Assembly Business And Professions Committee

Thank you. Thank you. Thank you Thank you. Thank you. Thank you Thank you. Thank you. Thank you Thank you. Thank you. Thank you Thank you. Thank you. Thank you Thank you. Thank you. Thank you Thank you. Thank you. Thank you Thank you. Thank you. Thank you Good morning everybody It is now 9.07. We have no authors. We have no Republican assembly members. So we have no ability to start a hearing. So if we can get one Republican assembly member, Joe Patterson, I'm looking at you. And if we could get one senator to come present their bill, our options are Senators Umberg, Dr. Weber Pearson, Ochoa Bogue, Nilo, McGuire, or Richardson, we'll have a hearing. If we can't get – we don't need a Republican Assembly member, so if we can just get a senator to present their bill, then we'll start the hearing. If we can't get a senator to come and present their bill by 9.15, we'll adjourn the hearing. So that's seven minutes from now. Thank you. Thank you. Thank you Senator Richardson gets the prize. Don't we all right now? Don't we all? Thank you, Senator. So actually, as you're coming up, this is my mistake. I didn't dispense with all the formalities. Good morning, everyone. Welcome to this morning's meeting of the Assembly Business and Professions Committee. Thank you to Assemblymember Patterson for joining us on the committee for purposes of today's hearing, subbing in for Vice Chair Johnson. There are a total of seven bills on today's agenda and no bills on consent. Before we begin with today's agenda, I want to remind everyone that the Assembly has rules to ensure we maintain order and run an efficient and fair hearing. We apply these rules consistently to all people who participate in our proceedings, regardless of the viewpoint they express. In order to facilitate the goal of hearing as much from the public within the limits of our time, we will not permit conduct that disrupts, disturbs, or otherwise impedes the orderly conduct of legislative proceedings. For each of the measures being presented today, we will be allowing primary witnesses here in the room to speak for up to two minutes each with up to two primary witnesses per side. Any additional witnesses will be limited to name, position on the bill, and the organization they represent, if any. For those wishing to provide further comments, we are accepting written testimony through the position letter portal on the committee's website. With that, happy to start today's hearing. Senator Richardson, thank you for joining us.

Thank you, Senator. Do we have any primary witnesses in support? Seeing none, anybody who wants to add on in support of the bill? Nope.

Thank you. That's a technical term, messed up. Any primary witnesses in opposition to the bill? Come on up. You've got two minutes. Go ahead.

public cemetery districts would be wholly inappropriate targets of leveraging past land use decisions against something that they were uninvolved in and played no role in. Public cemetery districts are also distinct from cities and counties in that they have no general purpose revenues. Public cemetery districts are funded primarily through taxes and assessments or fees for services. They are ill-equipped to absorb the financial shock associated with the sudden transfer and sudden inheritance of an abandoned endowment care cemetery site. And therefore, this bill creates a problematic endpoint and a problematic dumping point for these abandoned endowment care cemeteries. However, it is not unreasonable to think that some public cemetery districts may be able to appropriately shoulder the burden associated with these abandoned cemetery sites. In those instances, it is most appropriate that these cemeteries be granted the ability to express their affirmative approval before they are transferred to these abandoned cemeteries and all the rights, responsibilities, and obligations arising therefrom. Therefore, we believe that SB 1312 should be amended to require the express affirmative consent of a public cemetery district before any such transfer is effectuated. Thank you very much. Thank you. Any additional witnesses in opposition to the bill who want to add on, provide your name, come on up, provide your name, organization you're with, if any, and position on the bill? Sarah, on behalf of the rural county representatives of California and the urban counties in California, we're actually a tweener. We have concerns based on the timeline this bill is moving and the work that still needs to be done to make sure a lot of the technical issues with implementation are addressed, as well as including other provisions that are missing that were part of the rapport, like making these a memorial park cemetery, which really would address some maintenance issues and some other issues around the insufficiency of the liability provisions. Thank you. Thank you. Good morning, Eric. On behalf of the California State Association of Counties, I would align my comments with those of my colleague with RCRC. Appreciate the senator's work. Looking forward to more of that. Thank you. Thank you. Any questions or comments from colleagues? Seeing only Democrat colleagues. Still no Republicans. Senator, would you like to close? Normally I close very rapidly, but I think I do need to respond to the witnesses' comments, which were he presents well, but I think leaves out some facts. We're actually taking some steps. Today, what we're working to do is, number one, to define officially, legally, that when a cemetery becomes abandoned, so then the Consumer Bureau can actually begin to take some action. Right now, because a private entity would own a property, you first have to go through that legal part before we can do anything because we can't take over someone's property without their knowledge, without due process, and so on. So really, much to my comments of the witness, I would much rather be having the discussion he just had, but we're not there yet. That's next year. Stay tuned. And I look forward to working with you on it. What the public cemetery district the role of a public cemetery district that we have talked about thus far is and that was not described by the witness is that when a city or county if they would then be deemed to be responsible for a cemetery public cemetery districts exist. And so what has initially been discussed is if an existing public cemetery exists where a abandoned cemetery is, then there would be the opportunity for it to either one go into the existing public cemetery district or to have a new one created. But it is by no means the suggestion of myself that the public cemetery districts would have to incur that cost themselves. That is, stay tuned for next year, where we're going to have to discuss what will be the monetary requirements for public cemetery districts, for counties, for whoever, when we're going to have to deal with this problem. But right now, we're strictly trying to address the issue of identifying legally that a cemetery is, in fact, abandoned, and then to discuss how can we resolve the title. Because, unfortunately, it would be wrong of us to expect the public cemetery districts to do any work if they actually did not have title to the property. And then finally, it is the intention of the Bureau, which is what they currently do, would be to disperse those endowment funds that do exist with some of these cemeteries. Those endowment funds would be then passed on to the public cemetery district and hopefully additional funds that I'll be fighting for to make sure that they'll be able to adequately do their work. So I thank you for the testimony for those who spoke, and I look forward to working with all of them to continue to flesh out an effective policy that will certainly incorporate the comments of the witnesses today. And with that, I respectfully ask for your aye vote on this bill, 13-12. Thank you, Senator Richardson. When this committee heard SB777 last year, our commitment was to consider a bill this year to pursue a solution to the abandoned cemetery issue following the submission of the Bureau's workgroup report. And I very much appreciate your cooperation through this process. I also just want to say I appreciate you taking on this issue because it is such a big, important issue. It's only going to become a bigger issue in the coming years and decades. And it wasn't one that colleagues were tripping over themselves to take on, but it needs to be addressed. And so I appreciate you championing the issue of abandoned cemeteries. Given the short timeline we've been working with, with the Bureau's report just coming out, I think, two weeks ago, So I understand that there will still need to be further conversation with local stakeholders, like you mentioned, Senator, and that the language in this bill will need to be reconciled with what the Bureau has since provided. This bill will be going to local gov after this committee, so there's more time to have those conversations. And I know a lot of those issues fall under their purview and not necessarily ours. So I'm happy to support the bill in BNP today and wish you luck with that conversation in local government. We don't have a quorum yet, but as soon as we do, I'm sure we'll have a motion in a second. Thank you very much. Senator Umberg, good to see you, sir. You've got SB 758, agenda item number one. I only been here 14 years so I pleased to present SB 758 I want to thank the committee's chief consultant, Robert Sumner, for his assistance, hard work on this bill. I'll be accepting the committee amendments, which remove convenience stores from the nitrous oxide sale exemption list. The purpose of SB 758 is to restrict the sale of nitrous oxide. The easy access point of nitrous oxide at smoke shops and convenience stores has led to a rise in harmful misuse over the last decade. Recreational inhalation of nitrous oxide can cause long-term neurologic effects, paralysis, and even death. Those products are not FDA approved and have raised alarms due to an increase in poison control calls. With me here to testify in support of the bill is Jolena Voris with the California League of Cities. Thank you, Mr. Chair. Mr. Chair and members, Juliana Voris on behalf of the League of California Cities. We're proud to be a co-sponsor of this bill. As the senator indicated, nitrous oxide is an odorless gas and is supposed to be used for dentistry and food preparation. Over the past several years, nitrous oxide, also known as whippets, laughing gas, has emerged as significantly and largely unaddressed concern across the United States. Once considered a relatively obscure issue, recreational abuse of nitrous oxide has increased at alarming rates, particularly among teenagers and young adults. Despite its legitimate use in dental and medical and culinary contexts, nitrous oxide is frequently diverted for recreational use due to its low cost and easy accessibility. California law currently prohibits sales for recreational purposes, but however, in practice, what's going on is that at these smoke shops and convenience stores, they're putting on a label that says it's for food prep and selling it without much restrictions or any legality. medical authorities have documented the serious health risks associated with recreational use of nitrous oxide, including association paralysis and permanent neurological damage. Probably approximately 25 cities have already passed bans on nitrous oxide. And when we saw that last year, we thought it would be easier to do a statewide solution than have every city adopt these ordinances. So SB 758 would address the proliferation of these illegal sales by prohibiting the sale of nitrous oxide at those retailers with a tobacco license except for grocery stores. As the senator said, we're trying to ensure that it still would be effective at smoke – this ban would be effective at smoke shops and convenience stores. And with that, we are pleased to support and urge your aye vote. Thank you. Thank you. Go ahead. Good morning, Mr. Chair and members. Ryan Shermer with the California Narcotic Officers Association, also a proud co-sponsor of the bill. I agree wholeheartedly with the comments of my colleague and the senator as well. We're just grateful to be here, thankful for the author. Our members see daily the dangers of intoxicating substances posed to our communities, families, children, and for these reasons, we strongly support the bill. I can go on, but I think the point's been made. Thank you, sir. Thank you very much. Any additional witnesses who want to add on and support? Come on up, provide your name, organization you're with, if any, and position on the bill. I'm going to call on behalf of the Orange County Board of Supervisors and support. Thank you. Kasha Hunt with Political Solutions on behalf of American Academy of Pediatrics and support. Thank you. Good morning. On behalf of the City of Carlsbad and El Cerrito, Kendra Bagley in support. Thank you. Ashley Walker with Nassim and on behalf of the City of Ventura in support. Thank you. Paul Yoder, good morning, Chairman and members. On behalf of the counties of Tulare, Kern, and Humboldt, and also the California State Association of Psychiatrists in support. Thank you. Thank you. Mandy Strela on behalf of Rethink Waste in support and apologize for the late letter. Thank you. Good morning. Amy Jenkins on behalf of the rural counties of California and strong support. Thank you. Thank you. Any primary witnesses in opposition to the bill? Seeing none. Anyone wants to add on in opposition to the bill? Or be a tweener on the bill? Nothing. All right, colleagues, someone were at us. Thank you. And thank you so much, Senator, for bringing this forward. I just want to say I I appreciate the bill. If you're taking co-authors, I'd be happy to co-author the bill. Super important issue. Thank you. We'd be honored to add you. Thank you. Thank you. And if we get Corham while I'm here, I'd be happy to move the bill. I don't know if we will, but. Not yet. Fingers crossed. Text your friends. Any additional questions or comments from colleagues? Dr. Jackson, any questions or comments on Senator Umberg's bill? No, not at all. All right. Senator, would you like to close? Thank you. I want to thank Ms. Morrison, League of Cities, as well as Mr. Sherman for their support, and I urge an aye vote. Thank you, Senator Umberg, and to your sponsors for your advocacy on this very important issue. This is the second hearing in a row that we've heard, Bill, on this really important issue. I absolutely agree that we need a variety of approaches to address the serious problem of nitrous oxide misuse. Totally agree that a statewide approach is always better than 300-plus city-by-city approaches. So I'm very happy to support this bill today as part of that holistic effort. And I'm sure you'll have many motions in seconds when we get a quorum. Thank you, Senator. All right. Thank you, Mr. Chair. Thank you, members. Dr. Weber Pearson, good to see you. You have two bills, SB 849 and SB 1094, and we'll hear them in whatever order you prefer. Great. We're going to start with SB 1094. Well, good morning and thank you, Chair and committee staff, for working with us to improve this bill. I am planning to take the amendments in the health and safety and insurance code we'll be taking up in the Assembly Health Committee. This includes some of the issues that you and I have discussed, Chair Berman, which will require health plans and insurers to notify providers about this bill, and that beginning January 1, 2027, their patients who are on a reference biologic will be eligible for a pharmacy substitution of biosimilars on the formulary, listing patients and possible substitutions. The intent with this amendment is to let prescribers know in advance that their patients' medications may be substituted at the pharmacy, And if there are any clinical concerns with this substitution the provider can reissue the prescription and indicate do not substitute Other amendments that will be taken in Assembly Health will provide more detail in the required notice to patients and providers when there is a formulary change regarding AB-rated generics, biosimilars, and interchangeable biological products and expand the advance notice from 30 days to 60 days. Another amendment will prohibit a PBM health plan or insurer or affiliated entity from requiring utilization of only a biosimilar product in which the entity has a direct or indirect financial interest when other biosimilars may also be available. Healthcare affordability is one of the top concerns here in California. Over half of Californians report healthcare costs rising faster than their incomes and 60% report that they or a family member has skipped medical care due to cost. One of the underlying drivers in rising health care costs is the cost of prescription drugs, which has increased by 72% since 2017. Biological products are particularly expensive, costing hundreds to thousands of dollars per injection. These are critical treatments, but their high price tag are putting a real strain on patients and our healthcare system in general. Fortunately, lower-cost alternatives like generics or biosimilars offer the same clinical result as their brand-name counterparts. But over the past decades, studies have consistently shown that switching from a reference product to a biosimilar is not associated with any clinical significant difference between safety, efficacy, or the immunogenicity. Despite having many safe, effective, lower-cost alternatives available, we are still not using them to their full potential. This bill offers two practical ways to encourage biosimilar use to bring down cost and inject more competition into a system that brand-name pharmaceutical manufacturers have controlled for far too long. First, it allows for pharmacists to substitute a lower-cost biosimilar for biologic when appropriate, unless the prescriber indicates otherwise by adding do not substitute to the prescription. And second, it allows health plans to require patients to try a generic or biosimilar unless a prescriber indicates otherwise by adding do not substitute to the prescription. and the plan is, in this current version, is required to provide 30-day advance notice to the provider, which we've stated we will be changing that to 60 days. This bill only allows health plans to require a patient to try a biosimilar when the net cost of the plan's biosimilar is lower than the reference product and the patient's cost sharing is the same or lower than the reference product. The bill also requires health plans to report on the impact of this policy on premiums and patient cost sharing. According to the Chiburb analysis, this bill is estimated to generate savings for patients and our health care system, including $4 million in cost-sharing savings for those patients who switch to a biosimilar, and $90 million in savings in the form of reduced premiums for employers, enrollees, and Medi-Cal. At its core, this bill is about affordability, safety, and access, which are key components for adherence to any treatment. It is about making sure that Californians can get the care they need without having to choose between their health and their financial stability With me today to explain how this bill will make health care costs more affordable while maintaining high quality care is Nick Luis from California Association of Health Plans and Dr. Kiran Bairang from Western Health Advantage. Thank you. And you have two minutes each. Thank you, Chair and members. Nick Luisos on behalf of the California Association of Health Plans. We're the proud sponsor of SB 1094 and thank Dr. Weber for her leadership on this critical affordability measure. Policymakers have rightly declared affordability a top priority, and I think most average citizens would agree. And this is why our association is actively working to promote policies like SB 1094 to drive down spending while expanding access to FDA-approved drugs that are safe and effective, thus making health care more affordable and accessible for all Californians who depend on health plans and their providers for their care. The senator went over the data on rising drug costs, but the independent analysis of this bill is clear. As the senator stated, it offsets premiums by tens of millions of dollars and is projected to lower out-of-pocket costs for patients. And I'll just add, in my two decades of lobbying for this trade association, I've reviewed countless independent reports. And although one may exist, I can't remember a CHBRP analysis, which is the independent body that looks at these bills, showing a decrease in premium growth until this bill. So it's pretty momentous from that perspective. SB 1094 is very simple. It achieves these results by simply updating outdated statutes to reflect modern science. It aligns California with FDA clinical evolution and Medicare policy, allowing for the automatic substitution of safe, effective, and lower-cost biosimilars. This is a common-sense update that expands access to life-saving medications without compromising safety. It's carefully crafted with robust consumer protections. And as the author stated, those protections will be expanded in the next committee, transparent notification rules, and rigorous reporting requirements on behalf of my members. And that is why you see such a broad and diverse coalition in support of this bill, ranging from labor, business, and other advocates. And so we need more solutions like this, and we respectfully urge your I vote. Thank you. Thank you. Good morning, Chair and members. My name is Dr. Karen Byring. I serve as a chief pharmacy officer for Western Health Advantage, and I am here to support SB1094. As a pharmacist with more than two decades of experiencing managing medication access and affordability, I have seen firsthand the positive impact biosimilars can have for patients and the health care system. SB 1094 allows pharmacists to substitute FDA-approved biosimilars unless the prescriber indicates otherwise. So I think that's a very important indication the prescriber is still in control. This not only helps our patients receive safe and effective lower-costing treatments while preserving the patient and provider autonomy and decision-making. At Western Health Advantage last year, we transitioned our entire book of business for patients using Stellara to a FDA-approved biosimilar. Each one of our patients were handheld through the process, through proactive physician engagement, patient education, pharmacist-led coordination, and through that we achieved an exceptionally successful conversion with no member abrasion no disruption in care and continued positive clinical outcomes Our experience demonstrates what evidence has already shown Biosimilars are safe effective and can reduce unnecessary health care spending while maintaining high quality of patient care. SB 1094 provides pharmacists with an important tool to help Californians access these therapies more efficiently and affordably. For these reasons, I respectfully ask for your support in SB 1094. Thank you for your time and consideration. Thank you. Any additional witnesses want to add on in support of the bill? Come on up. Provide your name, organization you're with, if any, in position on the bill. Morning, Chair and members. John Cherican on behalf of the Association of California Life and Health Insurance Companies in support. Thank you. Good morning, Chair and members. Beth Malnowski, registering support on behalf of SCA California, also registering support for health access. Thank you. Thank you. Good morning, Natalie Pita on behalf of the California Academy of Family Physicians in support. Thank you. Alexis Rodriguez with the California Chamber of Commerce in support. Thank you. Thank you. Thank you, Mr. Chair and members. David Gonzalez on behalf of America's Physician Groups in support. Thank you. Good morning, Mr. Chair and members. Andres Amides with Blue Shield of California in support. Thank you. Good morning, Mr. Chair and members. Sean Hoffman with the Pharmaceutical Care Management Association in support. Thank you. Chair and members, John Winger on behalf of America's Health Insurance Plans in support. Thank you. Good morning, Al Austin on behalf of AFSCME California and AFSCME Council 57 in strong support. Thank you. Good morning. Justin Faisal on behalf of CVS Health in support. Thank you. Any primary witnesses in opposition to the bill? Come on up. You have two minutes each. Chairs and members, I'm Dr. Michelle Min. I was recently appointed medical director of my dermatology department, and I prescribe biologics numerous times a week. In addition to skin cancer, dermatologists treat chronic inflammatory skin diseases. For severe disease, we previously relied on cumbersome in-hospital treatments for broad immunosuppressants, so biologics have been a game changer. I'm here today on behalf of CalDerm, which has an opposed-unless-amended position on this bill because it increases patient risk by allowing pharmacists to substitute any biosimilar, not just those that are interchangeable. To clarify, I overall support biosimilars and appreciate their cost savings, but the decision about which drug to prescribe to which patient should remain the physicians. Increasingly, non-providers are making medical decisions for patients they've never met based on cost. A switch in therapy can flare disease due to gaps or inferior efficacy, even if slight. I want to introduce you to a woman with hydradenitis, a horrible condition that impacts young patients. She initially had painful, foul-smelling, draining lumps of her chest and groin. She regularly missed work and refused to date. After years, we finally found the right biologic. However, once she was doing well, her insurer switched her to a biosimilar, which we later realized was on back order, so not available, forcing us to go through lengthy paperwork again. With a gap in therapy, she flared. When we finally did start a biosimilar, she didn't respond the And because biosimilars are not exact copies, new problems can arise. One of my patients with Crohn's disease had been doing well on Humira for years, but was then forced to switch to a biosimilar. Not only did his Crohn's flare, he also developed new painful ulcerating rash of his legs requiring hospitalization. His new treatments have caused depression, trouble breathing, and liver toxicity, and now insurance won't approve the next biologic. Finally, I add that because the nature of biologic switching back is not that simple, time off biologics can lead to antibody development and resistance. My patients trust me to make decisions based on their individual cases. We believe allowing substitution by a pharmacist for biosimilars increases risk to our patients. Thank you. Thank you. Thank you, Chair and members. Tim Madden represented the California Rheumatology Alliance with an opposed and less amended position. The analysis for SB 1094 does an excellent job at pointing out the policy concerns rheumatologists have with the bill. To illustrate the complexity in treating patients with rheumatoid arthritis, there are over 100 medications that can be utilized to treat the disease. There are 10 distinct biologic types, which include brand names like Humira, Enbrel, and Remicade. If you include the biosimilars of these biologics, the number is more than 25. This helps explain why it can take months, if not years, of patients trying different medications to find the right one to help them be free from the pain that they've been suffering. Once the patient is free from the painful symptoms, it doesn't mean that they're cured. They're simply in remission. They are one flare-up away from being right back where they started when they first went to the rheumatologist. This is why it is so important for a physician to be involved when a pharmacist intends to switch a patient to a different medication. That involvement before a switch is made does not happen today. and with SB 1094 allowing the pharmacist to switch non-interchangeable biosimilars, it becomes even more important. The proponents and author respond to this by saying, if the physician is concerned about switching, they should just mark the do not substitute box. This option is an illusion of choice. Speaking with multiple rheumatologists, each of them shares stories of marking the do not substitute only to then have the prescription denied by the health plan. Once the prescription is denied, the physician is then forced to go back through the prior authorization process that adds delays to the patient receiving their medication, risking a flare-up. Many times, it also ends up with the health plan only approving a different medication than what was initially prescribed when marking the do not substitute box. If the intent for checking the do not substitute box is to prevent a substitution, SB 1094 should simply be amended to state that protection very clearly. It does not do that right now. Until the bill is amended, to accomplish this along with our other suggested amendments, we respectfully ask for your no vote. Thank you. Any additional witnesses you want to add on in opposition to the bill? Come on up, provide your name, organization you're with, if any, in position on the bill. Jennifer Snyder with Capital Advocacy on behalf of the Biotechnology Innovation Organization. We have an opposed unless amended position. Thank you. Good morning, Alex Kahn on behalf of the California Chronic Care Coalition and respectful opposition. Thank you. Gilbert Lara here with Biocom with an opposed unless amended position. Thank you. Matt Back representing the Osteopathic Physicians and Amgen, both opposed. Thank you. Any additional witnesses? Seeing none, bringing it back to colleagues for questions. Excuse me, we have a quorum. We're gonna take a little break to establish the quorum. Madam Secretary, please call the roll. Berman Here Patterson Addis Aarons Alanis Baines Barakahan Colosa Chen El Huori. Hadwick. Haney. Hart. Irwin. Jackson. Lowenthal. Here. Macedo. Quinn. Pellerin. Here. Great, we have a quorum. I'm gonna go to Senator Pellerin and then Bauer-Cahan. Got a motion? Thank you. So thank you. While I appreciate the goal of lowering prescription drug costs, can you just explain to me the specific safeguards in SB 1094, what they provide to ensure that patients who are stable on a medication are not harmed by this non-medical switch and how patients can effectively appeal or opt out of that switch when their physician believes it's not in their best interest? Thank you. Thank you so much for that. And I'm not sure if everyone was here or was listening to me at the beginning when I was talking about the amendments that we are taking because of timing, we're going to have to take it in health committee. But ensuring that providers have the final say as a provider myself who treats many of these conditions like HS has always been extremely important to me. And so we've been trying to work on making sure that we at every possible angle, the provider will get a chance to state whether or not he or she would like their patients switched. So what the amendments will do is that 60 days prior to the medication being placed on the formulary, the insurance company will inform the doctor of the switch. and not just the basic generic information that we get right now when something's coming on a formulary. It will actually tell the doctor, your patients, John, Jane, and Jim, will have this on their new formulary and may be switched over. That will let the patient, the doctor know, oh, John, Jane, and Jim, John shouldn't be switched. Let me go in and change his prescription and put do not substitute. In this bill, because of issues that happen, even now, if I do not substitute on a generic, I may have to go through hoops and bounds to get that done. On this bill, if a provider puts do not substitute, he or she does not have to go back for an authorization, and the pharmacist will not substitute. So that is in this bill, in the amendment. So some of the concerns that you were raising, we've already addressed with the amendments. So that's 60 days prior to any switch happening. The providers will always be notified of a new change of the formulary. Now, another issue that came up when I was speaking to Chair Berman is that currently there are already some biosimilars on formularies. And so there would be no switch notification. And that's why I stated at the beginning, January 1st of 2027, all providers who have patients on reference biologics will get a notification of the new law and any patients that may be switched as a result of that. So there will be ample notification the ability for providers to determine whether or not their individual patient should be switched over to a biosimilar and the fact that once they put do not substitute that must be honored and there will be no extra hoops that they must go through in order to get it approved Okay I appreciate that And then what about the situation when you come in to get a refill of your medication that not substituted but it not available Is there a way in an emergency like that? I'm particularly concerned about people with mental health medications that have to stay on track. And at that point, can it be back to substituting as a catch-all in the event that the original medication is not available? So I'll turn that over to the pharmacist. That has nothing really to do with this bill because that's just an issue that we have now, right, whether or not a drug is actually available. That is not particular to this bill, but I will let the pharmacist talk about what happens when you go to a pharmacy and your medication is not available. Very important question, and I appreciate the question because, you know, if you've been following pharmacies, you know that through the COVID pandemic, there have been significant shortages in medications. When there is a shortage, it is the pharmacist's due diligence to ensure the patient continues to have access. So things that we allow pharmacists to do, they can transfer that prescription to another pharmacy that will have available stock. They can work with the patient to identify alternatives, which would require them to have a new prescription from a provider. So let's say the medication is not available. We searched high and low. We searched home delivery. It's not available. We as a pharmacist cannot switch the patient without a provider being engaged and prescribing that requested alternative drug.

Thank you for those answers. I appreciate it. Senator Barakahan.

Thank you.

Senator Hart.

Thank you. Senator Radice. Oh, excuse me. I apologize. Senator Radice. Vice Chair Patterson. And then Senator Radice.

Temporary Vice Chair Patterson.

Thank you, Mr. Patterson. Thank you.

plans talk about what will happen if the patients don't actually see the savings. But, you know, as you pointed out, the zero to six dollars are for patients who aren't currently on biologics, right? So they're not, you know, having some of these high costs. And yet they still do, They still will see savings, even if it is a dollar or two. But the reality is, as I stated at the beginning, since 2017, our health care costs have gone up by 72 percent. And anything that we can do to have some savings is better than nothing. The vast majority of the bills that we do actually add cost to our ever-growing cost of our health care system. I think this is the first bill that I have had that actually saves anything. And so, you know, when we talk about health care cost savings, yes, we want to touch individuals as well. But we're also talking about an entire system where some people happen to be contributing more. Some people may be on different types of medications and having to pay out of their pocket more. And so you're not going to see an equal balance across everyone here in California. But the reality is that we need to do something, and this is a part of that something. But I will turn it over.

The only thing that I would add to that is we believe that the cost savings associated with this bill would probably grow over time. There are about 188, I believe, is the number of biologics that are going off patents. And so those will be open to competition. And so the more biosimilars there are on the market, the greater opportunities there will be for savings. And so I think the CHBRP analysis is a snapshot in time, and I think those savings will grow over the years.

I guess on that I certainly appreciate the idea of competition in the market It the concern though is you know say the report comes out the savings haven been passed on to patients I love having an annual report on things. And, of course, we want the data. But ultimately, as we're lowering costs, we are making changes for people's lives. And so they're going to want to know that that positively affected their pocketbook. if there's something they're giving up. And so over time with competition in the market, how does that, how do we make sure that patients actually get that? And that doesn't just become absorbed by the kind of quote unquote rising cost of healthcare that supposedly we can't do anything about. No, is that a question to me or?

So this is one puzzle piece in the affordability equation. We strongly believe, and the independent report plainly lays out, that this will offset premiums by hundreds of millions of dollars and result in cost-sharing savings to the consumer. The first step towards the goal that you're talking about is transparency, which is why we agreed at the author's insistence to have this report. And so we already do a prescription drug pricing report. It's called the SB 17 report that's been in place for a number of years. And so our plans already provide data to the Department of Managed Health Care about drug spending and what that means. It also includes what the savings are, what the offsets to premiums are as a result of rebates. So I imagine the way the report would come out would also show a line for biosimilars.

Thank you. And you have a very broad range of support. It's not often that you see the chamber and the unions coming up at the same time. So I certainly appreciate that. And my colleagues asked very good questions. I have a big concern about the do not substitute, and you certainly have answered that. We do know now that if a physician says do not substitute, that there are a lot of hoops that they have to jump through. But as we're talking about cost savings, what is now the physician's motivation to agree to a biosimilar with this bill if they're able to say let's just keep a stable patient on the current drug? So I think –

Well, you know, every patient is different, right? And so you may have a patient that you were able to place on a biosimilar or a biologic and they were stable from day one. They may do just fine switching over. You may have another patient where it is taking you a very long time to get them stable on a particular medication. You may have had to switch and try multiple things. that's not a patient that I would want to switch. And so as a provider, you look at each patient and each patient's course differently. And so for me, that's what would drive me, is how difficult has it been to get you to a place of stability? And I would not want to risk switching you over. Now unfortunately fortunately whatever my patients are switched every day unfortunately to a generic And so I look at a biosimilar like a generic Some of my patients do perfectly fine. The vast majority of them do perfectly fine. Some of them start having some symptoms again. And if I've had a patient that I've had to try many different medications and I don't want them switched, then that is when I'll say do not substitute or check the DAW. So it's really dependent on the particular patient and the course that they've had with their treatment. But again, the physician doesn't have necessarily – I understand what you're saying,

Well, we don't – for the most part, we don't get into cost because we don't know how much things cost, and we don't know what insurance, like when I go and see a patient, I don't look to see what insurance are you on and do I know what drugs are going to be covered under your insurance. We don't generally get into that area and say, we're going to prescribe this for you because it's cheaper or this because it's more expensive. We're prescribing based on your condition or your symptoms. and the financial part is dealt with outside of us. So that's not something I don't go in and write a prescription because this medication is cheaper. I don't know if it's cheaper. I don't know if what I'm specifically prescribing your insurance is going to cover because I don't know if you have Blue Cross, if you have Sharp, if you have a different – we don't generally move in that direction. That's not how we practice.

If I may, again, that would happen in an ideal world. There is not often open dialogue. We're not here to argue over what happens at the insurance companies. I'd like to move the bill because this is too much. If I may, the pharmacist does not often openly speak with the provider. They don't work in the office, so there isn't that much dialogue. As someone that prescribes lots of biologics, that's different than a generic med.

Okay.

Well, thank you. I really want to thank the committee for this very robust conversation. I think the more people talk about the fact that it's important for providers to be able to have that ability to say do not substitute, the more it helps the outside world understand the importance of it as well. And, you know, we are facing healthcare affordability crisis in this state, actually in this nation And we need to do all that we can to ensure that we are lowering costs But at the same time, still able to provide high quality care And this bill gives that balance to lower costs but still gives providers the opportunity to ensure that their patients are on the right medications and actually gives them more ability than what we actually have currently with any other medication to not have to go through another prior authorization, to not have to jump through hoops, to not have to wonder if when we say do not substitute if that will be honored. This bill is stronger than anything that we have currently in health care practice today here in California. And so with that, I respectfully ask for an aye vote.

I'm here to present SB 849, a bill that addresses physician sexual misconduct. I would like to start by accepting the committee amendments. According to the Business and Profession Code, Section 2001.1, protection of the public shall be the highest priority for the Medical Board of California in exercising its licensing, regulatory, and disciplinary functions. The physician-patient relationships involve significant vulnerability and relies on ethical judgment and integrity. Patients place extraordinary trust in their physician, and any violation of that trust, especially when it is broken through sexual abuse or harassment, should be disciplined to the greatest extent. In 2022, AB 1636 removed the medical board's discretion to reinstate a physician or surgeon who had lost their license due to sexual misconduct with the patient. At that time, the LA Times had reported instances where physicians committed acts of sexual misconduct against their patients. And in all of the reported instances, the physician had either their license revoked or the physician surrendered their license, but subsequently petitioned the Medical Board of California for license reinstatement. For that reason, the bill removed the board's ability to reinstate those individuals. But more recently, articles about sexual misconduct within the medical industry brought forth this issue again. AB 849 originally required the medical board to automatically revoke the license of a physician or surgeon who had committed specified sexual offenses against a patient and had their license subsequently reinstated by the board on or after January 1, 2020. Due to concerns from this committee on the risk of litigation and constitutional issues raised, we are removing that particular section. And the bill will now only prevent someone from seeking reinstatement if their license was surrendered while a board accusation was pending against them due to any active sexual misconduct or exploitation with a current or former patient or client. This ensures that a licensee cannot try to get ahead of the process by surrendering their license before an investigation of misconduct is completed and before their final hearing from the board. Additionally, as mentioned in the committee analysis, I would like to clarify the inability for physicians who have committed improper sexual acts to renew their license. Due to short timing, we were not able to include that clarification in the most recent round of amendments, but we will continue working with the stakeholders to make sure that change is present down the line. Thank you, and I respectfully ask for an aye vote on SB 849.

George Torres with the California Medical Association in support.

Aaron Bone with the Medical Board of California. We're a tweener. We appreciate the committee's analysis and working with the senator and look forward to collaborating on future law changes to address physician sexual misconduct.

Thank you for your time and would respectfully ask for an iVone on SB 849.

As Sunniveau Radice said, thank you for your leadership on this important issue. We strongly support what you're trying to accomplish, and so really appreciate you working with the committee on the constitutional issue that got addressed in the accepted amendments.

Berman? Aye.

All righty, whenever you are.

Thank you. Good morning, Mr. Chair, Vice Chair, and members of the committee. I'm pleased to present SB 993, a bill that will restore previous protections for mental health professionals working in certain correctional and psychiatric settings by allowing these employers to limit the routine disclosure of a mental health provider's identifying information to patients. Mental health professionals working in correctional settings and other facilities face unique concerns as they work in some of our state's most challenging environments. They often work with individuals experiencing serious mental health challenges or with patients who have a history of violence. Providers should not have to face unnecessary personal safety risks simply because they choose to serve a population who needs critical care. Rather than waiting for safety concerns to arise, SB 993 limits the routine disclosure of their information, but also preserves accountability by requiring these facilities to provide an accessible complaint process for patients in correctional and psychiatric settings. Let me be clear. SB 993 does not remove any of the accountability procedures these facilities already have in place. Patients will continue to have access to a complaint process and licensing oversight will remain unchanged. These new safety measures will simply allow therapists and other professionals to feel safe enough to continue their work with vulnerable populations. California needs to recruit and retain qualified mental health professionals, which makes establishing safe working conditions and continued protection for our providers essential. With me is Carl Miller, President of the American Federation of State, County, and Municipal Employees, Local 2620, the sponsor of the bill.

Good morning, Mr. Chair and members of the committee. My name is Carl Miller, and I am president of AFSCME Local 2620, and I represent more than 5 health and social service workers employed by the state of California I am also a frontline licensed clinical social worker at the California Health Care Facility in Stockton And I thank you, Senator, for asking me to come to speak on this. Our members provide mental health services throughout California's correctional system, and we strongly support SB993. SB 993 restores critical safety and privacy protections for mental health professionals working in CDCR and DSH facilities. While SB 1024 was well-intentioned and appropriate for most therapeutic settings, it unintentionally removed longstanding safeguards that correctional clinicians have relied on for our safety. This bill helps protect clinicians from harassment, threats, and stalking by restoring appropriate professional boundaries. These protections are not theoretical concerns. A colleague of mine continues to recount the fear and distress she experienced after an incarcerated individual obtained information about her, stalked her, sent packages and other individuals to her home, and she ended up having to move. SB 993 also supports recruitment and retention of qualified mental health professionals.

Good morning, Mr. Chair and members. Malik Bynum with the County Behavioral Health Directors Association in support.

Good morning, Bindu Mukhamla on behalf of the National Association of Social Workers, California's chapter in strong support.

Good morning. My name is Aileen Sagala. I'm a licensed clinical social worker at California Department of Corrections, and I'm in support. Thank you. My name is Carla Tyson. I work in one of the biggest psychiatric inpatient yards in the state of California, and I urge you guys to please support this bill.

Good morning, Al Austin, on behalf of AFSCME California and AFSCME Council 57 in strong support. Thank you.

I hope you'll join me in supporting mental health professionals who deliver critical care that leads to positive outcomes for individuals in correctional facilities. I respectfully ask for an aye vote. Thank you very much.

Thank you, Mr. Chair and members. I appreciate the opportunity to present SB 1002. This bill is important, but it really is just a modest extension of the David Hall Act of 2023. That allows for eligible patients to access out-of-state care via telehealth with eligible providers. Under the David Hall Act, an eligible patient is someone with an immediately life-threatening diagnosis, meaning there is a reasonable likelihood that death will occur in a matter of months. An eligible physician and surgeon is required to be licensed in another state in good standing with no history of prior discipline, and their medical expertise must be that of the eligible patient's illness. SB 1002 seeks to allow patients that at one point qualified to receive out-of-state telehealth care under that act to continue seeing that previously established provider via telehealth if they receive remission. The bill is about access to care and continuum of care for these patients while preserving existing safeguards. Now, I am aware that some are concerned with any broader expansion of out-of-state telehealth care availability. This bill, however, deals with a very specific, very personal patient issue with significant, very significant emotional and vital care issues. Imagine. Imagine being given a cancer-related death sentence. Then, finding an out-of-state physician who treated you as allowed by the David Hall Act and you went into remission Imagine that joy Without AB 1002, that joy would then be crushed. Crushed when you find out that you can no longer rely on that lifeline with a now very trusted doctor. That, I'm afraid, is not only very poor consumer affairs treatment, it is totally insensitive and a complete disservice to the patient. That's why SB 1002 has had bipartisan support passing unopposed out of the Senate Business Professions and Economic Development Committee, as well as the Senate floor. So with me this morning, I'll pass this over in support of the bill to Robin Cloth, a member of the Senior Assembly.

Good morning. Excuse me. Good morning, chair and members. My name is Robin Clow, and I live in Santa Clarita and Campbell. I was wheeled into the operating room for thyroid surgery that was scheduled to take three hours. Nine and a half hours later, I was wheeled out to discover that my life would be forever changed. I was diagnosed with a rare and aggressive type of thyroid cancer known as anaplastic. The typical survival time for this cancer is four to six months. My daughter was expecting our first grandchild. I underwent seven weeks of simultaneous radiation and chemotherapy at Cedars-Sinai in Los Angeles. When the cancer returned, my physicians supported my decision to seek care at MD Anderson Cancer Center in Houston. I received a newly discovered targeted therapy that so far has been successful for me. It is uncommon for a bill to undergo a test run in public before enactment, but this is true for SB 1002. The pandemic led to federal and state executive orders allowing telehealth visits, which enabled doctors and patients to communicate about health issues across state lines. These executive orders have expired, though, leaving patients like me without life-saving expertise from specialists practicing outside of California. There are times when I have been too ill or weak to travel, and because I am immunocompromised, I was at risk of exposure to other illnesses. Telehealth visits are truly a lifeline. Patients in my anaplastic cancer support groups are desperate to receive care from specialists beyond California when needed. Some of us are in remission or with no evidence of disease. This does not mean we are cured. We're still in jeopardy of recurrence and require careful, ongoing monitoring by our out-of-state specialists. Continuity of care is critical I survived over three years and now not only have a grandson but have a granddaughter and just learned there another granddaughter on the way So please allow Californians struggling with cancer and other life-threatening diseases to receive the care they need. Thank you.

Natalie Peeta on behalf of the California Academy of Family Physicians in support. Good morning. Donna Matias on behalf of Pacific Legal Foundation here in support.

Good morning. Dr. Graham Press on behalf of the National Vehicle Residency Coalition here in strong support.

Good morning. Veronica Zaire, retired United States Army, in support. Thank you.

Heidi Hanneman, El Dorado County resident, breast cancer survivor and support.

Thank you, Mr. Chairman. Aaron Bone with the Medical Board of California. We understand the goal of the bill, but the board is respectfully opposed to SB 1002, as we believe that licensure is a vital form of consumer protection and ensures that physicians practicing in this state have met the relevant statutory requirements to treat patients here. We appreciate the committee's analysis, which indicates that without a license in the state, The board would be unable to discipline a physician who fails to treat our residents outside of the standard of care and points out the existing law that facilitates access to out-of-state physicians and their ability to consult with them on a diagnosis and treatment plan alongside a California licensed physician who is in charge of the patient's care. Furthermore, an out-of-state physician could simply seek a license from the board. Although we are opposed to this measure, we do appreciate the dialogue with the author's office and the sponsors, and we are open to collaborating on other law changes that would increase access to care while also preserving licensure requirements and related consumer protections. At this time, though, we must respectfully request a no vote. Thank you. Good morning, Chair and members. George Sorris with the California Medical Association. We're here respectfully opposed unless amended to SB 1002 by Senator Nilo. We understand that this legislation is well intended, but it would dangerously expand existing law, which was intended for people with life-threatening diseases who have not been accepted into a clinical trial in California. In general, granting license exemptions risk introducing physicians who may not be familiar with California's laws, regulations, and standards of care. As noted, out-of-state physicians who seek to provide care to California residents can apply for temporary license with the medical board. This bill creates an unnecessary loophole to that process. We understand the desire for some patients in remission to continue dialogue with out-of-state physicians. We believe our proposed amendments would allow for patients to consult with out-of-state physicians regarding medical opinions, such as receiving a second opinion, while protecting patients from a physician who would otherwise not be eligible to practice medicine under California law. For these reasons, we are respectfully opposed unless amended to this bill, and I'm happy to answer questions. Thank you.

Thank you. I also have known both of the opposing witnesses for a while, and I will second the comments of my friend and person with whom I share a representation in Placer County. but here's the deal with regard to their position it's fundamentally clinical and I get that they're concerned about any expansion any broader expansion of the David Hall Act I'm pretty sure that they were opposed to the David Hall Act in the first place so that's perfectly consistent but it's clinical They would probably say that this patient to whom I sort of fictitiously brought up but is backed up by reality in any case could get equal quality care by a licensed physician located physically in the state of California. And I won't challenge that necessarily. but recovery for health issues, especially one as serious as cancer. And I would say I am uniquely sensitive to that myself. My wife has had two bouts with cancer. So I've experienced that up close and personal. It is emotional. It is clinical. Yes, but it is emotional. And if you destroy the emotional part of that, you significantly compromise the ability for the clinical approach to be truly effective. And I just repeat again, imagine you are a patient that qualified for the David Hall Act and had out-of-state care and went into remission and then found out that that trusted lifeline that brought you, you believe, brought you to remission, that may not, in fact, clinically be true, but it is emotionally true, and you can't use that anymore. Now, maybe if you can afford to travel, there's an equity issue there. I just don't see, and this is a very narrow expansion, I just can't see how we could deny that patient the emotional comfort of continuing to deal with that trusted provider. I ask for an aye vote.

Hey, good morning, Mr. Chair, Mr. Vice Chair. Good morning, committee. I hope –

Hey, good morning, Mr. Chair, Mr. Vice Chair. to the committee Thank you so much for allowing us to be able to present SB 1263 Mr Chair I want to say thank you to your staff work to your work on this and of course we going to accept the committee amendments SB 1263 is our latest measure to be able to protect wildfire survivors from unscrupulous contractors and better prepare this state for large-scale post-disaster community cleanups. We've passed legislation over the last several years with bipartisan support That's increased the statute of limitations for unscrupulous contractors to perform shoddy work on post-disaster home rebuilds. We've required the state through CalRecycle to pre-qualify large contractors to perform wildfire debris cleanup and removal work, which has now expedited statewide debris cleanup efforts. And now we are in front of you with 1263, which has received bipartisan support thus far. It's pretty damn straightforward. It mandates only licensed general engineering, earthwork, paving, building, and demolition, along with general building contractors can perform post-disaster residential debris removal work. The bill also ensures that these three categories of contractors meet the baseline safety and training standards that protect workers, as we refer to HAZWAP. I know that is one of the chair's favorite terms. So we're working, Mr. Chair, directly with the Contractors State License Board on this measure. I'm grateful to the head of the board, Dave Fote, who is here today. He's going to be testifying. And I also want to take a moment to say thank you to Operating Engineers Local 3, who are always on the ground after these disasters and representing Local 3 today. We have Mike Pickens. I respectfully ask for an aye vote. Thank you.

Thank you, Mr. Chair. Thank you, Mr. Chair, Mr. Vice Chair, and members of the board. My name is Mike Pickens. I'm district rep for the Operating Engineers Local 3. I cover Sonoma Lake, Marin, and Mendocino counties. My area has been devastated by wildfires and disaster throughout the recent years here. We represent over 40,000 men and women in the construction industry who do this work, run out of equipment, keep our infrastructure running in Northern California. OE3 is proud to support SB 1263. We've worked hand-in-hand with Senator McGuire on several bills and legislation in the past, along with our efforts to ensure that this work is done to the safety of our workers and the fellow trades who are involved in that, as well as the residents and the citizens in the affected areas. In the aftermath of those events, we saw an influx of out-of-state contractors. There's none more importantly or more that stands out more to me than the Tufts fire in Sonoma County that we saw an influx of out-of-state contractors. And what we saw when we went out there and looked at the job sites was truly scary to see these contractors put these workers in that kind of environment to work in without the proper protections. This bill would ensure that those laws and standards are the level playing field, the bare minimum that contractors must do And to secure, you know, the safety of not only the workforce, but the residents Make sure there's no runoff, make sure that the particulate matter is being dealt with and watered down And not being dispersed into the atmosphere For us, worker safety is paramount That's what unions were built on That's where the eight-hour workday come from, the minimum safety standards that we enjoy today so to see to have a friend like center mcguire champion that for us is truly been a blessing for local three for the reasons i have stated operating engineers local three respectfully request an aye vote and we hope we can count your support thank you Thank you very much Good morning Chair Berman and members of the Business and Professions Committee I David Fote the Registrar for the Contractor State License Board

Thank you. Any additional witnesses in support of the bill?

Thank you. Any primary witnesses in opposition to the bill? Come on up. You've got two minutes.

removing mudslides, another material that's come down from the burn scars and have damaged homes. There's no burning, it's simply the removal of dirt and mud. We don't think it's necessary to require hazmat training or hazmat certificates for that type of emergency. Therefore, we have an opposed and less amended position. We have been in contact with the sponsors. We have been in contact with the authors. We think this is a real simple fix, and we would appreciate it getting fixed. Thank you, Mr. Chair. On behalf of SCCA, we have an opposed and less amended position. Thank you. Any additional witnesses want to add on in opposition to the bill?

Thank you. Any comments or questions or motions or seconds from colleagues on the committee?

Thank you so much, Assemblyman. And I want to say how grateful I am for your work. I know this has been very personal for you when it comes to wildfire. On the amendments that are in front of the committee that I know that there's been some concern with the special districts, and I don't want to speak for them. But thanks to the work of the chair, the debris removal definition has been refined. And then tree and palm contractors. And that's where California Special Districts Association was also concerned. And we have refined that definition and what activities that they can perform. So I do believe, I don't want to speak for them, but we've heard them loud and clear and working with them to be able to hopefully get them to neutral on this bill. And I want to say thank you to the chair for engaging on that. On SCCA, we're going to continue to have conversations, and our next stop on this train is going to be emergency management, and know that we're going to continue those conversations. You have my word on that, Assemblywoman, and continue working through.

Thank you.

Seeing no additional questions or comments. Senator, would you like to close?

Thank you, Senator. We're definitely closing out the hearing with a hazwhopper of a bill, but I couldn't help it. I couldn't. I'm a new dad. It's dad joke time. It's Father's Day week. It's the whole thing. I'm just going to lean into it. That's right. Appreciate your work on this bill. Appreciate your openness to working with concerned stakeholders and continuing to try to refine different definitions in the bill. Happy to support it today. You missed a terrible joke. Respectfully ask for an iVote. Thank you. All right. Sorry. That's me closing for your bill. Happy to support the bill today. Madam Secretary, please call the vote. On SB 1263 McGuire the motion is do pass as amended to the Committee on Emergency Management Berman Berman I Patterson Patterson I Addis Addis I Aaron's Aaron's I Alanis Alanis I Baines Baines I Barcahan Coloza Coloza I Chen Chen I Elhori Elhori I hadwick Hadwick I Haney Haney I heart heart I Irwin or when I Jackson Jackson I Lowenthal Macedo Macedo not voting when I'm sorry oh when when I Pellerin Pellerin I that bill is out thank you very much so we have We're going to open the roll for a couple of bills. We're going to add votes to a lot of bills. Yeah. Okay. So this is for SB 758 Umberg. Got a motion. Need a second for a bill that the chair supports. Got a second. Thank you. Madam Secretary, please call the vote on SB 758 with a share. I, Reco. On SB 758, Umberg, the motion is due passed to the Committee on Public Safety. Berman? Aye. Berman, aye. Patterson? Aye. Patterson, aye. Addis? Aye. Addis, aye. Aarons? Aarons, aye. Alanise? Aye. Alanise, aye. Baines? Baines, aye. Bauer-Cahan? Coloza? Coloza, aye. Chen? Chen, aye. El-Hawori? Aye. El-Hawori, aye. Hadwick? Aye. Hadwick, I. Haney. Haney, I. Hart. Erwin. Erwin, I. Jackson. I. Jackson, I. Lowenthal. Macedo. I. Macedo, I. Wynn. Wynn, I. Pellerin. I. Pellerin, I. That bill is out. We're just going to take it from the top and run through the file. on SB 849 Weber Pearson Alanis Alanis I Baines SB 849 Weber Pearson Baines I Barricade of Colosa Colosa I Haney Haney I Nguyen I Pellerin Pellerin I that bill is still out On SB 993 Ochoa Bogue Alanis Alanis I Baines Baines I Colosa Colosa I Haney? Haney, I. Yeah. This is going to be – we're going to open the roll on agenda item number 4, SB 1002. The chair has a no recco on this bill. On SB 1002 Nilo, the motion was due passed to the Committee on Appropriations. Baines? Baines not voting. Barcahan? Haney? This is agenda item number four, SB 1002. The chair has a no record on this bill. Haney, no. Jackson? No. Jackson, no. Lowenthal? We'll leave that open. On SB 1094, Weber Pearson. Alanis? Alanis, I. Baines? Baines, I. Colosa? Colosa, I. Haney? Haney, I. On SB 1094, Weber Pearson, Mr. Lowenthal? Lowenthal, I. Wynn? Wynn, I. Pellerin? Pellerin, I. On SB 1263, McGuire, Lowenthal. Lowenthal, aye. So we need a motion and a second for agenda item number 7, SB 1312 by Richardson. Got a motion and a second. Madam Secretary, please call the vote. On SB 1312 Richardson, the motion is due pass to the Committee on Local Government. Berman? Aye. Berman, aye. Patterson? Aye. Patterson, aye. Addis? Aye. Addis, aye. Aarons? Aye. Aarons, aye. Alanis Alanis I Baines Baines I Bauer Kahan Colosa Colosa I Chen I'm sorry Chen Chen I Ohori Ohori I Hadwick Hadwick no Haney Haney I heart Irwin Irwin I Jackson Aye. Jackson, aye. Lowenthal? Aye. Lowenthal, aye. Macedo? Macedo, no. Nguyen? Nguyen, aye. Pellerin? Aye. Pellerin, aye. That bill is out. Madam Secretary, please take it from the top again, just in case we missed anybody. On SB 758 Umberg, Lowenthal? Aye. Lowenthal, aye. On SB 849 Weber Pearson, Lowenthal? Aye. Lowenthal aye On SB 993 Ochoa Bogue Lowenthal Aye Lowenthal aye Nguyen? Aye. Nguyen, aye. Pellerin? Aye. Pellerin, aye. Aye. On SB 1002 Nilo, Lowenthal? Lowenthal, no. Thank you. Thank you. On SB 758 Umberg, Bauer-Kahan. Bauer-Kahan, aye. On SB 849 Weber-Pearson, Bauer-Kahan. Bauer-Kahan, aye. on SB 993 Ochoa Bogue Bauer-Cahan Bauer-Cahan aye on SB 1002 Nilo the motion was due passed to the committee on appropriations Barcahan Barcahan aye that measure fails reconsideration is granted on SB 1094 Weber Pearson Barcahan Barcahan I on SB 1263 McGuire Barcahan Barcahan I On SB 1312 Richardson, Bauer-Cahan? Bauer-Cahan, aye. Hart? Aye Hart aye On SB 758 Umberg Heart. Aye. Heart, aye. Thank you. Yes. Thank you, everyone. Hearing's adjourned. Thank you. Thank you.