Transcript Highlights:

• impact, changes the federal impact on the upper payment limit from federal funds to dedicated funds.
• That's netting against some federal funds on that line.
• ... ...had a bit of a typo on the federal column, federal and dedicated column on a couple of those lines
• the Department of Administration.
• she is the administrator within the Division of Insurance in the Department of Administration.

Summary: The committee received a broad budget overview from Legislative Services staff on the state’s fiscal position, focusing on the general fund, structural balance, cash reconciliation, and the governor’s budget recommendations for fiscal years 2026 and 2027. Staff explained that projected revenues are below the current budgeted level, creating a need for either budget reductions or the use of cash balances and reserve funds to maintain balance. They reviewed major drivers of spending growth over recent years, including Medicaid expansion, public schools, the State Public Defender, IT services, and water resources, and noted that these statutory and ongoing obligations are crowding out other spending. Members also discussed the governor’s proposed use of interest earnings and reserve balances from several funds, the Budget Stabilization Fund cap, and the policy question of whether changes to fund interest allocations would require legislation or could be handled through appropriation language. The committee also reviewed current-year adjustments, including supplementals, rescissions, deficiency warrants, and the governor’s proposed holdbacks. Specific items discussed included public school enrollment adjustments, the proposed rescission of Empowering Parents funding, Medicaid growth and provider rate changes, Department of Corrections costs tied to inmate placement and medical services, invasive species treatment funding, and a possible tax conformity impact tied to federal law changes. Members asked about fire suppression deficiency funding, the use of reserve balances, and the difference between current-law and governor-recommended spending levels. Staff emphasized that the governor’s budget relies on short-term money and reserve transfers to smooth the current deficit, while the legislature must decide whether to follow that approach or make deeper structural changes. Later, staff provided an overview of the budget hearing process and the Legislative Budget Book, explaining the standard reports, agency organization charts, fund analyses, performance measures, and five-year snapshots that committees will use during hearings. Another presentation clarified the difference between deficiency warrants and supplemental appropriations, noting that deficiency warrants cover certain last-year expenses authorized by statute, while supplementals adjust the current-year appropriation and can apply to general, dedicated, or federal funds. The committee then heard a detailed presentation on state health insurance costs, including rising medical claims, reserve balances, the 80/20 employee-employer cost split, and projected FY 2027 premium increases. Members asked about school district participation in the state plan, the role of the insurance carrier contract, and whether broader participation could lower costs. No votes were taken during the meeting, and the committee adjourned after the presentations and questions.

Transcript Highlights:

• Now, we are facing a direct federal assault on our state.
• , we face federal cuts that are impacting funding here in California.
• Challenges as the Trump administration has been defunding public education.
• Administration is defunding research grants, so much of the federal funding that is so critical for
• level. civil service, science, and the environment at the federal level.

Committee: House Budget

Transcript Highlights:

• I had a couple of questions just in regards to some of the federal policies as well as federal investments
• There are restrictions around those if federal dollars are used.
• dollars that we bring in for the administrative costs.
• The administration does not propose a cohort model.
• Fortunately, the federal law just changed in January.

Summary: The Senate Budget Subcommittee on Education heard the Governor’s proposals on universal school meals, the Expanded Learning Opportunities Program (ELOP), and community schools, with the Kitchen Infrastructure and Training Grants Program also discussed. For universal meals, the Department of Education supported continued investment, citing high student meal need, reported gains in meal participation and service efficiency from prior kitchen grants, and concerns that federal changes and underreporting could affect funding. The Department of Finance outlined $1.8 billion Proposition 98 General Fund for universal meals and an additional $100 million for a fourth round of kitchen grants, while the LAO recommended rejecting the new kitchen grant round because prior rounds are still being spent and the allowable uses are broad. Members raised questions about federal matching requirements, Summer EBT, and whether immigration-related federal policy changes could reduce meal counts and state/federal reimbursements. For ELOP, the Department of Finance described $4.7 billion ongoing Proposition 98 General Fund plus $62.4 million to set a minimum Tier 2 rate of $1,800 per pupil. The LAO recommended modifying the proposal to fully fix Tier 2 at the current $1,579 rate and tie future changes to program requirements, while CDE supported the Governor’s approach and said the added stability would help districts plan. Committee discussion focused on whether ELOP should remain a standalone before- and after-school program or be folded into LCFF, with some members and witnesses arguing for more local flexibility and clearer outcome measures, while others emphasized the value of guaranteed expanded learning access, especially for elementary students and working families. CDE noted new CalPADS reporting will provide more data beginning with the 2025-26 school year. For community schools, the Governor proposed $1 billion ongoing Proposition 98 General Fund to expand the model to thousands more schools and sustain existing ones, along with stronger technical assistance and future accreditation/self-certification. The LAO recommended continuing the current one-time grant approach instead of creating a new ongoing categorical program, citing concerns about scalability, administrative burden, and the need for earlier planning and clearer accreditation timelines if ongoing funding is adopted. CDE strongly supported the ongoing investment, saying community schools have improved attendance, suspensions, and achievement, and that technical assistance and county office support are essential for expansion. Members and public commenters largely supported community schools, with some urging stronger accountability, more support for county offices and MTSS, and debate over whether non-classroom-based charter schools should be excluded from eligibility. No formal votes were taken in the portion provided; the committee heard testimony and moved through the agenda items and public comment.

Transcript Highlights:

• </c><00:17:36.039><c> so</c> administration at the federal level so administration at the federal level
• You have community health clinics that aren't receiving their federal funds.
• So the conversation is: can we protect Minnesotans from the federal government?
• But the federal government is still the federal government, and we need to make sure that we're holding
• is still but the the federal government is still the<00:19:29.919><c> federal</c><00:19:30.240><c> government

Transcript Highlights:

• The stated purpose of SB 73 is to build protections against federal interference.
• Federal agencies have every right and duty to inspect and audit voting systems used in federal elections
• to ensure compliance with federal laws. ...used in federal elections to ensure compliance with federal
• There is basically no accountability to the federal law.
• Sheriffs are not election administrators.

Committee: House Public Safety

Transcript Highlights:

• Is that correct for administration?
• We also have a trailer bill item for federal background checks.
• It's my understanding that, in order to continue being able to utilize those federal databases, the federal
• Administration is withdrawing that request to generate a budget solution.
• Small Business Administration State Trade Expansion Program award.

Summary: The subcommittee first heard an informational presentation on the May Revision’s proposed reorganization of the Business, Consumer Services and Housing Agency into separate housing-focused and consumer/business-focused entities. Administration officials said the split would improve oversight, streamline decision-making, and create a dedicated California Housing and Homelessness Agency with a new housing development and finance committee. The Department of Finance said funding was needed in 2025-26 to begin implementation, while the LAO recommended rejecting the proposal without prejudice because the Little Hoover Commission review was still pending and the plan would require ongoing General Fund costs. Members raised concerns about the timing, the lack of alignment with the budget process, and whether the reorganization would improve accountability for homelessness spending; several public witnesses supported the concept but stressed it could not substitute for new housing and homelessness dollars. The committee then took up the Department of Veterans Affairs. CalVet requested funding for phase three of its electronic health care record project and a trailer bill to preserve authority for federal background checks, but the May Revision withdrew requests for deferred maintenance and additional administrative support. The LAO noted deferred maintenance can prevent larger future costs, and the chair criticized the withdrawal of less than $1 million for veterans’ homes as short-sighted given existing repair needs. No vote was taken. Next, the Department of Housing and Community Development presented its budget. HCD said the May Revision provides no new affordable housing or homelessness funding, but does retain existing rounds of funding and proposes a $31.7 million reversion from undersubscribed housing programs. Members from both parties expressed concern about zeroing out ongoing housing and homelessness investments, especially for LIHTC, the Multifamily Housing Program, and HAP. HCD also defended its homelessness accountability and compliance work, saying the unit includes about 30 program staff and six attorneys, with three additional attorneys requested mainly to handle public records and litigation workload. Public commenters largely opposed the lack of new funding and urged continued support for housing and homelessness programs, while some supported the reorganization and accountability efforts. Finally, the committee heard Go-Biz proposals. The administration requested authority to increase funding for a federal trade program match if needed, plus reappropriations for administrative funds tied to the Containerized Ports Interoperability Grant Program, zero-emission vehicle operations, and the Women’s Business Center Enhancement Program. It also proposed withdrawing the Cal Competes grant request and reverting remaining funds from the Performing Arts Equitable Payroll Fund. The LAO said Cal Competes is generally effective but could be cut as a budget solution, while warning that the performing arts fund was close to awards and should be considered carefully. Members objected to pulling back committed funds for performing arts organizations and questioned why the state would withdraw support after applications had already been submitted.

Transcript Highlights:

• From executive order to agency action, the federal administration has used all of its tools to make life
• This is a significant focus for the administration and for our programs.
• Despite federal threats to the LGBTQ+ community and the impact of federal actions such as H.R. 1 on the
• You will hear more about federal impacts in the coming panels, but recent federal actions attempting
• My administration is concerned my survival is a debt I can never repay.

Transcript Highlights:

• Due to the federal shutdown, we had a few federal folks who were going to be speaking today, but unfortunately
• It's mostly federal funds.
• That's where things stood federally.
• The science developed by all of our academic institutions is so much more important in this federal administration
• Here's what I would say: If the federal landscape is changing, the federal landscape could change.

Committee: House Radioactive & Hazardous Materials Committee

Transcript Highlights:

• My name is Jonathan Gulliver, and I am the State Highway Administrator.
• Thank you, Administrator. Good afternoon.
• Gorkowitz's team at the Executive Office for Administration and Finance.
• Finally, as the administrator mentioned, For small and rural communities.
• Okay, I just have one question for Administrator Galaba.

Committee: Joint Joint Committee on Bonding, Capital Expenditures and State Assets

Summary: The Joint Committee on Bonding, State Assets, and Capital Expenditures held its first public hearing on House Bill 4257, a transportation bonding bill. The administration testified in support, describing the bill as a $1.185 billion authorization: $300 million for Chapter 90 municipal road funding and $885 million for statewide transportation capital programs. Officials said the bill would increase municipal aid by 50%, with $200 million distributed under the traditional Chapter 90 formula and $100 million based solely on road mileage to better help rural communities. They also highlighted $500 million for bridge and pavement lifecycle asset management, $200 million for culverts and small bridges, and $185 million for congestion, safety, ADA, sidewalk, and multimodal improvements. Committee members asked about how municipalities would apply, how the road-mile formula would affect rural towns, and how the bill would interact with federal funding uncertainty and debt financing. Administration witnesses explained that projects would be administered through MassDOT district offices and Grant Central, that the bill would not backfill rescinded federal funds, and that the proposal would likely use special obligation bonds backed by Fair Share revenues to reduce pressure on the Commonwealth’s general obligation debt limit. Members also pressed the administration on the shift from general obligation to special obligation financing and on whether the Chapter 90 increase keeps pace with inflation. Administration officials said the special obligation structure would be credit-rated separately and was intended to expand available capital without affecting the GO bond cap, while acknowledging that the Commonwealth’s debt portfolio would grow. They said the Chapter 90 increase would roughly restore purchasing power lost since 2012, though construction inflation has outpaced general inflation. Several members and witnesses emphasized the importance of the road-mile formula for rural communities and the need for technical assistance for small towns. The Massachusetts Municipal Association testified in strong support of the bill, calling Chapter 90 and the new infrastructure authorizations critical for cities and towns facing federal uncertainty and rising costs. The Massachusetts Aggregate and Asphalt Pavement Association also supported the bill, citing the importance of the funding for road and bridge work, the construction season, and the industry’s economic impact. A committee member asked about asphalt price inflation, and the witness said liquid asphalt costs rose sharply after COVID, including increases of around 20% in some years. At the end of the hearing, the chair said members would receive a poll by email to move the bill out quickly, and the committee then voted to adjourn.

Transcript Highlights:

• consolidated administrations.
• consolidated administrations: the Home and Community Living Administration and the Behavioral Health
• and Habilitation Administration.
• Support Administration, Behavioral Health agencies, and the Developmental Disabilities Administration
• Rehabilitation Administration.

Summary: The Early Learning and Human Services Committee held public hearings on three bills. HB 2468 would update the Revised Code of Washington to match DSHS’s 2025 reorganization, replacing references to eliminated administrations with the new Home and Community Living Administration and Behavioral Health and Habilitation Administration, and also removing a 2028 sunset on the Dementia Action Collaborative, adjusting advisory committee membership, and eliminating a staffing mandate tied to no-paid-services caseloads. The sponsor and DSHS testified in support as a technical cleanup bill, while members raised questions about possible amendments, including whether to keep or remove the Dementia Action Collaborative sunset. DSHS said it was open to changes and noted some statutory references still need correction. No vote was taken. HB 2529 would rename the DCYF Oversight Board as the DCYF Accountability Board, move it to OFM for administrative purposes, narrow some duties, require at least twice-yearly engagement with affected communities, allow the board to request ombuds reports, broaden some membership qualifications, and change the annual report to an every-other-year report starting in 2027. Representative Dent, a board member, said the changes were intended to make the board less political, improve attendance and membership flexibility, and focus the report on more useful recommendations. A union representative asked for language ensuring a DCYF caseworker board member can attend meetings as part of job duties rather than using personal leave. Members also questioned whether the reduced reporting frequency was appropriate given recent fatalities and near-fatalities at the agency. No action was taken. HB 2455 would create a two-year pilot program providing rental assistance and related housing fees for 50 youth in extended foster care who are homeless or at imminent risk of homelessness, beginning January 1, 2027, with a report due in 2029 and transition planning required before youth age out at 21. The sponsor and multiple youth advocates testified strongly in support, describing homelessness, instability, and barriers such as “double-dipping” restrictions that prevent youth from combining housing supports. Testifiers said the bill would help youth focus on school, work, and healing, and urged the committee to expand the program if possible. Members asked about the pilot timeline and whether an interim review might be useful. The hearing closed with no vote on the bill, followed by committee announcements about Friday’s 8:30 a.m. meeting and an agenda change removing HB 2200 from Friday executive session and moving it to possible executive session next week.

Transcript Highlights:

• When you take a look at what the federal...
• When you take a look at what the federal government tried to do just recently under the Biden administration
• insurance tax policy, federal regulation.
• Federal funds and if they didn't receive federal funds, which I'm not aware of any, but if they didn't
• There's all that federal money that we could go grab.

Committee: Joint Health Insurance Affordability Task Force

Transcript Highlights:

• And oversight of these folks in federal immigration custody really can only take place at the federal
• hobbled under the present administration.
• , is under a federal law enacted in 1996 that allows the Trump administration to basically proceed in
• That gives us the ability to conduct federal investigations and charge criminally at the federal level
• is necessary from a federal judge or in a federal system that they're not getting. in a state court.

Committee: House Courts, Corrections & Justice Committee

Transcript Highlights:

• We have Antonio Murphy, Director of Administrative Services, here to present.
• We have Lisa Saliba, Assistant Secretary for Finance and Administration, here to present.
• Federal law establishes an annual allotment for each state that limits federal financial participation
• Does the agency anticipate any current or potential federal disallowances this year?
• Florida KidCare is jointly financed with state and federal funds.

Summary: The Legislative Budget Commission met with a quorum present and considered 12 budget amendments, most of which were adopted without opposition. The first amendment transferred $8.2 million in Department of Corrections general revenue authority from salary incentives to contracted services to support the phased demobilization of Florida National Guard troops assisting with correctional staffing. Senator Pizzo questioned the length of the Guard’s deployment and urged a long-term staffing solution, while the department said the Guard presence was being reduced and that about 2,200 employees were in training. The Department of State received an additional $618,391 in federal grant authority for library grants and private cloud costs, and the Department of Transportation’s two amendments were zero-sum work program changes: one realigned funds to production-ready projects and another added three projects over $3 million each to the current-year work program. The commission then approved several Agency for Health Care Administration amendments tied to Medicaid supplemental payment programs. These included funding for the Florida Cancer Hospital Program, indirect medical education payments, disproportionate share hospital payments for the state mental hospitals, the Low-Income Pool program, physician supplemental and public hospital payments, Florida KidCare, and Medicaid services realignment. Members asked about possible federal disallowances in the LIP and physician/public hospital programs, and agency staff said some disallowances were likely but the amount was not yet known. For KidCare and Medicaid, staff explained the changes were based on the December estimating conference, enrollment shifts, and updated actuarial assumptions, including changes to managed care regions and program design. The final amendment restored budget authority for a hospital direct payment program after a prior payment, including a $24.3 million CMS-related amount and $3.2 million in administrative fees, was not processed before fiscal year-end and reverted. Senator Pizzo pressed the agency on how the payment was missed and whether any penalty applied; staff said the invoice was not received and processed in time and that communication issues contributed. After brief debate on each item, the commission adopted all amendments, with one recorded nay on the final item, and then adjourned.

Transcript Highlights:

• </c><00:08:12.720><c> Administration</c> about the uh the federal Administration about the uh the federal
• </c> this relates to ethics administr this relates to ethics administr administrative<00:08:38.399><c
• </c> administer that I think Administration administer that I think Administration would<00:32:50.639
• If there's a blank there, we can just look to the federal IRC, to federal law, and we can conform to
• If there's a blank there, we can just look to the federal IRC, to federal law, and we can conform to

Committee: Senate Judiciary

Summary: The Judiciary Committee heard several bills on January 30. SB 286 and SB 287 both concerned supplemental funding for the Honolulu Department of the Prosecuting Attorney: SB 286 for the career criminal prosecution unit and SB 287 for the victim witness assistance program. Testimony from the department explained that these bills are filed each year because the Attorney General’s core budget allocation may not be sufficient, though the department said the core had recently been increased and the supplemental request might no longer be necessary. For SB 287, the department also warned of a possible federal Victims of Crime Act funding freeze that could cut about $1.88 million and severely harm victim services. Both bills drew support from county and community witnesses, and members asked about prior-year funding and why the requests were limited to fiscal 2025-26; no votes were taken in the excerpt. SB 289, from the State Ethics Commission, would create a more uniform administrative fine process under the ethics code and lobbyist law. The commission said the measure would not change substantive enforcement but would let it issue a notice and order of fine first, with the respondent able to request a hearing within 20 days, which would speed up cases that are not factually disputed. Members questioned whether the bill would deny due process or function like an automatic parking ticket, and the commission responded that respondents could still challenge the fine and that the process would apply to violations with fines under $1,000. The committee also heard SB 304, which would add 11 positions for the First Circuit Adult Client Services Branch; Judiciary testimony said probation caseloads are high, with an average of 116 cases per officer, and the added staff would help meet national supervision standards and better serve higher-risk clients. Members asked whether the positions were already in the budget and about current staffing ratios; the witness said the positions were not already funded and that the Judiciary supported the bill with amendments. The committee then heard SB 311, a proposed constitutional amendment to exclude spending money to influence elections from protected free speech. Testimony was strongly divided: supporters argued that Citizens United has distorted elections and empowered special interests, while opponents warned the language was too broad and could affect nonprofit advocacy and grassroots groups. Finally, SB 313 would impose a 1% wealth asset tax on individuals with $20 million or more in assets. The Department of Taxation said it had concerns about the bill’s ambiguity and administration and noted it would require annual valuation and likely additional resources; opponents, including family business representatives and the Tax Foundation of Hawaii, argued the tax would be difficult and costly to administer, would require sensitive business disclosures, and could force family businesses to pay from company cash. Supporters said wealthy residents should pay a fair share. The committee heard testimony and questions on these bills, but the excerpt does not show final committee votes or actions.

Transcript Highlights:

• . ...and post-Newsom administration.
• And I think under this administration, it's now in the billions.
• It also allows the state to unlock a lot of federal tax credits, a lot of federal funds.
• It only addresses the 4% federal tax credits.
• I do want to ask really quickly on the federal 9%.

Transcript Highlights:

• Current federal law, 5 U.S.
• Reimbursement will be paid by the federal government to the agency.
• Current federal law, 5 U.S.
• Current federal law, 5 U.S.
• Current federal law, 5 U.S.

Summary: The Senate Standing Committee on State and Local Government considered three bills. House Bill 321, sponsored by Rep. DJ Johnson and supported by the Kentucky League of Cities and the Kentucky Realtor Association, was amended by committee substitute and adopted unanimously. As amended, it extends training deadlines for planning commission and board of adjustment members and adds required training on how planning and zoning policies affect housing supply and accessibility. The committee substitute also limits appeals of final board of adjustment actions to persons or entities claiming injury who own real estate in the same zone as the affected property. The bill passed 8-0, and a title amendment was adopted. House Bill 340, sponsored by Rep. Tony Hampton with support from law enforcement and federal security representatives, would create a new section of KRS Chapter 13 to require criminal justice agencies to provide criminal history records for federal suitability or fitness background checks and allow a $25 fee for records requests reimbursed by the federal government. It also conforms juvenile records law to the new process. The committee approved the bill 9-0 with no opposition. House Bill 520, sponsored by Rep. Chris Fugate and backed by the Kentucky Sheriff's Association, Kentucky Police Chiefs Association, and Kentucky League of Cities, generated the most debate. The bill and committee substitute would exempt certain open police investigation records from disclosure under the Open Records Act when an agency says release could harm an investigation or reveal informants or witnesses. Several senators raised concerns that the “could” standard was too broad and could weaken transparency, while supporters argued it was needed to protect ongoing investigations, witnesses, and officers. The committee initially failed the bill 6-4, then after additional vote changes and discussion, reconsidered it and advanced the amended bill with favorable expression 6-4 to the floor.

Transcript Highlights:

• As I mentioned, the federal work requirements kick in and— As I mentioned, the federal work requirements
• The federal government would work with us and say, 'You're trying.'
• . of either legislation that has passed or rules that have changed federally.
• Hank Chaudry, President and CEO of the Federation of State Medical Boards.
• Hank Chowdrey, President and CEO of the Federation of State Medical Boards.

Committee: Senate Health & Long-Term Care

Summary: The committee opened with an extensive update on the expected effects of federal HR1 on Washington’s health care system, especially Medicaid and the individual market. Governor’s office and Health Care Authority staff said the bill is likely to cause immediate coverage losses in the exchange beginning in January, followed by larger Medicaid impacts over the next several years. They highlighted likely premium increases, administrative burdens from more frequent eligibility checks and work requirements, reduced retroactive coverage, limits on state-directed payments and provider taxes, and possible effects on rural hospitals and safety-net providers. They also noted separate CMS rules already being implemented in Washington on prior authorization, managed care access, home- and community-based services, and eligibility/enrollment, and explained how those rules interact with HR1’s new requirements and timelines. Members asked about Planned Parenthood funding, work requirements, rural health grants, provider impacts, and how the state will use existing systems and a forthcoming timeline to prepare for implementation. The committee then received an update on the International Medical Graduate Work Group and Washington’s efforts to create pathways for internationally trained physicians. Presenters described the state’s clinical experience license, the clinical evaluation tool used to assess readiness, a grant program for career guidance and clinical training, and a 2025 law adding a hardship waiver process. National presenters from World Education Services and the Federation of State Medical Boards said many states have adopted similar pathways because of physician shortages, but approaches vary widely. They recommended clear guardrails, employment offers before application, ECFMG certification, supervised provisional practice, data collection, and protections against exploitation. Committee members asked about portability across states, retention of IMGs, and whether Washington should pursue additional options such as dedicated residency slots, preceptorships, or practice-ready assessment models. The final topic was an update on the Apple Health doula benefit and the statewide doula hub and referral system. Senator T’wina Nobles praised the state’s work, noting Washington’s high Medicaid reimbursement rate for doulas and the importance of building infrastructure to support equitable maternal care. Health Care Authority staff said the benefit launched on January 1, 2025, and covers prenatal intake, labor and delivery, postpartum visits, and telehealth-supported services. They reported 336 state-certified doulas, 134 enrolled with Apple Health, 287 clients served, and 641 claims paid so far, while also acknowledging barriers such as provider enrollment, claims submission, client matching, and language access. Doulas for All described the hub as part of a broader effort to expand access, support community-based birth workers, and reduce maternal and infant mortality disparities, especially for Black and Indigenous families.

Transcript Highlights:

• side of the Developmental Disabilities Administration.
• And those are fully funded by federal Money Follows the Person dollars.
• The Consumer Direct rate is a straight labor and administration.
• And then the administrative rate covers all of the administrative costs.
• So here, this is the federal health plan price transparency tool codified in federal regulation.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• With the pressure of the world on their backs and a federal administration who thinks transgender people
• also has... ...state requests the federal government.
• It is contingent on the federal government approving this. Right.
• It's saying that we're asking the federal government.
• We're asking the federal government to do it.

Committee: House Communications and Conveyance

Transcript Highlights:

• There was a federal law... That's how individuals get paid.
• I'm sure there's other LTSS programs that draw federal financial participation.
• That half of the state expenditures are matched by the federal government. So it's desirable.
• There isn't a provider that oversees it that takes an administrative cut.
• government will not provide any federal funding.

Summary: The subcommittee met with MassHealth LTSS Chief Leslie Darcy to review the Personal Care Attendant (PCA) program and the legislative work group focused on its long-term sustainability and cost containment. Darcy and Charlie described the work group’s five meetings and three consensus recommendations: enforce the 66-hour overtime cap, address fraudulent activity in the PCA program, and eliminate MassHealth handling of PCA paperwork/administrative work for members without a live-in exemption because those members are subject to EVV. They explained EVV as an electronic visit verification system replacing paper timesheets, and noted the rollout is expected to be completed this fall. The group estimated about $7 million in savings from the consensus recommendations and agreed to continue meeting through June to consider additional ideas. Darcy presented data showing the PCA program served about 56,000 members in state fiscal year 2024 and has grown from $1.2 billion in FY20 to $1.6 billion in FY24, with projections near $2 billion by 2027. She said much of the growth is driven by wage increases and older adults using more services, and compared PCA costs with other LTSS programs. The discussion also covered overtime spending, the role of federal financial participation, and how Massachusetts’ PCA program differs from other states because it has no hard caps on hours or activities. Several members emphasized the program’s value for independent living and community participation, while also acknowledging the need to control growth without undermining services. Members asked about undocumented immigrants and MassHealth funding, and Darcy explained that some eligibility categories are state-funded only and do not receive federal matching funds. Another member asked about workforce recruitment and wage pressures; Darcy said recent collective bargaining agreements raised PCA wages, with some workers eventually reaching $25 per hour and the entry wage reaching $20. The group also discussed whether IADL hours are disproportionately high compared with ADL needs, and reviewed data suggesting potential savings if IADL hours were limited relative to ADL hours, though no consensus recommendation was made on that point. The meeting ended with approval of the prior minutes by roll call vote, an update that the next health equity informational hearing is scheduled for May 19, and a motion to adjourn carried unanimously.