Assembly Standing Committee on Health

Good afternoon, and welcome to the Assembly Health Committee's hearing on Tuesday, June 9. Before we begin, I wanna make sure everyone understands our committee procedures to ensure we maintain order and run a fair and efficient hearing with the goal of hearing as much from the public within the time limits that we have. We seek to protect the rights of all who participate in the legislative process so that we can have effective deliberation on the critical issues facing California.

Rules of conduct for members of the public include no engaging in conduct that disrupts, disturbs, or otherwise impedes the orderly conduct of this hearing, engaging in personal attacks of members of this committee, author, staff, or other witnesses, talking or loud noises from the audience. Please be aware that violations of these rules may subject you to removal or other enforcement processes.

If you are providing witness testimony at this hearing, all witnesses will be testifying in person. Main support and opposition will be allowed two main witnesses for a maximum of two minutes each. As a reminder, primary witnesses in support must be those accompanying the author or who otherwise have registered a support position with the committee. And the primary witnesses in opposition must have their opposition registered with the committee per the instructions on our website.

All other support and opposition can be stated at the standing mic when called upon to simply state name, affiliation, and position.

All testimony comments are limited to the bill at hand. For some our housekeeping items, I would like to note that the speaker has appointed assembly member Al Hawari to be a substitute for assembly member Mark Gonzalez for today's hearing. Welcome, assembly member. And, for our consent, the following bills are proposed for consent for today's hearing. Any member of the committee may remove a bill from the consent agenda.

Item two, SB 918 by Sayardo with a motion of do pass as amended to appropriations. And item number seven, SB 122 by Weber Pierson with a motion of do pass as amended to appropriations. With that, we will start as a subcommittee of in order to be able to hear bills and will await our first author. Look at that. And Senator Laird, thank you so much.

Beginning with item number five, SB 1023, regarding health care coverage and to antiretroviral drugs, drug devices, and drug products.

Thank you, Madam Chair and committee Member. This bill increases access to a critical HIV prevention mechanism that's called pre exposure prophylaxis or PREP. PREP is highly effective. It prevents HIV transmission. It can be taken in the form of a daily pill or a long acting injection.

Currently, the billing process for the long acting injectable options can be administratively complex if the health plans limit reimbursement to the medical benefit. This bill requires that insurers that provide PREP to the medical benefit to also provide PREP through the pharmacy benefit pathway, which supports timely reimbursement to health care providers. It'll increase access. The bill was sponsored by the LGBTQ caucus, insurance commissioner Ricardo Lara and the Department of Insurance, the San Francisco AIDS Foundation, Equality California AIDS Project Los Angeles.

And with me, and also the Los Angeles LGBT Center with me to provide, testimony is Jonathan Froxwieck, director of health justice policy with the San Francisco AIDS Foundation.

At the appropriate time, I would respectfully ask for an Aye vote.

Thank you, Senator. You'll have two minutes.

Chair Bonta, committee Members, my name is Jonathan Froxweig, again from San Francisco AIDS Foundation, proud cosponsor of this bill. In the last year for which data is available, almost five thousand Californians were newly diagnosed with HIV, and that number was approximately the same the year before that and the year before. So unfortunately, our state's progress on reducing new HIV infections is stalling out.

And while HIV is now a manageable chronic condition, every person diagnosed with the disease must take medication for the rest of their life, manage side effects and complications, and cope with intense stigma. This cost not only individuals, but our health system as

a whole. The estimated per patient lifetime cost associated with HIV is more than $850,000.

PREP is one of our most powerful tools for preventing HIV transmission, and the introduction of these long acting injectable forms has made this tool even more powerful. Unfortunately, the way many commercial insurers are paying for injectable prep is preventing health care providers from prescribing these medications. These insurers only cover injectable prep under their medical benefit, meaning they reimburse providers for the medication after the provider has administered it.

So in practice, this means providers typically must purchase injectable prep at their own expense, store the drugs at their own risk, dedicate staff time to billing and appealing improper denials, and wait an average of twenty six days to be reimbursed. These are clearly major barriers, especially for providers and settings that lack resources.

San Francisco AIDS Foundation, my organization, is one of the largest prep prescribers in California, but we have to turn away patients seeking injectable prep if their insurer only covers the drug under their medical benefit. The LA LGBT Center, another cosponsor, cannot provide the injectable PrEP drug, Linacapavir, to commercially insured patients due to difficulties with medical benefit coverage. So this issue is repeating itself at clinics across the state, blocking the rollout of a highly promising HIV prevention strategy.

Senate bill 1023 will solve the problem by requiring commercial insurers that already cover injectable PrEP under their medical benefit to also cover it under their pharmacy benefit. There is ample precedent for pharmacy benefit coverage of injectable prep.

In fact, some insurers already cover the drugs under their, pharmacy benefit. We just need more too.

So we urge you to advance a simple solution. Thanks so much.

Thank you.

Thank you very much. We will now hear from anyone in the hearing room who would like to offer a Me Too in support of this measure. Please come forward. State your name, affiliation, and position only.

Good afternoon, Chair. Farrah Mc Daid Ting on behalf of the County Health Executives Association of California in support.

Thank you.

Ben O'Brien with California Life Sciences in support.

Sarah Weber on behalf of the Drug Policy Alliance in support.

Molly Mala on behalf of Planned Parenthood Affiliates of California in support.

Katie Van Dynes with Health Access California in support. Thank you.

Thank you, Madam Chair. Megan Subers on behalf of the Los Angeles LGBT Center, cosponsor in support.

Good afternoon. Ryan Sues on behalf of APLA Health and Essential Access Health in support. Thank you.

Miguel Bastidos with the California Department of Insurance here on behalf of insurance commissioner Ricardo Lara, proud cosponsor to the bill in strong support.

Nico Vincent. I'm here with UC Davis Health and Upti in strong support.

Kevin Guzman with the California Medical Association in support.

Madam Chair and Members, Rand Martin on behalf of the AIDS Healthcare Foundation in strong support. Thank you.

Ryan Spencer with the American College of OBGYN's District 9 in support.

Thank you so much. We will now move on to any primary witnesses in opposition. Please come forward. Thank you. You'll each have two minutes.

Please go ahead.

Thank you, Chair and Members. Kassidy Heckman on behalf of the California Association of Health Plans. Unfortunately, we are still opposed to the bill today, but wanna thank the author, his staff, and the sponsor for engaging with us throughout the session on it. I wanna start by stating, as mentioned, that health plans already cover PrEP and PEP, and more importantly, health plans cover these drugs without step therapy or prior authorization consistent with state law.

Because these drugs are widely available treatments and are broadly covered service, it remains unclear to our organizations why mandate that directs plans on how to structure their benefits as necessary.

And while we understand that SB 1023 is intended to help providers with certain parts of administration, this bill sets a troubling precedent as benefit design is an area that has traditionally been within a plan's purview and is based on clinical care guidelines, actuarial considerations, and regulatory standards.

Mandates that attempt to control how a plan designs their benefits but does not actually change the coverage of a drug or treatment reduces flexibility and hinders the plan's ability to design clinically appropriate benefits that are responsive to a patient's needs. Additionally, it impacts their ability to manage the costs associated with health care. For these reasons, we oppose the bill, but thank you again to the author and his sponsor.

Good afternoon, Chair, Members. Matt Akin with the Association of California Life and Health Insurance Companies, also respectfully here in today in opposition to Senate Bill 1023. I'd like to first align my comments with my colleague at cap and reiterate we are concerned about the precedent that this bill would set regarding the health plan's ability to design and administer its own benefits. Generally speaking, prescription drug benefits are intended for medications that patients self administer, such as drugs obtained through a pharmacy and taken at home.

In contrast, medical benefits cover drugs that are administered by a health care professional in a clinical setting such as a physician's office or a hospital.

This bill would blur that well established line by requiring provider administered drugs used to treat prep and and pep to be treated as outpatient prescription drugs, even though these medications are not self administered and are delivered in clinical settings under the supervision of health care providers. As a result, the bill would fundamentally alter how plans are permitted to structure and manage these benefits. While some plans may choose to structure their benefits in this way, there's an important distinction between allowing flexibility and opposing a mandate.

SB 1023 would require all plans and insurers to adopt a specific approach designed and administer prep and pet benefits, limiting their ability to tailor coverage and operational processes to best serve their members. Beyond the immediate impacts of these requirements, we are also concerned about the broader precedent the bill would establish.

By prescribing how a specific benefit must be designed and administered, this bill could open the door to similar mandates and other areas of coverage, ultimately reducing the flexibility health plans need to effectively manage benefits and respond to evolving member needs. For these reasons, we are respectfully opposed to the bill, but we wanna sincerely thank the author and the sponsors for their continued dialogue and look forward to future conversations if the bill moves forward today. Thank you.

Thank you. Are there others in opposition in the hearing room? Seeing none, I will bring it back to committee for any questions or comments. Moved by at the appropriate time when we are full subcommittee, Ahrens. And I'd like to Seconded by Elhawary, and she has a comment or question.

I just wanted to thank you so much, to the author just for being able to bring this bill. We know how much it'll help, our communities, especially our communities of color who oftentimes are facing barriers with PrEP access, and our LGBTQ communities as well. Appreciate

you. Thank you. And, perhaps, Senator Laird, in your, closing comments, you can address some of the opposition's points raised. We're talking specifically kind of about injectables. I think that that's important to be able to note for everybody and a very critical advancement in order to be able to ensure, we are at the height of prevention for HIV and AIDS.

And, want you just to be able to speak to some of the opposition's concerns in your closing. However, I'm very supportive of this, legislation and believe that we have the ability within the confines of this legislation around this particular device product and administration of drug. We can encapsulate the need around that and don't serve

and don't believe that there's slippery slope arguments that we should be attending to at this moment. So please go ahead and close.

Thank you very much, Madam Chair. I appreciate the comments from the dice and I appreciate the the people that testified. And I wanna continue to engage the opponents. But let me be clear, this you we have what you saw is sort of two things conflicting. And our desire is to actually make this assessable and deal with prevention.

And the current system doesn't allow for that with the injectable in an expeditious way. And so it's hard to deal with the argument that's a precedent. And so what I think we want to do is see is there anything that is that serves both purposes. Because we wanna serve the purpose of lowering HIV transmission and making sure there's good prevention, and we don't wanna sell that out in the bill.

But if there's a way that we can do that and work with the opponents, we will do that.

And just on a personal note, I ran an aid service agency in the first half of the nineties at the local level. It was our dream that there would be drugs for both treatment and prevention. And now there are in a major significant way and notwithstanding the cuts in HR 1. I mean, there there is a real shot at getting close to zero on prevention, and we could have some steps back from the federal legislation.

And it's individual bills like this that in California will make sure that we do everything we can to keep the virus from being transmitted.

So we'll continue to work, but our goal is the prevention of transmission. And I would, at the appropriate time, respectfully request an Aye vote.

Thank you so much. We will conclude this portion of our hearing in hearing SB 1023. And at the appropriate time, we have a motion in a second. The measure will be considered. Thank you, Senator.

Seeing no other authors, we will wait.

Thank you. We have, the ability to hear now item number four, SB 964 by the honorable senators all with Columbus.

Thank you, Madam Chair and colleagues. Good afternoon. I am proud to present SB 964, our continuity of care bill. This bill helps patients with chronic complex conditions receive the right medication doses without unnecessary prior authorization delays, allowing up to two clinically appropriate adjustments while protecting continuity of care. If the dose is off label, two articles from major peer reviewed medical journals must present supporting data that the off label use is safe and effective.

Under current practice, health plans often require a new prior authorization whenever a medication dose or frequency needs to be adjusted. This happens even when the change is medically necessary and the medication itself is already covered. Think about what that means in real life. You have a doctor that determines that a patient needs a small adjustment to their medication to keep their condition under control. And instead of being able to make that change right away, the request must go through a prior authorization with the health insurance.

And we know what this means. This means that we have patients who, unfortunately, will see an increase in their pain and their suffering. We also understand that valuable time is lost in terms of doctors and care teams having to spend on paperwork hours and that the treatment ultimately is delayed and that doesn't help the patient, the practitioners, nor our insurance companies. So for patients, these delays are not just inconvenience.

I've had a chance to meet with some of our community members who just talked about how this interrupted care just creates what is preventable disease from getting worse, having more flare ups, having, in some cases, unavoidable trips to the emergency room.

And we know that costs more money and more time. SB 964 would allow licensed health care professionals to adjust the dose or frequency of a covered medication up to two times without prior authorization when clinically appropriate. And we also know how important it is that we wanna maintain our existing clinical standards. We wanna be sure to be excluding controlled substances as part of this bill. This bill ultimately reduces unnecessary delays.

It supports provider judgment. It protects the continuity of care. It helps patients. And today, here to testify with me is Ryan Spencer from Crohn's and Colitis Foundation who's sponsor of this bill and doctor Archana Leguenannan, board certified pediatrician with the Valley Children's Specialty Medical Group, and I respectfully ask for your aye vote.

Thank you. You'll each have two minutes. Go ahead.

Chair and Members of the committee, thank you for the opportunity. My name is doctor Archana Linganin, and I'm a pediatric gastroenterologist working at Valley Children's Hospital in Madera. And I'm here in support of SB964. I treat patients with inflammatory bowel disease. Inadequately treated IBD causes ongoing intestinal damage, risking bone health, fertility, cancer risk, and child development.

Early effective treatment is crucial to prevent lifelong complications. Here is the challenge. A fixed dose does not work the same for every patient. Multiple studies show what matters is the therapeutic drug level needed to control the inflammation, and that is why national GI guidelines recommend checking patients' clinical response, biomarkers, drug levels, and adjust the dose when medically necessary. Physicians do not take these decisions lightly and always include safety considerations.

But even with this due diligence, we wait weeks for prior authorization only to get denied. When appealed, the vast majority are ultimately approved anyway. During this delay, patients suffer. Imagine a child being afraid to eat because it hurts every time. Imagine being afraid going to the bathroom because it feels like pooping fire every time.

Parents call us begging for help when we know that the solution is actually stuck in paperwork. Delays don't contain costs. They shift costs to the ER visits, hospitals, missed school, work, and emotional trauma. A few dollars saved on the pharmacy line, but much more spent on the hospital line. A denial forces us to add steroids or older riskier medications with more side effects.

Where is the safeguard in that? IBD is a lifelong disease with limited treatment options. Inadequate doses create antibodies against the drug or loss of response. Every delayed decision risks losing a medication forever. This bill simply asks to stop relitigating decisions already made for the same patient, same drug, same disease.

For the health, safety, and future future of our patients, I respectfully urge your support for SB 964. Thank you.

Ryan Spencer on behalf of the Crohn's and Colitis Foundation sponsors of the measure. And I think the comments by doctor Linden pretty much said it all. And so I just simply ask for your Aye vote and here to answer any questions. Thank you.

Thank you. We will now hear from anyone in the hearing room who would like to offer support for this measure with your name, affiliation, and position on the bill.

Thank you. Vanessa Kahina with the California Academy of Family Physicians here in support.

Good afternoon. Lizzie Guansona here on behalf of the California Academy of Child and Adolescent Psychiatry in Chronic Care Coalition in support.

Sandra Poole on behalf of Western Center on Law and Poverty in support.

Good afternoon. Megan Loper on behalf of the California Hospital Association in support.

Tim Madden representing the California Rheumatology Alliance and the California chapter of the Marion College of Cardiology in support.

Molly Maller representing Planned Parenthood Affiliates of California and support.

Kevin Guzman with the California Medical Association and support.

Katie Bindiance with Health Access California and support. Thank you.

Thank you. We will now hear from any primary witnesses and opposition. Please come forward. Thank you. You'll each have two minutes.

Chair and Members, Olga Shilo on behalf of the California Association of Health Plans. We appreciate the author's intent to reduce delays in care and improve continuity of for patients with complex chronic conditions. However, as drafted, SB 964 raises serious concerns related to patient safety, affordability, and the removal of clinically appropriate oversight. For these reasons, we continue to have reservations about the bill, the bill's approach, and have taken opposed unless amended position.

SB 964 would allow dose or frequency increases without confirming they align with FDA study dosing or approved indications.

Removing that safeguard increases the risk of adverse reactions, misuse, or dosing that has not been proven safe or effective. Finally, SB 964 broadly removes the ability of health plans to review dosage increases even when new clinical evidence, safer alternatives, or formulary options may exist. In light of these concerns, we recommend that the bill be amended to require that the dose and frequency of the drug conform to FDA approved labeling and applicable FDA guidance.

Patients are best served when providers and help ends work together and not when essential safety and cost controls are eliminated. For these reasons, we request respectfully urge no vote.

Thank you.

Madam Chair and Members, Stephanie Watkins on behalf of the Association of California Life and Health Insurance Companies. In the interest of time, I'd like to underscore much of what my colleagues' comments, as well as acknowledge the thoughtful conversations we've had with the sponsors and the author regarding this bill. Unfortunately, we remain opposed unless amended to the bill in print. As was stated earlier, the issue related to safety and cost along with the bill's impact on proven utilization management safeguards is hard to ignore.

As my colleague mentioned, plans and insurers often limit a dose or a drug for very specific reasons related to preventing abuse or overdose, ensuring the use aligns with FDA approved labeling as well as avoiding doses that have not been adequately studied for effectiveness or safety.

Unfortunately, SB 964 removes key safeguards. And while we appreciate the sponsor's attempt to narrow the bill, the core concerns remain. SB 964 as drafted allows providers to modify a patient's medications without review even in instances when those modifications clearly exceed established FDA guidelines. Lastly, we strongly believe SB 964 undermines existing utilization management protocols like prior authorization and step therapy that help ensure patients receive the right medication at the right time and at the right dose.

These tools are especially important in prescription drug coverage given the potential for misuse and high cost of specialty drugs.

For these reasons, we remain opposed to the bill, but certainly look forward to continuing conversations if the bill moves forward today. Thank you.

Thank you. Are there others in the hearing room who would like to offer their opposition to the bill? Seeing none, I will bring it back to the committee for any comments or questions. I would love, Senator, perhaps in your closing as well. Well, actually, I do have a a question for doctor Lingenen.

So you are a gastroenterologist?

Yes, sir.

Okay. And and this is being sponsored by the also by Colitis Foundation. So are there any things within the kind of the GI space or anti inflammatory space that make, this legislation all the more critical to be able to pursue as as written, Kinda given the opposition's concerns?

Absolutely. So, specifically, as, you know, as a GI doctor, the the medications when they're being FDA approved at the time that they were approved, like, ten, twenty years ago, It was only one specific dose which was studied. It doesn't necessarily mean that the other doses were studied and they were found to be dangerous and they're telling us don't use any other dose. Use only that specific dose.

But since then, so much of studies has come out which has shown that it's not the dose of the medicine that matters.

It actually matters what it happened what it does inside the patient's body. And so all the guidelines are now saying, okay. Check the levels. Follow the patients. And we start with the FDA approved dose, which is, you know, goes through the first prior authorization.

It you know, we go through all of the guardrails. We take all the precautions. And then when we have decided later that, no, this is not enough, we have to take a higher, you know, a different dose, that is when we we have to choose the off label decision. As a pediatric GI doctor, this is even more critical because there is only one drug which was FDA approved all these years for pediatrics, and only this year there was a second drug which was approved.

And it's very, very difficult for us to get these medications drug approved by FDA.

So we use all the necessary, like, research studies and the guidelines, everything that has been published to take care of our patients. And this bill says that we will provide the necessary, you know, the papers proving this. The alternatives, which is like you know, the other alternatives that we have to use also have very similar side effects, if not added side effects. And so we always choose the safest option for the patient for that specific patient based on their history and all of those things.

And we are using the exact same medication, which was already approved by the insurance anyway.

And so I think that, you know, it is very critical. It's definitely gonna be very, very helpful for our patients. You know, we don't have to wait for, like, weeks and weeks, you know, to just change, just tweak the dose a little bit for the patient.

I really appreciate that explanation. I think it's helpful for us to kind of keep in mind that it sounds like the the research has advanced be beyond the initial FDA studies and in practice, it's much more helpful to have the ability to either increase or decrease dosage based on the first kind of authorized drug that it has been approved. So this bill also makes a lot of sense to me. I wanna appreciate, Senator Smallwood Cuevas for bringing it forward. With that, would you like to close?

Well, thank you very much, Madam Chair, and particularly for that this bill is about patients having comfort, patients being able to access care, and physicians being able to do the job that they are called to do, which is to make sure that patients are, living with comfort and doing all to manage their disease and condition. This is a simple bill, then I continue to work with opposition on this as we move forward. And with that, I respectfully ask for your aye vote.

Thank you. And with our arrivals, as I hear the door closed, we have opportunity for quorum. So we will call a roll right now, secretary.

[Roll Call]

We have quorum. Can I have a motion by okay? You have that? Stefani, seconded by Elhawary. And with that, secretary, please call the roll.

The motion is due passed to Appropriations Committee. [Roll Call]

That bill's out. Thank you so much, Senator. Seeing no authors committee, we will wait for our next Senator. While we wait, we can dispense with the consent calendar. There are two items on it. Secretary, please, can I have a motion and a second? Moved moved by Patel, seconded by Arons. Please call the roll.

[Roll Call]

Consent calendar is out. We have already heard item number five SB 1023 that has a motion and a second, so we will call the roll on that bill.

[Roll Call]

That measure's on call. Excuse me, sir. We will hear item number 8, SB1323 by Rubio. Whenever you're ready, Senator, we will compose ourselves in the meantime.

Thank you. Thank you and good afternoon. Thank you for this opportunity to present. I wanna begin by saying that I will be accepting the committee's amendments that you've offered. SB 1323 is a patient protection dignity measure that strengthens existing laws for individuals receiving medical care while in in while in immigration custody.

This bill clarifies and reinforces fundamental rights that should already be upheld. At its core, SB 1323 is about ensuring humane treatment for those that end up in hospitals after being detained. It really is about transparency and accountability in medical settings. Under current law, healthcare facilities must limit immigration enforcement access to non public areas. However, existing statutes do not address communication rights for patients.

These patients are in custody and sometimes harmed, shot, and we wanna make sure that they have the opportunity to notify their families and let them know what their medical condition is or where they're at. As a result, detainees sometimes are isolated and unable to, again, communicate with their loved ones, which is not good for anyone. Reports indicate that some individuals in custody have been denied communication as they're in their care, worsening medical conditions, and in extreme cases, preventable deaths.

SB 1323 requires health care entities to inform staff and volunteers how to respond to requests from individuals in immigration custody and allows patients to notify a family member or loved one of their location. SB 1323 ensures communication is timely, consistent across all hospitals and facilities and ensures that no one receiving medical care in California is cut off from any other family members simply because of immigration status.

Joining me, today to speak in support of my bill is Monica Madrid on behalf of the Coalition for Humane Immigration Rights, Hector Pereira on behalf of the Inland Coalition for Immigration Justice. And if I may, I can turn it over to them

Thank you. For the testimony. Two minutes. Thank you.

Good afternoon, chair Vanta, members of the committee. Name is Hector Pereira, political manager for the Inland Coalition for Immigrant Justice, regional immigrant rights organization representing over 40 organizations, in San Bernardino and Riverside Counties. Since the beginning of the current federal administration, we've seen a sharp escalation in violence, including an incident in our region last year in August in San Bernardino where federal agents fired three unprovoked shots into a family's vehicle, and similar incidents are happening across the country.

And these harms aren't isolated to incidents of arrest. The harm continues when individuals are sent to detention centers across the state, notorious for their inhumane living conditions and their egregious records of human rights violations.

Through our work around the Adelanto ICE processing center, we've documented four in custody deaths due to systemic medical neglect contributing to the over thirty deaths nationally, which was the deadliest record since DHS was created. Many more individuals suffered from untreated injuries sustained during their arrest and other chronic conditions. And let me be clear. This medical neglect is purposeful and intentionally cruel. We've worked with detained individuals that have been hospitalized because their pleas for medical treatment are disregarded until they are urgent life threatening conditions.

When they are hospitalized, federal agents intimidate hospital staff into blocking out their information, a practice used for some criminal detainees, but not at all required for civil immigrant detainees. And federal agents monitor private immigrant detainees. And federal agents monitor private medical interactions and restrict access to families and legal counsel. In a couple cases, we've had partners with hospitalized clients who were told that if they even hinted at where they were at, they would be completely cut off from their families.

In another case, a family was only notified when their loved one was on their death bed and told to come say their final goodbyes.

The statements do everything that it can to protect against these kind of abuses, and I respectfully ask for your eye vote for SB 1323.

Good afternoon, chair and committee members. My name is Monica Madrid. I'm a state policy advocate with the Coalition for Humane Immigrant Rights, CHLOE. And I'm here today in support of SB 1323 by Senator Rubio. This measure is both urgent and necessary.

Through CHIRLA's LA Rapid Response Network, we have documented a growing number of people in DHS custody who have experienced medical emergencies and detention or sustained in injuries during civil immigration arrests. Recently, we spoke with a man who was arrested and thrown face first into a vehicle during an enforcement sweep as federal agents rushed to detain before LA rapid response volunteers could arrive and document what happened. In another instance, a gentleman was injured during an ice raid and suffered a catastrophic injury in his right leg.

He was taken to Harbor L c u UCLA Medical Center where I where ICE and d h a DHS agents remained stationed at his bedside and kept him in handcuffs and ankle shackles throughout the entire stay. Initially, the hospital would allow either his immigration council or his family to visit him despite the fact sorry, would not allow initially, the hospital would not allow either his immigration counsel or his family to visit him despite the fact that he required multiple surgeries.

The family was not given information about his condition despite making repeated calls to the hospital. Imagine learning that your loved one had suffered a catastrophic injury, undergone multiple surgeries, and being unable to see them speak speak with them or even obtain information about their condition. It was only after CHERLA, labor partners, and several advocacy organizations intervened that the hospital allowed visits with legal counsel and family members.

Even then, ICE and DHS agents refused to leave the room during attorney visits, preventing confidential attorney client communications, and what we believe was a clear violation of HIPAA and privacy protections. We respectfully ask for your aye vote.

Thank you so much. Are there others in the hearing room who would like to offer support for this measure? Please go forward.

Thank you. Any others seeing

Seeing no others in support, we will move to any primary witnesses in opposition. Seeing none, any who would like to offer a me too in opposition in the hearing room? Seeing none, I will bring it back to committee for any questions or comments. Assembly member Carrillo.

Thank you. Moved by Carrillo, seconded by Agua Curry, Assemblymember Rodriguez.

I guess also wanted to thank you for bringing forth this really important measure and asked to be added as a co author.

Thank you.

Thank you. Seeing no other comments, I think, Senator Rubio, you are basically building on a piece of legislation that was carried and extending by Senator Adegin last year, making sure that we have an opportunity to move from, you know, possible to the extent possible to require requiring in many instances, which I think is very critical given the examples of the testimony that have been provided by our our advocates here.

At the end of the day, people should have the ability to heal particularly when they are in the middle of civil proceedings to be able to do so with the care that they deserve. So with that, would you like to close?

Yes. Thank you. So, yes. Thank you. This is not just about policy.

It's about people. And I just wanna leave you with one more example and that's a young lady who was shot several times, ended up in one hospital. They patched her up, ended up in the detention center. They refused to take her because she was bleeding so badly. They took her to another hospital, all the while refusing to let her call her mother.

And the last piece of information is that she was a US citizen. And she kept saying that over and over again. And they didn't believe her because she was brown. So this is protection for US citizens as well. So with that, I ask for an eye vote.

Thank you.

Thanks so much. We have a motion and a second. Please call the roll.

The motion is do passes amended to the Judiciary Committee. Bonta?

Aye.

Bonta, aye. Chen Addis? Aye. Addis, aye. Agaracari?

Aye. Agaracari, aye. Arons? Aye. Arons, aye.

Colosa? Aye, Carillo? No. Carillo, Aye, Elhoari Elhoari, Aye, Johnson. Johnson, no.

Patel? Aye. Patel, Aye, Patterson, Rodriguez? Rodrigue z, Aye, Sanchez? Chiavo, Sharp Collins, Sharp Collins I Stephanie, Stephanie Aye.

That bill's out. Thank you very much, Senator. We are going to move on now with, Senator Wiener's, permission item number six. SB 1099 by Reyes.

Thank you to my congressman.

Afternoon, Senator. Please begin whenever you're ready.

Thank you, Madam Chair. Thank you for this opportunity to present SB 1099. SB 1099 clarifies California local government's authority to provide state or local public benefits to all residents under the statutory exemption provided under the Federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, also known as PRWORA. Historically, California has relied on the statutory exemption under PRWORA that allows local governments at their discretion to provide state and local public benefits to all residents.

Thanks to this exemption, our local governments have been able to provide critical services such as health care and safety net programs to all residents without worrying that they are in violation of federal law.

Unfortunately, the California statute that provides this PRWORA exemption is too vague and is not directly tied to how local and state public benefits are defined at the federal level. This creates risk because if the federal definition changes or is reinterpreted, our California exemption may fall out of alignment, potentially exposing local governments to compliance issues. SB 1099 addresses this by explicitly tying state law to the federal definition, ensuring clarity and consistency with federal requirements.

While technical, this is a high impact bill that strengthens and protects local government's existing authority to serve all residents. Here to testify in the bill today are Erin Evans-Fudem, Legislative Deputy County Council on behalf of the County Of Santa Clara, and Jordan Flanders, Interdepartmental Counsel for homeless services, Oakland City Attorney's Office.

Moved by Cecilia Aguiar-Curry. Seconded by Sharpe Collins, I think I heard. You'll have two minutes each.

Thank you, madam chair and members. I'm Erin Evans-Fudem, legislative deputy county council with the County Of Santa Clara. I'm here on behalf of the Civil Prosecutors Coalition today. The Civil Prosecutors Coalition is proud to sponsor SB 1099 with the County Of Santa Clara. The coalition is composed of seven city attorneys and county councils from the cities of Oakland, San Diego, San Francisco, San Jose, and the counties of Los Angeles, San Diego, and Santa Clara.

We represent some of the largest public law offices in the state and advise our local government clients on all issues, including protecting our authority to use public funds to benefit the most vulnerable residents in our jurisdictions. This is a very straightforward clarification of longstanding California law that allows local agencies to spend state and local funds to offer critical programs and safety net services to all of our residents based on criteria established locally. This bill doesn't require local governments to do anything.

City attorneys and county councils do our best to provide as much legal clarity as possible for our local government clients. And this bill will minimize risk and uncertainty, particularly in this difficult budget times.

Thank you, and we would request your I vote.

Thank you for the opportunity to speak today. I'm here as the interdepartmental counsel for homeless services for the Oakland City Attorney's Office in support of SB 1099. This bill makes a simple but important change to California law. It clarifies and reaffirms that local governments have the authority to provide essential services to the residents who live in their communities using state and local funding sources.

Local governments are on the front lines of providing services such as health care, emergency shelter, crisis intervention, and food distribution.

These programs must operate quickly with minimal barriers and often without collecting any personal information. Many programs serving people in crisis cannot realistically incorporate documentation checks or detailed intake requirements because it would conflict with their operational design. For example, homeless outreach teams often engage people in encampments for only a few minutes at a time. Encampment management teams need the flexibility to offer services to all individuals living in encampments on their streets.

These teams focus on transportation to shelter and crisis de-escalation, and they generally do not conduct identification checks during these brief encounters.

Similarly, street medicine teams prioritize urgent medical and behavioral health stabilization, which depend on speed and low barrier access. Suicide prevention and crisis hotlines operate anonymously by design, and callers decline, often decline, to provide any identifying buying information at all. Gaps or uncertainty about the scope of required screening may cause local governments to hesitate in providing services as designed.

This bill would take advantage of existing provisions of federal law to clarify that local governments in California can continue to use state and local funding for these services if they choose to do so. It does not mandate any local action.

Instead, it provides the legal certainty that cities and counties need to continue providing essential frontline services to their residents using state and local funding to the fullest extent that federal law allows.

Thank you. Are there any others in the hearing room who would like to offer support for this measure? Please come forward.

Thank you. Good afternoon, Madam Chair and members. Dylan Elliot on behalf of the City and County of San Francisco as well as San Francisco City Attorney David Chu, both in strong support.

Kevin Guzman with the California Medical Association in support.

Thank you. Are there any primary witnesses in opposition? Seeing none. Any in the hearing room who would like to offer a me too? Seeing none, I will bring it back to committee for any questions or comments. Assemblymember, Ahrens.

you. Are there any primary witnesses in opposition? Seeing none, any in the hearing room who would like to offer a me too? Seeing none, I will bring it back to committee for any questions or comments. Family member, Aaron.

Thank you. Thank you, Senator. I just want to remark, what a remarkable county representative for your testimony today. One of the best counties in the State of California.

Thank you for for noticing.

And prior to hearing the close from our Senator, I want to thank our witness from Oakland, from Alameda County, for also being present today, on this very important measure. Thank you. Senator, you may close.

Thank you so much. I sincerely appreciate the the the testimony from our witnesses. This is an important bill. Just closes a minor issue, a technical issue. And with that, I respectfully ask for your I vote.

Thank you so much. We have a motion and a second. Please call the roll.

Please call the roll.

The motion is do pass to the Human Services Committee.

[roll call]

Addis. Addis, Aye. Agarikari. Agaracari, Aye. Arons?

A. Arons, Aye. Colosa. Carrillo? A.

Carrillo, Aye. El Hawari? A. El Hawari, Aye. Johnson?

Patel? Patel, I Patterson? Rodriguez Rodriguez, I Sanchez? Shievo? Sharp Collins?

Sharp Collins, I Stephanie? Aye. Stephanie, Aye.

That measure is out. Thank you so much, Senator. We will now hear from our last Senator for the hearing today. We will start with whichever he prefers, but item number one, SB 895 by Wiener.

Whenever you're ready.

Great. Thank you very much, Madam Chair. Thank you for hearing this bill today. I'm here to present Senate Bill 895, which will authorize a twelve billion dollar science research bond for the November ballot and the creation of a scientific research funding institute in California to make sure that California can stay on the cutting edge and in global leadership on scientific research, even as the Federal Government retracts and takes a wrecking ball to science. We know that scientific research is just part of California's DNA.

It is part of our economy and a central part of our economy. It cures diseases and creates treatments that allow people to fully function as human beings, improves our environments, and just improves the lives of millions of Californians. California based science research has directly saved millions of lives. It's made foundational contributions to the invention of major technologies, including the internet, CRISPR, and artificial intelligence.

It has led to the discovery of chemicals that so that we know which chemicals are responsible for holes in the ozone, and it has helped sequence the human genome.

Research constitutes approximately 5.9% of California's GDP, and our state contributes roughly one third of all US investment in R&D. One third, and the next highest state contributes 6.8%. Research and development contributes over two hundred billion dollars annually to California's economy, and the sector directly employs nearly 700,000 people. In 2024, California researchers patented more new technologies than every other state combined. Research drives local economies. It helps create strong middle class, often with union jobs that benefit entire regions.

For all these reasons, for many, many years, top science talent has come to California from across the world. They seek out California, our universities, our research institutes, to work at leading institutions and make a home for themselves. From biotechnology to medicine, agriculture, climate, AI, and beyond, California is a global leader. Yet despite the clear benefit and importance of this research, and, of course, as important as it is to California, it's also a pillar of American prosperity for the last eighty years.

Our current federal administration has attempted to stifle what is, what can only be called the golden goose.

I will still never understand why they're doing this because science benefits everyone. Science is not partisan. Curing Alzheimer's is not partisan. Curing cancer or having a vaccine for cancer is not partisan. Allowing farmers to be more efficient in creating more food at a lower cost is not partisan, but they have taken a wrecking ball to our federal science agencies, the NOAA, NIH, CDC, just in time for Ebola and Hantavirus, National Weather Service, which I'll never understand, and they are slashing research grants to universities.

And then last week, the administration issued a proposed regulation that will put political people in charge of science research grant decision making. So instead of experts on peer reviewed advisory committees, it'll be political people making decisions about which diabetes research gets funded or doesn't get funded. While courts have rejected a number of the administration's attacks on science, it just keeps coming, and it is having a severe toxic impact.

We are starting to see a brain drain in this country and in the state where if you talk to young scientists, some wonder, do I have to go to Europe or Canada or China because I can't get funded here? And we know that consistency of funding and predictability is so important.

It can't be a political football every year whether science is getting funded. People need to know, these labs need to know for the long run. We know that in 2025, NIH and the National Science Foundation funded about a quarter fewer grants than they had compared to the average of previous ten years.

So when we started working on this last year, I I initially put a very bare bones unfunded bill into print saying we should have a California Scientific Research Funding Institute just to see what would happen. And almost immediately, a massive coalition formed.

I wanna thank UAW for coming forward immediately saying we wanna partner with you on this, and they have been tremendous. And I wanna thank all of the the UAW members, these young, brilliant researchers who are just moving mountains on this bill. And then the UC and the UAW and UC are partnering on this legislation. That's how important and comprehensive this issue is. And then we have a it's just a really wonderful coalition that's formed behind it.

I know that bonds are always hard, and they are always a political issue, and the next two, three weeks are gonna be pivotal. I just wanna say to my colleagues in the assembly, I would be very appreciative to have your vote today. But beyond the vote today, I think it is so important for this bond to go on the November ballot.

We are at such severe risk of being just set back decades in curing diseases and creating all sorts of scientific innovations that'll make the world a better place. I want California to continue to be a global leader and to triple down on that status.

So I also would ask for your support in helping us to prioritize this bond along with the housing bond, of course, for, for the ballot. I will and the one last thing I will say, there will be a science bond on the ballot this year. There's one that's already qualified with signatures. This is a more comprehensive one, and I think it's important for us in the legislature and the governor and this coalition to drive the future of science in California.

So I respectfully ask for your I vote.

And with me today to testify, is Seeta Rajpara, a PhD candidate at USC, studying racial health disparities in colorectal cancer, And Jennifer Ahern, a PhD and master's in public health, Associate Dean for Research at UC Berkeley School of Public Health. We also have technical experts here if needed. Thank you.

Thank you. We have.

And I also I just wanna thank Assemblymember Patel in particular, Assemblymember Solache, and others for really helping us out here. Thank you.

We have a motion by Aguiar-Curry seconded by Patel, and you'll each have two minutes.

Hi, everyone. My name is Seeta Rajparan. I'm a PhD candidate in cancer biology and genomics at Keck School of Medicine at USC. I'm here today in support of California's proposed twelve billion dollar investment in science and research. My research focuses on early onset colorectal cancer in Hispanic and Latinx communities, a project that is part of the broader national Cancer Moonshot Initiative.

We know that some populations continue to experience worse cancer outcomes, and my work seeks to understand why so that we can develop better tools for early detection, treatment, and prevention. Over the past eighteen months, I've watched funding uncertainty create real challenges for scientific research. At my institution and our partner organizations, staff reductions and budget cuts have slowed down research, increased administrative bottlenecks, and placed significant strain on the shared research facilities and core resources that labs depend on every day.

These are the behind the scenes services that process samples, generate data, and support the research that ultimately reaches patients. These cuts affect patients waiting for answers, families hoping hoping for better treatments, and communities that continue to experience disproportionate burdens of disease like cancer.

Every delay in research is a delay in progress. This bond measure is especially important because the Trump administration hasn't implemented significant reductions to federal scientific and biomedical research funding. Just last week, Russell Vaught at the Federal OMB announced plans to eliminate peer review and give unilateral control over all research funding to political appointees. At a time when federal investment is becoming less reliable, California has a unique opportunity to lead in this field. I'm also a lifelong Californian.

And before pursuing my PhD, I worked throughout California's many by flourishing biotechnology, companies, including established companies and startup environments. I've seen firsthand how scientific discovery fuels economic growth. My own PhD adviser actually started up a company that's translating her scientific discoveries into commercial applications. And, so, you know, this research does generate benefits far beyond the lab.

Thank you.

Oh, sorry. Go ahead.

Go ahead.

Thanks so much. You'll have two minutes.

Good afternoon, Chair Bonta and members of the Assembly Health Committee. Thank you so much for your time. My name is Jennifer Ahern. I'm honored to serve as the Executive Associate Dean and Associate Dean for research at the UC Berkeley School of Public Health. I've been a faculty member at UC for twenty years, and I started at UC as a graduate student almost thirty years ago.

The potential loss of funding for scientific research we are now facing is devastating. When I first moved to California in 1998, I came because of UC. California was charting its own path by combining unparalleled university excellence with a public mission in the UC system, and I desperately needed to be a part of it. Today, California has an opportunity to chart its own path in a new and critically important way.

SB 895, the California Foundation for Science and Health Research, will restore the capacity of our UC and other research entities to be an engine for the economy, workforce, and our public health.

The university currently receives 5.7 billion in federal support for research each year, and any loss of that funding would devastate the university and cause enormous harm to all Californians. Research at UC generates as much as 55 billion in economic activity each year. This is an amazing contribution to the success of California. As federal uncertainty continues, PhD program funding has been compromised in my school. Trainees and faculty are leaving research right now.

If this continues, the impacts will be immense. We will not be able to train the next generation. And let me be clear, research right now is at risk, including work that's helping us understand and reduce health disparities and important things like childhood cancers and injuries due to violence. UC generates cutting edge research and translates it to real world programs and clinical care that can alter the course of someone's life.

SB 895 is a critical investment in science that will ensure the strength of California's workforce pipeline, economic future, and health.

For all these reasons, the University of California is in strong support of SB 895. Thank you.

Thank you.

Thank you. All those in support, please come forward. State your name, affiliation, and position on the bill. Let's make sure we have a very tight line.

Gary Cooper representing UAPD, Union of American Physicians and Dentists. Proud support, and we are a proud co-sponsor. Thank you.

Good afternoon. Sandra Poole with Western Center on Law and Poverty in support.

Adam Zarrin with Blood Cancer United in support.

Hello. Natalia Cornejo-Ayers with the UC Student Association in solidarity with UAW, and we are in strong support. Thank you.

Hi. On behalf of the UCLA Graduate Students Association, UCLA Center for LGBTQ+ Advocacy, Research and Health, we're in support of the bill. Thank you.

Claire Nazanff, Berkeley legislative director on behalf of ASUC and UCSA, and we come here in strong support.

Miguel Martinez on behalf of UC Berkeley transfer Rich Lyons in support.

Madam chair and members, Ami Alden on behalf of UCSF in strong support. Kelly Brooks on behalf of the California Association of Public Hospitals and Health Systems here in support.

I'm Nico Vincent, a UC Davis researcher here with UPDI in strong support.

Nick Ramon on behalf of the Palo Alto and San Mateo County Chambers of Commerce in support.

Jessica Hay with AFSCME California in support.

AJ Mendiola on behalf of the lieutenant governor and Ellen Ikenalakis in support.

Dylan Elliot on behalf of the California State Association of Psychiatrists in support.

Tiffany Mok on behalf of CFT, a union of educators and classified professionals in support. Thank you.

Professor Donald Palmer on behalf of the Davis Faculty Association in support.

Thank you, chair members. Mark McDonald on behalf of the, consortium for the development of leadership in science in support of the bill. Thank you very much.

Sharon Lawler, professor emeritus, UC Davis entomology and hematology in support.

Magali Zagal on behalf of Equality California in support.

Jonathan Clay on behalf of the County Of San Diego in support.

Kathy Mossberg on behalf of the Public Health Institute in support. Isabelle Meagan on behalf of the Silicon Valley Leadership Group in support. Thank you.

Sarah Nocido on behalf of

Heather Dawson on behalf of the ALS Association in full support.

Blair excuse me. Blair Barton on behalf of the ALS Association in full support.

Nancy Wakefield, ALS Association in support. Thank you.

Mario Guerrero on behalf of the California Faculty Association in support. Thank you.

Marky Sking Mason on behalf of Natural Resource Defense Council in support. We haven't got our letter in yet, but we'll send it. Thank you. Chris Morales on behalf of the CSU office of the chancellor in support.

Monica Miller on behalf of Alzheimer's Los Angeles, San Diego, and Orange County in support. Thank you.

Mari Lopez with the California Nurses Association in support.

Good afternoon, madam chair and members. Janet Lopez representing UCLA and UCLA Health in support.

Hello. Ivy Foster, researcher at UC Davis, proud member of UAW in strong support.

Hello. Jess Fine with UIW, in support.

Hello. Fallon Duffy, UOW forty eight eleven member at UC Davis Health, in support.

Hello. Solana Glass on behalf of UAW four one two three representing CSU academic student workers. Thank you. In support.

Danielle Dela Pasqua, with UAW forty eight eleven, in strong support.

Ernest Walker, with UAW forty Eleven, in strong support.

Hello. Arthi Sakar, UAW in support.

Simon Hyatt, elected member representative of California Working Families Party and in solidarity with our member organization, UAW, strong support. Thank you.

Good afternoon. Chloe Shea on behalf of California Environmental Voters in strong support.

Good afternoon. I'm Sona Mahal, UCSF RN. I'm here to support on behalf of my patient my multiple patients with Parkinson's disease, my dad with Parkinson's, and many California residents living with Parkinson's. Thank

you. Thank you.

Thank you.

Good afternoon. Jared Gerusso Cloek with the Michael J. Fox Foundation for Parkinson's Research and proud support.

Allison Lee. I'm an incoming medical student at the UC San Diego School of Medicine representing universities allied for central medicines in strong support. Thank you.

Joy Williams Brook, doctor of physical therapy in clinical health scientist research, also a part of the Parkinson's Association of Northern California in strong support.

Madam chair and members, Adam Caitlin on behalf of Natera in support.

Jason Murphy, UC office of the president, proud co sponsor in strong support.

Alan Shadd, Northern California Parkinson's Association in support.

Lee Schuler. I'm I support it.

Doctor Halab Mahmood, UOW forty eight eleven, strong support.

Thank you. We will now hear from any primary witnesses in opposition.

Thank you. We will now hear from any primary witnesses in opposition.

The supporters win the day. No other me too's in opposition?

Seeing none, I will bring it back to committee for any comments or questions.

Assemblymember Patel?

I do have some comments prepared today. Thank you. I wanna start by saying thank you to Senator Wiener for your leadership on this very important bill. I'm honored to be a principal co author because this bill epitomizes why I got into public service. I'm a former research scientist, and I received my PhD in biophysics from UC Irvine.

And the NIH funded my dissertation and those of almost all of my colleagues. Some were also funded by the CSF. It was during my grad school days when my research faced threats similar to those now, but, of course, now it's, I think, orders of magnitude more pressing. And many of my colleagues lost their funding during that time.

And I truly understood the critical role that politics plays in the innovation of our state and the nation, and we need to take pride in the research that is occurring within our borders.

Developing drugs that have the potential to save thousands or millions of lives and improve the quality of life for so many more is not a linear process. And just because politicians don't see the value of a given research project in the moment, it doesn't mean that there isn't foundational value for future research. When funding cuts threaten this research, we threaten the future of our public health and California's economy.

This bill is solutions oriented, doing what is within California's capacity to ensure that the innovation we pride ourselves on, that we build entire economies on, markets, and communities around, that continues to serve its critical function, which is improving public health outcomes across our state and the world. And the stakes could not be higher.

This work generates $226,000,000,000 annually within California and accounts for 47% of The United States biotech research and development spending. So I can't stress more than enough how thankful I am for you bringing this very important piece of legislation forward at such an important time in California's economy.

Thank you for your work, and I look forward to working to get this across the finish line. Thank you.

Assemblymember majority leader.

Good afternoon. Thank you, Senator Weiner for bringing this forward. I have UC Davis right out my door. And, how many times I had researchers come into my office during the past couple years just really threatened and frightened of what's gonna happen and how we can move science forward. And I really wanna thank you for bringing this forward.

I would like to be a co author of this. But number one is that we're changing the world and what's happening right here in California with all the UCs and all the research we're doing. And so we can't turn our back on that. Thank you.

Assembly member Elhawary.

I just really wanna thank the author for bringing this forward, for all the work that you've done, for putting it out there, and building this huge coalition. It's so powerful. Really grateful and and proud to see UAW really, stepping up to do this work alongside you as well as the UCs. And I especially wanted to just thank the folks here who, mentioned that they have Parkinson's and came all this way to share just the importance of us continuing this work. Thank you.

Assemblymember Johnson.

Thank you so much.

I just wanna say thank the author, and I really appreciate the intent and especially all the support today. And I know that it's a wonderful coalition. I wanted to be very clear as it's not easy to say no, but the bond makes it very difficult for me. I think that this is very important work and in a way that we need to figure out to continue it. But, I just wanted to share it to the author directly.

We haven't had a chance to talk, but that is why there's no position for me today. But thank you.

Seeing no oh, Assembly member Sharp Collins.

Just thanking you for bringing forth for such an important bill and I just would like to be added on as a coauthor.

Assembly member Caloza.

Thank you, madam chair. I just wanted to thank the Senator for your leadership on this and for really continuing to ensure that California safeguards our own institutions and really continues to lead on this issue. I hope you're proud of the coalition that you've built. I think the entire room stood up for the Me Too, which I think is a testament to your leadership. And thanks to everyone that's come forward from business, labor, students, health care, patients.

It was really incredible to see. So proud to be a co author on this and excited to see it move forward to the next step. Thank you.

Assembly member Stefani.

Thank you, madam chair. Of course, I need to echo all of the comments from my colleagues to you, Senator Wiener. Thank you for bringing this forward and to everyone who came up, for me too. The coalition you have built is absolutely impressive. We are very lucky to share UCSF and all the research that they do.

As someone who, had a father recently passed away from Lewy Body Dementia, which is a form of Parkinson's, which we've been trying to prove to the Veterans Administration for some time.

But, I just thank you so much for standing up and for making sure that we are doing everything we can to advance research to find cures, for all these ailments. So thank you so much. And if I'm not already, I'd like to be added as a co author.

Well, thank you, Senator, for bringing this forward.

added as a co author. Well, thank you, Senator, for bringing this forward.

I we've had an opportunity to hear from, our UCs in, I think, over the interim and understanding the incredible devastation of the decisions to defund our research and development nationally has been, yep, something that I know is going to essentially devastate our ability to support our UC system in particular and the in great advancements that we've been able to make in research and development and the innovation economy that California is so proudly known for. I did have some comments.

I think they're reflected in the policy comments in the analysis wanting to just make sure that, you know, the California work that we invest in through this bond measure, should this get on the ballot and be successful, actually is able to return in terms of investment and economic growth for the State of California.

I think that's very critical. We know that bonds as Assemblymember Johnson mentioned, they cost California, you know, a hefty price over time. And so I think it's very important that we make sure that we capture the economic growth that can happen along with the ability to maintain our and retain jobs and a pipeline of leaders in our university system and beyond to be able to support us. So with that, would you like to close?

Thank you. I wanna thank my colleagues. I think about a little more than a third of the legislature is co authoring this bill because I think there's such broad support, and we and we and we do have bipartisan support. We do have few Republicans co authoring as well, and science has very, very broad support. And I got at the risk of sounding like a broken record, I asked for help trying to get this on the ballot by the end of June.

But when we think about science, it can get very technical very quickly because science can be very technical and health treatments can be very technical. It's so important to boil it down to human beings. I'm very grateful for all the folks at Parkinson's who were here today, for the folks at ALS who have really engaged. But I will just point to two specific aspects of science that benefit California so tremendously.

There's amazing research going on about wildfires and how do we more efficiently, effectively, and more quickly put out fires, perhaps without using water.

And that is research that's happening here in California. I will also point out, I believe it was may have been in this, it was probably it may have been in Senate Health. Last year, for last year's version of the bill, we had someone from the UC Davis, primate lab who was testifying. And for those who don't know, UC Davis primate lab, played a key role in the creation of protease inhibitors that turned HIV from a death sentence for many people into a chronic manageable illness.

Forty five million people globally have died of HIV, including many here in California and my community in San Francisco.

I was absolutely devastated by HIV at a time when the Federal Government turned its back on gay men in particular and trans people and others who were dying. And there was no effective treatment. And it's because, in significant part of the UC Davis primate lab, that about twenty plus years ago, a treatment came into existence, and people are alive in my community and communities around the state today.

Because of that research, UC Davis primate lab was targeted with massive cuts last year. So this is very, very real for just day to day regular Californians and for the lives of communities, around the state and this is California's contribution to the planet in many ways as well.

So this is very, very real for just day to day regular Californians and for the lives of communities, around the state, and, and this is California's contribution to the planet in many ways as well.

So thank you for the conversation today, and I respectfully ask for an aye vote.

Thank you, Senator. We have a motion and a second. With that, please call the roll.

The motion is do passed to the Appropriations Committee. Bonta?

Bonta, aye. Chen? Addis?

Aye.

Aye.

Addis, aye. Aguiar Curry?

Aye.

Aguiar Curry, aye. Ahrens?

Aye.

Ahrens, aye. Caloza?

Aye.

Caloza, aye. Carrillo?

Aye.

Carrillo, aye. Elhawary?

Aye.

Elhawary, aye. Johnson?

No.

Johnson? Johnson, no. Patel? Aye. Patel, Aye.

Johnson, no. Patel?

Aye.

Patel, aye. Patterson? Rodriguez? Sanchez?

Patterson. Rodriguez? Sanchez? Sanchez, no. Schiavo?

No.

Sanchez, no. Schiavo? Sharp Collins?

Sharp Collins? Sharp Collins, Aye, Stephanie? Aye. Stephanie, Aye.

Aye.

Sharp Collins, aye. Stefani?

Aye.

Stefani, aye.

That measures out. Thank you, Senator.

Thank you very much.

And you will stay put. You have another piece of legislation. I'll go ahead and clap. Go ahead. It's all good.

Thank you. Item number three, SB 944 by Weiner.

Okay. So the last bill was about future bill is about future advances in science, this bill is about a very ancient form of science that's been around for many, many years and makes people's lives better and that is acupuncture.

So I'm here to present Senate Bill 944, which will stabilize and help protect access to acupuncture in MediCal. I'll be honest with you that MediCal's acupuncture benefit has been a political football every year.

Every year, the administration cuts it and every year, we rally in the legislature and with the community of statewide coalition to restore it.

It's not a huge amount of money, but for the people who benefit from acupuncture, it is a big, big deal. It is a cost effective option that helps people who are undergoing chronic pain with an option other than opioids that helps people with mental health conditions, with addiction. It can be a real a life changer for a lot of people, and we need to preserve access to it.

So this bill will help formalize that this is a MediCal benefit as we go through the budget process to get it to get that funding restored this year. And so I respectfully ask for your aye vote.

And with me, today to testify is Doctor Lin Yang, member of

Madam Chair, I'd like to move the bill.

Chair, I'd like to move the bill.

Oh. Member of the California Acupuncture Coalition, and Doctor Lily Chao, Director of Integrative Medicine at Northeast Medical Services.

Yeah. Please go ahead and press the button. And while you're doing that, we have a motion by Johnson.

Thank you. Good afternoon, chair

Second by Stephanie. Please go ahead. Thank you.

Thank you. Good afternoon, Chair Bonta and members. My name is Lin Yang, former president of California Acupuncture Coalition, sponsor of SB 944. I'd like to thank Senator Wiener for offering this important bill. Licensed acupuncturists across California care for patients living in chronic pain, stress related conditions, and serious long term health challenges.

In California, licensed acupuncturists are recognized as primary health care providers within our scope of practice. We know our patients well, understand their medical histories, and often serve as an important part of their ongoing care team.

Many patients rely on acupuncture to help manage chronic conditions when they cannot tolerate strong medications or invasive procedures. Acupuncture provides a safe, gentle, and effective option. Patients reporting improved sleep, greater mobility, reduced pain, and improved quality of life after treatment.

For some, acupuncture can help reduce reliance on opioids and other potent pharmaceutical drugs. MediCal patients should have equal access to acupuncture as other Californians. Managing acupuncture differently within MediCal's with the MediCal system creates unnecessary barriers and it leaves patients and the providers uncertain about their options.

Ensuring fair and consistent coverage will improve care, reduce reliance on more costly or high risk treatments, and advance health quality health equity across our state. SB 944 insurance acupuncture remains an established MediCal benefit on par with other covered treatments.

SB 944 insurance acupuncture remains an established Medi Cal benefit on par with other covered treatments.

This bill will help protect access to care for millions of Californians who rely on MediCal. Thank you for your time and for supporting patient access to acupuncture.

Good afternoon, madam chair and members. My name is Doctor Lily Chao, and I'm the Director of Integrate Medicine at Northeast Medical Services, one of the California's largest community health care serves thousands of patients across underserved populations, many of whom are MediCal beneficiaries.

I'm here today in strong support of SB 944. As a practicing acupuncturist, I see firsthand how acupuncture helps patients manage chronic pain, recover from injury, and address the range of a musculoskeletal and stress related condition.

So for many patients, acupuncture provides a non pharmacological treatments options that can reduce in reliance on more invasive interventions and support a whole person approach of care.

In the community we serve, acupuncture, it is also an important component of culturally responsive care. Many patients seeking treatments, modalities that align with their preference and life experience. And when acupuncture is available, patients are more engaged in their care and more likely to follow through treatment plans that improve the outcomes.

SB 944 helps ensure that the patient can continue to access medical appropriate acupuncture services. Acupuncture, it is essential care. It is not luxury care. I also want to briefly note that the acupuncture has again, being proposed for limitations in the main revisions for the third consecutive year.

It is not luxury care. I also want to briefly note that the acupuncture has, again, being proposed for limitations in the main revisions for the third consecutive year. Despite the prior rejections by the legislatures. This ongoing uncertainty underscores the importance of maintaining stable and reliable access pathway for the patients who depending on the services. SB 944 provides clarity for patients, providers, and the health systems.

Despite the prior rejections by the legislatures. This ongoing uncertainty underscores the importance of maintaining stable and reliable access pathway for the patients who depending on the services. SB 944 provides clarity for patients, providers, and the health systems.

On behalf of Northeast Medical Services and the patient we serve, I respectfully asking for your vote on SB944. Thank you.

Thank you so much. Are there others in the hearing room who would like to offer support for this measure? Please come forward with your name, affiliation, and a position on the bill.

Paul Fox, Northeast Medical Services in support.

Sydney Pon, Northeast Medical Services in support.

Junjiao Xia. I'm a local acupuncturist. I strong support.

Sam Wang, licensed acupuncturist. Behalf, American Association of Chinese Medicine and Acupuncture. Strong support.

My name is Chuan Li. Licensed acupuncture. I'm strongly support. Thank you.

Thank you.

Hello. I am a acupuncture patient. I my name is Yoon He. I live in Sacramento. I strongly support SB 944. Thank you.

Thank you.

My name is Pierce Robertson. I'm a acupuncture patient. I live in Sacramento and I absolutely support SB 944. Thank you.

Matt McCormack, Northeast Medical Services in support.

Christine Smith of Halifax, California in support.

Omar Altamimi with the California Pan-Ethnic Health Network in support.

Madam chair and members, Rand Martin on behalf of the AIDS Healthcare Foundation in strong support. Thank you.

Thank you. We will now move on to any primary witnesses in opposition.

Seeing none. Any in the hearing room with a me too?

Seeing none, I will bring it back to committee for any comments or questions.

Assemblymember Sharp Collins.

Here you go again. Good bill. Thank you so much, Senator for bringing forth the bill. I would like to be added on as a coauthor, and I just wanted to really appreciate you continuously advocating because as a as a patient, I've had to use acupuncture to help me get through. And because of the medication I was given was not working.

And, of course, as you continue to get different medications, you don't want to develop some type of addiction. And so to go through that process, I can tell you 100% it did help me heal as I prepared to get surgery and even after surgery.

But just to be able to have that opportunity to have another alternative, and that was a organic alternative just to make sure that I can continue to remain healthy and be able to move forward and also show others that there are some other healthy alternatives out there until, you know, to help you be able to move forward and be able to recover and walk around. I'm wearing heels now, and I wasn't wearing heels for over two years because of, because of the surgery.

But honestly, acupuncture helped me get through that. So I'm very grateful for the industry, and I appreciate you bringing forth the bill. Thank you.

So I'm very grateful for the industry, and I appreciate you bringing forth the bill. Thank you. Assemblymember Patel.

Assemblymember Patel.

Thank you, Senator Wiener for bringing this bill forward. As we all know, acupuncture is increasingly covered by private health insurance because it's a cost effective, evidence based non pharmacological treatment for chronic pain and nausea and helping reduce the reliance on opioids and other expensive, more invasive procedures. And yet, as you said, it is consistently used as a political football, in the budget building process.

And I wanna share, to connect ancient science with cutting edge research and development, the kind of programs we wanna support with your previous bill that you mentioned. There's recent news coverage sharing that there's an interstitium, which is a newly recognized fluid filled network of connective tissue that spans the entire body, and that is what is believed to act as the physical pathway for acupuncture meridians.

is a newly recognized fluid filled network of connective tissue that spans the entire body, and that is what is believed to act as the physical pathway for acupuncture meridians. So our ancient scientists knew this all along, and we only now have the modern science words to describe what has been known for a very, very, very long time. And we understand that these needles engage with this specific fascia, this connective tissue, creating that needle grasp that triggers those chemical signals such as neurotransmitters through that interstitial space.

So our ancient scientists knew this all along, and we only now have the modern science words to describe what has been known for a very, very, very long time. And we understand that these needles engage with this specific fascia, this connective tissue, creating that needle grasp that triggers those chemical signals such as neurotransmitters through that interstitial space.

So if we can continue to offer life saving, life enhancing treatments that are noninvasive without side effects that are nonaddictive, wouldn't that be just a wonderful thing? So my hope is that with this bill that we put an end to this political football with acupuncture and just continue to offer it as a credible, legitimate form of pain management.

With that, I am excited to support your bill and would love to be added as a co author.

Thank you.

Thank you. Assemblymember Stefani?

Thank you, chair. And thank you again to the author for bringing such a good bill forward. I definitely wanna be added as a co author. I don't think I'm on it yet. This is extremely important to my district.

There's over a dozen NEMS clinics in District 19. I've toured many of them, and I've seen how important and how critical acupuncture is to my constituents, something I think I need to try. And I wanna make certain that it continues to be funded and that it's not the political football. So you definitely have my support, and thank you again, Senator Wiener, for bringing such a good bill forward.

Assembly member Ahrens.

Thank you, madam chair. I wanna thank the author for bringing this forward. Love to be added as a co author, but I also just wanna say how much when we talk about these political footballs and budgetary footballs being thrown around and acupuncture being caught in the middle of that, how much this benefit actually saves the State of California in preventing further chronic pain. And so I just wanna say that for the record.

I also wanna say how it also prevents so many of our constituents from switching to often very addictive opioids, which we don't have to get into about how dangerous that could lead.

But overall, you know, before being elected in the legislature, I was a staffer for nearly fifteen years. And Senator Wiener is and his leadership is really the reason why the acupuncture benefit has been able to be reintroduced and remained in assigned budget. And it's really because of Senator Wiener's leadership. So I just wanna highlight that for the record, Senator Wiener.

If it wasn't for you, I'm not sure we would be even talking about this because this would have been stripped for the budget long ago.

And legislators from years past would would be grappling with this from trying to reintroduce it. And it's really your leadership as chair of the budget committee that forced these conversations, forced the legislature and the administration to reinsert it.

So it's thanks to you and and the acupuncture community who are making sure that Sacramento is listening, and we are really indebted to your leadership and service. Thank you.

Assemblymember Johnson.

Thank you, chair. Yes. Also to the author, if you'll have a Republican co author, I'd love one

I love that.

To be one. Something it's interest wow. Calm down. One of the things I wanted to share, in addition to normal ideology of what acupuncture can do for you, and I shared in another committee hearing personally, I you know, for surgery and injuries and all the things. But as women age and something I can personally attest to is the hormonal storms that happen in aging women.

And I would say I wouldn't be serving here at the state legislature if it weren't for my acupuncturist helping me get through without having to take hormonal therapy. So I think that this is and especially now as there's so much awareness for women's hormone health, it's such an important conversation that maybe doesn't get enough attention, especially in this community.

this

is and especially now as there's so much awareness for women's hormone health, it's such an important conversation that maybe doesn't get enough attention, especially in this community. So I wanna say thank you. It's it's incredible, legislation. Like I said, happy to be a Republican co author, and I'm in full support today. Thank you.

So I wanna say thank you. It's it's incredible legislation. Like I said, happy to be a Republican co author, and I'm in full support today. Thank you.

Well, thank you, Senator, for bringing this forward. I also wanna note that Assembly member Lee has AB 1949, that is pending in the Senate Health Committee, which would require a MediCal program to cover 24 acupuncture visits per recipient per year and additional acupuncture visits when medically necessary.

I think, obviously, those two pieces of legislation, go very well in hand and essentially, combat what we have had to do time and time again, which is a fight for an incredibly nominal amount of funding relatively to be able to ensure that we include acupuncture as the medically necessary treatment that it is in for so many Californians in my district. In particular, acupuncture therapy is incredibly important with many acupuncturists.

And I too have my own success story with being able to be a recipient of acupuncture over a year.

So definitely know how incredibly important it is. And I wish we would just recognize it for the relative importance and contribution to our our physical and quite frankly mental health that it is in our budget and in this legislature and in the administration.

Note to self, please, I hope that we don't see this again as an item to be cut on the budget with the passage of the spill certainly. So I wanna thank you, Senator. I also hope to be a coauthor on this measure.

And with that, would you like to close?

I respectfully ask for an aye vote, and I think the committee members said it all. So thank you so much.

Thank you. We have a motion and a second. Please call the roll.

The motion is do passed to the Appropriations Committee. Bonta?

Aye.

Bonta, aye, Chen?

Aye.

Chen, aye, Addis?

Addis, aye. Aguiar Curry?

Aye.

Aguiar Curry, aye. Ahrens?

Aye.

Ahrens, aye. Caloza?

Aye.

Caloza, aye, Carrillo?

Aye.

Carrillo, aye. Elhawary?

Aye.