, would you like to close?

Thank you so much, Mr. Chair. Appreciate an aye vote on this measure.

Thank you very much for that, Madam Secretary, please call the roll.

On AB 2133, Kalra, the motion is do pass as amended to the Committee on Appropriations. [Roll Call]

A Bill is on call. We'll leave it open for absent Members. Thank you. We have one more Bill. We're going to start back at the top of the file. We'll start with the consent calendar so Miss Irwin can add on.

[Roll Call]

Okay. While I catch my breath. Assembly Member Zbur, we're ready for agenda item number nine. AB 2442. Thank you, sir. Got that?

Good morning, chair Members. I want to thank give extend my sincere thanks to the Committee and staff for the diligent work on this critical issue. I also accept the Committee's proposed amendments. AB 2442 is sponsored by Planned Parenthood affiliates of California and Equality California. This Bill seeks to improve access to gender affirming care in anticipation of a surge in out of state patients seeking care in California.

In recent years, the number of states with laws or policies restricting access to gender ferbing care has increased dramatically, climbing from just four cases in June 2022 to 23 states in 2024. These laws and policies often impose severe professional or criminal penalties on medical providers and other professionals offering gender affirming care, making it harder for people to access gender affirming care in these states.

According to the US transgender survey, nearly half of transgender respondents have considered moving to another state due to anti transgender legislation 5% of respondents have already relocated. It is imperative that we proactively fortify our gender affirming care provider network to ensure timely access to care for both in state and out of state patients. AB 2442 requires the expedited processing of licensure applications for providers demonstrating a commitment to gender affirming healthcare or mental health care services within their scope of practice.

California has long served as a safe haven for reproductive healthcare and gender affirming care. AB 2442 reflects our state's commitment to upholding these values and ensuring equitable access to essential services. Today with me are Craig Pulsiver, representing Equality California and Doctor Benji Lanakay. Did I pronounce that correctly? From Stanford Medical to provide additional information and assist with questions.

Great. You each have two minutes.

Good morning chair and Members Craig Pulsipher on behalf of Equality California, proud to co sponsor this Bill to ensure that Trans gender, nonconforming and intersex people have access to essential healthcare. As the summer Member noted, over the past two years, the number of states with laws or policies restricting access to gender affirming care has increased dramatically, climbing from just four states in June of 2022 to 23 states in January 2024. And many of these laws impose severe penalties on medical providers.

As just one example, in Idaho, healthcare providers can be charged with a felony and face up to 10 years in prison for providing gender affirming care. The growing wave of anti LGBTQ legislation has especially harmed Trans youth, as highlighted by the Williams Institute's recent estimate that about one third of Trans youth in the US currently live in states that ban access to gender affirming care.

Following the Dobbs decision in 2022, California enacted legislation to expedite medical licensure for providers of abortion services to ensure that California remains a safe haven for abortion and reproductive health care. Similarly, given attacks on gender affirming care across the country, this Bill seeks to improve access to gender affirming care in anticipation of a surge in out of state patients seeking care in California, as well as medical providers who may relocate to California to provide this care.

To meet the growing demand and ensure timely access for both in state and out of state patients, AB 2442 will expedite medical licensure, the processing of applications for those providers demonstrating a commitment to providing gender affirming healthcare or mental health care within their scope of practice. This Bill is an essential and timely measure to strengthen our network of affirming healthcare providers and ensure that TGI people have access to the essential healthcare they need and deserve. I urge your aye vote. Thank you.

Thank you very much.

Good afternoon, chair and Members of the Committee, my name is Doctor Benjamin Laniakea and I have the honor of serving as the chief of the Stanford LGBTQ Adult Clinical program, where we provide gender affirming medical care as well in the scope of the spectrum of LGBTQ care. Today, I am testifying as an individual citizen and not a Member of my institution, or not representing my institution. Rather, I'm here today to ask for your support on Assembly Bill 2442.

We know that our LGBTQ patients, and especially the gender diverse patients, really struggle to find adequate healthcare, adequate gender affirming care, and every single major reputable medical organization has recognized this as medically necessary care. The World Professional Association for Transgender Health, the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, all are in agreement that this is medically relevant care. It improves suicidality rates, it improves anxiety rates, improves rates of depression.

We know that these laws in other states are driving people to consider and even to move and to relocate. These are parents. These are children. These are families who want to make sure that they're doing best by their family Members. These are providers who feel like they have nowhere else to go. They're not able to practice their medicine in their state. And as an example, our own primary care clinic at Stanford is booked out for six to eight months, actually overpaneled by 300 patients.

That means we have 300 patients, more than we actually have the capacity to see. But we don't want to turn anyone away. People who need this life saving care, this medically necessary care, we want them to be able to have that access.

So AB 2442 means that we're really going to make sure that we're prioritizing licensure applications for these physicians and these providers that are going to be providing gender affirming care, like neglect any of the requirements that are already in place, it just expedites it so that it doesn't take six months or sometimes more to make sure we get that licensure done for these providers. So now more than ever, patients and providers are turning to California as a safe haven.

And we really need to make sure that when they come here, we're ready to provide that for them. We're not changing anything about what the regulations are, what's needed, the care that we're providing.

Thank you very much. Any additional witnesses who want to add on in support of AB 2442?

Leah Barros, on behalf of Planned Parenthood Affiliates of California, as proud co sponsors in support.

Thank you.

Kathy Mossberg on behalf of APLA Health and Essential Access Health, both in support.

Thank you.

Good morning. Ruth Dawson with ACLU California Action and support. Thank you.

Thank you. I see we have a primary witness in opposition. You have two minutes.

Thank you. David Bollog, SFV alliance, neighbors of the 40th Assembly District for sane legislation and also for the Protect Kids Initiative. This Bill will expedite the licensing of the staff of the medical infrastructure that will provide more ways for our youth to sterilize and mutilate their bodies. On top of the legislation and actions that the proponents and the authors spoke about, there is also AB 665 that was been passed last session that will remain remove children from their parents without their parents knowledge.

There's also the mandated education through Education Code 51933, Section six, D six. If that did not inform children that they could be whatever gender they choose, children would not even have thought that they are a different gender. Without the indoctrination of our children, there would be very little need for these medical professionals to provide puberty blockers, cross sex hormones, breast removal, breast implantation, vaginal plastic hysterectomy and phalloplasty procedures. Since the ED code inflammation.

There has been a dramatic increase of youth in California attempting to seek gender, mental and healthcare treatment. Gender dysphoria is said to be a mental health disorder or issue that mental health and physical is necessary. Youth that are not mentally fully developed to understand the long term effects of their decisions. The courts and medical professions have agreed that part of the brain has not fully developed until the age of 25. Unfortunately, one of the results of gender affirming care can be and is infertility.

Puberty blockers can pause the maturation of sperm cells and thus affect fertility potential. Testosterone therapy in transgender men can suppress ovulation and ultra ovulation histology. Well, estrogen therapy in transgender women can lead to impaired spermatogenesis and testascular atrophy. The effects of hormone therapy on fertility is potentially reversible, but the extent is unclear. Having a chance of reversibility the longer it is implemented. Having less of a chance of reversibility, the longer it's implemented.

Gender affirming surgeries that include hysterectomies, surgical removal of one or both of the ovaries in Trans men, or removal surgical removal of the testes and Trans women result in permanent sterility. It is recommended that fertility preservation being introduced to the patients before the above treatment. Unfortunately, data shows that only 13% of the patients are introduced to this ideal. I speculate this might be because medical professionals are told not to gatekeep or attempt conversion therapy. We wouldn't want to talk to kids applying.

That's over two and a half minutes.

Thank you, sir. I appreciate that. For this reason, I believe this will cause more sterility in children that they don't really understand. So I ask you to vote no on this. Thank you.

Thank you. Thank you. Any additional witnesses in opposition to the Bill?

Thank you, Mister Chairman. Tom Sheehy. On behalf of PERK-ADVOCACY in opposition, we would only note that there are many other healing arts applicants for licensure that could also benefit from the same sort of expedited review that this Bill would call for. And if we don't add more staff to DCA, speeding up one group may slow down another group and that could hurt other segments of our society.

So why not add more staff and speed up the licensure process for everyone rather than picking out one particular group, a needy group, a valuable group, but not the only group in this state that could benefit from expedited licensure. Thank you.

Thank you. Any additional witnesses and support our opposition? Seeing none, bring it back to colleagues for questions or comments or motions or seconds. Got a motion? Got a second. Mister Lowenthal.

First of all, thank you, Mister chair. I want to thank the author for bringing forward this very, very important legislation. I don't want to discount the last comment that was just made, but there is absolutely. This is an exceptional population in the United States right now that is in the midst of crisis. And dare I say, while there are many groups that are in need of attention through the Department, this can be a life or death situation, and so we need to view it differently.

I'm exhausted by the ideological warfare that's taking place with this. I'm sick of this being used as a political hot potato over and over, and this is about values and what the values of our state are, what we stand for. So I thank you very much for bringing this forward.

Thank you, assemblymember. Any additional comments or questions from colleagues? Seeing none. Assemble Member Zbur, would you like to close?

I think I was just saying, gender affirming care encompasses care that is aimed at aligning an individual's body with their gender identity. And for many transgender individuals, this care is not merely elective but necessary for gender dysphoria and improving overall well being. As I said, 5% of respondents of this survey from other states have already moved because of what's happening in other states. And California has always been a refuge for Members of the LGBTQ community.

And so this Bill is important to making sure that we are there with this community, that we. That we have the resources to provide the care that they need. And I respectfully ask for your aye vote.

Thank you, Assemblymember, for introducing this Bill. I'll second the comments made by Assemblymember Lowenthal. And while the Committee amendments are intended to ensure that we can take a comprehensive look in the future at all the expedited licensure bills, there's no question that expanding access to providers of gender affirming care is essential. And I'm more than happy to support the Bill as amended today. Thank you very much, Madam Secretary.

[Roll Call]

That Bill is out. We'll leave the roll open for absent colleagues. Thank you, everybody. So folks who have missed votes can come back to BNP and we'll also run through the agenda to allow folks to add on.

[Roll Call]

[Roll Call]

Looks like we're good to go. B&P is adjourned.