Assembly Standing Committee on Health

Good morning, and welcome to the Assembly Health Committee's hearing on Thursday, August 27th. Before we begin, I wanna make sure everyone understands our committee procedures to ensure we maintain order and run a fair and efficient hearing with the goal of hearing as much from the public within the 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 other witnesses, talking or loud noises from the audience. Please be aware that violations of these rules may subject you to removal or other enforcement processes. If you are providing witness testimony at this hearing, all witnesses will be testifying in person.

Main support and opposition will be allowed two main witnesses for a maximum of two minutes each. As a reminder, primary witnesses in support must be those accompanying the author or who otherwise have registered a support position with the committee, and the primary witnesses in opposition must have their opposition registered with the committee per the instructions on our website. All other support and opposition can be stated at the standing mic when we call upon you to simply state your name, affiliation, and position.

All testimony comments are limited to the bill at hand. The committee has four items on the agenda for today's hearing. We will begin when we have an author, and we will also begin as a subcommittee until we are able to establish quorum. Thank you. We will be starting with File Item Three: AB 2405 by Gipson, followed by Item Four: AB 2499 by Gipson.

Good morning. Good morning, madam Chair and members. We'd like to present first of all, let me say thank you very much for allowing me to present Assembly Bill 2405. It's a straightforward public and patient safety measure that would establish a consistent statewide, standard for, transport of individuals on a fifty one fifty. And I wanna stress for the committee, fifty one fifty.

As you as I paint this picture, our our hospital are being pushed to the breaking point with rising demands, limiting resources, and exhausted staff members, making it increasingly difficult to provide timely, highly qualified care for our communities that they depend on each and every day. Facilities like Martin Luther King Community Hospital, located in my district in South Los Angeles provides critical underscore critical, critical care to some of our, state's most vulnerable and at risk populations.

But every day, they are met with a dozens of patients who, who who are brought through the doors by law enforcement, brought through the doors by law enforcement from outside of their jurisdiction. Data shows that there has been over 400 law enforcement transports to Martha King Community Hospital over a four month period from November 2025 to February 2026. Martha King has been have seen patients coming from as far as Santa Monica.

And we're talking about Martha King sits in the middle of Watts. And Santa Monica, which is about 20 something miles, 22 miles away, and they're transporting from Santa Monica to Martha King Hospital. They're passing up seven other hospitals and other facilities that can handle 51 fifties. To address these concerns from opposition, the Senate amendments are as follow. Clarify that a person's being transported by law enforcement must take must must be taken to the closest appropriate designated facility.

Two, remove reporting requirements, for law enforcement. Three, permit flexible flexibility for patient's choice. And four, permit law enforcement to adhere to local written policies and agreement. Assembly bill 2405 ensures that vulnerable Californians can receive the timely medical care they deserve and provides, relief for some of our most impacted hospitals like Martha King Hospitals.

Here with me to provide supporting testimony is Christy Weiss, a representative from Martin Luther King Community Hospital, who will speak in support of twenty four zero five and also the journey we have had.

Good morning, madam Chair and members. Christy Weese of Capital Good morning, madam Chair and members. Christie Weese of Capital Advocacy on behalf of the Martin Luther King Junior Community Hospital. The Assembly member did an eloquent job presenting the issue that we're trying to solve here. We have been working, with all stakeholders and this is a delicate needle to thread as you can appreciate.

The bill before you, has been significantly amended down since it

was heard in the Assembly. We've removed the reporting language. We've removed the penalty language, but

the bill still will be a helpful tool to really make sure that patients who are brought in on a fifty one fifty get to the appropriate and nearest hospital to receive care. We ask for your eye vote.

Thank you. Are there any witnesses in support who would like to register? Me too.

Vanessa Gonzales with the California Hospital Association in support.

Move the bill.

Second. Thank you.

Moved by Agri Curry, seconded by Addis. Are there any primary witnesses in opposition? Seeing none, any who would like to register opposition? Seeing none, we'll bring it back to the committee. We've had a motion in a second.

Any comments or questions from the committee? Seeing none, we already did that.

you. Assemblymember, please close.

Thank

Thank you very much. I just wanna underscore that we've done everything we could without losing the purpose of this bill. Martha King Hospital, this legislative body has heard the name of this hospital. I wanna invite you to come and visit, this hospital. We have to do everything we can to save Martha King Hospital.

It is on the distressed hospital's list in the state of California. I will begin to talk about how Kaiser Permanente just donate $25,000,000 to expand their ER room. Their ER room only has 25 beds excuse me, 29 beds. So you can imagine taking 51 fifties from Santa Monica, Pasadena and passing up other facilities that can handle 51 fifties and putting a burden on Martin Luther King Hospital who only has 29 bed. We are servicing people in the parking lot.

Let me say that again in case you missed it. We are serving people in the parking lot in tents, and we're turning no one away. But 51 fifties who could be handled in other places, it is unreasonable. So we're trying to look at every way imaginable to save this hospital that are saving lives each and every day. I respectfully ask, but I vote.

Thank you. Assembly member, very much appreciate that and your long standing championship of of Martin Luther King Hospital Junior Hospital in particular. And I think you've raised a very important point for us to be able to make sure that we're directing services where they are most needed instead of overburdening one particular institution. Thank you. You've had an opportunity to close on that.

We are going to now establish quorum so that we can take a vote on your behalf.

Vanta? Aye. Vanta here? Here. Yes.

Here. Vanta here. Right. Sanchez. Addis.

Here. Addis here. Agaracari? Here. Agaracari here.

Aaron's?

I'm here.

Aaron's here. Kolozha? Here. Kolozha here. Carrillo, Jeff Gonzales?

Here. Jeff Gonzales here. Mark Gonzales, Johnson Patel? Here. Patel here.

Patterson, Rodriguez, Shavo?

Here.

Schiavo here. Sharp Collins. Stephanie?

Here.

Stephanie here.

We have a quorum, and now we can vote on item three AB 2405 with the motion of concurrence in Senate amendments. Please call the roll.

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

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

Aye. Arons, aye. Colosa? Colosa, aye. Carrillo?

Jeff Gonzales? Mark Gonzales, Johnson, Patel, Patel, Aye, Patterson, Rodriguez, Schiavo,

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

Aye.

That measure is on call. We'll move you to your next item.

Thank you very much.

Assembly member. Now item number 4, AB 2499 by Gibson.

Thank you very much once again to the chair and to the committee for allowing me to present. Assembly Bill 2499 seeks to address an outdated, inefficient asset of our healthcare system. Currently, many healthcare plans impose restrictive file size limits on electronic claims submissions. As a result, healthcare providers, hospitals, and clinics are often faced-- are forced to fax or mail thousands of pages--we're still sending and using fax machines--thousands of pages of supporting medical documents to process claims.

The Senate amendments amend the bill to require health plans and insurers to accept and confirm electronic medical records and support documentations necessary to process claims through a standard electronic submission method. With me to provide supporting testimony for Assembly Bill 2499 is Eduardo Martinez, representing Providence Saint Joseph Health. Take it away.

Thank you. Thank you, Mr.-- or Madam Chair and members. Eduardo Martinez, legislative adviser for Manatt, Phelps & Phillips, speaking on behalf of Providence, proud to sponsor AB 2499. Physicians and claims teams across Providence continue to report that claims administration is being slowed by outdated and incompatible systems. Although providers increasingly maintain medical records electronically, they're often forced to fax or mail large volumes of documentation because a plan's portal cannot accept the file size or volume of records needed to adjudicate a claim.

These limitations lead to repeated submissions, avoidable claim pends, delayed payments, and additional manual work, and this takes staff time away from patient care and can create strain for physician practices and healthcare organizations serving high-need communities. AB 2499 offers a narrow and practical solution. It requires plans and insurers to provide a workable electronic process for accepting medical records and supporting documentation they already request to process claims.

As the author said, the bill was amended in the Senate to align its implementation date with May 2028, a federal compliance date for new electronic claims attachment standards. It was also amended to provide a reasonable exemptions for system outages, disasters, and cybersecurity incidents that are outside of a plan's reasonable control. The bill does not change coverage, medical necessity, or claims adjudication standards. It does not apply to prior authorization. It simply modernizes how requested information is submitted. For this reason, we respectfully ask for your aye vote.

Thank you. Are there any others in the hearing room who would like to register a support position?

Good morning. George Soares with the California Medical Association, in support.

Moved by Aguiar-Curry. Seconded by Gonzalez.

Thank you.

Are there any in the hearing room that would-- or any primary witnesses in opposition? Please come forward.

Good morning, Chair and members. Olga Shilo, on behalf of the California Association of Health Plans. We're in respectful opposition to AB 2499. Health Plans already widely accept electronic claim submissions. We have not seen evidence of significant or systemic problems with Plans's ability to receive electronic medical records or supporting documentation necessary to process claims.

And given that the bill would take effect and-- would not take effect until 2028, its introduction mature, federal <inaudible> regulators have recently finalized nationwide standards for electronic claims attachments. Health Plan's providers, clearinghouses, and technology vendors are investing significant resources to prepare for implementation beginning in 2028. Creating a separate California framework before the federal standards have taken effect risks increasing administrative costs and adding unnecessary operational complexity.

Additionally, we are very concerned that the bill would prohibit Plans and insurance from denying, pending, or delaying claims simply due to system limitations. This creates a risk of improper payments and weakens important safeguards against fraud, waste, and abuse. We believe it'd be more appropriate to allow the forthcoming federal standards to take effect and then provide additional time for stakeholders to work together to identify the underlying issue and determine whether any state action is actually necessary. For these reasons, we oppose the bill and urge a no vote. Thank you.

Good morning, Chair and members. Matt Akin with the Association of California Life and Health Insurance Companies, also in respectful opposition to Assembly Bill 2499. In the interest of time this morning, I'd just like to align my comments with my colleague at CAHP. Thank you very much.

Thank you for that. Are there any in the room who would like to register opposition to the bill? Seeing none, I will bring it back to the committee for any comments or questions. This has been-- I received a motion and a second. Seeing none. Oh.

Can you address some of the-- thank you for bringing this bill forward. Can you address some of the concerns that the opposition has brought forward regarding the premature nature or that it's in a last minute process?

No, thank you for the question. So the bill was amended in the Senate to align with those federal requirements which are set to take effect in 2028, so we thought that this bill actually really complements those standards. I also neglected to mention the bill contains language that says if there is a federal, a state standard on attachment sizes that is implemented, that those standards would take effect.

In the meantime, what we have found is that there are instances with some payers where the attachment size can be as low as 10 megabytes. And for those of you who are anywhere familiar with, you know, email attachments, things like that, like, that is far insufficient for providers to be able to attach claims and get claims adjudicated in a timely manner. So we feel like we've really stretched ourselves to accommodate the concerns of the opposition, and, you know, hopefully-- we view this bill as complementary to some of those efforts that are happening at the federal level.

Seeing no other comments or questions, Assembly Member, I thank you for bringing forward this bill. I do hear and understand the concerns that have been raised by Ms. Shilo and Mr. Akin. However, I think we are dealing with a situation where, because we don't have the ability to use very available electronic means to be able to process these claims, we most importantly are seeing a lot of friction in our system that is quite costly to care and to our providers to be able to receive reimbursement for the care that they provide.

And so I'm hoping that we will continue to move in a direction of trying to expedite as much as we can any of these-- elimination of these friction points by going digital as much as we can. With that, I respectfully ask for you to close.

First of all, I wanna say thank you very much to the chair and to the committee. We wouldn't have brought this bill forward if we didn't see a strong need for this bill. Providence has already indicated-- our representative from Providence has already indicated--Mr. Martinez--that there's a strong need.

And we live in a day and age--and I think the chairwoman has already summed it up in her comments--we live in a day and age where we have technology available. So why are we faxing and we're mailing these documents, which slows down the kind of care and the kind of response that we need for patients, especially when it comes down to health? I respectfully ask an aye vote. Thank you. This committee.

This has been motioned and seconded. The motion is do pass as-- or a concurrence in Senate amendments. Secretary, please call the roll.

[Roll call].

That bill is out. Thank you, Mister Gibson. Thank you. Assembly member. We are gonna move on to item number 2, AB 2093 by Bauer-Kahan.

Good morning, everybody. Good morning. Thank you, madam Chair and members. In 2022, the legislature passed AB 988, which started to set up our 988 crisis lifeline. And just this year, under the speaker's, oversight efforts, we did some oversight over how 988 is working.

And through that, we realized that some changes were needed. This is really a good government bill. We realized that in AB 988, we had required there to be interoperability between 911 and 988. If the person calls the wrong number, that shouldn't be their problem.

We should make it seamless for them to be transferred between the two systems so people in mental health crisis get to the 98 system, and people who need true health care, maybe an ambulance, something else can get into the 911 system.

The agencies had defined interoperability differently than we as a legislature had, so this bill cleans that up. It also deals with some of the things we'd heard from the call centers around the inability to truly fund with a one year horizon on a fee that is, we have a fee that our, constituents pay that is going to pay for the call centers year after year, yet they only get a one year horizon for how much they're receiving, which makes it very hard to staff up.

So this deals with that problem and others. And so I'm hopeful that this bill will continue to make $9,898.08 work better for Californians. And with that, I will turn it over to my witness from c

please go ahead.

Good morning, everyone. It's us on. I'm doctor Leandra Clark Harvey, CEO of the California Behavioral Health Association and proud sponsor of AB 2093. For CBHA, this bill is a part of a larger commitment to building upon behavioral health crisis response system that Californians can definitely depend on. We were a strong supporter of a v nine eight eight because we believe then, as we do today, that the implementation of nine eight eight represented a transformational opportunity. Our involvement in this work is also deeply informed by our membership. CBHA represents 988 call centers in every region of the California. This gives us a very unique window into how the system is actually operating on the ground, not simply how it was envisioned in statute. Importantly, since AB 988 was enacted and California's nine eight eight system became operational, we have learned a great deal. Implementation has allowed us to identify gaps, operational challenges, and areas where additional clarity and infrastructure are necessary.

This is not a failure of AB 988. It's the natural evolution of building a new statewide crisis system of this magnitude. So AB 293, as you just heard, is about taking what we've learned and strengthening what we've already built. CBHA has been engaged in this work from the beginning. We supported the vision behind 988 AB 988, and we've worked alongside our 988 call center members.

This is the next step in this work we believe, and it builds upon, not away from, the foundation established for AB 988 and helps ensure that California's large investment in a in nine eight eight translates into a crisis response infrastructure capable of meeting the needs of Californians when they need it most. Thank you.

I'd like to make a motion to approve. Sorry.

Motion by Patel, seconded by Addis. Are there any other in the others in the hearing room who would like to register support? Please come forward.

Good morning. Jordan Curley on behalf of the Steinberg Institute proud cosponsor and support.

George Cruz, on behalf of the California Behavioral Health Association, proud cosponsor and strong support. Thank you.

Danny Offor was the National Alliance on Mental Illness, also known as NAMI California. Another proud, hopeful cosponsor in support. Thank you.

Thank you. Are there any primary witnesses in opposition who would like to register opposition? Any others in the hearing room would like to register opposition? Seeing none, I'll bring it back to the committee with a question from doctor Patel.

appreciate your support. Don't do it. You are you are there in spirit. Appreciate the support, doctor Patel.

If the if there's any way that you're taking co authors, I would love to be added. I know it's late in the day, but if there's any way possible.

Very much so. I will say that, we had a health, oversight hearing on, the kind of the status of nine eight eight and wanna thank, Assembly member, Bauer Kean, for, seeking to basically first establish help establish the nine eight eight system and then making sure that we were following through on our all of the implementation opportunities that we had to strengthen the program.

I think many of the Senate amendments speak to the interoperability component and also just making sure that we have a seamless process for being able to have, you know, any door that anybody answers Goes through to be able to have somebody who will answer the call to be supportive of their need at the in the moment.

And I wanna thank you for making sure that that is the case and certainly appreciate your this being certainly one of the many legacies that you will leave in in the state of California. With that, would you like to close?

No. On that,

I will take that as my close. Thank you,

madam Chair.

Thank you. We'll call the roll, please. The motion is concurrence to in Senate amendments.

Bonta? Aye. Bonta, aye. Sanchez? Aye.

Sanchez, aye. Addis? Aye. Addis, aye. Agarikuri?

Aye. Agaracari, aye. Aarons? Aye. Aarons, aye.

Colosa, aye. Carrillo? Jeff Gonzalez? Aye. Jeff Gonzalez, aye.

Mark Gonzalez? Johnson Patel? Aye. Patel, aye. Patterson?

Aye. Patterson, aye. Rodriguez?

Aye.

Rodriguez, aye. Schiavo?

Aye.

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

That bills out. Thank you, Assembly member.

Thank you, madam Chair members.

We're gonna move on now to item number 1, AB 1199 by Patterson.

Assemblymember Patterson, whenever you're ready.

Great. Thank you, Madam Chair. Good morning. Here to present, AB1199. This measure simply aligns California law with federal law and national accreditation standards by allowing hospitals to recredential and reappoint medical staff every three years rather than two years.

We have a two year process here in California. The Federal Government's recently changed to, three years. With me today to testify, I have Vanessa Gonzalez from the California Hospital Association.

Good morning. Vanessa Gonzales with the California Hospital Association here in support. The author did a great job out outlining the bill, so I'll keep my comments brief. I would just emphasize that the bill is addressing routine reappointment. So if an issue does arise related to physician performance, there are processes in place to address the concern and take action immediately.

The bill would simply reduce administrative work for practitioners with no identified performance concerns. Respectfully request your aye vote.

Are there any others in the hearing room who would like to register support?

George Soares of the California Medical Association in support.

Are there any primary witnesses in opposition?

Any who would like to register opposition?

Seeing none, I will bring it back to the committee for comment or question.

Moved by Gonzales, seconded by Sanchez. With that Assembly member, would you like to close?

Respectfully ask for an aye vote.

The motion, that has been seconded is concur in Senate amendments. Secretary, please call the roll.

[roll call]

That measures out. Thank you. Assemblymember.

Thank you.

We need to lift the call on one bill. Item number 3, a B2405 by Gibson.

Sanchez? No.

Sanchez, no. Carrillo? Mark Gonzalez? Mark Gonzalez? Not here.

Johnson? Patterson?

Yeah.

Patterson, no. Rodriguez? Aye. Rodriguez, aye. Sharp Collins?

That

measure is now out. We will hold the roll open for three minutes for anybody who would like to add on to any of these measures. It is 09:35. We'll run through the agenda right now for any add ons.

Adding on item one, AB 1199 Patterson. Carrillo, Mark Gonzales, Johnson. Aye. Johnson, aye, Sharp Collins. Add ons for item two, a B2093 by Bauer Kehan.

Carrillo, Mark Gonzales, Johnson? Aye. Johnson, aye. Sharp Collins? Adding on to item 3 a B2405 by Gibson, Carrillo, Mark Gonzales, Johnson?

No. Johnson, no. Sharp Collins. Adding on to item 4 a B2499 by Gibson, Carrillo, Mark Gonzalez, Johnson? Aye.

Johnson, aye. Sharp Collins.

All those measures are out, and we are now adjourned.