Transcript Highlights:

• Proposition 35, the Health Care Act, includes $90 million for reproductive health care services support
• That includes direct care workers and support staff across both fee-for-service and managed care delivery
• telehealth services, e-consults, and evidence-based care models, really focusing on primary care and
• services, e-consults, and evidence-based care models, really focusing on primary care and maternity
• They need to buy equipment to do that service for maternity care.

Keywords: 987, senate, all

Transcript Highlights:

• in foster care or extended foster care.
• Foster care represents the greatest number of young people exiting systems of care.
• of any system of care... ...homelessness at one year upon an exit of any system of care, foster care
• The goal is that we're doing for services of care grants.
• While I have no direct experience with foster care, I have a lot of experience with the overrepresentation

Summary: The Senate Human Services Committee held a work session focused on housing and services for youth and young adults, especially those exiting public systems of care. DCYF Assistant Secretary Vicki Ibarra described existing supports, including family reconciliation services and the youth and young adult housing response team, which coordinates with other agencies to help young people ages 12 to 24 avoid homelessness. Office of Homeless Youth Director Casey Hannawer Sutton outlined the office’s role in reducing youth homelessness, citing a 40% reduction since 2016, expansion of services to 37 counties, and ongoing work on prevention and “functional zero” efforts. Treehouse and the Mockingbird Society testified about education, transition, and housing barriers for foster youth and young adults, including funding cuts to Treehouse’s Graduation Success program, eligibility gaps, and the need for peer supports, financial literacy, and housing stability. A health impact review from the State Board of Health on a prior version of the extended foster care housing proposal found the bill would likely improve housing stability, health outcomes, and equity for some young adults in extended foster care. The committee then heard public testimony on Senate Bill 5911, which would stop DCYF from using Social Security benefits of young adults in extended foster care to reimburse the state for care costs. Sponsor Sen. Emily Alvarado said the bill would protect federal benefits that belong to the young person and help them meet basic needs; supporters from Partners for Our Children, TeamChild, Mockingbird Society, and a former foster youth testified that the current practice harms housing, education, and stability and urged the state to end it. Members discussed the need for financial literacy and the federal government’s recent direction discouraging the practice. The committee also heard Senate Bill 5940, a two-year extended foster care housing pilot that would provide rental assistance for up to 50 eligible youth in extended foster care who are homeless or at risk of homelessness, with transition planning required before age 21. Sen. Wilson said the bill is intended to keep young people in care from having to choose between foster care support and housing assistance. Testimony from Mockingbird Society, current and former foster youth, and Communities in Schools supported the bill as a way to reduce homelessness and improve educational and health outcomes. The committee briefly heard Senate Bill 5942, which would rename the DCYF Oversight Board as the DCYF Accountability Board and shift its reporting structure while keeping its oversight role, and Senate Bill 5957, which would expand the Office of Homeless Youth Advisory Committee to include additional members with lived experience and representation from disproportionately affected communities.

Transcript Highlights:

• Because there could be some contracts that are direct Services, right?
• So, LFC's best estimate in the current operating year, direct services is about 856 million of their
• So, it's a big portion of it is going out To the community and direct services.
• facilities I hope are offering, and I've seen signs that say we offer 24-hour child care service.
• I do have a service. Please go ahead and conclude your comments. Kids that are in foster care.

Bills: SB2

Committee: House House Appropriations & Finance

Keywords: SB 2, State Highway Project Bonds, highway funding, transportation bonds, state road fund, motor vehicle fees, vehicle registration fees, electric vehicle fee, EV surcharge, plug-in hybrid fee, weight distance tax, road construction, infrastructure financing, Department of Transportation, State Transportation Commission, bonding authority, county road funds, municipal road funds, transportation improvement program, state highways

Transcript Highlights:

• And other meal service streamlining.
• Growing our health care and mental health care workforce presents a pragmatic and principled strategy
• We do now have basic needs services we're trying to improve and increase, STEM programs, health care
• The demand for eye care is rising, but the workforce supply is... ...care.
• The direct costs?

Keywords: 988, house, all

Transcript Highlights:

• and fortifies access to care.
• and fortifies access to care.
• and fortifies access to care.
• and fortifies access to care.
• Lines 29.21 to 30.21 add a new section that directs the commissioners of health, human services, and

Committee: Senate Finance

Keywords: 1187, senate, all

Transcript Highlights:

• Minnesota's health care system, our hospitals, our EMS, and our dental services, then what's going to
• We also have sliding scale services, and Minnesota also has other forms of charity care.
• Immigrants make up one-third of the direct care workforce helping seniors and those with disabilities
• care services.
• This also requires a habitability inspection within the recuperative care services to ensure that the

Transcript Highlights:

• Sharing staff and staffing shortages had a direct impact on the quality of care my mom received.
• Sharing staff and staffing shortages had a direct impact on the quality of care my mom received.
• spend on direct care, costs to spend on direct care, severance,<01:18:53.280><c> and</c><01:18:53.440
• c><01:24:47.679><c> nursing</c><01:24:48.000><c> homes</c> direct care staffing in nursing homes direct
• /c><01:25:10.639><c> 0.18</c><01:25:11.280><c> hours</c> direct care staff by about 0.18 hours direct

Committees: Senate Health and Human Services , Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• delivery methods: fee-for-service and managed care.
• So, clients can access DD and long-term care services via three different pathways.
• The waiver services overall, though, represent about 20% of the services that long-term care delivers
• If they receive developmental disability or long-term care services through the ACA, which personal care
• , personal care in your home, personal care in an adult family home, services in a skilled nursing facility

Summary: The Ways and Means Committee held a work session to review how H.R. 1 (the One Big Beautiful Bill Act) could affect Washington’s Medicaid, long-term care, developmental disabilities, and food assistance programs, with a focus on implementation challenges, fiscal impacts, and likely coverage losses. Staff and agency officials explained Washington’s Medicaid financing structure, eligibility categories, caseload trends, and the role of the Health Care Authority and DSHS in administering Apple Health and related services. They also described how Medicaid expansion increased access to behavioral health services and how H.R. 1’s provisions are expected to affect the expansion population most directly. Health Care Authority and DSHS officials outlined several major H.R. 1 changes: new work and community engagement requirements for the Medicaid expansion population, six-month redeterminations instead of annual renewals, changes to immigrant eligibility, limits on provider taxes and state-directed payments, new cost-sharing requirements, reduced retroactive coverage, and changes affecting long-term care eligibility. They said Washington is still awaiting federal guidance on many details, but estimated that about 620,000 Apple Health expansion enrollees could be subject to work requirements, that roughly 30,000 immigrants could lose Medicaid eligibility under the new definition of qualified alien, and that some long-term care and developmental disability clients could be indirectly affected. Officials also said the state is working with other agencies to build shared verification systems and may seek a delay waiver, though they do not expect broad federal flexibility. The committee also heard that H.R. 1 immediately blocks Medicaid reimbursement for Planned Parenthood services for one year, with the state planning to backfill about $11 million to preserve access. In addition, officials warned that the law could reduce federal Medicaid revenue by billions over time and strain hospitals and emergency rooms as more people become uninsured. They noted that Washington’s rural health transformation grant application is due November 5 and could bring some funding, but not to offset coverage losses. No votes were taken; the session was informational only. The committee then heard a separate presentation on food assistance, where staff and DSHS described H.R. 1’s SNAP changes, including expanded work requirements, immigrant eligibility restrictions, higher state administrative costs, and a possible future state share of benefit costs tied to payment error rates. DSHS estimated a four-year fiscal impact of about $750 million for food assistance changes and said the state is working on system and policy changes across agencies before the new requirements take effect.

Transcript Highlights:

• So it was a direct contract.
• This is a state-directed payment, meaning the money has to flow through the managed care organizations
• The uniqueness of AIHP and our fee-for-service members is that they are able to access care from anyone
• In addition, they also have the ability to transition from fee-for-service to managed care if they wanted
• direct care that they may need, from your everyday type of service to very specific, like DBT, which

Committee: Senate Senate Health and Human Services COR

Summary: The Committee on Health and Human Services held another oversight hearing on Access, focusing on fee-for-service behavioral health management, prior authorization and claims processing, the Targeted Investment Program (TIP), and network adequacy. The chair criticized Access for implementing a covered behavioral health services guide without public comment and for failing to produce records such as decision-making documentation, work group minutes, and public/tribal feedback. Members also raised concerns about ARPA compliance, the reduction of intensive outpatient reimbursement to a $157 per diem, and the impact of these actions on providers and Native American communities. Interim Director Roberta Harrison said Access had improved fraud controls and operations after the sober living fraud crisis, including tripling prior authorization speed, reducing denial codes by 64%, cutting claims processing to under 30 days, and adding dashboards and staffing. She said the agency is modernizing outdated systems and invited fraud referrals. On questions about claims and prior authorizations, Access reported average processing times of six days overall and 17 days for behavioral health prior authorizations, and said it had hired Constellation under a direct procurement to help with claims backlog. Harrison acknowledged that a proposal language suggesting higher ROI from denying more claims was not part of the contract scope. The committee also pressed Access on TIP delays. Staff explained that TIP payments depend on provider documentation, programmatic review, and allocation across many sites, and said year one of TIP 2.0 had been paid while years two and three had not yet been distributed. The chair requested a formal plan within 30 days to pay the delayed year two and year three TIP funds, estimated at about $122 million, along with all CMS-related TIP 2.0 documentation. On network adequacy, Access described its standards and annual MCO reporting process, but acknowledged gaps in tracking and said it would follow up on whether a fiscal year 2025 report was submitted to CMS. Members cited a federal ghost network report finding 28% of providers in Santa Cruz County inactive or unavailable, and requested unredacted network adequacy reports and further information on CMS engagement. The hearing ended with the chair noting some improvements but saying more oversight may follow, and the committee adjourned.

Transcript Highlights:

• Shared purchasing, bookkeeping support, and access to services like telehealth and preventative care
• Shared services models like the Children's Bridge matter because they stabilize the child care system
• I actually was able to benefit from a shared services model as a child care director in another state
• Luke's Children's at Risk Services through St. Luke's CARES, in Boise and Twin Falls.
• Luke's, the Children's at Risk Services, through St. Luke's cares, both in Bois, through St.

Keywords: 989, all

Transcript Highlights:

• apply to crisis service under Minnesota care<00:15:46.720><c> and</c><00:15:46.880><c> it</c><00:15:
• c> and</c> Minnesota care for these services and Minnesota care for these services and provides<00:19
• Finally, section five of the bill would direct the Commissioner of Human Services to seek a waiver from
• support care hours, and they're essentially a direct support staff and could be making less than the
• </c><01:08:37.679><c> they're</c> direct support care hours and they're direct support care hours and

Committee: House Human Services Finance and Policy

Keywords: 1183, house

Transcript Highlights:

• At the same time, AB 1634 ensures the Department of Social Services Child Care Licensing Division and
• At the same time, AB 1634 ensures the Department of Social Services Child Care Licensing Division and
• This means that 1.8 million children who are eligible are not receiving child care services.
• like THP, SILP, and other extended foster care services.
• AB 2765 directs the California State Department of Social Services to seek a waiver for the able-bodied

Summary: The committee heard a series of child and family services bills, with testimony from authors, county officials, advocates, and members of the public. AB 2083 would authorize a regional child care special district for Marina Valley and Paris; there was no public opposition, but a vice chair raised concerns about lack of outreach to Riverside County and possible added fees for residents. The bill was held pending quorum and later noted as enjoying a due pass recommendation, though no final roll was taken in the excerpt. AB 1579, which expands the Children’s Crisis Continuum Pilot Program to allow additional CDSS-approved residential models, drew strong support from San Francisco County, Seneca Family of Agencies, and several counties and advocacy groups, who argued the current crisis residential model is financially and operationally unworkable and leaves youth in hospitals or emergency departments. The Youth Law Center and allied organizations opposed the bill, saying it departs from the original small, community-based crisis model and could lead to more institutional care. The committee passed the bill 6-0 to Appropriations. AB 1628 would extend California’s safe surrender window for newborns from 72 hours to 30 days. The author and fire service supporters said the change would better reflect postpartum recovery and help prevent unsafe abandonment; there was no opposition, and the bill passed 6-0. AB 1634, dealing with the “Kids” specialty license plate program, sought to raise plate fees and revise distribution formulas to generate more revenue for child safety and child care programs. Supporters said the update would modernize outdated 1992 pricing and expand county access, while a committee member objected that the bill would reallocate funds away from state agencies and private nonprofits; the bill was moved on a 5-0 vote with some members not voting. AB 1643 would streamline child support enrollment by having courts transmit support orders directly to child support agencies unless a custodial parent opts out. Supporters said automatic enrollment would reduce poverty and remove paperwork barriers, while opponents warned it could undermine parent choice and create problems for families with sensitive circumstances. The committee passed the bill 6-0. AB 1708 would require regions receiving HHAP homelessness funds to more meaningfully engage smaller cities; many city officials supported it as a way to include jurisdictions that are doing local homelessness work, while Los Angeles’ mayor’s office opposed it. The bill passed 5-0. AB 2395 would standardize access to the child support debt reduction program; supporters described it as a way to help low-income obligors escape uncollectible government-owed debt, while receiving parents and child support agencies warned it could reduce money owed to families and needs more work. The bill passed 4-0. The committee then began AB 1914, which would require local governments to plan for child care in general plans; supporters framed child care as essential infrastructure, while at least one member raised concerns about state mandates on local jurisdictions, and the excerpt ends before any vote.

Transcript Highlights:

• services.
• These changes may put millions of Californians at risk of losing health care coverage and the care that
• So we're not, you know, a heavy private care provider. We're a heavy public care provider.
• We're a heavy public care provider.
• today can continue to provide those services.

Summary: The Assembly Budget Subcommittee on Accountability and Transparency held a hearing focused on three issues: federal funding cuts and delays, possible state revenue impacts from reduced IRS enforcement, and the fiscal effects of AB 218 on local governments. The Franchise Tax Board described how state and federal tax systems are closely linked, how most returns are filed electronically through software, and how FTB relies on IRS information sharing for compliance, fraud prevention, offsets, and nonfiler work. Members raised concerns that federal staffing cuts at the IRS could weaken audits of large corporations and reduce California revenue, and asked about VITA and ITIN filers; FTB said it was not aware of VITA reductions, noted ITIN returns are processed the same as other returns, and said ITIN filing appeared slightly down this year. The Department of Finance said it is monitoring federal developments, summarized the continuing resolution and reconciliation process, and noted that California lost nearly $940 million in earmarked federal projects under the CR, while major federal budget decisions remain uncertain until the President’s budget and later congressional action. The University of California reported substantial federal pressure on research, student aid, and health care. UC said hundreds of millions of dollars in federal awards have already been canceled, with additional threats to NIH and DOE facilities-and-administration rates, graduate fellowships, student loan repayment plans, international student visas, Pell Grants, and Medicaid/Medi-Cal funding. Committee members pressed UC on the effects of DEIA-related federal restrictions, the loss of clinical trials and research staff, and the impact on low-income students and patients. UC said it is pursuing litigation with the Attorney General and other institutions, but emphasized that court action is only a temporary solution and that sustained state and private support may be needed. The second panel addressed the fiscal consequences of AB 218, which extended the statute of limitations for childhood sexual abuse claims against public agencies. FCMAT presented a report with 22 recommendations, including better statewide data collection, financing mechanisms, a possible victims compensation fund, and prevention measures. Los Angeles County described a tentative $4 billion settlement tied to AB 218 claims, saying it will require reserves, borrowing, and long-term annual payments through 2050, while also forcing curtailments and cuts to vacant positions to preserve services. Members discussed insurance pools, retroactive premiums, unidentified future claims, and the need for a compensation fund or other financing tools. No formal votes were taken; the hearing concluded with public comment, including testimony from local health officials about nearly $400 million in terminated federal public health grants and the resulting layoffs and service impacts.

Transcript Highlights:

• SERVICES.
• A GROUP OF CARE IS A WAY TO CATEGORIZE SIMILAR SERVICES OR ACTIVITIES THAT HAVE AN EXPENDITURE OUTCOME
• GROUPS OF CARE WERE REFINED.
• THE CBC'S AREN'T OPERATIONS AND THEY ARE DIRECT PAYMENTS AND DIRECT SERVICE.
• IT IS NOT THAT THIS IS INCORRECT BUT WHEN YOU DO IT YOU LOSE VISIBILITY ON A DIRECT SERVICE PAYMENT THAT

Transcript Highlights:

• </c><00:07:48.039><c> your</c> our Direct Care andat I appreciate your our Direct Care andat I appreciate
• </c><00:48:18.520><c> Care</c><00:48:18.920><c> staff</c> Revenue to Direct Care staff Revenue to Direct
• </c><00:53:38.480><c> Care</c><00:53:38.680><c> and</c> agency Direct Care and agency Direct Care and
• </c><01:37:19.000><c> conference</c> direct care and treatment and conference direct care and treatment
• </c> nursing care or Assisted Living Services nursing care or Assisted Living Services and<01:59:34.360

Committees: Senate Health and Human Services , Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• Section 13 and 24 of Senate Bill 76 directed the agency to seek federal approval for these services and
• The acute hospital care at home program directed the agency to seek federal approval necessary to implement
• So rural emergency hospitals will provide rural emergency services and other care that do not require
• The legislation directed the Agency for Health Care Administration to seek federal authority to draw
• the Board of Pharmacy to ensure patients have access to primary care services.

Committee: Senate Health Policy

Summary: The Senate Health Policy Committee received updates from the Agency for Health Care Administration and the Department of Health on implementation of 2024 health care laws. AHCA reviewed progress on workforce and reimbursement measures in Senate Bill 7016 and related bills, including FRAME and TEACH funding, graduate medical education reporting, behavioral health teaching hospitals, acute hospital care at home, advanced birth centers, non-emergent care access plans, and rural emergency hospitals. Agency officials said several programs are already operational or have begun payments, while others are still in rulemaking, federal approval, or report-preparation stages. Senators asked about timing, funding reversion concerns, and whether appropriated dollars would be spent on schedule, especially for behavioral health teaching hospitals and the new birth center category. The Department of Health then reported on practitioner licensure and public health programs. MQA described implementation of the Interstate Medical Licensure Compact, the Mobile Act licensure pathway, massage therapy enforcement changes, background screening expansion, liposuction safety requirements, pharmacist HIV post-exposure prophylaxis authority, and chiropractic dry needling. Public health staff updated the committee on FRAME and dental loan repayment, the Sinati screening grant program, the cancer research and innovation changes, the health care innovation council and loan program, the pediatric rare disease grant program, telehealth maternity care expansion, newborn screening for congenital CMV, the sickle cell registry and grants, and the swimming lesson voucher program. Members focused questions on how practitioners were being recruited to underserved areas, the pace of licensure approvals, and whether new programs were on track to use appropriated funds. The committee also heard a lengthy update from the Office of Medical Marijuana Use. The director reported more than 900,000 qualified patients, real-time seed-to-sale tracking now integrated across most dispensaries and labs, and ongoing compliance work on product testing, advertising, diversion, and patient safety. Senators questioned the decline in qualified physicians, how THC potency is labeled and verified, and what the agency can do about diversion to non-patients. The director said the office relies on complaints, inspections, lab audits, and coordination with law enforcement, and that patients can be suspended if violations are confirmed.

Transcript Highlights:

• Domestic violence services, services for the developmentally disabled, broad-based health services, property
• I direct the Secretary to close the machine for tally.
• Direct the Secretary to close the machine for a tally.
• You can direct the question to the chair.
• I direct the Secretary... I direct the Secretary to close the machine for a tally.

Keywords: 1146, all

Transcript Highlights:

• The first service is individual directed goods and service. This is a relatively small cut.
• sit on the rate range compared to other services and the direct support wage that is being paid for
• I don't know. $7 pay reduction for staff who are serving under self-directed services.
• care through the SDS model and developmental disability services as well.
• That act requires states to implement EVV for all personal care services and home health care services

Committee: House Budget

Keywords: 959, house, all

Transcript Highlights:

• Over 3.2 million recipients receive their services through managed care, and we absolutely should be
• Taking up tab 13, which is Senate Bill 1412 on home health care services by Senator Kaladeu.
• services, to provide under an enhanced care coordination model through the Medicaid plan.
• This real, the movement of children's medical service managed care plan is really a technical move in
• The movement of the children's medical services managed care plan is really a technical move.

Summary: The Health Policy Committee met for its final meeting of the session and handled a very full agenda, beginning with a few housekeeping items and a brief thank-you to staff. Senate Bill 596 was temporarily postponed. The committee then reconsidered and amended SB 1606 on patient access to records, clarifying portal access obligations and deleting a section that would have improperly affected nursing home facility records; the bill was reported favorably as a committee substitute. The committee also recommended confirmation of a block of appointees and separately confirmed Chavon Harris as Secretary of the Agency for Health Care Administration after testimony focused on transparency, financial oversight, Medicaid managed care accountability, and internal controls at AHCA. Harris said she would prioritize staffing, monitoring, and improved reporting, and several health care groups waived in support. The committee next heard and passed several bills, including claims bills SB 28 and SB 22 for South Broward Hospital District settlements, both reported favorably. It also approved SB 772 on undesignated glucagon in schools, SB 998 on allowing physician assistants and APRNs to complete death certificates under hospice/palliative protocols, SB 1412 on home health agency administration and staffing flexibility, SB 1800 creating a Parkinson’s disease research consortium at USF, SB 306 on Medicaid managed care network access during holidays and after hours, SB 1768 on stem cell therapies and informed consent, SB 1602 on pediatric readiness standards in emergency departments, SB 1156 on the home health aide program for medically fragile children, SB 1490 on Children’s Medical Services and Medicaid managed care administration, and SB 1182 on Medicaid coverage of continuous glucose monitors. Most of these bills were amended, generally to narrow scope, align with the House, or make technical changes, and most received support from provider associations, advocacy groups, or affected institutions. The most debated measure was SB 1270, which combined several health freedom and medical marijuana provisions. The strike-all amendment retained language prohibiting discrimination based solely on vaccination status, added protections related to mRNA vaccine documentation requirements, and included medical marijuana regulatory and background-screening language. The committee heard extensive testimony both in support and opposition, including concerns from senators about whether the bill would force providers to treat patients contrary to medical judgment, and support from witnesses arguing it protected patient autonomy and access to care. After a time-certain motion, the bill was reported favorably as a committee substitute. At the end of the meeting, senators recorded their votes on selected tabs, and the committee adjourned.

Transcript Highlights:

• </c><00:33:53.320><c> access</c> will backfill the healthc care access will backfill the healthc care
• development block grants Ma Care development block grants Ma Minnesota<00:35:28.480><c> care</c><00:
• </c><00:43:27.119><c> directed</c><00:43:27.640><c> to</c> would be direct directed to would be direct
• ." to uh go the direction of tax cuts or to uh go the direction of tax cuts or rebates<01:11:05.960><
• The services that they need and count on could be negatively impacted by this: Education, Health Care

Keywords: 1183, house