Transcript Highlights:

• We do have the provider tax program.
• </c><00:14:09.920><c> that</c> program which is a federal program that program which is a federal program
• Um I think provider tax program.
• </c> how the program is designed nationally. how the program is designed nationally.
• And for the nursing full costs.

Bills: SB2936 , SB2850 , SB2851 , SB2521

Committee: House Health

Keywords: accessible parking, disability, kupuna, public accommodations, small business exemptions, Hawaii Revised Statutes, parking permit, blind, deaf, accessibility, deafness, traffic safety, law enforcement, vehicle registration, communication, emergency services, commercial driver's license, first responders, public safety, authorized emergency vehicle

Summary: The joint hearing covered House Bill 251, which would require hospitals to report costs associated with Medicare and uninsured patients, and House Bill 1875, which would expand protections for gender-affirming health care services. On HB 251, the Department of Health said it supported the intent but described the bill as complicated and potentially impractical as drafted because the department lacks the expertise to produce the required analyses without outside help. Hawaii Health Systems Corporation echoed those concerns, while the Queen’s Health System said it was willing to work with the department to provide the information. In committee discussion, officials explained that hospital support in Hawaii includes public hospital appropriations and the provider tax program, which uses hospital and nursing home contributions to draw federal matching funds; a department witness estimated the net benefit at about $150 million for hospitals and $20 million for nursing facilities, though exact figures would be provided later. On HB 1875, the Insurance Division testified with concerns that the bill’s language on prohibited actions by malpractice insurers was broad and vague, and that a rate-increase prohibition could conflict with actuarially based insurance pricing. The division also noted it was not the primary enforcement agency for the statute. In contrast, many testifiers strongly supported the bill, including the Hawaii State Commission on the Status of Women, the Hawaii State LGBTQ+ Commission, the Hawaii Public Health Institute, PFLAG Oahu, the ACLU of Hawaii, the Drug Policy Forum of Hawaii, the Hawaii County Democratic Party, and others. Supporters argued that gender-affirming care is medically necessary, evidence-based, and protected by privacy and bodily autonomy principles, and that the bill would protect patients and providers from outside political interference. No votes or final committee actions were taken during the portion of the hearing provided.

Transcript Highlights:

• Yet this program remains chronically underfunded.
• Yet this program remains chronically underfunded.
• Hanna, and I'm representing the California Nurses Association, National Nurses United, and its more than
• Hanna, and I'm representing the California Nurses Association, National Nurses United, and its more than
• Nurses witnessed firsthand how public support programs like food, housing assistance, and Medi-Cal help

Keywords: 987, senate, all

Transcript Highlights:

• Support Program.
• in the state's sheep program and the state home energy assistance program.
• program.
• For school nurses, I would urge you to reject the $1 million cut to the BEST program, which is the Beginning
• Nurses are not often trained to work in a school setting, and this program is a lifeline, often for school

Summary: The House Appropriations Committee opened with committee guidelines for the 2026 session, including limits on testimony, amendment deadlines, confidentiality expectations, and professionalism rules. Chair Ormsby also reviewed housekeeping for the public hearing, noting the meeting was recorded and live streamed, and that testimony would be limited to one minute because of the large number of sign-ups. The committee then began its work session on Governor Ferguson’s proposed 2026 supplemental operating budget, presented by OFM Director Katie Chapman, who outlined the state’s fiscal pressures: higher caseloads in major programs, a revenue forecast decline of about $390 million, federal policy changes tied to H.R. 1, inflation, and a relatively small ending fund balance. She said the governor’s budget solves about a $2.3 billion shortfall through nearly $800 million in spending reductions, revenue shifts, fund transfers, use of about $1 billion from the Budget Stabilization Account, and some tax preference changes, while also making targeted investments in areas such as child welfare, behavioral health, wildfire response, housing, and IT modernization. Chapman also explained that the proposal does not fully balance over the four-year outlook under the state’s statutory assumptions, but said the governor relied on the budget-balance law’s exception tied to BSA use and low employment growth. A question from Rep. Connors about credit ratings was answered with the view that the impact is difficult to predict and that Washington’s strong pension funding and balanced-budget framework remain positives. The public hearing drew testimony from state officials and many advocates, most of whom opposed specific cuts or fund shifts in the governor’s proposal. Secretary of State Steve Hobbs objected to proposed sweeps from the corporations and charities fund and the library archives account, citing prior cuts, layoffs, cyberattack-related costs, and the need to upgrade aging systems. Commissioner of Public Lands Dave Upthegrove urged restoration of wildfire prevention funding, saying the proposed amount was still $30 million short of the commitment in House Bill 1168 and that underfunding would increase suppression costs and risk to communities. Many education witnesses opposed reductions to Working Connections Child Care, transition to kindergarten, local effort assistance, Running Start, and higher education across-the-board cuts, arguing they would harm access, equity, and workforce development. Higher education leaders from community colleges, the University of Washington, Western Washington University, and Evergreen State College described staffing cuts, program reductions, and pressure on student services, while K-12 groups and OSPI said the budget would deepen existing funding gaps. A large portion of testimony focused on human services, health, housing, and civil legal aid. Child welfare and youth-serving organizations supported some targeted investments but opposed cuts to child care, child welfare network administration, and youth programs; advocates for foster youth, homeless youth, and mentoring programs asked for continued or increased funding. Health care and long-term care providers warned that proposed Medicaid and rate changes would reduce access for seniors, people with disabilities, and safety-net patients, while Planned Parenthood and abortion access advocates urged full restoration of the Abortion Access Project and related reimbursements. Housing and legal aid witnesses backed the governor’s proposed right-to-counsel funding but asked for more support, and homelessness advocates sought contingency funding for federal housing programs. Crime victim and domestic violence service providers repeatedly said the proposed $12 million was far short of the roughly $21.38 million needed to avoid service cuts and closures. Other testimony addressed the Climate Commitment Account shift for the Working Families Tax Credit, with environmental advocates opposing the diversion of CCA dollars and workforce advocates supporting the governor’s economic security and employment programs. No votes or formal committee action were taken during the hearing portion described in the transcript.

Transcript Highlights:

• That's a federally funded program that provides free vaccines for eligible children in Hawaii.
• That's a federally funded program that provides free vaccines for eligible children in Hawaii.
• I'm a retired nurse now.
• 01:09:09.920><c> they</c><01:09:10.040><c> went</c><01:09:10.239><c> to</c> nurses I trust a nurse they
• went to nurses I trust a nurse they went to school<01:09:10.679><c> for</c><01:09:10.920><c> so</c><

Keywords: 910, house, all

Summary: The House Committee on Education met on April 1 at 2:04 p.m. and first heard HCR 129/HR 125/HD1, which asks state and county transportation and education agencies to work together on pedestrian safety and traffic congestion around Haiku Elementary School. The Department of Education said it stood on its written testimony, and no other testimony was offered on that measure. The committee then took up HCR 173/HR 169/HD1, urging the Department of Health to begin education outreach and vaccination drive efforts at schools with vaccination rates under 30 percent, starting in the 2025-26 school year. The Department of Education and Department of Health both supported the resolution and stood on their written testimony. Support also came from the Hawaii Public Health Institute, Hawaii Nurses Association, the Democratic Party of Hawaii Health Committee, and Free Citizens of Malua. A number of testifiers opposed the measure, arguing that vaccination efforts do not belong in schools, that the proposal would pressure families and undermine parental rights and religious freedom, and that it could create liability and misuse public funds. Several opponents also raised concerns about informed consent, government overreach, and vaccine safety. One supporter, Kye Swan, said vaccines are the way to fight infectious disease and asked the committee to pass the resolution so children could be vaccinated before the school year starts. No vote or final committee action on the resolutions was announced in the portion of the transcript provided.

Transcript Highlights:

• This is simply setting up the grant program.
• program they're going to go to, whether they're going through a LISL or spoken language program, or
• for the spoken language program but not for the American Sign Language program, and yet we already have
• And it was because of programs like the Arizona Early Intervention Program that helped give my daughter
• Raymond, so if I'm coming into the program with my child, even with the creation of this new grant program

Committee: House House Health & Human Services Committee of Reference

Summary: The committee heard a JLBC presentation on H.R. 1’s SNAP impacts, including expanded work requirements, higher state administrative costs, and a potential state share of benefits if Arizona’s payment error rate remains above 6%. JLBC estimated the administrative cost increase at about $33 million in FY 2027 and $44 million in FY 2028, and said a 2024 error rate of 8.8% could expose the state to about $139 million in benefit costs starting in FY 2028. The chair also opened the meeting by asking members and speakers to keep remarks shorter to improve efficiency. The committee then considered several SNAP-related bills. HB 2797, which requires DES to more frequently verify eligibility through data matching, post fraud/noncompliance data, and address out-of-state EBT purchases, passed 7-5. HB 2442, requiring certain able-bodied SNAP adults with school-age children to participate in employment and training unless exempt, also passed 7-5. HB 2448, which limits DES’s ability to seek work-requirement waivers or discretionary exemptions without legislative authorization, passed 7-5. HB 2206, which sets a goal of reducing the SNAP payment error rate to 3% by 2030 and adds reporting and corrective-action requirements, passed 7-5 after debate over staffing, technology, and whether the target was realistic. The committee also advanced HB 2180, appropriating $2.5 million to the University of Arizona for AZ REACH, a hospital transfer coordination program serving rural facilities. Supporters said it improves patient transfers and reduces burdens on rural hospitals; some health system representatives were neutral but asked for operational improvements. HB 2180 passed 11-1. HB 2184, as amended, passed 7-4-1; it would extend fetal death certificate filing and require patients to be informed of the option to transfer fetal remains to a funeral home, with supporters describing it as a matter of parental dignity and closure. HB 2188, as amended, creating a Language Acquisition Grant Program for deaf or hard-of-hearing infants and toddlers, passed unanimously after testimony about balancing spoken-language and ASL options. The committee then began hearing HB 2194, a bill requiring insurers to provide a contact for detailed explanations after claim or prior-authorization denials, but the transcript ends before action on that bill.

Transcript Highlights:

• There are already many reusable devices that could be used for tobacco cessation programs.
• We've been struggling with how we could do an EPR program for this.
• But there's an existing embedded battery program as well.
• AB 1704 does not suspend the embodied carbon program.
• It could delay the program for at least five years before it's even begun.

Committee: Senate Environmental Quality

Keywords: 987, senate, all

Transcript Highlights:

• This program is federally required.
• , including the Medicaid program.
• That program ended January 1st.
• program, which is cash assistance.
• Maybe just a clarification on the act program. You stated that you that you unbundled it. program.

Summary: The Joint Finance-Appropriations Committee held a budget hearing on the Division of Medicaid within the Department of Health and Welfare. Legislative Services analyst Alex Williamson reviewed Medicaid’s five budgeted programs, enrollment groups, staffing, historic spending growth, and the distinction between ongoing base adjustments and one-time enhancements. She explained that most Medicaid spending is in trust and benefit payments, discussed the large FY 2026 and FY 2027 budget changes, and walked through the governor’s recommendations, including hospital assessment fund alignment, claims forecast updates, MMIS procurement funding, estate recovery, program integrity support, and population forecast adjustments. Members asked extensive questions about the 4% provider rate reduction, the expansion population, federal match rates, and the effect of House Bill 345 and federal changes on Medicaid costs and eligibility. Williamson and Deputy Director Sasha O’Connell said the expansion population has declined, but costs are driven by utilization, provider rates, pharmacy, hospital, developmental disability, behavioral health, and long-term care services. They said the department is pursuing cost containment through prior authorization, redeterminations, higher cost sharing, and program integrity efforts, while noting that expansion is codified in law and any repeal or major eligibility change would require legislative action and could affect hospital assessment revenue and other offsets. The committee also discussed the MMIS replacement project, with lawmakers emphasizing milestone-based funding and risk control. O’Connell explained the estate recovery request as a replacement case management system plus contractor support to help recover Medicaid costs from estates, and said the program is federally required and revenue-generating. Several members raised concerns about backlogs, contractor costs, and whether AI or other technology could improve efficiency in program integrity and estate recovery. No votes were taken during the hearing; the discussion remained informational and focused on the governor’s budget recommendations and possible future reductions or policy changes.

Transcript Highlights:

• Nursing good morning chair Vice chair Nursing good morning chair Vice chair members<00:13:29.839><c>
• </c> in addition to the successful program in addition to the successful program that<00:13:44.600><c
• The social work program also is relatively small in size, particularly in comparison to nursing and medicine
• </c> one in Kona um the social work program one in Kona um the social work program also<00:17:37.559>
• </c> particularly as comparison to nursing particularly as comparison to nursing and<00:17:44.080><c>

Committee: House Health

Keywords: 910, house, all

Summary: The House Health Committee held its first hearing of 2025, with Chair Greg Takayama and Vice Chair Representative Leoy opening the meeting and outlining housekeeping rules, including a two-minute limit for testifiers and Zoom etiquette. The committee first heard HB 303 on health care preceptors. The Department of Health, Department of Taxation, University of Hawaiʻi, Hawaii State Center for Nursing, and several health care organizations supported the bill, saying the existing preceptor tax credit program has been successful and that expanding eligibility to additional professions and students would help address workforce shortages. In response to questions, the Department of Health said the annual tax credit cap is $1.5 million, about 650 to 670 credits are currently used each year, and the bill applies only to unpaid preceptors. The committee then moved on to HB 441, which would raise cigarette taxes. The Attorney General, Department of Health, University of Hawaiʻi Cancer Center, Hawaii Public Health Institute, American Cancer Society Cancer Action Network, and others supported the measure as a way to reduce smoking, especially among youth, and to support tobacco control and cancer-related programs. Opponents, including the Taxpayers Protection Alliance and the Cigar Association of Hawaii, argued the tax is regressive and unreliable as a revenue source. The Department of Health noted the last cigarette tax increase was in 2011, and one witness urged a larger increase than proposed. No vote was taken on either bill in the portion of the hearing provided. The committee also heard HB 557 on telehealth. The Department of Health supported the bill so long as it did not displace executive budget priorities, and the Hawaii State Health Planning and Development Agency and Hawaii Primary Care Association supported it. HPCA said the bill would conform state insurance law to recent Medicare changes expanding audio-only telehealth coverage beyond mental health services, and it emphasized access for rural residents, kupuna, and people with disabilities. HMSA opposed the bill as written, saying it strayed from the intent of Act 107 and that audio-only telehealth should remain limited because of quality-of-care concerns, though it supported continued access and asked for a different amendment approach. A telehealth provider also testified that payment disparities limit provider expansion and that audio-only access remains important for patients with serious illness. The hearing ended in the excerpt before any committee action or vote on HB 557.

Transcript Highlights:

• examiner program.
• We have had the same program, which is a sexual assault forensic nurse program, which has received significant
• This is about a teleSANE program. This is about a teleSANE program.
• It reinstates the funding back for the PIC program, which I believe is a really important program to
• So it's a good program in many ways.

Bills: SB5998

Committee: Senate Ways & Means

Keywords: fiscal appropriations, budget, state funding, financial management, operating expenses, 904, all

Transcript Highlights:

• They did not have a full bus, a full transportation program until the 2022-23 school year.
• to improve access for students and families and to enhance our educational program through increased
• Today we are simply asking to be treated the same as other schools operating transportation programs.
• the program or expand it to serve more students and families.
• They're doing well in the classroom teaching our CTE programs. Let them move.

Committee: Senate Education

Summary: The Senate Education Committee heard House Bill 815, a narrow fix for Answer Charter School in Boise. Rep. Sonia Galavis and school representatives explained that a past, very small transportation reimbursement request from 2010 was being used as the school’s base for a transportation block grant, leaving Answer with far less funding than similarly sized schools despite operating a full bus program since 2022. Supporters said the bill would correct an unintended funding disparity affecting only Answer and would not create a broader fiscal impact. The committee asked whether other schools could qualify, and Galavis said the language had been checked with the Department of Education and Legislative Services to ensure it applied only to this school. The committee voted to send HB 815 to the floor with a do pass recommendation. The committee then took up House Bill 849, which would change Idaho’s career ladder rules for career technical education instructors and pupil service staff such as counselors, psychologists, nurses, physical therapists, and occupational therapists. Rep. Galavis, Sen. Lent, and Legislative Services analyst Jared Taitro explained that CTE teachers can currently receive placement credit for industry experience but must wait four years and meet evaluation requirements before moving up the ladder, while pupil service staff do not currently receive the same placement treatment for prior professional experience. The bill would allow both groups to count relevant experience for placement and movement, with the goal of improving recruitment and retention in hard-to-fill positions. Testimony in support came from Dr. Joy Jansen of Lake Pend Oreille School District, who said districts struggle to recruit pupil service staff and often must pay much more for contracted services, and from Rep. Sean Dygert, who emphasized the importance of retaining industry-based CTE teachers, especially in rural districts. The committee voted to send HB 849 to the floor with a do pass recommendation before adjourning.

Transcript Highlights:

• It ignited a person within him to pursue a career in nursing.
• Through the delivery of comprehensive school counseling programs, school counselors help students.
• HB 1389 by Garcia-Bear relating to a grant program for junior reserve officers training corps programs
• HB 1416 by Allen relating to the program.
• The program is Accessibility for Female Inmates of the Texas Department of Criminal Justice.

Keywords: 1184, house, all

Transcript Highlights:

• </c> management programs. management programs.
• </c> our physician associates and our nurse our physician associates and our nurse practitioners.<02:
• Now, our nurse practitioners and this.
• </c> um our friends from the um nurse um our friends from the um nurse practitioner<02:02:07.199><c>
• </c> and advanced practice registered nurses and advanced practice registered nurses uh<02:03:08.080>

Committee: Senate Health and Human Services

Keywords: 1191, senate, all

Transcript Highlights:

• And it’s not the school nurse, okay?
• doesn't</c> nurse, okay?
• The school nurse doesn't nurse, okay?
• This program teaches teachers sounds.
• They model these this program teaches.

Committee: Senate Education

Keywords: 1191, senate, all

Transcript Highlights:

• that program, I guess you could say.
• These are my case managers; they're nurses. They've been nurses for many, many years.
• These are my case managers are nurses. They've been nurses for many, many years.
• We want them to graduate from our program.
• I talked about our Oklahoma program, and they did a five-year study of the program, and over five years

Summary: The committee heard House Bill 723, which Representative Erickson said was developed in response to a state oversight report on children’s residential care and testimony about abuse and neglect in licensed youth treatment facilities. The bill would codify and strengthen oversight standards, require individualized service planning, create a youth bill of rights for residents and parents, and require critical incident reporting to parents or guardians within one business day. Erickson said the bill largely mirrors existing department rules, was drafted with the Department of Health and Welfare to avoid a fiscal note, and includes enforcement tools such as corrective action plans, sanctions, payment withholding, and law-enforcement referral for crimes. Several senators raised concerns about whether the bill was strong enough, whether unannounced inspections could raise Fourth Amendment issues, whether faith-based facilities would be affected, and whether the department would have too much discretion. Erickson responded that the inspections apply only to licensed facilities, not private homes, and that the bill is intended to improve transparency and oversight without changing existing rights or imposing new costs. Survivors and advocates testified in strong support, describing seclusion, restraints, forced medication, medical neglect, lack of private communication, humiliation, and retaliation in Idaho and out-of-state residential programs. They argued the bill would improve accountability, transparency, and safety for children and families. After testimony, the committee discussed the bill further. Some members said the bill was a meaningful step but wanted stronger consequences, while others noted the seriousness of the abuse described and the need for oversight of Medicaid-funded facilities. Senator Wintrow moved to send H723 to the floor with a do pass recommendation, and the motion passed by voice vote. The committee then received a presentation from Teligen on its role as Idaho Medicaid’s quality improvement organization. Nancy Johnson explained that Teligen handles prior authorization, quality oversight, fraud and abuse reporting, and a small case management program for complex Medicaid participants. She said the case management team of five Idaho-based nurses reached out to just over 1,000 participants in 2025, fully engaged 160, and reported about $850,000 in cost savings through reduced readmissions and better care coordination. Members asked about contract costs, staffing, the scope of services, and how suspected fraud is reported to the Medicaid program integrity unit. The committee adjourned after the presentation.

Transcript Highlights:

• For 28 years, Marie served as a certified nursing assistant, surgical technologist at Cape Cod Hospital
• In 2024, she became a licensed practical nurse. In 2024, she became a licensed practical nurse.
• This achievement was a significant step toward her future goal of becoming a registered nurse.
• This state championship win marks the first Voke crown in Tri-County football program history, an especially
• contributed to the overwhelming strength, determination, and sense of teamwork exemplified by this program

Keywords: 995, all

Summary: The Senate session was largely ceremonial and began with the Pledge of Allegiance and recognition of the Wellesley swim team for winning its fifth straight state championship. Members praised the team’s consistency and accomplishment, but no formal action was taken on that recognition. The chamber then adopted a motion that the Senate adjourn in memory of Marie Nancy Azor of Harwich, honoring her life, community service, work as a nursing assistant and later licensed practical nurse, and her support of family and local youth sports. The motion prevailed, followed by a moment of silence. The Senate also welcomed and honored two championship athletic teams: the Tri-County High School football team for winning the MIAA small school state vocational Super Bowl, their first such title, and the Westborough girls varsity volleyball team for winning its third consecutive MIAA Division II state championship. Members and guests congratulated the students, coaches, and families. Finally, the Senate adopted an adjournment order and adjourned to meet again Monday at 11:00 a.m., again in memory of Marie Nancy Azor.

Transcript Highlights:

• Yet this program remains chronically underfunded.
• Yet this program remains chronically underfunded.
• Hanna, and I'm representing the California Nurses Association, National Nurses United.
• Hanna, and I'm representing the California Nurses Association, National Nurses United, and it's more
• Nurses witnessed firsthand how public support programs like food, housing, and housing assistance, Medi-Cal

Summary: The joint informational hearing examined California’s taxation of multinational corporations, especially the state’s water’s-edge election versus worldwide combined reporting. The LAO and Franchise Tax Board explained the basic mechanics of unitary taxation, apportionment, and how water’s-edge generally excludes most foreign subsidiaries while worldwide reporting includes the full unitary group. FTB officials said water’s-edge filers are a small share of corporate filers but account for a large share of tax liability, and they described filing trends, industry mix, and the administrative steps needed to administer either system. Members and witnesses debated the policy trade-offs. Supporters of moving away from water’s-edge argued that it enables profit shifting, especially for large multinational and IP-heavy firms, and that eliminating it could raise significant revenue and improve fairness for smaller domestic businesses. They cited estimates of billions in potential revenue and said California already has the audit and reporting infrastructure to handle worldwide reporting, though some transition time would be needed. Opponents argued that worldwide reporting would tax foreign activity unrelated to California, create double taxation, increase compliance burdens and litigation, and could be difficult for foreign-based multinationals to document. They also warned that some of the revenue estimates are highly uncertain because foreign affiliate income is not directly observable. Committee members asked about foreign government pushback, the risk of companies leaving California, the effect on intellectual property shifting, and whether federal or Supreme Court action could block a change. Witnesses generally said major firms would be unlikely to leave because California taxes sales rather than physical presence, but some costs could be passed on to consumers. The panel also discussed alternatives such as conforming to federal international tax rules like NCTI/GILTI and adding anti-abuse rules. No vote or bill action was taken; the hearing was informational only.

Transcript Highlights:

• for nurse practitioners.
• , and the non-compete prohibition applies only to nurses, not nurse practitioners.
• </c> nurses it doesn't cover the nurse nurses it doesn't cover the nurse practitioners<01:32:46.920><
• This program is a good program.
• This program is a good program.

Keywords: 1191, senate, all

Transcript Highlights:

• We know that this program works.
• Between 2014 and 19, I desperately needed some money to start a nursing program, and didn't have it.
• And they still don't have a nursing program, but now they have some partnerships.
• know that there's necessarily a large number Of arts programs or music programs in those.
• You know, the program at this point has been basically an income-based program based on the adjusted

Committee: House Appropriations and Budget

Keywords: 914, all

Transcript Highlights:

• the program with no funding.
• </c> program required under Vermont law. program required under Vermont law.
• Nurse<01:10:32.658><c> [clears throat]</c><01:10:32.960><c> practitioners,</c> Nurse [clears throat]
• </c> use value appraisal program. use value appraisal program.
• These are existing programs.

Keywords: 926, house, all

Transcript Highlights:

• Standing in between them, with her big smile on today, we're proud to have our nurse, Ms.
• Standing in between them, with her big smile on today, we're proud to have our nurse, Ms.
• to help support the work of the full independent practice nurse practitioner committee.
• Also creates the appropriation for the Rural Health Transformation Program.
• Also creates the appropriation for the Rural Health Transformation Program.

Keywords: 1204, all