Transcript Highlights:

• he is remarkably accessible and practical as well as being visionary.
• We're not Informed, accessible, but frankly also I want to give a very strong message.
• When beneficiaries come forward to claim funds, they face barriers to access.
• When beneficiaries come forward to claim funds, they face barriers to access.
• This can delay access for years.

Keywords: 987, senate, all

Transcript Highlights:

• <00:21:06.000> School access or withholding data. School access or withholding data.
• :39:18.560> and<00:39:18.800> data speak about data access and data speak about data access
• <00:39:29.040> to act as you know governs access to act as you know governs access to government
• This is of access a county network.
• Um to to gain access to county networks.

Keywords: 919, house, all

Summary: The committee approved the October 15, 2025 minutes and then held a broader discussion on current challenges with data retention and government transparency. Judy Randall of the Office of the Legislative Auditor said historical data is essential for post-audits, which often look back three to five years, and that retention decisions must balance audit needs with the burden of separating public and nonpublic data. She described the records-retention panel process as informal and largely based on individual judgment, noting she had objected to a proposed 60-day email retention period and generally uses a three-year guideline, though she said that standard is not grounded in a formal rule. Members discussed whether auditing standards should set retention periods, with Randall saying auditing is a good starting point but other offices, including the attorney general, also have needs, and that some agency discretion is unavoidable because of the gray area between official records and non-records. Representative Elkins raised the related principle of data minimization, arguing that government should not keep data longer than needed and citing a University of Minnesota legacy data warehouse breach as an example of the risks of retaining unnecessary sensitive information. Randall agreed that data no longer needed is a liability and said her office purges workpapers after five years. Representative Scott pressed whether three years is enough for fraud investigations and financial records; Randall responded that a reasonableness standard is needed and that longer retention can produce diminishing returns, though she said she would follow up on whether financial records should be treated differently. Tanya Tacker of the Rum River Special Education Cooperative testified in support of updating Minnesota’s data-retention laws for schools. She said districts want to protect student information and maintain transparency, but the current general retention schedule dates to 1985 and 2000 and does not reflect digital records, modern systems, or the volume of special education data. She urged modernizing the schedule, clarifying what must be kept in paper versus digitized form, aligning state rules with IDEA and other federal requirements, and providing practical guidance and tools. Members praised the specificity of her recommendations. Dr. BB Newman testified that retention failures in St. Anthony Village have made it difficult to obtain routine municipal and police data, with records delayed, missing, or inconsistently produced and no clear explanation of what systems were searched or whether records were destroyed. Newman argued these gaps undermine statutory access rights and force residents into costly litigation, and recommended stronger retention auditing, documentation of destruction, mandatory disclosure of systems searched, and consequences for noncompliance. In response to questions, Senate counsel said there is generally no direct penalty, but affected parties may seek mandamus, Data Practices Act claims, or informal mediation/opinions from the Data Practices Office. The discussion closed with calls for clearer standards and possible legislative updates to improve compliance and transparency.

Transcript Highlights:

• the premium gets their bill and access the premium gets their bill and access to<00:19:33.960>
• to care being important I I ask access to care being important I I ask Mr<00:19:45.159> chair
• other motans who are not able to access other motans who are not able to access this<00:51:03.280
• Accessing mental health care providers can be incredibly difficult to do on your own.
• Accessing mental health care providers can be incredibly difficult to do on your own.

Keywords: 1187, senate, all

Transcript Highlights:

• But with that, appreciate... ...access to this and this is what you can and can't do.
• It's to increase the access of the disaster rebuilding fund are really twofold.
• Finding forms to access, as you say, disaster funds.
• How do people get access? I think it was through EDD and a hearing.
• Thank you. access those funds as sub-recipients. So we'd like that to be really clear.

Summary: The committee opened with the State Controller’s Office May Revision requests, including funding for Fiscal book-of-record stabilization, a Broadcom IDMS licensing adjustment, the California State Payroll System, ACFR reporting automation, and $3 million for unclaimed property outreach. Testimony emphasized progress on Fiscal becoming the state’s accounting book of record in July, faster ACFR publication, and the move to electronic unclaimed property claims. Members asked about the size of the unclaimed property fund and how quickly money is transferred to the General Fund; the Controller’s office said about $15 billion is held, with most excess transferred regularly, and the LAO noted the fund is the General Fund’s fourth-largest revenue source. No concerns were raised by Finance or the LAO, and the item was closed after no public comment. The committee then heard the administration’s proposal to tax prewritten digital software and software-as-a-service, with Finance saying it would modernize sales tax treatment and raise an estimated $450 million General Fund and $560 million local revenue in 2026-27. The LAO supported modernizing the tax but suggested broader digital goods coverage and a business-use exemption; industry and taxpayer groups opposed the proposal, warning of higher costs for consumers and businesses. Members also heard CDTFA’s administrative request tied to the proposal, plus a separate CDTFA budget reduction reflecting lower operational needs; that reduction was presented as a savings item and drew positive reactions. Next, the committee considered federal conformity for “Trump accounts,” which would align California tax treatment with federal rules for tax-deferred children’s accounts and avoid tracking burdens for families. The LAO recommended approval, and the item drew no opposition. The committee also heard a proposal to cut the first-year $800 annual business tax to $400 for LLCs, LPs, and LLPs; Finance argued it would lower startup costs and encourage new business formation, while the LAO said the benefit was not well targeted and could subsidize entities that would form anyway. Members discussed the policy tradeoff, and public commenters split between support for small business relief and concern about revenue loss. The final major revenue item was a permanent business tax credit limitation, capping credits at the greater of $5 million per corporation or 50% of pre-credit liability, while excluding the low-income housing tax credit and personal income tax credits. Finance said it would raise significant revenue from large profitable corporations, and the LAO said it was a reasonable option but noted it would mainly affect the R&D credit and could have future implications for programs like California Competes. Public testimony was sharply divided, with business groups opposing the cap and anti-poverty advocates supporting it as a way to recapture revenue. The committee also heard FTB’s CalFile realignment request, which would return most of the direct-file-related resources to the General Fund while retaining a smaller staff to improve CalFile, and the California Arts Council’s request to reauthorize the Keep Arts in Schools voluntary contribution fund, which members and advocates supported despite relatively modest annual donations. The hearing continued with GoBiz proposals on civic media funding, CA RISE reappropriation, and a semiconductor facility reversion, with the LAO supporting the latter two and members raising questions about the civic media program’s scope, outreach, and inclusion of broadcast and ethnic media.

Transcript Highlights:

• Many people in these areas face language access challenges and barriers.
• Many people in these areas face language access challenges and barriers.
• People drive to work, school, to access health care, and other basic services.
• AB 2734 helps achieve in expanding access and opportunity.
• Communities that have never had access to the coast showing up for the first time.

Keywords: 988, house, all

Summary: The committee heard a long series of bills, beginning with AB 2026 on groundwater recharge. The author and supporters said the bill would streamline permitting, codify existing CEQA exemptions for recharge diversions, and help California capture flood flows for storage in aquifers. Water agencies and local districts supported the measure, while environmental groups and some irrigation districts opposed it or sought amendments, warning about CEQA, streambed, Delta, and tribal-resource concerns. The bill was held open pending a quorum. Members then heard AB 1577 on data center energy accountability, which would require monthly reporting of energy use and related information to the Energy Commission and local agencies. The author and the Little Hoover Commission argued the bill would improve transparency, help protect ratepayers, and support grid planning. Data center industry and business groups opposed it as duplicative, burdensome, and uniquely targeted, while several environmental and local-government groups supported or supported if amended. The bill was left with a due-pass recommendation once a quorum was present. The committee also took up AB 2245 on producer responsibility for vehicle lubricant products and containers, AB 2170 on CEQA language-access and environmental protections in overburdened communities, AB 2059 on rural transportation/VMT analysis, AB 1808 on Western Joshua tree permitting and fee relief, AB 2182 on industrial energy efficiency program changes, AB 2231 on streamlining two hospital projects, and AB 2433 on density bonus housing incentives. Each bill drew a mix of support from sponsors, local agencies, labor, housing, or environmental justice groups and opposition or concerns from business, local government, or conservation organizations. Several measures were amended in committee, and multiple bills were reported out on due-pass or due-pass-as-amended votes, with some roll calls left open for absent members.

Transcript Highlights:

• our justice system play in safeguarding democracy, in upholding the rule of law, and ensuring equal access
• are, by a dedication to the rule of law and inspired by the desire to give back, to deliver equal access
• Inspired by the desire to give back, to deliver equal access to justice for all Californians.
• And most importantly, the option to appear remotely gives litigants a choice about how they access the
• This... ...safety, and our courts can focus on providing access to justice to every single person who

Summary: The California Legislature met in joint convention for the annual State of the Judiciary address, with judges and justices from across the state in attendance along with Governor Newsom and other statewide officials. The opening included prayer and the Pledge of Allegiance, followed by the formal introduction of Chief Justice Patricia Guerrero and the California Supreme Court justices. Speakers emphasized the importance of judicial independence, the courts’ role in protecting rights and democracy, and the value of collaboration between the legislative and judicial branches. Chief Justice Guerrero focused on the state of the judicial branch, beginning with budget pressures from prior cuts and noting partial restoration in the governor’s proposed budget, while urging continued stable funding for courts, court-appointed counsel, and judgeships in high-need counties. She highlighted the expansion and benefits of remote proceedings, ongoing judicial vacancies, workload growth, and efforts to improve data collection and case-weighting. She also discussed implementation of the CARE Act, the court interpreter workforce pilot, CASA and kin-first child welfare efforts, courthouse security and facilities projects, and the judiciary’s work on generative AI guardrails. A major portion of the address addressed the recent problems with the California bar exam and broader State Bar oversight. Guerrero said the court would pursue remedies for examinees harmed by the failures and would strengthen admissions oversight, including the role of the Committee of Bar Examiners. She also reiterated support for pro bono legal services and discussed immigration-related courthouse access, citing state laws limiting cooperation with federal immigration enforcement in courthouses. The convention concluded after remarks thanking the judiciary and Legislature, and the joint session adjourned without any recorded votes or formal legislative action.

Transcript Highlights:

• help us continue that access in areas. help us continue that access in areas.
• the ability to continue that access. the ability to continue that access.
• <00:09:54.959> any helpful. again without accessing any helpful. again without accessing any
• <00:14:49.519> to exercise motivation or even access to exercise motivation or even access
• I appreciate your comments. reduce access to primary care, to reduce access to primary care, to behavioral

Keywords: 00:00:00 - Call to Order/Roll Call 00:02:20 - Discussion of 26RS HB 689 00:13:13 - Discussion of 26RS SB 201 00:27:45 - Discussion of 26RS HB 583 00:46:37 - Discussion of 26RS HB 488 00:48:13 - Discussion of 26RS HB 2 01:14:34 - Discussion of Kentucky State Plan Amendment (SPA) 26:0001: School-based Medicaid Services Program 01:18:24 - Public Comment, 958, all

Summary: The Medicaid Oversight Board met on March 9 with a quorum present and no minutes to approve. The chair reordered the agenda to hear House Bill 689 first. Representative Amy Neighbors presented HB 689, which would authorize Kentucky to seek CMS approval for a Medicaid state-directed payment program for physician and non-physician professional services delivered through qualifying hospital-affiliated groups, beginning January 1, 2026, with retroactive payments for that year. She said the bill is intended to improve access to care in rural and underserved areas, support workforce retention, and generate about $29 million annually in federal Medicaid funds without using general fund dollars. Representatives from Owensboro Health and St. Elizabeth Healthcare testified in support, describing staffing and subsidy pressures, lower Medicaid and Medicare reimbursement, and the importance of the program for maintaining access and quality in rural and safety-net settings. Committee members noted the bill had already passed the House Health Services Committee unanimously and discussed broader concerns about Kentucky’s low reimbursement rates and the need to consider other systems not covered by the proposal. The board then heard Senate Bill 2011 from Senator Donald Douglas and Cody Hunt of the Kentucky Medical Association. The bill would address a Medicaid coding issue by ensuring that coverage limits do not reduce payment to fewer than two evaluation and management service units per provider, per patient, per day. Douglas argued the current one-visit, one-issue limitation forces multiple visits, increases no-shows, and prevents providers from treating the whole patient. Hunt explained that the bill is meant to correct a longstanding regulation that limited E&M services to one per physician per recipient per date of service, which can prevent providers from coding additional medically necessary work during the same visit. He said DMS has already filed a regulatory amendment to fix the problem, but a statutory change is still needed to prevent the issue from returning. He also said the bill is not intended to change reimbursement policy, only coding rules, and that MCO payment practices vary. Members generally supported the concept. Senator Berg asked about fiscal impact and private-payer billing; Hunt said there should be no fiscal impact because the bill does not change payment policy, only coding. Representative Moore said the proposal could reduce costs and improve convenience by avoiding extra visits. Chairman Meredith said the bill illustrated problems with fee-for-service care and supported moving toward a more holistic delivery model. Dr. Schuster raised a drafting concern about the bill summary language, and Hunt responded that the regulatory amendment should address the issue generally for providers. No votes were taken on either bill during this portion of the meeting.

Transcript Highlights:

• cost sharing, and transportation access cost sharing, and transportation access for<00:34:46.800
• Um, or if you have accessibility needs, those need to be accommodated.
• Um, or if you have accessibility car.
• with people who are trying to access with people who are trying to access care<00:47:15.520>
• <01:38:59.920> the for eligible people to access the for eligible people to access the medical

Keywords: 958, all

Summary: The House convened with an invocation and Pledge of Allegiance, established a quorum, excused absent members, suspended rules to allow co-sponsorships and vote modifications, and approved the journal from February 26, 2026. The clerk then reported several bills on second reading, including measures on state personnel, domestic violence, fish and wildlife resources, open records, workforce investment, data centers, guardians ad litem and domestic relations, along with Senate Concurrent Resolution 9 on a Medicaid pilot feasibility study and Senate Joint Resolution 23 declaring Kentucky a “food is medicine” state. The main floor business was House Bill 2, the Medicaid reform and appropriation bill. The sponsor described it as a response to rising Medicaid costs and federal changes, saying it would improve transparency, oversight, fraud prevention, and program operations. He said the bill would apply mainly to the Medicaid expansion population and include community engagement, cost-sharing, eligibility safeguards, stronger managed care oversight, transportation and dental delivery changes, waiver program prioritization, greater legislative access to CHFS data, a transparency dashboard, periodic auditor review, and limits on certain weight-management drug coverage. A House committee substitute was adopted, and a floor amendment on phasing in a marginal medical loss ratio requirement over four years was offered as a friendly amendment and adopted. The House then debated House Floor Amendment 1, which would have removed state-mandated co-payments and limited cost sharing to the federal minimum, while also prohibiting reporting medical debt to credit agencies. Supporters argued the amendment would protect low-income Kentuckians from barriers to care and prevent medical debt from worsening poverty. Opponents said the bill’s co-pays were intended to encourage appropriate use of care, especially to reduce non-emergency emergency room visits, and noted that providers and MCOs could waive or work around some charges. After a roll call vote, the amendment failed 20-39. After the amendment vote, the House continued discussion of the bill, with the sponsor defending the co-payment structure as a way to promote personal responsibility and sustainability while preserving access to primary care. The transcript ends during further debate on House Bill 2, and no final passage vote is shown in the provided excerpt.

Transcript Highlights:

• Um we do not have equal access services.
• When our children have access to a computer or a smartphone, we are allowing them access to unlimited
• <01:32:53.120> So<01:32:53.360> if accessible for convenient use.
• So if accessible for convenient use.
• <01:33:59.679> to people to be able to have access to people to be able to have access to

Keywords: 1187, senate, all

Transcript Highlights:

• The first area is free and discounted access.
• The first area is free and discounted access.
• The first area is free and discounted access.
• to do this to have the zoo be accessible to do this to have the zoo be accessible and<00:43:31.880
• <01:05:04.160> to in my Co-op do not have access to in my Co-op do not have access to traditional

Keywords: 1187, senate, all

Transcript Highlights:

• I was fortunate to have access to one. I was fortunate to have access to one.
• <01:24:12.000> testing Canada to provide accessibility testing Canada to provide accessibility
• Let every granite have access to the Let every granite have access to the mental<02:42:45.600> health
• <03:12:20.479> to the pandemic, and without access to the pandemic, and without access to
• <05:12:24.400> to argues that this is a basic access to argues that this is a basic access

Keywords: 1191, senate, all

Transcript Highlights:

• access<00:19:28.480> expand<00:19:29.120> access<00:19:29.520> and child care
• to access expand access and child care to access expand access and address<00:19:30.080> child
• And I'm the communication access specialist for DECAP.
• <00:37:08.000> for the communication access specialist for the communication access specialist
• <00:57:49.920> resources students aren't accessing resources students aren't accessing resources

Keywords: 910, house, all

Summary: The committees heard testimony on HB 1872, which would create an early learning apprenticeship grant program to help early childhood providers participate in approved apprenticeship programs, require annual reporting, and appropriate funds. Testifiers in support included the University of Hawaiʻi, the Executive Office on Early Learning, the City and County of Honolulu, Commit to Keiki, the Chamber of Commerce Hawaiʻi, the Commission on the Status of Women, Hawaiʻi Children’s Action Network Speaks, Parents for Public Schools of Hawaiʻi, and Kīʻoka Family Learning Centers. Supporters said the bill would reduce financial barriers, strengthen recruitment and retention, improve compensation and career pathways, and help address child care shortages and workforce instability. The committee then voted to pass HB 1872 with amendments, including an HD1 and a defective date to allow further discussion. The committee next took up HB 2489, which would appropriate funds for the University of Hawaiʻi to establish a bachelor’s degree program in American Sign Language interpretation, with a longer-term plan for a master’s program. Testimony in support came from the Disability Communication Access Board and the University of Hawaiʻi, and members also heard detailed support from DECAP and other advocates describing a statewide shortage of ASL interpreters, long waiting lists for ASL courses, and the need for locally trained interpreters who understand Hawaiʻi’s cultural and community needs. Witnesses said the shortage affects schools, courts, hospitals, emergency services, and other settings, and that the program could be expanded through articulation with other campuses. The committee voted to pass HB 2489 with amendments, again using an HD1 and defective date. After those two measures, the committee moved to HB 441 on campus safety, which would require students, including transfer students, to complete training on federal laws and university policies regarding sexual misconduct before initial registration and would change how often training is provided to students and employees. The University of Hawaiʻi stood on its written testimony, while supporters including IMUA Alliance and other testifiers urged passage, citing survivor experiences, national best practices, and the need for prevention before harm occurs. No vote on HB 441 was reached in the portion provided.

Transcript Highlights:

• To preserve the safety of everyone here and ensure the public's access to the discussion, please follow
• To preserve the safety of everyone here and ensure the public's access to the discussion, please follow
• To preserve the safety of everyone here and to ensure the public's access to the discussion, please follow
• Contracts under $350,000 will continue to be offered while expanding access and opportunity for small
• We're limiting access to opportunities that better reflect today's market costs and project needs for

Keywords: 988, house, all

Transcript Highlights:

• I ask you for a permanent office for new Americans to support the expansion and access to opportunities
• for the... ...for new Americans, to support the expansion and access to opportunities for the workforce
• Immigrant workers urgently need access to job trainings so that we can develop new skills and pursue
• There is a clear need for the state... ...in the state needing access to special education services.
• We represent a lot of the families who have had these challenges in accessing the community.

Keywords: 996, all

Transcript Highlights:

• Let's make sure that everyone in Massachusetts has full access to due process and fair representation
• When people fear that accessing health care, enrolling in supportive services, or even showing up for
• This bill helps restore the confidence necessary for people to seek care, access safety net programs,
• When people feel safe advocating for their needs and accessing care, we see earlier intervention and
• And third, the Commonwealth should support access to legal representation in immigration court.

Keywords: 995, all

Summary: The hearing focused on the Safe Communities Act, House 2580 and Senate 1681, along with related proposals to limit local and state cooperation with federal immigration enforcement, prohibit 287(g) agreements, and expand legal defense for immigrants. Most testimony came from advocates, attorneys, labor leaders, health care professionals, educators, and community members who argued that fear of ICE discourages immigrants from reporting crimes, seeking medical care, attending school, or cooperating with courts, and that a clear statewide policy would improve public safety, due process, and trust in institutions. Several speakers described personal or client experiences involving domestic violence, trafficking, workplace abuse, or children affected by deportation, and many emphasized economic harms to workers, families, and small businesses. Health care witnesses said immigration enforcement is causing patients to miss appointments, avoid emergency rooms, and delay preventive care, with resulting public health consequences. Labor and education representatives said immigrant workers and students are increasingly fearful, and that the state should not allow local police to act as ICE agents or enter 287(g) agreements. ACLU and coalition witnesses cited examples they said showed existing or recent collaboration between local agencies and ICE, including courthouse alerts, vehicle stops, and use of municipal spaces, while also arguing that the bill would still allow cooperation on criminal matters and public safety emergencies. One witness opposed the bill, arguing that serious criminal offenders should be deported and defending ICE’s role. Committee members asked several questions about whether the harms described were widespread or anecdotal, and about the distinction between assisting ICE in civil immigration arrests versus responding to violent or public safety emergencies. Witnesses said the bill was aimed at civil immigration enforcement, not criminal investigations or emergency situations. At the end of the hearing, a committee member requested a study on immigration enforcement’s effect on emergency room wait times, and the committee then adjourned without taking a vote on the legislation.

Transcript Highlights:

• lenders. ...particularly for communities of color who continue to face documented disparities in access
• As Assembly Member Bonta has noted, the legacy of that redlining still lives on today in who can access
• AB 2116 does not eliminate access to capital, and it does not ban merchant cash advances.
• It ensures that access to capital is... This bill, again, does not restrict capital.
• It ensures that access to capital is fair, transparent, and responsible.

Keywords: 987, senate, all

Transcript Highlights:

• That is the other access bills that are outside of FOIA.
• the details of that information in a consistent fashion, instead of some localities granting access
• And now that's not how you access information. It's not really what the fees are about now.
• That's not how you access information. It's not how you do it.
• Access to the law.

Keywords: Freedom of Information Advisory Council, 976, house, all

Transcript Highlights:

• There's five hours a day where students have access to schedule time with an academic coach and Dr.
• challenges that may be happening, helping students to engage in university life, and giving them access
• So that is very individualized in terms of supports and planning with access to that residential mentor
• So walkability, immersion in nature, access to the Kessler Mountain Regional Park where a lot of the
• But the CSSP designation with the access to the behavioral health waiver, there are enhancements that

Summary: The committee heard presentations on three Arkansas programs serving students and adults with autism and other developmental disabilities. University of Arkansas representatives described the Empower Program, a non-degree, four-year inclusive postsecondary program for young adults with mild intellectual disabilities, and the Autism Support Program, which provides intensive academic, peer, and career coaching for degree-seeking students with autism. They explained the programs’ person-centered planning, residential and employment supports, fee structure of $5,000 per semester for each program, and scholarship/fundraising efforts to offset costs. Members asked about dorm arrangements, mentoring, individualized plans, and how students move in and out of support services, and the presenters emphasized independence, integrated campus life, and transition planning. Pulaski Technical College staff then presented the 3D program, a three-year transition program in culinary, baking, and hospitality for students with intellectual and developmental disabilities. They outlined integrated classes, internships, job placement outcomes, and data showing strong completion and employment retention rates. Questions focused on how success is measured, tuition and financial aid, and the challenge of securing community partners for practicum and employment sites. The presenters said the program uses rubrics that include technical and professional skills, charges $5,700 per semester, and is pursuing accreditation through the Inclusive Higher Education Accreditation Council. The final presentation was from SLS Community, a Fayetteville nonprofit serving neurodivergent adults through residential supports, supported employment, and community initiatives. Leaders described their vision for a future mixed-use “live-work-play” development at Cato Springs, current residential and vocational services, and community events such as a 5K and a neurodiversity health care conference. Family members testified about the need for adult services, trained direct support professionals, and better reimbursement and behavioral health supports after age 21. No formal votes were taken beyond approving the prior meeting minutes, and members also announced upcoming autism-related events and requested future discussion on task force appointments and ABA-related issues.

Transcript Highlights:

• Uh, replace line 51 on page two with the following: Amount of $200 million from the Broadband Accessible
• Uh, replace line 51 on page two with the following: Amount of $200 million from the Broadband Accessible
• Uh, replace line 51 on page two with the following: Amount of $200 million from the Broadband Accessible
• Uh, replace line 51 on page two with the following: Amount of $200 million from the Broadband Accessible
• Thank you. million from the broadband accessibility million from the broadband accessibility fund<00:

Bills: SB146, SB143, SB144, SB145, HB224, SB152, SB153, SB154, SB162, SB226, SB146, SB143, SB144, SB145, HB224, SB152, SB153, SB154, SB162, SB226

Keywords: supplemental appropriation, FY2025 budget, general fund, Alabama State Board of Public Accountancy, Unified Judicial System, court automation, advanced technology and data exchange, judiciary funding, transportation debt service, highway bonds, bridge bonds, Alabama Department of Transportation, ALDOT, public highways, federal matching funds, state appropriations, bond principal and interest, special funds, budget amendment, SB143

Transcript Highlights:

• We do make hospital access payments and cost settlements.
• We do make hospital access payments and cost settlements.
• And the hospitals contribute through what we call access payments.
• We're really proud of the 27 critical access hospitals we have in the state.
• We're really proud of the 27 critical access hospitals we have in the state.

Summary: The subcommittee met to review Arkansas DHS hospital spending and reimbursement methods, with Secretary Janet Mann and Deputy Secretary Misty Eubanks explaining Medicaid hospital payments. They described fee-for-service per diem payments, cost settlements, and the upper payment limit (UPL) program, noting that SFY 2025 hospital payments included $688 million in inpatient/outpatient claims, $473 million in UPL payments, $248 million in cost settlements, and about $47 million in other payments such as graduate medical education and disproportionate share hospital funds. Members asked about why per diem rates vary, how cost settlements work, why UPL applies mainly to private hospitals, and how assessment fees are structured and funded. DHS said the hospital assessment fee is broad-based and uniform, used as the state share to draw federal funds, and that supplemental hospital payments after federal match totaled $548 million with no general revenue used. The Arkansas Hospital Association’s Jody Ann Tritt then gave a broader overview of the hospital landscape, explaining the different hospital types in the state, including critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals. She said Arkansas hospitals face financial strain, citing a negative 5.18% patient service margin statewide and lower reimbursement than surrounding states. She argued that Arkansas hospitals are paid less than hospitals in neighboring states for similar services, that commercial payer rates and administrative burdens are a major problem, and that Medicaid and Medicare rates remain below cost even with UPL support. She also said hospitals are the backbone of community care, provide emergency and public health functions, and are looking for ways to invest in technology and telehealth but often lack the revenue to do so. Members pressed for clearer data on hospital finances, reimbursement adequacy, and the impact of commercial insurers. Tritt said the association had just authorized a statewide survey to gather updated financial information from hospitals, which she said would take about a year to complete. She also explained that Medicaid pays weekly, Medicare and commercial plans can involve delays and denials, and that hospitals often spend significant resources on revenue cycle work. The discussion ended with a brief update on assisted living reimbursement: DHS said one facility, The Pillars of the Community in Crossett, had announced closure, nine Living Choices waiver clients were being transitioned, and the updated rate study would be available after cost reports are collected, likely before the end of the fiscal year. The meeting then adjourned.