Transcript Highlights:

• of respiratory care practitioners.
• Respiratory care practitioners provide highly specialized, often life-sustaining care under physician
• My colleagues and I are frontline health care workers.
• Good morning, Respiratory Care Board.
• Good morning, respiratory care board.

Summary: The joint sunset oversight hearing reviewed five California regulatory entities: the Respiratory Care Board, the California Council for Interior Design Certification, the Speech-Language Pathology, Audiology, and Hearing Aid Dispensers Board, the Board of Occupational Therapy, and the Board of Naturopathic Medicine. Each agency described its mission, recent modernization or enforcement work, and requested continuation of its authority. Committee members focused on access to care, workforce impacts, fee structures, transparency, and whether proposed changes would improve public protection without creating unnecessary barriers. For the Respiratory Care Board, the main issues were a possible move from an associate to a bachelor’s degree for entry-level licensure, fee cleanup changes, and ongoing work on the role of LVNs in respiratory tasks. Board representatives said the degree change would better align with national trends and could support future reimbursement and professional advancement, while public commenters and some legislators warned it could worsen shortages, especially in rural and underserved areas. Much of the public testimony centered on families and facilities relying on LVNs for trach and ventilator care in congregate living health facilities, with requests to preserve or expand exemptions. The board also discussed its reserve cap and efforts to modernize licensing and enforcement systems. The interior design item drew the most debate. CCIDC leaders argued the current voluntary certification/title-act model works, that complaints have not shown public harm, and that licensure would disrupt the workforce and create barriers for experienced designers. Committee members questioned the lack of enforcement authority, transparency, and whether the model provides enough accountability or consistent plan acceptance by local jurisdictions. Public testimony was split between supporters who said the current system is flexible and effective, and critics who said the private structure lacks accountability and creates confusion, especially for commercial work and plan check acceptance. The Speech-Language Pathology, Audiology, and Hearing Aid Dispensers Board reported major modernization gains, including online licensure processing, faster application times, new continuing education audits, and updated supervision and advertising rules. Members and stakeholders discussed a proposed audiology assistant license, which the board and the California Academy of Audiology supported as a way to improve access to care and reduce workload pressures. The Occupational Therapy Board described strong enforcement and licensing performance, a new strategic plan, and a request for additional fee authority to address rising costs and reserve concerns; public testimony largely supported the board and a proposed reduction in advanced practice hand therapy training hours. The Naturopathic Medicine Board emphasized consumer protection, unlicensed practice enforcement, and consumer confusion over titles, saying most of its enforcement workload involves unlicensed activity and that stronger title protection and clearer statutory authority are needed.

Transcript Highlights:

• other kinds of health care needs that dietitians provide really important care for.
• Specialty care transports provide care for patients who are critically injured or ill and require care
• Before a registered nurse provides patient care during an inter-facility specialty care transport, the
• Before a registered nurse provides patient care during an inter-facility specialty care transport, the
• In-hospital care is distinctly different than out-of-hospital care.

Summary: The Senate Health and Long-Term Care Committee held public hearings on several House bills and later took executive action on two others. The committee heard testimony on House Bill 2242, which would let the Department of Health issue immunization recommendations and tie preventive-service coverage to federal recommendations as of June 30, 2025, while preserving access to vaccines and other preventive services. Supporters, including the Governor’s office and the Insurance Commissioner, said the bill would protect access, affordability, and stable vaccine purchasing; opponents argued it politicizes vaccine policy and gives too much influence to state agencies and outside groups. The committee also heard testimony on House Bill 2152, allowing terminally ill patients in hospitals, nursing homes, and hospice facilities to use medical cannabis under facility policies, with supporters emphasizing dignity, symptom relief, and safeguards, and House Bill 2088, joining the dietitian licensure compact, which supporters said would help military spouses, telehealth, and workforce shortages. House Bill 2110, on ambulance inter-facility specialty care transports, drew support from rural hospitals seeking more staffing flexibility and opposition from nurses and EMS personnel concerned about training, accountability, and patient safety. House Bill 2247, on veterinarian-client-patient relationships and telemedicine, drew support from the sponsor and some stakeholders as a workforce and access measure, but also criticism from the state veterinarian and others who said it could conflict with federal VCPR requirements and public health protections. House Bill 2340, expanding substance use disorder monitoring program eligibility to nursing assistants and stipend support, was presented as a way to help low-wage health workers stay in the workforce; there were no in-person testifiers against it. In executive session, the committee considered House Bill 2155, concerning the use of nursing titles, and House Bill 2531, aligning the ambulance transport fund quality assurance fee with federal regulations. Both bills received do-pass recommendations and were sent to the Rules Committee. For the public hearings, no final committee votes were taken on the other bills in this transcript, and testimony concluded on each measure after the committee heard from sponsors, agency officials, advocates, and opponents.

Transcript Highlights:

• , whether it be in a child care center, whether it be in a family child care home.
• We're going to talk about Working Connections Child Care, Washington's child care subsidy program that
• One is in our licensed child care settings, and we have over 6,600 licensed child care providers.
• Fund, which are federal funds that help support licensed child care and child care subsidy.
• And that is caring for them and caring about their health, their safety, and their spirit.

Summary: The committee began with a work session on Washington’s child care oversight and subsidy system, focusing on Working Connections Child Care, licensing, audits, and fraud prevention. DCYF officials said the program serves over 63,000 eligible families, with about 6,600 licensed providers and roughly 2,200 license-exempt family, friend, and neighbor providers. They described annual unannounced licensing visits, complaint investigations, attendance tracking, eligibility verification, random and focused audits, and referrals to the Office of Fraud and Accountability or Office of Financial Recovery when needed. Senators asked about voucher amounts, visit frequency, and what happens when children are not present; officials said the average subsidy is about $2,200 per month, providers are paid directly, and repeated failed visits can lead to license closure. Child Care Aware and provider testimony emphasized the quality system, Early Achievers, and a virtual provider described the practical realities of home-based care and unannounced inspections. The committee then heard Senate Bill 5952, which would standardize the process for waiving high school physical education requirements. The bill’s sponsor said the goal was to make PE waiver decisions consistent across districts so students who move schools are not disadvantaged, especially in six-period schedules with limited room for electives. Student supporters said a uniform process would improve fairness and help students fit in AP, career, or other coursework. Opponents, including PE teachers and the Washington Association of School Principals, argued that PE is a core academic subject, that athletics is not interchangeable with PE, and that local flexibility should remain. The State Board of Education supported the bill, saying current district policies vary widely and a standardized process would improve equity and transparency. Next, the committee took testimony on Senate Bill 5961, which would transfer the Imagination Library of Washington from DCYF to OSPI. The sponsor called it a simple administrative move to align the book-gifting program with early literacy and K-12 education, noting the program serves about 120,000 children in all 39 counties. OSPI and program representatives supported the transfer, saying it better fits the birth-to-grade-three literacy continuum and strengthens accountability. Testifiers highlighted the program’s role in school readiness, early brain development, and access to physical books for young children. Finally, the committee opened Senate Bill 5969, which would allow a student’s IEP transition plan to satisfy high school and beyond plan requirements if the IEP team chooses. The sponsor, a special education teacher, said the bill would reduce duplication and better support students with disabilities as they transition to postsecondary life. The committee then began hearing testimony on the proposal.

Transcript Highlights:

• if the only unrelated adults receiving personal care in the home are those foster care youth.
• if the only unrelated adults receiving personal care in the home or those foster care youth.
• And for foster care providers caring for children who become young adults with care needs, this presents
• And under current definitions, foster care providers who care for more than one unrelated person with
• And for foster care providers caring for children who become young adults with care needs, this presents

Summary: The committee held public hearings on several health-related bills. House Bill 2384 would require continuing care retirement communities that offer life care contracts to submit actuarial analyses every other registration cycle for review by the Office of the Insurance Commissioner, with the Department of Social and Health Services using the review in registration decisions. The bill sponsor and residents’ advocates said it would improve transparency and protect seniors’ prepaid care promises, while the CCRC industry supported the goal but raised concerns about scope, cost, and implementation details. House Bill 2505 would exempt certain foster family homes and child-specific foster care homes from adult family home licensure when former foster youth remain in the home as adults and certain safety conditions are met; DSHS supported the narrow exemption as a way to avoid displacing vulnerable young adults. House Bill 2402 would phase out DEHP and other orthophthalates in IV solution containers and later IV tubing, with exemptions for certain blood and cell therapy products; supporters cited health and environmental risks and the availability of safer alternatives, while manufacturers and hospitals supported the goal but asked for longer timelines, supply-chain protections, and implementation assistance. In executive session, the committee took action on a series of bills. It adopted an amendment and passed House Bill 1904, which prohibits cat declawing, on a 13-3 vote. It passed a proposed substitute for House Bill 2145 on the 340B drug program on an 11-5 vote after debate over reporting requirements and the state’s authority. It rejected several amendments to House Bill 2182 on abortion medications held by the Department of Corrections, adopted an Indian health care provider priority amendment, and passed the bill on a 10-6 vote. House Bill 2211 on medically tailored meals passed 15-1. The committee also passed Substitute House Bill 2247 on veterinarian-client-patient relationships, Substitute House Bill 2329 on midwives and lactation consultants, and Substitute House Bill 2339 on nurse licensing, each with technical amendments and broad support.

Transcript Highlights:

• Direct Care and Treatment is a highly specialized behavioral health care system.
• </c> of care uh one to one intensive care of care uh one to one intensive care because<00:11:48.720><
• Since their care, St. Peter was moving to a health care facility.
• Since their care, St. Peter was moving to a health care facility.
• Since their care, St. Peter was moving to a health care facility.

Committee: Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• ><c> care.
• <00:34:57.280><c> care</c> I'm really having a care a care I'm really having a care a care management
• care.
• Nobody likes top-down<00:51:34.200><c> care.</c> top-down care. top-down care.
• in Care Partnerships in Care we<01:14:16.320><c> do.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board received a presentation from Dr. Stack and Commissioner Langfeld on Kentucky’s application for a federal Medicaid-related funding opportunity tied to House Resolution 1. They described a compressed six-week stakeholder process that produced more than 50 responses and letters of support, and said the application was organized around five broad priorities: maternal health, behavioral health and substance use disorder, oral health, EMS/trauma response, and chronic disease. They emphasized that the proposal was designed to align with CMS goals, use allowable funding categories, and focus on sustainability rather than a short-term grant. Commissioner Langfeld outlined five core initiatives: rural community hubs for chronic care innovation, beginning with obesity and diabetes; a maternal and infant health effort called POWER; a behavioral health and substance use model called IMPATH; an oral health initiative called Rooted in Health; and an integrated crisis-to-care EMS and trauma response effort. He said the chronic disease work would include prevention, food-as-medicine concepts, and technology tools, while the maternal health effort would expand team-based care around mothers and infants using community health workers and doulas. The behavioral health proposal would build on existing crisis intervention models, oral health would address workforce and access gaps through training, mobile vans, and telehealth, and the EMS proposal would better connect emergency response with home-based and community care. Several senators questioned whether the proposal would meaningfully address rural hospital closures or the broader rural health care crisis. Senator Meredith said the plan was not transformational and would not save rural hospitals, while Senator Berg asked how success would be measured. In response, the presenters said they would use both lagging and leading indicators, with an emphasis on rapid-cycle feedback and data use that is more actionable in real time. They also said the work could help existing models that already show promise, such as behavioral health units and dental workforce expansion, even if it would not solve the larger funding gap created by HR1. Senator Douglas asked how the proposals would motivate patients to participate in their own health care. The presenters responded that the chronic disease prevention work would focus on obesity, diabetes prevention, nutrition, and consumer-facing technology tools to help people engage in their own care, and that EMS-community health worker partnerships could identify unmet needs in the home and reduce preventable problems. The board then moved on to its next agenda item, Medicaid managed care delivery models, with Tom Stevens, Katherine North, and Dr. Patel scheduled to present.

Transcript Highlights:

• Someone mentioned pregnancy care. Some of these places provide early prenatal care.
• , but it's also really important to recognize that abortion care is health care.
• , but it's also really important to recognize that abortion care is health care.
• But it's also really important to recognize that abortion care is health care.
• I'd be careful with that.

Committee: Senate Budget and Fiscal Review

Summary: The Senate Budget and Fiscal Review Committee heard AB 106, an early-action budget bill providing $90 million one-time General Fund to support reproductive health providers affected by the federal H.R. 1 prohibition on Medicaid funding. Department of Finance staff explained that the money would be administered as grants through the Department of Health Care Access and Information because affected providers can no longer bill Medi-Cal during the federal restriction, which lasts through July 4, 2026. Members also discussed why the amount increased from an earlier $60 million estimate, with Finance saying the figure was updated based on additional claims data and provider information. The committee debate focused heavily on the policy implications of the funding. Supporters argued the bill is an emergency response to a targeted federal attack on Planned Parenthood and related family planning services, emphasizing that the funding would backfill non-abortion services such as cancer screenings, contraception, STI testing, mammograms, and prenatal care. Opponents questioned the use of General Fund dollars, the grant structure versus loans for other distressed providers, the Public Records Act exemption, and the bill’s priority compared with rural hospitals, developmental services, public safety, and other budget needs. Finance clarified that the federal funds at issue do not pay for abortion services and that the grant program would be open to eligible providers meeting criteria set by the department. Public testimony was overwhelmingly in support from Planned Parenthood affiliates, Essential Access Health, Western Center on Law and Poverty, the California Medical Association, family physicians, OBGYN groups, and others, while some commenters used the opportunity to raise unrelated budget concerns such as Medi-Cal dental cuts, IHSS, and CalHome funding. After discussion, the committee approved AB 106 on a 12-4 vote and reported it out. The chair also noted that a later hearing would examine broader H.R. 1 impacts in more detail.

Transcript Highlights:

• Christiana Care yesterday.
• This bill will support hospitals, long-term care facilities, public health providers, ambulatory care
• care, child care subsidy program.
• care, education, and employment opportunities.
• automatically eligible for Purchase of Care.

Bills: HB359 , HB385 , HB165

Committee: Senate Health & Social Services

Keywords: human remains, indigent, burial, cremation, next of kin, social services, environmental impact, nursing education, preceptorship programs, healthcare workforce, nurse shortage, clinical training, dry needling, physician assistant, nurse practitioner, occupational therapist, referral process, neuromusculoskeletal pain, Western medicine

Summary: The Senate Health and Social Services Committee met with a quorum, approved the minutes from the prior two meetings, and briefly acknowledged the tragedy at Christiana Care before moving to legislation. The committee heard House Bill 385, which creates a statewide nurse preceptor grant program to expand clinical training placements for nursing students; testimony from nursing organizations, health care associations, and educators emphasized workforce shortages, the need for preceptor stipends and training, and the bill’s potential to help students complete programs and remain in Delaware. Members asked about eligibility and reporting, and several senators asked to be added as co-sponsors. Public comment was uniformly supportive, and the bill was advanced out of committee. The committee then considered House Bill 424, which repeals Delaware’s Autism Surveillance and Registration Program and requires DHSS to expunge protected health information collected through the registry. The sponsor and DHSS said the registry is no longer used for research or policy development and that repeal would reduce outdated reporting burdens; Autism Delaware, the Delaware Health Care Association, and the State Council for Persons with Disabilities support the change. A committee member raised the question of whether families would be notified before records are expunged, and DHSS said that process was not yet clear and would need further verification. Members discussed the issue, and the bill also moved forward. House Bill 419 was next, making children in foster care automatically eligible for the Purchase of Care child care subsidy and extending the same treatment to certain kinship and safety-plan placements through House Amendment 1. The Children’s Department and advocacy groups said the bill would provide immediate stability for children and caregivers, reduce delays from applications and income verification, and support working foster and kinship families. The committee also heard House Bill 359, which would allow cremation as an option for unclaimed and indigent remains when there is no family objection or next of kin cannot be found, addressing a shortage of burial plots and lowering costs; funeral industry testimony focused on preserving next-of-kin rights. Finally, the committee heard House Bill 475, creating a Delaware Nursing Advancement Fund financed by a $10 surcharge on nursing licenses and disciplinary fines to support workforce data collection and analysis through a nonprofit partner, and House Bill 165, authorizing physician associates, occupational therapists, and APRNs to perform dry needling under training and practice standards set by the Board of Medical Licensure and Discipline. All of the bills received supportive testimony, several members added their names as co-sponsors, and the committee adjourned after moving through the agenda.

Transcript Highlights:

• It creates a pathway to help dismissed Care Court respondents needing a higher level of care to get other
• of personal service requirements in Care Court.
• It codifies Governor Newsom's Care Court ICU and Care Court champions list.
• In other words, Governor Newsom's Care Court ICU and Care Court champions list, in other words, sort
• for those people who need care the most.

Committee: House Health

Keywords: 988, house, all

Transcript Highlights:

• While health plans must meet time and distance standards for primary care and specialty care and hospitals
• Not just delays in care, but...
• They're essential to our care. Also essential to prenatal care, Ms. Counseling, what to avoid.
• They're essential to our care.
• Enhanced care management are individuals that are contracted with our managed care plans to do this work

Summary: The committee heard several health-related bills, with extensive testimony on maternal health, prenatal safety, privacy, valley fever, Medi-Cal contracting, anti-discrimination protections, and health data sharing. SB 32 would require time-and-distance standards for labor and delivery units in health plan networks; the author and supporters said it would address maternity care deserts and improve access, while health plans opposed. SB 646 would require testing and public disclosure for toxic elements in prenatal vitamins; supporters emphasized fetal and maternal safety and transparency, while industry opponents warned it could confuse consumers or lead to reduced nutrient content. Both bills drew broad support from medical and public health groups, and both were advanced on party-line or near-unanimous votes after committee discussion. The committee also approved SB 313, which moves a parent’s birthplace on birth certificates into the confidential section to protect privacy, and SB 297, which directs CDPH to identify high-incidence valley fever regions and publish them for screening and awareness; valley fever experts and supporters stressed rising cases and the need for earlier diagnosis, while local health jurisdictions raised concerns about mandates. SB 324, dealing with Medi-Cal enhanced care management and community supports, would prioritize local community-based organizations and clarify contracting and data practices; it received strong support from nonprofits and community health advocates, with children’s hospitals and health plans seeking amendments, and it was sent forward after amendments were discussed. The committee then considered SB 418, which would codify ACA nondiscrimination protections in state law and allow up to a 12-month prescription supply for hormone therapy when medically necessary. Supporters framed it as protecting continuity of care for transgender patients and others using hormone therapy, including IVF and menopause patients, while opponents argued it would conflict with federal policy and promote harmful treatments. The bill passed to the next committee. Finally, SB 660 would strengthen the California Health and Human Services data exchange framework by creating governance and accountability for data sharing across health and social service entities; supporters said it would reduce duplication and improve care coordination, while some providers and hospital groups raised concerns. It was approved and sent to the Privacy and Consumer Protection Committee. The consent calendar and the other measures were also voted out, with the committee recording the required roll-call votes and sending the bills onward.

Transcript Highlights:

• managed care organizations...
• And now from the transition from Centennial Care 2.0 to Turquoise Care, we're no longer able to compare
• caring, and we want quality.
• Ideally, if you're running a health care organization, you want the patient care delivery to manifest
• taken care of.

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• And every additional year in extended foster care, in pre-year, in extended foster care, foster care.
• CARES is significantly different.
• kids in our care, the tiered rates are an increase for the caregiver themselves in terms of the care
• They help place children in family settings and provide residential care when youth need additional care
• Adult and senior care, children's residential, child care, and home care services programs have each

Summary: The Assembly Budget Subcommittee on Human Services heard an informational hearing on child welfare, foster care, community care licensing, child support, and related budget issues. CDSS described the Governor’s proposed child and family services budget, emphasized a family-centered and kin-first approach, and reported that foster care entries and congregate care placements have declined over the past decade. Witnesses also highlighted the importance of extended foster care to age 21, while noting persistent racial disparities for Native American and Black children and the need for stronger prevention, family finding, and community-based supports. A major focus was the proposed tiered rate structure (TRS), which CDSS said would shift funding from placement-based rates to child-centered supports, including care and supervision, strength-building dollars, and immediate needs funding paired with high-fidelity wraparound services. CDSS and county representatives said implementation is on track, with foundational policy guidance expected by the end of the year, CANS/CFT timeliness targeted by year-end, and the CWS CARES system nearing go-live in October 2026. Counties and providers raised concerns about whether the rate model and wraparound capacity will be sufficient, especially for higher-acuity youth, and asked for more data, clearer guidance, and continued collaboration. County Welfare Directors Association representatives also requested continued emergency response funding and an extension of flexible family supports, arguing both are needed to stabilize front-end child welfare work and bridge to TRS. Providers from FFAs and STRTPs warned that insurance costs, provider closures, and the transition to TRS could threaten service capacity unless the state addresses long-term insurance and reimbursement issues. LAO noted the Governor’s budget contains no new child welfare augmentations and said the main General Fund change reflects the expiration of one-time funding. No votes were taken; members instead asked for follow-up data, technical assistance, and possible future legislative or trailer bill solutions, including on insurance and implementation timelines.

Transcript Highlights:

• </c><00:05:09.800><c> in</c><00:05:10.000><c> this</c> care when a child enters care in this care when
• care businesses.
• care businesses.
• <c> Care</c><01:19:32.239><c> businesses</c> in existing Child Care businesses in existing Child Care
• </c><01:33:29.719><c> um</c> Care Northstar care for children um Care Northstar care for children um

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• managed care organizations.
• We provide emergency care, inpatient care, surgical services, and obstetrics, delivering more than 400
• As a retiree, I care for an aging parent in my home who requires a variety of medical specialty care
• We get like 8.3% of the cost of our care for, it covers our care for Medicaid, for instance.
• We get like 8.3% of the cost of our care for, it covers our care for Medicaid, for instance.

Summary: The House Appropriations Committee held a public hearing on a series of bills, beginning with House Bill 2689 on Working Connections Child Care. Staff explained that the proposed substitute would keep eligibility at 60% of state median income, eliminate scheduled expansions to 75% and 85%, reduce future subsidy rates from the 85th to the 75th percentile of market, end enhanced regional rates, and change reimbursement rules from prospective enrollment-based payments back to attendance-based payments with a reduced monthly payment after 11 absent days. Child care advocates thanked the committee for removing the proposed cap on the program but opposed the cuts to provider rates and eligibility expansions, warning of harm to families and providers. The committee then heard Engrossed Substitute Senate Bill 5124 on Medicaid network adequacy for post-acute care, with staff noting administrative costs and indeterminate fiscal effects; hospitals supported the bill as a way to reduce discharge delays and reliance on single-case agreements. Senate Bill 5832, which would raise the new motor vehicle arbitration fee from $3 to $6 to support the Lemon Law arbitration program, drew support from the Attorney General’s Office and auto dealers, who said the fee had not been updated since 1995 and the program was underfunded. The committee also heard Substitute Senate Bill 5862, providing a one-time 3% COLA for certain PERS 1 and TRS 1 retirees, with retirees testifying in favor and local government representatives warning about added employer costs. The committee next heard Senate Bill 5922, allowing school districts to transfer money from the Transportation Vehicle Fund to other funds if they reduce their fleet and receive OSPI approval; staff said the bill would mainly add administrative work for OSPI, and no one testified. Substitute Senate Bill 5923 would allow a hospital on an island in Skagit County to qualify as a critical access hospital if federally certified; Island Health testified that the designation would help sustain rural services, and a committee member asked about bed count and Medicaid/charity-care pressures. Senate Bill 5944 would require language access providers to bargain over compensation for missed or canceled appointments and clarify that statutes prevail over conflicting contract terms; WFSE supported the bill, saying it would equalize bargaining rights across agencies. Substitute Senate Bill 5972 would extend interest arbitration rights to correctional employees in city and county jails regardless of population size; labor supported the bill as a retention tool, while cities and counties opposed it, arguing it would raise costs and should include ability-to-pay protections. The committee also heard Senate Bill 5988, authorizing the Department of Health to continue accrediting opioid treatment programs and charge accreditation fees, which DOH said was needed to avoid winding down the program. Later, the committee heard Senate Bill 6151, which would move Ecology fee revenues for landfill methane emissions and laboratory accreditation into dedicated accounts; Ecology supported the bill as improving transparency and reinvesting fees into the programs, and staff said the lab fee shift would be offset by a related budget action. Engrossed Substitute Senate Bill 6194 would pay a rural hospital on a federally recognized Indian reservation, specifically Astria Toppenish, at 150% of the Medicaid fee-for-service rate beginning in 2027; hospital leaders and community members testified that the hospital serves a high-Medicaid, rural, and tribal population and faces persistent losses. Finally, Engrossed Substitute Senate Bill 6302 would direct L&I to investigate possible misclassification of independent contractors on public works projects involving multiple workers doing the same finishing work; labor and business representatives both described it as a negotiated compromise to address underground economy abuses. The committee took no final votes during the hearing and ended by reiterating amendment deadlines for bills scheduled for executive session.

Transcript Highlights:

• Long-term care workers must become certified as home care aides by the Department of Health unless an
• Long-term care workers must become certified as home care aides by the Department of Health unless an
• Among the persons exempted from home care aide certification requirements are long-term care workers
• Until January 1, 2027, long-term care workers who are being paid to care for a parent, sibling, aunt,
• in providing the very best care that they can for their one loved one who they care for.

Summary: The committee held a public hearing on HB 2337, which would repeal the planned 2027 requirement that certain family-member long-term care providers complete annual continuing education. Rep. Barnard said the bill was intended to reduce burdens on relatives caring for one loved one and to avoid forcing them into courses that are often not relevant to the person they support. Supportive testimony from family providers and disability advocates emphasized that family caregivers already receive individualized training from doctors and therapists, that the available course library is often geared toward aging-related care rather than developmental disabilities, and that mandatory CE could create compliance barriers and risk losing caregivers. Opponents, including SEIU 775 representatives and family caregivers who support the current system, argued that continuing education improves care quality, helps caregivers stay prepared as needs change, and should remain mandatory; they also said the state had already responded to prior concerns by expanding the course catalog and allowing repeat courses for credit. No action was taken on HB 2337. The committee then heard HB 2311, a technical bill making administrative changes to the Workforce Education Investment and Accountability and Oversight Board. The bill would extend co-chair terms, allow more than four meetings per year, shift consultation on workforce investment effectiveness to the Student Achievement Council, and eliminate the requirement for a public data dashboard. The bill sponsor and supporters from WASAC, Microsoft, and the United Faculty of Washington State said the changes would improve board operations and oversight, while also raising broader concerns that WEA funds have been used to supplant general fund support for higher education. Testimony noted the dashboard had not been funded and that WASAC already tracks related metrics through other tools. No vote was taken on HB 2311 during the hearing. The committee then moved to executive action on HB 2132, which limits disclosure and retention of personally identifying information in WASFA records. An amendment by Rep. Levitt was adopted to allow the Student Achievement Council to share applicant information with entities beyond higher education institutions under binding data-sharing agreements. The committee then adopted the amended substitute bill and voted it out of committee. The final roll call was 9-8 in favor, and Substitute HB 2132 was reported out with a do pass recommendation. The committee also announced that executive action on HB 288 and HB 2148 would be delayed and that no action would be taken on those bills that day.

Transcript Highlights:

• care model.
• , they know who's caring for them.
• Make sure that when a patient is receiving care, that they know who's caring for them.
• An ALF must obtain a memory care services license if the ALF serves one or more memory care residents
• We like that it defines memory care resident and memory care services.

Committee: Senate Health Policy

Keywords: 999, senate, all

Summary: The committee first considered SB 268, a public records bill for emergency physicians. A strike-all amendment narrowed and clarified the exemption, and the sponsor said it was intended to protect current emergency department physicians and eligible family members who submit a written request. Emergency physician Dr. Sean Patterson and several health care organizations supported the bill, citing threats, harassment, and safety concerns tied to mandatory reporting and patient encounters. The committee adopted the amendment and reported SB 268 favorably as a committee substitute. The committee then heard SB 514, creating the Doula Support for Healthy Births Pilot Program in Broward, Miami-Dade, and Palm Beach counties for pregnant and postpartum women, with priority for those affected by substance use disorder. Members discussed how the Department of Health would implement the pilot, collect data, and work with existing maternal health partners. An amendment changed the funding source to specific appropriations in the General Appropriations Act. Supporters said doula care can improve maternal and infant outcomes and help address Florida’s maternal health crisis. The bill was reported favorably as a committee substitute. SB 36, on use of professional nursing titles, drew extensive debate over whether nurses with doctoral degrees should be able to use the title “doctor” in clinical and advertising settings while clearly identifying themselves as nurses. The sponsor said the bill was about transparency and patient clarity, while several senators raised concerns that patients could confuse DNPs with physicians. Supporters from nursing groups said the bill protects earned credentials and does not expand scope of practice. The committee adopted an amendment aligning the bill with the House version and reported SB 36 favorably as a committee substitute. The committee also reported favorably SB 864, creating a public records exemption for uterine fibroid research data; SB 844, requiring continuing education on sickle cell disease care management for certain health professionals; SB 1404, revising memory care licensing for assisted living facilities; and SB 914, clarifying dry needling authority for occupational therapists. Finally, the committee took up SB 1758, a broad public assistance bill affecting Medicaid and SNAP. The sponsor described reforms including stronger fraud enforcement, a Medicaid work requirement for certain able-bodied adults, expanded behavioral health services through a waiver, pharmacy program changes, and SNAP fraud reduction measures. Members questioned the work requirement, implementation costs, eligibility verification, and due process concerns, while the sponsor said the bill would require federal approval and legislative review before implementation. Three amendments were adopted to adjust drug list update timing, expand public testimony on the high-cost drug list, and require faster prior authorization responses with a temporary supply in emergencies. The transcript cuts off before the final disposition of SB 1758.

Transcript Highlights:

• The health care cost is...
• The cost, the health care cost is enormous, and every year the health care cost is getting higher and
• , memory care issues, whatever?
• need care at all prisons for broken legs and diagnostic and... primary care.
• Health care-related costs. So this isn't even the other costs, but health care-related costs.

Keywords: 987, senate, all

Transcript Highlights:

• Child Care, per capita rates and utilization, and long-term care caseload forecasts, among other factors
• This leaves 2,100 vulnerable residents with no access to care, and they will lose care in October 2026
• , child care, and education.
• Long-term care is a continuum.
• We’re also concerned the House budget level funds Cascade Care Savings and long-term care for those losing

Summary: The House Appropriations Committee held a public hearing on proposed substitute House Bill 2289, the House operating budget. Budget staff Mary Monroe gave a detailed overview of the proposal’s near general fund outlook, reserve levels, major revenue assumptions, and major spending and savings items. She highlighted assumed revenue from capital gains and a proposed “millionaires tax,” a transfer from the budget stabilization account, administrative reductions across agencies, and several major policy shifts, including changes affecting Working Connections Child Care, K-12 education, higher education, long-term care, behavioral health, wildfire response, and state employee compensation. Members then asked questions, including about the higher education building account/operating fee swap and its interaction with the capital budget and Climate Commitment Act funds. The committee also announced amendment deadlines for the budget process. The bulk of the meeting was public testimony, with many speakers generally supporting or opposing specific parts of the budget. Supportive testimony praised funding for wildfire prevention, public health, reproductive health, civil legal aid, the Poison Center, some higher education institutions, and certain disability and child welfare services. Many speakers urged restoration or protection of funding for K-12 education, especially transition to kindergarten, local effort assistance, bus depreciation, and Running Start; others opposed cuts to child care, early learning, public defense, long-term care, adult day and home care services, occupational/physical/speech therapy for Medicaid patients, and community and technical colleges. Several local government, health, and nonprofit representatives also asked the committee to preserve public works, homelessness, energy assistance, environmental justice, and recovery/diversion programs, while some business and public safety groups sought continued funding for organized retail crime prevention and related initiatives. No votes were taken during the hearing. The committee recessed briefly and later resumed with virtual testimony, where additional witnesses repeated concerns about education cuts, long-term care, health care access, disability services, dispute resolution, early childhood programs, and the need for ongoing or increased funding in those areas.

Transcript Highlights:

• Someone mentioned pregnancy care. Some of these places provide early prenatal care.
• , but it's also really important to recognize that abortion care is health care.
• , but it's also really important to recognize that abortion care is health care.
• But it's also really important to recognize that abortion care is health care.
• I'd be careful with that.

Committee: Senate Budget and Fiscal Review

Keywords: 987, senate, all

Transcript Highlights:

• </c> all necessary training prior to caring all necessary training prior to caring for<00:04:51.360><
• care providers.
• care providers.
• care providers.
• The National Family Child Care Association, it's family child care providers.

Keywords: 919, house, all

Summary: The committee took up House File 2617, and first adopted a DE1 amendment. The bill, as amended, was presented as a major child care licensing reform that would narrow licensing to core health and safety requirements, reduce what supporters described as punitive or overly technical citations, and shift quality standards toward accreditation and professional organizations. The author also described the bill as a response to long-standing problems in the current licensing structure and county oversight of family child care. Public testimony was uniformly supportive. Child care providers and directors from Duluth, Rochester, and Esko said the current system penalizes minor clerical or cosmetic issues, creates inconsistent interpretations, and contributes to provider burnout and the child care shortage. They argued the bill would separate health-and-safety licensing from quality measures, which they said are better addressed through accreditation, coaching, and national standards. One testifier also said the bill would help with background study delays by creating a liaison to improve visibility into the process. Members asked about the difference between licensing and accreditation, how other states handle similar models, and how the bill would interact with the department’s licensing modernization work. The bill’s supporters said licensing would remain focused on foundational health and safety items such as ratios, background checks, hygiene, and facilities, while quality standards would be left to national organizations like NAEYC or the National Family Child Care Association. They cited Connecticut, Indiana, and Florida as examples of states using national standards in some form. The committee closed public testimony, took member questions, and the author renewed his motion to lay over House File 2617 as amended.