Transcript Highlights:

• We do take that into consideration as well because Medicare, Medicaid, and other payers do also fund
• and support those beds in the system. ...payers do also fund and support those beds in the system.
• So we are one payer source, and we work very closely through the provider to make sure that we're maximizing
• case manager, to employ people who fight for those dollars and track them constantly and hound our payers
• So to the extent that we can take individuals that are identified in a primary care clinic that also

Summary: The Health Care Budget Subcommittee held a panel discussion on Florida’s mental health and substance abuse system, with representatives from DCF, AHCA, two managing entities, and two providers describing how the state’s behavioral health network is funded and operated. Members focused on the implementation of prior legislative investments, especially the $50 million in recurring funding from Representative Maney’s bill and the earlier $126 million community behavioral health appropriation. Witnesses said the newer funds were used mainly for crisis beds, discharge planning, outpatient services, regional collaboratives, and a USF Marchman Act report, while the larger behavioral health appropriation supported CAT, FACT, FIT, forensic teams, residential and outpatient services, and crisis care, with most dollars going directly to services and only a small share to administration. A major theme was access to crisis care and the role of mobile response teams, 988, and central receiving facilities in diverting people from Baker Act admissions and reducing readmissions. DCF and providers said mobile response teams have expanded, are being used to de-escalate crises and connect people to care, and have shown strong diversion results and reductions in Baker Acts in some regions. Members also asked about waitlists, children in crisis, and how to handle people without housing or support; providers said discharge planning is individualized but often constrained by homelessness, transportation, and a lack of safe placements, and several witnesses identified housing as one of the biggest barriers to recovery and stability. The committee also examined provider sustainability, reimbursement, and funding gaps. Witnesses described delays caused by contract timing, cost allocation rules, and Medicaid reimbursement rates that do not always keep pace with labor and operating costs, especially for smaller providers and rural networks. DCF and AHCA said managing entities can provide advances, retroactive rate adjustments, and technical assistance, and that Medicaid managed care plans have network standards and complaint/dispute processes. Members raised concerns about a reported $7 million loss in federal non-sustainable funds, provider closures, and whether there is a formal ombudsman process for disputes; DCF said the federal reductions were known and tied to one-time funds, and that the department generally handles provider issues informally while working with managing entities to preserve continuity of care.

Transcript Highlights:

• To date, such loans have been paid back with interest to ensure that the fee payers for the lending fund
• we continued to send those letters repeatedly over and over again to initially get the number of payers
• Few years, we've gotten the portion of payers who pay by electronic means up from in the mid-30% range
• But if a payer certainly just simply refuses to, then we do have the penalty.
• This decrease reflects two primary things.

Summary: The Assembly Budget Subcommittee 5 on State Administration held a May Revise hearing focused on state administration proposals, with the chair noting no actions would be taken and all items would remain open. The committee heard presentations on a range of budget proposals, including technical adjustments for the Governor’s Office of Service and Community Engagement and the California Workforce Development Board, security and election-related funding for the Secretary of State, modernization and loan-backfill requests for the Department of Consumer Affairs, and multiple Employment Development Department updates covering EDD Next, UI and DI/PFL benefit estimates, workforce funding, and an EMT training reappropriation. Several items drew discussion from the LAO and committee members. The LAO generally supported technical or modernization items such as PERB’s implementation requests, GoServe’s College Corps adjustment, the Secretary of State’s security and HAVA grant items, and the Board of Pharmacy modernization proposal, but raised concerns about the Bureau for Private Postsecondary Education’s proposed $10 million General Fund backfill and interest-free loan language. For EDD, the LAO flagged the size of the DI/PFL benefit adjustment and the unusual structure of the document management system proposal within EDD Next, while EDD said the changes reflected higher participation and benefit levels after SB 951 and ongoing modernization needs. The Department of Industrial Relations drew the most extensive questioning. It proposed funding for legal unit reclassifications, EAMS and Cal/OSHA data modernization, a new Cal/OSHA emerging technologies unit, a COYA reappropriation, and trailer bill changes requiring electronic payment of employer assessments and adjusting the Workers’ Compensation Appeals Board timeline. Members pressed DIR on high vacancy rates, long wage theft and workers’ compensation backlogs, low collection rates for fines, and the need for clearer workload and outcome measures. DIR said the requests were intended to improve efficiency, support audits and corrective action plans, and better address emerging workplace risks, while the LAO said the workload drivers behind delays remain unclear. The hearing also included support for CalHR’s employee assistance program consolidation and CDT’s proposal to expand “Poppy,” a statewide generative AI assistant for state employees.

Transcript Highlights:

• This graph, this would be the primary. So if you are dual eligible, Medicare is your primary.
• We are also exploring a primary care residency to increase the number of primary care doctors who can
• Are we deficient of primary care doctors in the rural hospitals?
• A lot of that's primary care as well.
• So yes, primary care is very key.

Transcript Highlights:

• HCMC provides primary care and treats specialized situations like catastrophic injuries such as burns
• Every hospital system struggles with achieving a balanced payer mix, but HCMC has less control over this
• c> but<00:03:05.959> HCMC<00:03:06.840> has<00:03:07.080> less a balanced payer
• mix, but HCMC has less a balanced payer mix, but HCMC has less control<00:03:07.959> over<00:
• You cannot treat the ED like a primary You cannot treat the ED like a primary care<00:56:33.320>

Bills: HF4841, HF4234, HF3697

Keywords: Hennepin County, sales tax, health care facilities, ballpark improvements, tax revenue, HF4234, Minnesota private activity bonds, tax-exempt bonds, bond cap, aggregate bond limitation, residential rental projects, multifamily housing, affordable housing finance, housing bonds, public finance, bond allocation, private activity bond cap, Minnesota Statutes 474A.02, tax committee, tax refund

Transcript Highlights:

• It's those shadowy hedge funds that are the primary drivers of this vicious cycle.
• And ultimately, you know, those costs are passed on to rate payers.
• Okay, so that's how the long run moving on to rate payers.
• what I wanted to say about the division of utility outlays, outlays between shareholders and rate payers
• Allowing utilities to recover costs outside of the general rate cases, which should be the IOU's primary

Summary: The Assembly Committee on Utilities and Energy held a hearing on the California Earthquake Authority’s SB 254 report and broader options for reforming California’s utility wildfire recovery system. The chair framed the discussion around the Palisades and Eaton fires, the scale of wildfire-related costs on utility bills, and the need to weigh trade-offs among survivors, ratepayers, utilities, insurers, and taxpayers. The first panel featured wildfire survivors William Abrams and Joy Chen, who described long delays in compensation, housing insecurity, and what they viewed as a system that protects utility shareholders more than victims. They urged greater transparency, clearer accountability for utility spending and safety performance, faster and fuller compensation for survivors, and reforms such as independent audits and better alignment of utility incentives with wildfire prevention and restitution. The second panel began with Tom Welsh of the California Earthquake Authority, who explained that the SB 254 report was intended as a broad inventory of policy pathways rather than recommendations. He described the report’s process, including stakeholder submissions, workstreams, and a convergence process, and outlined the current wildfire fund structure: utilities remain liable, the fund reimburses eligible claims after a covered wildfire, and the CPUC later determines prudency and possible reimbursement back to the fund. RAND’s Lloyd Dixon summarized compensation data, saying utilities paid about $38 billion between 2017 and 2024, with major shares going to injured parties, insurers, and public entities, while litigation costs and survivors’ own losses remain substantial. He noted that legal fees and delays reduce the amount survivors ultimately receive. Utility and public-interest witnesses offered differing views on the report’s pathways. PG&E’s Tyson Smith said the report shows inaction is the worst outcome and argued for community wildfire risk reduction, equitable allocation of catastrophe costs, and state-led resilience tools. LADWP’s Fernando Valero emphasized the vulnerability of municipal utilities and cities, and supported inverse condemnation reform, a state-sponsored liability insurance framework, damages and subrogation limits, and stronger insurance access. Consumer Attorneys of California’s John Fisk argued that IOU-caused fires are not natural disasters but the result of negligence and sometimes criminal conduct, and opposed reducing utility liability while supporting stronger oversight and audits. The Public Advocates Office’s Nathaniel Skinner focused on affordability, saying ratepayers already bear large and growing wildfire costs and warning against shifting more costs onto bills without measurable risk reduction and tighter accountability. Committee members then began questioning witnesses about what counts as measurable mitigation, how to define full and fair compensation, and how any fast-pay process should work.

Transcript Highlights:

• So that's the rough split of how those payers essentially pay on a unit basis.
• Triricare other smaller payers. Triricare other smaller payers.
• essentially pay on a unit unit payers essentially pay on a unit unit basis. basis. basis.
• It really was about primary care, maybe integrated with behavioral health.
• It really was about um primary basics.

Bills: HB0004

Keywords: medical assistance, birthing centers, healthcare, Medicaid, Wyoming, 916, all

Transcript Highlights:

• I think, in many cases, they would be seen by their primary care practice outside the school for the
• I think, in many cases, they would be seen by their primary care practice outside the school for the
• enrollment um just unlike primary enrollment um just unlike primary Insurance<00:37:16.400> where
• One of which would be a single-payer system.
• <02:14:35.960> systems structures such as Single Payer systems structures such as Single Payer

Keywords: 1189, house, all

Transcript Highlights:

• Are these the two primary types of solar systems? While not mentioned here, might qualify?
• Are these the two primary types of solar power systems? So, Mr.
• And so I just wrote down six possible payers in this case: your home insurance, if you have it, the ratepayers
• Either way, the rate payer is going to see some cost.
• That's a double hit to the rate payer.

Keywords: 996, all

Transcript Highlights:

• The bill gives Kentucky primary oversight with the Energy and Environment Cabinet and aligns the state
• The bill<00:08:15.080> gives<00:08:15.480> Kentucky<00:08:16.120> primary<00:08:
• 16.600> oversight<00:08:17.880> um bill gives Kentucky primary oversight um bill gives
• Kentucky primary oversight um with<00:08:18.960> the<00:08:19.160> Energy<00:08:19.520>
• <00:25:37.600> than<00:25:37.800> otherwise lower to the rate payer than otherwise

Keywords: Meeting Start 00:00 Attendance Roll Call 00:25 HB 667 Discussion 01:21 HB 667 Roll Call Vote 03:56 HB 677 Discussion 05:01 HB 677 Roll Call Vote 11:51 HB 535 Discussion 13:33 HB 535 Roll Call Vote 34:46 HJR 77 Discussion 38:33 HJR 77 Roll Call Vote 44:23, 958, all

Summary: The committee first considered House Bill 667, described by the sponsor as a cleanup measure to a 2024 solid waste law. Testimony said the bill would clarify issues involving indirect access to protected information, contractors and consultants, Open Records Act interactions, and remedies when protected material is obtained. The committee voted 13-0 to pass the bill favorably and recommended it for passage on the House floor. The committee then took up House Bill 677, which would establish Kentucky’s legal and regulatory framework for carbon dioxide geological sequestration and help the state seek EPA primacy over Class VI injection wells. Supporters said the bill was the product of 18 months of work among industry, landowner, environmental, and cabinet stakeholders, and argued it would promote economic development, protect landowners, and support carbon-capture investment and related infrastructure, especially in Western Kentucky. An amendment was adopted by voice vote, and the bill then passed favorably with committee amendment attached. Finally, the committee discussed House Bill 535 as amended by a committee substitute. The bill would authorize securitization for certain investor-owned utilities with out-of-state assets, including Kentucky Power, to refinance assets such as the Mitchell plant and certain regulatory assets, with a two-year rate freeze and PSC review for net savings. Sponsors and supporters framed it as an affordability and jobs measure that could finance new natural gas generation at Big Sandy, create several hundred construction jobs, and support long-term economic development in Eastern Kentucky. Members raised concerns about utility fees, PSC discretion, and transparency; sponsors said the proposal would not be approved without overall savings and that applications would also be reviewed by the legislature, the Attorney General, and EPIC. The committee adopted the committee substitute and then passed House Bill 535 favorably, with several members explaining their votes and some noting continued reservations for floor consideration.

Transcript Highlights:

• So this lack of adequate and representative primary care physician workforce...
• care out and dissuading younger people from coming into primary care.
• And most of the people in primary care have left primary care to go to more lucrative settings like concierge
• medicine, direct primary care, aesthetics in our area.
• I heard the testimony regarding primary care physicians.

Keywords: 995, all

Summary: The Joint Committee on Mental Health, Substance Use, and Recovery held a public hearing on 17 bills focused on behavioral health workforce shortages, studies, and commissions. Chairs Mindy Domb and Senator John Velis opened by emphasizing the severity of the Commonwealth’s mental and behavioral health workforce crisis, the resulting gaps in access to care, and the legislature’s ongoing use of loan repayment programs, studies, and commissions to address these issues. They outlined hearing procedures and noted that testimony would be limited to three minutes, with written testimony also accepted. A major portion of the hearing focused on bills to expand the primary care workforce, including H. 2205/S. 1385, which would broaden eligibility for the Mass RePay loan repayment program. Testimony from the Massachusetts Medical Society, Senator Jo Comerford, and Dr. Kate Atkinson described severe primary care shortages, long wait times, physician burnout, high debt burdens, and the need to recruit and retain physicians in more practice settings and regions. Committee members asked about the likely impact of loan repayment, the role of nurse practitioners and physician assistants, and how to prioritize limited funding. Witnesses argued that primary care investment improves access and outcomes and that the bill would help sustain community-based practices. Another large block of testimony supported H. 2208/S. 1411, the proposed perinatal behavioral health care workforce trust fund, often referred to as the Moms Matter Act. March of Dimes, perinatal mental health advocates, doulas, clinicians, parents, and organizations such as the Boston Public Health Commission and Empty Arms Bereavement Support testified that postpartum depression, anxiety, substance use, and grief are widespread, often untreated, and worsened by long waitlists and a shortage of trained, culturally competent providers. Speakers repeatedly stressed that screening alone is not enough without a workforce to provide timely treatment, and several shared personal stories of postpartum illness, loss, and difficulty accessing care. The bill was also framed as a needed complement to the Commonwealth’s recent maternal health law, which increased screening and therefore increased demand for treatment. The committee also heard support for the Bridge Act, H. 2207/S. 1388, which would create mental health capacity grants for organizations serving communities at high risk of hate crimes or hate incidents. Testimony from the Jewish Community Relations Council and the bill’s sponsor described the mental health harms of hate, including anxiety, trauma, isolation, and loss of trust, and argued that community organizations need resources to build resilience and provide support. In addition, the committee heard from the Massachusetts Mental Health Counselors Association on H. 2218/S. 1380, which would update job classifications to explicitly include licensed mental health counselors and licensed supervised mental health counselors in state behavioral health roles. Witnesses said the change would modernize hiring, expand access, and better reflect current licensure and scope of practice. No votes were taken during the hearing, and the session ended with a motion to adjourn after all testimony was completed.

Transcript Highlights:

• So with those claims with just a primary diagnosis code of behavioral health or substance use, you can
• And the more diagnosis codes that you go down, for example, on a claim form, if you look at primary,
• <00:08:19.800> diagnosis<00:08:20.440> code<00:08:20.759> of just a primary
• secondary um third fourth um at primary secondary um third fourth um U<00:08:47.640> diagnosis
• <00:13:19.639> of Medicaid is the largest payer of Medicaid is the largest payer of Behavioral

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services held its first meeting and received an overview from the Department for Medicaid Services on Medicaid’s behavioral health and substance use disorder services. Commissioner Lisa Lee and CFO Steve Beal said Kentucky Medicaid serves about 1.4 million members, including over half of Kentucky children, with 485,000 expansion members, more than 69,000 enrolled providers, and total fiscal year 2024 expenditures of $18.5 billion. They said Kentucky covers a broad range of behavioral health services, and behavioral health provider enrollment has grown from a little over 4,500 in 2019 to nearly 8,000 in 2024. They also described how Medicaid spending and utilization are tracked through claims and encounter data, with most members served through managed care organizations. Members focused on sharp increases in certain behavioral health billing codes, especially peer-to-peer services, and asked about reimbursement, utilization review, and whether the growth reflected increased need or expanded coverage. DMS said the rise was partly tied to combining facility and nonfacility behavioral health fee schedules in 2023, choosing the higher reimbursement rate to avoid cuts, and that the department has seen an uptick in peer-to-peer services. In response to concerns about overutilization, DMS said it mailed a letter to behavioral health providers, is considering limits and prior authorizations for some services, and plans to create a standardized monthly behavioral health report to monitor trends consistently and identify when controls may be needed. Lawmakers also asked whether the provider network is sufficient and whether access is adequate, especially for children. DMS said provider enrollment has expanded because behavioral health services were added to Medicaid in 2014 and because demand increased after COVID, but acknowledged studies showing children have less access than adults and said that would be an area of focus. The department said managed care organizations are required to ensure access to needed services and that current trends indicate access is available, though one member disagreed and said workforce shortages remain a major concern. Another member asked about non-emergency medical transportation spending, and DMS explained that it is handled through a capitated arrangement administered by the Transportation Cabinet rather than directly by the managed care organizations.

Transcript Highlights:

• Care at the of Rural Health and Primary Care at the Health<00:13:28.000> Department.
• In<00:15:53.680> rural<00:15:54.000> areas,<00:15:54.399> primary<00:15:54.720><
• c> care<00:15:54.959> providers In rural areas, primary care providers In rural areas, primary
• ,<00:47:38.319> for<00:47:38.400> example,<00:47:38.800> from public payers,
• for example, from public payers, for example, from Medicare,<00:47:39.599> where<00:47:39.920

Keywords: 918, senate, all

Summary: The Select Subcommittee first took up adoption of three previously prepared nonpartisan committee summary reports dated October 15, November 13, and November 21. Senator Rasmusson objected to the lack of advance notice about the day’s testifiers and criticized the practice of having nonpartisan staff summarize what he described as a partisan agenda. The chair responded that the committee’s purpose is to gather information, not hear bills, and that the summaries were intended as neutral resources for the Senate. Senator Coopek moved adoption, the motion was opposed by Rasmusson and another member, and the motion passed. The committee then turned to the day’s hearing on federal impacts on Minnesota, with the chair focusing on federal funding threats and the effect of congressional budget actions on health care, especially in greater Minnesota. The first presentation came from the Minnesota Department of Health on the state’s rural health transformation work. Assistant Commissioner Carol Broom introduced the team and described the rural hospital transformation program as a major opportunity to invest in rural health, while acknowledging longstanding challenges such as demographics, transportation barriers, and the financing of care. Nitha Moibi outlined the state’s rural health chart book and data showing an aging population, workforce shortages, and many health professional shortage areas, and described proposed strategies including workforce pipelines, bridge payments for low-volume birth hospitals, telehealth access points, mental health urgent care, and chronic disease prevention. Acting Assistant Commissioner Anna Ashby of the Minnesota Management and Budget office explained the state’s application to CMS for the Rural Health Transformation Program, which was created in federal law and awarded Minnesota just over $193 million for federal fiscal year 2026. She said the application was shaped by public comments, stakeholder meetings, and legislative outreach, and included initiatives on preventive care, workforce, care access, behavioral health, and provider financial stability. She also reviewed implementation constraints, including a January 30 revised budget deadline, limits on administrative spending, restrictions on using funds to offset Medicaid losses, and the need to show measurable progress to remain eligible for future funding. The presentation noted that most year-one funding would go to rural hospitals, with additional support for federally qualified health centers, community mental health centers, tribal partners, and technical assistance.

Transcript Highlights:

• Um, though Medicaid is a large payer in this space.
• Um we are a payer uh provider setting.
• source of support and respit for primary source of support and respit for primary caregivers.<00
• payers are involved too.
• Um the question this case public payers.

Keywords: 1183, house

Transcript Highlights:

• The primary purpose of the board, its duties are to authorize NMFA to make loans and grants from the
• So that is the primary driver of the funding that you see, and you'll see.
• So that's the primary purpose. That really hasn't changed.
• I will turn you to page five because, again, the Water Trust Board's primary activity is to evaluate
• mean to us as rate payers?"

Bills: HB3767, HB3934, HB4199, HB4336, HB2947, HB3834, HB4302, HB4095, HB3287, HB3649, HB4430, HB4431, HB2059, HB3647, HB3986, HB3548, HB3661, HB4346, HB3075, HB4273, HB3391, HB4128, HB3557, HB3239, HB3982, HB2123, HB2979, HB2997, HB3148, HB4108, HB4143, HB4266, HB2053, HB4058, SR30

Keywords: dentistry, licensing, dental hygiene, foreign-trained dentists, temporary license, public health, emergency response, child care, workforce, pilot program, affordable care, income eligibility, interventional pain management, pain management clinic, chronic pain, acute pain, spinal injections, epidural steroid injection, peripheral nerve block, nerve ablation

Bills: HB4274, HB3076, HB4358, HB3312, HB3288, HB3885, HB3147, HB4299, HB4265, HB4266, HB3011, HB3143, HB3144, HB3881, HB3519, HB3522, HB3530, HB2976, HB4459, HB3142, HB4316, HB4338, HB4230, HB3985, HB3883, HB4335, HB3416, HB3417, HB3418, HB3619, HB3624, HB3463, HB4423, HB3342, HB3645, HB3647, HB3887, HB4430, HB4431, HB2964, HB3834, HB4193, HB4272, HB3277, HB3148, HB3651, HB3323, HB4287, HB4105, HB3304, HB3345

Keywords: HB4274, Oklahoma schools, interdistrict transfer, open transfer, school enrollment, military families, active duty, National Guard, Reserve orders, military installation, residency requirements, district of choice, public school transfer, student transfer, special education, IEP, Section 504, military housing, base housing, electronic enrollment

Transcript Highlights:

• Hawaii Primary Care >> Um, let's see. Hawaii Primary Care Association. Association.
• shortages of the primary care physician. shortages of the primary care physician.
• She did not have a primary care provider because her primary care provider had died.
• primary care spend. primary care spend.
• rates for primary care services. rates for primary care services.

Keywords: 910, house, all

Summary: The joint hearing opened with House Bill 1969, which would provide state funding for colorectal cancer screenings for uninsured and underinsured residents. The Department of Human Services said it supports the goal of early screening but would need new administrative capacity, including a program manager and claim pre-screening, to run the program. The Department of Health supported the measure and cited low screening rates in Hawaii, noting an educational campaign to encourage screening. The Insurance Division raised concerns about reliance on federal FAQs, warning that guidance can change and may create state cost exposure. Supporters including the American Cancer Society Cancer Action Network and the Hawaii Medical Association argued the bill would close a preventive-care gap, reduce late-stage diagnoses, and save long-term costs; the committee also discussed implementation costs, estimated by DHS at roughly $1.4 million to $2 million annually plus administrative expenses, and a 6-month to 1-year timeline to establish the program. The committee then took up House Bill 1965, which would require health carriers to spend at least 6% of total medical expenditures on primary care providers. The Insurance Division said several provisions raise technical and legal concerns, including the premium freeze, the medical loss ratio language, the lack of an existing external review process for downcoding claims, and a new mandate for medically necessary inter-island transportation that could trigger an ACA defrayal. The Department of Human Services supported the intent but suggested broader language to include primary care supports and services, and noted that QUEST integration plans already invested at least 9% of total medical expenditures in primary care in 2024, with additional spending on supports and low-value care reductions. State health planning officials strongly supported the bill as an investment in primary care, saying it could improve outcomes and lower long-term costs, though they acknowledged a possible temporary premium increase during the transition. Testimony in support emphasized Hawaii’s physician shortage, especially on Maui, the Big Island, and other neighbor islands, and warned that clinics are under financial strain and may close without higher primary care reimbursement. The Hawaii Healthcare Task Force, AARP Hawaii, and other supporters said the bill would help retain providers, improve access for Medicare and Medicaid patients, and prevent downstream costs from emergency room use and avoidable hospitalizations. No votes or final committee action were taken in the portion of the hearing provided.

Transcript Highlights:

• investments in prior budget acts, included short-term and long-term strategies centered around two primary
• goals. budget acts included short-term and long-term strategies centered around two primary goals, the
• Our primary tools are data and policy research, program evaluation, grant making, technical assistance
• And also bring in other payers and funding sources.
• Community members can access a local mobile crisis team through two primary pathways.

Summary: The subcommittee heard presentations from the Department of State Hospitals (DSH), the Commission for Behavioral Health, and the Department of Health Care Services (DHCS) on budget proposals and implementation updates. DSH outlined its proposed 2026-27 budget, including funding for patient operating expenses, IST solutions savings, conditional release program costs, LPS bed allocation changes, electrical infrastructure projects at Napa and Patton, SB 380 transitional housing feasibility work, and expanded dental services at Metropolitan and Patton. DSH also reported that it has met court-ordered IST treatment benchmarks in the Stiavedi v. Clinton case, with average time to initiate treatment down to about five days and pending placements reduced to roughly 250, while noting that Proposition 36 could increase referrals and SB 1323 may divert some individuals earlier into community-based treatment. Members asked about rising outside hospitalization costs, Medicare enrollment, the timing and structure of capital projects, and whether IST solution funds are being fully used; DSH said the savings reflect slower-than-expected ramp-up of community programs and that the Central California FACT replacement program is still on track for January 2027 activation. The Commission for Behavioral Health described its role under the Behavioral Health Services Act (BHSA), including data, evaluation, grantmaking, technical assistance, and transparency work. It highlighted the new statewide Innovation Partnership Fund, a five-year, $20 million-per-year program with small and large grant categories; the first RFA drew strong interest, with more than 400 questions and over 1,000 bidders’ conference participants. The Commission also discussed a proposed extension to spend down about $4.1 million remaining for the Alcove Youth Drop-in Center grants so sites can finish implementation and Stanford can complete the final evaluation. Members asked about grant duration, whether projects can be renewed, what qualifies as innovation, and whether the fund could support service delivery rather than awareness campaigns or training; the Commission said awards are expected to be three-year contracts and that proposals must be new or meaningfully expanded approaches that support BHSA priority populations. DHCS reviewed major behavioral health changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, updated specialty mental health access criteria, and new substance use treatment standards based on ASAM’s fourth edition. DHCS reported strong contingency management results, with more than 13,000 members served and 95% testing negative for stimulant use during treatment, and said 21 Indian health care providers have been approved to offer traditional health care practices. It also described BH Connect initiatives such as the $1.9 billion access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation by four counties, and transitional rent services. On BHSA implementation, DHCS said it is not tracking individual county contract cuts but is monitoring county plans and statewide outcomes, while stakeholders raised concerns about local prevention and service gaps. DHCS also outlined its H.R. 1 implementation strategy, including outreach, streamlined renewals, exemptions for disabled, substance use, and medically frail individuals, and proposed clinic navigator and outreach funding; it said it has not yet produced a focused estimate of H.R. 1 impacts on behavioral health populations. The discussion ended with DHCS noting that B-CHIP bond funding has supported 437 infrastructure projects, creating 546 new or expanded facilities and more than 9,500 residential beds across the state.

Transcript Highlights:

• So if there's some other payer, it's a payer of last resort, but that's the case for Medicaid and Medicare
• They're payers of last resort in a way, but in this it's even more like you cannot just go if there's
• So if there's some other payer, it's a payer of last resort, but that's the case for Medicaid and Medicare
• <00:15:23.839> of there's some other pay it's a payer of there's some other pay it's a payer
• <00:15:27.600> of Medicaid and Medicare they're payers of Medicaid and Medicare they're payers

Keywords: 958, all

Summary: The Health Services Committee heard a presentation from Dr. Steven Stack, Secretary of the Cabinet for Health and Family Services, on Kentucky’s Rural Health Transformation Program. He said Kentucky received about $213 million in federal funding, among the highest awards nationally, after a fast application and negotiation process. He emphasized that the grant is time-limited, must be used for the specific goals in the state’s application, and cannot be treated as a general bailout or replacement for existing funding. He also noted the state will use a website, ruralhealthplan.ky.gov, to share the full application, award terms, and future opportunities. Dr. Stack outlined five focus areas: maternal health and prenatal/early childhood supports; EMS and trauma response workforce and transfer capacity; behavioral health crisis care through the EMPATH model and mobile crisis services; oral health access through more hygienists, telehealth, and hub-and-spoke models; and rural community hubs for chronic disease prevention and innovation, including food-as-medicine and healthier lifestyle interventions. He stressed that the program is meant to be transformative, not duplicative, and that it cannot pay clinician salaries, fund new construction, replace EMR systems broadly, or duplicate billable services. He said the state will work with community partners, hospitals, universities, and others, including the Foundation for a Healthy Kentucky, to begin implementation. Members responded positively overall. Senator Berg praised the award and the goal of integrating care across the state, but raised concerns about access to prenatal care and about possible future changes to water fluoridation, warning both could harm children and rural families. The chair and other members thanked Dr. Stack for the update and congratulated him on the award. No votes or formal committee actions were taken during this portion of the meeting.

Transcript Highlights:

• care, mental health, and SUD as primary care, mental health, and SUD care<00:21:06.799> as<00
• Tax programs that assess a rate on Medicaid revenue that is higher than other payers will not be allowed
• 00:28:20.480> care than um the rest of the health care than um the rest of the health care payers
• . payers. payers.
• will not be higher than other payers will not be allowed<00:28:34.880> even<00:28:35.120>

Keywords: 919, house, all

Summary: The Department of Human Services briefed the committee on how the federal HR1 law will affect Minnesota Medicaid and related programs. Budget Director Elise Bailey said the 900-page bill makes sweeping changes that will reduce coverage, increase administrative complexity for counties and tribal governments, raise uncompensated care for providers, and reduce federal funding. She reviewed current Medicaid spending and enrollment, emphasizing that the largest impacts will fall on the adult expansion group (adults ages 21-64 without children), which currently receives a 90% federal match. Bailey walked through several major provisions: work and community engagement requirements for the adult expansion group beginning January 1, 2027; six-month renewals for that same group; shorter retroactive coverage periods; new cost-sharing requirements for expansion enrollees above 100% of poverty; narrower Medicaid eligibility for certain lawful noncitizens; limits on provider taxes and state-directed payments; a reduced federal match for emergency medical assistance; and tighter federal rules on payment error penalties. She said many provisions require state law changes and additional federal guidance, and she cited research from Georgia suggesting work requirements increased administrative burden and caused coverage losses without increasing employment. The department estimated fiscal effects including reduced Medicaid spending in some areas but higher state costs in others, such as MinnesotaCare, emergency medical assistance, administrative systems, and provider uncompensated care. Bailey said the immigration-status changes would shift some people from Medical Assistance to MinnesotaCare, and that provider-tax and state-directed-payment changes could reduce future funding to hospitals and other providers. No votes or formal committee actions were taken in the portion provided; the presentation was informational and the department indicated it would return with proposed state-law language as needed.