Transcript Highlights:

• We just wanted to share an overview about the HDCs.
• Services Division of Developmental Disability Services.
• We act as subject matter expert on all IDD programs and services, including autism services, OT/PT speech
• We are sharing that information 100%.
• and so we've been sharing that with other HDCs.

Keywords: 1204, all

Summary: The Joint State Agencies committee met to approve the October 8, 2025 minutes and then held an extended oversight discussion with the Department of Human Services about the death of Zachary Moore at the Southeast Arkansas Human Development Center (later clarified in testimony as the Warren facility). DHS officials described Moore’s background, said he died after being restrained in a prone position for about 13 minutes, and reported that a nurse later administered a chemical restraint before CPR was attempted. They said the agency settled with the family for $725,000, terminated 13 staff members, changed facility leadership, and brought in consultants under a directed plan of correction from the Office of Long-Term Care to review policies, retrain staff, and conduct a root-cause analysis. Later testimony clarified that the death certificate listed the manner of death as homicide and the cause as physiologic stress associated with struggle and prone restraint; committee members also noted that six people had been charged with manslaughter and neglect of a vulnerable person. Members focused on restraint policy, staff training, chain of command during emergencies, family communication, and whether warning signs had been missed. DHS said it has written restraint protocols, annual restraint training, and a mortality review process, but acknowledged that the Warren facility had multiple failures, including use of a prone restraint, improper chemical restraint, poor supervision, inadequate communication, and problems with equipment and behavior plans. Officials said they were revising policies, creating clearer crisis-team roles, and retraining staff, and that the consultant work would be shared across the other human development centers. Several members pressed DHS on why the family had not been kept informed, why the agency was not prepared with basic facts, and whether a more formal independent audit of facilities should exist. The committee also discussed broader staffing and funding issues across the human development centers. DHS said CNAs start at about $39,000 a year, that the centers rely heavily on float and contract staff, and that there are about 2,000 people on a waiting list for services. Members argued that low pay, turnover, and rural staffing shortages contribute to risk and asked for recruitment and retention plans, possible regional pay differentials, and more legislative support. DHS said it is drafting a systemwide retention and recruitment plan and expects to bring it to ALC, while also implementing a separate rate study for certain PASS program services in January 2027. The meeting ended after comments from Zachary Moore’s mother, Angela Stevens, who said money cannot replace her son and urged the state to ensure no other family experiences the same loss; the committee asked DHS to keep members and Ms. Stevens updated on consultant reports and recruitment efforts before adjourning.

Transcript Highlights:

• California's hospitals share the author's core principle. with those requirements.
• California's hospitals share the author's core principle.
• So please come forward to the stand-up mic and share with us your name, your affiliation, if you have
• And I want to thank your witness for sharing her story. I'm so sorry for your loss.
• If so, please come forward to the mic and share with us your For the bill.

Keywords: 987, senate, all

Summary: The committee heard several bills focused on privacy, AI, consumer protection, and public safety. AB 1979 would require a licensed health care professional to retain final clinical judgment when using AI tools in health care and would limit chatbot access to medical records; supporters, including nurses and TechEquity, said it preserves human decision-making, while hospitals and industry groups opposed it unless amended, citing burdens and training concerns. The bill passed 6-1 and was placed on call. AB 2624 would expand the Safe at Home confidentiality program to immigrant service providers and workers facing harassment and doxing; supporters described threats against advocates and their families, while one senator raised concerns about a private right of action and penalties. The bill passed 4-1 and was placed on call for further committees. AB 2103 would make Engaged California a permanent statewide public engagement program; supporters said it broadens civic participation and transparency, while concerns were raised about partisan balance in topic selection. It passed 6-0 and was placed on call to Appropriations. The committee also considered AB 2, which would set statutory damages and other financial accountability measures for large social media platforms when negligence causing harm to children is proven in court. The author and supporters, including a parent who lost her daughter and child-safety advocates, argued that stronger remedies are needed because social media design features are harming children and existing enforcement has been insufficient. Opponents, including TechNet, CCIA, CalChamber, and others, argued the bill blurs content and conduct, could increase litigation, and is unnecessary given existing lawsuits and verdicts. Several senators said the bill was a consumer-protection measure and supported it; it passed 5-0 and was placed on call. AB 883, as amended, would use California’s Delete Act/DROP system to help elected officials and judges remove personal information from data brokers, while also shortening the deletion timeline for all Californians from 45 to 30 days. Supporters said the bill responds to rising threats against public servants and improves privacy tools broadly; some opponents removed or softened opposition after amendments, though CalChamber and CCIA remained opposed unless amended, largely over the private right of action. The bill passed 4-0 and was placed on call. The committee then recessed briefly before taking up AB 2023, a chatbot safety bill for children that would require age verification, safety audits, default protections, parental controls, crisis-response measures, and limits on targeted ads and data sharing. Supporters said it builds on prior AI and child-safety legislation and is needed to prevent harms like self-harm and manipulation; opponents raised concerns about vague harm standards, audit requirements, and liability. The hearing continued with testimony and committee discussion, but no final vote on AB 2023 was shown in the transcript.

Transcript Highlights:

• for for legal services. Is that correct? for for legal services. Is that correct?
• shared in our travels across the state. shared in our travels across the state.
• capital procurement services for KCTCS. capital procurement services for KCTCS.
• Then other than the fee for service, service, service, what<01:21:34.320> benefit<01:21:34.719
• uh rates just for fee for service? uh rates just for fee for service?

Keywords: 958, all

Summary: The committee met with a quorum and first approved the minutes from its May 13 meeting. Members then reviewed a deferred contract with the Kentucky Board of Pharmacy for the Kentucky Pharmacist Recovery Network (KYPRN), a program that provides monitoring and support for pharmacists and pharmacy interns with substance abuse or mental health issues. Board representatives explained that the contract is a long-running arrangement, renewed periodically, with an option for two additional two-year renewals. Senators asked about the program’s structure, participation trends, follow-up, and consequences for noncompliance. The board said enrollment has remained fairly consistent at about 52 participants, with roughly 500 participants over the life of the program, weekly and monthly check-ins during the five-year typical enrollment period, and possible additional sanctions if participants fail to meet obligations. The committee then approved the contract. The committee next considered a group of economic development contracts, including items from the Cabinet for Economic Development. Secretary Jeff Null and general counsel Matt Wingate testified about contracts tied to regional innovation and entrepreneurship hubs. Members focused on the large differences in funding between regions and pressed for more support for rural and eastern Kentucky. Null said the cabinet is working on a more tailored, non-one-size-fits-all approach, including possible changes to capital support, build-to-suit options, and additional resources for rural areas. He said the hubs have helped 193 startups over the last two years and helped attract nearly $350 million in private capital, and he agreed to provide a written report by hub district on startup viability. The committee approved the economic development contracts. The Kentucky Lottery Corporation then presented its contracts with vendor IGT for retail and internet sales systems. Lottery officials said the contracts are mission-critical, cover both the traditional retail system and iLottery, and are structured as a percentage of sales so no payment is made until revenue is earned. They described planned equipment upgrades, including refreshed terminals, new ticket checkers, cashless vending and bill acceptors, and connected-play features that would link retail and online wallets. Officials said keeping the same vendor reduces the risk of business disruption and that the arrangement has already produced cost savings. They also said the lottery continues to see year-over-year growth and expects to meet its annual contribution target of $360 million for scholarships and grants. The committee approved the lottery contract after discussion.

Transcript Highlights:

• five persons, that would also be an acceptable use for those residential congregate-type living services
• kitchen and a shared bathroom and all that, so that’s also considered a congregate living.
• <00:14:47.279> bathroom<00:14:47.720> and shared kitchen and a shared bathroom and
• shared kitchen and a shared bathroom and all<00:14:48.160> that<00:14:48.360> so<00:14:
• And we put money aside for addiction services. No one's asking for it now.

Keywords: 1191, senate, all

Transcript Highlights:

• . director and 4-H agriculture agent for Hidalgo County Cooperative Education Service.
• Let her share her story with you all.
• I will share a few thoughts with you anyway.
• Which we live, if we put ourselves out there and share them.
• We are at our best when we walk together towards progress and shared prosperity.

Transcript Highlights:

• The Committee on Health and Human Services is called to order.
• committee is convened to examine the performance of Access and, specifically, its division of fee-for-service
• We'd be happy to share what those look like. Awesome, thank you.
• That was part of the proposal that was shared from Constellation Health.
• For each type of service provision.

Keywords: 1182, all

Summary: The Committee on Health and Human Services held another oversight hearing on Access, focusing on fee-for-service behavioral health management, prior authorization and claims processing, the Targeted Investment Program (TIP), and network adequacy. The chair and other members criticized Access for repeated transparency failures, including missing records related to the Covered Behavioral Health Services Guide, lack of public comment, unanswered questions about ARPA compliance, and concerns about ghost networks and delayed payments to providers, especially in Native communities and rural areas. Interim Director Roberta Harrison said Access had improved fraud controls after the sober living scheme crisis and acknowledged the need for modernization. She reported faster prior authorization processing, fewer denial codes, real-time dashboards, additional staffing, and claims processing under 30 days. She also said the agency wants more fraud referrals and is working to strengthen internal systems and communication. On the TIP program, Access officials explained that payments are delayed because of complex data validation and allocation across many provider sites; they said year one of TIP 2.0 was paid, but years two and three had not yet been distributed. The committee requested a formal plan within 30 days for paying the estimated $122 million in delayed TIP funds and asked for CMS-related documentation. Committee members also questioned Access about a direct contract with Constellation for claims processing, noting language in the proposal suggesting higher ROI from denying more claims; Access said that language was not part of the contract scope and was verbally rejected. On network adequacy, officials described time-and-distance standards, annual MCO reports, and internal review processes, but could not immediately confirm whether a fiscal year 2025 report had been submitted to CMS or whether any corrective action plans had been imposed. The chair concluded that Access’s improvements appeared to be driven by legislative pressure, said the committee would review the information received, and announced that Access would be sent detailed monthly reporting directions before the hearing adjourned.

Transcript Highlights:

• Here's the image that the National Weather Service shared on social media.
• But this is a really important example of how the National Weather Service is actively sharing this information
• Here's the image that the National Weather Service shared on social media.
• example of how the National Weather Service is actively sharing this information to the public.
• Health Services.

Keywords: 1185, senate, all

Transcript Highlights:

• Helpful if we know what kind of services those facilities offer and such.
• Integris wanted to share their financial impacts.
• stepping into homeless services.
• I like to always share the positive with the opportunity we've...
• Medicaid does offer a limited service for skilled nursing as well as home health services, but even with

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:

• Services team.
• Data sharing is always a problem, right?
• , better services, with less funding.
• services and share information, so if someone is receiving a gas card from Oklahoma Works, the Department
• of Human Services will know that and know not to provide that service themselves.

Summary: The meeting began with a budget presentation from the Oklahoma Department of Agriculture, Food and Forestry. Secretary Blaine Arthur and Deputy Commissioner Jan Lee described the agency’s divisions and recent efforts to improve efficiency, including expanded online licensing, electronic veterinary inspection certificates, and a new laboratory information system. They highlighted youth and workforce programs, local food initiatives for schools, market development efforts, and ongoing animal health concerns such as avian influenza, equine herpesvirus, and the threat of New World screwworm. They also discussed staffing, turnover, and uncertainty around federal cooperative agreement funding, while noting they were not requesting new or additional appropriations for the upcoming fiscal year. Members asked about meat inspection staffing, the use of one-time forestry firefighting funds, biosecurity and national security coordination, and agency staffing levels. The department said meat inspection was currently in good shape but dependent on federal funding stability, and explained that prior firefighting dollars had been used for equipment purchases. They also said they work with state and federal partners, including DHS and FBI, on threat preparedness and have reduced turnover by adjusting salaries and maintaining staffing at or below prior levels. The Oklahoma Conservation Commission then presented its budget and program overview. Staff described the agency’s long history and current work in water quality, flood control, soil health, unpaved roads, wetlands, and woody species control, especially eastern red cedar removal. They emphasized data-driven, voluntary conservation practices, citing stream cleanups, flood-control dam benefits, pond cleanouts during drought, and the Cherry-Peach watershed project as examples of programs that improve water resources and reduce wildfire risk. The agency said its workload has grown significantly and requested funding for critical dam repairs, local conservation district staffing, continued unpaved roads work, and expansion of woody species control statewide. Members asked about county matching for road and dam projects, who to contact about flooding roads, sediment removal from pond cleanouts, and the effectiveness of county training programs. Commission staff explained that county in-kind work can count as match, local conservation districts are the first point of contact, and the road training has produced measurable savings and better maintenance practices. They also clarified that “high hazard” dams are those where failure could threaten people or infrastructure downstream, not necessarily dams that are structurally failing.

Transcript Highlights:

• brought eight uh programs and services brought eight uh programs and services from<00:04:43.680>
• Community Based Services. Community Based Services.
• service deserts. service deserts.
• services per year. So, I had to choose. services per year. So, I had to choose.
• <01:57:11.400> Very here and sharing your stories. Very here and sharing your stories.

Keywords: 958, all

Summary: The committee first approved the minutes from its September 24 meeting after a motion and second. It then heard a presentation from New Mexico Early Childhood Education and Care Secretary Elizabeth Gragensky on that state’s early childhood system and planned universal child care rollout. She described how New Mexico consolidated multiple prenatal-to-age-five programs into a cabinet-level department, expanded pre-K to a longer day, and uses a cost model to set reimbursement rates intended to cover true provider costs, including wages, benefits, occupancy, food, and reserves. She also said the state created an Early Childhood Trust Fund and secured a constitutional amendment to dedicate 0.60% of the land grant permanent fund to early care and education, with the department’s budget growing from about $400 million in 2021 to just under $1 billion this year. Gragensky said families can begin applying for universal child care on November 1, with participation voluntary for both families and providers. She reported that New Mexico is aiming to expand capacity by adding 1,000 registered home providers, 120 group homes, and about 55 more centers, supported in part by a $13 million low-interest loan fund and a request for an additional $20 million. She said the state has seen growth in early childhood professionals, including a 64% increase over the last three to four years, and pointed to reported outcomes such as a 21% increase in literacy and a 75% kindergarten readiness rate, while noting that some measures are new and baseline comparisons are still being developed. Members asked about the funding sources, provider profitability, workforce development, and measurable outcomes. Gragensky said the program is designed to support provider sustainability through rates tied to true cost and includes allowances for sick leave, vacation, benefits, and reserves. She also said maternal labor force participation is 10% higher than the national rate and attributed that in part to child care access. The committee then moved to a separate presentation by Department for Community Based Services Commissioner Lisa Dennis and Division of Family Support Director Roger McCann on anticipated cuts to TANF and SNAP, beginning with an overview of TANF as a federal block grant with a fixed annual Kentucky allocation of about $180.7 million.

Transcript Highlights:

• services.
• this afternoon to share an overview of the services that are provided through the Division of Blind Services
• Service hours for the Medallion, 75 service hours, or Academic 100 service hours, or, for either particular
• So I share that to respond to your question to say, our mission that I shared to provide services that
• Our mission, that I shared, is to provide services that lead to competitive employment, self-sufficiency

Summary: The Higher Education Budget Subcommittee met for an introductory overview of the higher education programs under its jurisdiction. After roll call and member introductions, Chair Busatta outlined that the subcommittee oversees programs in the Department of Education and the State University System, including vocational rehabilitation, blind services, private postsecondary licensure, student financial aid, career and adult education, the Florida College System, and the Board of Governors. The chair and staff also noted that these areas represent roughly $9 billion in current-year funding. Officials from the Department of Education presented on several programs. Vocational Rehabilitation Director Kelly Rogers described services for adults and youth with disabilities, including pre-employment transition services, job coaching, assistive technology, and employer support; she said the program served more than 55,000 people last year, has no wait list, and reported a return of $7.61 to the economy for every $1 invested. Division of Blind Services Director Robert Doyle explained services from birth through older adulthood, including early intervention, school-age support, vocational rehabilitation, independent living, the Business Enterprise Program for blind vendors, and the Braille and Talking Book Library; he said the division serves about 12,000 people annually and also has no wait list, though some community rehab providers may have one. Tiffany Hurst of the Commission for Independent Education described licensure and consumer protection for independent postsecondary institutions, reporting oversight of about 1,100 institutions and 721 non-degree schools, along with enforcement actions against unlicensed operators. Sean Haskin of Student Financial Assistance reviewed 22 scholarship and grant programs totaling about $1 billion for more than 200,000 students, including Bright Futures, Benacquisto, need-based grants, EASE, EASE Plus, veterans’ scholarships, dual enrollment reimbursement, first responder scholarships, and the Ocoee and Rosewood scholarships. Members asked about surplus funds, marketing, Bright Futures eligibility requirements, and whether EASE awards had changed; Haskin said any unused funds are reverted to the Legislature, that the department markets through schools and the Florida Lottery, and that EASE remained at $3,500 per FTE for the last two fiscal years. Several members raised concerns that students and parents may not learn about aid programs early enough, especially in economically disadvantaged communities. Chancellor Kevin O’Farrell then presented on Career and Adult Education, highlighting record participation in career and technical education, adult education, and apprenticeship. He said about 800,000 secondary students and 480,000 postsecondary students are in CTE, adult education serves about 183,000 learners, and apprenticeship/pre-apprenticeship programs include more than 22,000 participants. He also described the workforce development fund, Perkins, WIOA Title II, the Pathways to Career Opportunities Grant, workforce capitalization grants, CAPE performance funding, and the Pipeline nursing initiative, noting strong NCLEX outcomes and expanded outreach through the Get There, Your Way, Future of Work Florida, and Zello platforms. Kathy Hebda began the Florida College System presentation by emphasizing open access, workforce preparation, statewide reach, and strong enrollment and completion growth, including more than 672,000 students, over 131,000 degrees and certificates, and significant dual enrollment savings for students and families.

Transcript Highlights:

• services fraud? services fraud?
• communities and sharing their stories. communities and sharing their stories.
• I'd be more than happy to share.
• state uh department of human services. state uh department of human services.
• <02:03:59.920> This human services committee. This human services committee.

Keywords: 1187, senate, all

Transcript Highlights:

• Due to a drafting oversight, TWC is not authorized to procure goods and services necessary to operate
• Workforce boards will provide them with free services ranging from a job posting and work in Texas to
• It's a formal partnership between the Texas Workforce, uh, Commission, the Health and Human Services
• It's gonna reduce service redundancies and improve data sharing to better support individuals navigating
• who are utilizing these services, um, it gives these agencies that opportunity to collaborate.

Transcript Highlights:

• enhancing WAV services across Minnesota. enhancing WAV services across Minnesota.
• State Patrol staff taxi services.
• with disabilities in their service area. with disabilities in their service area.
• . service. service.
• respondent shared respondent shared um um um reliable<00:43:12.240> transportation<00:43:

Keywords: 1187, senate, all

Transcript Highlights:

• These services are very cost-effective.
• That's one of our services. Six years.
• We were constantly changing and updating to ensure we were providing the best service. Services.
• And like I said, it covers a broad range of services: mental health, re-entry, addiction services, like
• We provide wraparound services. We provide mentoring, academics, and health services.

Transcript Highlights:

• and certainly in philanthropy. ...in helping workers in public service and certainly in philanthropy
• That spirit of coalition and shared advocacy is something we should continue to uplift and honor.
• I also wanted to share with all of you in conclusion.
• No other state imposes uncapped vicarious liability for peer-to-peer vehicle sharing platforms.
• No other state imposes uncapped vicarious liability for peer-to-peer vehicle sharing platforms.

Keywords: 988, house, all

Summary: The Assembly convened after a quorum call, heard a prayer from Rabbi Mona Alfie, and recited the Pledge of Allegiance. The chamber then held its first official Jewish American Heritage Month ceremony, beginning with Assembly Concurrent Resolution 195 by Assembly Member Gabriel. Gabriel and several colleagues from multiple caucuses spoke in support, emphasizing Jewish Californians’ contributions, the diversity of the Jewish community, solidarity with other communities, and opposition to anti-Semitism. The resolution was adopted by voice vote after 67 co-authors were added, and the Assembly then recognized 14 honorees for their service and leadership in California. After the ceremony, members offered guest introductions and the body moved to floor business. Assembly Constitutional Amendment 9 by Assembly Member Bonta, which would add affordability as a required factor in CPUC rate-making, remove telecommunications from the CPUC, create an Office of Broadband, and expand legislative appointments to the commission, was adopted. The Assembly also passed AB 1697 delaying implementation of a 2025 labor law, AB 2322 on stormwater permit definitions, AB 1653 on pupil instruction, AB 2274 and AB 2273 on criminal justice and child sexual abuse-related prosecutorial practices, AB 2512 on Anaheim Angels naming language tied to a potential land exemption, AB 1956 on suicide prevention for young men and boys, AB 1809 on job order contracting, AB 1970 banning step therapy for serious mental illness and substance use disorder medications, AB 1973 expanding authority for advanced practice clinicians, and AB 2055 on vessel law modernization. The Assembly also adopted ACR 186 designating May as California Physical Fitness and Mental Well-Being Month and H.R. 111 recognizing the International Day Against Homophobia, Biphobia, Interphobia, and Transphobia, after extensive debate reflecting both support and criticism over LGBTQ rights and parental rights issues. Several measures were passed with recorded votes, while some items were passed and retained on file or continued. The transcript ends as the Assembly was moving into AB 2059, a CEQA-related bill on rural transportation projects, with the sponsor describing it as a narrow exemption for 21 rural counties.

Transcript Highlights:

• service or who received the services. service or who received the services.
• of Human Services. of Human Services.
• <00:27:41.080> on services is that the the services on services is that the the services on
• Um, next up, Nathaniel Olson. services. services.
• Services. Services.

Keywords: 1183, house

Transcript Highlights:

• <00:09:10.079> um information that needs to be shared um information that needs to be shared
• The data sharing work group is really just focused on making sure that we have data sharing agreements
• that all impacts the amount of services that all impacts the amount of services we<00:52:35.119>
• discuss we have a a data sharing discuss we have a a data sharing agreement<01:00:03.480> as<
• We'll share resources.

Keywords: 1187, senate, all

Transcript Highlights:

• service.
• And I think the idea is that the state should pay for the share of the prosecuting work For the share
• Service.
• Kind of a basic service for a hospital. OB labor and delivery services somewhere nearby.
• , our ambulance... our EMS services, our ambulance services, and our workforce initiatives.

Keywords: 916, all

Transcript Highlights:

• And 83% of what fire service agencies do now is respond to EMS, emergency medical calls for service.
• A study on dental services that was reviewed by the Interim Health Services Committee, chaired by Senator
• partner with North Dakota HHS to provide services.
• Resources and Services Administration.
• Tribes pay a better rate for services than IHS.

Summary: The committee first approved the minutes and then heard a detailed annual presentation from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and review findings. He explained the committee’s structure, the de-identified review process, and the distinction between pregnancy-associated and pregnancy-related deaths. He said national maternal mortality has declined from its 2021 peak, but mental health conditions, substance use, overdose, suicide, cardiovascular disease, hemorrhage, infection, and embolism remain major causes. He emphasized that many deaths are preventable, with especially high rates among non-Hispanic Black women and in the American Indian/Alaska Native population, and noted that a large share of deaths occur after 42 days postpartum. Committee members asked about suicide, domestic abuse, pregnancy testing in unexplained deaths, and the role of home births and midwife training. Dr. Arnold said the committee is adding a caseworker, exploring post-mortem pregnancy testing in suspicious cases, and working with coroners and forensic officials; he also said home births and untrained midwifery pose safety concerns and that better public education and facility-based care are important. The committee then heard from State Fire Marshal Dr. Matt Clark on cigarette ignition propensity standards and fire prevention. He recommended updating North Dakota’s cigarette ignition legislation to the current national standard and also considering legislation requiring fast-breakaway oxygen tubing, citing fatal fires involving smoking around home oxygen. He explained that his office verifies manufacturer testing and maintains certification for cigarettes sold in the state, but does not itself conduct the testing. Members asked about implementation, cost, and whether the standards apply in tribal communities; Clark said he would follow up with cost information and additional details, and that he had not seen evidence of a major issue on tribal lands but would look further. Christine Greff of the Department of Health and Human Services presented the North Dakota Stroke System of Care report. She described the statewide network of two comprehensive stroke centers, four primary stroke centers, and 30 acute stroke-ready hospitals, along with the stroke registry and quality-improvement efforts. She reported that most strokes are ischemic, that the median stroke patient age is 71.5, and that common risk factors include hypertension, dyslipidemia, obesity, and diabetes. She highlighted improvements in door-to-CT, thrombolytic treatment times, dysphagia screening, EMS pre-notification, and interfacility transfer performance, and said new priorities include hemorrhagic stroke quality measures and standardized EMS stroke screening tools. Members asked about the VA hospital’s participation, and Greff said she would pursue outreach. After a break, the committee heard testimony from Taha Khan of Vertex Pharmaceuticals as part of the prior authorization study, focused on non-opioid pain treatment. He argued that prior authorization can delay access to acute pain treatment and may push patients toward opioids, especially in the critical 24- to 72-hour post-discharge window. He cited data showing that even short opioid exposure can increase the risk of long-term use and said prior authorization is often a barrier for physicians and patients. Khan recommended open access with a quantity limit rather than prior authorization, suggesting a 14-day limit supported by the product’s data and an episode-of-care approach. Members asked about dental use, payer discussions, and cost; he said the product’s wholesale acquisition cost is about $16.10 per tablet, with patient assistance available, and that he would follow up on payer and comparison-cost questions.