Video & Transcript Research : 'guaranteed issue'
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CO
Colorado 2026 Regular Session
Colorado House 2026 Legislative Day 112 May 5th, 2026
Colorado House Floor Meeting
Transcript Highlights:
- And I don't have any issue that the banks can handle the complexity.
- And I don't have any issue that the banks can handle the complexity.
- And I don't have any issue that the banks can handle the complexity.
- But it does set us up really well to continue working on this issue for our friends in the disability
- And I guarantee they didn't tell do it.
HI
Transcript Highlights:
- <00:11:39.120>
an benefits are issued through an benefits are issued through an electronic<00: - We have issues for SNAP. Go ahead. And then we have WIC issues as well as the food bank issues.
- as well as the food bank wick issues as well as the food bank issues.<00:51:00.160>
But <00:51 - issues. But go ahead. issues. But go ahead.
- So kind of guaranteed their paychecks.
Summary:
The Senate Committee on Health and Human Services held an informational briefing on the federal shutdown’s impact on state benefits, with the main focus on SNAP. DHS Benefit, Employment and Support Services Division Administrator Scott Morish explained that SNAP serves about 86,229 households statewide, or 168,947 individuals, and averages roughly $58–60 million in monthly federal benefits. He said USDA directed states to suspend November SNAP benefits effective November 1 if the shutdown continues, while existing October balances on EBT cards remain usable and cash benefits such as TANF, General Assistance, and AABD are not affected. DHS said it has continued processing applications, recertifications, interviews, and required reporting, and has posted public guidance on its website.
Morish also reviewed other SNAP-related changes taking effect November 1 under the One Big Beautiful Bill Act, including expanded able-bodied adult work requirements and tighter non-citizen eligibility rules. He said the work requirements now extend from ages 18–54 to 18–64 and apply to additional groups previously exempt, while only lawful permanent residents, COFA residents, and Cuban or Haitian entrants will remain eligible among non-citizens. He also noted Hawaii’s ongoing SNAP benefit reduction tied to a federal calculation error in the thrifty food plan, which has lowered benefits by about $8 per person per month for the past three years.
On the state response, DHS said it is working with the Hawaii Food Bank and seeking $2 million in state funding to support it, and is also developing a Hawaii Relief Program using TANF reserve funds. The program is intended as a short-term housing and utility assistance program for families with dependent children under 300% of the federal poverty level, with up to four months of assistance. Senators questioned why rainy day funds were not being used and whether the state could directly fund EBT cards; DHS responded that the TANF approach was the fastest available option, that EBT delivery involves significant technical and administrative mechanics, and that the department is still in discussions with the vendor and other stakeholders about additional options.
HI
Transcript Highlights:
- So, there were a couple of issues.
- especially if it's land court issues. especially if it's land court issues.
- issue a notice to cure.
- So you can issue issue a notice to cure.
- . issue. issue.
Keywords:
public school land transfer, Department of Education, DOE, land conveyance, fee simple title, tax map key, TMK, Act 307, Session Laws of Hawaii 2022, Act 139, Board of Land and Natural Resources, BLNR, Department of Land and Natural Resources, DLNR, Kauai, Maui, Honolulu, Kaimuki Middle School, Wilcox Elementary School, school property
Summary:
The committee heard SB 2613, a cleanup bill relating to public school land transfers under Act 307 (2022), which revises tax map key references and the conveyance process for properties transferred to the Department of Education. The Hawaii State Public Library System supported the measure, saying it would complete the long-unfinished separation of the library system from DOE property control and make future building projects more efficient and cost-effective. DOE also supported the bill and requested an amendment to remove TMK 43-62 parcel 10, the Wilcox Elementary School parcel, so that it could instead be transferred to the county for use with the adjacent park and tennis courts.
Members focused heavily on why land transfers and construction approvals have been slow, especially the need for right-of-entry documents and an MOA for a library construction project. Library and DOE witnesses said the delays stemmed from site-control issues and confusion over property status, and that the bill would clarify which parcels are transferred by operation of law and remove the need for additional transactional documents in many cases. Several members questioned whether the bill actually changes authority or simply clarifies existing practice, and DOE said it wanted legislative clarity so the transfers are unmistakably effective on a date certain.
The committee also discussed a separate section of the bill dealing with public use of school facilities after hours, including parking fees on property under DOE jurisdiction. DOE explained that any parking charges would apply only to property it controls, not county roads, and that fees are set through existing facility-use procedures. Members raised concerns about the pace of land transfers generally and urged DOE to move more expeditiously on pending parcels. The hearing then moved on to SB 2147, which would designate the first Friday in February as Love My Library Day; the library system testified in support as the committee began that measure.
TX
Texas 89th Regular
S/C on Defense & Veterans' Affairs Apr 14th, 2025
S/C on Defense & Veterans' Affairs
Transcript Highlights:
- to a license issued by this state.
- As mentioned, the bill subsequently addresses these issues. rather than looking at the education they
- We also work in the education freedom space as well and free speech issues too, but I focus a lot on
- But when Gage joined, I guarantee you there was no second thought.
- We've been talking about homelessness, addiction, and all of those issues.
Keywords:
commemoration, military, navy seal, honor, January 12, Nathan Gage Ingram, military funeral honors, JROTC, veterans, training, grant program, military honors, community engagement, funeral services, education grants, community service, HB 3359, veteran status, Texas Veterans Commission, veterans services
HI
Hawaii 2025 Regular Session
EDT-HRE, HRE Public Hearings 03-13-2025
Economic Development and Tourism
Transcript Highlights:
- Yes, as you might imagine, we've become very sensitive to these issues.
- HTA, we've had issues.
- So as issues come up, if there are procedural issues that need to be investigated, then we ask them.
- I mean, we have other issues. We're in the middle of the island of the Pacific.
- Well, that is the issue that I have.
Summary:
The Senate Committee on Economic Development and Tourism and Higher Education heard HB 1494, relating to sports facilities. Testimony was largely in opposition to the bill as drafted from the Stadium Authority, the Department of Accounting and General Services, and the Department of Business, Economic Development and Tourism, with several other written comments also opposing; each asked that if the measure advances, Senate language from related stadium bills be incorporated instead. The University of Hawaiʻi testified in support of the Nāʻid project and said it wants the project delivered at Halawa so the university can have a football facility, though members pressed the university on whether it was effectively supporting both the project and the bill’s current approach.
A substantial portion of the hearing focused on the stadium project’s financing, schedule, and oversight. DAGS and Public Works discussed a consultant contract that had grown to about $28 million and an audit that recovered $441,000 after improper travel and expense reimbursements, including first-class airfare and other personal expenses; officials said the audit exposed weak internal controls and led to revised reimbursement policies. Members questioned whether the problems would have been found without media reporting and whether stronger oversight should have been in place earlier.
The committee also discussed the current Ching Field setup for UH football, with witnesses describing it as less than ideal and temporary until the new stadium is built. Stadium Authority representatives said the current preferred offeror is Aloha Halawa Development Partners, negotiations have recently accelerated, and the goal remains a contract this summer and a fall 2028 opening. They said the state is committed to $350 million in general obligation bonds, with the overall project expected to cost more, and that the developer is exploring other financing sources such as TIF or CFD while the state and city work to expedite permits and demolition. No vote or final action on the bill was taken in the portion provided.
NH
New Hampshire 2025 Regular Session
House Judiciary (03/10/2025)
Transcript Highlights:
- and some other property rights issues.
- How can they possibly— you know, that’s some kind of a due—” issue that has been litigated by the issue
- So I'm confused as to how this would be a budgetary issue.
- here really addresses the the the issue here really addresses the the the issue of<01:51:51.599>
- <01:52:02.760>
but issue but issue but this<01:52:05.679>you <01:52:05.840>know
Summary:
The committee first took up House Bill 313, and Representative Perez moved to retain the bill, saying it needed work and was not ready as written. Representative Smith supported that approach, and the motion to retain passed 18-0. The committee then considered House Bill 391, an anti-SLAPP measure. Representative Smith and others argued the bill was too broad, could create litigation and discovery disputes, and might even be read to affect criminal cases. The committee voted 18-0 to retain HB 391 as well, and the chair agreed to place it on consent with a report to be prepared.
The committee next heard House Bill 462, establishing a cause of action for unwarranted video imaging of residential properties. Representative McFarland moved to retain, saying the bill raised First Amendment and property-rights concerns. The motion passed 18-0. The committee then took up House Bill 509, a fiscal note bill requiring reporting related to forfeitures. Members on both sides discussed the bill’s cost, the burden of collecting and collating the data, possible duplication across fiscal years, and whether the information was already being collected. The OTP motion passed 11-7, and Chairman Lynn asked Representative McFarland to prepare the report; a minority report was anticipated.
Finally, the committee considered House Bill 520, which would authorize Department of Education hearing officers to issue subpoenas. Representative Kuttab supported the bill, saying similar authority exists in other agencies and states. Opponents argued the DOE already can obtain information through the attorney general, that the bill would create an unbalanced internal enforcement process, and that the subpoena authority was not tied to the curriculum-related concerns raised in testimony. Representative Ter offered Amendment 0842H to shift subpoena authority from DOE hearing officers to the attorney general; the amendment failed 7-11. The committee then voted on the bill as amended, and the OTP motion passed 10-8, with a minority report also requested.
FL
Transcript Highlights:
- IT HAS BEEN RECOMMENDED WE SPEAK THE LEGISLATURES TO AIR THIS ISSUE BEFORE WE GO AHEAD MY PARTNER HERE
- PRESIDENT REAGAN IN THE 80s PICKETING WAS 85 AND CHIP O'NEILL GOT TO GOT ABOUT THAT ISSUE WAS 3.5 MILLION
- THAT'S THE ONLY WAY WE CAN HELP EVERYBODY AND THEY CAN DO IT IF WE PUT POLITICS ASIDE AND LOOK AT THE ISSUES
- HAVE TO DO IT IN THE RIGHT WAY AND THE SKILLS PATCHWORK AND NOT ACTUALLY GETTING UP THE HEART OF THE ISSUE
- I GUARANTEE EACH ONE OF YOU HAS HAVE A FAMILY MEMBER OR A FELLOW CHURCH MEMBER OR A NEIGHBOR WHO HAS
DE
Delaware 2025-2026 Regular Session
House of Representatives Legislative Session - Session 2 - 42nd Legislative Day- REASSEMBLE Part 1 Jun 30th, 2026
Delaware House Floor Meeting
Transcript Highlights:
- I could not find a guarantee that there are any in New Jersey. There are some in New York State.
- Life, liberty, and the pursuit of happiness directly affects them in this issue. What's not.
- Life, liberty, and the pursuit of happiness directly affects them in this issue.
- This became a real-world issue for OAW.
- Senate Bill 75 simply ensures state-issued licenses have a realistic path to exist.
Summary:
The House convened on June 30, 2026, with opening ceremonies, guest introductions, and moments of silence for Gerlindy Lancelotti and Iva Durham. Members then took up a long agenda of bills and resolutions, including consent calendar items and several measures related to agriculture, lottery reporting, health care, fire service membership standards, inmate work, telecommunications, rent increases, youth camp licensing, primary elections, respiratory care practice, and marriage equality. The chamber also heard extended debate on Senate Bill 233, concerning removal of snow and ice from vehicles, and on House Bill 188, which would allow unaffiliated voters to choose a party primary while barring participation in both parties’ primaries.
Among the notable actions, House Concurrent Resolution 157 passed as amended, directing the State Lottery to report on options to support traditional lottery retailers. Senate Bill 53, preserving the Delaware Farm to Community Program if federal support declines, passed unanimously. Senate Bill 307, giving the Public Service Commission authority to designate eligible Lifeline carriers, and Senate Bill 339, clarifying advance health care directives, also passed. Senate Bill 235, removing a sunset on manufactured home rent increase calculations, passed, as did Senate Bill 325 after House Amendment 1 narrowed disqualifying offenses for fire service membership and adjusted related background-check rules. Senate Bill 309, discharging remaining incarceration-cost balances, and Senate Bill 324, addressing constable-related firearm permit provisions, both passed.
The chamber tabled Senate Bill 233 once to consider a proposed amendment for trucks and other hard-to-clear vehicles, but the amendment failed and the bill later passed as amended by the Senate. Senate Joint Resolution 19, directing DHSS to study strategies to reduce health care costs, was tabled pending legal review. Senate Substitute 2 for Senate Bill 100, proposing a constitutional amendment to protect the right to marry, passed after extensive floor debate and personal statements from members on both sides. Senate Bill 293, creating a licensure pathway for summer camps to participate in purchase-of-care, passed after House Amendment 1. House Bill 188 on open primary access for unaffiliated voters passed 22-17, and Senate Bill 94, concerning respiratory care practitioners and ECMO medication delivery, passed after House Amendment 2. The transcript ends as the House begins consideration of House Substitute 1 for House Bill 404.
AL
Alabama 2025 Regular Session
Alabama Senate Banking and Insurance Committee Mar 19th, 2025
Banking and Insurance
Transcript Highlights:
- I appreciate the opportunity to talk to you today about this important issue.
- In fact, there are many provisions... ...issues.
- So rather than a temporary fix to this issue, a more effective approach would be a thorough examination
- There are solutions to these issues, and I think SB252 is the first step in the process.
- That was one of the issues, but they're currently getting that medication, I think through mail order
MN
Transcript Highlights:
- <00:07:05.879>
funding heritage is not a guaranteed funding heritage is not a guaranteed funding - That’s probably going to be a bigger issue as we move forward.
- That’s probably going to be a bigger issue as we move forward.
- there unfortunately but it is an issue there unfortunately but it is an issue certainly<01:03:19.520
- <01:15:39.199>
uh with folks um and your issues uh with folks um and your issues uh throughout
Summary:
The Legacy Finance Committee held its first meeting of the session, with members and staff introducing themselves and the chair emphasizing the committee’s role in overseeing Minnesota’s Legacy Amendment funds. The committee then received an overview of the Arts and Cultural Heritage Fund from Mary Davis. She explained that the fund receives 19.75% of the 1% sales tax, is constitutionally limited to arts education, arts access, and preserving Minnesota history and cultural heritage, and is not a guaranteed base for prior recipients. She reviewed major recipients and statutory requirements, including the Minnesota State Arts Board’s 47% share, funding for the Historical Society, libraries, humanities and cultural organizations, public media, and the Minnesota Indian Affairs Council. She also noted the 5% reserve requirement, reporting obligations, and a 2023 legislative directive to improve access through free or reduced admission and outreach to households regardless of income.
The committee next heard from Janelle Taylor on the natural resources funds, focusing on the Clean Water Fund and Parks and Trails Fund. She said the Clean Water Fund receives 33% of Legacy revenues and must be used to protect, enhance, and restore water quality and protect groundwater, with at least 5% dedicated to drinking water sources. She described the Clean Water Council’s recommendation process and said most of the money goes to Board of Water and Soil Resources projects, with additional funding for PCA and DNR monitoring. In response to a question about Hastings and PFAS contamination, she said the legislature could appropriate clean water money if the project fits the constitutional criteria and protects drinking water sources. For the Parks and Trails Fund, she explained it receives 14.25% of Legacy revenues and is allocated under the long-standing 40-40-20 split: 40% to state parks and trails, 40% to metropolitan regional parks and trails, and 20% to Greater Minnesota regional parks and trails.
House Fiscal Analysis staff then reviewed the reserve requirement and available balances, noting that each Legacy fund must keep a 5% reserve to protect against forecast changes. For the upcoming biennium, they cited approximately $327.229 million available for the Outdoor Heritage Fund, $184.73 million for the Arts and Cultural Heritage Fund, and $133.13 million for the Parks and Trails Fund, with the Clean Water Fund total discussed earlier at about $311 million. Members briefly discussed the importance of the reserve and the zero-base nature of the funds. The committee then moved on to an overview of the Outdoor Heritage Fund and Outdoor Heritage Council from Mark Johnson and Joe Pelco, who explained that the fund was approved by voters in 2008, lasts 25 years, receives about one-third of the 3/8 of 1% sales tax, and is used to protect, restore, and enhance wetlands, prairies, forests, and habitat for fish, game, and wildlife. They described the council’s statutory role, the small grants program for projects from $5,000 to $500,000, and the annual recommendation process, but no votes or formal actions were taken in the portion provided.
HI
Hawaii 2025 Regular Session
TCA-EDT, EDT, EDT-CPN Public Hearings 03-13-2025
Transcript Highlights:
- That's kind of what we want, but this is a technical issue. So, uh, yes. Okay, sounds good.
- <00:24:22.400>
So, want, but this is a technical issue. - So, want, but this is a technical issue. So, uh,<00:24:23.279>
yes. - Um there's a lot<00:32:18.159>
of <00:32:18.240>issues <00:32:18.480>that <00:32: - This can devastate families and communities, increasing financial hardship, mental health issues, and
Summary:
The joint committees on Transportation and Culture and the Arts and Economic Development and Tourism heard three measures. HB 450, which would transfer the State Foundation on Culture and the Arts to the Department of Business, Economic Development, and Tourism, drew support from DBEDT, the State Foundation, the Hawaii Arts Alliance, DAGs, and individuals. Members asked about the bill’s purpose and the relationship between arts administration and international/cultural considerations. The committees voted to pass HB 450 with amendments, including a housekeeping change allowing specific legislative direction in narrow cases; the measure was adopted with unanimous or near-unanimous votes.
HB 437, relating to out-of-state offices, received testimony in support from DBEDT and representatives of the Filipino Chamber of Commerce and another individual. The discussion focused on whether an overseas office in the Philippines was the best use of funds, given existing offices and trade relationships in places like Beijing and Taiwan. Members questioned the return on investment, fiscal priorities, and whether DBEDT had a broader strategic plan for selecting markets. The committees ultimately passed HB 437 with a Senate Draft 1 and technical amendments, with some members voting with reservations.
HB 1391, relating to trade and creating a Hawaii-Ireland trade commission, also advanced after a lengthy discussion. DBEDT said it offered comments rather than a firm recommendation and explained that the bill appeared intended to build economic ties with Europe through Ireland, but members questioned why a commission was needed, how it would be structured, and whether similar efforts should focus on other countries. DBEDT said it would provide reports on sister-state relationships and office performance, and noted that trade initiatives would likely require private-sector participation. The committees passed HB 1391 with amendments and reservations from some members.
NH
New Hampshire 2026 Regular Session
Senate Health and Human Services (03/11/2026)
Health and Human Services
Transcript Highlights:
- So, I don't think it's going to be an issue.
- So, I don't think it's going to be an issue.
- As I said, we're health issues in youth.
- >> was there any issues with it? >> was there any issues with it?
- <02:21:17.280>
um minors that were have had issues um minors that were have had issues um
KY
Kentucky 2026 Regular Session
Senate Legislative Session Day 30 (2-19-26)
Kentucky Senate Floor Meeting
Transcript Highlights:
- President, is where courts have found issue with this legislation.
- <00:19:45.440>
And officer issues a stay back order. - And officer issues a stay back order.
- issues that are going on in the school. issues that are going on in the school.
- I guarantee you if that we can shoot up.
Summary:
The Senate convened with prayer, the Pledge of Allegiance, roll call, approval of the prior journal, and remarks welcoming visitors, including military children in the annex. The House clerk then communicated several House-passed measures to the Senate, and the clerk reported second readings of Senate Bills 70, 74, 80, 127, and 154, which were sent to the Rules Committee. Committee reports also advanced SB 129, SB 101 with Committee Substitute 1, SB 124, SB 50, SB 162 with Committee Substitute 1, SB 170 with Committee Substitute 1, and Senate Resolution 103. The chamber also introduced SB 211 on prescription drug coverage and SB 212 on mental health coverage and declared an emergency.
The main floor action was on Senate Joint Resolution 74, which directs the Legislative Research Commission and state agencies to create a statewide fiscal map of substance use disorder programs and funding sources. Supporters said the map would consolidate fragmented funding information across agencies, identify gaps and duplication, improve budgeting, and provide a public-facing report; the resolution also requires posting the map online and submitting a report to the General Assembly by October 30, 2026. The Senate passed SJR 74 by a vote of 38-0.
The chamber then took up Senate Bill 104, the “Halo Act,” which would create a 25-foot safety buffer around first responders while they are performing official duties. Supporters argued it would protect first responders and EMTs from interference and still allow bystanders to document events from a distance. Opponents said existing laws already cover obstruction and related conduct, and warned the bill is vague, duplicative, and could chill First Amendment activity such as filming police or protesting. The debate included multiple explanations of votes, with some senators citing public safety and others raising constitutional concerns; the excerpt ends before the final vote on SB 104 is completed.
NH
Transcript Highlights:
- We have a lot of issues in the state with speeding, with people riding the wrong side down the road,
- We have a lot of issues give us an idea.
- And one of the issues too that they brought up was the fact that this is a major issue for women truck
- Um, so for them this is a very big issue. It's highlighted on page 12 in there.
- so for them this is a very big issue. so for them this is a very big issue.
MN
Minnesota 2025 1st Special Session
Committee on Judiciary and Public Safety - Part 2 - 03/27/25
Judiciary and Public Safety
Transcript Highlights:
- We can talk about the volunteer and the stipended issue as a separate issue, but I guess my question
- We can talk about the volunteer and the stipended issue as a separate issue, but I guess my question
- We can talk about the volunteer and the stipended issue as a separate issue, but I guess my question
- We can talk about the volunteer and the stipended issue as a separate issue, but I guess my question
- <00:21:52.679>
but stipended issue as a separate issue but stipended issue as a separate issue
OK
Transcript Highlights:
- sincere about addressing the science behind the medicinal application of cannabis to address PTSD issues
- But in addition to that, as I've stated, I'm going to be running legislation next year to guarantee that
Bills:
SJR50, SJR51, SJR52, SJR53, SJR54, HJR1090, HJR1091, HJR1092, HJR1093, HJR1094, HJR1095, SJR49
Keywords:
Medicaid, federal funding, state law, healthcare, low-income adults, Oklahoma Constitution, healthcare regulations, Oklahoma Health Care Authority, permanent rules, joint resolution, OHCA, health care rules, administrative rules, major rule, Title 75, Title 317, Oklahoma Administrative Code, OAC 317:30, health policy, state health programs
ND
North Dakota 2025-2026 Regular Session
Senate Appropriations - Human Resources Division Apr 11th, 2025 at 09:30 am
Appropriations - Human Resources Division
Transcript Highlights:
- So if I don't have the authority somewhere to guarantee that the money is there, I can't sign the contract
- So I don't have any issue with adding this to 10-12. It's kind of a minor cleanup thing.
Bills:
SB2015
Keywords:
corrections, rehabilitation, prison budget, department of corrections, adult services, youth services, correctional facilities, Heart River correctional center, Missouri River correctional center, James River correctional center, minimum security facility, county jails, regional jails, deferred maintenance, capital construction, strategic investment and improvements fund, Bank of North Dakota, line of credit, tasers, body cameras
Summary:
The Senate Appropriations Human Resources Division met to finalize changes to the human services budget bill and related amendments. Members discussed several items, including a proposed $5 million appropriation for the Altru Hospital project to address inflationary costs, with the rest of the funding question left for conference committee. They also agreed to keep the 10-year operating requirement language for the project and remove a matching-funds provision that was no longer needed.
The committee spent considerable time on the OASIS child welfare IT system. Donna Auckland explained that the project is still in the RFP stage, with vendor selection and contract negotiation likely taking months, and that the system will require 50-50 federal matching authority. Based on that testimony, the committee agreed to reduce the general fund amount from $14 million to $6 million and use a line of credit for the remaining authority, while preserving the federal match authority so the contract can be signed and the project can proceed.
Members also approved a technical fix to add governor’s designee language for the Children’s Cabinet, which had been missed in another bill already on the governor’s desk. Keith reviewed updated long sheets showing additional budget adjustments, including provider inflation changes, a $50,000 Family Voices grant, reductions to CARES Act COVID funds, and moving the $5-per-day basic care rate increase from ongoing to one-time funding. No formal votes were recorded in the transcript, and the committee adjourned with plans to reconvene Monday if the final bill version was ready.
TX
Transcript Highlights:
- relates the procedure of amending and revoking certifications of public convenience and necessity issued
- HB 3380 by Rosenthal relates to the basic allotment and guaranteed yield under the public school foundation
MN
Transcript Highlights:
- <00:11:11.120>
are <00:11:11.279>always the issue with schools are always the issue - those uh um deferred maintenance issues those uh um deferred maintenance issues over<00:13:00.639
- issue that we've got a new MCA test? issue that we've got a new MCA test?
- , not a finance issue.
- And I can guarantee you, like Tom Bach used to say, I’ll guarantee you, John.
KY
Kentucky 2025 Regular Session
Medicaid Oversight and Advisory Board (12-10-25)
Transcript Highlights:
- <00:20:24.160>
in reinforce uh SUD really is an issue in reinforce uh SUD really is an issue - <00:38:01.359>
visits <00:38:01.760>of guarantees coverage for 20 visits of guarantees - and moral issue.
- It is a public only a medical issue.
- We often issue, and a moral one as well.
Summary:
The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well.
Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk.
Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.