Transcript Highlights:

• Issues that we could clear up and make function better for patients and citizens in Missouri as far as
• And then that person, the patient, would get handed off to them.
• So we're going to make sure that we're doing the best level of care we can for the patients that come
• So I would think that's more, when it comes to patient care, when it comes to customer service, making
• sure that the right thing is done, making sure that the patient is the ground zero taking care of, that

Committee: House General Laws

Summary: The General Laws Committee met without a quorum and heard House Bill 2749, sponsored by Rep. Davidson. The bill would allow hospital systems, rather than only individual physicians, to sign and maintain collaborative practice agreements for physician assistants in hospital settings. The sponsor said the measure is intended to reduce administrative burden and paperwork without changing scope of practice, supervision requirements, or liability, and noted it has a $0 fiscal note. Committee members asked about how the bill would work in practice, including what happens when physicians leave a hospital system, whether the collaborating physician relationship would still be meaningful, and whether the bill could affect liability or accountability. Supporters, including a long-time PA with BJC and the Missouri Hospital Association, said large hospital systems already use credentialing and chart-review processes, and that centralizing the paperwork would help hospitals, physicians, and the Board of Healing Arts while freeing physician time for patient care. They emphasized that the bill would not change clinical oversight or reimbursement arrangements. Opposition came from the Missouri State Medical Association and the Missouri Association of Osteopathic Physicians and Surgeons. Their witness argued that collaborative practice agreements are personal physician agreements, not mere paperwork, and warned that shifting them to a hospital-level document could weaken physician accountability and potentially increase liability. The hearing concluded after testimony, with no vote taken.

Transcript Highlights:

• Could this mandate require a physician or PA, etc., to spend their very precious patient contact time
• to spend their very precious patient contact time screening a patient with no risk factors instead of
• just allowing the provider to determine if the patient needs screening?
• I do think many of these screeners are incorporated into charts as patients enter.
• Our goal with this bill is to provide hope for terminally ill patients who have exhausted all approved

Bills: SB1328 , SB1380 , SB1436 , SB1558 , SB1572 , SB1651 , SB1805 , SB1831 , SB1836 , SB2014 , SB2023 , SB2044 , SB2179 , SB933

Committee: Senate Health and Human Services

Summary: The Health and Human Services Committee met to consider a series of Senate bills, beginning with SB 2014, which would allow ivermectin to be sold over the counter with FDA approval. After questions about whether a prescription would still be required and how FDA guidance would affect the law, the bill passed 9-3. SB 1805, as amended, barred detention and youth facilities from using temporary agencies or contracting organizations for staffing; the author said the change was intended to address transparency and records issues in a related lawsuit. That bill passed 12-0. SB 2044, also amended, clarified chiropractic-related language regarding serum and multiple vitamins; members discussed whether the bill changed scope of practice, and it passed 10-2. The committee then approved SB 1836, which requires a board-approved mental health screener during routine annual primary care visits. The author said it was meant to normalize mental health screening and noted an updated fiscal impact estimate of $284,000 to $560,000; some members raised concerns about mandates and cost, but the bill passed 8-4. SB 1380 would require the Oklahoma Health Care Authority to verify Medicaid eligibility against death records and conduct monthly death-record checks for enrollees; after questions about current practice, costs, and recoupment from deceased enrollees, the author requested title be stricken, and the bill passed 10-2. SB 2179, dealing with not-guilty-by-reason-of-mental-illness cases, adds staff accompaniment for therapeutic visits, requires structured violence-risk assessments before discharge or conditional release, and adds drug screening when substance-use monitoring is ordered; Department of Mental Health staff testified about treatment planning and monitoring, and the bill passed 11-1. Later, the committee passed SB 1436, which requires families to be informed of their right to certification after fetal death or miscarriage, and SB 1558, which clarifies that older youth in OJA custody may be placed in Level E group homes. SB 933, the “Right to Try for Individualized Treatment Act,” passed 11-0 and would allow certain terminally ill patients to seek individualized investigational treatments after informed consent. SB 1651, an Oklahoma Medical Board cleanup bill covering several licensed professions, also passed 11-0. Finally, SB 1328 modernizes parental access to minor medical records with safeguards for abuse situations, and SB 1572 removes the DHS and OJA directors from the OCCY board; both passed 11-0. The committee adjourned after noting a possible interim meeting for a Tier 1 nomination.

Transcript Highlights:

• So, um, we just, uh, you know, want to try to limit some barriers that some of our patients have been
• Um, that would allow for patients to potentially seek help sooner because we know the longer you wait
• limit some barriers that some<00:09:06.800><c> of</c><00:09:06.880><c> our</c><00:09:07.040><c> patients
• have been seeing some of our patients have been seeing over<00:09:08.160><c> the</c><00:09:08.399><c
• </c><00:09:18.800><c> to</c> that would allow for patients to that would allow for patients to potentially

Committee: House Banking & Insurance

Transcript Highlights:

• </c> S. 245, an act relating to allowing telehealth appointments to be recorded with patient and provider
• teleaalth appointments to be recorded teleaalth appointments to be recorded with<00:14:03.920><c> patient
• </c><00:14:04.399><c> and</c><00:14:04.800><c> provider</c><00:14:05.360><c> consent</c> with patient
• and provider consent with patient and provider consent introduced<00:14:06.800><c> by</c><00:14:07.120
• </c> with patient and provider consent. with patient and provider consent.

Transcript Highlights:

• the program, to make certain that hospitals can continue to provide the care and services that our patients
• 00:20:32.960><c> services</c><00:20:33.280><c> that</c><00:20:33.520><c> our</c><00:20:33.760><c> patients
• </c> the care and services that our patients the care and services that our patients need<00:20:34.799
• </c><00:20:44.320><c> and</c><00:20:44.480><c> their</c> care for their patients and their care for their
• patients and their communities.<00:20:46.159><c> Followup,</c><00:20:46.559><c> Mr.

Summary: The committee first went into executive session on SB 83, which concerns an elderly, disabled, blind, and deaf property tax exemption reimbursement fund, lottery-related changes, and a voluntary statewide self-exclusion database. Representative Ulery moved to retain the bill, saying more work was needed to make the bill clear. The motion passed 17-0 with three members absent, and SB 83 was retained in committee. The committee then took up SB 249FN, a bill relative to the uncompensated care and Medicaid fund. Representative Ulery offered House Amendment 2025-2465H, which was described as incorporating a recent agreement between the state and hospital parties into state law and setting the stage for future action. Medicaid Director Henry Litman explained that the agreement keeps the Medicaid enhancement tax at 5.4%, uses directed payments rather than traditional DSH payments, and is intended to be budget-neutral for the state while increasing hospital payments through a higher federal match. He also said critical access hospitals would continue under the existing directed-payment approach, and that the agreement includes a mechanism to revisit the arrangement if federal law changes substantially. New Hampshire Hospital Association President Steve Hearn said the association supports the amendment and the bill as amended, calling the settlement fair and beneficial to hospitals and the Medicaid program. The amendment and the subsequent ought-to-pass-as-amended motion both passed 18-0. At the end of the meeting, the chair said the committee had now gone through all of its bills and had retained nine in total, with a future meeting planned in September or October to review retained bills. Members briefly discussed possible future committee of conference work and noted there would be no House session that Thursday. The meeting then adjourned.

Transcript Highlights:

• Planned Parenthood has 114 clinics in our state that serve over 1 million patients a year.
• Thank you. ...million patients a year. Without it, many Californians would not get care.
• And these closures have put millions of the most vulnerable patients' health care at risk.
• is that they would then be flooded with management of patients... ...and over-flooded with patients
• Medi-Cal patients.

Summary: The Senate opened with prayer, the Pledge of Allegiance, and several floor recognitions, including St. Mary’s High School football team for its first state championship and Black-owned businesses honored by the Legislative Black Caucus and Black Chamber of Commerce. The Rules Committee also reported Senate Resolution 77 to third reading. The chamber then confirmed Tyler Sadwith as Chief Deputy Director for Health Care Programs at the Department of Health Care Services and State Medicaid Director by a 33-0 vote. The main floor debate centered on SR 77, a resolution condemning racist and dehumanizing imagery posted by President Trump depicting former President Barack Obama and former First Lady Michelle Obama. Supporters from multiple caucuses, including the Black, Latino, Jewish, LGBTQ, and API caucuses, described the post as racist, harmful, and part of a broader pattern of dehumanization and urged a public apology. A few Republicans objected to the resolution’s language and process, saying it was overly partisan or not collaborative, but the resolution was adopted on a 28-0 vote. The Senate also took up SB 106, a budget bill to provide $90 million in state funding for family planning providers, especially Planned Parenthood, after federal cuts under H.R. 1. Supporters argued the bill would preserve essential reproductive and preventive health services, especially in rural and underserved communities, and backfill lost reimbursements. Opponents criticized the bill’s transparency, no-bid contracting structure, and priorities compared with other needs such as distressed hospitals and developmental disability services. After debate, the Senate concurred in the Assembly amendments to SB 106 by a 26-9 vote.

Transcript Highlights:

• I know what ERISA is because of some cancer legislation I've passed on behalf of cancer patients.
• Patient steering, where we're making sure that a patient is going to a pharmacy that is owned by the
• Patient steering, where we're making sure that a patient is going to a pharmacy that is owned by the
• Patients exhaust assistance faster. It leads to sudden, significant out-of-pocket costs mid-year.
• It's got an administrative burden on doctors and delays patient access.

Committee: House Insurance

Transcript Highlights:

• Let me begin by acknowledging the patients and the families who shared their stories.
• We believe that if a physician who takes care of a patient orders such a test, patients should adhere
• Because the doctor would be making that—the doctor who's interacting with the patient, not the person
• So I can understand your concern, not only as a physician, but as a patient. I'm a human being too.
• Not only as a physician, but as a patient. I'm a human being, too.

Committee: House Insurance

Transcript Highlights:

• We're patient with the studies. Please help us as we continue to suffer. Please pass 6240.
• And now it mainly benefits a group of really large national distributors, not patients.
• And now it mainly benefits a group of really large national distributors, not patients.
• HDA members are the link between manufacturers and where Washington patients receive their care.
• HGA members are the link between manufacturers and where Washington patients receive their care.

Bills: SB5989 , SB5898 , SB6240 , SB6244 , SB6231 , SB6228 , SB6220

Committee: Senate Ways & Means

Keywords: aircraft fuel tax, tax revenue distribution, aviation funding, transportation, state revenue, aeronautics, taxation, aircraft fuel, state funding, aviation fuel, hazardous substance tax, air quality, noise mitigation, environmental impact, tax exemption, agriculture, hazardous substances, crop protection, warehousing, data center

Transcript Highlights:

• So, Aiden, you've been waiting patiently. Thank you for being with us today.
• For the Washington Hospital Association, SNFs take in roughly 40,000 patients a year, and ALs play a
• We've identified two successful patient pathways to support the needs of this population.
• Pathway 1 addresses emerging behavior issues for current nursing home patients who are aging in place
• But it's also peace of mind for family members and the patient as well.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• Really what we need to look at and what it comes down to is there are patients who need help and the
• They witness firsthand the stress patients experience not only due to their health conditions, but also
• We do support protecting patients from being unfairly crushed by medical debt, and we're committed to
• They witness firsthand the stress patients.
• We do support protecting patients from being unfairly crushed by medical debt, and we're committed to

Committee: Senate Commerce and Labor

Transcript Highlights:

• So they're letting that person take care of the patient, but they're billing it under their name. if
• We may need additional strategies, which may mean a provider must see fewer patients to take on this
• These are highly regulated by the FDA, we can't. go back and just take care of these patients.
• So you're talking that that that $2,000 to $3,000 is paying for between four to six patient visits, as
• When we were doing missionary work and they were putting glass on in patients.

Bills: HB2646 , HB3941 , HB5153 , HB5155 , HB5394 , HB 1106 , HB426 , HB4529 , HB3984 , HB4273 , HB 1097 , HB3940 , HB1941 , HB4377 , HB3153

Committee: House Human Services

Transcript Highlights:

• I want to know my patients the best I need to know my patients the best.
• I need to know that I have patients with sickle cell.
• I need that for all of my patients. Please. I'm begging you.
• Black patients are less likely to be given pain medication.
• I cannot care for my patients without a proper education.

Transcript Highlights:

• For providing the same kind of office visit to the same patient population in the same town, I'm paid
• My practice has 6,000 patients in New Castle County, including pediatrics and care coordination.
• I still see my newborn and other patients in the hospital and care for my own hospice patients, since
• , with less continuity, and patients often not even knowing who their doctor is.
• This bill will get us back on track. ...and patients often not even knowing who their doctor is.

Bills: SB268 , SB306 , SB264 , SB312

Committee: House Administration

Summary: The House Administration Committee met to consider a series of resolutions and bills covering arts districts, child care background checks, federal worker relief, health care reform, court transparency, school tax reassessment, municipal charter changes, constitutional amendment procedures, data center nondisclosure agreements, state employee benefits governance, and lieutenant governor vacancies. Members also noted that House Concurrent Resolution 12 had been removed from the agenda and that public comment would be limited to one minute per speaker. The committee released SCR 167 to study arts, culture, and creative districts in Delaware; HB 438 to close a loophole in the child care service letter requirement; SB 268 to provide interest-free loans, free transit, and tax deferrals for federal workers during shutdowns; SS2 for SB 1 to expand and permanently strengthen primary care investment while also addressing hospital cost growth; HCR 147 to request a Court of Chancery report on audio recordings and automated case assignment; SB 322 to replace the current post-reassessment 10% school revenue increase authority with a 2% annual increase option under safeguards; SB 306 to amend the Rehoboth Beach charter; HB 440 to require voter approval for constitutional amendments after legislative approval; SB 312 to bar nondisclosure agreements for large data center projects; SS1 for SB 289 to change State Employee Benefits Committee governance; and SB 264 to require a special election to fill a lieutenant governor vacancy. Testimony was mixed on several measures. Arts, child care, federal worker relief, primary care, court transparency, data center transparency, and the lieutenant governor vacancy bill drew mostly supportive testimony, while SB 322 and SB 306 drew both support and opposition, especially over tax impacts and the proposed spouse/partner restriction in Rehoboth Beach. HB 440 prompted debate over whether 55% voter approval was the right threshold for constitutional amendments, and SB 312 was supported as a transparency measure by residents affected by prior data center NDAs. All of the listed measures were released from committee by roll call vote, with some members voting no on HB 440, SB 306, SB 312, SS1 for SB 289, and SB 264.

Transcript Highlights:

• Idaho patients can access a medical option that is already permitted under federal law.
• When something is federally allowed and medically appropriate, but patients can't regain access to it
• It simply ensures that a facility may not prohibit a patient from pursuing this option when it can be
• This is about clarity, alignment with federal law, and access for Idaho patients.
• This is about clarity, alignment with federal law, and access for Idaho patients.

Transcript Highlights:

• </c><00:20:32.400><c> in</c> the percentage of Medicaid patients in the percentage of Medicaid patients
• </c> a patient direct pays. a patient direct pays.
• So we get the enhanced patients.
• </c><01:16:14.080><c> These</c> centers and their patients. These centers and their patients.
• So my know these patients cannot pay.

Summary: The Division 3 work session focused largely on amendment 1176 to HB 2, which would have incorporated the substance of HB 548FN, a House-passed bill creating a direct-pay or membership-based model for health care facilities. Representative Mlan described the proposal as a way to increase competition in health care by extending the direct-care model used in primary care to facilities, arguing it could encourage innovation and that concerns about widespread harm to critical access hospitals were overstated. He pointed to Oklahoma’s long-standing Surgical Center model as evidence that the approach had not spread broadly or displaced hospitals there. Several members and witnesses raised concerns. Representative Stringham questioned whether the model would shift profitable services and patients away from existing hospitals, potentially worsening their finances and affecting Medicaid-related funding. David Ross, speaking for county nursing homes, opposed the language because it also removed moratoriums on nursing home, skilled nursing, inpatient rehabilitation, and self-pay beds, warning that it could increase pressure on Medicaid rates and undermine community-based care. Ben Bradley of the New Hampshire Hospital Association said the proposal appeared to create a separate regulatory framework for direct-pay facilities and raised concerns about patient safety, CMS participation rules, and a separate patient bill of rights. The chair concluded that, because HB 548 was already moving through the Senate, the HB 2 process was not the best vehicle for the policy and that the issue should be left to the Senate’s more deliberative committee process. Representative Ferski moved to not accept or remove amendment 1176 from the agenda, and the committee approved the motion by roll call, 9-0, withdrawing the item from HB 2.

Transcript Highlights:

• There is solid evidence, however, of the harm to the mental health of the patient.
• , related surgical procedures should generally be deferred until patients reach adulthood.
• and that high-quality guidelines are available to guide qualified providers in treating pediatric patients
• They identified transgender or gender-diverse patients based on gender-related diagnoses and then checked
• No patients under 12 were prescribed gender-affirming hormones.

Transcript Highlights:

• We see all patients regardless of ability to pay. We see all patients regardless of ability to pay.
• When those three practitioners I told you that left, the first day we took patients, 600 patients filled
• We took patients, 600 patients filled the logs, and we have a six-month backlog. Now that's worse.
• There will be basic x-ray in there to help practitioners screen patients quickly.
• We have 51% governing boards composed of patients of the clinic services.

Bills: SB21 , SB42 , SB81 , SB101 , SB139

Committee: Senate Senate Health & Public Affairs

Transcript Highlights:

• But my main concern is what happens when the doctor and the patient show up and the interpreter doesn't
• What happens when the doctor and the patient show up and the interpreter doesn't.
• That patient or lost that time and the patient who, anyway, so I think it's a two-way street that we've
• We're asking that any deviation must be medically appropriate based on patient-specific or clinically
• Franklin looked at the outcomes of those procedures and found that patients who had had those operations

Summary: The committee first held a public hearing on Senate Bill 6136, which would require Labor and Industries to publish actuarial indicated workers’ compensation rates for each risk class and disclose when rate increases are capped below those indicated levels. The sponsor and supporters from the hospitality, retail, business, and construction sectors said the bill would improve transparency about how rates are set and how reserve funds and investment earnings are used to hold down premiums. L&I testified that the bill would require publication of a large amount of rate-setting information, but said it was already developed in the normal process and that the bill had no fiscal impact. Questions focused on reserve use, advisory committee involvement, and how the actuarial calculations interact with investment returns. The committee then moved to executive session and took action on several bills, adopting substitutes or amendments and advancing bills including SB 5292, 6014, 5972, 5869, 5874, 6058, 6039, 5944, and 6180, with most sent to Rules and SB 5292 sent to Ways and Means. The committee then heard Senate Bill 5847, which would expand injured workers’ access to medical care by allowing treatment outside the L&I provider network when no provider is available nearby, limiting employer steering to specific providers, shortening utilization review timelines, allowing provider deviation from L&I guidelines when medically appropriate, and expanding continued treatment and cancer monitoring. Labor and worker advocates argued the bill would better reflect the Murray decision and reduce delays in care, while L&I and employer groups said the current evidence-based guideline system works for most claims and warned the bill could weaken quality controls, create vague standards, and increase costs. Testimony also raised concerns about the 15-mile access rule, the employer communication restrictions, and the appeal process for provider removal. The sponsor said the goal was to improve individualized care and continue working with stakeholders. Finally, the committee heard Senate Bill 6067, which would change workers’ compensation time-loss calculations so that 100% of the employer-paid health insurance contribution is included in the benefit calculation instead of the current partial inclusion. Supporters said the bill would help injured workers keep health coverage during recovery and reduce pressure to choose between medical care and income, while opponents argued it would not guarantee the money is actually used for health insurance, could be diverted to other uses or attorney fees, and would significantly increase costs for employers and the accident fund. L&I said the bill would require IT and administrative changes and estimated substantial ongoing benefit costs. The hearing ended without further action on SB 6067, and the chair closed the session after public testimony concluded.

Transcript Highlights:

• So there are many different types of patient consent.
• So there are many different types of patient consent.
• Uh the most types of patient consent.
• where they live, um, from, the patient where they live, um, and<00:12:49.200><c> determine</c><00:12
• </c> of the of the the patient. of the of the the patient.

Summary: The Budget Review Subcommittee on Health and Family Services opened its first meeting of the 2026 interim session, took roll, and moved directly into presentations. The main presentation was from Ryan Bramble of Crisp Shared Services, who described the organization’s health information exchange and health data utility model in Kentucky and other states. He emphasized that Crisp is a nonprofit, that data ownership remains with providers, and that governance is local. He also outlined the technical infrastructure, including a master patient index, cloud-based data lake, support for modern standards like FHIR and USCDI as well as older formats, and data quality tools used to normalize and standardize information. Bramble said the model is intended to reduce duplication, lower costs, and support rural providers and future use cases such as reporting, analytics, and AI-enabled decision support. Members asked how the state can ensure the data is actually used and who should drive priorities for health care improvement. Bramble said Crisp can provide tools, expertise, and examples from other states, but local teams such as KHI and state stakeholders must tailor and lead utilization efforts. In response to questions about ownership and coordination, he stressed that successful HIE governance requires a multistakeholder body that includes hospitals, health plans, government, and other interests, with a unified approach rather than multiple competing directives. He also said the Commonwealth has an opportunity to convene those stakeholders and set clear priorities. A senator raised concerns that responsibility for Medicaid and broader health policy has become fragmented and suggested a stronger central role for the state, possibly through the Department of Public Health, to coordinate health priorities. Bramble agreed that a single convening authority and multistakeholder governance are important, and noted that local governance should determine what data is shared and how it is used. No votes or formal actions were taken during this portion of the meeting. After Bramble’s presentation and questions, the committee was told that Secretary Stack from the cabinet would testify next on the rural health transformation plan.