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Senate Health Committee California State Senate
Follow its sittingsSpeaker 2
The bill establishes the California Foundation for Science and Health Research within GovOps that will oversee the monies that are generated that will go into a fund. The measure also will include provisions to recoup some of the public investment we're making from these discoveries to benefit the people of California, both our budget, as well as the cost of drugs that Californians pay. So, I respectfully ask for your aye vote, And with me today to testify is Doctor. Kim Elaine Barrett, PhD, Vice President for Research and Distinguished Professor of Physiology and Membrane Biology at UC Davis, and Doctor. Ben Cox, PhD Assistant Project Scientist in the Department of Molecular and Cell Biology, also at UC Davis, and an elected officer of UAW four thousand eight and eleven.
I want to thank UAW, the UC, and UAPD for sponsoring this bill. We also have us for any technical questions that come up. Jason Murphy from the University of California.
Speaker 1
Thank you, Senator. You will have a total of five minutes for both of your presentations. You may begin.
Speaker 4
Good afternoon, Chair Weber Pearson and members of the Senate Health Committee. Thank you for giving me a few moments to share why this proposal is so important to our health, our economy and the State of California. My name is Kim Barrett. I'm Vice Dean for Research at the UC Davis School of Medicine. I've been with the University of California for more than forty years.
In all my time at UC, I have never seen a more precarious situation for scientific research and greater challenges to our economy, our workforce development and, most importantly, our public health. The California Foundation for Science and Health Research is an opportunity for California to control its own destiny at a moment when UC is facing one of the greatest threats in its history. The university currently receives $5,700,000,000 in federal support for research each year. Sustained loss of even a portion of this funding would devastate the university and cause enormous harm to all Californians. Research at UC generates as much as $5,200,000,000 in economic activity every year.
Medical breakthroughs alone generate approximately $13,000,000,000 in economic activity across California and have produced more than three thirty three hundred and forty thousand jobs in biosciences. As federal funding uncertainty continues, we are threatened with a talent exodus, and our ability to train the next generation of innovators, researchers and physician scientists is reduced. This leads to a weaker talent pipeline to tackle the next pandemic, to create the next cell or gene therapy, or to devise safer and less invasive surgeries. Loss of funding hurts communities and patients the most. A loss of funding threatens clinical trials that give hope to those suffering from chronic illnesses and slows the development of life altering therapies for depression or interventions that can delay the onset of dementia.
We generate cutting edge research and translate it to real world care that can alter the course of someone's life. California has been a leader in scientific inquiry and should invest in its ability to protect jobs, health care and the economic future of our state. And for all of the reasons noted above, the University of California is in strong support of SB eight ninety five.
Speaker 5
Thanks for the opportunity to speak to this panel today. My name is Doctor. Ben Cox. I'm an assistant project scientist in the lab of Doctor. Celina Giuliano, Department of Molecular and Cell Biology at the University of California Davis, and an elected officer of UAW four thousand eight and eleven, the Union of Academic Researchers and Academic Workers at the University of California.
My lab studies the biological mechanisms behind tissue regeneration. Understanding these pathways can help us lead to new treatment for traumatic brain injuries and neurodegenerative diseases. Over the last year, many of California's scientific institutions have seen grants canceled or frozen, causing layoffs and research stoppages. Two NIH funded training programs, Maximizing Access to Research Careers, or MARC, and the Post Baccalaureate Research Education Program, or PREP, were canceled in 2025. These programs aim to increase participation in the sciences, especially among historically underrepresented groups.
I and other members of my lab have mentored many first generation California college students in these programs, all of whom have gone on to prestigious graduate schools or jobs at California biotech firms. While some of the Trump administration's proposed cuts have been rolled back or delayed by courts, many of these injunctions are temporary, and the administration is still exerting enormous influence over science. For example, by mandating that funding calls be approved by Trump appointees, This has caused month long delays for research as crucial and bipartisan as type one diabetes and an overall 90% decrease in funding calls this year, which has disproportionately affected early career researchers like myself. Further, the switch to multi year funding at institutes like the National Cancer Institute has reduced chances of obtaining funding by more than half. The administration has deprioritized scientific peer review and instead now favors proposals that align with the administration's priorities.
Beyond just biomedical research, the Trump administration is also targeting renewable energy as the global economy reckons with another oil crisis. I believe a s b a 95 can address the political interference, sabotaging research, and deliver on the promise of California science, which is that we can simultaneously attract the greatest minds from across the world and also uplift our own first generation scientists and not only protect but advance California's status as a world leader in science. Thank you for your time.
Speaker 1
Thank you. That was within five minutes. Very good. Alright. So we will now hear from any other witnesses in support of this bill.
Please come to the mic here. Please state your name, your organization, and your position only.
Speaker 6
Good afternoon, Madam Chair. George Osborne for the Union of American Physicians and Dentists. We're a cosponsor of SB eight ninety five with strong support.
Speaker 8
Good afternoon. My name is Jack Fin. I'm a UCLA PhD student representing UCLA Graduate Students Association, a UCLA Center for LGBTQ plus advocacy, research, and health. We're in support of the bill. Thank you.
Speaker 1
Good afternoon, Senator Ami Alden, on behalf of UC San Francisco, in strong support.
Speaker 5
Good afternoon. Michael Miller, Director of the West Coast Region of the UAW, strong support and a proud cosponsor.
Speaker 12
Hi. I am Koon van Rompe, head of the unit of infectious diseases at the California National Primary Research Center at UC Davis. I strongly support this bill.
Speaker 13
Kathy Yalick from UC Berkeley, Vice Chancellor for Research and a Professor of Electroengineering and Computer Sciences. I strongly support this bill.
Speaker 14
Hi. Miguel Martinez. On behalf of chancellor UC Berkeley Chancellor Rich Lyons, I'm strongly in support of this bill and urges your support, well.
Speaker 10
Afternoon. Alex Graves, the Association of Independent California Colleges and Universities in support. Also just wanted to register the support of California Institute of Technology, one of our members. Thank you.
Speaker 16
Doctor. Annette Hilton from UC Davis Center for Community and Citizen Science, in strong support of this bill.
Speaker 10
Good afternoon. A. J. Mendiola on behalf of the Lieutenant Governor Eleni Kunlakis in support.
Speaker 17
Afternoon. Ernest Walker with UAW four thousand eight eleven in strong support.
Speaker 11
Name is Nika Vincent. I'm a clinical research coordinator and UPDAE member at UC Davis Health, and I strongly support this bill.
Speaker 10
Good afternoon. Jared DeRusso Cloak with the Michael J. Fox Foundation for Parkinson's Research in strong support.
Speaker 18
Chair and members, Nate Solov on behalf of several organizations from the Parkinson's community who couldn't be here today. Appreciate the author and all his hard work. Parkinson's Association of San Diego, Parkinson's Community Los Angeles, Parkinson's Association of Northern California, Greater Fresno Parkinson's Support Group, and the Parkinson's Network of Mount Diablo. Thank you.
Speaker 10
Good afternoon, Chair and members. Keyship on behalf of Northeastern University, and the California Academy of Nutrition Dietetics, in strong support. Thank you.
Speaker 19
Good afternoon. Gia Chen, on behalf of the California Consortium of Addiction Programs and Professionals, in strong support. Thank you.
Speaker 16
Good afternoon. I'm Ivy Foster, junior specialist at UC Davis and in strong support.
Speaker 20
Good afternoon, members. Janet Lopez representing UCLA in strong support. Thank you.
Speaker 13
Good afternoon. Doctor. Katherine Keatsman. I'm the Director of the Health Equity Program at the UCLA Center for Health Policy Research and Associate Researcher at the UCLA Fielding School of Public Health in strong support. Thank you.
Speaker 10
Good afternoon. Connor Roderick, PhD candidate at UC Berkeley Chemistry and rank and file member of UAW four thousand eight hundred and eleven, in strong support.
Speaker 21
Afternoon. Martha Zaragoza Diaz representing the University of California ChicanaX Latinx Alumni Association, and we are in strong support.
Speaker 2
Hello. I'm Tom Shang. I'm a PhD candidate at UC Berkeley and a UAW member, and I'm in strong support as well.
Speaker 22
Good afternoon. Kim L. Spock, Professor of Management, Graduate School of Management, UC Davis, in strong support.
Speaker 10
Gabe Klassen. I'm a UC Berkeley graduate student and a member of UAW Local four thousand eight hundred and eleven,
Speaker 10
Good afternoon. Doctor. Khaled Mahmoud, UAW four thousand eight hundred eleven at UC Davis, strong support.
Speaker 14
I'm Richard Scalitar. I'm in the Physics Department at UC Davis, and I'm in strong support.
Speaker 17
Donald Palmer, professor in the Graduate School of Management at UC Davis, and I support the bill.
Speaker 2
Good afternoon, committee. Patrick Dexter on behalf of United Auto Workers Region six in strong support.
Speaker 24
Good afternoon. John Rundle, professor of physics and astronomy at UC Davis, researching earthquake forecasting and prediction using artificial intelligence. I'm in strong support.
Speaker 25
I'm Marie Rundle. I'm a retired K-twelve science and health teacher from Davis, and I'm in strong support.
Speaker 27
Good afternoon. Eric Baredes with the California Faculty Association in support.
Speaker 2
Afternoon. Chris Morales with the California State University Office of the Chancellor in support.
Speaker 10
Good afternoon. Marshall Nakatani on behalf of UAW Local four thousand eight hundred eleven, representing nearly 50,000 members Berkley National Lab, proud cosponsor on the legislation.
Speaker 28
Good afternoon, Chair members. Mari Lopez with the California Nurses Association, in support.
Speaker 29
I'm Sharon Lawler, Professor Emeritus, UC Davis Entomology and Nematology, in strong support.
Speaker 28
Good afternoon. Linda Way with Western Center on Law and Poverty, in support.
Speaker 31
Doctor. Robin Adcock, I'm the Director of Pediatric Integrative Medicine at the University of California San Francisco. I'm also a clinical researcher and volunteer faculty in the School of Medicine at UCSF. Strongly support.
Speaker 32
Madam Chair and members, Jason Murphy, on behalf of the UCE Office of the President, in strong support, also co sponsor.
Speaker 28
My name is Melanie Lendenal. I'm with the ALS Association, in strong support. Thank you, Senator Weiner.
Speaker 14
Lawrence Gill, representing, ALS Association Sacramento, in strong support of this bill.
Speaker 30
My name is Jack Davis. I have ALS, and I support this bill. My name is Christopher Holz. I'm a representative of the families of people that have lost ALS. My father passed away from ALS in 2011, and I'm in full support of this bill.
Speaker 32
Aaron Johnson, former caregiver and spouse of someone who had ALS and representing the ALS Association in strong support of this bill.
Speaker 36
I'm Jason Van Cort. I'm a research scientist with CAPS UAW and also a friend of, Mary Hooper. I support this bill.
Speaker 30
John Campos, brother of Christopher Campos, part of the ALS Foundation, and I strongly support this bill.
Speaker 1
We will now move and see if we have any lead witnesses in opposition. Seeing none, if anyone would like to register opposition, you may come down to the mic, state your name, your organization, and your position only. Seeing none, I will now move back to the committee to see if the committee has any questions. Senator D'Arrazzo.
Speaker 25
Just a comment. I want to thank the author and proud to be a coauthor of this bill. We know scientific research is one of the engines that have really driven California's success. I especially appreciate that this bond measure will create high quality union jobs and strengthen our public research institutes. And a particular provision that I want to highlight, because I've been working on procurement for years, is that the bond prioritizes purchasing goods and services from California suppliers, and with a good faith effort to have more than 50% of the purchases come from within state businesses.
So, with that, I'm proud to support the bill.
Speaker 38
Senator Caballero. Thank you, Madam Chair. I want to also thank the author, and I'm proud to be a co author as well. Thank you to everybody who showed up here today in support of this really important research. We have some of the best educational institutions in the world, and the ability to do research and the potential for life changing cures or, you know, assistance is really important.
And now, more than ever, we need to make the investments in our institutions. So, thank you for taking the lead on it.
Speaker 1
Well, saying no other comments, I want to echo the comments of the other committee members who have spoken and really thank you for bringing this bill forward again. I am a proud coauthor on this one as I was the previous version of the bill. But I really want to thank the author and the staff, the health committee staff, on working through some of the amendments to really kind of clean up and fine tune some of the things in this bill, especially when you're dealing with the council that will be created. And so I want to thank you, the health committee staff and your staff, for working so hard on this bill and the amendments. And with that, you are welcome to close.
Speaker 2
Thank you, colleagues. I want to thank everyone who came out today, and particularly the folks with lived experience. You know, I and I've actually talked about this in this committee before, so forgive me for repeating myself, but since I was 19 years old, I've had Crohn's disease, an autoimmune disease, and I've always been able to manage it. But it was about a little over ten years ago when biologics came around, and that really was transformational for my life. And so you have people who are living with chronic conditions, some of which have very poor treatment, some of which have good treatment, and all of which we want to cure.
And the idea that we would just sit by as research funding that can cure diseases, make people's lives better, prevent diseases, help us deal with the impacts of climate change, and which is impact upending so many people's lives, and so on and so forth, about the possibility that we would sit back and just let that, fall apart is just not tenable. And so for everyone whose life can be better, for for, frankly, the entire world, which can which has been improved and will be improved by scientific research here in California. We do this on behalf of all of them, and this is a I think a unique opportunity, for us. I when I introduced the first version of the bill last year, was very bare bones, and I didn't know what would happen. And the coalition just sort of materialized, because there are so many people who get it and who care deeply about the future of science.
And so I respectfully ask for your I vote.
Speaker 1
Thank you, senator. And once we have a quorum, we'll be able to move on that bill. I would like to invite the other members of the health committee who are not here. You can come down so we can establish a quorum. We will now move to file item number two, s b nine four four.
Senator Weiner, you're ready to go.
Speaker 2
Great. Maybe I'll just wait for I can. They're pretty efficient. Very efficient. Oh, I know.
Thank you very much, Madam Chair and colleagues. I'm here to present Senate Bill nine forty four, which will help stabilize and protect access to acupuncture as a Medi Cal benefit for all Californians. Acupuncture is a critical form of health care with proven benefits for pain management, mental health conditions, addiction treatment, nausea, digestive issues, and complications from chemotherapy. It can be especially helpful for populations where traditional treatments may carry higher risks or side effects, including adolescents and pregnant women. For millions of Medi Cal beneficiaries, and people living with chronic pain, and undergoing chemotherapy, and so forth, acupuncture can be a low risk, cost effective option that improves their quality of life, and reduces reliance on more invasive forms of care.
In the midst of our opioid crisis, in particular acupuncture is exactly the kind of non addictive intervention for chronic pain we should be promoting. And in our affordability crisis, this is a far less expensive, kind of treatment. Acupuncture is prominently used in our, Chinese American community. I'm proud that in San Francisco, we have just many amazing providers, but this is really true throughout the state and for many communities. Ensuring that acupuncture is covered in Medi Cal provides a critical lifeline for people who rely on it.
And so, this bill will, enshrine in law, that acupuncture is a covered benefit and that it is not, dependent on whether we have matching funds, from the federal government. So, I respectfully ask for your I vote. I want to welcome folks who have come here today from San Francisco and elsewhere to express their support for acupuncture as a Medi Cal benefit. And with me today to testify is Doctor. Zhang, the president of the California Acupuncture Coalition, which is sponsor of SB nine forty four, and Doctor.
Lily Chow, the director of integrative medicine at Northeast Medical Services, NEMS.
Speaker 1
Thank you. Before you begin, we are going to establish a quorum. Assistant, please call the roll. Senators Weber Pearson? Here.
Speaker 19
Weber Pearson here. Valladares? Here. Valladares here. Cavallero?
Here. Here. Here. Gonzales. Grove.
Here. Here. Here. Rubio. Smallwood Cuevas.
Speaker 1
Quorum has been established. You may begin. You both have a combined total of five minutes. Thank you.
Speaker 39
Thank you for the opportunity. Can you hear me? Okay. It's better now. Okay.
Thank you for the opportunity to being a witness today. Good afternoon chair and members. My name is Doctor. Lili Chow. I serve as the director of Integrate Medicine at Northeast Medical Services, one of the larger FQHC in the Bay Areas.
And in my clinical experience, acupuncture play crucial roles in helping patients manage chronic pain, recover from illness, and improve their overall quality of life. Particular for those with complex and also long term conditions, and also including cancer patients. And many medical patients, acupuncture, it is not alternative. It's a essential part of their care. Without it, our patients often face unmanaged pain, which can lead to increasing reliance on emergency rooms and more expensive interventions or OPO use.
And for a system perspective, acupuncture, it is a low cost and high value service and a helps reducing unnecessary health care's utilizations while improving patient outcomes. And this is exactly the type of investment we should be making as we move towards more integrative and a whole person care in California. So making this benefits a permanent ensures stability for both patients and providers and reinforce California's commitment to equitable access to effective and non pharmacological treatments. The demand is already there and the infrastructure is already there. What's missing is the policy stabilities.
So SB nine forty four is not about expanding anything new. It is about securing something that is already working and allow it for function as a skill. At a time when California was looking for a cost effective and non pharmacologic solutions to chronic pain and dispute align directly with that goal. So I respectfully asking for your support on SB nine four four. Thank you.
Speaker 23
Okay. Good afternoon, chairs and the members. My name is Danny Zhang. I'm president of California Aquapulture Collision. The sponsor of Senate Bill nine forty four.
I'd like to thank Senator Wiener for offering this important bill. Every day in my clinic, I treat medical patients who live with chronic pain, stress, and serious health condition. In California, licensed acupuncturists are recognized as the primary health care provider with our scope of practice. We know our patients well. We understand their medical history.
Many of our patients rely on us to help manage serious long term and chronic health conditions. Many of these patients cannot tolerate strong medications or invasive procedures. Acupuncture gives them another option that is safe, gentle, and effective. Patients report improved sleep, a great mobility, reduced pain, and higher spirit after acupuncture treatment. For some, acupuncture help provide reliance on opioids and other potent medication and drugs.
Medical patients should have equal access to acupuncture as other Californians. Manage acupuncture differently within medical activities, unnecessary barriers and leaves patients and providers uncertain about their options. Insertion fail and constant coverage will improve care, reduce reliance on more costly or risky treatment, and advance health equity across the state. SB nine forty four ensures acupuncture is an established medical benefit paired with other covered treatments. This bill will help protect access to care for millions of Californians who rely on medical.
Thank you for your time and for supporting patient access to the acupuncture.
Speaker 1
Thank you. We will now move to public testimony. For those of you who wish to speak in support of this bill, please come to the mic. State your name, your organization, and your position. You may begin.
Speaker 10
You. Good afternoon. Dylan Elliott on behalf of the San Francisco Board of Supervisors in support.
Speaker 10
Ryan McCarthy on behalf of Alhambra Medical University Alumni Association, United Acupuncture Association, in support. Thank you.
Speaker 35
Lynn Yang. I'm a licensed acupuncturist, and I'm former president of CAC in strong support of SB nine forty four. Thank you so much. Sharon Zhang, acupuncturist in strong support.
Speaker 3
Hello. My name is Steven Chan, a patient, retired engineer and also acupuncture student. I'm in strong support.
Speaker 15
Hello. Hong Lee Chen from the Academy of Chinese Culture and Health Sciences in Downtown Oakland. I'm a student, patient, and educator, and strongly support the bill. Thank you.
Speaker 11
I'm Christa Chan from the Academy of Chinese Culture and Health Sciences, and I'm a student and a patient in strong support of this bill. Thank you.
Speaker 35
Hi. My name is Hong Luo, licensed acupuncturist in California, and I graduated from Oakland Chinese Chinese acupuncture Medicine school for over twenty years. I serve a lot of patients. So I really strong this bill. Thank you.
Speaker 40
Good afternoon. My name is Jane Zhao Vincent. I'm practicing Sacramento Old Town, licensed acupuncturist. I have strong support. Good
Speaker 33
afternoon. My name is King Huizong. I'm a licensed acupuncturist in California. I am in strong support of nine forty four. Thank you.
Speaker 9
Hi, Robert Hoffman, president of Yoseon University of Traditional Chinese Medicine in Los Angeles, California. We're in strong support of this bill. Thank you.
Speaker 42
Good afternoon. My name is Chulong Shui. I'm an acupuncturist in California, and I'm serving thousands Medicare patients per year. I'm very strong support of this bill. Thank you.
Speaker 43
Good afternoon. I'm Doctor. Cho. I'm Korean Association Ecopetrol Group, the President. I'm a strong support SB nine forty four.
Thank you.
Speaker 44
Good afternoon. I'm Xian Huang, and I licensed acupuncture and practice acupuncture almost forty years. Acupuncture is safe, effective, side effect free and also cost effective therapy. Thank you. Thank
Speaker 45
Good afternoon. My name is Ying Li, the president of American Association of Chinese Medicine and Acupuncture. And I'm in strong support of SB nine forty four. Thank you.
Speaker 35
I'm Junghu, local acupuncturist. I'm practiced acupuncture almost thirty nine years from America Association of Chinese Medicine, acupuncture member. So I help a lot chronic pain patient, I strong support the bill. Thank you.
Speaker 46
Hi, Sheng Zhong. I'm a licensed acupuncturist from University of East West Madison and support the bill.
Speaker 47
Hello, I'm Korean. I'm an acupuncturist in California. I'm a member of the Korean society. I'm a strong support. Thank you.
Speaker 35
Hi, my name is Carissa Chan. I'm a licensed acupuncturist in Roseville, California. I'm support SB nine forty four. Thank you.
Speaker 15
Hello. My name is Casey Ching. I'm the licensed acupuncturist in California. I'm in support of SB nine forty four.
Speaker 10
My name is Kevin Kim. I'm a licensed acupuncturist in California. I'm in support of SB four ninety nine.
Speaker 15
My name is Yun Jin Han, and I'm a licensed acupuncturist in Sunnyvale. I support SB nine forty four.
Speaker 35
Good afternoon. This is Ivy Chen. I'm presenter of the company under the city Silicon Valley. I'm Director of Administration, Armstrong in support, SB nine forty four. Thank you.
Speaker 48
Good afternoon. My name is Wanlin Liu. I have been a acupuncture patient for five years and I strong support SB nine forty four. Thank you.
Speaker 49
Good afternoon. My name is Tian Yang. I'm an acupuncture patient for ten years with low back pain and neck pain. I strongly support this bill. Thank you.
Speaker 39
Hi. My name is Mia Zhang. I'm an acupuncture patient. I strong support this bill.
Speaker 46
My name is Zhong Hua Fu, acupuncturist. For more than thirty years. I strongly support SB944.
Speaker 35
My name is Seung Hee Lee, Sofia, doctor of acupuncture, herbal medicine specialist. Association is the Korean Medicine Association. I support SB nine forty four.
Speaker 33
Hi. My name is Seok Jang. I'm a licensed acupuncturist in California. I support this SB nine forty five.
Speaker 11
Good afternoon, Madam Chair and Senators. Sydney Pond with Northeast Medical Services in strong support. Afternoon. Dee Woo of Northeast Medical Services in strong support of this building.
Speaker 31
Good afternoon. I'm Robin Adcock. I'm a doctor of acupuncture in Chinese medicine, licensed acupuncturist. For this bill, I'm representing the California State Oriental Medical Association, a thirty year association of students and clinicians, and we strongly support SB nine forty four. Thank you.
Speaker 19
Good afternoon. My name is Joey Kwan. I'm an integrative medicine assistant at Northeast Medical Services, and I am in strong support.
Speaker 35
Good afternoon. My name is Xiaoxing. I'm working in greatest medicine assistant in medical Northeast Medical Service. I strongly support for this bill. Thank you.
Speaker 3
Good afternoon, senators. My name is Otto Lee, current board supervisor in Santa Clara County. Speaking on my own personal capacity today, I'm strongly supporting this bill. Thank you.
Speaker 1
Seeing no others that wish to speak in support, we will now give time for any lead witnesses in opposition. Is there anyone who would like to come forward and speak as a lead witness in opposition? Seeing none, if there is anyone in the audience that would like to register, their opposition, please come to the mic. State your name, your organization, and your position. Seeing none, I will now turn it back to the committee to see if anyone on the committee has any questions or comments.
Senator D'Arrazzo? Thank you, Madam Chair. I just want
Speaker 25
to thank everyone who was here today. Thank the author for bringing this up. I represent several API communities in the Los Angeles area. And I know how important it is, not only to the API community, but everyone who relies on care acupuncture care for their health and well-being. So thank you.
I want to thank also the acupuncture providers for doing what they do. It's culturally rooted care That's very important for people to have the trust to go to those to those providers. So I'm many of us are strong advocates for Medi Cal to make sure that our immigrant communities are covered by Medi Cal, but they also have to have access, and you're part of giving them access to true medical coverage. So, thank you very much.
Speaker 50
I just wanted to speak to also express my support for the bill, SB nine forty four. And appreciate, I know that we have some folks here from Alhambra today who offered their support of this bill. Somebody that grew up in Alhambra and Monterey Park, you know, two communities in the SGV that have some of the largest populations of API communities in the state. I know how significant this is. It's really important that we honor and respect Eastern medicine and the role that it plays in the lives of so many.
It's certainly something that I have incorporated and my family has incorporated growing up in the SGV, and it's had such a tremendous benefit for my family. So making sure that we're continuing to provide Medi Cal coverage for acupuncture is really necessary. I know so many of my constituents and their parents who I grew up with really rely on it as a form of care. So, you, and we'll be excited to vote aye.
Speaker 38
to thank the author. I'm a big believer in acupuncture. It's kept me away from any serious health issues. I'm absolutely convinced. My acupuncturist is in Salinas, she was trained in China.
And she's a doctor. One of these days, we'll get it right, and that you can become a doctorate of acupuncture here as well. And I've gone to her for over twenty five years. So I appreciate the work you do, keeping everyone healthy. And thank you to everybody who came to testify as well.
Speaker 1
And senator D'Arrazza has moved the bill. Wanna thank the senator and thank everyone who came out to speak in support and also our lead witnesses. I think that, you know, we are all aware of the fact that under Medicaid or Medi Cal, we don't determine what is a mandatory coverage or an optional coverage. And so this is an optional coverage per federal guidelines. However, I do want to commend you for recognizing that in our code, there was an interesting qualifier that was only placed on acupuncture and not the some of the other optional benefits.
And so that is what we will be correcting with this bill today. And with that, would you like to close?
Speaker 2
Great. Thank you very much. And, again, I want to thank everyone who took the time to come out today. I actually I had not, until recently, ever had acupuncture, and I had a strained forearm, and it basically fixed it. And I was so everything that I had been told over time turned out to be true.
This really helped a lot of people maintain their health, but also just improve their quality of life and deal with chronic pain in ways that are not that is highly beneficial without the risks of some of the medication. And so we want to make sure people can continue to have access, and it makes no sense to single acupuncture out from other forms of health care and treat it in a more negative way, which is what the law does now. And so this is equalizing it, protecting access, and I respectfully ask for your I vote.
Speaker 1
Thank you. The motion has been made by Senator D'Arrazzo. The motion is, do pass and re refer to the committee on appropriations. Please call roll. Assistant, please call roll.
Speaker 19
Senators Weber Pearson? Aye. Weber Pearson, aye. Valladares? Caballero?
Aye. Caballero, aye. Dorado, aye. Aye. Dorado, aye.
Aye. Aye. Mangevar, aye. Padilla, Perez, aye. Perez, aye.
Rubio? Smallwood Cuevas? Aye. Smallwood Cuevas, aye.
Speaker 1
That is eyes six, nose zero. We will leave that bill on call. And since we have a quorum, we will move back to file item number one. Do I have a motion on s b eight nine five? So moved.
Moved by senator D'Arrazzo.
Speaker 1
motion is due passed as amended and re refer to the committee on natural resources and water. Assistant, please call roll. Senators Weber Pearson? Aye. Weber Pearson, aye.
Valladares? Papageiro? Aye.
Speaker 19
Caballero, aye. Dorado? Aye. Dorado, aye. Gonzalez, Grove, Menjivar?
Aye. Menjivar, aye. Padilla, Perez? Aye. Perez, aye.
Rubio? Smallwood Cuevas? Aye. Smallwood Cuevas, aye.
Speaker 1
Before we move on to our next bill, we will consider the bills on the consent calendar. Thank you. These are file item three, s b nine eighteen with amends. Item four, s b nine seven one with amends. Item five, s b ten forty seven with amends.
And item nine, s b nine seven seven with amends. Senator Meenjivar has made a motion. Assistant, please call the roll.
Speaker 19
Senators Weber Pearson? Aye. Weber Pearson, aye. Valladares? Caballero?
Aye. Caballero, aye. Dorado, aye. Dorado, Dorado, aye. Gonzalez, Grove, Menjivar?
Aye. Menjivar, aye. Padilla, Perez, aye. Perez, aye. Rubio, smallwood, Cuevas, I.
Small Wood Quivos, I. 60 on call.
Speaker 1
That is 60, and we are going to place that as well on call. I would like to strongly recommend that any authors who will be presenting today to come down to health committee in Room 1200.
Speaker 51
We will now be moving on to file item 10, SB nine eighty seven. Madam chair? Whenever
Speaker 1
you're ready. Thank you. Thank you. Good afternoon, colleagues, and thank you for the opportunity to present SB nine eighty seven, California Health Access Fund. H.
R. One, the federal reconciliation bill signed last year, makes significant changes to Medicaid eligibility, including new work and community engagement requirements, and more frequent eligibility renewals for certain populations. These changes increase the risk that eligible individuals will lose coverage due to administrative barriers, rather than changes in income or need. The Department of Health Care Services estimates up to 2,000,000 Californians could lose their Medi Cal coverage as a result of these federal changes. While coverage loss reduced state Medi Cal expenditures on paper, they do not eliminate health care needs.
Individuals who lose coverage often delay care, rely on emergency services, or receive uncompensated care from safety net providers and safety net hospitals, shifting costs rather than reducing them. Absent state actions, savings generated by reduced enrollment may not be directed towards maintaining access to care, supporting providers and those safety net hospitals, or addressing gaps created by federal disinvestment, but instead may be just swept back into the general fund. SB nine eighty seven would require the state to establish the California Health Access Fund separate from the Medi Cal program. This fund would capture any savings resulted from the reduced Medi Cal enrollment caused by H. R.
One. The Department of Health Care Services would then be tasked with administering the fund to ensure that Californians who lose Medi Cal coverage can still receive the health care access and services, and health care providers and their facilities will be reimbursed for providing those services. This bill is intended to start the conversation as to how we will continue to provide health care and pay providers and safety net hospitals when a large number of Californians can no longer rely on Medi Cal. At a minimum, we need to repurpose any money that the state saves when people lose Medi Cal, and use that money for the health care system who will still be serving these individuals. I respectfully ask for your I vote.
Speaker 51
Thank you, Senator. Do you have any lead witnesses in support? No. Okay. Would anyone like to record their Me Toos in support of SB nine eighty seven?
Please step forward.
Speaker 52
Afternoon, madam chair, members. My name is Conrad Crump with Disability Rights California. On behalf of the many Californians, with disabilities who access life saving care through Medi Cal, all in support of this measure.
Speaker 28
Good afternoon. Linda Way with Western Center on Law and Poverty in strong support.
Speaker 41
Thank you. Katie Van Dyens with Health Access California in support. Thank you.
Speaker 22
Vanessa Hina on behalf of the California Academy of Family Physicians here in support.
Speaker 34
Angela Pontes on behalf of Planned Parenthood Affiliates of California in support.
Speaker 9
Tim Madden, representing the California Chapter of the American College of Emergency Physicians in support. Thanks.
Speaker 10
Dylan Elliott on behalf of the California State Association of Psychiatrists in support.
Speaker 21
Sette Short, on behalf of Adventist Health and PEACH representing Community Safety Net Hospitals in support.
Speaker 51
Ms. Sette Short, don't see any registered lead opposition. Anyone anyone like to record their me tos in opposition of this bill? Seeing no one's to be forward. Bringing it back to senator Caballero to
Speaker 38
start our discussion. I really appreciate what, you're trying to accomplish with this bill. We always end up in a situation where we expect there's going to be savings and then we don't ever see them, they just kind of Disappear. Disappear, yeah. So, I get it.
So, I expect we're going to see some changes over the time that the bill is run. But just my 2¢ worth is we've got to figure out what are the biggest holes we have left after HR1. I think operationally we're going to see, and from my perspective, I think we need to prioritize indigent care, people that are not covered by insurance, prevention models, maybe people with disabilities and children. The most vulnerable in our communities are, I think, going to be impacted. And so, if we had to pick something that, in my mind, would be a priority over really expensive care that's necessary, but, you know, you can use up an entire fund with very little impact.
So that's thank you for doing this. I really appreciate it. And when the appropriate time comes, I'd like to move the bill.
Speaker 11
No. Thank you very much for bringing this bill forward. And it's our short term general fund savings will rely on the coverage loss, which shifts our long term cost to emergency care. And that's one of my questions is, as we hopefully will receive these the savings, will some of those funds be earmarked for indigent care so that we ensure that those folks who may be losing their benefits can somehow gain them and have support for health care access within the system?
Speaker 1
Yeah. So that's a great question. And that will be a part of the conversation. Really, the point of this bill as of right now is to ensure that those funds that are saved don't end up being taken up by future administrations, and we aren't able to have that conversation and that decision as to where it will go. We know that patients are still going to they're not going to get sick.
They're still going to go to emergency rooms. Our hospitals are going to have to pay for that uncompensated care. We already have issues with hospitals closing their doors, which is why we had to do the emergency distress hospital loan a few years ago. We're still going to have clinics. We're still going to have an access issue.
And we need to ensure that we have the funds to start having those conversations as to where that could go. I really like Senator Caballero's suggestion about not just potentially using these funds for when they come into the emergency room, but trying to figure out a way to use it in a preventative way so that they don't end up getting that more expensive care. So those are all conversations that will be had. But the purpose of this bill is to really take those funds and say, you can't just throw them into the general fund or have them disappear somewhere else, that it needs to be redirected back into the health care system.
Speaker 11
I appreciate that common sense bill, and we need both. We need that emergency indigenous care reality, but also that preventative care. So, you for bringing this bill forward.
Speaker 37
Seeing no other questions, we do have a motion from Senator Caballero. Oh, would you like to close?
Speaker 1
I want to thank my colleagues for this robust conversation. I think we have to really start thinking outside the box and how we're going to help Californians in this very interesting time some from things that we never thought we would have to deal with. But with that, I respectfully ask for an
Speaker 37
I vote. Thank you, secretary. The motion is do pass and re refer to the committee on appropriations. Please call the roll.
Speaker 19
Senators Weber Pearson? Aye. Weber Pearson, aye. Valladares? Aye.
Valladares, aye. Caballero? Aye. Caballero, aye. Dorado?
Dorado, aye. Gonzalez, Grove, Menjivar? Aye. Menjivar, aye. Padilla?
Aye. Dia I. Perez? Aye. Perez I.
Rubio? Smallwood Cuevas? Aye. Smallwood Cuevas I. That authors.
Speaker 1
We will now move to file item seven, SB nine sixty four. Senator Smallwood Cuevas, you
Speaker 11
may begin. Thank you so much, madam chair, and thank you for your patience. My missing folder. I want to thank the committee for their diligent work on this bill, and I am accepting the committee's amendments clarifying that the health care professional and the enrollee or insured prescribing provider are treating providers. I am also accepting the committee's amendment to remove subdivision B.
So, I'm happy to present SB six ninety four because it really helps patients with chronic, complex conditions to get the right dose for medications they are already approved to take without unnecessary prior authorization delays, allowing up to two clinically appropriate adjustments while protecting continuity of care. Under current practice, health plans often require a brand new prior authorization every time a medication dose or frequency needs to be adjusted. This happens even when the change is medically necessary, and the medication itself is already covered. Think about what that means in real life. A doctor determines that a patient needs a small adjustment to their medication to keep their condition under control.
And instead of being able to make that change right away, the request must go through a prior authorization process with the health insurance. Many of these requests are denied and eventually overturned on appeal. But by then, valuable time has already been lost. Doctors and care teams spend hours on paperwork. Patients wait in pain, and treatment is delayed.
For patients, these delays are not just inconvenient. They can mean interrupted treatment, on preventable disease, having to manage flares, and in some cases, avoidable trips to the emergency room. I had the opportunity to hear a personal story from a patient who is suffering with Crohn's disease. And she talked about how she has this disease is refractory, which means she has persistent inflammation and damage to her gut despite using advanced therapies. And that she has had to rely heavily on continuous medication adjustments just to keep her, out of the operating room.
And too often, she's forced to have to wait because of these delays to get that necessary relief from this chronic disease and pain. And we know that women living with chronic disease often face additional burdens, including delayed diagnosis, higher out of pocket costs, and reduced quality of life. So, for this, we think SB nine sixty four allows a licensed health care professional to adjust the dose or frequency of a covered medication up to two times without prior authorization, when clinically appropriate, and while maintaining existing clinical standards and excluding controlled substances. We think this is a common sense bill that helps us provide necessary reforms and to ensure that we don't have unnecessary insurance delays. Today, testifying with on this bill item today is Lisa Lum, a mother of a child with Crohn's disease, and Ryan Spencer, Crohn's and Colitis Foundation, who is the sponsor of the
Speaker 1
Thank you. You will each have a combined five minutes for your presentation.
Speaker 20
Good afternoon. Good afternoon, madam chair and members. My name is Lisa Lum. Thank you for letting me speak today on SB nine sixty four. I'd also like to thank Senator Smallwood Cuevas for authoring the bill.
At the age of nine, our son Trevor was diagnosed with Crohn's disease after three months of constant blood in his stool. Immediately, all the worries of how we were going to control this lifelong disease flooded into our minds. What I remember most was his doctor saying that there are not many approved medications for a patient of his age. Therefore, it's important to make sure each one is given in a timely manner to determine if it's truly ineffective before we move on to another. Once he stops, his body will create antibodies, and he won't be able to use it again.
On 11/01/2022, Trevor was placed on REMICADE. The insurance approved the first three infusions, which were only a few weeks apart, followed by a maintenance infusion every eight weeks. Within those first weeks, we were excited. He had minimal bleeding and more energy for the first time in eight months. Although we saw progress, his doctor said that his blood work is showing that his body is using the Remicade, but he doesn't have enough in his system to last until the maintenance infusion every eight weeks.
So she requested a dosage change from every eight weeks to every four. This was denied by insurance, stating that it was not medically necessary. Even after Trevor's doctor submitted clinical trials to support the increase, the insurance denied the request and appeals for a total of three times. I have records of appeals, denials, expedited review request, letters, and emails of me asking and pleading, what else do we need to submit? What else do we need to get it approved?
After over a month and a half of back and forth, I submitted an independent medical review complaint to the Department of Managed Health Care. Within two days, the increase was approved by the insurance and now considered medically necessary. We did not provide any additional information than the first three times the insurance company had it all, and yet it took them one and a half months versus two days to overturn their denial. Meanwhile, it had been six weeks since Trevor's last infusion, and he was now home from school due to cramping, increased bleeding, and he had to begin a round of steroids, which was exactly what his doctor was trying to avoid given the risk of long term steroid therapy. Ultimately, even after the increase, Trevor had to move off of Remicade onto another medication.
But we will never know we will never truly know if he would have received the full benefits of the Remicade had he got it in a timely manner. There are limited medications out there, and I fear one day he will run out of options. I'm a stay at home mother who had the time and resources to fight for him during this desperate period, and I still could not save him from the pain he experienced. After this whole ordeal, I remember it so clearly. We were at our children's soccer game, and I made a beeline to mister Spencer, who I knew worked closely with the Crohn's and Colitis Foundation, and I said, is there anything we can do to improve this process, and what can I do?
Because Trevor cannot go through this again, and I know he's not the only one that this is happening to. Sure enough, they had already started drafting SB nine six four to address this very issue. Thank you again, senator. So I'm here today in front of people who can make change. Please don't let patients like Trevor suffer or slip through the cracks because of a barrier that insurance creates to get effective health care.
We ask the committee to please vote aye on SB 9.4. Thank you for your time and listening to our story. Thank
Speaker 27
Thanks. Fine. I'll be really quick, I'll tell a quick personal story. About ten years ago, my mother was diagnosed with triple negative metastatic breast cancer, and she looked for months for treatment that would work. Sadly, she couldn't find one and it went terminal.
But I'll tell you, if she found medication that would work, we'd do our damnedest to make sure that she would stay on that medication. And if for some reason those antibodies started to fight off its effectiveness and the knows her condition and has the clinical supporting data to support it, said one way to keep the same clinical response is to increase that dose, then we're going to do it. And if that means that it goes beyond what the FDA approves, but it's something that the doctor knows is worth the shot, we're not going to gamble on a new drug. We're going to find one that works. Now, my mom never actually had that chance, but other people do.
And so I asked for a high vote. And I represent the Crohn's and Colitis Foundation sponsors of the bill. Thank you.
Speaker 1
Thank you. At this time, if anyone else in the audience would like to speak in support of the bill, please come forward, state your name, your organization, and your position. Thank you. Vanessa Hina, on behalf
Speaker 53
Good afternoon. Kaylyn Dean, California Hospital Association, in support.
Speaker 28
Good afternoon. Linda Wei with Western Center on Law and Poverty, in support.
Speaker 9
Tim Madden, representing the California Chapter of the American College of Cardiology and the California Rheumatology Alliance, in support.
Speaker 26
Kevin Wooswan with the California Medical Association. And with the proposed committee amendments, we'll be moving to full support. So, thank you.
Speaker 1
Seeing no others that wish to speak in support, if there's anyone from lead opposition that would like to come and speak in opposition, this is your time. You will both have a combined five minutes. Thank you.
Speaker 54
Thank you, Chair and members. Cassidy Heckman, on behalf of the California Association of Health Plans in respectful opposition today. We appreciate the author's intent to reduce delays in care for patients with complex and chronic conditions. However, as drafted, SB nine sixty four raises serious concerns related to patient safety, affordability, and oversight. SB nine sixty four would allow dose or frequency increases without confirming they align with FDA guidelines.
Proving that safeguard increases the risk of adverse reactions, misuse, or dosing that has not been proven to be safe or effective. The bill also encourages higher dose use of costly specialty and brand name drugs when clinically appropriate and lower cost alternatives may be available. The higher costs ultimately impact premiums and affordability for consumers across the state. Health plans use authorization of care to ensure medications and dose increases are safe, evidence based, and consistent with FDA approved labeling. It is not arbitrary nor used as a means to deny care.
But it does ensure the right medication at the right dose is being used at the right time. We are committed to continuing discussions with the author and sponsors. However, at a time when health care affordability is at the forefront of our minds, we urge careful consideration of health care mandates. We respectfully ask for a no vote. Thank you.
Speaker 7
Madam Chair and members, Stephanie Watkins, on behalf of the Association of California Life and Health Insurance Companies, I'd first and foremost like to thank the sponsors we've had over the last couple years, some very thoughtful conversations about this bill and about issues related to prior authorization as this committee has as well. And in the interest of time, I'd like to underscore much of my colleagues' comments. The issues raised related to safety and cost, along with the bill's impact on proven utilization management safeguards, is hard to ignore. With respect to patient safety, plans and insurers often limit a drug or dose for specific reasons related to preventing abuse or overuse, ensuring that the use aligns with FDA approved labeling, as well as avoiding doses that have not been adequately studied for effectiveness or safety. Unfortunately, SP nine sixty four removes key guardrails by allowing dose increases without ensuring prescription to remain consistent with FDA labeled dosages or approved uses.
That reduced oversight could increase the risk of adverse outcomes if dosages change, are not clinically appropriate, are not carefully monitored. Additionally, as noted in a previous analysis of a similar proposal, SB nine sixty four will result in higher health care costs through the increase of premiums. While we appreciate the sponsor's attempt to narrow the bill, the core concern remains. It can encourage continued use of expensive specialty or brand name drugs even when a generic or lower cost therapeutic alternative is available. Those added drug costs ultimately affect affordability to patients, employers, and taxpayers.
Given the instability in today's market, even minor increases could make the difference between an individual choosing to purchase coverage or opting to risk going without. Lastly, while we strongly believe SB nine sixty four undermines existing utilization protocols, like prior authorization and step therapy, that help ensure patients receive the right medication at the right time and at the right dose. These tools are especially important in prescription drug coverage, given the potential for misuse and high cost of specialty medications. Allowing providers to increase dosages up to two times without plan review essentially weakens critical safety and appropriateness checks. It also ignores the clinical evidence, and best practices evolve, and plans may appropriately work with patients to transition them to more effective or lower cost formulary options.
For these reasons, we are currently opposed to the bill. That being said, we do look forward to working with the author and sponsor if the bill moves forward today, and looking to see if there are potential options going forward. Thank you.
Speaker 1
Thank you. If there's anyone else in the audience that would like to register the opposition, please come to the microphone and state your name, your organization, and your position. Seeing none, I am going to turn it over to the committee to see if anyone has any questions or comments. Seeing none, I have some questions. So when I look at this bill, first of all, thank you for bringing it forward.
Thank you. Thank you so much for your testimony and coming in and sharing your personal story. It talks about the authority for a provider to adjust the dose or frequency of a drug. But in the opposition statement, they were talking about exceeding FDA approvals. Is that what we're referring to here?
Speaker 11
No. This bill is focused on making sure that physicians who, already understand and manage these drugs, who understand how they interact with patient care, to ensure that the evidence based care that they're giving, that their patients are able to access this easier. This is not about looking at experimental drugs. This bill only applies to drugs that are already covered. So
Speaker 1
this question of Right. So let me make it a little clearer. If I have prescribed a medication at a certain dosage and my patient needs a higher dose that is not necessarily in excess of that dosage. That is what this bill is trying to prevent me or that patient from having to wait from the insurance. Or is it when I prescribe a dose that exceeds the recommended dose?
Speaker 27
It's the former. It is when you are prescribed actual when you prescribe a drug and it is approved by the plan, they approve that drug. Then that drug starts to lose effectiveness on the patient and the physician decides based on their research, their clinical data, that the best interest of the patient is to keep them on that drug and increase the dose or, in the case of a Crohn's patient, the frequency of that dose, then that's the request that they make to the plans.
Speaker 1
And it's still within the approved dose regimen that is FDA approved. We're not exceeding a dose. We're not Go ahead.
Speaker 27
Potentially, but potentially not. In some cases, will see and you'll see some of these denial letters that if FDA approves it, say an infusion for eight weeks, but that's the standard infusion, but yet the body of the patient has developed antibodies for it so it's not responding. The doctor thinks more frequent infusions would be better for the patient. So they ask for four weeks. FDA did not approve four weeks.
They approved eight weeks. And so, yes, that would be considered off label.
Speaker 1
So is there any way to, in the future, as this bill is being moved forward? Because I know, as providers, we will oftentimes go by clinical practice. But even within that, it has been studied, it is widely used within our own profession. It may not necessarily be FDA approved for that particular length of time. Is there any way to clarify that just to ensure that?
I don't believe any providers would go rogue, but addressing the concerns that the opposition may have that someone may be doing some kind of, hey, let's try this, which is not necessarily standard of care for that particular condition or area. Are we able to do that?
Speaker 27
And I say that with absolute certainty because in the information that Ms. Lum sent to the doctor, they provided that medical information, They provided that data. And it was still denied.
Speaker 1
Right. I guess what I'm saying is they're saying in this bill that it would allow for that. Is that right?
Speaker 7
Yeah. There's nothing in the bill that prohibits If the initial diagnosis and prescription is either unlabeled or within FDA approved limits, there's nothing then that says that it has to remain within that. It just says that it can't be a controlled substance or it can't be I mean, there's a couple of different qualifying. But certainly, you would assume and we have to look at the breadth of this bill. While most of the testimony has always been around Crohn's and colitis, the bill really does touch across all segments of health care space and a really large amount of drugs and treatment plans.
So in those instances, I think and this is something that we had talked at one point, I think, with the sponsors about limiting it to either FDA approval to ensure that there were protections there about either the frequency of the dose or that it was on label use. So I think those would be key components we would be I I think that's going to be a concern for the sponsors, to be quite honest with you, to specifically limit that.
Speaker 1
Well, I'm not saying limited to FDA, but there are clinical, best clinical guidelines that include off label or more frequent. And you might want to consider including that in the language just to ensure that, you know, no one is harmed.
Speaker 11
Well and that's the intention of this bill is that we want folks to not have to go to the emergency room to need emergency care. We want to create an environment where they are able to, under their doctor's prescription, under their doctor's guidance, be able to access the medication that is prescribed. And we're happy to continue to work with the opposition on this. I think this is a nuance that we will dig into as we move the bill forward, because we don't want anyone harmed. This the goal here is to help folks reduce some of the suffering.
Speaker 37
Yes. So I think they say you shouldn't marry a comedian because they'll tell your personal stories, and you shouldn't marry a legislator either because they'll also talk about their personal stories. And my husband, who takes thyroid medication, has been through this very similar situation so sorry, Shane where he needed an increased dosage and he wasn't approved for it. He ran out of the existing prescription. And there are side effects when you're not on your thyroid medication.
And so, I've seen it personally from the patient's perspective, how important having access to a really quick turnaround on the prescription dosage is important. My question, though, on, I guess, the clinical side or the doctor side is, if a doctor prescribes, you know, the wrong dosage or an unsafe medication or messes up, are they not liable for that? And that would still be the case. So for me, it seems really simple that we trust our doctors. And when we're dealing with any type of chronic illness, that we should easily be able to trust the recommendation and prescriptions from our doctors.
The other question I have is, your doctor prescribes you a medication, then the pharmacist often also looks at that dosage to weigh input as well, typically. Is that also correct?
Speaker 20
is monitored through the doctor, but also the specialty well, it must be because I haven't had any the specialty pharmacy will call me about deliveries, or we go to UC Davis for the infusions, and no one has ever said anything. But I would assume that if it was dangerous, that they would say something, you know? I mean, I work with the doctors. I speak directly to the specialty pharmacies every month, and I would assume that they would say something. Okay.
Speaker 37
And so for me, it seems pretty basic. For the opposition, do you have amendments that could make this better, clarification language? Was that ever presented? On earlier iterations
Speaker 7
of the bill, and this is, you know, a much more narrowed bill than we've seen. I think this is the third time fourth. Sorry. Right? Fourth time we've had this conversation, it certainly evolved.
I think there are amendments we would be happy to sit down and discuss. I think some of where we would want to go, either directing to clinical care guidelines or some pointing to a requirement that they meet a certain standard. I understand that many of the usages are often off label. So that's I mean, it's I think what we would want isn't something necessarily that they could agree to given the population that they're looking at. We can certainly continue to have those conversations, and we're happy to do that.
But there is that concern, partly because the bill is so broad. It isn't just about the Crohn's and Colitis condition, but everything. And so you as you're trying to address such a wide span of diagnosis, treatments, it gets you know, there's lots of off label. There's lots of things that are really standard of care that are off label. And then there are ones that are not.
And how do you kind of remedy that? But we're committed to having the conversation if the bill booms forward today and see if there's a pathway. Thank you.
Speaker 1
Hey. Well, want to thank senator Smallwood Cuevas for introducing this bill and for allowing us to have this robust conversation. Look forward to those continuing conversations. Yes, you're not going to get exactly what you want, but I do think that you have brought up some concerns that we may be able to address with looking at clinical practice, clinical standards of care, which are less stringent than FDA, but are things that we, as providers, use and our patients definitely need. There was one part of your bill, and you and I talked about it, and I did with the sponsor as well, that excluded Medi Cal managed patients from this.
And I have generally been very clear about the fact that if we're going to do something for one set of patients, we should do them for all, especially for those that are on Medi Cal, because they often have very chronic, significant illnesses. We did reach out to DHCS, and it seems like they already have a system in place, and that they only utilize prior authorizations for like, very high dosage that would exceed the maximum dose restrictions. And so, because of that, and I think that this is very much needed, I will be supporting, and you may close.
Speaker 11
Well, thank you so much, Madam Chair, and really appreciate your expertise in this subject matter area. This is about helping patients. This is about making sure Californians can get the access to care and pain and suffering relief as quickly as possible. And also to save money so that folks aren't having to go to the emergency room or needing a more expensive treatment because they weren't able to access an adjustment in their dose. So, we will continue to work with the opposition.
We think this is a good bill, even if it is the fourth time around. Fourth time's a charm. And I respectfully ask for your I vote.
Speaker 1
Thank you. Would anyone like me to move the bill? Move the bill by the bill has been moved by senator Padilla. The motion is do pass as amended and re referred to the committee on appropriations. Assistant, please call the roll.
Senators Weber Pearson.
Speaker 19
Aye. Weber Pearson. Aye. Valladares. Aye.
Valladares. Aye. Cavallero. Aye. Cavallero.
Aye. Dorazo. Aye. Gonzales. Aye.
Gonzales. Groove.
Speaker 19
Grove I. Menjivar? Aye. Menjivar I. Padilla?
Aye. Padilla I. Perez? Aye. Perez I.
Rubio? Aye. Rubio I. Smallwood Cuevas? Aye.
Smallwood Cuevas, aye. 110. It's out.
Speaker 1
Wow. 110. That bill is out. Thank you. Good job.
Alright. We will now move back in file to file item number six, s B1099 from senator Reyes.
Speaker 29
Thank you, Madam Chair and members, for this opportunity to present SB ten ninety nine. SB ten ninety nine clarifies California local government's authority to provide state or local public benefits to all residents under the statutory exemption provided in the Federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, also known as PROWARA. Historically, California has relied on a statutory exemption under PROWARA that allows local governments at their discretion to provide state and local public benefits to all residents. Thanks to this exemption, our local governments have been able to provide critical services such as health care and safety net programs to all residents without worrying that they are in violation of federal law. Unfortunately, the California statute that provides this pro rata exemption is too vague and is not directly tied to how local and state public benefits are defined at the federal level.
This creates risk because if the federal definition changes or is reinterpreted, our California exemption may fall out of alignment, potentially exposing local governments to compliance issues. SB ten ninety nine addresses this by explicitly tying state law to the federal definition, ensuring clarity and consistency with federal requirements. While technical, this is a high impact bill that strengthens and protects local government's existing authority to serve all residents. Here to testify on the bill today are Tony Lopresti, the chair of the Civil Prosecutors Coalition and Santa Clara County Council, and Jordan Flanders, Interdepartmental Counsel for Homeless Services, Oakland City Attorney's Office.
Speaker 55
Good afternoon, Chair Weber Pearson and members. My name is Tony Lopresti, County Counsel for the County Of Santa Clara and Chair of the Civil Prosecutors Coalition. Civil Prosecutors Coalition is proud to support SB ten ninety nine. The coalition is composed of seven city attorneys and county councils from the cities of Oakland, San Diego, San Francisco, and San Jose, along with the counties of Los Angeles, San Diego, and Santa Clara. We represent some of the largest public law offices in the state and advise our local government clients on all issues, including protecting our authority to use public funds to benefit the most vulnerable residents in our communities.
And that is precisely why we are so thrilled to work with Senator Reyes on SB ten ninety nine. This bill is a straightforward clarification of longstanding California law that allows local agencies to spend state and local funds to offer critical programs and safety net services to all of our residents. As the federal government continues to layer safety net programs with grant conditions and eligibility criteria, we hope to partner with the state to protect our autonomy and our authority to use state and local dollars to serve our residents as we deem appropriate. As cities and counties, we know our residents and their needs best, and we design programs to respond to those needs. That's why local control over how we spend state and local funds is so critical.
I want to be clear that this bill doesn't require local governments to do anything. It doesn't require that locals spend their money in any specific manner or on any specific constituency. Instead, it clarifies in statute local government's authority to develop and maintain programs that serve our residents based on criteria that we establish, rather than criteria established by the federal government. As city attorneys and county councils, it's our role to provide as much legal certainty as possible to our local government clients. This bill will minimize risk and uncertainty, particularly in these very difficult budget times.
Civil Prosecutors Coalition, request your support for this bill. Thank you.
Speaker 56
Good afternoon. Thank you to the chair for the opportunity to speak today, and thank you to senator Reyes for bringing forward s v ten ninety nine. I'm here as the interdepartmental homelessness council for the city city of Oakland city attorney's office in support of this bill, which makes a simple but important change to California law. It reaffirms and clarifies that local governments have the authority to provide essential services to the all residents who live in their community using state and local funding sources despite any changes to federal law. Local governments are on the front lines of providing services such as health care, emergency shelter, crisis intervention, and food distribution.
These programs must operate quickly, with minimal barriers, and often without collecting personal information. Many programs serving people in crisis cannot realistically incorporate documentation checks or detailed intake requirements. For example, homeless outreach teams often engage people in encampments or on the street for only a few minutes at a time. These teams focus on transportation to shelter and crisis de escalation. Encampment management teams leverage a wide variety of resources to address encampments and must be able to provide those resources to all people living on the streets, if they so choose.
These teams generally do not have time or the ability to conduct identification checks during these brief encounters. Similarly, street medicine teams prioritize urgent medical and behavioral health stabilization, which depend on speed and low barrier access. Finally, suicide prevention and crisis hotlines operate anonymously by design, and callers frequently decline to to provide any identifying information at all. Gaps or uncertainty about the scope of required screening may cause local governments to hesitate in providing services or to restrict eligibility for locally funded programs unnecessarily. This bill would take advantage of existing provisions of federal law to clarify that local governments in California can continue to use state and local funding for these services if they choose to do so.
It does not require or mandate any local action. Instead, it provides the legal certainty that cities and counties need to continue providing essential frontline services to their residents using state and local funding to the fullest extent that federal law allows.
Speaker 1
Thank you. And at this point, if you are in the audience that would like to register your support, please come to the microphone, state your name, your organization, and your position. Madam Chair and members, I'm Erin Evans. I've been asked to register the support of the San Diego City Attorney Heather Ferbert. Thank you.
Speaker 10
Dylan Elliott, on behalf of San Francisco City Attorney David Chu, as well as the city and county of San Francisco, both in support. Thank you.
Speaker 3
Good afternoon again, senators. My name is Otto Lee Still, serving as the board president of the Santa Clara County Board of Supervisors, and we are strongly supporting and also a cosponsor of this bill representing 2,000,000 people of our county, largest county in Northern California. Thank you.
Speaker 1
Thank you. At this time, if there's anyone in the audience that would like to speak as lead opposition? Seeing none, if there's anyone in the audience that would like to register your opposition, please come to the mic, state your name, your organization, and your position. Seeing none, I will now turn it over to the committee if anyone has any questions or comments. The bill has been moved by Senator Gonzalez.
Senator Reyes, you may close.
Speaker 1
Thank you. The best close we've had all day. Alright. So the motion by senator Gonzalez is to pass and re refer to the Committee on Human Services. Assistant, please call the roll.
Senators Weber Pearson. Aye. Weber Pearson. Aye. Valladares.
Aye. Valladares. Aye. Caballero. Aye.
Caballero. Aye. Dorado.
Speaker 19
Aye. Gonzales. Aye. Gonzales I. Grove?
Aye. Grove I. Menjivar? Aye. Menjivar I.
Padilla? Aye. Padilla I. Perez I. Rubio?
Aye. Rubio I. Smallwood Cuevas?
Speaker 1
Eleven zero. Eleven zero. That bill is out. Thank you, senator. Thank you.
Thank you. We will now move to file item eight, s p ten thirty three by senator Padilla. And you may begin when you are ready.
Speaker 17
Afternoon, Madam Chair and members. It's my honor to present SB ten thirty three. I want to begin by thanking the committee and the chair for working with my staff on this bill. We're happy to accept committee amendments that were worked out to define protein product as either a protein supplement, as defined in federal law, or a food product that is a protein supplement premixed with water. You can see those highlighted materials in front of you.
This bill requires manufacturers of protein products to test their items for heavy metals and disclose those findings. In recent years, there have been increasing demand for protein fortified items that have led manufacturers releasing in abundance, large quantities of these products. This rapid market expansion has occurred without any regulatory oversight. In October 2025, Consumer Reports conducted an independent investigation of multiple protein powders and protein beverages, and their results were disturbing. They found that several products contained levels of heavy metals, including arsenic, cadmium, and lead.
At the federal level, the Food and Drug Administration does not review dietary supplements for safety or for effectiveness, and there are not any federal limits on the amount of heavy metals and products to consumers. Without transparency and standards, consumers are left unaware of the potential toxic exposure from these contaminants in the products they are consuming. These supplements contaminated with heavy metals can contribute to numerous serious health outcomes, including neurological issues, immune suppression and reproductive harm, and long term health impacts. In order to protect consumers, create transparency at these toxic levels, and ensure people are purchasing safe products, SB ten thirty three requires manufacturers to test their products for heavy metals and disclose these findings. This addresses a growing public health concern, protects Californians from preventable harm, reinforces our state's commitments to transparency, safety, and responsible product regulation.
With me today, I have Ryan Spencer from Environmental Working Group and Caitlin Marr, Research Manager for the Center on Environmental Health.
Speaker 27
Thank you, Madam Chair and members of the committee. Ryan Spencer, on behalf of the Environmental Working sponsors of SB ten thirty three. First, I'd like to thank the senator for introducing this bill as a direct response to the mounting evidence that some protein products contain levels of heavy metals high enough to raise serious public health concerns, particularly for teens and frequent users. Protein powders, shakes, and bars are not occasional use products. Many Californians, not just athletes, incorporate them into their daily routines, sometimes multiple times per day.
The pattern of use matters because even low levels of toxic elements can accumulate over time and create real health risks, particularly for pregnant individuals, adolescents, and those with chronic exposure. This is particularly alarming when you consider even a single scoop of protein powder can push someone past the recommended limits for lead, a problem that has grown over the years. A recent Consumer Reports study the center mentioned showed average lead concentrations higher than those identified in testing conducted fifteen years ago, and fewer products today are testing below detectable levels. But all, thankfully, is not lost. Safer outcomes are achievable.
That same Consumer Reports study also identified products containing much lower levels of heavy metals than others, which tells us this is not an unavoidable problem. It's a solvable one. Yet consumers have no way to distinguish between those products and what is best for them. SB ten thirty three corrects this imbalance by introducing a simple but powerful concept, transparency backed by accountability. By requiring manufacturers routinely test their products and make those results publicly available, the bill does two things.
First, it gives consumers the ability to make informed decisions based on real data. Second, it creates a strong incentive for companies to improve sourcing and manufacturing practices to remain competitive by lowering their levels of heavy metal. We've already seen this model in California work. We passed a bill last year, SB six forty six, by the chair, dealing with prenatal vitamins and heavy metals contained in them. So when disclosure requirements are in place, con contamination levels drop, not because of mandates and formulation, because transparency drives better behavior.
This bill is not about restricting access or limiting consumer choice. It's about ensuring the choice is informed and that products marketed as part of a healthy life lifestyle meets a basic standard of accountability. SB ten thirty three is a straightforward, common sense consumer protection measure, one that aligns with California's longstanding leadership in consumer protection and public health. I respectfully ask for your I vote. Thank you.
Speaker 16
Good afternoon. My name is Caitlin Moore, and I am the research manager at the Center for Environmental Health. We are proud to cosponsor SB ten thirty three and commend Senator Padilla for carrying this bill. When Consumer Reports tested protein powders and shakes, it discovered high levels of lead in more than two thirds of the products, and some products contained cadmium and arsenic. There is no safe level of lead exposure.
Exposure to lead can cause cancer, reproductive and developmental issues, and neurological harm. Low levels of lead can cause cognitive impairment in children. According to the World Health Organization, long term exposure to arsenic in food can cause cancer and skin lesions. Arsenic has also been associated with cardiovascular disease and diabetes. The CDC says that metallic mercury most commonly affects the nervous system.
Exposure can cause tremors, incoordination, and problems with vision, learning, hearing, memory, and mood. Mercury also hinders fetal and child development. Cadmium can cause developmental and reproductive harm. In addition, consuming just one serving a day of some protein products will cause a person to exceed the FDA's recommended daily limit from food. Many people consume more than one serving of a protein product daily and could easily exceed this limit.
Remember that heavy metals can accumulate in the body. With more people increasing their consumption of protein, many are consuming protein products daily. SB ten thirty three will equip consumers with information they need to make informed decisions about their nutrition.
Speaker 1
I respectfully request your I vote. Thank you. If there's anyone else in the audience that would like to register their support, please come to the microphone at this time, state your name, your organization, and your position. Thank you.
Speaker 5
Good afternoon. Christopher Sanchez on behalf of the Consumer Federation of California in support.
Speaker 29
Susan Hello. Susan Little on behalf of Consumer Reports, Unleaded Kids, and CalPERC.
Speaker 56
Good afternoon. Kai Klauson on behalf of Breast Cancer Prevention Partners in strong support.
Speaker 25
Ilana Latteser with the American Nurses Association of California in support.
Speaker 27
Ryan Spencer, on behalf of the American College of OBGYNs, in support. Sorry.
Speaker 57
We're tweeners? Of course. Is that okay? Dett tweeners, all right. Thank you.
Dennis Albioni, on behalf of Consumer Brands Association, I want to compliment the staff of the senator as we met with them and the consultant to really try to bring this down and get some where the testing would be the most effective. We do express some still additional concerns. We think this should be focused on supplements and supplements themselves. And this one still has beverages and some of the other products beyond that. We would further narrow that.
And I think the folks know some suggested amendments that have been provided and discussed. Second of all, I think we also would consider moving the testing up from the actual end product to the suppliers of the protein supplements. That way, would when we discussed it with the staff, it would focus that and have much less testing requirements on all these products. You'd get it at the source. So we think those are constructive options to discuss as this goes forward, and we appreciate your time.
Thank you.
Speaker 1
Thank you. We will now open it up to anyone who is here speaking in lead in opposition.
Speaker 58
Well, we're all debating that. My apologies, Madam Chair members. Trent Smith, on behalf of the Consumer Products Association. We're also, I guess, we are listing concerns. We don't have a problem with testing or reporting over certain levels.
I think our concern right now is, as the analysis points out, heavy metals are naturally occurring and found in soil and leafy greens, spinach, root vegetables. If you're all looking for an excuse not to eat your spinach perhaps, this is one. But the point being is that these are naturally occurring in our plant based, dietary supplements. And so having reporting everything, we think, is counterproductive as far as, you could actually scare consumers into not having anything. So again, we're fine with certain elements of it, but concerned about just the overall testing of trace amounts.
So, again, we've listed our concerns. Happy to work with the sponsors and author. Thanks.
Speaker 1
Thank you. If there's anyone else that would like to register opposition, please come to the mic, state your name, your organization, and your position.
Speaker 27
Madam Chair and members, Anthony Molina on behalf of the Natural Products Association in opposition. Thank you. Thank you.
Speaker 59
Madam Chair and members, Mike Vines on behalf of Dairy Institute. We are still listed in opposition on our letter, but all the comments that were made, we share. We appreciate the staff working with the amendments. We've met with you. We appreciate them.
We've talked about their your staff. So, we'll continue to work through the process. We're still in this locked position of oppose, but I think we can get somewhere. We're optimistic. So, thank you.
Speaker 1
Thank you. At this point, I will, bring it back to committee members if there's any questions or comments. Senator Grove.
Speaker 60
Thank you, madam chair. I appreciate the bill. I do. And, I'm I am gonna vote yes on it, but I I would like your commitment that you continue working with opposition because sometimes we, you know, we do things, like, in a different industry, and I know this is going to freak everybody out when I say that. We did fence line monitoring for refineries, but there are certain refineries that don't produce any constituents that would the product they produce, they would be no pollutants at all, because they don't do gasoline.
They do asphalt and ink oils and things like that. But they still make them test for the stuff that would be in refiners for gasolines. That was a well intended bill to make sure that we didn't have anything passing over the fence line. So it's a well intended bill, but we need to make sure that it doesn't exclude things that are naturally occurring in spinach or vegetables or anything else. And so I just like your commitment that you're going to continue to work with the opposition.
Speaker 25
Thank you. Senator Carrazzo. Thank you, Madam Chair, and thank the author. I did a bill last year on menstrual products, right to know. And it was really important to begin the process of people knowing what's in the product that they're using.
In that case, of course, using menstrual products for several hours at a time, many consecutive days at a time. Different product, but the same idea is that to watch out for all these things that you need to test. Otherwise, you wouldn't you wouldn't know. You wouldn't know if there's anything in there hurting you or damaging you. So I I appreciate your your bill.
Speaker 1
Seeing no further comments from the committee, I want to thank you so much for bringing this bill forward. Thank your sponsors. And also, I really want to give kudos to the health staff, who really did an amazing job with the amendments and really dug deep, looked at the different products, looked at the different ingredients to try to really narrow it, because it was very, very broad initially. And so I just want to give kudos to our amazing consultant for that. Yes.
You know, it's interesting. When I was listening, I was hearing some of the same arguments that I heard from my prenatal vitamin bill as to why it shouldn't happen. Oh, it's naturally occurring. We can stop eating spinach and all these leafy green like, the same thing. But at the end of the day, we really need to make sure that what we are consuming is safe.
And this is not removing products, it is allowing individuals to know what's in their products. And I think it was Ryan who started off stating that our kids are now consuming these protein bars and protein shakes. And I said, oh my goodness. You're right. Because my 14 year old who's trying to bulk up eats his protein bars every single day.
And we need to make sure that our kids are healthy, that we're healthy, but also our kids, especially since it's so widely available. And so appreciate you doing this. And with that, you may close.
Speaker 17
Thank you very much, Madam Chair. I do want to thank you for your extraordinary leadership in this space. Certainly, with respect to the sponsors and our office, we did have some good inspiration from a similar bill to try to build on that. And I would echo your compliments of your committee staff. Our committee staff did an amazing job fixing what, for a quick second there, felt almost like we were going go off a cliff, and you brought it back.
And so, very, very grateful for your work. I would just only say that knowledge is power. There are many factors that contribute to what ends up on our plate. And we have the you know, we only have the ability to mitigate that, or deal with that, or have informed choices as consumers if we have the information. Knowledge is power.
That's what this bill is about. I respectfully ask for an I vote.
Speaker 1
Moved by senator Gonzalez. The motion is due pass as amended and re refer to the committee on environmental quality. Assistant, please call the roll.
Speaker 19
Senators Weber Pearson. Aye. Weber Pearson, aye. Valadais? Aye.
Valadais, aye. Cavallero? Aye. Cavallero, aye. Dirazzo?
Aye. Dirazzo, aye. Gonzalez? Aye. Gonzalez, aye.
Grove? Menjivar. Aye. Menjivar I. Padilla I.
Padilla I. Perez. Rubio. Smallwood Cuevas. Smallwood Cuevas I.
Speaker 37
Now moving to file item number 11, s B. Ten forty nine. Senator Weber Pearson, you're recognized when you're ready.
Speaker 1
Thank you. Good afternoon, colleagues. Today, I will be presenting S. B. Ten forty nine, which will ensure providers have a fair opportunity to correct minor technical errors on claims.
I want to thank the committee for your thoughtful review, and I accept the amendments. At its core, SB ten forty nine addresses a gap in current law by ensuring providers have a meaningful opportunity to correct claims after a plan takes action. Today, providers are working in an increasingly complex administrative system. Even when they deliver appropriate care, they face denied payments or retroactive recoupments. Not because care was wrong, but due to minor correctable errors like coding or documentation.
These are not cases of fraud. They are simple mistakes that should be fixable. But under current law, providers often blocked from correcting them because of rigid filing deadlines tied to the original date of service. From a clinical perspective, that's deeply concerning. When payments are denied or clawed back months or even years later, it creates real instability, especially for small, independent practices.
That instability affects staffing, limits access to care, and ultimately impacts patients. Let me share a real example. An obstetrics practice in Sacramento was told that 40 claims spanning nearly two years were overpaid, resulting in a $90,000 repayment demand. The issue wasn't the care. It was a missing diagnostic code, which is a simple fixable error.
But when the providers tried to correct and resubmit, they were denied because the filing deadline had passed. Meanwhile, the health plan began recouping payments from ongoing care. So, in this case, the care was appropriate, the error was fixable, but the system did not allow for it to be corrected. That is not a fair nor efficient system. The core issue is simple: Providers don't have a meaningful opportunity to fix errors once they're identified, especially when they're flagged after the deadline.
SB ten forty nine offers a balanced, straightforward solution. It allows providers to correct claims within ninety days of a health plan's latest action, like a denial or overpayment notice, and prevents plans from rejecting those corrections solely due to the fact that it was past the deadline. It is not open ended. It is reasonable, time limited fix. And importantly, this bill does not excuse improper claims or expand liability for health plans.
It simply gives providers a fair chance to correct honest mistakes. SB ten forty nine is sponsored by the American College of Obstetricians and Gynecologists, and co sponsored by the California Medical Association. And we are actively working with health plans and other stakeholders, and we remain committed to continuing those conversations to address any concerns and find a balanced solution. This is a common sense reform that reduces unnecessary conflict, improves efficiency, and keeps the focus where it belongs on our patients. I respectfully ask for your aye vote.
And with that, I'd like to introduce our two witnesses, Doctor. Kathleen Rooney. She's an OBGYN and ACOG fellow. And Ryan Spencer, again, who is here this time I know he's been here all day this year as a legislative advocate for ACOG District nine. We're going have
Speaker 37
to put your name on that seat. Is that what's going on? You're both recognized for five minutes, two and a
Speaker 34
half minutes each. Great. Thank you. I would like to thank the committee for this opportunity to speak with you all. And I would especially like to thank Doctor.
Weber Pearson for authoring SB ten forty nine. My name is Doctor. Kathleen Rooney. I am an OBGYN and a managing partner of a Sacramento private practice consisting of seven doctors. We care for over 10,000 women in our Sacramento community.
I'm here to speak about the importance of SB ten forty nine. In April 2025, I was notified by my biller that our health plan was withholding payment from current patient care due to a coding error from past claims. These were from sixty one pregnancy claims dating from January 2023 to January 2025. After having to contact the plan to learn why they were withholding our current money, we learned it was simply because the claims did not include a diagnostic code. In this industry, this type of behavior is called a clawback.
Upon this discovery, our biller immediately fixed the claims and sent them back. The resubmitted claims were denied as untimely because it had been more than ninety days from the date of service. As you can see, we were notified two years after a claim was submitted. And so, of course, we were past the timely filing limit. My biller has then spent over a hundred hours fighting each of these claims.
Overall, the plan has withheld a $120,000 from my partnership during the past year, and to date, $60,000 is still not paid back to us from 31 pending claims. She has to contact the plan multiple times to find a representative that understands the problem. And if she finds a representative that understands the situation, they will process only three claims at a time. Currently, we have 31 outstanding claims that they will not process. I want to be very clear here.
The work that we did was competent, gold standard care that was approved by the plan. The only thing missing was the gestational age code. My business filed a financial loss this year specifically due to this clawback. My first thought when I determined what happened was this should be illegal. Why should an insurance company be afforded so much time to recoup a payment, yet we are restricted to ninety days from date of service to correct it?
It does not make sense. The insurance company may say they have a process for denied claims, but I hope my words resonate today that their process is horribly broken and unfair. It only benefits the insurance company financially while harming physicians like me and, most importantly, the patients that we serve. Without financial stability and necessary resources, our ability to provide appropriate care to our patients is severely limited. SB ten forty nine presents a reasonable solution that could have prevented all of this.
By allowing providers extra time to cure a defect in the claim form itself, it ensures that minor correctable errors, like a missing gestational age code, do not result in permanent nonpayment for medically necessary approved care. Being a small business, fighting insurance companies over a coding error is exhausting, time consuming, and financially draining, and has affected other private practices like my own throughout California. Please help restore a fair and balanced process between plans and providers that prevent an easy to fix solution from becoming a multiyear nightmare. I respectfully ask for your I vote on SB ten forty nine. Thank you for your time.
Speaker 27
Sure. I'll be quicker. Ryan Spencer, on behalf of the American College of OB GYN, Statistics nine, sponsors of the measure, just like to thank the sender for authoring this bill and the witness for bringing this to our attention. Thank you very much. Ask for your I vote.
Speaker 37
We will now open this up to any Me Toos here that would like to state your name, your organization, and your position.
Speaker 26
Kevin Guzman with the California Medical Association, proud cosponsors of the bill.
Speaker 34
Angela Pontis on behalf of Planned Parenthood Affiliates of California in support.
Speaker 53
Caitlin Dean on behalf of the California Hospital Association in proud support.
Speaker 9
Lawrence Gayden on behalf of the California Dental Association in support.
Speaker 36
Joe Monroe, licensed marriage and family therapist in private practice, my full support.
Speaker 9
Tim Madden representing the California Chapter of the American College of Emergency Physicians, the California Chapter of the American College of Cardiology, the California Rheumatology Alliance, and the California Society of Plastic Surgeons, all in support.
Speaker 37
Thank you. We'll now open it up to two lead witnesses in opposition. Please come forward.
Speaker 54
Thank you, chair and members. Cassidy Heckman on behalf of the California Association of Health Plans. We are in an opposed unless amended position today, but we've had productive conversations with both the author and the sponsor of the bill. We're still concerned about the inclusion of denials and the ninety day timeline, but we're looking forward to continuing those conversations.
Speaker 7
Stephanie Watkins, on behalf of the Association of California Life and Health Insurance Companies, similar position to pose unless amended, look forward to working with the author and sponsor sponsor of the bill most for today.
Speaker 37
Thank you. Is there anyone else here in opposition or tweeners? Seeing none, let's bring it back to the committee. Any questions? Seeing none, would you like to close?
Yes. Well,
Speaker 1
first off, I want to thank you all. I thank the committee staff again for the amendments. Thank the sponsors. And I really want to thank my witness, Doctor. Kathleen Rooney.
As I was listening to your story, one of the things that I kept thinking about is the fact that we are dealing with an issue of access. We are losing providers left and right here in California, and having a really hard time recruiting them. And we're also having an issue with large corporations coming in and gobbling up smaller, private practices. And this is a huge obstacle for those, especially practices. And we should not be allowing something as small as an error for a billing code.
And I've been in those same positions. Mean, they keep changing. So, it's like, how do we know what to check at which time to really be the reason why someone has to close their doors, why that access for our patients will continue to be limited. And so, with that, I commit to continuing to work with those who are opposed unless amended, but this really is a very serious issue for our providers, for our patients, for our community. And with that, I respectfully ask for an I vote on SB ten forty nine.
Thank you.
Speaker 37
Thank you. Do I have a motion? Senator Caballero, who is the bill? Secretary, the motion is due passed into the committee on in appropriations. Please call the pass as amend do pass as amended to the committee on appropriations.
Please call the roll.
Speaker 19
Senators Weber Pearson? Aye. Weber Pearson, aye. Valladares? No.
Caballero? Aye. Caballero, aye. Dorado, aye. Dorado, aye.
Gonzalez, aye. Gonzalez, aye. Gonzalez,
Speaker 19
Benjivar, Benjivar, aye. Padilla, aye. Perez, Rubio. Smallwood Cuevas. Smallwood Cuevas I.
On
Speaker 1
call. That bill is seven zero and is on call. Thank you. We are going to go through all of the bills. I would strongly recommend that anyone who is on the committee and wishes to register their votes, come down.
We're gonna start with the consent calendar. Assistant, please call the absent members. Senators Valladares? Aye.
Speaker 1
90. We'll place that back on call. We'll go to file item number one, s b eight nine five. Assistant, please call the absent members.
Speaker 19
The motion is due pass as amended and re refer to the committee on natural resources and water. Senators by Via Viadares? No. Viadares, no. Gonzalez?
Aye. Gonzales, I. Grove? Padilla?
Speaker 1
Eight to one. We will put that on call. We will now move to file item two, s b nine four four.
Speaker 19
Motion is due pass and re refer to the committee on appropriations. Senators Valadares What she do? Gonzales? Aye. Gonzales, aye.
Grove? Pascoe. Padilla? Aye. Padilla, aye.
Rubio.
Speaker 1
Eyes eight, nose one. That's on call. We will move to file item number six, s b ten nine nine. Motion do pass and re refer to the committee on human services. That one over are you out?
That one is out. 7 is out. 1033. We will move to file item eight s b ten thirty three. Motion is do pass as amended and we refer to the committee on environmental quality.
Senators Grove?
Speaker 1
nine Eyes, nine. No. Zero. That bill is on call. We will move to file item 10, s b nine eight seven.
Motion is due passed, and we refer to the committee on appropriations. Assistant, please call the absent members. Senators Grove or Gonzales? Aye.
Speaker 1
Sorry. Correction on s p nine four four. The vote is eight zero. On call. And it's on call.
So we are now on file item 11 s b ten forty nine. Motion is due pass as amended and re refer to the committee on appropriations. Assistant, please call the absent members. Senators Grove? No.
Grove, no. Perez? Rubio. That's seven one. That will be on call.
We will open the roll again for the consent calendar. Assistant, please call the absent members. Senators Grove. Aye. Grove, I.
Speaker 1
That's 100. We will place that back on call. We will open up file item number one, s b eight nine five. Motion do pass as amended, and we refer to the committee on natural resources and water. Assistant, please call the absent members.
Senators Grove? No. Grove, no. Rubio? 82.
We will leave that on call.
Speaker 1
Okay. So which ones? All right. We will open the roll. If there are any other members who wish to add on to the roll, please come down now.
This is the last time we will be going through the roll. We are starting with the consent calendar. Assistant, please call the absent members. Senator Rubio? Aye.
Rubio, aye. So eleven
Speaker 1
That vote is eleven zero. That is out. We will move back to file item number one, s b eight nine five. Motion is due pass as amended and re refer to the committee on natural resources and water. Assistant, please call the absent members.
Senators,
Speaker 1
to two. That vote is nine to two. That bill is out. We will move to file item number two, s b nine four four, recommendation. The motion is do pass and re refer to the committee on appropriations.
Assistant, please call the absent members. Senators Valladares, Grove, Rubio. Aye. Rubio, aye. Nine to zero.
That vote is nine to zero. That bill is out. We are now at file item eight, s b ten thirty three. Motion is due pass as amended and re refer to the committee on environmental quality. Senators Rubio?
Aye. Rubio, aye. It's ten zero. 100. That bill is out.
We are now at file item number 10, s B987. File item 10 s b nine eight seven. Motion is due pass and re refer to the committee on appropriations. Assistant, please call the absent members.
Speaker 1
Ten zero. That bill is out. We are now at file item 11, s b ten forty nine. Motion is due pass as amended and re refer to the committee on appropriations. Assistant, please call the absent members.
Senators Valladares, Grove,
Speaker 19
Rubio? Aye. Rubio, aye. Oh, oh, sorry. Perez.
Just Perez. Oh, senator Perez.
Speaker 1
to thank everyone who presented today. Thank all of the members for the committee.
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