Transcript Highlights:

• Commissioners from newly issuing a Class Commissioners from newly issuing a Class A<00:23:57.680>
• A co-payment, co-insurance, or deduction requirement on coverage for services provided in accordance
• Fund must pay to an insurance producer that issues insurance policies on behalf of the fund.
• Insurance Fund must pay to an insurance Insurance Fund must pay to an insurance producer<00:42:02.720
• > producer that issues insurance policies producer that issues insurance policies on<00:42:04.920>

Keywords: Senate streaming session for Tuesday, March 10, 2026, 960, senate, all

Summary: The Senate convened on March 10, 2026, established a quorum, and began with an invocation by Reverend Damien Flowers, which was journalized without objection. The chamber then recognized several guests and honorees, including Dr. Courtney Glickman for being named 2025 Play Therapist of the Year, Sigma Gamma Rho Sorority, Dr. Sonja B. Santelises for her leadership of Baltimore City Public Schools, students shadowing legislators, Navy Alliance representatives, the Maryland Alliance for Advocacy for Sickle Cell, and Ms. Kimberly Body for her lupus advocacy. The Senate also journalized prior remarks about the 6888 regiment. The Finance Committee report then moved several bills forward. Senate Bill 348 would allow hospitals and freestanding birthing centers to contact, rather than only call, patients after high-risk pregnancies; its amendments were adopted and the bill was ordered to third reading. Senate Bill 390 on Wicomico County liquor licenses was laid over under the rule. Senate Bill 492, addressing massage therapy advertising and prohibiting misleading sexual-service advertising, was amended and sent to third reading. Senate Bill 562, concerning pharmacist-prescriber agreements for opioid use disorder treatment, was amended and advanced. Senate Bill 773 would let pharmacists order certain vaccines, including intranasal flu vaccines, for self-administration and was advanced without amendment. Senate Bill 53, on Maryland Port Administration land acquisition notice in Anne Arundel County, was amended and advanced. Senate Bill 428 would bar cost-sharing for collaborative care model services under Medicaid and private coverage and was advanced without amendment. Senate Bill 473 would require human trafficking awareness training for for-hire and transportation network drivers; its amendments were adopted and it was sent to third reading. Senate Bill 585 would shift administration of the human relevant research fund from Health to Agriculture and was advanced. Senate Bill 606, the Easy Pass Commuter Fairness and Transparency Act, would require an MDTA report on commuter plans and unused trips; its amendment was moved as the transcript ended. During debate on Senate Bill 917, which would expand the definition of audiology practice to include certain screenings and non-radiographic imaging, a senator questioned whether the bill would make Maryland the only state restricting a health occupation from performing Medicare-required screenings. The floor leader said the committee had heard that claim in testimony but had not verified it, and the senator moved to special order the bill for amendment, which was granted without objection. Most other bills were reported favorably, with committee amendments adopted without objection and several bills ordered printed for third reading.

Transcript Highlights:

• > who's<00:05:24.640> no The prior uh commissioner, who's no The prior uh commissioner,
• still So, the commissioner can still So, the commissioner can still have<00:06:59.400> a
• lines 14 and 15 gives the commissioner lines 14 and 15 gives the commissioner specific<00:10:22.000
• do and that the commissioner there do and that the commissioner there probably<00:13:05.680> looks
• :53.720> taxes<00:59:54.760> is think it's insurance insurance taxes is think it's insurance

Keywords: 1189, house, all

Transcript Highlights:

• For the record, I am Wendy Underwood, Deputy Commissioner for the Minnesota Department of Health.
• We provide six months unemployment and six months contribution to insurance.
• We provide six months unemployment and six months contribution to insurance.
• We provide six months unemployment and six months contribution to insurance.
• So, uh we are rapidly uh insurance.

Keywords: 1187, senate, all

Transcript Highlights:

• AG, insurance.
• They're competing for the same insurance dollars.
• Or insurance. Or insurance. Yes, I was going to say, or insurance can be procured for it.
• I guess in one sense it's up to their insurance limits and then to what they choose to pay.
• Or is it that we have to pay up to what insurance we voluntarily get?

Keywords: 1184, house, all

Transcript Highlights:

• insurance be referred to workman's comp? insurance be referred to workman's comp?
• insurance or they're aware of before. insurance or they're aware of before.
• not buying insurance. not buying insurance.
• of these people who have no insurance. of these people who have no insurance.
• it an insurance program of some sort? it an insurance program of some sort?

Keywords: 1189, house, all

Transcript Highlights:

• conversation, you know, And so this conversation around all the increase in the cost, transportation, insurance
• But not only that, the allotment, the new buckets, the allotments for offsetting insurance and costs.
• they have in that, but not only that, the allotment, the new buckets, the allotments for offsetting insurance
• does not allow for the governor, lieutenant governor, or a legislator to communicate with TCEQ commissioners
• , transmit the communication to the commissioner.

Summary: The Senate first adopted a motion to suspend Rule 5.14 and move the intent calendar deadline to 6 p.m. that day. It then took up and passed several bills, often by suspending the regular order of business and the constitutional three-day rule. HB 1866 gave limited Texas peace officer authority to National Park Service law enforcement officers within the San Antonio Missions National Historical Park; HB 4996 increased the penalty for refusing to release a fraudulent lien when the victim is a public servant; and HB 5033 created a trigger mechanism for ending vehicle emissions inspections if federal law changes. HB 1533 made a range of appraisal and property tax procedure changes, HB 2282 raised the arrest warrant reimbursement fee from $50 to $75, HB 3421 updated probate and estates procedures, and HB 4263 revised Texas Juvenile Justice Department grievance procedures. Each of these measures advanced through second reading, third reading, and final passage, with recorded votes generally showing strong support and some opposition on a few bills. The chamber also considered major policy bills. HB 2, the large public education and school finance package, drew extensive floor discussion and multiple amendments. Senators emphasized its $8.5 billion investment, including teacher and staff pay, school safety funding, special education, charter and traditional school funding changes, and other allotment adjustments. Several senators praised the bill as historic and collaborative, while also noting the need to monitor implementation and future effects. After adopting amendments and hearing supportive remarks from multiple members, the Senate passed HB 2 on final vote, 31-0. Other debated measures included HB 143, which codified cooperation between the Railroad Commission and the Public Utility Commission to address electrical safety hazards at well sites and related facilities, and CS SB 3074/3070, which allowed limited written communications from the governor, lieutenant governor, and legislators to TCEQ commissioners about permit applications, with disclosure and response requirements. Senator Johnson raised concerns that the TCEQ bill could politicize an apolitical permitting process and potentially affect federal delegation, but the bill was amended and passed 28-3. The Senate also passed HB 4426 on Railroad Commission permits for commercial surface disposal facilities, HB 3161 giving TMRS cities more flexibility on employee contribution rates, and HB 2712 allowing future test years for certain water and sewer utility rate-making, with an amendment to protect ratepayers if projections overcharge them. At the end of the session, the Senate handled several procedural motions, including re-referring HB 1904 from Criminal Justice to State Affairs and suspending posting rules so committees could meet later that day. The chamber then recessed until 2:00 p.m. Sunday, May 25, 2025, for a local and uncontested calendar, and planned to adjourn until 5:00 p.m. that same day after that calendar concluded.

Transcript Highlights:

• I've also suggested that the representative have a discussion with the commissioner of the Department
• of Insurance and work through that way as well, because they're supposed to be overseeing that.
• of the department with the commissioner of the department of<00:49:12.319> insurance<00:49:12.960
• ,<00:50:43.760> probably it's department of insurance, probably it's department of insurance
• insurance regulation.

Keywords: 928, house, all

Summary: The Legislative Performance Audit and Oversight Committee met to accept prior minutes and receive updates on ongoing audits. Audit staff reported progress on three education-related reviews: special education (34 of 71 observations completed, draft expected in the second quarter and final in the summer), education freedom accounts (22 of 41 observations completed, draft expected in the second quarter and final in the summer), and the doorway program (5 of 13 observations completed, draft expected by the end of February and final by April or May). No committee questions were raised on the audit status update. The committee then discussed possible future oversight topics, beginning with SNAP and concerns about fraud and work requirements. Members suggested inviting DHS officials and contract administrators to explain program operations and compliance, and also discussed whether the Department of Justice Medicaid fraud unit or other experienced officials could provide useful context. Members noted New Hampshire’s existing oversight layers, including the Executive Council and the joint HHS oversight committee, while also expressing interest in hearing more directly from department staff about staffing and contract management capacity. A substantial portion of the meeting focused on whether to pursue an audit of special education at the local school level. Members debated whether to wait for the ongoing statewide special education review and a legislative study commission report, or to begin scoping a local audit now so work could start sooner. Supporters argued that local-level spending, identification rates, and effectiveness vary widely by district and that an audit should examine both costs and outcomes; others cautioned that the scope would need to be manageable given limited audit staff and that the statewide report may help narrow the focus. The committee also briefly discussed a potential audit of the Bureau of Elderly and Adult Services, but no decision was made on that item.

Transcript Highlights:

• You have already asked the qualification of the Commissioner of Agriculture. Next question.
• The Office of Commissioner of Immigration.
• It gave me an opportunity to become a city commissioner in public office.
• It gave me an opportunity to become a city commissioner in public office.
• Property insurance, crowding, and housing affordability.

Summary: The House convened with prayer, pledge, quorum call, approval of the journal, and adoption of the Rules and Ethics Committee’s special order report for the day. The chamber then took up House Bill 1B, the immigration bill, and members were told they would have one opportunity to question the sponsor on both the House version and the anticipated Senate changes. Representative McClure described the bill as a major immigration-enforcement package creating a chief immigration officer housed in the Department of Agriculture, an Office of State Immigration Enforcement, a local law enforcement grant program, a state immigration council, and new penalties and enforcement tools. He also outlined anticipated Senate language, including stronger 287(g) participation requirements, enhanced penalties for unauthorized aliens, a mandatory death penalty provision for certain capital offenses, and additional coordination with federal agencies. The bill drew extensive questioning from Democrats about due process, constitutional issues, school and workplace impacts, and the treatment of people whose immigration status changes over time. Members asked about birthright citizenship, TPS, asylum seekers, pretrial detention standards, the lawful basis for detaining someone based on suspected status, and whether teachers, social workers, school resource officers, and even children could be required to cooperate with immigration enforcement. McClure and Representative Garrison repeatedly said the bill would require cooperation with federal authorities, that status determinations would be handled under existing court procedures, and that the Senate death-penalty language was intended to fit within Hurst by requiring a jury finding beyond a reasonable doubt that the defendant was an unauthorized alien. They also said the bill did not provide DMV funding, did not address teacher shortages, and included appropriations such as $25 million for the local law enforcement participation incentive program and broader funding for enforcement and training. Several amendments were considered. Representative Chambliss offered an amendment to protect schools, churches, and places of worship from enforcement activity; supporters argued it would preserve trust in sacred and educational spaces, but the amendment failed. Representative Escamani offered an amendment to preserve in-state tuition for Dreamers; supporters emphasized the educational and economic contributions of Dreamers and the hardship of higher tuition, but that amendment also failed. The debate ended with no bill vote in the excerpt, but the House completed the amendment votes and continued consideration of the immigration measure.

Transcript Highlights:

• White because as I commissioner and Mr.
• And I'm going to hand this over to the commissioner.
• And I'm going to hand this over to the commissioner.
• <00:16:36.000> um have no uh insurance, no Medicaid. um have no uh insurance, no Medicaid.
• We don't give years as commissioner.

Keywords: 928, house, all

Summary: The committee met after recess to hear a Department of Health and Human Services overview of its contract structure, with CFO Nathan White explaining that DHS currently has 969 active agreements spanning service contracts, grants, data-sharing agreements, use-of-premises agreements, and MOUs. He said contracts are budgeted across multiple class lines and accounting units, often braided with federal funds, which makes the system complex; he also noted that the department’s top spending list was limited to 18 items rather than 20 and included both individual contracts and grouped regional/provider contracts. White emphasized that many contracts support direct services to residents, while others support departmental operations such as software support and staffing. Commissioner Hardy said the listed contracts are essential to serving vulnerable populations and supporting required administrative infrastructure, and she stressed that the department tries to work with providers and families rather than impose changes on them. In response to questions about area agencies and developmental disability services, DHS officials said the agencies’ duties are spelled out in contract and statute, including family support services, billing-related functions, and services tied to the state’s community-based system; they said some billing duties have already been moved outside the contract. They also explained that the department rejected a previously discussed two-tier waiver concept after stakeholder feedback in October 2023 and instead shifted to rate-based work, including CIS assessments, to better align payment with individual need. Members also raised concerns about possible waste, sole-source contracting, and subcontracting. Hardy said she had not seen specific evidence of waste beyond a whistleblower call mentioned by a member, but acknowledged that inefficient execution can occur in government and said the department is trying to improve management. On procurement, she said sole-source contracts require her approval and that competitive procurement is the default when possible. White added that subcontracting is allowed only with written state permission under the standard P-37 terms, and subcontractors must meet the same obligations as the prime contractor. No votes or formal actions were taken.

Transcript Highlights:

• ><01:12:52.719> didn't >> The health insurance companies didn't >> The health insurance
• Did the did the health insurance Did the did the health insurance companies<01:13:05.040> weigh
• So if that would be insurance.
• <02:02:37.679> of >> House 1216, insurance certificates of >> House 1216, insurance
• 02:03:21.040> of >> It is insurance certificates of >> It is insurance certificates

Keywords: House streaming session for Friday, March 20, 2026, 957, house, all

Summary: The House met in Annapolis with 107 members present and proceeded through the journal and a series of Appropriations Committee reports. Several bills were advanced on favorable reports without amendment, including measures on constitutional officers’ salaries, correctional officer retirement systems for Dorchester and Allegany counties, Carroll and Calvert County public facilities bonds, higher education financial assistance for incarcerated individuals, and a bill on community college promise scholarship eligibility for Delmar High School graduates. Other bills received amendments before being ordered for third reading, including measures on community college trustee membership, Frederick Community College board meeting and training requirements, Howard County school funding disclosures, courts administrative judges’ stipends, correctional officers retirement membership clarifications, the Children’s Cabinet Fund, and a law enforcement pension bill limiting military service credit eligibility to helicopter pilots in state aviation units. The chamber also considered HB 1581 on horse racing facility ownership, development, licensing, and operations. Amendments expanded the bill to include additional economic development provisions for the Prince George’s County Blue Line corridor, Pimlico-related funding and community input requirements, a larger lottery-fund distribution for the racing community development financing fund, and changes to the bus rapid transit grant program. The bill’s favorable report as amended was adopted, and it was ordered for third reading. During debate on a separate amendment to HB 894, the Maryland Transit and Housing Opportunity Act, members argued over project labor agreements: opponents said PLA requirements raise costs and limit competition, while supporters said the provision was optional, supported stability and predictability, and was part of a broader compromise. The amendment was rejected after discussion, and the bill remained amended. The House also took up HB 1430 on charter school facilities funding, adopting amendments that reduced the per-pupil amount and narrowed eligibility for certain districts, then advancing the bill as amended. In addition, HB 1248 was amended to convert a part-time state employment pilot program into a work group, and HB 680 was amended to adjust future appropriations for local management boards. Across the session, most actions were routine committee report adoptions and amendment votes, with no recorded roll-call counts in the excerpt except the initial quorum call.

Transcript Highlights:

• Chairman, just to add, Commissioner Shilkin, the new incoming commissioner, welcomes any of this.
• It's run by five commissioners. The budget is all special funds.
• It's run by five commissioners. The budget is all special funds.
• It's run by five commissioners. The budget is all special funds.
• And this is interesting because it's $404.54 in insurance, or $12,000.

Keywords: 908, all

Summary: The committee first heard Senate Bill 2271, which would formally place adult residential facilities in code and rebase their Medicaid reimbursement rates. Sponsor Chairman Ruby and HHS staff explained that these facilities, often serving people with dementia or acquired brain injury, are reimbursed at a much lower rate than skilled nursing care and help reduce bottlenecks in higher-level facilities. Members questioned how the program differs from basic care and nursing facility memory care, and the bill was referred to the HR section for deeper review before possible action on Monday. The committee then took up Senate Bill 2396, as amended, which would authorize an independent third-party performance audit of the Department of Commerce and the North Dakota Development Fund, with findings shared with the state auditor. Sponsors said the proposal was prompted by concerns raised in testimony and that a private audit could begin faster than a state audit. The committee adopted an amendment adding an emergency clause and directing the report to the Legislative Audit and Fiscal Review Committee, then passed the bill 20-0 with 3 absent. Next, Representative Clemine presented Senate Bills 2226, 2036, and 2037. SB 2226 would presume an incarcerated person indigent at initial appearance so counsel can be provided at that critical stage; the commission said the appropriation would fund contract attorney hours, and the bill was sent to HR for further review. SB 2036 would create procedures for determining juvenile fitness to proceed in delinquency cases, with a $500,000 appropriation for mental health evaluations, and SB 2037 would begin a juvenile criminal code framework and include a $300,000 appropriation for fitness-to-proceed evaluations; both were also referred to HR, with some concern raised about staffing and overlapping functions. After a short break, the committee heard education-related appropriations bills. SB 2234 would replace expired ESSER funding for Choice Ready grants, but members noted the program was not included in the K-12 budget and sent it to E&E for comparison with existing appropriations. SB 2286, a University of North Dakota request for a new nursing school facility, drew extensive discussion about the age and condition of the current building and the size and scope of the project; the committee ultimately adopted a do-not-pass motion 22-0. SB 2213, the “science of mathematics” bill modeled on the science of reading initiative, would fund math professional development and implementation; it was also referred to E&E for further review. The committee then briefly passed the Racing Commission budget, SB 2023, and began discussion of the Trust Lands budget, SB 2013, including a proposed retention increase for investment-related positions.

Transcript Highlights:

• There were insurance.
• insurance is well, bad. insurance is well, bad.
• health insurance company is? health insurance company is?
• health insurance potentially. health insurance potentially.
• that when it comes to health insurance that when it comes to health insurance insurance<02:08:18.200

Keywords: 1187, senate, all

Transcript Highlights:

• Commissioner<00:18:03.520> Gandhi. Commissioner Gandhi. Commissioner Gandhi.
• >> Commissioner Gandhi. >> Commissioner Gandhi.
• Commissioner<00:29:01.520> Gandhi. Commissioner Gandhi. Commissioner Gandhi.
• Commissioner<00:53:27.280> Ghandi<00:53:27.800> or Commissioner Ghandi or Commissioner
• Commissioner<01:02:30.120> Gandhi. Commissioner Gandhi. Commissioner Gandhi.

Bills: HF3542

Keywords: data privacy, investigative data, welfare system, public funds, transparency, 1183, house

Transcript Highlights:

• Commissioner of the Department of Commerce and Consumer Affairs Insurance Division.
• Commissioner of the Department of Commerce and Consumer Affairs Insurance Division.
• Commissioner of the from the Insurance Commissioner of the Department<02:53:55.360> of<02:53:
• <02:54:09.440> Commissioner and also the Insurance Commissioner and also the Insurance Commissioner
• My reservations are based on the testimony of the insurance commissioner. Thank you, Madam Speaker.

Keywords: 910, house, all

Transcript Highlights:

• That's MDH's policy bill that regulates HMOs and the insurance industry.
• Uh, currently, HMOs must notify the commissioner when they terminate a provider within their network.
• regulates HMOs and the insurance regulates HMOs and the insurance industry. industry. industry.
• <00:04:12.440> when<00:04:12.840> they must notify the commissioner when they must
• upon termination of all commissioner upon termination of all participating<00:04:22.960> entities

Keywords: 1187, senate, all

Transcript Highlights:

• drafting error so what the commissioner drafting error so what the commissioner suggested<00:14:
• the an example that the commissioner the an example that the commissioner brought<00:27:31.080><
• This is something that was suggested by the commissioner.
• owner um and so the so yeah commissioner owner um and so the so yeah commissioner J<01:09:41.679
• <01:43:23.280> identifi liability insurance identifi liability insurance identifi identification

Keywords: 928, house, all

Summary: The committee worked through a draft bill amending animal cruelty and protective custody provisions, focusing on how animals may be seized, cared for, and returned, and on what rights owners have when animals are taken. Members discussed adding language requiring officers to inform a charged person in writing of the right to petition for a veterinarian of their choice, clarifying that any documents presented for signature must be fully and honestly explained, and revising language so confiscated animals cannot be altered without notarized owner authorization. They also considered a new prohibition on using confiscated animals for fundraising or donations, ultimately preferring the term “financial gain” over “profiteering.” The discussion also covered protective custody procedures, including adding “municipal animal control officer” to the list of officers involved, allowing return of animals to the owner or caretaker if no charges have been filed or no warrant establishing probable cause has been sought or issued, and clarifying the distinction between criminal seizure and temporary protective custody. The commissioner’s comments led to several proposed deletions or revisions, including removing language viewed as redundant or inconsistent with protective custody, and striking references to live racing provisions that are no longer relevant. Members further addressed lactating animals, agreeing to add language that confiscated lactating animals should not be separated from their nonweaned offspring. They also discussed a proposed confidentiality provision requiring people assisting in investigations or taking possession of seized animals to sign a binding nondisclosure agreement, though members noted similar protections may need to be duplicated in the temporary custody section as well. The conversation was largely about drafting and legal clarity, with no final vote or formal action recorded in the excerpt.

Transcript Highlights:

• Now, this is a little bit different because the county commissioners, the Harris County commissioners
• Christine Lee, Harris County Commissioner, Precinct 2.
• Commissioner Garcia was here this morning.
• I'm sorry, are you the commissioner for Precinct 2, or are you on behalf of the commissioner for Precinct
• And the Harris County Commissioners don't control it.

Bills: SB39, SB2129, SB2141, SB2246, SB2323, SB2439, SB2722

Keywords: commercial motor vehicle, truck liability, motor carrier, trucking, civil liability, respondeat superior, negligent entrustment, negligent maintenance, negligent loading, negligent repair, bifurcated trial, exemplary damages, punitive damages, personal injury, collision, employer liability, vicarious liability, Civil Practice and Remedies Code, Texas tort reform, commercial truck accident

Summary: The Senate Transportation Committee reconvened on SB 2722, as substituted by Senator Bettencourt, which would redirect a portion of Harris County Toll Road Authority surplus revenues to the City of Houston and impose audit and tax-rate penalty provisions. Houston Police Chief Noe Diaz and Fire Chief Thomas Munoz testified in support, arguing that Houston bears a large share of toll-road public safety burdens, citing thousands of police and fire responses on toll-road property and the need for compensation for emergency services. Bill King, testifying neutrally, said the toll authority generates large excess revenues and urged stronger oversight and clearer controls on how the money is spent. Opponents, including Harris County officials, business and neighborhood representatives, and toll-road critics, argued the bill would divert transportation dollars, create a precedent for taking toll revenues for general municipal use, and could worsen project delivery and incentives; several also questioned the accuracy and interpretation of the revenue figures and the lack of comparable audit requirements for the city. The committee took extensive testimony but left SB 2722 pending without a vote. The committee then heard SB 2129, which would increase fines for motorists who disregard railroad crossing gates or flaggers, and SB 2323, which would redact railroad crew members’ personal information from public accident reports. Both bills were presented as safety measures, with railroad labor testimony in support, and both were left pending after brief public testimony. The committee also heard SB 2141, a Zaffirini bill concerning specialty license plates for judges, with the substitute aimed at reducing security risks by changing how judges are identified on plates; it too was left pending. Finally, the committee heard SB 2439, another Zaffirini bill, described as a TDLR cleanup measure related to ATV and off-highway vehicle safety certification. The bill would abolish the current training and certification program, which supporters said was burdensome and underused given the small number of approved instructors statewide. With no significant opposition on the record, the committee closed testimony and left SB 2439 pending as well.

Transcript Highlights:

• <00:32:04.799> the deserve the office insures the deserve the office insures the department
• <00:45:31.760> Landry's addition to social commissioner Landry's addition to social commissioner
• That commissioner will be testifying. I will defer to Deputy Commissioner... Thank you very much.
• c> again<00:49:04.640> if next and the commissioner uh again if next and the commissioner
• No, no insurance or anything like that.

Keywords: 1189, house, all

Transcript Highlights:

• Langfeld, who's our commissioner for public health, used at one of the budget committees a couple weeks
• Langfeld, who's our commissioner for public health, used at one of the budget committees a couple weeks
• commissioner for public health commissioner for public health presenting<00:17:46.880> on
• But appreciate Commissioner Stack's availability to us, done a great job.
• Commissioner Stack um appreciate Commissioner Stack um availability<00:25:58.240> to<00:25:58.480

Keywords: 958, all

Summary: The Health Services Committee heard a presentation from Dr. Steven Stack, Secretary of the Cabinet for Health and Family Services, on Kentucky’s Rural Health Transformation Program. He said Kentucky received about $213 million in federal funding, among the highest awards nationally, after a fast application and negotiation process. He emphasized that the grant is time-limited, must be used for the specific goals in the state’s application, and cannot be treated as a general bailout or replacement for existing funding. He also noted the state will use a website, ruralhealthplan.ky.gov, to share the full application, award terms, and future opportunities. Dr. Stack outlined five focus areas: maternal health and prenatal/early childhood supports; EMS and trauma response workforce and transfer capacity; behavioral health crisis care through the EMPATH model and mobile crisis services; oral health access through more hygienists, telehealth, and hub-and-spoke models; and rural community hubs for chronic disease prevention and innovation, including food-as-medicine and healthier lifestyle interventions. He stressed that the program is meant to be transformative, not duplicative, and that it cannot pay clinician salaries, fund new construction, replace EMR systems broadly, or duplicate billable services. He said the state will work with community partners, hospitals, universities, and others, including the Foundation for a Healthy Kentucky, to begin implementation. Members responded positively overall. Senator Berg praised the award and the goal of integrating care across the state, but raised concerns about access to prenatal care and about possible future changes to water fluoridation, warning both could harm children and rural families. The chair and other members thanked Dr. Stack for the update and congratulated him on the award. No votes or formal committee actions were taken during this portion of the meeting.

Transcript Highlights:

• . the the cost of cost of insurance. the the cost of insurance<00:04:02.799> has<00:04:02.959>
• ,<00:15:47.040> maintenance, food, payroll, insurance, maintenance, food, payroll, insurance
• I'm the commissioner for the Department for Medicaid Services. >> I'm Steve Beal.
• ><00:40:55.920> for commissioner for the Department for commissioner for the Department for Medicaid
• And that 600,000 Insurance Program.

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses. The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness. Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.