Transcript Highlights:

• We have contracted services, which include daycare, family services, and substance use treatment services
• Those services are delivered through fee-for-service.
• on those services.
• what services were delivered. service occurred; the date of that service; the time the visit started
• The services are based on that service plan and do vary by waiver.

Keywords: 1184, house, all

Transcript Highlights:

• services or CART providers, and we provide those referral services for them.
• The social services program also provides services to children, birth to 13.
• The social services program also provides services to children, birth to 13.
• The other area that we provide services in is vocational rehabilitation services. These services...
• Protective services.

Keywords: 995, all

Summary: The hearing was an informational and oversight session of the Joint Committee on Children, Families, and Persons with Disabilities, with chairs and members hearing agency updates from several commissioners. The Department of Public Health’s Bureau of Family Health and Nutrition described its maternal and child health work, including home visiting, early intervention, WIC, newborn hearing screening, and cross-agency efforts on prenatal substance exposure, respite care, children’s vision, and maternal health initiatives. DPH emphasized that federal grant cuts, layoffs, and the loss of data systems such as PRAMS would weaken services and planning, and members asked about Title V funding and the impact of federal uncertainty. The Massachusetts Commission on the Deaf and Hard of Hearing highlighted communication access services, interpreter and CART referrals, emergency after-hours support, family navigation, and independent living services. Commissioners and members discussed the shortage of ASL interpreters and the need to expand training pipelines, including partnerships with colleges and possible ASL programming for younger students. The Department of Developmental Services reported serving nearly 50,000 people and focused on youth and adult services, transition-age supports, autism services, self-direction, respite, and new high-acuity residential models. Members asked about respite availability, self-direction outcomes, and workforce shortages; DDS said it was expanding clinical capacity and provider rates while monitoring possible federal Medicaid, SNAP, and immigration-related impacts. The Commission for the Blind described services for about 28,000 legally blind residents, most of whom are older adults, including social rehabilitation, orientation and mobility training, children’s services, assistive technology, vocational rehabilitation, and Turning 22 supports. The commissioner discussed a UMass-based effort to build the workforce pipeline for blindness services and said the agency was watching federal restructuring but had not yet seen direct cuts. MassAbility’s leadership then warned about major federal changes affecting Social Security disability determinations, including staff restructuring, office closures, and a new overpayment repayment policy, and said the agency was preparing for possible increases in claims and uncertainty around reallotment dollars that help fund services. The Disabled Persons Protection Commission closed the hearing with an update on its abuse investigations and protective services for adults with disabilities. DPPC reported rising hotline calls and investigations, a growing caseload, its sexual assault response team, the abuser registry, and a new interagency protective services integration system funded by ARPA dollars through 2027. The agency also flagged new federal rules that could affect funding eligibility and said it may need statutory changes to comply. Members asked about funding, reporting pathways, and how complaints reach DPPC, and the commissioner said the agency uses both mandated reporting and proactive outreach to identify and respond to abuse.

Transcript Highlights:

• We offer various services, and I would point out that many of these services are not covered by Medicare
• We offer various services, and many of these services are not covered by Medicare, nor are they covered
• for providers offering specific Services for providers offering specific Services if<00:13:21.160
• through our state plan services.
• says if your services are services says if your services are covered<00:36:29.160> in<00:36:29.280

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services met with a quorum still coming together and first handled roll call and minutes. The main presentation came from the Department for Medicaid Services, with Commissioner Lisa Lee and CFO Steve Beckle giving an overview of Kentucky Medicaid, its federal-state financing structure, and the department’s 1915(c) home- and community-based waiver programs. They explained FMAP funding levels for traditional Medicaid, administration, IT, expansion adults, and CHIP, and noted the size of the program, including more than 600,000 Kentucky children eligible for Medicaid or CHIP, about 485,000 expansion adults, over 69,000 enrolled providers, and $18.5 billion in 2024 expenditures. A major focus was the waiver system, including the acquired brain injury waivers, model waiver, independence waiver, Michelle P. waiver, and Supports for Community Living waiver. The department said these waivers are intended to keep people with physical or developmental disabilities in home and community settings rather than facilities, and that many services are not covered by Medicare or commercial insurance. Officials described participant-directed services, interagency administration, and eligibility rules, including that some waiver programs use the child’s income only rather than family income. They also reported an unduplicated waiver wait list of 13,930 people and said the General Assembly had added waiver slots in the last budget, including 650 ABI slots and 1,275 more to be allocated July 1, 2025. The department also discussed a waiver rate study conducted by Guidehouse, explaining that CMS requires a defensible rate methodology because there is no Medicare or commercial benchmark for many waiver services. They said the study used cost and wage surveys, provider and stakeholder input, and aimed to improve transparency, provider stability, and rate parity. Officials reviewed prior COVID-era Appendix K rate increases and budget-driven increases, and said the budget ultimately funded rates at about 70% of the benchmark study, while preserving higher existing rates where needed so no provider would be cut. They highlighted larger differences in behavioral support and case management rates, and said a public report is available. Members asked several questions about the potential impact of federal FMAP changes, especially possible reductions in the enhanced match for expansion adults and Medicaid IT/admin activities. DMS said any FMAP reduction would require more state general fund dollars, estimating about $75 million for each 1% drop in the expansion match, while impacts on administrative IT funding would depend on the systems being built or implemented in a given year. Members also pressed for clarification on waiver wait-list procedures, funded versus filled slots, and what happens when someone on the wait list is later found ineligible. DMS said people on the wait list may not yet have been assessed, can be reevaluated if conditions change, and are still eligible for regular Medicaid state-plan services if they qualify, even if they are waiting for waiver services.

Transcript Highlights:

• , CalFresh, CalWORKs, General Assistance, Adult Protective Services, In-Home Supportive Services, and
• , CalFresh, Cal Works, General Assistance, Adult Protective Services, In-Home Supportive Services, and
• We rely on CSBG funding services.
• in those services.
• CSBG also allows us to offer support services and wraparound services to our enrolled customers.

Summary: The Senate and Assembly Human Services Committees held a special oversight hearing on California’s 2026-27 Community Services Block Grant (CSBG) state plan, a federal anti-poverty funding stream. Committee members opened by citing statewide poverty and homelessness data and said the hearing was meant to review how CSBG dollars are used, how local agencies respond to community needs, and how the state is preparing for possible federal funding cuts. Jason Wimbley of the Department of Community Services and Development (CSD) explained that California’s CSBG network works through 60 organizations in 58 counties, serving about 1.5 million low-income Californians in 2023, and that the state received $68.4 million in federal CSBG funds in fiscal year 2025. He described the program as flexible funding used for housing, employment, education, food, health, transportation, and emergency response, and noted that the federal administration had proposed eliminating CSBG, though the Senate Appropriations Committee had voted to fully fund it for the coming year. Representatives from the California Community Action Partnership Association and several CSBG-funded agencies described how the program supports local anti-poverty work and leverages other funding. CalCAPA emphasized local flexibility, workforce development, partnerships, and data systems such as ROMA, while also warning that agencies are preparing for possible reductions by tightening budgets, planning staffing contingencies, and seeking private foundation support. Agency witnesses from Contra Costa County, Northern California Indian Development Council, Proteus, and Sacred Heart Community Service described services including housing assistance, food distribution, utility help, employment training, youth programs, and culturally specific services for Native communities and migrant farmworkers. They repeatedly said CSBG is essential because it funds staffing and infrastructure that allow them to braid other grants and serve people who do not qualify for standard safety-net programs. Members also asked about the impact of federal staffing changes and the Los Angeles fires. Wimbley said federal layoffs had affected some CSD programs but not CSBG administration, and that the department coordinated disaster response with state agencies and used CSBG-funded supply distribution, food, water, clothing, and documentation support during the fires. Witnesses said they were preparing for possible future cuts by diversifying funding, reducing expenses, and considering service changes, while county officials warned that state and federal reductions could not be backfilled locally. During public comment, one speaker urged stronger oversight of community action agencies and raised concerns about transparency and compliance with state law. The chair then thanked the witnesses, emphasized the importance of CSBG for low-income seniors, youth, and people with disabilities, and adjourned the hearing without any votes or formal action taken.

Transcript Highlights:

• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.
• They brought that service in.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to behavioral health as the main topic. Representatives Woodridge and Vaught described the work of the behavioral health working group, saying Arkansas needs a more proactive system that improves access, reduces red tape, and focuses on a few achievable policy changes for the 2027 session rather than many bills. Members discussed barriers such as low reimbursement, workforce shortages, licensing and credentialing hurdles, rural access problems, and the need to better use community providers, compacts, and step-down services. Director Paula Stone of DHS’s Office of Substance Abuse and Mental Health gave a detailed overview of the behavioral health system. She said Medicaid pays for more than 75% of behavioral health services in Arkansas and explained that when people are jailed or admitted to the state hospital, Medicaid generally stops, leaving state general revenue to cover care. She described current efforts including family-centered treatment for children, community reintegration group homes, a new adolescent substance use disorder residential unit, expanded community mental health center contracts, a secured restoration unit to reduce state hospital backlogs, and an IMD waiver to allow Medicaid payment for certain residential services. She also said DHS is working on crisis services, forensic evaluations, and provider rebidding in areas previously served by ERISA. Members asked about reimbursement for jail services, the lack of a statewide behavioral health dashboard, civil commitment options, crisis stabilization units, and whether Arkansas should expand step-down or long-term facilities for people who cannot safely return to the community. Stone said the state hospital backlog remains significant, average stays are still about 14 months, and crisis stabilization units have had mixed success, with Fort Smith and Jonesboro performing better than Fayetteville and Little Rock. The meeting ended with a commitment to continue the work, with more substantive discussion planned for August.

Transcript Highlights:

• Business services supported residential services.
• for your phone service.
• , not just to voice service.
• service standards, right?
• or improve their service.

Keywords: 988, house, all

Transcript Highlights:

• Services, and the Bureau of Family-Centered Services.
• 15% for uh developmental Services 15% for uh developmental services<00:07:57.120> and services
• <00:15:08.959> let for services um funding for services let for services um funding for services
• services in the community.
• those Services um the the major service those Services um the the major service types<01:37:17.119

Keywords: 928, house, all

Summary: The Division of Long-Term Supports and Services presented its budget and program overview as part of the Department of Health and Human Services operating budget review. Leadership described the division’s three bureaus—Aging and Adult Services, Developmental Services, and Family-Centered Services—and explained that the division provides guidance, technical assistance, quality monitoring, and contracted provider oversight across the lifespan. Members also discussed staffing, with reported vacancy rates of 4% in Aging and Adult Services, 15% in Developmental Services, and 6% in Family-Centered Services; the division said the higher BDS vacancy rate is partly due to the small number of authorized positions. The governor’s budget had left eight positions unfunded in the division, including three in Aging and Adult Services and five in BDS. A major topic was the division’s roadmap initiatives, especially building a system of care for healthy aging and strengthening developmental disabilities systems through a new reimbursement rate structure. The division said it contracted with an actuary to study DD service costs and found rates had not been reviewed since 2017 and were significantly below actual costs and other states’ rates, contributing to provider shortages even when services are authorized. Members asked about the impact on service delivery and whether rates would need to rise overall; the division said its strategy is to focus on lower-cost services that help people remain in the community. The division also reported waiver enrollment figures, including about 4,161 people on the Choices for Independence waiver, 3,688 average nursing facility residents, 5,061 people on the DD waiver, 228 on the acquired brain disorder waiver, and 488 children on the in-home support waiver, while noting there is no funding waitlist but provider availability remains a constraint. The division highlighted IT modernization as a major accomplishment, especially moving Adult Protective Services and Developmental Services into the New Heights system. Officials said these changes improve case-note access, data retrieval, service authorization tracking, and transparency for providers, and they asked for future oversight discussion focused on IT leverage. Members noted that New Heights maintenance is budgeted in the Office of the Commissioner under class 27 and suggested better transparency on system costs and benefits. The division also reported that it closed out a long-running CMS corrective action plan for BDS on July 1, 2023, and said it is now focused on strengthening the system rather than compliance alone. Other discussion covered the Aging and Adult Services bureau’s name change from Elderly and Adult Services to Adult and Aging Services, intended to avoid negative connotations and better reflect preventative services. The bureau described Adult Protective Services trends involving scams, financial exploitation, self-neglect, and isolation, and explained that it administers the CFI waiver, determines medical eligibility for nursing facility level of care, and braids funding from Medicaid, state funds, Older Americans Act money, Social Service Block Grants, and other grants. Members asked about waiver growth targets and federal consequences if enrollment remains below projections; the division said it would explain the shortfall in a future waiver amendment and did not anticipate a federal penalty. The meeting ended without any votes or formal actions taken.

Transcript Highlights:

• And so that's a step-down service.
• They provide a service called restoration, but then they also provide some services.
• So here are our adult services.
• So we'll be able to provide that service and pay for that service for individuals.
• services manual.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to a broad discussion of behavioral health policy, taking up work previously handled by a behavioral health working group. Representatives Wooldridge and Vaught described major gaps in Arkansas behavioral health care, emphasizing access problems, workforce shortages, rural service barriers, low reimbursement, and the need to move from a reactive crisis system to more proactive community-based care. Members discussed possible 2027-session priorities such as reducing red tape, improving provider licensing and supervision pathways, expanding billing codes and reimbursement structures, and considering interstate compacts and other workforce fixes. A major focus was the state’s crisis and forensic system, including long waits for competency evaluations, the backlog at the Arkansas State Hospital, and the use of county jails for people awaiting treatment. DHS Director Paula Stone explained that Medicaid pays for most behavioral health services, but cannot pay for services in jails or state hospitals because those individuals are treated as inmates of public institutions, leaving state general revenue to cover much of that cost. She outlined DHS efforts including secured restoration beds, therapeutic communities, community mental health center contracts for jail-based services, and plans for an institution-for-mental-disease waiver that could allow Medicaid payment for certain hospital-based services. Members also discussed crisis stabilization units, with DHS noting that Fort Smith and Jonesboro have been more successful than Fayetteville and Little Rock, largely because of location, partnerships, and law enforcement coordination. Questions covered reimbursement for county jails, step-down facilities, civil commitment options, non-emergency behavioral health transportation, and whether DHS should create a bed-availability dashboard similar to hospital systems. DHS said it does not currently have such a dashboard but is exploring the idea. The meeting ended with a commitment to continue the work, with more detailed discussion planned for August, and the subcommittee adjourned.

Transcript Highlights:

• This service amounts to nearly 77% of Southwest Transit's local service.
• service, as well. service, as well.
• , yet we were not receiving service, yet we were not receiving service. service. service.
• Transportation Services. Transportation Services.
• That service coverage continuity that maintains substantially similar transit service routes and service

Keywords: 1183, house

Transcript Highlights:

• Who are receiving services.
• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.

Keywords: 1204, all

Transcript Highlights:

• So our Consumer Services Department... So our Consumer Services Department. Good morning.
• covers our transition services.
• We use the integrated service model. We use the integrated service model.
• The same services.
• We provided the same services.

Keywords: 977, all

Summary: The committee met to receive a detailed financial operations presentation from the South Carolina Vocational Rehabilitation (VR) agency, with staff walking members through funding sources, budgeting, accounts receivable, accounts payable, and grants management. Sabrina Walker explained VR’s blended funding structure, including federal grants, state appropriations, program income, and interagency contracts, and emphasized that state funds are essential to meeting the federal match and maintenance-of-effort requirements. Members asked repeatedly about transparency, audit controls, and the risk that state cuts could reduce federal drawdowns; staff responded that all reports reconcile back to the SCEIS accounting system, are subject to state audits and internal reviews, and that even modest state reductions could significantly reduce total available funding. The committee also discussed pre-employment transition services for students with disabilities, with staff confirming services are offered through school districts, charters, and private schools, and that contracts are monitored for performance and compliance. The presentation then shifted to budgeting and internal controls. Walker described a zero-based departmental budgeting process, monthly monitoring reports, contingency reserves for unexpected expenses, and a formal annual cycle that culminates in board approval. Members asked about facilities tracking, culture, and how the agency maintains accountability; staff said facilities staff inspect buildings and equipment, supervisors justify line-item requests, and the process has become smoother over time as departments learned the system. Cynthia Johnson followed with an accounts receivable overview, describing invoicing, receipting, aging, customer verification, year-end reporting, and the use of cross-training, shared email inboxes, and spreadsheets as checks and balances. She also explained work training center billing, interdepartmental transfers, and the revolving fund used to issue consumer checks more quickly than standard vendor payments. Olivia Perez presented accounts payable operations, including invoice processing through SCEIS and OnBase, the three-way match, travel reimbursements, revolving fund checks, State Treasury Office interactions, and handling of reversals, rejections, and levy notices. She reported that AP processed 67,723 SCEIS payments, 13,670 case management system invoices, 3,379 travel reimbursements, and 15,693 revolving fund checks in fiscal year 2025, with only 70 payment rejections. The final portion of the meeting covered Grants and Funds Management, where Walker explained federal reporting, drawdowns, payroll allocation, asset tracking, lease and IT contract reviews, cost allocation, and closing packages. She noted upcoming system changes such as S/4HANA, Workiva, and SC Pro, but said the agency is receiving training and feedback opportunities. No formal votes or legislative actions were taken during the presentation portion beyond approval of the prior minutes and a brief recess.

Transcript Highlights:

• They're very different services. Uh bus. They're very different services.
• Contracted services cost sometimes less than directly operated service.
• > service<00:35:36.240> level<00:35:36.560> increased the service the service level
• . service. service.
• mobility service service requires mobility service associated<00:46:56.319> with<00:46:56.480

Keywords: 919, house, all

Summary: The committee heard a Met Council report from Charles Carlson on high-subsidy transit route analysis required by the transportation bill. Carlson explained that the study uses per-passenger operating subsidy, compares routes by type and service day, and is intended to help providers improve cost-effectiveness while recognizing transit’s importance for access, affordability, safety, and the region’s economy. He noted that routes more than 60% above peer averages are considered the highest-subsidy tier, and that the report also estimates the cost of Metro Mobility associated with those routes. Members asked several questions about why contracted service can cost less than directly operated service, whether contracting affects wages, union membership, or service quality, and why the Met Council targets about 20% of regular route service for contracting. Carlson said contracted service can be cheaper because of lower overhead and other market factors, that the council sets minimum wage and service-quality requirements in contracts, and that customers should not notice a quality difference. He also said the 20% target is meant to balance cost-effective service, geography, and a mix of providers, and that some routes may become more cost-effective with more frequent service depending on local demand. Carlson reported that in 2024, 206 of 264 routes met guidelines, 16 were in the lowest intervention tier, 14 in the middle tier, and 28 were in the highest-subsidy tier. He said the regional share of high-subsidy service was about 4.1%, but the share varied widely by provider, with some at 0% and others much higher. He estimated that discontinuing the highest-subsidy routes would save about $23 million annually and up to $72 million in capital costs. For Metro Mobility, he said the cost associated with trips tied to high-subsidy routes rose from about $368,000 in 2023 to about $6.1 million in 2024, largely because the mix of routes triggering federally mandated paratransit service changed, especially in the Shakopee area.

Transcript Highlights:

• elderly disabled waiver Services elderly disabled waiver Services Alternative<00:04:58.120> Care
• But those services are tied to people who are using those services to stay on the planet, and as the
• > Services DHS Human Services DHS Human Services programs<00:32:09.080> chapter programs
• <00:33:36.399> and Services related to service planning and Services related to service planning
• uh the regional service centers Services uh the regional service centers and<00:35:31.760> the

Keywords: 1183, house

Transcript Highlights:

• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Services, Independent Living Services.
• Legal services. Administrative law judge services. Payment to risk management services.

Keywords: 981, all

Transcript Highlights:

• Services, deviated Fix Route Services, complimentary Americans with Disabilities Act.
• They cannot be denied service. They must be meet delivered service, all trips.
• for ADA services.
• And a door-to-door service can really slow down the service and that actually time equals money.
• But the demand of services also do that. This is just typical service quality.

Keywords: 999, senate, all

Transcript Highlights:

• . services. services.
• Services, right? Services, right?
• services to people? services to people?
• . services. services.
• episode of services. episode of services.

Keywords: 1187, senate, all

Transcript Highlights:

• APD will reimburse for the waiver services on a fee-for-service basis.
• APD will reimburse for the waiver services on a fee-for-service basis.
• service network.
• And those services can consist of medical services or long-term care kind of home health services or
• services, residential services, a variety of things.

Summary: The Health and Human Services Committee received an overview of Florida’s intellectual and developmental disabilities (IDD) managed care pilot, created by legislation in 2023 to test whether a managed care model could integrate Medicaid medical services with iBudget waiver home- and community-based services for adults in pre-enrollment categories. AHCA explained the existing system, the pilot’s scope in Regions D and I, and the rollout timeline, including federal approval, contract execution with Florida Community Care, and the October 2024 go-live. Officials reported that, as of early February, 370 individuals had been sent for onboarding and 168 more were in queue, with about $35.8 million of the appropriation remaining. APD also clarified the difference between the pre-enrollment categories and the waiver waitlist, and noted that crisis cases can be enrolled more quickly depending on eligibility and funding. Florida Community Care described the pilot as a comprehensive managed care model offering medical, long-term care, and iBudget services, plus enhanced benefits such as bed-hold days, caregiver transportation, and help with legal guardianship costs. The plan said it uses one care coordinator, a 1:18 coordinator ratio, a face-to-face assessment within five days of enrollment, and 180 days of continuity of care for existing providers. The company emphasized that it is recruiting providers by offering higher rates than some iBudget rates, lower administrative burden, and network adequacy incentives, while APD said it continues to monitor provider supply and demand and recruit across service types and regions. Members repeatedly questioned whether the pilot’s costs, provider rates, and service levels were truly comparable to the iBudget system, and AHCA and APD said it was too early to draw firm conclusions because claims data are still lagging. Committee members also raised concerns about communication, enrollment delays, provider shortages, and whether the pilot could scale statewide. APD said it has used letters, phone calls, texts, emails, and community meetings to reach eligible individuals, and that some delays stem from required assessments, Medicaid eligibility checks, and level-of-care determinations. Several members asked for more detailed comparisons of costs and provider reimbursement between the pilot and iBudget, and APD said it would provide additional data. Public testimony at the end was strongly critical of managed care, with a participant and his mother describing poor service, transportation failures, and loss of control under prior managed care arrangements, and urging the committee not to expand such a model without safeguards. No votes or formal committee action were taken before adjournment.

Transcript Highlights:

• Services.
• . services. services.
• service permitted per day in the service service permitted per day in the service uh<00:39:59.440
• Human Services. Human Services.
• . services. services.

Keywords: 1183, house

Transcript Highlights:

• They are service providers, right?
• Service is awesome.
• Service is awesome.
• services.
• It does include congregate meal services, caregiver support services, etc.

Keywords: 912, senate, all

Summary: The Committee on Health and Human Services held an informational briefing on Kupuna Care funding, distribution, utilization, and the status of program rules. The Office of Aging explained that state Kupuna Care funds are distributed using the same federally approved interstate funding formula used for Older Americans Act funds, with eight weighted factors tailored to Hawaii’s conditions: older adults, greatest economic need, low-income minority status, disability, language barriers, geographic isolation, inverse population density, and older adults living alone in poverty. The department said the formula is based on census and American Community Survey data, with current county shares listed as Kauai 7.45%, Honolulu 69.61%, Maui 11.7%, and Hawaii County 17.88%. Officials said the formula is being reviewed with current data and will need federal approval and then public hearing before final adoption. Members questioned how the program works in practice, noting that the statute and eligibility language can sound like direct individual benefits even though services are delivered through area agencies on aging, ADRCs, and contracted providers such as meal and adult day care programs. The Office of Aging said ADRCs determine eligibility and then refer clients to authorized providers, who must meet service standards in their contracts. The chair pressed repeatedly for long-delayed rules, saying the Legislature had expected them years earlier and that clear rules are needed to ensure funds are spent properly and to avoid conflicts of interest. The department acknowledged the delay, said draft rules were written in 2023 after earlier commitments to finish sooner, and said it paused while federal Older Americans Act rules were being updated; it now expects to send the rules to the Deputy Attorney General, then out for public hearing, with a goal of completion in 2025. The department also reported utilization data for the last two fiscal years. In 2023, it expended about 93% of its allocation and served 5,473 older adults at an average annual cost of $1,358; in 2024, it expended about 97% and served 5,520 older adults, with the average cost down by about $200, which officials said may indicate fewer services per person. Eligibility was described as age 60 or older, U.S. citizen or qualified alien, with cognitive impairment or disability and functional deficits, and the statewide profile showed many participants were homebound, living alone, or below poverty. The most-used services were transportation, case management, and home-delivered meals. The chair also asked about the former Kupuna caregiver program; officials said the programs are now combined under Kupuna Care, with most funding going to adult day care to provide respite for working caregivers. County representatives then described local conditions, especially on Hawaii Island. Hawaii County officials said the county covers about 5,000 square miles, has about 208,000 residents, and roughly 24% are age 65 or older. They identified three main challenges: staffing shortages and retention problems among providers, shortages within the county department itself, and the loss of adult day care capacity, with only one center remaining on the island and none on the west side. They said these constraints limit service delivery even as demand grows. At the same time, they highlighted successes such as serving people in the community before they need higher levels of care, providing caregiver counseling and training through adult day care, serving 467 individuals locally, and ensuring the Resource Center answers calls from caregivers seeking help.

Transcript Highlights:

• So this is a state plan service.
• So this is a state plan service.
• So this is a state plan service.
• and other supportive services such as social work services.
• :28.040> we Services such as Social Work Services we Services such as Social Work Services we

Keywords: 1187, senate, all

Summary: The committee heard a presentation from DHS on its early intensive developmental and behavioral intervention (EIDBI) study and related licensing proposal. Christy Grom explained that EIDBI is a Medical Assistance state plan service for children and young adults under 21 with autism or related conditions, and that DHS’s multi-phase evaluation included standards review, community engagement, and a comparison with other states. She said the service is important but that DHS identified gaps in oversight, including stretched clinical supervision, providers affiliated with many centers, out-of-state providers, and rapid growth in enrollment that has outpaced current monitoring capacity. DHS’s main recommendation was to create a provisional license for EIDBI in Chapter 245A as an immediate step, with later work toward full licensing standards. The proposal would let DHS identify controlling individuals, disqualify ineligible people, investigate maltreatment, suspend or revoke licenses, require background studies and qualifications before service delivery, move EIDBI providers into a higher-risk category for revalidation, and make DHS the lead investigative agency for maltreatment. DHS also recommended statutory standards for supervision, caseloads, training, and documentation, while emphasizing the need to balance oversight with continued access to services. Grom said the provisional licensure proposal is part of the governor’s budget and that DHS hopes to begin implementation in 2025, with a possible full license start date in 2028. Testifiers then spoke in support of EIDBI while urging the committee to preserve access and include more community input. Ana Hagi Muhammad, a parent of three autistic children and a Somali community advocate, said EIDBI has been beneficial for her family and that community organizations serving Somali families have not been sufficiently engaged in DHS’s process. Ana Muhammad, a Black mother of a young autistic child, said ABA has helped her son with communication, self-regulation, and independence, and asked that discussions reflect the diversity of family experiences. Committee members asked testifiers to keep remarks brief and to identify which modality they use, and the chair indicated the committee would continue hearing from additional testifiers before further discussion.