Senate Standing Committee on Health

The Senate Committee on Health will come to order. Good afternoon. File item nine, AB 2538. Macedo has been pulled from today's agenda. That leaves us with nine bills on the agenda, with three of them on our proposed consent calendar.

File item one, AB 1571 by Michelle Rodriguez. File item number three, AB 1864 by Assemblymember Berman. And file item six, AB 1956 by Assemblymember Valencia. We will begin as a subcommittee until a quorum is established. I do see that we have authors here.

Thank you so much for being on time. We will start with file item number two, AB 1734 by Assemblymember Stefani. You may begin when you are ready.

Thank you, Madam Chair and colleagues. First, I would like to thank the committee chair and staff for the collaboration on this bill. I truly appreciate working with me and I will be accepting the committee amendments. Today, I'm presenting AB 1734, the Count Hunger Act, which responds to the federal government's decision to scale back hunger data collection by strengthening California's own food insecurity research. California has one of the highest cost of livings in the nation, yet our current surveys do not reflect that reality.

Without accurate data, we lose sight of who is struggling to put food on the table, where the gaps exist, and how policy changes are affecting families across our state. But hunger, we know, does not disappear when we don't look for it, and what disappears really is our ability to respond.

We cannot solve a problem that we cannot see, and the Count Hunger Act recognizes the importance of food insecurity research and to expand the survey to 400% of the federal poverty level so that we are capturing the realities of California's high cost of living, such as in San Francisco, LA, San Diego, areas where normally food insecurity isn't considered at a higher, level beyond the federal poverty level. This bill is about making sure that struggling Californias are seen, counted, and not left behind.

And with me today to testify in support are Marchon and Maxwell from the San Francisco Marin Food Bank.

Thank you. You have a combined total of five minutes for your presentation.

Thank you, Assemblymember Stefani. Good afternoon, Chair Pierson and members of the committee. My name is Marchon Tatmon, associate director of policy and advocacy with the San Francisco Marin Food Bank. This CHIS survey is fun foundational and fundamental and has been used in foreign key policy decisions, data products, and datasets. The California Health Interview Survey is an annual health survey administered by UCLA Center for Health Policy Research.

It reaches over 25,000 households yearly across a variety of topics in health. The CHIS study has been a valuable supplement alongside the the recently canceled national survey. Conducted annually, this is valuable research that California can use. However, with the impacts of federal cuts to these social safety net programs and a uncertainty, funding for future surveys. This survey is too in jeopardy, of not being a tool that California can use.

The actions California should take, is to, expand a survey to include households at 400% of the poverty line. That's approximately a 128,000 for a family of four, roughly the cost of living in California. The expansion will provide us with a sustainable source of data on food, security prevalence as the cost of living in California increases. I will let my colleague Maxwell explain further. Thank you for your time.

Thanks, Marchon. Good afternoon, Chair and members of the committee. My name is Maxwell Titsworth, and I'm the chief data and technology officer of the San Francisco Marin Food Bank. And I can tell you that we are at risk of flying blind. As you heard, the USDA hunger survey has been suspended and its most recent data showed us that food insecurity is reaching a record high nationally.

And this CHIS food security screener, our best remaining state tool, is at risk. AB 1734 aims to fix this. We aim to retain the existing CHIS food security measurement and also expand it from 200 to 400% of the federal poverty line because research shows that a third of food insecure households nationally earn above 200% of that line. CHIS is a unique California asset. Respondents in every county surveys in six language with data collection running for more than 20 years.

No existing survey in California matches that reach. This is targeted. It's evidence based, and it ensures that California doesn't leave struggling families invisible simply because they earn a few dollars above an outdated cutoff. This is evidence based policy making in action. I will now pass it back to Assemblymember Stefani. Thank you.

Thank you so much for your presentation. If there's anyone else in the audience that would like to register their support for this bill, please come to the microphone. State your name, your organization, and your position only.

Peter Hansel on behalf of a a AARP California in support.

Kelly Brooks on behalf of the County Of Santa Clara here in support.

Josh Wright with the California Association of Food Banks, proud cosponsors, and also giving a Me Too on behalf of Californians Against Waste in support.

Good afternoon. Lizzie Guansona here on behalf of Stop Waste, City and County of San Francisco, Napa County, and Marin County, all in support. Thanks.

Keshav Kumar, on behalf of the California Academy of Nutrition and Dietetics in strong support. Thank you.

Good afternoon, Chair and members. Jonathan Munoz, on behalf of First Life Los Angeles, in support, and we thank the author for her work.

Thank you. If there's anyone in the audience that would like to speak as a lead opposition witness, this is your time to come forward to the table. Seeing none, if there's anyone that would like to register their opposition on this bill, this is your time to come to the microphone to state your name, your organization, and your position. Seeing none, I will bring it back to the committee if anyone has any questions, comments, no.

Wanna thank you so much, Assemblymember Stefani, for working with us and the committee.

This is a very important issue and, you know, wanna make sure that we're able to, have accurate data here in California, recognizing that California is unique in many ways. And one of those is that our cost of living is often higher than others. And so we can't necessarily look at our state and our people through the same lens as every other state. So I really wanna thank you for working with us and invite you to close.

Thank you, Chair. And I respectfully ask for an aye vote.

Thank you. And once we get a quorum, that motion will be made.

Great. Thank you.

Thank you. I see Assembly Member Lee is in the audience for file number five, AB 1949. Would also encourage any other Assembly Members who have a bill to come down if you'd like to present it today. And also would like to encourage any other Senators on this committee to come down to Committee Room 1200 so that we can start voting on these bills. Assembly Member Lee, you are, you may begin when you're ready.

Assembly member Lee, you are you may begin when you're ready.

Thank you, Chair, and thank you to the on time caucus of this, of this committee. Thank you. Thank you first to the committee staff for their thoughtful analysis. I'm here today to present AB 1949, which will expand access to acupuncture for Medi-Cal patients, ensuring more Californians can receive safe, effective pain management.

Currently, Medi-Cal patients are restricted to two visits per month across a variety of outpatient services, forcing them to make hard choices between needed treatments. These limitations create barriers to timely care and disrupt continuity of treatment for patients.

AB 1949 addresses this problem by treating acupuncture as its own benefit, allowing patients access up to 24 acupuncture visits per year. Acupuncture is an evidence based and cost effective treatment for managing chronic pain that can reduce dependency on opioids and other costly treatments.

This bill will improve patient health outcomes while maintaining responsible use of state resources. With me today in support, I have Grace Ying Li from the American Association of Chinese Medicine Acupuncture and Dr. Qiao from Northeast Medical Services.

Thank you. You will both have a combined total of five minutes for your presentation.

Good afternoon, Chair Weber Pierson and the Senate Health Committee Members. My name is Grace Ying Li. I'm a licensed acupuncturist with over 30 year practice in San Jose. I'm also the president of American Association of Chinese Medicine and Acupuncture, AACMA, one of the main sponsors of AB in 1949.

First, I want to thank Assembly Member Alex Lee for his leadership on this important issue. Acupuncture is a safe, evidence based, and a cost effective treatment that helps patients manage chronic pain and other health conditions while reducing reliance on opioids and the costly medical interventions.

Under current Medi-Cal policy, acupuncture is limited to a shared cap of just two visits per month across multiple therapies. This restriction is clinically inadequate and often prevents patients from receiving meaningful care. Coverage may exist on paper, but access is limited in practice.

More importantly, acupuncture is a dose dependent therapy. Meaningful and lasting results require treatment at an appropriate frequency, typically at least twice per week during the initial phase of care. When treatments are far apart, the therapeutic benefit is reduced. This is an access issue, not a utilization issue.

Limiting access to non drug therapies can increase reliance on medications and lead to higher healthcare costs. AB 1949 provides a balanced solution by allowing providers to develop treatment plans based on clinical needs rather than arbitrary visit limits. I respectfully urge your support for AB 1949. Thank you.

Good afternoon, Madam Chair and Members. My name is Dr. Lili Qiao. I'm the Director of the Integrate Medicine and North East Medical Services. NEMS is one of the largest FQHC in California, and I'm here today in strong support of AB 1949. NEMS serves thousands of patients across the San Francisco Bay Area, and the majority covers by Medi-Cal.

Our patients are living with a chronic pain, cancer related symptoms, neuropathy, and arthritis, and other complex conditions that do not resolve within a single visit. Acupuncture, it is a core part of the whole person care we provide, and we see it works.

A patient experience real improvements in pain, functions, sleep, and quality of life. Many reduce their reliance on medications. But acupuncture works as a course of treatments, not a one time fix. When coverage is interrupt, the progress stalls, symptoms returns, and continuity breaks down.

So that's the gap of AB 1949 closes by guarantee up to 24 visits per year without a burdensome utilization managements while preserving the pathway for additional medical necessary visits. This bill aligns coverage with how care actually works.

For our patients, this is not about visits counts. It's about equity, access to safe, evidence informed, and non pharmacological cares. It is about allowing people to manage chronic conditions, stay active, and care for their families and living with dignity.

So NEMS is committed to integrated patient centered care. AB 1949 supports that mission directly. And on behalf of North East Medical Services and the patients we serve every day, I respectfully urge you yes vote on AB 1949. Thank you.

Thank you. If there's anyone else in the audience that would like to speak in support, please come to the microphone, state your name, your organization, and your position.

My name is Elaine Yang, former president of CAC, sponsor of SB 944, and in strong support. Thank you so much.

Christine Smith, Health Access California, in support.

Xin Gao, local acupuncturist. I strong support.

Good afternoon. My name is Zhao Chen. I'm the member of AACMA. I support 1949. Thank you.

Hi, good afternoon. My name is Frank Zhang. I'm acupuncture licensed. I'm AACMA member. I'm supporting AB 1949.

Matt McCormick representing North East Medical Services in support. Also expressing support for Petaluma Health Centers. Thank you.

My name is Xiao Xing. I'm strongly support AB 1949. I'm from North East Medical Service, integrative medicine department. Thank you.

My name is Carissa Cheung. I'm local acupuncturist. I'm strongly support AB 1949. Thank you.

Hi. My name is Shen Zhang. I'm a local acupuncture practitioner. I strongly support AB 1949. Thank you.

Madam Chair and Members. Rand Martin on behalf of the AIDS Healthcare Foundation. Important treatment for people with HIV. Thank you for supporting AB 1949. Thank you.

Hi. My name is Fee Yee. I'm a retired state employee for 33 years. And I have personally experienced a lot of obvious, well, I would say medical issues. Like as we know, we suffer a lot of chronic pains throughout our work.

So my personally experience was very marking was the last time they came into basic office campus and providing us a free exempt or free treatments. And I also have a lot of great feedbacks from my colleagues and they really appreciate this time.

Thank you. Are you in support?

Yes. I'm supporting. Yes.

Thank you. Seeing no further members of the audience that would like to speak, is there anyone here that would like to speak in lead opposition to this bill? Seeing no one. Is there anyone in the audience that would like to register their opposition? If so, come to the microphone, state your name, your organization, and your position. Seeing none, we'll bring it back to the committee. Senator Menjivar.

Assembly Member, I know this this service in particular is seems to always be on the chopping block when there's budget negotiations. I appreciate that there are Members looking to ensure that that doesn't happen moving forward. I'm a true believer of this of this service, having been a recipient of it.

And when we talk about our Medi-Cal funding and how it's ballooning so much, it's because we don't invest on in preventative, effective, less expensive treatment, and I think this is one of them. So I wanna thank you for the energy for coming up and sharing this technique that is really important. So thank you for that.

So thank you for that.

Okay. Seeing no further comments. I wanna thank you so much for bringing this bill forward. It's an interesting thing to try to restrict two visits per month for a year when we know that people may need more in a shorter period of time. So really want to thank you for keeping the total number of the year correct, but just allowing for more flexibility for people can actually get on the proper treatment regimen. So with that, you may close.

Well, thank you to the Chair and Senators. I do appreciate what Senator Menjivar did bring up that it is unfortunate that acupuncture is continually on the chopping block when it comes to the May governor revises for Medi-Cal.

I think it is really important that we have a culturally competent health care system that, of course, also serves the diversity of people, but also the diversity of medical, true medical practice as well. Acupuncture is one of those things that is deeply associated with the Chinese and East Asian cultures.

And it is a shame that it's one of those things that keeps getting cut in the budgets and stuff. So this is one of those important things that we make sure that Medi-Cal patients have a cost effective, non opioid based pain management system, and acupuncture is that. Respectfully ask for an aye vote when the time comes.

We're so fast for I vote when the time comes.

Thank you. Alright. We will now move to file item number four, AB 10 1910 by Assembly Member Borner. And you may begin when you're ready.

Good afternoon, senators. AB 1910, my Postpartum Pelvic floor health bill is a Tasha b special to aimed at increasing visibility and education on the health of our pelvic floor. And I want to be sure that I accepted committee amendments. One in three people who have given birth will suffer from Postpartum Pelvic floor health disorders in their lifetime. There are people every day dealing with life altering functional problems that could have been avoided with preventative Postpartum Pelvic floor care.

We should not only support new parents before they give birth, but throughout their postpartum journey. AB 1910 addresses this gap by adding information, advising individuals to discuss any pelvic floor concerns with their healthcare provider. I respectfully ask for your aye vote.

Thank you. If there's anyone that would like to speak as lead witness and support, this is your time to come forward. Seeing none, if there's anyone else in the audience that would like to register their support for this bill, please come to the microphone, state your name, your organization, and your position. Seeing none, if there's anyone that would like to register lead opposition, this is your time to come forward.

Or if anyone who would just want to register opposition come to the microphone, state your name and your organization and your position.

Seeing none, we'll bring it back to the committee. Really wanna thank you so much. Assembly member, I know this is your one of your passions, being here. And so, you know, I think that as we're educating, we also need to make sure that the information that we're putting out there is actual factual and evidence based by the things that we have here in The United States.

And so, appreciate your willingness to kind of pivot a little bit as we continue to get data from the pilot's day that you, authored previously.

And with that, I invite you to close.

Respectfully ask for your aye vote.

Thank you. Alright. Once again, I would invite any members of the health committee to come down. We are flying through these bills. I see our next author is here.

File item seven, AB 2011, Assemblymember Hart.

Thank you, madam chair. I wanna thank the committee staff and the chair for their work on this bill and I'll be accepting the committee amendments. These amendments clarify that annual review requirements and ensure the Department of Insurance is providing guidance for health plans compliance. I'm pleased to present AB 2011, a bill to codify existing federal mental health parity standards into state law. Mental health and substance use disorders affect millions of California's and are growing health challenge.

Last year, the Trump administration recklessly stopped enforcing federal protections that require insurers provide equal access to mental health and substance use disorder care as they do with physical medicine. Due to this order, access to care is at risk for many, and the state should take the lead in preserving protections. Federal regulations require that health plans must collect data and conduct comparative analysis to demonstrate the treatment limitations are not more restrictive than those applied to medical or surgical benefits.

These are limit these are limitations that are non quantitative like requirements for prior authorization. California has continued enforcing these regulations through the Department of Insurance and Department of Managed Healthcare, but the state's authority to do so could be revoked if federal rules are ultimately rescinded or weakened.

AB 2011enshrines protections in state law, so state regulators can continue to enforce parity requirements as they currently are no matter what changes occur at the federal level, especially during this administration. Many states like Colorado, Washington, Maryland, and Virginia have taken similar steps to prevent the Trump administration from undermining important health access using the federal protections as the gold standard. This bill does not expand covered benefits, create any new mandates, or impose any new duties on regulators.

At a time when our state is working to expand behavioral health, AB 2011 ensures that the promise of equal access becomes a reality for Californians. Speaking in support of the bill is Lauren Finke Mel Miguel Bastedas from the California Department of Insurance.

Thank you. You all have a combined total of five minutes for your presentation.

Good afternoon, chair and member. Is this oh, got it. Okay. Great. Good afternoon, chair and members.

Lauren Finke, senior director of policy at the Kennedy Forum, proud cosponsor to AB 2011. TKF was founded by Patrick Kennedy, author of the Federal Parity Act to advance access to mental health and addiction care and ensure parity laws designed to protect people with these needs are implemented with Fidelity. I want to thank the chair and this committee for their hard work in sharing the bill does just that.

AB 2011 is a simple common sense bill codifying federal rules into state law to preserve Californians existing and mental health and substance use disorder protection and regulators ability to enforce them. It simply codifies the twenty twenty four federal rules into California law.

It ensures Californians don't lose access to care if protections are rolled back by the Federal Government. Parity has been a federal law since '20 or since 2008 but enforcement has been inconsistent. The biggest barriers we continue to see are not about coverage on paper but how plans operate in reality. So prior authorization barriers, overly restrictive medical necessity criteria, inadequate provider networks for example. The 2024 rules were a major step forward because they finally gave regulators clear enforceable standards and data driven tools to actually measure compliance.

With growing uncertainty around federal enforcement those gains are at risk. AB 2011 simply codifies those federal standards into California law preserving the authority of DMHC and CDI to enforce parity and ensures those protections remain in place regardless of what happens at the federal level. It doesn't change the rules. It makes sure we don't lose them. The bill does not create new mandates or expand benefits.

Plans are already required to comply with these standards today. This is about maintaining the status quo and ensuring continuity for patients and regulators alike. AB 2011 ensures parity is real, enforceable and protected for Californians regardless of federal changes or cuts to consumer protections. We respectfully ask for your aye vote.

Good afternoon, chair and committee members. My name is Miguel Bastidas. I'm with the California Department of Insurance here under the leadership of Insurance Commissioner Ricardo Lara, proud cosponsor of the bill. I'd like to thank Assemblymember Hart for his leadership and authoring this important critical parity measure. As one of the regulators of the private health insurance market in California, it is critical that the department has clear, consistent, and enforceable statutory or regulatory guidance to ensure mental health and substance use disorder care parity.

The MPO 2024 rules provided that guidance. The Federal Government updated MPO regulations in 2024, responding to both congressional action and widespread deficiencies in insurer compliance. The 2024 NPA rule provided much needed clarity and was created under the extensive public rule making process. Clear standards provided by the rule enable the department to more effectively determine whether insurers are restricting access to mental health and substance use disorder services compared to medical and surgical care.

Despite NPA being in effect since 2014, in 2023, not a single insurer comparative analysis reviewed by the department met the requirements on first submission.

Many of the comparative analysis we reviewed were missing key information needed to evaluate them properly. Without this information, we cannot determine whether insurers are applying NQTLs in compliance with NQTL. Clarifying these requirements will help the department ensure that insurers apply NQTLs correctly and consistently with the law. California has a proud history of leadership in codifying federal standards to protect consumers from instability and inconsistency at the federal level. This legislation simply codifies what is already good law.

On behalf of insurance commissioner Ricardo Lara, I respectfully ask for your aye vote.

Thank you. If there's anyone else that would like to register their support for this bill, please come to the microphone, State your name, your organization, and your position.

Good afternoon. Crystal Strait representing the Steinberg Institute. Proud to cosponsor this bill. Thank you.

Lizzie Guansona here on behalf of the California Academy of Child and Adolescent Psychiatry and the California State Association of Psychiatrists in support of proud cosponsors.

Vanessa Cahina on behalf of the California Academy of Family Physicians here in support.

Angela Hill with the California Medical Association in support.

Malik Bynum with the County Behavioral Health Directors Association in support. Thank you.

Christine Smith, Health Access, California in support.

Charles Contrebecki, internist on advocacy on behalf of the California Children's Hospital Association in support.

Good afternoon. Tyra Vrindi, California Psychological Association in support. Thank you.

Tim Madden representing the California chapter at the American College of Emergency Physicians in Support.

Good afternoon, madam chair, members of the committee. Louis Brown here today on behalf of the California cons consortium of addiction programs and professionals and support.

Seeing no one else, I would like to register their support. If there's anyone that would like to speak as a lead opposition witness to this bill, this is your time to come forward.

Seeing no one else, I would like to register their support. If there's anyone that would like to speak as a lead opposition witness to this bill, this is your time to come forward.

And you will have a combined total of five minutes for your presentation.

Good afternoon Chair and members. Olga Shiloh here on behalf of the California Association of Health Plans. Respectfully in opposition to AB 2011. We appreciate the author's office and the committee for the ongoing engagement and discussions on this bill and we share the legislature's commitment to mental health parity and ensuring meaningful access to mental health and substance use disorder services. Help plans already are required to cover medically necessary behavioral health treatment on par with medical and surgical care.

AB 2011 attempts to codify an unsettled federal rule. The 2024 federal parity rule has been paused for review and at the same time is subject to ongoing litigation. And just last month, I think the federal government announced that it plans to issue a new proposed rule by December 30. Despite this, the mental health parity laws, including the ACA requirements that 2013 federal rules enacted by the Obama administration, along with additional state protections such as SB 855, do remain in effect.

Moving forward at the state level with premature legislative action while the federal framework is in flux risks locking California into requirements that may soon change or be invalidated, creating conflicting obligations and unnecessary disruption.

Efforts to advance parity laws at the sale level should be held off until federal rules are shored up. Additionally, AB 2011 imposes a highly burdensome compliance structure that may not actually improve access to care and differences in access to behavioral healthcare services are often driven by factors outside of plan controls. This bill would hold plans accountable for those external challenges diverting resources toward administrative compliance rather than patient care.

CAP remains committed to working with the author of the bill moves forward today, but this time we request a respectful ask and no vote. Thank you.

Madam Chair and members, Steffanie Watkins on behalf of the Association of California Life and Health Insurance Company.

First and foremost, we'd like to thank the Life and Health Insurance Company. First and foremost, I'd like to thank the author and the sponsor. We've had any number of engagements and conversation about this bill, and we appreciate the openness and the willingness to hear us out. Unfortunately, today we are opposed to the bill in print.

In the interest of time, I'd like to echo many of my colleagues' comments and underscore our shared goal of ensuring timely access to medically necessary mental health and substance use disorder care as well as our strong commitment to complying with current mental health parity standards.

Regrettably, we are here today in opposition as, as AB 2011 seeks to incorporate the federal 2024 mental health parity and addition equity act into California law while key legal issues remain unsettled. As was mentioned earlier, the federal 2024 rule is the subject of current litigation, which has resulted in a federal non-enforcement order being issued for the new portions of the 2024 rule. While the federal department considers whether to revise or rescind them.

We think this is a key element to really consider as we look forward as we move forward with this issue. As my colleague mentioned, we do expect new rules to be issued as early as December, and we imagine that those are with the goal of addressing the current litigation that has now been paused while this is being reconsidered.

So for those reasons, we would just ask the legislature to consider holding off on incorporating this into California law until we see that revision, and then we'll have an opportunity at that point to engage in a bigger and broader conversation based on the new federal rules, as well as how to incorporate them into California's law. So for those reasons, we are opposed today. Thank you.

Thank you. If there's anyone else that would like to register their opposition, please come to the microphone. State your name, your organization, and your position.

Madam Chair, members. John Winger here on behalf of America's Health Insurance Plans, also in respectful opposition.

Thank you.

Seeing no one else that would like to register their opposition, I will bring it back to committee if anyone has any questions or comments. Vice Chair Valladares.

Thank you to the sponsors, to the Department of Insurance. Are are we essentially legislating because there's a gap in the law or because where there's concerns that we may lose a lawsuit?

This is Sorry. I don't know if this one. This is in response to preventative kind of proactive approach to ensure that we maintain these protections in place if there is a rollback. These rules remain in effect whether the pause or the order to to pause is in in effect or not is they remain in effect until they're repealed and replaced by something different. So we wanna make sure there's no gap in between when that is rolled back and new rules potentially come out.

And the bill allows the recent amendments allow us to take a look at those whatever the Federal Government comes out with and provide guidance based on that and respond to that/

So to the opposition, do you read read it similarly?

I would say we probably have a slightly different take on it. I mean, there's nothing while the Fed sent out an encouraging non enforcement order to states, states currently have the right to continue to enforce, I think, as was mentioned. That wouldn't be repealed even if a new rule was issued. So if the new rules come out in December, they have to go through a pretty lengthy, as we've all seen here, regulatory process for consideration before they're adopted.

Nothing would potentially rescind either the 2013 rule that's currently in order or the 2024.

I mean, certainly that would be in question. The litigation we feel strongly really speaks to the issue of the vagueness of the current existing 2024 rule and confusion amongst plans about how to comply. We don't think those go away if we just adopt that into California law. We think those issues still remain.

And so for right now, we think it makes more sense for the state to wait till December and see what comes out and see if that's able to address the original ... litigation, which is on the federal level and also to have compliance across all segments.

Right now, they're not enforcing this in the self insured market, So you would have differing standards. And so, I mean, I think as a general rule, when there's active litigation and uncertainty, you know, we would always respectfully ask that that be allowed to work its way through before we take and move forward with legislation. And so I think that's the position that we're at right now.

Thank you. So to the author, I understand what you're trying to accomplish and I'm not necessarily in disagreement especially when it comes, to mental health services that that individuals need. We we understand the need right now. But I do think because there is federal litigation, we don't know what's gonna happen. This is a little premature.

And I also have some serious concerns about the implementation cost. And right now, especially as we're having a major budget fight over how we find dollars, I have major and most likely, premiums are gonna go up for everyday Californians. I don't know that adding another layer in cost that it's the right time to do that. So unfortunately, I won't be able to support the bill. They appreciate you thinking this issue through.

Thank you.

Thank you. Seeing no further comments. Wanna thank you very much for bringing, this bill forward so that we can have this conversation. It is an important conversation to have. What we do in the space of mental health is, very critical and and I think we are having these discussions now on a yearly basis, because we realize that we do need to put more focus and more resources and really reduce a lot of the barriers that that individuals have to getting, the services that they need.

I do have, some concerns about this actually, going through the, litigation process right now and the confusion around the 2024, rules and and guidance. With our amendments, you know, we try to make it as best as possible given, you know, this current situation, but I do I do understand the concerns. I hope that you will continue to have conversations with the opposition. You know, I'm not sure if there will be any agreement that's able to be made.

With the amendments that we have here today, I will be supporting it in committee.

I can't guarantee that I would continue to support it on the floor, if it were to make it there because of some of the concerns that were addressed today. But we'll be supporting it to help it move out of this committee. And with that, you may close.

Well, I just appreciate, the dialogue. And this is a very complex area, but it's really an important, area for our constituents. And we had a meeting yesterday evening, to talk with the opposition. Their description of the complexity of the situation is not lost on me, and, trying to do the best to create a floor in California in case the federal regulations go the direction that we would not like to see.

And, this is really an attempt to codify the status quo, but it is it is a challenge to do that in the actively litigated space.

So we're gonna continue to work together and try and find a way to to protect Californians who are seeking the behavioral health services that they should be entitled to.

Thank you.

And I respectfully request an aye vote.

Okay. Thank you. And once we get a quorum, we will move on that. I'm going to once again put out a plea for any members of the health committee to come down. We are on our last two bills.

Would love to be able to establish quorum and vote on our, our bills today. So we will now go to file item number 10, AB 2706 by Assemblymember Soria. And would also like to put a call out to Assemblymember Carrillo. If you would like to present your bill today, this would be your time to make your way to Room 1200 on 0 Street. Assemblymember Soria, you may begin.

Thank you, madam chair. And members, AB 2706 is a collaborative effort between the Department of Public Health and Industry to reform California's cannery law to be easier to comply with and a more sustainable while maintaining California's high health standards. The cannery inspection program which was established in 1925 regulates the commercial manufacturing and packing of food susceptible to botulism contamination.

While this law was an important step in protecting Californians from foodborne pathogens a hundred years ago, it has not kept pace with larger changes in how we ensure food safety today. Today, all food processors nationwide must comply with the Food Safety Modernization Act, a more comprehensive federal law with similar definitions but more consistent requirements that ensures operations in different states meet the same standards.

However, only processors located within California are subject to the California cannery law whose enforcement has been mirrored by delays as well as inconsistent requirements and cost for food processors in the state. This has penalized those operating in our state and discourages new investments in food processing facilities along with along with the economic activity and jobs those operations bring.

AB 2706 will shift California's cannery law to a more modern and streamlined approach to food safety that is in harmony with federal standards and current industry practices. This will put California's packing industries on an even footing with operations in other states to create a more sustainable food safety program and ensure California's packaged food products are safe for all. Here with me today to testify in support is Louis Brown on behalf of the California Dairies Inc.

Thank you. You have a total of five minutes for your presentation.

Good afternoon, madam chair, members of the committee. Louis Brown here today on behalf of California Dairies Incorporated. We are the largest California based dairy cooperative, representing over 300 family owners. And we recently made the decision to invest in California and built the first milk processing facility, that this state has seen in over twenty years, And it is state of the art, bringing in technology from all over the world to manufacture shelf stable milk.

And what we found after we made that investment that we were subject to the 1925 cannery law.

And notwithstanding the experts that we had, helping design and build our plant, we found that we were also subject to a law that created duplication and excessive costs. To which had we built our plant outside of the state, we would not have been involved in the cannery law. So we engaged in a conversation with the administration. We engaged in conversation with your committee last year as well as the assembly and have now worked our way through, to the language that you see in this bill today.

It reduces duplication.

It cuts red tape. It does not penalize those that wanna invest in California, and at the same time, protects consumer health. And we're excited to be part of that. We're, appreciative of the efforts of the administration to get us here. And with that, we ask for an aye vote.

Thank you. If there's anyone else in the audience that would like to register their support, please come to the microphone. State your name, your organization, and your position.

Good afternoon, chair and members. Katie Davey, executive director of the Dairy Institute of California, here in support.

Thank you.

Jim Lights on behalf of Baldwin Richardson Foods, a fairly new food ingredient manufacturer established in Riverside in strong support. Thank you.

Thank you. Seeing no one else, if there's anyone that would like to speak and lead opposition, this is your time to come to the table. Seeing none, if anyone would like to register their opposition, this is your time to come to the microphone, state your name, your organization, and your position. Seeing none, I will bring it back to Senator Groves.

Seeing no one else, if there's anyone that would like to speak and lead opposition, this is your time to come to the table. Seeing none, if anyone would like to register their opposition, this is your time to come to the microphone, state your name, your organization, and your position. Seeing none, I will bring it back to Senator Groves.

Thank you. I'm gonna thank the author for bringing this forward. Actually, Tony Atkins was helping me with this because the facility you're talking about is in my district and they produce whole milk, 2% milk, change a line over to invest in the state of California to produce shelf stable milk, they came in contact with this 1925 cannery law, which was for sardines and stuff in the on the in the Bay Area, and it was crazy. And I do wanna applaud the governor.

We don't agree on a lot of things, but he actually got doctor Pan, to engage in this process.

They sent a crew out to make sure that we didn't lose that facility and the investments that were put in California. And, thank the author for bringing it forward to fix it so that and I'm glad that the administration had you expand it because it was just specifically for this, but I did get a text that say that you were gonna expand it, to make sure that no other dairy facilities or facilities like this for for food production would have to do the duplicative issues.

And just the monitoring from the 1925 law would have been extraordinarily expensive when you were already producing milk products as is. So, thank you for bringing it forward. And and, and miss, former Pro Tem Atkins has toured that facility as well.

And she said you could eat off the floors. So thank you. Thank you.

Thank you.

Thank you. Seeing no further comments, I wanna thank the author for bringing this bill forward and invite you to close.

I respectfully ask for an aye vote.

Thank you. And once we get quorum, we will do that. Speaking of quorum, if there's any members of the Health Committee, Senate Health Committee that would like to come down to 0 Street Room 1200 so that we may establish quorum and vote on all of the bills that we've heard, Please come now. Additionally, looking for our last presenter, Assemblymember Carrillo, if you would like for your bill to be heard today, recommend that you come to 0 Street Room 1200. And we have our final author here.

File item eight, AB2041 by Assemblymember Carrillo. You may begin when you are ready.

Thank you, Madam Chair. Thank you for allowing me to present Assembly Bill 2041. Last year, my bill AB94645, excuse me, AB645 established a requirement for public safety agencies to train nine eleven dispatchers on how to provide callers with pre arrival medical assistant instructions related to chalking, CPR, childbearing, bleeding control and other emergencies.

AB2041 seeks to build upon this lifesaving work to help Californians help their family members, their friends, and their neighbors when they are experiencing a critical public health need. We reached an agreement with a position to amend this bill so that it will only require public safety agencies that were not in compliance at the start of this year to report their status of compliance to their local EMS agency by 01/31/2027.

The only way to today to testify is Sean Sullivan as the president-elect of the California Ambulance Association and CEO of Life West Ambulance.

Thank you. You have a total of five minutes for your presentation.

Thank you, Madam Chair. Thank you, members. I'll be brief knowing, excuse me, that this is the last item for you guys. As assembly member said, I'm with the California Ambulance Association. I'm also an EMT.

I've been in the profession for over twenty five years. And I my abbreviated statement would actually just be personal. Three years ago, my good friend, who's a high school basketball coach, collapsed, after practice. And, his son, who was the other person with him in the gym, called 911. And the 911 dispatcher provided CPR instructions for seven minutes before the local fire department and EMS crew arrived.

He recovered. He, is alive today and well and would not be here today if it weren't for those instructions. So, I'm so grateful to the assembly member for bringing this bill forward. Thank you for your time and respectfully ask for your high vote.

Thank you. If there's anyone else that would like to register their support for this bill, this is your time to come forward. State your name, your organization, and your position. Seeing none, if there's anyone that would like to speak as lead opposition to this bill, please come forward to the table now, seeing none. If there's anyone who would like to register their opposition to this bill, please come forward, state your name, your position at this time.

Seeing none, we'll bring it back to members of committee. Seeing no comments, wanna thank you assembly member so much for bringing this bill forward and continuing to work on it. Would invite you to close.

Well, now that I call my breath, thank you madam chair and committee members for your patience. Appreciate it and I respectfully ask for an aye vote. Thank you.

Thank you so much. Once we get a quorum, we will do that.

Thank you.

I am now, once again, calling for any member of the Senate Health Committee to come down to 0 Street Room 1200. We have heard all of our bills for today and would love to be able to establish a quorum so that we can vote on the bills that we've heard.

Alright.

Alright. Well, let's establish quorum. Assistant, assistant, please call the roll.

[Roll call]

Valadares here. Caballero? Here. Caballero here. Durazo?

Gonzales? Grove? Here. Grove here. Menjivar, Padilla, Perez.

Perez here. Rubio, Smallwood Cuevas. Present. Smallwood Cuevas present.

We have a quorum. We will now consider we will now consider the bills on the consent calendar. This is file items one, three, and six, AB1571, 1864, and 1956. Do I have a motion on the consent calendar? Move motion made by Senator Valladares.

Assistant, please call the roll.

[Roll call]

Valadares, aye. Caballero?

Aye.

Caballero, aye. Durazo? Gonzales? Grove? Aye.

Grove, Aye. Menjivar? Padilla? Perez? Aye.

Perez, Aye. Rubio? Smallwood, Cuevas? Aye. Smallwood, Aye.

Six zero

6-0. We'll place that on call. We'll now move to file item number two, AB 1734 by Assemblymember Stefani. Do I have a motion? As amended.

As amended.

As amended.

Moved by, assembly member, I'm sorry, Senator Caballero. Excuse me. Motion is do passed as amended and re refer to the committee on education. Assistant, please call the roll.

I'll move.

[Roll Call]

Aye. Valadares, aye. Caballero. Aye. Caballero, aye.

Durazo, Gonzalez, Grove. Aye. Grove, aye. Menjivar, Padilla, Perez. Perez, Aye.

Rubio, Smallwood Cuevas. Aye. Smallwood Cuevas, Aye. Six zero on the

6-0 will place that on call. We'll now go to file item number four, AB 1910 by Assemblymember Boerner with, amendments. Do I have a motion?

So moved.

Moved by vice chair Valadares. Assistant, please call The motion is do passes amended and we refer to the committee on appropriations.

I have the motion.

The motion is do passes amended and we refer to the committee on appropriations. Senators Weber Pearson.

[Roll Call]

Caballero.

Aye.

Caballero, aye. Durazo? Gonzales? Groves. What

is it? Sorry. Four.

Item four.

Nineteen ten?

Aye.

Grove, Aye. Menjivar, Padilla, Perez? Aye. Perez, Aye. Rubio, Smallwood Cuevas?

Smallwood Cuevas, Aye. Six zero.

Six zero. We'll place that on call. We are now at file item 5AB1949. Do I have a motion?

I move.

Moved by vice chair Valladares. Motion is do passed and we refer to the committee on appropriations. Assistant, please call the roll.

[Roll Call]

Valadares, aye. Caballero?

Caballero, aye. Durazo? Gonzales? Grove? Aye.

Grove, aye. Menjivar? Padilla? Perez? Aye.

Perez, aye. Rubio? Smallwood, aye. Smallwood, aye. 60 on call.

6-0, that is on call. We are now on file item seven, AB 2011, Assemblymember Hart with amendments. Can I get a motion? Moved by Senator Smallwood Cuevas. Motion is do passed as amended and re referred to the committee on appropriations. Secretary, please call the roll.

Secretary, please call the roll.

[Roll Call]

The Valadares, no. Caballero?

Caballero, aye. DeRazzo? Gonzales? Grove? No.

Grove, no. Menjivar? Padilla? Perez? Aye.

Perez, aye. Rubio? Smallwood Cuevas? Smallwood Cuevas, aye.

Four ayes to Four to two. We'll place that on call. We're now at file item eight, AB 2041 by Assemblymember Carrillo. Can I get a motion?

So moved.

Moved by Vice Chair Valladares. Motion is do passed and we refer to the committee on appropriations. Assistant, please call the roll.

[Roll Call]

Valadares, aye. Caballero. Aye. Caballero, Aye. Durazo?

Gonzales?

Grove? Aye.

Grove, Aye. Menjivar? Aye. Menjivar, Aye. Padilla?

Aye. Perez? Aye. Perez, Aye. Rubio?

Aye. Rubio, aye. Smallwood Cuevas? Aye. Smallwood Cuevas, aye.

80. On call.

8-0, we'll place that on call. We are now at file item number 10 AB 2706 by Assembly Member Soria. Can I get a motion?

So moved.

Moved by Senator Menjivar. Motion is do passed and we refer to the committee on appropriations. Assistant, please call the roll.

[Roll Call]

Aye.

Valadares, aye. Caballero? Aye. Caballero, aye. Durazo?

Gonzales? Grove? Aye. Grove, Aye. Mangivar?

Aye. Menjivar, Aye. Padilla? Aye. Perez, Aye.

Rubio? Aye. Rubio, Aye. Smallwood Cuevas? Aye.

Smallwood Cuevas, Aye.

8-0. We'll place that on call. We'll go back to the top. Alright. We'll start back up at the top with our consent calendar. Assistant, please call the absent members.

Assistant, please call the absent members.

[Roll Call]

Aye. Rubio, aye. Let's go

to file item two. I'm sorry.

call. Thank you.

item on

90.

We'll place that on call.

Oh, wait. Sorry. It's 8-0. On call.

8-0. On call. We'll move to file item two, AB 1734. Assistant, please call the absent members.

[Roll Call]

Rubio, aye.

8-0. We'll place that on call. We'll now move to file item four, AB 1910. Assistant, please call the absent members.

[Roll Call]

Rubio, aye. 80.

8-0. We'll place that on call. We'll go to file item five, AB 1949. Assistant please call the absent members.

[Roll Call]

Aye.

Menjivar, Aye. Padilla? Rubio? Aye. Rubio, Aye.

Eight zero. We'll place that on call. We'll go to file item seven, AB 2011. Assistant, please call the absent members.

[Roll Call]

Aye.

Six two. We'll place that on call. We'll move to file item We will reopen the roll starting with our consent calendar. Assistant, please call the absent members.

We will reopen the roll starting with our consent calendar. Assistant, please call the absent members.

[Roll Call]

9-0. We'll place that on call. File item two, AB 1734. Assistant, please call the absent members.

[Roll Call]

9-0. We'll place that on call. File item four, AB 1910. Assistant, please call the absent members.

Assistant, please call the absent members.

[Roll Call]

Nine zero. We'll place that on call. Go to file item five, AB 1949. Assistant, please call the absent members.

[Roll Call]

Padilla, aye. Nine.

Nine zero. We'll place that on call. File item seven AB 2011. Assistant, please call the absent members.

[Roll Call]

Seven two will place that on call. File item eight, AB 2041. Assistant, please call the absent members.

[Roll Call]

Nine zero will place that on call. And finally, file item 10, a B27066. Assistant, please call the absent members.

[Roll Call]

9-0 will place that on call. Okay. We'll open up the roll. Again, starting with our consent calendar. Assistant, please call the absent members.

Assistant, please call the absent members.

[Roll Call]

Gonzales. Ten zero.

10-0. Our consent calendar is out. We'll move to file item two, AB 1734. Assistant, please call the absent members.

Durazo, aye. Gonzales. Ten zero.

[Roll Call]

Ten zero. That bill is out. We'll move to file item four AB 1910. Assistant please call the absent members.

[Roll Call]

Ten zero. That bill is out. We'll move to file item five, AB 1949. Assistant, please call the absent members.

[Roll Call]

Durazo, aye. Gonzales?

Ten zero. That bill is out. We'll move to file item seven AB 2011.

[Roll Call]

So that is eight to two. Eight to two. That bill is out. Oh, I'm sorry. We will now move to file item eight, AB 2041. Assistant, please call the absent members.

We will now move to file item eight, AB 2041. Assistant, please call

[Roll Call]

Ten zero. That bill is out. And our final bill, file item 10 AB 2706. Assistant, please call the absent members.

[Roll Call]

Thank you everyone for presenting your bills today. Thank you to the committee members for showing up. Health committee is now adjourned.