Transcript Highlights:

• </c><00:42:02.520><c> home</c> prior to VBR, and it pays a nursing home prior to VBR, and it pays a nursing
• </c> projects at the nursing home. projects at the nursing home.
• And this is really important because Minnesota has the most severe long-term care home care nursing workforce
• </c><01:25:20.040><c> care</c><01:25:20.240><c> nursing</c><01:25:20.640><c> workforce</c> care home
• care nursing workforce care home care nursing workforce shortage<01:25:21.520><c> in</c><01:25:21.640

Committee: Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• We have set some standards of improving in all areas.
• Workforce is a major driver and a challenge for folks, and how do we think about getting trained workforce
• Initiative 5 is focused on workforce development.
• The legislation did provide driver requirements and insurance standards as well.
• So we have board-certified transplant surgeons, medical doctors, nurses, social workers, dietitians.

Committee: Joint Joint Select Committee on Health Care and Behavioral Health Oversight

Summary: The committee met to hear introductory briefings from the Department of Health and the Health Care Authority on agency priorities, federal changes, and implementation challenges. Secretary of Health Dennis Worsham said his department’s listening tour is focused on strengthening governmental public health, improving health care quality and access, and responding to federal funding disruptions and the shutdown’s effects on programs such as WIC. HCA Director Ryan Moran said the agency is prioritizing coverage preservation, oversight of major contracts, affordability, behavioral health integration, rural health transformation, and internal agency operations. Members asked about licensure delays; Worsham said the backlog had been reduced from about four months to six weeks and should be caught up by January 1, with possible further process changes if needed. A major portion of the meeting focused on H.R. 1 and its Medicaid-related implementation. Governor’s health policy advisor Caitlin Stafford, HCA staff, and interim Medicaid Director Trinity Wilson said the state is working with DSHS, the Health Benefit Exchange, tribes, and other partners to prepare for eligibility changes, work requirements, and six-month redeterminations. They said the state expects up to 30,000 Apple Health enrollees could lose coverage under the law’s non-citizen eligibility changes, and that the work requirement/redetermination provisions could affect about 620,000 adults, with roughly 80,000 also enrolled in SNAP. HCA said it hopes to automate most verification, but about 15% to 20% of cases may require manual review, with technology costs estimated at up to $30 million. Staff also said they are trying to keep H.R. 1 implementation mostly in budget language rather than statute, and that communication and navigator support will be important to minimize confusion and coverage loss. The committee also received an update on the Rural Health Transformation Program created in H.R. 1. HCA said Washington submitted its application to CMS on November 5 after extensive stakeholder engagement, including more than 310 written comments, webinars, and tribal consultation. The application centers on six initiatives: rural hospital innovation, community care and prevention, tribal investments, technology and data, workforce development, and rural behavioral health. HCA said the state is likely to receive less than the full $200 million annual amount assumed in the federal program, and that an advisory committee may be created to help guide spending over the five-year program. Members asked about palliative care, small business impacts, and communication with enrollees; HCA said it expects to share outreach toolkits and that no 2026 statutory changes are currently anticipated, though that could change. The final panels covered organ donation and transplant services. Department of Health staff explained the 2023 “Lights and Sirens” law for organ transport vehicles, including licensing, driver qualifications, insurance requirements, and use of emergency lanes and traffic preemption; the department said one company is currently licensed and there have been no complaints. LifeCenter Northwest described the organ procurement process, the legal framework under the Uniform Anatomical Gift Act, and the rarity and complexity of deceased donation, noting Washington has seen strong growth in donation and transplants over the past decade. University of Washington Medical Center staff then outlined its transplant programs for kidney, liver, heart, lung, pancreas, and multi-organ transplants, describing the multidisciplinary evaluation and waitlist process and the coordination required with donor organizations and hospitals.

Transcript Highlights:

• Those repercussions would be, it's a violation of a standard of care, and that would be up to their board
• Additionally, the bill aligns Florida law with federal regulations, ensuring that nursing homes provide
• care nurse practitioner.
• I'm a family nurse practitioner and psychiatric nurse practitioner.
• This amendment clarifies the responsibilities of the home health agencies when nursing services are ordered

Summary: The committee took up a large health and human services agenda and first approved HB 711, the Spectrum Alert bill, which would create a statewide alert system for missing autistic children and require FDLE to coordinate training with state and local agencies. The measure drew a supportive waiver from the Florida Smart Justice Alliance and passed unanimously, 24-0, reported favorably. Members then considered CS for HB 229 on health facilities, which modernizes the Health Facilities Authority Act to allow additional nonprofit health system structures to use tax-exempt financing. Two amendments were adopted: one requiring advance notice, public hearings, and stakeholder notifications before a nonprofit hospital closure, and another removing a property tax exemption for a nonprofit hospital that closes and fails to maintain emergency services for 120 days, applied retroactively to January 1, 2025. The Florida Hospital Association opposed the amendments, citing workforce and nonprofit-status concerns, but the bill as amended passed 24-0. The committee also approved CS for HB 1405 on juvenile justice status offenders, expanding early truancy intervention, parent involvement, and shelter placement review timelines; it passed 24-0. CS for HB 27, joining the Social Work Licensure Interstate Compact, and its linked public records bill CS for HB 29 both passed unanimously after supportive testimony from several advocacy and business groups. The committee then debated HB 111 on out-of-network referrals and HB 1083 on patient access to records. HB 111 would require referring practitioners to inform patients in writing when a referral is out of network and to apply out-of-network payments to deductibles; it drew opposition from medical groups over administrative burden and patient-care concerns, but passed 17-8. HB 1083 would shorten the time for producing medical records to 14 working days and standardize access rules, with amendments clarifying portal access and delaying the effective date to January 1, 2026; despite opposition from some health information and provider groups over HIPAA and access concerns, it passed 19-7 as amended. Later, the committee approved HB 883, allowing autonomous practice for psychiatric nurse practitioners with the required credentials, after strong support from nurse practitioner groups and opposition from psychiatric and medical associations; it passed 23-3. HB 1297, which aligns Florida’s electronic prescribing exceptions with federal law and removes several state exemptions, passed 19-7 despite opposition from hospice, emergency physician, rheumatology, and medical groups concerned about paper prescriptions in emergencies and hard-to-find medications. HB 1353 on home health care services and CS for HB 989 on foster home licensure transfers both passed unanimously after supportive amendments. The committee also heard HB 1505 on parental rights, which would require written parental consent for many health care services, surveys, and biofeedback devices for minors and expand parental access to records; the bill drew extensive support testimony but also questions and concerns about confidentiality, abuse reporting, and existing exceptions, and the transcript ended before a final vote on that bill.

Transcript Highlights:

• Free, and they are able to enter the workforce and be successful.
• We've really put a major, major emphasis on workforce in this budget.
• The Board of Governors also has oversight.
• All those numbers represent about 3% across the board to hospital reductions.
• to nursing education line funding program that is so, so important to helping educate our nurses, and

Summary: The Senate began with prayer and the Pledge of Allegiance, then moved into floor consideration of the 2026-2027 budget. Appropriations Chair Hooper presented Senate Bill 2500, describing a $115 billion budget that reduces overall spending from the prior year, maintains reserves, and includes a 3% pay raise for state employees and 5% raises for state law enforcement, firefighters, correctional officers, and park rangers. Committee chairs then outlined major spending in their areas, including K-12 education, higher education, health and human services, criminal and civil justice, transportation/tourism/economic development, and environmental and agricultural programs. Highlights included increased funding for school scholarships and safety, workforce and university programs, Medicaid and child welfare, corrections operations, affordable housing, rural communities, Everglades and water quality projects, and infrastructure. Members then asked detailed questions about several budget items. Senators sought clarification on the Emergency Management Trust Fund, arts and cultural grants, Florida Forever land acquisition versus conservation easements, teacher salaries, charter school capital outlay funding, EASE grants, New College funding, DOC inmate counts and reimbursement, lottery staffing, concealed weapons licensing positions, election security funding, iBudget waiver support, ADAP funding, Medicaid hospital rate reductions, and scholarship and enrollment supplements in K-12 education. Chairs explained that some reductions reflected technical shifts or right-sizing, that some funds were being moved below the line for better tracking, and that several items—such as ADAP and corrections operations—would likely remain conference issues with the House. After questions, the Senate substituted House bills for the budget and implementing measures and adopted amendments placing the Senate language onto the House vehicles to prepare for conference. The chamber passed the budget-related bills and several conforming measures, including bills on retirement, fuel taxes, the state agency law enforcement radio system, court trust funds, judgeships, and K-12 and higher education conforming changes. Votes on the major bills were overwhelmingly unanimous or near-unanimous, and the Senate repeatedly voted to accede to the House’s request for conference on the substituted bills.

Transcript Highlights:

• Our posthospitalization capacity planning and innovation, our nursing home bed restrictions, really need
• Unhoused Oklahomans or various workforce initiatives for nursing facility staff.
• Workforce initiatives could vary from streamlining education for nursing facility staff on homelessness
• For those who might need a higher level of care, they're working with nursing care and nursing home systems
• Medicaid does offer a limited service for skilled nursing as well as home health services, but even with

Committee: House Public Health

Summary: The meeting focused on hospital “avoidable days” and the difficulty of discharging medically stable patients who still need post-acute placement or social services. Presenters from Saint Anthony Hospital Midtown, the Oklahoma Hospital Association, City Care, and OU Health described common barriers including lack of skilled nursing, rehab, long-term care, behavioral health, and hospice placements; insurance prior authorization delays; Medicaid and Social Security eligibility delays; guardianship and Adult Protective Services bottlenecks; limited home health and private duty nursing; and the challenge of placing unhoused, uninsured, or medically complex patients. Several speakers emphasized that these delays reduce bed availability, increase emergency department boarding, contribute to staff burnout, and expose patients to hospital-acquired conditions and other harms. The testimony included multiple examples of patients remaining in acute care for days, weeks, or even months after being medically ready for discharge, including patients awaiting guardianship, disability determinations, or placement in facilities willing to accept them. Speakers also highlighted special populations such as patients with behavioral health or substance use disorders, medically fragile children, patients with criminal histories, and unhoused individuals who need respite or hospice care. City Care described its planned 40-bed medical respite facility, set to open in 2027, as a way to provide clinical support and housing navigation for patients too sick to recover on the street or in shelters. Witnesses recommended policy and system changes such as standardizing preauthorization protocols, expanding rural swing-bed and home-based services, increasing public guardianship resources, improving data collection on homelessness, expanding private duty nursing hours, and creating more placement options for complex patients. They also suggested better coordination between hospitals, DHS, APS, the Health Department, and post-acute facilities, including a database of facility services to improve discharge planning and keep patients closer to home. No votes or formal committee actions were taken in the transcript, but the chair indicated the issue would require collaboration across multiple agencies and partners.

Transcript Highlights:

• As the committee analysis notes, high-road employment standards are becoming the standard.
• In response to disasters like this, OSHA, or the Occupational Safety and Health Standards Board, adopted
• I'm also on the executive board, and I strongly support this.
• data collection and sharing between the new internet agency council, the workforce development board
• data collection and sharing between the new internet agency council, the workforce development board

Committee: House Labor and Employment

Keywords: 988, house, all

Transcript Highlights:

• claims solely for mental health conditions, physician assistants, and licensed advanced registered nurse
• And licensed advanced registered nurse practitioners. Thank you.
• I would say it's great to be here, but I was at home just a little while ago, and that was a little nicer
• But that workforce continues not to feel like they can speak up.
• But that workforce continues not to feel like they can speak up.

Summary: The Senate Labor and Commerce Committee heard testimony on several bills. SB 6152 would add physical and occupational therapists as attending providers in workers’ compensation claims. Supporters said it would reduce delays, improve access to care, and speed return to work; opponents, including the Washington State Medical Association, retail and business groups, and L&I, raised concerns about diagnosis, scope of practice, network enrollment, implementation time, and the $1.9 million fiscal note from accident and medical aid accounts. The committee also heard SB 5437, which would prohibit non-compete agreements and clarify non-solicitation rules. The sponsor and labor and physician groups supported ending non-competes as anti-competitive and harmful to worker mobility, while business, banking, and clinic representatives argued non-competes protect investments, confidential information, and patient/customer relationships and asked for narrower changes. The committee then heard SB 6058, which would give L&I discretion over whether to investigate wage complaints and would toll civil statutes of limitation when a complaint is filed. The sponsor said it would better match agency resources, and testimony was entirely supportive. SB 5944 would require language access provider compensation bargaining to include missed or canceled appointments and make CBAs prevail over conflicting agency policies; the sponsor and union representatives said it would create consistency across agencies, with no opposition testimony. SB 6039 would modernize L&I communications by allowing electronic notices while preserving a non-electronic option; supporters called it a permissive modernization, while worker advocates warned email could be missed and could burden vulnerable workers, though L&I said the bill preserves choice and has no fiscal impact. Finally, the committee heard SB 6117, which would place workers and employers not covered by the NLRA under PERC jurisdiction if federal law no longer applies, with card-check and secret-ballot procedures and interest arbitration provisions. Supporters said it would create a state backstop if federal labor enforcement fails and protect workers’ organizing rights; opponents from agriculture, business, and small business groups warned it was too broad, could sweep in agriculture and small businesses, and could weaken secret-ballot protections and disrupt harvest operations. The sponsor closed by saying the bill is intended to create a clear framework where federal jurisdiction is absent. No votes or executive actions were taken in the hearing.

Transcript Highlights:

• Um we now have a nurse we had one nurse.
• Um, like I said, nurses, nurse practitioner, and every—um, we have one nurse practitioner.
• and a nurse practitioner than we were for two to three nurses.
• Martin told you: that with a nurse in every school and a nurse practitioner and a provider nurse that
• </c> nurse practitioner and a provider nurse nurse practitioner and a provider nurse that<00:40:32.960

Keywords: 1. Call to Order and Roll Call – 00:00:00 2. Approval of Minutes – 00:01:32 3. Getting to Know the Foundation for a Healthy Kentucky – 00:02:26 4. Healthy Kids Clinic – 00:26:58 5. Pharmacy Payment Parity – 00:56:36 6. Ibogaine – 01:17:37 7. Consideration of Referred Administrative Regulations – 01:53:05 8. Adjournment – 01:53:19, 958, all

Summary: The committee first approved the prior meeting minutes and recognized Eric Clark for his service, noting this may be his last meeting before he leaves state government. The main presentation was from Allison Adams, president and CEO of the Foundation for a Healthy Kentucky, who described the organization’s history, nonpartisan mission, and focus on health equity, prevention, and upstream policy solutions. She said Kentucky’s poor rankings in chronic disease, preventable hospitalizations, and life expectancy show the need to shift resources toward prevention and community-driven strategies rather than relying mainly on treatment after people become sick. Adams emphasized leading health indicators, arguing that lawmakers should track actionable measures such as quit attempts and smoke-free policies instead of only lagging indicators like disease rates and mortality. In response to questions, she said accountability should be shared across communities and systems, with possible incentives and disincentives tied to outcomes, and she supported creating a public data utility or dashboard, ideally with university partners, to help legislators and communities monitor progress. She also cited examples of accountable health community models and said Kentucky could adapt similar approaches. The committee then heard from Meade County Schools Superintendent Mark Martin and district health coordinator Karen Kotche about the Healthy Kids Clinic partnership with Cumberland Health. They described a seven-year effort that led to full implementation in the district, which now has a nurse in every school and a nurse practitioner, allowing services such as sports physicals and other clinic functions to be provided on campus. They said the program has been a strong investment for students and the community and began explaining how the district built the partnership after earlier efforts and delays, including the pandemic.

Transcript Highlights:

• In response to disasters like this, the Occupational Safety and Health Standards Board adopted updated
• This bill applies skilled and trained workforce standards to pharmaceutical facilities.
• It actually applies skilled and trained workforce standards to pharmaceutical facilities.
• We've applied skilled and trained workforce standards to refineries, chemical plants, and high-hazard
• We've applied skilled and trained workforce standards to refineries, chemical plants, and high-hazard

Summary: The committee heard and later voted on six labor-related bills. SB 1059 would modernize the Employment Training Panel by allowing electronic record-keeping, digital attendance documentation, and updated training terminology; supporters said it would reduce paperwork and better match current workforce training practices, while no opposition appeared. SB 966 would make permanent 2017 refinery process safety protections, including worker participation in safety reviews and stop-work authority; refinery workers and unions supported it as a safeguard against rollback, while the Western States Petroleum Association opposed it, arguing it conflicted with a settlement and could be preempted by federal labor law. SB 1024 would provide 26 weeks of paid postpartum and recovery leave for firefighters who give birth and require return to the prior position; supporters said it would improve retention and equity in a male-dominated profession, and there was no opposition. The committee also heard SB 1316, which would strengthen wage theft and workplace safety enforcement by allowing renewal of labor commissioner liens, limiting employers’ late use of records, and requiring Cal/OSHA to report complaints and citations data annually. Supporters said the bill would help workers collect judgments and address long backlogs; there was no opposition, and the bill passed 4-0 on call before the full committee vote. SB 1185 would apply skilled-and-trained workforce requirements to pharmaceutical facility construction and maintenance; supporters from the building trades said these projects require specialized precision to protect public health and supply chains, while contractors opposed the bill as an unnecessary expansion of public-work-style mandates into private projects. Finally, SB 1227 would create apprenticeship pathways into Department of Industrial Relations enforcement jobs, including Cal/OSHA and the Labor Commissioner’s office, to address staffing shortages and backlogs. The author and supporters said apprenticeships could help fill vacancies while preserving the civil service merit principle and creating opportunities for displaced workers; there was no opposition. After discussion and roll calls, the committee reported all six bills out of committee, with SB 966, SB 1024, SB 1059, SB 1185, and SB 1227 sent to Appropriations, and SB 1316 sent to Judiciary.

Transcript Highlights:

• home care nursing services.
• to our home care workforce shortage.
• home care nursing services.
• to our home care workforce shortage.
• to our home care workforce shortage.

Keywords: 1183, house

Transcript Highlights:

• home and that nursing home needs help evaluating. the rest of their patients, and so we'll go in and
• But long term care providers such as nursing homes and assisted living facilities, child care providers
• home rather than an institution.
• Center for Nursing Workforce Statistics that can outline where they see shortages, you know. and nursing's
• home? Group homes? That would have been the perfect question for DSHS. Got it. Okay, yeah.

Committee: House Public Health

Keywords: 1184, house, all

Transcript Highlights:

• We assist people with care transitions from hospitals and nursing homes back into the community.
• And I'm thinking specifically of those who are most at risk of nursing home admission.
• And I'm thinking specifically of those who are most at risk of nursing home admission.
• Workforce remains another area of focus.
• To better quantify workforce challenges, CHIA is building its second workforce survey this year.

Committee: Joint Joint Committee on Ways and Means

Keywords: 995, all

Summary: The committee heard budget testimony from Department of Mental Health Commissioner Brooke Doyle, who said DMH serves about 29,000 people and is facing rising demand, higher operating costs, and uncertainty about federal funding. She explained that the FY26 budget prioritizes fully funding the state-operated inpatient system, which is at 100% occupancy and often serves people transferred from Bridgewater State Hospital, while making reductions in other areas to balance the budget. Those reductions include a 50% cut to case managers, a pause on closing the Pocasset unit pending a working group on Cape access, and changes to youth and contracted services such as right-sizing IRTP and CIRT, reducing Youth PACT from seven teams to three, scaling back flex and jail diversion grants as ARPA funds wind down, and preserving the behavioral health helpline and community-based crisis services. Members from Western Massachusetts and the Cape raised concerns about access, staffing, and the impact of cuts, and Doyle said the department would continue operating IRTP services, improve the referral process, and work with stakeholders on the Pocasset review and other access issues. The committee also discussed school-based mental health, 988, loan forgiveness for workforce recruitment, and the role of co-response programs for law enforcement. Secretary Robin Lipson then testified for the Executive Office of Aging and Independence, describing a proposed FY26 budget increase of about 21% to support councils on aging, home care, elder abuse investigations, caregiver support, care transitions, and nutrition programs. She said the agency is managing rising demand, especially from the growing 80-plus population, and noted uncertainty around federal Older Americans Act funding after the federal disbursement agency was disbanded. To control costs, the office will manage intake and caseload growth in a fully state-funded home care program, but current clients will not lose services. Lipson also highlighted a new $1 million line item for local mini-grants to support age-friendly initiatives. In questions, members focused on elder scams, and Lipson said scams are increasing and the agency is working with banks, district attorneys, and public awareness campaigns. The Health Policy Commission’s Executive Director David Seltz presented the agency’s FY26 request and said the biggest challenge is health care affordability, with family premiums near $29,000 annually and many residents delaying care because of cost. He emphasized that recent legislation significantly expands HPC’s role through a new Office of Pharmaceutical Policy and Analysis, which will examine the drug supply chain and pricing, and a new Office of Health Resource Planning, which will support statewide planning around closures and access gaps. The new law also creates task forces on maternal health access and primary care, and adds transparency and oversight for private equity in health care. Members asked about pharmaceutical costs, GLP-1 weight-loss drugs, 340B, and maternal health closures; Seltz said the data show rapid growth in GLP-1 spending and that the new offices will help the state better understand cost drivers and access problems. The Center for Health Information and Analysis then began its testimony, describing its role as the state’s data hub for health care spending, utilization, quality, and affordability analysis.

Transcript Highlights:

• So our ultimate goal is to have a thriving workforce.
• As I mentioned before, workforce well-being is being...
• and assisting our workforce.
• About workforce enhancements, can you give us a few examples of workforce enhancements that you're doing
• We also apply a standard, I believe it is $180 per day, which is the standard group care rate from the

Committee: Senate Children, Families, and Elder Affairs

Summary: The committee heard three presentations focused on child welfare workforce development and the needs of children in Florida’s dependency system. First, the Florida Institute for Child Welfare described its Grow Center and related initiatives, including academic curriculum enhancements, simulations, virtual reality training, coaching, on-demand learning, advanced certifications, and the planned Tallahassee learning lab opening in January 2026. Members asked about conflict resolution, domestic violence, addiction, and microcredentials; the presenter said the institute is expanding training in those areas and is working with DCF to align advanced certifications with the department’s career ladder. The Department of Children and Families then presented on the Continue the Mission initiative, which recruits veterans, military spouses, and former law enforcement officers into CPI, API, and case management roles. DCF said it has held more than 240 hiring events and hired 372 such workers since launch, while also improving recruitment and retention through higher starting pay, streamlined hiring, rebranding, wellness supports, and enhanced pre-service training. Senators asked about PTSD concerns, staffing levels, caseloads, hotline vacancies, and salaries; DCF said it had not seen direct PTSD issues from the hiring effort and provided figures including a $50,000 starting salary for CPIs, $37,000 for APIs, and average caseloads of 12 to 15 investigations for CPIs and about 10 for APIs. Finally, DCF discussed the increased acuity of children in the dependency system, explaining that fewer children are entering care overall but those who do often have more complex behavioral, mental health, developmental, or medical needs. The department highlighted a new Behavioral Qualified Residential Treatment Program (BQRTP) designed for youth who need more intensive support than traditional foster or group home settings but do not require inpatient psychiatric treatment; one facility is licensed with 12 of 14 beds filled, and DCF said it is seeking funding for placement for 230 youth total. Members pressed for details on licensure timelines, standards, funding, and the handling of crossover youth and lockouts, and DCF said it uses braided funding and works with DJJ, APD, and lead agencies through local and state review teams. A representative of the Florida Coalition for Children also testified, saying the issue is complex and multi-year, and that the coalition is working on possible legislative and programmatic solutions. The committee took no formal votes and adjourned after the presentations and discussion.

Transcript Highlights:

• HOMES INCLUDING EXPANSION OF THE DEBENTURE UNIT AT THE STATE VETERANS NURSING HOME AT LAND O LAKES.
• AMAZING NURSING HOME CARE PROVIDERS ACROSS OUR STATE.
• A NURSING HOME.
• OF A NURSING HOME HOME OFFICE OR THE NURSING HOME.
• OF A NURSING HOME THAT FAILS TO SUBMIT FINANCIAL DATA TO THE FLORIDA NURSING HOME UNIFORM REPORTING SYSTEM

Keywords: 999, senate, all

Transcript Highlights:

• First, the elimination of the Skilled Nursing Facility Workforce and Quality Incentive Program, or WQIP
• Provides nursing facilities which meet workforce and quality benchmarks directed payments through the
• It sounds like it's a dart being thrown at the board.
• That, and it's not really an appropriate standard.
• for nursing facilities.

Keywords: 988, house, all

Transcript Highlights:

• So we're going to have standardized language.
• So, for example, the director of State Board of Ed, director of the Workforce Development Council, we
• Things going out for workforce, technology, vehicles.
• workforce development.
• It's about nurse burnout and those types of things.

Summary: The Rural Health Transformation Committee met to receive an overview from Department of Health and Welfare Director Juliet Sharon on Idaho’s Rural Health Transformation Program application and the federal rules governing the five-year funding. Sharon explained the program was created by the One Big Beautiful Bill Act, that Idaho’s award is about $186 million annually in year one, and that the state must obligate the funds by October 30 or risk losing them. She reviewed the application timeline, the federal scoring process, reporting and audit requirements, and the state’s plan to hire a 12-person limited-term team to manage solicitations, monitoring, and compliance. Committee members asked about scope-of-practice issues for dental hygienists and physician assistants, the risk of losing or gaining funds, survey methodology, telehealth, and how the state will use the money for workforce, technology, behavioral health, infrastructure, and tribal set-asides. Sharon said the department would continue working with the legislature on scope-of-practice policy, provide more detail on survey data and funding caps, and set up a shared information space with LSO for committee access. Sharon also walked through the five main initiative areas in Idaho’s plan: technology and access, innovative models, workforce, chronic disease and behavioral health, and rural infrastructure/partnerships. She emphasized that allowable uses include telehealth and EHR modernization, cybersecurity, EMS support, workforce recruitment and retention incentives, evidence-based behavioral health and chronic disease programs, renovations and mobile units, and a 3.5% tribal set-aside. She said the department is still refining what is allowable with CMS and that the committee will receive monthly summaries, procurement information, and performance reports. Members raised concerns about the survey’s heavy use of “other” responses, the amount of money going to administration, and whether telehealth spending is the best use of funds. Chris Jones of Catalyst Policy Group then offered outside perspective on rural health strategy and the federal program. He praised Idaho’s application but urged the committee to think in terms of integrated, patient-centered systems rather than isolated projects. He highlighted examples from other states involving community health workers, telehealth hubs, remote monitoring, value-based care networks, rural training pipelines, and partnerships among hospitals, FQHCs, and tribal providers. He cautioned against focusing on social determinants of health funding, encouraged use of technology to reduce labor burden and improve sustainability, and emphasized that training providers in rural areas tends to keep them there. No votes were taken. The committee agreed to tentatively meet again on May 28 during CMS’s planned Idaho visit, and the meeting adjourned.

Transcript Highlights:

• </c><00:36:35.920><c> By</c> the cost of nursing home care. By the cost of nursing home care.
• </c><00:40:05.839><c> nursing</c><00:40:06.320><c> care</c> could they get um home nursing care could
• </c><00:53:39.280><c> other</c> nursing home or for whatever other nursing home or for whatever other
• nursing home and they maybe they're in a nursing home and they need<00:54:30.000><c> to</c><00:54:30.079
• homes. 150 for the facilities or nursing homes. 150 for the home<00:55:09.680><c> and</c><00:55:09.839

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board’s fourth meeting focused primarily on a presentation from University of Kentucky and University of Louisville health leaders about the state university directed payment program. Mark Birdwhistle and Ken Marshall described the program as a long-running, value-based Medicaid arrangement that began in 2019, uses university-provided matching funds rather than provider taxes, and ties a portion of payments to quality outcomes. They said the program has improved measures such as tobacco cessation, diabetes control, depression screening, and cancer screening, while supporting access to specialty care, medical education, and workforce training. They also emphasized that Kentucky’s model is nationally notable and has helped improve health rankings and generate cost savings. A major topic was the federal reconciliation bill signed July 4, which the presenters said will reduce directed payments by 10% annually for 10 years beginning in 2028. UL Health estimated a first-year loss of about $75 million and a cumulative loss of about $600 million over the decade; UK estimated about $100 million in the first year, for a combined first-year impact of roughly $175 million. Both speakers warned the cuts could affect access to care, training capacity, and the sustainability of Kentucky’s value-based model, though they expressed hope that congressional action could alter or delay the changes. They also noted that 340B drug pricing changes could further strain already thin operating margins, but did not provide exact figures during the meeting. Committee members responded positively to the program’s reported outcomes and the institutions’ role in Kentucky health care. Senator Berg praised the quality of care and shared a personal example of being advised to stay at UofL for breast cancer treatment. Representative Moer highlighted Kentucky’s strong cancer-control score and asked for more explanation of the value-based payment structure; the presenters said the system is built around ongoing measurement, accountability, and collaboration with the Cabinet for Health and Family Services. No votes or formal actions were taken beyond approving the amended August 27 minutes by voice vote.

Transcript Highlights:

• I'm also on the board, the Leadership Council, National Association of Home Builders.
• As a student in Washington, home to leading AI companies, I believe we can set the standard for responsible
• Safety standards.
• This grant program uses the insurance industry's own gold standard for home hardening and directly reduces
• future workforce.

Bills: SB6346 , SB6347 , SB6147 , SB6246 , SB5940 , SB5882 , SB6223 , SJR8206 , SB5762 , SB5828

Committee: Senate Ways & Means

Keywords: millionaires tax, wealth tax, income tax, state revenue, tax reform, Washington estate tax, estate tax, inheritance tax, death tax, probate, decedent, gross estate, taxable estate, exclusion amount, tax rate, estate planning, heirs, beneficiaries, RCW 83.100, Department of Revenue

Transcript Highlights:

• home Workforce Standards Board; the Minnesota Secure Choice retirement program; the producer responsibility
• home Workforce Standards Board; the Minnesota Secure Choice retirement program; the producer responsibility
• home Workforce Standards Board; the Minnesota Secure Choice retirement program; the producer responsibility
• home Workforce Standards Board; the Minnesota Secure Choice retirement program; the producer responsibility
• home Workforce Standards Board; the Minnesota Secure Choice retirement program; the producer responsibility

Committee: Senate State and Local Government

Keywords: 1187, senate, all

Transcript Highlights:

• Baskin, McComb, Mississippi, Mississippi Board of Nursing as a nurse educator, remainder of a four-year
• of Nursing Home Administrators as a nursing home administrator, 4-year term effective June 30th, 2025
• Home Administrators as Nursing Home Administrator.
• of Nursing Home Administrators as Nursing Home Administrator.
• Board of Nursing as a Licensed Practical Nurse.

Keywords: MS Senate Floor - 1 April, 2026; 10:00 AM, 925, all