Transcript Highlights:

• needs of Louisiana opportunity youth, with a focus on building a stronger, connected fabric that supports
• Opportunity in Action Day at the Capitol, and does hereby encourage all communities in the state to support
• House Concurrent Resolution by Representative Lecombe to express legislative support for the request
• H.R. 14 by Representative Carver to express support for federal efforts to eliminate the U.S.
• H.R. 14 by Representative Carver to express support for federal efforts to eliminate the U.S.

Bills: HR19, HR20, HR21, HR22, HR23, HR24, HR25, HR26, HR27, HR28, HR29, HR30, HR31, HR32, HR33, HR34, HR35, HR36, HR37, HR38, HCR15, HCR16, HCR17, HCR18, HB115, HB208, HB465, HB832, HB964, HB965, HB966, HB967, HB968, HB969, HB970, HB971, HB972, HB973, HB974, HB975, HR14, HR15, HR16, HR17, HR18, HCR14, SCR4, SCR7, SCR8, HB362, HB963, HB207, HB300, HB331, HB428, HB464, HB587, HB618, HB629, HB801, HB853, HB891, HB78, HB112, HB148, HB149, HB190, HB221, HB346, HB354, HB355, HB356, HB358, HB384, HB427, HB657, HB675, HB716, HB901

Keywords: HR19, House Resolution 19, Louisiana Nursery and Landscape Association Day, LNLA, nursery industry, landscape industry, horticulture, green industry, environmental stewardship, beautification, sustainability, state capitol, special day resolution, commemoration, trade association, wholesale growers, landscape architects, grounds maintenance, interiorscapers, Louisiana agriculture

Transcript Highlights:

• I, for one, am supporting it.
• And we ask for support. Thank you. Anyone else here in support of this bill?
• Consumer Reports is proud to support AB 1921. Consumer Reports is proud to support AB 1921.
• And I very much support that.
• from EQCA—strong support.

Summary: The committee heard AB 1988, which would require AI companion chatbots to respond to credible self-harm or violence-related crisis expressions by displaying the 988 Suicide and Crisis Lifeline, warning users, and pausing the chat for human review after repeated crisis signals. The author and supporters said the bill is a measured safety standard to redirect vulnerable users to human help, citing research and cases where chatbots worsened suicidal ideation or violent behavior. Support came from crisis and medical advocates, while no opposition testimony was offered. The chair and members expressed strong support, and the bill was held pending quorum before later action on the agenda. The committee then took up AB 1709, which would set a minimum age of 16 for users to create or maintain accounts on social media platforms with harmful addictive features and would create an E-Safety Advisory Commission in the Attorney General’s office. The author argued the bill targets product design, not speech, and is intended to curb compulsive features such as infinite scroll, autoplay, and algorithmic feeds while allowing safer or non-addictive platforms to remain available. Supporters, including a psychologist and the Organization for Social Media Safety, described cyberbullying, predation, compulsive use, and mental health harms; opponents, including EFF, ACLU-Cal Action, TechNet, and youth advocacy groups, warned about privacy, First Amendment, and access-to-community concerns, especially for LGBTQ youth and other marginalized groups. Committee members debated whether the bill is a ban or a delay, how age assurance would work, and whether the proposal would be effective or could push youth to less safe spaces. Several members said they would support the bill as a first step, while others raised concerns about enforceability, privacy, and constitutional issues. The author emphasized that the bill is limited to specific harmful design features, not content or general internet access, and that the new commission would monitor evolving technology and recommend future updates. No final vote was taken during the portion of the hearing provided.

Transcript Highlights:

• So by 2020, we have, or in 2020, they have like 26 elderly dependents per 100 working-age individuals
• By 2035, we'll have 37 elderly dependents for 1,048 individuals.
• stock is more affordable over time, making sure that we have abundant housing, and are providing supports
• We're going to continue to encourage and support new housing production all across the state while working
• take a look at the housing plan, achieving housing abundance is one of five strategies, providing support

Summary: The Senate Committee on the Census, chaired by Senator Will Brownsberger with Senator Liz Miranda and other members participating, held a hearing on mid-decade population estimates and projections for Massachusetts. Susan Strait of the UMass Donahue Institute presented the latest Census Bureau estimates and explained the main components of population change: births, deaths, domestic migration, and international migration. She said Massachusetts has continued to grow, but much more slowly than in the immediate post-2020 period, largely because net international migration has fallen sharply after a pandemic-era surge. She also reviewed fertility and aging trends, noting that births are concentrated among women in their 30s, that the state’s population is aging, and that the share of residents 65 and older is projected to rise substantially, increasing the dependency ratio. Strait and committee members discussed the role of immigration in Massachusetts’ population growth, the concentration of immigrants in Greater Boston and other regions, and the effect of immigration on births and the labor force. They also discussed domestic out-migration, especially among young adults, and the possibility that housing affordability is a major driver. Senators raised questions about how the Census counts people in group quarters such as prisons and dormitories, and Strait explained that the Census counts incarcerated people where they are housed and generally does not treat dormitory residents as migrants in the same way as household residents. She said the Census Bureau is still working on methodological issues such as extending a “college fix” to more areas. Jesse Partridge Guerrero of the Metropolitan Area Planning Council described how MAPC uses Donahue Institute population projections, household headship rates, and UrbanSim to allocate projected households down to regional, municipal, and sub-municipal levels. He said the projections used for MassDOT’s long-range transportation plan anticipated slower statewide growth and regional decline in the Cape and parts of western and central Massachusetts. Tim Reardon of the Executive Office of Housing and Livable Communities then explained how those projections feed into the statewide housing plan, including three population scenarios and associated housing needs. He said the plan estimates a need for about 115,000 homes to address existing shortages and another 73,000 households even under a low-growth scenario, with total housing needs rising to roughly 222,000 units under the middle scenario and 262,000 under the high scenario. Members pressed him on whether the scenarios may understate future need given the recent drop in immigration and ongoing affordability problems, and he said the state is also pursuing housing production, rental assistance, shelter response, seasonal conversion prevention, and infrastructure support for communities. No votes were taken.

Transcript Highlights:

• Directed Community Supports program, and the consumer support grant.
• </c> always receive strong bipartisan support always receive strong bipartisan support and<01:31:13.199
• for our direct support staff.
• </c> for our direct support staff capping for our direct support staff capping these<01:36:59.360><c>
• </c><01:41:49.639><c> Housing</c> is an effective Supportive Housing is an effective Supportive Housing

Keywords: 1183, house

Transcript Highlights:

• John Johnson from AdventHealth is in support. Thank you, John.
• Thank you for your support of this great bill. Thank you.
• AAU waves in support. Next, we have Joel Dragoan. Dragan. Dragon.
• To be very clear, we support House Bill 431.
• I just want to thank you for your continued support there.

Summary: The Health Care Facilities and System Subcommittee met and heard three bills, all of which passed favorably. HB 229 by Rep. Oliver would update the Health Facilities Authority Act to reflect modern health system structures, allowing not-for-profit LLCs and not-for-profit parent corporations of health systems to use the financing authority, and clarifying that authorities may use loan agreements as well as lease financing. An amendment narrowing and clarifying the not-for-profit definition was adopted without objection. AdventHealth testified in support, and the bill passed 17-0. The committee then heard HB 527 by Rep. Trabulsi, which creates a public records exemption for current and former AHCA personnel who investigate complaints, Medicaid fraud, abuse, waste, or inspect licensed health facilities. The sponsor said the exemption is intended to protect investigators and their families from retaliation. There was no public testimony, and members discussed balancing transparency with safety. The bill passed 17-0. Finally, the committee heard HB 431 by Rep. Trabulsi, which extends by one year the requirement for athletic coaches and similar youth sports volunteers to complete Level 2 background screening through AHCA’s clearinghouse, with the sponsor saying the delay would give the system time to expand and reduce costs over time. Public testimony from youth sports organizations supported the goal of screening but raised concerns about cost, implementation details, and age thresholds for screening. Members generally supported the bill as a child-safety measure, and it also passed 17-0. The meeting then adjourned.

Transcript Highlights:

• So, please support HB545. costs. So, please support HB545.
• And I'm here in support of SB546. And I'm here in support of SB546.
• </c> support SB546. support SB546.
• So, I urge your support.
• So we are in support.

Keywords: 1191, senate, all

Transcript Highlights:

• So I fully support the investment.
• Do we have any other lead support witnesses? Lead support. Yes. Two minutes. Thank you.
• Again, when you have friends on both sides that are supposed to be supportive of an issue that supports
• Obviously, the support at this point is to support our business directly.
• I want to support this bill.

Keywords: 987, senate, all

Transcript Highlights:

• THE HUD HOUSING INVENTORY COUNT SHOWED ABOUT 2400 SUPPORTIVE 2,400 SUPPORTIVE HOUSING UNITS ACROSS THE
• I urge you to support additional funding for supportive housing and Senate File 5060 to prevent that
• I urge you to support additional funding for supportive housing and Senate File 5060 to prevent that
• I URGE YOU TO SUPPORT ADDITIONAL FUNDING FOR SUPPORTIVE HOUSING AND SENATE FILE 5060 TO PREVENT THAT
• I'm here to support the investment in supportive housing and FHPAP in the budget bill.

Keywords: 1187, senate, all

Transcript Highlights:

• </c><00:36:23.280><c> for</c> save somebody that's in support for save somebody that's in support for
• </c> did not wish to speak in support did not wish to speak in support and and and the<00:52:25.440><
• </c><01:03:17.119><c> exemptions</c> you know mandating elderly exemptions you know mandating elderly
• </c> legislation, we would support the bills. legislation, we would support the bills.
• which tends to support one online count which tends to support one and<01:19:46.719><c> with</c><01:

Keywords: 1191, senate, all

Transcript Highlights:

• We don't have strong prevention support services.
• So I encourage your support.
• It's great to see so much support. PCC also strongly supports the bill.
• This is the primary reason we support it.
• We are signed in support of HB 2382. We are signed in support of HB 2382.

Summary: The committee heard briefings, sponsor presentations, and public testimony on several finance bills. HB 2038 would impose an additional B&O tax on businesses operating social media platforms beginning in 2027 and create a youth behavioral health account funded by the tax. The sponsor argued the bill would help address youth mental health harms linked to social media and support implementation of the Washington Thriving plan. Supporters in testimony, including youth advocates and some public health voices, said social media contributes to youth anxiety and addiction and that the revenue should be used for behavioral health services. Opponents, including technology and business groups, argued the tax unfairly singles out one sector, could be passed on to consumers, and may violate federal internet tax law. The hearing on HB 2038 was suspended and later reopened for public testimony; no vote was taken. HB 2297 would create tax incentives for grocery stores in underserved communities, including local B&O preferences, a sales tax exemption for security services, a 30-year property tax exemption program, a B&O tax credit, and a B&O exemption for certain locally owned or employee-owned stores. The sponsor and supporters said the bill is intended to preserve and attract grocery stores in food deserts, especially after recent store closures, and to help communities with limited transportation and access to healthy food. County representatives supported the goal but raised concern about the bill’s sales tax exemption and its effect on local revenues. Public testimony was largely supportive, with advocates, local officials, grocers, and residents describing grocery stores as essential community infrastructure. No action was taken. HB 2382 would raise cigarette taxes by $2 per pack, restructure vapor and other tobacco product taxes, and dedicate portions of the revenue to a time-sensitive emergency system, tobacco enforcement, and the foundational public health services account. The sponsor said the bill would generate needed revenue, support cancer research funding, and strengthen public health and enforcement. Supporters said higher tobacco taxes reduce use and help cover long-term health costs, while some public health witnesses supported the revenue but suggested directing more funds to existing tobacco prevention accounts. Opponents from retail and industry groups argued the proposal is regressive, could increase illicit sales and cross-border purchasing, and would hurt small businesses and low-income consumers. The committee also heard HB 2487, a Department of Revenue request bill that would narrow the B&O exemption for insurers to clarify that it applies only to premium income subject to insurance premium tax, and apply the change retroactively to 2019. The sponsor and supporters said the bill closes a loophole created by a recent Supreme Court ruling and preserves tax equity, while insurers and business groups objected to the retroactive application, warning of higher premiums and unfair taxation. Finally, HB 2018 would increase the solid waste tax by 0.5% per year for five years and direct the new revenue to a local government solid waste assistance account for county and city waste management plans. County officials supported the bill as a way to stabilize funding for solid waste systems, and testimony emphasized rising disposal and infrastructure costs. No votes were taken on any of the bills during the hearing.

Transcript Highlights:

• So I'm happy to be here in support of our midwives. But this is a... support of our midwives.
• And I'm fully in support of House Bill 1904.
• I am here today in support of House Bill 2247.
• I hope the committee will join me in support of HB 2247 to support the health and wellness of animals
• UW Medicine supports this bill.

Summary: The committee heard public hearings on several health-related bills. House Bill 1904 would prohibit cat declawing except for therapeutic purposes, with staff explaining definitions, fines, recordkeeping, and reporting requirements. The prime sponsor and animal welfare advocates described declawing as cruel and linked it to pain and behavior problems, while the Washington State Veterinary Medical Association supported the substance of the bill but asked to remove the added reporting and disciplinary provisions as redundant and burdensome. House Bill 2211 would provide guidance for medically tailored meals under existing Medicaid-related nutrition supports, including standards for Washington-based nonprofit providers where possible, menu review, and nutrition requirements. The sponsor said it would clarify implementation without expanding the program, and supporters from meal providers, food distributors, and local farms said it would improve health outcomes, keep dollars local, and support Washington jobs and agriculture. House Bill 2329 would allow licensed midwives to delegate certain tasks to medical assistants and to supervise medical assistants, with the sponsor and birth center operators saying it would fix an omission in current law and help rural and under-resourced birth centers operate more efficiently. Supporters said it would improve staffing and financial stability, while the sponsor indicated the lactation consultant language would likely be removed because those consultants are not regulated by the Department of Health. The committee then returned to House Bill 1904 for additional testimony from humane organizations, veterinarians, shelter leaders, and local officials, all supporting a ban on declawing and emphasizing animal pain, shelter impacts, and available alternatives. House Bill 2247 would expand and clarify veterinary telehealth and veterinarian-client-patient relationship rules, allowing a VCPR to be established in certain telehealth circumstances and setting guardrails for consent, practice standards, and when in-person exams are still required. Supporters from shelters, animal welfare groups, mobile clinics, and veterinarians said telehealth would improve access in rural and underserved areas, reduce shelter intake, and help animals receive care sooner; the veterinary association supported the bill with amendments to clarify recordkeeping and access-to-care findings. House Bill 2339 would update nursing license terminology and processes for advanced registered nurse practitioners, including title changes, controlled substance rules for CRNAs, transcript submission, and interim permits. Nursing board and ARNP representatives supported the technical updates, while the hospital association and medical association raised concerns about title language for clinical nurse specialists and the deletion of a reference to the medical profession. Finally, House Bill 2106 would require health carriers to give 90 days’ notice of significant mid-contract payer modifications and provide the actual modification language, with the sponsor and hospital and provider representatives saying insurers are increasingly making unilateral changes that affect payment, services, and patient access. UW Medicine and a rural hospital district described examples where insurers changed imaging or preventive service coverage mid-contract, causing financial losses and forcing difficult choices about network participation. Carriers were noted as opposing the bill, while providers and facilities argued it would improve transparency and prevent one-sided contract changes that disrupt care.

Transcript Highlights:

• And, like Mark said, we have the support of the Mashpee Tribe and we have the conditional support of
• So whatever we could do to be supportive, if we can get there, I definitely would be supportive of that
• We just need your help and support.
• They are providing basic life support, right?
• Also, in Massachusetts, if you want to just stand up and state your name and you support or don't support

Keywords: 995, all

Summary: The committee first heard testimony on H. 3599, a bill concerning access to historic Indian lands and easements for landlocked tribal parcels in Massachusetts. Witnesses, including members of the Mashpee Wampanoag and Herring Pond communities, said the bill would restore access to family lands that have long been treated as landlocked and had been denied easements by necessity in prior court rulings. They described heavy tax burdens, prior litigation, and support from the Mashpee Wampanoag Tribe, with conditional support from the Aquinnah Wampanoag Tribe pending language changes. Committee members asked about the tax assessments and the status of tribal support, and the chair said the committee would follow up on possible amendments. The committee then took up S. 2922, which would authorize an underground easement at Magazine Beach in Cambridge for the Greater Cambridge Energy Project. Eversource representatives said the easement is needed for a transmission line connecting the Brighton and Kendall Square substations, supporting grid reliability and the Commonwealth’s clean energy transition. They said DCR would receive fair market value and replacement land in Wendell to satisfy Article 97 requirements. No objections were raised, and the panel’s testimony concluded without a vote recorded in the transcript. Most of the hearing focused on H. 5047, which would authorize the Commonwealth to take the Norwood Hospital site by eminent domain so the hospital can be restored. Sponsors, local officials, hospital task force members, EMS and fire representatives, a chamber of commerce leader, and a former hospital administrator all argued that the 2020 flood and Steward’s bankruptcy left the region without adequate care, causing longer ambulance transports, emergency room boarding, staffing strain, and economic losses. They said the site remains a partially completed shell, that the state should be able to acquire it and bring in a nonprofit operator, and that the taking would not require state funding because an operator would pay the acquisition costs. Committee members from both chambers expressed support and asked about costs, timing, infrastructure, and whether a nonprofit operator is being pursued. The chair took the bill under advisement after extensive testimony; no vote was taken in the transcript.

Transcript Highlights:

• And like Mark said, we have the support of the Mashpee tribe and we have the conditional support of the
• So whatever we could do to be supportive, if we can get there, I definitely would be supportive of that
• So whatever we could do to be supportive, if we can get there, I definitely would be supportive of that
• We just need your help and support.
• Also, in Massachusetts, if you want to just stand up and state your name and you support or don't support

Summary: The committee heard testimony on H. 3599, a bill concerning access to landlocked Indian lands in Massachusetts. Witnesses, including members of the Mashpee Wampanoag and Herring Pond communities, described long-standing family land access problems, tax assessments they said treated inaccessible parcels as buildable, and a 2016 Supreme Judicial Court ruling that denied easements by necessity on the basis of tribal custom. They said the bill would restore equal treatment under the law and noted support from the Mashpee Wampanoag Tribe and conditional support from the Aquinnah Wampanoag Tribe, with possible language changes still under discussion. Members asked about the tax impacts and the status of tribal support, and the chair said the committee would review the conditions and written letters before proceeding. The committee then took up H. 5047, authorizing the Commonwealth to take the Norwood Hospital property by eminent domain so the site can be restored as a hospital. Sponsors Rep. Rogers, Sen. Rush, and Rep. Lynch argued that the closure of Norwood Hospital after the 2020 flood and Steward bankruptcy left a regional medical gap affecting more than a dozen towns, major venues, and emergency responders. They said the site should be returned to a not-for-profit operator, that the state would not be asked to fund the hospital itself, and that eminent domain would allow an independent valuation and move the project forward. Several committee members voiced support, while Rep. Davis asked about timing, cost, and whether negotiations with the current owner could still resolve the issue; sponsors said the private owner had delayed too long and that the state needed a contingency path. Testimony from local officials, chamber representatives, nurses, firefighters, EMS leaders, and residents emphasized the hospital’s regional role, the strain on ambulance and emergency room capacity, longer transport times, boarding at other hospitals, and added costs to towns for ambulances and staffing. Speakers also described personal experiences with delayed care and said the hospital had been profitable before the flood. The Massachusetts Nurses Association and the Professional Fire Fighters of Massachusetts supported the bill, stressing the need for inpatient beds, emergency preparedness, and a stable regional health care system. The committee also briefly heard and accepted testimony on S. 2922, an Eversource-backed bill authorizing an underground easement at Magazine Beach in Cambridge for the Greater Cambridge Energy Project, before returning to the Norwood Hospital bill; no votes were taken during the hearing.

Transcript Highlights:

• I'm definitely in support of House Bill 288.
• So I would appreciate your support.
• Levin has supported and sponsored this bill.
• I'm here to testify in support of HB 2110.
• I believe this flexibility is critical to support timely transfers and will support improved patient

Summary: The Senate Health and Long-Term Care Committee held public hearings on several House bills and later took executive action on two others. The committee heard testimony on House Bill 2242, which would let the Department of Health issue immunization recommendations and tie preventive-service coverage to federal recommendations as of June 30, 2025, while preserving access to vaccines and other preventive services. Supporters, including the Governor’s office and the Insurance Commissioner, said the bill would protect access, affordability, and stable vaccine purchasing; opponents argued it politicizes vaccine policy and gives too much influence to state agencies and outside groups. The committee also heard testimony on House Bill 2152, allowing terminally ill patients in hospitals, nursing homes, and hospice facilities to use medical cannabis under facility policies, with supporters emphasizing dignity, symptom relief, and safeguards, and House Bill 2088, joining the dietitian licensure compact, which supporters said would help military spouses, telehealth, and workforce shortages. House Bill 2110, on ambulance inter-facility specialty care transports, drew support from rural hospitals seeking more staffing flexibility and opposition from nurses and EMS personnel concerned about training, accountability, and patient safety. House Bill 2247, on veterinarian-client-patient relationships and telemedicine, drew support from the sponsor and some stakeholders as a workforce and access measure, but also criticism from the state veterinarian and others who said it could conflict with federal VCPR requirements and public health protections. House Bill 2340, expanding substance use disorder monitoring program eligibility to nursing assistants and stipend support, was presented as a way to help low-wage health workers stay in the workforce; there were no in-person testifiers against it. In executive session, the committee considered House Bill 2155, concerning the use of nursing titles, and House Bill 2531, aligning the ambulance transport fund quality assurance fee with federal regulations. Both bills received do-pass recommendations and were sent to the Rules Committee. For the public hearings, no final committee votes were taken on the other bills in this transcript, and testimony concluded on each measure after the committee heard from sponsors, agency officials, advocates, and opponents.

Transcript Highlights:

• </c> Medicare delaying care for our elderly Medicare delaying care for our elderly our<00:46:31.559><
• <01:10:12.520><c> that</c><01:10:12.719><c> first</c> supports that first supports that first portion
• They were supporting their governor.
• They were supporting their governor.
• They were supporting their governor.

Keywords: 1183, house

Transcript Highlights:

• I see a very strong support.
• These are employees who support.
• This will support really good ongoing state work.
• Just common sense, and we can support without.
• And so, I'm happy to support this bill.

Transcript Highlights:

• I am in support of House Bill 369.
• And so, just to wrap up, for those reasons, we support the bill and we support the amendment, and we
• Candidly, it had significant support on my side of the aisle, and it had less support on my side of the
• </c><04:10:13.040><c> in</c> and others who sanctimony support in and others who sanctimony support in
• </c><05:35:01.400><c> living</c> Hampshire wall we should support living Hampshire wall we should support

Keywords: 928, house, all

Summary: The committee first heard House Bill 199, which would extend the statute of limitations for civil actions seeking damages from PFAS contamination from six years to 20 years. The prime sponsor and other supporters argued that PFAS contamination in southern New Hampshire has long-term and often delayed health and property impacts, making the current six-year period too short for victims to discover harm, connect it to exposure, and seek relief. Supporters described contamination in places such as Merrimack and surrounding communities, cited health concerns including cancer, developmental issues, and other illnesses, and said a longer period would better preserve legal rights while still requiring proof of causation. The Department of Environmental Services said it was not taking a position but acknowledged the contamination and ongoing work to address it. The Business and Industry Association opposed the bill, arguing that evidence becomes stale over time, memories and documents fade, and a longer window would make it harder to determine causation when other exposures or intervening factors may be involved. Committee members questioned both sides about causation, the difficulty of proving PFAS-related illness, and whether a 20-year period was necessary if a plaintiff already knows of the injury and its source. Supporters responded that PFAS effects can emerge slowly, that scientific understanding continues to develop, and that current knowledge is still incomplete. Opponents said the existing discovery rule already starts the clock when harm and causal connection are known, and that extending the period would reduce clarity and fairness in litigation. After testimony and questions, the chair closed the hearing on HB 199. The committee then opened House Bill 268 FN, which was described as a technical measure to confirm that the Board of Tax and Land Appeals may hold hearings in its Concord hearing rooms. The sponsor indicated the bill reflects current practice and does not require additional facilities. With only one witness listed and no apparent opposition, the discussion was brief and focused on why the authorization should be placed in statute rather than left to practice.

Transcript Highlights:

• </c><00:02:43.160><c> with</c> long-term services and supports with long-term services and supports with
• </c> and support is unpaid. and support is unpaid.
• . supports. supports.
• </c> support our caregivers. support our caregivers.
• </c> an elderly person to live in? an elderly person to live in?

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board met on September 24, 2025, approved the minutes from the September 9 meeting, and then continued its discussion of Medicaid waivers with Leslie Hoffman and Carmen Hancock from the Department for Medicaid Services. Members asked for updates on the 2024 waiver waitlist management assessment recommendations, including aligning waiver policies, standardizing applications and waitlist placement, and modernizing data systems. DMS said that work is being done jointly with Aging and Independent Living and Behavioral Health/Developmental and Intellectual Disabilities through task forces, that ARPA spending delayed action, and that implementation timelines extend through March 2027. The board also reviewed per-member waiver cost averages for fiscal years 2023 through 2025 for ABI, ABI long-term care, HCBS, Model II, Michelle P, and SCL. DMS emphasized these figures were benefit-only averages based on paid claims, not full waiver costs, and explained that true budget neutrality is calculated on an aggregate basis against institutional care comparisons approved by CMS. DMS said all six waivers remain in compliance with budget neutrality and that the most recent 18-month lag review for FY 2022 and FY 2023 found costs at or below institutional care. Members also asked about unused waiver slots; DMS said slots generally cannot be reallocated mid-year if they have been used, except in cases such as death or reserved capacity, because CMS treats participants as unduplicated for the waiver year. A major portion of the meeting focused on the new child waiver created under House Bill 6. Legislators questioned whether the waiver’s design, including the exclusion of participant-directed services and the emphasis on high-acuity children with behavioral health, DCBS, or juvenile justice involvement, matched the bill’s intent to keep children at home. DMS said it used the $14.7 million appropriated for FY 2026 to develop the program, that there is no priority list, and that the waiver is intended to serve the highest-acuity children while also addressing residential needs for those sleeping in offices or placed out of state. Members also raised concerns about the rapid growth of the HCBS waiting list and asked for more detail on age and timing patterns, which DMS said it would provide later. Finally, DMS gave average processing times from application to eligibility determination and from approval to service start, and said the overall average from application to services beginning was about 80 days, while members requested follow-up information on the Carewise assessment contract and related costs.

Transcript Highlights:

• First up in support. How many do we have in support and opposition? Support, opposition. None.
• Two for support. Okay. Well then next up in support, please step forward. Okay.
• Next up in support. This will be the last five-minute testimony in support.
• Next in support. Please step forward. State your name. Begin when ready. Support.
• How many more do we have in support? You're in support, Chris? Two.

Summary: The Commerce Committee first heard Senate Bill 1020, which would let the Department of Revenue award a Missouri license office contract without rebidding if no qualifying bids are received on the initial solicitation. Senator Sandy Crawford and Director of Revenue Trish Vincent said the change would help keep rural license offices open, reduce repeated bidding delays, and allow the department to work with local entities such as chambers, counties, or cities when smaller offices are hard to staff profitably. Members asked about the process, the challenges in low-volume communities, and whether more online services could eventually reduce the need for offices; no opposition testified, and the hearing concluded without a vote. The committee then took up House Bill 3093, which would extend Missouri’s direct-to-consumer shipping framework from wineries to distillers and breweries. Sponsor Rep. Nick Kimball and many supporters argued the bill would create parity for Missouri craft producers, preserve age-verification and signature requirements, and keep tax collection and other safeguards in place. Supporters included distillers and brewers who said the current system favors wine, limits small Missouri businesses, and makes it harder to reach customers who want products shipped after visiting a taproom or distillery. Several members also raised questions about enforcement, the three-tier system, and whether the bill could be narrowed or paired with other changes. Opponents, including representatives of wholesalers, grocers, convenience stores, and beer wholesalers, argued the bill would weaken the three-tier system, increase competition from out-of-state producers, and create enforcement and tax-collection problems. They said wine shipping has shown compliance and auditing difficulties, cited concerns about underage access and online ordering, and urged the committee to preserve the existing distribution structure or strengthen wine-shipping rules before expanding them. Supporters countered that alcohol shipments are already tightly regulated, that direct shipping is already occurring in other forms, and that the bill would simply add another regulated avenue for Missouri-made beer and spirits. The hearing ended after extensive testimony and questions, with no final committee action reported in the transcript.

Transcript Highlights:

• Johanna Wunderley, parent, here in support. Catherine Wanderley supports.
• Kathlin Wanderley supports. Caprice Schuller, in support.
• Are there any other witnesses in support? Any other witnesses in support? Okay.
• Are there any others in support? Thank you. Are there any others in support?
• I fully support and encourage you to support this bill as well.

Summary: The Assembly Health Committee heard a long agenda of health bills focused on access to preventive care, behavioral health, hospital services, and patient safety. Early items included AB 554, which would expand and protect access to HIV prevention drugs like PrEP, including injectable forms and coverage protections; supporters said it would shore up access amid federal threats, while insurers opposed it as a costly benefit mandate. AB 577 would limit insurer and PBM practices that steer medications away from physician offices and require more transparency and patient consent; doctors and patient advocates supported it, while health plans and insurers warned it could raise drug costs and disrupt specialty pharmacy networks. AB 546 would require coverage for portable HEPA purifiers for vulnerable enrollees during declared emergencies, especially wildfire smoke events, with support from air quality and public health groups and opposition from insurers concerned about benefit expansion and cost. The committee also heard AB 224, which would codify California’s updated essential health benefits benchmark plan after a public review process, adding infertility treatment, hearing aids, and durable medical equipment if approved by CMS for the 2027 plan year. DMHC said the state had completed the review and needed legislation to meet federal timing, and the measure drew broad support. AB 1032 would require plans and insurers to reimburse up to 12 additional behavioral health visits for enrollees in wildfire-affected counties for a limited period after an emergency; supporters argued it would fill gaps in trauma care after disasters, while insurers said existing parity and continuity-of-care rules already address the issue and that the bill could create inequities. AB 849 would require trained chaperones for sensitive ultrasound exams and training on how to observe and intervene; it was backed by a survivor and patient advocates, with hospitals and health districts raising staffing concerns. Later, AB 1196 would direct the Department of Public Health to update outdated rules requiring three surgeons for certain heart surgeries using cardiopulmonary bypass; supporters said the rule no longer reflects modern practice and strains staffing, while cardiology representatives had no formal opposition but wanted to review amendments. AB 1113 would codify a right to wear a mask for health reasons in public spaces, with support from disability and public health groups. AB 1386 sought to add perinatal care to the list of basic hospital services, prompting testimony about maternity ward closures, workforce shortages, and rural access; the author said the bill would be amended further and that the committee would need to revisit timelines and implementation details. The committee also heard AB 1429, which would address Kaiser’s repeated mental health parity violations and improve access to behavioral health care, though the transcript cuts off before any action on that bill is shown. Several bills were moved with motions and seconds, but many were held for quorum; AB 1196, AB 1113, and AB 1386 were among the measures advanced to a roll call or held on call, and the committee repeatedly noted that final votes would occur when quorum was available.