Assembly Standing Committee on Health

Good afternoon, and welcome to the Assembly Health Committee's hearing on Tuesday, June 23. 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 limits of our time. 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 by 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 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 and support must be those accompanying the author or who otherwise have registered a support 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 your name, affiliation, and position. All testimony comments are limited to the bill at hand.

Some housekeeping items, I would like to note that SB 381 Wahab has been pulled from today's agenda and will not be heard. Additionally, the speaker has appointed Assembly member Sanchez as our new vice Chair. I would also like to welcome the committee's newest member, Assembly member Jeff Gonzales, who is helping us to kick off this hearing today. Thank you very much. I wanna thank Assembly member Chen for his service as vice Chair.

It was an honor to be able to work with you, and look forward to our ongoing work in the space. For 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. We have item four, bill SB 977 by Weber Pierson with a motion of do pass to appropriations. Item number eight, SB 1150 by Jones with a motion of do pass to appropriations.

And item number nine, SB 1186 by Sayerto with a motion of do pass as amended to appropriations. With that, we will begin as a subcommittee and start with item number one, SB 16 by Blake Spear. Thank you so much, Senator.

Thank you, Senator. Good afternoon, madam Chair. Good afternoon. Thank you for having me. I'd like to start by stating that I accept the committee's amendments.

Thank you to the Chair and the committee staff for their work on this bill. I'm pleased to author SB 16, which is sponsored by the California State Association of Psychiatrists. SB 16 requires county behavioral health directors to maintain procedures governing the designation and training of professionals authorized to perform evaluations and initiate involuntary holds under Section fifty one fifty. California is increasingly investing in clinician led response models, mobile crisis teams, and alternatives to traditional law enforcement responses for behavioral health emergencies.

When someone is experiencing a behavioral health crisis, we want the right professional with the right authority to handle it.

But the problem is we have a shortage of professionals available to do this and inconsistent and confusing regulations across counties for who is qualified. According to the Department of Health Care Access and Information, California faces nearly a 40% shortage of behavioral health Clinicians and needs approximately 72,000 additional licensed professionals. At the same time, pathways for Clinicians to become authorized fifty one fifty evaluators vary significantly across California. Some counties maintain clear designation and training programs, while others have limited or no formal process at all.

SB 16 fixes this by requiring counties to maintain procedures governing eligibility requirements, training standards, application and renewal processes, and ongoing oversight of designated professionals.

By making clear what is required to be designated as a fifty one fifty evaluator, SB 16 will help counties recruit and train professionals for these positions. Importantly, SB 16 gives county behavioral health agencies flexibility to tailor policies based on local workforce needs, resources, and service delivery models. By strengthening pathways for qualified Clinicians to participate in crisis response, SB 16 helps build the workforce required to meet California's growing behavioral health needs.

With me today in support, I have doctor Aaron Meyer on behalf of the California State Association of Psychiatrists.

Thank you. You'll have two minutes.

Good afternoon.

Good afternoon, Chair Bonta, member of the committee. My name is Aaron Meyer, associate clinical professor of psychiatry at the University of California, San Diego, speaking on behalf of the California State Association of Psychiatrists, proud sponsor of Senate Bill 16. In the absence of county procedures for the designation and training under Section fifty one fifty, law enforcement becomes the default professional authorized to initiate involuntary holds. California is working to move away from a law enforcement only response to behavioral health crises.

SB 16 helps move us closer to that goal.

My understanding is that 27 counties identify specific professional disciplines eligible for fifty one fifty designation. 16 counties reference county staff authority to place holds, but do not identify the qualifications required to exercise that authority. At least three counties lack fifty one fifty procedures. SB 16 requires counties to develop procedures identifying the professional disciplines, qualifications, and clinical experience necessary for fifty one fifty designation. This bill creates much needed clarity and accountability.

And it also promotes statewide consistency. Despite statewide statutes governing fifty one fifty holds, county training requirements remain uneven. Our review found that eight counties continue to require imminence for detention and five exclude major neurocognitive disorders from fifty one fifty eligibility, standards that are inconsistent with the LPS act. By requiring counties to establish clear designation and training procedures, SB 16 will help expand the pool of qualified behavioral health professionals, reduce reliance on law enforcement, and improve consistency in the application of California's involuntary treatment laws.

For For these reasons, I respectfully ask for your aye vote.

Thank you. If there are others in the hearing room who would like to state their, support for the bill, please come forward. Hit the mic so that you don't get goofed again. Nope.

Yeah. There he goes.

Alright. Thank you, Chair

and members. Tim Madden representing the California chapter of American College of Emergency Physicians and Support.

Thank you so much.

June Duda San Diego, family member of someone who's severely mentally ill and also representative for the National, Shattering Silence Coalition California chapter in support.

Thank you. We will now move to any, primary witnesses in opposition. Any who would like to off register their opposition as a me too in the hearing Room.

Good afternoon, Chair and members. Amara Rashid with the County Behavioral Health Directors Association of California, an opposed and less amended position. We appreciate the committee amendments. We should take a step in the right direction, but look forward to future dialogue in the same vein. Thank you.

Thank you. Ethan Laura Salinas on behalf of ACLU Cal Action in opposition. Thank you. Thank you.

Mary Anne Bernard, member of NAMI, member of AFASEME, family advocates. I never remember. Family advocates for individuals with severe mental illness, mother of a severely mentally ill young man, former lawyer in Minnesota for eighteen years representing state hospitals. I speak only in my own behalf because I have not pulled the membership of my group, but I speak in opposition. This is a real problem, and it is the wrong solution. We don't need 58 solutions. We only need one We don't need 58 solutions. We only need one

Please just go ahead and say

your I wrote you a letter. I have told you how to solve this problem. Read my letter. Thank you.

Okay. Thank you. We didn't have that registered. So just thank you for Oh, I have another copy.

Thank you. We will accept that. We will bring that now back to the committee for any questions or comments on this measure. Assemblymember Gonzalez.

A question for the author on on clarity, and it's really I appreciate your your leadership on this. Is this telling the counties that they should establish it and have the same programs in place or the same training? Or but I can also understand you can't cookie cutter this. So can you just kind of elaborate a little bit more?

I'm gonna turn to my sponsor, if you don't mind.

Yeah. So all this bill does is change the, permissive may create designations, protocols, training to a shall. So this doesn't require counties to have a certain type of program, designate only these x number of professionals. It's, it allows local control for the county, but requires the counties to develop policies and procedures.

Thank you. And, you know, I think we got a little bit of a preview from the public about some of the concerns that I have with this bill. I am supporting this bill, obviously, Senator, we've been able to, talk, with your team about, basically, this creating more people who are able to designate.

But, certainly, we all both know that it doesn't really address the kind of downstream issues around making sure that there are enough placements, making sure there are enough opportunities, but does kind of widen the net of people who can actually do the designation. So absence those things being in place, we have more people who are likely to be designated because there are more designators without really result a solution for those folks who get designated.

So I know that you are going to continue to address this along with, Senator Umberg's, departure and, believe that, given the your body of work, this is going to be an area that you will continue to lean into, and know that you will seek to be able to address that in other ways in other legislation. But this is a very straightforward measure, around that particular designation piece, which I am comfortable with supporting, obviously, at this time. With that, would you like to close?

Yes. Thank you very much. And I I appreciate the comments from the opposition. You know, she's come forward before in support of other Care Corp bills, and there's always a balance between, local control, which the 58 counties would like to have some authority, over their processes versus, you know, a state top down mandate of of how to do it. So I think there are many ways to skin a cat, and there are many problems.

So we're working to try to improve the functionality of Care Court as well as deal with the realities, as my lead witness said, of trying to move this out of the carceral system and into behavioral health, which is more which is the counties. The counties do behavioral health. It's not a law enforcement that is doing that. So to be able to make sure that we have clinicians, through the county who are able to to do this designation is really important.

So, this is a a relatively small change, but it it is important that we continue to make progress on improving the system so that we can help more people.

Because, ultimately, that's what we're trying to do here is to help more people who need it, and and this is just one step in that direction. Yeah.

So with that, I respectfully ask for your aye vote.

Thank you. And, we don't skin cats, but we do maybe peel oranges or something like that. But appreciate your, your clothes. And when we have a subcommittee or when we are not a subcommittee and have quorum, we will be able to consider this bill. Thank you.

Thank you. With that, I don't see any authors, for this Senate hearing. So we will continue to wait for senators Umberg, Weber Pearson, Becker, Archuleta, or Jones or Benjovar. Thank you. And we will now be able to hear item number seven SB 1124 by Senator Archuleta.

Whenever you're ready, Senator. I think you might have to press that button.

There we go. We were moving everywhere today. Quite busy day.

Thank you.

All right. Thank you. Madam Chair and members, thank you for allowing me to present my bill, Senate Bill 1124, and I wanna thank the staff for working with us, and we do accept all the committee amendments. Senate Bill 1124 would require the California Department of Public Health to create signage for lung cancer screening eligibility criteria. It would also require the signage to be displayed at the point of sale in locations where tobacco products are sold.

Lung cancer is the leading cause of cancer death in California and nationally, yet California has the lowest lung cancer screening rate in the country, and that's the issue--screening, bringing people in to be looked at, examined, and told exactly what's happening with their possible cancer. The primary barrier is awareness, given that 62% of Americans don't even know lung cancer screening exists.

In 2024, an estimated 16,900 California residents were diagnosed with lung cancer and 9,300 died from the disease, which is more than from other cancers and even to include leukemia, cancers combined, all of them. Terrible numbers. Eighty percent of patients diagnosed with lung cancer at an early stage are alive 20 years after initial detection.

However, in California, only 25% of lung cancer are diagnosed at an early stage, which is significantly lower than the national rate. To address California's particularly low screening rate and the disparities in access across communities, Senate Bill 1124 will require signage created by the California Department of Health for lung cancer screening eligibility criteria at the point of sale of the tobacco products. With me today are Dr. Hari Keshava and--who's a surgeon at UCI Health--and Elaine Doan at UCLA, student and member of the American Lung Cancer Screening Initiative.

Thank you. You'll each have two minutes.

Well, thank you very much, Madam Chair, members of the committee. I'd like to thank you again, and I'm speaking today in support of SB 1124, and I'd also like to thank the senator here for his leadership in authoring this bill as well as the bill's co-authors for their support. I'm Hari Keshava. I'm a thoracic surgeon.

I specialize in cancers of the chest, specifically lung cancer, and I'm the Chief of Thoracic Surgery at the Long Beach VA as well as an Assistant Professor of Surgery at UC Irvine. I'm also a member of the American College of Surgeons-Southern California Chapter, which is in support of this bill. Unfortunately, I see a lot of patients with lung cancer, but I do see the beneficial effects of finding lung cancer early. As we're hearing, lung cancer is a leading cause of cancer-related death, killing close to 10,000 Californians a year, more than any other cancer. When found early, lung cancer is curable with a survival rate at five years over 90% with therapies like surgery.

Unfortunately, most lung cancer is found in later stages when it is spread to lymph nodes and other organs, where treatment includes expensive therapies like chemotherapies, immunotherapies with worse prognosis. Additionally, lung cancer, when causes symptoms like cough or bloody sputum, is usually a later stage. Recently, I've had a 65-year-old patient. He's a Marine veteran. He had a chronic cough and eventually got a CT scan of the chest where he found an upper lobe lung cancer.

Unfortunately, it was Stage III, already spread to the lymph nodes. He got chemotherapy, immunotherapy, got a rash because of that. That complicated his treatment. Eventually, I took him to surgery, which had a tougher surgical course. That being said, he had smoked in the past--quit 10 years ago--he's a teacher, back to teaching, but he did not know about lung cancer screening. His lung cancer was found incidentally. He told me-- he kept telling me-- he was like, Doc, I wish I knew about lung cancer screening because I would have gotten it done, and I just didn't know.

Thank you.

That's where this bill would help us out.

Thank you.

Madam Chair Bonta and members of the committee, thank you for the opportunity to testify in support of SB 1124 today. My name is Elaine Doan. I'm a student at UCLA and a member of the American Lung Cancer Screening Initiative, or ALSCI, the sponsor of this bill. We are a student-led organization dedicated to raising awareness of lung cancer screening. This issue is deeply important to me and many of us.

My aunt was diagnosed with Stage IV lung cancer only after she began experiencing symptoms. By that point, the cancer has already spread to her bones, and her treatment options were limited. This is why lung cancer screening matters. It helps detect cancer early before symptoms appear and when treatment is more effective. Through ALSCI, we spend most weekends at HealthSpheres and speak directly with Californians about lung cancer screening.

Time and time again, I'm struck by how few people have heard of screening, even if they may be eligible. Compared with other recommended cancer screenings, lung cancer screening rates remain far lower. That is because many people who qualify for screening do not know that screening exists, do not realize that they may be eligible, or are unaware that it may be available to them at no cost.

Under current USPSTF guidelines, eligible individuals include adults ages 50 to 80 with a significant smoking history who currently smokes or have quit within the past 15 years. By providing clear information about lung cancer screening at the point of sale of tobacco products, SB 1124 would reach high-risk individuals and connect them with potentially life-saving knowledge about early detection and cessation resources. This is a simple but meaningful step towards closing the awareness gap and helping more Californians learn about screening before it is too late. For these reasons, I respectfully ask for your support. Thank you.

Thank you, and thank you for sharing the personal story that is so close to you. We will move on now to those who are in support of this measure in the hearing room who would like to register support.

Hi. I'm Paul Kimpel, and I-- California born adoptee, so I don't know my full family history, health history, but I'm very much in favor of 1124.

Thank you.

Clifton Wilson, on behalf of the Fresno County Board of Supervisors, in support. Thank you.

Thank you. We will now hear from any primary witnesses in opposition. Seeing none, I will bring it back to the committee for any comments or questions. Majority Leader?

Thank you, Senator, for bringing the bill forward. I think early detection is so important. As we all know, we have many friends that have battled, and we all wish they would have had an outcome much sooner, so thank you very much for bringing the bill, and I'll be supporting it today. I'd like to move the bill when it's appropriate.

Thank you. Assembly Member Gonzalez.

Thank you, Madam Chair. Just a couple of questions. I know you accepted the amendments. Did they clarify the size of the sign, require DPH to provide signage to retailers at no cost and correct a cross-reference?

Yes. What we're-- one of the issues was, imagine a gas station that sells cigarettes, obviously, and the signage would be proportionate to the window and the availability. That was a big issue because the sign would be so big, it would be detrimental to the proprietor. So it's been reduced. We've accepted that.

And also, we've made sure that if there was a violation, hypothetically, that didn't go up, we would give the proprietor 30 days to put it up. So it's not-- we're trying not to be punitive, but informative. And if I may continue, Madam Chair-- and this bill is important to me and I know it is to those who love our veterans because when I served back during the Vietnam era, they would give us cigarettes with our food, our C-rations.

And in the packet you had three little cigarettes and then you trade them off. And when we're in formation, they would say, okay. Light 'em up. If you don't have them, bum them, because you'd bum a cigarette from a buddy and everybody was smoking. Look-- it was a cloud over the platoon. We grew up in the military smoking, thinking that was the macho thing.

And so now when these veterans are-- have reached that age that cancer could be a problem, the screening that-- just the fact that-- imagine grandpa walking in with a grandson, and granted, grandpa's still reaching for those cigarettes, but at least the grandchild will say, grandpa, did you see the sign? You can be screened free, but just follow up. That's what this is about. Let's save some lives and pass Senate Bill 1124. That's my closing, Madam Chair.

Thank you so much for that closing, Senator. I will be very supportive of this bill. I thank you for bringing it forward, and couldn't agree with you more as a person who has had all too many family members who have been taken by cancer. With that, I think we have a motion. Do we have a second? Seconded by Ahrens, and when we are-- have quorum, we will be able to vote on that measure. Thank you so much.

Thank you. And I'm so honored to have your vote. Thank you.

Thank you.

We can now move on to item number two, SB 28 by Umberg. Thank you so much, Senator. Whenever you are ready.

Thank you, Madam Chair. A special thank you to Logan Hess and to you for your work on this bill. The CARE Court concept was originated by the governor in 2022 and has been implemented now throughout the state of California starting with eight pilot counties about three years ago. Since that point in time, each year we've done a cleanup bill to help to strengthen the CARE Court process and concept.

CARE Court concept is a civil matter, and the purpose of it is to address schizophrenics and now those with bipolar disorder with psychotic features so that we can make them productive citizens. We put them in a structure with adequate shelter, adequate behavioral health support, and other support. There have been some challenges that we've met and we're continuing to meet. One of the challenges is accountability.

And so what this bill does is this bill helps to address some of those gaps that still need to be filled, particularly with respect to accountability and also with respect to allowing those decision makers, whether it be a judge or health care professional, to have access to the full panoply of information to be able to make those decisions. One of the other challenges is that there are two sort of modalities in CARE Court.

One is an agreement and one is a plan. And, historically, in California, most of the CARE Court participants have engaged in an agreement. Very few in a plan, and a very few have been basically directed to a plan from an agreement. And what this bill does, it is it strengthens the ability to allow CARE Court agreements to evolve or transition into plans. It creates a pathway to help dismissed CARE Court respondents needing a higher level of care to get other assistance.

So we have a continuum of care. Requires the department to create a model guidance on those participants that may be too mentally ill for CARE Court. Ensure that CARE Court eligibility takes into account relevant information like involuntary holds up to six months prior to the decision as to whether to admit someone to CARE Court, reduces the excessive personal service requirements in CARE Court. It codifies Governor Newsom's CARE Court ICU and CARE Court Champions list.

In other words, sort of the good and the not as good list. Require CalHHS to create a dedicated CARE Court ombudsperson appointed by the governor and confirmed by the Senate to oversee and investigate complaints by petitioners, participants, advocates, and governmental actors involved in the CARE Court, requires public guardians to consult and adhere to the recommendation of medical professionals before making the LPS referrals to CARE Court.

Requires courts to accept CARE Court petitions electronically, explicitly allows for the remote participation of respondents, requires long reaching reporting on outcomes of CARE Court participants. Very important in terms of our ability to adjust as is necessary. Requires the court to create findings if the county is not complying with CARE Court. Thus far so far as we're aware, there's not been a single sanction issued under CARE Court.

And one of the original concepts was to allow the court to issue sanctions to institutions that were not being cooperative. Maybe that's a good thing. Maybe everybody's being cooperative, but that's the reality. It's not been a single sanction. And require the court shall not terminate the respondent's participation in the CARE Court process solely due to failure of the county or other local government to engage in the process, the CARE Court process.

With me here to testify is Dr. Aaron Meyer, who is San Diego's Behavioral Health Officer and Governmental Affairs Vice Chairman of the California State Association of Psychiatrists and who has been a great resource both to the governor's office and to our office with respect to CARE Court. And with that, Madam Chair, I'd like to turn it over to Dr. Meyer.

Thank you so much, Dr. Meyer. You'll have two minutes.

Good afternoon, Chair Bonta, Members of the Committee. Aaron Meyer, associate clinical professor of psychiatry at University of California, San Diego, speaking on behalf of the California State Association of Psychiatrists, proud supporter of Senate Bill 28. This CARE Act cleanup legislation advances the goal of connecting individuals with the most severe mental illness to stabilizing treatment and services.

The introduction of formal state oversight is an important step forward. For too long, families and first responders have had limited avenues to raise concerns when individuals with severe mental illness fall through the cracks of our behavioral health system. The ombudsperson creates a mechanism for accountability, transparency, and continuous improvement.

The ombudsperson may hear from petitioners in Sacramento County, where only 17% of petitions resulted in a care agreement or care plan. Or from petitioners in San Diego County, where 77 petitions were dismissed because the individual was either unable or unwilling to engage in treatment.

The ombudsperson may also examine reports that some individuals are being dismissed before meaningful county engagement because they appear to require a higher level of care. These conversations matter. By identifying patterns across counties and barriers to engagement, the ombudsperson can highlight opportunities for intervention before individuals experience further deterioration, hospitalization, incarceration, homelessness, or death.

CARE Court works best when it serves as a bridge to treatment, not a dead end. People who need more support should receive more support, not simply be dismissed. SB 28 strengthens accountability and helps ensure individuals are connected to the level of care they need. For these reasons, I respectfully ask for your aye vote.

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

I'm Mary Ann Bernard. I am a member of NAMI. I am a member of FASMI, Family Advocates for Individuals with Serious Mental Illness, Sacramento Group. I am also the mother of a severely mentally ill adult, and I am a lawyer who used to represent mental hospitals in another state off and on for 18 years. And in this instance, I speak on behalf of FASMI, and we are in favor of this bill. And just to be clear... That's it. Okay. Bye.

June Dudas, San Diego family member and representing the California Chapter of the National Shattering Silence Coalition. My cousin has been denied CARE Court three times due to his lack of insight. SB 28 protects his due process...

Ma'am. Ma'am, your position on the bill only. Are you in support of the bill? Thank you.

Madam Chair. Oracio Gonzalez on behalf of the California Business Property Association in support.

Charles Kontrabecki, intern, Stone Advocacy, on behalf of the California District Attorneys Association in support.

Michael Dudas, San Diego family member with mental health issues, and I'm in support of this bill.

My name is Bonnie Gupta. I'm part of the California Chapter of the National Shattering Silence Coalition, and I'm in support of this bill.

Oracio Gonzalez. My apologies. California Business Roundtable, also in support.

Thank you. We will move now to any primary witnesses in opposition. Please come forward. Feel free to come up to the dais.

Just you'll each have two minutes. Feel free to start whenever you can.

Thanks.

Thank you so much, honorable Chair and members. My name is Leslie Napper. I'm a senior advocate with Disability Rights California. I'm also a person diagnosed with bipolar one disorder who has navigated California's mental health delivery system firsthand. I respectfully urge you to vote no on s p 28.

I know what it's like to be in crisis and to need help. I also know what actually helps people recover. My mental health wellness and recovery did not come from coercion or court orders. It came from voluntary voluntary care, peer support, trusted providers, and stable housing. That matters because policy should be grounded in what works.

SB 28 moves us in the wrong direction. Right now, the data shows that Care Core is not delivering on its promise. Fifty six percent of the participants are not receiving services. Eighty two percent are missing at least one critical support like housing or care coordination. This is not a compliance problem.

This is a systems issue. Care court does not fix SP 28 does not fix that. Instead, it expands care court to include people who are already engaged in treatment and or already stable, creating the harm, of services disruption and unnecessary court involvement. From a policy standpoint, it that undermines continuity of care, the very thing we know people need to stay well. This bill deepens the connection between care court and involuntary commitment, creating new pathways into detention and evaluation.

That shifts the system towards coercion, even though we know voluntary, community based care leads to better engagement and long term outcomes. I would also be remiss if I don't mention that black Californians are already three times more likely to be pulled into care court, and indigenous communities face similar patterns of disproportionate involvement. SB 28 deepens the investment into the program that is not working and moves us into even further direction. Thank you.

For these reasons, I thank you and urge you to please vote no on SB 28.

Thank you.

Madam Chair and members, good afternoon. Michelle Cabrera with the County Behavioral Health Directors Association of California, and we are respectfully in opposition. Counties are proud of the work that they've put in to making Care Act a success throughout the state. They understand the author's desire to improve based on lessons learned. However, the goal posts have constantly changed since we reached full implementation at the end of twenty twenty four, which challenges our ability as a state to understand what is working and what isn't.

And there are many provisions in this bill that actually would potentially jeopardize our progress rather than help with the continued positive impact of care. For example, this bill would require us to wait until a person in an LPS conservatorship is determined to be no longer gravely disabled before we submit a care petition. This change could actually undermine our ability to safely transition and step individuals down because once an individual has been deemed no longer gravely disabled, the courts must move immediately to release that conservatorship.

This would leave a massive vulnerability gap and compromise our ability to safely transition into a care plan as we currently do. It would also expand the reasons that a person could be petitioned into care to include criteria that have absolutely nothing to do with their mental health condition, such as multiple calls to 911 regardless of the nature of those calls.

It would expand the criteria to any person who has had two involuntary holds in the last six months. My subject matter experts tell me that that is an incredibly low bar to meet given that, an individual could be placed on two holds on the same bad day. We have concerns with various provisions of this bill, which moves us further away, not only from the original intent of care, but also from making decisions based on what is most clinically appropriate to ensure individuals are truly helped.

This bill is an overhaul, not a cleanup of Care Act. Therefore, we respectfully oppose this bill.

Thank you for that. We will move now to anyone in the hearing room who would like to register opposition to this measure. Please come forward.

Thank you, madam Chair and members. Brandon McCarthy with the California State Association of Counties, also on behalf of the Rural County representatives of California in opposition.

Danny Therical on behalf of Mental Health America of California, Cal Voices, and Project Return Peer Support Network in opposition.

Ethan Lars Salinas on behalf of ACLU Cal Action in opposition. Thank you.

Josh Gaugher on behalf of the Urban Counties of California in opposition.

Thank you. And we are going to pause right now to make sure that we are able to establish quorum. Secretary, please call the roll.

Bonta?

Here.

Bonta here. Sanchez? Sanchez here. Addis? Agua Curry?

Agua Curry here. Aaron's Aaron's here. Colosa? Colosa here. Carrillo?

Carrillo here. Jeff Gonzales. Jeff Gonzales here. Mark Gonzales. Johnson.

Patel. Patterson. Rodriguez. Shivo. Shivo here.

Sharp Collins. Stephanie. Stephanie here.

We have a quorum. Thank you so much, and I will bring it back to committee for any comments or questions. Assembly member, Shivo, and then majority leader.

So I wanna thank the author for bringing this forward. I know it's it's a difficult issue. It's something that, if we're all being honest, was a little bit rushed. And I think that making sure that we reevaluate as we go and make the, you know, improvements and tweaks that are needed is really important.

I really appreciate the the ombudsman piece because as you and I actually work together supporting a veteran who was mistakenly fifty one fifty to a a facility, and and it was a very difficult situation to get eyes on his case and and him to be able to be released.

And, you know, so having someone to call and someone to go to, I think, is a really important resource. I wonder if you could respond to some of the concerns that would were raised by the opposition around the, you know, having a hold on the same bad day. For example, that veteran was put on a fifty one fifty and then immediately put on I can't remember what it is, but the fourteen day hold, right afterwards. Right?

And so if someone is in crisis and having, you know, having their worst day, then I can see that happening commonly.

Right? And and I wonder if that's what you're trying to capture or you're more trying to capture, like, over time, this is a common occurrence that shows more of a a standard need for care and intervention?

Let me begin to respond, then I'll let doctor Meyer actually give you all the facts. So what the purpose of the bill is is basically to gather as much relevant information as is possible for the decision maker to actually make an informed decision. So, for example, with respect to 911 calls, if there's been a number of 911 calls that may indicate that

this person is continuing in crisis, person, is continuing in crisis and maybe there's a home situation that is exacerbating things. So that's important, I think, for the decision maker just to know what what those calls have been about and how many. Same thing with fifty one fifty holds. If there's been a hold, the bill is originally constructed, didn't encompass all that information. And and again, I I think it's it's not a matter of saying you've had two holds, therefore, you're eligible or ineligible.

It's simply saying that all this information, all the mental health information that one can gather is is is important in assessing whether they're, one, eligible, and two, what the treatment plan or agreement should contain. And I'll I'll ask doctor Meyer if he's got additional information to convey.

Yeah. I'm I'm fortunate to be in the city where Mayor Tata Gloria's supported involvement of behavioral health professionals and embedded within first responder agencies. First responders have access to fifty one fifty information. They have access to attempts that they've made to link someone to a full service partnership program, but they won't have access to 52 fifties, the fourteen day hold in a inpatient psychiatric unit.

It's important to note that the information about fifty one fifty holds is is not part of the eligibility criteria which remain unchanged.

The person has to have a psychotic diagnosis. They still have to have a severe mental illness. Their condition must be substantially deteriorating to the point where grave disability is is likely without additional services and supports. That part hasn't changed at all. But what has changed is access to practical information where first responders can use that information in in lieu of staff that they don't have in their agency. And

and so you so currently, they do not have the fifty two fifty information.

That's correct. Okay.

I mean, I I appreciate that. I think the like, clearly, you're trying to get at giving people the care and support and treatment they need. And I think at the end of the day, that's something that we all get. I hope that there's gonna be continued conversations with the opposition to address some outstanding concerns, but I'll be supporting it today.

No. And along the way, the opponents have helped us to keep our eyes open, helped us to this is, I think, the fourth iteration, and several of the facts and factors have come from the opposition. So this this is a new paradigm. I kinda hate that expression, but it is. And so because we're dealing with something that's not been done in other states, we we benefit.

We benefit from all the information we can gather.

Thank you. Majority Leader.

Thank you very much for bringing the bill forward. I remember back in 2022 when this came about and there was a lot of conversation about it. And I remember, I believe it was Senator Eggman at the time said, this is a foundation. And a good foundation is that we build upon it each time that we'd bring policy forward.

That's what I see this bill's about Because as much as we all think that we can do the perfect bill, we need to, grow on that and expand it and make it better.

So I'm gonna support your bill today because I think there's a lot of good things in it, and I know you'll continue to work with the opposition. So thank you very much for your work on this.

Thank you. And thank you for referencing, Senator Aigman. Yes. She was one of the, sort of founders of this concept. Yes.

Assembly member Addis.

Thank you so much, and thank you, Senator, for bringing this forward. Aye, I really appreciate your commitment year after year to working on this issue. And I know we have done a a bit of work, on hard to treat mental illness and schizophrenia and the condition or the symptom of Anosognosia where people don't actually know that they are ill.

It can happen with schizophrenia and with other mental illness where people don't know that they're ill, and so it's very, very challenging to get them treatment if the only treatment available to them is by choice, but they don't know that they need treatment. And I've heard from particularly from moms, in my district, in my local community that are just desperate for us to do something to make some kind of change.

And we have obviously a very delicate balance between preserving people's civil liberties and provide, you know, compelling treatment. And it's a it's a delicate walk to walk, for sure. But one of the things that guides me and particularly is guiding me today is hearing from those moms that are that are literally begging for help because they know what their children are like when they've had treatment.

And they know that when they're able to and and that some of that treatment is only available to their children through the incarceration system. And then their children begin to improve and a whole cycle begins, where they're no longer treated.

So I just wanna appreciate the work that you're doing. I absolutely support the bill and, and think we could probably do even more in this space, but appreciate that this is a beginning.

Thank you.

Thank you. I will just as we're wrapping up

I'd like to be added as co author.

Thank you.

Wrapping up, I I do wanna kind of validate the concerns that were raised by the opposition in particular doc director Cabrera around the the extensive nature of this bill. Certainly, I think, Senator, you have been somebody who's been leading in this space for quite a while, and I certainly appreciate that. I appreciate that and do believe that you've kind of approached this, area from this pace of of, as the majority leader said, kind of setting the foundation and then building on that year over year.

My primary concern as I've shared with you is just that we have, right now, a pilot program a report on pilot program, and we are awaiting a more substantive report and evaluation on the implementation of this, which is why I we worked over the course of last week, this weekend, to be able to make sure that we were narrowing the bill to some extent, pulling out the things that we just didn't have some information about.

So I appreciate you working with us on this measure including taking the amendments.

Just formally, do you accept the amendments?

Oh, if I hadn't said that, yes, we accept the amendments.

Thank you so much. And I do believe that there is a lot of work to do in this space. I do want to caution authors that it would be very helpful if we actually had the information from the research and evaluation around the implementation of care act as we move forward.

Senator Umberg is on his last hurrah here as a leader in this space, and and I think that that likely drove the need to make sure that we had as much captured around what he hoped the care act to be and wanna appreciate and acknowledge that as well. I will be supporting this bill as it stands right now.

Know that you will continue to work with the opposition as this bill moves forward. There's still some significant areas to be addressed. In particular for me, making sure that we're finalizing the metrics around what a successful implementation for county looks like, and, and what's, you know, a county that needs some technical assistance looks like beyond just, logging in the number of of of referrals, which I think is pretty low bar of for us to be able to judge whether or not there's been success around that.

So looking forward to that work as it moves forward. I will be supporting this bill.

Do we have a motion by Agar Curry, seconded by Arons? Would you like to close that number?

Well, thank you, madam Chair. And you are correct. We I appreciate your personal engagement in this subject and personal engagement in this bill. Yes. As as we gather more data and we create more metrics, that I think is going to improve the system.

And I think that will continue for, I hope, for a very, very, very long time. This is a this is a very challenging area as pointed out by some of you, Addis. You know, like many families, our family has lived experience in this space. And one of the challenges for families is that they are desperate. They are desperate for some hope, if nothing else.

I have lived experience in the space where you hope when you get the phone call at three in the morning that you're finding out that your loved one's incarcerated versus somewhere else, or where you simply drive around hoping to find that person knowing that you probably won't but you just can't sleep. So I have tremendous empathy for the family members, and that's why we're in this space. And that's why I hope that, you've noted my departure from legislature next year that that that work will continue.

So and thank you to doctor Meyer. Thank you to the opposition for their engagement.

With that, I urge an aye vote.

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

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

Bonta, aye. Sanchez. Aye. Sanchez, aye. Addis.

Aye.

Addis, aye. Agaracari. Agaracari, Aye. Arons. Arons, Aye.

Colosa. Carrillo Carrillo, Aye. Jeff Gonzales. Mark Gonzales. Johnson Patel.

Patterson? Aye. Patterson, Aye. Rodriguez, Schiavo? Aye.

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

That measures out. Thank you, Senator. Just a quick announcement as, Senator Weber Pearson comes forward as we do hear items in file item order, she has two. We have, Senator Jones, in the hearing room and then just Becker and Menjivar who will be going after. We'll begin with file item three, Senator.

SB847 eight seven four.

Well, thank you, and Chair, and good afternoon. Thank you for the opportunity to present SB 874. SB 874 strengthens oversight and standardization of behavioral health treatment services in Medi Cal. Behavioral health treatment services include applied behavioral analysis, commonly referred to as ABA treatment, and other behavioral interventions that prevent or reduce behaviors that interfere with learning and social interaction most commonly for children diagnosed with autism.

Recently, utilization of ABA services has grown significantly in both Medi Cal and in the commercial market here in California, but also across the nation.

However, as a result, a referral for behavioral health services is simpler than a referral than many other Medi Cal Subspecialty services, and many of those providers do not have the same licensing requirements as for other medical services. At the same time, there have been several media reports documented ABA services that were overcharged or overprescribed, and at least one ABA provider in California has been charged with false billing and settled.

This highlights the need for more oversight, reevaluation of our process, for transparency, efficiency, and also for patient protection. SB 874 requires DHCS to take the following actions to evaluate and improve Medi Cal's behavioral health treatment services. It requires background checks for BHT providers who are not already subject to fingerprinting during licensing.

It convenes a stakeholder work group to advise on standards for BHT services, issue and maintains clear clinical guidance for BHT services based on stakeholder input and federal guidance, and report to the legislature on BHT utilization and recommendations to improve program integrity and compliance. Back in 2014, when these services were first added to Medi Cal, there were very few providers and much less awareness of services available.

The services and the field have since changed considerably, and so now is a good time to conduct a very thorough review. People who work with our vulnerable children, whether in their homes or at treatment centers, should absolutely have a background check. And finally, I wanna thank the committee for your thoughtful analysis.

With regard to the policy comment on the feasibility of background checks, we are currently working with the Assembly Public Safety Committee on amendments that would require a simpler form of background checks by employees in the short term and have the work group also determine how most efficiently to do a complete fingerprint background check that conforms to state and federal guidelines in long terms.

And with regards to the comment on the impacts this bill would have on commercial coverage, we have reached out to DMHC to see how to best include them. With me today is Lisa Kumar, a board certified behavioral analyst representing the California Association of Behavioral Analysis, and I respectfully ask for your aye vote. Thank you.

You have two minutes.

Thank you. Good afternoon. My name is Liz Quiller Kumar, and I am a board certified behavior analyst and serve on the board of directors of CALBA or the California Association for Behavior Analysis. For over a decade, I have worked alongside families who trust our field with their most vulnerable children, and that trust carries an enormous responsibility. And right now, our system has gaps that leave those children exposed and families without care.

The first gap is safety. Behavioral health treatment does not currently require providers to hold state licensure, meaning anybody can provide services without a background check. SB 874 closes that gap by requiring fingerprint based background checks for all individuals providing medical funded services, ensuring every person entering a child's home or treatment setting has been vetted. And this is a baseline standard of care that all these families deserve. The second gap is access.

Many qualified providers are reluctant to accept Medi Cal families because the system is so complex and inconsistent that it isn't viable. Each managed care plan, for example, has its own rules, its own forms, and its own timelines. And providers that do participate, credentialing alone can take over two hundred days. And that's two hundred days that a family is waiting while their child goes without care. SB 874 addresses both gaps by bringing together providers, plans, and consumers to make recommendations grounded in clinical reality.

And critically, it creates a thoughtful data driven pathway to explore longer term solutions, including potential licensure frameworks in a way that protects existing access and workforce stability. CalABA looks forward to actively participating in this process to ensure the resulting policies reduce administrative burden, reflect evidence based standards, and expand access to high quality care for Medi Cal beneficiaries. SB 874 gives California a real framework to fix a system that's currently pushing providers out and leaving families behind. We respectfully ask for your aye vote.

Thank you. Are there others in the hearing room who would like to register support for this measure? Chair members, Kathy Mossberg with the local health plans in support.

Thank you.

Cassidy Heckman with, the California Association of Health Plans in 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 register opposition? Moved by Agi or Curry, seconded by Aaron's. Seeing none, I'll bring it back to the committee for any comments or questions.

Seeing Assemblymember Addis.

Just very briefly, I wanna thank the author. I used to teach students with autism and just know what a struggle it is for families to find outside supports and outside services. And I think this is when they do, they wanna know that those folks are safe, that, that they have all the background checks that they need. So really appreciate this from a personal perspective. Thank you.

And, also, Senator, very thankful that you are, helping us, particularly in the medical space, to make sure that we have a standard of care for behavioral health therapy, in a way that we need to. I think this measure is long overdue and very thankful that you are making sure that we're launched into a space of of greater standard of care for those people who need care the most. With that, would you like to close?

Wanna thank once again the committee and the Chair and respectfully ask for your aye vote.

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

The motion is do passed to the public safety committee. Bonta. Aye. Bonta, aye. Sanchez.

Aye. Sanchez, Aye. Addis. Aye. Aye.

Aye. Aye. Aye. Aye. Aye.

Aye. Aye. Aye. Aye. Aye.

Aye. Aye. Aye. Aye. Aye.

Aye. Aye. Aye. Aye. Aye.

Aye. A Patterson, Patterson, Aye, Rodriguez, Schiavo, Schiavo, Aye, Sharp Collins, Stephanie, Stephanie, Aye.

Aye. Aye. Aye. Aye. Aye.

That measure's out. Thank you, Senator. And thank you to your witness. We're gonna move on now to your second bill, which is item number five, SB 1049, regarding health care claims reimbursements.

Thank you. And once again, good afternoon. Thank you for the opportunity to present SB 1049, the Provider Timely Payment Act. At its core, SB 1049 is about fairness, ensuring that minor technical issues with claims don't interfere with medical necessary care. Health care providers operate within an increasingly complex claim system.

Even when medically necessary care is appropriately delivered, providers can face payment denials or recoupment demands because of minor clerical coding or documentation errors. These situations are not cases of fraud or abuse. They are often simple, fixable mistakes. For example, missing a gestational aid, age, or coding error, forgetting to put your last name on something. Yet under current law, providers may be prevented from correcting those errors because of filing deadlines are tied to the original date of service.

From a clinical perspective, that is deeply concerning. When payments are denied or clawed back months or even years later, and providers are unable to remedy these technical defects, the consequences can be significant. Unexpected payment denials and retroactive recoupments create financial uncertainty, straining staffing resources, and can ultimately affect patients' access to care. Let me share a real example. One obstetric provider recently shared a case involving 61 pregnancy related claims submitted between 2023 and 2025.

More than two years after some of those claims were originally filed, the health plan began withholding payment for current patient care due to a minor coding issue, a missing diagnostic code on prior claims. As soon as a provider was notified, the billing team corrected and resubmitted the claims. However, the health plan denied the corrected claims as, quote, untimely, end quote, because they were outside the filing deadline even though the provider had not been informed of this issue until years later.

As a result, the provider's practice had approximately a $120,000 withheld with roughly $60,000 still outstanding on dozens of claims. The billing team has spent more than a hundred hours attempting to resolve the issue, navigating repeated calls and administrative hurdles to secure payment for services that had already been provided.

This is exactly the type of situation that SB 1049 seeks to address. When a claim is denied or a payment is recouped due to a correctable technical defect, Providers should have a meaningful opportunity to fix and resubmit the claim without being automatically barred by filing deadlines they had no ability to meet or be forced into a drawn out uncertain dispute resolution process. SB 1049 offers a balanced straightforward solution.

It allows providers to submit a collect a corrected claim within ninety days of a health plan's latest action, like a denial or overpayment notice, and prevents plans from rejecting those claims solely due to the fact that the previous deadline had passed. It is not open ended.

It is reasonable. It is time limited fix. And importantly, this bill does not excuse improper claims or expand liability for health plans. It simply gives providers a fair chance to correct honest mistakes. This bill is sponsored by the American College of Obstetrician and Gynecologist and is cosponsored by the California Medical Association.

We've had productive conversations with the opposition, and we respectfully have disagreements regarding whether current law adequately protects providers in these circumstances. However, we do actively remain engaged, and we'll be having, meetings with the department, later on this month. With me to speak as my witness is doctor Kathleen Rooney, an OB GYN and Aycock Fellow, and doctor Shereen Gaddusi. I'm sorry. And Shereen Gaddusi, senior legal counsel, not a doctor, for CMA.

Thank you.

Well, a different kind of doctor. Juris doctor. Please go ahead.

Madam Chair and members, my name is Kathleen Rooney. And on behalf of the American College of OB GYNs District nine, I'm speaking in support of SB 1049. I'm an OB GYN in a Sacramento private practice consisting of seven doctors who care for over 10,000 women in our community. In April 2025, I was notified by my biller that our health plan was withholding payment from current patient care due to a coding error from past claims.

These were from 61 pregnancy claims dating from January 2023 to January 2025.

After having to contact the plan to learn why they were withholding our money, we learned it was simply because the claims did not include a diagnostic code. Upon this discovery, our biller immediately fixed the claims and sent them back. The resubmitted claims were denied as untimely because it had been more than ninety days from the date of service. My biller has then spent over a hundred hours fighting each of these claims through provider disputes and making phone calls.

Overall, the plan withheld a $120,000 from my partnership during the, past fourteen months, and to date, 33,000 is still not paid from 19 pending claims.

This is after being connected to the vice president of the insurance plan. The blah blah blah. Sorry. In April through ACOG connections. I want to be very clear that our work was competent, gold standard care, and approved by the plan.

The only thing missing was the gestational age code. Why should an insurance company be afforded so much time to recoup a payment, yet we are restricted to ninety days from the date of service to correct it? It does not make sense. The insurance company may say they have a process for denied claims, but I hope my words resonate today that their process is horribly broken and unfair and only benefits the insurance company. Financially, well, how many physicians like me and the patients we serve?

Without financial stability and necessary resources, our ability to provide appropriate care to our patients is severely limited. SB 1049 presents a reasonable solution that would have prevented all this by allowing providers extra time to cure defect in the claim form itself, ensuring that minor or correctable errors like a missing gestational age code do not result in permanent nonpayment for medically necessary approved care.

Thank you.

I ask for your aye vote on SB 1049.

Thank you.

Good afternoon, madam Chair and committee members. Shireen Gattusi, California Medical Association here for any technical questions.

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

Kathleen Galgiani on behalf of the California Radiological Society, the California Society of Pathologists, the California Association of Medical Product Suppliers, the California Orthopedic Association, and the California Podiatric Medical Association. Thank you. Thank you.

Kevin Guzman with the California Medical Association, proud cosponsor.

Tim Madden representing the California chapter at the American College of Emergency Physicians, the California chapter at the American College of Cardiology, the California Rheumatology Alliance, and the California Society of Plastic Surgeons, all in support.

Angelo Pontes on behalf of Planned Parenthood Affiliates of California in support.

Dennis Cuevas Romero with the California Primary Care Association, advocates in support.

Lawrence Gaiden with the California Dental Association in support.

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

Thank you. Are there any primary witnesses in opposition to this? Please come forward.

Thank you. Are there any primary witnesses in opposition to this? Please come forward.

You'll each have two minutes. Please go ahead.

Madam Chair and member, Stephanie Watkins, on behalf of the Association of California Life and Health Insurance Companies, respectfully with an oppose unless amended position on SB 1049 today. We appreciate the author's goal of ensuring providers are paid appropriately and would like to sincerely thank the author, the sponsors for their willingness to engage on this bill, and also look forward to future conversations with the Department of Managed Health Care and CDI if this bill moves forward today.

Unfortunately, we are concerned that SB 1049, as currently drafted, creates a new and potentially duplicative process that overlaps with California's existing claims payment and provider dispute resolution framework. Today, California has a clear procedures for providers to dispute claim denials, challenge payment decisions, and resolve billing disagreements with health plans and insurers. Plans and insurers must pay, contest, or deny completed claims within a specified time frames and must provide written notice explaining the basis for any contested or denied claim.

Additionally, existing law appropriately affords providers access to a formal dispute resolution process to address any payment disagreements or claims disputes. Under current statute and regulation, providers generally have three hundred and sixty five days from a plan's most recent action to submit a dispute, and plans and insurers must issue a written determination within 45 working days. Our concern is that 1049, rather than resolving the issues identified by the sponsors, will create additional uncertainty as to which process applies in any given situation.

That uncertainty would not benefit providers, regulators, or plans and insurers, but rather take resources away from existing processes. For that reason, we would recommend the author consider evaluating or updating the existing dispute resolution process to address any deficiencies that concerns and the issues that were faced were very frustrating for all, and we really look forward to finding a pathway to a resolution for that.

Thank you. Thank you. Go ahead.

Thank thank you, Chair and members. Cassidy Heckman on behalf of the California Association of Health Plans. In the interest of time, I want to align my comments with my colleague. But, you know, we understand the problem. We think there's a workable solution, and we look forward to continuing conversations. Thank you.

Thank you. Any others in the hearing room who would like to register opposition to this measure? Seeing none, I will bring it back to committee for any comments or questions. Well, I wanna thank you, Senator, for bringing this forward. I too was very moved by the testimony of your witnesses, so thank you for bringing the perspective of of a provider. The idea that you could have a $130,000 withheld, I don't know how big your practice is, but I'm sure that that is, not something that is sustainable, and so, elucidate is why we having this challenge and wanna thank the Senator for bringing this forward.

I'm sure that you will continue to work with the opposition to try to understand their perspective around the fact that this may be duplicative process.

I pause around that though because I imagine that if this were duplicative process and there wouldn't be providers who would be waiting so long for the ability to be reimbursed for minor errors, ministerial errors, that are are deeply concerning to me given the fact that we're moving into a space where it's gonna be really hard to be a provider, in our healthcare system. With that, Senator, would you like to close?

Yes. Thank you so much. Wanna thank the supporters and those who've come out, this week in support of this bill. Wanna thank the committee and you, Chair, for, evaluating and and helping us work on this bill and also the opposition.

You know, like I said in my statement, I think we have differences of opinion as to what is currently supposed to happen and what is currently happening, difference in an opinion as to whether or not there are, you know, if there's a situation where you've got one rogue, you know, insurance company, which I don't think that's the case because we've got multiple instances of this being a problem and really causing providers to think twice, especially if they're in private practice as to whether or not they can keep their doors open.

And we already have an issue with access here in California, and this is just compounding on top of that. And so, I look forward to the meeting that we will collectively be having with DMHC and CDI. But, clearly, in practice, there is a problem. And this bill, is a common sense reform to fix that problem. And with that, I respectfully ask for an aye vote on SB 1049.

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

The motion is do passed to Appropriations. [Roll Call].

That measure's on call. Thank you, Senator. We are gonna move now to item number 10, SB 1224, by Jones. Thank you, Senator, for your patience...is heading up here.

Senators Becker and Menjivar are the remaining items left to be heard in this hearing. Go ahead. Press the button so we can hear you.

Thank you.

Thank you, Chair and members. It's an honor to be with you this afternoon in the assembly. I'm here to introduce SB 1224, the California Emerging Therapies Research Partnership Act. I wanna thank principal coauthor - my principal coauthors, Senator Weiner and Becker and Assemblymember Lowenthal, for their work on this issue. SB 1224 is a narrow research infrastructure bill intended to position California to compete for available federal research funding through the Advanced Research Projects Agency for Health or ARPAH.

Earlier this year, the federal government directed ARPAH to make available at least $50 million in funding to states with qualifying emerging therapies research programs. California is uniquely positioned to compete for those funds. The University of California system already has federally registered clinical trials underway at campuses including UCSF, UC San Diego, UCLA, UC Berkeley, and UC Davis. What California currently lacks is the statutory framework needed to apply for and receive this federal partnership funding.

SB 1224 addresses that gap and will allow California's research universities to continue their work in this important area with this new funding.

Importantly, this bill does not spend general fund dollars. The fund established would hold $0 unless and until federal awards are eligible, non general fund monies are received. Joining me today to speak in support of the bill is Dr. Manpreet Singh of the UC Davis School of Medicine and David Cuda, state commander of the VFW California.

Thank you. You'll each have two minutes.

Good afternoon, Chair Banta and members of the committee. My name is Dr. Manpreet Singh. I hold the Endowed Putnam Chair in Bipolar Research and Treatment at UC Davis School of Medicine in the Department of Psychiatry and Behavioral Sciences, where I'm a board certified psychiatrist and a clinical trialist. I'm here testifying as a private citizen, so my title and UC Davis affiliation are for identification purposes only.

I currently lead a portfolio of six phase three and two phase two clinical trials, and I see patients in our department's advanced psychiatric therapeutics clinic where we brought breakthrough treatments including s ketamine, transcranial magnetic stimulation, and deep brain stimulation to patients who have exhausted every other option.

My professional home is to work to accelerate novel therapies for patients continuing to struggle in spite of available treatments, and it is exactly why I'm here today. UC Davis is ready to be a national leader in emerging therapies research by building a world class clinical trial infrastructure. We have a dedicated institute for psychedelics and neurotherapeutics conducting foundational neuroplasticity science that's among the most cited in the field.

We have experienced investigators ready to lead first in human psychedelic trials, and we have patients, including veterans, with treatment resistant depression and PTSD, people who have tried everything and who are waiting for the next generation of treatments that this research could deliver. SB 1224 is what connects that infrastructure to the federal investment that is now available.

The April 2026 executive order placed at at least 50,000,000 on the table specifically for states with qualifying emerging therapies research programs. California and the UC system should be at the front of the line for that funding. This bill creates a framework to take what happens, by recognition of what the state and this university system have already built. The science is ready. The Clinicians are ready.

SB 1224 makes California ready. I urge you respectfully to support this bill. Thank you.

Good afternoon, Madam Chair Bonta, committee members. I'm David Cuda. I'm a disabled army veteran, retiree, and the Commander of the Veterans of Foreign Wars for California. I thank you for the opportunity to speak on behalf of the over 85,000 members of the Veterans of Foreign Wars, its auxiliary, and those who represent the 1,600,000 California veterans we serve. I also speak for the Vet Fund, California Vet Fund, as well.

Today, I'm asking for your support of 1224, Senate Bill 1224 of the California Emerging Therapies Partnership Act. It represents funding for veterans suffering from PTSD, depression, and other invisible wounds of war by increasing access to alternative and complementary treatment options. It is of utmost importance that it affect as it affects lives. We must state the reality is sobering. On average, more than twenty one veterans die by suicide every day here in America.

Thousands more struggle silently with PTSD, depression, anxiety, substance abuse, and social isolation. While traditional treatments such as counseling and medication help many veterans, they do not work for everyone. The one, two, three, four, ten pill approach that fits all has left a fatal legacy in its wake for these men and women who have borne the battle for this country and its citizens. Our veterans deserve access to every tool available to support the recovery.

Doing the same thing over and over is the definition of of insanity and it doesn't work the same.

Across the country, veterans are finding success through some programs such as equine therapy, service dog programs, peer support programs, and other innovative approaches that complement traditional care. These programs often help veterans reconnect with their families, communities, in a sense with a sense of purpose. But we're not asking to replace this evidence based medical treatment.

We're asking for this bill that will allow the California medical research hospitals and their partners to expand this access to alternative therapies that have shown promise in improving mental health outcomes and reducing suicide risk. When a veteran reaches the point of crisis, we all have more than one path to healing.

I sincerely ask for your aye vote. Thank you.

Thank you so much. Are there any others in the hearing room who would like to register support? Please come forward.

Good afternoon. Dana Nicol with Reeve Government Relations speaking on behalf of the American Legion Department of California, the Vietnam Veterans of America, California State Council, in support. Thank you.

Madam Chair and members, Anthony Maligne, on behalf of Heroic Arts Project and Healing Breakthrough, in support. Thank you.

Thank you. Are there any in the hearing room as primary witnesses in opposition to this measure? Any who would like to offer just a register of opposition? Seeing none, I will bring it back to committee. Assemblymember Addis moves the bill.

Seconded by Aguiar-Curry. No other comments from committee at this time. Well, I wanna thank you, Senator. I know that you were alone here at present, but you have several joint authors on this measure. And I think that this does culminate several years of work trying to make sure that we are able to both support, research, and advancement around this particular therapy while also, ensuring that we are protecting consumers in the process.

I think it strikes a very nice balance, which is why I'm supportive of this measure as it has been amended. And with that, I ask if you want to close.

I appreciate your aye vote. Thank you very much.

Thank you. We have a first and a second, and we will call the roll.

The motion is do passed to the Military and Veterans Affairs Committee. [Roll Call].

That measure's on call. Thank you, Senator. And, we will now, while we're waiting for our last two - thank you so much, sir. As we are waiting for our last two senators to come to present, we will go through and vote on consent and other items that have been heard. Assemblymember, Aguiar-Curry motions and Schiavo seconds.

Actually, no. Strike that all. Assemblymember Sanchez motions, and we'll keep the second as is. Thank you. Please call the roll.

On consent, [Roll Call].

That measure's on call, and I wanna, again, welcome our new Vice Chair to our Health Committee. With that, we will move now through the entire? Yep. We'll start with item number one, SB 16 by Blakespear. We have we need a motion and a second. Moved by Addis.

Seconded by Stephanie. Please call the roll.

The motion is do passes amended to the Judiciary Committee. [Roll Call].

That measure is still on call. Item number seven, SB 1124 by Archuleta, for a vote. We have a motion and a second.

The motion is do passes amended to Appropriations. [Roll Call].

That measure's on call. We are all caught up as we can be right now waiting on authors. And item number six, SB 1057 by Becker, and item number 11, SB 1314 by Menjivar. I'm gonna turn the gavel over to the Vice Chair for a moment.

Senator Becker by by a hair.

We will hear item number six, SB 1057 by Becker regarding licensing for certified nurse assistants and home health aids.

Oh, here we go. I've been in this room in a while. Good to see you. Thanks for having us. Sorry for the wait here.

This bill represents a common sense shift towards a sort of justice in the health care sector. What it does specifically is modernize the the certification process for certified nurse assistants and home health aids, move state away from a a rigid automatic denial system towards a discretionary rehabilitation first model. Currently, California is facing a massive shortage of frontline caregivers by removing permanent barriers for qualified rehabilitated individuals. This bill expands the labor pool for nursing homes and health, agencies without compromising, safety.

It requires Department of Public Health to form an individual assessment based on three factors, the actual nature and gravity of the offense, the amount of time there's elapsed since the conviction, concrete evidence of rehabilitation such as recent work history, and character references.

This bill aligns health care licensing with our state's broader fair chance employment goals. And this comes out of a personal situation with someone I know who we've tried for years to the system to to allow them to do the work they wanna do. They've done years and years of work around it, and it's really led to this bill, the the issues we've Harabedian in clearing something from the far distance path. If the judicial system is recognized in Mitchell's rehabilitation, our licensing boards should do the same.

With me today to support is Ed Little with Californians for Safety and Justice.

Thank you.

Thanks so much.

Good afternoon, madam Chair and members. My name is Ed Little, and I'm a government affairs manager with Californians for Safety and Justice and proud sponsor of SB 1057. Californians living with past convictions face lasting barriers to sustainable work, safe housing, education, and other opportunities to succeed. This bill would increase access to direct care worker jobs for people with past records by aligning the Department of Public Health certification standards related to conviction history with those of other healing professions under existing law.

AB 2138 passed by the legislature in 2018 established critical protections and greatly improved access to licensure for people with records, including for registered nurses and vocational nurses, physicians, surgeons, and clinical social workers, and more.

However, under existing law today, people seeking certifications for similar patient care roles such as certified nursing assistants and home health aids are not afforded the same protections. This bill seeks to close that gap. This bill is critical step towards not only ensuring fair opportunity for people with past records to pursue meaningful careers, but also advising and addressing California's direct care workforce shortage.

Extending accepted standards and practices for considering conviction history and other health and caregiving fields to CNA and home health aid certifications will help achieve these goals. For these reasons, we ask for your aye vote on SB 1057.

Thank you.

Thank you. Are there any others in support who would like to register support?

Madam Chair and members, Peter Kellis on behalf of the California Association of Health Services at Home. I wanna thank the author, staff, and sponsors for working with us to amend the bill to tailor it specifically to the needs of patients in the home being served by these professionals. Thank you.

Thank you. Are there any primary witnesses in opposition? Any who would like to register a Me Too in opposition? Seeing none, I will bring it back to the committee for any comments or questions. Seeing none.

Oh, Mister Patterson.

Thank you very much. You know, I was just looking at I was trying to look up AB 2138 from 2018. Did that apply also to convictions pertinent to the the job, the vocation?

So convictions that are directly related to the work would be excluded from consideration. Okay. Okay. Thank you.

Seeing no other comments, moved by Carrillo. Seconded by Stephanie. Senator, you may close.

Ask for an aye vote respectively.

Respectfully.

Thank you.

Before we do that, have you accepted the committee amendments? Yes. We have. Thank you. With that, we have a motion and a second.

Please call the roll.

The motion is do passes amended to Appropriations Committee. Bonta. Aye. Bonta, aye. Sanchez.

Sanchez, no. Addis. Aguirre Curry. Aye. Aguirre Curry, aye.

Arons. Colosa. Carrillo. Carrillo, aye. Jeff Gonzales.

Mark Gonzales. Johnson. Patel. Patel, aye. Patterson.

Patterson, no. Rodriguez. Shivo. Sharp Collins. Stephanie.

Aye. Stephanie, aye.

That measure is on call. Thank you, Senator.

Thank you.

We're gonna move now to our final bill for hearing today, which is item number 11 SB 1314 by Menjivar. And as the Senator is preparing her opening, I wanted to just make the committee aware that at this moment, the motion for this bill would be do passed to business and professions. The committee is, rescinding its amendments for the moment, and we'll continue to work with the Senator as this bill moves forward.

Thank you so much, madam Chair. I'll dive into a little bit more on that. I wanna thank the ongoing conversations with the committee, the committee Chair, and even up to the last wire conversations on on this bill. So committee members, what you will see in print is what you will be voting on. There is, no committee proposed amendments for right now.

I have committed to the Chair, given the unintended consequences that were coming out of the proposed committee amendments, to be able to land that. And I have given the Chair my commitment that I will not be presenting in BPED next week until we land those amendments, in a way that, avoids some of those unintended consequences that were coming out of, that that language. So thank you so much for for that work.

The bottom line for me is to, prevent the access, the really prevalent or ongoing access that kids have to tobacco, and sometimes it's strategic. You'll see that there are more smoke shops close to schools than that there are parks than that there are libraries, that there are statues of people who have done amazing things that they can read on or small libraries.

On the way to as kids are walking to school, this is what they're exposed to. And if you're seeing this day in and day out, it's no fault to them that they're gonna be hooked on those products. So the intent here is to make it harder for these kids to be lifelong addicts of that tobacco, and the goal was to create a buffer like we see with cannabis, for smoke shops.

That that buffer be 600 feet that they cannot, be built near a school or a daycare center so that this is not what they're exposed to every single day when they're walking to and from school. We also as this committee has probably heard, we're looking to address the increased use of nitrous oxide or whippets amongst our youth both in middle school and in high school.

If you're not a parent, then you probably are not hearing this, but it's increasing dramatically. These kids are sniffing these whippets. You were hearing from law enforcement that they are finding people passed out behind the steering wheel because they were just inhaling nitrous oxide. And the weird gap that exists right now is that it is not currently illegal to sell, but once you step out of the store, you can be arrested because it's illegal to, be in possession of it.

Really weird law that we're looking to address, and I know a lot of my colleagues are I have bills similar to that.

So that's also a part of my bill, and it's looking to, close those gaps with the with this bill. We're seeing that a lot of the violations that are coming out of California in terms of those selling to kids are coming out of tobacco retailers, which are which includes smoke shops, gas station, community stores, and deli markets who are being caught illegally selling to youth and young adults because if you didn't know, you have to be now 21 to purchase these products.

Back in our day, colleagues, I was 18 years old. So like I mentioned, the whole goal is here to prevent access to that, and I will continue to be work with the with the Chair on landing those amendments before the next committee. Because this was a last minute changes, I don't have witnesses to this because they now need to see where the bill is gonna land to be able to provide witnesses.

So, Madam Chair, with that, I'd like to turn it over back to you.

Do we have any others in the hearing room who would like to offer support for the measure?

Good afternoon, Chair and members. Kim Stone on behalf of the California District Attorneys Association in support.

Brian Sherman with the California Narcotic Officers Association in support.

Caroline Grinder on behalf of the League of California Cities in support. Thank you.

Amy Jenkins on behalf of the Orange County Board of Supervisors in support and the California Cannabis Operators Association in support. Thank you.

Madam Chair and members, Sarek Kaminski on behalf of the Association of California School Administrators in support.

Brandon McCarthy with the California State Association of Counties in support.

Brian Ricks with Los Angeles Unified School District in support.

Good afternoon. Kendra Begley on behalf of the city of El Cerrito in support.

Thank you. We'll move now to any primary witnesses in opposition. Please come forward.

Greetings. Tim Gibbs with the campaign for Tobacco Free Kids. We had been prepared up until about ten minutes ago to support the bill, but based on the bill that's in print, our position is opposed unless amended. And, you know, based on what's in our letter, it's precisely because the there's no reason to update the definition of cigars that has a potential to put our flavored tobacco law at risk.

And then also for defining cigar lounges, you know, we already have we already regulate cigar lounges through the private smokers lounge provisions.

Our fear is that defining a or coming up with a new definition of cigar lounge would has the potential to proliferate not only cigar use, but cigar lounges throughout California. So look forward to continuing to work with the author and the committee. But based on what's in print, our position is opposed unless amended.

Good afternoon. Kesa Bruce with the American Lung Association. In the interest of time, I'm going to align my comments with my colleagues here, but I just wanna reiterate that we are concerned about, the definition of the cigar lounge and the potential for that proliferation to, oversaturate areas that already have, increased density with tobacco retailers, and allowing this new definition for the cigar lounge. So, again, we were prepared to support this bill and had presented amendments, but we are opposed unless amended.

Thank you.

Thank you. And I'm certain that with the new iteration of amendments, we are going to be able to address the concerns that we've been able to hear from you previously. So I'm look forward to your ability to support this bill as it moves forward should it get out of this committee at this point. Are there others in the hearing room who would like to register opposition on this measure?

Hi. Judith Gutierrez with the American Heart Association. I'm here aligning with my colleagues. We were ready to remove our opposition, but we remain opposed unless amended. Thank you.

Thank you.

Good afternoon. Gema Gonzales with California Hispanic Chambers of Commerce in opposition. Thank you.

Thank you. Hearing no other seeing of no other opposition, I will bring it back to the committee for any comments or questions. Assemblymember Patterson.

Great. Thank you. Well, on the cigar one, I was kind of excited about the definition in the cigars. You know, I actually, I see the cigars you know, as a former city council member, I think, you know, seeing the the smoke shops kinda pop up all over the place is a problem, and we had a lot of issues, I think, really defining that in our in our code on what that is. Right?

Because if you've zoned something for business, for example, or retail or something like that, and then, you know, it's very hard to stop, you know, when you get an application for a smoke shop. And, you know, while I understand, you know, there's some discussion on the cigar lounges, you know, I think that not that I want them, like, next door to schools or anything like that. But, you know, it is a different business.

It is a different business model for sure. But I think, you know, as the amendments move forward and, you know, we're trying to I know there's a lot of discussion going on.

I think, you know, it's really important that we don't you know, I actually see a lot of day care centers in retail shopping centers. So I think it's important to to you know, that we don't stop, you know, like grocery stores, for example, from being in a similar location as as a day care center. Actually, as a parent of a bazillion kids myself, I find that quite convenient.

So so, you know, I think really what you're going for, I and I could be wrong, is obviously the the the stand alone shops that are selling cigarettes or other things, and I honestly have no idea how these places stay open. I don't know who I can only guess what's going on there in a lot of them.

Rockland Police Department does a great job at enforcing the laws that we have, and we've been on some of those stings, if you will. But if with those limits sort of in mind and that we're not impacting major retailers that sell, you know, donuts and milk and other types of goods, you know, and create sort of like these food islands. Right?

You know, where people also need to have their kids at daycare, you know, that as long as the amendments kinda move forward with that in mind, I think that, you know, I would continue supporting the bill. But as in print right now and I think, you know, a lot of discussion continuing to happen, I'll support it today, and I trust that the the process will play out.

So thank you.

I think that very much captures the spirit of where we are intending to go with the amendments that we will see going forward in other committees. Thank you for raising that, Assemblymember Patterson. Moved by Aguiar-Curry, seconded by Sanchez. Assemblymember Sharp-Collins.

Thank you, madam Chair. I just had a a couple of questions. I didn't get a chance to make it back for the opening part of it. So hopefully, my questions, I don't wanna have you go back to repeat, but maybe you can be 05:30. I've been running around all day.

But Just I think you might have missed Assembly member that I indicated that we are removing the committee amendments as it stands right now. The bill is gonna be moving forward to business and professions should it get out of this committee with a commitment from the author to rework some of the definitions. Okay. And I think that will likely alleviate some of the concerns that you had with the bill.

This is what I was trying to identify. Thank you so much for doing that. And then I guess the only question that I will go ahead and and and pop down to is just the impact that it could have on program funding dealing with the, tobacco tax, like, medical, dental programs and in tobacco, disease research and first five. So just so just looking at that too as well.

If we if they continue on, the way it was previously done with today's amendments that I saw, I just wanted to make sure that funding is not impacted because of that tobacco tax.

Just wondering how that would go.

I would think that the that tobacco tax funding that we know supports programs like First Five and others, is a declining revenue source because over time, we've been blessed with the fact that we've been successful in getting people to smoke less and, use tobacco products, which means that they are less there's less revenue generated for those. So I think the reality is that there would be a decrease in funding around the sale of tobacco products that will impact first five.

But I think the senator's intention with this bill is to make sure that the people who are buying those tobacco products are not children and youth. So I think we are aligned in that way.

No. Thank you. I'm sure that my other two questions will be answered based on what you previously stated. But thank you. Thank you so much for your time and I thank you.

Thank you, Assemblymember. Assemblymember Carrillo and then Addis.

Thank you, madam Chair. I do have similar concerns expressed by Assemblymember Patterson. You know, as a recovering city planner, I know that local jurisdictions have even further distance requirements from sensitive uses. For instance, the city of Palmdale for ten years, they have a minimum district requirement of 1,000 feet from bakers, not only the ones we are mentioning in the bill, but also churches and many other sensitive receptors.

So in in in understanding that those amendments will be discussed later at the next committee, but I'm concerned that the 600 foot decent requirement is actually less than some jurisdictions have.

Like I said, in Palmdale, it's 1,000 feet. And I also think that this puts in a disadvantage for those ethnic stores that wanna be in communities. Like, for instance, in Palmdale again, we have a small Filipino community and Korean community that they wanna have their ethnic stores. They wanna sell them their products. Right?

Fortunately or unfortunately, they they do rely on the sales of alcohol. I know this is not about alcohol, it's about tobacco. And that would also actually think that they will put them in a disadvantage too for them to be able to survive in a competing economy. So for those reasons, I wanna stay off of this this bill today. Again, the concern is the distance requirement seems to be shorter than what other local jurisdictions have.

I'd like to assure you there is language here that if a local ordinance has a more stringent requirement that that would supersede our requirements. So there is language on there. So it wouldn't remove your Palmdale a 1000 feet. This is just a minimum of what local ordinance would have to consider if they have a stronger one they that can move forward with that. I just wanna clarify.

I did see that. Well, thank you for that clarification. Okay.

Assembly member Addis.

Thank you so much and wanna say thank you to the author. I'll call myself a recovering city council member and worked on issues like this when I was on the local city council, and it became very contentious. And I know I'm sure you've gone through many of those conversations. I'm gonna support the bill today. I wanna, say, I don't think it's your intention to have opposition from, American Heart Association and American Lung Association, and I'll see this bill again in BNP.

Hope that issues that have been raised from their concerns are gonna get worked out. It sounds like from the chair's comments, there's some work that might be done in that realm. It's a couple organizations that I've worked closely with, particularly around these kinds of ordinances. And so but also understand there were some kind of late breaking changes with the bill, and so we need we need a little more time.

And knowing that I have the opportunity to see this back again when it comes to BMP and a support today and wanna thank you for your work.

It's these are hard bills to do. They shouldn't be, but they can be hard bills to do. So thank you.

Thank you. Seeing no other committee amendments, reiterating that we are tabling the committee amendments for now. We are gonna work on some of the definitions to make sure that we aren't unduly pulling in the kind of larger retailers, supermarkets, and groceries. And we'll work with the Senator as it moves into business and professions and believe that we will be able to find a nice balance to be able to hopefully get your current oppose unless amended back on in support of this measure.

And with that, Senator, would you like to close?

Press the press the button. I keep turning off. Yeah.

My honest, genuine thank you to the Chair for allow allowing a little bit more time to to land the plane here with the unintended consequences. But I do agree with some of your Patterson's, you know, point though, you know. I personally don't think cigar lounges are the where kids are going to smoke and buy tobacco products.

I know that these aren't the ones here at local, you have to be a member for that I don't think is a cost that young people are paying for. I think, you know, to the chair's point, we are seeing, some convenience stores and then the smoke shops, be, the go to place for our young people to go and smoke.

So being able to balance that and also to the some of your Paterson's point of we don't want to prevent, childcare places from being in retailers or retail locations. That's where people work. There should be a place for their kids to be taken care of as well. Given those, considerations, I know with the Chair, we'll be able to, land a good balance.

For right now, I'm asking you to vote for the bill in print to get me to the next committee, respectfully asking for an aye vote.

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

The motion is do passed to the Business and Professions committee. [Roll Call]

That bill's out. Thank you so much, Senator. Alright. Committee, if you are a committee member and wish to vote on any of the bills that have been heard fully by this committee, please come back to committee. I will be adjourning as soon as, we get the majority of the votes here.

Thank you. Thank you. We will start from the beginning and thank you. We'll start with the consent calendar.

[Roll Call]

[Roll Call]

That measure is out now out. Item number two, SB 28 by Umberg for add ons.

[Roll Call]

That measure is still out. Item number three, SB 874 by Weber Pearson for add ons.

[Roll Call]

Measure's still out. Item number five, SB 1049 by Weber Pierson. Lifting the

[Roll Call]

That measure is now out. Item number six, s B1057 by Becker lifting the call.

[Roll Call]

That measure's out. Item number seven SB 1124 by Archuleta lifting the call.

[Roll Call]

That measure is now out. Moving on to item number 10, SB 1224 by Jones. Lifting the call.

[Roll Call]

Adding on for item number 11, SB 1314 by Menjivar.

[Roll Call]

That measure is still out. We will go back one more time through.

We are gonna go through one more time for the people in the back on consent for add ons.

[Roll Call]

Still out. Item number one by Blakespear SB16 for add ons.

[Roll Call]

Still out. Item number 3, SB874, Weber Pierson. Oh, sorry. Item number 2SB28 by Umberg for add ons.

[Roll Call]

Item number three, SB874, Weber Pierson for add ons.

[Roll Call]

Item number five, SB1049, Weber Pierson for add ons.

[Roll Call]

Item number 6, SB1057 by Becker for add ons.

[Roll Call]

Item number 7, SB1124 for add ons.

[Roll Call]

Item number 10, SB1224 by Jones for add ons.

[Roll Call]

Item number 11, SB 1314 by Menjivar for add ons.

[Roll Call]

All bills heard in the committee hearing have are are out have and have been dispensed with, but we are going to run through the hearing agenda again for add ons.

[Roll Call]

We are adjourned. Thank you.