Transcript Highlights:

• From strengthening our foster care system to expanding promised neighborhoods or advancing the CWS CARES
• A foster care multi-agency office would ideally have the ability and authority to direct public agencies
• So within kinship settings and extended foster care, but I think the most direct response is the evaluation
• care licensing.
• This is related to an emerging issue within community care licensing for child care programs.

Keywords: 988, house, all

Transcript Highlights:

• primary child care provider types, family child care and child care centers.
• <00:03:51.319><c> um</c> child care and Child Care Centers um child care and Child Care Centers um this
• care center respondents.
• and child care centers.
• </c><00:24:47.240><c> from</c> child care and Child Care Centers from child care and Child Care Centers

Keywords: 1183, house

Transcript Highlights:

• </c><00:08:41.880><c> Jefferson</c> added back language directing Jefferson added back language directing
• </c> in the 24 regular session and directs in the 24 regular session and directs the<00:39:22.400><c>
• </c> And then Medicaid Medicaid managed care And then Medicaid Medicaid managed care organization<00:
• payments and directs DMS to apply for federal approval for the K Care program to be operated by ARH.
• </c><00:46:40.280><c> incentive</c> match for managed care incentive match for managed care incentive

Keywords: 958, all

Summary: The Free Conference Committee on the 2026 General Assembly budget met to reconcile differences between the House and Senate versions of House Bill 500. Leaders opened by thanking the other chamber’s work, asking members to turn microphones on and off to avoid feedback, and stressing the need to clearly note decision points so both chambers record the same actions. Staff then walked through the bill page by page, explaining that the committee was comparing only House and Senate differences, not the governor’s proposed budget. The discussion covered a wide range of appropriations and language items, including next generation non-911 services, school safety reporting tools, restored funding for brain injury, epilepsy, veteran service, homeless veterans, and rocket docket programs, debt service changes, rural infrastructure, disaster aid caps, Attorney General and Medicaid fraud funding, agriculture and county fair grants, auditor and pension-related appropriations, school facilities and SEEK funding, and numerous education programs. Members also discussed charter-related funding such as Star Academy, Dolly Parton Imagination Library, school resource officers, school-based mental health providers, AP/IB exams, Governor’s Scholars and Entrepreneurs, and several pilot or initiative programs in economic development, energy, and labor. Several items were described as technical corrections or restorations of language and funding, while others reflected differences in amounts or how funds would be distributed. There were several questions and comments from members about wording such as “implement and carry out,” the absence of the governor’s budget from the comparison document, and whether SEEK funding should be tied to teacher raises. The chair and other members emphasized that the committee’s role was to reconcile the two chambers’ budgets, not to adopt the governor’s proposal. Members also raised concerns about opioid settlement funds and the Dolly Parton Imagination Library match rate, with one senator urging restoration of the House language. No final vote or formal action was taken in the portion provided; the meeting primarily consisted of explanation, questions, and discussion of proposed budget differences.

Transcript Highlights:

• while they were trying to take care of the patient.
• while they were trying to take care of the patient.
• to hospice care.
• That's no care for those patients.
• People are scared to seek emergency care.

Summary: The committee met with a quorum and considered several health-related bills. SB 398, by Senator Burgess, would create a statewide Alzheimer’s and dementia awareness campaign through the Department of Elder Affairs, focused on early detection, brain health, risk reduction, clinical trial access, and community resources. Supporters said Florida has a large and growing Alzheimer’s population and that the campaign would help families and vulnerable communities; the bill was reported favorably after a roll call vote. The committee also adopted an amendment to SB 714, by Senator Burton, which would create non-opioid advanced directives and add liability protections for providers in medical emergencies involving opioids. Supporters framed it as a patient-choice measure, while opponents argued it was vague and could interfere with appropriate pain treatment; the amended bill was then reported favorably. The committee also approved CS/SB 756, which removes the current age-eight diagnosis requirement for autism-related insurance coverage and extends coverage beyond age 18 for those diagnosed with autism. Senator Burton said the bill would help families whose children are diagnosed later or whose needs continue into adulthood. There was brief discussion about existing lifetime benefit caps, but the sponsor said the bill did not change those limits. The committee then took up SB 734, a proposal by Senator Yarbrough to repeal Florida’s wrongful death exception that bars certain parents and adult children from recovering non-economic damages in medical negligence cases. The sponsor and supporters described the current law as discriminatory and unjust, especially for families of older adults and disabled individuals, while opponents warned it would raise malpractice costs, increase premiums, and worsen provider shortages. The bill drew extensive public testimony from both grieving family members and health care/insurance representatives, and members debated whether caps or other safeguards should be added. No final action on SB 734 is reflected in the transcript excerpt.

Transcript Highlights:

• Recently, in response to the board's feedback and direction, the Office of Health Care Affordability
• and some specialty care.
• The bottom of why health care costs keep on increasing and the quality of care or access to care keeps
• And over 200 sites of care.
• quality care for patients and at the same time drive down the total cost of care.

Keywords: 988, house, all

Transcript Highlights:

• patient care.
• patient care.
• Wraparound services, for example, might not meet the definition of direct patient care, but they're important
• for improving health care outcomes and they reduce costs to our health care system.
• Direct patient care is a large area.

Bills: HB2720, HB2073, HB2487, SB5816, SB5919, SB5831, SB6137, SB6244, SB6044, SB6132, SB5109, SB5877, SB6258, HB2720, HB2073, HB2487, SB5816, SB5919, SB5831, SB6137, SB6244, SB5420, SB5868, SB6044, SB6132, SJM8002

Keywords: behavioral health, emergency services, health insurance, provider access, mental health funding, premium assistance, funding, healthcare, subsidies, insurance tax, state regulation, insurers, taxation, budget impact, juice grapes, agriculture, commerce, market access, fire safety, insurance incentives

Transcript Highlights:

• direct care workers.
• I'm also a big supporter of being able to support our direct care providers.
• grants and other grants that can deliver education and resources to direct care workers. unpaid family
• The funds were used for various programs, one of which was a respite care program that provided direct
• care providers in primary care.

Transcript Highlights:

• You can't find a direct care provider that you trust to have in your home.
• You can't find a direct. And the money is there for the care. You can't find the caregivers.
• You can't find a direct care provider that you trust to have in your home.
• So they came in and, in what they call a directed plan of care that they gave Warren... ...a directed
• directed by Long-Term Care, and there are federal surveyors.

Summary: The Joint State Agencies committee met to approve prior minutes and then focused on the death of Zachary Moore at the Southeast Arkansas Human Development Center, later clarified in discussion as the Warren facility. DHS officials described Moore’s background, said he died after a prolonged prone restraint followed by a delayed chemical restraint, and reported that 13 staff were terminated, the superintendent was replaced, a consultant was brought in, and the agency entered a settlement with the family for $725,000. Members pressed DHS on the cause of death, restraint policies, staff training, supervision, family notification, and why the family had not been kept informed; DHS said a family-notification procedure exists but that communications during litigation had been handled through counsel. The committee also heard that six staff had been criminally charged with manslaughter and neglect of a vulnerable person, and that the death certificate listed the manner of death as homicide with cause of death tied to physiologic stress associated with struggle and prone restraint. DHS officials gave broader context on the five human development centers, their licensing and accreditation, resident population, mortality review process, and training programs. They said the centers serve highly medically and behaviorally complex residents, that annual restraint training and CPI-based instruction are required, and that the mortality review committee and Office of Long-Term Care review deaths and make recommendations. Members repeatedly criticized the agency for not having complete information at the meeting and for what they saw as gaps in oversight, staffing, and chain-of-command clarity during emergencies. DHS responded that the Warren facility had not been meeting the same standards as the others, that the consultant’s root-cause analysis identified multiple failures, and that new crisis-team and chain-of-command procedures were being drafted. A second major topic was staffing and recruitment. Members discussed low pay, turnover, use of float and on-call staff, rural staffing shortages, and a waiting list of about 2,000 people for home- and community-based services. DHS said CNAs at the centers start at about $39,000 a year, that a broader retention and recruitment plan is being drafted for all five centers, and that a separate rate study for PASS services will be implemented in January 2027 but does not cover CNA pay. The meeting ended with testimony from Moore’s mother, Angela Stevens, who said money could not replace her son and urged stronger training, background checks, and supervision so other residents would be protected. The committee asked DHS to keep members and Stevens updated on consultant reports, recruitment efforts, and follow-up on the family communication issue, and then adjourned.

Transcript Highlights:

• Our decisions around access to care.
• care hours via telehealth.
• For example, there might be situations where a waiver agency hasn't verified that a direct care provider
• care delivery system.
• Leveraging these state-directed payments to advance population health, quality of care, and health equity

Keywords: 988, house, all

Transcript Highlights:

• at least $2,000 per child for a direct payment made to a licensed child care entity.
• at least $2,000 per child for a direct payment made to a licensed child care entity.
• at least $2,000 per child for a direct payment made to a licensed child care entity.
• at least $2,000 per child for a direct payment made to a licensed child care entity.
• of at least $2,000 per child for a direct payment made to a licensed child care entity.

Keywords: Finance - Room 216, 19 February, 2026; 1:30 PM, 925, all

Transcript Highlights:

• </c> any stakeholders from the team at Direct any stakeholders from the team at Direct Care<00:04:58.800
• </c> officially the the uh the head of direct officially the the uh the head of direct care<00:10:44.720
• </c><00:14:46.320><c> Care</c><00:14:46.480><c> and</c> 1800s where the uh whole Direct Care and 1800s
• direct care and treatment that we have a direct care and treatment agency<00:23:02.360><c> that</c><
• c> on</c><00:23:13.000><c> some</c> from Direct Care and treatment on some from Direct Care and treatment

Keywords: 1187, senate, all

Transcript Highlights:

• most long-term care services, such as custodial care provided in nursing homes.
• Yet many do need long-term care, home care, adult day health care, and assisted living at some point
• care facilities.
• care facilities.
• With respect to direct services, in close collaboration with the Department of Health Care Services,

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• </c> health care. health care.
• But we can't direct them. We can direct the other three. True. good.
• We can direct the other direct them. We can direct the other three.<00:05:23.760><c> True.
• So uh this is about access to care. So, this is about access to care.
• care care the<00:25:56.400><c> health</c><00:25:56.600><c> care</c><00:25:56.760><c> system</c><00:25

Keywords: 958, all

Summary: The Senate Standing Committee on Health Services met with a quorum and first took up Senate Joint Resolution 116, sponsored by President Stivers. The resolution directs the University of Kentucky, the University of Louisville, and Eastern Kentucky University to work over the next year on a statewide framework to improve health care access, especially in underserved and unserved areas. Members discussed physician shortages, maldistribution of doctors, recruitment and retention, loan forgiveness, scholarships, technology, and the connection between health care access and economic development in rural Kentucky. The resolution was reported favorably on a unanimous roll call vote. The committee then considered Senate Bill 116, relating to physician assistants and a shift from a supervisory to a collaborative practice model. The sponsor and PA witnesses explained that the bill was heavily revised through a committee substitute after discussions with the Kentucky Medical Association, physicians, and hospitals. They said the substitute keeps physician supervision in place while allowing health care teams to function more efficiently, and they emphasized that the bill is intended to improve access to care, particularly in rural areas with few doctors. Some members supported the compromise and the collaboration, while others raised concerns that expanding PA practice could worsen long-term physician shortages or reduce incentives for doctors to practice in rural Kentucky. The bill passed the committee 7-2 with favorable expression.

Transcript Highlights:

• So these are for certain primary care clinics, adult day care, adult day health care centers, and home
• So these are for certain primary care clinics, adult day care, adult day health care centers, and home
• health care adult day care, adult day health care centers and home health agencies that are exclusively
• For example, there might be situations where a waiver agency hasn't verified that a direct care provider
• It requires health care service plans, including Medi-Cal managed care and dental managed care plans

Summary: The committee heard a budget oversight hearing on the Department of Health Care Services, focusing first on the overall Medi-Cal budget and a March General Fund loan to cover a current-year shortfall. DHCS said the 2025-26 budget proposal totals $193.4 billion, with Medi-Cal projected at $188.1 billion total funds and $42.1 billion General Fund, driven by higher enrollment, pharmacy costs, managed care growth, and costs tied to eligibility expansions and the COVID-era redetermination unwinding. The department said the $3.44 billion loan was needed to manage cash flow and ensure timely payments to providers and plans, while the LAO noted Medi-Cal’s cash-basis budgeting creates volatility and that more detailed estimates would come with the May Revision. Members discussed federal Medicaid threats, the need for transparency on cost drivers, and the impact of pharmacy spending, long-term care, and immigration-related coverage expansions. The second major topic was family health programs, including California Children’s Services, the continuous coverage unwinding, and opioid settlement fund spending. DHCS described CCS funding methodology changes, ongoing county stakeholder work, and a delayed rollout of CCS monitoring and oversight until July 1, 2025, while county representatives and advocates argued the program is underfunded and asked for more technical assistance and a delay in implementation. On the unwinding, the department explained that federal redetermination flexibilities helped maintain coverage after the pandemic, but the Governor’s budget proposes ending them at the end of June 2025; advocates urged making the flexibilities permanent to avoid coverage losses. For opioid settlement funds, DHCS and Finance said the budget increases funding for naloxone distribution while reducing other harm-reduction spending based on updated settlement revenues, prompting criticism from members and public commenters who argued the change would weaken effective harm-reduction programs. The hearing also included an update on Proposition 35 implementation. DHCS said the voter-approved measure continuously appropriates MCO tax revenues beginning in 2025, with up to $4.6 billion annually available for specified Medi-Cal and provider investments in 2025 and 2026, but implementation depends on consultation with the required stakeholder advisory committee. The department and LAO noted uncertainty about future federal rules affecting the MCO tax after 2026. Public testimony largely supported maintaining Medi-Cal expansions, protecting immigrant coverage, preserving harm-reduction funding, and increasing support for community health workers, pediatric dental care, and CCS county administration. No votes were taken during the portion of the hearing provided.

Transcript Highlights:

• </c> directed payments facing out in 2028. directed payments facing out in 2028.
• </c><00:10:26.880><c> to</c> care, primary care, and to continue to care, primary care, and to continue
• </c><01:14:39.760><c> John</c> Care is Dr. John Care is Dr.
• And so, when we talk about charity care and the value of that care, isn't the value of that care kind
• and the value of talk about charity care and the value of that<01:30:28.400><c> care,</c> that care,

Keywords: 1183, house

Transcript Highlights:

• </c> and taking care of daily with the kids. and taking care of daily with the kids.
• </c> out because there is no care. Both. out because there is no care. Both.
• </c> even pay for child care. even pay for child care.
• .<01:19:06.159><c> Um,</c> care.
• Um, care.

Keywords: 1191, senate, all

Transcript Highlights:

• </c> care plans managing the long-term care care plans managing the long-term care uh<00:32:09.120><c
• </c> 24hour 7 day a week care. 24hour 7 day a week care.
• There are, you know, if the legislature moves in the direction of managed care, there certainly the rural
• in the direction of managed care<00:48:17.119><c> there</c><00:48:17.839><c> um</c><00:48:18.240><c>
• Medicaid managed care a managed care Medicaid managed care organization<00:51:31.040><c> the</c><00:

Keywords: 928, house, all

Summary: The committee to study long-term managed care met to approve the prior meeting minutes, with a clarification that “OB3” referred to the “one big beautiful bill.” The minutes were then approved. Chair Jim Kofalt outlined the day’s agenda, which included testimony from the Granite State Home Health and Hospice Association, the New Hampshire Association of Counties, and later DHHS. He also noted that future meetings were expected soon and that the meetings were being livestreamed on YouTube. Granite State Home Health and Hospice Association, represented by Kellyanne Totten and Amy Moore, urged inclusive planning and a cautious, phased approach if managed care is considered. They emphasized that home care providers are not uniform, with different licensing and service models, and said any pilot should include varied provider types, rural and southern regions, and agencies of different sizes. They warned that workforce shortages, inflation, and a possible 9% CMS cut to Medicare home health payments could force agencies to reduce service areas or service types. They also said the 2023 Medicaid CFI rate increase has begun to lose its effect. In response to questions, they said the rural health transformation fund may help with planning and telehealth but likely cannot be used directly for rates or recruitment/retention. They also described the New England Home Care Nurse Residency Program, a Department of Labor grant, as a way to bring new registered nurses into home care with added training and school partnerships. The New Hampshire Association of Counties, through county nursing home administrators Craig Labore and David Ross, revisited the earlier Step Two managed care discussions from 2016-2018. They said prior consultants found the long-term services and supports system was underfunded and needed investment to stabilize providers and expand community-based care. They argued the same concerns remain today and said a managed model would jeopardize the Medicaid quality incentive payment program and, for county nursing homes, the proportionate share payment program. Their testimony was generally opposed to moving forward with managed long-term services and supports without significant additional funding and safeguards.

Transcript Highlights:

• So, like the direct primary care model already in use in the state, what the bill does is it will grant
• Shortly thereafter, in 2019, New Hampshire passed its direct primary care legislation.
• </c><01:54:47.440><c> This</c><01:54:47.599><c> is</c> direct primary care legislation.
• This is direct primary care legislation.
• </c> direct pay models on the health care direct pay models on the health care system?

Keywords: 1191, senate, all

Transcript Highlights:

• have to go in this direction?
• health care.
• We know New Mexico And co-health care is predominantly about rural health care.
• care clinical staff.
• or primary health care.

Bills: SB903, SB2101, SB2550, SB2983, HB2433, SCR8, SCR20, SCR28, SCR32, SCR40, SCR48, SCR55, SCR57, SCR69, SCR74, SCR83, SCR87, SCR94, SCR99, SCR114, SCR139, SCR160, SCR165, SCR177, SCR178, SCR179, SCR41, SCR78, SCR90, SCR130, SCR159, SCR162, SCR173, SB2024, SB2075, SB2730, HB2581, SB2050, SB2471, SB2466, HB1163, HB1514, SB3082, SB2135, SB2727, SB3097, HB1696, HB2021, SR20, SCR110

Keywords: public land trust, Hawaiian affairs, OHA, ceded lands, financial reporting, income settlement, trust responsibility, organic waste, solid waste, waste diversion, composting, bioconversion, recycling, food waste, green waste, food-soiled paper, wood waste, landfill diversion, waste reduction, waste management