Transcript Highlights:

• AS I MENTIONED PART OF WHAT WE HAD TO DO IN ORDER TO IMPLEMENT THIS BILL IN OUR STATE IS TO DO A LOT
• BUT I HAD STAFF PULL PLANS THAT WE RECEIVE FROM AROUND THE STATE BECAUSE I KNOW YOU ARE ALL FROM AROUND
• ONE OF THE HOSPITAL STATED IN THEIR PLAN THAT THEY WOULD ASSIST THE PATIENT WITH ACTUALLY MAKING THE
• ONE OF THE HOSPITAL STATED IN THEIR PLAN THAT THEY WOULD ASSIST THE PATIENT WITH ACTUALLY MAKING THE
• I'M SURE THE HOSPITALS ARE FULLY IMPLEMENTING AND ENGAGING THEIR NONEMERGENT CARE ACCESS PLANS AS THAT

Keywords: 999, senate, all

Transcript Highlights:

• CPEHN urges state leaders to consider Prop 1 implementation in our broader health and behavioral health
• Connect and its major components, as well as provide an update on the funding plan and status of implementation
• under California's Medicaid state plan or other state authorities.
• And so in addition to the engagement we've done with Medi-Cal managed care plans on how to implement
• , the implementation.

Summary: The hearing opened with remarks from the chair and members about recent federal cuts to public health, mental health, family planning, and Title X funding, with strong concern about the impact on California programs and providers. The committee then turned to the Department of State Hospitals, which presented its 2025-26 budget proposal of $3.4 billion, including new positions, capital improvements, and funding tied to increased patient costs and incompetent-to-stand-trial services. DSH reported major progress in reducing the IST waitlist and wait times, said it had met the court’s 28-day treatment benchmark for those without extenuating circumstances, and described workforce recruitment and retention efforts such as residency programs, fellowships, outreach, and hiring streamlining. Members asked about future IST referral trends, SB 1323’s effect on diversion and community treatment, and workforce lessons in high-cost regions; public comment urged reconsideration of county IST growth cap methodology in light of new criminal justice initiatives. The committee next received an informational overview of Proposition 1 and its changes to behavioral health funding and governance. The Legislative Analyst’s Office explained that Prop. 1 restructured county MHSA funding buckets, expanded the Commission for Behavioral Health, shifted prevention and early intervention responsibilities, and authorized a $6.4 billion bond, including $4.4 billion for behavioral health facilities through BHCIP. DHCS said it had released guidance for county integrated plans and was receiving extensive public comment. Members focused on BHCIP application requirements, especially letters of support and tribal projects, and raised concerns about whether DHCS’s implementation matched statutory intent. DHCS said it had authority to set application requirements and that tribal entities were treated differently because of sovereignty and funding structure. DHCS then updated the committee on BHCIP, the Behavioral Health Bridge Housing Program, and related bond implementation. The department said BHCIP had awarded about $1.7 billion across five rounds, with more than 130 projects and 223 distinct facilities funded, and that it was preparing to award the new bond funds after receiving nearly $8 billion in applications. The LAO’s assessment found that more than half of awards served at least 80% Medi-Cal enrollees, but also raised concerns that the regional allocation model could reinforce inequities, that the program had not sufficiently addressed the highest-need regions such as the southern San Joaquin Valley, and that smaller counties and less launch-ready applicants faced barriers. For bridge housing, DHCS said more than $1.1 billion had been awarded, serving over 5,000 people and supporting more than 2,000 operational beds, but the Governor’s budget proposes to eliminate Round 4 funding as the administration weighs other statewide investments and Proposition 1 implementation workload. Public commenters and members urged more accountability, better regional equity, stronger labor and community involvement, and caution about funding for for-profit psychiatric facilities. Finally, the committee heard on the Children and Youth Behavioral Health Initiative. CalHHS and DHCS described CYBHI as a broad prevention- and equity-focused effort with more than 1,300 organizations funded, over $2.1 billion awarded, and multiple work streams spanning schools, community programs, workforce, and digital supports. DHCS highlighted school-based services, the fee schedule rollout, and digital platforms BrightLife Kids and Soluna, which it said are reaching users statewide and providing low-barrier access to coaching and support. Members and public commenters raised concerns about delays in school fee schedule implementation, the large share of funding going to digital tools, the need for more in-person services, and whether the initiative is sufficiently tracking outcomes and equity impacts. No formal votes were taken during the hearing.

Transcript Highlights:

• This is necessary to develop a funding plan and provide the federal government with state plan amendments
• This requires the state to clearly articulate a funding plan so physicians can increase their patient
• Some plans have failed to implement the 2023 and 2024 rate increases included in the budget nearly two
• The second would be a matter of updating the California state plan.
• We have requested design and implementation resources through state fiscal year 2028-2029.

Keywords: 988, house, all

Transcript Highlights:

• , if they've been implemented yet.
• , if they've been implemented yet.
• Has that been implemented, the pre-approved ADU plans? It has been implemented at the local level.
• Also, there's in the local governments that have implemented pre-approved middle housing plans.
• What we're focusing on is what is the appropriate role in state government for a pre-approved plan, given

Summary: The Local Government Committee met in work session and heard a series of presentations on SEPA, permitting reforms, and building code implementation. Department of Ecology staff gave an overview of the State Environmental Policy Act, explaining its role in state and local decision-making, common exemptions, planned actions, and recent housing-related statutory changes such as transit-oriented development exemptions and SEPA appeals protections for certain local ordinances. Committee members asked about repeated SEPA reviews, cultural and historic resource review, and how SEPA relates to NEPA; Ecology responded that repeated reviews usually occur when proposals change and that programmatic EISs can help front-load analysis. Seattle’s Department of Construction and Inspections described how recent SEPA exemptions reduced residential review volume and supported more housing permits, and said the city is considering raising thresholds further. The State Building Code Council provided an update on code adoption timelines and legislative tasks tied to the 2024 codes, including single-stair housing, multiplex housing, dwelling unit size, and temporary emergency shelter standards. Council staff said the content of the codes is largely set, but administrative timelines have been delayed, prompting a motion to postpone final adoption while pursuing ways to preserve the planned implementation schedule. Members asked about the timing of code changes and the impact on housing costs, and staff said the legislative topics remain on track for inclusion in the 2024 code package. Committee staff then reviewed recent permitting legislation, including SB 5290’s permit decision deadlines and fee-refund provisions, later bills limiting pre-application meetings and clarifying that building permits are excluded from those timelines, and project-specific changes affecting middle housing, ADUs, lot splits, passive house projects, self-certification, transit-oriented development, and parking requirements. Commerce’s Dave Anderson reported on SB 5290 implementation, including guidance on permit fees, studies on staffing and statewide permitting systems, grants to local governments, and the first annual performance report, which showed mixed results and highlighted the importance of digital tools, clear checklists, staff training, and coordination across departments. Local officials from Issaquah and Kitsap County described their own process improvements, including code updates, optional pre-application meetings, new staffing, reporting systems, and a phased “Two by Six” review model in Kitsap, while also noting challenges from staffing shortages, agency coordination, and the burden of implementing multiple new mandates.

Transcript Highlights:

• C-PAN urges state leaders to consider Proposition 1 implementation in our broader health and behavioral
• and status of implementation.
• under California's Medicaid state plan or other state authorities.
• Counties have reported to us that 35 counties plan to implement at least one of the new optional benefits
• In addition to the engagement we've done with Medi-Cal managed care plans on how to implement the rental

Keywords: 988, house, all

Transcript Highlights:

• Implementation at this scale is complex, and it creates new expectations, new planning requirements,
• Our focus is on ensuring that counties submit complete and compliant three-year implementation plans,
• So DHCS's H.R. 1 implementation plan is first focused on minimizing coverage loss to the greatest extent
• developed as part of BHSA implementation to really monitor the performance of our managed care plans
• Under the federal American Rescue Plan Act, or ARPA, states were given a five-year window, April 1st,

Summary: The subcommittee heard presentations from the Department of State Hospitals (DSH), the Commission for Behavioral Health, and the Department of Health Care Services (DHCS) on budget proposals and implementation updates. DSH outlined its proposed 2026-27 budget, including funding for patient operating expenses, IST solutions savings, conditional release program costs, LPS bed allocation changes, electrical infrastructure projects at Napa and Patton, SB 380 transitional housing feasibility work, and expanded dental services at Metropolitan and Patton. DSH also reported that it has met court-ordered IST treatment benchmarks in the Stiavedi v. Clinton case, with average time to initiate treatment down to about five days and pending placements reduced to roughly 250, while noting that Proposition 36 could increase referrals and SB 1323 may divert some individuals earlier into community-based treatment. Members asked about rising outside hospitalization costs, Medicare enrollment, the timing and structure of capital projects, and whether IST solution funds are being fully used; DSH said the savings reflect slower-than-expected ramp-up of community programs and that the Central California FACT replacement program is still on track for January 2027 activation. The Commission for Behavioral Health described its role under the Behavioral Health Services Act (BHSA), including data, evaluation, grantmaking, technical assistance, and transparency work. It highlighted the new statewide Innovation Partnership Fund, a five-year, $20 million-per-year program with small and large grant categories; the first RFA drew strong interest, with more than 400 questions and over 1,000 bidders’ conference participants. The Commission also discussed a proposed extension to spend down about $4.1 million remaining for the Alcove Youth Drop-in Center grants so sites can finish implementation and Stanford can complete the final evaluation. Members asked about grant duration, whether projects can be renewed, what qualifies as innovation, and whether the fund could support service delivery rather than awareness campaigns or training; the Commission said awards are expected to be three-year contracts and that proposals must be new or meaningfully expanded approaches that support BHSA priority populations. DHCS reviewed major behavioral health changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, updated specialty mental health access criteria, and new substance use treatment standards based on ASAM’s fourth edition. DHCS reported strong contingency management results, with more than 13,000 members served and 95% testing negative for stimulant use during treatment, and said 21 Indian health care providers have been approved to offer traditional health care practices. It also described BH Connect initiatives such as the $1.9 billion access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation by four counties, and transitional rent services. On BHSA implementation, DHCS said it is not tracking individual county contract cuts but is monitoring county plans and statewide outcomes, while stakeholders raised concerns about local prevention and service gaps. DHCS also outlined its H.R. 1 implementation strategy, including outreach, streamlined renewals, exemptions for disabled, substance use, and medically frail individuals, and proposed clinic navigator and outreach funding; it said it has not yet produced a focused estimate of H.R. 1 impacts on behavioral health populations. The discussion ended with DHCS noting that B-CHIP bond funding has supported 437 infrastructure projects, creating 546 new or expanded facilities and more than 9,500 residential beds across the state.

Transcript Highlights:

• and provide the federal government with state plan amendments in order to raise rates.
• plan and provide federal government with state plan amendments in order to raise rates.
• Some plans have failed to implement the 2023 and 24 rate increases which were included in the budget
• We've submitted a State Plan Amendment.
• That has also led to some variation across the state regionally and across plans.

Summary: The committee heard a budget oversight hearing on the Department of Health Care Services, focusing first on the overall Medi-Cal budget and a March General Fund loan to cover a current-year shortfall. DHCS said the 2025-26 budget proposal totals $193.4 billion, with Medi-Cal projected at $188.1 billion total funds and $42.1 billion General Fund, driven by higher enrollment, pharmacy costs, managed care growth, and costs tied to eligibility expansions and the COVID-era redetermination unwinding. The department said the $3.44 billion loan was needed to manage cash flow and ensure timely payments to providers and plans, while the LAO noted Medi-Cal’s cash-basis budgeting creates volatility and that more detailed estimates would come with the May Revision. Members discussed federal Medicaid threats, the need for transparency on cost drivers, and the impact of pharmacy spending, long-term care, and immigration-related coverage expansions. The second major topic was family health programs, including California Children’s Services, the continuous coverage unwinding, and opioid settlement fund spending. DHCS described CCS funding methodology changes, ongoing county stakeholder work, and a delayed rollout of CCS monitoring and oversight until July 1, 2025, while county representatives and advocates argued the program is underfunded and asked for more technical assistance and a delay in implementation. On the unwinding, the department explained that federal redetermination flexibilities helped maintain coverage after the pandemic, but the Governor’s budget proposes ending them at the end of June 2025; advocates urged making the flexibilities permanent to avoid coverage losses. For opioid settlement funds, DHCS and Finance said the budget increases funding for naloxone distribution while reducing other harm-reduction spending based on updated settlement revenues, prompting criticism from members and public commenters who argued the change would weaken effective harm-reduction programs. The hearing also included an update on Proposition 35 implementation. DHCS said the voter-approved measure continuously appropriates MCO tax revenues beginning in 2025, with up to $4.6 billion annually available for specified Medi-Cal and provider investments in 2025 and 2026, but implementation depends on consultation with the required stakeholder advisory committee. The department and LAO noted uncertainty about future federal rules affecting the MCO tax after 2026. Public testimony largely supported maintaining Medi-Cal expansions, protecting immigrant coverage, preserving harm-reduction funding, and increasing support for community health workers, pediatric dental care, and CCS county administration. No votes were taken during the portion of the hearing provided.

Transcript Highlights:

• Implementation at this scale is complex, and it creates new expectations, new planning requirements,
• Our focus is on ensuring that counties submit complete and compliant three-year implementation plans,
• So DHCS's H.R. 1 implementation plan is first focused on minimizing coverage loss to the greatest extent
• Under the federal American Rescue Plan Act, or ARPA, states were given a five-year window, April 1, 2020
• We support the state's five-year 988 implementation plan but cannot achieve the comprehensive continuum

Keywords: 987, senate, all

Summary: The subcommittee heard updates from the Department of State Hospitals on its proposed 2026-27 budget, including a $3.2 billion total budget, patient-driven operating cost increases, savings in the IST solutions program, and progress in meeting the Stiavedi court-ordered 28-day treatment standard. DSH reported it has met court benchmarks, reduced the IST pending placement list from a pandemic high of 1,953 to about 250, and is now averaging about five days to initiate treatment. Members asked about the effects of Proposition 36 and SB 1323 on referrals, outside hospitalization costs, Medicare coverage, and whether IST solution funds were being overbudgeted; DSH said referrals are slightly down overall, outside medical costs are rising due to inflation and an aging population, and the IST savings reflect slower-than-expected activation of community programs rather than a service gap. The department also outlined proposed funding for electrical infrastructure upgrades at Napa and Patton, a feasibility study under SB 380 for transitional housing for the CONREP SVP program, and a dental services expansion at Metropolitan and Patton. The committee held those DSH items open after discussion. The Commission for Behavioral Health presented its role in overseeing the transition from MHSA to BHSA, including data, evaluation, transparency, grantmaking, and technical assistance. It described the new Innovation Partnership Fund, a statewide innovation grant program funded at up to $20 million annually for five years, with small and large grants, and said it had received strong interest ahead of the May 8 application deadline. Members asked about what qualifies as innovation, whether grants could be renewed, and how the state would ensure the program supports service delivery rather than general outreach or training. The commission also sought a liquidation deadline extension for up to $4.062 million in remaining Alcove Youth Drop-in Center funds so sites can finish implementation and Stanford can complete the final evaluation; that item was also held open. DHCS provided an overview of behavioral health policy changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, the access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation, transitional rent, and upcoming youth-focused guidance such as high-fidelity wraparound and activity funds. On BHSA implementation, DHCS said it is not tracking specific local program cuts, but is monitoring county plans and outcomes while noting that counties must still preserve Medi-Cal specialty mental health and DMC-ODS services. The department also discussed its H.R. 1 implementation strategy, including outreach, streamlined renewals, ex parte exemptions, and proposed clinic navigator and outreach funding to reduce Medi-Cal coverage loss, especially for people with behavioral health needs. In response to questions, DHCS said it has not produced a specific H.R. 1 impact estimate for county behavioral health populations, and later explained that counties can still use BHSA and other funding streams for prevention and early intervention while the state tracks impacts through integrated plans and new performance measures. The department also reported on BH-CHIP bond spending, saying it has awarded $5.8 billion for 437 infrastructure projects creating 546 new or expanded facilities and more than 9,553 residential beds, with tribal set-asides exceeding the original allotment.

Transcript Highlights:

• The State Department of Housing and Community Development and the regional planning agencies oversee
• planning and housing laws, and enforcement of those state laws to ensure they're being implemented at
• wide discrepancies that show us that plans aren't being fully implemented.
• plan.
• These local plans implement the Coastal Act on the local level and include the local zoning and development

Summary: The Assembly Select Committee on Regulatory Authority held its first hearing to examine how California’s regulatory framework affects housing production, affordability, and timelines. Chair Pacheco and Assemblymember Haney framed the discussion around the state’s housing shortage and the need to reduce costs while maintaining environmental, safety, and community protections. The first panel featured housing experts and industry representatives who argued that state regulations, code complexity, utility constraints, and agency review processes add substantial cost and delay to development. Bill Fulton described overlapping state and local land-use authorities and the tension among housing, coastal protection, climate, and wildfire goals. CBIA’s Chris Ochoa and California Apartment Association representative Bob Raymer said building codes, energy mandates, and agency processes have materially increased per-home costs, and they urged more centralized affordability analysis and greater scrutiny of regulatory impacts. The Bay Area Council’s Louis Marante called for a statewide cost target for housing and stronger timelines and accountability for state agency reviews. The second panel brought in state agencies to explain their roles. HCD said its housing element enforcement, streamlining laws, and technical assistance have helped increase production, shorten entitlement timelines, and improve compliance by local governments. CARB said SB 375 is a planning law that does not directly regulate land use, and argued that regional housing assumptions in sustainable communities strategies are not being fully implemented on the ground. The Coastal Commission said it works with local governments to balance coastal protection, sea-level-rise risk, and housing, and noted recent guidance and pilot efforts to streamline housing approvals in the coastal zone. The Energy Commission said its building energy standards are designed to be cost-effective and save consumers money over time, though they can add some design and documentation complexity. Fish and Wildlife and DTSC both emphasized early engagement and collaboration to reduce delays while protecting natural resources and public health; DTSC said it is refining vapor intrusion guidance and using brownfield grants to support redevelopment. The State Water Resources Control Board said it uses general orders and basin planning to provide predictable permitting while balancing water quality, water rights, and housing needs, and noted billions in grants and loans for water infrastructure and site remediation that can support housing affordability. In response to questions from Assemblymember Haney, several agencies described ongoing coordination across departments, including regular meetings among HCD, CARB, the Coastal Commission, and transportation agencies, as well as broader interagency efforts to reduce redundancies and identify pinch points in project delivery. No formal votes or legislative actions were taken during the hearing; the main outcome was informational testimony and discussion of possible future reforms to improve coordination, predictability, and affordability in state regulatory processes.

Transcript Highlights:

• And yet the California State Senate proposed a plan that also had the same amount of budget solutions
• , such as working with Cal OES, in the implementation of the five-year plan.
• and state implementation can reflect the lived experiences of those who use the services.
• They’re targeted... ...available online in terms of CDPH’s implementation plan.
• We have to pay for this as a state. Our health plans did their best to estimate last year.

Keywords: 987, senate, all

Summary: The hearing opened with Department of Finance and Legislative Analyst’s Office remarks on the May Revision, which both described efforts to reduce large out-year operating deficits through a mix of revenue increases, spending reductions, and reserve use. Finance said the May Revision more than halves projected deficits in later years, while LAO stressed that revenues are at unprecedented levels yet the state still faces a significant structural deficit and is drawing down reserves; LAO urged maintaining at least the administration’s level of budget solutions and adding to reserves rather than new ongoing commitments. The chair echoed concern about cuts to vulnerable populations and noted the tension between service reductions and requests for additional administrative positions. The committee then heard a series of California Health and Human Services and HCAI proposals, including additional legal support for CalHHS to respond to federal HR1 changes; a net-zero transfer of positions for a centralized eligibility/data-sharing platform; 988 crisis line implementation funding and continued work with the Trevor Project to train crisis centers to better serve LGBTQ youth; EMS data system maintenance funding; HCAI implementation of AB 1312 hospital charity care screening; SB 660 data exchange framework funding; CalRx biosimilar insulin reappropriation; and a diaper access initiative that would provide free diapers to newborns in participating hospitals and support a future direct-to-consumer purchasing option. Members questioned the diaper program’s universal design, the use of a Public Contract Code exemption, and the selection of Baby2Baby, with the chair expressing concern about optics and the lack of an income threshold. The committee also discussed distressed hospital funding, with HCAI requesting up to $50 million for another round of grants to hospitals in immediate financial distress. HCAI said it receives annual and quarterly financial reports but the data lag limits real-time monitoring, and the LAO recommended stronger program parameters and turnaround plans. Members argued the repeated need for distressed hospital aid reflects a structural problem, not a short-term gap, and raised broader concerns about hospital reimbursement and patient flow. Other items included reverting $19.6 million in unused opioid settlement funds from HCAI to DHCS for General Fund offset, and a Rural Health Transformation Program request to increase HCAI spending authority to cover the full federal award. Later, DMHC presented funding requests to implement PBM licensing and financial review requirements under AB 116, modernize the managed care complaint system, and build an electronic claims settlement data system under AB 3275. The final major discussion focused on the Behavioral Health Services Oversight and Accountability Commission, which opposed the May Revision’s proposed reduction of its Innovation Partnership Fund from $20 million to $10 million and a $6.7 million cut to community advocacy grants. The Commission argued these programs are core to Proposition 1’s goals of statewide innovation and community accountability, while Finance said the proposal is consistent with Proposition 1’s maximum funding levels and reflects a broader effort to prioritize direct services and use unspent prior-year funds; members pressed for more information and questioned whether the cuts would undermine the new behavioral health framework.

Transcript Highlights:

• PLANNING AS WE MOVE FORWARD WITH IMPLEMENTATION.
• PLAN.
• SUNSHINE ALSO OPERATE STATE WIDE AND IS OUR LARGEST PLAN SERVING ONE PERCENT AND THEIR ENROLLMENT AS
• IF THIS WAS SUPPOSED TO BE A PRIORITY THE STATE AND YOU ARE OCCA AND YOU ARE IN CHARGE OUR PLANS AND
• FOR PLANS IN THE LOWEST QUARTILE, IMPLEMENTING THINGS LIKE FOR THE EIGHT MEASURES ENROLLMENT FREEZES

Transcript Highlights:

• Okay, the administration's climate bond expenditure plan for state parks' deferred maintenance program
• The administration plans to do similar outreach with the last program to state parks and also to local
• Given that we are driven by project-level implementation at over 100 state park units to date, and we
• I completely agree, and we will develop a plan and get back to your staff with how we'll implement that
• State Parks will engage with the community and stakeholders on a robust planning process to develop a

Keywords: 988, house, all

Transcript Highlights:

• employee group health plan, and the operation of the state Medicaid and children's health insurance
• , and they can also provide services that aren't even state plan services and do additional services
• Other states have implemented certain federal authorities to disregard certain types of income.
• And so my team works with several state Medicaid plans on programs just like this one.
• And so my team works with several state Medicaid plans on programs just like this one.

Summary: The subcommittee held its first meeting of the 2025-2026 term, took attendance, confirmed a quorum, and heard introductory remarks from members and staff. Chair Anderson outlined the subcommittee’s jurisdiction over access and affordability issues, including health facility regulation, insurance, Medicaid, CHIP, and state employee health coverage. The main agenda item was an update on implementation of HB 391, which created a family home health aide program for medically fragile children. Representative Tramont, the bill sponsor, explained that the law was intended to let trained family caregivers be paid through Medicaid to care for their children, reduce reliance on private duty nursing, and relieve families. He and several members expressed frustration that implementation had taken nearly two years and that families still faced barriers. Deputy Secretary Brian Meyer of AHCA and Bridget Royce of DCF said the program was implemented October 1, 2024, with billing available, but no home health agencies had yet launched the required 80-hour training program and no claims had been paid. They described the program’s requirements, including agency employment, background screening, training, a $25-per-hour Medicaid rate paid to the agency, and an annual assessment report. A major issue discussed was that income earned by family caregivers counts toward Medicaid eligibility and could cause families to lose coverage. AHCA and DCF outlined two possible fixes that would require CMS approval: disregarding the income for eligibility purposes or treating the child as a family of one. Members and public witnesses strongly urged changes to avoid forcing families to choose between income and coverage. Several providers said they had begun preparing training programs, but asked for clearer approval processes and more patient-specific training requirements. The committee then heard extensive public testimony from parents and caregivers of medically fragile children, who described the financial, emotional, and logistical strain of caring for children with severe disabilities and argued that the bill should be expanded to include Florida KidCare families and others in the coverage gap. They also raised concerns about the eight-hour-per-day limit, low pay, and the need for simpler rules and direct support. Home health providers and associations supported the concept but asked for modifications, including more targeted training and clearer implementation guidance. The meeting then shifted to a second agenda item on the Andrew John Anderson Rapid Whole Genome Sequencing Program, which was funded in the 2023 budget. Deputy Secretary Meyer said the program has been implemented since January 1, 2024, but utilization has been lower than expected, with only about 60 claims paid and many denials occurring through managed care. Public testimony from a lab, a hospital, and a pediatric rare disease expert said the program is clinically valuable and cost-saving, but managed care billing barriers, prior authorization issues, and DRG-related denials are limiting access; they urged direct billing to Medicaid and possible expansion to all newborns.

Transcript Highlights:

• No other state has fully wrapped its arms around all of these local plans and planning data, and California
• So they're not planning, they're not implementing.
• successful in implementing their general plans and the needs of its constituents.
• Next, we ask the state to provide ongoing state financial resources like predictable formula planning
• to help implement the general plan.

Summary: The committee first heard AB 253, by Assembly Member Ward and presented by Assembly Member Quirk-Silva, which would allow licensed third-party professionals to review certain post-entitlement permits if a local building department would take more than 30 days. Supporters, including California YIMBY, the California Chamber of Commerce, the Housing Action Coalition, the Bay Area Council, SPUR, and Abundant Housing LA, said the bill would reduce permitting delays and help housing production. League of Cities and the California State Association of Counties expressed concerns but were not formally opposed. Members voiced strong support, and the bill passed the committee 10-0 to Appropriations. The committee then held an informational hearing on California’s general plan. The first panel, led by UC Davis professor Catherine Brinkley, gave an overview of the general plan structure, required elements, update cycles, and the new PlanSearch database that makes adopted plans searchable statewide. She emphasized that general plans are long-term, locally tailored documents that integrate housing, transportation, safety, environmental justice, and other policy areas, and noted that many plans and elements are outdated. Members asked about update timelines, public participation, and whether AI tools could help with drafting and analysis. A second panel of local government representatives described the practical challenges of preparing and updating general plans, especially in rural and small jurisdictions. Speakers from Calaveras County, Sacramento, San Joaquin County, and Fountain Valley cited staffing shortages, consultant availability, funding constraints, CEQA and outreach costs, changing state mandates, and the difficulty of keeping plans aligned with local conditions and board turnover. They asked for more funding, more time, clearer prioritization, and more flexibility. A third panel from the Governor’s Office of Land Use and Climate Innovation explained its role in issuing general plan guidelines, technical advisories, and annual planning surveys, and said it is updating its guidance through 2027 to reflect recent housing, climate, safety, environmental justice, and open space laws. No public comment was offered, and the informational hearing was adjourned.

Transcript Highlights:

• plan a few minutes ago, individuals who are on the wait list can get services in the state plan.
• plan a few minutes ago, individuals who are on the wait list can get services in the state plan.
• plan a few minutes ago, individuals who are on the wait list can get services in the state plan.
• be covered in the state plan they cannot be covered in the state plan they cannot be delivered<00
• the either in that state plan benefit or the either in that state plan benefit or the waiver<00:36

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services met with a quorum still coming together and first handled roll call and minutes. The main presentation came from the Department for Medicaid Services, with Commissioner Lisa Lee and CFO Steve Beckle giving an overview of Kentucky Medicaid, its federal-state financing structure, and the department’s 1915(c) home- and community-based waiver programs. They explained FMAP funding levels for traditional Medicaid, administration, IT, expansion adults, and CHIP, and noted the size of the program, including more than 600,000 Kentucky children eligible for Medicaid or CHIP, about 485,000 expansion adults, over 69,000 enrolled providers, and $18.5 billion in 2024 expenditures. A major focus was the waiver system, including the acquired brain injury waivers, model waiver, independence waiver, Michelle P. waiver, and Supports for Community Living waiver. The department said these waivers are intended to keep people with physical or developmental disabilities in home and community settings rather than facilities, and that many services are not covered by Medicare or commercial insurance. Officials described participant-directed services, interagency administration, and eligibility rules, including that some waiver programs use the child’s income only rather than family income. They also reported an unduplicated waiver wait list of 13,930 people and said the General Assembly had added waiver slots in the last budget, including 650 ABI slots and 1,275 more to be allocated July 1, 2025. The department also discussed a waiver rate study conducted by Guidehouse, explaining that CMS requires a defensible rate methodology because there is no Medicare or commercial benchmark for many waiver services. They said the study used cost and wage surveys, provider and stakeholder input, and aimed to improve transparency, provider stability, and rate parity. Officials reviewed prior COVID-era Appendix K rate increases and budget-driven increases, and said the budget ultimately funded rates at about 70% of the benchmark study, while preserving higher existing rates where needed so no provider would be cut. They highlighted larger differences in behavioral support and case management rates, and said a public report is available. Members asked several questions about the potential impact of federal FMAP changes, especially possible reductions in the enhanced match for expansion adults and Medicaid IT/admin activities. DMS said any FMAP reduction would require more state general fund dollars, estimating about $75 million for each 1% drop in the expansion match, while impacts on administrative IT funding would depend on the systems being built or implemented in a given year. Members also pressed for clarification on waiver wait-list procedures, funded versus filled slots, and what happens when someone on the wait list is later found ineligible. DMS said people on the wait list may not yet have been assessed, can be reevaluated if conditions change, and are still eligible for regular Medicaid state-plan services if they qualify, even if they are waiting for waiver services.

Transcript Highlights:

• plan amendment.
• The state plan amendment was submitted in September 2024, and we're hopefully anticipating approval this
• We're anticipated to publish the program distributions, as well as submit a report and the state plan
• for implementation.
• These changes have already been implemented since May of last year, when a memo stating the change and

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:

• spending plan.
• All those good things for the state.
• They're responsible for implementing the strategies in those plans. There's hundreds of them.
• ACF is a key measure in California's federally mandated state implementation plan, or SIP.
• And so we think it's very important that the state continue to move forward, implementing and enabling

Summary: The committee hearing focused heavily on CARB’s broad trailer bill request for regulatory fee authority. Finance and CARB argued the proposal would let CARB develop fees to recover reasonable costs for implementing and enforcing regulations, while the LAO recommended rejection because the authority was too broad, could apply to an entire division of code, and would delegate core legislative taxing/fee-setting power without enough guardrails. Members from both parties raised concerns about the breadth of the authority, accountability, affordability impacts, and whether the Legislature would be put in an up-or-down position after CARB had already developed regulations. CARB responded that fees would still go through a budget change proposal and legislative approval before collection, and cited existing examples such as transport refrigeration units and commercial harborcraft fees. The committee then reviewed CARB’s request for permanent resources to implement SB 905 on carbon capture, utilization, storage, and carbon dioxide removal. CARB said the Legislature had previously authorized limited-term positions and funding, but it had struggled to recruit and retain staff with specialized regulatory and technical expertise, and that the work had included pre-rulemaking contracts, technology review, and permit-related preparation. Members questioned the pace of work, the use of limited-term positions, and whether additional permitting authority would be needed. CARB said it hoped to begin rulemaking later in the year if permanent resources were approved. Members also discussed the cap-and-trade spending plan, noting lower-than-expected auction revenues but higher interest earnings, and the need to monitor the Greenhouse Gas Reduction Fund and possible May Revision changes. The committee then heard overviews of the zero-emission vehicle package, the Community Air Protection Program, demand-side grid support, and e-bike incentives. CARB described ongoing investments in community-based transportation equity, drayage trucks, harbor craft, and other clean technology demonstrations, while members pressed on affordability, program duplication, and whether enough funding was being directed to incentive programs. No formal votes were taken during the portion provided, and the chair repeatedly indicated that the hearing was intended to surface concerns for later budget negotiations.

Transcript Highlights:

• It really starts around an implementation plan, so there's a required implementation plan.
• They provide an implementation plan to receive their award, and then they report on how that implementation
• There is an implementation plan to make sure that we are being appropriate stewards of state funding,
• In your list just now, that is the implementation plan.
• And you're talking about implementation plans.

Transcript Highlights:

• and public health plan enrollment in the state.
• State law requires health plans to provide enrollees with medically necessary care within timely access
• the status of its implementation and completion of the reimbursement plan to the DMHC and will post more
• We actively engage with state and federal agencies on parity implementation and collaborate with state
• All around the state, we've heard the same refrain from Kaiser plan members: If you break your arm, if

Summary: The Assembly Health Committee held an informational hearing on Kaiser Permanente’s behavioral health care system, focusing on Department of Managed Health Care enforcement actions, Kaiser’s corrective action work plan, and testimony from patients, advocates, and union representatives. DMHC officials reviewed a long history of complaints, surveys, fines, and settlements involving Kaiser’s access to behavioral health services, including deficiencies found in 2012 and 2016, a 2022 non-routine survey, and a 2023 settlement that imposed a $50 million penalty and required $150 million in community investments over five years. DMHC said it continues to monitor Kaiser through quarterly meetings, complaint review, follow-up surveys, and a reimbursement process for members who could not obtain timely in-network care. Committee members pressed DMHC on what “timely access” and continuity of care mean in practice, how virtual care and group therapy fit into the standards, and what triggers a non-routine survey. DMHC said initial behavioral health appointments generally should not take more than two weeks, urgent care should be within days, and follow-up care within 10 days, with out-of-network care required when plans cannot meet standards. Officials also said Kaiser’s initial corrective action work plan lacked detail, but the revised plan was accepted and will be tracked through quarterly reporting and possible additional enforcement if Kaiser fails to comply. The second panel featured testimony from a Kaiser enrollee, a behavioral health policy expert, a Kaiser therapist, and the NUHW president. The enrollee described serious delays and inadequate treatment for his daughter after a suicide attempt, while the therapist and union leader said Kaiser’s behavioral health system is understaffed, relies too heavily on short appointments, group therapy, and webinars, and treats behavioral health as less important than medical-surgical care. They argued Kaiser’s one-appointment-at-a-time scheduling rule and limited treatment time violate parity requirements and harm continuity of care. Several members criticized Kaiser for not appearing at the hearing and said the testimony underscored the need for stronger oversight, clearer metrics, and faster remedies for patients.

Transcript Highlights:

• So with that, we'll begin with our first panel on state implementation updates.
• Both the crisis care continuum plan and the five-year 988 implementation plan focused not just on developing
• So that's the goal long-term, and that is supported by the 988 implementation plan that Ms.
• So that's the goal long-term, and that is supported by the 9-8 implementation plan that Ms.
• Department of Health Care Services-approved implementation plan for the mobile crisis.

Summary: The hearing focused on California’s 988 suicide and crisis lifeline and the broader crisis response system, with members and witnesses emphasizing both the system’s life-saving role and the risks posed by funding gaps, rising demand, and uneven local implementation. Opening remarks highlighted the personal impact of suicide and the need to strengthen crisis response so calls are answered quickly and linked to appropriate care rather than defaulting to 911, emergency rooms, or law enforcement. State officials described the AB 988 five-year implementation plan, which sets goals around public awareness, equitable access, high-quality call/chat/text response, and better integration with ongoing behavioral health services. State agencies reported progress on infrastructure, coordination, and related behavioral health investments. CalHHS said California has expanded mobile crisis teams, crisis stabilization units, and youth behavioral health supports, and is preparing additional public awareness and grant programs tied to Proposition 1. DHCS explained that 988 is funded through a federal SAMHSA grant and the AB 988 surcharge, while Medi-Cal separately funds mobile crisis services; officials said the mobile crisis benefit is active in 53 counties and that statewide expansion remains a work in progress. Cal OES described the statewide technical buildout, including network infrastructure in all 11 crisis centers, interoperability with 911, and a pilot of next-generation routing and call-handling tools. The 988 California Consortium said call volume continues to rise sharply, missed calls remain a major concern, text/chat capacity is limited, and centers need more stable funding, better reimbursement, and stronger feedback loops with the state. County and community witnesses stressed that local systems need more flexible, sustained support to match the demand. Lake County described a peer-led rural mobile crisis model that has reduced law enforcement holds and increased housing placements, but said county-run mobile crisis teams still cannot reliably access 988 surcharge dollars and face reimbursement problems from Medi-Cal and commercial plans. Santa Clara County reported strong performance metrics, rapid call answer times, and a broad continuum of mobile crisis services, but said staffing and funding are strained and commercial reimbursement remains slow. The Mental Health Association of San Francisco said the peer-run warm line complements 988 by offering non-emergency support and warm handoffs, but recent budget changes forced cuts to Spanish-language service, federation support, and hours. No formal votes or legislative actions were taken during the hearing; members mainly asked questions about surcharge levels, budget timing, coordination among agencies, data collection, and how to improve collaboration with frontline crisis centers.