Transcript Highlights:

• direct primary care, or DPC.
• This bill ensures that direct primary care payments apply toward the individual's deductible under their
• This bill gives Texans greater flexibility to choose the primary care services that work best for them
• Uh, I'm a practicing physician locally using the direct primary care model actually.
• Called Texas Direct Medical Care. So this is an excellent bill.

Committee: House Pensions, Investments & Financial Services

Transcript Highlights:

• If we determine that they are not employable, then we we direct them to Health and Human Services or
• Children five and under can access child care service scholarships.
• The other thing about our child care services program is the direct benefit it has to employers.
• budget for the Child Care Services program.
• This underscores the urgent need for a more robust investment. in child care services.

Bills: SB1 , SB 1

Committee: Senate Finance

Keywords: appropriations, budget, state funding, education, healthcare, infrastructure, campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards, 1185, senate, all

Transcript Highlights:

• , and primary care.
• It directs the J-LEC to coordinate with the Universal Health Care Commission, the Health Cost Transparency
• services.
• Washington, we can ensure that these funds are used for direct patient care, and I'm asking for a yes
• These funds are used for direct patient care, and I'm asking for a yes. Thank you, Senator Bateman.

Summary: The Senate Health and Long-Term Care Committee held confirmation hearings for Ryan Moran to lead the Health Care Authority and Dennis Worsham to serve as Secretary of Health. Moran emphasized his personal background, experience in Maryland Medicaid, and priorities of protecting coverage amid federal changes, addressing health disparities, strengthening tribal partnerships, and improving agency operations. Worsham described his long public health career in Washington, his statewide listening tour, and his focus on collaboration, science-based decision-making, accountability, workforce support, and rebuilding public trust. Senators raised questions about behavioral health, social determinants of health, communication, misinformation, and the impact of federal policy changes; both nominees said Washington should continue leading on coverage, prevention, and public health resilience. In executive session, the committee advanced several bills. It passed SB 5899, allowing qualified chiropractors to perform chiropractic diagnosis and adjustments on animals; SB 6292, creating a joint legislative-executive committee on health care financing with a substitute; SB 6182, establishing an abortion savings program, after rejecting several Christian-sponsored amendments and adopting a Bateman amendment limiting eligible organizations to DOH-contracted abortion providers or funds; SB 5947, creating the Washington Health Care Board; SJR 8206, proposing a constitutional right to affordable health care; and SB 5933, on overdose mapping information sharing, with a substitute. The committee also recommended confirmation of both gubernatorial appointments. In a second group of bills, the committee passed SB 5823 on patient advocates with a substitute requiring at least one person physically present daily in acute care settings and expanding exemptions for certain hospitals; SB 6210 on the health plan certification process with a substitute; SB 5921 on psilocybin; SB 6226 protecting audiologists’ clinical autonomy with a substitute; and SB 5924 expanding pharmacists’ prescriptive authority with a substitute. Members discussed access, affordability, rural workforce shortages, and patient safety, and the committee adjourned after completing its agenda.

Transcript Highlights:

• WE WERE DIRECTED TO PROVIDE A MONTHLY RECONCILIATION WHILE GRANTS AND DONATIONS AND MEDICAL CARE EXPENDITURES
• AND THEN SIMILARLY WITH THE MANAGED-CARE DON'T RATE INCREASES THIS DIRECTS US TO A RATE INCREASE FOR
• CARE, PERSONAL CARE IS THE LOWER LEVEL OF SERVICE THAN IT IS ON THE PRIVATE DUTY NURSING SIDE WHICH
• CONSUMER DIRECTED CARE, YOU EMPOWERED PARENTS, YOU EMPOWERED FAMILY MEMBERS TO MAKE CHOICES AND AGAIN
• LIKE THE HOME HEALTH CARE, PERSONAL CARE ASSISTANTS AND CARE THAT MAY BE IN THEIR REACH TO WHILE THEY'RE

Transcript Highlights:

• , or 19%, on basic care services for children and families.
• <c> with</c> basic care services for people with basic care services for people with disabilities<00:
• </c> billion or 19% on the basic care billion or 19% on the basic care services<00:03:05.319><c> for<
• health care costs, and a whole host of ancillary services.
• > and</c><00:59:03.920><c> a</c> impacts direct health care costs and a impacts direct health care costs

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• , longer waits for care, ...is fewer behavioral health services, longer waits for care, and families
• When our state lacks stable revenue, services like birth control, abortion care, cancer screenings, and
• I'm not opposed to funding education, health care, or central services.
• For direct care registered nurses, the time period is after being employed on a fully compensated basis
• All licensed ambulance and aid services are required to submit patient care records into the system.

Summary: The Ways and Means Committee met on February 6, 2026, and first voted to suspend the five-day notice rule for all bills on the agenda. Senators Braun and Gildon objected, arguing the bill needed more public review and that the fiscal note had only just been released, but a roll call vote passed 15-9 and the committee proceeded to Senate Bill 6346. Staff briefed SB 6346 as a proposal to create a 9.9% income tax on Washington taxable income above a $1 million per-household standard deduction, with a $50,000 charitable deduction, apportionment rules for nonresidents and certain professions, quarterly estimated payments, and credits for capital gains tax and certain business taxes. Staff said the tax would begin in 2029 and eventually raise about $3.5 billion annually from roughly 30,000 taxpayers. The bill also would expand the Working Families Tax Credit, create a sales tax exemption for grooming and hygiene products, increase the small business B&O tax credit and filing threshold, and end the B&O surcharge on high-grossing businesses one year early. Members questioned the bill’s constitutionality, its exemption from referendum, treatment of student athletes, natural-resource industries, and whether real estate gains would be captured. Public testimony was sharply divided. Supporters, including labor groups, educators, health care advocates, counties, child care workers, and some business owners and high-income individuals, said the bill would make the tax code more progressive and provide stable funding for health care, education, child care, public defense, and other services, while expanding the Working Families Tax Credit. Opponents, including many small business, construction, housing, and taxpayer advocates, argued the measure would function as a tax on pass-through businesses and retained earnings, harm housing production and investment, encourage wealthy residents and businesses to leave the state, and violate the state constitution or the will of voters. No final action on SB 6346 was taken during the hearing.

Transcript Highlights:

• patient care, direct primary care, in small scope.
• In direct primary care in small scope.
• , pharmacy services, vision care, and other support services.
• We have after-hours primary care services for primary care.
• And the CNA role of direct care and skilled care in hospitals.

Committee: House Public Health

Keywords: 1184, house, all

Transcript Highlights:

• We do a lot of direct service work in our community support line and in our care coordination program
• Public Health, we have, we had a lot of, like, you know, direct service.
• We do a lot of direct service work in our community support line in our care coordination program.
• So what we do is we engage care... ...directed to this kind of community.
• So what we do is we engage care providers to deliver enhanced care coordination services to children

Keywords: 1212, all

Summary: The Equity Committee meeting of the Permanent Commission on the Status of Persons with Disabilities began with roll call, approval of the prior minutes, and a presentation from the Massachusetts Department of Public Health’s CATER Center (Care Coordination, Assistance, Training, Education, and Resource Center). Staff described CATER’s role in providing training and technical assistance to MassHealth Cares for Kids providers serving children with medical complexity, including e-learning modules, coaching, case review support, and informal virtual drop-in sessions. They emphasized a family-centered, racially and culturally equitable approach, and noted that the program is funded through a MassHealth contract and has been operating for about two to three years. Committee members asked about which providers participate, how many families are served, how CATER coordinates with other regional or grassroots programs, and whether the model could be expanded beyond Boston-based hospitals. The presenters said they currently work with five providers, including Boston Children’s, BMC, Tufts, NeighborHealth, and Baystate, but do not track enrollment numbers because that is handled by providers and MassHealth. Members also raised concerns about workforce shortages, funding stability amid federal Medicaid cuts, and the need to share the curriculum and connect with other networks such as ACOs, DDS contacts, case management organizations, and the Health Equity Compact. The presenters said the work remains a priority and that they are open to growth and broader partnerships. After the presentation, the committee agreed to have the CATER slides and curriculum circulated to members. The only other agenda item was a lengthy NIH strategic plan for disability health research, which members had not yet reviewed; they agreed to defer discussion to a future meeting and add it to next month’s agenda. No votes beyond approving the minutes were taken, and the meeting adjourned after thanking the presenters and attendees.

Transcript Highlights:

• I am a registered nurse appointed by Governor Newsom to serve on the board in a direct care provider
• Before they actually go in and can provide the direct care.
• That is for everybody, whether it's U.S., California, or international. 500 hours in direct patient care
• Without the clarity of care, care would be delayed or services may not be offered at all.
• We also have seen significant changes to skin care services.

Keywords: 988, house, all

Transcript Highlights:

• programs related to older adults and long-term care supports and services.
• most long-term care services, such as custodial care provided in nursing homes.
• Services that many individuals prefer as alternatives to institutional care.
• care services, social services, physical, occupational, and speech therapies, mental health, hot meals
• With respect to direct services, in close collaboration with the Department of Health Care Services,

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:

• Section 6 of the article requires the Commissioner of Human Services to establish a health care eligibility
• Examples of those reliable sources include managed care plans, other human services programs, return
• ><c> in</c> long-term care services that begins in long-term care services that begins in 2028. 2028.
• Uncompensated care places immediate pressures on clinics, staffing, and services in a time where we see
• </c> primary care services. primary care services.

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• I am a registered nurse appointed by Governor Newsom to serve on the board in a direct care provider
• Before they actually go in and can provide the direct care.
• Without the clarity of care, care would be delayed or services may not be offered at all.
• Without the clarity of care, care would be delayed or services may not be offered at all.
• We also have seen significant changes to skin care services.

Summary: The joint Assembly and Senate Business and Professions sunset oversight hearing focused first on the Board of Registered Nursing (BRN), with committee chairs emphasizing oversight, consumer protection, workforce access, and economic mobility. BRN leaders reported improvements since the last review, including faster licensing timelines, streamlined enforcement, higher consumer satisfaction, growth in pre-licensure enrollment, and expanded data collection. Members questioned the board about nurse practitioner scope and supervision, international and military pathways to licensure, online nursing education and clinical requirements, rural workforce shortages, and the 30-unit LVN-to-RN option. BRN staff explained California’s tiered advanced practice system, the NCLEX and certification requirements, English proficiency rules, clinical hour standards, and the board’s role in approving programs and supporting schools through nursing education consultants. Several members and the board president also discussed the need to retain new graduates, improve diversity in the workforce, and better support nontraditional students and rural placements. Public comment on the BRN sunset review was extensive and largely supportive of the board, while also urging policy changes. Nurse practitioner, nurse anesthetist, nurse midwife, and nursing education groups generally supported the BRN report and especially backed clarification of APRN-to-RN delegation authority under issue 13. Other commenters asked for clearer implementation of AB 890, more flexibility for clinical nurse specialists, streamlined renewals for nurse midwives, and changes to federal loan limits affecting graduate nursing education. Higher education representatives and private nursing schools raised concerns about duplicative BRN documentation, clinical placement bottlenecks, and barriers faced by out-of-state and online programs seeking to serve California students. The California Medical Association and some physician groups opposed easing transition-to-practice requirements for out-of-state nurse practitioners and cautioned against changes to specialty and delegation rules, while the California Nurses Association and others stressed the importance of community college pathways, new graduate support, and workforce retention. The hearing then moved to the Physical Therapy Board of California. Board leadership reported that the board oversees more than 41,000 active licensees, has seen about 15% growth since 2021, and continues to maintain high exam pass rates among California physical therapy and physical therapist assistant programs. The board described its mission as consumer protection through licensing, enforcement, continuing competency oversight, and stakeholder engagement. The vice president’s remote testimony encountered technical problems, so the executive officer continued with a brief overview of the board’s work and its commitment to efficient service and public protection. No votes or formal actions were taken in the portion of the meeting provided.

Transcript Highlights:

• Care and reliance on emergency room services.
• I'm Susan Philip, Deputy Director for Health Care Delivery Systems at the Department of Health Care Services
• I'm the State Medicaid Director at the Department of Health Care Services. of Health Care Services.
• And long-term supports and services into managed care.
• Yet to integrate waiver services into managed care nor to determine which services should remain in fee-for-service

Keywords: 988, house, all

Transcript Highlights:

• regarding their care, placement, and services.
• Then you have health care services, and then you have behavioral health.
• This includes services to children and non-minor dependents in the foster care system.
• This includes the Department of Health Care Services (DHCS), the Department of Social Services (DSS),
• Program that is able to use federal Title IV-E dollars to provide direct services.

Keywords: 988, house, all

Transcript Highlights:

• Hi, my name is Nancy Freeman, and I'm the Operations Services Chief Operating Officer for Direct Care
• Chief Operating Officer for Services Chief Operating Officer for Direct<00:03:32.600><c> Care</c><00
• Thank you for Direct Care and Treatment.
• </c><00:03:58.480><c> care</c><00:03:58.680><c> and</c> will be operated by direct care and will be operated
• ><c> is</c> Direct care and treatment is Direct care and treatment is appreciative<00:04:13.600><c> and

Keywords: 1183, house

Transcript Highlights:

• And these are providers who are specifically able to provide personal care services.
• Totally of my care of the in-home services.
• Department of Health Care Services, Social Services, the State Council on Developmental Disabilities
• services at 100% General Fund cost if no other source of care is available.
• The other just consists, consistent with what we do in social services and health care services in terms

Keywords: 987, senate, all

Transcript Highlights:

• It provides domestic and personal care services to children and adults with disabilities and to older
• Totally of my care of the in-home services.
• Care Services, Social Services, the State Council on Developmental Disabilities, Department of Education
• services at 100% General Fund cost if no other source of care is available.
• The other, just consistent with what we do in social services and health care services in terms of fiscal

Summary: The subcommittee heard an overview of the governor’s IHSS budget proposals and extensive testimony from the Department of Social Services, Department of Finance, the Legislative Analyst’s Office, county representatives, labor, consumer advocates, and advocates for older adults and people with disabilities. The administration described IHSS as a large and growing program serving more than 900,000 recipients, and outlined three proposals: shifting the cost of growth in authorized hours per case to counties, eliminating the backup provider system, and aligning IHSS terminations with Medi-Cal terminations. The LAO said the overall budget estimates appeared reasonable but raised concerns about the hours-per-case proposal, including the lack of a comprehensive root-cause analysis, the limited control counties have over statewide cost growth, and uncertainty about how the baseline and savings would work. CWDA, SEIU, and consumer advocates strongly opposed the hours cost shift, arguing that counties use state-designed tools, that demographic changes and rising need explain much of the growth, and that the proposal would pressure counties to cut services and destabilize care. The chair and members repeatedly questioned the administration about the proposed baseline, the claimed savings, and whether the measure effectively circumvents the county maintenance-of-effort agreement. On the backup provider system, the administration said the statewide program is underutilized and administratively expensive, and proposed eliminating it to save about $3.5 million. The LAO suggested the Legislature consider whether administrative costs could be reduced while preserving some version of the program. County and consumer advocates opposed the cut, saying the system is a critical safety net when regular providers are unavailable, especially in rural areas and for people with complex needs. They argued that low utilization reflects the difficulty of finding emergency backup care, not lack of need, and that many counties already rely on local backup systems or other models. Committee members also pressed for better data on requests, fulfillment, and administrative costs, and discussed whether the state could support local alternatives instead of eliminating the program. The final topic was the proposal to align IHSS terminations with Medi-Cal terminations by automating the process when recipients fail to complete Medi-Cal redeterminations. The administration said this would reduce General Fund costs by about $86 million by preventing payment of IHSS in the residual program when recipients are no longer eligible for Medi-Cal, while also automating reinstatement when Medi-Cal is restored. The LAO noted the proposal has been rejected in prior years and suggested improved notice and communication to recipients as an alternative. CWDA and advocates warned that the change could create gaps in care, especially for people who lose Medi-Cal for procedural reasons, and urged additional safeguards such as better notices, faster reprocessing, and automatic reinstatement. Members questioned how many people would be affected, how the residual program currently works, and whether providers could go unpaid during the gap; the department said the automation is already built and would be activated if the proposal is approved. No votes were taken during the discussion, and the committee moved through public comment and questioning without final action on the proposals in the excerpt provided.

Transcript Highlights:

• a number of very critical child welfare services, including foster care, Adoption Services, family preservation
• , a number of permanent initiative and other services that are needed to take care of the kids in care
• Tier 2, this is the costs associated the direct cost associated with serving children in care.
• I had a higher acuity of kids coming into care that required additional services that cost more money
• We should be focused on what dollars are going to those direct services.

Keywords: 999, senate, all

Transcript Highlights:

• child welfare services, including foster care, adoption services, family preservation, a number of permanency
• initiatives, and other services that are needed to take care of the kids in care in our state.
• For Tier 2, this is the cost associated, the direct cost associated with serving... ...children in care
• And that was one of the reasons, because I think direct care to the child is very important, even with
• And that was one of the reasons, because I think direct care to the child is very important, even with

Committee: Senate Children, Families, and Elder Affairs

Summary: The committee heard a presentation from Dr. Kelly O’Dare on first responder behavioral health access, peer support, and suicide prevention. She described UCF Restores, the Second Alarm Project, and related partnerships that provide culturally competent treatment, peer training, clinician education, disaster response support, and behavioral health navigation. She cited survey and state data showing significant rates of sleep problems, anxiety, depression, substance use, and suicide among Florida first responders, and said evidence-based treatment has helped many patients recover, including a reported 76% who no longer met PTSD diagnostic criteria after treatment. Senators asked about measuring outcomes, peer support standards, and whether the state should create more consistent statewide requirements; O’Dare said peer support training must be specialized, linked to higher levels of care, and supported by sustainable funding and statewide coordination. The committee also heard from a public commenter who supported the work and emphasized the need for adequate resources and peer support infrastructure. The committee then received a Department of Children and Families presentation from Casey Penn on the proposed funding methodology for community-based care lead agencies under HB 7089. Penn explained that the new model is intended to be actuarially based, reimbursement-oriented, and more transparent than prior funding approaches, using historical expenditures, standardized reporting, and two main tiers: Tier 1 for largely fixed administrative and operational costs, and Tier 2 for direct child-serving costs based on per-child-per-month blended rates. He said the model includes a 2% risk corridor for Tier 2, hold-harmless funding in the first year, and optional Tier 3 performance incentives, with an estimated additional state appropriation need after offsets. Senators raised concerns about prevention, historical inequities, reasonableness of costs, administrative overhead, blended state and federal funds, adoption subsidies, high-acuity placements, and disaster-related disruptions. Penn said some of those issues could be addressed in future iterations as the child welfare information system is modernized, and he agreed to provide written responses to committee questions. Representatives of the Florida Coalition for Children and CBCs responded that the model is a major improvement but urged additional safeguards, including an administrative cap, clearer separation of direct and indirect costs, and better treatment of federal and pass-through funds. They argued that the system already has oversight and that deficits reflect insufficient appropriations rather than excess spending, while also noting that higher-acuity children and regional differences can drive costs. No votes were taken on either topic, and the meeting ended with committee staff introductions and adjournment.

Transcript Highlights:

• health care gaps at home, I can confidently say that this bill will save services, support providers
• protections to ensure that no individual is excluded from health care coverage or services based on
• Across the country, we are seeing rollbacks in gender-affirming care services and ...uncertain.
• Across the country, we are seeing rollbacks in gender-affirming care services and clinics.
• or other gender-affirming care that the health care service plan would otherwise cover if the denial

Committee: House Health

Keywords: 988, house, all