Transcript Highlights:

• to our community-based care lead agencies.
• to our community-based care lead agencies.
• focus on developing, administering, and overseeing the system of care, while direct service providers
• The first thing is community-based care.
• care.

Summary: The Human Services Subcommittee held its first meeting of the term and heard introductory remarks from the chair, vice chair, ranking member, and members, who broadly described their interest in child welfare, mental health, aging services, homelessness, and agency accountability. The chair then outlined the subcommittee’s jurisdiction, including child welfare, mental health and substance abuse safety net services, domestic violence, developmental disabilities, elder services, and child support, and introduced the Department of Children and Families (DCF) as the first agency panel for the term. DCF presented an implementation update on HB 7089, a 2024 law aimed at increasing accountability and transparency for community-based care (CBC) lead agencies that deliver most child welfare services under contract. The department said the bill was prompted by forensic examinations that found problems such as noncompetitive procurement, related-party transactions, excessive executive compensation, and weak financial oversight. DCF described new contract requirements and monitoring tools covering board governance and annual training, conflict-of-interest disclosures, financial penalties for noncompliance, fidelity bond requirements, limits on direct service provision by lead agencies, related-party procurement rules, procurement thresholds, real-property approvals, compensation caps, expanded public reporting, and a new Future of Child Protection and Funding Work Group. DCF reported that some lead agencies had completed required board training, others were still on schedule, and two agencies exceeding the direct-service threshold had been referred to the Auditor General. Members asked DCF about the reasons for the bill, the impact on children, the work group’s regional representation, aging-out youth, the Embrace Families transition, board training requirements, and whether enforcement actions had been taken. DCF said the bill was intended to protect funds for children and families and improve oversight, and clarified that the Central Florida lead agency contract was awarded through competitive procurement rather than an absorption. DCF also said the board training was designed to be meaningful but not overly burdensome, with timing left partly to lead agencies as they implement the new requirements. The committee then heard from two CBC leaders, who generally supported the accountability goals of HB 7089 and said their agencies had already addressed most of the new governance and disclosure requirements. They reported that board training had been completed or was being scheduled, but both agencies said the fidelity bond requirement has been difficult or impossible to obtain in the market as written, though they were able to secure the separate performance bond. The CBC witnesses also warned that recruiting providers is increasingly difficult, especially for higher-acuity children and group-home placements, due to limited provider supply, regulatory burden, insurance costs, and rising risk. They said these pressures are contributing to budget deficits in some areas and urged lawmakers to consider the funding model, insurance and indemnification issues, and the risk of overregulation reducing provider participation.

Transcript Highlights:

• is expanded, and it allows jails to bill the Department of Direct Care and Treatment for the cost.
• There are significant waiting lists for priority admissions to direct care and treatment.
• The current average wait times to access beds at direct care and treatment for forensic services and
• In 2015, I was asked to serve in the capacity of addressing the direct care workforce shortage crisis
• In 2018, we had a direct care workforce shortage of approximately 10,000 people.

Transcript Highlights:

• The child care providers, and so I believe that's with our modernization of our IT systems.
• Child care providers, and so I believe that's with our modernization of our IT systems.
• and staff, so it's furthering the workforce and supporting the workforce in child care.
• other licensed health care practitioners.
• For this amendment, current GAA and implementing bill directs the... questions?

Keywords: 999, senate, all

Transcript Highlights:

• The child care providers, and I believe that's with our modernization of our IT systems.
• Child care providers, and I believe that's with our modernization of our IT systems.
• and staff, so it's furthering the workforce and supporting the workforce in child care.
• On behalf of the Agency for Health Care Administration, my name is Brian Meyer.
• other licensed health care practitioners.

Summary: The Legislative Budget Commission met to consider 21 budget amendments, beginning with the Department of Education’s request for $14.751 million in federal grant authority for the Preschool Development Grant. Members asked whether any funds would support VPK or provider payments; the department said the money is for birth-to-kindergarten early learning work, including IT modernization, workforce credentialing, training, and streamlining director certification. The amendment was adopted without objection. The commission then approved amendments for the Department of Veterans Affairs to shift $2.2 million within its trust fund to cover higher nursing home occupancy and reduce staffing agency use, and for the Department of Health to realign about $9.1 million for disability determinations amid a backlog of roughly 140,000 cases. The Agency for Health Care Administration presented multiple Medicaid-related amendments, including $766 million for indirect medical education, $1.9 million for managed care network adequacy audits, $209 million for the Rural Health Transformation Program, and several large supplemental payment programs for KidCare, hospitals, physicians, cancer hospitals, nursing IME, and public hospital payments. Members questioned network adequacy, rural access, and the KidCare surplus and expansion; the KidCare realignment drew debate, with some members objecting because the 2023 eligibility expansion has not been implemented, but the amendment passed on a roll call vote. Other amendments adopted included FDLE’s $16.3 million for counter-UAS detection and mitigation equipment, DJJ’s $1.6 million for Florida Scholars Academy and a Social Services Block Grant realignment, and emergency management pass-throughs for FIFA World Cup security and counter-drone funding to the Miami host committee. The Department of Commerce received $148.4 million for disaster recovery under the CDBG-DR program, with questions about the split between housing, infrastructure, and administrative costs. The Department of State also received $408,377 for arts and culture grant authority. Most amendments were adopted without objection, and the commission adjourned after completing the agenda.

Transcript Highlights:

• </c><00:22:34.240><c> Care</c><00:22:34.400><c> and</c><00:22:34.640><c> treatment</c> other Direct Care
• and treatment other Direct Care and treatment facilities<00:22:35.840><c> so</c><00:22:36.760><c> um
• </c><00:23:10.080><c> Care</c><00:23:10.279><c> and</c> forensic um and uh other Direct Care and forensic
• </c><00:24:49.080><c> Care</c><00:24:49.240><c> and</c> at a cbhh or any other Direct Care and at a cbhh
• </c> to attract and retain quality direct to attract and retain quality direct care<01:37:13.679><c>

Keywords: 1183, house

Transcript Highlights:

• </c><00:34:11.879><c> certification</c> and the Medicaid direct certification and the Medicaid direct
• struggling to pay for child care.
• struggling to pay for child care.
• Chairman Ladd: That takes care of where we are today.
• Chairman Ladd: That takes care of where we are today.

Keywords: 928, house, all

Summary: The committee first took up HB 112, which would require students in the University and Community College systems to pass the U.S. citizenship civics naturalization test. A motion was made to retain the bill, and the committee voted unanimously to retain it, resulting in no report. HB 510, dealing with due process rights for students, student organizations, and faculty in higher education disciplinary proceedings, was passed over for a later meeting so the University and Community College systems could meet with the committee. The committee then discussed HB 659, creating a college graduate retention incentive program, but retained it without further debate after noting the prime sponsor was unavailable. HB 770, concerning tuition credits for community service, was also held for later in the day because an amendment was expected. The most extensive discussion centered on HB 583, which would have the state participate in Medicaid direct certification for free and reduced-price school meals. Supporters argued it would identify more eligible students, reduce paperwork, improve accuracy in school funding formulas, and bring in additional federal child care scholarship money; opponents argued it would significantly affect school funding calculations and should be delayed. The committee rejected the amendment by a 10-8 vote and then voted 10-8 to retain the bill, with a majority report and minority report to follow. HB 646, requiring school districts to establish an online application for free and reduced-price meal participation, was also debated. One member said many districts already do this voluntarily and that the bill was unnecessary; another proposed an amendment to convert the mandate into a grant program to offset startup costs, but the committee proceeded on the underlying motion and voted 10-8 to retain the bill, with a majority report and a minority OTP report. HB 665, concerning eligibility for the free school meals program, was then retained by an 11-3 vote. Finally, the committee began work on HB 703, which would prohibit school districts from denying meals to students with unpaid balances and appropriate funds for that purpose. An amendment was explained that would remove state payment of district meal debt and instead require district policies against shaming or bullying students and allow voluntary donations to reduce debt. After discussion, a motion was made to ITL the bill, with the sponsor saying constituents opposed subsidizing the program and wanted districts to retain collection tools; further debate was underway when the transcript ended.

Transcript Highlights:

• In the biennial operating budget last year, the Legislature directed the Health Care Authority to apply
• House Bill 2555 directs the Health Care Authority to apply for that waiver from CMS to allow for the
• House Bill 2555 directs the Health Care Authority to apply for that waiver from CMS to allow for the
• Since supporting direction of this work last session, the Health Care Authority has been engaged with
• Second, it directs the State Board of Health to adopt rules requiring health care providers, facilities

Bills: HB2555, HB2658, HB2683, HB2685, HB2168, HB2196, HB2545

Keywords: Medicaid, healthcare, traditional practices, health insurance, coverage expansion, mental health, insurance coverage, transparency, consumer protection, efficiency, health carriers, providers relations, tribal data, data protection, privacy, sharing of information, Indigenous rights, overdose prevention, data sharing, public health

Transcript Highlights:

• If a person self-directs or if they don't self-direct, it will be the same budget regardless. self-directed
• Kylin requires 24-hour care. He gets his care right now on a CAC waiver.
• he gets his care right now on a CAC care he gets his care right now on a CAC waiver<01:18:05.719><c>
• However, direct care workers in those facilities are not seeing that money in their wages and their benefits
• Our son has a CAC waiver, which is a hospital-level-of-care waiver, and uses Consumer Directed Community

Keywords: 1183, house

Transcript Highlights:

• dollar add-on increases; state-directed payments for hospital care; behavioral health throughputs; county
• And for private hospitals, we are proposing to increase managed care directed payments and fee-for-service
• care and outpatient care.
• health care needs.
• I'm here on behalf of Aviana Health Care, as well as Maxim Health Care.

Summary: The subcommittee heard a lengthy Department of Health Care Services presentation on the governor’s Medi-Cal budget, including a $229.1 billion total-funds proposal, projected Medi-Cal enrollment declines as redeterminations continue, and several major cost drivers such as managed care growth, Medicare-related costs, pharmacy spending, and changes tied to federal policy. Members focused heavily on the elimination of Prop. 56 dental supplemental payments beginning July 1, 2026, questioning the likely impact on provider participation and utilization. DHCS said it is completing the required rate reduction/access analysis for CMS, has been holding stakeholder meetings and issuing provider bulletins, but could not yet quantify the real-world effect. The committee also discussed a $50 million savings proposal tied to new hospice utilization management authority and asked about possible effects on emergency dental care and provider participation. The hearing then moved through the November 2025 family health estimate and several county and program administration issues, including CCS, GHPP, and Every Woman Counts. DHCS said family health costs are rising despite slight caseload declines because of higher utilization and medical costs, and members raised concerns about CCS website accessibility, county administrative funding, and the transition of youth aging out of CCS. The department said most CCS beneficiaries are also on Medi-Cal, that counties have long raised funding concerns, and that it had clarified use of maintenance-and-operations dollars to address some county workload issues. Members also asked about Every Woman Counts potentially seeing higher demand as Medi-Cal changes take effect; DHCS said that is possible and that the program has multiple funding sources including General Fund. A major portion of the hearing focused on provider taxes and federal changes under H.R. 1, especially the Medi-Cal managed care organization tax and the hospital quality assurance fee. DHCS explained that H.R. 1 restricts new or increased health care-related taxes, phases down allowable tax levels over time, and tightens “generally redistributive” rules, which could sharply reduce the state’s ability to use the MCO tax for Medi-Cal financing. Members asked whether the Legislature could amend Prop. 35 or whether voters would need to act; DHCS said a three-fourths legislative amendment may be possible if it aligns with the measure’s purpose, but the department is still evaluating options. The committee also discussed hospital financing, with DHCS describing recent increases in state-directed payments and the effect of H.R. 1 in capping those payments at Medicare levels, and the LAO noting the tradeoff between preserving provider taxes and maintaining Medi-Cal funding. The subcommittee also reviewed a series of DHCS budget change proposals and trailer bill items, including managed care final-rule implementation, managed care operations, a hospital value strategy, a one-year extension of skilled nursing facility financing, long-term care payment transparency, and interoperability/prior authorization requirements. Members repeatedly questioned the use of limited-term versus permanent positions, the overlap among proposals, and the timing of new financing reforms. DHCS said the SNF extension would preserve current workforce standards, sanctions, growth limits, and the SNF quality assurance fee while the department develops a broader 2027-28 redesign. No votes were taken; items were repeatedly held open for later action. Covered California then presented on the expiration of the federal enhanced premium tax credit and the resulting affordability crisis. The agency said Californians will lose about $2.5 billion in premium assistance for 2026, average premiums could nearly double for many enrollees, and as many as 400,000 people could eventually leave marketplace coverage. Open enrollment ended with 1.9 million sign-ups, down 3% from the prior year, with especially steep declines among middle-income consumers and increased movement into bronze plans. Covered California said the state’s $190 million affordability subsidy is helping lower-income enrollees retain coverage, but cannot fully replace the lost federal assistance. Members also asked about the Health Care Affordability Reserve Fund, repayment of loans from that fund, the status of federal review of California’s essential health benefits benchmark, and implementation of the new gender-affirming care benefit under AB 144.

Transcript Highlights:

• In the biennial operating budget last year, the legislature directed the Health Care Authority to apply
• House Bill 2555 directs the Health Care Authority to apply for that waiver from CMS to allow for the
• Since supporting direction of this work last session, the Health Care Authority has been engaged with
• Second, it directs the State Board of Health to adopt rules requiring health care providers, facilities
• care, and 16 times higher for inpatient care.

Summary: The House Health Care and Wellness Committee held public hearings on four bills and then took executive action on three measures. HB 2555 would require the Health Care Authority to apply for a Medicaid waiver to cover traditional health care practices provided through Indian Health Service, tribal, and urban Indian facilities. Supporters, including the prime sponsor, tribal health leaders, and the Health Care Authority, said the bill would recognize traditional medicine, expand access, and leverage federal funding, though HCA noted the July 1, 2026 waiver deadline and urban Indian reimbursement questions may be difficult to resolve. HB 2685 would codify tribal data sovereignty principles for state agencies, require reporting of notifiable conditions to tribal health jurisdictions, and exempt certain tribal data from public disclosure. Tribal representatives supported the bill as necessary for access, governance, and better public health planning, while the Washington Coalition for Open Government and HCA raised concerns about the breadth of the PRA exemption, undefined ownership interests, and implementation details. HB 2658 would require health carriers to submit standardized public data on behavioral health and other coverage and access metrics, with the Insurance Commissioner posting the information on a public dashboard. Supporters said the bill would improve transparency about mental health parity and help families, employers, and policymakers compare plans; opponents argued it duplicates or complicates recent parity reforms and could be misinterpreted. HB 2683 would shorten carrier credentialing timelines from 90 days to 30 days and require carriers to post billing and coverage information online. Supporters said it would reduce delays for providers and patients, while opponents warned the shorter timeline could be hard to meet and that posting information without login protections could raise privacy concerns. In executive session, the committee adopted two amendments to HB 2168, which concerns overdose mapping data, then reported the substitute bill out with a due pass recommendation by a vote of 16-1. It rejected an amendment to HB 2196 that would have extended PANDAS/PANS coverage to public and school employee plans, then advanced the substitute bill with a due pass recommendation by a vote of 15-2. Finally, the committee passed HB 2545, which would allow ambulatory surgical facilities to perform elective percutaneous coronary interventions, by a vote of 13-4, after members discussed safety, access, and cost savings.

Transcript Highlights:

• This is an unacceptable reality, but it's the direct result of a health care system that leaves rural
• This is an unacceptable reality, but it's the direct result of a health care system that leaves rural
• This is an unacceptable reality, but it's the direct result of a health care system that leaves rural
• This is an unacceptable reality, but it's the direct result of a health care system that leaves rural
• </c><01:09:37.839><c> Care</c> in collaboration with our Direct Care in collaboration with our Direct

Keywords: 1183, house

Transcript Highlights:

• In New Mexico, the managed care program is known as Turquoise Care, and that replaced Centennial Care
• So, Turquoise Care is the name of the Medicaid managed care program that replaced Centennial Care.
• Managed care organizations, so we added Molina Health Care and United Health Care and dropped Western
• Sky Community Care.
• through their managed care. organizations.

Transcript Highlights:

• SB 1736 addresses a critical gap in care by allowing direct support professionals and relatives to administer
• SB 1736 addresses a critical gap in care by allowing direct support professionals and relatives to administer
• might go as a provider, a home health care provider, twice a day.
• Right now, direct support professionals are coupled with home health aides, personal care attendants,
• So I wanted to direct about We're facing the same situation.

Summary: The committee met with a quorum present and took up several bills. SB 894, relating to faith-based content in batterers’ intervention programs, was explained as allowing certified programs to offer voluntary faith-based components alongside existing models. Members raised questions about how faith would be defined, whether participation would be optional, and how all faiths would be included. An amendment was adopted clarifying that faith-based activities may be offered but not required and removing language directing DCF to repeal a rule. After supportive testimony from faith-based advocates and some debate, the committee reported the bill favorably, with Senators Harrell and Garcia later recording affirmative votes. The committee then considered SB 1240 on substance abuse and mental health care, which would assign state oversight of the 988 Lifeline, remove the annual needs assessment barrier for medication-assisted treatment licensing, and require annual continuing education for forensic evaluators. An amendment with technical conforming changes and two substantive clarifications was adopted. Members expressed support for expanded access to behavioral health services, and the bill was reported favorably. Later, the chair presented SB 1736, which would allow direct support professionals and relatives to administer insulin in group home settings for individuals with developmental disabilities. After an amendment clarifying sliding scale insulin and related medication administration, the committee heard testimony from family advocates describing how the bill would prevent unnecessary institutionalization and reduce costs. The bill was reported favorably. The committee also passed SB 1286, which clarifies that allowing children to engage in unsupervised activities such as biking or playing outside does not by itself constitute neglect unless reckless or dangerous. After brief support testimony, that bill was also reported favorably, and the meeting adjourned.

Transcript Highlights:

• direct primary care, or DPC.
• This bill ensures that direct primary care payments apply toward the individual's deductible under their
• That are affected by this right now, that is, these direct, uh, primary care are not, um, able to be
• Uh, I'm a practicing physician locally using the direct primary care model actually.
• Called Texas Direct Medical Care. So this is an excellent bill.

Transcript Highlights:

• as a whole, from the managed care organization tax to hospital fees to state-directed payments.
• , including transportation, lodging, meals, abortion care doulas, and child care and elder care.
• , including transportation, lodging, meals, abortion care doulas, and child care and elder care.
• And then directed payments are ways that the state can direct payments Through the managed care system
• care.

Keywords: 988, house, all

Transcript Highlights:

• HB 1567 addresses a critical gap in care by allowing direct support professionals and relatives to administer
• Does the pilot program include any type of consumer-directed care, like take that into consideration,
• Because I know one reason why folks prefer the current system is that consumer-directed care, where they
• The managed care does include the acute medical, the long-term care, and the home-care, home-community-based
• I mean, I’m on Medicaid Advantage Care. Medicare Advantage Care. I like it.

Summary: The committee met with a quorum present and heard six bills, all of which were reported favorably. HB 1567, relating to insulin administration by direct support professionals, was amended to clarify the type of insulin that may be administered and to allow supervision of self-administration of an insulin pen. Supporters described the bill as a way to keep people with developmental disabilities in group homes rather than forcing institutional placement; the amendment and bill both passed unanimously, 17-0. PCS for HB 1103, on services for persons with disabilities, would expand the APD managed care pilot statewide in phases, require more transparency on waitlist data, create a statewide family care council, and address transition services for young adults leaving foster care. Testimony was mixed: supporters emphasized the long APD waitlist and the need for a voluntary option, while some witnesses and members raised concerns about the accelerated rollout, limited data, and preserving consumer-directed care. The committee adopted the bill 17-0. CS for HB 127, on exceptional student education, would create micro-credentials and coordinate with the Florida Center for Students with Unique Abilities and OSHA to support students with disabilities transitioning to work; it passed 17-0 after testimony from a parent and advocates. HB 989, concerning licensure of family foster homes, was amended to streamline license transfers for foster parents moving within Florida while maintaining oversight and directing DCF rulemaking. A teacher and other supporters said the bill would reduce bureaucracy and help children remain in stable homes; it passed 17-0. PCS for HB 1091, on substance abuse and mental health care, updates processes related to the 988 crisis line, methadone treatment needs assessments, and forensic evaluators, and adds data/reporting requirements for DCF managing entities. After one amendment and testimony from supporters and one opponent, it passed 16-0. Finally, HB 633, on behavioral health managing entities, was amended and then approved 17-0; it requires more structured data and reporting from managing entities to increase accountability and transparency in the behavioral health system.

Transcript Highlights:

• health care.
• We've also directed our statewide Medicaid managed care plans to share these outreach materials with
• You're recognized for a three-part, very direct. Very direct. This is very direct.
• Providing the same care and in many cases even more specialized care.
• I take care of my kids.

Summary: The subcommittee held its first meeting of the 2025-2026 term, took attendance, confirmed a quorum, and heard introductory remarks from members and staff. Chair Anderson outlined the subcommittee’s jurisdiction over access and affordability issues, including health facility regulation, insurance, Medicaid, CHIP, and state employee health coverage. The main agenda item was an update on implementation of HB 391, which created a family home health aide program for medically fragile children. Representative Tramont, the bill sponsor, explained that the law was intended to let trained family caregivers be paid through Medicaid to care for their children, reduce reliance on private duty nursing, and relieve families. He and several members expressed frustration that implementation had taken nearly two years and that families still faced barriers. Deputy Secretary Brian Meyer of AHCA and Bridget Royce of DCF said the program was implemented October 1, 2024, with billing available, but no home health agencies had yet launched the required 80-hour training program and no claims had been paid. They described the program’s requirements, including agency employment, background screening, training, a $25-per-hour Medicaid rate paid to the agency, and an annual assessment report. A major issue discussed was that income earned by family caregivers counts toward Medicaid eligibility and could cause families to lose coverage. AHCA and DCF outlined two possible fixes that would require CMS approval: disregarding the income for eligibility purposes or treating the child as a family of one. Members and public witnesses strongly urged changes to avoid forcing families to choose between income and coverage. Several providers said they had begun preparing training programs, but asked for clearer approval processes and more patient-specific training requirements. The committee then heard extensive public testimony from parents and caregivers of medically fragile children, who described the financial, emotional, and logistical strain of caring for children with severe disabilities and argued that the bill should be expanded to include Florida KidCare families and others in the coverage gap. They also raised concerns about the eight-hour-per-day limit, low pay, and the need for simpler rules and direct support. Home health providers and associations supported the concept but asked for modifications, including more targeted training and clearer implementation guidance. The meeting then shifted to a second agenda item on the Andrew John Anderson Rapid Whole Genome Sequencing Program, which was funded in the 2023 budget. Deputy Secretary Meyer said the program has been implemented since January 1, 2024, but utilization has been lower than expected, with only about 60 claims paid and many denials occurring through managed care. Public testimony from a lab, a hospital, and a pediatric rare disease expert said the program is clinically valuable and cost-saving, but managed care billing barriers, prior authorization issues, and DRG-related denials are limiting access; they urged direct billing to Medicaid and possible expansion to all newborns.

Transcript Highlights:

• I know we have, like, Cares in the middle, but, like, you know, those are the Cares for Kids providers
• We do a lot of direct service work in our community support line and in our care coordination program
• We do a lot of direct service work in our community support line in our care coordination program.
• So what we do is we engage care... ...directed to this kind of community.
• We are immersed in our DPH care coordination... ...DPH care coordination, enhanced care coordination.

Keywords: 1212, all

Summary: The Equity Committee meeting of the Permanent Commission on the Status of Persons with Disabilities began with roll call, approval of the prior minutes, and a presentation from the Massachusetts Department of Public Health’s CATER Center (Care Coordination, Assistance, Training, Education, and Resource Center). Staff described CATER’s role in providing training and technical assistance to MassHealth Cares for Kids providers serving children with medical complexity, including e-learning modules, coaching, case review support, and informal virtual drop-in sessions. They emphasized a family-centered, racially and culturally equitable approach, and noted that the program is funded through a MassHealth contract and has been operating for about two to three years. Committee members asked about which providers participate, how many families are served, how CATER coordinates with other regional or grassroots programs, and whether the model could be expanded beyond Boston-based hospitals. The presenters said they currently work with five providers, including Boston Children’s, BMC, Tufts, NeighborHealth, and Baystate, but do not track enrollment numbers because that is handled by providers and MassHealth. Members also raised concerns about workforce shortages, funding stability amid federal Medicaid cuts, and the need to share the curriculum and connect with other networks such as ACOs, DDS contacts, case management organizations, and the Health Equity Compact. The presenters said the work remains a priority and that they are open to growth and broader partnerships. After the presentation, the committee agreed to have the CATER slides and curriculum circulated to members. The only other agenda item was a lengthy NIH strategic plan for disability health research, which members had not yet reviewed; they agreed to defer discussion to a future meeting and add it to next month’s agenda. No votes beyond approving the minutes were taken, and the meeting adjourned after thanking the presenters and attendees.

Transcript Highlights:

• For the past two years, her care has been provided through Missouri's self-directed services program.
• What care will these people have if they lose their self-directed care staff?
• Home health care is a care model where staff takes care of their needs.
• Beyond daily expenses for Cameron's direct care, this is the financial cost to our family.
• care.

Keywords: 959, house, all

Summary: The committee first heard from State Auditor Scott Fitzpatrick on his fiscal year 2027 budget request. He said the office had been rebuilt from a historic staffing low and is now at 119 FTE, but still is not fully staffed and needs more time to train auditors into management roles. He also discussed the office’s use of lapses, the workload of required audits, and the need for more authority to investigate subrecipients of public funds. Members asked about the auditor’s ability to examine state agencies, the Department of Conservation decision, general revenue projections, the effect of eliminating the state income tax, and the use of “E” appropriations. Fitzpatrick also requested $290,000 to raise CPA stipends, citing a shortage of CPAs and pending legislation to ease CPA education requirements. His core budget request was about $14 million, including payroll, E&E, and a small amount for sports betting audit work. The committee then moved to public testimony on House Bill 10, focusing mainly on Department of Mental Health funding for day habilitation and self-directed services. Witnesses representing providers, families, and service recipients opposed proposed cuts, arguing that lower reimbursement rates would reduce access, force staff losses, and push people into more expensive institutional or emergency care. Several speakers described the personal and financial impact of SDS and dayhab services, including the ability to keep disabled family members at home and the higher cost of facility care. One witness from the Alzheimer’s Association also urged the committee to preserve caregiver program funding in the Department of Health and Senior Services, warning that a proposed $1 million reduction would harm families and increase Medicaid and institutional costs. Committee members asked questions about provider costs, the share of services delivered by private providers versus state facilities, and whether the cuts would fall mainly on community providers. The chair repeatedly reminded witnesses about the three-minute limit and the need to identify whether they were testifying in support, opposition, or for information. The hearing was briefly recessed for floor activity and later resumed, with the chair apologizing for earlier tension and noting that an ASL interpreter was available for a limited time. No votes were taken in the portion provided.

Transcript Highlights:

• This could be directed to you, Senator, or staff, because you're speaking towards ICE.
• I love it when students, oh wait, go Ducks, no one cares, nobody cares.
• Interviewers give no direction about answers and do not introduce content.
• OPD is prepared to staff the task force as directed in the bill.
• First, I'll echo the request to have a definition of health care facilities.

Keywords: 904, all