Transcript Highlights:

• So I've been in health care since 2001, wrote software packages in health care, have physician offices
• care services.
• Home care services.
• care have increased awareness.
• care.

Summary: The Health Care Budget Subcommittee met to organize the new term, take roll, and hear introductory presentations from the six agencies under its jurisdiction: the Agency for Health Care Administration, Agency for Persons with Disabilities, Department of Children and Families, Department of Elder Affairs, Department of Health, and Department of Veterans’ Affairs. The chair outlined the committee process, including assigning members to review agencies and make budget recommendations. Each agency head gave a high-level overview of their budget, staffing, major programs, and priorities, with recurring themes including Medicaid, long-term care, disability services, child welfare, mental health, aging services, public health, and veterans’ health care. Several agency leaders highlighted recent initiatives and funding priorities. AHCA emphasized Medicaid managed care, provider regulation, Hope Florida, hospital-at-home, and cancer-related efforts; APD discussed iBudget services, Hope Florida, a managed-care pilot, online applications, and forensic care costs; DCF focused on child protection, foster care, adult protective services, food/cash/medical assistance, mental health, and opioid treatment; Elder Affairs highlighted Alzheimer’s services, community-based senior care, guardianship, ombudsman services, and disaster outreach; DOH covered cancer innovation, maternal telehealth, cybersecurity, HIV/hepatitis/syphilis screening, and school nursing; and Veterans Affairs described benefits and health care access for veterans, long-term care, and federal reimbursement. Several speakers also raised concerns about rising costs, provider rates, disaster response, and access to services. The committee heard two public comments from disability advocates about Medicaid redeterminations affecting iBudget waiver recipients and provider payment delays. In response, AHCA and APD said they were coordinating on data sharing, early outreach, escalation processes, and efforts to reduce disenrollments and make recertification smoother. Members then asked questions about provider rates, opioid settlement spending, managed care quality measures, pediatric rare disease grants, group home transparency, senior outreach, ABA services moving into managed care, annual Medicaid recertification, veterans’ service utilization, waiting lists for elder services, and prevention spending. No formal votes were taken during the meeting.

Transcript Highlights:

• pay for child care as well.
• care.
• for child care.
• We know that child care, it's not just an issue for working parents to care about.
• You said dependent care? Dependent care spending accounts. A lot of employers offer them.

Committee: House Economic Development

Keywords: 959, house, all

Transcript Highlights:

• Pregnancy care is not compromised.
• Restrictions to reproductive care and gender-affirming care often disproportionately impact people with
• health care for women.
• the leadership of my health care system does and other health care systems across the state.
• To establish a pediatric palliative care benefit under Medicaid, palliative care is not end-of-life care

Summary: The committee first took up House Bill 279, on a committee substitute that narrowed the bill to privacy and safety protections for reproductive and gender-affirming health care. The substitute would strengthen limits on disclosure of protected health information, restrict geofencing around care facilities with exceptions for security and research, clarify emergency stabilization obligations under state licensing law, and allow abortion-medication labels to omit a prescriber’s personal name and address. Supporters including ACOG, the ACLU, the League of Women Voters, the Health Care Authority, and advocacy groups said the bill protects patients and providers from surveillance, harassment, and out-of-state investigations. Some members raised concerns about HIPAA, research data, and whether the bill could go too far, but the substitute passed 6-2. The committee then approved House Memorial 1, which asks the Legislative Finance Committee to study whether a constitutional amendment should create an independent commission to manage CYFD. Supporters said the department needs a comprehensive structural review, while opponents argued New Mexico already has enough reports and should act on existing recommendations instead of commissioning another study. House Memorial 31 also passed; it directs the Health Care Authority to re-evaluate a rule limiting home health agencies to serving patients within 100 miles of their licensed locations, in light of access needs in remote areas such as the Navajo Nation and anticipated demand from uranium workers. House Bill 306, dealing with facility fees, was amended by substitute to prohibit such fees for certain preventive services, vaccinations, telehealth, and some services provided in vehicles, while exempting rural hospitals and requiring notice to patients. Hospital representatives opposed the bill, warning it would add financial pressure and could still be passed through to patients or premiums, while insurers, retiree advocates, and consumer groups supported it as a way to curb confusing and costly add-on charges. The committee also advanced House Memorial 36 to create an unfunded nursing shortage task force focused on graduation rates, retention, and barriers to training, and House Memorial 35, which would ask HCA to seek a Medicaid state plan amendment for pediatric palliative care. Supporters of the palliative care memorial described major access gaps for children with complex conditions, especially in rural areas, and the memorial passed after testimony from a rural pediatric hospice nurse and committee discussion about the small number of eligible children and the burden on families.

Transcript Highlights:

• health care programs.
• Maybe they don't necessarily seek care with counties for indigent care.
• They don't necessarily seek care with counties for indigent care.
• and home care.
• and home care.

Keywords: 987, senate, all

Transcript Highlights:

• And they were going to manage care and they call them managed care organizations.
• And they were going to manage care and they call them managed care organizations.
• </c> coordinate care better. coordinate care better.
• </c> health care providers? health care providers?
• :04:45.720><c> primary</c><00:04:46.160><c> care</c> increase in primary care increase in primary care

Keywords: 918, senate, all

Summary: The interview focused on Senate File 3612, which the senator described as “patient-centered care” legislation for Minnesota’s Medicaid and MinnesotaCare programs. He said the bill would remove private insurers and HMOs from administering those public programs, replace them with a state contract for claims processing and administrative services, and shift care coordination directly to primary care clinics, counties, and nonprofits. He argued the current managed-care system creates churn, prior-authorization barriers, and fragmented care, and said providers should manage care rather than insurers. The senator repeatedly cited Connecticut as a model, saying that state moved away from managed care, improved primary care participation, and saved money. He also argued Minnesota’s current system lacks transparency and may be overpaying health plans, pointing to fraud concerns and a past example in which UCare returned money to the state after an overpayment. He said the bill would improve accountability, make fraud easier to detect, and could save taxpayers billions, though he emphasized his main goal was better care rather than savings. On support and prospects, he said the bill has backing from the governor and the American Cancer Society but currently only DFL co-authors. He said he does not expect it to become law this year because the fiscal note and details are still pending, and he does not expect insurance companies to support it. He added that he is open to discussion but sees the insurers as fundamentally opposed. The interview ended with him saying workers in insurance and claims processing should be treated fairly and offered retraining or dislocated-worker support if broader reforms reduce their roles.

Transcript Highlights:

• management programs such as enhanced care management and transitional care services.
• services, HIV care, and broader health care are structured as separate health systems.
• , primary care, behavioral... navigating care.
• Aging services, HIV care, primary care, behavioral, Aging services, HIV care, primary care, behavioral
• care coordination goals.

Summary: The committee held an inaugural hearing on the health care and support needs of older LGBTQ Californians, with members and witnesses emphasizing that this population has made major gains in rights and longevity but still faces discrimination, isolation, economic insecurity, and gaps in services. Opening remarks highlighted concerns about older LGBTQ people entering nursing homes and feeling forced back into the closet, as well as the growing number of Californians aging with HIV. The hearing was structured into three panels, with public testimony considered if time allowed. The first panel focused on the overall health and support landscape. Justice in Aging described survey findings showing discrimination, poor health, difficulty with errands, and economic insecurity among older LGBTQ Californians, and warned that federal Medicaid cuts and broader federal actions could worsen access to home- and community-based services and culturally competent care. CalHHS and the Department of Aging described the Master Plan for Aging, the first statewide LGBTQIA older adult survey, and efforts to support gender-affirming care, PACE, care management, and community supports. Witnesses stressed the need for better outreach, data collection, and a “no wrong door” approach so people can more easily find and access services. The chair and senators pressed the departments on how survey findings are being translated into concrete action and how state agencies are coordinating across silos. The second panel addressed health care for seniors living with HIV. A longtime survivor described severe financial and benefits consequences from a federal clawback and argued that California needs stronger legal, navigation, and housing supports, including HIV-specific housing funding. The Department of Aging reported on implementation of SB 258, saying it has educated area agencies on aging, added HIV data to planning tools, and found that 20 of 33 area agencies identified HIV as a target population, with 16 including specific strategies. The Office of AIDS outlined Project Cornerstone, Ryan White, ADAP, HOPWA, a Medi-Cal waiver, and PrEP-AP, noting these programs serve thousands of older clients and that local case managers are expected to coordinate whole-person care. Case managers and advocates said housing, food, transportation, mental health, and premium assistance remain major needs, and senators asked whether future ADAP rebate funds could support navigation, housing, and other gap-filling services. The final panel turned to transgender, gender nonconforming, and intersex seniors. The Department of Social Services described protections under SB 219, including nondiscrimination notices, resident rights postings, required records for preferred names and pronouns, and annual inspections of licensed facilities. The Department of Public Health and a TransLatin Coalition leader were introduced to discuss additional supports for TGI seniors. Across the hearing, members repeatedly returned to the themes of visibility, coordination, and implementation, asking departments to follow up on how they will better connect services, improve outreach, and ensure that existing laws and programs are actually reaching the people they are meant to serve.

Transcript Highlights:

• I've spent most of my career in health care. My passion for health care is personal.
• Every time you or a loved one steps into a health care facility, you want to know that someone cared
• of Medicaid managed care?
• We're very careful. We are very careful.
• I'm in that mode today, taking care of these children that really need care.

Summary: The Health Policy Committee met for its final meeting of the session and handled a very full agenda, beginning with a few housekeeping items and a brief thank-you to staff. Senate Bill 596 was temporarily postponed. The committee then reconsidered and amended SB 1606 on patient access to records, clarifying portal access obligations and deleting a section that would have improperly affected nursing home facility records; the bill was reported favorably as a committee substitute. The committee also recommended confirmation of a block of appointees and separately confirmed Chavon Harris as Secretary of the Agency for Health Care Administration after testimony focused on transparency, financial oversight, Medicaid managed care accountability, and internal controls at AHCA. Harris said she would prioritize staffing, monitoring, and improved reporting, and several health care groups waived in support. The committee next heard and passed several bills, including claims bills SB 28 and SB 22 for South Broward Hospital District settlements, both reported favorably. It also approved SB 772 on undesignated glucagon in schools, SB 998 on allowing physician assistants and APRNs to complete death certificates under hospice/palliative protocols, SB 1412 on home health agency administration and staffing flexibility, SB 1800 creating a Parkinson’s disease research consortium at USF, SB 306 on Medicaid managed care network access during holidays and after hours, SB 1768 on stem cell therapies and informed consent, SB 1602 on pediatric readiness standards in emergency departments, SB 1156 on the home health aide program for medically fragile children, SB 1490 on Children’s Medical Services and Medicaid managed care administration, and SB 1182 on Medicaid coverage of continuous glucose monitors. Most of these bills were amended, generally to narrow scope, align with the House, or make technical changes, and most received support from provider associations, advocacy groups, or affected institutions. The most debated measure was SB 1270, which combined several health freedom and medical marijuana provisions. The strike-all amendment retained language prohibiting discrimination based solely on vaccination status, added protections related to mRNA vaccine documentation requirements, and included medical marijuana regulatory and background-screening language. The committee heard extensive testimony both in support and opposition, including concerns from senators about whether the bill would force providers to treat patients contrary to medical judgment, and support from witnesses arguing it protected patient autonomy and access to care. After a time-certain motion, the bill was reported favorably as a committee substitute. At the end of the meeting, senators recorded their votes on selected tabs, and the committee adjourned.

Transcript Highlights:

• Some examples that I wanted to list were medication administration, trach care, enteral care, airway
• Further, the cares are bowel care, wound care, central line care, or IV fluid administration, airway
• We created it for complex care assistant called enhanced care services.
• We created it for complex care assistant called enhanced care services.
• Personal care attendant hours to be able to switch those to complex care assistance so that they can

Bills: HB2402 , HB2555 , HB2599 , HB2685

Committee: House Health Care & Wellness

Keywords: phthalates, medical equipment, healthcare regulation, intravenous therapy, toxic substances, Medicaid, healthcare, traditional practices, health insurance, coverage expansion, therapy, psychotherapy, mental health, regulation, professional standards, tribal data, data protection, privacy, sharing of information, Indigenous rights

Transcript Highlights:

• Without these changes, we will lose more rural health care providers, making health care even harder
• We know that it cuts $880 billion from needed health care and nursing home care and mental health care
• :31.920><c> the</c> care and Mental Health Care from the care and Mental Health Care from the people<
• care practice.
• Care the collaborative care Rural Health Care the collaborative care model<01:47:33.080><c> is</c><01

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• I cycled through urgent care, primary care, gynecology, gastroenterology, and otolaryngology.
• But we... ...care and to support and protect our providers who are offering that care.
• health care.
• No health care provider wants to provide illegal care or even be in a situation where care could be considered
• No health care provider wants to provide illegal care or even be in a situation where care could be considered

Committee: Joint Joint Committee on Public Health

Keywords: 995, all

Summary: The committee opened by explaining hearing procedures and time limits, then heard testimony on House 2499, a bill to create a public awareness campaign on menopause and related midlife health issues. Supporters, including a nurse, the Massachusetts Commission on the Status of Women, and other advocates, said menopause is widely misunderstood by patients and providers, leading to delayed care, unnecessary suffering, workplace impacts, and inequities in women’s health. Several speakers shared personal experiences with symptoms being dismissed or misdiagnosed and urged the committee to advance the bill. The committee then took testimony on a package of endometriosis bills, including House 2527 and Senate 1564, calling for a task force and broader awareness efforts. Patients, a physician, and advocates described long diagnostic delays, severe pain, infertility, medical gaslighting, and limited access to specialists and effective treatment. They argued for more research, provider education, and a coordinated state strategy, and several asked for favorable reports. The chair also noted the hearing was running behind and extended time to allow more testimony. Later, the committee heard Senate 1579, which would eliminate parental consent and judicial bypass requirements for abortion access for minors under 16. Planned Parenthood representatives, physicians, legal advocates, and students argued the current law creates unnecessary delays and harms vulnerable youth, especially those in unsafe homes or foster care, while supporters said minors can already consent to other reproductive health care. A pro-life witness opposed the bill and emphasized parental involvement and support services. The committee also heard House 2403 and Senate 1560, which would create a Human Service Transportation Consumer Advisory Board; disability advocates and riders described past safety problems and current service gaps, and supported the board as a low-cost way to improve accountability, rider input, and reliability. No votes or final actions were taken in the excerpt.

Transcript Highlights:

• care setting or maybe in urgent care as well.
• Those were things that you may want to go to your primary care physician for are seek an urgent care
• With that managed care plan to ensure that that applicable plan assigns them an in-network primary care
• areas, urgent cares, or federally qualified health care centers, but actually where there might be some
• I know you said you're working with Medicaid managed care on making sure that non-emergent care needs

Committee: Senate Health Policy

Summary: The committee opened with roll call, welcomed members back for the first committee weeks, and heard brief personal updates from several senators before moving into agency implementation updates on recently enacted health care laws. The Agency for Health Care Administration reported on Senate Bill 64 creating rural emergency hospitals, explaining that AHCA adopted the required rules effective June 1, 2025, but that no hospitals have yet been designated. Members asked about possible hospital conversions, accreditation and survey responsibilities, and whether Florida would apply for federal rural health transformation funding; AHCA said it intends to apply and has already been working on the issue with federal officials. AHCA also reviewed the non-emergent care access plan requirement under Senate Bill 7016. The agency said hospitals with emergency departments must submit plans that help redirect non-emergent patients to appropriate care settings while complying with EMTALA, and that 83 plans had been received and 63 approved as of September 30. Members asked about data collection, managed care coordination, and the state’s health information exchange; AHCA said it has moved to a new HIE vendor and will continue monitoring implementation and possible care gaps. AHCA then updated the committee on the TEACH program, saying $6.8 million was spent in 2024-25 across 59 parent organizations and 229 facilities, with more than 1,800 students and nearly 380,000 clinical hours reimbursed. The agency said rulemaking is nearly complete, a new nursing student category and expanded facility eligibility were added, and a federal 1115 workforce waiver remains stalled after CMS signaled it will not approve new workforce demonstrations. AHCA also reviewed House Bill 121 on KidCare eligibility, explaining that implementation of the 300% poverty-level expansion remains blocked by federal litigation and waiver issues tied to premium nonpayment rules; members and public speakers urged action to close the coverage gap. Public testimony on AHCA’s presentation came from representatives of health centers and advocacy groups, who said the non-emergent care access plan has improved hospital-health center coordination and reduced repeat emergency use, and who urged implementation of KidCare expansion for children in the coverage gap. The Department of Health then presented updates on FRAM, the Sanadi screening grant program, the Health Care Innovation Revolving Loan Program, telehealth maternity care, swimming lesson vouchers, and House Bill 159 on pharmacist dispensing of HIV post-exposure prophylaxis. DOH reported strong participation in FRAM and the telehealth maternity program, 24 Sanadi grant awards in 42 counties, 4,945 swimming lesson vouchers issued last year and 2,371 so far this year, and three approved certification courses with five pharmacist certifications issued under HB 159. Committee members asked about recruitment of dentists and other providers, telehealth maternity outcomes, and why participation in the maternity program remains below expected levels; DOH said outreach and regional referral networks are expanding and more detailed outcome data will be included in the upcoming legislative report.

Transcript Highlights:

• We have limited skilled nursing facility and long-term care facility, particularly long-term acute care
• chronic care management plans.
• And then, if an unhoused individual needs care in a higher level of care, it is even more difficult to
• Respite care is also sometimes referred to as recuperative care, and it's a setting where Individuals
• Long-term care.

Committee: House Public Health

Summary: The meeting focused on hospital “avoidable days” and the difficulty of discharging medically stable patients who still need post-acute placement or social services. Presenters from Saint Anthony Hospital Midtown, the Oklahoma Hospital Association, City Care, and OU Health described common barriers including lack of skilled nursing, rehab, long-term care, behavioral health, and hospice placements; insurance prior authorization delays; Medicaid and Social Security eligibility delays; guardianship and Adult Protective Services bottlenecks; limited home health and private duty nursing; and the challenge of placing unhoused, uninsured, or medically complex patients. Several speakers emphasized that these delays reduce bed availability, increase emergency department boarding, contribute to staff burnout, and expose patients to hospital-acquired conditions and other harms. The testimony included multiple examples of patients remaining in acute care for days, weeks, or even months after being medically ready for discharge, including patients awaiting guardianship, disability determinations, or placement in facilities willing to accept them. Speakers also highlighted special populations such as patients with behavioral health or substance use disorders, medically fragile children, patients with criminal histories, and unhoused individuals who need respite or hospice care. City Care described its planned 40-bed medical respite facility, set to open in 2027, as a way to provide clinical support and housing navigation for patients too sick to recover on the street or in shelters. Witnesses recommended policy and system changes such as standardizing preauthorization protocols, expanding rural swing-bed and home-based services, increasing public guardianship resources, improving data collection on homelessness, expanding private duty nursing hours, and creating more placement options for complex patients. They also suggested better coordination between hospitals, DHS, APS, the Health Department, and post-acute facilities, including a database of facility services to improve discharge planning and keep patients closer to home. No votes or formal committee actions were taken in the transcript, but the chair indicated the issue would require collaboration across multiple agencies and partners.

Transcript Highlights:

• health care programs.
• Maybe they don't necessarily seek care with counties for indigent care.
• They don't necessarily seek care with counties for indigent care.
• and home care.
• and home care.

Summary: The Budget Subcommittee on Health and Human Services heard an overview of the expected California budget and program impacts from H.R. 1, including changes to Medi-Cal and CalFresh eligibility, redeterminations, work requirements, immigration-related coverage rules, retroactive coverage limits, and reductions in federal matching for certain services and provider financing mechanisms. DHCS and CDSS described implementation plans focused on automation, data matching, clearer communications, county training, and outreach, while noting that many federal details are still pending. The Legislative Analyst’s Office also reviewed how H.R. 1 could increase pressure on county indigent care systems, explaining the history of county responsibility under Section 17000, 1991 realignment, and AB 85, and warning that counties may face large increases in uninsured residents seeking care without corresponding funding flexibility. An independent policy expert urged consideration of a more standardized statewide approach to indigent care and raised questions about governance, benefits, and financing. Department witnesses estimated substantial coverage losses and fiscal effects: DHCS projected major Medi-Cal disenrollment tied to work requirements, six-month renewals, narrowed immigrant eligibility, and reduced retroactive coverage, while CDSS estimated large CalFresh benefit losses and a significant increase in administrative workload and payment accuracy pressure. Members questioned how exemptions would work for older adults, people experiencing homelessness, undocumented residents, and cash workers, and asked about the effect on the CalFresh Minimum Nutrition Benefit Pilot and on county administrative funding. Officials said they would use available data and self-attestation where possible, but acknowledged that many cases would require manual screening and that the county workload estimates remain in dispute. They also said the state is still evaluating the impact of H.R. 1 on provider taxes and state-directed payments, which could create additional budget pressure. County representatives from Los Angeles, Santa Clara, Tulare, and San Bernardino described major local consequences if H.R. 1 is implemented as written. They warned of higher uninsured rates, more strain on emergency rooms and public hospitals, increased homelessness and food insecurity, and a likely need to rebuild or expand county indigent care programs that were largely scaled back after the ACA. Counties said they are already freezing hiring, cutting positions, reducing overtime, deferring spending, and launching outreach and coordination efforts with managed care plans and community partners, but argued that these steps are not enough without additional state support. Several counties backed the California County Welfare Directors Association’s request for $373 million in General Fund support for eligibility work and asked for a CalFresh match waiver to soften the new county share of administrative costs; Los Angeles and Santa Clara also emphasized that their local revenue measures would not close the projected gaps. No votes or formal actions were taken in the portion provided.

Transcript Highlights:

• care force.
• He cannot receive care in Westfield. He does receive care in Springfield.
• and the kind of care and the various interagency collaboration the level of care and the kind of care
• for hospital care.
• Do they need a lower level of care or a higher level of care?

Keywords: 1212, all

Summary: The hearing focused on the future of Pappas Rehabilitation Hospital for Children, with commissioners, agency officials, workers, and families describing the hospital as a unique integrated setting combining medical care, rehabilitation, education, residential services, and adaptive engineering. Opening remarks from legislators emphasized continued budget funding, the legal requirement that Pappas not close before the commission reports, and a request to extend the commission’s deadline. Several commissioners and witnesses argued that admissions have effectively been curtailed while discharges continue, creating what they described as a de facto closure. Union leaders from AFSCME, SEIU, and the Massachusetts Nurses Association said staff are experiencing uncertainty, morale problems, and loss of confidence because referrals are being discouraged and the census is shrinking. They urged immediate action to stop admission denials and unnecessary discharges, and some proposed temporary modular units or other short-term investments to restore admissions while longer-term plans are developed. Parents and former patients testified that Pappas provided life-changing opportunities and supports that they could not find elsewhere, and that alternative programs or proposed Western Massachusetts options would not meet the same needs. Department of Public Health Commissioner Robert Goldstein said the administration supports keeping Pappas open and stable during the commission’s work, but argued that admissions must comply with hospital-level-of-care rules and that the campus’s deteriorating infrastructure limits who can be safely served. He said DPH is continuing admissions where appropriate, backfilling staff, and exploring ways to expand services, including outpatient therapies and adaptive engineering, while also acknowledging that Pappas is a one-of-a-kind system with no true in-state duplicate. Commissioners requested de-identified admissions and denial data and continued to press the department on whether the current operational changes amount to a silent closure.

Transcript Highlights:

• I stand here today because Texas is in a health care crisis.
• But the Care No Matter What Act is the solution.
• health and limiting access to that care.
• Perolale care no matter what.
• But the Care No Matter What Act is the solution.

Transcript Highlights:

• of care.
• Care and maternity care, strengthens local capacity to reduce avoidable out-of-area travel for care.
• care, including care integrated into OBGYN or primary care visits.
• nursing home care.
• care for youth, et cetera.

Summary: The hearing began with testimony from Let California Kids Hear and supporters urging action on pediatric hearing aid coverage. Advocates said California has repeatedly failed to enact a workable solution over the past eight years and argued that children need early access to sound to support development. The proposal discussed would limit the coverage mandate to the large-group market, which advocates said would cover roughly 70% to 80% of affected children and avoid the exchange-related cost issue that contributed to prior vetoes. Supporters, including parents, audiologists, and children’s health groups, backed the proposal, and the chair expressed sympathy and support while noting hope for a federal solution for exchange plans. The Department of Finance then gave opening remarks about the state’s structural deficit and the need to balance new investments against projected out-year shortfalls. HCAI followed with a broad overview of its programs, including CalRx insulin and naloxone initiatives, reproductive health grants, the Office of Health Care Affordability, hospital seismic compliance, workforce programs, and the diaper access initiative. Members asked about geographic targeting of workforce funds, the behavioral health workforce pipeline, and the status of the 21st Century Nursing Initiative, which HCAI said had reverted funds. The committee also discussed a proposed transfer of the Data Exchange Framework and Office of the Patient Advocate to HCAI, new reporting on long-term care staffing and health coverage waiting periods, and a Behavioral Health Services Act workforce proposal that would use BHSA funds to support training, stipends, and technical assistance while offsetting $100 million in General Fund spending; members and LAO questioned the offset and asked for more detail, and the item was held open. HCAI also presented the Rural Health Transformation Program, explaining that California received $233.6 million in federal funds for the first year and had to revise its proposal so that $35 million in provider payments would be tied to specific transformative activities rather than general financial relief. The program will fund rural care model redesign, workforce development, and technology/infrastructure improvements, with grants to be rolled out on a tight timeline and subject to CMS approval. Members asked about the size of California’s award, the use of funds for maternity care, labor and delivery access, dialysis, tribal set-asides, and the role of a technical assistance contractor. The department said the program will use supply-and-demand workforce modeling to target funding and that all funds must be obligated by October 30. Finally, the Department of Managed Health Care outlined its budget and two major bill-related proposals: SB 41 on PBM reform and SB 306 on prior authorization transparency. DMHC said SB 41 would require PBM licensure, ban spread pricing, require rebate pass-through, and regulate pharmacy network practices, while SB 306 would require reporting on prior authorization and create a list of services exempt from prior authorization. DMHC requested additional positions and funding to implement both measures.

Transcript Highlights:

• of Managed Health Care.
• care.
• surgical care.
• But Kaiser doesn't value behavioral health care like it does medical-surgical care.
• Part of that is mental care, mental health care services.

Summary: The Assembly Health Committee held an informational hearing on Kaiser Permanente’s behavioral health care system, focusing on Department of Managed Health Care enforcement actions, Kaiser’s corrective action work plan, and testimony from patients, advocates, and union representatives. DMHC officials reviewed a long history of complaints, surveys, fines, and settlements involving Kaiser’s access to behavioral health services, including deficiencies found in 2012 and 2016, a 2022 non-routine survey, and a 2023 settlement that imposed a $50 million penalty and required $150 million in community investments over five years. DMHC said it continues to monitor Kaiser through quarterly meetings, complaint review, follow-up surveys, and a reimbursement process for members who could not obtain timely in-network care. Committee members pressed DMHC on what “timely access” and continuity of care mean in practice, how virtual care and group therapy fit into the standards, and what triggers a non-routine survey. DMHC said initial behavioral health appointments generally should not take more than two weeks, urgent care should be within days, and follow-up care within 10 days, with out-of-network care required when plans cannot meet standards. Officials also said Kaiser’s initial corrective action work plan lacked detail, but the revised plan was accepted and will be tracked through quarterly reporting and possible additional enforcement if Kaiser fails to comply. The second panel featured testimony from a Kaiser enrollee, a behavioral health policy expert, a Kaiser therapist, and the NUHW president. The enrollee described serious delays and inadequate treatment for his daughter after a suicide attempt, while the therapist and union leader said Kaiser’s behavioral health system is understaffed, relies too heavily on short appointments, group therapy, and webinars, and treats behavioral health as less important than medical-surgical care. They argued Kaiser’s one-appointment-at-a-time scheduling rule and limited treatment time violate parity requirements and harm continuity of care. Several members criticized Kaiser for not appearing at the hearing and said the testimony underscored the need for stronger oversight, clearer metrics, and faster remedies for patients.

Transcript Highlights:

• settings, including home care.
• I care deeply for my patients, and it is heartbreaking and morally distressing to repeatedly care for
• That's discrimination just as care.
• For such cases, providers are legally required to provide all care available, even though this care can
• In fact, my practice is consulting on the goals of care, the patient's goals of care, about what they

Committee: Senate Health Policy

Summary: The committee first received an update from the Department of Health on the Cancer Connect Collaborative, the Cancer Innovation Fund, and the new Cancer Connect Collaborative Research Incubator, created and expanded by recent legislation. The department reported that the Cancer Innovation Fund has awarded $80 million to 95 researchers to date, with $60 million available in the current cycle and 65 projects funded across 28 institutions in 16 cancer areas last year. The new pediatric cancer incubator received $30 million and awarded four Florida children’s hospitals $7.5 million each. Senators asked about outreach to oncologists statewide, peer review and accountability, funding for National Cancer Institute-affiliated institutions, and whether underserved and rural areas are being prioritized; the department said it uses website notices, listservs, collaborative outreach, and eligibility criteria favoring rural and high-cancer-care providers, and that it monitors projects through reports, expenditures, and contract provisions. The committee then heard Senate Bill 312 on patient-directed medical orders, which would create a voluntary, portable, physician-authorized electronic registry for patients to document end-of-life and serious-illness treatment preferences. Supporters, including nurses, hospice and emergency care advocates, and medical professionals, said the bill would help ensure patient wishes are accessible in emergencies, reduce unwanted interventions, and improve continuity of care. Opponents, including Florida Right to Life, argued the bill could broaden end-of-life decisions too far, raise privacy and coercion concerns, and allow withdrawal of care inappropriately. The sponsor said the measure is intended to support patient autonomy and is not anti-life, and noted she was open to amendments. After public testimony, the committee voted on SB 312 and reported it favorably. The roll call showed support from Senators Berman and Harrell, with the bill passing on the committee vote. The meeting then adjourned.

Transcript Highlights:

• Mental health care is health care. Mental health care is health care.
• , Home Care Alliance, Alzheimer's Association, Home Care Aid Council, Home Care Alliance, Mass Aging
• care attendants, and home care consumers.
• It is a protection for the home care attendants, the home care consumers, and the home care workers.
• withdraws from providing care and then we have a consumer of that care with no one to provide the care

Summary: The Senate took up a series of local and statewide measures, including bills on parking fines in Scituate, a conservation restriction in Middleton, park and field dedications in Boston, toxic-free medical devices, a regional school district vote, and several local personnel and land-use matters. It also approved or engrossed bills concerning the Dalton Fire District, fire and police employment in Conway, reclassifying Beverly fire alarm operators, a Waitley Water District dissolution, a Dighton conservation land/public way issue, Milton liquor licenses, Billerica bike path land transfer, and an easement exchange involving Eversource. Several of these were advanced by suspending rules, ordering third readings, or concurring in House amendments; the Senate also accepted a committee report consolidating S. 545 with H. 899 and passed the consolidated park-dedication bill to engrossment. A major focus was the bill requiring health care employers to develop and implement workplace violence prevention programs. Senators and sponsors described the measure as a compromise aimed at protecting health care workers through annual risk assessments, prevention plans, paid leave, reporting requirements, privacy protections, and a narrow warrantless-arrest provision for assaults on health care workers. The Senate adopted a number of amendments, including changes to employee definitions, complaint protections, disfigurement language, paid leave coverage, federally qualified health center exemptions, de-escalation and community-based response language, mental health treatment coverage, and a one-year pause for certain DDS-related provisions. Some proposed amendments were adopted, while others were rejected or withdrawn, and the bill was ultimately ordered to third reading and passed to be engrossed. The Senate also considered the home care and long-term services bill, with members emphasizing home care licensure, oversight, and planning for long-term care financing. Amendments added or modified provisions related to home care training, evacuation procedures, minority-party representation on commissions, MassPACE participation, and representation for people living with dementia; one amendment on family caregiving was withdrawn after discussion. The chamber likewise advanced an economic development bond and appropriation package through a Ways and Means substitute and adopted a conference committee process on a separate energy affordability bill after the House disagreed with the Senate’s version. The session included ceremonial moments honoring guests and memorializing Jane Yolen and Charlene M. Naylor, and it ended with the Senate adjourning to meet again the following Monday.

Transcript Highlights:

• health care programs.
• Maybe they don't necessarily seek care with counties for indigent care.
• They don't necessarily seek care with counties for indigent care.
• care of myself.
• and home care.

Summary: The subcommittee heard an extended briefing on the impacts of H.R. 1 on Medi-Cal and CalFresh, followed by testimony from the Legislative Analyst’s Office and county officials. DHCS described major Medi-Cal changes in H.R. 1, including work/community engagement requirements, six-month redeterminations, reduced federal matching for some emergency services, narrower immigrant eligibility, reduced retroactive coverage, and limits on provider taxes and directed payments. CDSS outlined CalFresh changes, especially the expanded able-bodied adults without dependents time limit, reduced exemptions and waivers, and the new federal-state-county administrative cost split. Both departments emphasized implementation plans, automation, outreach, and county coordination, while acknowledging significant expected coverage losses and administrative burden. The LAO and an independent policy expert discussed how H.R. 1 could increase demand on county indigent care systems and public hospitals as people lose Medi-Cal. They reviewed the history of county indigent care, 1991 realignment, and AB 85, explaining that counties already rely on a patchwork of funding and that current realignment revenues are often used for public health rather than indigent care. They warned that counties may face large increases in uninsured residents, with wide variation in how counties respond, and raised concerns about equity, financing, and whether a more standardized state-county program should be created. Committee members pressed witnesses on county funding, exemptions, homelessness, older adults, undocumented residents, and the effect of administrative burden versus true ineligibility. County representatives from Los Angeles, Santa Clara, Tulare, and San Bernardino described the expected local impacts and asked for additional state support. They said H.R. 1 would drive major losses in Medi-Cal and CalFresh enrollment, increase uncompensated care, strain eligibility staff, and worsen homelessness and food insecurity. Several counties urged the Legislature to fund eligibility workers, preserve enrollment, and consider a CalFresh match waiver; Santa Clara and San Bernardino also cited local tax measures and staffing reductions already underway. No formal vote or committee action was taken in the portion provided.