Transcript Highlights:

• Health Services, and University Recreation.
• , conduct, disability services, and our civil rights compliance team. ...conduct, disability services
• It seems like you've got a lot of great services here.
• So Meg and I am thinking about what we wanted to share today.
• Student supportive services.

Summary: The committee spent much of the meeting hearing presentations on student mental health supports at Central Washington University, Washington State University, the University of Washington, and the State Board of Community and Technical Colleges. CWU described high levels of student distress, loneliness, anxiety, depression, suicidal ideation, and basic-needs insecurity, along with a campus-wide holistic well-being model that includes behavioral intervention teams, emergency aid, peer outreach, community partnerships, and a collegiate recovery community. WSU emphasized loneliness, common presenting concerns such as anxiety, depression, PTSD, and relationship distress, and the role of housing and residence life, resident advisors, living-learning communities, and coordinated crisis response in identifying and supporting students. UW highlighted prevention and support programs through LiveWell, including alcohol and other drug consultations, confidential advocacy, suicide intervention, student needs navigation, peer health educators, and peer wellness coaches. The community and technical college system reported persistent access barriers, especially for students ages 18 to 24 and those facing housing or food insecurity, and said the legislature-funded mental health pilot at four colleges expanded counseling access, telehealth, and referral pathways, while broader system efforts focus on awareness, telehealth, basic-needs supports, and workforce training in behavioral health fields. Members asked each panel how they gather student feedback, and the institutions said they use surveys, evaluations, and ongoing outreach to students in services. Questions also focused on substance-use and recovery resources, Greek life outreach, and whether colleges have enough licensed mental health staff versus academic advisors; the community college board said not all colleges have licensed mental health providers on staff, and some rely on community contracts or telehealth. The committee also discussed whether counseling services are increasing because of post-pandemic effects or because students are more willing to seek help, with presenters saying both factors likely play a role. The committee then shifted to artificial intelligence in higher education. Washington State University, the University of Washington, Western Washington University, and the community and technical college system described campus AI task forces, governance structures, and efforts to set policies for students, faculty, and staff. Presenters said institutions are requiring course-level AI use statements, promoting ethical and transparent use, expanding access to approved tools such as Microsoft Copilot, and using AI for teaching, research, advising, and administrative support while guarding privacy, equity, and academic integrity. Members raised concerns about deepfakes, bias, student monitoring, and whether AI should be used to screen applications or evaluate student work; presenters said human review remains essential and that some institutions prohibit AI use in hiring or admissions screening. The final presentation, from OSPI, described the statewide rollout of the School Links high school and beyond plan platform under 2023 legislation, saying it will standardize career and college planning across K-12, provide better data and student guidance, and connect students to postsecondary pathways and employers; OSPI said the rollout is underway but current funding only extends through June 30, 2026.

Transcript Highlights:

• One testifier shared that she had One testifier shared that she had testified<00:25:14.720> in
• that I thought was worth sharing. that I thought was worth sharing.
• She said the services are something everyone can get behind, and that it is housing with services.
• He said the services are something everyone can get behind, and that it is housing with services.
• with services.

Keywords: 1183, house

Transcript Highlights:

• Reimbursement for services, particularly services like mental health and others, pays well below the
• brink reimbursement for services brink reimbursement for services particularly<00:09:10.680>
• services like mental health particularly services like mental health and<00:09:12.920> others
• OB Services we do not offer OB Services OB Services we do not offer OB Services although<01:13:16.199
• dollars in federal share funding.

Keywords: 1183, house

Summary: The Health Finance and Policy Committee heard testimony from the Minnesota Hospital Association and several hospital leaders about the financial strain facing hospitals across Minnesota. The association’s CEO said hospitals are essential 24/7 safety-net providers, but rising labor, supply, technology, and drug costs are outpacing reimbursement from Medicaid, Medicare, and commercial payers. He warned that many not-for-profit hospitals are struggling, that workforce shortages remain significant, and that the committee should consider help on Medicaid rates, discharge/boarding problems, mental health services, workforce development, protecting the 340B drug discount program, and avoiding new mandates that add costs. Relle Schultz of Winona Health described a community hospital with a 49-bed facility and long-term care services that has faced years of losses, including a $17 million loss in 2023 and $12 million in losses the following year. She said government payers now make up about 65% of the hospital’s mix, and each 1% increase in that mix costs about $1 million. She highlighted the difficulty of sustaining services such as dialysis, which was nearly closed until a local donor provided $3 million to keep it open for three years, and she emphasized the importance of 340B savings and the need for higher Medicaid payments. Carrie Mulski of Riverview Health in Crookston said critical access hospitals are also under pressure despite their federal designation. She explained that federal support has eroded, that Medicaid and other public programs do not cover full costs, and that her hospital’s 340B savings help keep the doors open. She said Riverview opened a new hospital in 2020 but was hit by the pandemic and inflation, leading to annual losses of $5 million to $6 million and a negative operating margin of 9% to 10%. She also described bond covenant problems, low cash on hand, the prior closure of the nursing home, and the need for rapid state action to stabilize rural hospitals and preserve access to care.

Transcript Highlights:

• of Social Services.
• human service agencies.
• welfare services we can provide.
• , legal services, and more.
• , legal services, and more.

Summary: The Assembly Budget Subcommittee on Human Services held an informational hearing on child welfare, foster care, child support, and related prevention efforts. The chair opened by emphasizing mandated reporting reform, foster care system improvements, and community-based prevention, and noted that no votes would be taken. Public testimony focused first on mandated reporting, where a lived-experience advocate and several organizations argued that the current system overreports families, especially Black, Native, and Latino families, causes trauma, and should be reformed through standardized training, clearer thresholds, and stronger community supports rather than more hotline referrals. Casey Family Programs cited data showing nearly 90% of reports are unsubstantiated, while CDSS said it is already forming a Mandated Reporting Advisory Committee, updating training, and exploring community pathways and possible changes to the list of mandated reporters. CWDA and SEIU supported training and alternative response concepts but stressed child safety, county capacity, funding, and the need for careful implementation and accountability. The committee then discussed a proposal to create a foster care multi-agency office within the California Health and Human Services Agency, led by a chief foster youth advocate with authority to coordinate across departments. Advocates said foster youth often need services from education, health, housing, and behavioral health systems that do not coordinate well, and argued that a central office with real authority could improve placement stability and access to services. CDSS responded that existing structures already provide coordination, including AB 2083 interagency teams, the Child Welfare Council, complex care steering committees, and the foster care ombudsperson, but said it was open to technical assistance. Members raised concerns about whether the new office would have enough authority and funding to avoid becoming another layer of bureaucracy, and the chair emphasized the need for real “teeth” and better interagency action. The final major topic was the continuation and expansion of Promise Neighborhoods. A community leader described strong early results from the state-funded neighborhoods, including improved kindergarten readiness, reduced chronic absenteeism, higher graduation rates, food access, housing supports, and mental health services, but warned that current funding sunsets in June 2025 and that a fiscal cliff could jeopardize staff and services. CDSS said the four funded neighborhoods have reported positive outcomes and valuable flexibility, but also noted challenges with one-time funding, student mental health, and long-term planning. Assemblymember Mia Bonta urged continued investment, saying the place-based model is difficult to rebuild once lost, and the chair asked LAO to help identify the minimum funding needed to preserve the existing infrastructure while evaluation results are still pending.

Transcript Highlights:

• revenue share space. revenue share space.
• So the way the revenue share is written, depending on the type of service, there is a gross revenue contribution
• So the way the revenue share is written, depending on the type of service, there is a gross revenue contribution
• So the way the revenue share is written, depending on the type of service, there is a gross revenue contribution
• So the way the revenue share is written, depending on the type of service, there is a gross revenue contribution

Keywords: Meeting Start 00:00:00 Roll Call 00:00:15 Kentucky Department of Education 00:01:20 Kentucky Communications Network Authority 00:36:45 Accelecom 01:01:22 Auditor of Public Accounts 01:29:50, 958, all

Summary: The Information Technology Oversight Committee met to hear a presentation from Kentucky Department of Education officials David Couch and Mike Lingham on the history and current status of Kentucky’s K-12 internet network, including its relationship to KentuckyWired. They described the original KETS design from 1995, when KDE established district internet hubs and left local districts to connect to them, and said that model helped Kentucky become a national leader in school connectivity and cloud-based services. They also emphasized the importance of E-rate eligibility, saying it has saved the state substantial money and remains central to KDE’s network contracting. Couch and Lingham said the current “next generation Kentucky K-12 internet” contract with Education Networks of America is more reliable, offers more functionality, and costs less than the prior system, including lower bandwidth and firewall costs. They explained that the transition was complicated by build-out and provisioning issues, especially the need for more “type two” connections through local providers, which pushed some implementation past the June 30, 2024 E-rate deadline. As a result, 39 sites remain on type two connections, and KDE absorbed the loss of federal discount dollars for the portion of the transition that extended into July. The witnesses also discussed home internet access for students. They said KDE has tracked home access for about 20 years and estimates about 4.5% of students still lack adequate internet at home, with roughly 3% able to reach access nearby and 1.5% having no access. They said the biggest barrier is usually cost rather than lack of available lines, and noted that temporary hotspot support during COVID helped students continue schoolwork. Senator Williams asked about the costs of the transition, the current type two sites, and the potential cost of any future transition, but the transcript cuts off before a full answer was given.

Transcript Highlights:

• behavior health clinic services, children’s therapeutic services and supports, and crisis response services
• behavior health clinic services, children’s therapeutic services and supports, and crisis response services
• behavior health clinic services, children’s therapeutic services and supports, and crisis response services
• behavior health clinic services, children’s therapeutic services and supports, and crisis response services
• behavior health clinic services, children’s therapeutic services and supports, and crisis response services

Keywords: 1187, senate, all

Transcript Highlights:

• Thank you for sharing that.
• We share the author's goal of improving early detection. Thanks.
• absolutely agree that follow-up services do really matter.
• services, which are covered today but are generally subject to cost sharing.
• Our employers need to pay their fair share.

Summary: The Assembly Health Committee heard several bills focused on mental health access, preventive care, health care costs, detention oversight, and daylight saving time. SB 989 would streamline Care Court referrals by allowing first responders to ask county behavioral health agencies to review and file petitions; supporters, especially firefighters and families, said the current process is too burdensome, while Disability Rights California and other opponents argued Care Court is coercive and unproven. SB 1089, as amended, would direct CalRx/HHS to help distribute GLP-1 medications more broadly and more affordably; the author described her own experience with the drugs, and the bill drew support from medical and life sciences groups with no opposition. SB 1309 would eliminate out-of-pocket costs for medically appropriate lung cancer screening follow-up care; cancer advocates and survivors strongly supported it, while health plans and insurers opposed it as costly and said the bigger problem is low initial screening rates. The committee also heard SB 1284, which would require DHCS to report large employers whose workers are enrolled in Medi-Cal and estimate taxpayer costs, framed by supporters as a transparency measure about corporate reliance on public coverage. SCR 7, urging permanent standard time for health reasons, passed with support from medical groups and no opposition. SB 995, the Masuma Khan Justice Act, would create statewide inspection and enforcement standards for large involuntary residential facilities, including private immigration detention centers and certain youth facilities; supporters cited unsafe and inhumane conditions, while county probation officials objected to duplicative oversight for secure youth treatment facilities. The committee took votes on each measure, and the bills and resolution advanced, with SB 1309 and SB 1284 moving on amended and the others also reported out; the consent calendar was approved as well.

Transcript Highlights:

• Cost sharing, once again, we sharing.
• > services.
• non-emergency transport services. non-emergency transport services.
• getting their their ser services getting their their ser services in<00:34:35.280> there.
• still receiving Medicaid services. still receiving Medicaid services.

Keywords: Meeting Start 00:00:00 Roll Call 00:00:15 HB 1 Discussion 00:02:00 HB 1 Vote 00:15:05 HB 2 Discussion 00:17:20 HB 2 Vote 01:13:20, 958, all

Summary: The committee met on House Bill 1, which would implement Kentucky’s participation in the federal education freedom tax credit program. Sponsors said the bill would allow donors to receive a federal dollar-for-dollar tax credit for contributions to scholarship granting organizations, with no state dollars involved, and that public school districts could potentially create their own SGOs. Members asked about the removal of state tax language in the committee substitute, the meaning of the 11th Amendment waiver, whether SGOs could serve only public school students, and whether data collection could be added. The sponsors said the state tax language was unnecessary because the credit is federal, the waiver would allow federal-court litigation over the act, and a district could establish an SGO if it met federal requirements. The committee adopted the substitute and then reported HB 1 favorably with 16 yes votes, one nay, three pass votes, and one abstention. The committee then took up House Bill 2, an act relating to Medicaid and making an appropriation. The sponsor described the bill as a response to federal HR 1 and to concerns raised by the Medicaid oversight board, saying it would address program integrity, eligibility redeterminations, cost sharing, and managed care organization contracts. He said the bill would require periodic eligibility verification for expansion Medicaid enrollees, add modest cost-sharing for some services to encourage use of primary care over emergency rooms, and strengthen enforcement of MCO contracts, with penalties going into a restricted compliance fund. Members asked about the committee amendment, and the sponsor explained it restored flexibility on the number of MCOs in future procurement rather than locking in a reduction. Members also asked whether the bill had gone before the Medicaid oversight advisory board and whether a fiscal note was available; the sponsor said the board’s recommendations were incorporated and fiscal notes were included in the packet. After discussion, the committee adopted committee amendment one to PHS2 and then adopted PHS2 as amended for consideration. The sponsor continued outlining the bill’s provisions, emphasizing that it applied to the expansion population and was intended to align Kentucky law with federal requirements while improving oversight and accountability.

Transcript Highlights:

• They are coming for the services.
• more intensive outpatient services or step-down services.
• Services (DFPS) is also working, in limited circumstances, to provide these services.
• Those services, particularly case management services, often work best when done in person.
• Is it tied to the service?

Keywords: 1184, house, all

Transcript Highlights:

• It shared earlier such horrific. It's of completion were not the goal.
• If you could share what role you play in the transition process. Thank you.
• is likeness Ford shared. >> Her challenges.
• So there were options being shared. But again, it has been more formalized.
• And so all of those cases providing services I yes, he's using the Apple next.

Transcript Highlights:

• outpatient mental health services and substance use disorder services.
• The caseload for these programs are not capped, and these services represent the largest share of services
• These programs represent the smallest share of service delivery in both long-term care and DD, and include
• There are a number of services that are not, you know, that are not—you don't need to do cost sharing
• So there are some services that aren't cost sharing.

Summary: The Ways and Means Committee held a work session to review how H.R. 1 (the One Big Beautiful Bill Act) could affect Washington’s Medicaid, long-term care, developmental disabilities, and food assistance programs, with a focus on implementation challenges, fiscal impacts, and likely coverage losses. Staff and agency officials explained Washington’s Medicaid financing structure, eligibility categories, caseload trends, and the role of the Health Care Authority and DSHS in administering Apple Health and related services. They also described how Medicaid expansion increased access to behavioral health services and how H.R. 1’s provisions are expected to affect the expansion population most directly. Health Care Authority and DSHS officials outlined several major H.R. 1 changes: new work and community engagement requirements for the Medicaid expansion population, six-month redeterminations instead of annual renewals, changes to immigrant eligibility, limits on provider taxes and state-directed payments, new cost-sharing requirements, reduced retroactive coverage, and changes affecting long-term care eligibility. They said Washington is still awaiting federal guidance on many details, but estimated that about 620,000 Apple Health expansion enrollees could be subject to work requirements, that roughly 30,000 immigrants could lose Medicaid eligibility under the new definition of qualified alien, and that some long-term care and developmental disability clients could be indirectly affected. Officials also said the state is working with other agencies to build shared verification systems and may seek a delay waiver, though they do not expect broad federal flexibility. The committee also heard that H.R. 1 immediately blocks Medicaid reimbursement for Planned Parenthood services for one year, with the state planning to backfill about $11 million to preserve access. In addition, officials warned that the law could reduce federal Medicaid revenue by billions over time and strain hospitals and emergency rooms as more people become uninsured. They noted that Washington’s rural health transformation grant application is due November 5 and could bring some funding, but not to offset coverage losses. No votes were taken; the session was informational only. The committee then heard a separate presentation on food assistance, where staff and DSHS described H.R. 1’s SNAP changes, including expanded work requirements, immigrant eligibility restrictions, higher state administrative costs, and a possible future state share of benefit costs tied to payment error rates. DSHS estimated a four-year fiscal impact of about $750 million for food assistance changes and said the state is working on system and policy changes across agencies before the new requirements take effect.

Transcript Highlights:

• service.
• A less expensive service, like a transition service.
• as a service program.
• We share responsibility for the system as it stands, and we share the duty to fix it.
• case management services?

Transcript Highlights:

• service is never forgotten. service is never forgotten.
• Your service, your us today.
• stress that comes with military service. stress that comes with military service.
• rooted in service, not status. rooted in service, not status.
• through service. through service.

Keywords: 926, house, all

Summary: The caucus of the whole was held as the annual State of the Guard address, featuring Adjutant General Gregory Knight’s remarks to legislators and guests. Knight said this would likely be his final address before retirement and thanked Gold Star families, military survivors, Governor Phil Scott, honorary commanders, legislative leaders, his family, and many Guard and community partners. He emphasized that the Vermont National Guard is a civic institution, not just a military force, and said its strength depends on a strong relationship with the legislature. Knight reviewed several priorities and accomplishments, including regular transparency updates to the governor, legislature, congressional delegation, and force; the creation of the Vermont National Guard and Veterans Caucus; and legislation supporting education, workforce development, benefits, and service members’ families. He highlighted recruiting and retention efforts, including the Prime employer partnership program, which he said now has 40 employer partners and 24 more pending, and argued that Vermont can attract and retain service members by connecting military experience to civilian jobs and education opportunities. He also discussed organizational climate improvements, mental health and prevention staffing, and the need for more providers who accept military patients and Tricare, noting the Howard Center and other health centers are expanding military and veteran care. The address also covered the Guard’s broader role in emergency response, citizenship, diversity, and international partnerships. Knight described recent deployments and state responses to COVID-19, flooding, and other emergencies, explained Guard duty statuses and called for congressional reform to simplify them, and outlined state partnership work with Austria, North Macedonia, and Senegal, as well as related educational and economic initiatives. He recognized numerous Guard members, recruiters, fiscal staff, media partners, and outside collaborators for their contributions. No votes were taken. The meeting concluded with Speaker recognition of Knight’s service and an announcement that the caucus had ended and the House would gavel in shortly afterward.

Transcript Highlights:

• I will just share one stat: 80%.
• It was too good not to share.
• it into shared databases.
• types of services.
• Let me share one of those stories.

Keywords: 995, all

Summary: The Senate Committee on Juvenile and Emerging Adult Justice held an informational hearing focused on diversion programs and services for high-risk youth, with no bills before the committee and no votes taken. The chair and members emphasized that the session was intended to hear from invited testimony and discuss how to strengthen diversion, reduce court involvement, and improve outcomes for youth. The committee heard first from the Office of the Child Advocate and diversion providers, who described the Massachusetts Youth Diversion Program, its statewide expansion to 10 of 11 court counties, and its reported success rate of about 80% completion without reoffending. Testimony highlighted that diversion keeps youth out of court, connects them more quickly to community-based services, and can address needs such as mental health, education, and substance use. Witnesses also pointed to racial and ethnic disparities in arrests versus summonses, regional variation in diversion access, and the need for clearer statutory authority, more funding, and broader use of pre-arrest diversion. Committee members asked about the difference between arrest and summons, who can initiate diversion, why arrest rates have increased relative to summonses, and how diversion might prevent harmful downstream consequences such as detention or immigration enforcement involvement. Witnesses said police, clerk magistrates, district attorneys, and judges can refer youth to diversion, and argued that local policy, training, and legislative changes could expand use. They also discussed the impact of detention on youth, including stigma, lost school time, and the lack of credit for time served in the juvenile system. Testimony from Citizens for Juvenile Justice focused on prevention, school discipline, and the school-to-prison pipeline, arguing for more restorative practices, better data, and legislation to limit suspensions and expulsions, especially for younger students and nonviolent conduct. They also raised concerns about DCF-involved and foster youth, who are disproportionately represented in the juvenile system. The final panel, the Children's League of Massachusetts and transition-age youth providers, shifted to child welfare and young adult supports. They supported reducing court involvement in child requiring assistance cases, expanding family resource centers, and strengthening services for transition-age youth leaving DCF or DYS custody. Providers described housing instability, homelessness, and the need for education, employment, behavioral health, and supportive housing services for young adults ages 18 to 23. Across the hearing, witnesses consistently argued that early intervention, community-based supports, and diversion are more effective than court processing or detention for most youth, and that the legislature can help through funding, statutory clarity, expanded eligibility, and stronger data collection.

Transcript Highlights:

• We have a wide range of services.
• To take over the core service designation for children's services for our area because the agency that
• A vast array of services in outpatient therapy, psychiatry, family support services.
• Provide service across settings.
• But I'd be happy to share with you.

Transcript Highlights:

• which provide fixed-route and demand-response service, generally bus service, outside the MBTA service
• We are an organization that has regulatory responsibility for vehicle services, driver services, driver
• We have a very bare-bones Registry service center at the service plaza on the Pike, but they're very
• We're also excited that the ride app companies have agreed to restart the ride share service, which is
• You cannot share a ride... The ride share service, which is currently suspended.

Keywords: 995, all

Summary: The Joint Committee on Transportation held an informational hearing with invited testimony from MassDOT leadership, the MBTA, Massport, and the state’s Federal Funds and Infrastructure Office. MassDOT officials outlined work across highways, rail and transit, the Registry of Motor Vehicles, and aeronautics, emphasizing major capital spending, bridge and roadway programs, transit grants, rail expansion, airport safety, and modernization efforts. They highlighted Chapter 90 and municipal grant programs, the Compass Rail and West-East Rail efforts, RMV upgrades such as electronic titles and driver licensing systems, and aeronautics work on airport pavement, drones, and advanced air mobility. Committee members focused on safety, service access, and project implementation. Questions to MassDOT covered automated enforcement and rising roadway fatalities, the Allston multimodal project’s federal funding, Complete Streets access for rural communities, and South Coast Rail staffing and future electrification. The RMV was asked about the Work and Family Mobility Act, Real ID demand, and appointment access, especially in Metro West. Members also raised concerns about South Coast Rail operations, Keolis staffing, and whether the Stoughton route remains part of future plans; MassDOT and MBTA officials said they are working on staffing, service reliability, and long-term expansion, while noting that nothing is off the table for future rail improvements. MBTA General Manager Phil Eng reported progress including workforce growth, elimination of subway speed restrictions, expanded reduced-fare access, bus network redesign, South Coast Rail launch, and commuter rail signal upgrades. He said the agency is pursuing a new commuter rail operating contract designed to support future regional rail, electrification, and higher-frequency service, while maintaining service and workforce stability amid funding uncertainty. Members also asked about fare collection data privacy and the impact of state funding levels; Eng said the MBTA needs the governor’s proposed funding to preserve service and staffing, and that the fare system’s data are encrypted and handled through a secure vendor system. Massport CEO Rich Davey reported record activity at Logan, Worcester, and the cruise and maritime facilities, along with major capital and climate investments such as sustainable aviation fuel planning, shore power at Flynn Cruiseport, renewable diesel, and expanded ground transportation. He said Massport is planning for continued passenger growth and managing congestion through parking, HOV, and curbside changes, while monitoring federal policy, tariffs, and air traffic control staffing issues. Federal Funds Director Quentin Palfrey described the administration’s efforts to secure federal infrastructure dollars, citing about $9 billion in federal awards since the start of the administration, including major transportation grants for the Cape Cod Bridges, Allston, West-East Rail, North Station drawbridge replacement, roadway safety, and clean school buses. He warned that changing federal policies, grant delays, and possible future congressional actions create uncertainty, but said the office is working case-by-case with municipalities and agencies to protect awarded funds and find alternative financing where needed.

Transcript Highlights:

• But I wanted to share two personal experiences.
• And we'll let Abby share her story.
• The services are personalized and flexible.
• Calling the committee back to order and asking Victoria to share whatever it is she has to share.
• And he had a menu of sexual services.

Summary: The committee first approved the December 16 minutes and then heard a presentation from Dr. Ramona Danielson on adverse childhood experiences (ACEs) and their economic and public-system impacts. She explained that ACEs are population-level risk indicators, not individual diagnostic tools, and said higher ACE exposure is associated with more chronic illness, mental health challenges, child welfare and justice involvement, and lower workforce participation. She cautioned that precise dollar estimates are difficult because of the many interacting factors across the life course, but said the direction of the impact is clear and that evidence-based interventions and protective factors can reduce harm. Members asked about definitions of a “healthy family,” same-sex couples, divorce, substance abuse, trends in ACEs, and home visiting; she emphasized supportive relationships, protective factors, and the importance of positive childhood experiences. The committee then heard from Allison Mahoney and Missy Barranco, along with a recorded family story from Abby, about evidence-based home visiting programs in North Dakota. Abby described how Healthy Families North Dakota supported her family after a premature birth and NICU stay by providing weekly in-home coaching, developmental screenings, postpartum mental health check-ins, referrals, and parenting support. The presenters explained that home visiting is voluntary, relationship-based, and usually begins prenatally or shortly after birth, with referrals coming from hospitals, WIC, pregnancy navigators, human service zones, self-referrals, and other community partners. They said North Dakota currently has four main evidence-based models operating through 12 organizations, with Healthy Families available in all 53 counties, though only a fraction of eligible families are served. Funding was described as a patchwork of federal MIECHV/Title IV-E, Medicaid, state and tribal funds, philanthropy, charitable gaming, and other grants; members discussed whether the Legislature or agencies should expand support and how to improve outreach and sustainability. Finally, the committee received a memorandum on artificial intelligence and sexual exploitation, focusing on AI-generated child sexual abuse material, deepfakes, sextortion, and chatbot-related risks. The report summarized federal and state law, including North Dakota’s existing computer-generated image provisions, the federal PROTECT Act, the Take It Down Act, and recent federal executive orders on AI policy. Members discussed the need for child-safety protections, the limits of executive orders, and broader concerns about AI’s effect on critical thinking and misinformation. The committee then heard from BCI Special Agent Cassidy Halsef, who said AI is already driving a sharp rise in child exploitation cases in North Dakota, including AI-generated explicit images of real minors and school-based incidents involving mass-shared manipulated images. She said investigators are seeing more cyber tips, more difficult forensic work, and lasting harm to victims and families, and urged stronger legal penalties, specialized training, victim services, and prevention education in schools and communities.

Transcript Highlights:

• rather than fee for service dollars. rather than fee for service dollars.
• and peer support services 80038. and peer support services 80038.
• fee for service. fee for service.
• <01:01:05.200> are services to determine if services are services to determine if services
• medically necessary services. medically necessary services.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board reconvened and heard a presentation from the Attorney General’s Office Medicaid Fraud and Abuse Control unit. AG staff described the unit’s structure and work: it investigates and prosecutes Medicaid provider fraud, and also handles abuse, neglect, and exploitation cases involving vulnerable adults in facility settings when asked to assist. They said the office has prosecutors, detectives, auditors, and support staff, works with federal partners, Commonwealth’s attorneys, CHFS, DMS, OIG, and MCOs, and uses a hotline and referral line for complaints. They also explained the MCO referral process, including monthly meetings, stand-down lists, and review of referrals for a “credible allegation of fraud” before the AG office decides whether to open a criminal or civil investigation. The presentation focused heavily on current fraud trends. Staff said behavioral health is a major concern, along with participant-directed waiver services, medically assisted treatment, cash billing for services, controlled-substance billing, and vision and dental fraud. They gave examples such as duplicate time sheets for family caregivers, questionable Suboxone counseling and urine drug screening practices, and a prior optometry case involving false claims for children’s glasses. They also discussed CMS’s estimate that about 5% of Medicaid payments are improper, noted that most improper payments are at the fee-for-service level, and said there is no reliable overall fraud-rate estimate. They highlighted a sharp shift in behavioral health billing after the cabinet’s November 1, 2024 policy changes, saying individual psychotherapy spending dropped while group billing increased, suggesting providers may have moved billing to different codes. Members asked about the scale and timing of cases, how MCO referrals are screened, and whether the data reflected more people being served or just higher spending. The AG office said investigations can take years, with some federal cases still awaiting sentencing from 2018 and 2019 matters, and that they currently had nine individuals awaiting sentencing in federal court. They also reported 58 hotline reports during the referenced period, six cases opened from MCO referrals, and four additional MCO referrals not accepted for active cases. Several members raised concerns about home-based services and the risk of abuse or fraud when family members are reimbursed, and asked whether the process could be streamlined; the AG office said it had no immediate recommendations but would be willing to return with suggestions after further review.

Transcript Highlights:

• So the fee-for-service models are arranged between the hospital and the private ambulance services.
• We offer comprehensive services at five community health centers, including services at Dorchester House
• By requiring private insurance plans to cover an adequate amount of doula services without cost sharing
• insurance plans to cover doula services.
• Regarding private insurance coverage, through no cost sharing for doula services, this would ensure equitable

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a lengthy public hearing with testimony on a wide range of health insurance and access-to-care bills. Early testimony focused on prescription drug pricing and pharmacy reimbursement, with supporters of H. 1326 arguing that pharmacy benefit managers and MassHealth managed care arrangements reimburse independent pharmacies too little, contributing to pharmacy closures and “pharmacy deserts.” The committee also heard repeated support for H. 1151/S. 742 on cognitive rehabilitation for acquired brain injury, H. 1288/S. 716 on telehealth parity for nutrition counseling, H. 1309/S. 761 on full-spectrum pregnancy care without cost-sharing, H. 1312 on insurance coverage for doula services, H. 309 on prompt access to health care by removing deductibles for certain services, H. 809/H. 1227 on biomarker testing, H. 1162/S. 810 on reducing inequities in access to medical procedures by limiting insurer cuts tied to Modifier 25, and S. 726 on insurance coverage for mobile integrated health. Testifiers included legislators, physicians, pharmacists, dietitians, emergency and rehabilitation clinicians, and patients and family members. Supporters of the brain injury bill said cognitive rehabilitation is medically necessary, improves long-term outcomes, and can reduce institutional care and public costs; they noted the bill has been heard repeatedly and has support from the Brain Injury Commission and prior favorable committee action. Supporters of the pregnancy care and doula bills described out-of-pocket costs as a barrier to maternal health and shared personal stories of high bills and unmet support needs. Biomarker testing advocates and cancer patients said coverage gaps deny patients access to precision treatment, can lead to avoidable suffering, and should be standardized across insurers; several speakers said insurers often deny claims despite clinical benefit. Dermatology witnesses said insurers’ use of Modifier 25 cuts reimbursement for same-day evaluation and procedure visits, forcing separate appointments and increasing patient burden. Mobile integrated health supporters described home-based care as a way to reduce emergency department use and hospital readmissions, especially for patients with transportation or mobility barriers. No votes or formal committee actions were taken during the hearing itself.

Transcript Highlights:

• And as we know, it's an important service to allow people to age in place and receive their services
• For those who don't know, Indian Health Services individuals who are enrolled in Indian Health Services
• I'll share, and I think we've shared in other forums, that costing out the technology, we're looking
• services, SUD services, and lower-level preventative behavioral health clinical services, are all really
• , particularly crisis services, SUD services, lower level kind of preventative based like behavioral

Summary: The committee met to hear introductory briefings from the Department of Health and the Health Care Authority on agency priorities, federal changes, and implementation challenges. Secretary of Health Dennis Worsham said his department’s listening tour is focused on strengthening governmental public health, improving health care quality and access, and responding to federal funding disruptions and the shutdown’s effects on programs such as WIC. HCA Director Ryan Moran said the agency is prioritizing coverage preservation, oversight of major contracts, affordability, behavioral health integration, rural health transformation, and internal agency operations. Members asked about licensure delays; Worsham said the backlog had been reduced from about four months to six weeks and should be caught up by January 1, with possible further process changes if needed. A major portion of the meeting focused on H.R. 1 and its Medicaid-related implementation. Governor’s health policy advisor Caitlin Stafford, HCA staff, and interim Medicaid Director Trinity Wilson said the state is working with DSHS, the Health Benefit Exchange, tribes, and other partners to prepare for eligibility changes, work requirements, and six-month redeterminations. They said the state expects up to 30,000 Apple Health enrollees could lose coverage under the law’s non-citizen eligibility changes, and that the work requirement/redetermination provisions could affect about 620,000 adults, with roughly 80,000 also enrolled in SNAP. HCA said it hopes to automate most verification, but about 15% to 20% of cases may require manual review, with technology costs estimated at up to $30 million. Staff also said they are trying to keep H.R. 1 implementation mostly in budget language rather than statute, and that communication and navigator support will be important to minimize confusion and coverage loss. The committee also received an update on the Rural Health Transformation Program created in H.R. 1. HCA said Washington submitted its application to CMS on November 5 after extensive stakeholder engagement, including more than 310 written comments, webinars, and tribal consultation. The application centers on six initiatives: rural hospital innovation, community care and prevention, tribal investments, technology and data, workforce development, and rural behavioral health. HCA said the state is likely to receive less than the full $200 million annual amount assumed in the federal program, and that an advisory committee may be created to help guide spending over the five-year program. Members asked about palliative care, small business impacts, and communication with enrollees; HCA said it expects to share outreach toolkits and that no 2026 statutory changes are currently anticipated, though that could change. The final panels covered organ donation and transplant services. Department of Health staff explained the 2023 “Lights and Sirens” law for organ transport vehicles, including licensing, driver qualifications, insurance requirements, and use of emergency lanes and traffic preemption; the department said one company is currently licensed and there have been no complaints. LifeCenter Northwest described the organ procurement process, the legal framework under the Uniform Anatomical Gift Act, and the rarity and complexity of deceased donation, noting Washington has seen strong growth in donation and transplants over the past decade. University of Washington Medical Center staff then outlined its transplant programs for kidney, liver, heart, lung, pancreas, and multi-organ transplants, describing the multidisciplinary evaluation and waitlist process and the coordination required with donor organizations and hospitals.