Transcript Highlights:

• There's a 23-hour care, and there's respite care for up to, I think, two weeks, up to 14 days.
• But ideally, we don't want youth in extended foster care on the day before they turn 21 without having
• But ideally, we don't want youth in extended foster care on the day before they turn 21 without having
• or who will leave foster care within 90 days.
• One day that child will leave foster care, and one day Texas will graduate that child into adulthood.

Keywords: 1184, house, all

Transcript Highlights:

• , met by their nurse, and over the next four to five days receive all the same care they would usually
• DPC and to make meaningful care the standard of care in Massachusetts.
• for every day.
• My first experience with direct primary care came when I was a home care nurse caring for a young ALS
• Every day in my current role, I hear from patients desperate to find a primary care doctor.

Keywords: 995, all

Summary: The committee held a public hearing with testimony on several health care bills, with most of the discussion focused on primary care access, community health center reimbursement, midwifery and birth centers, telehealth, hospital-at-home, direct primary care, and trans-inclusive health care access. Chair Feeney and Chair Murphy opened by noting the large number of signups and asking testifiers to keep remarks brief because of time constraints. Legislators and witnesses repeatedly emphasized that Massachusetts’ primary care system is under strain and that federal policy changes and reimbursement gaps are worsening financial pressure on providers. On community health centers, Representative Blay, Senator Lovely, Michael Curry, Bethany Keeley, Jag Deep Trevetti, Sean Cahill, and Christina Severin all supported H. 1096/S. 711, which would require commercial insurers to pay federally qualified health centers at least the MassHealth prospective payment system rate. They argued that commercial plans currently reimburse health centers below Medicaid rates, threatening sustainability, staffing, and access, especially as federal cuts and coverage losses could increase uncompensated care. Testifiers said the bill would stabilize health centers, protect primary care access, and not cost the state money. A second major topic was H. 1117/S. 784 on sustaining birth centers and the midwifery workforce. Senator Lovely, Senator Miranda, Emily Anesta, Rebecca Orden, Catherine Rushworth, Nishira Burrill, Joel Sutherland, Rachel Blessington, Joelle Ward, and others described the 2024 maternal health omnibus as an important first step, but said birth centers and midwives still face low reimbursement, workforce shortages, and financial instability. They urged reimbursement parity, a workforce development fund, and support for freestanding birth centers, citing improved outcomes, lower C-section rates, better patient experience, and racial equity in maternal health. Several speakers shared personal birth stories and said the bill would help preserve and expand birth options in communities like Roxbury, Worcester, and the North Shore. The committee also heard support for H. 1343 on direct primary care from Dr. Garofalo, Dr. Altman, Dr. Nair, Stephanie Cameron, Dr. Haley Moke-Blessed, and others, who said current insurance rules force patients to use a separate in-network primary care doctor for referrals and sometimes prevent physicians from dispensing medications. They argued the bill would reduce delays, administrative burden, and costs while improving continuity of care. In addition, Dr. Miklides and Sue Stempeck supported H. 1141 on hospital-at-home parity, saying the model has strong outcomes and should be reimbursed at the same rate as brick-and-mortar hospital care. Heather Myers and Katrina Cook testified on telehealth and digital health equity, urging broader coverage for asynchronous care, remote monitoring, interpreter services, and digital literacy supports. SEIU Local 509 supported H. 1188/S. 681 on trans-inclusive health care access, saying it would remove arbitrary insurance barriers to gender-affirming care. No votes or committee actions were taken during the hearing.

Transcript Highlights:

• families with special needs kids have to go through day to day.
• So proposing that 28-day, my level of care is 3.1, we get 90 days.
• and 2.1 level of care, which is intensive outpatient care. 1.1 level of care and 2.1 level of care,
• -day, because 28-day is important, and as you say, 28-day is not enough, but they do get a significantly
• care for who are foster care children.

Summary: The committee heard public testimony on several budget requests tied to health and human services. Louisiana Children’s Advocacy Centers asked for continued support and a supplemental appropriation of $1.173 million for infrastructure and standardization, explaining that the money would expand use of the Guardify digital evidence system, improve chain of custody, and reduce reliance on DVDs. Baton Rouge and statewide CAC leaders said prior funding helped eliminate a therapy wait list and speed services for abused children. Members asked detailed questions about the digital system, MDT coordination, and how the request related to SB 237, which would strengthen multidisciplinary review of child abuse cases. The Alzheimer’s Association sought $824,000 to sustain the dementia care specialist program, saying it helps families navigate services, keep loved ones at home longer, and reduce Medicaid costs. AARP and the Live at Home Coalition also testified for 750 additional Community Choice waiver slots at a state cost of $3.3 million, arguing that home- and community-based care is cheaper than nursing homes and that the current wait list is more than 11,000 people. Legislators discussed the size of the need, the state’s long-term care spending mix, and whether more support should go to family caregivers and community-based options. Testimony also focused on disability support services, substance use treatment, and developmental disability provider rates. A parent and direct support worker described the Children’s Choice waiver’s 20-hour cap and low pay, saying it makes it hard to retain caregivers and meet the needs of medically fragile children. Odyssey House and O’Brien House asked for higher Medicaid reimbursement rates under ASAM 4, warned that removal of room-and-board payments and weak Medicaid eligibility pathways are reducing access, and called for more oversight of sober living homes; members questioned outcomes data, length of stay, and links to homelessness. Finally, the Arc of Louisiana said the LDH rate study confirmed underfunding and supported a $53.6 million increase in state general funds, with local ARC leaders describing the services they provide and the need for higher direct support professional wages.

Transcript Highlights:

• these days.
• So 13% of parents in our survey responded that they worry about the cost of child care every day or nearly
• rent, bills, child care, health care.
• child care, health care.
• access to at least 96 child care slots a day.

Summary: The California State Assembly Select Committee on Child Care Costs held its first hearing to examine the state of child care access, affordability, and provider compensation. Chair Cecilia Aguiar-Curry and other members described child care as essential infrastructure for working families and the economy, noting that costs are unaffordable for many households and that providers are underpaid. Early testimony came from a San Francisco parent, Quinn Chung, who described the difficulty of finding safe care and the financial and career sacrifices caused by lack of child care, and from Tuolumne County provider Anita Viscini, who detailed her monthly costs, low margins, and the need to work weekends and teach CPR classes to make ends meet. Assemblymembers also emphasized the crisis in rural communities and the need for a long-term strategy. The first policy panel featured Jennifer Troia of the California Department of Social Services, Laura Pryor of the California Budget and Policy Center, and Alexa Frankenberg of Child Care Providers United. Troia said the state has nearly doubled child care funding in five years, expanded subsidy slots, and reached a new tentative three-year agreement with providers that includes cost-of-living adjustments, stabilization payments, and continued work on an alternative rate methodology and single rate structure. Pryor argued that despite funding gains, child care remains too expensive, only a fraction of eligible children receive subsidies, and provider wages remain far below comparable jobs, worsening racial and gender inequities. Frankenberg said the tentative agreement is progress but not enough, calling for a true cost-of-care system, fair wages, paid time off, better support for emergency and nontraditional care, and stronger integration of family child care into the mixed-delivery system. Members asked about why the crisis persists, how the alternative methodology will work, how family fees and sliding-scale help are being used, and why middle-income families still struggle. The panel said the problem reflects long-term underinvestment, a broken market, and a system that still leaves many families without access. The committee also heard an economic panel from Ashley Hoffman of the California Chamber of Commerce and Sarah Bone of the Public Policy Institute of California. Hoffman described employer child care benefits and public-private partnership models in other states, including shared-cost programs and local chamber efforts. Bone said child care costs reduce family financial security and labor force participation, especially for mothers of young children, and estimated that if mothers of young children worked at the same rate as mothers of older children, more than 80,000 additional women could be in the workforce each year. In the final panel, parent and provider advocates, including Jennifer Greppie and Black Californians United for Early Care and Education co-founder Keisha Doyle, argued for fully funding child care, ending waiting lists, protecting culturally affirming care, and addressing racial inequities and private equity’s role in the sector.

Transcript Highlights:

• Um, personal care homes are of care.
• for</c><00:09:42.640><c> the</c> personal care homes that cared for the personal care homes that cared
• As owners of 16 personal care homes in the state of Kentucky, we're grateful every day for the opportunity
• As owners of 16 personal care homes in the state of Kentucky, we're grateful every day for the opportunity
• As owners of 16 personal care care for.

Keywords: 958, all

Summary: The Health and Family Services committee heard an informational 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, often with serious mental illness, who do not meet nursing home criteria but need structured supervision, medication assistance, meals, and daily support. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and are supported largely through state supplementation payments and residents’ SSI income. The presenters argued that the current reimbursement rate of about $50.70 per day is no longer sufficient to cover staffing, food, insurance, utilities, maintenance, and other costs, and said the sector has shrunk significantly over time. They cited figures showing a decline from 64 to 34 homes serving the seriously mentally ill since 2002, with 30 closures over 23 years, and said the loss of beds contributes to homelessness, hospital overcrowding, and longer psychiatric stays. They also gave examples of residents who had spent many months in hospitals before being successfully placed in personal care homes, which they said can prevent more costly institutional care. Committee members asked about staffing credentials, fraud controls, referral processes, and how reimbursement works in other states. The presenters said Kentucky does not require licensed or certified staff in these facilities, though some homes use certified medication technicians or an LPN, and they described a county case-manager-based assessment process used to set individualized rates in other states such as Minnesota. Members expressed support for the work but emphasized the need for documentation of savings and budget offsets. The presenters said they are seeking an incremental reimbursement increase over two years, roughly 25% to 50% in the first year and another 50% after that, and urged the committee to support the homes to prevent further closures.

Transcript Highlights:

• </c><00:02:37.519><c> a</c> operations, 7 days a week, 365 days a operations, 7 days a week, 365 days
• care, surgery, inpatient care, primary care, specialty<00:10:26.880><c> care,</c><00:10:27.600><c> behavioral
• On a bad day in the people or more in one day. So those people or more in one day.
• </c> five days. five days.
• We've earned that trust, and we're taking care of anyone all times of day or night.

Keywords: 919, house, all

Summary: House File 369 was the main topic, with House authors Rep. Natalie Zeleznikar, Rep. Robert Bierman, and Rep. Dave Baker arguing that the bill would give Minnesota’s 2024 340B law “teeth” by enforcing protections for nonprofit and rural hospitals’ access to the federal drug pricing program. They said the measure costs the state nothing, aligns with similar laws in more than 20 other states, and is needed before adjournment to help hospitals close funding gaps, support services like emergency care, obstetrics, behavioral health, and pharmacy access, and preserve care in remote communities. Several hospital leaders from across greater Minnesota testified that 340B revenue helps keep their facilities viable and that losing it would threaten services and, in some cases, hospital survival. Witnesses described severe financial pressure on rural hospitals, including reimbursement cuts, workforce shortages, inflation, and rising drug costs. Leaders from United Hospital District in Blue Earth, Lakewood Health System in Staples, Ely-Bloomenson Community Hospital, Northshore Health in Grand Marais, Community Memorial Hospital in Cloquet, and Cuyuna Regional Medical Center in Crosby said their hospitals serve as safety-net providers and often operate with thin or negative margins. They emphasized long travel times to other hospitals, seasonal tourism pressures in some areas, and the importance of local emergency, ambulance, inpatient, and specialty services. The Minnesota Hospital Association president also criticized pharmaceutical company messaging and said nonprofit hospitals are working around the clock to maintain access. In response to questions, Zeleznikar said she had considered other enforcement approaches but now supported using the original Senate-passed bill, citing concerns about fraud and the difficulty of alternative enforcement mechanisms. She and hospital leaders distinguished this bill from a separate hospital stabilization-grant proposal, saying both are needed but serve different purposes. No vote was taken at the meeting, and the speakers repeatedly urged House leadership to bring the bill to the floor before session ends.

Transcript Highlights:

• Child care, daycare, preschool, all words to describe the same thing, which is any care for a child from
• What we mean when we say that is the cost of child care is very high, and availability of child care
• So you alluded to the wage, and the wage is low for our health care or our child care providers.
• to retain child care providers.
• to retain child care providers.

Summary: The Human Services Subcommittee met and first took up HB 47, Child Care and Early Learning Providers, sponsored by Rep. McFarland. The bill was presented as an effort to reduce child care costs and regulatory burdens by exempting preschools from special tax assessments, moving teacher training and testing online and making it free, allowing abbreviated inspections for top providers, extending license-exempt status to employer-provided child care, and addressing an insurance issue affecting family child care homes. Members asked about DCF transparency, accreditation, background screening timelines, accountability for exempt facilities, and whether violations would still be searchable; McFarland said accreditation would still be required, DCF reporting and abuse hotlines would remain available, and the bill would not eliminate existing transparency for licensed providers. An amendment was adopted to add clarifying language and exempt certain DOD and Coast Guard child care facilities operated by DOD personnel. Several witnesses and members spoke in support, emphasizing workforce needs, affordability, and safety. HB 47 was reported favorably by a vote of 18-0. The committee then heard HB 259, which designates August 21 as Fentanyl Awareness and Education Day. Rep. Gerwig said the bill is intended to raise awareness of fentanyl’s dangers and overdose risks. Members spoke in strong support, citing fentanyl’s impact on families, youth, and first responders, and the need for education because fentanyl is often unknowingly ingested or mixed into other drugs. Gerwig also described a personal example involving a child exposed to fentanyl in a vacation rental. HB 259 was reported favorably by a vote of 17-0. The meeting then adjourned.

Transcript Highlights:

• </c> light of day. light of day.
• How does this bill help with affordability of child care? 28 days. Now we're saying 90 days.
• I do 28 days. Now we're saying 90 days.
• care.
• care.

Keywords: 1183, house

Transcript Highlights:

• <c> 11</c> care needed on day one and on days 11 care needed on day one and on days 11 through<00:04:
• And there's a chance that 120 or 240 days into the year, care goes completely away.
• And there's a chance that 120 or 240 days into the year, care goes completely away.
• And there's a chance that 120 or 240 days into the year, care goes completely away.
• </c><00:30:58.240><c> goes</c> 120 or 240 days into the year, care goes 120 or 240 days into the year

Keywords: 1183, house

Transcript Highlights:

• care not acute care for for uh le less care not acute care but<00:02:25.120><c> long-term</c> but long-term
• bed, accumulating 105 unnecessary care bed, accumulating 105 unnecessary extra<00:02:49.920><c> days
• </c> long-term care within the system of care long-term care within the system of care for<00:03:22.800
• Texas requires health care providers to furnish records in 15 days. Arizona, 14 days.
• Even in in 15 days. Arizona 14 days.

Keywords: 1191, senate, all

Transcript Highlights:

• The data evaluated looks at life expectancy, number of days spent sick, number of primary care physicians
• Collaboration is something that happens every day in the health care team based on the real-time needs
• Yet not a day goes by that she and I do not communicate about patient care.
• Residency is direct care with a supervising doctor. We work day and night. We take call.
• I've got an hour at the end of every day. I do give you charts and care plans every day.

Bills: SB1888, SB3003, SB2417, SB2459, SB3055, HB1393, HB2884, SB2943

Keywords: grand jury, jury qualifications, jury wheel, small counties, Texas legislation, age verification, obscene devices, online sales, juvenile protection, penalties, antitrust, attorney general, Texas Free Enterprise, business regulations, legal confidentiality, personal identifying information, data brokers, judicial safety, civil rights, data privacy

Transcript Highlights:

• "I'm not quite sure, but I think it was more than the $490 a day for congregate care, I believe.
• And in the ICU, it's about $10,000 a day in hospital care. I work at our local trauma one levels.
• And in the ICU's, it's about $10,000 a day in hospital care.
• Additionally, I want to also comment on digital care funding, as noted on the dais.
• Additionally, I want to also comment on digital care funding, as noted on the dais.

Keywords: 988, house, all

Transcript Highlights:

• and school-day programs to operate a minimum of five and a half hours per class day.
• or school-day basis and are located in a Licensing when they operate on a part-day or school-day basis
• Each year, we have transitioned classrooms from part day to school day.
• school-day hours of six hours a day until we receive a license.
• to six hours a day.

Summary: The Early Learning & Human Services Committee held public hearings on several child care and disability-related bills. House Bill 2317 would exempt certain ECAP and Head Start programs from DCYF licensing when they operate part-day or school-day in public school buildings or on public school property. Staff and the prime sponsor said the bill would remove duplicative licensing barriers and help expand preschool seats, especially as Washington prepares to add more ECAP slots. Testifiers from Head Start, school-linked providers, and the Washington Federation of Independent Schools supported the bill, describing licensing delays, added costs, and lost classroom time; no one testified in opposition. The committee also heard House Bill 2099, which would expand ECAP access for military families with incomes up to Working Connections Child Care limits and adjust prioritization for families with deployed or single custodial military parents. The prime sponsor and multiple supporters, including retired military leaders, Head Start/ECAP advocates, ESD staff, and a military-community partnership, said military families face frequent moves, deployment-related strain, and child care shortages that affect readiness and family stability. Testifiers said the bill would help families access care without changing the program’s low-income focus or adding state cost. House Bill 2350 would require DSHS to notify residents, guardians, and family members when a residential habilitation center is found out of compliance with federal CMS requirements, and to provide follow-up notices on correction and enforcement actions. The sponsor said the bill responds to limited communication around recent noncompliance issues at Rainier School and would improve transparency; DSHS had requested a narrow amendment about how notice is provided to residents. Disability rights advocates strongly supported the bill, saying families need timely information to protect loved ones and make informed decisions. Finally, House Bill 2318 would let ECAP and Head Start children count toward the 5% subsidy participation threshold needed for Early Achievers quality improvement awards. Supporters said the current rule can discourage providers from enrolling ECAP children because it risks losing an award, even though ECAP already requires Early Achievers participation. The sponsor and testifiers described the bill as a small fix to reduce a funding disincentive for providers serving high-need children. The committee took no votes and adjourned after closing the hearings on all four bills.

Transcript Highlights:

• A significant percentage of the days in care are paid for by Medicaid.
• Inpatient treatment is $194 a day; for managed care, it's $1,000 a day.
• I fought every day for 13 years to find appropriate care for Taylor, but I still couldn't.
• I know this has been a very long day, but we appreciate your care and attention to all these people who've
• I'm here to speak on behalf of the direct care staff that work in our day habilitation and our ISS program

Bills: SB1, SB 1

Keywords: appropriations, budget, state funding, education, healthcare, infrastructure, campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards, 1185, senate, all

Transcript Highlights:

• Welcome back for the second public hearing on the Joint Committee on Health Care Financing of the day
• they come and see our hands-on care for the family folks that we care for.
• We every day take care of the elderly in their own homes, and we need to get good conditions that can
• Every day we care for the elderly, giving them our full attention and support year after year.
• We represent home care workers, both personal care attendants, home care agency workers, hospital workers

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing focused largely on senior long-term care issues, family caregiving, post-acute care access, and direct care workforce pay. Testimony strongly supported bills to raise the personal needs allowance for nursing home and rest home residents (including H. 1411, S. 482, and related bills), with speakers from Mass Senior Action, Dignity Alliance, nursing home residents, providers, and former state officials arguing that the current $72.80 monthly allowance has been unchanged since 2008 and is inadequate for basic items like clothing, toiletries, haircuts, and transportation. Witnesses also backed bills to increase MassHealth asset and income limits for seniors and to stop counting life insurance as cash, describing the current rules as outdated and harmful to low-income elders. The committee also heard testimony on bills allowing family members, including spouses and guardians, to be paid caregivers (H. 1394/S. 886), with supporters saying this would help families keep loved ones at home and reduce reliance on costly institutional care. Another set of bills (H. 1412/S. 903) drew support from a physician who said clearer MassHealth communication and improved post-acute care determination processes would help reduce delays and backlogs for patients awaiting skilled nursing, rehabilitation, or other post-acute placement. Several speakers emphasized that better home- and community-based care can prevent hospital readmissions and support independence. A major portion of the hearing focused on S. 877, which would establish an enhanced care worker minimum wage of $25 per hour, indexed to inflation, for certain home care and human services workers. Union representatives and direct care workers from SEIU Local 509, 1199 SEIU, and the AFL-CIO described severe staffing shortages, burnout, low wages, and high turnover across home care, mental health, disability services, and crisis response. They argued that higher pay is necessary to recruit and retain workers and to stabilize services for vulnerable residents. Committee members asked about costs, comparisons with other states, and whether non-wage incentives could help, but witnesses repeatedly said wages were the central issue. The hearing concluded after all registered testimony was heard, with the committee noting it would continue accepting written testimony and then adjourning.

Transcript Highlights:

• to post-acute care settings.
• to post-acute care. problem in timely discharges from acute care to post-acute care settings.
• Have a good day. Any other questions? Seeing none. Thank you very much. Have a good day.
• So this bill would actually encourage more primary care physicians to do direct primary care.
• So this bill would actually encourage more primary care physicians to do direct primary care.

Keywords: 995, all

Summary: The committee held a hearing on several health care access and insurance-related bills, with most testimony focused on H.1136 to improve the prior authorization process. The Massachusetts Medical Society, Massachusetts Health and Hospital Association, Health Care for All, the Leukemia & Lymphoma Society, physicians, and hospital representatives all supported the bill, arguing that prior authorization delays care, increases administrative burden, contributes to clinician burnout, and can worsen patient outcomes. Witnesses described examples involving delayed cancer treatment, diabetes care, COPD medication, shingles pain treatment, and hospital discharge delays. They said the bill would preserve prior authorization but add guardrails such as longer validity periods, continuity-of-care protections, faster responses for urgent care, clearer lists of services requiring authorization, and more transparency and standardization. The committee also heard testimony on H.1142/S.783 regarding equitable reimbursement for certified registered nurse anesthetists (CRNAs), with Senator Lovely and CRNA advocates supporting parity with physician anesthesiologists. They said CRNAs provide the same services at the same standard of care, but private insurers sometimes reimburse them at lower rates than physicians, which they argued is inconsistent with federal and state policy and harms access. Senator Keenan testified in support of a bill addressing claim denials and appeals, saying insurers should provide clearer explanations, time to resubmit claims, and timely appeal responses. Dr. Lorraine Schratz supported H.1126 to align state patient disclosure requirements with federal No Surprises Act rules, and Dr. Michael Trimbley supported H.1120 to recognize direct primary care as not being insurance and to encourage primary care participation. The committee also heard testimony on H.1140/S.801 to remove barriers to patient care by updating insurance statutes to reflect nurse practitioners’ full practice authority, and on H.1168/S.A.18 to eliminate the PCP referral requirement for specialty gynecological care. Witnesses on those bills described delays and denials affecting autism diagnosis, nutrition coverage, and endometriosis care, and said the proposals would reduce unnecessary barriers and improve timely access. After testimony and a few member questions, the chair closed the hearing; no votes were taken during the session.

Transcript Highlights:

• health care.
• Members, our health care system is quite complex, so over the next couple of days our staff will be delivering
• Members, our health care system is quite complex, so over the next couple of days our staff will be delivering
• So, but that's okay because they're taking care of someone eight hours a day.
• Every day we pour our hearts and souls into caring for our children, but it's important that we have

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:

• how vital home-based care is. ...where I see every day how vital home-based care is, not only for older
• I took care of him at night. ...be able to take care of him during the day.
• Luca is entirely home-based, requires 24-7 care, and does not have access to day programming or respite
• care and their caregivers, and continuity of care.
• and Companion Care, and Melinda Boulaye of Alera Caring.

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing focused on two broad sets of issues: home- and community-based care, and school-based Medicaid reimbursement. In the morning session, legislators and advocates testified on bills affecting children and disabled enrollees, including proposals to clarify rate-setting for home health and home care services (H. 767/S. 870), allow family members and spouses to be paid caregivers under MassHealth (H. 1394/S. 886 and related bills), extend MassHealth coverage for applied behavior analysis and other therapies beyond age 21 for adults with autism and developmental disabilities (H. 1351/S. 871), and protect medically fragile children by improving access to continuous skilled nursing. In the later portion of the hearing, testimony shifted to a bill to improve MassHealth reimbursement for schools (S. 862), with speakers describing the school mental health crisis and the need to reinvest Medicaid funds directly into school health services. Witnesses on the home care rate-setting bill said current reimbursement methods are opaque and outdated, contributing to workforce shortages, unfilled shifts, long waitlists, and patients remaining in hospitals longer than necessary. Home care providers and trade groups argued the bill would not set rates directly but would require more transparent methodology and fuller consideration of real costs such as wages, benefits, taxes, training, and technology. On caregiver bills, many family members and provider organizations described the financial and emotional strain of caring for disabled or medically fragile relatives, especially when parents, spouses, or guardians are barred from being paid caregivers. They argued the bills would recognize existing unpaid care, help families remain at home, and reduce reliance on more expensive institutional care. Advocates for adult ABA coverage said services remain medically necessary after age 21 and that ending coverage at that age creates an inequitable “cliff” for MassHealth members compared with those with private insurance. For the PACE/community care bill, elder law attorneys and PACE advocates said current MassHealth income rules force some older adults with modestly higher incomes to spend down to $542 per month, making community living unrealistic and pushing people toward nursing homes. They supported changing the eligibility structure to a premium-based approach that would allow more people to remain in the community. On the school Medicaid bill, advocates said schools are providing effective, preventive mental health care, but reimbursement currently flows to municipalities rather than directly back to school health budgets, limiting districts’ ability to hire and retain staff. No votes were taken during the hearing; the committee heard testimony and several witnesses requested favorable reports on the bills.

Transcript Highlights:

• So we are here today because today is the day that Republicans are going to take away health care for
• Today is a day that we are going to make our health care system worse as ER wait times increase and as
• </c> away health care for 17,000 people. away health care for 17,000 people.
• that we are going to make our is a day that we are going to make our health<00:03:33.360><c> care</c
• care through Minnesota Care life-saving care through Minnesota Care does<00:09:43.839><c> not</c><00

Keywords: 919, house, all

Summary: Minnesota lawmakers and advocates held a press event focused on a special-session budget agreement that would repeal health coverage for undocumented immigrants. Speakers, including Rep. María Isa Pérez-Vega, Sen. Lieman, labor leaders, immigrant advocates, faith leaders, and other DFL/POCI caucus members, argued the repeal would harm about 17,000 people, increase uncompensated care costs, worsen ER and clinic wait times, reduce productivity, and ultimately raise costs for taxpayers and employers. They also said undocumented immigrants contribute significant tax revenue and that the measure was motivated by cruelty and scapegoating rather than fiscal responsibility. Testimony emphasized moral, public health, labor, and faith-based objections. Unidos Minnesota, SEIU Local 26, the Minnesota AFL-CIO, and Pastor Ingred Ramson all framed health care as a human right and said the policy would punish working families, immigrants, and communities of color. Several speakers linked the repeal to broader attacks on immigrants, labor rights, and other social protections, and warned that the compromise budget framework included a “poison pill” tying the health bill to the repeal. POCI caucus members said they had tried unsuccessfully to negotiate alternatives, including changes to paid leave, earned sick and safe time, non-compete bans, premiums, enrollment caps, and protections for children, elders, and people with chronic conditions. They said leadership was not part of the negotiations and expressed disappointment with DFL and governor-level decisions, while also saying they would continue to fight the policy and hold leaders accountable. No vote was taken in the event itself, but speakers repeatedly said the repeal was expected to pass and that they would oppose it and continue organizing in future sessions.

Transcript Highlights:

• Child care is very important. Kids get three USDA meals a day.
• So I hope everybody understands, are we for day care for all kids? Yeah.
• So I hope everybody understands, are we for day care for all kids? Yeah. Do we?
• , caring for children 24 hours a day.
• $21 a day, but it sounds like they can sign up, possibly, as providing this care.

Summary: The committee heard first from LFC staff on a brief about New Mexico’s universal child care expansion. Staff said child care assistance has clear benefits for parents and families, but LFC has not found evidence in New Mexico that it improves children’s educational outcomes; they argued pre-K is the better tool for that goal. The brief highlighted four concerns with universal access: an estimated annual cost of about $849.7 million, a sharp decline in registered homes, possible crowding out of lower-income families, and reduced access for children under age two. Staff also suggested possible mitigations such as prioritizing slots for low-income and at-risk families, reinstating sliding-scale co-pays, and tying quality improvements to workforce wages. Members raised questions about the cost estimate, funding sources, provider quality, and whether the data showed actual crowding out. Several lawmakers expressed support for child care generally but concern about the fiscal impact and whether universal access would divert resources from the families most in need. Others emphasized the importance of child care for workforce participation, rural communities, and family stability, and questioned how registered homes are counted and regulated. LFC staff clarified that the cost estimate was for child care assistance only, not the entire ECECD budget, and that the data showed declines in the share of lowest-income children and infants/toddlers served, though not causation. The ECECD secretary then presented the department’s response, saying universal child care is intended to complete a cradle-to-career system and that the department has already seen strong uptake, increased capacity, and rising workforce participation. She said 6,206 families were found eligible in the first month, the share of infants and toddlers served rose, and new provider applications and licensed slots increased after the November rollout. The department also emphasized wage increases, quality improvements, and a new wage scale/career lattice, while projecting a lower near-term cost than LFC’s estimate and requesting additional funding for child care, early pre-K, home visiting, workforce systems, and capacity-building. No votes or formal actions were taken in the portion provided; the discussion was informational and focused on questions and testimony.