Transcript Highlights:

• Those rates are lower than we'd like, of course.
• And so we're having to take a look at why those rates are so low.
• So we're way too early to see really a success rate yet on Prop 36.
• Success rates in the other collaborative courts are high. And the recidivism rates are excellent.
• Our panel is paid at the top rate, the very top rate, $130 an hour. The low rate is $110.

Transcript Highlights:

• This one goes to long-term care Medicaid ALF rates: where in the budget do those rates come from?
• Rate differentials calculated for the different regions of our state.
• And quite frankly, we do have to subsidize Medicaid reimbursement rates.
• That has like a 96% diversion rate for those who call on the phone.
• That has like a 96% diversion rate for those who call on the phone.

Summary: The Health Care Budget Subcommittee held a panel discussion on Florida’s mental health and substance abuse system, with representatives from DCF, AHCA, two managing entities, and two providers describing how the state’s behavioral health network is funded and operated. Members focused on the implementation of prior legislative investments, especially the $50 million in recurring funding from Representative Maney’s bill and the earlier $126 million community behavioral health appropriation. Witnesses said the newer funds were used mainly for crisis beds, discharge planning, outpatient services, regional collaboratives, and a USF Marchman Act report, while the larger behavioral health appropriation supported CAT, FACT, FIT, forensic teams, residential and outpatient services, and crisis care, with most dollars going directly to services and only a small share to administration. A major theme was access to crisis care and the role of mobile response teams, 988, and central receiving facilities in diverting people from Baker Act admissions and reducing readmissions. DCF and providers said mobile response teams have expanded, are being used to de-escalate crises and connect people to care, and have shown strong diversion results and reductions in Baker Acts in some regions. Members also asked about waitlists, children in crisis, and how to handle people without housing or support; providers said discharge planning is individualized but often constrained by homelessness, transportation, and a lack of safe placements, and several witnesses identified housing as one of the biggest barriers to recovery and stability. The committee also examined provider sustainability, reimbursement, and funding gaps. Witnesses described delays caused by contract timing, cost allocation rules, and Medicaid reimbursement rates that do not always keep pace with labor and operating costs, especially for smaller providers and rural networks. DCF and AHCA said managing entities can provide advances, retroactive rate adjustments, and technical assistance, and that Medicaid managed care plans have network standards and complaint/dispute processes. Members raised concerns about a reported $7 million loss in federal non-sustainable funds, provider closures, and whether there is a formal ombudsman process for disputes; DCF said the federal reductions were known and tied to one-time funds, and that the department generally handles provider issues informally while working with managing entities to preserve continuity of care.

Transcript Highlights:

• in the most recent year is higher than the average rate of the previous three years.
• be the academic progress rates?
• How do we factor in the graduation rates into this process?
• Can they raise tuition rates, Mr. Speaker, gentlelady? Mr.
• I have data on retention rates, but I don't know about their annual raising of rates of tuition.

Bills: HB111 , HJR1 , HB61 , HB8 , HB30 , HB43 , HB156 , HJM2 , HM7 , HM17 , HM4 , HM22 , HM23 , HM24 , HM26 , HM2 , HM16 , HM11 , HM14 , HM21 , HM34 , HM50 , HB70 , SB3 , HJM3

Transcript Highlights:

• At last check, we had a 15% error rate.
• I think the only state that had a higher error rate today would be like Alaska.
• At last check, we had a 15% error rate.
• Because previously we did not have this very high error rate.
• Do we know why our error rate spiked over the last four years?

Transcript Highlights:

• the mandate that an app store must display a rating.
• provides that if the app store has a rating or other type of content notice, it shall display the rating
• or reason for the rating.
• It does not set medical billing rates.
• These are not market rates; they're administrative rates.

Bills: SB30 , SB517 , SB1313 , SB1314 , SB1316 , SB1541 , SB1698 , SB1845 , SB1860 , SB2420 , SB2429 , SB 30

Committee: Senate State Affairs

Transcript Highlights:

• There are states whose error rate is below 6%, and there are states whose rates are much higher than
• is measuring it, and we need to bring that error rate below 6%.
• And their rates were between $750 and $1,500.
• That that was so that was so. and their rates were between $750 and $1,500.
• of spending line item with a very significant rate of growth.

Committee: Joint Joint Committee on Ways and Means

Transcript Highlights:

• From our numbers, 121 D and F rated schools are now down to 39—less than 40 D and F rated schools.
• So, we do not, of course, have actual A through F ratings...
• It's an 8.25% state payroll contribution rate.
• In just six years, the cumulative inflation rate has been over 20%.
• The rate for paraprofessionals across the state is $17.30.

Bills: SB1 , SB 1

Committee: Senate Finance

Transcript Highlights:

• that time of those rates.
• And rates were repaid in that.
• The rates were those have been paid.
• Those rates were repaid years ago.
• </c> how the capitation rates are developed? how the capitation rates are developed?

Summary: The Medicaid Oversight and Advisory Board received a presentation from Dr. Stack and Commissioner Langfeld on Kentucky’s application for a federal Medicaid-related funding opportunity tied to House Resolution 1. They described a compressed six-week stakeholder process that produced more than 50 responses and letters of support, and said the application was organized around five broad priorities: maternal health, behavioral health and substance use disorder, oral health, EMS/trauma response, and chronic disease. They emphasized that the proposal was designed to align with CMS goals, use allowable funding categories, and focus on sustainability rather than a short-term grant. Commissioner Langfeld outlined five core initiatives: rural community hubs for chronic care innovation, beginning with obesity and diabetes; a maternal and infant health effort called POWER; a behavioral health and substance use model called IMPATH; an oral health initiative called Rooted in Health; and an integrated crisis-to-care EMS and trauma response effort. He said the chronic disease work would include prevention, food-as-medicine concepts, and technology tools, while the maternal health effort would expand team-based care around mothers and infants using community health workers and doulas. The behavioral health proposal would build on existing crisis intervention models, oral health would address workforce and access gaps through training, mobile vans, and telehealth, and the EMS proposal would better connect emergency response with home-based and community care. Several senators questioned whether the proposal would meaningfully address rural hospital closures or the broader rural health care crisis. Senator Meredith said the plan was not transformational and would not save rural hospitals, while Senator Berg asked how success would be measured. In response, the presenters said they would use both lagging and leading indicators, with an emphasis on rapid-cycle feedback and data use that is more actionable in real time. They also said the work could help existing models that already show promise, such as behavioral health units and dental workforce expansion, even if it would not solve the larger funding gap created by HR1. Senator Douglas asked how the proposals would motivate patients to participate in their own health care. The presenters responded that the chronic disease prevention work would focus on obesity, diabetes prevention, nutrition, and consumer-facing technology tools to help people engage in their own care, and that EMS-community health worker partnerships could identify unmet needs in the home and reduce preventable problems. The board then moved on to its next agenda item, Medicaid managed care delivery models, with Tom Stevens, Katherine North, and Dr. Patel scheduled to present.

Transcript Highlights:

• </c> seriously diminished by a 50% rate seriously diminished by a 50% rate reduction<00:55:47.760><c>
• And those rates vary by facility.
• I think uh there are different rates at I think uh there are different rates at 1,170<01:45:57.119><c
• And those rates vary by facility.
• </c> getting the special rate. getting the special rate.

Bills: HF2115 , HF2276 , HF1644 , HF99 , HF2068 , HF2707 , HF2704 , HF2406 , HF1674 , HF1579

Committee: House Human Services Finance and Policy

Transcript Highlights:

• </c><00:40:25.359><c> um</c> under existing net metering rates. um under existing net metering rates.
• </c> reducing the rates for other rateayers. reducing the rates for other rateayers.
• The individual rate of return changes as those rates change.
• ><c> rates</c> as those rates as those rates change. change. change.
• The individual rate of return changes as those rates change.

Committee: House Science, Technology and Energy

Transcript Highlights:

• </c> rates are are set appropriately. rates are are set appropriately.
• And comparing our 2025 rates to our 2026 rates, you know, on average, across all of our plans, we had
• </c> I would say is that um you know our rate I would say is that um you know our rate increases<01:27
• </c><01:36:46.400><c> is</c> how we kind of are doing those rates is how we kind of are doing those rates
• </c> those will impact our uninsured rate those will impact our uninsured rate just<02:08:50.239><c>

Summary: The joint informational briefing by the Health and Human Services and Commerce and Consumer Protection committees focused on projected impacts to Hawaii consumers from federal changes affecting Med-QUEST and the ACA marketplace, including the loss of ACA premium tax credits, OBVA/HR1-related Medicaid changes, immigrant eligibility restrictions, and new Medicaid work/community engagement requirements. Committee members noted the meeting was being streamed live and emphasized the need to explain potential coverage losses affecting a significant share of the state population. Med-QUEST administrators reported current enrollment at 390,766, about 27% of Hawaii’s population, and broke that down into major groups including roughly 128,000 ACA expansion adults and about 52,000 parent/caretaker relatives. They said the expansion adult population would be most affected by the new federal requirements, which will shorten renewal periods from 12 months to 6 months and impose community engagement rules beginning in late 2026 and 2027. They described the work requirement as 80 hours per month of work, community service, work program participation, or half-time education, with an income-based pathway tied to $580 per month at the federal minimum wage; they also noted a long list of exemptions, but said many details are still awaiting federal guidance and rulemaking. The administrators said federal changes to immigrant eligibility would eliminate Medicaid coverage for certain noncitizen categories, with an estimated 1,200 to 2,400 people affected, though about 200 may remain covered through a state-funded program for otherwise eligible individuals. They also said marketplace subsidies would no longer be available for some immigrants under 100% of the federal poverty level starting January 1, 2026, with further restrictions expected in 2027. For Hawaii overall, they estimated the new Medicaid work and renewal rules could push an additional 19,000 to 38,000 people into uninsured status, with another estimated 6,000 at risk from the six-month renewal process alone. Members asked about how exemptions would be determined, especially for medically frail and seriously mentally ill individuals, and administrators said they were still awaiting detailed federal rules and were working on data-matching and verification processes to reduce coverage losses.

Transcript Highlights:

• Under the current statutory rate-setting structure, nurses can't be figured into the rate-setting structure
• Under the current statutory rate-setting structure, nurses can't be figured into the rate-setting structure
• Under the current statutory rate-setting structure, nurses can't be figured into the rate-setting structure
• There's a high turnover rate.
• I've heard from a high turnover rate.

Bills: HF3738 , HF2295 , HF3520 , HF3666

Committee: House Human Services Finance and Policy

Transcript Highlights:

• The first is the base rate per ride, and then, depending on the distance, there is a per-mile rate component
• The first is the base rate per ride, and then, depending on the distance, there is a per-mile rate component
• The first is the base rate per ride, and then, depending on the distance, there is a per-mile rate component
• Prior to this year, rates for fee-for-service were put in statute, and those rates often weren’t even
• So, we'd have to kind of work rates.

Committee: House Fraud Prevention and State Agency Oversight Policy

Transcript Highlights:

• That has increased mortgage delinquency rates.
• We have below-market interest rate loans for rental developments.
• What's the interest rate of those loans? Mr.
• How do I get a 0% rate versus, you know, the 3% or 4%? Mr.
• Why are we not or why do we have such a low participation rate?

Committee: House House Appropriations & Finance

Transcript Highlights:

• So inflation has almost doubled the historical rate of growth.
• So inflation has rate is 2.2% per year.
• </c><00:14:22.639><c> Uh</c> had grown at the rate of inflation.
• Uh had grown at the rate of inflation.
• </c> continue at our current rate of growth. continue at our current rate of growth.

Summary: The committee met for its fifth and final Interim Joint Budget Review Subcommittee on Education meeting, but did not initially have a quorum and approved the minutes later when enough members were present. The Council on Postsecondary Education, represented by President Aaron Thompson and Vice President Bill Payne, opened with condolences for the UPS crash victims and then presented higher education budget recommendations for the 2026-2028 biennium. Thompson emphasized the return on investment from state support for higher education, citing gains in retention, enrollment, persistence, graduation, reduced time to degree, lower student debt, and expanded dual credit participation, while noting that affordability and access remain priorities. Payne outlined CPE’s operating funds request, including $43.3 million in the first year and $86.6 million in the second year for inflation adjustments, plus $30 million and $45 million for performance funding. He said the inflation request would apply across the board to institutions to offset rising costs, and that the KSU land grant match would not need additional funding because the state has already met the matching requirement. He also explained that state support for educating students has not kept pace with inflation over time, creating pressure on institutional budgets and tuition, though tuition increases have been held to historic lows in recent years. A major portion of the discussion focused on the performance funding model and how it affects smaller institutions. CPE proposed two approaches to address institutions that have received little or no performance funding, especially Kentucky State University and Morehead State University. The first approach would create a $20 million minimum distribution pool, providing $1.95 million to each university and $4.4 million to KCTCS, with the goal of giving smaller and rural institutions a base level of support. The second approach would provide direct appropriations totaling a little over $5.6 million to Kentucky State, Morehead State, and five community colleges that have not been receiving performance funding. Members, especially Representative Tipton and Senator West, questioned how the model had treated small schools over time, and CPE officials explained that the original small school adjustment was not large enough to prevent KSU and Morehead from effectively being left out of the distribution. No votes were taken.

Transcript Highlights:

• There is no set rate, and therefore there will be no exceptions to rates that have been set.
• There is no set rate and no board.
• So, the bill star ratings to fall?
• annual rate increases.
• While the rate annual rate increases.

Committees: Senate Health and Human Services , Senate Human Services

Transcript Highlights:

• rate was 89.9% influenza vaccination rate was 89.9% this<00:26:10.520><c> is</c><00:26:10.640><c> a<
• I just wonder why the rates are so... It's good.
• Do we know what that death rate is in the rest of long-term care facilities?
• Do we know what that death rate is in the rest of long-term care facilities?
• </c><00:50:11.400><c> of</c> ill to be able to get um a a rate of ill to be able to get um a a rate of

Summary: The committee first handled organizational business, electing Representative Mark Pearson as chair for the coming term, appointing Representative Lucy Weber as clerk, and approving the November 22 minutes with abstentions from members who were absent. Members also noted excused absences for Senator Avard and Representative Jessica Lontine. After the vote, the committee moved to the DHHS commissioners’ update. DHHS associate commissioners Patricia Tilly and Chris Santinello described a process-improvement effort to improve transitions for youth moving from DCF care into adult developmental services and Medicaid. They said the old process was fragmented, dependent on personal relationships, and not sustainable, so staff from DCF, the Bureau of Family Assistance, Developmental Services, and public health used a Kaizen/Lean event to map the workflow, identify bottlenecks, clarify roles, and create a more consistent playbook. Members asked about IT support and whether the process would create new bureaucracy; DHHS said current systems are antiquated, especially DCF’s CWIS, but the goal is to streamline coordination, not add bureaucracy, and future systems like Granite Families may help with reminders and age-based ticklers. Several members praised the work, including a CASA volunteer who said the added attention has improved services for vulnerable youth. The committee then received the annual healthcare-associated infections update from Ctin Hansen of the Division of Public Health Services. Hansen reported that New Hampshire’s HAI program, created by statute, tracks infections in hospitals, ambulatory surgery centers, dialysis centers, and long-term care facilities. For 2023, hospitals reported fewer infections than predicted nationally, with 135 infections statewide and 174 C. diff infections also below national rates; hospital influenza vaccination was 89.9%. Ambulatory surgery centers reported low infection counts and an 80.1% staff flu vaccination rate; dialysis centers reported fewer infections overall than the prior year but higher local access-site infections, with staff vaccination at 52.6%; and long-term care facilities reported a 50.1% flu vaccination rate, up from 37.8%. Hansen also said the program conducted over 100 investigations, handled 84 antibiotic-resistant organism reports, completed 20 infection-prevention assessments, and operated on a budget of about $348,000 plus grant funding, including an Epidemiology Laboratory Capacity Grant that was later reduced.

Transcript Highlights:

• The rate of digital adoption and just the depth of expertise—it doesn't matter.
• New Mexico has an aggregate rate that would be closer to the 6.9% mark.
• And Brian, just a little clarification on the oil tax rate.
• And Brian, just a little clarification on the oil tax rates by state.
• The monthly oil rates are on the y-axis over cumulative years on the x-axis.

Committee: Joint Tax Reform and Relief Advisory Committee

Summary: The committee met to receive updates from the Tax Commissioner’s office on property tax relief programs and related compliance work. Commissioner Brian Croshys reviewed the Homestead Property Tax Credit, Disabled Veteran Credit, and Primary Residence Credit, noting that the Homestead program expanded significantly after HB 1158, that some households are “adjusting out” of eligibility as incomes rise, and that the committee may want to consider indexing income thresholds. Members asked for additional data on bracket breakdowns, possible costs of eliminating income limits for seniors, and how many households are zeroed out by the combined programs. Croshys also discussed the simpler administration of the disabled veteran credit, the growth in participation, and the heavy workload and auditing safeguards built into the new primary residence credit system. He said the department found no material compliance findings and that the program is designed to be digital-first, with county auditors and the Tax Commissioner’s office both involved in review and notification. The committee recessed for lunch and later reconvened, with the chair noting that more detailed PRC information would likely be available at a September meeting. Shelly Myers then presented the statewide property tax increase, or “zero growth,” report and the 2025 statistical report. She explained how county auditors report levy and valuation data, how increases and decreases are counted, and which jurisdictions showed the largest percentage changes in countywide, citywide, school district, and park district levies. In the statistical report, she summarized recent trends in assessed values: agricultural values remained relatively flat, while residential, commercial, and centrally assessed property values increased over the past five years. She also reviewed statewide tax levies by property class and clarified that centrally assessed growth figures were annual averages. Members discussed how shifts in land use and annexation can make it appear that tax burdens are moving from ag to residential/commercial property. Myers then summarized the interim study on the 3% levy limitation under HB 1176, saying most counties complied without budget changes, while some used hiring freezes, deferred purchases, or reserve funds; 23% of counties had to reduce levies, and the affected funds were mainly general, road and bridge, and weed control. She said 12 counties reported zero new growth in the data and that 35 counties reported not using all of their cap. The committee also received an oil tax presentation from Croshys on the stripper well extraction tax exemption. He outlined the number of active stripper wells, the production and revenue implications of the exemption, and projections for future biennia under different tax scenarios. He said the exemption represents substantial savings to operators but also corresponds to production tax revenue that would otherwise be collected, and he emphasized that future outcomes depend on oil prices, well counts, and technology such as CO2 enhanced oil recovery. Nathan Anderson of the Department of Mineral Resources briefly answered a question about why Red River wells have a different production threshold than Bakken wells, explaining it was tied to completion costs and lateral length. The committee then heard from Charlie Gorecki of the EERC, who presented an analysis of typical Bakken well decline curves and argued that most oil is produced before a well reaches stripper status, but that keeping wells open and investing in refracturing or other interventions can recover additional production. No votes were taken during this portion of the meeting; the main actions were receiving reports, asking for follow-up data, and scheduling further discussion for a later meeting.

Transcript Highlights:

• So our compliance rates, our repeat violations, and.
• If that rating drops, then our interest rates rise, and that could cost the state millions of dollars
• Now, comparing the average billing rate of several external firms to our billing rate in light blue,
• We have had two bond rating increases. We'd like to have one more.
• The bond rating people love that.

Committee: House A&B General Government Subcommittee

Transcript Highlights:

• Our answer rate is 92%, exceeding the required 90%.
• Our hang-up and disconnect rate meets the 5% standard.
• Our answer rate is 92% exceeding the required 90%.
• Our flowout rate is just 3%, well below the 5% threshold.
• Our hang-up and disconnect rate meets the 5% standard.

Summary: The hearing focused on California’s 988 suicide and crisis lifeline and the broader crisis response system, with members and witnesses emphasizing both the system’s life-saving role and the risks posed by funding gaps, rising demand, and uneven local implementation. Opening remarks highlighted the personal impact of suicide and the need to strengthen crisis response so calls are answered quickly and linked to appropriate care rather than defaulting to 911, emergency rooms, or law enforcement. State officials described the AB 988 five-year implementation plan, which sets goals around public awareness, equitable access, high-quality call/chat/text response, and better integration with ongoing behavioral health services. State agencies reported progress on infrastructure, coordination, and related behavioral health investments. CalHHS said California has expanded mobile crisis teams, crisis stabilization units, and youth behavioral health supports, and is preparing additional public awareness and grant programs tied to Proposition 1. DHCS explained that 988 is funded through a federal SAMHSA grant and the AB 988 surcharge, while Medi-Cal separately funds mobile crisis services; officials said the mobile crisis benefit is active in 53 counties and that statewide expansion remains a work in progress. Cal OES described the statewide technical buildout, including network infrastructure in all 11 crisis centers, interoperability with 911, and a pilot of next-generation routing and call-handling tools. The 988 California Consortium said call volume continues to rise sharply, missed calls remain a major concern, text/chat capacity is limited, and centers need more stable funding, better reimbursement, and stronger feedback loops with the state. County and community witnesses stressed that local systems need more flexible, sustained support to match the demand. Lake County described a peer-led rural mobile crisis model that has reduced law enforcement holds and increased housing placements, but said county-run mobile crisis teams still cannot reliably access 988 surcharge dollars and face reimbursement problems from Medi-Cal and commercial plans. Santa Clara County reported strong performance metrics, rapid call answer times, and a broad continuum of mobile crisis services, but said staffing and funding are strained and commercial reimbursement remains slow. The Mental Health Association of San Francisco said the peer-run warm line complements 988 by offering non-emergency support and warm handoffs, but recent budget changes forced cuts to Spanish-language service, federation support, and hours. No formal votes or legislative actions were taken during the hearing; members mainly asked questions about surcharge levels, budget timing, coordination among agencies, data collection, and how to improve collaboration with frontline crisis centers.