Transcript Highlights:

• This amendment aligns Florida's building code with national standards and makes rules predictable for
• I think we can continue to look at it and make it a good model that can still function and do what we

Summary: The committee first took up SB 80, the Parks Preservation Act, which would define state park purposes around conservation-based recreation and public access, prohibit uses such as golf courses, tennis courts, pickleball courts, ball fields, and hotels, require more public notice and advisory input on land management changes, and mandate reporting on park spending and maintenance backlogs. Testimony was overwhelmingly supportive, with conservation groups, youth advocates, and other members of the public backing stronger protections for state parks. The bill was reported favorably. Members then approved SB 200, directing DEP to develop a statewide waste reduction and recycling plan, and CS for SB 496, which clarifies that timeshare facilities are governed by Chapter 721 and only need annual board meetings. CS for CS for SB 1404, dealing with illegal gambling, was amended to add reporting requirements, tighten penalties, preempt local gambling legalization, and create a process for vetting certain machines and veteran-service-organization gaming questions; the bill drew significant concern from veterans groups and others over vague machine definitions and the need for clearer standards, but it was still reported favorably. The committee also passed SB 622 to allow pari-mutuel permit holders to lease facilities across horse-racing classes. The committee next approved CS for CS for SB 712 after adopting a strike-all and amendment that covered synthetic turf rules, change-order timelines, public works scoring, elevator and alarm contractor issues, mass timber code updates, pool and spa contractor scope changes, spaceport building-code exemptions, and solar/energy-storage inspection provisions. Support came from timber, construction, and industry groups, while pool contractors objected to parts of the scope changes. The committee also reported favorably CS for CS for SB 1742, a major condominium reform bill that pauses reserve funding after milestone inspections, expands financial flexibility, adds disclosure and conflict-of-interest rules, and increases data collection and oversight; members from both parties praised the sponsor’s work on condo issues. Finally, the committee approved SB 1574 on renewable natural gas infrastructure and SB 1580 authorizing DEP coastal resiliency public-private partnerships. It also passed CS for SB 1760, which requires certain public officials and agency leaders to meet Florida residency or proximity requirements. The last bill, SB 820, would codify the Office of Faith and Community in the Governor’s office; while supporters said it would permanently support faith-based and community organizations and improve coordination, several senators raised concerns about church-state separation, the office’s ties to Hope Florida, and whether codifying it could make the program more political. Despite those concerns, the bill was reported favorably.

Transcript Highlights:

• So I think that sort of underlies the need to consider sort of looking where to expand that model to
• there are these, we call them granular vulnerabilities in supply chains that. make it very hard to predict

Keywords: 988, house, all

Transcript Highlights:

• The having a federal authority on food safety and labeling, uh, gives us predictability in what we can
• And, um, I appreciate. and are looking to our state manufacturers to be a model.

Bills: HB25, HB38

Keywords: ivermectin, pharmacist authority, prescription-free, healthcare regulation, patient access, interest rate, ad valorem taxes, homesteads, property tax, tax deferral

Transcript Highlights:

• strategic work plan to prioritize critical water projects similar to the state's transportation planning model
• there's no consistency, and it's very difficult for individual consumers or businesses to have predictability

Summary: The Committee on Environment and Natural Resources met with a quorum present and considered a series of environmental, water, waste, boating, and land-use bills. SB 834 on recreational fishing vessel licenses was briefly explained as aligning licensure rules for freshwater and saltwater captains and was reported favorably. SB 1208 on service lateral assessment and rehabilitation would require periodic CCTV inspections, a seven-year assessment cycle, and a long-term public database for sewer laterals; county representatives opposed it over private-property and cost concerns, but the bill was reported favorably. SB 978 on advanced wastewater treatments, as amended, would require DEP reports and a long-term prioritization plan for upgrading large wastewater facilities to advanced treatment; the committee adopted the amendment and then reported the bill favorably. The committee then took up SB 1822 on auxiliary containers, which would preempt local regulation of certain packaging and define the term in statute. The sponsor argued it would reduce a patchwork of local rules and help businesses, while opponents from environmental groups, local advocates, and some local governments warned it would weaken plastic and foam restrictions, including in parks and coastal communities. Despite substantial opposition and several senators expressing concern, the bill was reported favorably. The committee also approved CS for SB 384 on notice for annexation of state-owned lands, after a technical amendment requiring written or email notice to legislative delegations, and reported it favorably. SB 1008 on waste incineration would bar new ash-producing incinerators or waste-to-energy facilities within a half-mile of residential, commercial, or school property. The sponsor said the bill was aimed at preventing another fire-related incident like the Doral plant and clarified it was intended to apply only to new facilities, not existing ones; waste-to-energy and county representatives opposed it as too restrictive, while several senators sought clarifying changes. The bill was reported favorably. The committee also adopted a substitute amendment to CS for SB 594 on port channel and turning basin buffer zones, reducing the proposed anchoring setback from 5,000 feet to 2,500 feet and allowing ports to create buffer zones after public hearings and rulemaking; the bill was then reported favorably. Finally, SB 830 on lost or abandoned property, aimed at streamlining removal of migrant vessels that pose navigational and environmental hazards, was reported favorably after brief support testimony.

Transcript Highlights:

• We obviously can't predict if there would be a potential challenge or what issues would be raised, and
• Arts, Music, and Instructional Materials Discretionary Block Grant, on which we understand it was modeled

Keywords: 988, house, all

Transcript Highlights:

• that opened the doors for every parent and for every student in the state of Florida and has become a model
• continue to build the 2025-26 pre-K through 12 budget, we're relying on forecasts and we're looking at predictions

Summary: The Pre-K through 12 Budget Subcommittee met to continue reviewing how Family Empowerment Scholarship students are funded through the FEFP and the role of scholarship funding organizations. Staff gave a statutory overview of parent, SFO, and Department of Education responsibilities, including application deadlines, eligibility verification, quarterly payment timing, cross-checks to prevent duplicate funding, and the 99% district FEFP limitation for certain awards. The committee then heard demonstrations from Step Up for Students and AAA Scholarship Foundation showing their parent portals, application workflows, reimbursement systems, school enrollment/invoice processes, and marketplace tools for tuition, tutoring, and approved goods and services. Step Up reported major growth since HB 1, saying its scholarship population expanded from about 260,000 to more than 440,000 students, with application processing averaging about 10 days. It also highlighted faster tuition, provider, and reimbursement payments, multilingual support in English and Spanish, and resources such as videos and a call center. Members asked about support for Creole speakers, optional Florida ID numbers, student identifiers, marketplace pricing, tutor qualifications, background screening, and how awards differ from funded status. Step Up said it does not currently support Creole, does not do background screenings for tutors, sets no marketplace prices itself, and uses a unique internal student ID separate from the state ID. AAA demonstrated its revised software for the 2025-26 school year, including an eligibility screener, household and student application steps, messaging with staff, reimbursement requests, and administrative review and payment batching. AAA said the new system is custom-built, more transparent about award value versus available balance, and designed to better handle quarterly funding for UA students. Members questioned AAA and Step Up about student ID numbers, public-school cross-checks, fraud controls, school fee schedules, whether schools must participate, and reimbursement timing. Both organizations said they report quarterly to DOE, receive public-school cross-checks, and recover funds when students return to public school; AAA said its average reimbursement turnaround is about 14 business days, while Step Up said its reimbursement approvals have improved significantly. The committee also requested follow-up information, including one-pagers, data on income levels and demographics, and additional details on forecasting and system costs.

Transcript Highlights:

• The ACP is a model of public infrastructure management, and its independence has been key to ensure a
• Depending on any one sea lane is awfully risky in this very, very difficult-to-predict world.

Transcript Highlights:

• That will be models for the country.
• foundation effort so that we can use philanthropy as one of the tools and not just the reimbursement model
• So we can actually use some of the predictive capabilities and the automated capabilities to get people

Keywords: 908, all

Summary: The committee was called to order, the roll was taken, and the March 18 minutes were approved. Members then received several project and program updates, beginning with CHI St. Alexius’s behavioral health buildouts in Bismarck, Williston, and Grand Forks. St. Alexius reported that the Bismarck project remains on track for June 2027 completion, with demolition underway and final design work nearing completion. Williston reported construction is progressing, staffing recruitment is underway for psychiatrists and other staff, and an air handler replacement is creating a roughly $750,000 unbudgeted barrier that will slightly delay the timeline. Grand Forks reported its expansion is about 30% complete, with no major barriers beyond weather, and leaders said the project should be substantially complete in the first quarter of 2027. The Department of Health and Human Services then presented a series of budget and program updates. Donna Ockland explained several recent line-item transfers as technical corrections that net to zero and do not require new spending, then reviewed salaries, wages, and FTE counts, noting the department remains within its authorized staffing levels. Pat Rainer followed with an update on the Rural Health Transformation Program, saying 12 opportunities have been posted, 422 applications received, and $8.4 million obligated so far, with a goal of obligating the full $199 million by September. He described grants for workforce retention, rural rotations and housing, community gardens, school wellness, behavioral health promotion, safety net services, equipment, technology, EMS, and other initiatives, emphasizing that the program is intended to be transformational and tied to metrics. Members asked extensive questions about how rural eligibility is defined, how grants will support both rural facilities and hub hospitals, and how future years of funding will build on current awards. The committee also heard an update on certified community behavioral health clinics from Elena Zeller, who said North Dakota has been accepted as a demonstration state, implementation is underway in Williston, North Central/Minot, Fargo, and Dickinson, and care coordination and service counts are increasing. Rebecca Askins then reviewed SNAP payment error rates, saying the 2025 rate was finalized at 9.89%, with the state aiming to get below 6% through policy updates, training, data tools, and a quality assurance team. Members pressed her on the causes of the error rate, the role of the SPACES software system, and the need for accountability and improvements. Finally, Dirk Wilkie reported the state laboratory project reached substantial completion on June 12 and is on budget at about $69.95 million, though a service elevator had to be redesigned because it was too small for equipment.

Transcript Highlights:

• That will be models for the country.
• foundation effort so that we can use philanthropy as one of the tools and not just the reimbursement model
• So we can actually use some of the predictive capabilities and the automated capabilities to get people

Summary: The committee met with a quorum, approved the March 18 minutes, and then received a series of updates on major health-related projects and programs. CHI St. Alexius representatives reported progress on behavioral health buildouts in Bismarck, Williston, and Grand Forks, including demolition and construction milestones, staffing plans, and timelines. The Bismarck project remains on track for completion in June 2027 with about $346,500 spent to date. Williston reported construction underway, a $750,000 unbudgeted air handler replacement, active recruitment for psychiatrists and other staff, and a projected substantial completion in early 2027. Grand Forks reported about 30% completion, weather-tight status expected in August, and continued staffing ramp-up as the facility expands from its current 24-bed operation. The Department of Health and Human Services then reviewed a set of technical line-item transfers, emphasizing that they were administrative corrections with no net change in funding. The department also walked through the Salaries and Wages Block Grant and FTE counts, noting overall staffing remained within appropriated limits and that behavioral health staffing had increased. Members asked about vacancies, consultant use, and the mix of in-state versus out-of-state expertise for the Rural Health Transformation Program. HHS said it had posted 12 funding opportunities, received 422 applications, obligated $8.4 million so far, hired 26 people, and was preparing additional grant rounds and a CMS budget submission. The department said the program is structured around workforce, prevention/healthy living, care closer to home, and technology/data, with ongoing stakeholder engagement and community forums. The committee also heard on the certified community behavioral health clinic implementation plan, SNAP payment error rates, and the state laboratory project. HHS said CCBHC certification is being implemented in four regions—Williston, Minot/North Central, Fargo/Southeast, and Dickinson/Badlands—with care coordination expanding and baseline data still being collected. On SNAP, the department reported a 2025 payment error rate of 9.89%, acknowledged cost impacts under HR1, and said it is using training, system changes, and pre-authorization quality checks to reduce errors toward a 6% target over the next 6 to 12 months. Finally, Public Health reported the state laboratory reached substantial completion on June 12, with total costs at $69.95 million of the $70 million budget, though a service elevator issue will require a new lift to be added using contingency funds.

Transcript Highlights:

• That will be models for the country.
• foundation effort so that we can use philanthropy as one of the tools and not just the reimbursement model
• So we can actually use some of the predictive capabilities and the automated capabilities to get people

Summary: The committee met with a quorum, approved the March 18 minutes, and then received a series of updates on health-related projects and Department of Health and Human Services budget matters. Representatives from CHI St. Alexius in Bismarck and Williston, and Altru in Grand Forks, reported progress on behavioral health expansion projects, including demolition and construction milestones, updated timelines, funding status, staffing plans, and barriers such as an unbudgeted air handler replacement in Williston. Members asked about original completion dates, use of telehealth, recruitment of psychiatrists and other staff, and whether the new beds might reduce the need for patients to travel to Jamestown State Hospital. The projects were described as on track overall, with completion expected in 2027 for the larger builds and earlier openings for some phases in Williston. The committee then heard from HHS leadership on technical line-item transfers and the Salaries and Wages Block Grant. Donna Ockland explained that recent transfers were administrative corrections to place spending in the proper budget lines and did not involve new spending, and she reviewed FTE counts and vacancies across the department. Questions focused on behavioral health staffing changes and the use of consultants in the Rural Health Transformation Program. Pat Rainer outlined the rural health program’s first-year grants and priorities, including workforce retention, rural rotations and housing, community wellness initiatives, behavioral health promotion, safety net services, hospital equipment, suicide prevention training, technology, and EMS support. He said North Dakota’s plan was drawing positive national attention, but the department still needed to obligate roughly $199 million by September and was working with CMS on timing and compliance. The committee also received an update on certified community behavioral health clinics from Elena Zeller. She said North Dakota had been accepted as a demonstration state, with certification efforts underway in Williston, North Central, Fargo, and Dickinson. Members asked about care coordination, service growth, staffing, and whether certification would expand to all clinics; the department said it was still collecting baseline data and evaluating impacts before making future recommendations. Finally, Rebecca Askins reviewed SNAP payment error rates, explaining that the 2025 rate was finalized at 9.89 percent and that the department is working on training, system changes, and quality assurance steps to get below 6 percent. Members pressed on the causes of monthly variability, the performance of the SPACES system, and accountability for ongoing errors, and the department said it expects improvement over the next 6 to 12 months.

Transcript Highlights:

• implemented criminal negligence, including New York and other states across the country, which we think is a model
• this loss, missing a husband, a father, son, a brother, a friend, and many young children lost role models
• We, this committee, reports it out favorably typically, and I assume and predict we'll do it again.

Keywords: 995, all

Summary: The Joint Committee on Public Safety and Homeland Security held a public hearing on a wide range of bills affecting law enforcement, corrections, fire services, emergency management, telecommunicators, and sex offender policy. Testimony strongly focused on proposals to restore an education incentive for Massachusetts State Police troopers hired after the Quinn Bill was repealed, with State Police Association witnesses arguing the current system creates unfair pay disparities, hurts recruitment and retention, and leaves newer troopers earning less than some supervisors with the same or less education. They urged favorable reports on H. 2651, S. 1759, and S. 1783. A separate witness also supported H. 2627, a sheriff’s pay-parity bill, while suggesting amendments to avoid distinctions between correction officers and jail officers and warning that the proposal should not be viewed as a funding issue alone. The committee also heard testimony on public safety and oversight bills. A rape survivor testified in support of S. 1663, arguing that municipal fire or police personnel convicted of sex offenses should not remain in positions of public trust. Senator Miranda testified in support of S. 1723, S. 1724, and S. 1727, which would create correctional officer training/accountability standards, a correctional inspector general, and privileged communication with legislators for incarcerated people; he said the bills respond to misconduct and lack of independent oversight in the Department of Correction. In contrast, the Fire Chiefs Association and Professional Fire Fighters opposed H. 2572/S. 1668/S. 1740 on emergency management, saying the bill was developed without enough collaboration, lacked local-control safeguards, and could undermine incident command and local decision-making during disasters. Several panels supported other public safety measures. The Fire Chiefs Association and PFFM backed S. 1641 and S. 1744 to create a Massachusetts Public Safety Building Authority to help fund fire station and municipal public safety building projects, and supported S. 1647 to implement the Walsh-Kennedy Commission recommendations on hot works and welding safety, including tougher penalties and training requirements. Witnesses also supported H. 2664/S. 1736 to create a hoisting machinery regulations board, saying current licensing standards for heavy equipment are too minimal. Another panel backed H. 2663/S. 1761 to classify 911 telecommunicators as first responders, citing stress, burnout, and the expanding role of dispatchers. Finally, an attorney from CPCS testified in opposition to S. 1752, warning that expanded sex offender residency restrictions would likely increase homelessness, make supervision harder, and raise constitutional concerns based on prior court rulings.

Transcript Highlights:

• , over 400 risks that were identified and calculated in this way, and that is a component of the modeling
• That creates that 70th percentile concept because they're running many model runs to develop that figure
• That gives predictability to contractors that likely tightens up bids because they can see what they

Keywords: 907, all

Summary: The committee first received an informational update on the Interstate Bridge Replacement Project from Carly Francis and Travis Brower. They described the project’s purpose as improving seismic resilience, safety, freight movement, transit, and bicycle/pedestrian access across the Columbia River, and said the updated cost estimate is $13.2 billion to $14.4 billion for the full corridor. They explained the increase from the 2022 estimate as driven by construction inflation, a more conservative inflation curve, schedule delays, more detailed engineering, and risk modeling. They also outlined the funding plan, including $2.1 billion in federal funds, $1 billion each from Oregon and Washington, and $1.5 billion in projected toll revenue, and said they are working to obligate federal funds by the end of September. The panel described a first funded phase that would include the bridge, highway connections, tolling infrastructure, bridge removal, and transit design, with light rail to Vancouver still intended but dependent on additional funding. Members questioned the risk of losing federal transit funds, whether bridge design decisions were being made with legislative input, and whether the space reserved for light rail could be used for buses if transit funding does not materialize. The committee then heard testimony on maintaining Oregon’s existing roads and bridges from representatives of Knife River, the Asphalt Pavement Association of Oregon, and CRH. Witnesses said pavement and bridge preservation is severely underfunded, with ODOT needing about $400 million per year for pavement preservation but receiving roughly $100 million annually. They showed examples of deteriorating highways such as U.S. 97 and I-84 and argued that delaying maintenance leads to much higher reconstruction costs, more safety risks, and higher user costs. Knife River described layoffs and reduced work in Oregon because of limited preservation funding, while witnesses also said rising wages, equipment costs, fuel, and permitting delays are increasing project costs. Committee members asked about the role of prevailing wage, diesel equipment, hauling distances, and whether preservation work could be prioritized more effectively. Finally, economist Joe Cortright presented on recent ODOT megaproject cost overruns. He said Oregon has experienced persistent overruns driven by overly optimistic revenue forecasts, heavy reliance on debt, consultant costs, inflation above forecast, and projects that have become much larger in scope than originally presented. He cited major increases in the Interstate Bridge, Rose Quarter, and Abernathy Bridge projects and argued that some designs are far wider and more expensive than necessary. Cortright said better accountability, clearer priorities, and more disciplined project sizing are needed, and committee members pressed him on why agencies proceed with larger designs even when consultants recommend narrower, less expensive alternatives.

Transcript Highlights:

• She also supports indigenous fashion and has modeled for indigenous fashion designers during the Santa
• She lives and models the Kiowa words be pete pete, which means don't give up, keep trying.
• currently have an obesity epidemic right now in our younger people in school, and those people are now predicted

Bills: HR1036, HB2975, HB3026, HB3297, HB2981, HB2978, HB4144, HB1322, HB1818, HB3194, HB3767, HB3342, HB3344, HB4170, HB3287, HB3288, HB4454, HB3264, HB3266, HB3268, HB4095, HB4115, HB4316, HB3530, HB3428, HB4272, HB4273, HB4274, HB3405, HB3406, HB3467, HB3469, HB3931

Keywords: poultry waste, nutrient management, environmental regulations, agriculture, water quality, pollution prevention, best management practices, kindergarten, military families, education policy, school districts, international military dependents, age eligibility, towing services, Oklahoma Wrecker and Towing Services Fund, Department of Labor, vehicle storage fees, consumer protection, nonconsensual towing, open meetings

Transcript Highlights:

• with them to identify and correct hazards, as well as award and recognize Missouri businesses that model
• with them to identify and correct hazards, as well as award and recognize Missouri businesses that model
• And so there's, I guess, you can't predict the timeline on that.

Keywords: 959, house, all

Transcript Highlights:

• WORK I GOT MYSELF COMFORTABLE I WOULD ENCOURAGE YOU TO MEET WITH THEM SO THEY KNOW WHAT THE BUSINESS MODELS
• CONTINENTAL US, ISN'T WHAT WE DO AND WHAT POSITION AND STANCE WE TAKE, DOESN'T IT NOT JUST ACCEPT THE MODEL
• ELSEWHERE NEVER GOING TO SOLVE ANY SORT OF PROBLEM AND AT THE SAME TIME WE SHOULD PROVIDE THEM PREDICTABILITY

Keywords: 999, senate, all

Transcript Highlights:

• understand it, alcohol is more of a linear metabolism and... ...more of a linear metabolism and more predictable
• If you're a certain level of drunk, we... ...If you're a certain level of drunk, we can predict that

Bills: SB274

Keywords: cannabis, psychoactive cannabinoids, CBD, delta-8 THC, delta-9 THC, delta-10 THC, criminal penalties, youth protection, medical cannabis, 923, senate, all

Transcript Highlights:

• For whatever reason, they don't like Alabama because they like the predictability of the assessment..
• . the predictability of the assessment collections.

Bills: HB145, HB311

Keywords: HB145, scrap tires, scrap tire disposal, illegal dumping, ADEM, Alabama Department of Environmental Management, environmental enforcement, Class 2 municipality, municipal court, local enforcement, delegation agreement, primacy, waste management, tire recycling, tire hauling, environmental quality act, misdemeanor penalties, Class A misdemeanor, Class B misdemeanor, Class C misdemeanor

Transcript Highlights:

• You have open language models that can write your script, open language models that can create your soundtrack
• You have open language models that can write your script, open language models that can create your soundtrack
• You have open language models that can write your script, open language models that can create your soundtrack
• What is interesting about what you see on the screen here is this model can be replicated across the
• <01:51:11.119> the while I don't want to predict the while I don't want to predict the outcome

Keywords: 910, house, all

Transcript Highlights:

• It's very similar to the model we have for supporting lakes. town they're based in but they do a lot
• /c><00:53:36.680> similar<00:53:37.040> to<00:53:37.200> the<00:53:37.359> model
• <00:53:37.720> we it's it's very similar to the model we it's it's very similar to the model
• bringing it back to a present value because of the uncertainty of the facts, whereas dollars you predict
• of the facts whereas dollars you predict of the facts whereas dollars you predict the<04:59:55.878

Keywords: 1189, house, all

Summary: The committee first took up House Bill 187, which would allow parents or guardians to seek restraining orders on behalf of a minor child even when the alleged perpetrator is not a family or household member. Tracy Sirles testified that the bill was prompted by her family’s experience after being told by state police to seek a restraining order, only to learn the current law did not allow it because the offender was the child’s best friend’s father. Members agreed the change was straightforward, noted the fiscal note reflected only a small indeterminate cost to the judicial branch, and moved House Bill 187 ought to pass; the motion was approved unanimously. The committee then discussed House Bill 66, a Right-to-Know bill that removes “citizen” language in favor of “person” in some provisions and allows certain New Hampshire-connected requesters to seek records electronically if the records already exist in that format. Members reviewed concerns about defining “member of the media,” the scope of electronic requests, and a sentence stating appeals would have no filing fee or search charge. After debate, the committee voted to amend the bill by removing that fee-waiver sentence, then recommended House Bill 66 ought to pass as amended. The vote was 6-3. Next, the committee heard from the Environment and Agriculture chair about several solid-waste-related bills being folded into trailer bill language, including House Bill 215 and House Bill 171, with discussion of a possible three-year landfill moratorium and the need to address DEES staffing and funding concerns. DEES later clarified that the revised approach would not require new positions or create a fiscal impact because the new solid waste commission would be self-funded through filing fees. The committee voted unanimously to retain House Bill 215. Finally, the committee considered House Bill 566, which requires landfill permit applications to include a detailed leachate management plan and more information about disposal contracts. The sponsor said the bill was developed with DEES to address leachate problems and improve safety oversight. DEES testified that the bill largely reflects current practice and would have no specific fiscal impact, with existing staff able to absorb any review workload. The committee moved House Bill 566 ought to pass, and the motion was approved unanimously. The committee also briefly discussed House Bill 624, a grant program for local river management advisory committees, but no vote was taken in the portion provided.

Transcript Highlights:

• It is turning into what you could consider an AI model that can help you predict and use once it continues
• And unfortunately, some of these modeling assumptions when they're looking at a non-opioid and thinking
• And unfortunately, some of these modeling assumptions when...
• And unfortunately, some of these modeling assumptions when they're looking at a non-opioid and thinking
• ; increased funding... ...provided in Western North Dakota using selected models; increased funding and

Summary: The committee first approved the previous meeting minutes and then heard a detailed annual report from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and policy issues. He explained the committee’s review process, confidentiality protections, and national and North Dakota data showing that most maternal deaths are preventable and that mental health conditions, substance use, cardiovascular issues, infection, hemorrhage, and embolism are the leading causes. Members asked about suicide, domestic violence, midwife training, home births, and whether pregnancy testing at death scenes should be expanded; Dr. Arnold said better coroner education, more investigation of unexplained deaths, and possible post-mortem pregnancy testing could improve case identification, especially in rural areas. He also noted that deaths often occur well after 42 days postpartum and that mental health-related deaths remain a major concern. The committee then heard from State Fire Marshal Dr. Matthew Clark on cigarette reduced-ignition-propensity standards and related fire prevention issues. He recommended updating the state’s cigarette propensity law to current national standards and also raised a separate recommendation to require fast-breakaway oxygen tubing for home oxygen users, citing fatal fires linked to smoking around oxygen. Members asked about implementation, cost, insurance coverage, and whether the standards apply in tribal communities; Dr. Clark said he would provide follow-up information and was willing to help with any legislation, but no agency bill had yet been planned. Next, Christine Greff of the Department of Health and Human Services reported on the North Dakota Stroke System of Care. She described the statewide network of stroke-ready hospitals, registry-based quality improvement, and performance data showing continued improvement in stroke recognition, imaging, thrombolytic treatment, transfers, and EMS pre-notification. She highlighted new quality measures for inter-facility transfers and intracerebral hemorrhage care, and said the system remains strong but depends on continued legislative and hospital support. Committee members asked about participation by the VA hospital and were encouraged to consider outreach to include it more fully in the stroke system. Finally, the committee began a presentation on prior authorization and non-opioid pain treatment from Taha Khan of Vertex Pharmaceuticals. He argued that prior authorization can delay access to non-opioid acute pain medications, especially in the 24- to 72-hour post-discharge window when pain is most severe, and said delays can push patients toward opioids. He emphasized that prior authorization has a role in utilization management but should not create barriers in acute pain care, and he noted that current use of the company’s non-opioid product remains very low. The discussion was still underway when the transcript ended.