SO. SENDING A MESSAGE OUT TO ALL
REALLY, JUST I MEAN, ALL THE
STAFF OF BNP COMMITTEE MEMBERS,
ESPECIALLY THE STAFF OF
REPUBLICAN BNP COMMITTEE MEMBERS
. WE WOULD LOVE TO GET A
REPUBLICAN HERE SO WE CAN START
AS A AS A SUBCOMMITTEE, UM SO WE
CAN WRAP THIS UP AS QUICKLY AS
POSSIBLE, AND EVERYONE CAN GET
ON TO THE OTHER THREE COMMITTEES
HAVE TO GET TO TONIGHT. UM
THAT'D BE GREAT. IF WE DON'T GET
A REPUBLICAN HERE IN THE NEXT
COUPLE OF MINUTES. IT'S NOT
ACTUALLY PART OF THE RULES THAT
WE NEED ONE. WE JUST TRY TO DO
THAT. UM BUT WE'LL GET STARTED
AS A SUBCOMMITTEE REGARDLESS IN
LET'S SAY THREE MINUTES. THANKS.
ALRIGHT AS PROMISED. WE'RE GOING
TO GET STARTED AS A SUBCOMMITTEE
WELCOME TO THE ASSEMBLY,
BUSINESS AND PROFESSIONS
COMMITTEE'S HEARING FOR BILLS RE
REFERRED TO THE COMMITTEE
PURSUANT TO ASSEMBLY RULE 77.2
TODAY WE'RE HEARING FIVE
ASSEMBLY BILLS BACK ON
CONCURRENCE THAT WERE
SUBSTANTIALLY AMENDED WHILE IN
THE SENATE AS WELL AS ONE SENATE
BILL ONE BILL, MAYBE 26 85,
AUTHORED BY THIS COMMITTEE IS
PROPOSED FOR CONSENT. FOR EACH
BILL HEARD TODAY WE WILL BE
ALLOWING PRIMARY WITNESSES TO
SPEAK FOR UP TO TWO MINUTES EACH
WITHOUT THE TWO PRIMARY
WITNESSES PER SIDE IN ADDITION
TO HEARING FROM THOSE HERE IN
THE ROOM TODAY, WE WILL BE USING
A MODERATED TELEPHONE SERVICE
THROUGH WHICH ANY WITNESS CAN
TESTIFY ON A BILL. THE CALLING
NUMBER FOR THIS HEARING IS
877692. AGAIN. THAT'S 8776928957. THE ACCESS CODE IS 185011.
AGAIN. THAT'S 1850110. IF YOU
WERE CALLING IN, PLEASE PLAN TO
DO SO. AS THE AUTHOR OF THE
BILL, YOUR TESTIFYING ON IS
BEGINNING THERE BILL
PRESENTATION. WITH THAT WE WILL
BEGIN TODAY'S HEARING. FIRST UP
IS SENATE BILL 774. BY THE GREAT
SENATOR HERZBERG READY WHEN YOU
ARE, SIR? THANK YOU, MR CHAIRMAN
AND MEMBERS. WE HAVE VOLUME
HERE. YEAH, THERE IS. NOW I'M
NERVOUS DAD WAS FULL
CONSTITUTIONAL LAWYER AND HE
USED TO ALWAYS SAY WHEN THE
REASON FOR THE RULE CEASES THE
RULE C SIS USED TO SAY IN LATIN,
BUT I'M NOT THAT GOOD. AND I
CAN'T REMEMBER THE LATIN THAT'S
WHAT THIS BILL IS ABOUT LAST
YEAR. ASSEMBLY MEMBER. FRIEDMAN.
PASSED THE MEASURE A B 4 68 TO
PREVENT FRAUDULENT, INACCURATE,
INACCURATE LABELING OF EMOTIONAL
SUPPORT ANIMALS AS A MEDICAL
SERVICE ANIMAL MADE A LOT OF
SENSE. WE PASSED IT, GOVERNOR
SIGNED IT, OKAY. NOW ALL OF A
SUDDEN, WE'RE IN A SITUATION
WHERE UM, WE NEED EMOTIONAL
SUPPORT ANIMALS FOR THE HOMELESS
FOLKS. AND SO WHAT WE'RE DOING
WITH THIS MEASURE BEFORE YOU
TODAY EXEMPTS HOMELESS
INDIVIDUALS FROM THE EXISTING
REQUIREMENT TO HAVE A 30 DAY
RELATIONSHIP WITH THE DOCTOR
BEFORE OBTAINING AN EMOTIONAL
SUPPORT A CERTIFICATION FOR
THEIR ANIMAL. SO YOU KNOW AGAIN
AS WE DEAL WITH THE ISSUE OF
HOMELESSNESS, WHICH IS
EXTRAORDINARY EFFECTS, EVERY ONE
OF OUR COMMUNITIES, ALL CORNERS
OF THE STATE OF CALIFORNIA. IT'S
HORRIBLE TRAGEDY. WHAT DO WE DO
TO FIX THE LAW TO MAKE IT EASIER
? AND THIS IS ONE OF THESE
THINGS? I HAVE BEEN WORKING VERY
HARD ON HOMELESS PETS. WE PUT
MONEY IN AT THE BUDGET MANY
YEARS. THANK YOU, MR BUDGET
CHAIRMAN. UM YOU KNOW, BECAUSE A
LOT OF THESE VARIOUS HOMELESS
FACILITIES WON'T TAKE PETS, AND
WE HAVE BETWEEN 15 AND 20% OF
THE PEOPLE WHO HAVE PETS, AND IF
YOU TAKE CARE OF THEIR PETS,
THEY'LL GO INTO THE SHELTERS.
RELIED DEEPLY ON THEM, AND THIS
IS ANOTHER ELEMENT OF THE SAME
THING. AND IT'S A WAY TO MODIFY.
UH WHAT? WHAT UH,
ASSEMBLYMEMBER'S FRIEDMAN HAD
DONE LAST YEAR AGAIN, AS I SAY
WITH A B 4 68. THIS BILL WAS
AMENDED TODAY AND YESTERDAY,
AUGUST 29TH YESTERDAY AND SO
IT'S TRYING TO FIX THIS PROBLEM%
BEFORE WE GET A SESSION. RIGHT.
ASK YOUR EYEBALL. THANK YOU VERY
MUCH. THANK YOU, SENATOR GERMANY
. WITNESSES TOLD THAT I DO YOU
MURPHY FROM LOS ANGELES
HOMELESSNESS AUTHORITY AND JOSE
MARTA LOSS, ANGELES COUNTY
DEPARTMENT OF HEALTH SERVICES
GREAT AND THEY'RE BOTH
TESTIFYING BY PHONE OPERATOR.
CAN YOU IDENTIFY THE LINES FOR
COLLEEN MURPHY AND JOSE MATA? UH
TO TESTIFY, PLEASE TWO MINUTES
PER WITNESS, ALTHOUGH YOU DO NOT
HAVE TO TAKE ALL TWO MINUTES.
MURPHY. YOUR LINE IS OPEN. THANK
YOU VERY MUCH CHAIR AND
COMMITTEE MEMBERS. MY NAME IS
COLLEEN MURPHY AND THE ASSOCIATE
DIRECTOR OF UNSHELTERED
STRATEGIES AT THE LOS ANGELES
HOMELESS SERVICES AUTHORITY. THE
LAST DECADE I'VE HAD THE
PRIVILEGE TO SUPPORT THOUSANDS
OF PEOPLE EXPERIENCING
HOMELESSNESS IN THEIR JOURNEY
INDOORS, WHILE EACH JOURNEY IS
UNIQUE TO THINGS HOLD TRUE ONE
NAVIGATING THE PROCESS OF
HOUSING IS NOT EASY AND ANYTHING
WE CAN DO TO MAKE IT EASIER, NOT
HARDER. IT'S SOMETHING WE SHOULD
COLLECTIVELY D TO OUR
UNSHELTERED NEIGHBORS WHO HAVE
ANIMALS SERVING AS VERY
EMOTIONAL STRIP SUPPORTS SHOULD
NOT HAVE TO CHOOSE BETWEEN THEIR
ONLY SUPPORT SYSTEM AND THE
HOUSING AFTER THE PASSAGE OF A B
FOR 68 HEALTHCARE PRACTITIONERS
COULD NO LONGER SIGN OFF ON
INDIVIDUALS, EMOTIONAL SUPPORT
ANIMAL ORRY FAA CERTIFICATIONS
WITHOUT WORKING WITH THESE
CLIENTS FOR AT LEAST 30 DAYS
PRIOR, AND UNFORTUNATELY, MANY
PEOPLE EXPERIENCING HOMELESSNESS
DO NOT HAVE THAT 30 DAY
RELATIONSHIP WITH OUR LIMITED
STREET MEDICINE, INFRASTRUCTURE,
OR TRADITIONAL BRICK AND MORTAR
CLINICS. THIS IMPACTS WOMEN LIKE
THE WHO I MET ON THE STREETS
LAST WEEK AND A SMALL
ENCAMPMENT. SUPPORTING HER WHILE
SHE WAS BACK GETTING VACCINATED
AGAINST COVID 19. WHEN I ASKED
HER ABOUT HER DESIRE TO MOVE
INDOORS, THE FIRST QUESTION WAS
, BUT WHAT ABOUT MY CAT? SHE
DEPENDS ON ME, AND I DEPEND ON
HER. I ASKED HER WHAT HER CAT'S
NAME WAS, AND SHE REPLIED WITH A
SMILE, TINKLY, BUT WITH THE
CURRENT LAWS OF STANCE. THIS
WILL MAKE HER JOURNEY AND HER
CAST JOURNEY AND THE JOURNEY OF
MANY OTHERS, MUCH HARDER.
POPPING OUT. THE SOUTHERN 74
WILL MEAN PEOPLE LIKE THE DO NOT
HAVE TO PUT THE IMPOSSIBLE TO BE
PUT IN THE IMPOSSIBLE POSITION
TO CHOOSE BETWEEN HOUSING AND
HER ANIMAL COMPANION. THANK YOU
FOR YOUR TIME AND ASK YOU FOR
YOUR I VOTE FOR SB 774. THANK
YOU. THANK YOU, MR MURPHY AND MR
MOTTA. HI. THIS IS SALLY MALONE.
I'M SPEAKING ON BEHALF OF JOSE
MODEL. HE WAS, UNFORTUNATELY,
NOT ABLE TO JOIN THIS AFTERNOON.
THAT'S GREAT. WE'RE BOTH THANK
YOU. WE'RE BOTH WITH HOUSING FOR
HEALTH AND JOSE, THE HOMELESS
SERVICE AND STREET BASED
OUTREACH PROGRAM MANAGER WITH US
. HE'S BEEN DOING THIS FOR FOUR
YEARS IN THE COUNTY HOUSING FOR
HEALTH WORKS WITH THE HIGHEST
SECURITY MOST VULNERABLE ON
HOUSED INDIVIDUALS IN L, A WITH
COMPLEX HEALTH AND BEHAVIORAL
HEALTH CONDITIONS. SOME OF THE
HARDEST HOUSE FOLKS UM, AND
WHILE LOS ANGELES COUNTY DOES
NOT HAVE AN OFFICIAL OPINION, SB
7 74. I'M HERE TO TELL YOU ABOUT
THE UNINTENDED CONSEQUENCES OF A
B OF 468 TO THIS WORK AND
HOMELESS SERVICES. UM AS YOU YOU
KNOW WHAT A B 468 DOES. SO LET
ME TELL YOU THAT IT TAKES A LOT
OF TIME TO BUILD A RELATIONSHIP
WITH OUR HOMELESS NEIGHBORS WHO
ARE SLEEPING OUTSIDE AND GETTING
THEM INTO SHELTER, WHICH IS AN
IMPORTANT STEP IN RESOLUTION OF
THEIR HOMELESSNESS CAN OFTEN
TAKE WEEKS AND MONTHS OF
RELATIONSHIP BUILDING WHEN
SOMEONE IS READY TO MOVE INSIDE,
IMPORTANT TO REMOVE AS MANY
BARRIERS AS POSSIBLE FOR THAT.
SOMEONE TELL YOU A STORY OF
SOMEONE WHO HAS A NOSE. I WAS
ONLY KNOWS AS WELL. THIS IS A
CASE FOR GENTLEMAN NAMED COWBOY
. A PERSON WHO HAS SPENT OVER 15
YEARS LIVING ON THE STREETS IN
L. A UNFORTUNATELY, THEY WERE
ABLE TO GET HIM A HOUSING
VOUCHER. BUT WHILE THEY WERE
SEARCHING FOR AN APARTMENT THEY
WANTED TO PLACE WHERE ONE OF THE
NEWLY CONSTRUCTED A BRIDGE HOME
SHELTERS ALONG WITH HIS DOG.
THERE'S NO WAY THAT COWBOYS HAVE
LEFT HIS DOG BEHIND. BEEN WITH
HIM FOR SO LONG. WE WERE ABLE TO
QUICKLY OBTAIN AN S A LETTER TO
HELP FACILITATE THE MOVE. A
SHELTER WILL NOT BE ABLE TO
ACCEPT AN ANIMAL WITHOUT THAT.
UM AND SO HE WAS ABLE TO STAY IN
THE SHELTER WITH HISPET UNTIL
HE GOT HOUSED WHERE HE IS NOW
AND HOUSTON. HOW STABLE FOR
THREE YEARS, BUT THAT STORY
COULDN'T HAVE HAPPENED IF HE
WASN'T ABLE TO STABILIZE IN THE
SHELTER AND BRING HIS TYPE WITH
HIM AND THEN BRING HIS PET WITH
HIM INTO HIS HOME. SO WE
APPRECIATE YOU LISTENING AND
APPRECIATE YOUR TIME. THANK YOU.
THANK YOU VERY MUCH. AH ANY
WITNESSES HERE IN THE HEARING
ROOM? UH, FIRST WE GO CHECK. NO
THERE ARE NO PRIMARY WITNESSES
IN OPPOSITION ANY ADDITIONAL
WITNESSES WHO WANT TO ADD ON IN
SUPPORT OR OPPOSITION TO THE
BILL IN THE HEARING ROOM? I
DON'T SEE ANY. WE DON'T HAVE A
REMOTE TESTIMONY STATION. I'M
ASSUMING THAT PROBABLY HAVE DONE
THAT IN A WHILE. ALL RIGHT. I'M
BRINGING BACK THE COLLEAGUES FOR
ANY QUESTIONS OR COMMENTS ON THE
BILL. WE STILL DON'T HAVE A
QUORUM, SO IT'S A LITTLE TOO
EARLY FOR EMOTION IN A SECOND,
WHICH I'M SURE THIS BILL WILL
GET QUESTIONS, COMMENTS. NOT
SEEING ANY SENATOR HERZBERG.
WOULD YOU LIKE TO CLOSE?
RESPECTFULLY ASTRONAUT? I VOTE.
THANK YOU FOR YOUR TIME. I
APPRECIATE VERY MUCH. THANK YOU,
SENATOR. AND THANK YOU FOR
BRINGING FORWARD THIS CRITICALLY
IMPORTANT BILL TO ENSURE THAT
ARE MOST VULNERABLE POPULATIONS
DO NOT ENCOUNTER BARRIERS TO
OBTAINING TEMPORARY HOUSING AND
SERVICES. WHEN THE TIME COMES,
I'LL BE SUPPORTING THE BILL ON
THE FLOOR. AH WE DO MOTIONS IN
SECONDS FOR THIS. YEAH. WHERE
THE WINDS GOT IT. UM. MOVING ON
TO I'M NUMBER TWO ON THE AGENDA
CENTER OR SOME MEMBER COOPER
WITH A B 6 57 READY WHEN YOU
ARE, SIR. THANK YOU. MR CHAIR.
MEMBERS OF CALIFORNIA'S PROVIDE
TIMELY ABORTION CARE TO
CALIFORNIA PATIENTS AND ABSORB
THE INCREASE IN OUT OF STATE
PATIENTS. DO THE ROAD BEING
OVERTURNED. WE MUST TAKE STEPS
NOW TO ENSURE THE GROWTH OF A
NETWORK OF ABORTION PROVIDERS.
MAYBE 657 WOULD REQUIRE MEDICAL
BOARD OF CALIFORNIA, THE
OSTEOPATHIC MEDICAL BOARD OF
CALIFORNIA BOARD OF REGISTERED
NURSING THE PHYSICIAN ASSISTANT
BOARD TO EXPEDITE THE LICENSE
HERE. PROCESS OF AN APPLICANT
WHO INTENDS TO PROVIDE ABORTION
SERVICES BUT THEN THEIR SCOPE OF
PRACTICE IN ORDER TO BE ELIGIBLE
FOR AN EXPEDITED LICENSING
PROCESS. APPLICANT MUST PROVIDE
A LETTER OF INDICATING THEIR
ATTENTION TO PROVIDE ABORTION
SERVICES. A LETTER FROM THE
EMPLOYER INDICATING THAT THE
APPLICANT HAS ACCEPTED
EMPLOYMENT WILL BE PROVIDING
ABORTIONS WITHIN THE SCOPE OF
PRACTICE OF THEIR LICENSE.
ALRIGHT, WE'RE STEPHANIE. YOU'RE
DRY VOTE TUESDAY OR RYAN SPENCER
FROM THE AMERICAN COLLEGE OF
OBSTETRICIANS, OBSTETRICIANS AND
GYNECOLOGISTS AND MOLLY WROTE
WITH ROBINSON FROM PLANNED
PARENTHOOD. GREAT TWO MINUTES
EACH. THANK YOU, MR CHAIR,
ACTUALLY PAUSE REAL QUICK AND
ESTABLISH A QUORUM, WHICH WE
APPARENTLY HAVE. MADAM
SECRETARY. PLEASE CALL THE ROLL.
FURMAN. LARA. ALVAREZ. I WANT TO. CHEN CUNNINGHAM. DOLLY! PHÊN
GIBSON. GRAYSON. IRWIN. LEE.
PARTY. MAKIN, ER MEDINA. SALAS.
THING. WEBER. GREAT CORNER IS
ESTABLISHED. PLEASE CONTINUE.
THANK YOU, MR CHAIR RYAN SPENCER
ON BEHALF OF THE AMERICAN
COLLEGE OF O B. G. Y N S
DISTRICT NINE. WE ARE THE
SPONSORS OF THE MEASURE FIRST
LIKE TO THANK THIS AND REMEMBER
FOR AUTHOR AND IT'S IMPORTANT
MEASURE AND WE'D ASK FOR SIMPLY
JUST ASK FOR YOUR SUPPORT FOR
ALL THE REASONS STATED BY A
SUMMER RICK COOPER. THANK YOU.
THANK YOU. HI MOLLY ROBSON WITH
PLANNED PARENTHOOD AFFILIATES OF
CALIFORNIA AS YOU ALL WELL AWARE
OF ROE V. WADE WAS OVERTURNED
EARLIER THIS SUMMER, LEAVING
PROTECTING ABORTION ACCESS UP TO
THE STATES WITH ROE OVERTURNED
14 STATES, AS OF TODAY HAVE
ENACTED FULL OR SIX WEEK
ABORTION BANS, WHICH MEANS A LOT
OF FOLKS FROM OTHER STATES ARE
GOING TO BE SEEKING CARE HERE IN
CALIFORNIA, WHERE ABORTION IS
STILL SAFE AND LEGAL AH, THIS,
UH DESPITE THAT 40, CALIFORNIA
COUNTIES DO NOT HAVE AN ABORTION
PROVIDER IN THEIR COUNTY ANYWAY
, SO WE ALREADY HAVE A PROVIDER
WORKFORCE ISSUE HERE IN
CALIFORNIA. MAYBE 6 57 WILL
ENSURE WE CAN WORK TOWARDS
FILLING THESE GAPS IN THE
ABORTION WORKFORCE AND WOULD
RESPECTFULLY URGE YOUR VOTE
TODAY. THANK YOU. THANK YOU VERY
MUCH. I DON'T SEE ANY PRIMARY
WITNESSES IN OPPOSITION. UM WANT
TO OPEN IT UP TO LET'S FIRST
HAVE ANYBODY IN THE HEARING ROOM
WHO WANTS TO ADD ON IN SUPPORT
OR OPPOSITION TO THE BILL? JUST
YOUR NAME ORGANIZATION YOU'RE
WITH, IF ANY IMPOSITION ON THE
BILL ARI STEINBERG WAS THE
CALIFORNIA NURSES, MIDWIVES
ASSOCIATION AND SUPPORT. THANK
YOU. THANK YOU. MR TURN MEMBERS
, AARON EVANS ON BEHALF OF NARAL
PRO CHOICE CALIFORNIA AND
SUPPORT. THANK YOU. MR CHAIR
MEMBERS OF THE COMMITTEE,
BRANDON MARCY WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT THANK YOU VERY MUCH.
ANY ADDITIONAL WITNESSES IN THE
HEARING ROOM TODAY WHO WANT TO
TESTIFY IN SUPPORT OR OPPOSITION
TO A B 657. SEEING NON. LET'S GO
TO THE PHONE LINES OPERATOR OR
THERE ANY FOLKS WHO WANT TO ADD
ON AND SUPPORT OR OPPOSITION ON
THE PHONES TO A B 6 57 AGAIN,
JUST PROVIDING THEIR NAME
ORGANIZATION THERE WITH IF ANY
IMPOSITION ON THE BILL. THANK
YOU. LADIES AND GENTLEMEN, IF
YOU WOULD LIKE TO EXPRESS
OPPOSITION OR SUPPORT FOR BILL
86 57 PLEASE PRESS ONE, THEN
ZERO AT THIS TIME. AND WE DO
HAVE A COMMENT FROM LINE 109
PLEASE STATE YOUR NAME AND
ORGANIZATION. PLEASE GO AHEAD.
AND ONE OF NINE YOUR LINE IS
OPEN. OH, UM, HI. THIS WAS
ACTUALLY FOR SPEED 774. BUT
THERE WASN'T A CHANCE FOR ME TO
TIME IN BUT REAL QUICK, DON
ATTAIN LEGISLATIVE OF HER
ANALYST AT FROM THE LOS ANGELES
HOMELESS SERVICES AUTHORITY, AND
I'M A PROUD SPONSOR. AND IN
SUPPORT OF SB 774. THANK YOU.
THANK YOU VERY MUCH. THANK YOU.
WE HAVE SOMEONE ELSE QUEUING UP
AT THIS TIME. ONE MOMENT. AND WE
HAVE LINE 1 24, PLEASE GO AHEAD.
I THINK I'M TRYING TO SPEAK TO A
DIFFERENT BILL. I APOLOGIZE. NO
PROBLEM. THIS IS FOR AGENDA ITEM
NUMBER TWO A B 6 57. YEAH.
ALRIGHT, I BELIEVE HE'S DIE, DIE
DIE! WILL MOVE TO LINE 108
PLEASE STATE YOUR NAME AND
ORGANIZATION, PLEASE GO AHEAD.
ERIN BONE WITH THE MEDICAL BOARD
OF CALIFORNIA IN SUPPORT. THANK
YOU. AND WE HAVE NO ONE ELSE IN.
Q PLEASE CONTINUE. GREAT UH, SO
WE'VE, UH, BRING BACK THE
COLLEAGUES. COLLEAGUES
QUESTIONS, COMMENTS MOTIONS
SECONDS. GOT EMOTION, GOT A
SECOND ANY QUESTIONS OR COMMENTS
, SAYING NONE OF SOME MEMBER
COOPER WOULD YOU LIKE TO CLOSE?
RESPECTFULLY ASK FOR YOUR I
VOTE. THANK YOU, SIR. UH AND I
WANT TO THANK YOU AS ONLY MEMBER
COOPER AND THE BILL SPONSORS
ACOG FOR YOUR TENACIOUS WORK AND
EFFORT TO BRING THIS CRITICAL
POLICY FOR TODAY. WE KNOW THAT
CALIFORNIA IS EXPERIENCING A
WORKFORCE SHORTAGE AND IT'S
CRUCIAL. ENSURE OUR STATE HAS AN
ADEQUATE WORKFORCE BREAD, RIGHT
ACCESS TO REPRODUCTIVE RIGHTS
AND FAMILY PLANNING SERVICES,
WHICH IS WHY I'M HAPPY TO
SUPPORT THE BILL TODAY IN ON THE
FLOOR. APPRECIATE YOU ARE
AUTHORING THIS BILL. SECRETARY.
PLEASE CALL THE VOTE. A B 6 57.
THE MOTION IS WITH
RECOMMENDATION THAT SENTIMENT.
SENATE AMENDMENTS BE CONCURRED
IN BERMAN. FLORA. ALVAREZ.
PONTA. CHEN. NOT CHINA VOTING
Ó. UM CHEN CHEN, NOT VOTING.
CUNNINGHAM. DOLLY! SALLY NO.
PH UP, BANG, NO. GIBSON.
GRAYSON. LEE. MCCARTY. MCCARTY I
MAKIN ER MCCAIN KHEDINA.
MEDINA. I SALAS. SALAS? AYE.
TING TING I WEBER WEBER. AYE.
THAT BUILDS EIGHT VOTES. WE'LL
LEAVE IT ON CALL FOR ABSENT
MEMBERS. THANK YOU. SOME MEMBER
COOPER MOVING ON. I DON'T SEE IS
SOMETHING NUMBER WOULD I DO SEE
ASSEMBLYMEMBER'S LOW PLEASE DO.
YOU HAVE EMOTION IN A SECOND ON
AGENDA ITEM NUMBER ONE SB 7 74.
LET'S TAKE A QUICK VOTE ON THAT.
SECRETARY CAN YOU PLEASE CALL
THE VOTE ON SB 7 70 FOR THE
MOTION IS DUE PASS. BERMAN
BERMAN. I LARA ALVAREZ. BANTA.
TÔI CHEN CHEN. I CUNNINGHAM.
DOLLY! SALLY, I BANG. FUNGI
GIBSON GRAYSON LEE MCCARTY.
BACARDI I MAKIN ER MCKENNA. I
MEDINA. MEDINA. I SALAS. SALAS I
THING. THING I WEBER WEBER. AYE.
THAT BILL IS OUT. WE'LL LEAVE
THE ROLE OPEN FOR ABSENT MEMBERS
, WITH 11 VOTES MOVING ON TO THE
GENERALNUMBER FOUR, MAYBE 20 TO
36. ASSEMBLYMEMBER'S, UH, LOW
READY WHEN YOU ARE. THANK YOU
VERY MUCH, MR CHAIR AND
COLLEAGUES. FIRST OF ALL, LET ME
THANK THE INCREDIBLE HARD WORK
OF MY TEAM AND STAFF AS WELL AS
YOUR COMMITTEE STAFF. I KNOW
THERE HAVE BEEN A NUMBER OF
CONVERSATIONS ABOUT WHETHER OR
NOT THIS CAME IN THE LAST
MINUTE. BUT IN FACT THAT THIS
HAS BEEN GOING ON FOR A NUMBER
OF YEARS WITH RESPECT TO THIS
ISSUE, AND THE ANALYSIS THAT HAS
PROVIDED THAT AND I WANT TO
AGAIN THANK MY, UM, SLEEP
DEPRIVED CHIEF OF STAFF JENNA
FRISBEE WHO'S ALSO WORKED
DILIGENTLY ON THESE ISSUES. AND
SIMILARLY AS WRITTEN, SHE GAVE A
NUMBER OF TALKING POINTS TO
MAKING SURE THAT WE ADDRESS ALL
THESE ISSUES. SO IF YOU INDULGE
ME FOR A MOMENT TO READ ACCESS
TO EYE CARE IN RURAL CALIFORNIA
IS A CRITICAL PROBLEM AND MADE
WORSE BY THE FACT THAT IT CAN
TAKE MONTHS TO FIND AN
OPHTHALMOLOGIST. THAT ACCEPTS
MEDICAL OPTOMETRY ALREADY
PROVIDES ANY 1% OF THE EYE CARE
PROVIDED BY MEDICAL AND WHILE
OPPOSITION IS GOING AROUND,
CHARACTERIZING THIS BILL AS
BEING NEW, THIS IS NOT TRUE. AS
PREVIOUSLY STATED, THESE
NEGOTIATIONS HAVE BEEN GOING ON
FOR FIVE PLUS YEARS SINCE THEN
SENATOR DR ED HERNANDEZ WERE WAS
SPECIFICALLY INVOLVED IN THESE
MEETINGS. IN FACT, EVEN IN THIS
PAST YEAR, AS SOME OF THEM ARE,
SALAS HAS ALSO BEEN WORKING ON
THESE KEY CONCEPTS. UM BUT
NOTHING IS NEW, AND THIS IS A
MATTER OF FACT. THE OPPOSITION
TO THIS BILL, WROTE 91% OF THIS
BILL. LET ME JUST REPHRASE THAT
OPPOSITION WROTE 91% OF THIS
BILL. AND THIS IS FACT. THE BILL
CURRENTLY ALLOWS FOR THE USE OF
LASERS FOR A CONDITION IN WHICH
OPTOMETRY IS ALREADY ALLOWED TO
TREAT. IN FACT, 10 OTHER STATES
ALLOWED OPTOMETRIST TO USE THESE
SUCH LASERS. THE BILL ALSO
ALLOWS THE REMOVAL OF SKIN TAGS,
SKIN TAGS AND MINOR LUMPS NO
LONGER THAN FIVE MILLIMETERS
OPTOMETRIST AGREED TO SEND ALL
OF THESE REMOVALS. FOR REVIEW TO
THE RESPECTIVE LABS. 17 OTHER
STATES ALLOW THESE TYPES OF
LUMPS AND BUMPS TO BE REMOVED.
FINALLY THIS BILL ALLOWS FOR THE
PROCEDURE. REFER TO AS CORNEAL
CROSS LINKING A MINIMAL INVASIVE
PROCEDURE THAT STRENGTHENS THE
COLLAGEN IN THE EYE. WE
SPECIFICALLY ASKED THE U. C
BERKELEY OF SCHOOL OF OPTOMETRY.
IF THIS IS INDEED A GOOD IDEA.
THE RESPONSE WAS IMMEDIATE,
CREDIBLE AND ADAMANT THAT YES,
INDEED, OPTOMETRISTS ALREADY
DOING THE MOST DIFFICULT PART OF
THE PROCEDURES. AND THE
PRESIDENT OF SCOPE OF PRACTICE.
QUESTION. IS THIS SAFE? THERE
HAVE BEEN NO COMPLAINTS WITH
RESPECT TO OPTOMETRISTS OR AN
INCREASE IN MALPRACTICE RATES,
WHERE THE PROCEDURES ARE
CURRENTLY ALLOWED TO HAVE.
THERE'S OFTENTIMES A QUESTION
AND I'VE HAD THE OPPORTUNITY TO
SPEAK TO A NUMBER OF YOU ABOUT
PATIENT CARE AND SAFETY. AND IN
FACT THIS IS NOTHING BUT SAFE
WITH THE APPROPRIATE TYPE OF
TRAINING THAT AGAIN IS
COMMENSURATE AND IF NOT EVEN
MORE THAN OTHER STATES IN THE
STATE OF CALIFORNIA. AND OTHER
STATES OF THOMAS'S CAN DO THE
PROCEDURE BY ONLY TAKING A 32
HOUR COURSE, WITH LITTLE TO NO
TRAINING ON LIVE PATIENTS. OF
COURSE, AS WE KNOW IN THIS
COMMITTEE, THIS IS REFERRED TO
AS A COURSE BATTLE A TURF BATTLE
I SHOULD SAY MADE INCREDIBLY. SO
WITH THE CONCESSIONSFOR
EDUCATION AND TRAINING AS A
REMINDER THE PROFESSION OF
OPTOMETRY IS A DEMANDING
PROFESSION THAT REQUIRES
STUDENTS WHO QUALIFY FOR FOUR
YEARS OF OPTOMETRY SCHOOL THE
FIRST YEAR REPLICATING MEDICAL
SCHOOL AND THE FOLLOWING YEARS
FOCUSED ON I CARE FOR HEALTH.
THIS BEAUTIFUL REQUIRES 32
HOURS. THAT OTHER STATES
SIMILARLY REPLICATE WE IN THE
STATE OF CALIFORNIA IN THIS BILL
WILL REQUIRE AN INDEPENDENT
NATIONAL EXAMINATION TO ALSO, IN
ADDITION, BE PASSED. TO PROVE
THAT THESE OPTOMETRISTS ARE
CAPABLE AND QUALIFIED.
OPPOSITION MAY HAVE MADE
REFERENCE TO OPTOMETRIST
PROVIDING COMPLETE TREATMENT ON
42 LIVE PATIENTS AS PART OF
THEIR EDUCATION. OUR SCHOOLS AND
DOCTORS ARE ALL BELIEVED. THIS
TO BE EXCESSIVE, HOWEVER. THESE
OPTOMETRISTS AGREED TO THESE
CONCESSIONS JUST TO REITERATE IS
THAT OF THE OPTOMETRIST WHO
AGREED TO THESE CONCESSIONS?
PLEASE. PLEASE. NOTE THAT THESE
CONCESSIONS. SPECIFICALLY DOES
NOT MEAN SEEING JUST ONE PATIENT
AND IT IS. I KNOW THAT
OPPOSITION HAS STATED IT MEANS
FOLLOWING THE PATIENT FOR UP TO
SIX MONTHS. TO CONTINUALLY
MONITOR THEIR CONDITION.
UNFORTUNATELY, THERE IS
MISINFORMATION ABOUT HAVING
EVERY MAJOR PROBLEM ADDRESSED.
WE WANTED TO HAVE A CONVERSATION
ABOUT ATOMIC TREE NOT TO BE
DICTATED ABOUT HOW SCHOOLS RUN
THEIR CLASSES, BUT RATHER TO
HELP ENSURE THAT WE CAN
ACCOMPLISH A SPECIFIC GOAL WITH
PATIENT CARE IN MIND. THIS
LEGISLATION INCLUDES VERY
DEMANDING ROLES ON CONSULTATION
AND REFERRING ANY PROBLEMS. IF
ANY OF THESE ISSUES ARISE, AND
UNLIKE ANY OTHER HEALTH CARE
PROFESSION, THESE DOCTORS MUST
PROVE THEIR EFFECTIVENESS
THROUGHOUT THEIR CAREERS OR BE
SUBJECTED TO RE EDUCATION. AGAIN
25% OF MEDICAL DOCTORS OVER
APPROACHING RETIREMENT AND WE
NEED QUALIFIED PROVIDERS.
ESPECIALLY IN THE HIGHEST AREAS
OF NEED. THIS PROVIDES THE
HIGHEST STANDARDS OF CARE. IN
THE UNITED STATES AGAIN THE
HIGHEST STANDARDS. UM, AND WITH
ME ARE ADDITIONAL. EXPERTS THAT
WILL BE ABLE TO PROVIDE ESPER
EXPERT TESTIMONY. AND I KNOW
THAT THIS COMMITTEE HAS MEMBERS
OF THIS COMMUNITY THAT
UNDERSTAND THESE ISSUES WITH
PERSPECTIVE, HEALTHCARE AND
ALLOW OUR EXPERT WITNESSES TO
ANSWER ANY TECHNICAL QUESTIONS
AND RESPECTFULLY ASKED RIVAL
THANK YOU. SOME OF THEM ARE LOW,
TERRY MCHALE, I BELIEVE YOU'RE
HERE TO TESTIFY AND SUPPORT
MCHALE WITH AARON REGION,
REPRESENTING THE CALIFORNIA
OPTOMETRIC ASSOCIATION. I'M
EXTRAORDINARILY PLEASED TO
REPRESENT THE OPTOMETRIST. THEY
ARE THE BEST IN THE BRIGHTEST OF
OUR UNIVERSITY STUDENTS. THEY
FIGHT TO GET INTO OPTOMETRY
SCHOOL, WHICH IS A FOUR YEAR
PROGRAM, THE FIRST YEAR
REPLICATES MEDICAL SCHOOL THE
NEXT THREE YEARS. I FOCUS ON I
CARE. OUR OPTOMETRISTS ARE
ALLOWED TO DIAGNOSE AND TREAT
DISEASES, INCLUDING GLAUCOMA.
THEY'RE ABLE TO DEAL WITH GLORIA
CORNEAL ABRASIONS AND CORNEAL
ULCERS. THEY'RE ABLE TO
PRESCRIBE ALL FDA APPROVED DRUGS
. THEY DESERVE TO BE CALLED
DOCTORS. THEY DO THE CARE THAT
WE NEED DONE, ESPECIALLY IN THE
RURAL AREAS OF CALIFORNIA. IN
THOSE AREAS WHERE THERE ARE
DEARTH OF DOCTORS REMEMBER, 25%
OF OUR DOCTORS ARE OVER THE AGE
OF 55, RETIRING AT THE SAME TIME
THAT WERE DEMANDING MORE CARE.
THE OPPOSITION. HAS SUGGESTED
THAT THERE ARE THINGS IN THIS
BILL THAT OPTOMETRIST SHOULD NOT
DO. I WOULD REFERENCE A LETTER
SENT BY THE CALIFORNIA ACADEMY
OF LIFE PHYSICIANS TO THE SENATE
BNP COMMITTEE ON JUNE 25TH 2022
, IN WHICH THEY WROTE THAT C M A
AND THE ACADEMY OF APPROACHED
THESE PROCEDURES, NOT AS
SOMETHING AN OPTOMETRIST
SHOULDN'T DO, BUT RATHER IT'S
SOMETHING TOM INTEREST. SHOULD
DO WITH THE PROPER EDUCATION AND
TRAINING AND THAT'S THE RUB.
WHAT IS THE PROPER EDUCATION AND
TRAINING? SOME WOMEN LOW HAS
CERTAINLY POINTED OUT IN OTHER
STATES, 10 OTHER STATES ALLOW
THE TREATMENT OF LASERS, AND
THEY ALLOW IT WITH 16 HOURS OF
EDUCATION AND NOTHING ELSE. 17
OTHER STATES ALLOW THE TREATMENT
OF LUMPS AND BUMPS WITH A 16
HOUR COURSE IN NOTHING ELSE IN
CALIFORNIA WHAT WE ARE DEMANDING
IS NOT ONLY THE 32 HOUR COURSE,
BUT THEY ALSO HAVE TO SEE 43
OTHER PATIENTS, AND THOSE ARE
THEIR NUMBERS BASED ON WHAT
OPHTHALMOLOGY DOES AND IN SEEING
THOSE PATIENTS, AS THE ANALYSIS
SAYS THEY MUST INDEPENDENTLY
ASSESSED THE PATIENT DEVELOP A
TREATMENT PLAN, EVALUATE THE
CLINICAL OUTCOMES AND POST
TREATMENT DEVELOP A PLAN TO
ADDRESS ANY ADVERSE OR
UNINTENDED CLINICAL OUTCOMES.
AND DISCUSS AND DEFEND MEDICAL
DECISION MAKING, MR CHAIRMAN AND
MEMBERS OF THIS COMMITTEE UNLIKE
ANY OTHER STATE IN THE UNITED
STATES, WE ARE DEMANDING OF
THESE OPTOMETRISTS THAT THEY DO
VIRTUALLY A SIX MONTH COURSE IN
ORDER TO DO WHAT IS ALLOWED IN A
32 HOUR COURSE. OTHERWISE LET ME
JUST CLOSE WITH ONE LAST THING.
THERE IS THIS DISCUSSION OF
CORNEAL CROSS LINKING AND
THEY'RE ALL THESE FEARMONGERING
OF WHAT IT DOES. LET US BE
ABSOLUTELY CLEAR ONCE AGAIN IN
THIS BILL, CALIFORNIA IS NOT IN
THE FOREFRONT. FIVE OTHER STATES
EXPLICITLY ALLOW THAT CORNEAL
CROSS LINKING BE ALLOWED. U C.
BERKELEY AND THE OTHER SCHOOLS
SAY WE SHOULD HAVE DONE IT YEARS
AGO. FOUR OF THE FIVE ASPECTS OF
THIS CORNEAL CROSS LINKING WE
ALREADY DO. THANK YOU VERY MUCH
FOR YOUR PATIENTS. WE'RE HERE TO
ANSWER ANY QUESTIONS. BUT I WILL
ALSO SAY, I KNOW YOU'VE HEARD
THAT THESE THIS DISCUSSION IS
NEW. MR CHAIRMAN AND MEMBERS.
THANK YOU. MR I HAVE SPENT.
EVERY THURSDAY FOR THE LAST SIX
MONTHS, TALKING WITH
OPHTHALMOLOGIST AND THE AND THE
AND THE CMA ON THIS BILL, THANK
YOU. THANK YOU VERY MUCH. THANK
YOU VERY MUCH. HI THERE.
CHRISTINE SCHULTZ AND THE
EXECUTIVE DIRECTOR FOR THE
CALIFORNIA OPTIMA TRICK
ASSOCIATION HERE TO ANSWER ANY
KIND OF TECHNICAL QUESTIONS. AND
WE HAVE. I GUESS THE ONLY THING
I WOULD ADD TO THIS IS IT. YOU
KNOW, IT'S REALLY HARD FOR ALL
OF YOU TO CHOOSE BETWEEN TWO
HEALTHCARE PROVIDERS. YOU KNOW,
YOU HAVE TO EXPERTS TELLING YOU
TWO DIFFERENT THINGS. BUT WHAT I
WOULD SUGGEST IS THAT IF YOU
LOOK AT THE SUNSET REVIEWED
REPORT THAT HAPPENED IN COLORADO
IF YOU LOOK AT THAT REPORT,
YOU'LL SEE THAT THE STAFF DID IT
. INDEPENDENT ANALYSIS CALLED
THE STATE OTHER STATES STATES
THAT ALLOW THESE PROCEDURES AND
ASK THEM. IS THERE ANY HARM TO
PATIENTS AND WHAT THEY SAID WAS
EQUIVOCAL. NO, THERE IS NOT HARM
AND THEY EXPANDED THESE
PROCEDURES AND INCLUDED CORNEAL
CROSS LINKING, SO I HOPE THAT
YOU LOOK AT THAT INFORMATION. I
KNOW IT'S IN THE MATERIALS WE
PROVIDED. AND I'M HERE TO
RESPOND TO ANY QUESTIONS. THANK
YOU. THANK YOU VERY MUCH, AND I
BELIEVE WE HAVE A COUPLE OF
WITNESSES AND OPPOSITION JO LING
AND BRANDON MARCHI, WHO ARE BOTH
HERE IN PERSON WATCHING. COME ON
UP. ARE YOU EACH 12 MINUTES PER
WITNESS OR TOTAL OF FOUR
HOWEVER, YOU WANT TO WANT TO
SPLIT THAT UP.
HERE WE GO. MR CHAIRMAN MEMBERS.
JOE LANG ON BEHALF OF THE
CALIFORNIA ACADEMY OF PHYSICIANS
AND SURGEONS. THAT WAS A LOT TO
RESPOND TO. AND I THINK IT'S
IMPORTANT TO SIT BACK AND LET'S
JUST TALK ABOUT A FEW FACTS. ONE
WE HAVE BEEN NEGOTIATING. W HAD
BEEN NEGOTIATING UP UNTIL AUGUST
1ST WHEN WE WERE GIVEN A
PROPOSAL. AND NEGOTIATIONS WERE
SHUT DOWN FOR TWO WEEKS.
SUBSEQUENT TO THAT WE MET ONE
MORE TIME. WE WERE TOLD WE WOULD
HAVE A RESPONSE TO OUR CONCERNS
THAT ARE IN THESE AMENDMENTS,
RIGHT? THE LAST AMENDMENTS
YOU'RE TALKING ABOUT THE NEXT
DAY. WE GOT NO RESPONSE. IN
FACT. A WEEK LATER, WE SAW THESE
AMENDMENTS NOT KNOWING WHAT WAS
GOING TO BE THEIR RESPONSE. NOW
HAVING SAID THAT BECAUSE I DO
WANT TO SAY WE HAD BEEN UNTIL
THAT TIME IN VERY GOOD FAITH,
DIALOGUE AND DISCUSSIONS, BUT
THESE ARE HARD ISSUES.
CONCESSIONS HAVE BEEN MADE. LOOK
AT THE DETAILS. EVERY CONCESSION
THAT WAS MADE, THERE IS LANGUAGE
THAT UNDERMINES THE BASIC VALUE
OF THE CLINICAL TRAINING IN THIS
BILL, AND THAT'S WHAT'S GOING ON
RIGHT NOW. WE HAVE A FUNDAMENTAL
DISAGREEMENT ABOUT THE VALUE OF
CLINICAL TRAINING. OUR EDUCATORS
TRAINED RESIDENTS TO DO
SURGERIES. THAT'S WHAT WE DO.
TRAINING IS CRITICALLY IMPORTANT
. WE KNOW THAT IT'S IMPORTANT TO
HAVE MORE TRAINING, NOT LESS.
THE FACT THAT THIS BILL ADDS
MORE TRAINING THAN PERHAPS A
STATE OF OKLAHOMA OR KENTUCKY.
THAT'S A GOOD THING. BUT LET ME
TELL YOU. THIS BILL INCLUDES
CORNEAL CROSS LINKING SURGERY.
LET ME TELL YOU WHAT THAT IS FOR
JUST A MINUTE BECAUSE THE
SPONSOR OF THIS BILL WILL TRY TO
MAKE YOU THINK THAT SOMEHOW THAT
IS A SIMPLE EYE SURGERY. CORNEAL
CROSS LINKING IS TAKING A
SCALPEL TO YOUR EYE AND REMOVING
THE EPITHELIUM, THE SMALL FILM
THAT PROTECTS YOUR EYE FROM THE
ENVIRONMENT. FROM INVASIVE
OBJECTS FROM POLLEN AND FROM
INFECTION. YOU REMOVE THAT
EPITHELIUM. YOU THEN APPLY DRUGS
, EITHER BY INJECTION OR BY
DROPS OVER A PERIOD OF AN HOUR.
YOU ALSO DURING THAT HOUR APPLY
ULTRAVIOLET LIGHT. THIS SURGERY
THAT'S IN THIS BILL IS MOST
OFTEN IN OUR WORLD DONE IN AN
OPERATING ROOM IN A SURGERY
CENTER. THIS IS NOW BEING ASKED
TO BE DONE IN AN INDEPENDENT
PRACTICE OFFICE. THE THREAT OF
INFECTION AND THE MELTING OF THE
CORNEA, WHICH CAN HAPPEN IN THIS
PROCEDURE. IS VERY SIGNIFICANT
AND THEY'RE SUGGESTING THAT ONE
TRAINING PROCEDURE IS SUFFICIENT
TO LEARN HOW TO DO THIS, AND BY
THE WAY IN THE FINE PRINT OF THE
BILL ACTUALLY SAYS THAT THAT
TRAINING PROCEDURE THAT ONE CAN
BE SUBSTITUTED WITH ANOTHER
SCALPEL SURGERY. THAT WOULD MEAN
YOU WOULD HAVE NO EXPERIENCE, NO
CLINICAL TRAINING. ON A CORNEAL
SURGERY AND BE ALLOWED TO DO IT.
THAT SEEMS TO ME THAT'S JUST NOT
RIGHT. MAYBE WHAT YOU SHOULD
LOOK AT IS THE MEDICAL BOARD THE
BOARD JUST AS A TIME CHECK.
THAT'S THREE MINUTES OF YOUR
FOUR MINUTES TOTAL. UH OKAY,
THEN I'M GONNA JUST SAY MEDICAL
BOARD THAT REGULATES SURGEONS
LOOKED AT THIS AND SAID THIS IS
DANGEROUS AND THEY UNANIMOUSLY
OPPOSED IT. GO AHEAD. I'M SORRY.
NO WORRIES. THANK YOU. MR
CHAIRMAN, MEMBERS OF THE
COMMITTEE BRANDON MARCHI WITH
THE CALIFORNIA MEDICAL
ASSOCIATION HERE IN OPPOSITION
AS WELL. UNFORTUNATELY I WANTED
TO START BY THINKING
ASSEMBLYMEMBER'S LOAFER,
BRINGING BOTH SIDES OF THE
DEBATE TOGETHER TO SEE IF AN
AGREEMENT COULD BE REACHED ON
THE ISSUE, AS WE HAVE DONE FOR
SEVERAL YEARS RUNNING, AS THE
ASSEMBLY MEMBER SAID.
UNFORTUNATELY IT IS THE DETAILS
OF MAYBE 20 TO 36 THAT WE HAVE.
UH CONCERNS WITH AND PUT
PATIENTS AT A HEIGHTENED RISK OF
MEDICAL COMPLICATIONS. AND FOR
THAT REASON WE'RE ASKING YOU TO
VOTE NO TODAY WHILE THE TRAINING
REQUIREMENTS IN THIS BILL HAVE
BEEN RAISED TO 43 LIVE PATIENTS
, PROCEDURES FOR OPTOMETRISTS TO
BE ALLOWED TO PERFORM. THE EIGHT
DIFFERENT SURGICAL AND LAYERS
ARE PROCEDURES IN THE BILL. THIS
CONTINUES TO BE WELL BELOW THE
CLINICAL TRAINING THAT
OPHTHALMOLOGISTS RECEIVED
THROUGH THEIR RESIDENCY
PROGRAMS. ON AVERAGE
OPHTHALMOLOGISTS PERFORM 133
PROCEDURES OF JUST THREE OF THE
LASER PROCEDURES THAT ARE LAID
OUT IN THE BILL. THERE ARE FIVE
ADDITIONAL PROCEDURES THAT THIS
DOES NOT APPLY TO UH, I THE
DEVELOPMENT OF CLINICAL JUDGMENT
. INCOMPETENCY IS IMPORTANT,
WHICH IS WHY THEY ARE EXPOSED TO
SO MUCH AND I RESPECTFULLY
REQUEST YOUR YOUR NO VOTE. THANK
YOU. THANK YOU VERY MUCH. LET'S
OPEN UP TWO WITNESSES ANY
ADDITIONAL WITNESSES IN THE
HEARING ROOM TODAY YOU WANT TO
ADD ON AND SUPPORT OR OPPOSITION
? THIS IS A SIMPLE NAME
ORGANIZATION YOU'RE WITH IF ANY
POSITION ON THE BILL, PLEASE GO
AHEAD. GOOD EVENING CHAIR AND
MEMBERS PAT WHELAN ELLISON
WILSON ADVOCACY HERE ON BEHALF
OF THE UNITED NURSES ASSOCIATION
OF CALIFORNIA UNIONS, HEALTHCARE
PROFESSIONALS. THAT'S YOU, NAK
YOU HCP 35,000 MEMBERS,
INCLUDING HUNDREDS AND HUNDREDS
OF OPTOMETRISTS IN STRONG
SUPPORT OF THE BILL, WHICH DOES
NOT ALLOW SUBSTITUTION OF CROSS
LINKING THANK YOU VERY MUCH.
GOOD AFTERNOON. I'M MARK MAN IS
CHAIR OF THE DEPARTMENT OF
OPHTHALMOLOGY AT THE UNIVERSITY
OF CALIFORNIA, DAVIS. I'VE BEEN
PERFORMING SURGERY AND TRAINING
SURGEONS. THE LAST FOUR DECADES
AND I STAND IN STRONG
OPPOSITION. ISABELLE, WHICH I DO
NOT THINK PROVIDES. SAFE
TRAINING AND IS A DETRIMENT TO
THE CITIZENS OF OUR STATE. THANK
YOU VERY MUCH. SHARING MEMBERS
CLIFF KOSTA ON BEHALF OF
GOVERNOR FOR CALIFORNIA AND
STRONG SUPPORT. THANK YOU. THANK
YOU VERY MUCH. ANY ADDITIONAL
WITNESSES IN THE HEARING ROOM
WHEN I ADD ON IN SUPPORT OR
OPPOSITION, SEEING NONE, LET'S
OPEN IT TO THE PHONE LINES
OPERATOR ANYONE CALLING IN WHO
WANTS TO ADD ON AND SUPPORT OR
OPPOSITION TO MAYBE 20 TO 36
AGAIN TO PROVIDE THEIR NAME
ORGANIZATION THERE WITH IF ANY
IMPOSITION ON THE BILL. I THANK
YOU AGAIN, PLEASE PRESS ONE,
THEN ZERO IF YOU'D LIKE TO
EXPRESS SUPPORT OR OPPOSITION TO
A B 20 TO 36, OUR FIRST LINE IS
1 29, PLEASE GO AHEAD. THEY MUST
HAVE TAKEN HIMSELF OUT OF QUÊ.
WE'LL GO TO LINE 1 40, PLEASE GO
AHEAD. FIND MY NAME IS KENDALL.
UM AT THE JOKER, LIKE POSE. YOU.
THANK YOU VERY MUCH. AND NOW TO
LIE IN 1 49. PLEASE GO AHEAD. HI
MY NAME IS ANGELA CHEN. I'M IN
OPHTHALMOLOGIST SINAI INSTITUTE
, AND I AM IN STRONG OPPOSITION
OF A B 2 TO 36. THANK YOU VERY
MUCH. THANK YOU. AND NOW UNTIL
I'M 1 50, PLEASE GO AHEAD. YES
MY NAME IS RANDY GRAHAM CHANDRA
AND MY COMPANY'S ADVANCED RETINA
INSTITUTE. I'M AN
OPHTHALMOLOGIST AND A RETINA
SPECIALIST. AND I'M IN STRONG
OPPOSITION TO A B 2 TO 36. THANK
YOU. THANK YOU NOW TO LINE 1 24,
PLEASE GO AHEAD. HI MY NAME IS
CRAIG KLIGER. I'M AN
OPHTHALMOLOGIST. I'M ALSO IN
STRONG OPPOSITION. THANK YOU.
THANK YOU. AND NOW TO LINE 1 34,
PLEASE GO AHEAD. THANK YOU,
CHAIRMAN MEMBERS, TIM MADDEN,
REPRESENTING THE CALIFORNIA
SOCIETY OF PLASTIC SURGEONS IN
OPPOSITION. THANK YOU. NOW TO
LINE 1 21. THIS IS JENNIFER. WE
I'M AN, UH, LET SPECIALISTS AND
I STRONGLY OPPOSE THIS BILL, AND
AS A SPECIALIST, I SEE ALL KINDS
OF REFERRALS FROM OPTOMETRIST
FOR THE DIAGNOSIS WERE WRONG. I
APPRECIATE THAT. JUST THE
OPPORTUNITY FOR YOUR NAME
ORGANIZATION YOU'RE WITH OF ANY
POSITION ON THE BILL. OPPOSE OR
SUPPORT. THANKS. JENNIFER. HI,
OKAY. BUBBLE IN THE
OPHTHALMOLOGY DEPARTMENT AND
OPPOSITION. THANK YOU. THANK YOU
NOW LINE 1 37, PLEASE GO AHEAD.
AND 1 37. YOUR LINE IS OPEN.
WE'LL MOVE ON TO LINE 1 16,
PLEASE GO AHEAD. 1 16. YOUR LINE
IS OPEN. IS YOUR PHONE ON MUTE?
OH, HELLO. PLEASE GO AHEAD.
WE'LL MOVE ON TO LINE 1 19,
PLEASE GO AHEAD. LET'S GO AHEAD
AND MOVE ON. ALRIGHT LINE 108.
YOUR LINE IS OPEN. AARON DONE
WITH THE MEDICAL BOARD OF
CALIFORNIA IN OPPOSITION. THANK
YOU. THANK YOU. THANK YOU AND
OUR LINE 1 52, PLEASE GO AHEAD.
AND 1 52. HELLO CAN YOU HEAR ME?
CAN YOU PLEASE GO AHEAD? OKAY UM
, MY NAME IS DR CHENG NHÀ FROM
CENTRAL VALLEY, CALIFORNIA I'M
REPRESENTING TWO ORGANIZATIONS,
WESTERN OCCUPATIONAL AND
ENVIRONMENTAL HEALTH ASSOCIATION
AND ALSO CURRAN COUNTY MEDICAL
ASSOCIATION IN STRONG
OPPOSITION. THANK YOU VERY MUCH.
NOW A LINE 1 35, PLEASE GO
AHEAD. MR CHAIRMAN, MEMBERS OF
THE COMMITTEE. THIS IS RANDALL
HAGAR. I REPRESENT THE
PSYCHIATRIC POSITIONS ALLIANCE
OF CALIFORNIA AND WE'RE IN
STRONG OFFICE SESSIONS. THANK
YOU. THANK YOU. THANK YOU NOW
LINE 1 29, PLEASE GO AHEAD. HI
THIS IS I MEAN, A STRESS CITY
OPHTHALMOLOGISTS AND MODESTO,
CALIFORNIA IN STRONG OPPOSITION.
THANK YOU. THANK YOU. LINE 1 27.
YOUR LINE IS OPEN. LINE 1 27.
MOVE ALONG TO LINE 1 47, PLEASE
GO AHEAD. HI MY NAME IS ROBERT
JOHNSON HAUSER. I'M AN
OPHTHALMOLOGY RESIDENT AT U. C.
L. A STEIN INSTITUTE. UM I'M
IRISH SONG. I'M ALSO AN
OPHTHALMOLOGY RESIDENT AT MY
INSTITUTE. AND I'M ERIC ELLIS.
I'M ALSO AN OPHTHALMOLOGY
RESIDENT AT SINAI INSTITUTE, AND
WE ARE ALL IN OPPOSITION TO THIS
BILL. THANK YOU. THANK YOU FOR
BEING SO EFFICIENT. THANK YOU.
AND NOW TO LINE 1 18, PLEASE GO
AHEAD. HI. THIS IS VICTORY. I'M
ON FACULTY. CHINA INSTITUTE FROM. THANK YOU VERY MUCH. AND NOW
TO LINE 1 46, PLEASE GO AHEAD.
MY NAME IS ALEX ONISHI. I'M A U
C. L A RESIDENTS WELL AND I'M
STRONG OPPOSITION. THANK YOU,
MHM. THANK YOU. AND NOW ALIGN. 1
40, PLEASE GO AHEAD. HI, I'M BUT
YEP. FEEL LIKE IT. AND I
STRONGLY UP. BILL. THANK YOU
VERY MUCH. THANK YOU. AND NOW TO
LINE 1 61, PLEASE GO AHEAD. FIND
MY NAME IS CHRISTOPHER G. TOM
INTEREST IN DUBLIN, CALIFORNIA
AND I'M CALLING TO EXPRESS
SUPPORT FOR THIS BILL. THANK
YOU. AND NOW TO LINE 1 19,
PLEASE GO AHEAD. LINE 1 19. YOUR
LINE IS OPEN. WE BELONG TO LINE
1 59, PLEASE GO AHEAD. THANK
YOU, MR CHAIR. THIS IS DR DIANA
ARE SHEBA. SPEAKING OF BEHALF OF
LOS ANGELES COUNTY MEDICAL
ASSOCIATION AND OPPOSITION.
THANK YOU. THANK YOU. THANK YOU.
AND NOW TO LINE 1 63, PLEASE GO
AHEAD. THIS IS DR DAVID ASUS OF
OPHTHALMOLOGY ASSOCIATES OF THE
VALLEY SPEAKING AND STRONG
OPPOSITION. THANK YOU. THANK
YOU. AND NOW TO LINE 1 65,
PLEASE GO AHEAD. THIS IS DR
CAMILLE HARRISON AMERICAN
ACADEMY OF OPHTHALMOLOGY AND
STRONG OPPOSITION. SIX. WELL,
THANK YOU. AND NOW TO LINE 1 64,
PLEASE GO AHEAD. THEY TOOK
THEMSELVES OUT OF. Q WE HAVE NO
ONE ELSE IN Q AT THIS TIME,
GREAT BRING IT BACK TO
COLLEAGUES FOR QUESTIONS OR
COMMENTS. MOTIONS ARE SECONDS.
COLLEAGUES ANY QUESTIONS OR
COMMENTS, EMOTIONS OR SECONDS.
DR WEBBER THANK YOU. CHAIR.
THANK YOU ASSEMBLYMEMBER'S LOW,
UM OR ENGAGING IN A VERY LENGTHY
DISCUSSION WITH ME EARLIER TODAY
ABOUT THIS BILL. UM, I HAVE A
COUPLE OF QUESTIONS FOR YOU. UM,
AS I DISCUSSED EARLIER. I AM
VERY CONCERNED ABOUT THIS BILL
AND VERY CONCERNED ABOUT PATIENT
SAFETY, BUT I'LL GET INTO THAT
IN A MINUTE. IN YOUR OPENING.
YOU TALKED ABOUT THE FACT THAT
WITHIN THIS BILL, YOU COULD
PROVE EFFECTIVENESS OF THE, UM,
THE OPTOMETRIST WHO WOULD BE
PERFORMING THESE PROCEDURES. HOW
EXACTLY WOULD THAT BE DONE? THE
CHAIRMAN MAY REFER TO THE
PROMISES IT IS THAT ACCEPTABLE,
DR WEBBER. SO THIS IS WHAT I'M
GETTING AT. SO IN YOUR IN YOUR
OPENING STATEMENT, YOU BILL WOULD ALLOWED TO PROVE
EFFECTIVENESS. AND ONE OF MY
CONCERNS IS THAT, UM I DON'T SEE
I DIDN'T SEE ANYTHING IN THIS
BILL ABOUT HOW THEY WOULD HAVE
TO MAINTAIN THEIR PROFICIENCY
AND SURGERY. LIKE THE REST OF US
SURGEONS DO. UM, I SAW SOMETHING
ABOUT THE FACT THAT THEY WOULD
HAVE TO ATTEST WHEN THEY'RE
RENEWING FOR THEIR LICENSE THAT
THEY HAD DONE AT LEAST ONE OF
THESE PROCEDURES THAT ARE
OUTLINED, BUT I DON'T REALLY SEE
ANYTHING IN THERE THAT
SPECIFICALLY STATES THAT THEY
WOULD HAVE TO SHOW THAT THEY HAD
MAINTAINED PROFICIENCY OF THESE
PROCEDURES, ESPECIALLY LASER
RIGHT BECAUSE FOR ME LASER
PROCEDURES WE LASER CANDLE,
LOMAS RELAYS THE ENDOMETRIOSIS.
YOU HAVE TO MAKE SURE THAT YOU
ARE MAINTAINING YOUR PROFICIENCY
IN THOSE AREAS. SO HOW WOULD
THAT BE ADDRESSED IN THIS
PARTICULAR BILL?
ASSEMBLYMEMBER'S TERRY MCHALE
WITH AARON REID AND ASSOCIATES.
WE'RE GOING TO ANSWER THIS IN
TWO PARTS. THE FIRST PART IN
TERMS OF PROVING EFFECTIVENESS.
WE TOOK AN AMENDMENT IN THIS
BILL THAT DOES NOT EXIST
ANYPLACE ELSE. AND WHAT WE
AGREED TO DO IS THAT AT ANY TIME
THAT AN OPTOMETRIST CONSULTS OR
REFERS. THEY MUST RE ON THESE ON
THESE PARTICULAR PROCEDURES.
THEY MUST REPORT IT TO THE BOARD
OF OPTOMETRY. SO THERE WILL BE
ABSOLUTE TRANSPARENCY EVERY YEAR
AND UNDERSTANDING OF WHETHER OR
NOT THE OPTOMETRIST HAS NEEDED
HELP, AND THAT INCLUDES
CONSULTATION. IT WAS AN
EXTRAORDINARY GIVE AMONG MANY
EXTRAORDINARY GIFTS THAT WE HAVE
GIVEN UH, THE SECOND THING I
WOULD SAY IS THAT OVER 100,000
PATIENTS HAVE BEEN SEEN ACROSS
THE COUNTRY. BY OPTOMETRISTS WHO
HAVE ONLY HAD THE 16 HOURS
TRAINING FOR EACH OF THE
PROCEDURES. WE BELIEVE. U C.
BERKELEY BELIEVES THE OTHER
SCHOOLS BELIEVE THAT THIS ON
UNPRECEDENTED AMOUNT OF
EDUCATION AND TRAINING WILL MAKE
OUR OPTOMETRIST IN CALIFORNIA.
THE MOST QUALIFIED, EDUCATED AND
TRAINED TO PROVIDE THESE
PROCEDURES ANYWHERE IN THE
UNITED STATES, AND I WOULD ALSO
ADD THAT OUR OPTIMA TRICK
SCHOOLS EDUCATE OPTOMETRIST WHO
GO TO THE OTHER STATES WHO TAKE
THESE 16 HOUR COURSES AND CAN
THEN PROVIDE THAT TREATMENT.
SOMETHING THAT IS DENIED TO THEM
IN THEIR OWN STATE OF
CALIFORNIA. AND WHEN IT COMES TO
CONTINUE COMPETENCY SPECIFICALLY
FOR THE VAST MAJORITY OF
HEALTHCARE PROVIDERS. ALL THAT'S
REQUIRED IS CONTINUING EDUCATION
. THEY DO A NUMBER OF HOURS FOR
PHYSICIANS AND, OF COURSE FOR
OPTOMETRIST. IT'S 50 HOURS AND
DIDN'T EVEN EDUCATION THEY HAVE
TO DO EVERY TWO YEARS IN THIS
BILL, IT TAKES THE EXTRAORDINARY
STEP OF REQUIRING OPTOMETRY TO
PERFORM AT LEAST ONE PROCEDURE
EVERY YEAR. THAT WAY, WE MAKE
SURE THAT THEY'RE DOING THESE
PROCEDURES. MAKE SURE THAT
THEY'RE NOT, YOU KNOW, JUST GOT
THE CERTIFICATE AND AREN'T
ACTUALLY PERFORMING THE
PROCEDURES, SO THEY'RE DOING IT
ON A REGULAR, AT LEAST A REGULAR
BASIS. AND IF THEY ATTEST TO
THAT, THEN THEY CAN CONTINUE TO
PERFORM THESE PROCEDURES. IF
THEY DON'T ATTEST TO THAT, THEN
THEY LOSE THEIR ABILITY TO DO
THAT PROCEDURE UNTIL THEY GO
BACK TO THE COLLEGE AND PROVE
THEY CAN DO IT. NOW. THERE'S NO
REQUIREMENT FOR THAT FOR
PHYSICIANS. RIGHT NOW THERE IS
FOR PEOPLE WHO HAVE MEDICAL
PRIVILEGES. YOU KNOW, OF COURSE
YOU HAVE. REQUIREMENTS TO GET
YOUR CONTINUED COMPETENCY FOR
MEDICAL PRIVILEGES. BUT THESE
THESE PROCEDURES ARE DONE IN THE
OFFICE. FOR THE MOST PART, THESE
ARE NOT THOSE TYPES OF
PROCEDURES THAT WOULD REQUIRE
THAT TYPE OF CONTINUED
COMPETENCY. SO WE THINK THAT
THIS GOES WELL BEYOND ANYTHING
REQUIRED FOR PHYSICIANS IN TERMS
OF THAT TYPE OF CONTINUED
COMPETENCY. THANK YOU SO MUCH
FOR THAT ANSWER. I WOULD, UM,
SLIGHTLY DISAGREE WITH WITH WHAT
YOU'RE STATING, YOU KNOW, ONE OF
THE PROCEDURES THAT STATED UM,
YOU DO REQUIRE INCISIONS AND WE
DO HAVE, UM, MAINTENANCE OF
PROFICIENCY. AS YOU STATED, WE
DO HAVE TO HAVE HOSPITAL
PRIVILEGES. WE DO OPERATE AND
HOSPITALS OR OUTPATIENT SURGERY,
SO THAT ALONE IS AN AREA OF
MAINTAINING YOUR PROFICIENCY
BECAUSE YOU DO HAVE OVERSIGHT AT
THAT POINT, WHICH YOU DON'T HAVE
WHEN YOU'RE IN A CLINICAL
SETTING. UM YOU KNOW, I AM ALSO
VERY CONCERNED ABOUT THE
DISCREPANCY IN THE NUMBER OF
PROCEDURES THAT ARE REQUIRED. SO
FOR EXAMPLE, YOU SAY THAT, UM
AND THIS BILL, THEY WOULD NEED
TO DO EIGHT CAPSULE AUTUMN EASE.
BUT WHEN YOU LOOK AT YOU KNOW
RESIDENTS AND OPT OUT AND
OPHTHALMOLOGY, THEY HAVE TO DO
60 ON A LIVE PATIENT. THAT IS A
HUGE DISCREPANCY THE SAME WITH
YOUR TREBEK YOLA PLASTICINE
EIGHT IN THIS BILL 50 WITH THE
OPHTHALMOLOGY RESIDENT. UM FIVE.
VERY ODD, AMIS. WE'RE TALKING
ABOUT AT LEAST 23. THIS IS THE
MINIMUM IN ORDER TO GRADUATE SO
YOU KNOW, UM, WE TALK A LOT
ABOUT ACCESS TO CARE, WHICH IS
EXTREMELY IMPORTANT. EXTREMELY
IMPORTANT. WE HAVE SEEN THE
DEVASTATING IMPACT OF THAT
DURING COVID WHEN YOU DO NOT
HAVE ACCESS TO CARE. ACCESS TO
CARE SHOULD NEVER BE SUBSTITUTED
FOR A LOWER STANDARD OF CARE.
AND ONE OF MY CONCERNS IS WHEN
YOU HAVE TWO SEPARATE ENTITIES
WITH TWO SEPARATE REQUIREMENTS
IN ORDER TO DO THE SAME
PROCEDURES. YOU DO END UP WITH
THE LOWER STANDARD OF CARE JUST
BECAUSE YOU'VE HAD LESS
TRAINING. AND THEN THOSE
PARTICULAR INDIVIDUALS END UP
GOING OUT AND PRACTICING IN OUR
RURAL AREAS IN OUR INNER CITY
AREAS WHERE WE ALREADY HAVE
ISSUES OF HAVING POOR ACCESS TO
CARE AND POOR ACCESS TO QUALITY
OF CARE. YOU KNOW, I THINK THAT
IF THIS IS SOMETHING THAT WE
WANT TO EXPAND CONTINUING TO
WORK WITH OPPOSITION, FIGURING
OUT A WAY TO BALANCE OUT THE
NUMBER OF PROCEDURES THAT ARE
PERFORMED BEFORE YOU CAN GO OUT
AND DO IT ON YOUR OWN. IT'S
PROBABLY A GOOD THING. YOU KNOW,
I AM A SURGEON. I LOVE SURGERY.
I DO. UM BUT I DO IT WHEN IT'S
NECESSARY BECAUSE THERE ARE
RISKS WITH EACH AND EVERY
SURGERY, WHETHER IT IS MINIMUM
AND WE DO IT IN THE OFFICE. OR
WE END UP TAKING TO THE PATIENT
TO AN OUTPATIENT UP HOSPITAL OR
EVEN THE HOSPITAL ITSELF. AND SO
WHEN YOU'RE TALKING ABOUT
SURGICAL PROCEDURES, WHETHER
THERE'S AN INCISION OR LASER
USED, YOU REALLY NEED TO MAKE
SURE THAT YOU ARE HAVING PEOPLE
THAT ARE VERY WELL TRAINED DOING
THESE PROCEDURES, AND THIS
DISCREPANCY MAKES ME CONCERNED
ABOUT THE TRAINING. BUT THANK
YOU VERY MUCH ASSEMBLYMEMBER'S
LOW, YOU KNOW, I LOVE YOU. WHEN
IT THANK YOU, DR WEBBER. UH,
SOMEONE, MCCARTY THANK YOU, MR
CHAIR, AND I'M NOT SURE IF IT
WAS ONE OF THE MEMBERS OF ONE OF
THE WITNESSES SAID, LOOK, IT'S
THE 50TH OF AUGUST 2ND CLASS DAY
SESSION. WE DON'T LIKE GETTING
IN THESE FIGHTS DURING APRIL OR
JULY, BUT THE SECOND TO LAST
DAY. IT'S NOT SUPER COMFORTABLE
, AND WE HAVE TO HEAR BETWEEN
RESPECTED PROVIDERS AND
LITERALLY, I HAVE MY
OPHTHALMOLOGIST IN THE AUDIENCE
AND MY OPTOMETRIST WHO SENT ME
AN EMAIL TWO HOURS AGO. THAT WE
WERE HERE ON BOTH SIDES OF THESE
ISSUES, SO I'M HAVING A
DIFFICULT TIME UNDERSTANDING
THESE AND MAYBE IF WE HAVE TWO
QUESTIONS SO FIRST IF I COULD
ASK THAT THE CHAIR AND THE
PROPONENTS OUTLINE YOU SAID THAT
90 1% OF THE BILL WAS WRITTEN BY
THE OPPOSITION. I THINK, THE
LETTER FROM THE OPTOMETRIST SAID
. IT'S 98% SO WHAT PIECES ARE
ARE NOT IN. IN THERE THAT WERE
ASKED UPON FROM THE OTHER SIDE.
THROUGH THE CHAIR MADE ME. AS A
GREAT QUESTION. ASSEMBLY MEMBER.
UH AGAIN. WE SPENT. HOURS DOZENS
AND DOZENS OF HOURS GOING
THROUGH THE BILL. ORIGINALLY THE
BILL WAS DIFFERENT. AH! THE 43
HOURS OR THE 43 PATIENTS. TO
GUARANTEE THAT THERE IS NOT A
LOWER STANDARD OF CARE. THAT
NUMBER CAME FROM CALIFORNIA
MEDICAL ASSOCIATION AND
OPHTHALMOLOGY AND ALSO INCLUDED
AND WHY IS IT DIFFERENT THAN
WHAT THEY'RE DOING IN
OPHTHALMOLOGY? IT IS ALSO
BECAUSE OF HOW DETAILED THE PLAN
NEEDS TO BE AS WE FOLLOW THESE
43 PATIENTS. THROUGHOUT THE
PROCESS. AH CAPES WANTED AH,
THERE'S A FLEXIBILITY QUESTION
IN THE NUMBERS. SO YOU SEE THESE
NUMBERS FOR ALL OF THESE
PRODUCTS FOR PROCEDURES EXCEPT
CORNEAL CROSS LINKING YOU CAN
HAVE A ONE OUT, WHICH MEANS THAT
IF YOU'RE DOING A YOU KNOW AN
ARID AUTUMN E. AS OPPOSED TO
ANOTHER PROCEDURE. YOU CAN DO
ONE AS LONG AS THEY'RE SIMILAR.
THE SWITCH. WE REMOVE THE
ABILITY OF OPTOMETRIST TO
PERFORM INTRA MUSCULAR SUBJECT
AND TITLE AND SUBCUTANEOUS
INJECTIONS. WE TOOK THEM OUT.
THAT WAS A MAJOR MAJOR
CONCESSION TO TAKE THOSE THREE
INJECTIONS OUT. WE DID IT
BECAUSE WE WANTED TO FOCUS ON
THE OTHERS. WE TOOK OUT BOTOX
EVEN AS A MAN AS I AS A PERSON
PROCEDURE TO DEAL WITH OTHER
THAN COSMETIC PURPOSES. WE
LISTEN TO THE COSMETIC SURGEONS
AND TOOK OUT ANY REFERENCE THAT
THE OPTOMETRIST CAN DO ANY KIND
OF REMOVAL. OF SKIN TAGS OR
LUMPS AND BUMPS FOR COSMETIC
PURPOSES IN TERMS OF THE LUMPS
AND BUMPS. YOU KNOW? THERE'S
SURGERY AND THEIR SURGERY JUST
AS THERE'S HEMINGWAY AND THERE'S
JAMES PATTERSON. YOU DO IT IN
DIFFERENT LEVELS. THE SURGERY WE
ARE TALKING ABOUT. LET'S BE VERY
, VERY SPECIFIC BECAUSE WE
REALLY WORKED ON THIS WITH THIS
BILL, AND WE REALLY WORKED ON IT
WITH THE ACADEMY AND C M A. AND
THEY AGREED TO THIS. THE SURGERY
WE ARE TALKING ABOUT IS A LUMP
AND A BUMP. THERE CAN BE NO
LONGER THAN FIVE MILLIMETERS AND
CANNOT IMPERIL THEY PICULA ARIS
MUSCLE WHICH MOVES THE ISLANDS
TO MAKE SURE THAT THE DANGER IS
NOT GOING TO BE THERE AGAIN.
ANOTHER SAFETY PROCEDURE, WE
ADDED A REQUIREMENT THAT ALL
LESIONS EVEN THE SKIN TAGS THAT
WE TAKE OFF MUST BE BIOPSIED.
UNLIKE OTHER STATES, WE REQUIRED
THE THREE DIFFERENT WAYS OF
TRAINING. THEY DON'T EXIST. WE
AGREED TO COMBINE LASER IN MINOR
PROCEDURES CERTIFICATIONS INTO
ONE CERTIFICATE. WE AGREED TO
REQUIRE NOT ONLY THE 32 HOUR
COURSE, BUT A NATIONAL BOARD
TEST BE TAKEN WITHIN TWO YEARS
OF THE HANDS ON TRAINING. WE
REQUIRED OPTOMETRIST TO COMPLETE
ALL HANDS ON CLINICAL TRAINING
WITHIN THREE YEARS. THEY WANTED
TO MAKE SURE THAT THE
EDUCATIONAL COMPONENT THAT THERE
WAS A NEXUS TO THE ACTUAL DOING
OF THE PROCEDURES. ALL OF THIS.
ALL OF THIS. CAME WITH THOSE
LONG LONG DISCUSSIONS WAS CMA IN
THE ACADEMY. WHAT ELSE DID WE
DO? WE ACCEPTED CAPES DEFINITION
OF QUALIFIED EDUCATORS. WE
ACCEPTED THAT THE CLINICAL
TRAINING MUST BE CONDUCTED ON
THE LIVE PATIENTS. WE ACCEPTED
THEIR LANGUAGE REGARDING
REFERRALS TO MDS OR URGENT CARE
UNDER SPECIFIC CONDITIONS. THERE
ARE SAFETY NETS IN THIS BILL
THAT DO NOT EXIST IN ANY OTHER
BILL AND OTHER STATES. AND WE
DID IT BECAUSE OF THE LONG HOURS
OF NEGOTIATIONS. IN DISCUSSIONS
WITH CM A. WE ACCEPTED THEIR
LANGUAGE AND REQUIRING THAT THE
OPTOMETRY BOARD WITHIN THREE
WEEKS OF ANY ADVERSE EVENT MUST
BE NOTIFIED. WE AGREED TO ENSURE
COMPETENCY OF RETENTION. WE
AGREED TO REQUIRE THE OPTOMETRY
BOARD TO REVIEW AND ADDRESS
ADVERSE TREATMENT OUTCOMES, AND
WE SHOULD POINT OUT THAT THE
OPTOMETRY BOARD WITHIN THE
DEPARTMENT OF CONSUMER AFFAIRS
SO CAREFUL ON THIS HAS INDEED
SUPPORTED THIS BILL LAST WEEK.
THANK YOU FOR THE VERY THOROUGH
ANSWER, MR MCHALE. THANK YOU, MR
MCCARTHY. YEAH I THINK THE
OPPOSITION WANTED TO RESPOND TO
WHAT WAS IT IN THERE THAN I DO
HAVE A FOLLOW UP. QUESTION FOR
THE, UM FOR THE OPPOSITION. I
THINK, MR CHAIRMAN. THERE WERE
SOME IN MCCARTY. QUICK ANSWER IS
, YOU KNOW IF WE HAD WRITTEN
THIS BILL, AS IT WAS JUST
PORTRAYED, WE WOULDN'T BE HERE
IN OPPOSITION. UM I'LL JUST TELL
YOU REAL QUICKLY ONE THING. YES
WE HAD SUGGESTED EARLY ON IN THE
NEGOTIATIONS LOOKING AT SIX
DIFFERENT SURGERIES. WHAT A
REASONABLE MAN OF TRAINING
SHOULD BE MINIMUM. NOT WHAT WE
THINK IT REALLY IS IN A
RESIDENCY, BUT WHAT IT SHOULD
BE. WE SUGGESTED 42 DIVIDED A
PUNK, SIX SURGERIES. THAT WAS
BECAUSE THEY HAD SOLD US ON THE
IDEA OF GRAND ROUNDS TRAINING,
MEANING THAT THE COHORT OF FIVE
TRAINEES WOULD BE DOING 42
PROCEDURES THEMSELVES, BUT WOULD
ALSO BE OBSERVING EVERYBODY ELSE
DOING THOSE PROCEDURES THAT
OBSERVATIONAL LEARNING THEY SOLD
US ON WHEN THEY INCREASE THE
NUMBER 2 42. A UNDERCUT. COHORT
TRAINING. IF YOU LOOK IN THE
BILL NOW THERE'S A PROVISION
THAT SAYS WELL, WE'LL DECIDE
WHETHER THERE'S GOING TO BE A
PERCENTAGE OF COHORT VERSUS
PRECEPT ER SHIP WHICH IS OUT IN
THE COMMUNITY AND YOU LOSE THAT
OBSERVATION. SO MY POINT WITH
THAT IS YES. WE RAISED A VARIETY
OF THINGS AND THE NEGOTIATIONS
SOME OF THOSE THINGS THAT WE
RAISED OUR IN THIS BILL RIGHT
NOW. BUT IN EACH AND EVERY CASE,
ALMOST EXACTLY. THERE IS
LANGUAGE THAT UNDERMINES THOSE
VARIOUS THINGS. SO DID WE WRITE
THIS BILL? NO THAT'S ONE EXAMPLE
. THE COHORT TRAINING IS ANOTHER
EXAMPLE. THE KEY UNANSWERED
QUESTION. I THINK. IS THAT YOU
DESCRIBED A PROCEDURE THE
ACADEMY POSITION TO FORGET WHAT
YOU CALLED IT. YEAH CORNEAL
CROSS LINKING ITS CORNEAL
FRIGHTENING TO ME. YES IT IS.
YES IT'S SERIOUS SURGERY IN YOUR
PERCY VIEW OF THE WORLD. WOULD
YOU RATHER OPTOMETRIST. NEVER
HAVE THE OPPORTUNITY TO DO THIS,
OR ARE YOU SAYING THAT THEY
COULD IF THEY HAD WHAT DR.
WEBBER IS SAYING, WHICH IS MORE
TRAINING AND MORE TO YOUR POINT
, RIGHT? WE GETTING AT 42
TRAINING PROCEDURE IN THE BILL
WERE DEVELOPED WITHOUT THAT
SURGERY BEING IN THE BILL. AFTER
THE 42 RATTED. THEY ADDED THAT
ONE SURGERY CORNEAL SURGERY AND
SAID ONE TRAINING PROCEDURE THAT
MAKES 43 RIGHT? WE SUGGESTED HAD
WE HAD THE OPPORTUNITY BECAUSE
NEGOTIATIONS WERE CUT OFF, BUT
THAT TRAINING FOR THAT PROCEDURE
SHOULD BE 10 PROCEDURES AND
SUDDENLY MCCARTHY AND WHY IS
THAT? BECAUSE YOU'RE REMOVING
THE EPITHELIUM, YOU'RE EXPOSING
IT TO INFECTION AND THINGS IN
THE ENVIRONMENT AND BY GOSH IF
YOU DON'T DO IT RIGHT INFECTION
, CORNEAL MELTING AND IT'S GOT
TO BE HEALED THE RIGHT WAY. SO
YES, WE SUGGESTED 10. WHAT'S IN
THE BILL IS ONE. ANY OTHER
COLLEAGUES, PLEASE. UH, THAT'S
ANOTHER MACHINERY. THANK YOU.
CHAIR. HELLO THANK YOU. CHAIR
THANK YOU ASSEMBLYMEMBER'S LOW,
SO LET ME UNDERSTAND. WE'RE ALSO
SAYING THAT ONCE A YEAR UM, THIS
CRITICAL SURGERY, UM, THAT HAS
SIGNIFICANT RISK OF INFECTION
AND POTENTIAL DAMAGE TO THE
CORNEA. THEY SHOULD ONLY DO ONE
SURGERY PER YEAR. IS THAT
CORRECT? IS THAT WHAT WE'RE
SAYING? AND IT IT? DO YOU THINK
THAT'S ENOUGH? IN THE BILL.
THERE'S A REQUIREMENT FOR THESE
MINIMUM. I WANT TO TALK A LITTLE
BIT ABOUT THE MINIMUM NUMBERS
BECAUSE IN THE BILL, THERE IS A
REQUIREMENT FOR ONE MINIMUM
NUMBER TO BE DONE IN TERMS OF
TRAINING. WHEN YOU LOOK AT THE
NUMBERS THAT THEY PROVIDED THAT
IS THE AVERAGE NUMBER THAT THEY
DO DURING THEIR TRAINING, NOT
THE MINIMUM NUMBER, SO THEIR
MINIMUM NUMBER FOR THESE
PROCEDURES IS QUITE MUCH LOWER
AND IS EVEN LOWER. THEN WHAT IS
REQUIRED FOR OPTOMETRISTS IN
THIS BILL? FOR EXAMPLE, THE
MINIMUM NUMBERS FOR, UM
TUBERCULAR PLASTIC THAT IS IN
OUR BILL REQUIRES EIGHT
PROCEDURES AS A MINIMUM IN THEIR
STANDARDS, NOT EVEN IN STATUTE.
BUT IN THEIR GRADUATE STANDARDS.
IT'S FIVE AND SO SURE THERE
MIGHT BE MORE DONE. THERE'S A
REQUIREMENT IN THE BILL THAT
SAYS IF THE OPTOMETRIST NEEDS
MORE TRAINING ON THESE
PROCEDURES, THE COLLEGE AND THE
INDIVIDUAL PRECEPT ER HAVE TO
CERTIFY THAT THEIR COMPETENT TO
PERFORM THESE PROCEDURES SO YES,
ONE IS A MINIMUM. BUT THAT
DOESN'T MEAN THAT'S THE ONLY ONE
THEY'LL BE DOING. IT MEANS THAT
THAT IS THE MINIMUM THE BILL TO
MAKE SURE THAT THEY'RE
COMPETENT. THERE IS THE ABILITY
TO HAVE IT BE MORE THAN ONE AND
IT'S MORE. THE MINIMUMS IN THE
BILL ARE HIGHER THAN WHAT IS
REQUIRED FOR OPHTHALMOLOGISTS
DURING THEIR GRADUATE TRAINING.
I'M SORRY. I JUST I HAVE TO
REBUT BECAUSE I'M THE ONE WHO
MENTIONED IT. THAT IS A
REQUIREMENT FOR THEIR TRAINING.
SO THE 60 60 24. WHATEVER I GAVE
YOU, 23. THAT IS A REQUIREMENT.
IT'S NOT AN AVERAGE. IT'S NOT UM
, YOU KNOW, ONE PERSON DID 100.
THE NEXT PERSON DID FIVE. THAT
IS A MINIMUM THAT THEY ALMOST
DO. THANK YOU. AND THEN I JUST
HAVE ONE MORE COMMENT. YOU GUYS
TALKED A LOT ABOUT DOCTORS
RETIRING. UM, WE SHOULDN'T. UM
GIVE PATIENTS LESS CARE BECAUSE
WE HAVE DOCTORS RETIRING. WE
SHOULD MAKE SURE THAT WE DO
SOMETHING TO, UM GET MORE
DOCTORS TO DO THE WORK. UM, I'M
JUST GONNA STOP HERE AND SAY I
ASK MY COLLEAGUES TO OPPOSE THIS
BILL BECAUSE IT FALLS SHORT IN
TRAINING REQUIRED. ACHIEVING OF
SURGICAL SURGICAL JUDGMENT. AND
REGULATING OVERSIGHT. SO I'M
JUST ASKING MY COLLEAGUES AT
THIS POINT TO OPPOSE THIS BILL.
THANK YOU VERY MUCH, AND THE
ADDITIONAL QUESTIONS OR COMMENTS
AND COLLEAGUES, MR GRAYSON.
THANK YOU VERY MUCH, AND I DID
WANT TO HEAR AGAIN FROM
OPPOSITION ON THIS LAST QUESTION
AND COMMENT. ON WHAT YOUR
RESPONSE WOULD HAVE BEEN TO THAT
AS FAR AS THE TRAINING. AND, UH,
SO I ASK. DO YOU THINK THAT ONE
SURGERY TO REQUIRE ONE SURGERY?
A YEAR IS ENOUGH TRAINING? IS
THAT ENOUGH? THAT'S REALLY KEY.
I THINK BRANDON WILL ANSWER THAT
TO MY SHORT ANSWER, AND I'LL
HAND IT TO BRANDON IS THAT YOU
KNOW IN THE REAL WORLD,
REQUIRING ONE SURGERY OF ONE
TYPE EVERY TWO YEARS. JUST AS NO
WAY TO MAINTAIN PROFICIENCY.
IT'S LIKE ANYTHING ELSE, WHETHER
YOU'RE A PILOT, YOU'RE A DRIVER
OR WHATEVER. THE MORE YOU DO IT,
THE BETTER YOU GET AT IT. ONE IS
JUST A NOTHING BRANDON. YOU
CONNECT WITH? YEAH
ASSEMBLYMEMBER'S THANK YOU FOR
THE QUESTION. UM, THE AS HAS
BEEN MENTIONED. THE ONE
PROCEDURE IS FOR THE INITIAL
ACCREDITATION RIGHT AFTER. FOR
THE RETENTION OF SKILLS THAT
SAYS THAT THE THAT THE
OPTOMETRIST HAS TO PERFORM TO IN
ORDER TO KEEP THAT ACCREDITATION
ON ON RESTRICTION OR OUT OF
RESTRICTION. EXCUSE ME. UM WE
DON'T THINK THAT THAT'S ENOUGH.
WE'VE DURING OUR NEGOTIATIONS
WITH MY COLLEAGUES. WE DID OFFER
DIFFERENT SORT OF RETENTION OF
SKILLS AND RE LICENSURE. SCHEMES
IN ORDER TO MAKE SURE THAT THEY
WERE PERFORMING MORE AND IN
ORDER TO MAKE SURE THAT THEY ARE
RETAINING THOSE SKILLS IN A
HOLISTIC MANNER, MAKING SURE
THAT THAT ACCREDITATION THESE
SKILLS BUILD OFF OF EACH OTHER.
SO WE WANTED TO KEEP THAT AND
HAVE AND PROPOSED THAT THE
RETENTION OF SKILLS IN THE
RELICENSED EARPIECE STAY
HOLISTIC AND NOT ALLOW FOR THE
RESTRICTION OF ONE OR TWO
DIFFERENT PROCEDURES. BECAUSE
AGAIN WHEN YOU DON'T ARE NOT
EXPOSED TO THOSE TYPES OF
SKILLS, YOU BEGIN TO LOSE THEM.
UH AND SO THAT IS THAT'S THE
REASON WHY WE, UH, HAVE OFFERED
DIFFERENT TYPES OF LICENSING
SCHEMES IN THE BILL, BUT THE ONE
THAT IS IN FRONT OF YOU IS NOT
OURS, AS WE HAVE RECOMMENDED.
OKAY THANK YOU. AND THEN ON THE
NUMBER OF PROCEDURES THAT ARE
PUT INTO THE BILL, AND FOR
EITHER THE AUTHOR OR THE
WITNESSES. HOW DID YOU COME UP
AND FORGIVE ME? YOU MAY HAVE
ALREADY COVERED THAT I CAME IN A
LITTLE BIT LATE, SO I APOLOGIZE
FOR ANY REPETITION. HOW DID YOU
COME UP WITH THE NUMBER OF THOSE
VERSUS THE NUMBER? THAT ALREADY
EXISTS FOR ARE YOU TALKING WITH
RESPECT TO THE CONTINUED
COMPETENCY OR THE INITIAL
LICENSURE INITIAL LICENSE? THOSE
NUMBERS THAT 88 BY THOSE NUMBERS
, ALL EXCEPT FOR CORNEAL CROSS
LINKING CAME FROM THE OPPOSITION
. AND THEN DID DID I UNDERSTAND
IT CORRECTLY THAT THE CROSS
LINKING CAME IN AFTER DID YOU
PUT THAT IN AFTER YOU HIT IT IN
AGREEMENT WITH THE TRUE THAT
PROVISION WAS WE HAD TALKED
ABOUT CORNEAL CROSS LINKING
THROUGHOUT THE ENTIRE THING. WE
BROUGHT IT UP AT THE VERY
BEGINNING OF THE DISCUSSIONS.
THEY DID NOT INCLUDE IT IN THEIR
PROPOSAL TO US, THEY SAID THEY
STILL HAD CONCERNS ABOUT CROSS
LINKING AND THE INJECTIONS. AND
SO THEY GAVE US THE PROCEDURE
NUMBERS. THE 885 THOSE ALL THOSE
PROCEDURE NUMBERS CAME FROM
OPHTHALMOLOGY WITH RESPECT TO
EVERYTHING EXCEPT FOR CROSS
LINKING AND THEY HAD NO NUMBER
FOR CROSS LINKING, AND SO WE PUT
IN THE BILL ONE AS A
PLACEHOLDER, AND THAT'S HOW THAT
NUMBER CAME UP AS A ONE, BUT WE
KNEW THAT THE COLLEGES COULD
REQUIRE MORE TRAINING IF THEY
FELT LIKE THAT PARTICULAR
INDIVIDUAL. NEEDED MORE
TRAINING. BUT IF THEY DIDN'T
INCLUDE IT IN THE 40 TO THEIR
RESPONSE OR THEIR AMENDS OR
WHATEVER IT WAS, THEN WHY NOT GO
BACK TO THEM AND SAY, HEY, YOU
DIDN'T INCLUDE THIS IN THERE WAS
THAT ON PURPOSE, OR WAS THAT
BECAUSE YOU MISSED IT, AND WE
NEED TO FIGURE THAT OUT AND
NEGOTIATE THAT WE DID. THEY
EVENTUALLY CAME UP WITH 10. THEY
EVENTUALLY CAME TO US WITH 10,
WHICH IS A RIDICULOUS NUMBER
FROM OPPOSITION. UM THERE'S
SOMETHING, GRAYSON. THE REAL
ANSWER IS WHILE THEY HAD RAISED
CORNEAL CROSS LINKING EARLY ON
DURING THE YEAR, WE HAD NEVER
AGREED TO IT. WHEN WE PRESENTED
WITH A PROPOSAL ON AUGUST 1ST
FIRST INCLUDED ACTUAL LANGUAGE
GOING ACROSS, LINKING OTHER THAN
THE LANGUAGE OF ZERO WITH BLANK
IN SENATE BMP COMMITTEE, THEY
SUGGESTED ONE WE GOT BACK TO
THEM WITHIN TWO DAYS AND SAID NO
, THAT IS THE MOST SERIOUS
SURGERY. THERE SHOULD BE 10
TRAINING PROCEDURES. WE DIDN'T
DIDN'T HERE FOR TWO WEEKS. WE
THEN HAD A SUBSEQUENT DISCUSSION
WHEN WE WERE TOLD WE'D HEAR BACK
ONE DAY LATER. THAT WAS A WEEK
AGO THURSDAY, WE HEARD NOTHING.
THE AMENDMENTS WERE PUT IN THE
BILL, AND IT'S ONE TRAINING
PROCEDURE. THAT'S IT'S JUST, YOU
KNOW, YOU THINK ABOUT IT THE
QUESTION I HAVE TO ASK YOURSELF
IS WOULD YOU WANT TO HAVE
SURGERY WHERE YOUR EPITHELIUM IS
REMOVED AND DRUGS ARE INJECTED
OR PLACED IN YOUR EYE FOR AN
HOUR IN A NON HOSPITAL, SETTING
WITH SOMEBODY WHO HAS ONLY DONE
ONE OR PERHAPS AS AN EVEN DONE
ONE? BECAUSE IT WAS SUBSTITUTED
. WOULD YOU WANT YOUR CHILD?
WOULD YOU WANT YOUR RELATIVE?
WOULD YOU WANT YOUR CONSTITUENTS
TO BE SUBJECT TO THAT? I THINK
THE ANSWER IS NO, THERE NEEDS TO
BE MORE TRAINING. THANK YOU. I
APPRECIATE THAT. AS YOU WELL
KNOW, WE ARE CLOSING IN ON THE
LAST 24 HOURS. OF THIS OF THIS
SESSION THAT WE ARE IN AND TO
HAVE SOMETHING LIKE THIS COME
BEFORE US WHERE THERE'S CONFLICT
IN TESTIMONY AND VERY COMPLEX. I
YOU KNOW, I JUST WANT TO SAY
WHATEVER DR WEBBER SAID, UH, AS
FAR AS THE QUESTIONS AND THE
COMMENTS AND HAVE A SURGEON
LITERALLY SITTING ON THIS
COMMITTEE, YOU'D THINK THERE WAS
A GREAT APPEAL TO REALLY INDULGE
IN MAKING SURE THAT THE DETAILS
WERE THERE AND VERY CLEAR ON
BOTH SIDES, SO I AM INCLINED AT
THIS POINT. I MAY BE OPENING UP
THE FLOODGATES FROM MY POOR
OFFICE. BUT I'M INCLINED TO TRY
TO FIGURE OUT A WAY TO LEARN
MORE ABOUT THIS. SO IT VERY WELL
MAY BE THAT THIS BILL SHOULD
FIND ITS ITS DESTINY HERE
TONIGHT. AS FAR AS, UH, NOT
MOVING FORWARD, BUT I DO WANT TO
LEARN MORE ABOUT IT. AND SO I AM
. I'M WILLING TO ALLOW IT TO
ADVANCE BUT I HAVE SUCH
INCREDIBLE GREAT RESERVATIONS.
AND REALLY STRUGGLING WITH, UM
UM, I'M NOT SURE IF I WOULD. I
WOULD SIT IN A SEAT AND LET
SOMEONE, UH MESS WITH MY EYES
THAT HASN'T DONE IT ENOUGH TO
WHERE I'M COMFORTABLE, AND I
SURE WOULDN'T LET ANY OF MY
FAMILY MEMBERS SO WITH THAT. I
DON'T EVEN KNOW IF I JUST MADE
SENSE OUTSIDE THE FACT THAT, UH
, I AM REALLY STRUGGLING. I'M
REALLY STRUGGLING WITH THIS BILL
RIGHT NOW. THANK YOU, MR GRAYSON
FOR CHANNELING CHANNELING. I
THINK THE ZEITGEIST OF THE
COMMITTEE. ANY ADDITIONAL
QUESTIONS OR COMMENTS FROM
COLLEAGUES. YEAH, YEAH, MR FONG,
PLEASE. THANK YOU, MR CHAIR. UM
YOU KNOW, I AM IN A SIMILAR
SITUATION IS MR MCCARTY. I'VE
BEEN CONTACTED BY MY OPTOMETRIST
AND MY AND OTHER
OPHTHALMOLOGISTS THAT THAT AND
THROUGHOUT MY COMMUNITY, SO
THERE ARE MULTIPLE PROCEDURES
AND CERTAINLY, UM, I AM A
GENERALIST, NOT AN EXPERT AS MY
COLLEAGUES TODAY, NEXT TO ME. UM
AND SO WE HAVE KIND OF THE
SURGICAL PROCEDURES. THE CORNEAL
ACROSS THINKING, I THINK IS THE
MOST INTENSE CONVERSATION WE'VE
HAD, AND THEN WE'VE GOT LASER
PROCEDURES AND OTHER THINGS. I'M
JUST TRYING TO UNDERSTAND. THE
OTHER STATES THAT HAVE DONE
THIS. ARE WE EVEN AND I KNOW
THAT WE ARE CERTAINLY UNIQUE AND
WE'RE DEVELOPING OUR OWN. YOU'RE
TRYING TO DEVELOP YOUR OWN
SYSTEM, AS AS MR LOWE IS TRYING
TO DO. HOW ARE THESE?
REQUIREMENTS IN COMPARISON TO
THE OTHER STATES THAT ALLOW
LASER PROCEDURES AND ALLOW
SURGICAL PROCEDURES. MM HOME.
AND THAT GOES TO BOTH THE
PROPONENTS IN THE OPPOSITION.
YOU GUYS. I THINK THE EASY
ANSWER IS THERE ARE A FEW STATES
THAT ALLOW SOME OF THESE LASERS
TO BE DONE, AND THERE ARE FOUR
STATES ACCORDING TO THE C. E. O
S ON MAPS THAT THEY USE IN
ADVOCATING THAT ACTUALLY ALLOW
REMOVAL OF LESIONS UNDER THE EYE
WHAT THEY CALL LUMPS AND BUMPS
WHICH MAY OR MAY NOT BE
CANCEROUS. THERE ARE SEVEN
STATES. I BELIEVE THAT ALLOW
DIFFERENT TYPES OF LASERS. THERE
ARE THEN ADDITIONAL STATES THAT
ALLOW FOR AN INJECTION,
ESSENTIALLY A PINPRICK TO DO
DIABETES TESTING. THAT'S THE
REAL DATA. THE REASON WE DON'T
HAVE THAT IN FRONT OF US TO
REALLY HELP YOU ALL MAKE THIS
JUDGMENT IS THERE IS NO DATA NO
OF THE NONE OF THOSE STATES SAVE
ONE. COLORADO, WHICH JUST PASSED
THEIR BILL REQUIRES REPORTING OF
ANY DATA. IF WE HAD DATA TO LOOK
AT, YOU MIGHT BE ABLE TO MAKE
THIS JUDGMENT A LITTLE BIT
BETTER. BUT BUT TO BE HONEST
WITH YOU, UM YOU KNOW, WITHOUT
DATA WHAT WE'RE TALKING ABOUT.
IF YOU IF YOU'RE IN A REMOVAL
LESION FROM THE INSIDE OF THE
EYEBALL, AND YOU'RE GOING TO
INJECT LOCAL ANESTHETIC INTO AN
EYELID THAT'S TWO MILLIMETERS
THICK, AND YOU HAVEN'T PRACTICED
THAT ENOUGH. YOU'RE LIKELY TO
PUNCTURE THE GO THROUGH THE
EYELID IN AND HIT THE EYE RIGHT
PRACTICES. WHAT'S IMPORTANT HERE
? I FOLLOW UP IN TERMS OF THE
SPECIFIC LIKE THE SPECIFIC
PROCEDURE THAT I THINK HAS HAS
PROVIDED A LOT OF, UM UH, I
OPENING TESTIMONY. NO PUN
INTENDED. M THE CORNEAL CROSS
LINKING IS THAT ALLOWED IN ANY
OF THE OTHER STATES, MY
UNDERSTANDING AND I FEEL PRETTY
CONFIDENT ABOUT THIS ONE OTHER
STATE. WHAT STATE IS THAT? IT
HASN'T GONE INTO EFFECT. OKAY,
THAT'S CALLED. THAT'S COLORADO.
I PRESUME AND YOU KNOW, I'M
SORRY. HE MY COLLEAGUES ARE
RIGHT. WE HAVE SPENT HOURS AND
HOURS AMONG THIS, AND OUR
EDUCATORS HERE HAVE DONE THEIR
BEST TO TRAIN BRANDON AND I TO
UNDERSTAND THESE COMPLEX
SURGERIES AND KNOW WHAT WE'RE
TALKING ABOUT. I AM NOT A
SURGEON. WE TRY OUR BEST. AND
THAT'S DANGEROUS. TOTALLY
TOTALLY APPRECIATE THAT. I
APPRECIATE THE CANDOR, YOU KNOW
, CLEARLY I'M NOT A SURGEON, SO
I'M TRYING TO KIND OF WRAP MY
HEAD AROUND THESE THESE ISSUES
AS WELL AND GREAT. THANK YOU.
10. OTHER STATES ALLOW
OPTOMETRIST TO PERFORM LASER
PROCEDURES. MANY OF THEM HAVE
DONE IT FOR 20 YEARS, LIKE
OKLAHOMA, 17 OTHER STATES ALLOW
FOR LESION REMOVAL. THESE TYPES
OF LESION REMOVAL. THERE ARE A
LOT OF OTHER STATES THAT ARE
REQUIRED ALLOW FOR INJECTIONS.
WE'RE NOT TALKING ABOUT THOSE
YOU CAN'T INJECT INTO THE
EYEBALL. THERE'S NO INJECTION
INTO THE EYEBALL. THERE'S NO
LESION ON THE EYEBALL THAT
YOU'RE REMOVING. IF YOU DO AN
INJECTION, THERE'S A CLAMPED FOR
INTERNATIONAL INJECTION IS
ALLOWED IN THE BILL. THERE'S A
CLAMP THAT IS THERE SO THAT YOU
CAN'T POSSIBLY HIT THE EYEBALL.
THERE'S NO WAY TO BE ABLE TO DO
THAT, UNLESS YOU'RE COMPLETELY
INCOMPETENT. AND IN TERMS OF
CORNEAL CROSS LINKING THERE ARE
FIVE OTHER STATES THAT ALLOW FOR
CORNEAL CROSS LINKING CURRENTLY
, AND THEY'VE BEEN DOING IT FOR
A LONG TIME AS WELL. AND IN
TERMS OF THE SAFETY RECORD, AS I
MENTIONED BEFORE THAT COLORADO
SUNSET REPORT IS PRETTY CLEAR.
THAT'S THE CLOSEST THING YOU'RE
GOING TO HAVE TO INDEPENDENT
DATA THAT YOU CAN RELY ON. SO
WHAT ARE THOSE FIVE STATES? THE
FIVE STATES ARE. ALASKA KENTUCKY
, ARKANSAS, LOUISIANA AND
COLORADO. AND IT'S VERY
IMPORTANT ASSEMBLY MEMBER FIRST
OF ALL, I WANT TO BE VERY CLEAR.
MR LANGE SUGGESTED LUMPS AND
BUMPS INSIDE THE EYEBALL. HE
KNOWS THAT IS NOT IN THE BILL.
IT'S NEVER BEEN IN THE BILL.
WE'VE NEVER DISCUSSED IT TO BE
IN THE BILL. THE SECOND THING IS
JOE LANG IS AN OUTSTANDING
LOBBYISTS AND HONEST GUY AND A
GREAT PERSON. BUT ON THE
DISCUSSION OF CORNEAL CROSS
LINKING IS DISINGENUOUS AND HE'S
WRONG. WHAT WE DECIDED TO DO ON
THIS WAS NOT TO RELY JUST ON THE
LOBBYIST. WE WENT TO THE
UNIVERSITY OF CALIFORNIA AT
BERKELEY. WE ASK CHRISTINA
WILMER, WHO'S THE DEAN OF THE
CLINIC THERE ON OPTOMETRY. MR
GRAYSON. I WOULD NO MORE ALLOW A
PERSON. TAKE A LAYER OFF MY
CORNEA. WE'RE SITTING THERE FOR
ONE TIME, THEN I WOULD ALLOW
SOMEONE TO THROW ME OFF OF A
BUILDING. WHAT GETS FORGOTTEN
HERE. IS THAT OPTOMETRIST GO TO
FOUR YEARS OF OPTOMETRY SCHOOL.
THEIR THEIR THEIR EDUCATION IS
AKIN TO THAT OF A DENTIST.
THEY'RE NOT PHYSICIANS, BUT THEY
ARE HIGHLY EDUCATED
PROFESSIONALS. THIS IS WRITTEN
FROM THE UNIVERSITY OF
CALIFORNIA AT BERKELEY. CORNEAL
CROSS LINKING PROCESS INCLUDES
THE FOLLOWING THE DOCTOR WILL
REMOVE THE EPITHELIUM THE OUTER
LAYER OF THE CORNEA. THIS IS THE
MOST COMPLEX TASK IN THE
PROCEDURE. DOCTORS OF OPTOMETRY
I'VE SPENT FOUR YEARS AFTER
GRADUATING SCHOOL AND OPTOMETRIC
SCHOOL AND ARE INVOLVED IN THE
TREATMENT OF 25,000 LIVE PAGE
2500 LIVE PATIENTS WHILE IN
SCHOOL, AND SHE UNDERLINES THIS.
OPTOMETRISTS ARE ALL READY
ALLOWED. THE BRIDE, THE
EPITHELIUM. AND THAT'S THE DEAD
TISSUE AND THE LIVE TISSUE
THEY'RE ALLOWED TO REMOVE. IF
YOU GET SOMETHING IN YOUR EYE,
THEY'RE THE ONES WHO TAKE IT
OUT. AND THEN THEY'RE THE ONES
WHO FIX IT. WE'RE NOT TALKING
ABOUT TAKING SOME GUY OUT OF
JUNIOR COLLEGE AND GIVING THEM
THESE RESPONSIBILITIES. WE ARE
TALKING ABOUT SOME OF THE MOST
HIGHLY EDUCATED AND TRAINED
PROFESSIONALS IN THE STATE OF
CALIFORNIA. THE SECOND THING IT
ALLOWS IS THE DROPPING OF THE
VITAMIN B. WELL, WE'RE ALREADY
ALLOWED TO INTRODUCE EYEDROPS.
WE'VE BEEN ABLE TO DO IT AND
SINCE 2008 IN THE TREATMENT OF
GLAUCOMA IN THE MOST SERIOUS
DISEASES THAT EXIST TO THE I IN
THE STATE OF CALIFORNIA ARE
OPTOMETRISTS ARE ALLOWED TO DO
IT IF I MAY, UM SO LET ME JUST
STIPULATE. THERE'S I HAVE. I
HAVE ONE STATE FIVE STATES.
LET'S JUST SAY THAT'S FIVE
STATES. WE JUST SAY, UH, BEFORE
AT LEAST THE CORNEAL SURGERY
PART LET'S SET ASIDE THE LASERS
OF FOR THE MOMENT, UM IN THIS
BILL OF MY MIND FROM MY READING
IT AND, OF COURSE FROM WHAT WAS
THE TESTIMONY THAT IT'S 111
PROCEDURE, RIGHT? THESE FIVE
STATES. IS THAT THE STANDARD
ONE. THERE'S NOT A REQUIREMENT
IN THOSE OTHER STATES FOR
SPECIFIC TRAINING. IT'S REALLY
UP TO THE COLLEGE DEVELOPMENT.
WE'RE DEVELOPING IT HERE. WE'RE
TRYING TO DEVELOP HERE. WHAT
WE'RE DOING IS PUTTING IN
SAFEGUARDS. AT LEAST THERE'S ONE
BUT THE COLLEGES AREN'T GOING TO
RISK THEIR ACCREDITATION STATUS
OVER MAKING OVER LETTING OUT
OPTOMETRIST FOR UNTRAINED AND
DANGER TO THE PUBLIC. THAT IS
THE JOB OF /C BERKELEY SCHOOL
OF OPTOMETRY TO MAKE SURE THAT
THEY'RE SAFE. THAT IS THERE THEY
WOULD RISK THEIR ACCREDITATION
STATUS TO DO ANYTHING ELSE.
OKAY? I APPRECIATE THE
INFORMATION. I CERTAINLY DON'T
WANT TO BELABOR THE
CONVERSATION. I KNOW THIS IS A
VERY INTENSE CONVERSATION.
CERTAINLY AS MY COLLEAGUE MR
GRAYSON HAS SAID, WE ARE, UH WE
ARE APPROACHING A RAPID DEADLINE
AND INTENTIONS ARE HIGH OF OTHER
ISSUES. SO UM, YOU KNOW, I I'M
GOING TO I'M STILL TRYING TO
DIGEST INFORMATION. BUT YOU
KNOW, AS AS I'VE AS I GRAPPLE
WITH THIS, UM I THINK IF THERE'S
ANY ADDITIONAL INFORMATION THAT
YOU CAN GIVE ME THERE'S A PAIR
GOING. FORMACION CERTAINLY WILL
WOULD WANT TO LOOK AT THAT
BECAUSE I BELIEVE THIS ISSUE IS
NOT GOING AWAY AS WE MOVE
FORWARD, SO THANK YOU VERY MUCH.
THANK YOU AND DR WEBBER, DID YOU
I WANT TO MAKE A POLL COMMENT. I
JUST WANT TO SAY THAT IF I GO
OUT AND I, YOU KNOW, WATCH UP
THE NEXT FIVE SURGERIES. UM
NEITHER MY MEDICAL SCHOOL NOR MY
RESIDENCY NOR MY FELLOWSHIP SITE
WOULD BE HELD ACCOUNTABLE. AND I
DON'T THINK THERE'S A QUESTION
ABOUT, UM SHOULD THESE
PROCEDURES BE DONE, AT LEAST NOT
FOR ME. I JUST DON'T THINK THAT
THE NUMBERS ARE ADEQUATE TO SAY
THAT YOU CAN DO ONE PROCEDURE OR
A PROCEDURE AND THEN GO OUT AND
DO THEM ON YOUR OWN. BUT I
THINK, UM ASSEMBLY MEMBER THERE
. SOMEONE ELSE WANTED TO SPEAK.
THANK YOU, DOCTOR. OUR MR MEDINA
. YEAH, I WANT TO APOLOGIZE THAT
I WASN'T HERE TO HEAR ALL OF THE
DISCUSSION AND I'M REALLY SORRY
THAT I WASN'T ABLE TO, BUT I HAD
TO RUN ACROSS THE STREET OR
ANOTHER COMMITTEE TO VOTE. THEY
WERE READY TO ADJOURN AND I VERY
MUCH APPRECIATE THE SERIOUSNESS
OF THE DISCUSSION THAT WE'VE
HAD. AND UM, AND FOR THAT, I'M
SORRY THAT I MISSED IT. UM. AND
I ALSO, YOU KNOW, UH, KIND OF,
UH, YOU KNOW WHERE TO LAND ON
THIS BILL, BUT I WILL VOTE FOR
IT THIS AFTERNOON EVENING WITH
THE RESERVATION THAT I MADE
DIFFERENTLY ON THE FLOOR. FAMOUS
MEDINA ANY ADDITIONAL QUESTIONS
OR COMMENTS FROM COLLEAGUES
SEEING NONE REMEMBER LOW WOULD
YOU LIKE TO CLOSE? UH THANK YOU
VERY MUCH, MR CHAIR AND MEMBERS
OF THE BUSINESS AND PROFESSIONAL
COMMITTEE. THIS IS THE COMMITTEE
ACTUALLY TO DISCUSS MANY OF
THESE POLICY AREAS. SPECIFICALLY
TO ADDRESS THAT OF PATIENT
SAFETY AND INCREASE ACCESS. AS
WE REFERENCED EARLIER THIS
COMMITTEE AND ITS STAFF HAS BEEN
IN THESE CONVERSATIONS FOR A
NUMBER OF YEARS AND WILL
CONTINUE TO DO SO. AND PLEASE
KNOW THAT I TAKE THIS VERY
SERIOUSLY AS I KNOW THAT WE EACH
AND EVERY ONE OF US DO BUT
MAKING SURE THAT WE ADDRESS SOME
OF THE CONCERNS, ESPECIALLY WHEN
YOU HAVE EXPERTS ON THIS
COMMITTEE WHO CAN SPEAK TO THESE
ISSUES, BUT YOU SHOULD ALSO JUST
KNOW WITH RESPECT TO LEGISLATIVE
APPROACHES MANY TIMES, THESE TWO
SIDES WILL NEVER AGREE ON
ANYTHING. LET'S JUST BE FACTUAL
ABOUT THAT. BUT AT SOME POINT WE
NEED TO HELP APPROACH AND
ADDRESS SOME MIDDLE GROUND TO
HELP ENSURE THAT WE HAVE THE
SAFE PROTECTION. THAT HAVE THE
STANDARDS OF CARE THAT IS WITHIN
THE VALUES OF CALIFORNIA, WHICH
IS GREATER THAN THAT OF A NUMBER
OF STATES. WE NEED TO CONTINUE
TO ENSURE THAT WE HAVE THE
PATIENT PROTECTION WHILE
INCREASING ACCESS AT LARGE. BUT
THIS BEFORE YOU IS THE FINAL
PRODUCT OF A WIDE VARIETY OF
GOOD FAITH NEGOTIATIONS, MAKING
SURE THAT THE PROTECTIONS ARE IN
PLACE AND PICKING UP THE PIECES
FROM A NUMBER OF YEARS OF OTHER
MEMBERS OF THIS COMMITTEE WITH
THAT, I WILL STAY DEEPLY
COMMITTED. SHOULD THIS LEAVE
THIS COMMITTEE AND TO THE FLOOR
TO HAVE ADDITIONAL CONVERSATIONS
, MAKING SURE THAT WE PROTECT
ALL OF CALIFORNIANS AND THAT YOU
FEEL COMFORTABLE WITH AN I VOTE.
AND THAT CAN STAND UP THE TEST
OF TIME WITHIN YOUR
CONSTITUENCIES FOR PATIENT CARE
AND RESPECTFULLY ASKED FOR A
BELT. THANK YOU. SEPTEMBER LOW.
I'D LIKE TO START BY RECOGNIZING
YOU FOR YOUR YEARS OF WORK AND
SUPPORT OF THE ISSUES FURTHER BY
THIS BILL AND COMMEND ALL THE
STAKEHOLDERS FOR WHAT I KNOW HAS
BEEN LOT OF DISCUSSION OVER A
NUMBER OF YEARS AND THAT'S BEEN
MADE CLEAR TONIGHT. WHILE IT'S
UNFORTUNATE THAT A FULL MEETING
OF THE MINDS DID NOT OCCUR
BETWEEN THE OPTOMETRIST AND THE
PHYSICIANS AND THE
OPHTHALMOLOGISTS, I DO BELIEVE
THIS BILL HAS A NUMBER OF
SAFEGUARDS AND SENSIBLE
COMPROMISES THAT WERE A PRODUCT
OF THOSE NEGOTIATIONS. UH IN AN
IDEAL WORLD, WE WOULD HAVE
GOTTEN THIS BILL LAST WEEK WITH
ENOUGH TIME TO HAVE, UH UM
ENCOURAGED AMENDMENTS. UH AND I
WOULD HAVE ENCOURAGED SOME
AMENDMENTS. UM, GIVEN THE RULES
OF THE LEGISLATURE, THAT'S
THAT'S NOT POSSIBLE. UM TODAY I
WILL BE RECOMMENDING THAT THE
ASSEMBLY CONCUR IN THE
AMENDMENTS. BUT HAVING SAID THAT
I UNDERSTAND THAT UNDER THIS
BILL, THE FIRST COHORT OF
OPTOMETRISTS WOULDN'T LIKELY BE
ELIGIBLE TO PERFORM ANY OF THE
ADVANCED PROCEDURES. UNTIL A FEW
YEARS FROM NOW, UH, SO I WOULD
ENCOURAGE AND I ANTICIPATE, UH,
THAT WE MIGHT SEE ADDITIONAL
LEGISLATION NEXT YEAR, MAYBE TO
CLEAN UP SOME OF THE ISSUES THAT
HAVE BEEN DISCUSSED IN THIS
HEARING TODAY. UH AND I URGE THE
STAKEHOLDERS TO KEEP MEETING UH
, KEEP NEGOTIATING AND SEE IF
THE OUTSTANDING ISSUES CAN BE
WORKED OUT IN THE NEXT YEAR OR
SO BEFORE FULL IMPLEMENTATION OF
THE BILL IS UNDERWAY. MADAM
SECRETARY, PLEASE CALL THE VOTE.
OH, EXCUSE ME. WE NEED A MOTION
IN A SECOND. I HAVE A MOTION IN
A SECOND. MAYBE 232236. THE
MOTION IS WITH RECOMMENDATION
THAT SENATE AMENDMENTS BE
CONCURRED IN BERMAN BERMAN. I
FLORA ALVAREZ PONTA. CHAN. CHEN.
I CUNNINGHAM. DOLLY! DOLLY! I
FANG. NOT VOTING. GIBSON.
GIBSON. I GRAYSON. GRACE AND NOT
VOTING. LEE. WE I MCCARTY.
MCCARTHY NOT VOTING LIKE OH, I
MCCARTY AYE. WIENER. MAKIN, ER
NO MEDINA. MEDINA. I SALAS.
THING. I THINK I WEBER WEBER NÓ.
THAT BILL HAS EIGHT VOTES. UH
IT'S ALL WE'LL MOVE IT ON CALL.
LEAVE THE ROLE OPEN FOR ABSENT
MEMBERS. THANK YOU VERY MUCH. WE
HAVE THREE MORE BILLS THAT WE
WOULD LIKE TO GET THROUGH AS
QUICKLY AS POSSIBLE. IN TODAY'S
HEARING, I SEE I SAW EARLIER OR
SOMETHING MEMBER WOULD DO. I
STILL THERE HE IS, SOME MEMBER
WOULD PLEASE COME FORWARD TO
PRESENT A B 8 52. UH UM. AND
YEAH. DO IT. I WAS GONNA SAY
THIS HAS A CONCUR CONQUER, BUT
IT DOESN'T IT AS A CONCURRING
RECOMMENDATION ON THE DEM SIDE
AND NONE RECOMMENDATION ON THE
REPUBLICAN SIDE. UM BUT I'M SURE
WE CAN GET THROUGH IT QUICKLY,
REGARDLESS. THANK YOU, MR
CHAIRMAN, BIPARTISAN MOTION AND
SECOND FOR YOU AND YOUR
WITNESSES TO NOTICE. TRYING TO
BE AS SUBTLE AS USUALLY USUALLY
THE ONE THAT DOES THAT? YEAH.
PROBABLY IF YOU INDULGE ME JUST
ADMITTED ON THE STATEMENT, AND
THEN WE'LL WE CAN LEAVE THESE
PEOPLE OFF IF YOU WANT TO BUY,
BUT IT IS IMPORTANT IN THE
REASON WHY WE'RE HERE AND FIRST
OF ALL, THANK YOU. THANK YOU TO
THE CHAIR AND MEMBERS OF THE
REASON WHY WE'RE HERE. SENATE
AMENDMENTS DELETED ALL OF THE
NURSE PRACTITIONER PROVISIONS
RESULTING IN THE BILL THAT NOW
DEALS ONLY WITH ELECTRONIC
PRESCRIBING REQUIREMENTS. MAYBE
8 52 IS AMENDED FURTHER IN THE
SENATE THAT THE REQUEST OF THE
BOARD OF PHARMACY TO ACHIEVE
CONFORMANCE WITH FEDERAL LAW
RELATED TO ELECTRONIC
PRESCRIBING OF CONTROLLED
SUBSTANCES. THE BOARD ALSO
REQUESTED CLARIFICATION OF THE
INTENT OF MY ELECTRONIC
PRESCRIBING BILL OF 2018 80 27
89 2 RELATED TO PHARMACY
REQUIREMENTS FOR ACCEPTANCE OF
ELECTRONIC DATA TRANSMISSIONS.
UM I COULD GO ON HERE. UM BUT I
WILL NOT. AND IF THERE ARE
QUESTIONS THAT COME UP, I'M
HAPPY TO DO THAT. BUT BASICALLY,
UM. WELL WHEN EIGHT WHEN A B 27
89 WAS PASSED IN 2018. I AGREED
TO A THREE YEAR DELETE, DELETE
DELAYED IMPLEMENTATION PERIOD TO
ALLOW PRACTITIONERS AND
PHARMACIES TIME TO FULLY
UNDERSTAND THE IMPLICATIONS OF
THE BILL AND ACHIEVE COMPLIANCE.
THERE ARE NO NEW PROVISIONS OR
REQUIREMENTS PLACED ON EITHER
PRACTITIONERS OR PHARMACIES IN
THIS BILL. INSTEAD, IT CLARIFIES
THE ORIGINAL INTENT. PROVIDES
EXIST ADDITIONAL EXEMPTIONS IN
LANGUAGE FROM 27 89. THAT, UM.
OH SAVE MY WITNESSES AS UH,
PEOPLE THAT BE ABLE TO ANSWER
QUESTIONS IF WE NEED TO, AND I
THANK THEM FOR BEING HERE. THANK
YOU, DOCTOR WOULD THANK YOU,
DEAR WITNESSES FOR BEING HERE.
ANY QUESTIONS COME UP. UH WE'LL
BE SURE TO BE SURE TO CALL ON
YOUR EXPERTISE. ANY WE DO HAVE A
WITNESS IN OPPOSITION, UM
JENNIFER SNYDER FROM THE%
CALIFORNIA RETAILERS
ASSOCIATION. WHO'S TESTIFYING IN
PERSON AND DOCTOR WOULD IF YOU
DECIDE THAT YOU WANT TO UH HUH.
TAKE BACK UP YOUR WITNESSES
AFTERWARDS. WE'LL GIVE YOU THAT
OPPORTUNITY. THANK YOU. GOOD
EVENING, JENNIFER SNYDER ON
BEHALF OF THE CALIFORNIA
RETAILERS ASSOCIATION. IT'S
THEIR PHARMACY MEMBERS, RETAIL
PHARMACY MEMBERS. REGRETFULLY
WE'RE HERE TODAY IN OPPOSITION
AND ACTUALLY OPPOSED UNLESS
AMENDED POSITION BUT AGAIN NO
CHANCE FOR AMENDMENTS TODAY. UM
AND YOU KNOW, FIRST JUST WANT TO
ACKNOWLEDGE SOME MEMORABLE WOODS
WORK ON THE SPILL THE AMENDMENTS
THAT HE HAS TAKEN THUS FAR AND
WORKING WITH US ON THE ON THE
LEGISLATION. I THINK IN A
NUTSHELL FOR US. WE CONTINUE TO
HAVE CONCERNS WITH WHAT WE
CONSIDER TO BE NOW NEW
PROVISIONS THAT WILL BE IN STATE
LAW, WHICH WILL PUT PHARMACIES
IN AN UNTENABLE POSITION WHERE
THEY WILL HAVE TO ACCEPT ANY
PRESCRIPTION WHEN THEY DON'T
KNOW IF THAT E PRESCRIPTION
ACTUALLY CAN SPEAK, UM, CAN
SPEAK TO THEIR SOFTWARE, AND NOR
CAN THEY HAVE IN A LEAD TIME TO
BE ABLE TO HAVE THE OPPORTUNITY.
TO KNOW WHETHER OR NOT THAT E
PRESCRIPTION IS COMPLIANT WITH
STATE OR FEDERAL LAW. SO WHAT
WE'VE BEEN HOPING TO DO IS COME
UP WITH AN AMENDMENT THAT WILL
ALLOW FOR SOME OF THAT LEAD
TIME, SO WE DON'T HAVE
PHARMACIES IN THAT POSITION
WHERE THEY'RE MANDATED TO TAKE A
PRESCRIPTION THAT THEY DON'T
BELIEVE IS EITHER MAYBE
COMPLIANT WITH STATE OR FEDERAL
LAW OR SAFE FOR PATIENTS
TRANSACTIONS SO AGAIN APOLOGIZE
FOR HAVING TO STILL BE IN
OPPOSITION TO A BILL THAT WE
KNOW THAT ASSEMBLYMEMBER'S WOULD
VERY MUCH WANTS TO MOVE FORWARD,
AND THERE'S PROVISION THAT WE
LIKE AS WELL SO, UM, BUT I JUST
WANTED TO MAKE SURE WE ARE ON
RECORD AS STILL OPPOSED UNLESS
AMENDED ON THE BILL. THANK YOU.
THANK YOU VERY MUCH. WE ALL GOOD
DOCTOR WOULD. UM IT'S OKAY. I'M
HAPPY TO COMMENT ABOUT THAT. BUT
PERFECT TIME. TIME WOULD BE
GREAT. UM ANY ADDITIONAL
WITNESSES IN SUPPORT OR
OPPOSITION IN THE HEARING ROOM
YOU WANT TO ADD ON BRANSON'S UP
AT THE CALIFORNIA PODIATRIC
MEDICAL ASSOCIATION ANDSUPPORT
THANK YOU VERY MUCH. THINK IT
OVER THE PHONE LINES, AND HE
WITNESSES ON THE PHONE LINES YOU
WANT TO ADD ON IN SUPPORT OR
OPPOSITION NAME ORGANIZATION
YOU'RE WITH, IF ANY POSITION ON
THE BILL. HE'S AND GENTLEMEN ON
THE PHONE IF YOU'D LIKE TO
SUPPORT OR OPPOSE TODAY'S BILL
THIS PRESS ONE THAN ZERO AT THIS
TIME. AND WE'VE GOT TO THE LINE
OF 1 27. 1 27. YOUR LINE IS
OPEN, BUT HE'S STATE, YOUR NAME
AND ORGANIZATION. MOVING ON TO
LINE 108. PLEASE GO AHEAD. ERIN
BONE WITH THE MEDICAL BOARD OF
CALIFORNIA IN SUPPORT. THANK YOU
. THANK YOU. THANK YOU. WE HAVE
NO ONE ELSE IN Q GREAT. BRING IT
BACK TO COLLEAGUES. QUESTIONS,
COMMENTS, MOTION SECONDS. WE
HAVE A MOTION A SECOND ALREADY
FORGOT THAT ANY QUESTIONS OR
COMMENTS FROM COLLEAGUES SEEING
NONE. DOCTOR WOULD YOU GET THE
LAST WORD JUST TO JUST TO
COMMENT? UM WHEN WE IN THE BILL
, WE ACTUALLY AGREED TO A THREE
YEAR DELAY FOR IMPLEMENTATION,
SO PHARMACIES HAVE HAD PLENTY OF
TIME TO DO THIS. ACTUALLY, WE'RE
INTO THE FOURTH YEAR NOW ON THIS
AND YET ONE OF THE THINGS THAT
HAS BEEN CONTINUE TO ASK FOR IS
ANOTHER YEAR. WHAT I WILL NOTE
IS THAT IT'S VERY INTERESTING
THAT SMALLER PHARMACIES DON'T
EVEN HAVE AN ISSUE WITH THIS.
THEY'VE BEEN ABLE TO IMPLEMENT
IMPLEMENT THIS QUITE EASILY.
IT'S THE LARGE CHAIN PHARMACIES
THAT ARE PUSHING BACK AND I
THINK THAT'S DISAPPOINTING.
THEY'VE HAD PLENTY OF TIME TO DO
THIS. I RESPECTFULLY ASK YOUR I
VOTE. THANK YOU, DOCTOR WOULD,
UH AND THANK YOU FOR TAKING
STEPS TO ENSURE A SMOOTH
IMPLEMENTATION OF LEGISLATION I
UNDERSTAND, PASSED A FEW YEARS
AGO AND RECENTLY WENT INTO
EFFECT. WHILE I UNDERSTAND THAT
THE OPPOSITION HAS CONCERNS
ABOUT COMPLYING WITH SOME
PORTIONS OF THE BILL. I DO
BELIEVE THE BILL AS A WHOLE IS
NEEDED TO FAIRLY URGENTLY. IT
DOESN'T QUITE WORK. REGARDLESS
WITH THAT, I'LL BE RECOMMENDING
THE ASSEMBLY CONCUR IN SENATE
AMENDMENTS TODAY. THANK YOU VERY
MUCH. MADAM SECRETARY. PLEASE
CALL THE VOTE. A B 8 52. THE
MOTION IS WITH RECOMMENDATION
THAT SENATE AMENDMENTS BE
CONCURRED IN BERMAN BERMAN. I
FLORA ALVAREZ. ON TO CHEN.
CHENNAI CUNNINGHAM. DOLLY!
SOLLY, I BANG. BANG, I GIBSON.
GRAYSON. GRACE AND I LI LI I
MCCARTY MCCARTHY. I'M MAKIN ER
MAKIN HER I MEDINA. MEDINA. I
SALAS. TING. THING I WEBBER
WEBBER. AYE. GREAT THE BILLS OUT
WITH 11 VOTES. WE'LL LEAVE IT
OPEN FOR ABSENT MEMBERS. CAN I
GET A QUICK MOTION SECOND AND
VOTE ON THE ON THE CONSENT
CALENDAR? GOT A MOTION IN A
SECOND. AND MR MAIENSCHEIN, IF
YOU'D LIKE TO COME UP WHILE
WE'RE DOING THIS, UM MADAM
SECRETARY, CAN YOU PLEASE CALL A
VOTE ON THE CONTENT CALENDAR?
WHICH IS A B 26 85. THE MOTION
IS WITH RECOMMENDATION THAT
SENATE AMENDMENTS BE CONCURRED
IN BERMAN. I FLORA. ALVAREZ.
PONTA. CHAN. CHENNAI CUNNINGHAM.
DOLLY! DOLLY! I FANG. BANG, I
GIBSON GIBSON. I GRAYSON. GRACE
AND I. LI LI I MCCARTY CARDI I
MAKIN ER MCKENNA. I MEDINA.
MEDINA. I SALAS. TANG. THING I
WEBBER WEBBER. AYE. THE CONSENT
CALENDARS OUT WITH 12 VOTES WILL
LEAVE IT OPEN FOR ABSENT MEMBERS
AND ASSEMBLYMEMBER'S MAIENSCHEIN
LAST BUT NEVER LEAST. WE GOT A
2ND 2ND. THIS HAS BIPARTISAN
SUPPORT KINKIRK AND CARRY ON
BOTH SIDES READY WHEN YOU ARE,
SIR. BECAUSE OF THAT, I'LL JUST
LIMIT IT TO ABOUT 15 MINUTES.
PERFECT A B. 23 80 PROHIBITS AN
ONLINE PET RETAILER FROM
OFFERING FACILITATING LOAN OR
OTHER FINANCING OPTIONS FOR THE
PURCHASE OF A PET. AND I WOULD
RESPECTFULLY REQUEST AND I VOTE.
THANK YOU VERY MUCH FOR YOUR
CONCISE PRESENTATION. MR
MAIENSCHEIN WITNESSES AND
SUPPORT WITNESS WILL BE
AVAILABLE FOR QUESTIONS TOO
PERFECT LOVE THAT DON'T ANY
WITNESSES, PRIMARY WITNESSES AND
OPPOSITION. SEEING NINE. ANYBODY
IN THE CHAMBERS ARE IN THE
HEARING ROOM WANTS TO ADD ON AND
SUPPORT OR OPPOSITION. SEEING
NONE. UH MR OPERATOR, IS THERE
ANYONE ON THE PHONE LINES WHO
WANTS TO ADD ON AN OPPOSITION OR
SUPPORT? MAYBE 23 80. AND
GENTLEMEN ON THE PHONE IF YOU'D
LIKE TO EXPRESS OPPOSITION OR
SUPPORT FOR A B 23 80, PLEASE
PRESS ONE, THEN ZERO AT THIS
TIME. WE HAVE NO ONE QUEUING UP
BEAUTIFUL. BRING IT BACK TO
COLLEAGUES, QUESTIONS, COMMENTS.
WE HAVE THE MOTION IN THE
SECOND. BEING NONE
ASSEMBLYMEMBER'S. WOULD YOU LIKE
TO CLOSE? THANK YOU VERY MUCH.
MR CHAIR, RESPECTFULLY REQUESTS
AND I VOTE. THANK YOU REMEMBER
MAIENSCHEIN FOR WORKING WITH THE
COMMITTEE ON THIS BILL. THERE'S
STILL SOME OUTSTANDING
QUESTIONS. LISTEN TO THE
ANALYSIS, BUT I SUPPORT EFFORTS
TO PROTECT CONSUMERS AND DETER
PUPPY MILLS. WITH THAT I SUPPORT
CONCURRENCE TODAY TO ALLOW THESE
ISSUES TO BE ADDRESSED. GOING
FORWARD. WHICH WILL BE A
DIFFERENT YEAR. UM AND MADAM
SECRETARY, PLEASE CALL THE VOTE.
A B 23 80. THE MOTION IS WITH
RECOMMENDATION THAT SENATE
AMENDMENTS BE CONCURRED IN
BERMAN BERMAN. I FLORA ALVAREZ.
PONTA CHEN. CHENNAI CUNNINGHAM.
DOLLY DOLLY! I BANG! BANG! I
GIBSON HIPS AND I, GRAYSON GRACE
AND I LI LEE I MCCARTY MCCARTHY.
I'M MAKIN ER MCKENNA. I MEDINA.
MEDINA. I SALAS. TING TING I
WEBER WEBER. AYE. OF COURSE THAT
BUILDS OUT WITH 12 VOTES. THANK
YOU REMEMBER, WE'LL LEAVE THE
ROLE OPEN FOR ABSENT MEMBERS.
THANK YOU. MR CHAIRMAN
RELATIONS, SO LET'S MOVE TO ADD
ON IN ONE SECOND ONE SECOND REAL
QUICK.
SO LET'S OPEN. THINGS UP. YEAH
AH, FOR ADD ONS FOR, UH BILLS
THAT HAVE BEEN HEARD. LET'S
START WITH NUMBER ONE HERZBERG.
SB 7 74. TAKE YOUR TIME. GIBSON.
GIBSON. I GRAYSON. GRAYSON. I LI
MAY I? THAT BILL WAS ALREADY
OUT. IT'S STILL OUT. AGENDA ITEM
NUMBER TWO, MAYBE 6 57 COOPER.
GIBSON. GIBSON. I GRAYSON.
THAT'S NOT FUNNY, LEE ALRIGHT?
THIS IS JOHN ADAM. NUMBER 2 86
57 COOPER. MAY I? THAT THAT BILL
HAS 10 VOTES IS A V A V 6 57
COOPER. SO THAT BILL HAS 10
VOTES. IT IS OUT. WILL STILL
LEAVE THE ROLE OPEN. PERHAPS
SOME MEMBERS. WHICH ONE IS THIS
? GENERAL NUMBER? 3 88 52 WOULD
SALAS. THAT BILL WAS OUT THAT
BILL STILL IS OUT. STILL OPEN
FOR HAVE SOME MEMBERS. UH HUH.
UH AGENDA ITEM NUMBER FOUR,
MAYBE 2 TO 36. SALAS. MR CHERIF
, YOU MAY I'M SORRY I MISSED THE
DISCUSSION. BUT I KNOW I'VE
TALKED TO YOU, MR LOW, AND I
THINK I HAVE A COMMITMENT FOR MR
LOWE AND ACTUALLY WORKING ON ON
THESE ISSUES BECAUSE I KNOW I
HAD CARRIED THE PREVIOUS TWO
VERSIONS OF THE BILL. THAT I DID
WANT TO MENTION DURING
TESTIMONY. BUT WITH THAT I WILL
TRUST YOU, MR LOWE AND VOTE I AT
THIS TIME. MRS SALAS SALAS? AYE,
GRAYSON. GRACE AND I. THAT BILL
IS OUT. WE'LL LEAVE IT OPEN FOR
ABSENT MEMBERS. BUT MIGHT NOT
WAIT FOR HAVE SOME MEMBERS.
GENERAL AND FIVE MAIENSCHEIN.
MAYBE 23 80. OKAY? SAUCE.
AWESOME. THAT'S OUT IN CONSENT.
GIBSON, DID YOU GET YOUR
CONSENT? YES, WE DID. ON THE
CONTENT CALENDAR SALAS TONIGHT.
RIGHT. THANK YOU, EVERYBODY.
SB 774. FOUR. ALL RIGHT. A B 6
57 COOPER FLORA. OR NOT VOTING.
MAYBE 8 52 BONTA. I FOR ALL
RIGHT? MAYBE 20 TO 36 LOW BONTA
TÔI. MAYBE 23 80 MAIENSCHEIN
FLORA. OR I PLAN TO BUY. AND ON
THE CONSENT CALENDAR FLOOR OR I
PONTA TÔI. THANK YOU COLLEAGUES.
WE'LL WAIT TWO MINUTES TO TRY TO
GET A STATUS UPDATE ON THAT. UH,
ABSENT COLLEAGUES, AND THEN
WE'RE GONNA GET BACK TO SESSION.
GREAT THAT WRAPS UP THE LAST BMP
HEARING OF THE YEAR. THANKS,
EVERYONE.