Assembly Health Committee

I think you might have to press the button. Thank you, Chair and colleagues. I'm pleased to author SB 989, which is sponsored by the California Professional Firefighters. This bill would expand access to care court and help more Californians with schizophrenia spectrum and other psychotic disorders receive the care that they need. Care Court was created to provide a structured, voluntary, coordinated pathway to treatment for individuals with severe mental illness who are too often cycling through emergency rooms, jail, and repeated law enforcement encounters. While early implementation shows promise, barriers in the current petition process are preventing the program from reaching many of the individuals it was designed to serve. The Newsom administration originally estimated that between 7,000 and 12,000 people would qualify for care court. But after a full year of implementation through the start of this year, January of 2026, California courts had received only 3,817 care court petitions. So there was a prediction of 7,000 to 12,000, and there were only 3,800. This is clearly far short of the need. We know that first responders are often the first point of contact for individuals in crisis, but under current law, they must navigate a complex court filing process. They must obtain sensitive medical records, and they must appear in court to initiate a care court petition. First responders obviously have barriers to doing all parts of that. As a result, many individuals who would benefit from care court are never connected to the program. SB 989 creates a more practical and effective pathway by allowing first responders to request that county behavioral health agencies review and file care petitions on their behalf. Counties are required to assess these requests within 30 business days and then determine whether to file a petition when eligibility criteria are met or likely to be met. Finally, the bill directs the Department of Health Care Services to develop a standardized referral form, to provide guidance to first responders, and to establish data reporting requirements to improve transparency and program performance. This approach reduces administrative burdens, better aligns responsibilities with expertise, and ensures that individuals in crisis are connected to care and not lost in the system. SB 989 builds on the promise of CareCourt by making it more accessible, more accountable, and more effective. And with me today in support, I'm honored to have Megan Subers on behalf of the California Professional Firefighters.

Thank you, Madam Chair. Members, Megan Subers on behalf of the California Professional Firefighters, pleased to be a sponsor of the bill. CPF and our local affiliates have been leading and evolving the local response framework to improve patient care and outcomes for individuals who have been experiencing a mental health issue or a crisis. We've worked with this legislature to expand community paramedicine programs and mobile mental health units. Our members are committed to this work because I hear again and again that they are often running 911 calls on the same individual in the community, transporting them to the hospital, understanding that they're going to be able to do it. may not get the deeper level of care that they may need, and they're probably gonna have to respond on them again soon. And we see care as another tool for firefighters and other first responders to try to help make these connections to that deeper level of care. I often hear from my members that they feel helpless sometimes when they can't make those connections in the community. I've been fortunate enough to sit on the HHS Care Act advisory group along with one of my local presidents from the city of San Jose. And through that work and engagement, we've heard from our members and learned several things about implementation across the state. We have some examples of where CARE has been implemented in a fantastic manner with integrating the fire department, including Alameda City, Alameda County, and San Diego. So ironically, the two members that are here at the moment. But we've also heard from several other parts of the state where there have been challenges in integrating the fire department, getting the training and resources needed to the firefighters to do that work. And that is what this bill is focused on. There's a general lack of information about how a firefighter may be able to complete the petition process, have access to that medical record information, and be able to show up to court as required under care. So that is what this bill is really focused on doing, as you heard from the author, creating that streamlined process. We understand and respect there may be concerns from organizations about the underlying law of care, and I think we would just like to stress that if we thought the situation of trying to address the needs of this population was working prior to care, we wouldn't have CARE Act today. So we are focused on implementation and trying to make this program work. And for those reasons, we ask for your support today. Thank you so much.

Good afternoon, Madam Chair, members. Still in L.A. on behalf of the California State Association of Psychiatrists in support. Leah Barrows on behalf of California Hospital Association in support. Allison Monroe, Alameda County Families, advocating for the seriously mentally ill in support. Mary Ann Bernard, I am a member of FASME, family who assist the severely mentally ill here in Sacramento of NAMI. I am also a lawyer who used to represent mental hospitals in another state, as well as peace officers and firefighters here in support. Lauren Retaliata, mother of a person with schizophrenia, and I represent families on the CARE Act Working Group and NAMI Conacosta County. Please approve this bill. Elizabeth Kaino Hopper, Sacramento resident, member of NAMI Sacramento, volunteer on the helpline and parent of a person who qualifies for care court. Also chair of family advocates of individuals for seriously mentally ill, asking for support. Thank you. Hi, I'm Dick Donnelly, Sacramento County resident. and the father of a young man who died last year for lack of interventions like are addressed under this bill. And I'm asking for your support. Thank you. Ann Donnelly, the mother of a son that died that couldn't get help last year who was seriously mentally ill, and I ask for your support. Mark Donnelly the brother of that who died last year and I support this bill Lawrence Abbott San Leandro brother of a beloved baby brother who died by not getting support Thank you.

Thank you, Chair and members. I'm Evan Fern with Disability Rights California. We are sympathetic to the concerns of first responders that some individuals are not getting connected with treatment. SB 989 would create a streamlined referral process for first responders to subject individuals to CARECort. Funneling individuals into CARECort is not the solution. CARECort is an unproven, costly, and coercive program. We continue to expand CARECOR without fully understanding if it's actually working. The numbers so far are not promising. The first CARECOR annual report tells us that 56.4% of people in CARECOR did not receive at least one ordered mental health service. 82.2% of people in CARECOR did not receive at least one ordered social service or support. And there were high indicators of unmet needs. 25% of people still had criminal justice involvement, 21% had visited an emergency department, 20% had inpatient hospitalizations, and 20% experienced LPS holds. Despite not paying for services, the cost of care court is astronomical. A report from the state legislature last year found that the program costs $713,000 per participant in fiscal year 2023-24. That's more than the median cost of a single-family home in 35 California counties, and more than 40 times the cost of full-service partnership programs, which provide comprehensive services including housing, food, case management, medical care, and mental health care. Care Court subjects individuals with disabilities to court-ordered treatment. It relies on the black robe effect, which is not backed by research. Care Court is fear-based, not evidence-based. SB989 would add yet another process, more complexity, and more cost to an unproven coercive program. For these reasons, we ask you to oppose SB989. Thank you.

Zinit Yaya on behalf of ACLU CalAction in respectful opposition. Danny Therickel with Mental Health America of California, CalVoices, and the California Association of Mental Health Peer Run Organizations in opposition. Simon Vu, I'm the California Behavioral Health Planning Council in opposition.

Senator Blakespear, I'd like to thank you for authoring this piece of legislation. As a representative from San Diego County, I've seen for the past several years how we've struggled to help make the care court system work and know that there are still challenges within the system. And I want to share appreciation for you trying to tackle some of those challenges to make sure that we get to the point where it is functioning how we would like it to function how originally envisioned So thank you for this very important work and I would like to add on as a co Thank you.

I want to thank you for bringing forward this bill. I think it is very clear that we are still in a state of really fully understanding the impacts and the implementation challenges with the CARE Act. And so we are going to be looking forward to making sure that we're doing that more thoroughly next year. And at the same time, I also just want to recognize the incredible asset that our firefighters are in particular in being able to help to provide first response in a way that is connected to individuals. And this is in keeping with allowing them to be able to have ability to participate in that particular process of ensuring an ability to review. And with that, I will be supporting the bill. I think that this is a balanced approach at the time and look forward to hearing more about how this proceeds over time.

Yes, thank you. Well, thank you for your comments, Chair, and I appreciate the supportive comments from other members of the committee. I just want to address the issue of CARE Court being coercive because it's important to recognize that CARE Court is 100 percent voluntary. And so that means that people can stop participating at any time. And they stop intentionally, but also people stop participating because they're unable to participate. Their grave disabilities have progressed to such an extent that they lack the insight to be able to participate or other means. And so when you look at CARECORT, it has tremendous promise. and I spent several hours witnessing care court a couple months ago, which was a lot to get organized because every person has to consent. So I was in a courtroom in San Diego County, and my observation of the multiple people who we saw in the several-hour period is that everybody was tremendously grateful by the support that was provided and the feeling in the courtroom there was a black robe effect in that important people cared about them. And there were people who were from the county. It was in a courtroom setting, but it felt like a group therapy session. It wasn't being driven or directed in any way. It was checking in on the person. And one man played a song on the guitar that he'd written for us, and another one talked a lot about his dog. And so the reality is that people are accessing treatment and housing that they wouldn't be able to access otherwise by being part of care court. But it's also important to recognize that care court is not serving anywhere near as many people as need help. So as I mentioned at the beginning, there were – the estimate was that it would serve between 7,000 and 12,000 people. But actually there were only 3,800 care petitions. And of the petitions, there were less than a thousand that actually resulted in care plans. So, you know, something that was supposed to have up to 12,000 people involved has under 1,000 after we have had one full calendar year of care court. So the administrative barriers to entry associated with care court and all of the safeguards and process around it is including the fact that first responders are the ones sometimes who have the most contact with people who have estrangement with their family members or other reasons that nobody able to actually connect them to something But first responders don't have access to medical records. And so asking the county to be part of that process, having them evaluate and see if they could file actually something with care courts so that they could get involved in it. Again, a voluntary process. You know, this is something that that is not coercive, that is an opportunity that my observation was people are grateful for. So I recognize that there's a philosophic resistance or opposition to care court as a whole, as a concept. But the reality is we do have it in California. We are trying to get it off the ground in every county, and it is actually helping people who are involved. So figuring out more ways to have entrance points and then reducing the frictions that are at those entrance points so that people like our brave firefighters can help people access this care is just really important. So I'm grateful for the support of our first responders who are really looking at how we can make things better and want to thank the firefighters for that. And also I want to thank the committee and the staff for your involvement in helping the bill be better. And I thank you for your I vote.

I have the binder, but I don't have my talking points. So you're going to test me on knowing my bill backwards and forwards, which I do. So I'm okay with it. Good afternoon, Madam Chair and members of the committee. I'm here to talk to you about SB 1089, which has to do with GLP ones. I'm first going to tell you the amendments that we've agreed to accept from the committee Which is to essentially strike the first portion of the bill Which has to do with including CalPERS that CalPERS would offer GLP ones to state and other related employees I do hope to bring that forward Next year some aspect of that of getting us to the point where health plans do actually offer To have GLP ones, but I think Based upon the chair's recommendation We do have a very good portion in the bill which has to do with having the Department of Health and Human Services provide or I should say offer GLP ones through their distribution process and with CalRx and H Chi To be able to have a system so Californians beyond people who are on health plans would be able to access it. If you would indulge me, because I don't think I've used three or five minutes, I do want to tell you that I started taking GLP-1s in August. I won't say the brand just because I don't want to get in trouble of giving someone more advertisement than others, but I started in August of last year, and I have now lost approximately 50 pounds. When I began to take the GLP-1s, I was diagnosed as being pre-diabetic. My mother had been diagnosed as being diabetic. My father had been diagnosed as being diabetic. And when you look at particularly within the black and brown community Diabetes is a very significant illness or diagnosis that people have So at the point when I was aware that GLP-1s were potentially helpful For people who are diabetic and pre-diabetic Of course I sought to use them Not because I wanted to get into a prom dress or go to the Grammys But because I wanted to be healthy and I wanted to live And when I made the call, I got the prescription from my doctor And when I made the call to my health insurance as a state employee to Blue Shield I was told that they didn't offer it to me Even though I was one point off of everything of being diagnosed as diabetic So since August, I started paying over $800 a month, personally, cash And now, even though prices have dropped, I'm still paying over $450 a month. And so the point, the reason why this is so important, that the Department of Health and Human Services, HCAI and CalRx would offer a fair and affordable price to Californians is we shouldn't. It is well documented, and I know we have a doctor in the audience as well. There's enough data now It's well documented of the improvements That we're seeing of people taking GLP-1s and It is similar to a person Taking insulin as a person Taking high blood pressure medicine A person if Something is available to help you To be more healthy to avoid Core morbidities which you See in the bill analysis before you Why would we want to wait Till a person became diabetic To help them It is far cheaper and far less invasive and harmful to individuals not to have to have knee surgery, not to have gastro cancer, not to have so many of the things that we know GLP-1s can be helpful with. So I respectfully request your support on SB 1089. I will be also submitting amendments that, in addition to the one that I'm accepting of the committee to remove CalPERS, I would like to make sure anywhere where it references GLP-1s that it references all of them. Because we have to make sure, for example, Kaiser today and Blue Shield may offer Ozempic, but they don't offer WeGavi, the weight management piece of it. So we want to make sure not only all GLP-1s are being offered, but also, too, that future medications would be available. In January, right now, there's a study going on for a product, Retra, that actually has three of the components, not the two, which is the terrazeptite. So we want to make sure as our laws evolve that H-Chi and CalRx would have the flexibility to consider future products as well. And then the final thing is because now the bill is restricted to CalRx H alone it my hope that we would be able to change that from May to Shell because it based upon if it appropriated So only if even of us passing this bill, it would still have to be appropriated in order for them to enact the process. And so, of course, once we would appropriate the funds, we would certainly want them to do it, right? So with that, I respectfully ask for your aye vote and I'm available for any questions on the bill.

Thank you. Moved by Aguirre Curry, seconded by Carillo. Are there any primary witnesses in support? Please come forward.

And are there any primary witnesses in opposition? Any of those who would like to register opposition in the hearing room? Seeing none, I can bring it back to the committee for any questions or comments. Assembly Member Patel and then Assembly Member Coloza.

Well, I would probably need, I'll give you my perspective, but of course the governor and the administration and the department could give a, I will ask them and make sure to follow an answer to you. But as I understand it, some of the products currently that CalRx is providing is, for example, insulin. That was the most popular one. And originally the thought was that California, we could produce insulin and do it at a much cheaper price. And as has been told to me, that ended up being, I think, more complicated than expected. And so they ended up forming a partnership, which is what the current legislation provides, to be able to get that product and to be able to offer it. And so our bill is consistent with that, that CalRx through HKI, through Department of Health and Human Services, would be able to, because the manufacturers currently have a patent, they would be partnering with the manufacturers to provide the product. However, it's my understanding the manufacturers do have the ability to also produce generics as well. So at this point, it's my understanding they would be working with the manufacturer. Once the patent, you know this better than I do, once the patent would expire, then potentially other providers could seek to produce the product. I will say, though, what was encouraging that I learned a few weeks ago is that the Carpenters Union, for example, in Las Vegas has a major pharmacy that they provide products to their members at a significant reduction price So I hoping that this bill would also afford H CalRx to consider potentially working with entities such as the carpenters or directly with the manufacturers to distribute the product I will say for my experience with ZepBound, ZepBound, what they do, I buy direct from, oh, I wasn't supposed to say the name. They buy direct from the manufacturer. The manufacturer then offers that I could receive the product through the mail. through the mail is using a, I believe, pharmacy company named Gif Health, and they are the ones who distribute the product. However, if you have it where you pick it up, they utilize locations such as Walmart, Costco, whoever, where they use that distribution system, meaning a big store that provides a pharmacy. So how has it worked? I believe it's important that we include some dollars that would be required to set up the proper distribution center. But given the fact that, for example, carpenters and others are currently distributing the product, other than directly the manufacturer, I think it's very possible. And in my initial question to the governor of his willingness to include GLP-1s with CalRx, he was very positively open to that, given your approval. Okay, so another question. As I think about legal frameworks, do you know, does your bill have any provision for any liability? Who would assume the liability if there was any contamination of product or any something that happens with it along the way? Is that now, does that stay with the manufacturer who we're contracted with?

You know, that is an excellent question that I do not know the answer to, but I will find it out. I would assume, however, it would be similar to any medication situation. I remember, I'm trying to remember what the drug was, aspirin or something that people were contaminating. And the manufacturer, Tylenol maybe. And I believe the manufacturer had to pull the products and all of that. But I don't believe the distributor was responsible. I think actually the manufacturer pulled the products and had to check that their products were safe and so on. So I assume something similar would be in effect. And I would assume also, member, that any issues related to liability would be very well spelled out in whatever contract agreement that they had between the parties.

Thank you for your questions. Assemblymember Coloza.

So as the bill would go as of today, a doctor does need to prescribe the medication. You can't just go and say, hey, you know, go to CalRx and I want to order a GLP-1. it still requires a doctor's prescription. And so the doctors then follow the current guidelines. I believe currently I don believe doctors are able to prescribe you know younger than teenagers at this point But I believe there are discussions in the industry about whether that would be appropriate because there are some young children who are actually born diabetic, frankly. But it's my understanding the current rules that apply for a prescription for a GLP-1 would apply, which, as I know it today, not to include children. But I do believe there's an interest in that. But that would be something the Food and Drug Association would have to determine. Thank you for sharing that.

Thank you.

I would say you're one of our softball players, and we had softball practice a year ago, and for the first time in my life, I've been an athlete. I've tried out for the Olympics in 1980. Now I'm dating myself. But for the first time in my life, when our coach said, run from the one gate to the other, I couldn't run, and I was shocked. I just you know I could barely do more than a brisk walk and I said that's it enough and so I'm looking forward to seeing you out on the baseball field I'm not running a sprint yet but at least I'm not falling out either but it really I can tell a tremendous difference just in not feeling heavy, feeling lighter, feeling healthier, just so many things that really weight has a huge impact on beyond your physical appearance. It really is about the health. Thank you.

As a senator, I respectfully ask for an aye vote.

Thank you Madam Chair Members of this committee I appreciate the opportunity To present SB 1309 The Stop Lung Cancer Early Act Which will increase access To life-saving care By eliminating out-of-pocket consequences for medically appropriate lung cancer screenings. I'm accepting the committee amendments that were offered, and it's noted in the analysis. This bill makes an essential change. It will remove financial barriers, preventing patients from accessing life-saving follow-up care. As studies show, preventative care is the best way to keep people healthy, so expanded access to necessary screenings will save thousands of lives. We see its success to the lives safe when we decrease costs of screening for breast cancer, cervical cancer, and colorectal cancer. Lung cancer is California's deadliest cancer right now, killing over 10,000 Californians every year. However, our screening rates are very low. They're under 10%, whereas other cancer rates are above 70%. And costs are the main cause of avoidance for a lot of families. and the reason why people just avoid it altogether until it's too late. And we know that families are struggling with high cost of pretty much everything, and we don't want them to have to make that decision about their health care. I have heard stories of families not sharing with other family members because they don't want to put them in that situation. So this bill would help in that regard. We want people to have the access. And for example, veterans are far less likely to go to a follow-up appointment as it also disproportionately affects people of color. And bottom line, it's a difference between life and death for some patients. Less than a quarter of lung cancer cases are diagnosed at stage one when survival rates are at their highest. Around half are diagnosed at stage four when survival rates are at their lowest. but the cost of care is at its highest. By removing barriers, we increase early detection, improve survival rates, and reduce long-term health care costs associated with late-stage lung cancer treatments. SB 1309 is a targeted evidence-based early detection update to existing policies, one that aligns lung cancer screening with other covered preventative services, and family members will stay quiet often, as mentioned, because they don't want to put this burden on their family members, and this is an easy way to save lives. I'm going to turn it over to my witnesses, Denise Lee and Laura LaRose, if I may.

Moved by Aguirre Curry. Seconded by the vice chair. So please go ahead whenever you're ready.

Thank you. You'll have two minutes.

Please come forward with your name, affiliation, and position on the bill.

Megan Subbers on behalf of the California Professional Firefighters in support.

I am proud to be with you here today, and I'm, my heart is a little heavy, so I'm going to make it through this. presentation. And I want to thank all of you for your hard work. Many of you on the front lines of making sure that the state of California holds true to his promise that health care is for all, that it is a right. And that as we are facing H.R.1, that we stand up against Trump by protecting our most vulnerable Californians who rely on this health and safety net. So I am disappointed today, but I am not discouraged, but I am disappointed that once again, as California faces difficult choices, too many are willing to ask working families, our most vulnerable families our families that are being terrorized by ICE in particular Our seniors our children our babies The poor. To carry the burden while some of the wealthiest interests in our state contribute nothing. I just had a briefing with the controller, which was really eye-opening about how the state utilizes its resources, and she just completed an amazing audit, and I suggest everyone get a chance to be briefed on it. In the audit, $286 billion is spent on health care by the state of California. Imagine what we could do How many senior centers, parks, transit We could do if we could figure out a way to generate revenue To take some of the pressure off of our general fund To provide basic health care to the most neediest This is why my constituents sometimes scratch their head And ask me, what are you all thinking? Here we are, the shiny state on the hill And we are in fact doing a lot of what This administration is doing to us Denying basic care And we know the estimate of 1.3 million To 3 million Californians are going to be heard And I just want to say, again This conversation takes courage But we have to face it when we are spending so many resources on health care and subsidizing some of the wealthiest industries in the world who do not provide health care to their low-wage employees who, even though they work full-time, still qualify for Medi-Cal. And it's not to attack corporations because we need strong business. Strong businesses mean strong workers. Strong workers mean strong communities. We all know the intersectionality of this. But this is a moment where we all have to roll up our sleeves and not fight, but see the bigger picture. If we can deal with the $286 billion we're spending on health care, that means more resources for everyone. So we are not choosing between things like R&D tax credits and health care for our families. This is an all-hands-on-deck situation. And I want to say that the people of California have stepped up. As we expanded health care, ACA, we all enrolled. We all got in the game to make sure everyone was insured, and we saw the reduction in some of the costs. But now we are going to be looking at incredible increases in health care above what we're already spending because so many Californians now will have to go to the emergency room. Nearly one in five California jobs is held by a Medi-Cal enrollee, representing more than $20 billion in public spending tied to the workforce. That means taxpayers are subsidizing gaps in employer-provided coverage, even as large corporations remain highly profitable. Under existing law large employers are already required to offer affordable coverage Hell our small businesses are required to offer healthcare When full-time workers still rely on Medi-Cal, it signals a gap between what is required on paper and what is affordable in reality. And without transparency, taxpayers cannot see where their dollars are going or why costs keep rising. SB 1284 does not assign blame. It provides transparency so policymakers and the public can understand what is driving costs. In my district, I hear from workers because the majority of jobs created in my district, and I am the heart and soul of Los Angeles, downtown L.A., South L.A., Culver City. The overarching message is when we do things right, like go to work, we still fall behind. Their stories reflect a broader affordability crisis where our essential workers cannot afford health care even while contributing to our economy every day. Meanwhile, some of the largest corporations continue to report strong profits while relying on the taxpayers. the taxpayers to fund public programs that support their workforce. That also puts responsible employers, and we know there are many, we have many responsible employers in the state of California who do provide health care for their workers. It puts them at a competitive disadvantage. This raises a fundamental question about fairness. At a time of budget strain and rising costs, is it fair for taxpayers to subsidize corporate labor costs? There have been polls and research that says across the entire spectrum of California, independents, Republicans, Democrats, that fairness is the most important principle. and that everyone should pay their fair share. SB 1284 responds with a simple solution, transparency and accountability. It requires the Department of Health Care Services to publish the names of large employers with workers enrolled in Medi-Cal, along with the estimated costs to taxpayers, taxpayers who are asking us for relief. They're asking us to help them make ends meet when a carton of eggs is at $8.99. Over 70% of voters support requiring large corporations to take responsibility for their workers' health care instead of shifting the cost to them. That support is bipartisan, as I mentioned. And SB 1284 is a measured step because without transparency, nothing changes. And we have a plan put forward by the Senate, made actionable by members of the Assembly to make fairness the priority and strengthening the ways in which we generate revenues to help with California's health care crisis and our fiscal. With me to testify today is Nancy Mendoza organizer for UFCW Local 5 and Christine Smith with Health Access Thank you You each have two minutes Hello Thank you for your time Good afternoon

Thank you. You'll have two minutes.

We will now move to any who want to register support in the hearing room for this measure. Please come forward. Good afternoon.

Thank you. Mariko Yoshihara on behalf of UFCW, Western States Council, proud co-sponsor and strong

Good afternoon, Chair and members. Conor Gussman on behalf of Teamsters California in support.

Thank you, Madam Chair and members. Megan Subbers on behalf of the California Professional Firefighters in support. Thank you so much.

Thank you so much, Senator. I really appreciate you bringing this forward. I know you've been working on it for a very long time because I've been in many conversations with you and other members on this kind of concept. And as you know, it's my second year as the chair on the Assembly side of the health budget subcommittee. And last year was just probably one of the most difficult times of my time in the legislature grappling with what we were facing. We didn't really know yet what was coming with H.R.1 and Congress and the lack of re-upping the covered California subsidies and then the kind of disappointing proposals coming out of the governor's office last year. We ended up doing a lot of work. I think this year we made a ton of progress. But through all of that, you know, have always thought about the what ifs of this kind of a proposal. And if we had more money in the system so that we weren't making these difficult kinds of choices, I think I'll certainly personally stand behind what we all voted on last night in terms of this budget. But it would be so much better if we weren't in that position. It would be so much better if we weren't making the kinds of choices that we're making. And so I just want to commend you for your stick-to-itiveness on this kind of policy. I also want to commend our health policy chair, who has done a lot of work on similar policy and really appreciate the fortitude from both of you in terms of pushing this conversation And so I very glad to support today and just want to say thank you for all the hard work Thank you Assemblymember Assemblymember Chiavo I wanted to thank you for this bill, too. I think this is really so, so important. And for, you know, as someone similar to you who's come out of working with workers for 20 years before getting this job, I've heard the many stories of how, you know, stores like Walmart teach people how to sign up for a Medi-Cal and public assistance because workers are just not making enough to survive in some, you know, some of these places. and we've called it corporate welfare and other spaces. And so I think to have an accounting of this and really know where we stand and who's really taking advantage of this and where the workers in need are gives us a lot of information to be able to figure out kind of where to go with policy in the future as well. And I think this will be very interesting to see the results of. Thank you. Happy to support.

Well, I just want to thank you, Madam Chair, again, for all of your work and for your comments and proud and happy to add you as a co-author and for all of the members who spoke today. You know, this is about health care, but it's also about our economy. Health care sector is what's helped us weather this very dangerous time that we've faced from the federal administration. And it's unfortunate that whatever is to come because of H.R. 1, that that economic stabilizing force is going to be harmed. And so the sooner we can figure out ways to generate revenues that create fairness in our system that helps us not have to spend more than half of our budget on health and human services, the sooner we can get to a more fiscal stability. in our economy and be able to do the work that California needs to do the work to do moving forward and to continue to be the leader that we are. So I'm grateful for your commitment. I'm grateful for all of your consideration and discussion and time on this issue. And I respectfully ask for your aye vote. Thank you. We have a motion and a second. Please call the roll.

As you said I presenting SCR 7 relating to the well health benefits of permanent standard time Now this subject lists a lot of opinions Most people are tired of changing the time every six months or so. As I put it, everybody, almost everybody, agrees to ditch the switch It's just a question of which switch to ditch. I did not get that from Dr. Seuss. I made it up myself. But this is not a policy bill. It is speaking in favor of standard time because of the unquestioned health benefits of standard time. The discussion, this discussion is about biology, not personal preference. regardless of what your personal preference is. The fact is that standard time is better for your health. Medical study after medical study shows that when we make the switch to daylight saving time, heart attacks, strokes, car accidents, and medical errors go up. In addition, it has a negative effect on our youth. This House, this legislature, decided a few years ago that the majority were in favor of more sleep for our students when we moved to start time for school back. Daylight saving time forces them to rise in the dark, further disrupting their natural sleep. This is not beneficial for their health or their studies in school. We know we perform better when we sleep well at night and having daylight exposure closer to when we wake up better aligns us with the natural harmony of the earth and our circadian rhythm. All of these medical reasons are why the California Medical Association, the California Sleep Society, the American Academy of Sleep Medicine, the National Sleep Foundation, Sleep Research Society, and the Society for Research on Biological Rhythms advise standard time as the best for our health. Today, I hope you will join me in recognizing the health benefits of permanent standard time by giving your aye vote to SCR 7. Here to testify on behalf of the bill is Angela Hill with the California Medical Association.

Good afternoon, Madam Chair and members. My name is Angela Hill. I'm with the California Medical Association, and CMA does strongly support establishing a permanent standard time as a public health issue. As the senator mentioned, there is growing scientific evidence that shows that the twice-yearly transition between standard time and daylight saving times does disrupt our natural circadian rhythms, and it does carry real consequences for health and safety. As mentioned, those can include heart attack strokes, medical errors, collisions. And these aren't just inconveniences. They are preventable public health harms that do affect millions of Californians every year, maintaining a stable year-round standard time, better alliance with the human biology, and it supports healthy sleep cycles. And for physicians, protecting healthy sleep is a foundational preventative health strategy, just like promoting nutrition and physical activity. We do thank Senator Nielo for his attention to this issue, and we respectfully ask Thank you.

Senator Nilo, by chance will you be serving donuts again after you get this bill, after you get this across the assembly floor? My clever staff member who is here with me, who's also responsible for the wonderful decorations that change on our office door from time to time, I'm sure will think of something very clever. Thank you.

I would like to add that there would have been additional testimony and additional me to's. But most of the people that belong to these organizations are at a national conference discussing the sleep benefits of daylight of standard time. With that, I respectfully ask and I vote.

Good afternoon. I'm presenting SB 995, the Misuma Khan Justice Act, which establishes a statewide inspection and compliance framework for large and voluntary residential facilities in California, including privately operated detention facilities using existing state inspection authority and enforcement tools. These facilities house thousands of people who depend on them for shelter, food, medical care, and basic safety. Because individuals in these settings cannot freely leave, the state has a responsibility to ensure that conditions are safe, humane, and consistent with basic health and safety standards. Yet, across this country, inside private immigration detention centers, people are being denied their basic rights. The California Attorney General recently released the Department of Justice's fifth report and found conditions in these facilities to be cruel, inhumane, and unacceptable, citing issues such as undercooked food, limited access to clean drinking water, inadequate and delayed medical care, and six deaths in less than a year. The consequences are devastating. Last year alone, 32 people died in ICE custody, the deadliest year in decades. Regardless of where one stands in immigration policy, there should be agreement on this. No human being should be subjected to inhumane treatment. No corporation should profit from human suffering. And no system should operate without accountability. And yet accountability is exactly what is missing. Currently, California's inspection authority applies only to counties, and three of the four counties with this authority have not conducted any inspections. In practice, that means many of these facilities operate with little to no meaningful oversight. Recent reporting has underscored the consequences of the gap. Advocates have also exposed the human reality inside these facilities. At Ote Mesa, detainees have resorted to writing messages on small hygiene bottles, weighing them down with rocks, and throwing them over fences, hoping someone on the outside will hear them. Recently, about 20 migrants detained in the Atalanto Ice Processing Center's Desert View Annex Detention Center have begun a hunger strike, protesting what they describe as inhumane conditions and medical neglect by GEO Group. They are demanding adequate medical and mental health care, nutritious food, and accountability for recent deaths, among other reforms. This bill is named after Masuma Khan, a 64-year-old resident of Altadena. She survived the Eaton Fire, only to be detained by federal immigration agents during a routine immigration check-in appointment, and transferred to the California City Detention Facility in Kern County. Masuma has lived in the United States with her husband and daughter, both American citizens, for several decades. She has no criminal record. Yet she was held in a cold facility without warm clothing, without proper food, and without access to the medication she needed. Her story reflects a broader failure. SB 995 is grounded in a simple principle. If detention facilities operate in California, they must meet California's standards for safety, dignity, and human rights. To achieve that, SB 995 creates a uniform statewide system for inspecting and enforcing standards in large and voluntary residential facilities, including private detention centers. It designates the California Department of Public Health as the lead coordinating agency working in partnership with fire, environmental, water quality, and workplace safety regulators to ensure a comprehensive approach to oversight. The bill requires facility operators to grant reasonable access to inspectors and maintain records demonstrating compliance. It establishes a tiered enforcement framework that ties penalties to the severity of violations. And finally, the bill ensures transparency and accountability by requiring inspection findings to be documented and reported to the legislature within 30 days. This bill is sponsored by the Mexican American Legal Defense Educational Fund or MALDEF CHIRLA Public Counsel South Asian Network and is supported by over 37 organizations It has received unanimous bipartisan support on the Senate floor and at the appropriate time, I ask for your aye vote.

Good afternoon, Chair and members. Ronald Comen-Biesa here on behalf of Chirla. SB 995 is a straightforward exercise of California's core police powers, which seeks to regulate only one thing, health and safety conditions in large involuntary residential settings. Chirla's impact litigation team currently represents clients in Atalanto detention facility. Clients often reference deplorable health and safety conditions. Detainees are often given raw or uncooked food. Medical neglect is often rampant. Individuals with chronic pain are given Tylenol if they're lucky. Individuals with diabetes aren't given food that meets their nutritional standards and either have to forego food or eat very little. The lack of basic health and safety standards has no place in any facility within California's borders, and it must be addressed. This bill is constitutional for three reasons. First, it is neutral and generally applicable law. It applies to any facility that meets objective criteria, regardless of who operates it or why individuals are there. It expressly includes multiple categories of non-criminal facilities, which is exactly the kind of comparator framework that courts approve. Second, it regulates conditions, not government operations. This bill is explicit. It does not regulate detention decisions, security procedures, or custody determinations. Instead, it focuses on traditional public health concerns, Things like air quality, sanitation, fire safety, infectious diseases, or worker safety. Areas where states have long exercised this police power. Lastly, it fully complies with the doctrine of intergovernmental immunity. Enforcement runs against the operator, not against the government, and inspections must not unreasonably interfere with any security functions. For these reasons, we respectfully ask for your aye vote. Thank you.

Good afternoon, Madam Chair and members. Cajo Maeda with Public Counsel, a legal services nonprofit organization based in Los Angeles. We are proud to be one of the co-sponsors of SB 995 and ask that you support the bill. We first thank Senator Perez for sponsoring this important bill, which would allow for stronger oversight of private and voluntary residential facilities, including immigration detention centers. As Senator Perez explained, the bill allows the state to inspect facilities and impose fines and penalties for violations when facilities fail to meet basic health and safety standards. As an organization that serves the Los Angeles community, we have represented far too many clients who have been placed in dire and inhumane conditions by private detention centers, which are failing to provide critical medical care, packing more than 60 people in one cell, refusing to respect religious dietary restrictions, providing spoiled food and unsanitary water, and intentionally subjecting detained individuals to freezing temperatures without adequate clothing. Currently, there is very limited oversight of these centers, and they do not face consequences for these conditions, despite the many lives they've endangered and some even lost. These experiences, including that of Massima Khan, whom the bill is named after, are what inspired Senator Perez to sponsor this bill. Our organization secured Massima's release from California City Detention Center last year. She was denied safe food and water as well as critical medications and basic medical care for her chronic asthma high blood pressure glaucoma and other serious conditions She did not see a doctor until almost two weeks after her detention Massima and her family made repeated requests for her medications and thanks to their persistent advocacy, she was finally given some, but not all, of her medications. Due to public and legal advocacy, Massima was thankfully released, but many of our community members still face the same inhumane conditions today, and SB995 can provide necessary safeguards. We ask that you support SB 995 to increase oversight of involuntary residential facilities and help protect our community members. Thank you.

Cal Wistlow with the California Community Foundation in support.

Good afternoon Chair and members. Carol Gonzalez on behalf of Inclusive Action for the City in support. Thank you.

Vanessa Cajina on behalf of the California Academy of Family Physicians in Visión y Compromiso in support.

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

Thank you. Are there any in the hearing room who would like to offer primary opposition to this measure? Please come forward. Thank you. You'll have two minutes. You'll have to press the button. Thank you.

Are there any others in the hearing room who would like to offer or register opposition to this measure. Seeing none, I will bring it back to the committee for any questions.

Yeah, I appreciate it through the chair. So because those frameworks already exist, and again, understanding the legislature's desire, as is ours, to have those processes in place for review inspections, we really believe that those mechanisms exist and are working. I think it's difficult when you add new frameworks that run concurrent to that, that oftentimes, right, if you have duplicative directives or different things happening, the goal is to obviously reconcile those things and get – have meaningful conversations and get things addressed. And so right now, as the bill currently stands, it's unclear how all of those pieces would, in fact, work together that wouldn't inadvertently, again, have unintended consequences to impede the very thing, I think, being sought from this committee and from probation as well. And so we certainly welcome those conversations. But again, because this framework exists and it seems to be a recognition as to why all other governmental entities, state and local, were excluded except for this one category of facilities, that kind of further complicates how you would address it via different state frameworks.

Thank you. Assembly Member Rodriguez.

author. I'd love to be as a co-author as well, and just want to applaud your work in this area in particular. I know you worked on these issues last year as well and appreciate it. It's probably these issues with ICE are probably, and detention facilities, are one of the things I hear about the most from my community in terms of the highest level of concern around what we're able to do and people really feeling helpless if there's federal, you know, federal regulation and how that interacts with state regulations. I want to appreciate your witness testimony around how this is constitutional and just your perspective that we can take action at the state level, that there are things within our power. And then also really appreciate that you've crafted this so it's not just about immigration detention facilities but really that this should apply to any kind of detention facility Particularly I think the youth facilities are important and are vital That one area that this legislature has done a lot of work on is to try to make sure that we're caring for our children and that they're not in situations where they might experience abuse. And so I appreciate that this would be covering children as well. So thank you, and obviously I'll be supporting the bill.

Thank you to the author. I know we participated in a press conference together where I am the co-author, and I did meet the family, and we did hear about these conditions. So I just want to thank you again for bringing this forward and to my colleagues who have also joined on today. Also as co-authors, this is extremely important, so just thank you for leading the charge on that. Thank you.

Yeah. So part of the reason why secure youth treatment facilities are SYTFs, as they're referred to, or continue to be included is because these are locations that house youth for extended periods of time and secure settings. And they are much closer in their operation and in their definition to other long term and voluntary residential facilities that are addressed in this bill. And so that's why this bill is intended not to just apply towards those private operations that have contracts with the federal government. This applies to any state and local facilities that fall under that definition, which is why they've been captured. One of the things we did include in the bill, and let me see if I can bring up this section number. It's 19998.3. It was language to state that this, if there is any sort of duplicative language, that the State Department of Public Health has the ability to basically determine whether or not there is duplicative language so that they can make that determination. And so we recognize that there are some laws in place that regulate these facilities, as well as some of the other places that we ended up excluding from the bill and wanted to make note of that. So as was mentioned by the chair we wanna give the Department of Public Health really the ability and the flexibility to decide how they want to do enforcement here and how they want to provide oversight to these types of locations Okay, so just to clarify, so the process by which you were able to exclude some other government detention facilities didn't apply to secure youth treatment facilities?

And so we need to continue to capture locations that fall under those kinds of definitions. We cannot, because of the supremacy clause, target federal locations, right? And so we need to make sure that we're including all of those locations that fall under that definition. And so they happen to fall under that definition and are very close in the way that they operate to private detention facilities. Thank you. Thank you for that explanation. I think I have a better understanding about how those remain still within your provision, what you're proposing, and how the departments can prioritize inspection to make sure there isn't any duplication of effort or conflicting effort put through. Thank you.

Thank you. I don't see any more comments from the deus or questions, so Senator, please feel free to close.

We have a motion and a second. Please call the roll. The motion is do pass to the Judiciary Committee. Bonta. Aye. Bonta aye. Chen Addis. Addis aye. Aguirre-Curri. Aguirre aye Ahrens Aye Ahrens aye Coloza aye Carrillo aye Gonzalez Aye Gonzalez aye Johnson Patel Aye Patel aye Patterson Patterson, aye. Rodriguez. Rodriguez, aye. Sanchez. Sanchez, aye. Chiavo. Chiavo, aye. Sharp Collins. Sharp Collins, aye. Stephanie. Stephanie, aye. That bill's out. Thank you so much, Senator. All bills are out so we are now going to just complete some add-ons for any who want to add on to any of our votes. We'll begin with the consent calendar. On consent Carrillo. Carrillo aye. Patterson. Patterson aye. Item number one, SB989, Blake Spear. Carrillo. Carrillo, aye. Patterson. Patterson, aye. Item number two, SB995 by Perez for add-ons. We have everyone. Item number five, SB1089 by Richardson for add-ons. Carrillo. Carrillo, aye. Patterson. Patterson, aye. Item number six, SB1284 by Smallwood Cuevas for add-ons. Carrillo. Carrillo, aye. Item number six by, oh, we did this. Sorry, item number seven, SB1309 by Rubio for add-ons. Everyone's there. And finally, item number nine, SCR7 by Nilo for add-ons. Carrillo. Carrillo, aye. Patterson. Patterson, aye. That measure is out still. And with that, we are adjourned. Thank you. Thank you.