Transcript Highlights:

• </c> that aren't covered by the nursing that aren't covered by the nursing facility.<00:29:03.520><c>
• We don't regulate that.
• </c> patient account at a nursing facility. patient account at a nursing facility.
• /c><00:31:31.279><c> allowed</c> nursing facility recipient being allowed nursing facility recipient
• Well, we are regulating the not.

Summary: The committee heard testimony on Senate Bill 118, as amended, which contains several unrelated provisions with a modest fiscal note. Nathan White of the Department of Health and Human Services explained that section 1 would change the personal needs allowance for Medicaid-eligible residents of private and county nursing homes from an adjustment every five years to an annual adjustment, increasing the state cost by about $50,000 per year. He also described section 2, a one-time appropriation of about $160,000 to make certain Hampstead employees whole for missed bonuses and lost leave during the state’s transition of the facility to Dartmouth management. White then outlined sections 3 through 5, which would create a dedicated fund for Hampstead lease revenue to cover the state’s contractual obligation to match Dartmouth capital improvements dollar-for-dollar up to $3 million. He said the state receives about $1.141 million in lease revenue in the first year, with a 3% annual escalator, and that the fund would hold lease revenue until needed for reimbursement. Members questioned how the matching arrangement would work, what happens if Dartmouth spends before the fund has enough money, and whether the state could refuse to match certain improvements. White said Dartmouth has final determination under the agreement if disputes arise, and that if the bill does not pass the state could face difficulty meeting the obligation without cutting services or finding other general funds. Several members also raised policy concerns about the personal needs allowance becoming an automatic cost driver. Brian Clark, attorney for the Bureau of Adult and Aging Services, clarified that current law requires the allowance to be updated at least every five years, but the legislature could change it in an off year if it chose. He also explained that the allowance is money residents retain from their own income, such as Social Security, as part of Medicaid cost-of-care calculations, and that the department does not regulate how residents keep those funds. No vote was taken during the discussion, and the committee paused to correct the bill copy before continuing testimony.

Transcript Highlights:

• The reason for this is nursing homes are regulated and can only install what is allowed by state or federal
• And they came from Calcasieu, Tangipahoa, Lafayette, ... ...nursing homes are regulated and can only
• regulations.
• I contacted LDH last year with questions regarding those regulations.
• Just like in our medical counterparts, PT counterparts, and nursing.

Committee: Senate Health and Welfare

Summary: The Senate Committee on Health and Welfare met on May 13 and approved the minutes from the prior week before taking up a series of House bills, many of them with testimony from sponsors, agency officials, and stakeholders. Early action included HB 971, which would direct LDH to equalize Medicaid reimbursement rates between independent rural health clinics and hospital-owned rural health clinics; the sponsor described a significant payment disparity and the committee reported the bill favorably. The committee also deferred HB 1030 and HB 796 until the following week before moving to other items on the agenda. Several bills dealing with Medicaid and provider regulation were advanced. HB 414, as amended, closes a loophole so health care providers cannot hire unlicensed workers with certain serious out-of-state convictions; amendments addressed effective dates, FBI background-check issues for therapeutic group homes, and delays for direct support professional applicants caused by minor record issues. HB 740, as amended, creates an independent review process for Medicaid claims disputes in the coordinated system of care for behavioral health providers, with amendments clarifying applicability dates and program definitions. HB 786, which prohibits extrapolation in managed care claims recoupments and requires recovery to be based on actual overpayments or underpayments, was also reported favorably. HB 915 set timelines and accountability standards for prior authorization and utilization management in Medicaid managed care and was reported favorably after testimony about delays in care. The committee also heard and passed several bills affecting health professions and facilities. HB 405 simply updates the name of the national acupuncture certification body. HB 1095 allows nursing homes to use alternative power sources while keeping existing generator and fuel requirements. HB 557 defines long-term care pharmacies for policy purposes. HB 779 authorizes expedited partner therapy prescriptions for certain sexually transmitted diseases. HB 933 creates an optional commemorative birth certificate, with part of the fee going to the Office of Women’s Health. HB 796, carried by another representative for the author, establishes a chiropractic preceptorship program with on-site supervision requirements and was reported favorably after questions about student training and patient safety. The committee also heard emotionally charged testimony on HB 288, which would place the term “miscarriage” alongside “spontaneous abortion” in medical documentation and patient communication. Several witnesses described the distress caused by current coding language, and supporters said the change would make records more compassionate and understandable; the bill was reported favorably. HB 403 increased the cottage food gross-sales cap, and after testimony from small producers and the committee’s discussion of other states’ higher limits, an amendment raised the cap to $150,000 before the bill was reported favorably. HB 930 modernizes cosmetic-product regulation and creates a small home-based producer exemption under a wholesale-sales threshold; it was also reported favorably. Finally, HB 1041, a no-mandate bill restricting discrimination based on medical intervention status, prompted extended debate over exemptions for schools, hospitals, and other entities, with one amendment failing on a roll-call vote and the discussion continuing over the scope of the bill and federal funding concerns.

Transcript Highlights:

• There is money for those 100 nurses. You know that you're going to spend money for nursing labor.
• </c> say you have a custodian doing nursing say you have a custodian doing nursing work<00:42:30.400>
• <00:45:14.559><c> the</c><00:45:14.640><c> ER</c> nurse the ER nurse the ER nurse<00:45:17.800><c> if
• nursing component.
• what can we do to regulate that?

Summary: The joint Ways and Means and Health and Human Services committees heard Hawaii Health Systems Corporation’s biennium budget request, with testimony from HHSC leadership on the Hilo/Big Island region (HTH 212) and the Oahu region (HTH 215), plus discussion of capital improvement projects and systemwide partnerships. HHSC described its role as the rural healthcare safety net, serving a high share of Medicare, Medicaid/Quest, and uninsured patients, and said its costs are elevated by state employee fringe benefits, which it said are about 64% compared with roughly 30% in the private sector. HHSC also said pandemic-era federal aid, including relief funds and PPP loans totaling about $100 million, reduced the need for general fund support in prior years. For HTH 212, HHSC said its general fund request for fiscal years 2026 and 2027 was higher than the governor’s recommendation because of rising insurance, pharmaceutical, and contractor labor costs, and because it includes $13.2 million in FY 2026 and $2.3 million in FY 2027 for Epic electronic medical record implementation in East Hawaii. For HTH 215, HHSC said the requested general funds were aligned with the governor’s recommendation, in part because of increased Medicaid reimbursement rates for long-term care facilities under prior legislation. HHSC also said it was restoring a special fund ceiling so the region could spend its cash collections on operations. Members asked about the 64% fringe rate, and HHSC explained the difference was mainly due to defined-benefit pension and retiree health insurance costs, which private hospitals generally do not bear at the same level. Members also asked about the Daniel K. Akaka State Veterans Home, and HHSC said operations would be funded through the general fund corporation for the home when it opens, with management by Ohana Pacific, but no additional legislative operating funds were being requested at that time. Other questions focused on staffing and vacancies, including an abolished procurement position and an ongoing IT help desk recruitment need. HHSC highlighted several capital and partnership projects, including a $25 million state CIP request matched by $25 million from the Benioff family for the Benioff Health Center, an ER expansion and reconfiguration at Corner Community Hospital, and $7.5 million in each fiscal year for Kauai EMR capital funds to join the Epic platform. Testimony also described collaborations with Queen’s, the University of California San Francisco, Hawaii Pacific Health, the Hawaii Cancer Consortium, the Department of Health, and the state hospital to improve specialty access, clinical trials, behavioral health, and patient placement across the system.

Transcript Highlights:

• Are you seeing nursing homes?
• So you don't consider going to visit a nursing home if you have multiple complaints in a nursing home
• > homes,</c><00:42:31.040><c> they've</c> Are you seeing nursing homes, they've Are you seeing nursing
• </c> Um we do do investigations into nursing Um we do do investigations into nursing homes.<00:43:12.720
• </c> that we've received at nursing homes. that we've received at nursing homes.

Summary: The Interim Joint Committee on Families and Children opened its first meeting with roll call and a reminder about the number of children in out-of-home care with active placements, which the chair said was 8,641 as of June 1, 2025. The committee then heard a presentation from the Center for Courageous Kids, a donor-funded camp in Scottville that serves children with lifelong illnesses and disabilities at no charge. Representatives described the camp’s year-round family retreats and summer sessions, its medically safe and inclusive model, and examples of campers gaining confidence and independence. They said the camp has served more than 43,000 campers from Kentucky, other states, and other countries, and that it is seeking legislative support for two capital projects: a new art barn and a medical lodge, with a combined request of $3.2 million. Members praised the program and asked about awareness, staffing, volunteer recruitment, accreditation, and how the projects would expand capacity; the camp said the medical lodge would help increase volunteer housing and allow future growth beyond its current summer cap of 128 campers per session. The committee then moved to adult protective services and state guardianship programs. Jessica Wayne, director of the Division of Guardianship, and Cliff Bryant of DCBS explained the legal framework for guardianship and conservatorship, including state guardianship as a last-resort option when no family member or private entity is available or appropriate. They outlined the court petition process, emergency appointments, and the distinction between full and limited guardianship or conservatorship. They emphasized that guardianship is based on legal incapacity to make decisions, not simply on a medical disability diagnosis, and noted that state guardianship can be arranged for some 17-year-olds aging out of youth services. The presenters said the state currently serves 4,645 individuals under guardianship, with most cases involving developmental intellectual disabilities, supported community living waiver participants, and people in nursing homes or long-term care facilities. They also described the division’s three branches: field services, which handles visits and day-to-day decisions in all 120 counties; a benefits branch that applies for public benefits; and a fiduciary branch that manages funds and pays bills. They reported 89 field workers statewide, an average caseload of 52, and said the agency is hiring to reduce that load. No votes or formal committee actions were taken during the meeting.

Transcript Highlights:

• Senate Bill 1412 addresses the need to modernize Florida's home health regulations to ensure greater
• By modernizing Florida's home health regulations, we are reducing unnecessary administrative burdens,
• Senate Bill 788 is a veterans nursing homes bill.
• I'm also very concerned about nursing homes and how... ...handle this.
• With regard to nursing homes, it aligns us with the federal standard.

Summary: The committee met to consider a large agenda of health and human services bills, moving quickly because of a two-hour time limit. Early measures reported favorably included SB 976 on challenges to court-appointed psychologists in family law cases, SB 306 on Medicaid provider network access and after-hours availability, and SB 584 on housing supports for college students and youth in extended foster care. SB 1412 on home health regulation modernization also passed, with one support appearance from the Home Care Association. Members then approved several bills focused on research and care delivery, including SB 1800 creating a Parkinson’s disease research consortium at USF with an adopted amendment adding academic medical centers, SB 524 adding Duchenne muscular dystrophy to newborn screening, SB 1156 revising a Medicaid home health aide program for medically fragile children, and SB 1490 transferring and redesigning the managed care program for critically ill children. SB 1174 on foster home licensure transfers, SB 1620 implementing mental health and substance use commission recommendations, SB 1568 revising e-prescribing exemptions, and SB 788 on veterans nursing home beds were also reported favorably. The committee had more extensive debate on SB 1270, the Department of Health agency package, which included provisions on vaccination status, medical marijuana background screening, licensing and compact issues, and sovereign immunity for volunteer dental workers; it passed after an amendment and several members voiced concerns about patient treatment and “voting power” language. SB 1606 on patient access to records drew strong opposition from providers and health information professionals over privacy, HIPAA, and administrative burdens; it was initially reported unfavorably, then reconsidered and ultimately passed after a motion to reconsider. Other bills reported favorably included SB 1736 on insulin administration by direct support professionals and relatives, SB 1808 on patient refunds from providers, SB 1842 on referral disclosure of network status, SB 1354 on behavioral health managing entity oversight, SB 1768 on stem cell therapies with informed consent requirements, and SPB 7032 on presumptive Medicaid eligibility for permanently disabled individuals, which was submitted and reported as a committee bill. The meeting ended after all agenda items were handled and the committee adjourned.

Transcript Highlights:

• Our SANE nurses, which are so important to the work, to serving, All right.
• Our sane nurses, which are so important to the work, to serving, Representative Weible: Our SANE nurses
• So the activities of that nurse, yes, do fall under HIPAA.
• So the activities of that SANE nurse, yes. But also...
• The best is the 10th most regulated state in the country.

Bills: HR9 , HB709 , HB1011 , HB1057 , HB1186 , HB1245 , HB1247 , SB49 , SB425 , SB479

Committee: House House and Governmental Affairs

Transcript Highlights:

• , the State Nurses Association, and the Nurse Practitioner Alliance of Alabama to take care of some problems
• And, you know, a tax on it will be able to provide the regulation... will be able to provide the regulation
• Passing a... and regulate these products.
• So instead, we're over-regulated.
• Yes, sir, there are a lot of regulations happening.

Bills: HB194 , SB87 , SB237

Committee: Senate Healthcare

Transcript Highlights:

• Licensed practical nurses.
• Any time we would respond to a nursing home in Melrose, try and find a nurse at night to tell you which
• My wife's 31 years at Boston Medical Center as a nurse. My daughter's a nurse practitioner.
• But in the nursing homes, I saw my enlisted medics go into the nursing homes and operate as LPNs, so
• But in the nursing homes, I saw my enlisted medics go into the nursing homes and operate as LPNs, so

Committee: Joint Joint Committee on Veterans and Federal Affairs

Summary: The Joint Committee on Veterans and Federal Affairs held its second public hearing of the 2025–26 session, with opening remarks from Chairs John Velis and Joe McGonagle outlining testimony on 20 House bills and 18 Senate bills. The hearing covered a wide range of veterans issues, including municipal veterans assistance funds, pension equity, expanding the Office of the Veterans Advocate, veterans service officer staffing, disability benefits eligibility, service dogs, POW tax relief, courtesy parking spaces, women veterans and motherhood, and workforce-related licensing and employment measures. Chairs emphasized the hybrid format, three-minute testimony limit, and written testimony process. Several bills drew support focused on expanding services and access. Representative Arena-DeRosa spoke for bills to broaden municipal veterans assistance funds to cover housing and legal expenses and to study enhanced pension equity for veterans, citing burn pit exposure and shorter life expectancy among veterans. Senator Fattman, Representative Peas, and Veterans Advocate Bob Notch supported bills expanding the Office of the Veterans Advocate to include active-duty service members and their families, arguing it would improve transition support, coordination with state agencies, and retention of military talent in Massachusetts. Representative Arriaga backed a bill to incentivize municipalities to provide full-time or regional veterans service officers and another to study the impact of combat on women veterans and motherhood. Representative Moulton/another sponsor also sought to exempt veterans’ disability payments from income calculations for other state benefits, and Representative Hong and Senator Scanlan supported a state service dog program, POW income tax relief, and courtesy retail parking spaces for veterans. Testimony also focused on workforce and claims-assistance issues. The Military Officers Association of America and James Keene urged passage of bills waiving duplicative education requirements so qualified veterans and military medics can become licensed practical nurses, arguing it would help address health care shortages and recognize military training. Brave Veterans Inc. called for a Veterans Research Trust Fund to protect data and program evaluation work during budget cuts. On claims assistance, one witness supported criminal penalties for unaccredited agents who charge veterans for VA claims help, while a private consulting firm opposed the bill, arguing it would restrict lawful speech and veterans’ choice and that existing federal and HERO Act safeguards already address abuses. The VFW strongly opposed paid claims consulting, said its accredited service officers provide free help statewide, and urged more public awareness of existing free services. No votes or final committee actions were taken during the hearing.

Transcript Highlights:

• Thank 2027 federal regulations as well.
• practice registered nurses are also certified registered nurse anesthetists and also removing the cautisole
• practice registered nurses are also certified registered nurse anesthetists and also removing the cautisole
• </c> Hawaii Association of Nurse Hawaii Association of Nurse Anesthesiology<00:44:55.520><c> and</c><
• practice registered nurses are also certified registered nurse anesthetists and also removing the cautisole

Committee: Senate Health and Human Services

Summary: The committee heard testimony on several health-related measures, with most of the discussion focused on bills addressing tobacco/vape enforcement, psychology licensure, hospital price transparency, prior authorization, and medical cannabis. The chair opened by explaining the one-minute testimony limit and that written testimony had been reviewed. For SB 2175 on disposable electronic smoking devices, the Department of Health said the bill’s placement in litter-control law was not a good fit because disposable e-cigarettes contain hazardous materials like lithium and nicotine, but it supported the intent and pointed to a related measure. Public health and tobacco-control advocates strongly supported the bill, citing youth use, toxic waste, battery fires, and the need to tighten definitions and remove exemptions; a long list of organizations and individuals were noted in support, with no opposition mentioned. For SB 2410, which would create a state directory and enforcement tools for authorized e-cigarette products, the Attorney General’s office strongly supported the measure and said it would help enforce the FDA-authorized list of products through certification, inspections, and civil penalties. The Department of Health said thousands of illegal products remain on the market and cited youth usage rates, while public health groups also supported the bill. One tobacco industry-related witness was noted in opposition. SB 2080, the psychology interjurisdictional compact, drew support from the Department of Corrections, which said it had severe staffing shortages and that the compact would help fill gaps, especially for forensic psychology and neighbor island facilities. Some committee members raised concerns about whether the compact would loosen licensure standards and reduce licensing revenue, and the Board of Psychology was said to be meeting and had not taken a formal position; testimony also noted the need for resources if the compact were adopted. The committee also heard SB 2276 on surgical assistance, with DCCA in opposition and a supporter from the field, but little discussion followed. SB 2277 on hospital price transparency drew support from consumer and patient advocates, who argued that clearer pricing would reduce medical debt and help patients shop for care; DCCA and the Department of Health offered comments, with the department suggesting an alternative enforcement model using outside review entities and noting that implementation would require significant staffing and funding. The Healthcare Association of Hawaii opposed the bill, saying federal transparency rules already cover the issue and state law could create duplication. SB 2282 on prior authorization received comments from insurers and providers; HMSA asked that the bill be set aside pending the report of the prior authorization working group created by Act 151, while the Hawaii Medical Association said prior authorization is a major burden but deferred to regulators on resources. Finally, SB 2413 on medical cannabis was supported by the Office of Medical Cannabis and others, who said the bill would close a patient-access gap by allowing viable seed sales; one witness suggested clarifying jurisdictional language and allowing dispensaries to sell seeds to each other. The committee then began SB 2425 on health insurance, where an addiction treatment provider testified that insurers’ refusal to honor assignment-of-benefits payments can delay reimbursement and create relapse risk for patients, but the transcript cuts off before further action on that bill.

Transcript Highlights:

• In 1948, we added the regulation of LPNs, and in 1995 we added advanced practice registered nurses.
• Currently, the board regulates 72,000 nurses.
• nursing education programs, setting standards for maintaining competence, and disciplining nurses for
• nurses right now.
• who are nurses who apply to become nurses that have positive criminal backgrounds.

Committee: All ALC-OCCUPATIONAL LICENSING REVIEW SUBCOMMITTEE

Summary: The Occupational Licensing Review Subcommittee met to review two occupational licensing reports: the Arkansas State Board of Nursing and the State Board of Registration for Professional Soil Classifiers. For nursing, board officials described the board’s history, scope, and licensure categories, noting it regulates about 72,000 nurses and oversees RNs, LPNs, advanced practice nurses, medication assistants, and a new dialysis patient care technician registry. Members asked about workforce shortages, complaint types, and the board’s finances; the board said Arkansas has enough licensed nurses overall but has vacancy issues in some areas, complaints commonly involve criminal backgrounds, fraud, misrepresentation, drug abuse, and misappropriation, and the average case length is 191 days though some cases remain open much longer while awaiting criminal adjudication. Officials also said they are working on efficiency improvements and have added help positions with Department of Health support. The report was accepted without objection. The committee then reviewed the soil classifier program, now housed under the Natural Resources Commission after the former board was abolished in 2023. Agriculture Department officials explained that soil classifiers are a small, specialized profession requiring a four-year degree with coursework in biological, earth, and soil sciences, and that the state currently has 29 registered soil classifiers. Members asked whether that number is sufficient, what the work involves, and how the program’s finances are used. Officials said the profession is mainly used for septic system design, wetland determinations, nutrient management, and other soil-related work, and that current staffing appears adequate. They also noted the program has about $20,000 in reserves, above the statutory three-year balance, and discussed possible uses such as training, curriculum upgrades, and expanded administrative funding. The report was also accepted without objection, and the meeting adjourned with the next meeting scheduled for February 19 at 1:30 p.m.

Transcript Highlights:

• This regulation is being amended to allow nurse practitioners to apply for the Veterans Affairs nurse
• regulation? regulation? Not<00:02:05.360><c> seeing</c><00:02:05.600><c> any.
• </c> comments uh for the ordinary regulation. comments uh for the ordinary regulation.
• The regulation regulation regulation itself,<00:32:22.799><c> I</c><00:32:23.120><c> it's</c><00:32:23.360
• Please call next regulation. Board of Nursing 2011 K20215 amends to remove the requirement...

Summary: The subcommittee approved the minutes from the previous meeting and then took up several regulations. The first was a Department of Veterans Affairs regulation, with a staff amendment, to allow nurse practitioners to apply for the Veterans Affairs nurse loan repayment program year-round and to make technical drafting changes. The committee heard from the Office of Kentucky Veteran Centers, then adopted the staff amendment and approved the regulation without objection. The main item of the meeting was the Board of Optometric Examiners’ proposed amendment to 201 KAR 5:010, which would allow applicants to use the Optometry Examining Board of Canada written exam in place of part one of the National Board of Examiners in Optometry exam for licensure. The board said the change would improve access to care, provide an additional pathway for Canadian-trained candidates, and still require applicants to pass the remaining national board parts. Opponents, including NBEO officials, ARBO, Pearson VUE, and several optometrists, argued the Canadian exam is not equivalent, does not test the same biomedical science content, is not validated for U.S. scope of practice, and raises concerns about test security, transparency, and portability across states. They urged the committee to find the amendment deficient or vote no. Committee members questioned both sides about prior communication with the board, whether Kentucky would be the first state to adopt such a change, the rationale for the proposal, and the cost difference between the exams. Supporters said the board had received some written comments and one phone call, and that the proposal was driven by access concerns and the presence of Canadian students. Opponents said they had not had direct discussions with the Kentucky board before the hearing. No final vote on the optometry regulation is reflected in the transcript excerpt, but the committee heard extensive testimony and rebuttal before moving on.

Transcript Highlights:

• The reason for this is nursing homes are regulated and can only install what is allowed by state or federal
• The bill modernizes cosmetics regulation in our state.
• regulations.
• I contacted LDH last year with questions regarding those regulations.
• So is there any aspect of this... ...parts of nursing.

Committee: Senate Health & Welfare

Summary: The Senate Committee on Health and Welfare met on May 13 with a quorum present and approved the prior meeting minutes. The committee first heard HB 971, which would equalize Medicaid reimbursement rates between independent clinics and hospital-owned rural health clinics; supporters said independent clinics are disadvantaged by a large payment disparity, and the bill was reported favorable without objection. The committee also recognized visiting Alpha Phi Alpha members and other guests during personal privilege remarks. Members then considered HB 414, which would bar hiring certain health care workers and direct support professionals with serious disqualifying convictions from other states and address background-check issues for therapeutic group homes. After adopting three amendment sets, the bill was reported as amended. HB 740, creating an independent review process for Medicaid behavioral health claim disputes in the coordinated system of care, was amended to clarify applicability and CSOC definitions and then reported as amended. HB 288, which would place the term “miscarriage” alongside “spontaneous abortion” in medical documentation, drew emotional testimony from affected parents and advocates; the committee reported it favorable. The committee also advanced several more bills: HB 405, updating the name of the national acupuncture certifying body, was reported favorable; HB 786, prohibiting extrapolation in certain managed-care claims recoupments, was reported favorable; HB 1095, allowing alternative backup power sources for nursing homes, was reported favorable; HB 403, raising the cottage food gross-sales cap, was amended from $50,000 to $150,000 and then reported favorable; HB 930, modernizing cosmetic-product regulation and creating a small-producer exemption, was reported favorable; HB 557, defining long-term pharmacies for policy purposes, was reported favorable; HB 779, on expedited partner therapy for sexually transmitted diseases, was reported favorable; HB 915, setting utilization-management timelines and standards, was reported favorable; HB 546, expanding criteria for peace officers to take someone into protective custody during a mental health crisis, was reported favorable; HB 796, creating a chiropractic preceptorship program, was reported favorable; and HB 933, authorizing commemorative birth certificates, was reported favorable. The final major item was HB 1041, a “no-mandate” bill barring discrimination based on medical intervention status. The sponsor and Surgeon General said it was aimed at healthy, asymptomatic individuals and not at public health quarantine powers, but Senator Boudreaux objected to exemptions for schools and hospitals and offered an amendment to restore broader coverage. That amendment failed on a roll-call vote, and the bill remained under discussion as the transcript ended, with no final committee disposition shown in the excerpt.

Transcript Highlights:

• </c><00:13:28.720><c> midwives</c> College of nurse midwives College of nurse midwives I'm<00:13:29.959
• </c><00:17:15.400><c> to</c> thing that needs to be uh regulated to thing that needs to be uh regulated
• </c><00:19:16.320><c> profession</c> that of the regulated profession that of the regulated profession
• I got licensed as a nurse midwife here, and I'm practicing currently as a nurse midwife at Kaiser.
• </c> Program in Midwifery as a non-nurse Program in Midwifery as a non-nurse student<02:01:01.079><c>

Summary: The joint House Committee on Health and Committee on Consumer Protection and Commerce heard two midwifery bills, with testimony focused primarily on HB 1194. Committee chairs opened the hearing with rules for Zoom testimony and noted the bills relate to midwives. The Department of Commerce and Consumer Affairs said it supported the intent of HB 1194 and offered comments. Supporters of the bill, including the Midwives Alliance of Hawaii, argued that midwifery should remain subject to mandatory licensure to protect consumer safety, citing the state’s regulatory licensing standards and a 2025 state auditor sunset analysis. They said the bill would strengthen educational standards and public protection, and some offered clarifying amendments. Opponents argued HB 1194 would restrict access to care and fail to protect traditional, cultural, and community-based birth practices. Testifiers from the Hawaii Home Birth Task Force, the Hawaii Home Birth Collective, the Libertarian Party of Hawaii, the Center for Reproductive Rights, Pacific Birth Collective, and Papa Ola Lōkahi said the bill would limit licensure pathways, reduce access in rural and underserved areas, and burden Native Hawaiian and traditional practitioners. Several speakers said the measure could worsen Hawaii’s maternal health shortages, especially on Maui, and urged lawmakers to defer HB 1194 or instead advance HB 1328, which they said better protects practitioner access and cultural practices. The Hawaii affiliate of the American College of Nurse-Midwives said it opposed HB 1194 because it did not align with national or state standards for certified midwives and could create conflicts with Medicaid reimbursement and prescriptive authority. The ACLU also opposed the measure, emphasizing reproductive rights, privacy, and the need to preserve apprenticeship pathways to licensure. No vote or final committee action was taken during the portion of the hearing reflected in the transcript.

Transcript Highlights:

• House Bill 4115, Madam Witt, members, expands the applicability of statute regulating circulators and
• House Bill 2729 continues the Arizona State Board of Nursing for four years.
• I understand there's been some difficulties with the Nursing Board at this time.
• We watch California crumble because of regulation. We watch people leave New York.
• This bill addresses the regulation so that we can keep regulation equal or a little bit below the demand

Summary: The meeting was a lengthy caucus-style review of many bills and resolutions across multiple committees, with staff giving brief descriptions and most items placed on consent or third-read consent calendars. Topics included appropriations, commerce, education, government, health and human services, environment, public safety, and transportation. Measures discussed ranged from school policy and board continuations to housing, water, public safety, licensing, and election-related changes. Several bills were noted as strike-everything amendments or as having been amended in committee. A number of bills drew sponsor comments or brief questions. In education, members discussed bills on teacher strikes, school math placement, school meals, student clubs, bond election disclosures, and a proposed commission on student outcomes. In health and human services, members discussed nursing board rules, pharmacist testing and treatment authority, medical records timelines, opioid antagonist expiration dates, and a proposed constitutional amendment on the right to refuse medical mandates. In government and public safety, members debated funding and staffing issues for DPS and corrections, including a proposed public safety parity fund, as well as bills on county sheriffs, legal representation for DPS, and corrections oversight funding. There was also discussion of election and local government measures, including inactive voter list procedures, circulator disclosure rules, and committee termination filings. Other topics included housing affordability districts, development fees, historic-area middle housing exemptions, water and groundwater management, environmental compatibility siting, and trade-related commissions. One notable exchange involved HB 4044, where members debated whether using rainy day fund interest for public safety pay was fiscally responsible; supporters argued it was a practical way to fund raises, while opponents said it would weaken the fund and should instead be handled through the general fund. No roll-call votes were taken in the transcript, and most items were simply presented, briefly discussed, and left on consent or third-read consent calendars.

Transcript Highlights:

• </c> second to that is individuals in nursing second to that is individuals in nursing homes<00:30:19.679
• </c> Um we do do investigations into nursing Um we do do investigations into nursing homes.<00:43:08.319
• </c><00:43:41.280><c> home</c> consider going to visit a nursing home consider going to visit a nursing
• While the intent of the administrative regulation is very much appreciated, the regulation shows that
• You know, the regulation today is very... You know, the regulation today is very important.

Summary: The committee’s first interim meeting opened with roll call and a reminder that Kentucky had 8,641 children in out-of-home care with active placements as of June 1, 2025. The first presentation was from the Center for Courageous Kids (CCK), a donor-funded camp in Scottsville that serves children with lifelong illnesses and disabilities at no charge. Representatives described the camp’s history, its year-round family retreats and summer sessions, its medical and accessibility supports, and its impact on campers’ confidence and independence. They said CCK has served more than 43,000 campers from 46 states and 13 countries, including 22,000 from Kentucky, and noted plans to reach all 120 Kentucky counties. CCK also outlined future capital needs: a new art barn and a medical lodge. The organization said the art barn project would cost $2.5 million, with a legislative request of $1.5 million, and the medical lodge would cost $2.875 million, with a legislative request of $1.75 million. Members responded very positively, with several praising the camp’s work and one member asking about operational challenges. CCK said its main challenges are awareness, staff and volunteer recruitment, and expanding medical and housing capacity; it also said it is accredited by the American Camp Association and receives health and safety visits and audits. The committee then moved to a presentation on adult protective services and state guardianship programs from Jessica Wayne and Cliff Bryant of DCBS. They explained the legal framework for guardianship, the difference between full and limited guardianship/conservatorship, emergency appointments, and the state’s role as a last-resort guardian when no family member or private entity is available. They reported 4,464 individuals under state guardianship as of June 1, with most cases involving dementia, developmental disability, intellectual disability, nursing home or long-term care placement, severe mental illness, or brain injury. They also said the division has 89 field workers across 14 regional offices, with an average caseload of 52 and a goal of reducing that into the mid-40s through additional hiring.

Transcript Highlights:

• . physicians, nurses, and EMTs.
• Finally, we have nursing.
• We are one of 48 states to be in the nursing compact.
• As you all know, nursing homes are the most highly regulated facilities outside of nuclear facilities
• We have nursing students.

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• Yeah, well, it's like why do we have regulations? Why do we have regulations at that point?
• Yeah, well, it's like why do we have regulations? Why do we have regulations at that point?
• There's no regulation of cost.
• c> that</c><00:37:07.400><c> cost</c> Who regulates right now that cost Who regulates right now that
• </c> there is nothing regulating cost. there is nothing regulating cost.

Committee: Senate Human Services

Transcript Highlights:

• ,</c> stress can disrupt emotional regulation, stress can disrupt emotional regulation, sleep,<00:42:
• </c> This is not the way I think as a nurse This is not the way I think as a nurse we<00:46:19.920><c
• </c> retired was a school nurse retired was a school nurse and<00:46:26.600><c> I</c><00:46:26.640><c
• </c> regulate federal operations at all. regulate federal operations at all.
• Association, a vice president with National Nurses United, and a nurse who has been serving patients

Committee: Senate Health and Human Services

Transcript Highlights:

• Christopher Otto, Executive Director of the Delaware Nurses Association, registered nurse, here and offering
• Susan Cunditabuck, family nurse practitioner, thank you for this bill.
• I speak on behalf of the Delaware College of Nurse Practitioners, as well as the Delaware Nurses Association
• I’m a wound care and infection prevention nurse.
• and nursing community.

Bills: SB274 , SB301 , SB249

Committee: House Health & Human Development

Summary: The committee heard and advanced several measures related to health care, public health, and patient protections. House Concurrent Resolution 148, urging a statewide educational strategy on menopause, was presented as a workplace awareness measure and received supportive comments from members before being released. Senate Bill 274, updating Delaware’s MOST program to POLST and clarifying capacity determinations and documentation for end-of-life orders, also drew supportive testimony from medical and nursing groups and was released. House Bill 458, limiting local backflow preventer requirements for certain low-hazard buildings, was presented as a cost-relief measure for homeowners and small businesses; DHSS expressed concerns but said it was willing to work on amendments and a sunset provision, and the bill was released. Senate Joint Resolution 18, designating August 31, 2026 as International Overdose Awareness Day and ordering flags at half-staff, was released after brief supportive remarks. The committee then considered Senate Bill 339, a technical correction to the advance health care directive form clarifying that an agent’s authority for voluntary mental health admission cannot exceed 72 hours, consistent with existing law. Members asked detailed questions about how the 72-hour limit works and whether it applies to voluntary directives; the sponsor and a Disability Rights Delaware witness explained that the bill only aligns the form with current statute and does not expand authority. The bill was released. House Bill 301, requiring hospitals to create discharge plans for pregnant patients discharged while showing signs of labor, prompted extensive discussion. The sponsor and supporters said it would improve safety, transportation planning, and aftercare, while some members noted Delaware hospitals already do much of this work and questioned whether codifying it was necessary; supporters emphasized maternal mortality disparities and the need for guardrails. The bill was released. Senate Bill 196, creating ownership disclosure requirements for long-term care facilities and resident notice rules after ownership transfers, was presented as a transparency measure for seniors and families and was released after supportive testimony from the Delaware Nurses Association and elder-care advocates. Senate Bill 320, expanding pharmacists’ independent prescriptive authority for certain non-controlled medications and allowing opioid use disorder medications under standing order, with added malpractice reporting requirements in Senate Amendment 2, was supported by pharmacists and nurse practitioners as an access-to-care measure and was released. Senate Substitute 1 for Senate Bill 161, establishing a unified licensing and oversight framework for adult behavioral health providers under DSAM, was presented as a patient-protection measure; providers supported the goal but cautioned that regulations must be workable, and the substitute was released. Senate Joint Resolution 19, directing DHSS to study strategies to reduce health care costs, was released with a note reflecting concerns about broadening the analysis to include additional cost drivers and alternatives. Finally, Senate Bill 249 with Senate Amendment 2, modernizing harm-reduction programs and paraphernalia laws, generated the most extended debate: supporters framed it as life-saving public health policy, while opponents raised concerns about needle litter, community impacts, and whether the approach facilitates addiction. Despite the objections, the bill was released.

Transcript Highlights:

• </c> that we have state regulation over. that we have state regulation over.
• appointed by the Nurses Association, a pediatric nurse, licensed school nurses, health care providers
• appointed by the Nurses Association, a pediatric nurse, licensed school nurses, health care providers
• appointed by the Nurses Association, a pediatric nurse, licensed school nurses, health care providers
• appointed by the Nurses Association, a pediatric nurse, licensed school nurses, health care providers

Committee: Senate Commerce and Consumer Protection