Transcript Highlights:

• of respiratory care practitioners.
• Respiratory care practitioners provide highly specialized, often life-sustaining care under physician
• People are submitting plans all day, every day across the state and having them without requiring an
• or full-day rates.
• or full-day rates.

Keywords: 988, house, all

Transcript Highlights:

• every day.
• We care for patients.
• and risks restricting care that is already being provided safely every day.
• Team-based collaborative care is what we provide every day in our communities.
• aesthetics the next day.

Committee: Joint Joint Committee on Public Health

Summary: The Joint Committee on Public Health heard testimony on four bills: H. 5013 and S. 2928, which would establish a three-year celiac disease screening pilot program for children during routine cholesterol/lipid screening around ages 8 to 12; H. 5087, regulating the operation of medical spas; and H. 5115, establishing statewide food truck regulations, though the hearing focused almost entirely on the celiac and medical spa bills. Committee chairs outlined three-minute testimony limits and noted members present in person and online. Supporters of the celiac screening bills, including Rep. Badger, Sen. Lovely, patients, clinicians, and researchers, described long delays in diagnosis, the lack of a cure beyond a gluten-free diet, and the potential for early screening to prevent years of damage, missed school and work, and long-term complications. Testifiers said celiac disease is common but frequently undiagnosed, that a simple blood test can identify many cases, and that a pilot would help assess feasibility, cost, accuracy, and family acceptance. Several witnesses emphasized that the proposal includes education and support for families after diagnosis, and some cited international screening efforts, especially in Italy, as evidence that population screening can work. Testimony on H. 5087 was largely opposed by medical spa owners, nurse practitioners, physician assistants, and a plastic surgeon. Witnesses argued the bill is outdated, duplicative of existing Massachusetts licensing and public health rules, and inconsistent with current scopes of practice and team-based care. They said the proposal could restrict access, burden small and women-owned practices, and fail to address the real issues of training, compliance, and patient safety. Some said they support regulation in principle but want the bill revised to reflect current law and modern practice. Committee members asked a few clarifying questions, including about celiac testing methods and the relationship between the medical spa bill and current state law, but no votes or formal actions were taken during the hearing.

Transcript Highlights:

• They will be paid by attendance, the number of days that a child is in their care.
• a month of child care and they're only showing up for... ...20 or 25 days a month of child care, and
• We have child care centers on the one hand and then we have home child care on the other hand.
• And then we have home child care on the other hand. One is organized at home child care.
• And to this day, I'd like to make sure that she knows that I've never forgotten that day.

Bills: SCR8410

Keywords: returning bills to house of origin, sine die, end of session, legislative procedure, Rules Committee, third reading, unfinished business, pending bills, joint resolutions, concurrent resolutions, joint memorials, special session, bill numbering, legislative records, House of Representatives, Senate, Washington Legislature, session adjournment, procedural resolution, 904

Summary: The Senate took up several bills on final passage, beginning with Substitute House Bill 2689 on the Working Connections Child Care program. The chamber adopted a Ways and Means striking amendment, then passed the bill 33-16. Supporters said it would change provider payment to attendance-based reimbursement, require subsidy rates to reach at least the 75th percentile of market rates, update use of market rate surveys, and remove previously scheduled income-eligibility expansions. Opponents argued it would not treat all child care providers equally and could create unfair workarounds. The bill was immediately transmitted to the House. The Senate then passed Engrossed House Bill 2487, which clarifies how insurance companies and their affiliates are taxed, and Substitute House Bill 2089, which narrows a tax preference for certain financial institutions and dedicates the revenue to the Wildfire Mitigation Fund. HB 2487 drew criticism for applying the tax retroactively to 2019 despite prior court rulings, while HB 2089 was opposed on affordability grounds because it affects mortgage-related taxation. The chamber also passed Engrossed House Bill 2681, raising annual license fees for cannabis producers, processors, and retailers; opponents said the increase reflected broader budget pressures. A major portion of the meeting was devoted to Senate Resolution 8704 honoring Senator Rebecca Saldaña. Numerous senators from both parties praised her work on labor, environmental justice, child welfare, immigrant and worker rights, and her habit of centering marginalized communities and checking on colleagues personally. Saldaña responded with remarks about organizing, democracy, and the importance of collective action, saying she was grateful for the chamber and looking forward to the next chapter. The Senate adopted the resolution unanimously, and members agreed to add all senators’ names as co-sponsors. The Senate also adopted Senate Resolution 8702 honoring Senator Judy Warnick, with speakers from both parties highlighting her long service, agricultural background, calm leadership, bipartisan approach, and work on rural economic development, children and families, and capital projects. Warnick thanked colleagues and said she looked forward to spending more time with her family, farm, and horses. The meeting also included routine motions to move between orders of business and a message from the House concurring in Senate amendments to several bills.

Transcript Highlights:

• This bill would create a streamlined referral process for Care Court. Care Court is our...
• One day... One day stands out in particular for its heedlessness and devastation.
• day laborers.
• day laborers.
• There's plaques in New York and West Massachusetts of the Jewish day labor centers, the Italian day laborers

Committee: House Judiciary

Keywords: 988, house, all

Transcript Highlights:

• Access approval within 24 days.
• It continues to this day.
• The only problem was it was dated that day.
• Versus quality-of-care concerns?
• ..or timely, even as Access relies on aggregated percentage-paid statistics that do not reflect the day-to-day

Committee: Senate Health and Human Services

Keywords: 1182, all

Transcript Highlights:

• I have a suite of bills in the care and protection space.
• Another reason we need child care in the state, but that's a different conversation for a different day
• In fact, she threatened me. child care in the state?
• All three girls are in foster care.
• I was mad because she didn't come home for Mother's Day.

Committee: Joint Joint Committee on Children, Families and Persons with Disabilities

Keywords: 995, all

Summary: The committee heard testimony on a package of Department of Children and Families bills focused on care and protection proceedings, sibling placement, parenting time, foster parent eligibility, adoption timelines, and a proposed Harmony Montgomery Commission. Rep. Marjorie Decker framed her bills as a set intended to reduce trauma for children removed from home by promoting sibling placement, visitation, cultural continuity, and limits on barriers to foster/adoptive placement. Witnesses from CASA, the Massachusetts Child Welfare Coalition, CPCS, and others generally supported the sibling-placement and parenting-time bills and the Harmony Commission, while several urged that the commission include a birth parent with lived experience and that its scope remain focused on child safety and family rights. A former juvenile court judge also supported the Harmony Commission, citing failures in the Harmony Montgomery case and broader concerns about DCF power and child representation. No votes were taken during the hearing. A large portion of the hearing focused on Senate 114, the “Family Protection and Transparency Act,” which would require DCF to provide families with written and verbal notice of their rights during investigations, including the right to remain silent, consult counsel, and refuse entry absent legal authority except in emergencies. Supporters included parents, former foster youth, attorneys, advocates, and a peer mentor, many of whom described personal experiences of confusion, coercion, retaliation, and family separation when DCF became involved. They argued the bill would improve due process, language access, transparency, and accountability without limiting DCF’s emergency powers. Several witnesses also described intergenerational DCF involvement and said families often need resources and legal guidance rather than punitive intervention. Testimony on House 268 emphasized the importance of keeping siblings together in foster care whenever possible. Advocates cited research showing better mental health, educational, and reunification outcomes when siblings remain together, and several young people testified about being separated from brothers and sisters and the lasting impact of that separation. CPCS supported the bill and said regular sibling visitation should be required when joint placement is not possible. House 269, 270, 271, 288, and 293 were also on the notice, but the transcript reflects little or no testimony on some of those measures. The hearing concluded after the committee heard from all scheduled witnesses and invited written testimony for additional details.

Transcript Highlights:

• She requires ICU-level care every single day, care that my wife, our nurses, and I safely provide in
• care as visits.
• Two plans have reinterpreted the statute and capped home care nursing to just 10 days per year for 2026
• </c> but the total cost of care. but the total cost of care.
• . care. care.

Keywords: 918, senate, all

Summary: The committee heard public testimony on a health insurance/home care nursing provision and on other consumer protection items. Nick Keis and Emily Walters, both parents of medically complex children, testified that commercial health plans had recently begun capping home care nursing as if it were intermittent home health visits, which they said was contrary to Minnesota law and legislative intent dating to 2010. They described severe impacts on their families, including hospitalizations, loss of nursing coverage, strain on waiver budgets, and the risk of children being forced out of the home and into institutions. Representative Bierman echoed that the bill was a straightforward clarification of existing law, not a new mandate or added cost, and a staff member later cited the statutory definition of home care nursing as ongoing, continuous nursing services that cannot be met through intermittent or visit-based care. The committee also discussed the practical difference between home health visits and private duty/home care nursing, with testimony emphasizing that the latter is medically necessary, assessed, and not unlimited in practice. Laura Sales of the Minnesota Attorney General’s Office testified on changes to the Consumer Protection Restitution Fund (CIPRA). She said the fund has begun distributing restitution, starting with consumers harmed by the closure of Woodbury Dental Arts, but that current statutory language limits the office’s flexibility to prorate payments. She asked for an amendment allowing the AGO to distribute available funds more equitably so more eligible consumers can receive some payment, rather than requiring full payment to the oldest claims first. Annette Meeks, representing Citizens Against Gambling Expansion, testified in support of banning sweepstakes gambling in the Commerce Committee omnibus report. She argued that online sweepstakes casinos are an illegal gray-market form of gambling, cited rapid growth and billions in revenue, and said other states have acted through enforcement and legislation to stop them. She urged the committee to include language from Senate File 4474 to clarify state law and prohibit sweepstakes gambling. No votes were taken in the portion of the meeting shown; members mainly asked questions and received testimony.

Transcript Highlights:

• and home two days, gone 10 days, home two days.
• and home two days, gone 10 days, home two days.
• Yeah, so my question, day one, coming into this position was, to the point on managed care, just in general
• , but it's access to care.
• And everyone, have a great day.

Summary: The subcommittee heard budget presentations and questions from several health and human services agencies, with members repeatedly emphasizing that agency numbers had been posted since October and that questioning should stay focused and brief. The Office of Juvenile Affairs said its $5.45 million request would support 162 employees receiving a pay adjustment, and members asked about juvenile care conditions and staffing. The Department of Human Services discussed major changes to child care subsidy funding, including a reduced subsidy request, a $11.5 million child care teacher recruitment/retention request, and planned eligibility and reimbursement changes; it also reviewed SNAP administrative cost shifts under federal law, the state’s SNAP error rate, and the risk of large future state costs if the error rate is not reduced. DHS also addressed TANF reserves, the DDS waiver wait list, the Greer Center buildout, the Advantage waiver supplemental, and meal service options for waiver members. OCCY described a largely personnel-driven budget, requests for more oversight staff, and workload pressures in juvenile competency evaluations. The Office of Disability Concerns reported a flat budget and said it relies mainly on mediation and informal resolution rather than enforcement. OSU Medical Authority said its Tulsa expansion, VA skybridge, and c-section suites remain on schedule, that psychiatric residency funding is being phased in over several years, and that it is working to reduce contract labor and evaluate service lines. J.D. McCarty Center reported its new ABA outpatient clinic is on time and on budget and is nearing full capacity. OMMA said its lab is following required standards, its FTE count is below budgeted levels because hiring depends on lab accreditation and other unknowns, and dispensary numbers continue to decline as the market matures. Oklahoma Rehabilitation Services said it needs about $1.4 million to avoid a maintenance-of-effort penalty and discussed aging campus capital needs and staffing vacancies. The Oklahoma Health Care Authority then outlined a very large budget requirement driven by utilization growth and the shift to value-based care, saying FY26 is currently stable but FY27 would likely require additional appropriations if the request is not fully funded.

Transcript Highlights:

• So it rides Us up to $289.69 a day. The psychiatric care housing is $462.13 a day per person.
• detox or 11-day, whatever.
• We reduced days in jail from 102 days to 57 days in jail the next year.
• You forgot the first day?
• for the next day, etc.

Committee: House Courts, Corrections & Justice Committee

Transcript Highlights:

• AB 1973 ensures patients get timely care from providers, AB 1973 ensures patients get timely care from
• Fellowship, I have provided care up to 13 weeks and six days.
• We respectfully urge careful consideration of the price and any impact on health care premiums.
• Hospitals care for patients with the greatest health care needs.
• care.

Summary: The Assembly Health Committee heard a long agenda of health-related bills, with most items presented for later vote once quorum was reached. Early in the hearing, the committee adopted a consent calendar of multiple bills with motions for due pass to Appropriations, and it noted that AB 2029 had been pulled from the agenda. The committee also took up AB 1973, a bill by Aguiar-Curry to expand who may provide procedural abortion care. Supporters, including physicians and certified nurse midwives, argued the bill would align law with current training and improve access, while opponents said later-term abortion procedures require physician-level surgical training and raised safety concerns. The author emphasized hands-on training, consultation, and transfer protocols, and the bill was held pending quorum with a motion and second recorded. The committee then heard AB 1558 by Arambula, which would adopt the Uniform Emergency Volunteer Health Practitioners Act to speed the use of out-of-state licensed volunteers during declared disasters. Supporters from the Uniform Law Commission and the Red Cross said the bill would reduce delays and clarify legal authority for volunteer health workers; there was no opposition testimony. AB 2282 by Alanis, a temporary rural emergency stabilization center for Patterson while a permanent hospital is built, drew support from local emergency responders and a late opposition from the California chapter of ACEP. The chair praised the bill as a creative local solution and agreed to coauthor it; a motion and second were recorded, with the vote to occur later. Several public health access bills followed. AB 1843 by El-Hawari would limit prior authorization and align hepatitis C treatment coverage with medical guidelines; supporters said it would remove barriers to a curable disease, while health plans opposed it as a mandate, citing premium impacts and the recent SB 306 prior-authorization process. AB 2247 by El-Hawari would create the THRIVE program for mental health services for youth affected by gun violence; Youth Alive and other supporters described trauma-informed, community-based care, and the chair and another member asked to be added as coauthors. AB 2138 by Krell would expand access to certified peer support specialists in enhanced care management and remove automatic disqualifications based solely on criminal history; supporters said peers are essential to engagement and recovery, and the bill was held with a motion and second. Later, AB 1682 by Hart would require coverage of scalp cooling for chemotherapy patients, with emotional testimony from cancer survivors and clinicians; insurers opposed it as another mandate, but the author stressed the modest per-member cost and the bill was moved with a motion and second. AB 1879 by Dixon would standardize data reporting for alcohol and drug treatment facilities, including private providers, to improve statewide information on outcomes and access; the bill drew broad support from recovery organizations and the prior opposition was withdrawn after amendments. AB 1906 by Aguiar-Curry would require coverage of at-home cervical cancer screening kits without cost sharing; supporters cited improved access for rural and working Californians, insurers opposed it on affordability grounds, and the bill passed on a recorded roll call after quorum was established. Finally, AB 1556 by Haney would clarify and support drug-free recovery housing and return-to-use policies; supporters said it would expand sober housing options, while opponents warned it could allow evictions after relapse and conflict with Housing First principles. The hearing ended with the bill still under discussion and opposition-unless-amended concerns noted.

Transcript Highlights:

• And it was really, really tough for me because I care for you. I care for you.
• I care for you so much.
• plans every 30 days when a person is receiving inpatient care.
• We don't care. They didn't care so bad. You know what they did?
• Thank you. 20 days, 14 days, Mr. President. Show the bill passes.

Summary: The Senate convened with a quorum, opening prayer, Pledge of Allegiance, and several introductions and recognitions, including a resolution honoring Bob Graham and a moment of silence for firefighter Roger Timmy Miley. The chamber then moved through a special-order calendar with multiple bills, many of them paired with House companions and amended before final passage. Early action included adoption of a tax conformity bill tied to federal changes in the Internal Revenue Code, with a 34-0 vote. The most extensive debate centered on CS/CS/SB 1758, a Medicaid and SNAP reform bill. The sponsor described provisions to strengthen fraud enforcement, impose work requirements for able-bodied adults, expand behavioral health services through a waiver, modernize Medicaid drug purchasing, and require a SNAP fraud-reduction plan and photo ID on EBT cards. Democrats offered amendments to delay work requirements until Medicaid expansion and to add protections for SNAP users such as caregivers, seniors, disabled individuals, and domestic violence survivors; both amendments failed. Senators also questioned implementation details, exemptions, and potential effects on vulnerable populations. After debate, the bill was placed on the calendar for third reading. The Senate also passed bills on technology education and AI instruction, a public records exemption and related Parkinson’s Disease Registry measures, designation of the SS American Victory as the state flagship, electronic payments for local governments, repeal of the sunset on legal tender recognition for gold and silver, public records protections for financial and digital-asset custodians, a Florida stablecoin pilot program, local government budget transparency, digital voyeurism, insurance customer representative licensing, and a medical freedom bill with amendments on vaccine-related materials and anti-kickback provisions. Most of these measures passed with little or no opposition, though the public records bill for gold/silver custodians and the legal tender repeal drew a few dissenting votes.

Transcript Highlights:

• if they're not putting it in, they don't care, if I don't care.
• to lower levels of care.
• So. ...because it's being said, well, 180 days and in 30 days. It doesn't say that.
• But at the end of the day, we know health care is expensive.
• They're not out there working day in and day out. This bill is simply to protect workers.

Committee: Senate Commerce and Labor

Keywords: 909, all

Transcript Highlights:

• I move that the five-day rule...
• And folks are concerned about little access to care, but also the quality of care once these mergers
• care prices to rise.
• In health care generally causes health care prices to rise.
• And instead of spending the rest of that day playing with our young son, we spent the day with armed

Committee: Senate Law & Justice

Keywords: 904, all

Transcript Highlights:

• Our home care services are not the same as I think other people think about home care.
• Our direct care team delivers 6.11 hours of care per resident day, including 0.93 RN hours, 0.8 LPN hours
• Holyoke continues to exceed national long-term care benchmarks and direct care staffing.
• Our team delivers 6.99 hours of direct care per veteran day, including 1.48 RN hours, 0.79 LPN hours,
• Number two, taking care of the people that take care of veterans, that's all of us.

Committee: Joint Joint Committee on Ways and Means

Summary: The Joint Committee on Ways and Means held an FY27 Health and Human Services budget hearing in Mattapan, hosted at the Boston Public Library branch. Chairs Lydia Edwards and Russell Holmes, along with Rep. Brandy Fluker-Reid, emphasized the significance of holding the first Ways and Means hearing ever in Mattapan and highlighted the importance of bringing state budget deliberations into a majority-Black neighborhood. Several legislators introduced themselves as they joined, and the committee noted that public testimony was not part of the format, though agencies were invited to discuss priorities and challenges. MassAbility opened the agency testimony. Leadership described the agency’s mission to support people with disabilities through employment, training, home and community life services, and disability determination. They said Governor Healey’s FY27 budget funds MassAbility at $93.3 million, a 1% reduction from FY26, and explained that the agency is responding to federal funding uncertainty and shifting program needs by redesigning services internally. Members questioned a proposed $1.3 million reduction to the Home Care Program, staffing changes, and whether services could be maintained with fewer resources. MassAbility said it was reviewing data on who uses the program, that it does not provide nursing or personal care, and that it is working with a transition plan and a working group. The agency also discussed federal uncertainty around vocational rehabilitation funding and said it had received delayed federal awards but remained in contact with national associations and federal partners. The testimony included a personal story from a participant, Joshua Corcoran, to illustrate the impact of services. The Massachusetts Commission for the Deaf and Hard of Hearing testified next, requesting $11.27 million, about a 6% increase over FY26. The commission said it serves about 1.4 million residents and focuses on communication access in health care, courts, public safety, and other public systems. It highlighted interpreter and captioner workforce shortages, a mentorship program to expand the provider pool, and a modernized referral platform funded through capital contingency money. Members asked about interpreter availability, after-hours emergency coverage, ASL access for students and families, and training for police and emergency responders. The commission said staffing remains limited, especially for after-hours services, but that it is expanding training, school outreach, and partnerships with DCF and other agencies. The Massachusetts Commission for the Blind then presented its FY27 budget request of $30.8 million. The commissioner said the agency serves nearly 9,000 legally blind residents, provides training and peer support, and placed 190 consumers in competitive integrated employment this year. It also described services for older adults, vocational rehabilitation, and the Turning 22 program for young adults with additional disabilities. Members raised concerns about a 7% cut from the prior year and asked how the agency could maintain services; the commissioner said the agency had no waiting list, had trimmed overhead, and could manage the budget through internal efficiencies and strong partnerships. The Office for Refugees and Immigrants closed the session, describing expanded legal and support services for immigrants and refugees, including Know Your Rights trainings, the Massachusetts Access to Counsel Initiative, citizenship and financial literacy programs, and the Family Welcome Center in Mattapan. Members asked about federal funding losses and the structure of the new legal services program; ORI said FY26 funding is stable but FY27 federal cuts remain uncertain, and that the legal program uses a centralized intake system with priority for emergencies and first-come, first-served access.

Transcript Highlights:

• than exiting care.
• than exiting care.
• languishing in care.
• It was certainly day to day. What I can commit to...
• or behavioral health care.

Summary: The committee heard a lengthy update on Washington child welfare from Casey Family Programs and DCYF. Dr. David Sanders said Washington has sharply reduced out-of-home care and increased kinship placements, but he flagged concerns about low screening-in rates, long stays in foster care for many children, and a recent rise in repeat maltreatment and child fatalities, especially among infants. He urged more focus on infants and young children, better coordination among child protection, health care, and law enforcement, and more proactive review and investigation practices. Members asked for disaggregated data on children lingering in care, fatalities, and causes such as fentanyl exposure. DCYF said it has increased relative placements and guardianships, but also reported a concerning rise in 2025 critical incidents, mostly near-fatalities involving children age three and under, many opioid-related. The department described responses including safe child consults for opioid cases, more training, hotspot analysis, and proposed investments in peer support, public health nurses, community referrals, and an updated safety framework. Members also discussed whether a broader commission on child abuse prevention would be useful, and DCYF said it was open to that idea. The committee then received a DSHS reorganization update from Secretary Angela Ramirez, who described the “Reimagined” plan to consolidate four administrations into three new ones, with the stated goals of reducing silos, improving customer experience, and making transitions between services smoother. She said the agency is seeking statutory changes and CMS approval to align the new structure, and members asked about preparing for federal HR1 impacts, especially SNAP. Ramirez said DSHS is monitoring those impacts closely and emphasized the need for accurate data and cross-agency coordination. Finally, DSHS’s Behavioral Health and Habilitation Administration updated the committee on residential habilitation centers and implementation of Substitute Senate Bill 5393, which phases out Rainier School by June 30, 2027 and limits new admissions. Officials reported current census and staffing levels at the state’s RHCs, said Rainier has had some residents transition to supported living or adult family homes, and explained that emergency and permanent rulemaking was needed to implement the law. They also said Rainier was recently cited by federal surveyors for not meeting the active treatment requirement for two residents, and that the facility has 90 days to return to compliance before possible payment penalties or further remedies. Members pressed for details on the citation, the meaning of active treatment, the assessment process for admissions, and whether Rainier could be repurposed for other services; DSHS said it is working on corrective action and will follow up in writing.

Transcript Highlights:

• </c> every day compared to Primary Care every day compared to Primary Care Primary<01:58:36.040><c> Care
• care.
• </c><02:01:51.079><c> the</c><02:01:51.360><c> this</c> care and manage long-term care the this care
• One part you can get done in two days. The other part takes 60 days, some it's 90 days, right?
• We know these children need a level of care that a hospital simply cannot provide, and every day our

Committee: Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• , seven days a week.
• We all say if you elect me, we're going to take care of our kids, so let's take care of our kids, right
• provided in compliance with the applicable standard of care, including but not limited to care related
• such care.
• family members who provide that care.

Bills: S0164 , S0656 , S0892

Committee: Senate Appropriations Committee on Criminal and Civil Justice

Keywords: wrongful death, unborn child, civil liability, medical provider, parental rights, habitual felony offenders, violent crimes, enhanced penalties, criminal justice, recidivism, 999, senate, all

Transcript Highlights:

• Aging services, HIV care, primary care, behavioral health.
• If that was up every day, or if it was up just because I was there that day, and it was up every day,
• and non-medical care for our residents. ...proper medical care and non-medical care for our residents
• . ...into systems of elder care and long-term care facilities.
• care and advocacy.

Summary: The Select Committee on Older LGBTQ Californians held an inaugural hearing focused on the health care and support landscape for older LGBTQ Californians, including people aging with HIV and transgender, gender non-conforming, and intersex seniors. Opening remarks emphasized the long history of discrimination faced by older LGBTQ adults, the growth of the aging LGBTQ population, and the need to translate existing state commitments into concrete services. Senators highlighted concerns about nursing home vulnerability, the aging of people living with HIV, and the impact of federal actions and Medicaid cuts on California’s safety net. The first panel featured Justice in Aging, CalHHS, the Department of Aging, and the Aging and HIV Institute. Testimony described widespread inequities, including discrimination, social isolation, economic insecurity, and gaps in culturally competent care. State officials outlined the Master Plan for Aging, the first statewide survey of LGBTQIA older adults, gender-affirming care protections in Medi-Cal, and efforts to improve coordination across departments. Advocates argued the state has been too slow to respond to federal threats and that services are often hard to find or fragmented. Committee members pressed the departments on how survey findings are being turned into action, how rural and underserved communities are being reached, and whether more formal stakeholder coordination or “no wrong door” access systems are needed. The second panel focused on seniors living with HIV. A long-term survivor gave emotional testimony about the “survivorship penalty,” loss of benefits, housing insecurity, and the need for legal and navigation support, housing assistance, and protection from outdated disability standards. The Department of Aging reported on implementation of SB 258, which added HIV status to the definition of greatest social need for area agencies on aging; it said 20 of 33 area plans now identify HIV as a target population and many include specific strategies, such as LGBTQIA mental health connections programs. The Office of AIDS described Project Cornerstone, Ryan White, ADAP, HOPWA, the Medi-Cal waiver, and PrEP-AP, noting these programs serve thousands of older clients and rely on whole-person case management. Case management testimony underscored persistent needs for medication subsidies, transportation, food, and housing. Committee members questioned how ADAP rebate funds might be used, how SB 258 is enforced across local agencies, and how to reduce administrative barriers and auto-connect eligible people to benefits. The final panel began with the Department of Social Services outlining protections for TGI seniors in licensed care facilities, including SB 219’s nondiscrimination requirements and related provider notices and resident rights materials. The hearing remained focused on identifying service gaps, improving coordination across aging, health, and social service systems, and ensuring state programs better reflect the lived experience of older LGBTQ Californians.

Transcript Highlights:

• Certified evidence housing can provide nearly six months of care for what it costs for 30 days of clinical
• </c> of care. of care.
• cost of medical care.
• illness that we care about while providing them with this care.
• </c> This is an access to care bill. This is an access to care bill.

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well. Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk. Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.

Transcript Highlights:

• You have a safe, warm place to go each day and caring teachers who provide a positive learning environment
• You have a safe, warm place to go each day and caring teachers who provide a positive learning environment
• , child care, and education.
• Long-term care is a continuum.
• Every day, our team cares for residents who depend on Medicaid to access skilled nursing services.

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.