Senate Standing Committee on Health

This is your 10 second warning for the Senate Committee on Health. 10 seconds.

Senate Committee on Health will come to order. Thank you for, ladies and gentlemen, for attending this afternoon. As usual, we're going to allow six minutes of testimony per side. We have 12 bills on the agenda. Nine of them are on our proposed consent calendar.

I will read those now, probably read them again when we establish a quorum and take up the consent calendar. Item number two- AB 1943 Assemblymember Weber, Medi-Cal: Telehealth with amendments. Item number four- Assembly Bill 1792 Assemblymember Rodriguez, Emergency Medical Services: Personal Protective Equipment.

Item number five- Assembly Bill 2146 Assembly Member Rodriguez, Product Safety: Wearable Personal Flotation Devices. Item number six- AB 1936 Assemblymember Cervantes, Maternal Mental Health Screenings. Item number seven- AB 2129 Assemblymember Petrie-Norris, Immediate Postpartum Contraception. Item number eight- Assembly Bill 2131 Assemblymember Valencia, Certified Nurse Assistant Training Programs with amendments.

Item number nine- Assembly Bill 2154 Assemblymember Berman, Mental Health: Involuntary Treatment. Item number 10- AB 2556 Assemblymember Jackson, Behavioral Health and Wellness Screenings: Notice with amendments. And item number 11- AB 2841 Assemblymember Waldron, Controlled Substances: Research Advisory Panel: Meetings, it's an urgency matter with amendments. With that, we'll start as a Subcommitee with our first item.

Item number one, Assembly Bill 82, Assembly Member Weber, dietary supplements for weight loss and over the counter diet pills. Proceed when ready.

Well, thank you, Mr. Chair. I am here to present AB 82. AB 82 would ban the sale of diet pills to minors unless prescribed by a doctor. This bill would establish an ID check for the sale of dietary supplements and drugs to prevent minors from eating disorders. Eating disorders are a very serious public health problem affecting people of all races, ages, and genders, but it's especially troubling for our young people. While California is at the forefront of regulations concerning weight loss dietary supplements and diet pills, we do not prohibit the sale of these products to minors despite well documented dangers.

Teens are especially targeted by these diet pills as self image issues are prevalent in our adolescents. The opposition questions the claims that dietary supplements are laced with dangerous substances, when just last fall, the FDA found weight loss products contained yellow oleander, which is poisonous and can also cause heart problems.

This bill is needed so that parents may be aware of the products their children are taking and to prevent teens from looking to it towards a quick way to lose weight. The Legislature has passed a very similar bill recently. In 2022, the Governor vetoed this bill. In his veto message, he directed the Department of Public Health to convene a workgroup to study and develop a public policy to address the concern of dietary supplements and minors. The workgroup published their recommendations in February of this year, and among the recommendations that are in this bill include age restrictions for both dietary supplements and over the counter drugs and granting the Attorney General authority to assist with enforcement.

Additionally, this bill requires the CDPH to develop a notice to warn customers of the potential dangers when using this product. With that said, your vote today will ensure that we continue working to prevent already vulnerable youth from unnecessary health problems and eating disorders associated with weight loss supplements and over the counter pills. Today, testifying and witness, we have Naithrav Subbiah, a high school student from the Sacramento area, Allie Evans, a community advocate, and Dr. Sonya Frausto with Ten Acres Pharmacy. Thank you.

Okay, welcome. Thank you for joining us. Let's start with my left, your right. Introduce yourself and proceed when ready.

Good afternoon, honorable Members of the Committee. My name is Naithrav Subbiah. I'm a high school junior from Mira Loma High School in Sacramento, as well as a youth advocate for the Strategic Training Initiative for the Prevention of Eating Disorders based at the Harvard School of Public Health. I would like to share my experiences with witnessing firsthand the consequences of diet pills on the mental health of my close friends and my peers, as well as express my strong support for AB 82, which would ban the sale of deceptive over the counter diet pills and weight loss supplements to minors.

In our society, the pressure to conform to body image ideals is overwhelming, especially for teenagers. Throughout middle school and early high school, I too struggled with accepting my body. As a result of my weight, I grappled with my own mental health issues and tried hard to change who I was in pursuit of acceptance by my peers. But many of my peers also faced self esteem issues, especially during the Covid-19 pandemic, which only exacerbated these problems. In recent years, the rise of toxic gym culture and social media have increased in prevalence, only feeding into these harmful beauty ideals.

Children are convinced that they need to achieve an unattainable body, and they often turn to the deceptive claims toted by weight loss supplement companies. Paired with the promotion of strict diet plans, children ultimately develop poor mental health and body image issues. It is heartbreaking to see some of my close friends skipping meals on a daily basis and consuming diet pills in an attempt to achieve this body not knowing the consequences that it has on them.

At several points, I considered taking supplements so I could achieve a so called better body, and at times, my peers, who were unaware of potential risks, even encouraged me to take dietary supplements. This story can be seen in millions of Californian youth who lack this vital knowledge and, as a result, turn to diet pills in hopes of quickly achieving a certain body type. These are the children who urgently need protection from the deceptive weight loss industry.

AB 82 is crucial to shield the youth of California from these dangerous diet pills and weight loss supplements by preventing these companies from profiting off of and exploiting the insecurities of young children. Thank you for taking the time to listen to my concerns, and I hope that my efforts will inspire further action to keep diet pills out of kids' hands, and I urge you to vote in favor of AB 82.

Thank you. Excellent presentation. Thank you for joining us. Next, please.

Good afternoon, honorable Members of the California Senate Health Committee. My name is Allie Evans. I'm a sister and an advocate for a loved one with an eating disorder, and I'm here today to urge you to support Assembly Bill 82. At just 13 years old, I began making content online. I quickly cultivated an audience of hundreds of thousands, and though the opportunities that came along with that changed my life in profound ways, the lasting implications of growing up online didn't become clear until I entered my late twenties. I rationalized the things that I experienced because I was a child.

My ability to discern harmful or exploitive environments was impaired by my lack of life perspective. That's why I did not find it odd or manipulative when brands like Skinny Time Tea and other detox supplement brands reached out to me, offering thousands of dollars to promote their weight loss supplements, teas, and gummies to my hundreds of thousands of followers, most of which were between the ages of 12 to 16, just like me at the time.

Luckily, I had a team of adults behind me that passed on campaigns like this. But now, looking back as an adult, it is bone chilling to realize that these products are not just accessible to children, but they are strategically marketed and targeted to kids by adults. In the fall of 2021, my 12 year old sister Billie was diagnosed with Anorexia Nervosa. There were many factors that led to the development of her eating disorder, but we now know that social media played a major role in her obsessive thought patterns around eating and weight loss.

Her social media accounts for you pages were flooded with unsolicited weight loss videos created by unqualified fitness influencers, many of which were peddling the same supplements, teas, and gummies that brands had tried to make me promote as a kid. California's kids deserve the opportunity to enjoy their childhoods without being targeted by weight loss brands access to these products, along with round the clock advertisements for weight loss, are forever changing their sense of self and their relationships with their bodies.

This is why I am in support of Assembly Bill 82, a bill that, if passed, would regulate the sale of dietary supplements for weight loss and over the counter pills for minors. I support this bill because children do not have the ability to comprehend the impact that these supplements will have on their health and their development. Legislation is needed to protect kids because the brands behind these supplements have no plans to stop targeting our kids with manipulative and misleading marketing. And for that reason, I am urging you to pass Assembly Bill 82.

Thank you. And thank you for joining us as well. Yes, ma'am.

Thank you for the opportunity to talk to you. My name is Sonya Frausto. I'm a pharmacist for 20 years, and I hear these stories. I'm like, oh my gosh. I currently own Ten Acres Pharmacy here in Sacramento, California. We do not stock dietary supplements. We are located about a mile and a half from a middle school and a mile and a half from high school. I'm just hearing your stories, and I'm just thinking, wow. Currently, we are seeing an uptick of teenagers having multiple psychiatric issues requiring antidepressants, mood disorder medications.

And when we have supplements like this, there are potential drug drug interactions that they might not necessarily be aware of. And for them to be able to go buy these non-prescription products over the counter without the consultation of a pharmacist like myself, I am not able to help determine what potential side effects these kids could have.

They could be cardiac issues, there could be mental issues, obviously self esteem issues that all pharmacists have the ability to address when a patient properly comes to them and asks them for these medications. Pharmacists currently have several prescriptions that require an ID. Dextromethorphan, Robitussin, cough and cold medication, Pseudoephedrine. All of those require an ID to be purchased for patients under the age of 18. And this allows not only their parents, but allows the pharmacist to have direct interactions with these children, so that way we can determine if this is the correct medication for them.

So when dietary supplements are able to easily be sold anywhere without the purview of a pharmacist or the restriction of an ID, it puts our teens at risk for a host of issues, from cardiac to mental, body images, that we then have to increase the cost of healthcare. So I urge you, as a pharmacist, as a business owner, as a mom, listening to these stories, please support AB 82. Thank you.

Thank you. Thanks for coming, and thanks for your testimony. Are there any other witnesses in support of this measure? If so, please step forward. Name, affiliation, and position on the measure only, please.

Good morning, Mr. Chair and Members. Robert Moutrie, California Chamber of Commerce, in a tweener position. Just wanted to make on the record that we have removed our opposition due to recent amends, which were appreciated, to allow us to enforce the policy effectively. Thank you.

Thank you. Any other witnesses in support? Seeing none. Any witnesses in opposition to this measure, please step forward. You may take a chair at the table if you'd like.

Good afternoon, Chair and Members. Are you able to hear me? There we go. Anthony Samson, with Samson Advisors here on behalf of the Council for Responsible Nutrition. CRN is the leading trade association representing dietary supplement and functional food manufacturers and ingredient suppliers.

For starters, CRN is very much aligned with the Assemblymember's goals of addressing eating disorders among young adults. CRN's members adhere to a strict code of ethics, observe all federal requirements for quality manufacturing, and assure that the claims for their products are both truthful and lawful.

To be clear, CRN members do not make, manufacture, or market products with unsafe or illegal ingredients like steroids or unapproved drugs.

When Assemblymember Garcia initially introduced this Bill in the form of AB-1341 a few years ago, CRN noted that it was opposed to blanket restrictions on the sale of dietary supplements, absent scientific evidence of causation to health risk.

To that point, we raised at that time that there was no credible scientific causal link between CRN members products and eating disorders. That said, Assemblymember Garcia and her staff worked productively with us at the time to develop a solution, albeit an imperfect one.

Ultimately, Governor Newsom vetoed that measure and noted that the requirements that this Bill imposed on CDPH were beyond the scope of their capabilities. Since the veto, Assemblymember Weber has introduced this measure, and we very much appreciate the Member and her staff's open door policy since that time.

In those discussions, we've reiterated certain concerns, including with the warning requirement. As the Assembly Judiciary Committee analysis noted when it analyzed this warning language for AB-1341, the warning language may raise First Amendment implications because it amounts to compelled speech that disparages legitimate products with information that is not factual or without controversy.

In sum, CRN expresses our continued desire to work with the Assemblymember to further assist her efforts to combat the serious public health problem of eating disorders among our youth. But we do have some outstanding concerns.

We welcome the opportunity to narrowly tailor a Bill that would capture illegal, dangerous products while ensuring that safe and legitimate dietary products remain available. Thank you.

Thank you for joining us. Any other witnesses in opposition to the measure, please step forward. Seeing none, bringing the matter back to the dais and my colleagues. Colleagues, any comments, questions, or concerns? Senator Menjivar?

Assemblymember, thank you so much for bringing this legislation forward. You know, there's an image that I saw maybe 10-15 years ago on social media.

It was a young girl who was holding a bit of her belly fat with scissors about to cut it, and in front of her were magazines and so forth, because now, 10 years later, we know what social media is doing a lot to our self esteem of our youth and so forth.

So I also want to commend your witnesses for coming, bringing youth to the forefront of this conversation, because this is impacting you as youth. I think you should be part of this conversation. We're not just here to push legislation because we want to. It's because we're hearing from individuals that it's greatly impacted.

So thank you so much for this legislation, and when appropriate, I'd like to move the Bill.

Thank you, Senator Menjivar. Colleagues, any other comments, questions or concerns? Seeing none. Dr. Weber, would you like to close?

Well, thank you, Chair. First, I want to thank the Committee for looking and working on this Bill. I definitely have to thank my witnesses. This was a dynamic trio that I have up here today.

And, you know, if anyone can sit here and say that in California, we shouldn't do something at this point to stop our most vulnerable from having access, free access, to these supplements, they need to listen to these three individuals right here. So, thank you all so much.

You know, we'll continue to work with opposition, but the reality is that, you know, these are things, supplements that our youth should not be taking and not have access to it, to just go into a store and get it off the counter, because essentially what we're saying is that if you do that, there are no harmful effects, and we cannot say that for our most vulnerable.

And so we'll continue to work with them to ensure that we have a Bill that, you know, the Governor would sign this time so that we can really protect our adolescents. And with that, I respectfully ask for an aye vote on AB-82.

Thank you, Doctor. As soon as we establish a quorum, we'll take a motion and take a vote. Thank you all. Dr. Weber, would you like to proceed with Item Number Three, AB-2250, Social Determinants of Health.

All right, Chair and Members of the Health Committee, Senate Health Committee, I'm here to present AB-2250, which will require health plans and insurers to include coverage for social determinants of health screening and access to community health workers. And I will be accepting the Committee Amendments. Thank you very much for those.

Social determinants of health are commonly defined as the conditions in which people are born, grow, work, live and age, and a wider set of forces and systems shapes the conditions of daily life and affect health, function, and quality of life outcomes and risk. SDOH impacts about 80% of your health risk, health outcomes, and unfortunately, your life expectancy.

It is absolutely horrific that in this country and in this state, you can go on the website and type in your zip code and that will give you your life expectancy.

Social determinant of health screening tools and clinical practice help identify these social and economic risk factors of patients that are usually unknown to us, who are healthcare providers, but they are a critical piece and often the missing link to successfully preventing or managing health conditions.

Screening for SDOH are extremely important and this information can lead to health teams creating better health opportunities and plans for their patients. AB-2250 serves as a proactive solution to these challenges and helps address gaps in healthcare by requiring coverage and reimbursement for social determinant of health screening and access to community health workers.

While a similar Bill was vetoed last year. Despite what the Governor said in his veto message, this Bill is not redundant to federal initiatives, nor are adverse childhood experience screenings the same as social determinant of health screenings.

In regards to the question of redundancy to federal initiatives, these new efforts by the Centers for Medicare and Medicaid Services are only within the Medicare system and do not conflict with AB-2250, which targets the Medi-Cal and Covered California population.

And while aces can be considered one aspect of social determinants of health, they represent a specific subset of adverse childhood experiences that can influence health outcomes. Social determinants of health, on the other hand, encompass a broader range of social and environmental factors that influence the health and well being throughout a person's entire life.

By requiring coverage for screening and access to community health workers, AB-2250 ensure that Medi-Cal beneficiaries benefit from these essential services. Additionally, extend support beyond the Medi-Cal population to include other vulnerable groups, such as those under Covered California, who also face social needs but may not have access to those services previously.

With me here to speak in support of AB-85 are Tiyesha Watts, CAFP Legislative and Policy Advocate, and Dr. Robert Assibey, Family Physician at San Joaquin General Hospital. Thank you.

Welcome. Thank you for joining us. Please proceed when ready. Please introduce yourselves for the record.

Good afternoon, Chairman and Committee Members. My name is Dr. Robert Assibey, and I'm a Family Medicine Physician practicing in San Joaquin General Hospital in Stockton, California. I am here today to share why I passionately advocate for the inclusion of social determinants of health in our healthcare approach to address the needs of vulnerable patients outside the clinic walls.

As a physician, I see firsthand how critical it is to understand the broader context of my patient lives. For instance, I facilitate a street medicine clinic where we provide healthcare to the unhoused population.

In one case, I had a patient with heart failure who was extremely tearful because his medications would always get stolen from the encampment where he stayed.

Worse yet, he didn't want to take his water pill anymore for the fear of constantly urinating on himself as he was unable to walk and he was in a wheelchair due to his leg swelling and pain.

I had to navigate how to treat him with a specific dose, timing of his medication, one week prescription at a time, and have it delivered to the church where I was treating him at. Had he been screened earlier for social determinants of health, his outcome may have been different.

AB-2250 would provide the resources necessary to screen our patients early and help us, as physicians, identify the social needs that can cause unnecessary healthcare complexities down the line. Yet screening for these social determinants is only the beginning. Many of the patients face barriers beyond the clinic that hinder their ability to follow through with their treatment plans, like my patient.

AB-2250 addresses the gaps by bridging healthcare with essential community resources. Through the support of community health workers and social workers. These professionals can connect patients with necessary services such as food, transportation, housing, healthcare, and ensure they receive comprehensive and continuous care.

For example, I had another patient who was diagnosed with HIV and could not get her labs performed to accurately monitor her treatment plan.

When I was able to connect her with a community health worker who looked like her, talked like her, and understood her environment, were we then able to get her scheduled for her labs and appropriately managed her care. This Bill is a crucial step toward a more holistic healthcare system that truly meets the needs of our communities.

I respectfully urge you to vote yes on AB-2250. Thank you.

Thank you, Doctor. Next, please.

Hi. Good afternoon, Chair and Members of the Committee. Thank you for the opportunity to address this critical issue. My name is Tiyesha Watts, representing the California Academy of Family Physicians. Addressing patient's socioeconomic needs is essential for improving health outcomes.

Issues like lack of food, housing, clean water, transportation, and employment significantly impact health, especially for those with chronic conditions. Issues like, take for example, patients with type two diabetes. Without access to affordable medication or healthy groceries, managing the A1C levels becomes a difficult task. The rationale for screening for social determinants of health is simple.

If you don't ask, you won't know. And if you don't know about a patient's social needs, you cannot address them and provide the best care.

Despite progress with initiatives like the Community Health Worker Benefit under Medi-Cal, and Social Determinants of Health Diagnostic Codes under CalAIM, there are still gaps that AB-2250 seeks to fill. Primary care providers face barriers in collecting and documenting social determinants of health data, and without proper resources and reimbursement, they cannot effectively conduct screenings or connect patients to necessary resources.

As the first and often most consistent point of contact in the healthcare system, social determines of health screenings are typically conducted by primary care physicians. However, Medi-Cal does not currently reimburse them for these services. AB-2250 proposes covering social determinants of health screening in the primary care setting, ensuring equitable access to essential health services.

The Bill also bridges gaps between medical care and the vital role community health workers provide in providing social supports and services. By linking patients with community health workers, we can address unmet social needs and improve health outcomes and equity. Significant investments have been made to strengthen the community health worker workforce, including recruitment, training, and certification.

Health plans and insurer also play a key role in these efforts, either through partnerships with community organizations or employing community health workers directly. With the Bill's implementation date in 2027, we anticipate an even more robust community health worker workforce ready to serve vulnerable populations.

In closing, AB-2250 is vital for addressing social terms of health and advancing health equity. I urge your support for this legislation. Thank you for your time and consideration and I'm available to accept any questions.

Thank you for your presentation. Any other witnesses in support? Name, affiliation, and position on the measure only, please.

Mr. Chair and Senators, Dean Grafilo, with Capital Advocacy. Here on behalf of California Life Sciences, in support of AB-2250.

Thank you. Next please.

Mr. Chair and Members of the Committee, Mark Oprea, on behalf of Children's Choice. Urge your aye vote.

Thank you. Next.

Mr. Chair and Members, Rand Martin, on behalf of the AIDS Healthcare Foundation, in very strong support of this Bill. Thank you.

Thank you, sir. Next please.

Isabella Argueda, with the Health Officers Association of California. In support.

Thank you.

Kelly LaRue, for the California Kidney Care Alliance. In support.

Thank you.

Tim Madden, representing the California Chapter at the American College of Emergency Physicians. In support.

Thank you, sir.

Brian Spencer, on behalf of OCHIN and the American College of OB-GYNs District IX. In support.

Thank you sir. Next please.

Jennifer Robles, with Health Access California. In support.

Good afternoon. Sandra Poole, Western Center for Law and Poverty. In support.

Thank you.

Abby Alvarez, on behalf of Essential Access Health, APLA Health, and Local Health Plans of California. In support. Thank you.

Thank you. Next please.

Mr. Chair and Members, Dennis Cuevas-Romero, with the California Primary Care Association Advocates. Proud co-sponsor of the Bill. Thank you.

Thank you, sir. Next please. Yes ma'am.

Hello. Molly Robson, with Planned Parenthood Affiliates of California. In support.

Thank you.

Good afternoon. Kelly Mac Millan, on behalf of two clients, Children's Specialty Care Coalition, and DaVita.

Thank you. Yes, ma'am.

Hello. Marissa Montano, with the California Academy of Family Physicians. Speaking on behalf of our co-sponsors who couldn't make the hearing. The California Black Health Network. In support.

Thank you, ma'am. Yes, sir.

Mr. Chair and Members of the Committee, Brandon Marchy, with the California Medical Association. In support.

Thank you. Any other witnesses in support? Now let's turn to witnesses in opposition. Any witnesses in opposition? First lead opposition. Okay. Seeing none. Any other witnesses who wish to speak in opposition to this measure? Seeing none. Okay, let's bring the matter back to the dais. Colleagues, any comments, questions, or concerns? Senator Rubio, you may start.

Thank you. I want to thank the good Doctor here for bringing this forward. I think it's just such a great investment to tackle these issues early on. And I know, I just, you know, it brings me back to some of the days of when I was a teacher in the classroom and, you know, used to focus on some of the things that we discovered later on in life when we used to say, if only they had caught this early on, like the difference it would make for children and families.

And so I just don't think it's the family that benefits from this, but it's just our entire community, our school district. And at the end of the day, we invest upfront so that we don't have to take care of, you know, incredible costs at the end for families.

And again, just simply as a school teacher, just thinking of what it does to children sometimes when we cannot catch some of these things that we should have at the very beginning. So I want to say thank you, and I'm happy to add as a co-author.

Appreciate you.

Thank you, Senator. Any other comments, questions or concerns? Colleagues seeing none. Doctor? You may to close.

Thank you. Thank you. Once again, want to thank the Committee for your work. And again, we'll be accepting the Amendments. Want to thank those who came and spoke, testified in support, and also all of those who are in support. I want to thank Senator Rubio for her amazing comments, but she is a 100% correct.

A lot of these things we can catch early. The only way that we are really, truly going to be able to make a dent in closing some of the equity gaps within health and in our communities. Some of the disparities that we see, is to really get to the root.

And a lot of that has to do with the societal issues. And as providers, we try to do our best. We have changed the way in which we think. When I was in medical school and early residency, we used to talk about the noncompliant patient, right?

And we have now switched that thinking into saying, well, why is this patient late? Oh, because they had to take two buses here. Why is this patient not taking their medication? Well, because they don't have a refrigerator to hold their insulin.

And so we have switched our thinking, and now it's time for the state to which it's thinking and how we treat and we pay for, and we look at our patients to say, yes, we may need to do a little bit more upfront to prevent longer and more chronic healthcare issues and cost down the line.

And this is a Bill that will help us do more of that prevention. And so with that, I respectfully ask for your vote on AB-2250. Thank you.

Thank you, Doctor. As soon as we establish a quorum, we'll take a motion and we'll take a vote. Thank you for your presentation. Thank you for being here. Now let's turn to item number 12 AB 3245 Assemblymember Patterson, Coverage for Colorectal Cancer Screening. Proceed when ready, sir.

Hi, again. Thank you, Mister Chair. Senators, I'm here to present AB 3245, and I will be accepting the Committee amendments and really appreciate the work with my team on this piece of legislation. As you may know, there is currently litigation going on in Texas that puts into jeopardy the coverage of colorectal cancer screening.

And so what my legislation does is it ensures we bring in a little bit more of that control here in California to make sure we don't lose that coverage here for people who really depend on it. And I'm sure, unfortunately, many of us have been, our friends have been impacted by these types of cancers. It's very important.

I don't think there's really any debate on that, but we want to make sure, if the litigation causes problems in terms of the coverage, that we have a solution here in California to make sure that these screenings can continue and that lives continue to be saved. And so with that, happy to answer any questions and respectfully ask for your aye vote.

Thank you, sir. Is this a yes?

I have Director Emeritus Dean Grafilo with me.

Please proceed when ready, sir.

Chair Roth, Senator's Committee Staff. Dean Grafilo with Capital Advocacy on behalf of California Life Sciences. We are in support of AB 3245, which would require health plans to cover colorectal cancer screening. California Life sciences represents over 1200 entities representing pharmaceutical, biotechnology, medical technology, and academic research institutions throughout California.

After skin cancer colorectal cancer is the third most common cancer diagnosed in both men and women each in the United States. In 2023, over 150,000 adults in the United States were diagnosed with colorectal cancer. These numbers include over 106,000 new cases of colon cancer and over 46,000 new cases of rectal cancer. Over 50,000 deaths from this disease occurred in the United States just last year alone. However, when colorectal cancer is found early, it can often be cured.

The death rate from this type of cancer in 2020 in the United States was 57% less than it was in 1970 due to the improvements in treatment and increased screening, which detects colorectal changes before they turn cancerous.

Through AB 3245, Californians will have increased access to colorectal cancer screenings that can potentially save their lives, or at least catch the cancer early enough to save the cost of the most expensive and arduous late stage treatments. For these reasons, California life sciences strongly supports AB 3245. Thank you.

Thank you for attending and for your presentation. Before we take further support and opposition, let's establish a quorum. Please call the roll.

[Roll Call].

We have a quorum. Thank you. Any other witnesses in support of this measure? Name, affiliation and position on the measure only, please.

Brandon Marchy with the California Medical Association in support.

Thank you for joining us. Any other witnesses in support? Any other witnesses in opposition? First lead opposition. Come on down.

Mister Chair and Members. Stephanie Watkins, on behalf of the Association of California Life and Health Insurance Companies, first I'd like to thank the Committee and the author and the sponsors for their open dialogue on this.

Originally, AB 3245 required health plan contracts and health insurance policies to provide coverage without caution for colorectal cancer cancer screening assigned by the task force or in accordance with the most current recommendations established by another accredited or certified guideline agency.

Our primary concern was that the Bill was proposing to move away from utilizing the current task force standard and replacing it with any recommendation established by another accredited or certified guideline agency previously seen the standard proposed in other bills, and it certainly gives us pause as it would create not only uncertainty in the market, but also inconsistencies as individuals plans could have differing view standards as to what should be covered without cost sharing.

That being said, we much appreciate the Committee's amendments and feel they go a long way to address our concerns. We have those circulating out to our membership and hope to be re-evaluating our position if the Bill moves forward today. Thank you.

Thank you. Next, sir. Good afternoon, Chair and Members of the Committee. Robert Boykin with California Association of Health Plans. Regrettably here today in opposition AB 3245. I would like to echo the comments of ACLHIC, who just went before me.

We would also like to add that our concerns stemmed from the unknown premium impact should a new non evidence based screening that isn't consistent with national standards be covered without cost share? We are thankful for the amendments as well and we'll be reviewing our position as the Bill moves forward today. Thank you.

Also, sue. Thanks for being here. Thank you. Any other witnesses in opposition?

Chair Members, John Singer, on behalf of. America's Health Insurance Plans would echo the comments of CAAP and ALCHIC.

Thank you. Any other witnesses in opposition? Seeing none. Let's bring the matter back to my colleagues on the dais. Colleagues, any comments, questions or concerns? Looking right, looking left, seeing none. So may Member, you may close.

Well, thank you very much. You know, when this was brought to my attention, I was very interested in it. I had a really good friend of mine who was diagnosed with colon cancer at 40 years old. Fortunately, because of screening and detection, he just celebrated his 50th birthday. Three young, beautiful children.

And so because of that, gave me the motivation to do this Bill. I'm very pleased to work with the Committee and also the opposition. And I'm hopeful that we'll be able to remove the opposition. But if not, I think this is an important issue and continue to work with anybody that expresses concern and respectfully ask for your aye vote. Thank you.

Thank you. Nice presentation. This is Assembly Bill 3245. Is there a motion, colleagues? Senator Wiener moves the Bill. Please call the roll. And the motion is do pass, as amended. And we refer to the Committee on Appropriations.

[Roll Call]

Vote is 9-0. We'll hold the. We're open for absent Members. Great.

Thank you very much.

Let's return to item number one, AB 82, Assembly Member Weber, dietary supplements. The motion has been made by Senator Menjivar. The motion is do pass, re-refer to the Committee on Judiciary. Please call the roll.

[Roll Call]

Vote is 8-0. We'll hold the roll open for absent Members. Let's take up the consent calendar. The consent calendar is item number two, AB 1943, Weber, Medi-Cal telehealth. Item number four, AB 1792, Assembly Member Rodriguez, emergency medical services. Item number five, AB 2146, Assembly Member Rodriguez, product safety.

Item number six, AB 1936, Assembly Member Cervantes, maternal mental health screenings. Item number seven, AB 2129, Assembly Member Petrie-Norris, immediate postpartum contraception. Item number eight, AB 2131, Assembly Member Valencia, certified nurse assistant training programs with amendments. Item number nine, AB 2154, Assembly Member Berman, mental health involuntary treatment.

Item number 10, AB 2556, Assembly Member Jackson, behavioral health and wellness screenings with amendments. Item number 11, AB 2841, Assembly Member Waldron, controlled substances research advisory panel urgency with amendments. Is there a motion on the consent calendar? Senator Nguyen moves the consent calendar. Please call the roll.

[Roll Call]

Consent calendar, the vote is 10-0. We'll hold the roll open for absent Members. And let's take up item number three, Assembly Bill 2250, Assembly Member Weber, social determinants of health. The motion is do pass as amended and re-refer for the Committee on Appropriations. Is there a motion? Senator Hurtado moves the measure. Please call the roll.

[Roll Call]

Vote is 8-0. We'll hold the roll open for absent Members.

I'm sorry, I didn't... I was... Okay, let's open the roll. First on item number one, AB 82, Assembly Member Weber, dietary supplements. The motion is do pass and re-refer the Committee on Judiciary. The current vote is 8-0. Chair voting aye. Moved by Senator Menjivar. Please open the roll.

[Roll Call]

Vote is 9-0. That bill is out. Let's move to the consent calendar. Items on the consent consent calendar. Item number two... Do you need me to read these?

No, I have them here.

Okay. Let's open the roll on the consent calendar, starting with item number two, AB 1943, Assembly Member Weber, Medi-Cal telehealth. Senator Nguyen made the motion. The current vote is 10-0, Chair voting aye. Please open the roll.

[Roll Call]

Vote is 8-0. 11, rather, zero. The consent calendar is out. Next item is item number three, AB 2250, Assembly Member Weber, social determinants of health. Motion do pass as amended, re-refer to the Committee on Appropriations. Moved by Senator Hurtado. Current vote 8-0. Chair voting aye. Please open the roll.

[Roll Call]

Vote is 9-0. Item number three, AB 2250 is out. Last item, item number 12, AB 3245, Assembly Member Patterson, coverage for colorectal cancer. Motion by Senator Wiener. Current vote 9-0. Chair voting aye. Please open the roll.

[Roll Call]

Vote is 10-0. That matter is out. Seeing no other business before the Health Committee, the Health Committee hearing is adjourned.