Transcript Highlights:

• Number 2 specific services are provided by the program.
• But we also have parents services and then those parents services.
• There's also provide consultations, technical assistance, pre service in-service training for families
• that those services are not being diminished in with the services that would be provide in in the panhandle
• These services will provide the services to families.

Keywords: 999, senate, all

Transcript Highlights:

• Future planning included enhanced re-entry services which links individuals to post-release services.
• We don't have some of those wraparound counseling services.
• Education services. So they certainly could be eligible for all of those services.
• School nurses do IEP related services, which are federally mandated services, that kids are eligible
• Thank you all for your service to New Mexicans.

Transcript Highlights:

• We provide Emergency Welfare Services, SNAP, TANF, Child Support, Child Care, Adult Protective Services
• , and Child Welfare Services.
• Again, we focus on emergency services as well. ...and again, the Emergency Welfare Services SNAP program
• Crisis stabilization services.
• Need as far as mental health services or proper education services.

Keywords: 924, joint, all

Transcript Highlights:

• So let's talk about our services.
• and the health services that they need?”
• and the health services that they need.
• when there's time for services, et cetera.
• when there's time for services, et cetera.

Summary: The Senate Committee on Children, Families, and Elder Affairs held a panel discussion on Florida’s child protection teams (CPTs), child advocacy centers (CACs), and the related roles of DCF, DOH, and law enforcement. Testimony from DCF, the Department of Health, a local CAC director, the Florida Network of Children’s Advocacy Centers, a Pinellas County CPT nurse practitioner, and a Jacksonville sheriff’s sergeant described how the system is intended to work: hotline reports are screened by DCF, mandatory referrals are sent to CPT, forensic interviews and medical exams are coordinated through CPT/CACs, and multidisciplinary teams share findings with law enforcement and prosecutors. Speakers emphasized the value of co-location, telemedicine, multidisciplinary staffings, and trauma-informed practices to reduce repeated interviews and improve child safety and case outcomes. Committee members focused heavily on communication breakdowns, staffing shortages, and delays in response times. Senators raised Jordan’s Law and asked what had been done to improve coordination among DCF, CPT, and law enforcement. Several members questioned whether the promised 24-hour response standard is being met in practice, citing reports of delayed referrals, delayed forensic interviews, and bottlenecks that can affect medical evaluations and criminal investigations. Law enforcement testimony from Jacksonville described cases where CPT interviews were scheduled one to two weeks out and reports were not received for weeks, while DCF acknowledged average CPI caseloads of about 12 investigations and turnover commonly occurring within 12 to 18 months. The panel also discussed access gaps and funding concerns. The Florida Network of CACs said Florida has 26 member centers, with some counties lacking CAC coverage and some centers having closed due to funding challenges. Speakers said CACs are voluntary but critical for integrated services, and that workforce shortages in medical and mental health providers limit expansion. DCF and DOH representatives said they would provide follow-up information on the number of CPT medical staff and other requested data. No bills were voted on; the meeting ended with committee members requesting additional information and recommendations for statutory and budgetary changes, and the committee adjourned.

Transcript Highlights:

• I have seen them firsthand conduct the memorial service or their portion at memorial services for nurses
• I've seen them in that service.
• I have seen them firsthand conduct the memorial service.
• I have seen them firsthand conduct the memorial service or their portion at memorial services for nurses
• I've seen them in that service.

Keywords: 1204, all

Transcript Highlights:

• They provide some reentry services for parolees as well.
• We provide more case management and reentry services.
• In 2009, we serviced 510... About 2009.
• “What in-service training do you undergo?
• And so we... ...in reentry and service provision. So that’s more of an in-service training.

Keywords: 995, all

Summary: The Special Commission on Correctional Consolidation and Collaboration met on June 15 with co-chairs Senator Will Brownsberger and Representative Dan Hunt. After deciding not to approve prior meeting summary notes at this session, the commission heard testimony from the Massachusetts Parole Officers Association (Brian Lucier and Shauna Hawksley). They described parole officers’ work in both institutions and the community, including housing, mental health, substance use, employment, education, and benefits referrals, and argued that parole officers often know local service providers best. They also said the former reentry navigator positions were lost in 2025 and that regional reentry centers used in the past helped reduce duplication and improve information sharing; they urged more funding, staffing, and training, and said parole should be better integrated with MPTC/POST training and with community-based reentry resources. Commission members asked about the relationship between parole and Community Justice Support Centers, training and arrest authority, revocation practices, and coordination with sheriffs and the Department of Correction. The witnesses said CJSC access is limited by location, transportation, and scheduling, while parole’s older reentry centers were referral-based and did not require regular attendance. They also said parole officers are special state police officers with arrest authority, receive a parole-specific academy plus firearms/defensive tactics/first responder training, and would benefit from more formal reentry training. On revocations, they said they lacked data but believed parole now returns fewer people for mental health or first-time substance use issues and focuses more on public safety threats. They also said collaboration with sheriffs and DOC reentry staff is generally good but still suffers from duplicative referrals and last-minute changes that can undo work done inside facilities. After testimony, the commission discussed next steps, including extending its reporting deadline from September 30 to November 30 through the pending budget, finishing remaining DOC facility visits in the fall, and holding additional meetings on mental health and other unresolved issues. Members also discussed whether to seek more input from the judiciary and district attorneys, with agreement to continue outreach and document responses. The meeting ended with a motion to adjourn, and the commission indicated it would reconvene in the fall.

Transcript Highlights:

• attorney or one firm rendering services. attorney or one firm rendering services.
• personal services contract green list. personal services contract green list.
• administrative service. administrative service.
• Based Services. Based Services. >> Okay. >> Okay. >> Okay.
• Administrative Services. Administrative Services.

Keywords: 958, all

Summary: The committee first approved the September 19 meeting minutes and then took up a deferred University of Kentucky personal services contract amendment for guardianship services. UK officials explained that the contract covers court-appointed guardians for patients who cannot make medical decisions and are not eligible for state guardianship, with the work funded by UK Medical Center agency dollars rather than the general fund. Members questioned the large increase in the not-to-exceed amount, the number of cases, the hourly billing structure, and whether there are safeguards to prevent unnecessary costs or reimbursement issues if a patient later has resources. UK said the increase reflects shifting work from a prior firm, anticipated new cases, a move from a monthly fee to hourly billing, and the need for a second firm because one prior attorney died and another firm has had difficulty appearing in court promptly. The committee ultimately approved the contract, while Senator Thomas said he would vote aye but urged future review of attorney fee limits and broader guardianship statutes, which he described as outdated and inconsistent. The committee then deferred three Office of Energy Policy memorandum of agreement items to the November 2025 meeting without objection. After that, it approved the remaining agenda items, including the contract lists and deferred items not separately selected for review. The final major item was a University of Kentucky personal services contract related to fundraising and philanthropic outreach. UK representatives said the contract supports marketing and donor engagement efforts to grow the university’s endowment pipeline and philanthropic support. The transcript cuts off before the committee finished its questions or took final action on that item.

Transcript Highlights:

• The next unit is the security services unit.
• Lastly, the last group is the Florida State Fire Service.
• Years of service?
• I represent security services.
• The time of service would have to be within the bargaining unit.

Summary: The Joint Select Committee on Collective Bargaining met to hear impasse presentations from the Department of Management Services and several bargaining units. The department reported that most articles had been resolved in each of the full-book contracts, with remaining disputes centered largely on wages and a handful of non-economic issues. For the FDLE special agents, security services, law enforcement, Florida Highway Patrol, and Florida State Fire Service units, the state described its wage offers as generally a 2% competitive increase plus a 3% special pay increase, along with various bonuses, retention funds, or career-development funding in some units. The department also said it wanted to keep existing language on work schedules, seniority, grooming, equipment, grievance procedures, and other items, often characterizing its changes as housekeeping or alignment with current practice. The department noted that insurance had been agreed to with no increased employee cost, and it confirmed that correctional officers do receive overtime pay. Representatives for the Florida State Fire Service Association strongly disputed the state’s position, arguing that firefighters should not be required to perform major construction work, that their work schedules and on-call/callback arrangements unfairly suppress overtime, and that wildfire and fire-rescue employees are underpaid and underprotected. They also pressed for better compensation for EMT/paramedic-certified firefighters, additional protective clothing, on-site decontamination and shower/laundry facilities, and stronger cancer-prevention language. The association said the state had not bargained in good faith and urged the committee to support the union’s proposals. The Police Benevolent Association’s Florida Highway Patrol unit focused on wages and a career development plan, saying troopers remain underpaid compared with other states and are leaving for better-paying agencies. It also sought a veteran stipend, broader grooming/tattoo language, safety improvements for high-mileage vehicles, and changes to seniority and inflation-related pay. The PBA law enforcement unit raised similar safety concerns about aging vehicles, sought limits on performance evaluations tied to case presentations, and requested a $7,000 across-the-board wage increase. The security services unit, representing correctional officers, probation officers, and ISS officers, said its main issue was wages and asked for an $8-per-hour starting pay increase, retention bonuses, special pay for death row and close-management staff, added pay for SOTEC officers, and overtime pay for lieutenants and captains who currently receive comp time instead. No votes were taken, no public testimony followed, and the committee adjourned after taking the presentations under advisement.

Transcript Highlights:

• 78 service providers as our member providers.
• And then it says available service for seniors in Arkansas here.
• Well, I guess not children's service, but all these services are available to everybody, including any
• The birthday passes, and then we miss out on services.
• So I've always understood that to be a function of the services, the diagnostic services that kind of

Summary: The Arkansas Legislative Autism Task Force approved the April 1, 2026 meeting minutes and discussed several vacant membership slots, including positions tied to the Arkansas Psychology Board, Arkansas Blue Cross Blue Shield, UAMS, and parent or guardian appointments. Members said they would try to fill the vacancies and, if not, include the issue in the legislative report and consider statutory changes in the next General Assembly. The task force then heard from the Developmental Disabilities Provider Association and Civitan Services about DDPA’s role in supporting 80 provider organizations serving more than 13,000 children and adults with intellectual and developmental disabilities across 75 counties. They described services such as early intervention day programs, adult day programs, supported employment, intermediate care facilities, work activities, and community/residential waiver services, and said autism falls within the populations they serve. They also shared survey information on services used by older adults with IDD and offered contact information for providers. Members also heard a proposal to amend Act 656 of 2021 to add licensed psychological practitioners as qualified providers for autism waiver-related evaluations. The presenter argued this would reduce wait times, avoid duplicate assessments, and help families access services sooner, while noting that Arkansas Medicaid already pays for some of these evaluations. Task force members and Dr. Scott discussed the roles of psychologists, speech-language pathologists, and the possibility of using training or board oversight to ensure evaluators are properly qualified, with some noting that speech pathologists’ inclusion has historical and clinical roots. The task force also said it still needs a future discussion on fraud, plans to invite the Attorney General’s office, and wants to identify priorities for the 2027 session before adjourning.

Transcript Highlights:

• This pilot program aims to explore broadening the exemption for service members who did not enter service
• Then finally, the legacy of military service that through the... military service that, through the ongoing
• and after service. and after service.
• service.
• At the top left is a... of service.

Keywords: 1136, house, all

Transcript Highlights:

• being services results in services being services results in services being provided.<00:07:39.759
• controlling of services and rent costs. controlling of services and rent costs.
• Um, it's not a mandated service.
• Uh, welcome back to human services<00:54:12.640> and services and services and >> so<00:
• <01:45:16.159> I services. So, I'm not entirely sure. I services.

Keywords: 1187, senate, all

Transcript Highlights:

• We've been working with the Department of Health Care Services and the Department of Social Services
• Which Medi-Cal services is the bill referring to? Do they even exist today?
• They provide care and services to residents who need help with activities of daily living.
• Receiving these particular services in Medi-Cal. So I get that.
• facilities on emergency remote services.

Summary: The Assembly Aging and Long-Term Care Committee met on June 24 with a substitute chair presiding and considered three measures. SB 352 by Senator Reyes was placed on the consent calendar and approved unanimously, 7-0, to be re-referred to the Committee on Emergency Management. SB 433 by Senator Wahab, presented on behalf of Senator Stern, was heard next and focused on room-and-board protections for participants in the assisted living waiver and CalAIM assisted living transition community support programs. Supporters, including Justice in Aging, CANHR, the Western Center on Law and Poverty, the California Commission on Aging, and the Long-Term Care Ombudsman Association, argued the bill would prevent low-income Medi-Cal residents from being charged unaffordable rates and losing their housing. Opponents, including the California Assisted Living Association, LeadingAge California, and Six B’s, said they remained concerned about the bill’s rent-control implications and statutory scope, though they acknowledged recent amendments addressed some eligibility issues. After committee discussion, SB 433 was approved 5-1 with one abstention and re-referred to the Committee on Human Services. The committee also heard SB 582 by Senator Stern, presented by Senator Wahab, which would allow state departments to issue disaster suspensions of active licenses for facilities rendered inoperable by declared emergencies, waive some licensing fees, and provide temporary flexibility for community-based adult services, child care, and evacuation planning requirements for skilled nursing and residential care facilities. Support came from the California Assisted Living Association, LeadingAge California, the California Commission on Aging, the Long-Term Care Ombudsman Association, CANHR, and a child care resource center, all describing the bill as helpful for rebuilding and continuity of services after disasters. There was no recorded opposition, and SB 582 passed unanimously, 7-0, to the Committee on Health. The meeting then adjourned.

Transcript Highlights:

• um withdraw their request for services. um withdraw their request for services.
• services in quarter 2.
• Out of those 42, 30 individuals started services and 12 did not start services in quarter 2.
• or enhanced services.
• The fifth bullet health services.

Keywords: 928, house, all

Summary: The committee first handled roll call and approved the prior meeting minutes. Members discussed attendance and substitutions, then moved to the DHS commissioner’s update, which focused on New Hampshire’s Medicaid 1115 waiver and the new community re-entry initiative for people leaving correctional facilities. The presenter explained that the waiver lets the state cover certain services not normally covered under Medicaid, including substance use disorder treatment, serious mental illness services, adult dental benefits, and the new community re-entry component. She also noted that a separate youth re-entry component is federally required, with youth defined up to age 21 and foster-care-related coverage extending to age 26. The update described how the adult re-entry program works for incarcerated individuals with behavioral health needs, providing up to 45 days of pre-release services, care coordination with managed care organizations and DOC staff, telemedicine assessments, discharge prescriptions, insurance cards, and connections to community mental health, primary care, and substance use providers. For youth, the program includes more intensive case management, 30 days of pre-release services, and 30 days of post-release care coordination, with a stronger emphasis on screening, diagnosis, and holistic assessment. The presenter said New Hampshire received the adult waiver in July 2024, has implemented the program in state correctional facilities, and is beginning work at the youth center. Members and the presenter discussed why the program is structured as a waiver rather than a standard Medicaid benefit, with the explanation that CMS is allowing this as a newer policy area and that states generally pursue waivers for certain services. The chair and others emphasized the need for real cost and outcome data, and the presenter said an independent evaluator and evaluation plan are required under the 1115 waiver. Early results cited included 30 adults enrolled so far, 10 released, five youth enrolled with one released, and anecdotal early successes such as housing, employment, and better continuity of medication and treatment. The committee did not take any additional votes or formal actions beyond approving the minutes.

Transcript Highlights:

• with the Department of Human Services. with the Department of Human Services.
• <00:35:36.600> to Department of Human Services to Department of Human Services to pre-plan
• services article. services article.
• Is it net spending money in human services? Is it net saving money in human services?
• Services bill, I'm not entirely um sure. Services bill, I'm not entirely um sure.

Keywords: 1187, senate, all

Transcript Highlights:

• Services, LZ Ber. Uh in the audience we Services, LZ Ber.
• Goowens and administrative services Goowens and administrative services executive<00:11:06.240><
• DJJ determined that the services.
• In addition to adding X-ray services, vision and mental health services, specific services not included
• In addition to adding X-ray services, vision and mental health services, specific services not included

Keywords: 958, all

Summary: The committee heard from the Department of Corrections first about Wellpath’s medical services contract and the contractor’s Chapter 11 bankruptcy. DOC officials said Wellpath’s reorganization plan was confirmed in May 2025, the contract was automatically assumed, and services have continued without lapses. They said DOC has not seen any reduction in care, staffing problems, or known impact on Kentucky operations, and that DOC and health services staff meet with Wellpath almost weekly. Members asked whether “emergence” meant discharge from bankruptcy; staff clarified that Wellpath has not yet been discharged and is still in the process of paying debts. The discussion then shifted to the Department of Juvenile Justice’s proposed high-acuity juvenile mental health treatment facility. DJJ said the facility is still in the conceptual and preliminary programming stage, with no full design funding yet and no entry into the formal A/B process with DECA. The proposed facility would have 24 beds total, split into 16 clinical beds and 8 assessment/stabilization beds, and would need to separate males and females as well as high- and low-risk youth under Senate Bill 162. Officials said the concept was developed with DJJ and CHFS mental health staff and outside design experts, and that the project was submitted in the capital plan for consideration. Members questioned the need for the facility, the estimated construction and staffing costs, and whether the state has enough youth to justify it. DJJ said the number of youth needing this level of care changes frequently, that they currently have one youth in Pennsylvania and typically send one to five youth out of state each year, and that out-of-state placement is increasingly difficult. Officials argued that a dedicated facility would reduce delays, keep youth closer to home, and avoid the need to retrofit multiple detention centers. Some members expressed concern that the projected operating costs seemed high compared with the small number of current out-of-state placements, and asked for more information on annual out-of-state spending and the number of youth who would qualify for the facility.

Transcript Highlights:

• Calling the 1:00 calendar of Health and Human Services.
• The Department of Human Services is a value-driven public service organization whose purpose is to help
• is a value driven Public Human Service is a value driven Public Service<00:09:46.040> organization
• who can the Department of Human Services who can the Department of Human Services is<00:10:35.560
• Services for the last 4 and a half years Services for the last 4 and a half years um<00:29:32.960>

Keywords: 912, senate, all

Summary: The Health and Human Services committee heard several gubernatorial nominations and appointments, beginning with Sunshine Cho and Barbara Tom for the Language Access Advisory Council. Both nominees said they stood on their written testimony and expressed interest in continuing to serve, and multiple organizations testified in strong support. No opposition or questions were raised on either nomination, and the committee moved on after hearing the testimony. The bulk of the meeting focused on GM 642, the nomination of Ryan Yamane to be Director of the Department of Human Services. Yamane gave an extensive opening statement describing his social work background, long public service career, and philosophy of compassionate, balanced leadership. He emphasized DHS’s role in helping people from keiki to kūpuna with dignity and support, and shared personal stories from disaster response and family-service work to illustrate his approach. Support testimony came from a wide range of state officials, agency directors, community organizations, health systems, advocacy groups, and former colleagues, who praised his leadership, problem-solving, communication skills, and empathy. One witness, Moani Kiala Katherine Tu Alun, testified in opposition, raising concerns about retaliation and safety issues affecting foster youth and alleging harmful treatment within Child Welfare Services. Another witness, Angela Melody Young, supported the nomination and said Yamane could help overcome barriers for vulnerable communities and improve DHS programs such as financial assistance, SNAP, and disability services. The committee also heard from DHS staff and related officials about the uncertainty surrounding possible federal funding and staffing cuts; Yamane said the department is gathering information, coordinating with Budget and Finance and federal partners, and preparing to prioritize services and adjust if federal changes affect programs. No votes were taken in the portion of the meeting provided.

Transcript Highlights:

• <00:09:56.320> in a hospital ER and medical services in a hospital ER and medical services
• Our mission is to advance equity by addressing the lack of social service services in our communities
• Your support of our GIA request... services to our state holders these services to our state holders
• not present the alcohol rehab Services not present the alcohol rehab Services of of of Hawaii<01
• The first is our shelter services.

Keywords: 912, senate, all

Summary: The joint Ways and Means and Finance informational briefing on grants and aids was held February 14 and was organized as a high-volume public testimony session with strict procedures: no Q&A, one representative per applicant, one minute per testimony, in-person testimony first, and then Zoom participants. The chairs also announced a recess at 11:00 a.m. for floor sessions and a reconvening at 1:00 p.m. Testimony was heard first from neighbor island applicants, then Oʻahu applicants, with members repeatedly directing speakers to line up and keep remarks brief. Neighbor island testimony focused on a wide range of capital and operating requests. Health and community projects included Hawaii Island Community Health Center’s workforce housing in Kau, Wuli Hawaiian Homestead Association’s learning center and predevelopment work, Rescue Tube Foundation’s beach rescue tube expansion, Puna Community Medical Center’s planned hospital/ER campus, Maui Humane Society’s free veterinary care after the wildfires, Hawaiʻi Care Choices’ palliative care readiness, and the Lyman Museum’s HVAC replacement. Other requests included the Maui Advanced Manufacturing Alliance’s Pāʻia Mill redevelopment, Laua 2020’s preschool and learning lab, Mālama Aina’s USDA-compliant meat processing facility, the Hawaiian Lifeguard Association’s water safety programs, Kaha P Organization’s agriculture education support, Ohana Arts’ youth performance project, Friends of the Children’s Justice Center’s emergency closet, EOA Pacific’s Marshall Islands teacher training, and the Central Pacific Youth Athletic Club’s new facility. Oʻahu testimony included the YWCA Oʻahu/Pythink Center’s renovation of Juliet M. Atherton Hall and its community kitchen, West Oʻahu Community Health Center’s wildfire protection and security needs, the Early School’s playground improvements, Surfing the Nations’ food distribution center expansion, and Sounding Joy Music Therapy’s weekly services for people with disabilities. Speakers generally emphasized community benefit, workforce development, health access, food security, disaster recovery, and support for children, seniors, and underserved populations. No votes or formal committee actions were taken during the briefing.

Transcript Highlights:

• Michelle Dion Valhale, and you were with Health and Human Services Health and Human Services Associate
• , Child Protective Services involved.
• Are they are on state funded services, um.
• Currently language Access Service employees are housed in Health and Human Services, System Support Service
• services.

Bills: HB 2510, HB 3589, HB 4611, HB 4655, HB 4665, HB 4666, HB 4670, HB 4700, HB 4730, HB 4798, HB 4838, HB 5136, HB 5243, HB 5302, HB 5539

Keywords: assisted living, healthcare, licensing, criminal offense, personal assistance, group home, regulation, health and safety, inspections, resident care, criminal background checks, adoption, parental rights, registry, vital statistics, disclosure, counseling, foster care, independent living, financial literacy

Transcript Highlights:

• school funding of of uh of services. school funding of of uh of services.
• a medically necessary covered services a medically necessary covered services service<00:55:23.280
• receive a related service like speech. receive a related service like speech.
• They have an obligation to provide the services, and they have no one to provide the services.
• services? services? >> I'm<01:23:21.280> sorry.

Keywords: 1189, house, all

Summary: The commission to study special education costs under SB 57 met for its second meeting, with members introducing themselves and reviewing background materials on New Hampshire special education identification rates, NAEP results, and a Wall Street Journal article about the rise in autism diagnoses. The chair explained that the commission is examining special education aid formulas, including how New Hampshire’s current catastrophic aid threshold works and how changes to that threshold might affect school districts, but noted that the needed data on how many students would shift into the aid system at lower thresholds is not yet available. The main testimony came from Henry Litman of HHS on Medicaid reimbursement in schools. He explained that school-based Medicaid funding is tied to health-related services, not all special education services, and that federal rules are changing in state fiscal year 2027. Under the new approach, schools will move away from an in-kind methodology to a certified public expenditure model that may also allow recovery of some overhead costs, such as support staff time. He said the state won a federal grant to help build the new system, hired a vendor, and is setting up training and a help center for districts. Members asked about why Medicaid claims have declined and whether districts are leaving money on the table. Litman said claims are down about 25% from pre-pandemic levels, with declines tied to federal and state rule changes, documentation requirements, provider qualification rules, and the end of temporary pandemic flexibilities. He said some districts adapted better than others depending on local medical-provider access and administrative capacity. He also said the new federal legislation does not directly affect schools, while New Hampshire’s return to pre-pandemic eligibility rules has reduced enrollment somewhat. No votes were taken, and the discussion ended with agreement that the commission needs better data to determine how much special education spending is truly Medicaid-eligible and whether additional legislation is needed.

Transcript Highlights:

• fee-for-service rate.
• fee-for-service rate.
• fee-for-service rate.
• . services. services.
• services OB. services OB.

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.