Assembly Standing Committee on Business and Professions

For each measure being presented today, we will be allowing primary witnesses here in the room here in the room today to speak for two minutes each with up to two primary witnesses per side. You don't have to have two. Any additional witnesses will be limited to name position on the Bill in 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.

And with that we are going to begin today's hearing as a Subcommitee. And I see Assembly Member Haney is here for AB 2115. Ready when you are. Always a pleasure Mister Haney.

Same to you Mr. Chair. Thank you and good morning. AB 2115 will transform California from a state with the most restrictive methadone laws into a state that leads in accessibility for methadone treatment, which can save lives. Methadone is proven to be the most effective treatment for people with opioid addiction. It helps them change their lives and transition to sobriety. It works by easing the debilitating symptoms of opioid withdrawal for people who have quit drugs like heroin and fentanyl.

It also reduces the likelihood of dying from an opioid overdose by more than 50%. However, fewer than one in 10 people in the US with an opioid addiction are currently enrolled in treatment and thousands are dying each year. During the COVID-19 pandemic, the Federal Government relaxed many of the restrictions on methadone. These relaxed restrictions led to a higher rate of enrollment and increased patients access to this medication.

In April of 2024, the Biden Administration, recognizing that reduced reducing treatment barriers saves lives, adopted the COVID-19 rules and made them permanent. However, California continues to have outdated methadone policies that are more restrictive than federal regulations. This is leading to ambiguity for providers and patients, and ultimately results in less patients having access to methadone. Too many people are dying each year because of these unnecessary laws and bureaucratic hurdles.

The intense requirements, like standing in line every day to receive a single dose of methadone, often dissuades patients from pursuing care. They have to spend far too much time getting enrolled and then staying enrolled, and other aspects of their recovery, like finding a job and stable housing, are often interrupted. It often becomes easier for them to self medicate their symptoms by buying drugs off the street.

And additionally, drug dealers are keenly aware that people with addiction is gather every morning at these clinics and they often prey on these vulnerable people as they wait in line for the medication. California's laws need to be updated so that patients are able to access medication that can save them, not illicit drugs that can kill them.

AB 20115 will allow them to do that by making sure California methadone regulations are aligned with federal law and make sure patients can easily access treatment, remove ambiguity and prevent unnecessary deaths. With me today in support of the bill is Dr. Hom from SF Department of Public Health and Dr. Leslie Suen, an Assistant Professor of Medicine at UCSF.

Thank you very much. Ready when you are.

Oh, sorry. Thank you. Thank you so much for the opportunity to speak with you today. My name is Dr. Leslie Suen. I am an Assistant Professor of Medicine at the University of California, San Francisco. I am here today to speak on behalf of myself as an addiction medicine physician and primary care doctor providing substance use treatment as well as a health services and policy researcher in support of AB 2115.

Methadone is our nation's oldest medication for opioid use disorder, with over five decades of evidence showing its effectiveness in reducing deaths, drug use, crime, and improving rates of recovery. Methadone is also the most highly regulated medication in this country. In fact, California is one of the most restrictive states when it comes to methadone regulation. Many patients have nicknamed methadone "liquid handcuffs" because of how disruptive being on methadone is to their daily lives.

Many patients, for example, under current state regulations in California, have to attend their clinic daily for months to be observed while taking their medication, often commuting several hours each day. During the COVID-19 pandemic, the Federal Government loosened these restrictions to allow patients to shelter in place at home. This included allowing patients to receive doses of methadone that they could take home instead of having to come to the clinic every day.

Research in the past four years has revealed that with less restrictive COVID regulations, these patients were more likely to be retained in treatment and reported overall improved quality of care. The feared consequences of increasing doses, overdoses from methadone also did not occur. Based on these data, the Federal Government codified these exemptions into law as of this month. However, we as physicians in California must still abide by state restrictions from the pre-COVID era, preventing our ability to provide up to date care.

If passed, AB 2115 would codify these new federal regulations into California state law allowing substance use treatment providers to follow federal guidelines on methadone treatment and reduce barriers to accessing care, improving our ability to address the opioid epidemic. Individuals would be able to receive more doses of methadone to take home when they enter treatment, avoid disrupting other parts of their recovery, like obtaining a job or securing housing.

And if you could wrap up, that'd be great.

Thank you for inviting me to testify in support of this important bill, and I look forward to answering your questions.

Thank you very much.

Good morning Chair Berman, Vice Chair Flora, members of the Business and Professions Committee. Thank you for the opportunity to testify in support of AB 2115. My name is Jeffrey Hom, and I'm a physician in Behavioral Health in the San Francisco Department of Public Health. There, I care for patients with opioid use disorder, also known as opioid addiction, and help lead our overdose prevention efforts. As you all know, we're in the midst of a profound public health crisis.

More than 100,000 people die of unintentional drug overdoses every year in the United States. During the first four hours of this hearing alone, five more Californians will die of an overdose. Four of them will likely involve fentanyl. While deaths are often the most visible manifestation of the overdose crisis, hundreds of thousands of people in California suffer from opioid use disorder. But opioid use disorder, like other chronic medical conditions, can be effectively treated with medications. Methadone is the oldest and most well studied of these.

It is our gold standard and reduces the risk of dying by 50%. Despite this, fewer than 5% of the nearly 1 million Californians with opioid use disorder are treated with methadone. We must increase access if we are to turn this crisis around and save lives. AB 2115 will help do this. This bill will allow clinics to provide 72 hours of methadone to patients while referring them to an opioid treatment program.

In doing so, patients experiencing painful withdrawal symptoms can obtain relief, without which they may seek fentanyl to palliate their symptoms and risk an overdose. This bill is particularly important for the 21 counties in California that lack an opioid treatment program. Rather than residents of these counties driving potentially hours to another county while in withdrawal and potentially still miss the intake window, people can begin treatment immediately.

It's important to note that AB 2115 simply aligns California law with federal law, which was recently updated to meet the needs of people with fentanyl use disorder and the clinicians caring for them. Other jurisdictions have safely implemented this updated federal law and successfully increased referrals to opioid treatment programs. As a physician, I have seen the damaging health consequences associated with severe opioid addiction, and I have talked with family members who have lost a loved one to an overdose.

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

But I have also seen how well people do when provided with social support and treatment. Recovery is possible, but we must ensure people across California have every opportunity to start this life saving medication. And so I ask that you support AB 2115. Thank you for the opportunity to testify.

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

Good morning, Mr. Chair. Jonathan Clay, on behalf of the County of San Diego in support.

Good morning. Josh Gauger on behalf of the County of Santa Clara in support.

Trent Murphy with the California Association of Alcohol and Drug Program Executives, in support with some clarifying amendments.

John Drebinger with the Steinberg Institute, in support.

Yareli Magayon, on behalf of San Mateo County, in support.

Thank you.

Lisa Gardiner with the County Behavioral Health Directors Association, in support.

Thank you.

Robert Harris, on behalf of the California Society of Addiction Medicine, in support.

Paul Yoder, on behalf of the California State Association of Psychiatrists, in support.

Thank you. Any additional witnesses in support? Seeing none, any primary witnesses in opposition? You have two minutes. Come on up to the desk if you'd like.

Just to clarify, the California Association of Opioid Maintenance Providers has a concerns position. With the Chair's permission, can I still?

Sure.

Thank you.

Yeah. Any, any additional witnesses in opposition? Just checking the room real quick. No, go for it. You've got two minutes.

Good morning, Chairman Berman and Members of the Committee. I'm Jennifer Alley, the Executive Director for the California Opioid Maintenance Provider organization representing California's narcotic treatment programs, commonly referred to as NTPs. COMP has been advocating for improving access to high quality, evidence-based medication assisted treatment using methadone for over 30 years. As such, we fully support the intent of this legislation to increase access to treatment for individuals with opioid use disorder.

However, we do have a concerns position on the bill and have submitted amendments to help strengthen patient and public protections. Since then, we have met with the sponsors and are making progress on some safety issues, and we are committed to continuing the conversation to help ensure public safety and access to treatment for individuals with opioid use disorder. During our next few meetings, we will continue our discussions and focus on the following items.

A referral process, as mentioned, ensuring that that's incorporated into the bill, so when somebody receives treatment they can get into into recovery through an NTP. Just make sure that there's a process to help prevent doctor shopping for individuals. Accessing methadone treatment education so patients are educated on the risks of methadone and its unique pharmacological properties and oversight.

What type of clinics they're going to be and data collection, so we can see what's working, what's not, and continue to improve access to a treatment for opioid use disorder. So I would like to thank the Committee and the Chairman for allowing me to speak today and I am happy to answer any questions you may have.

Great, thank you very much. Any additional witnesses you want to add on in opposition to the bill? Seeing none, bring it back to colleagues for any questions or comments. We're still a Subcommitee, so no motions or seconds yet. Don't see a lot of questions or comments. You did that good of a job with your presentation. Our staff did that good of a job with their staff analysis. Yes, combination of the two.

Such a great Chair, that's really a deciding factor.

Very good timing. Very good timing. Would you like to close, Assemblymember Haney?

Yes. We of course are in the midst of the worst drug overdose epidemic that our state and our country has ever seen. And I know we are all working in various ways to confront this epidemic. This is a solution. This is the most effective treatment for people who are addicted to opioids. Right now, California is the most restricted state in the country to access this medicine. With this bill we will make huge steps to get more people onto the treatment.

And we are continuing to work with folks who operate the clinics who have concerns to address these issues. And this is something that we can do that will help, that will save lives. And respectfully ask for your aye vote when the time comes. And thank you, Mr. Chair.

Thank you Assemblymember Haney. This bill is double referred to Assembly Health Committee next where I trust that you'll continue working with the stakeholders to ensure that the bill strikes that right balance between easing access to methadone treatment, but also ensuring that there are adequate safeguards so that the allowances and flexibility created by this bill aren't abused, which I know is everyone's goal. So with your pledge to continue tweaking the bill and working with folks. Happy to support it today, once we have a quorum. Thank you very much.

Thank you.

Appreciate it.

Thank you. So with that, we're going to move on. I see Assembly Member Bonta who has the first two bills up, AB 1991 and AB 2051. Dealer's choice. Whichever. We're going to, we're going to go in numerical order.

Good morning Chair and Members. I thank the Committee staff for their work on this Bill and gladly accept the suggested amendment. I authored this Bill because, as we all know, California faces more major shortages of healthcare workers isn't producing enough new workers to meet future needs, and the current healthcare workforce does not match the diversity of the state. These workforce supply and diversity problems have a major impact on health access, quality, and equity.

In order to address workforce supply and diversity issues, the Legislature has enacted various scholarship and loan forgiveness programs that encourage healthcare providers to work in underserved areas in exchange for the financial assistance or loan forgiveness that they receive. However, we currently do not have data on how long they continue to work in underserved areas after the financial assistance ends, which stymies our ability to build the robust workforce pipeline that we so desperately need.

This Bill simply requires healing arts boards that regulate healthcare providers to require rather than request certain provider data, most importantly their national provider identifier number. This information will provide the Department of Health Access and Information which oversees the loan programs with the data necessary to assess the extent to which these programs are working as intended. Testifying in support is Ronald Coleman Baeza with the Pan-Ethnic Health Network.

Good morning. Ronald Coleman Baeza, Managing Director of Policy with the California Pan-Ethnic Health Network, CPEHN. Happy to be here today to offer testimony in support of AB 1991, which would require certain boards regulating health healing arts licensees or registrants to provide the Department of Health Care Access and Information HCAI with the data necessary to assess whether loan repayment programs are working as intended.

HCAI administers several loan repayment programs in our state that were established to increase diversity of the healthcare workforce and to encourage workers to work in underserved areas. However, California continues to face worker healthcare shortages not producing enough healthcare workers to meet future needs. Additionally, the current workforce does not match the state's diversity and this certainly impacts the care that these individuals can provide our communities. Reports have found that Latino and Black workers are underrepresented in existing healthcare workforce in California.

AB 1991 would help support workforce supply and diversity programs to help improve the impacts of healthcare access, quality, and equity in our most underserved communities. For all of these reasons, we respectfully ask for your aye vote and thank Assembly Member Bonta for her leadership.

Thank you very much. Any additional witnesses who want to add on in support of the Bill? Seeing none. Any primary witnesses in opposition to the Bill? Oh, come on up. You have two minutes. Yeah, come on up. Whatever your preference, you can either come to the table or you can speak from there, whichever you prefer. All right. There you go. You have two minutes.

Good morning. My name is Doctor Rene Dumet and I am the Chair of the PsyD. Program at the California Institute of Integral Studies. My intent is to point.

Sir, I believe you want to testify on the next bill.

Oh.

Yeah. So we'll.

No. Well, this was.

There are two Bonta bills, AB 1991 and AB 2051. And I believe you want to testify in 2051. Yeah. So we'll get to that one next. In the meantime, anybody who wants to add on in opposition to AB 1991, seeing none, bring it back to colleagues for any questions or comments on the Bill. Seeing none. Assembly Member, would you like to close?

Thank you. This Bill is fairly straightforward. We absolutely need to be able to have the information to assess whether or not our loan forgiveness and scholarship programs are actually increasing access in the long term in underserved areas, or whether or not we need to make changes. Our workforce needs are too drastic to not do this. Thank you, Chair. And I respectfully request your aye vote.

Thank you. I want to thank Assembly Member Bonta for accepting the Committee amendments and for all of your work as health chair to promote diversity in our state's healthcare professional workforce. This is a priority that I strongly share as Chair of this Committee and I'm happy to support your Bill. And when the time is right, we'll get motions and seconds and do all the voting.

Thank you.

Thank you very much. And in the meantime, do you want to move on to the next Bill?

Yes, please.

Great. So we're going to go on to agenda item number two, AB 2051.

Good morning, Chair and Committee Members. I want to start off by thanking the Chair and Committee consultants for their very hard work on this complex piece of legislation. I will be accepting the Committee amendments and I hope that this Bill marks the start of a serious and continued conversation on workforce shortages and occupational licensure compacts. Occupational licensure compacts allow states to adopt policies that improve the transferability of professional licenses. Through licensure compacts, states establish and agree upon uniform standards that enable multiple, multistate practice.

PSYPACT he Psychology Interjurisdictional Compact was established in 2014 by the Association of State and Provincial Psychology Boards in consultation with the American Psychological Association. In the past 10 years, PSYPACT membership has grown to include 41 states and territories. PSYPACT enables licensed psychologists across these 41 participating states and territories to administer telepsychology or temporary in-person psychology across state lines. In 2020, due to COVID-19 psychologists across the country quickly shifted to online therapy.

Because of COVID-19 office closures and the like, the number of psychologists using telehealth grew from 33% in 2020% to 50% in 2021. Also during the pandemic, many college students returned home and families across the country moved or temporarily relocated, and psychologists were presented with another challenge for continuing care provision. Many practitioners were no longer able to provide services to their patients because they had moved outside their State of licensure. Between 2021 and 2022, 22 states joined PSYPACT to be able to better serve the mental health care needs of their constituents.

California was not one of them. In California, mental health affects one in six people. Yet according to a 2018 poll, more than half of Californians 53% surveyed reported that they have been unable to access needed mental health services. According to the Steinberg Institute, California will need to add approximately 30,000 psychologists to California's workforce over the next 10 years in order to meet the growing need for behavioral health services.

With approximately 24 licensed psychologists in California today, the state will need to more than double its workforce over the next 10 years to give Californians the mental health care they desperately need. This cannot be done through workforce pipeline, programs alone, or investments. AB 2051 will expand California's psychology workforce by increasing patient access to psychologists across 41 other compact states and territories and allow for continuity of care when patients travel or relocate.

By not leveraging the benefits of occupational licensure compacts like PSYPACT, California is missing out on the telehealth advantages that Federal Government and other states are actually utilizing right now. I'll turn it over now to our Bill sponsors Tara Gamboa Eastman from Steinberg Institute and Danny Thirakul from Mental Health America.

Great, and you have two minutes each.

Good morning, Chair and Members Tara Gamboa Eastman with the Steinberg Institute, proud co-sponsor of AB 2050, California faces a crisis. Substance use rates have skyrocketed, tens of thousands of people are struggling with addiction and mental illness, and our behavioral health workforce is overwhelmed and understaffed. California is already unable to meet the growing demand for behavioral health services due to the workforce shortage. However, attrition across the industry is going to exacerbate this shortage in the years to come.

Profession changes, workers moving out of state, and retirement are all contributing to the ever-growing shortage of professionals able to serve people. To get a handle on this issue, the Steinberg Institute recently developed a tool that estimates a 10-year estimate of hiring needs for the behavioral health workforce in California. Leveraging Federal Bureau of Labor Statistics data at the county level, this tool allows California to look at occupation-specific needs because of growth and demand and attrition rates.

Based on our estimate, California needs to add approximately 375,000 behavioral health professionals to meet demand over the next 10 years. Specifically, California will need to add approximately 30,000 psychologists to California's workforce over the next decade. For reference, there are currently only around 24,000 licensed psychologists in California. We must look for innovative solutions to address the gap in available providers. PSYPACT is one such solution. To date, 41 states have enacted PSYPACT legislation, joining the Interstate Psychology Compact.

By providing a means for psychologists to practice across state lines, PSYPACT increases access by expanding the pool of providers available to Californians in need. California can't afford not to join PSYPACT. We must use all tools at our disposal to address our behavioral health workforce shortage. Respectfully request your aye vote. Thank you.

Thank you very much. Next witness.

Good morning, Chair and Committee Members. My name is Danny Thirakul with the California Youth Empowerment Network and Bill co-sponsors Mental Health America of California. I'd like to begin my testimony by sharing a short story about someone we've been working with. We've changed their name to protect their identity. Jane was born and raised here in California and has experienced mental health challenges since she was a child.

She was able to work with a therapist, though continuously for six-plus years, and saw significant improvements in her recovery. But when Jane was 25, she decided to move across the country to attend graduate school. In conversations with her therapist about her impending move, Jane found out that she would no longer be able to see her therapist once she had left the state.

The move and added stress led Jane to experience exasperated mental health challenges, even though she was referred to a psychologist located near her apartment. Jane spent weeks and hundreds of dollars in the intake process getting to know her psychologist before she could actually begin therapy. Despite these barriers, Jane made real progress with her psychologist, and once she had finished graduate school, she got an amazing opportunity to come back to California.

But once again, she found herself in the exact same position she did when she moved out of state. I shared this story with you to emphasize how important continuity of care and maintaining access to a trusted provider is for people undergoing mental health therapy. California's psychology laws would prevent Jane from continuing to see her provider once again. Her story is not uncommon and is just one example of how current state laws surrounding telepsychology and telehealth aren't working for people with mental health challenges.

These laws don't provide the flexibility our modern lifestyles, especially post COVID-19 require. If the Legislature doesn't act to do something about this, people will miss out on the care that they want and need. So today I urge you to support AB 2051 to help Californians like Jane Access mental health services when and where they need them. Thank you.

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

Thank you, Chair and Members. Ryan Perrini on behalf of ATA Action in proud support. Thank you.

Thank you.

Good morning, Chair and Members. Tyler Rinde on behalf of the California Psychological Association, we have an in-between position. We have a support if amended. I appreciate the conversations with the author and the sponsor to date and our concern is to address that 34% of California's licensed psychologists cannot participate in PSYPACT under their current rules and look forward to further conversations. Thank you.

Thank you. Any primary witnesses in opposition to the Bill? Please come on up, two of you. And you've got two minutes each. Come on. Come on up to the table.

Okay

Take two.

Beginning again. My name is Doctor Rene Dumetz, and I'm Chair of the PsyD Department at California Institute of Integral Studies. My intent is to point out the devastating impact that Bill AB 2051 would have on regionally accredited schools who are ineligible to participate in PSYPACT and thousands of California licensees as well. According to the Board of Psychology, 34% of all registered psychologists in the state are from regionally accredited schools.

At CIIS, we believe that the adoption of PSYPAC would place our students at a severe disadvantage within the psychology marketplace and their clients who are disadvantaged and underserved. Most of our students work in community mental health settings with socioeconomically disadvantaged individuals, minority communities, and marginalized groups. Our schools, our Department, and our clinicians have always been at the forefront of social justice in psychological education and practice.

These types of clients seek to have clinicians who are similar in racial, ethnic, and socioeconomic status, who understand their unique challenges of discrimination, oppression, systemic racism, and classism. For many of these clients, they have needs to be mirrored to have a model that can be idealized and someone they feel similar to. These are crucial therapeutic elements in their growth and healing. All regionally accredited universities and colleges will also be deeply impacted by this implementation.

Together, we have produced hundreds of graduates every year and provide tens of thousands of clinical hours in California through the public mental health system. PSYPAC would leave these clinicians and their clients at a serious disadvantage and restrict the practice of teletherapy to those who are from APA-approved schools that do not support community mental health clinics that are the most in need of qualified clinicians.

Thank you. And if you can wrap up, that would be great.

Last thing. Finally, we believe the public is best served through multiple voices, diverse approaches, and culturally appropriate interventions. Anything that restricts the practice.

Thank you. That's. Thank you very much. Appreciate it. We got a long hearing today. Thank you very much. Next witness.

Chair, Vice Chair, Members of the Committee, my name is John Burke and I'm the Assistant Executive Officer of the California Board of Psychology. The Board opposes AB 2051. The promulgation of rules and laws by PSYPACT's Commission, which would have the force of law in California, is a concern. This delegation of substantial authority to an entity located in another jurisdiction and dominated in large part by smaller states, many of which do not share some of the contemporary core values of California, is problematic.

For instance, many of the non-resident psychologists who practice telehealth with California consumers will not be from jurisdictions that share the same requirements for continuing professional development in social justice and diversity, equity, and inclusion. Further, some states in which out-of-state practitioners reside still allow practices such as conversion therapy for LGBT youth or mandatory counseling for women seeking to terminate a pregnancy. Another serious concern with this Bill is the requirement the psychologist must graduate from an APA-accredited program to obtain the e-passport.

Current law allows for flexibility for approval of APA accreditation. Approval of this Bill would constrict this flexibility. The exclusion of licensees due to the APA accreditation requirement would have a negative impact on historically underrepresented groups. This is a particular concern due to its iniquity, variable impact on California consumers, and the exclusion of a substantial proportion of our licensees. Further, it may impact the viability of graduate programs that contribute to a broader theoretical and philosophical diversity in the delivery of psychological services.

There is also a fiscal concern. There is no funding for California to become a compact state as all fees are paid to ASPPB and the Commission. However, the Board will be taking on substantial additional duties which will likely require the hiring of an additional staff member to discharge the responsibilities of a compact state without a concomitant source of funding. All of this despite a substantial percentage of our licensees not being eligible to participate in PSYPACT.

And if you could wrap up, that'd be great. Thanks.

I have additional work note and necessity concerns, but these were very well reflected in the Committee analysis, so thank you.

Thank you very much. Any additional witnesses in opposition to the Bill? Seeing none, I'm going to bring it back to colleagues for any questions or comments they have. Assembly Member Pellerin.

I want to thank the author for bringing this Bill forward. It's so critically important to add, increase, more behavioral health folks here in California, and I personally have had experience working with out-of-state folks. I'm just wondering what other protections we have to make sure that the people who are practicing out of state meet our laws and our requirements for licensing.

Wanted to address. Thank you for the question. Wanted to address some of the general opposition comments. First, the amendment that the Committee encouraged us to take, and we so willingly did, actually ensures that the Board of Psychology has to approve of becoming a part of PSYPACT as a part, as a safeguard, to be able to have California join PSYPACT. So, and it costs $6,000 annually to do so.

The issues related to ensuring that we have regionally accredited institutions considered, I definitely appreciate the need to have diversity in our, in our psychologists. Right now, 78% of the psychologists in California are white. So I think ensuring that we have a pool to be able to pull from that far goes beyond the State of California will further actually ensure issues in areas related to social justice and equity, diversity, and inclusion.

In that number, PSYPACT does not, the Board would still have the same licensure requirements for psychologists in the State of California that does not change.

And also as it relates to making sure that things that are uniquely, unfortunately, uniquely or certainly important issues of concern from a values perspective, whether or not we have practitioners supporting things like conversion therapy or considering that, you know, wanting to counsel against abortion access, things that California fervently believes in and is a part of psychology practice right now, to make sure that we are not running afoul of those values would still be in place.

Psychologists practicing telepsychology or temporary in-person psychology in California would be subject to the scope of practice and laws of California. If these laws are violated, the Board of Psychology can initiate an investigation and take disciplinary action. So our California consumers and people who are in desperate need of this will be protected under these, under the scope of already existing statute.

Any additional questions or comments? Seeing none. Assembly Member, would you like to close?

Yes. I want to first and foremost thank my fellow Natalie Peta, sitting here, who has a background in public health, who presented this Bill for our team's consideration. The depth of her understanding of this legislation has introduced a whole new world of important practice to me and in our office, and therefore to the State of California. So I want to just acknowledge that. And it's very rare that we have the opportunity to be able to do so for our fellows.

I will say that this is an area of certainly a lot of debate that we will see over the course of the coming months and years in the Legislature. But I want to hearken back to my opening comments and the comments of our experts who presented we cannot afford as a state to allow for more than half of Californians to not have the mental health services provisions that they need.

We can't afford to go back in providing and making accessible teletherapy as a very viable, important, impactful source to be able to relieve the need for mental health supports in the State of California. And we have crafted this Bill as such right now to be able to ensure that California is able to enter into this compact on its own terms based on the expertise and judgment of the Board of Psychology. There are a lot of compact bills out there.

This one is focused specifically on telehealth, something that we have in temporary services, something that we have the ability to do something about, that it distinguishes it from other kinds of compacts as well. With that, I respectfully request your aye vote and very thankful to the Committee for moving this Bill or for hearing this Bill.

Thank you. Thank you, Assembly Member Bonta. And I too was going to commend your fellow because I hear she did a fantastic job in representing you and advocating for the Bill to my staff. And I've been lucky to have fellows for most of my years in the Assembly, and my chief, my leg. director, and one leg aide. We're all fellows. Wonderful program, and awesome to see fellows dive into the deep end right off the bat. So congrats.

I very much appreciate the intent of this Bill and your efforts to ensure that Californians have adequate access to psychologists, as we've discussed. I'm also wary of ceding authority to a multistate compact commission to determine the minimum qualifications for out-of-state psychologists to provide psychological services to Californians, among some other concerns. But really appreciate your willingness to make the bill's enactment contingent upon the board of psychology's approval.

Appreciate that this by no means will be the last conversation on this issue and with the amendment, I'm happy to support the Bill today when we have a motion, when we have a quorum, which we still don't have. Public service announcement. Members of the Committee, come on down. Thank you very much.

You and me both, Chair. You and me both. Thank you so much.

Appreciate it. So we need Members and we need authors, but we've got authors on the Committee. So, Assembly Member Flora, you're first. So agenda item number 10, AB 2578. And ready when you are.

Thank you very much, Chair and Members. Today I present AB 2578. That would allow California nursing students to enroll in out who enrolled in out-of-state nursing programs to complete their clinical training here in California.

Currently, these students are barred from doing so, and we need to find a way for those nursing students to complete their clinical training in other states, and they end up staying in those states. AB 2578 aims to support the educational needs of these students while addressing the state's nursing shortage. There currently is no opposition to this Bill, and I respectfully ask for your aye vote when the time comes. And I've got a couple witnesses to share their story.

Great. And witnesses, you have two minutes each.

Thank you so much. My name is Laura Richitelli, and I appreciate the opportunity to speak in support of AB 2578. I'm a single mother and Air Force veteran who proudly served as a licensed vocational nurse in the United States Air Force during Desert Storm Desert Shield. As COVID-19 swept through the world. I watched the nursing workforce get decimated. I knew I had to mobilize, and I decided to return to nursing school in the nursing profession by pursuing my BSNRN degree.

Unfortunately, I was faced with multiple barriers. As I was told over and over, I'd have to sit on waiting lists that range from three to seven years. Online nursing school enables me the immediate access to the education I desired to support not only my family, but serve my nursing community and the patients who desperately needed me.

However, every semester I have to leave California to attend clinicals in states such as Kansas and Wyoming, adding an additional expense of 3,000-plus dollars in extra travel expenses and lost wages, plus the additional stress on my family and my special needs child. I thank the Committee and all of you who support this Bill in making this happen. Thank you.

Thank you very much. Next witness.

My name is Julie Heath. Thank you, Chairman and Members of the Committee for taking the time to hear us today. I am a California BSN student. I chose to do distance learning because the programs in this area are very impacted and don't allow me to have the flexibility that I need as a mom of five and a wife, excuse me, of a husband who has medical issues. Excuse me. I needed the flexibility to be able to be present for my family.

So I chose distance learning as the option which allows me that flexibility to be present for my family and get my degree. The downside of this is that we have to travel, as Laura was saying, and that costs quite a bit of money coming out of pocket. And so it is for that reason that I wholeheartedly support this Bill and I'm asking you to do the same.

It is not only going to to allow us to be able to stay close to our families, but it will also help the State of California and bring more economy to this area and support the state. So I ask that you say aye on this Bill.

Thank you very much. Any additional witnesses who want to add on in support of the Bill? Please come on up. Your name, organization you're with, if any, and position on the Bill?

Hi, my name is Ashley Jones. I'm Generations Healthcare Outreach and Recruitment Manager and I'm in support of this Bill.

Thank you very much.

Mikhail Shneyder, CEO, Nightingale Education Group in support of this Bill.

Thank you very much.

Good morning Mister Chair. Justin Fanslau, on behalf of the California Association of Nurse Anesthesiology and Davita, both in support.

Thank you.

My name is Blake Halliday, registered nurse. I support this Bill.

Thank you.

Regina Carson, resident of San Francisco. I support this Bill.

Thank you.

My name is Aranda Cisneros. I'm a nursing student from Sacramento and I support this Bill.

Thank you.

My name is Tanya Gomez Escovel. I'm a nursing student and I'm from Sacramento. I support this Bill.

Thank you.

My name is Marvel Doran Escovel. I am a nursing student in Sacramento and I support this Bill.

Thank you.

My name is Monisha Achari. I'm a student in Sacramento, California, and I support this Bill.

Thank you.

My name is Dolly Matthew. I live in Sacramento, California. I support this Bill.

Thank you. Any primary witnesses in opposition to the Bill? Seeing none. Any witnesses want to add on in opposition to the Bill? Seeing none. Bring it back to colleagues for questions or comments. We still are one shy of a quorum Assembly Member. Would you like to close? Vice Chair, would you like to close?

Just respectfully ask for your aye vote.

All right, well, thank you for continuing to work with us on this Bill.

The author already included our recommended amendments to the prior version of the bill, which were intended to reduce competition within state students for clinical placements, and so with that, I am happy to support the bill again today, and we'll vote on it when we have a quorum. Let's get a quorum. If you're staffed to a Member of the Committee, go find your boss, drag them on down. Room 1100. We'll be here. Assembly Member Wilson with Agenda Item Number Nine: AB 2566. Ready when you are.

But we are going to take a brief pause to establish quorum. Madam Secretary, please call the roll.

[Roll Call].

Great, we have a quorum. Assembly Member Wilson, ready when you are.

Thank you, Mr. Chair. Members, good morning. I'm pleased to present AB 2566. It's a bill that aims to add the State of California to the interstate Counseling Compact. I would like to start by thanking the Committee staff for their work on this bill and say that I am accepting the Committee amendments.

The broad goal of the Counselor Compact is to eliminate barriers to practice for licensed counselors and barriers to treatments for clients by ensuring cooperation amongst member states and regulating the counseling profession. The Counselor Compact provides greater access to mental health care in California, removes barriers to practice without sacrificing public protection, helps address health care workforce shortages, and allows California's LPCCs to provide greater continuity of care to patients who who travel or relocate.

If passed, AB 2566 provides seamless ability for military personnel and spouses who relocate to practice while preserving the regulatory oversight of the Board of Behavioral Services--I'm sorry--Sciences. The Compact does not impact the scope of practice in any state. Licensed counselors practicing under the Compact in another state must comply with the counseling laws and standards in that state in which they are practicing. The Compact does not affect the BBS Authority to protect public health and safety or regulate the LPCC profession.

The Counseling Compact is overseen by a public commission comprised of delegates from each member state. The commission issues appropriate rules to ensure a responsive, adaptive, and sustainable compact providing a long-term solution to interstate license portability. I have two witnesses with me here today, Dr. Anthony Rivas, a CALPCC Board Member, and also GV Ayers, representing the sponsor, California Association for Licensed Professional Clinical Counselors.

Great. You have two minutes each.

Thank you. My name is GV Ayers. I am the Legislative Representative for the California Association for Licensed Professional Clinical Counselors. Thank you so much for your analysis and thank you for your consideration of this bill. I'm here mainly for questions. I want to introduce Dr. Anthony Rivas to my right here, and he is testifying on behalf of the bill.

Great. Thank you.

Chair and Members, I wanted to start off by thanking you for the opportunity to testify today in support of AB 2566. I'm Dr. Anthony Rivas, and I am also a counselor educator here in Sacramento and I am dually licensed, and as GV said, I am a member of the California--a Board Member of the California Association for Licensed Professional Clinical Counselors or CALPCC. And CALPCC is the sponsor of this bill, and we are grateful to Assembly Member Wilson for offering this important bill for counselors.

AB 2566 will take great strides in providing access to mental health care to those in need in California. It provides an efficient pathway for qualified licensed counselors to provide counseling services in the state. We increase the mental health workforce and allow more people to get into the counseling services that they so desperately need, and we do know we are in a mental health crisis in our country.

Adding more licensed counselors to the workforce does not replace nor diminish the existing counselors in the state. Instead, it supplements and augments the workforce and strengthens California's ability to to follow through on its commitment to meet the mental health challenges that we see currently in our communities. It also allows LPCCs in the State of California, the vast majority of whom work in private practice, to supplement their income through teletherapy in member states.

AB 2566 also recognizes the mobility lifestyle of today's society and allows licensed professional counselors to seamlessly provide their services in different locations when members or clients move, go on vacation, or temporarily relocate due to their work requirements. It allows California LPCCs to provide a greater continuity of care, which is so important once you establish that therapeutic relationship when, as I said, their patients or clients move to another state or temporarily relocate.

The Counseling Compact makes it easier for counselors who come to California or California counselors who may relocate to another state to become licensed. I myself am one of those counselors who relocated to California, and when you relocate, a license is not the fun part to have to transfer over.

And if you could wrap up, that would be great. Thank you.

Yes, sir. The Compact does not impact the scope of practice for LPCCs and it preserves and strengthens the abilities of the Board of Behavioral Sciences to license and enforce the law regarding LPCCs. I want to thank you for the opportunity to testify on this important bill, and we request your support on this extremely important bill. Thank you.

Thank you very much. Any witnesses who want to add on in support of the bill?

Good morning. MJ Diaz on behalf of Kaiser Permanente, in support.

Thank you.

Good morning, Mr. Chair. Chris Micheli, on behalf of the Society for Human Resource Management and CalSHRM in support of the bill. Thank you.

Thank you very much. Any primary witnesses in opposition to the bill? Seeing none, any witnesses who want to add on in opposition to the bill? Seeing none. Bring it back to colleagues for questions or comments. Any motions or seconds now? Got a motion and a second. And a question. Assembly Member Grayson.

Thank you, Mr. Chair, and thank you to the author for bringing this forward. I appreciate your work and especially the intent with the much need--great need that's out there for therapists and counselors. As we all know, what it takes to become certified as a counselor or therapist in California is much different than what it would be to do that same practice in many other states. Are we setting the bar for those that become a part of this compact?

Are we setting the bar, the baseline bar at the California standard so that when they come into California, they're actually operating under our certification policies or will there be an occasion where someone could actually come into California with lesser qualifications and still be able to operate in an equivalent capacity to someone who went through the--as was testified by a witness--the arduous process of being licensed here in California?

I'll give it over to the witness, our witness, but it doesn't impact, you know, the scope of practice in any state. They must comply with the laws and standards in the state where the client is receiving the services and so it does require you a jurisprudence exam, but wanted to see if Mr. Ayers would like--Dr. Ayers would like to expand.

Right. Not Dr. Ayers, but anyway, thank you.

I was happy to give that upgrade.

I'm not going to take the promotion. No. What the Compact does is essentially they're all 50 states licensed professional counselors. They call them a little bit different things. Here in California we call them licensed professional clinical counselors. California was the 50th state, the last state to get the license, and we have throughout the states--throughout the state there are equivalent, they're considered to be equivalent standards to license all the counselors, equivalent, essentially the equivalent number of hours supervised experience.

The education is all--there are some minor distinctions between them, but it's--on the basic picture, it is considered equivalent even by the Board of Behavioral Sciences as well.

I appreciate that. However, there are some things that aren't equivalent, and so I can understand where someone practicing in New York may already have the experience and already meet the requirements of California. I would have absolutely no problem with that kind of an individual coming into California practicing because they meet California's minimum standards. But in California, you're going to have to spend 3,000 hours supervised before you can become licensed, and in other states they only require less than half of that.

So I would just want to make sure that in the bill, individuals in other states that are coming into California have met California's minimum requirements. And I know those people exist because there's some that have moved out of California that could come back and practice in this state, you know, as well as others that have worked.

I just want to make sure that we're not diminishing the very hard work that clinical counselors and therapists have done here in this state to become licensed and then allow someone else to come in with a lesser standard and practice right alongside in an equivalent scenario.

Right. No, we agree. We agree, and it does not say simply, blanket, if you have a license, you get to do this. It's if you have the license and meet the criteria that--

Thank you for that.

You get to do it.

I appreciate the assurance. Thank you. Thank you, author.

And one of--thank you so much. I appreciate the recognition of the intent and making sure that the standards are the same, but one of the things that is really important to me as it relates to this being a military family, you know, wife and mother, is the Service Member Civil Relief Act allows a military member who has a license to come in and practice in our state while they're active duty.

But if they were to retire in our state, they would no longer be able to practice. They would--say would have to go through that whole process again. It would completely go away. A Compact like this allows that person to retire in our state and still continue to practice.

Thank you for that clarification.

Thank you. Any additional questions or comments? Assembly Member, would you like to close?

Thank you for the questions. I appreciate the support. Thank you to my witnesses. This is really important. I just, I'm, you know, sitting in Public Safety right now. We were talking about mental health diversion and just the lack of counselors even be able to properly recognize the fact that we do have people in our criminal justice system that need mental health care services. So bills like this help alleviate issues that we're seeing even in other committees, and so with that, I respectfully ask for your aye vote.

Thank you very much. I want to thank Assembly Member Wilson for bringing this bill forward. As I mentioned, in regards to a similar bill, I think, two bills ago, I recognize and appreciate the seriousness of California's behavioral health workforce shortage, and I thank you for endeavoring to do something about it.

For the reasons I stated earlier, among others, I have concerns about the state entering into any compact, but I greatly appreciate the author's willingness to amend the bill to make its enactment contingent upon the Board of Behavioral Sciences's approval, and with that, I'm happy to support the bill today. And I think we have a motion and a second. Madam Secretary, please call the vote.

On AB 2566: Wilson, the motion is 'do pass as amended to the Committee on Appropriations.' [Roll Call].

We'll leave that bill on call. Thank you very much. Do we have any additional--Dr. Bains. Yeah, ready when you--do you see anybody else? Perfect. Agenda Item Number 11: AB 2651.

I keep forgetting. I'll get it one of these days. Thank you, Chair and Members. AB 2651 creates the licensed Alcohol Drug Counselor Board at the Department of Consumer Affairs, which would have the authority to establish regulations and standards for issuing licenses to qualified alcohol drug counselors.

Licensing alcohol drug counselors would help to address critical access to healthcare issues and the lack of substance use disorder services by enabling licensed counselors to provide individual counseling to persons seeking help with addiction at its earliest stages in a private practice setting. While there are always challenges that need to be overcome when we look to establish a new professional license, it is critically important to understand the real life barriers to care that patients face under our current system.

The state and federal Government have spent billions of dollars to improve access to care, including expanding Medi-Cal insurance coverage for those on the Affordable Care Act exchanges and expanded eligibility under Medi-Cal. However, what our reforms often overlook is that insurance coverage is only as valuable as a patient's ability to use it. If you cannot get in to see a provider who accepts your insurance, then we have done nothing to increase your access to care.

This dynamic is especially prevalent when we look at the options patients have to get treatment for substance use disorder. If you have health insurance and you have severe substance use disorder, that requires intensive outpatient partial hospitalization or an inpatient level of care, then the system mostly works for you. You can see a substance use disorder specialist and your insurance will generally pay for that care.

But these types of programs are designed for truly severe cases and are often not appropriate or necessary for mild to moderate cases that would be better treated in a normal office environment. It is in these mild to moderate cases where we see some of the biggest barriers to care. If a patient with insurance would be best treated by a substance use counselor in a typical office environment, in most cases their insurance will not cover the cost of that visit.

That means the only patients you are permitted to see, the only patients who are permitted to see a substance use counselor in an office environment are those who can afford cash pay, which raises significant equity issues and excludes millions of Californians from receiving care because of inability to pay. Our health systems so often refuses to help people until they have a crisis, and that is exactly what we see with substance use disorder.

Allowing patients to use their insurance coverage with licensed alcohol and drug counselors in an office setting would enable those who cannot afford cash pay to receive care before their disorder progresses in severity. By creating a license for alcohol drug counselors, AB 2651 ensures licensed counselors are eligible for insurance reimbursement when seeing patients.

This bill requires licensees to complete a master's degree supervised practicum from an approved educational institution, achieve a successful score on a national licensing exam, and receive either certification or completion of 2,000 hours of postgraduate supervised work experience. The bill also creates title protection by limiting the title licensed alcohol drug counselor to persons licensed by the board to ensure consumers can have confidence in their provider selection.

Substance use disorder was already a crisis before COVID hit, but the pandemic caused a significant spike in cases with more than 40 states reporting an increase in opioid related mortalities and an 18% increase in overdoses nationwide. AB 2651 acknowledges that we need to commit to establishing a robust substance use disorder workforce and we can provide care for patients before their addiction reaches crisis levels. AB 2651 is supported by a robust coalition of supporters from throughout the state. And with me today to testify in support, I have Michael Pritchard and Patty Vargas.

Thank you very much Dr. Bains. You each have two minutes and just hit the mic button real quick.

Good morning, Chair and Members. I've been a substance use disorder counselor for 13 years and have a master's degree in addiction counseling. Even with my degree in teaching at the college level, training helping professionals throughout the state, and more than a decade of experience, there is currently no pathway for me or any of my colleagues to obtain license in SUD counseling in California.

This impacts professionals like me, but has a larger implication for public health and safety, especially concerning the high rates of overdose that we are seeing. Not only is there an increase in SUD, but the potency and purity of available substances has increased, resulting in high frequency of overdose deaths. For the public good, we can no longer neglect avenues of access to care and workforce expansion. Licensure for SUD counselors would open more avenues for people seeking counseling services specific to addiction.

Due to the stigma surrounding addiction, many people in the early phases of SUD are hesitant to approach a treatment program, but would be willing to see a licensed SUD counselor in private practice. I know this because I regularly receive phone calls from the public asking if I can provide services. Unfortunately, I have to tell them no because as a certified SUD counselor I can't diagnose substance use disorder, nor can I receive reimbursement through Medi-Cal or most private insurance.

If I did private practice, I could only see those who could pay out of pocket. In addition to access barriers that create inequity along income levels, the current SUD workforce faces critical shortages and has for decades. Lack of licensure is a barrier to workforce retention and attraction to the profession as there is no upward mobility toward independent practice and higher level positions within integrated teams. There is also no incentive for colleges and universities to create graduate level degree programs.

This reduces California's efficacy in treating the disease. The increasing complexity of treating SUD, coupled with the advanced research available in the addiction treatment profession, necessitates that a higher percentage of addiction counselors be educated in addiction studies at the graduate level. To conclude, licensure will grow the workforce and give Californians additional avenues of care, especially in the early phases of the disease when they are still employed, insured, and still have supportive network of family and friends. I thank you for your aye vote. Thank you.

Thank you very much. Next witness.

Good morning, Chair and Members. Two of my three children struggled with substance use disorder. We lost my son Joel to his disease in 2017. Thankfully, my daughter Becca has been in recovery for three years now.

Between the two of them, we interacted with approximately two dozen treatment facilities with experiences ranging from a lockdown warehousing situation with little services to what we called the gold plated solution that required a second mortgage on our home, to a program consisting of terrifying physical and emotional abuse modeled after the Synanon protocol. Early on in our experience, we had no point of reference to know what to expect, what treatment should look like, and we just assumed that the people working in the programs were qualified experts.

People who use drugs and alcohol don't look alike, act alike, or have the exact same needs. So a one size fits all treatment model doesn't support the goal of getting people well. Some folks can't afford to go away for a month because they'll lose their job. Some fear a painful withdrawal. Still others have been abused by a system that's focused more on their treatment method and less on recovery, so they have no confidence in a good outcome. There is much reform needed in this space.

An important step forward is access to regulated, licensed counselors along with peer services, both inpatient and outpatient. In one program, my daughter went through three different counselors during a 45 day stay. The turnover is extremely high and it's impossible to establish consistency and trust with a revolving door of counselors. It's time for a continuum approach on leading people into sustained recovery. Educate our youth early on about addiction so they don't need to wait until they're extremely ill or court ordered into treatment.

Services should treat the whole person where they are and ensure a seamless experience that integrates recovery and overdose prevention and into a way of being. Thank you.

Thank you very much. And I'm very sorry for your loss. Thank you. Any witnesses you want to add on in support of the bill? Provide your name, organization you're with, if any, and position on the bill.

John Drebinger with the Steinberg Institute in support.

Thank you. We've got a motion and a second. Any? Yep, one more.

Sorry. Walk is a long way. Robert Harris, on behalf of the California Society of Addiction Medicine in strong, strong support of this long overdue measure.

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

Mic's on. Thank you, Chair Berman, Vice Chair, and Members of the Committee. My name is Trent Murphy. I'm a policy analyst for the California Association of Alcohol and Drug Program Executives. Our Association consists of members who provide SUD services at over 400 sites throughout the state and make up the infrastructure of the state's publicly funded SUD treatment network. Our members had concerns about the bill as introduced and we have been in talks with the sponsors who have addressed many of those concerns.

There's still one major issue where our members are opposed regarding the placement of this new licensing board. While we do support a professional license for SUD counselors, we believe the Board of Behavioral Sciences is already set up to handle these responsibilities as they already license mental health counselors. By including this licensure into the BBS, we would continue the work of ensuring SUD and mental health achieve parity within our systems of government. SUD needs this type of policy discussion and we value the bill's direction. And additionally we appreciate the author's leadership on this issue and we look forward to working with them to discuss our concerns in more detail. Thank you.

Thank you very much. Any additional witnesses in opposition to the bill? Seeing none, bring it back to colleagues for questions or comments. We already have a motion and the second. Seeing no questions or comments. Dr. Bains, would you like to close?

You know, I just want to point out that this is a critically long overdue bill. Really appreciate all the support that I've received. We are an ongoing talks making sure that everybody's concerns are addressed and I respectfully ask for your aye vote.

Thank you, Dr. Bains. And I want to thank the author and the sponsors for working with us on this bill. I absolutely agree that addiction is a very serious issue that we must do more to address. However, the need for a new licensing board is not yet as clear and so I want to urge the author to continue exploring a lower level of regulation as outlined in the analysis. I'm supportive of piloting title protection or other alternatives to licensure and then increasing regulation if problems persist. But with that caveat, I want to support the bill today to allow the conversation to continue. And I'm happy to recommend an aye vote. Madam Secretary, please call the vote.

On AB 2651, Bains, the motion is do passed to the Committee on Appropriations. [Roll Call]

[Roll call]

That Bill is out. Thank you very much. And next up is Assemblymember Zbur with AB 2918, agenda item 13. Got a bipartisan motion, second, and third.

Thank you. I also want to thank Assemblymember Gibson for letting me jump line. Very gracious. I owe him one. Mister Chair, Members, I'm proud to present AB 2918, which enhances transparency and accountability within the regulatory framework for the Board of Barbering and Cosmetology.

Current law requires the board to update its registration records when a licensee notifies them of a change in address within 30 days. However, there's no provision mandating the update of the licensee's public profile on the board's website. Without such a requirement, there may be discrepancies between the information available to the board internally and what's accessible to the public. So AB 2918 therefore makes technical changes by requiring the board to update its licensee information not only to its internal records, but also publicly on the website. I ask for the Committee's aye vote.

Thank you very much. Do you have any primary witnesses in support? No, seeing none. Any people who want to add on in support of the Bill? Seeing none. Any primary witnesses in opposition to the Bill? Seeing none. Any people who want to add on in opposition to the Bill? Seeing none. Bring it back to colleagues. We have a tripartisan motion and second and third.

I used to be able to say that when Chad Mayes was around. Seeing no questions or comments. Assemblymember, would you like to close?

Thank you, Mister Chair, Members of the Committee, I respectfully ask for your aye vote.

Thank you very much. I'm happy to support the Bill today. Madam Secretary, please call the vote.

On AB 2918, Zbur, the motion is do pass to the Committee on Appropriations. [Roll call]

That Bill is out. Thank you, Assemblymember. Assemblymember Gibson. You got three bills? Three bills? I'm guessing you're going with the top one first, AB 2231. Beautiful.

Thank you very much, Mr. Chairman and Members, thank you for allowing me to present Assembly Bill 2231 which seeks to propose a mandate continuing education for pawn brokers in California. First, I would like to thank the Committee for their Hard work on this bill working with us. And I would like to be. I would like to accept the proposed amendments by the Committee. Thank you. Thank you. This bill, in short, from the pawn brokers, imposed themselves on continuous education.

And to have an industry has been around for a long time to propose continuous education, I think it's a wonderful thing. And here with me again, I respectfully ask an aye vote, I would former familiar face, Senator, former state Senator Cathleen Galgiani, who will be speaking in support of Assembly Bill 2231.

Senator, it is an honor. Welcome back.

Thank you so very much. It's an honor to be here. I want to thank the Committee and the Committee staff for the wonderful review on the analysis. And of course I thank Assembly Member Gipson for carrying the bill. I'm here on behalf of the California Pawn Brokers Association. This bill requests one thing and one thing only. And that is for the pawn brokers to be become an education accreditor through the council. You have seen other models before you.

This has a distinct difference in that the pawn brokers are already, they already have oversight from the Department of Justice, and the Department of Justice is required to enforce the requirements that they fall under, under the financial code. With pawn brokers, the state has requirements with regard to the loan amounts that they can charge, the fees that they can charge, when and how property can be sold if it is not returned. And in addition, they have to have daily reporting requirements to the Department of Justice.

Again, this bill seeks to do one thing, and that is to allow pawn brokers to educate other pawn brokers. They believe that it will better allow them to provide advice and counsel to their clients and it will also enable them to stay in business because they will be able to educate one another on best practices, determining counterfeit items, determining the appropriate value of assessed items and so forth.

Under this bill, the council will have no enforcement authority. That will be left to the local licensing law enforcement entity that currently has the authority to license. Under this bill, we are actually going to accept the amendments that clarify that the council is not intended to serve as a licensing body, but that responsibility remains solely that of local government and the DOJ. For all these reasons, I respectfully ask for your aye vote.

Thank you very much. Any additional witnesses in support of the bill? Seeing none. Any primary witnesses in opposition to the bill? Seeing that it's always when people get up when you say primary witness in opposition, but they don't really oppose the bill, they're just talking to somebody. Any additional witnesses who want to add on in opposition to the bill? Seeing none. Bring it back to colleagues for questions or comments. Seeing none. Assembly Member, would you like to close?

Respectfully ask for an aye vote.

Yeah, it is respectfully given. I'm happy to support this bill today with the author's acceptance of the Committee's amendments. Madam Secretary, please call a vote.

Thank you.

On AB 2231, Gipson, the motion is do pass as amended to the Committee on Appropriations. [Roll Call]

The bad news is everyone has left to go elsewhere. The good news is we're gonna keep that open for absent Members. And would you like to move on to your next bill?

Yes, if I could ask the Chair to take Assembly Bill 2869 first?

Sure, whatever you prefer. 28?

69. File item number.

862? Or we might have it wrong. Agenda item 12?

2862.

Perfect. You're in.

Let's do it. Don't want to take the random bill. You might not like it.

Apologies.

Again, thank you very much, Mr. Chairman and Committees for allowing me to present Assembly Bill 2862, which seeks to require licensing boards to prioritize African American applicants seeking occupational license, especially those who are descendants from people of enslaved in the United States. First, I would like to thank the Committee on their hard work in helping strengthening this bill. I will be accepting the Committee's proposed amendments.

This bill is part of the culmination of thousands of hours, thousands of hours of research as part of the California Reparation Task Force Report. This bill presents evidence of descendants of African Americans and are facing in the business professional sector.

This bill, additionally, a priority bill for the California Legislative Black Caucus as a measure that will help bring parity to our communities that have been left behind. By allowing these populations to have expedited licensures, we can begin to close the gap between the earnings of African Americans in California and their White counterparts in California. African Americans in California are severely underrepresented in high skilled professions, including technology, business, architecture, and engineering. Currently, Black Californians make 72 cents to every dollar that their White counterpart makes in California.

Additionally, we're looking at the levels of professional employment. 61.4 percent are Whites and only 12.8 percent are African Americans in the nation. And lastly, it is estimated that annual salaries gap for African American employees is nearly 220 billion dollars. With me to supply and give and offer supporting testimony is Mr. Darryl Lucien, representing the 40 Acres Conservation League, who will self-introduce and also give witness testimony in support of this bill.

Great. You have two minutes.

Thank you, Mr. Chair and Members. Darryl Lucien here, representing 40 Acre Conservation League. We want to thank Mr. Gipson. We want to thank the California Legislative Black Caucus for all of their efforts to really move forward equity and really advance these conversations.

We appreciate this measure and what it aims to do because what my client has reported to me is as they are out in the field and they are looking to not only do any number or undertake any number of projects that are oriented toward reducing wildfire risk, mitigating greenhouse gas emissions, climate change, the like, and also do right by professionals in these spaces that don't always get the opportunities that they should, what they find is that is just frankly a challenge.

And so we appreciate any and all efforts to really diversify the professional license, the constitution of professional licensees in California because it's really going to take us all to address the problems that this state, this nation, this world face, and so we want to offer a supportive testimony on behalf of the 40 Acre Conservation League. Thank you.

Thank you very much. Got a motion. Got a second. Any witnesses want to add on in support of the bill?

Hi there. My name is Samantha Johnson, on behalf of the Greater Sacramento Urban League and the California African American Chamber of Commerce, in support.

Thank you very much. Any primary witnesses in opposition? Come on up, you've got two minutes.

Chairman Berman and honorable Members of this Committee, thank you for your time. My name is Caleb Trotter and I'm an attorney at Pacific Legal Foundation, which is the nation's leading public interest law firm advocating for equality and opportunity. I share concerns that California's occupational licensing regime creates very real burdens on the ability to enter a profession or trade. As the Little Hoover Commission reported in 2016, more than one in five Californians must obtain a government license before pursuing their chosen occupation.

That process serves as a serious barrier to upward mobility. AB 2862 however, would disadvantage certain Californians in obtaining occupational licenses based solely on their race and ancestry and should not become law for two reasons. First, prioritizing individuals based on race and ancestry is unconstitutional. Second, there are race neutral alternatives that this Committee should consider instead. AB 2862 advantages and disadvantages individuals based on race. The bill seeks to give African American license seekers priority while denying priority to members of all other races.

This is a straightforward constitutional violation. The United States and California constitutions guarantee citizens equal protection of the law. The government cannot, therefore, treat Californians differently based on their race or ancestry. Given the United States Supreme Court's decision last summer and Students for Fair Admissions v. Harvard, AB 2862 would unlikely withstand a legal challenge. The government cannot and should not pick winners and losers based on race. There are also race neutral alternatives to AB 2862 to increase participation in trades and occupations.

To the extent that reforms are needed to permit those with criminal records to obtain occupational licenses, for example, reforms should focus on criminal background and not race. Indeed, the Reparations Task Force Report recommends addressing the amount of time in which certain prior convictions can be held against licensed applicants. Ultimately, the state should go after the root causes of current disparities in licensing without disadvantaging workers based on race.

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

The state should focus on reducing economic barriers for all Californians, regardless of skin color and ancestry. Thank you.

Thank you. Any additional witnesses in opposition to the bill? Seeing none. Going bring it back to colleagues for questions or comments. We already have a motion and a second. Dr. Jackson.

I want to thank Member from Carson for taking the lead on this black caucus priority reparations legislation. There is no doubt that the reparations report was clear that the majority of California's existence created winners and losers, and people of African descent were on the loser list for hundreds of years for the majority of California, which means that California has some work to repairing that harm, and it is only the moral thing to do that we need to continue to reject this failed experiment on a colorblind society because it harmed African Americans even more. It harmed all people of color even more.

And if we're going to repair the harm, if this state was going to continue to focus directly to ensure that harm was done to black people in California, California must directly and intentionally focus on repairing the harm that was done to black people in the state. And so I want to thank you for your leadership on this issue and look forward to continuing the discussion along this process.

Thank you, Dr. Jackson. Assembly Member Lowenthal.

Thank you, Mr. Chair. I want to thank my colleague from Carson for bringing forward such significant, important legislation. I would just like to echo that which my colleague from Moreno Valley just pointed out, and to the gentleman who elucidated so well about the constitutionality of this issue, I would remind him and everyone that the very same constitutional provisions were in place during unbelievable, disproportionate, systemic racism that led us to the empirical outcomes that we have today. And it's very much important that we right those wrongs.

And as a legislative body, we shouldn't be afraid of standing up to legal scrutiny associated with that. It's the other way around. We should be pushing the envelope towards justice. That's our responsibility. Thank you, Mr. Chair.

Thank you, Assembly Member Lowenthal. Any additional questions or comments? Oh please. I'm going to start with Assembly Member Carrillo and then Dr. Bains.

Thank you. I also want to thank the author for bringing this up and I fully support this measure. Not until you really experience what it's like not to be treated the same as other Americans is when you really understand the impacts. And I'm going to share a story with you that happened to me in the classroom. I wanted to be an architect. I went to College of the Desert, enrolled in the architecture program.

During the first class of the program, a white male professor came to my desk, asked me to go to his office. Without telling me anything, he made a phone call. He was talking to a friend that had a construction company. He was getting me a job to get me out of the classroom because of the color of my skin, because of my accent.

And again, until you experience that there is no equality that the opposition talked about. I agree with the constitutional rights, I fully understand that. But when it's not done equally, and when you experience that type of systemic racism, is when you have to stand up and fight for it. I went to get an education and this professor was getting me a job in construction. Apparently that's where I belonged. I didn't say anything.

I said thank you for making a recommendation to get me a construction site and I showed up to the next class. Years later, here I am. Thank you, Assembly Member Gibson for having the courage. Thank you for the comments. And not until we find equality is when we will stop fighting for our rights. Thank you.

Thank you, Assembly Member. Dr. Bains.

Well said, Assembly Member Carrillo. I just wanted to thank the author for this bill so you guys stole the words right out of my mouth on every single thing. So thank you so much for your work on this. You know, it's a long time coming to make sure that we're held accountable for the actions that we have done under the constitution. So thank you so much for this bill.

Thank you. Any additional comments or questions?

I failed to ask the author if he would consider me to be a co-author on this bill.

I'll be honored. Thank you.

Great. Thank you very much, Assembly Member Gipson. Would you like to close?

Yes. I want to thank the Committee and the Chair for, one, allowing me to hear this bill and present this bill. And I want to line my comments for those who have boldly weighed in on this conversation. We believe we're going in the right direction and I want to say thank you very much and respectfully ask for an aye vote. Thank you.

Thank you very much, Assembly Member Gipson, for accepting the Committee's amendments and for the work you and the Legislative Black Caucus are doing to address California's historic inequities. While there are some outstanding issues raised by the opposition to this bill, I'm confident those issues will be further discussed in Judiciary Committee and for our purposes, I'm happy to recommend an aye vote today. Madam Secretary, please call a vote.

On AB 2862 Gibson the motion is do pass as amended to the Committee on Judiciary. [Roll Call]

That bill is out. Congratulations. Thank you very much. And try to go three for three.

Got one more bill.

One more bill. And as they are approaching, I'll just begin. Mr. Chair, again, thank you very much. I know it's been a long morning thus far. Thank you for allowing me to present Assembly Bill 2526, which aims to address critical gaps in dental anesthesia services and expand access to safe and effective dental care for all Californians.

I want to thank the Committee staff for their diligence in working on this bill with me and my team and I will be accepting the Committee amendments. General anesthesia plays a critical role in dental care, especially for pediatric patients and those with developmental disabilities. These patients often face challenges in receiving timely treatment and, consequently, many of these individuals require intensive restorative procedures under deep sedation or general anesthesia. Accessing deep sedation care can be problematic due to a shortage of providers often offering these services.

An LAO study highlights the issue, revealing long wait lists for up to three years in some cases at hospitals and oral surgery centers. Consequently, children and patients with disabilities, often during oral pain for extensive periods of time. To address these challenges, this bill seeks to increase the number of anesthesia providers available to provide these services. This bill would allow the CRNAs to obtain a general anesthesia permit from the Dental Board of California and allow them to order anesthesia medication to administer in the dental office.

This would enable more dentists to offer in-office anesthesia service provided by a licensed anesthesia provider while the dentists focus on providing high quality dental care. With me to provide supporting testimony we have Sandra Bordi, the President of the California Association of Nurse Anesthesiologists, and Monica Miller.

Thank you very much. First witness, two minutes a piece, please.

Good morning, Mr. Chair and Members. Monica Miller representing the California Association of Nurse Anesthesiology. Today I would like to introduce our witness, Sandra Bordi, who is with the California Association of Nurse Anesthesiology. She's our president. But before I do that, briefly, I really want to thank the Chair and the Vice Chair and your staff for all of the work and the time that you have given us on this legislation. We've worked diligently with all interested stakeholders and parties.

And, as a reminder, this has been an issue that we have been working on for over 10 years now and really want to, as we see the access continue to erode for patients that critically need these services, we really want to try and address to ensure that these patients can get access to the dental anesthesia, particularly in our special needs populations, so they have the ability to get the care that they need. And I am available for technical questions, but we'll turn it over to our president. And thank you so much, and thanks to everyone for all of your time today.

Thank you very much. Next witness, please.

Good morning, Mr. Chair and Members. My name is Sandra Bordi. I am a Certified Registered Nurse Anesthetist. I speak on behalf of the California Association of Nurse Anesthesiology, proudly supporting AB 2526. First of all, I do want to take the time to thank Chair Berman, the Committee consultant, and the staff who have put in a lot of work here to really resolve issues that affect access to care for Californians. So thank you.

We also appreciate the continued efforts and the continued communications that we've had with the California Dental Association. Their willingness to meet with us over these past 10 years has been very valuable, and, obviously, we're working more and having more communications and meeting those needs of those dental patients who need anesthesia care. So, and we look forward to continuing the dialogue with the California Dental Association. So, under current law, CRNAs administer anesthesia in a dental office when the dentist has a permit from the Dental Board.

Currently, only dentists and physicians can apply for and obtain this general anesthesia permit. This creates anticompetitive disincentives to work with CRNAs and, more importantly, reduces access to dental care. Since 2021, there's been a progressive increase in delinquent and canceled general anesthesia permits. This trend reflects an increased need for anesthesia providers for dental procedures. So this bill would really ensure access to care for those patients.

CRNAs are experts in anesthesiology and should be able to apply for and obtain a general anesthesia dental permit in the same way as dentists and physicians currently do. All current regulations, safety protocols, on site inspections, and oversight for the dental office would remain intact.

Thank you so much. We'll have a wrap up your thought, please.

Okay. Thank you. So again, CRNAs are experts in anesthesia care, and we appreciate your support on this bill. Thank you.

Thank you so much.

Great. Any additional witnesses you want to add on in support of the bill? Please provide your name, organization you're with, if any, and position on the bill.

Is it still morning? Good morning. Roxanne Gould representing the American Nurses Association of California in strong support, and I wish I had an anesthesiologist right now.

Thank you.

Hi. Good morning, Chair and Members. Brianna Pittman with the California Dental Association, representing 27,000 dentists throughout California. Actually here with a little bit of a tweener position. We had a support if amended position on the bill in print and are still reviewing and looking at the amendments. Really want to thank Vince and the Chair and everybody who's been engaged on this discussion for trying to balance the interests of many, many stakeholders.

You know, I think our main concern is that we do not believe that the treating dentist who is not otherwise trained in anesthesia should be ordering. At this point, state law still requires the nurse to administer under the order. So I think that the amendments still try to do that by using the word request. So I know we've talked with Vince about needing to clarify that, so looking forward to future discussions. I would also just say there's been a lot of discussion about access here.

And while we do believe and want to get to a place where we can expand the number of providers, the real issue with access to dental care, particularly anesthesia, is coverage. It's a lack of coverage. Health insurance doesn't cover it. Dental insurance doesn't cover it. Medi-Cal rates are abysmal.

There are a number of policy solutions that we have worked on in the past and would appreciate consideration of to increase coverage because that really is the major barrier there, and I believe the nurse anesthetist would agree with me there. There's also a growing awareness of options for alternatives to anesthesia, including behavior modification and desensitization, and those should really be encouraged. We have a budget proposal that would, before the Legislature, for $50 million to build specialty dental clinics. They have shovel ready projects.

We have four times as many applicants as we thought we might get. That money is at risk of being delayed. So there is a lot of work that's needed here in addition to just more providers. And so stand ready to work with the author, sponsor, other stakeholders on this bill, but also on other policies to improve dental access. Thank you.

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

You have two minutes each.

Good morning, Mr. Chairman and Members. I'm Doctor Brian Huang, President of the California Society of Dentist Anesthesiologists, and we are strongly opposed to the AB 2526. The CSDA is composed of dentists who have completed a specialized three year residency for anesthesiologist for both medical and dental procedures. This training requires rotations in office based anesthesia, and we are considered experts in providing safe anesthesia care to patients in the dental office.

We are very concerned about patient safety if this bill passes. We appreciate the schooling CRNA receive in anesthesia and the valuable contributions they make to the anesthesia care team. We do not believe that nurse anesthetists have the appropriate training to provide anesthesia in a dental office. Anesthesia in a dental office is very different than anesthesia in an accredited surgery center or hospital operating room. Not all patients are appropriate for anesthesia in a dental office setting.

As with nurse anesthetists, most dentists are not trained in making this evaluation. The management of urgencies and emergencies can be quite different as well. The anesthesia provider must plan for every contingency as a provider without the same support in the surgery center. The bill also does not require any in office anesthesia training for nurse anesthetists and allows nurse anesthetist to be evaluated by other nurse anesthesia that do not have a general anesthesia permit issued issued by the Dental Board.

It is essentially asking for someone who has no experience in dental office anesthesia to evaluate someone else. Even more troubling, many of these children receiving anesthesia in dental offices have special needs or disability requiring even a higher level of intervention than typical patients in a dental office. For all the reasons the California Society of Dentists Anesthesiologists strongly urges your no vote on AB 2526 to help ensure patient safety in dental office. Thank you.

Thank you very much. Next witness.

Thank you, Mr. Chair and Mr. Vice Chair. Gary Cooper, representing the California Association of Oral and Maxillofacial Surgeons. I'll be very brief. First of all, we don't want to malign the quality and the care and the talent and the education of the CRNAs.

Because many of our oral surgeons use them frequently, they retain them to do the work in the office as long as there is either a dental anesthesiologist in attendance or a healthcare provider that is trained in pediatric advanced life support or advanced cardiac life support. Right now, you're probably aware that SB 501 that's passed in 2018, and the regulations are being implemented right now, was brought to the Legislature because unfortunately, a young boy passed away in an oral surgeon's office.

It was malpractice, and it happened in 2016. So there were multiple, multiple, multiple hearings on this issue. And we were together with the dental anesthesiologists. We were together with the California Society of Anesthesiology. We were together with the California Dental Association, and ultimately SB 501 by Senator Glazer, passed. And the regulations are being implemented right now. The two words I want to leave you are preparedness and safety.

When you've got a child going under anesthesia, you want to make sure that there are three people in the room: the surgeon who's working, or the dentist who's working at the airway, at the mouth. You want to have somebody who's monitoring the anesthesia, and you want to have somebody who's there to take care of a situation that could arise. And frequently they do.

Now, I just read something in the analysis, and I don't want to quote who said it, but it said, why do we need three people? No one has died lately. Well, no one has died lately because SB 501 and bills like that have been passed by the Legislature and the oral surgeons, that is how they practice with a team anesthesia delivery model.

So while we're very, very supportive of CRNAs and we want to continue using them in our offices, we want to make sure that they are fully employed and fully accessible, our concerns are, again, safety. The one thing I want to leave you with, and I know it's kind of a tagline, but let me leave you with this, the secret to good anesthesia, there's no secret to putting people to sleep. The secret is making sure that they awake safely. For those reasons, we oppose AB 2526. Thank you.

Thank you very much. Any additional witnesses who want to add on in opposition to the bill?

Good morning. Thank you, Mr. Chair, Members. Bryce Docherty, on behalf of the California Society of Anesthesiologists, strongly opposed for all the reasons stated and then some. Thank you very much.

Thank you.

Good morning. George Soares with the California Medical Association. Opposed unless amended position. Really do appreciate the work from the Committee, staff, authors, stakeholders, and everyone. We want to continue working on the components about regarding nurse anesthetist and independent prescribing. So we'll continue to engage in that, but thank you for the time today.

Thank you. Bring it back to colleagues for questions or comments or motions or seconds. Dr. Bains?

Yes. I, of course, want to echo the comments about appreciating the work that RCRNAs do. They do a lot of great work in this space. However, I also have very, very big concerns, specifically as an advocate for communities, especially populations with intellectual and developmental disabilities. When it comes to our pediatric cases, oftentimes, a lot of the ones that require anesthesia, especially when it comes to dentistry, is our population with intellectual and developmental disabilities, and those have chronic underlying illnesses.

Oftentimes they can be those cases that can go sideways and making sure that we do everything we can to protect the population, I have been on the DDS task force as a person advocating for people with intellectual and developmental disabilities. I've been the Board President for my own current regional center.

So this is something that I am very concerned about, making sure that our kids are protected and making sure that we have the highest level of experience in the room to make sure that they wake up at the end of that anesthesia. For those reasons, I will not be supporting this bill today. I thank the author for their initiatives in this. Workforce is an issue. As the past commissioner for the Healthcare Workforce Policy Commission, I echo the comments of the California Dental Association. Medi-Cal reimbursements are abysmal, and that is literally what we should be working on to address healthcare access.

Thank you, Dr. Bains. Assembly Member Grayson.

Thank you, Mr. Chair. And I thank my colleague for her comments and to the author for what you're intending on doing here. I just want to state, without a pining, I just want to state that the concerns of opposition are legit. This may be one of those times it's appropriate to say, be careful what you asked for from a lens of liability. And so with that, I think it's worthy to continue the conversation on a Committee level. And so I'll support that to keep that happening today, however, it'd be very important for me to make sure those are resolved before it reaches the floor in order to continue my support.

Thank you. Assembly Member Ward.

Great. Thank you for introducing this bill and trying to improve on the situations that we find with these bottlenecks. And I guess I'm wondering either to both support and to opposition. So if the experience that we are having are these bottlenecks or delayed wait times to be able to receive the treatment that we are, and I know that LAO has studied this as well, how much of that is, say, solely a result of this particular pinch point?

The ability that a nurse who otherwise might, a CNRA, might be qualified to be able to perform this work, to order the medications are, as opposed to any other provider or operation that's necessary in the complement of services provided. In other words.

Whoops, sorry. I was going to have Ms. Miller.

Is this the pinch point or is there a broader issue here for us to be able to help reduce wait times?

Yeah. So I'll start and then I'll have Sandy Borde add on with it with the okay of the Chair, of course, through the Chair. Okay. Thank you. So thank you, Assemblyman, for the question. It's a good question. So ultimately, and we appreciate what CDA is saying about the Medi-Cal reimbursement rates as well as Dr. Bains. You are correct. So Denti-Cal and Medi-Cal, the rates are abysmal, but that's not what this bill addresses today.

And quite frankly, there are a lot of dentists who have access to Dental-Cal, but because, and specifically because they cannot use the CRNA, they choose to go the Medi-Cal rate because they can utilize that rate. The Denti-Cal rate is a higher reimbursement, but they would prefer to pay out of pocket because they prefer the services that we provide and that we are more accessible.

So for us to be able to address that at a later date, and while we are supportive of the $50 million that they are trying to protect and were supportive last year of those efforts two years ago, I believe it was, to get those dollars in the budget. Very supportive of that. But thats not what this bill does today.

So in terms of access, the bottom line is that dentists are not able to, unless they have the full general anesthesia permit, they are not able to utilize our services. And that's why this would be an appropriate piece of legislation to address what you refer to as the pinch point of ensuring that there is more access to care.

It's not that there's somebody that is the right qualified individual to be able to facilitate this function at the moment. This is coming down to budget.

From the studies that we have seen, and yes, the Medi-Cal issue is an issue, again, to be addressed later on, the reimbursement rate. But the bottom line from the dentist that we work with and that we, and the issues that we've worked on for the last 10 years plus in order to try and address this, is having access to be able to bring that CRNA in.

But the dentist doesn't want to provide the anesthesia because that's not what they're trained in. Just like they wouldn't ask a CRNA to put a crown on or fill a cavity, they would prefer to have an anesthesia provider in the room to provide that. Physician anesthesiologists, quite frankly, just aren't meeting that need, whereas CRNAs are meeting that need. And as I mentioned, physician anesthesiology may be covered under Denti-Cal, but CRNAs are not. But quite frankly, dentists prefer to use CRNAs is what we're told by the dental community that we work with and with that.

And with that, let's let Brianna from the CDA just chime in briefly on this. Thank you.

My favorite subject, dental anesthesia. So I do think that this will help. I mean, I just want to be really clear. CDA believes and has been working on this for decades. There are a lot of other pressure points. Health insurance only covers anesthesia for kids under seven and patients with special needs in hospital settings, not in other dental settings. Hospitals are very expensive. There's a whole lot of things that go with that. We've in the past tried to get coverage in other dental settings.

Dental insurance, while sometimes may cover, has caps on it annually, 1500, 2000, 3000. By the time you get to anesthesia, you've used it up and your dental insurance is probably only ever going to cover 50% of it anyways. The Medi-Cal rates that have been discussed, setting is an issue again. Hospitals are very expensive and complicated places to do dental anesthesia. And patients with special needs often need even things just like a sensory appropriate environment. So our $50 million grant is trying to do that.

We asked $50 million. We thought we'd get 10 to 20 settings. This was two years ago. You all approved this. The application period just ended. We had 101 applicants for $207 million. There are a lot of dentists who want to serve this population. Many of them may decide to use CRNAs, but they may use other levels of sedation. They may use physician anesthesiologists, they may be oral surgeons. There's a lot of pieces here. This is, I would say one small piece.

I don't know what the percentage is, but I would very much encourage looking at some of these other pieces as well, because the workforce is a piece, but a small piece.

Okay. A lot to think through on another time with the broader issues that are being discussed here. But on this, I guess moving forward to expand permission for CNRAs, who currently, right now, can administer right under under order or under in partnership with a dentist.

When the dentist holds the general anesthesia permit, yes, they can give general anesthesia.

But this would be in a situation where that is the permit is not held there by the dental office, but you can apply for the permit.

That's correct. So with recent laws, they've changed those permit requirements for GA permits for dentists. So there's fewer dentists meeting the qualifications for their permit. They're just not renewing them or it's burdensome to renew. It's a lot of effort.

And I guess what is of interest to me is, especially as we're thinking about children, that it's very difficult for any parent to know that somebody isn't going to be able to wake up from this procedure. There's a redundancy here that's already in place. You're there to back up and maybe double check the work of the dentist as things are happening in the surgery area.

If a CNRA is the only qualified individual now, as a part of a team that's working on this patient right now, how do we guarantee the redundancy there as well? For the benefit of the patient?

CRNAs meet and exceed the safety requirements made by the Dental Board. So we're all pals, ACLS certified. Safety is paramount to our practice. We have a proven safety record. There's literature stating that dental care or anesthesia care given by CRNA as compared to a physician anesthesiologist, there's no change or issues with safety. We've been in the dental office setting giving anesthesia for the past 40 years.

Yeah, I don't doubt that at all. Mr. Chair, just if I could, with our representative from the Dental Association, again, how might you respond to that as well?

Briefly, Mister Ward.

How would we ensure that the dentist who is on hand as well, is able to sort of double check the work?

I mean, I think that gets to kind of our point is that the treating dentist who's not trained in anesthesia is, there are requirements in place due to SB 501, where they would need to have some of that rescue responsibility and ability to support the CRNA in doing the rescue. We want to be really clear that when the training dentist who doesn't have that anesthesia training is working with the CRNA, that that CRNA sort of has the appropriate ability and resources, and we don't.

We're not saying that they don't. It's sort of a responsibility liability, and there are other staff who would be there, depending on the exact setup and whether you've got an oral surgeon or an anesthesiologist or CRNA who would support. And again, we do believe that dental anesthesia in dental offices is safe.

Okay. Thank you.

Thank you. And out of fairness, I want to give the opposition a minute to briefly, as briefly as possible, respond.

Thank you. I have some insight on why there's a huge waiting list at the operating room. So I'm a faculty at UCLA. I teach at the Hospital Dentistry Department. And part of the reason why there's such a long wait list is because a lot of these patients cannot be seen in the dental office.

Their last chance of being seen is in a hospital based setting in the operating room. And these type of patients would be very dangerous to be put under anesthesia in the dental office. And that's why there's such a long waitlist.

Thank you very much. Any additional questions or comments from colleagues? Seeing none. Assembly Member Gibson, would you like to close?

Thank you very much. Let me assure this body and this Committee and my colleagues, we will continue to work diligently in this space and work with opposition to try to close any gaps of misunderstanding and get to a neutral position, those who express such. We think this is very, very important. This is an access to care issue. This bill would increase access to care for some of California's most vulnerable populations while maintaining, strengthening safety standards. One of the questions was asked a few moments ago about Senate Bill 501.

These CRNAs will have to follow the law. There's no ambiguity there. And so that existing law is in place right now and they have to follow the law. I know this is a tough bill, but I think it's the appropriate bill for where we are right now. I think it's time for a paradigm shift, and I believe that this bill creates such a shift in our culture. I respectfully ask for an aye vote.

So we need a motion and a second. Got a motion. Got a second. I want to congratulate you, Senator Gipson, on having one of the most complicated bills of the year. And I want to thank the author, the sponsors, and all stakeholders for working with the Committee on this bill. Supportive of expanding access to dental anesthesia for those who need it, but also acknowledge that there are very serious safety considerations that must be taken into consideration.

While the recommended amendments attempt to add additional guardrails and simplify the bill, the Committee asks that the author continue to work with the opposition and other concerned stakeholders to ensure patient safety. I'm confident this is the first step of many conversations on this issue for the bill to be successful in the end, with the accepted amendments supporting the bill to allow those conversations to continue. Happy to recommend an aye vote. Madam Secretary, please call the vote.

On AB 2526, Gipson, the motion is do pass as amended to the Committee on Appropriations. [Roll Call]

We'll leave that--we'll leave the roll open for absent Members. Thank you very much. I thought you said it was nine. And I take that back; the bill is out, and we'll leave the roll open for absent Members. Thank you very much. I see Assembly Member Hoover. Thank you for your patience. Let's start with AB 3176, your bill on professional land surveyors. Got a motion and a second. And for those who are curious, we are going to finish this Committee hearing before anybody leaves for Caucus. So that's happening. We're going to make it happen. All right.

Just hit the mic button please, sir.

Thank you, Mr. Chair and Members.

Can you hear me?

Yes, sir.

Thank you, Mr. Chair and Members. Appreciate the opportunity to present AB 3176 today. Want to let you know we are accepting the Committee amendments. Thank you to the staff for all their work on that.

Thank you as well to the Board of Professional Engineers, Land Surveyors, and Geologists for their collaboration on this bill. This bill will expand the circumstances where a land surveyor or civil engineer must reconstruct or rehabilitate land surveying monuments, commonly referred to as property makers. Land surveying monuments define the location of private and public property lines. With me today is Mike Belote, on behalf of the California Land Surveyors Association, to share a little more.

I won't take that. Mike Belote, on behalf of the California Land Surveyors Association. These monuments are out there, hidden, sometimes in plain sight, but when they're disturbed and damaged, they can be hard to find to recreate boundary markers, so it's important that they be rehabilitated when they're in poor condition. Makes a simple but important change. We want to thank your newest consultant, Mr. Franco, for his hard work on understanding the subtleties of land surveying. Thank you.

Thank you very much. Any additional witnesses who want to add on in support of the bill? Seeing none, any witnesses in opposition to the bill? Come on up. You have two minutes.

Good morning. My name is Rick Moore. I'm the Executive Officer with the Board of Engineers, Land Surveyors, and Geologists. In our March board meeting, our Board took a position opposed unless amended and directed staff to work with the author's and sponsors' staff on the concerns they had. We had very good discussions with them, and we believe that the amendments that are in the very well-written Committee analysis satisfy the concerns, and at our May 9th board meeting, we see no reason to recommend to our Board to take or withdraw that opposition.

Great. Thank you. Thank you very much. Mr. Franco, don't get used to all the praise. Yeah. Any additional witnesses in opposition or tweener or anything other than support? Seeing none, bring it back. We've got a motion and a second. Colleagues, questions or comments? Seeing none, Assembly Member Hoover, would you like to close?

Respectfully ask for an aye vote. Thanks so much.

That's a great close. Thank you, Assembly Member Hoover, for bringing this bill forward. I understand that Committee amendments will address technical concerns brought forward by the Board. With the amendments accepted, I'm happy to support the bill today. Madam Secretary, please call the vote.

On AB 3176: Hoover, the motion is 'do pass as amended.' [Roll Call].

That Bill is out. Congratulations. And I believe you are here to guest introduce AB 2425. Guest present AB 2425, agenda item number seven by Assemblymember Essayli.

That is correct. I have presented more bills on behalf of others today than myself.

You are a gentleman and a scholar.

It's been a great day. All right, so thank you, Mister Chair, Members. I would like to begin by accepting the Committee amendments on behalf of Assemblymember Essayli.

As you mentioned here, to present AB 2425, a Bill intended to give our state more resources to combat California's animal shelter overcrowding crisis. Specifically, the Bill will expand the current dog breeder standards by lowering the number of dogs that must be bred for breeding regulations to apply. It imposes new microchipping and vaccination requirements for dog breeders consistent with similar regulations imposed on animal adopted from shelters.

It requires animal shelters to create a database of all adoptable animals or animals held pursuant to stray hold codes in their care published on either their Internet website or a third party platform. And it orders the California Department of Food and Agriculture to conduct a study on animal shelter overcrowding that includes recommendations and solutions that the state can use to facilitate facilitate further action.

With me today to testify as Nick Sackett on behalf of Social Compassion in Legislation, along with Katie Pettibone, volunteer at large for the Malinois and Dutch Shepherd Rescue.

Thank you very much. You each have two minutes.

Thank you, Chair and Members. I'm Nicholas Sackett, Director for Social Compassion in Legislation. I want to thank the Committee for working on the amendments, which, as the Assemblymember mentioned, we are taking. First, the Bill requires animal shelters to publicly post the availability of adoptable animals on their website or a third party website.

By ensuring all animal shelters are doing this, we can ensure that those looking to add a pet to their family are able to see the many wonderful pets available without having to necessarily travel to the shelter first. Additionally, posting online helps animal rescues know who is available and where their help is needed most. Secondly, the Bill reduces the threshold of sold dogs to be considered a breeder for the purposes of state regulation, as well as requiring all breeders to microchip and inoculate the dogs they sell.

According to the American Humane Society, each year approximately 10 million pets are lost in the United States and more than 6 million animals wind up in shelters. A significant source of the problem is animal identification and the ability to reunite these animals with their families. Only 15% of dogs and 2% of cats in shelters without identification are reunited with their owners.

Ensuring that breeders are also properly inoculating the dogs they sell will cut down on these new pet owners from incurring expensive veterinary bills early in animals life, which can lead to owner surrender and the animal ending up in a shelter. Lastly, to fully grasp the extent of the resources and policies required to solve the pet overpopulation crisis, a full study of the problem by the Department is crucial to help guide both policymakers and stakeholders. Thank you.

Thank you very much.

Hi, Katie Pettibone. On behalf of the Belgian and Dutch Shepherd Rescue, as well as the El Dorado German Shepherd Rescue. The analysis does an excellent job. And I'll note, pull out one of the pieces that I think is really important is that the report in 2003 notes that puppies and large dogs are being dumped in shelters or ending up in shelters at a rate that we haven't seen in many, many years.

The Bill is changing the definition of three to two litters a year for breeders is important from the perspective of it's going to, with these additional regulations and microchipping, help identify who is responsible for the dogs that are ending up in our shelters. I drive down to the shelters, I pull dogs, I drive them, actually fly them, drive them around the country at my own expense.

And we need to find out who is actually causing the cost to these shelters, to the government, because it is an unprecedented crisis. This microchipping requirement that requires actually the breeders and the people who are transferred to be registering them will help. I can tell you that I'm often at the shelter and they're saying there's a chip and its not registered or the dog isn't chipped.

And so this is one small step that will really, really, really help actually stem the problem of the influx that's happening in our shelters. It's super important. It's great policy. This is just simply not about politics. It's about policy. We need this. And I ask for your aye vote.

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

Thank you. Julianna Tetlow, on behalf of San Diego Humane Society, in support.

Thank you.

Julie Virga, on behalf of fix our shelters, in support.

Thank you.

Estella Drake. On behalf of the voiceless animal community of the State of California, in support.

Thank you.

Laila Adora with Layla's Animal Cause. I support.

Thank you.

Susie Emmel. In support from Fix Our Shelters. Thank you.

Thank you.

Elise Mize with Fix Front Street. I support.

Thank you.

Susan Falcon, Sacramento resident, in support.

Thank you.

Raina Gomes, I'm just a networker in support.

Thank you.

Mark Chican at animal outreach services in the community here in Sacramento, in the Bay Area. In support.

Thank you.

Good morning, Chair and Members of the Committee. Barbara Schmitz, on behalf of the San Francisco SPCA, in support.

Thank you.

Lisa Kirk, animal rescuer in Contra Costa County, in support.

Thank you.

Jan Schott, animal rescuer from Walnut Creek, in support.

Thank you. Any additional witnesses in support? Any primary witnesses in opposition to the Bill? Come on up. You've got two minutes.

Hi, Chair, Vice Chair, and Members of the Committee. My name is Bob Rilling-Smith, and I'm with the American Kennel Club. The AKC cares deeply about dogs and believes all dogs deserve a life in a safe environment with loving families.

We are proud to be the largest purebred rescue network in the United States and are a large funder of medical research benefiting canine health. We appreciate the intent of the Bill to improve the well being of dogs. We strongly support conducting a study to determine the issues that exist in animal shelters and the greater focus placed on microchipping and vaccines. We appreciate the clarifying amendments supported by the author and the sponsor around when vaccinations are given to dogs.

However, the AKC disagrees with changing the state definition of a dog breeder to include small scale hobbyists for several reasons. First, people are already subject to laws concerning animal welfare and animal cruelty that apply to all who own a dog, regardless of if they are a breeder or not. Yet as amended in this Bill, it could include someone who breeds and sells just one litter in their private home. This is a significant shift in who the state believes is a dog breeder.

Second, changing this definition before the animal shelter study is conducted seems to imply that small scale hobby dog breeders are the reason animal shelters are crowded. We disagree with this notion. Finally, cost. As the Committee knows, animal control is overworked and overstretched. This definition is a significant expansion in the number of people who could be regulated. Without extra money to localities for additional enforcement, it does not make sense to devote resources to many of the best dog breeders in the state.

Instead, cities and counties should continue to focus their limited attention and resources on ensuring the well being of all animals. We respectfully ask the definition of a dog breeder not be changed and that the Committee opposes the Bill unless done so. The study should be the first step, not the last. If amended, the AKC would happily support AB 2425. And thank you to the Committee.

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

The Bill will be available for motions or seconds until the end of the hearing. Thank you very much. Thank you. So now we are waiting on Mister McCarty. Mister McCarty, get over here. But in the meantime, we will do the consent calendar and then allow Members to add on to bills.

We do have a couple of bills that still need motions and seconds from earlier when we were acting as a Subcommitee. Madam Secretary, please call the consent calendar. So. Excuse me, I need a motion in a second on the consent calendar.

[Roll Call}

That Bill is out. Congratulations, Vice Chair.

[Roll Call]

All right, we've got agenda item number seven, AB 2420. No, excuse me. Agenda item number six, AB 2265 McCarty. Ready when you are, sir.

I'm the last one before lunch.

You are before caucus lunch.

All right, here we go. Yes.

Let's boogie.

Thank you, Mister Chair. And we will be accepting the Committee amendments. I realize this is a very emotional topic. Everybody wants to save animals in our communities, the people who work in the animal shelters. And I want to say I 100% respect them. I respect their concerns and their opposition. I respect their work they're trying to do, which is bring animals in, try to get them adopted, try to get them healthy, and focus on a win-win.

We will be working with the opposition to further narrow it to address some unintended issues. The real focus on this is to make sure that we can reduce euthanasia rates in our shelters by two things. Expanding public notice requirements that animals are about to be euthanized, like we did with last year's Bill in this Committee, and further requiring that oversight hearings shall be held, which allow the public to understand what changes are being made as far as some of their shelter policies.

Again, thank you for the Committee for engaging with us, and we know that this is a continued process and our commitment to work with the individuals who we may hear from in a few moments. With me today are two individuals and Sacramento leaders in this space and ask that you allow them to present. Thank you.

All right, you have two minutes each.

Thank you. There we go. Mister Chair, Mister Vice Chair, and Members. My name is Mark Rakich, and I don't represent anybody other than the dogs that we fostered who are on a euthanasia pathway and placed in good homes. I'm here because of my personal experience. Most of. Well, let me start over. My wife and I. I'm sorry.

That's okay. You got it.

I'm a little bit nervous. I'm not used to being on the side.

We're all friendly. We're all friendly.

My wife and I in the past 10 years have fostered and placed more than 80 small dogs that we've pulled from local shelters. Fully half of those dogs were designated not available to the public or on the euthanasia list. They were all on the pathway to be euthanized. Yet we pulled those dogs. Not surprising to us, they turned out to be really good pets, even though they failed the so-called triage tests that the shelters used.

You'd frankly be shocked at the reasons that shelters sometimes use to put a dog on its pathway to euthanasia. So approximately 40 dogs on a euthanasia pathway, we batted 40 for 40, 40 placed. Now, I understand the pressures Mister McCarty indicated as well. I mean, I understand the pressures the shelters are under, and some do a much better job than others.

And I want to particularly shout out to the employees at the Yolo County Shelter who do a great job of identifying dogs that failed their whatever tests, but nonetheless reach out to rescue groups. But by the way, this triage that they put dogs through to determine whether they're going to be on a euthanasia or not available to the public list has absolutely nothing to do with dangerous or vicious dogs.

They could be timid, they could be a little bit nippy because they're scared to death because they're in this shelter environment after having been found on the streets. But Yolo County and similar shelters are not why we need this Bill.

And I apologize. That's two minutes if you could wrap up.

Okay. My point is this. Sunshine works. When they reach out, sunshine works. People like my wife and I come forward and pull the dogs and make them available to be adopted. But not all shelters would do that very good, do a very good job of that. And our other witnesses are going to talk about why we need a Bill.

Great. Thank you very much. You have two minutes.

My name is Layla, and I represent the animals because they have no voice. AB 2265 will give animals the opportunity to be saved while reducing the exorbitant costs associated with euthanizing and disposing of their bodies. Isn't saving lives and saving money a good thing?

Although I work full-time in management, I was also a dedicated volunteer at a shelter in Sacramento, spending the majority of my weekends, holidays, and vacations helping at-risk animals by evaluating them, making videos, and sharing their stories on my social media. I was extremely successful creating public awareness so that fosters, adopters, and rescues could help save a life.

I along with many networkers and rescues across California, save at least half of the shelter population by sharing with the public which dogs are at risk for euthanasia. Unfortunately, I experienced firsthand that many shelters choose to hide which animals they intend to euthanize, and therefore many animals are killed without a chance.

While volunteering, I was blindsided when the shelter director, who is also director at Cal Animals, told me that I could no longer volunteer if I continued to use the words at risk for euthanasia on my own personal social media. I was bullied and retaliated against for telling the truth. This is not uncommon for volunteers and staff to experience. I have seen what happens to vulnerable animals when no one is made aware that their lives are at risk.

Volunteers were often heartbroken when we came in to find half a building empty, only to learn that they were killed without notice. We were devastated knowing we could have helped if only we had known. It is incomprehensible to me that anyone would oppose this simple, effective, life-saving notification that can easily be implemented using existing shelter infrastructure. Thank you.

Thank you very much. Any additional witnesses who want to add on in support of the Bill? Any additional witnesses in support who just want to add their name, organization there with, if any, and position on the Bill.

Julie Verga, sponsor in support of this legislation. Thank you.

Thank you.

In support of this.

Thank you.

Susan Falcon, in support of this legislation.

Thank you.

Cathryn Rakich, longtime foster mom and animal rescuer, and I support this Bill.

Thank you.

Estella Drake, comma, the Voice of the Voiceless Animals in the State of California. They I are in support.

Thank you.

Susie Yamel in support from Norse Led.

Thank you.

Elise Myers with Fixed Front Street in support.

Thank you.

Mike Yu in support of the Bill.

Thank you.

Claudia Borden Campbell, longtime animal rescuer and absolutely support of this transparency.

Thank you.

Mark Chican, 25 years of on the firing lines of animal care, rescue, and treatment at my home. Strongly, extremely in support of the Bill.

Thank you.

Jan Schott from Walnut Creek, longtime animal volunteer rescue.

Thank you.

Hello. Corinne Cooper from Suisun City, longtime animal advocate and supporter of the Bill.

Thank you.

Lisa Kirk, Contra Costa County. This also supports the Governor's intention of no shelters should kill healthy, treatable, adoptable animals. Thank you.

Thank you.

Gary Cooper, animal lover in support of the Bill.

Thank you. We got one more.

Nick Sackett for Social Compassion in Legislation. We're kind of a tweener position. We understand there's a lot of complications about how it's implemented, and it's not so simple, but we're happy to engage with the author and the Committee Going forward on this.

Thank you. Great. Thank you very much. Any witnesses in opposition to the Bill? Come on up. You've got two minutes each. Ready when you are.

Hello, my name is Jill Tucker and I'm the CEO of the California Animal Welfare Association, representing hundreds of municipal and nonprofit shelters. The shelters in California, joined by major animal welfare organizations, are opposed to AB 2265, even with the proposed amendments, because this Bill threatens public safety, reduces the public's interest in adopting, and threatens the safety of our staff.

Shelters have a legal obligation to hold animals for a period of 72 hours, yet they choose to hold them as long as they can to help them find a new home. Thus far, in 2024, the average length of stay for dogs and cats in shelters is 32 days. During this time, shelters are reaching out to hundreds of rescue partners daily, asking for help, and running extensive promotions to encourage adoptions.

Only 30% of people acquire their pets from a shelter or rescue, which means the vast majority of people are getting their pets elsewhere. Many people choose not to visit shelters, seeing them as sad, scary places or perceive shelter pets to be damaged. We have maxed out on the effectiveness of guilt, shame, and emotional extortion to get people to adopt.

This Bill does not offer a solution to increase adoptions, but will most certainly keep adopters away while inciting hatred, threats, and actual violence against our employees and volunteers. Additionally, this Bill affords significant public safety concerns. Deciding which dogs threaten our community's safety is a responsibility of animal control. This Bill creates very narrow criteria for weeding out dangerous dogs, referencing a code section that only applies to owned dogs that have gone through a hearing process.

Under this Bill, an unowned dog that has just mauled a member of the public would need to be promoted for release. We want to save more lives, and this Bill does not help. AB 2265 is a misguided attempt at a one-size-fits-all solution, and we respectfully ask for your no vote. Thank you.

Thank you very much.

Mister Chair and Members, Matt Broad here, on behalf of the teamsters and respectful opposition. You know, I think this Bill is a good example of well-intentioned, but perhaps poorly executed. You know, we opposed a very similar bBill with respect to the list provisions, the 24-hour to 72-hour window last year by assemblymember Essayli. And so we're certainly not picking on our friend Assembly Member McCarty. We represent workers in these shelters, and the reality is that our members love animals.

Many of them have adopted as many animals as you possibly could, but they've also faced threats. They faced actual assaults all too frequently. And so we're very worried that these provisions that would require listing could invite, unfortunately, subjecting our members to more risks. And so with that, we're in respectful opposition today and hope to continue working with the author. Thank you.

Thank you very much. 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.

Good afternoon, Mister Chair Members. Karen Lange, on behalf of the Humane Society of the United States in opposition. Thank you.

Thank you.

Sharon Gonzalez with the City of Rancho Cucamonga, in opposition.

Thank you.

Caroline Grinder, on behalf of the League of California Cities in opposition.

Thank you.

Doctor Gary Weitzman, a veterinarian and President of San Diego Humane Society, voicing opposition to this Bill.

Thank you. If everybody can, everyone's been respectful to everyone so far. I know we're 3 hours in. If folks can just come up and provide your name, organization you're with and position.

On behalf of the County of Los Angeles, respectfully opposed. Thank you.

Thank you.

Dylan Finley on behalf of the ASPCA, respectful opposition.

Thank you.

Yarelie Magallon on behalf of San Mateo County, in opposition. Thank you.

Thank you.

Ashley Kluza, representing the City of Stockton Animal Services, in opposition.

Thank you.

Phillip Zimmerman, representing the City of Sacramento Front Street Animal Shelter requesting your opposition.

Thank you.

Josh Gauger, on behalf of the County Health Executives Association of California and the Urban Counties of California, opposed.

Thank you.

Carrie Fennell of Marin Humane, and we oppose. Thank you.

Thank you.

Hi, I'm Lisa Block, animal lover, and I oppose.

Thank you.

Kathy Rednien, San Rafael, California, opposed.

Thank you.

Rajita Vimuri with Humane Society of the United States, seven years admiral advocacy and adoptions counselor and foster mom of 20 plus dogs, opposed.

Thank you.

Claire Minidi of Valley Humane Society we oppose.

Thank you.

Lindsay McCall, Executive Director of the Humane Society of Sonoma County. We oppose.

Thank you.

Barbara Schmitz on behalf of the San Francisco SPCA. Were opposed.

Thank you.

Wendy Taylor Chanelian, on behalf of joy bound people and pets in opposition.

Thank you.

Cassie Heffington, Tulare County Animal Services, opposed.

Thank you.

Good afternoon. Amy Schucley and Tulare County Board of Supervisors. I had no intention of being here today. I just am here for something else. And Cassie said she was in here. I oppose. I've worked in local government for 17 years, and I would not want to make that decision every day to euthanize an animal.

Thank you very much.

Thank you.

Seeing no additional witnesses want to bring it up to colleagues for questions or comments or motions or seconds. Assembled Member Pellerin.

Hi. So thank you to the author and thank you, Chair. I have shelters in my district that are very concerned about this Bill and have raised a number of concerns. So do I have confirmation from you Assembly Member that you'll be working with them to try to resolve the opposition that they have to this Bill?

Yes. And just to be specific, when I look at the letter and some of the issues raised, that's not the overall intent of our Bill. Our intent of the Bill is notification before euthanasia and public process when you change policies. If you look at some of the letters and so forth, they talk about some of the standards, adoptable and treatable animals, what that means, and we will, as I promised you and others, we will work and remove some of those elements to make sure we focus on the gist of the Bill. Thank you.

Okay. Yeah. Thank you.

Thank you. Got a motion, Got a second. Any additional questions or comments? Seeing none. Assembly Member McCarty, would you like to close?

Thank you. Respectfully ask for your aye vote.

Thank you. Assembly Member I just really want to start by acknowledging that the hearing room today is full of people who love their pets. No matter whether or not you oppose this Bill or you support this Bill. I know everybody loves their pets. I know everybody here is working very hard at different stages of the process to try to save as many pets as possible.

And I think everybody would benefit from acknowledging that of the other, that maybe is on the other side of this Bill. I also want to acknowledge that there are significant disagreements about how the state can achieve its goal of solving the overpopulation issues we face and finding homes for all adoptable animals. The author has worked with me and my Committee on significant amendments to this Bill. I appreciate his commitment, which he just stated on the record, to continue working with stakeholders.

I very much appreciate a lot of the concerns that were raised by the opposition to the Bill and the importance of refining language and working out some of those areas of disagreement. For now, I believe that the Bill has made good progress towards reaching that compromise, so I'm happy to support it as amended today. Madam Secretary, please call a vote.

On AB 2265, McCarty. The motion is do pass as amended to the Committee on Appropriations. [Roll call]

That Bill is out. We'll leave the roll open for absent colleagues. Thank you very much. I think we've got some folks who need to add on to some bills, so we're going to take it from the top and do add-ons.