Transcript Highlights:

• and services system.
• These include caseload, available services, utilization of those services, and the rates paid for services
• So even independent living services, residential services, day services, and employment providers, they
• remote services.
• I'm a director of deaf services, supported living services.

Summary: The subcommittee heard an overview of the governor’s IHSS budget proposals and extensive testimony from the Department of Social Services, Department of Finance, the Legislative Analyst’s Office, county representatives, labor, consumer advocates, and advocates for older adults and people with disabilities. The administration described IHSS as a large and growing program serving more than 900,000 recipients, and outlined three proposals: shifting the cost of growth in authorized hours per case to counties, eliminating the backup provider system, and aligning IHSS terminations with Medi-Cal terminations. The LAO said the overall budget estimates appeared reasonable but raised concerns about the hours-per-case proposal, including the lack of a comprehensive root-cause analysis, the limited control counties have over statewide cost growth, and uncertainty about how the baseline and savings would work. CWDA, SEIU, and consumer advocates strongly opposed the hours cost shift, arguing that counties use state-designed tools, that demographic changes and rising need explain much of the growth, and that the proposal would pressure counties to cut services and destabilize care. The chair and members repeatedly questioned the administration about the proposed baseline, the claimed savings, and whether the measure effectively circumvents the county maintenance-of-effort agreement. On the backup provider system, the administration said the statewide program is underutilized and administratively expensive, and proposed eliminating it to save about $3.5 million. The LAO suggested the Legislature consider whether administrative costs could be reduced while preserving some version of the program. County and consumer advocates opposed the cut, saying the system is a critical safety net when regular providers are unavailable, especially in rural areas and for people with complex needs. They argued that low utilization reflects the difficulty of finding emergency backup care, not lack of need, and that many counties already rely on local backup systems or other models. Committee members also pressed for better data on requests, fulfillment, and administrative costs, and discussed whether the state could support local alternatives instead of eliminating the program. The final topic was the proposal to align IHSS terminations with Medi-Cal terminations by automating the process when recipients fail to complete Medi-Cal redeterminations. The administration said this would reduce General Fund costs by about $86 million by preventing payment of IHSS in the residual program when recipients are no longer eligible for Medi-Cal, while also automating reinstatement when Medi-Cal is restored. The LAO noted the proposal has been rejected in prior years and suggested improved notice and communication to recipients as an alternative. CWDA and advocates warned that the change could create gaps in care, especially for people who lose Medi-Cal for procedural reasons, and urged additional safeguards such as better notices, faster reprocessing, and automatic reinstatement. Members questioned how many people would be affected, how the residual program currently works, and whether providers could go unpaid during the gap; the department said the automation is already built and would be activated if the proposal is approved. No votes were taken during the discussion, and the committee moved through public comment and questioning without final action on the proposals in the excerpt provided.

Transcript Highlights:

• want services.
• Remote services are…” “Remote services are voluntary.
• remote services.
• And so I do believe that each service, not just say a service, but each service has this level of fidelity
• likely that the client will lose services or not get the services that they need.

Summary: The Assembly Budget Subcommittee on Human Services heard testimony on Department of Developmental Services (DDS) and related budget and trailer bill proposals, with a major focus on the impacts of H.R. 1 on people with intellectual and developmental disabilities (IDD). DDS and the Department of Social Services (DSS) said H.R. 1 could affect Medi-Cal and CalFresh access, but that people with disabilities and caregivers are exempt from the work requirements; the administration is working on data matching and automation through the statewide eligibility system to identify exemptions, with June 1, 2026 as the implementation date for CalFresh changes. Witnesses and advocates warned that any loss of Medi-Cal could create fiscal pressure on regional centers and households, while public commenters described the real-life consequences of losing services. Committee members repeatedly expressed concern about cost shifts to counties and asked for harm-mitigation strategies before the May Revision. The committee also reviewed the governor’s IHSS-related proposals. DSS said the budget would set a baseline for authorized hours, align IHSS disenrollment/reinstatement with Medi-Cal eligibility processes, and eliminate the IHSS backup provider system, while emphasizing that individual service hours would still be based on assessed need. DDS said if a person loses IHSS or Medi-Cal, regional centers may have to step in as payer of last resort for some services, potentially at higher state cost. Members and the Legislative Analyst’s Office questioned whether counties could absorb the proposed shifts without reducing services, and asked for more detail on implementation, data quality controls, and how regional centers could help families navigate disruptions. A separate trailer bill on DDS rate reform and the Quality Incentive Program drew mixed reactions. DDS proposed extending a contract exemption and delaying final rate reform regulations to 2030, saying the changes are budget-neutral and needed for implementation. DDS reported that about 81% of providers had completed the current Quality Incentive Program requirements, but providers and advocates argued the 90-10 structure can function like a penalty and may destabilize services if providers lose 10% of funding. Committee members asked for clearer assistance to providers, possible flexibility for good-faith efforts, and a redlined version of the language before the May Revision. The committee also heard DDS’s proposed trailer bill on regional center governance and provider capacity. DDS said the language would consolidate regional center contracts and performance measures, strengthen board training and oversight, require consumer advisory committees, expand independent legal support, raise the threshold for board approval of contracts, and remove barriers such as physical-office requirements and duplicate vendorization. DDS said the goal is to improve accountability and efficiency while preserving person-centered services, and members indicated they wanted further refinement and stakeholder input before moving forward.

Transcript Highlights:

• want services.
• of Developmental Services.
• Remote services... Remote services are voluntary.
• remote services.
• So I do believe that we... ...we should be each service, not just say a service, but each service has

Keywords: 988, house, all

Transcript Highlights:

• The service array that we're...
• And then some Medicaid services are designed to be complementary to formal medical services.
• , preventive services, as well as more acute services and specialty services.
• services.
• and medical services.

Keywords: 907, all

Transcript Highlights:

• needs service.
• Business services supported residential services. We only had one kind of service.
• And we wanted to make sure that every service... ...service.
• your phone service."
• because it ensures that customers receive service and when we say service we're talking basic service

Summary: The committee held an informational hearing on Carrier of Last Resort (COLR) to examine its history, current operation, and possible future changes in California. Chair Tasha Berner said the hearing was prompted in part by AT&T’s 2023 request for relief from COLR obligations and by broader concerns about public safety, affordability, universal service, and access to modern broadband and telecommunications. The first panel featured a telecommunications expert who traced COLR back to universal service principles and explained how states have handled COLR differently, including full deregulation, limited rural obligations, or transition pathways tied to competition and customer protections. Members asked about affordability, federal and state processes for service withdrawal, and whether COLR remains necessary given modern competition. CPUC staff then described California’s COLR framework, explaining that universal service rests on access, reliability/quality, and affordability, and that COLR requires carriers to provide basic service, including voice-grade calling, 911 access, relay services, and Lifeline. Staff said AT&T’s application sought relief in nearly all of its territory, but no replacement COLR came forward during the proceeding, and public participation hearings drew thousands of comments and strong concern from rural and vulnerable customers. The CPUC outlined its ongoing rulemaking to reconsider whether the 1996 COLR rules and 2012 basic-service definition still fit current conditions, with workshops and public hearings scheduled and a proposed decision expected later in the year or into 2026. Members pressed staff on geographic outreach, wireless coverage, whether broadband can be part of basic service, public safety during wildfires, and what reporting and complaint processes currently exist. In the final panel, industry and public-interest witnesses sharply disagreed. A U.S. Telecom representative argued COLR is outdated, costly, and copper-focused, and said reform should allow technology-neutral alternatives such as wireless, fiber, and satellite while preserving reliable voice and emergency access. The CPUC Public Advocates Office countered that COLR remains a necessary public safeguard, especially for rural and low-income customers, and argued that any transition should maintain or improve service, with public benefits such as broadband investment and continued protections for 911, disability access, and affordability. Committee members focused on the difference between an obligation to serve everyone and a mere option to serve, and on whether the Legislature should provide clearer guidance as the CPUC’s rulemaking moves forward.

Transcript Highlights:

• beyond service limitations.
• for 10% service connection.
• for 10% service connection.
• or services.
• The Veterans Administration cannot advertise for service or services.

Summary: The joint informational hearing focused on the role of County Veterans Service Officers (CVSOs), CalVet’s support for them, and the growing problem of for-profit, unaccredited claims companies. Committee leaders and witnesses emphasized that CVSOs are often the first point of contact for veterans and their families, helping with disability claims, education benefits, survivor benefits, housing, health care, and other wraparound services. Testimony highlighted the return on investment from CVSO work, with witnesses citing hundreds of millions in new federal benefits secured for California veterans and arguing that current state funding is too low relative to the workload and need. County representatives from Nevada, Los Angeles, and San Luis Obispo described local models of service. Los Angeles County highlighted a “no wrong door” approach, peer navigators, suicide review work, justice-involved veteran services, and homelessness coordination, while San Luis Obispo described rural outreach, mental health partnerships, and high suicide rates in its county. Nevada County stressed that smaller counties can be disadvantaged by workload-based formulas and that additional funding would expand access, especially in rural areas. Several witnesses said veterans often need more than claims help and should be connected to mental health, employment, food, and family supports. Much of the discussion centered on predatory claims consultants, which witnesses said charge veterans for services that accredited CVSOs provide free. Members and witnesses described cases involving requests for VA and banking logins, misleading advertising, and contracts that can take a percentage of veterans’ benefits. Committee members expressed support for legislation to curb these practices and for increased funding for CVSOs, including the Legislature’s intent to fund 50% of county veterans’ services operations. A CalVet deputy secretary also testified that California’s accreditation and training system improves claim quality and appeal outcomes, and that CalVet works with CVSOs through training, district offices, and appeals representation.

Transcript Highlights:

• and services system.
• These include caseload, available services, utilization of those services, and the rates paid for services
• So even independent living services, residential services, day services, and employment providers, they
• So even independent living services, residential services, day services, and employment providers, they
• I’m a director of deaf services, supported living services.

Keywords: 987, senate, all

Transcript Highlights:

• Transportation Disadvantaged services are transportation services...
• services, deviated fixed-route services, complementary Americans with Disabilities Act paratransit services
• So persons that are eligible for ADA paratransit service, they cannot be denied service.
• They must be delivered service.
• It does get kind of complicated, but a commuter rail service is intended to ...of service.

Summary: The Senate Transportation Committee met, took roll, and heard introductory remarks from members about their districts and transportation priorities, with several senators noting congestion and mobility challenges in their regions. The committee then received a presentation from the Florida Transportation Commission on its oversight role for FDOT, including annual and quarterly performance reviews, review of the five-year work program, and monitoring of tolling and transit authorities. Members asked whether the commission gets involved in project prioritization; the answer was no, because it is statutorily limited to high-level oversight rather than day-to-day project decisions. The committee next heard two reports related to transportation disadvantaged and paratransit services. FDOT’s Melissa Smith described the statewide Transportation Disadvantaged program, its governance structure, service models, and challenges such as fragmented administration, cost, inconsistent reporting, and rural service limitations. She outlined recommendations including better use of technology, regional partnerships, improved training, and alternative delivery models like microtransit and TNC partnerships. A University of South Florida researcher, Martin Katala, discussed best practices for paratransit and demand-response service, emphasizing route optimization software, dynamic dispatching, service standards, vendor accountability, and the use of TNCs and mobility management to improve efficiency and reduce travel times. A later presentation from UF’s I-Street program focused on emerging technologies for transit, including in-cabin monitoring, automatic restraints, accessible booking and tracking tools, and the need for statewide safety standards and better driver interfaces. Finally, FDOT Secretary Jared Perdue and District 5 Secretary John Tyler provided an update on the transition of SunRail local entities. They explained the differences among commuter rail, intercity rail, and light rail, and said SunRail’s financial transition to local partners was completed on January 1, with operational transition to follow over up to three years. They contrasted that with Tri-Rail, where FDOT still funds operations and discussions about a future transition are ongoing. Members asked about the differences between SunRail, Tri-Rail, Amtrak, and Brightline, and the presenters explained that commuter rail serves regional daily commuters while intercity rail connects regions. The committee concluded without taking any formal votes or other legislative action.

Transcript Highlights:

• <c> is</c><00:25:09.159><c> if</c> Services forensic Services which is if Services forensic Services
• services.
• services.
• recovery support services, and service ongoing service coordination.
• and vocational services, rehabilitation services, and then forensic services.

Keywords: 1183, house

Transcript Highlights:

• </c> basic service. basic service.
• </c> service categories. service categories.
• </c> habilitation service. habilitation service.
• </c> essential services. essential services.
• </c> these services. these services.

Keywords: 1187, senate, all

Transcript Highlights:

• the last two biennia for a pretrial services pilot program to help courts expand the use of these services
• The first being supportive services.
• Services in this category focus more on providing referrals to community services that can help address
• The next is assistance services.
• count as pretrial services.

Keywords: 904, all

Summary: The Joint Legislative Audit and Review Committee held a hearing on a State Auditor’s Office performance audit about expanding pretrial services in Washington. Audit staff said most of the 14 courts reviewed wanted to expand or implement pretrial services but faced barriers such as funding, limited community resources, and public safety concerns. They also reported that only three courts could provide usable data, that pretrial service use varied across courts, and that some demographic disparities appeared in the data, including lower rates of pretrial services for Hispanic defendants at two Spokane courts and for Black defendants at Spokane Superior Court. The audit also found that many courts do not collect pretrial data in an accessible format and recommended clearer guidance, better data systems, stakeholder outreach, and evaluation of program effectiveness. The State Auditor’s Office also noted that the Administrative Office of the Courts’ pretrial pilot program had received legislative funding and was being expanded. Representatives from Spokane Municipal Court, Grays Harbor County District Court, and Yakima County discussed their local programs and data. Spokane officials described a robust integrated system and said their pretrial services unit, launched in 2021, had reduced bail use, jail time, failure-to-appear rates, and recidivism, while helping judges make quicker release decisions. Grays Harbor staff echoed the audit’s findings on cost savings and said data collection is labor-intensive for limited-jurisdiction courts, especially without dedicated staff. They also described using risk assessment tools and pilot funding to support alternatives to jail. Yakima and Spokane participants emphasized that stable funding and standalone pretrial services units would improve program consistency and outcomes. Committee members asked about how pretrial services reduce detention time, how courts can better communicate cost savings and public safety benefits, and why statewide data collection is difficult. Audit staff and court representatives said early assessments, better information at first appearance, and integrated case-management systems help reduce jail stays and improve release decisions. The hearing ended without formal committee action, and the chair adjourned the meeting after inviting written public testimony on the audit topics.

Transcript Highlights:

• </c> shared service rate go to workers. shared service rate go to workers.
• </c> personal care assistant PCA services. personal care assistant PCA services.
• </c><00:17:53.600><c> Okay,</c> getting services. Okay, getting services.
• traditional services.
• </c> providing that service to multiples. providing that service to multiples.

Keywords: 1183, house

Transcript Highlights:

• , CalFresh, CalWORKs, General Assistance, Adult Protective Services, In-Home Supportive Services, and
• , CalFresh, Cal Works, General Assistance, Adult Protective Services, In-Home Supportive Services, and
• We rely on CSBG funding services.
• in those services.
• CSBG also allows us to offer support services and wraparound services to our enrolled customers.

Summary: The Senate and Assembly Human Services Committees held a special oversight hearing on California’s 2026-27 Community Services Block Grant (CSBG) state plan, a federal anti-poverty funding stream. Committee members opened by citing statewide poverty and homelessness data and said the hearing was meant to review how CSBG dollars are used, how local agencies respond to community needs, and how the state is preparing for possible federal funding cuts. Jason Wimbley of the Department of Community Services and Development (CSD) explained that California’s CSBG network works through 60 organizations in 58 counties, serving about 1.5 million low-income Californians in 2023, and that the state received $68.4 million in federal CSBG funds in fiscal year 2025. He described the program as flexible funding used for housing, employment, education, food, health, transportation, and emergency response, and noted that the federal administration had proposed eliminating CSBG, though the Senate Appropriations Committee had voted to fully fund it for the coming year. Representatives from the California Community Action Partnership Association and several CSBG-funded agencies described how the program supports local anti-poverty work and leverages other funding. CalCAPA emphasized local flexibility, workforce development, partnerships, and data systems such as ROMA, while also warning that agencies are preparing for possible reductions by tightening budgets, planning staffing contingencies, and seeking private foundation support. Agency witnesses from Contra Costa County, Northern California Indian Development Council, Proteus, and Sacred Heart Community Service described services including housing assistance, food distribution, utility help, employment training, youth programs, and culturally specific services for Native communities and migrant farmworkers. They repeatedly said CSBG is essential because it funds staffing and infrastructure that allow them to braid other grants and serve people who do not qualify for standard safety-net programs. Members also asked about the impact of federal staffing changes and the Los Angeles fires. Wimbley said federal layoffs had affected some CSD programs but not CSBG administration, and that the department coordinated disaster response with state agencies and used CSBG-funded supply distribution, food, water, clothing, and documentation support during the fires. Witnesses said they were preparing for possible future cuts by diversifying funding, reducing expenses, and considering service changes, while county officials warned that state and federal reductions could not be backfilled locally. During public comment, one speaker urged stronger oversight of community action agencies and raised concerns about transparency and compliance with state law. The chair then thanked the witnesses, emphasized the importance of CSBG for low-income seniors, youth, and people with disabilities, and adjourned the hearing without any votes or formal action taken.

Transcript Highlights:

• services or CART providers, and we provide those referral services for them.
• The social services program also provides services to children, birth to 13.
• The social services program also provides services to children, birth to 13.
• The other area that we provide services in is vocational rehabilitation services. These services...
• Protective services.

Keywords: 995, all

Summary: The hearing was an informational and oversight session of the Joint Committee on Children, Families, and Persons with Disabilities, with chairs and members hearing agency updates from several commissioners. The Department of Public Health’s Bureau of Family Health and Nutrition described its maternal and child health work, including home visiting, early intervention, WIC, newborn hearing screening, and cross-agency efforts on prenatal substance exposure, respite care, children’s vision, and maternal health initiatives. DPH emphasized that federal grant cuts, layoffs, and the loss of data systems such as PRAMS would weaken services and planning, and members asked about Title V funding and the impact of federal uncertainty. The Massachusetts Commission on the Deaf and Hard of Hearing highlighted communication access services, interpreter and CART referrals, emergency after-hours support, family navigation, and independent living services. Commissioners and members discussed the shortage of ASL interpreters and the need to expand training pipelines, including partnerships with colleges and possible ASL programming for younger students. The Department of Developmental Services reported serving nearly 50,000 people and focused on youth and adult services, transition-age supports, autism services, self-direction, respite, and new high-acuity residential models. Members asked about respite availability, self-direction outcomes, and workforce shortages; DDS said it was expanding clinical capacity and provider rates while monitoring possible federal Medicaid, SNAP, and immigration-related impacts. The Commission for the Blind described services for about 28,000 legally blind residents, most of whom are older adults, including social rehabilitation, orientation and mobility training, children’s services, assistive technology, vocational rehabilitation, and Turning 22 supports. The commissioner discussed a UMass-based effort to build the workforce pipeline for blindness services and said the agency was watching federal restructuring but had not yet seen direct cuts. MassAbility’s leadership then warned about major federal changes affecting Social Security disability determinations, including staff restructuring, office closures, and a new overpayment repayment policy, and said the agency was preparing for possible increases in claims and uncertainty around reallotment dollars that help fund services. The Disabled Persons Protection Commission closed the hearing with an update on its abuse investigations and protective services for adults with disabilities. DPPC reported rising hotline calls and investigations, a growing caseload, its sexual assault response team, the abuser registry, and a new interagency protective services integration system funded by ARPA dollars through 2027. The agency also flagged new federal rules that could affect funding eligibility and said it may need statutory changes to comply. Members asked about funding, reporting pathways, and how complaints reach DPPC, and the commissioner said the agency uses both mandated reporting and proactive outreach to identify and respond to abuse.

Transcript Highlights:

• the last two biennia for a pretrial services pilot program to help courts expand the use of these services
• The first being supportive services.
• Services in this category focus more on providing referrals to community services that can help address
• The next is assistance services.
• count as pretrial services.

Summary: The Joint Legislative Audit and Review Committee heard a State Auditor’s Office performance audit on expanding the use of pretrial services in Washington. Auditors said most of the 14 local courts they reviewed wanted to expand or implement pretrial services but faced barriers such as funding, limited community resources, and public safety concerns. The audit found variation in how courts use pretrial services, potential disparities in who receives them, and major data limitations because most courts do not track pretrial outcomes in an accessible, standardized way. Auditors recommended that local courts engage stakeholders early, improve data collection and evaluation, and that the Administrative Office of the Courts provide more standardized guidance and support. They also noted the legislature had funded an AOC pilot program to help courts expand pretrial services. Court representatives from Spokane Municipal Court, Grays Harbor County District Court, and Yakima County described their own programs and supported the audit’s general conclusions. Spokane officials said their pretrial unit, funded locally and built around risk and needs assessments, had reduced bail use, detention time, failures to appear, and recidivism, but emphasized the need for stable funding and better public understanding of pretrial alternatives. Grays Harbor staff similarly said pretrial supervision and least-restrictive alternatives save jail costs and reduce reoffending, but that collecting data across all cases is labor-intensive and difficult without dedicated staff. Yakima and Spokane also highlighted the value of integrated case-management systems and centralized data tracking. Committee members asked about how reduced detention time occurs, how courts can communicate cost savings and public safety outcomes, and why many courts struggle to track pretrial data. Auditors explained that early risk and financial screening helps judges make quicker release decisions and that better data and stakeholder communication are key to building support. No formal action or vote was taken; the committee held the required hearing and then adjourned after public testimony was invited and written testimony information was provided.

Transcript Highlights:

• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.
• They brought that service in.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to behavioral health as the main topic. Representatives Woodridge and Vaught described the work of the behavioral health working group, saying Arkansas needs a more proactive system that improves access, reduces red tape, and focuses on a few achievable policy changes for the 2027 session rather than many bills. Members discussed barriers such as low reimbursement, workforce shortages, licensing and credentialing hurdles, rural access problems, and the need to better use community providers, compacts, and step-down services. Director Paula Stone of DHS’s Office of Substance Abuse and Mental Health gave a detailed overview of the behavioral health system. She said Medicaid pays for more than 75% of behavioral health services in Arkansas and explained that when people are jailed or admitted to the state hospital, Medicaid generally stops, leaving state general revenue to cover care. She described current efforts including family-centered treatment for children, community reintegration group homes, a new adolescent substance use disorder residential unit, expanded community mental health center contracts, a secured restoration unit to reduce state hospital backlogs, and an IMD waiver to allow Medicaid payment for certain residential services. She also said DHS is working on crisis services, forensic evaluations, and provider rebidding in areas previously served by ERISA. Members asked about reimbursement for jail services, the lack of a statewide behavioral health dashboard, civil commitment options, crisis stabilization units, and whether Arkansas should expand step-down or long-term facilities for people who cannot safely return to the community. Stone said the state hospital backlog remains significant, average stays are still about 14 months, and crisis stabilization units have had mixed success, with Fort Smith and Jonesboro performing better than Fayetteville and Little Rock. The meeting ended with a commitment to continue the work, with more substantive discussion planned for August.

Transcript Highlights:

• We offer various services, and I would point out that many of these services are not covered by Medicare
• We offer various services, and many of these services are not covered by Medicare, nor are they covered
• </c> for providers offering specific Services for providers offering specific Services if<00:13:21.160
• through our state plan services.
• says if your services are services says if your services are covered<00:36:29.160><c> in</c><00:36:29.280

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services met with a quorum still coming together and first handled roll call and minutes. The main presentation came from the Department for Medicaid Services, with Commissioner Lisa Lee and CFO Steve Beckle giving an overview of Kentucky Medicaid, its federal-state financing structure, and the department’s 1915(c) home- and community-based waiver programs. They explained FMAP funding levels for traditional Medicaid, administration, IT, expansion adults, and CHIP, and noted the size of the program, including more than 600,000 Kentucky children eligible for Medicaid or CHIP, about 485,000 expansion adults, over 69,000 enrolled providers, and $18.5 billion in 2024 expenditures. A major focus was the waiver system, including the acquired brain injury waivers, model waiver, independence waiver, Michelle P. waiver, and Supports for Community Living waiver. The department said these waivers are intended to keep people with physical or developmental disabilities in home and community settings rather than facilities, and that many services are not covered by Medicare or commercial insurance. Officials described participant-directed services, interagency administration, and eligibility rules, including that some waiver programs use the child’s income only rather than family income. They also reported an unduplicated waiver wait list of 13,930 people and said the General Assembly had added waiver slots in the last budget, including 650 ABI slots and 1,275 more to be allocated July 1, 2025. The department also discussed a waiver rate study conducted by Guidehouse, explaining that CMS requires a defensible rate methodology because there is no Medicare or commercial benchmark for many waiver services. They said the study used cost and wage surveys, provider and stakeholder input, and aimed to improve transparency, provider stability, and rate parity. Officials reviewed prior COVID-era Appendix K rate increases and budget-driven increases, and said the budget ultimately funded rates at about 70% of the benchmark study, while preserving higher existing rates where needed so no provider would be cut. They highlighted larger differences in behavioral support and case management rates, and said a public report is available. Members asked several questions about the potential impact of federal FMAP changes, especially possible reductions in the enhanced match for expansion adults and Medicaid IT/admin activities. DMS said any FMAP reduction would require more state general fund dollars, estimating about $75 million for each 1% drop in the expansion match, while impacts on administrative IT funding would depend on the systems being built or implemented in a given year. Members also pressed for clarification on waiver wait-list procedures, funded versus filled slots, and what happens when someone on the wait list is later found ineligible. DMS said people on the wait list may not yet have been assessed, can be reevaluated if conditions change, and are still eligible for regular Medicaid state-plan services if they qualify, even if they are waiting for waiver services.

Transcript Highlights:

• Business services supported residential services.
• for your phone service.
• , not just to voice service.
• service standards, right?
• or improve their service.

Keywords: 988, house, all

Transcript Highlights:

• And so that's a step-down service.
• They provide a service called restoration, but then they also provide some services.
• So here are our adult services.
• So we'll be able to provide that service and pay for that service for individuals.
• services manual.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to a broad discussion of behavioral health policy, taking up work previously handled by a behavioral health working group. Representatives Wooldridge and Vaught described major gaps in Arkansas behavioral health care, emphasizing access problems, workforce shortages, rural service barriers, low reimbursement, and the need to move from a reactive crisis system to more proactive community-based care. Members discussed possible 2027-session priorities such as reducing red tape, improving provider licensing and supervision pathways, expanding billing codes and reimbursement structures, and considering interstate compacts and other workforce fixes. A major focus was the state’s crisis and forensic system, including long waits for competency evaluations, the backlog at the Arkansas State Hospital, and the use of county jails for people awaiting treatment. DHS Director Paula Stone explained that Medicaid pays for most behavioral health services, but cannot pay for services in jails or state hospitals because those individuals are treated as inmates of public institutions, leaving state general revenue to cover much of that cost. She outlined DHS efforts including secured restoration beds, therapeutic communities, community mental health center contracts for jail-based services, and plans for an institution-for-mental-disease waiver that could allow Medicaid payment for certain hospital-based services. Members also discussed crisis stabilization units, with DHS noting that Fort Smith and Jonesboro have been more successful than Fayetteville and Little Rock, largely because of location, partnerships, and law enforcement coordination. Questions covered reimbursement for county jails, step-down facilities, civil commitment options, non-emergency behavioral health transportation, and whether DHS should create a bed-availability dashboard similar to hospital systems. DHS said it does not currently have such a dashboard but is exploring the idea. The meeting ended with a commitment to continue the work, with more detailed discussion planned for August, and the subcommittee adjourned.

Transcript Highlights:

• Who are receiving services.
• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.

Keywords: 1204, all