Senate Standing Committee on Rules

The Senate Committee on Rules will come to order. Before we begin today's agenda, let's establish quorum. Secretary, can we please call the roll?

[Roll Call]

Quorum has been established. Thank you so much. Thank you all for being here for my very first rules hearing. Everybody, if there's no objections, I'd like to take up first on today's agenda. Governor's appointments not required to appear, starting with item 2C.

The appointment of Courtney Welsh as a Member of the California Housing Partnership Corporation Board of Directors.

I would so move.

Thank you so much. Senator Laird has made the motion. Can we please call the roll?

[Roll Call]

All right, that item is approved with the 30 vote. Next, we have an item for the governor's appointments not required to appear. Item 2 D. Janessa Goldbeck for the California Veterans Board.

I would so move.

Thank you so much. Senator Laird has made a motion. Can we please call the roll?

[Roll Call]

All right, thank you very much. That item is Approved with the 30 vote. And the last item for the governor's appointments not required to appear is item 2E. Tom Huntington for appointment to the state Parks and Recreation Commission. I'll entertain a motion. Thank you so much. Senator Laird has made the motion. Can we please call the roll?

[Roll Call]

Thank you very much. So that motion is approved, three to zero. Next, I'd like to take up item three, which is reference of bills to committees. I will entertain a motion if there is one. Thank you so much. We have here. We have. Sorry, I'm going to call the roll. Thank you.

[Roll Call]

That item is approved with 4 to 0 votes. The next item I'd like to take up is item 4. Appointment of the chairs and Members of committees for the 2026 legislative session. Please note that all changes aside from the budget Committee, budget subcommittees and natural resources and water committees will take effect February 1st of 2026.

This includes the creation of the two new committees, which are contingent upon the adoption of the Senate. Senate resolution creating the new committees. I will entertain a motion. Thank you so much. Senator Jones, with The motion. Can we please call the roll?

[Roll Call]

All right, that is out. 4 to 0. Next, I'd like to take up item number five, the adoption of the 2026 session schedule. I'd welcome a motion. Thank you so much, Senator Jones, for that motion.

[Roll Call]

All right, that motion is out, 4 to 0. For the next item, I'd like to take up item number six, the 2026 Senate Holiday schedule. I will entertain a motion. Thank you very much. Senator Jones, can we please call the roll?

[Roll Call]

Next, we will move on to. For acknowledgments. So before we turn to our Governor appointees, we're going to move to items 7 and 8 Floor Acknowledgments, and I will entertain a motion. Thank you very much, Senator Jones, for the motion.

[Roll Call]

4 to 0. So now we're going to return to governor's appointees that are required to appear. And we're going to begin with item 1A, the appointment of Hernando Garzon, M.D. as Chief Medical officer, Emergency medical services authorities. You are welcome, or if you prefer to. Okay. Okay, great. Thank you. Thank you very much.

Dr. Garzon, you will have the opportunity to provide one to two minutes for your opening testimony to this Committee. And in your opening, you're welcome to introduce any guest. I will be keeping time of the opening and we'll give you a prompt when it is time to close that opening. Opening.

Thank you. Thank you, Senator. Good afternoon, Senators and distinguished guests. My name is Hernando Garzon. Thank you for your time for the opportunity to attend this confirmation hearing.

I've been serving as the acting Chief Medical Officer for the California Emergency Medical Services Authority since November of 21 and began my Governor appointment position for the same role on March 25. I serve in partnership with the Director of EMSA, Elizabeth Basnet, who was appointed to her position in 23.

I would like to thank Governor Newsom for the appointment to the position. I would like to give you a bit more background than you will find in my resume or LinkedIn page. Both for context and better understanding of how I got to sit here in front of you today.

I was born in Bogota, Colombia, and my family moved to New York City when I was 4 years old. I started kindergarten one month after we emigrated, not yet speaking any English except for four years in Western Massachusetts.

During college, I grew up and attended medical school at New York University and completed my Emergency Medicine residency in New York City. I characterize my career with two lifelong recurring themes. The first is the motivation to be of service. This has been my guiding principle as a physician.

The second is an endless curiosity to undertake new challenges and opportunities, particularly if I can apply my medical knowledge to them. I've been very fortunate to have a unique and diverse career as a physician.

The foundation of that professional career has been 30 years as an emergency Department physician doing emergency Department shifts in Northern California, primarily in Sacramento, but I've always been curious about using my medical knowledge in other settings.

Shortly after beginning my clinical practice in Sacramento, I joined the Sacramento Urban Search and Rescue Team in the nascent Urban Search and Rescue System under the Federal Emergency Management Agency.

In that role, I served as the Chair for the Urban Search and Rescue Medical Working Group federally and in 15 years of participation, I provided medical oversight for federal relief efforts in many federal disasters, including the Oklahoma City bombing, the World Trade center at 911 New Orleans during Hurricane Katrina, and others.

The FEMA work led to international training opportunities through the US State Department, and I have worked with many international non governmental organizations like Doctors Without Borders International, Medical Corps Relief International, and Project hope in over 20 countries.

Circling back to my career at home, I was able to bring emergency management and disaster response experience back home in two ways.

Perhaps most pertinent to this Committee is the second way was through my work with the Sacramento Fire Departments, and as a result of that work, I served as the Sacramento County EMS medical Director from 2008 to 2022.

All of this career experience led directly to my participation with EMSA and the California Department of Public Health in the state's response to the COVID 19 pandemic, and finally to the position I currently serve at EMSA.

On a personal level, I have three amazing children, three amazing granddaughters, and we had two family weddings in 2025 as two of my children got married that year. I enjoy almost any outdoor activity but skiing in particular, and in case you haven't guessed already, I love to travel. Thank you again for your time and attention. I'm happy to take questions.

Thank you very much, Dr. Garzon. For your service Members. We're going to open it up for questions. Questions, any questions. And I'm going to start with Senator Laird, followed by Senator Jones.

Thank you for your service and your willingness to serve. And I appreciate the the background you just described that you bring to this position because I think that will be really helpful. I just had a few questions and one is, is that in 2023 your agency did a strategic plan and it's supposed to cover 10 years.

What progress have you made and how has that given you some priorities that you are trying to move ahead with as you move into this position?

Senator, thank you for that question. So in addition to the Health and Safety Code, the statute and our regulations, our strategic plan has been a critical part of essentially laying the roadmap for our progress moving forward. Built into that strategic plan is a process to reevaluate and update that plan.

So we had short term, medium term and long term objectives. Our plan was and we're working on now is a two year update of revision to that where we review our short and medium term goals and assess them.

And so we've all the work we've done in the last couple of years which have worked in many areas but have been very focused on updating our regulations book with many of the chapters are outdated to address the objectives that we have laid out in that plan, defining the metrics that we're going to use to track success and progress in those areas.

And we should have a two year report at some point in this coming year for how we've been doing with that strategic plan.

And at a high level, are there certain places you've already adopted that there's real shortcomings that you need to address?

Well, we've been there were many I'll give you some of the highlights, I think of the strategic plan. One is to as some of you may know, EMSA has a role in disaster response throughout the state.

So part of this is to look at our preparedness, especially with changes that have happened at the federal level and knowing that we face increasing climate change issues and other things are are we prepared enough as a state and is MSEP prepared enough to participate the way it is designed to and supposed to in that so that's one component.

Another component has been our data because we have many silos of data, whether it's the central registry on EMS personnel or the clinical records that we have that paramedics complete the patient care reports.

And many questions have come up about and I think looking for data and I think both Director Besnett and I believe in a data driven, evidence based decision making process moving forward. Do we have the data we need and how do we bring that all together?

So we've done huge changes in our information technology section, worked with Department cdt, California Department of Technology to have. We're making this effort to bring all this data in house, have it all communicate with each other and have that more easily available so we can do the analytics we need to do for our EMS system.

And then sort of what you said tees up my next question a little.

And I really appreciate the, the sort of emphasis on climate because I mean I had a district and I'm sure Senator Lamone had a similar thing that were ground zero in the atmospheric rivers a couple of years ago, the Pajaro levee break, various pieces of wharfs floated away, seawalls were washed away.

It was into homes in a number of places. And a lot of those, despite the stereotype about the coast, were disadvantaged communities and disadvantaged people. And so helping be prepared is a big deal. But you sort of have 34 emergency medical services areas in the state and you work with them and they're all very different.

And so how do you take standardized protocols that are supposed to be for the entire state and deal with the fact that you might be dealing with wealthy coastal areas, disadvantaged farm worker communities? How do you make sure that that sort of isn't this one size fits all and it deals with these differences.

Thank you Senator for your question. So I think fortunately the EMS act of 1980, the health and safety code that is written for EMS, was very forward thinking to take this into account because we really have a two tiered system of EMS governance in the state.

We have the EMS that created this EMS authority for the state and we provide, as you mentioned, sort of statewide regulations and create a minimum standard. But then with the 34 local EMS agencies, they each have an administrator, they each have a medical Director and they write the local policy. And so we balance this carefully.

We meet with the administrators and the medical directors on a quarterly basis and even more often as a group, actually as a collective group, but also have calls with their leaderships monthly to address issues.

And as much as we can, we try and create state standards that then they can fine tune or make more specific to their particular circumstance. Because as you mentioned, we have wealthier areas, we have rural areas versus urban areas and different numbers of resources, both on the Ms. Side and the hospital side.

So some rural areas have to do more air medical transports of critical patients, whereas in an Urban center like Los Angeles or San Francisco, you see relatively little helicopter use. So all these things have to.

We appreciate the differences locally and we give them, I think, the minimum standard and the framework or the architecture for them to apply locally for their needs.

And if you ascertain that somebody in some area has not met the standards or is struggling, what recourse do you have to deal with that?

So I think there's two things we do. One is the struggling portion is we provide technical assistance. And we frequently, I think the, the administrators and the local EMS medical directors tend to be a close knit group of people that work collaboratively so they frequently share best practices.

And from the EMSA side, we provide technical assistance for people having problems resolving something or getting an application together for community paramedicine program or something like that. We provide help in doing those things.

And then when they're not meeting their regulatory responsibilities, we have a regular cadence of communication of meeting with them and working with them to see how can we get you in compliance with them.

Okay, I appreciate that. And that is an issue we all deal with with our locals. And my last question is, is that frequently either laws or budgets require reports and somehow it's up to us to make sure that the reports are actually done.

And there was a requirement for your agency to develop and publish a report on its work website showing the allowable maximum rates for ground ambulance transportation services in each county. And I think that report is late if it's been made. Are you working on that? Is that something you're going to have out there and meet that requirement?

Yes. So we're aware of that. I believe you're talking about Assembly Bill 716, that that legislation is really under the purview of the Director at emsa. I think as the chief medical officer, I typically don't get involved with ground ambulance transport rates. I tend to focus more on the medical side.

So I, I suspect you'll go back. To the office and you'll say, I was asked about that. When are you going to do the report? So. So you should probably just do that.

It doesn't come up in that confirmation hearing. Okay. Thank you. You've been very responsive. I appreciate it.

Okay.

Thank you. We're gonna go on to Senator Jones and then we'll do Senator Reyes.

Thank you. Actually, Senator Laird hit on a couple of points that I wanted to make as well. On the answer to the last question, I would second Senator Laird's request that you have a conversation with the Director and just mentioned that you know we're anticipating that report and we'd like to see it. Another. Sorry, two other.

One other issue he picked up on was the statewide standardization protocols. Specifically on that note on AB40 regulations, the ambulance patient offload time. I've received some feedback that the regulations were adopted and need some clarity to them.

Do you anticipate your authority doing an faq, facts and questions or other informative documents to respond to concerns raised by stakeholders for more clarity on those regulations?

Senator, thank you for your question. Yes, absolutely. So the AB40 legislation called for EMSA to produce emergency regulations for all the things that were required in the legislation. And so that process, I think, was a three month process.

We took public comments but didn't respond to them and that they were passed so that we can actually begin the program, begin the portal to verify the signature that EMS providers had to allow the hospital staff to sign. And so it's been a learning process for all of us. We work collaboratively with hospital partners and EMS partners.

They've given us feedback. We've heard similar things. We've actually been changing and improving the process along the way. For example, in the portal, initially you couldn't download the table of incidents that were happening and people requested that. So we made it so that they can download it to facilitate their work and their audits and things like that.

So after the emergency rulemaking process comes a process where you have to then go and go through the normal rulemaking process with a longer public comment period and all of that.

So all of the feedback we've gotten about the initial, the approved emergency regulations has gone into the drafting and revisions of those regulations, which we hope to have out for public comment in the, in the next three to six months.

Great, thank you. One final thing. You know, obviously we pass bills here that, you know, take effect and become law and then regulators pass things that, you know, become regulations and stakeholders have to respond to. So I kind of like to get a grip on kind of your personal leadership style on dealing with stakeholders.

Can you speak to your leadership style and how you would engage meaningfully with the full range of stakeholders. And if you want to mention a couple of stakeholders in your, if you have some in mind, that would be great with your emergency services space to ensure that all the stakeholders perspectives are heard.

Exactly. So I think Director Besnett and I are both very much on the same page about transparency and inclusivity. And when we both came on board, it was, okay, what are the issues? What are the people's position? And let's Bring them all to the table and discuss this and everything, starting with the strategic plan.

It took us a year to develop that plan. We did that in partnership and in meetings with all the relevant stakeholders. And so I think collaboration is a critical component of my leadership style for certain.

I mean, I think we have on the EMS side, we have both local EMS agency staff that they oversee EMS locally, and then the participants in that system include the EMS providers. And we have public and private EMS providers throughout the state. And then we also have hospital side. Right. Because EMS interfaces with the hospital system.

So we are in frequent communication with CHA and other hospital liaisons. And. And then we have the American College of Emergency Physicians and we have the Nursing Association, California association, and others that weigh in and participate in many of our committees and our technical advisory groups.

Do you have some particular ways that you like to do that? I think you mentioned roundtables. Do the stakeholders have access, I don't know if it's appropriate or not, for your cell phone number.

Do you bring people in for stakeholder meetings and kind of get their thoughts and ideas on how these regulations and laws are impacting the implementation?

Yes, all of those. I think I probably give out my cell phone too liberally, but have that same problem because. Yeah. And my goal is to be available. Right. For people. So I really don't hesitate to share that information.

And even, you know, the lowest level paramedic that call me and they say, zero no, we can't call you. We'll have my boss call you. I said, you call me if you have an idea or question or suggestion. So to be inviting that way to begin with. And then I think it depends on the topic.

So we have a number of ongoing quarterly meetings. When we're trying to get through, say, a regulations update, we may have more frequent. Sometimes it's a smaller regulatory update. It's not too contentious. It may not require a lot of meetings before. Before it goes through the formal rulemaking process and public comment and everything.

And sometimes if it's a bigger package of regulations or they're more challenging issues, we'll do multiple meetings with larger groups and get everyone's input.

So I think we try and tailor the opportunity to provide input and the duration that we do that or the frequency on the needs of the question at hand is this really challenging big pass package. Is this something we can. Everyone kind of agrees on. We're just adding one medication to a scope of practice, for example. That may be a quick one.

Well, I'm glad you mentioned paramedics I wasn't expecting that answer, but my son is completing his paramedic training so he should be finished by the end of March. I'll let him know that we met and I have your cell phone. Thank you very much.

Thank you. Thank you, Senator Jones. Next we're gonna. Senator Reyes.

Thank you. Madam PT. Dr. Garcon, thank you so much for your service, your continued service and after today, continuing your service. I believe you're familiar with confire.

In my district in San Bernardino county, they have made efforts to improve the 911 system through the Emergency Communications Nurse System, ECNS, which uses nurses to triage 911 calls to, to reduce unnecessary ambulance use. It's been very successful reducing preventable ER visits by 10 to 15%.

And my question again has to do with the offloading and I know that that isn't the exact area that you want to have this whole conversation about, but it is an important issue and you can tell by the questions being asked how important the issue is.

So given the problem of ambulance patient offloading and specifically the time that we're talking about the over reliance on 911 for health care and General recruitment issues, can you talk about your thoughts on how the state can use programs like Confire as a model to use statewide?

Senator, thank you for your question. And I don't mind spending time on this topic because it is the biggest topic I want to, one of the biggest and most challenging in EMS. And I lived it for 30 years doing emergency Department shifts and seeing this firsthand and the problem's only gotten worse over time.

So it's a very important issue. I think when the EMS act first passed, the paradigm in pre hospital care was to assess, stabilize and transport and transport to an acute care emergency Department. And right now, actually at the federal level from Centers for Medicare Services, they reimburse EMS when a patient is transported. So.

And a lot of people don't necessarily know that or understand that. So any other resolution to a 911 call generally doesn't generate income for EMS providers. But I think we realize that as you mentioned, many people who utilize 911 or even show up to emergency departments is, is part of what causes the ED crowding that we're experiencing.

Don't really have acute emergencies and so transport to an emergency Department is not necessarily the optimal outcome or the best services for a patient. I think as an emergency physician and EMS physician, I support other alternatives besides transport to an acute care ER.

And as long as, and I say this all the time when evaluating any program, it is done safely for patients. And so all these things that we're considering. So the nurse navigator that you're talking about is a wonderful idea if done safely.

And then what we've done, we've had pilot programs going back to 2012 in community Paramedicine and triage to alternate destination. Those pilot programs prove their safety and the efficacy in terms of saving money and doing diverting emergency Department visits. And so they passed the legislation that allowed community paramedicine and trash alternate destination programs.

Another thing that's in the conversation is the use of telehealth in 911. And there's some emergency medicine staff telehealth programs that know the prehospital environment and would be able to do a telehealth consultation for appropriate patients in the field and perhaps avert emergency Department visits.

So I think moving to the modern era of EMS, we have to consider all of these options to save costs to the health care systEms, to help decompress emergency departments, and to get patients safe and effective care for their presenting problem.

When you mentioned that if you don't transport to a medical facility or once you transport, then that ends the funding to the EMS provider.

So in General at the federal level, CMS reimburses for transport to the emergency.

Department and that then the funding then goes to the medical facility that's accepting them at that point.

No, that's. I'm talking about the Bill that's generated by the ambulance company that transported so that the hospital will generate their own Bill for the care they've provided once the patient's there.

Thank you for that. Recently in the Los Angeles fires, as you know, we lost so many of our wonderful citizens. 31, I believe in total, the majority of them being either seniors or those with disabilities.

When we're talking about disaster response, who do you work with to advise you on the best way to transport or evacuate vulnerable communities? And I'm talking in this case seniors and those with disabilities. For example, in the skilled nursing space with aging and developmentally disabled.

How do you encourage communication between the organizations who work with those populations and the local EMS agencies? And is there a known impending, if there's a known impending disaster, a flood, a fire, how do you pre position help?

Senator, thank you for your question. So in, I think it's a two part answer. So in the emergency management structure, there's a typical sort of response process that happens. So the local entities are really the first responders that are there.

And so you have the local law enforcement, fire, rescue and then the EMS side which is, can be EMS can be fire as well. And sometimes it's private ambulance companies. And so the incident commander, whoever's running the response is really life and safety first. I mean the fire is going, we need to put out the fire.

But who's at risk for like who needs to be evacuated, who needs help evacuating? And so there's a local response that's determined if the size of the event or the needs of the event are larger than the locals can respond to, then they go up and they may request regional help and then state help.

And so you can. The regional resources are other local EMS agencies or other counties that will send in their, their rescue personnel, their medical personnel. Often that's cord still the response is coordinated by the local incident commander.

But they start using the other resources that coming from outside and then from the regional level if they can go up and request state assets and things like that. So there's, and then there's an emergency operations center where you have all sorts of people there communicating.

And so if there's a request for staff or for ambulances or for medical supplies, there's a communication process for that request to go to a point where it can get filled, it can get filled at a regional level. If it can't, then it goes to the state and then the state fills it.

So we have Members or disaster medical services division within EMSA that are actively engaged in any response as and so we have staff Members that are in the emergency operations center and things like that.

The other part of your question is, I believe is that generally the knowledge of the vulnerable people, like where the nursing homes are and things like that, what hospital needs to be evacuated lies in the local response. That's where everyone knows their neighborhood, right?

They know where the candy store is, they know where the hospital, they know where their school is. So the incident commander who's local tends to have an awareness of all of those. And that's where the strategic decisions get made. We need to evacuate that nursing home, for example.

And so that gets communicated to the rescue side and the ambulance side and say the local ambulances don't have enough ambulances to send because they're engaged in other things. They make the request up and we get regional input and then state level input. And so we EMSET participates in this in we help oversee.

We have a medical health, the MOAC, medical health operational coordinator for disasters and then the RDMHCS, RDMHs, which is regional Disaster Medical coordinators and specialists. And so we have them meet regularly. We also run an ambulance strike team program. So are we have an ambulance strike team that typically is five ambulances and all the staff.

And so if we know as you're saying, we can pre position these assets or send them in.

And when there were the fires in Monterey and there was flooding in Monterey, that we were concerned the road was going to cut off and isolate that area, we put in a calmat team and ambulance strike teams in that area because we suspected that evacuation, evacuation from that area might be more difficult.

So there are strategic decisions made to pre stage assets. And then we can also respond to requests for assistance.

And the question was very specific because this is just the most recent fire. Tubbs fire the same thing. The majority of those we lost were seniors and those with disabilities. In the Los Angeles fires.

Mr. Miller, who was disabled, taking care of his son with Justin with cerebral palsy, called for an ambulance, waited for the ambulance, expected the ambulance. They perished in the fire because the ambulance never arrived. And so they would not know to call somebody above the local ambulance service.

So perhaps there is something more that needs to be done so that if an ambulance service does not receive, is not able to fulfill that request, then they have a responsibility. Put it up to the regional level and from the regional then to the state. Because it is a question of making sure we protect life.

Absolutely.

Thank you.

Thank you, Senator Reyes. And I'm going to actually just piggyback back on where Senator Reyes left off. And I think you've heard from all of us in some ways just about the state of the state when it comes to emergencies and our thought and our thinking about how we prepare, but also some of the lessons learned.

Senator Reyes focused a little bit on some of our elder communities, vulnerable communities, how we ensure that during natural disasters we have the best way to get to them, but also to help them. And I my question has to do with what are. I mean, every year I feel like we're learning lessons.

And so from your vantage point, what are those lessons that we've learned in the last two years about how the work that you do intersects with the natural disasters across our state in all regions and what we're learning and how we're improving on that specifically.

Senator, thank you for your question. I think one other thing that I would point out is that we work, EMSA work, our sister agencies, the California Department of Public Health and those two agencies are responsible for the medical and health response to disasters. So from the health side, EMSA is not acting alone.

We also work with CDPH and of course our hospital partners and then of course we collaborate with the fire and the rest rescue and the law enforcement and those other entities as well. I think two years.

I would say that we've learned a lot from COVID about long term statewide pandemic type of things, infectious disease, because that in some ways is an emergency situation that's very different from short term things like floods or earthquakes or things like that.

So we learned a lot from COVID but that's been a little bit more than two years. I mean we. We've had wildland fires going back years and decades really. We've had some years that we had four of the worst fires in history happened in one year or two year block.

So we've seen more fires and larger fires in General. We've. We evacuated the town of paradise when there was in Santa Rosa. We evacuated the Kaiser and the town Dignity hospitals there when the fires came through there back.

I think the coordination you spoke to this, the coordination and communication between operationally because the theory is there and the framework is there for the response and the communication sometimes in the chaos of a disaster, it doesn't always happen as ideally as it should.

And to your point, lessons learned, I'm sure all of these situations where you had an individual like you were mentioning that called 911 and didn't get an ambulance promptly or promptly enough that gets looked at very closely and what happened here and how do, how do we avoid that or mitigate that.

So the thing is that the lessons learned have to happen at all levels. They have to happen at the local response. Because was the gap something that happened at the local response level or is the gap something that happens at a regional level or at a higher level?

And on that note, can you speak to anything related to our rural communities that we know have their own limitations because they're harder to get to.

And certainly during natural disasters, what is already hard to get to or you know, takes a little longer to get to, you know, can you just speak to rural communities in particular and what our thought process is and how we're improving access in these critical moments?

I think one of the key things in rural areas is pre planning and having a plan ready because help may not be quick to come as happens. And we just know that's actually one of the rules of preparedness. I think the respondentities need to obviously augment what they do and do it well.

But one of the key things about disaster response is you know, fireproof your home, what's your plan? How are you going to communicate with loved ones when something happens and you have to evacuate?

So I think there's a lot of life saving that happens when individuals or smaller groups of people are empowered to assist in their response planning and evacuations.

Thank you. We have a follow up question from Senator Laird.

Oh, no, I just have a follow up comment and you were talking, talking about Monterey and the fact that the highway was out and people could only get in and out in convoys twice a day and you had to pre position things.

Behind the good news is, is today at noon, for the first time in three years, Highway 1 is completely open north to south so you can get anywhere in Big Sur starting today. And hopefully you don't have to deal with that again soon.

But appreciated the court not with that because it allowed for people to come in where they would have been excluded if we weren't pre positioning emergency services or fire things behind the closure where all the people lived during that period. So thanks for the work on that.

Thank you, Senator Laird. All right, well, thank you. Icc. No questions. We are going to open it up for public comments. So we will now take public comments on this appointee. If there are any. If there are, I ask that you come to the microphone.

All right, so seeing no Members wishing to testify in support, we want to walk up. I will ask if there are any Members of the public wishing to testify in opposition to please come forward and speak now. All right, seeing no Members, thank you all for this and we're going to bring it back to the Members.

Members, any final comments or questions?

I actually have a motion. I'm that we approve this appointment and send it to the Senate floor for full confirmation.

Thank you very much. We have a motion by Senator Laird and so we will go ahead and call the roll.

[Roll Call]

All right, the appointment has been approved and it will move to the full Senate for confirmation with four vote. Thank you so much, Dr. Garzon

Thank you.

Thank you. For our final item, we're going to return to Governor appointee required to appear. And that is Item 1b, the appointment of Stephanie Weldon as Deputy Director of the Office of Health Equity Department of Public Health.

Thank you very much. You'll have one to two minutes for your opening testimony to the committee. And in your opening, you're welcome to make any introductions that you need to. We will keep time of this, and we'll prompt you as you get close to that time. You may begin.

Stephanie Weldon. Thank you, Madam Pro Tem, Chair Limón, and honorable Senate Committee Members. Thank you for the opportunity to share about who I am and my vision with the team I'm here with today for the Office of Health Equity.

Since I have a short time, I'm going to try to share everything as quickly as I can. I just want to just make what a customary acknowledgement is for me and my culture is one to recognize before I get started the homelands of the people who are sitting on here today.

I know you do many land acknowledgments, but just want to recognize the people of this area. Maidu, Nisenan, Patwin people of this area, as they are the original stewards and welcoming and allowing me to do this work in their homelands. I come from Del Norte and Humboldt County on the Yurok Reservation. I'm Yurok, Tolowa, and Karuk.

So it's customary to do this. And finally, I want to recognize my family as they are here today and my ancestors. I have five of my six children, my husband, my mother, my brother, my community members, and mentors that are all here with me today. And I want to just acknowledge and them for supporting me and putting me on loan here to do this work for the greater state of California, and many family members that were not able to join.

I'm really proud and honored to be in this role because it's a significant responsibility as being the first Native American woman to sit in this position as not only the Deputy Director of Public Health, but also the tribal liaison for the department.

It has significant meaning to me and my family and community, as we expand some of the most significant health disparities in California and throughout this nation. Even more so, government has not historically been inclusive of many populations, including my community and family.

As you all probably can recall or know, the first Governor of this state waged a war against my people. So it's a testament to my family and community's resilience, but also to all of you and your commitment to making California more inclusive for everyone. Rural, I come from the Klamath River of a town of 300 people.

So when we talk about rural and we talk about emergency services and healthcare, I know it, I've lived it, I've experienced it, and I've witnessed it. So I am here today.

I don't know everything, but I know that my experiences as a young mother and grandmother, as a woman, and as a Yurok person will help give me significant insight to make mistakes, but also to lead and to touch and reach into community. That's what I bring with me is the value of community.

And it's a little bit different than the way other people have held this position. I come in with that deep understanding and wanting to do differently and to make government for all, including veterans, including elders, and including people in all different areas. And we have to do this differently.

We have to do it in a way of asking what has worked, what isn't working, and how can we not why isn't the reason, or this is the reason. This is how we've always done it. How can we do it? And so I have a vision with an amazing team that I'm lucky to be a part of. But I've got a lot to learn, and I just thank you for this opportunity to do that.

The other reason why I'm here and return back to state service because I served as an appointee before at CDSS doing tribal affairs work in the Indian child welfare space. I also have served in county government as a child welfare director, and I've worked for my tribe and nonprofits and healthcare organizations.

But another reason why I came to this role is primarily I lost an aunt to Covid. Her experiences and mistrust in government. And she was an educated woman in the Bay Area. She understood science, but she did not trust what was going on.

Because of the loss of her and many of my other family members who have experienced substance use and suicide, the impacts of suicide, I felt like I had a place and a spot to join an amazing team. So I'd like to thank you.

Wrap up because we are...

Yes. Thank you so much. And I am ready for questions that you may have.

Thank you so much. Thank you for that. Members, we will, if Members have any questions or comments. All right, we're going to start. We're going to start with Senator Reyes.

Thank you for being here. Thank you for... Thank you. We always, I always appreciate the cultural, historical lessons that we learn. And we have to remember our ancestors. They do allow us to be here. My question to you is how are the priorities of the Office of Health Equity identified?

How are you assessing whether the Office's efforts are producing meaningful change in public health systems and statewide progress through health and mental health equity? And what have you learned so far about the effectiveness of these efforts? There's a lot of questions.

Lots of questions. All related. So I'll do my best to streamline. Thank you, Senator, for that question. So first of all, our work starts with what you have prioritized through legislation, through Health and Safety Code. The Office of Health Equity, we have three key areas. I could recite all the numbers, but you probably know all those, primarily focused on equity. I like to explain our office in two parts.

One is we are the advisors and responsible for helping the department and other working with other departments to really put a lens on and operationalize and advise and connect to community about the work we do. So a lot of that is behind the scenes.

It's teaching what I like to call people to fish, teaching them how to do it and how to connect with community and show tangible results. And so we have some very specific examples of how we've done that.

And then the other side of the house is the programs that we implement in operation from legislation and funding that you all have provided and given us to operate. And so we do some direct and pass through. But also I think the really important piece is how we embed that work into our systems work.

So some of that progress I can, just give me a second and I'll start with. We have done a lot of the implementation very specifically and recently since I've been here in the last 10 months, we have made significant progress in our work with tribes in a couple of different spaces.

Behavioral health it's early on. However, through the work of the California Reducing Disparities, we have really worked to ensure that tribes and other populations have access to behavioral health prevention and funding and services that is culturally relevant and responsive. That was one of the biggest pieces of this office.

How we got started is that behavioral health was not accessible to many populations and communities for many different reasons. Also in the tribal space, we've held our first ever tribal consultation. Why that's important, because they are governments and our department had not had a consultation ever yet. Other specifics around behavioral health.

I heard you mention behavioral health. Is that we are seeing a reduction in opioid overdose and related deaths over time. So that's the work from many of us. In our other area of Children, Youth, and Behavioral Health Initiative, which is stigma reduction and campaigns, we are seeing more youth seeking help and recognizing signs and symptoms around their own mental health needs and behaviors.

So we're seeing lots of promises around that, as well as the pilot project from California Reducing Disparities in having more youth and families and individuals engaged in culturally responsive practices, specifically in Latino, Latinx, LBGTQ populations, African American, and rural communities as well.

And then some other progress areas that we've made, particularly we've had in the TGI Fund area, we've had in the gender affirming care, grantees have provided navigation services to well over 6,000 transgender individual Californians, referrals and linkages to care. We've also prescribed and treated well over 3,000 individual transgender patients with hormone therapy.

We've done a lot of work for mental health services for that population. And in the California Reductive Justice and Freedom Fund, we have awarded grants to over 17 community based reproductive health rights and justice organizations. And we've done some work with local health jurisdictions as well.

So a lot of progress, but we still have a lot more work to do in public health overall and ensuring that communities have access and are especially designing what the program is and tailored to their unique community needs and to track and measure that progress as well. Data is a big one.

I know I heard somebody before me talk about, the doctor before me, talk about data. The importance really with data is being able to co-design how we collect data, but how we share it back out. And often how we define data. We often define data as the bean counting or the measuring. But lived experience and stories are so important as a part of our data.

Those experiences from folks who have gone through flooding or fire or what worked and what didn't work and making sure we hear what that experience is and to build it into our processes of what we're doing. If we have bottlenecks, if we are being responsive. And so data is a big one. Redesigning how we are collecting, hearing data, measuring it, and utilizing it to be effective in our work.

Thank you. My last question, in the title, it's Office of Health Equity. But we also know that at the national level the administration has been very specific about against the DEI, diversity, equity, and inclusion. How do you balance that?

How do you continue to address those things that are important in the communities that have to do with a person's health and mental health, yet keep in mind that we have an administration that does not want those words used, does not believe in those words?

Yeah, thank you for that. One of the biggest challenges we face in our communities face right now is making sure that they are valued and validated. So the title itself, we know that we are in alignment with both federal and state law.

However, what we are doing is exploring with community, really trying to operationalize what do those words mean and who is missing out, who doesn't see themselves fitting into that, what does that look like?

And so we are working to plain language priorities and goals while still addressing. Because really what health equity and social determinants are at its foundational level are what are the factors that people are missing in their community and what can we as humans do about it?

And we as a department at its very basic level is what's different and how do we tailor things to help support those communities and how do we work with them? So that's what we're doing, is taking an approach.

We have several community advisory boards that have begun in the last year to year and a half who are advising plans, policies, and practices. But why that's important is because it's from their experience and what they have have seen and they're informing how we're doing our work.

Thank you.

Thank you.

Thank you. Senator Laird.

Thank you very much. And my first question you answered in your opening because I was going to ask how your life experience drove you in this position and outcomes. And by the way, I was lobbied by on your appointment by my niece. So you clearly brought in artillery to do that.

I want to drill down a little on a little bit that came from the previous question because you have 97 employees. What outcomes happen because of those 97 employees in your work that wouldn't happen without what you're doing? Because we talk about the high level. But what actually are outcomes that are happening because of your work?

Yeah, thank you so much for that question. I can give quite a few outcomes. So specifically the weatherization and the work that's being done with farm workers to have improve their ability to have safe housing. That's one example of the work that our climate team has done.

And much of our team, for example, we've worked with community health workers to work with farming community in Tulare County to help low income and farming community have housing. Another is...

Before you go past, let me just understand that so we can be clear. What does that mean? Does that mean you actually go out and inspect places and make sure there's safe housing or you are in contracts? I mean, what is...

Yes, thank you. The way it comes out is we advise, we receive funding, and we work with community partners to distribute or to fund those partners, and we provide technical assistance, we advise on plans, and then we provide training and TA. We're not actually the ones going in the home to do the activity.

But we are working collaboratively and reviewing and brainstorming with those partners to do. In some cases we are out in the community and doing these examples. Like for example, working with the Hoopa Tribe to develop a disaster plan with federal response folks and representatives as well.

So sometimes it's on the ground, and often it's through agreements with community based organizations and local health jurisdictions and with tribes. And other times, like I said that other side of the house, it's behind the scenes. It's making, you know, advisement on policies and practices. So it's both.

And then how do you measure that? So you're going to do a report to us saying we did all that? How do you measure it so we know either how many housing units or people or whatever were impacted in a good way because of your work?

Yeah, a couple of ways. So we have, our department has a strategic plan. But in a report to you, we have the demographic report that we return to all of you. And the way we measure is different ways. There's the bean counting, but there's also the stories and experiences.

I know we've done some reports for some of our funding, federal funding as well. But we track those and we will share, you know, we share those out through the demographic report is every couple of years though. So it's, you know, not immediate data and way of doing that. We're also working with those advisory committees to share information and come up with ways how we might be able to better communicate those successes.

I think that's important because there's lots of high level talk about the goals and the processes. But it's like, how do we know that if you weren't here, certain things weren't happening? I think that's an important thing because we get pressed all the time and we want to be able to tell the story and... Good.

The other question I had is that your office gives technical assistance. And when your office gives technical assistance, how do you guide it? Like how do you determine? And the Chair talked about rural areas, and rural areas just have completely different needs. And so if you're giving technical assistance to rural areas, how do you guide it to those specific needs that are totally different than some of the urban stuff that goes on?

Yeah, a couple of ways. So first we start with what research and science. And at the same time we work with those advisory boards. Like we have a lived experience advisory board. We have a higher level Office of Health Equity advisory board. We have a black health equity advisory board. And those are all people from the community and doing the work in the community to help communicate and provide input and walk us through. As well as we try, we work really hard.

Something I'm really proud of about working at the Department of Public Health is to really have staff with this experience who are from the community, who have that experience. That coupled with science and research and the input of community is really vital. And then we pilot things from there.

And could you give us just a specific case or a specific example where maybe you got feedback from one of these committees, it led to technical desistance or decision, and you had a different outcome that you would have had otherwise. What is something that falls in that category?

Yeah, I think there's a couple. Well, one that's in progress. I haven't, I'm going to be tying it to an outcome soon. But if you think about the black infant mortality rate and how we work in the health disparity space of black African American individuals. We now have a black health advisory board.

And our team, our staff have developed with those experts and internally are working early on on a black health equity action plan, all from their input and advisory. And we help to support and move forward the action plan and specific areas of health equity.

And so they can directly see how their input and we can tie it to some of these health measures and health areas as well. And so that's the idea of coming from community and these advisories into practice of what's occurring.

And does that mean the practical outcome is you can see different disparities because of actions you've gotten people to take? And so you get the feedback, you do that, and you actually see a change in the disparities based on what you do?

That's the hope. But change is time. It takes, that kind of change takes a long time. But we can hear stories and see direct connection or access. You know, that's the early piece of it is folks have access to something and then the behavior change.

I just know that we are heading into these extremely weird budget times. And if we're heading into weird budget times, we need those kinds of practical outcomes to defend against what might come. And that's very important. And I think that is the story to tell. So I'm just encouraging you to do it because it'll be to your advantage in all this, as well the advantage of everybody that's served by what you do.

Yeah. Thank you so much.

Okay. Thank you very much. I appreciate it.

Thank you, Senator Laird. Next, we'll go to Senator Jones.

Thank you, Madam Pro Tem. Probably, you've done a great job answering questions so far. Thank you. I didn't mean it to sound that way, regardless of what Senator Laird says. He normally banters with my Republican colleagues, so this is new to him to have to banter with me.

So the kind of just a generalization, as you've seen in national news recently, there's lots of interest now in state and county programs with fraud and abuse and waste. And I kind of, you know, I don't put waste in the same category as fraud and abuse as a lot of people do.

I think sometimes waste is unintentional, but fraud and abuse are. As a result of what we're seeing in other states, we've already got folks in San Diego doing independent journalism to find out what's going on there with some of the programs. And again, just a generalization, not a trick question.

Just wanted to kind of get your thoughts on your position with your department, you know, what do you see there? If something did show up, you know, kind of how do you think you would handle it? Are you concerned about it in any of your programs, and just kind of some just general thoughts on that?

Yeah. Thank you so much for that comment and question. Absolutely. I think there is I'm in the, in the same realm as you are. I think there's a difference. And I think if we look at it differently, we can really hone in on what is called as waste. And to me that's efficiency.

It's an opportunity to streamline and not duplicate. And that's another reason that drives my work. I have worked for a lot of organizations in my nonprofit and tribal work where you are very limited and you have to do a lot with a little.

And so the way that I approach it is is mapping out where the process is and making sure we're not duplicating. And that can happen when you're big or you've grown really large in a short amount of time, and making sure not only for the timeline, but the use of it.

And of course for me, you know, calling it out when I see it, following the process to do that, but really working with the staff and other experts to bring in to look at is a process. To me, it's always process oriented. What is working, what's not? And are we maximizing the resources that we have?

Is the money getting out? Are folks utilizing it? If not why, what's the reason? What's the rationale? I tend to make some assumptions, and then I check it out to see if my assumptions are correct or what I may not know. What are we missing? What needs to be here to be more efficient?

And I think as things are leaner and get more leaner, we have to look at how do we streamline so we can. And that really comes from just my experience of having to go without, both in my professional role and as an individual, having without means you streamline. And so that's my thoughts on it.

How would you address the political hot button now of fraud in these different programs?

So if there were fraud, of course I would follow the procedures of needing to do that. Politics, I don't, you know, that I want to get... I want to just... I think a lot of this builds back to communication. Senator Laird talked about communicating what we do and continuing to work hard to build trust with community.

And building trust means we're transparent about what we can and can't do, and we report back what we committed to doing. I think often we ask community for things, and then two years later, we're asking the same question again and we're tapping the same communities.

Rather than having a report card or a I call them tracker that says, here's what you asked for, here's our progress, here's why we didn't do it or couldn't do it, and here's what we're trying to do to get. So just that's the kind of concrete transparency that I think we and I plan to do. And that's what I've done in my history with tribal work and will do with many communities.

Well, I think that's a really good answer. And that's probably, as I was working this out in my own mind, you know, what I was looking for is that's probably the best antidote for any kind of fraudulent charges is transparency and being open about that.

And I'm hoping that other folks in state government will hear that answer and listen to that answer and take that to heart as well. Because I do think this is going to become a bigger challenge. You know, there's some organizations within the state bureaucracy that are fantastic and work well and they're going to welcome that transparency.

I do have a feeling that there's going to be other agencies that might not welcome that so much. But I'm hoping that everything as we work through this year and we're looking into these issues will be transparent. So thank you for that answer. I like it.

Yeah, thank you. And I have to note, I was raised by a single mother who did 25 years in law enforcement. So she's right back here, and she has taught me about be direct, be transparent, do your business, and be honest.

Thank you. And speaking of the folks that are behind you, as I look out, I look at a lot of youth that are here supporting. Five of her kids. Right. And that also brings me to just thinking a little bit more deeper about some of the things you've talked about.

But there are programs that are administered under, you know, the agency as, like for example the California Reducing Disparities Project and the Community Mental Health Equity Project. Can you talk a little bit about what we're doing for youth and particularly youth and mental health?

I think that we go through a lot of corners of this state and that's something that comes up that we see ourselves, that we've tried to address. I'm curious how you are addressing it through your lens and through this work.

Thank you. Really important question. Just as a mother of many young people and working with a lot of my career working with youth. So our scope of course is not always the out in front. We're the prevention, public health is prevention.

So how do we prevent. And for Behavioral Health Services Act, what we are doing, our office is really building upon the lessons learned of the great work of many of them probably are here today. The grantees who have done the reducing disparities work on culturally informed practices but messaging within communities.

We are working to ensure that those campaigns. I know often people don't think of campaigns as significant but they are, are relevant and accessible and co-designed by youth. And so that work's going to move forward along with ensuring the prevention work gets to community.

And so that's what we'll be doing is under the Prop 1 BHSA is that prevention funding will be put out and it will be really designed by the community. We've held, like I said, tribal consultation for tribes specifically, and we are working with other community and community partners. So that way when they that funding goes out the door, it can be designed specifically by those communities to access those funding because they know best.

And what we've shown through the evaluation of the campaign is that when things are designed in partnership with youth, it's more relevant and accessible and utilized. Rather than a bunch of older folks like my kid calls me doing things that aren't relevant or meaningful to them.

So being able to fund them and be able so they can design what's specifically there, and then being able to track the needs and provide technical assistance as well.

And what are the, you know, in the coming year, what are some of the elements that you feel are most needed to focus on for our state? There is a lot of issues. Every single one of them is a critical issue. But where is your focus most being, where is your focus being put in a most pressing way?

Yeah, thank you for that. I mean, there's a lot to do. But primarily, of course, behavioral health, that's right at the top of the list. Being able to implement the BHSA, Behavioral Health Services Act, Prop 1, and supporting that. Housing and homeless, of course. And then there's populations and communities within these main areas, of course, reproductive health.

So we need to really confront the disparities in access and outcomes in specific communities. And then of course, climate impacts, that's another big area. And Infectious diseases, supporting the department to address infectious diseases and preventable diseases. But really targeted approaches for unique communities.

Great, thank you. All right. Seeing no additional questions. I am going to open it up for members of the public if they would like to make any comments regarding this. So if there are any members of the public wishing to testify in support, you are welcome to step up and speak at the microphone. We ask that your comments are concise, but please.

CEO of the California Rural Indian Health Board and a member of the Yurok Tribe, in support of Ms. Weldon's confirmation.

Good afternoon. Johan Cardenas with the California Pan-Ethnic Health Network. We strongly support the confirmation of Stephanie Weldon and look forward to her continued leadership in directing the Office of Health Equity and collaborating with California's diverse communities.

CPEHN has a long standing partnership with the office and really values its critical role in bridging both governmental public health and community based organizations across the state. Such partnerships are especially important during a challenging political climate when evidence based public health programs face increasing threats. And so thank you.

Good afternoon. Heather Hostler, Executive Director of California Indian Legal Services, citizen of the Hoopa Valley Tribe, strong support of Stephanie Weldon's confirmation today. You have gotten a good candidate before you, and I would just say she was right when she said she's on loan. And support the work that she's doing for the great state of California.

Good afternoon. I'm Sergio Aguilar-Gaxiola, and I'm a professor at UC Davis in Internal Medicine. And I'm also the Founding Director of the Center for Reducing Health Disparities. And I'm here in strong support for the confirmation of Stephanie Weldon. Just very briefly, we had been working on a couple of projects, including the California Reducing Disparities Project.

And I can tell you that this is the most complex and the most comprehensive mental health project now, substance abuse as well, in the nation. There are over 200 people involved. Stephanie has done a stellar, brilliant, exemplary work with serving leadership, conducting herself in a very professional manner. And she has been, as I mentioned, servant leadership.

Another, very briefly, is the work that we have been doing with national experts that you had brought together as well to inform the work that is being done in different projects that has been extended to other offices of the California Disparities Project, including the Children and Youth Behavioral Health Division. You have someone that really has wonderful credentials and lived experience to lead this office. Thank you.

Thank you so much. We'll just remind folks that we are asking that you keep your comments succinct, please. Thank you.

Hello. My name is Lupita Rodriguez. I am Director at the Health Education Council, a local nonprofit who is also a grantee from the CRDP. And we are here in support of Ms. Weldon's confirmation. Since the time that you joined and OHE, we see your passion and we identify with your mission, and we want to work with you and continue working with you. Thank you.

My name is Michelle Sanchez-Higginbotham. I am... and I would like to extend my support of Stephanie Weldon, and I work for the California Consortium for Urban Indian Health. Thank you.

Good afternoon. My name is Gulshan Yusufzai. I'm the Executive Director of MAS-Social Services Foundation. On behalf of CRDP, I would like to strongly urge you to approve Ms. Weldon's appointment for the position of Deputy Director of Office of Health Equity.

In the time I've met Ms. Weldon, her career history, work experience, and sensitivity to the needs of the underserved communities that are being recognized in the CRDP is essential. And CRDP is a very important and major project under OHE. And in the past nine years, CRDP has been proven to successfully reduce disparities and improve mental health conditions of the BIPOC and LGBT communities. Thank you.

Good afternoon. My name is Kim DeOcampo. I am Tuolumne Mewuk. I'm a retired caseworker from California Tribal TANF in Fairfield. I live in Solano County, and Solano County is a county that lacks native services. We are not at the table on any of the issues that Stephanie has talked about.

And so I'm so happy to hear that we are going to have a representative. And I want to know more about your lived experience organization or commission, and I'd like to be a part of that. Because in our county, we are used as fodder for funding. We are used as a passing demographic. But we are totally erased.

And I find it such a hypocrisy in a county. Solano County is actually named after a native man, Chief Sem-Yeto, and his baptismal name is Francisco Solano. So I'm really looking forward to this. And we really need to think about our counties that lack these services. Thank you.

Good afternoon, Senators. My name is Dr. Roland Moore from the Pacific Institute for Research and Evaluation. I'm Center Director and Senior Research Scientist there, also serving as part of the Native American Technical Assistance Provider Team for the California Reducing Disparities Project.

And in her time with the Office of Health Equity, we have been so impressed by Stephanie Weldon's work and commitment and talent. So we strongly support her appointment.

Hello. Good afternoon. I'm Dr. Juliet Lee, also with the Native American Technical Assistance Provider Team. We provide technical training and technical assistance to seven grantees who are serving Native populations throughout the state in many of your regions, many of your districts. They're so proud and so happy and so pleased with Stephanie's leadership. It's an incredible moment, and we thank you very much and congratulations. Oh, I support her confirmation.

Good afternoon. My name is Alex Filippelli. I use he and they pronouns. I'm the Director of the LGBTQ TA Center for the California Reducing Disparities Project with the Center for Applied Research Solutions. I'm a resident of Santa Cruz County, and I am here in support of Stephanie Weldon.

It has been such a breath of fresh air since you've joined our project, and in particular, our annual convening last year. It's so evident, the energy, the leadership, the humility, and centering relationships and community. It's so evident that your approach is exactly what we need. And I'm in support of your confirmation. Thank you.

Donald Moore. As a young Native American male that's dealt with mental health, been affected by substance abuse, environmental impacts. As someone that was raised by a single mother, I definitely see her sitting up here and everything she says, and I feel very heard and motivated and proud. And I'm speaking on behalf of all of our Native American children and youth and siblings and as your son. So I support this confirmation.

Courtney Bear Quiver, Richmond resident, and proud member of the local urban community. I worked with you personally, when you were in ICWA. And so I really support you and your nomination and we're so proud of you. On behalf of AIM, American Indian Movement of the Bay Area, we show our support and congratulations. We're proud of you.

Mary McQuillen. I just want to say I support her confirmation. I'm Stephanie's mother. I'm retired a federal law enforcement officer. Started out in a uniform, ended as a criminal investigator, worked as a chief of police. I think maybe she got some of her drive from me.

She knows what it's like to do without. I personally, and she does too, I'm a consumer of the mental health. My son is mental health patient. He has schizophrenia. He's here with us today. He had to step out as things are a little bit hard for him right now. We know substance abuse as well.

And it's really important, really important that our communities have access to those services. I live in Del Norte County and those services are almost non-existent. We have a crisis response team that works Monday through Friday, 8 to 5. Our crises don't happen Monday through Friday, 8 to 5.

They usually happen after hours and there's nobody there to help us. And so I just want to point that out and say I support her confirmation. Thank you.

Thank you. Seeing no other witnesses in support, are there any members of the public who would like to speak in opposition? All right. Seeing none. I'm going to bring it back to Members for any final thoughts or comments, and just recognize how touching and moving this has been. All right. Senator Reyes.

I was really hoping to hear from your mother. And having her stand and speak in support of you is very meaningful. Having your entire family and your community here means a lot because when the work that you do touches so many, but you are supported by so many. Thank you.

Thank you. Seeing no other questions or comments from the dais, I will entertain a motion.

So moved. I'll make the motion to move the confirm it to the full Senate.

Thank you very... Thank you very much, Senator Jones. Can we please call the roll?

[Roll Call] Four to zero.

All right. The appointment has been approved to move to the full Senate for confirmation with a 4-0 vote. Congratulations. Members and public, this concludes today agenda, and we thank every member of the public who has been here today to engage with our process. And thank you for your feedback. With that, we will go ahead and conclude the hearing.