Transcript Highlights:

• As Chair Addis had mentioned in our opening comments, the C-BAS program is certainly a vital program
• Why would we cut this program?
• are providing the cost savings that Programs are providing the cost savings that these programs are
• The IHSS program is the largest home and community-based services program in the United States.
• with additional program data.

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• </c> Medicaid program um how does the program Medicaid program um how does the program work<00:52:53.440
• </c> EFA programs. EFA programs. &gt;&gt; Yeah. &gt;&gt; Yeah. &gt;&gt; Yeah.
• </c> eligible and you know which programs. eligible and you know which programs.
• Under the EFA program? >> I would have to double-check. I'm not as familiar with the EFA program.
• </c><01:26:35.120><c> But</c> boundaries of the program. But boundaries of the program.

Keywords: 1189, house, all

Summary: The commission to study special education costs under SB 57 met for its second meeting, with members introducing themselves and reviewing background materials on New Hampshire special education identification rates, NAEP results, and a Wall Street Journal article about the rise in autism diagnoses. The chair explained that the commission is examining special education aid formulas, including how New Hampshire’s current catastrophic aid threshold works and how changes to that threshold might affect school districts, but noted that the needed data on how many students would shift into the aid system at lower thresholds is not yet available. The main testimony came from Henry Litman of HHS on Medicaid reimbursement in schools. He explained that school-based Medicaid funding is tied to health-related services, not all special education services, and that federal rules are changing in state fiscal year 2027. Under the new approach, schools will move away from an in-kind methodology to a certified public expenditure model that may also allow recovery of some overhead costs, such as support staff time. He said the state won a federal grant to help build the new system, hired a vendor, and is setting up training and a help center for districts. Members asked about why Medicaid claims have declined and whether districts are leaving money on the table. Litman said claims are down about 25% from pre-pandemic levels, with declines tied to federal and state rule changes, documentation requirements, provider qualification rules, and the end of temporary pandemic flexibilities. He said some districts adapted better than others depending on local medical-provider access and administrative capacity. He also said the new federal legislation does not directly affect schools, while New Hampshire’s return to pre-pandemic eligibility rules has reduced enrollment somewhat. No votes were taken, and the discussion ended with agreement that the commission needs better data to determine how much special education spending is truly Medicaid-eligible and whether additional legislation is needed.

Transcript Highlights:

• It requires certified nursing assistants serving in a nursing home to receive training on recognizing
• Back to our regularly scheduled programming. Please read the next bill.
• home beds in a skilled nursing facility.
• to the entity responsible for the program design and implementation.
• the program.

Summary: The Senate opened with prayer, the Pledge of Allegiance, and several recognitions, including remarks from the new Democratic caucus leader, Senator Berman, who emphasized affordability, education, health care, public safety, and opposition to measures he said would roll back child labor protections, book access, and gun safety laws. The chamber also recognized military leaders from U.S. Army Special Operations Command and an intern from Senator Polsky’s office. No committee reports or executive messages were on the desk at the start. The Senate then took up and passed several bills, often after substituting House companions and adopting technical amendments. Among the measures approved were the dangerous dogs bill (the Pam Rock Act), local government land regulation, vessel-related voter freedom/boating provisions, blood clot screening and treatment, fleeing or attempting to elude law enforcement, concealed carry licensing for certain officers and service members, timeshare management firms, disability history and awareness instruction, manufacturing and manufacturing fees, public education on background screening requirements, utility service restrictions, educational opportunities for military children, Medicaid oversight, health facilities authorities, and veterans’ nursing home beds. Several bills were temporarily postponed, including measures on human trafficking, waste management, Bright Futures, Medicaid oversight earlier in the day, mammogram coverage, and others. Debate on the disability history bill was especially extensive, with senators discussing the use of the word “disability,” the role of bias, and whether the bill fit with broader DEI-related policy debates. The bill’s sponsor and supporters framed it as a first step toward helping students understand and respect people with disabilities, and the chamber opened co-sponsorship before substituting the House version. Other bills drew focused questions about local government costs, impact fees, staffing burdens, grant criteria for small manufacturers, and the scope of utility preemption. Most measures passed on strong votes, including several unanimous votes, with the concealed carry/firearms bill passing 33-3 and the local government land regulation bill passing 26-8.

Transcript Highlights:

• This is a newer program.
• </c> better for us to have this new program? better for us to have this new program?
• I was a nursing assistant at 16.
• </c> train locally at like the CNA programs train locally at like the CNA programs at<00:58:03.599><c
• I was a nursing assistant at 16. school. I was a nursing assistant at 16.

Bills: HF4598 , HF4884 , HF3732

Committee: House Workforce, Labor, and Economic Development Finance and Policy

Keywords: workers' compensation, Minnesota workers' compensation, Workers' Compensation Advisory Council, reinsurance association, Workers' Compensation Reinsurance Association, WCRA, occupational disease, presumption, first responders, firefighter cancer, PTSD, post-traumatic stress disorder, police officer, paramedic, emergency medical technician, correctional officer, security counselor, public safety dispatcher, temporary total disability, permanent partial disability

Transcript Highlights:

• The Honu program itself has been ... We're not arguing the program.
• </c><00:30:31.919><c> Jun's</c><00:30:32.320><c> program</c> Scott's program Jun's program Scott's program
• So I've been—I worked with Muna Basami on community college getting a nursing or nursing aide program
• program? program? &gt;&gt; Sure. &gt;&gt; Sure. &gt;&gt; Sure.
• programs at VOE.

Keywords: 912, senate, all

Transcript Highlights:

• programs.
• Because we hear that about nursing programs.
• We've got all these nursing programs all over the state or whatever, or engineering, that type of thing
• Because we hear that about nursing programs.
• We've got all these nursing programs all over the state or whatever, or engineering, that type of thing

Committee: Joint Higher Education Funding Review Committee

Summary: The Higher Ed Funding Committee met to review a proposed process for identifying and addressing low-producing academic programs, then moved into discussion of draft funding formulas for the university system. Lisa Johnson of the ND University System described how other states and systems define low-producing programs, emphasizing multi-year enrollment and completion thresholds, cost and workforce review, and the role of governing boards. She reported that North Dakota institutions already review programs in varying cycles, often use shared resources and stackable credentials to keep low-enrollment programs viable, and cited recent system actions over five years: 100 programs placed on inactivation, 75 terminated, and 384 new programs created. Committee members raised concerns about workforce-critical programs, duplication, exemptions, and whether the legislature or the State Board of Higher Education should drive the process. The chair said he wanted the board to bring a detailed proposal to the June meeting and suggested the legislature may use funding leverage, including a possible holdback, to encourage the review process. The committee then heard a Legislative Council presentation on a draft funding formula for UND and NDSU. The proposal used fall census FTE enrollment, with a placeholder rate of $7,000 per undergraduate FTE and $10,500 per graduate/professional FTE, plus incentives for completions in high-demand fields and research productivity. Alex from Legislative Council explained that the formula also included separate treatment for research funding, external grants, and capital building tiers, and that the MD program at UND would remain fixed funding outside the formula. Members questioned the use of the placeholder rates, the in-demand program list, the treatment of external grants, and how the proposal compared with current appropriations. The chair noted that the formula numbers were illustrative and not final budget amounts. A second draft formula for the other nine institutions was also reviewed. It used fall census FTE with no weighted economic factor, a higher undergraduate rate of $8,750 per FTE, and completion incentives for in-demand credentials and all other credentials. Members noted that the proposal would benefit some institutions, such as Bismarck State College, while reducing funding for others, such as Mayville State, and questioned whether the same structure should apply across institutions with very different missions and sizes. Committee discussion focused on fairness, hold-harmless concerns, and whether the nine institutions should be grouped differently. The committee did not take formal action, but the chair indicated the formulas would continue to be discussed later in the meeting and in future work.

Transcript Highlights:

• ,</c> all these great programs, all these great programs, but<00:09:25.839><c> then</c><00:09:26.040>
• We have to identify these program.
• program? program?
• So, the HANDS program is the HANDS program. It's one piece of a mosaic, right?
• </c> What kind of programs fall under that? What kind of programs fall under that?

Committee: Joint Health Services

Keywords: 958, all

Transcript Highlights:

• , or forensic services program.
• </c><00:35:48.079><c> We</c> Minnesota Nurses Association. We Minnesota Nurses Association.
• sector nurses, but public sector nurses also get paid less and have fewer benefits than most private
• /c> rights than private sector nurses, but rights than private sector nurses, but public<00:37:38.160
• 39.280><c> paid</c><00:37:39.520><c> less</c> public sector nurses also get paid less public sector nurses

Keywords: 1187, senate, all

Transcript Highlights:

• Relating to tax credit programs, the bill extends the child care tax credit program championed by Representative
• The nurses in my district always uplift this issue to me.
• Speaker, I have a nurse who left her job. Usually we have a house full, but we have a nurse.
• Florida Educational Leadership Program, led by Dr.
• It is a voluntary specialty court program.

Keywords: 998, house, all

Summary: The House convened with prayer, a moment of silence for two service members killed in the Middle East, the Pledge of Allegiance, and a quorum present. Members adopted the special order report and then began taking up the special order calendar. The first major measure was HB 7031, the annual tax package, which included a hunting, fishing, and camping sales tax holiday, a back-to-school holiday moved earlier in the summer, property tax changes for mobile home parks and other exemptions, reductions in pari-mutuel taxes and fees, extensions and expansions of several tax credit programs, vacation-rental tax collection changes, and a full decoupling from federal tax changes in the “One Big Beautiful Bill.” The bill drew questions about the fiscal impact of decoupling and the firearm-accessories holiday; supporters emphasized fiscal caution, housing and home-hardening provisions, and family tax relief, while opponents objected to the firearm-related tax break. HB 7031 passed 105-2. The House then passed CS/CS/CS HB 1177 on Space Florida and spaceport operations, which updates business development rules, board membership, and creates a strategic spaceport hub designation. CS/CS HB 639/CS SB 246 on specialty license plates also passed after a strike-all amendment that added several new plates, revised the Fraternal Order of Police plate, and tightened financial and nonprofit requirements for plate sponsors. CS HB 697 on drug prices and coverage passed after debate on pharmacy benefit manager reforms requiring equal reimbursement, prohibiting forced losses on drugs, and allowing consolidated appeals. CS/CS HB 1263 on the Office of Insurance Regulation passed with an amendment clarifying fingerprinting provisions, and CS/CS HB 527 passed with a human-review requirement for insurance claim denials so AI cannot be the sole basis for denying or reducing claims. Additional bills approved included CS HB 1449, which limits use of the statewide provider and health plan claim dispute resolution program when a claim is already in the federal process and, by amendment, narrows the bill to out-of-network emergency services and claims of $50,000 or less; CS HB 93, requiring surgical smoke evacuation systems in hospitals and surgical centers, which passed overwhelmingly after emotional bipartisan praise for the sponsor’s multi-session effort; and CS HB 1217, which prohibits governmental entities from adopting net-zero greenhouse gas policies, after Democrats argued it would preempt local climate and resilience efforts and Republicans argued it protects energy reliability and affordability. The House also passed CS/CS HB 1461 establishing a framework for licensing and regulating advanced nuclear reactors, with supporters framing it as a step toward reliable, affordable, cleaner energy. Later, CS HB 1229 on residential homes for medically or technologically dependent children was explained as creating a licensure program for medically complex children’s homes and was rolled over for final passage as the transcript ended.

Transcript Highlights:

• </c> funds in our state contracted programs funds in our state contracted programs such<00:48:21.839>
• 3,000 nurses short.
• I think it is a valuable program.
• > has</c> permanent program.
• The pilot program has permanent program.

Committee: House Finance

Keywords: 910, house, all

Transcript Highlights:

• </c> life of a nurse look like?" life of a nurse look like?" Right?
• </c><00:52:31.359><c> of</c> want to build AI research programs of want to build AI research programs
• , I have to say to that the nurses, I have to say to that horrendous<01:29:48.880><c> nursing</c><01:
• lensure compact to involved in the nurse lensure compact to allow<01:30:16.719><c> nurses</c><01:30:
• </c><01:30:21.600><c> allow</c><01:30:22.159><c> nurses</c> patients from other states. allow nurses

Committee: Senate Jobs and Economic Development

Keywords: 1187, senate, all

Transcript Highlights:

• Senate Bill 135, an act relating to the provision of the Supplemental Nutrition Assistance Program and
• His team included doctors, nurses, family members, friends, and so many others. Kentucky.
• His team included doctors, nurses, family members, friends, and so many others.
• His team included doctors, nurses, family members, friends, and so many others.
• /c> included doctors, nurses, family included doctors, nurses, family members,<00:18:58.400><c> friends

Keywords: 958, all

Transcript Highlights:

• So currently a compensation program.
• Again, this program is a proven program increasing fruits and vegetables, and decreasing sugary drinks
• Again, this program is a proven program increasing fruits and vegetables, and decreasing sugary drinks
• 21.640><c> program</c><00:16:22.160><c> increasing</c> program is a proven program increasing program
• implementing this program.

Keywords: 916, all

Summary: The committee opened by explaining it would work through a long list of interim topics one at a time and asked members to complete a selection form at the end. The first topic, long-term care, drew testimony from AARP Wyoming and the Wyoming Long-Term Care Association. AARP emphasized Wyoming’s aging population, the state’s roughly $200 million annual Medicaid spending on long-term care, and the need to examine whether more support for home-based care could reduce nursing home use and costs. The association agreed with supporting people at home as long as possible, but asked that any study also consider increased support for nursing homes and assisted living when home care is no longer feasible. Committee discussion also touched on adult day care and PACE-like services, with Mr. Laycock noting prior Department of Health discussion and limited adult day availability due to reimbursement concerns. The committee then heard proposals for neonatal intensive care unit family leave, expanded midwifery scope, and a modification to workers’ compensation law. The NICU leave idea, presented by the Wyoming Women’s Foundation, would explore leave options for families with premature infants in intensive care, potentially paid or unpaid, while considering business size and the burden on families who may need out-of-state care. The midwifery topic was framed as a way to address rural maternity and women’s health gaps by allowing midwives to practice to the full extent of their training. On workers’ compensation, the Wyoming Association of Municipalities sought to classify dispatch personnel as first responders so they could receive mental health coverage under workers’ compensation; the Department of Workforce Services explained that current law covers dispatchers under workers’ compensation generally, but the first responder mental health provision added in 2018 applies to law enforcement and firefighters and does not currently include dispatchers. Other topics included problematic gaming and program funding, breast cancer diagnostic and supplemental exams, prescription drug coverage for advanced metastatic cancer, SNAP education, behavioral health workforce clinical training site shortages, CPR in schools, and broader midwifery oversight. The behavioral health workforce proposal, brought by a WICHE commissioner, focused on increasing psychology internship slots in Wyoming, noting that the state currently has only three and that expanding placements could improve recruitment and retention. The CPR in schools topic drew strong support from the American Heart Association, which argued that CPR training in high school could improve bystander response in a rural state with long EMS response times; committee members asked about cost and curriculum fit, and the witnesses said hands-only CPR could be taught by school staff rather than requiring expensive certification. The midwifery discussion later broadened into concerns about oversight and standards after a representative described a constituent’s pregnancy loss and said complaints involving midwifery practice and staffing delays in investigations warranted a deeper review. No votes were taken during the portion provided, and most topics were simply introduced, discussed, and left open for further testimony or later committee selection.

Transcript Highlights:

• This would create a new testing program, $5 million in each fiscal year to develop a comprehensive program
• The whole blood pilot program, this would appropriate $10 million for a whole blood pilot program and
• This is not a current program at the agency. That's Article 11.
• Is additional funding to maintain women's health, uh, program services.
• Page 119 home visiting program is Representative Ross.

Committee: House Appropriations - S/C on Article II

Transcript Highlights:

• That program, the goals for that program is, and Kelly, this is one of our program highlights, but we
• That program, the goals for that program is, and Kelly, this is one of our program highlights, but we
• That program, the goals for that program is, and Kelly, this is one of our program highlights, but we
• </c> KStep program. KStep program.
• </c> places and programs. places and programs.

Keywords: 958, all

Summary: The Joint Committee on Families and Children met with a quorum, approved the August minutes, and received an update that the number of children in out-of-home care with active placements was 8,647 as of September 7, 2025. The first presentation was from Isaiah 117 House, a nonprofit that provides a home-like setting for children on removal day so they do not have to wait in a state office. Speakers described the mission as reducing trauma for children, lightening the burden on case workers, and easing transitions to foster or kinship placements. They said the Kentucky home in Logan County opened on August 15 and had already served 10 children in its first six days. Committee members asked about logistics, including whether children placed with kinship caregivers would still come to the house, how long children can stay, who remains responsible for them, and how volunteers are screened. The presenters said children are brought to the house regardless of whether they are headed to kinship or foster placement, that 72 hours is not a hard cutoff, and that a case worker remains in charge at all times while volunteers provide support. They also said volunteers undergo background checks, trauma-informed training, confidentiality instruction, and annual continuing education. In response to questions about funding and expansion, they said Isaiah 117 House is community-funded without state or federal money, and that new homes are opened only when fully funded, with construction costs typically ranging from $80,000 to $150,000 and first-year budgets around $180,000. The committee then heard a presentation from Remy Eastep Homes on its Family Centered Integrated Healthcare and related services. Leaders described the organization’s history from its origins as separate orphanages in Boyd County to residential treatment, treatment foster care, prevention services, and outpatient behavioral health. They said the organization shifted about 15 years ago toward engaging families more directly because family involvement improves outcomes and helps keep children safely at home when possible. The presentation continued into program details, but no votes or formal actions were taken on either presentation.

Transcript Highlights:

• home costs for people who have impoverished themselves to get Medicaid to pay their nursing home costs
• home costs for people who have impoverished themselves to get Medicaid to pay their nursing home costs
• home costs for people who have impoverished themselves to get Medicaid to pay their nursing home costs
• home care I've got that too um nursing home care I've got that too um but<00:10:42.959><c> it</c><00
• Now they're coming back again with a universal life or some kind of cash value program to it, so they

Committee: House Taxes

Keywords: 1183, house

Transcript Highlights:

• The information and training programs are for both workers and supervisors.
• L&I administers and enforces a broad range of programs, including the workers' comp program, the Washington
• This bill started with a couple of our programs saying, we all... ...started with a couple of our programs
• For example, our retro program with employers.
• And so we found a couple of our programs who were...

Summary: The committee held public hearings on several Labor and Workplace Standards bills. HB 2492 would require building and construction apprenticeship programs, beginning in 2027, to include two hours of behavioral health and wellness training covering topics such as suicide prevention, substance use disorder, recognizing distress, peer support, and connecting to resources. The prime sponsor and many labor, apprenticeship, and contractor witnesses supported the bill, describing high suicide and overdose rates in construction and sharing personal stories about losses and struggles in the trades. No vote was taken on the bill during the hearing. The committee then heard HB 2405, a Department of Labor and Industries request bill creating a pilot to allow earlier treatment for PTSD claims in workers’ compensation, including up to 11 treatment sessions before claim adjudication and limited follow-up treatment after closure. L&I and NFIB supported the measure as a way to speed treatment and reduce barriers, while one legal advocate supported it but raised technical concerns about pre-claim treatment and urged more focus on workplace prevention; another witness cautioned against emphasizing psychiatric drug treatment. The bill was heard only; no action was taken. HB 2406 would expand L&I’s ability to send notices electronically, with opt-in/opt-out provisions and some changes to timing rules for workers’ compensation and WISHA notices. L&I supported the bill as a modernization measure, while labor and workers’ advocates opposed changes affecting workers’ compensation notices, arguing that email should not become the default for vulnerable workers who may miss deadlines. HB 2478 would give L&I discretion, rather than a mandate, to investigate wage complaints and allow penalties when the department initiates an investigation; L&I supported it as a more efficient enforcement tool, and the committee discussed how complaints would still be handled and communicated. Finally, HB 2471 would create a state collective bargaining framework for private-sector workers if federal labor law or the NLRB no longer covers them. Supporters said it would preserve organizing and dispute-resolution rights if federal protections fail, while agricultural employers and NFIB opposed it, arguing it would inappropriately apply to agriculture and small businesses, could disrupt perishable harvests, and should rely on secret-ballot elections rather than card check. No votes were taken on any of the bills in the hearing.

Transcript Highlights:

• The last thing is a pilot program to explore broadening...
• Today, this program is largely taken advantage of by...
• Those were nurses at Camp Sheridan. Next, we come all the way to the present.
• This is Raven Christopher, an Army Nurse employed with... an Army Nurse employed with... it's going to
• You see there on the right Army personnel serving at a nursing home in... Next slide.

Committee: House Veterans and Military Affairs

Keywords: 1136, house, all

Transcript Highlights:

• On the other side of the program, program, program, our<00:12:17.279><c> new</c><00:12:17.519><c> dental
• program program and<00:18:54.320><c> that</c><00:18:54.559><c> they're</c><00:18:54.799><c> working<
• to 5% of the program.
• </c> nursing. Let's fix it for everyone else. nursing. Let's fix it for everyone else.
• CMS approval for those programs.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board meeting began with a roll call and approval of the October 7 meeting minutes. The chair then reordered the agenda to hear the item on Medicaid reimbursement rates and network adequacy first because of scheduling issues. Dr. Steve Robertson of the Kentucky Dental Association was sworn in and testified at length about Kentucky’s dental Medicaid program, arguing that reimbursement rates are unsustainably low, have been largely flat for decades, and are often below the cost of providing care. He said Kentucky ranks near the bottom nationally in oral health, dental Medicaid rates are often 60% or less of commercial rates, and the program’s share of the Medicaid budget has effectively remained around 2% despite growth in enrollment and services. Dr. Robertson said the low rates are contributing to provider losses, rural access gaps, longer wait times, dental deserts, and greater use of emergency rooms for preventable dental problems. He cited examples of office costs exceeding reimbursement for basic procedures, noted that many dentists are small private businesses, and said the state is struggling to recruit and retain dentists because of low payment levels and high student debt. He also pointed to disparities with neighboring states and said recent increases in some oral surgery and cleaning codes were not enough to address the broader problem. His recommendations included completing the rebasing study, increasing dental reimbursement in the upcoming budget, tying future reviews to inflation and cost data, aligning benchmarks, and prioritizing preventive and restorative care to improve workforce stability and access. Board members asked about the size of the needed increase, the effect of private insurance on dental practice finances, and what a new dentist might expect to earn. Dr. Robertson said the association is working on an appropriations request and that private insurance pressures are part of the problem as well, since many plans are HMOs or PPOs with limited provider control over rates. He also said the association can no longer conduct reimbursement surveys because of FTC restrictions, but would try to obtain current ADA data. In response to questions about the future of the program, he warned that without significant changes it could become unsustainable and cited Ohio and Missouri as examples where higher reimbursement improved provider participation and access. The board then heard from Mr. Bowman of Baldwin Consulting, who discussed outpatient behavioral health providers, including ABA therapy and mental health/substance use disorder services. He said these providers face similar issues of rising costs, flat reimbursement, and access problems. He reviewed Kentucky’s network adequacy standards, including travel-time standards, 30-day appointment limits, and newer federal requirements that will require services within 10 business days by 2029. He said wait times for outpatient behavioral health, especially children’s services and ABA, have grown substantially, sometimes to more than a year, and emphasized that the Medicaid department must enforce these standards.

Transcript Highlights:

• This is a bill brought forth by school nurses.
• I am Heather Hedeen, the state school nurse.
• So the Direct Admissions Program, this is.
• and education programs.
• Participation, because of all the benefits of this program, it's a wonderful, wonderful program.

Committee: House Education Policy