Transcript Highlights:

• So, moving to direct care and treatment. There are three proposals that are included.
• They were all the governor's proposals for direct care and treatment, starting on line 571.
• </c> So, moving to direct care and treatment. So, moving to direct care and treatment.
• ><c> care</c><00:14:06.080><c> and</c><00:14:06.200><c> treatment</c> proposals for direct care and treatment
• </c><00:47:26.960><c> care</c><00:47:27.240><c> and</c> Senate File 5029, the direct care and Senate

Committee: Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• Seniors access services like assisted living, home care, or adult day.
• going to get reimbursed 171% below the cost of delivering that care or that service.
• The</c><00:48:05.440><c> Proposal</c> Care Services um further The Proposal Care Services um further
• </c> Services to provide ongoing care Services to provide ongoing care coordination<00:49:22.720><c>
• when they need care and offers more connections to additional services they may need.

Committee: House Human Services Finance and Policy

Keywords: 1183, house

Transcript Highlights:

• This only deals with the foster care youth.
• direct donor blood.
• donor blood, and every individual deserves the right to direct their medical care to the furthest extent
• The direct donor participant...
• services.

Committee: Senate Health and Welfare

Keywords: 989, all

Transcript Highlights:

• So that's meals, transportation, respite care in the home, homemaker services.
• An example is to utilize the goods and services she gets through New Mexico Care to pay for adult daycare
• These conferences are more than just a gathering; they're direct services.
• We also are providing direct legal services and supports through this program.
• Our responsibilities include developing strategic IT direction and delivering essential services.

Transcript Highlights:

• They're direct materials relating to individual patient care, things like medication supplies that are
• used during the course of providing medical care in the ER and other services.
• care because of the number of people and how vast our country is and how far we are to services, or
• Bolley, we’ve spoken about... ...we’ve spoken about investing more in direct primary care, and I think
• There is an expectation in this contract that society has with health care for a certain level of services

Committee: Joint Health Insurance Affordability Task Force

Keywords: 916, all

Transcript Highlights:

• care services for their county residents.
• Direct Primary Care Alliance.
• So they might pay their direct primary care membership so they at least have a primary care physician
• So they might pay their direct primary care membership so they at least have a primary care physician
• my clinic, Texas Direct Medical Care, also using the direct primary care model.

Committee: Senate Health & Human Services

Keywords: 1185, senate, all

Transcript Highlights:

• Continuing care retirement communities, CCRCs, are entities that provide care and housing to residents
• Care services may include nursing care, medical care, assistance with activities of daily living, and
• who offer life care contracts.
• This is a more efficient way to deliver care and get people to imaging MRI services that they need.
• Again, this year we'll be careful.

Summary: The Senate Health and Long-Term Care Committee held a Friday morning hearing with several House bills and then took executive action on three measures. In executive session, the committee voted do pass on Engrossed Substitute House Bill 2242, Substitute House Bill 2152, and Engrossed Substitute House Bill 2168, sending the first two to Rules and the overdose-mapping bill to Ways and Means. The committee also waived the five-day notice rule for several bills on the agenda. Public hearings focused on hospital inspections, continuing care retirement communities, radiologic technologist supervision, music therapy licensure, nursing regulation, ambulance billing after motor vehicle accidents, and EMT recertification. Representative Macri presented HB 2577 to require hospital inspections at least every 18 months, allow limited pauses during emergencies, and clarify when CMS or accrediting-body surveys may substitute for state inspections; DOH supported the bill, citing JLARC recommendations, while many people signed in opposed. Macri also presented Second Substitute HB 2384, which would require actuarial analysis review for certain CCRCs; OIC supported the transparency goal, while CCRC representatives opposed the added cost, though residents and association witnesses argued the oversight would protect seniors and their life savings. Representative Engel’s HB 2113 drew strong support from radiology, hospital, and provider groups for allowing virtual direct supervision for IV contrast procedures and aligning state law with CMS practice. Representative Ryu’s HB 1187 would bar ambulance services from sending motor-vehicle-accident medical debt to collections for 120 days; she described a personal experience with an ambulance collection issue, and the hearing was closed after no testifiers appeared. Representative Reed’s HB 2363 would let music therapy applicants practice under supervision for up to six months while exam results are processed; music therapy witnesses said it would prevent workforce gaps. Representative Simmons’ HB 2339 would update nursing title and transcript requirements and allow the board to issue interim permits directly, with the Board of Nursing and ARNP groups calling it a technical cleanup. HB 2540 would extend EMT recertification intervals to six years for long-tenured EMTs, and firefighters supported it as an administrative simplification without changing training requirements.

Transcript Highlights:

• In FY 2024, critical investments were made to ensure a $20 an hour base wage for direct care workers,
• So this $25 minimum wage for health care workers would be a step in the right direction.
• These workers are home care aides, direct care staff, mental health, substance use, and disability service
• These workers are home care aides, direct care staff, mental health, substance use, and disability service
• Black and brown workers make up a disproportionate share of the home care and direct care workforce.

Committee: Joint Joint Committee on Labor and Workforce Development

Keywords: 995, all

Summary: The Joint Committee on Labor and Workforce Development held a hybrid hearing on legislation concerning unemployment insurance, non-compete agreements, prevailing wage, and minimum wage issues. Committee leaders outlined the hearing process, asked witnesses to keep oral testimony to three minutes, and invited written testimony through November 20. No votes were taken during the hearing; it ended with a motion to adjourn and notice of the next hearing on November 20. Much of the testimony focused on bills to expand unemployment insurance for striking workers, including H. 2168 and S. 1319. Labor leaders, union members, and legal advocates argued that workers who are out on strike for more than 30 days should be able to receive UI benefits, saying the policy would help workers and families meet basic expenses, reduce employers’ ability to “wait out” strikes, and encourage good-faith bargaining. Speakers cited recent strikes, including the Republic Services strike, and said the proposal would not meaningfully increase strike activity or strain the UI trust fund. Another major topic was minimum wage legislation, especially H. 2107/S. 1349 to raise the minimum wage to $20 by 2029 and index it to inflation, and H. 2191 to create a $25 enhanced care worker minimum wage. Supporters said current wages are not keeping pace with housing, food, and childcare costs, and that care workers, direct support staff, and human service employees face chronic vacancies, burnout, and turnover. Testimony also supported H. 2126 on prevailing wage by adding apprenticeship and training contributions to the wage calculation, and H. 2159 and S. 1363 on prevailing wage-related issues. One witness, Russell Beck, testified against S. 1336, which would ban non-competes, and against H. 2118, arguing Massachusetts’ current non-compete law is a balanced compromise that should not be disrupted.

Transcript Highlights:

• They have services somewhere else.
• They have services somewhere else.
• Next, Senator Chair Trumbull, Health Care. Chair Trumbull, health care.
• Senator Trombo, health care. Senator Trumbull, health care?
• Senator Trumbull, health care?

Summary: The Senate took up the conference report on House Bill 501E, the General Appropriations Act for fiscal year 2026-27, with Chair Hooper and the appropriations chairs walking through the $114.5 billion budget. Major highlights included pay increases for state law enforcement, firefighters, park rangers, and correctional officers; funding for teacher salary increases and K-12 enrollment stabilization; workforce and university funding in higher education; major Medicaid, nursing home, waiver, and opioid-related investments in health and human services; corrections and prison-capacity funding; transportation, housing, and emergency management spending; and large environmental appropriations for Florida Forever, Everglades restoration, and water quality projects. Members then asked detailed questions about specific items. Senators pressed on the Hamilton Center at UF, the difference between assistant state attorney and public defender pay, declining student enrollment funding, private school scholarship vouchers, mental health funding in schools, the lack of preeminence funding, APD’s iBudget waiver wait list and provider rates, ADAP premium assistance and the return of Biktarvy to the formulary, prison staffing and air conditioning, Florida Forever land-buying versus easements, SNAP and Sun Bucks funding, Hope Florida, election audit funding, and the IDD managed care program. Chairs generally explained the negotiated compromises, noted where funding was flat or omitted, and in several cases said items would be revisited next year or depended on agency implementation. Several senators used debate to praise the budget while also criticizing major policy choices. Leader Berman argued the state should have expanded Medicaid, invested more in public schools instead of vouchers, and accepted federal summer EBT funds. Other senators highlighted local wins such as Biscayne Bay restoration, Tri-Rail, housing assistance, ADAP funding, and declining enrollment support. The transcript ends with debate remarks thanking Chair Hooper for his work on the budget; no final vote is shown in the excerpt.

Transcript Highlights:

• </c><00:26:21.840><c> it's</c><00:26:21.960><c> a</c> Direct Care and treatment and it's a Direct Care
• The current average wait times to access beds at Direct Care and Treatment for forensic services and
• :04:05.440><c> of</c><01:04:05.559><c> the</c> care services and reviewing all of the care services and
• all</c><01:04:22.640><c> of</c> for all direct care workers for all of for all direct care workers for
• We're unique because we don't fund direct services.

Committee: House Human Services Finance and Policy

Keywords: 1183, house

Transcript Highlights:

• These funds maintain current patient care, including same-day in-clinic abortion care, sedation services
• and for behavioral health care, including for those whose services have been supported by Medicaid,
• and for behavioral health care, including for those whose services have been supported. homelessness
• services and for behavioral health care, including for those whose services have been supported by Medicaid
• and personal care services for those with disabilities.

Summary: The Senate Ways and Means Committee heard an overview from OFM Director Katie Chapman See on Governor Ferguson’s 2026 supplemental budget proposal. She said the budget was built in response to higher caseloads and inflation, a roughly $390 million revenue forecast drop, new federal costs tied to H.R. 1, and a relatively small ending fund balance. The proposal would increase near general fund spending by about $1.1 billion and solve an estimated $2.3 billion two-year gap through about $800 million in reductions, revenue shifts and tax preference changes, use of other funds, and about $1 billion from the budget stabilization account. She also noted the budget is balanced over two years but not fully over four years under the state’s outlook rules. Chapman See highlighted reductions in Working Connections Child Care, including a soft cap on enrollment and holding subsidy rates at the 75th percentile, delays to long-term care and developmental disability-related changes, and across-the-board reductions to higher education and administrative spending. She also described investments in wildfire suppression and preparedness, affordability programs like utility rebates and home energy assistance, housing-related planning and permitting support, One Washington IT replacement, behavioral health workforce programs, and continued support for some K-12 initiatives such as ninth grade success and homeless student stability. In response to questions, she said some proposed cuts were based on the governor’s subjective judgment about what was critically necessary, that current child care enrollees would not be cut off immediately, and that the budget would maintain services for about 500 highest-acuity Medicaid clients who lost eligibility under federal changes. Public testimony was largely critical of the proposed cuts in K-12, early learning, and higher education. School officials, educators, nurses, and advocacy groups opposed reductions to Transition to Kindergarten, Local Effort Assistance, Running Start, MSOC, school leadership and support grants, and higher education funding, arguing the cuts would worsen existing funding gaps and harm student outcomes. Several witnesses supported restoring or maintaining funding for ninth grade success, Treehouse’s foster youth graduation program, homeless student stability, and Science on Wheels. In early learning, child care providers and advocates opposed the Working Connections cap and subsidy-rate reduction, warning it would reduce access and destabilize providers. In higher education, campus leaders and labor representatives opposed across-the-board cuts and fund shifts, while some institutions and advocates supported targeted investments such as behavioral health workforce programs and DigiPen aid restoration. In human services, Planned Parenthood advocates praised restored abortion access funding and Medicaid reimbursements. The committee took no votes or final action in the transcript provided.

Transcript Highlights:

• The pilot program service package includes all services available under the long-term care program, the
• for service or managed care.
• And those services can consist of medical services or long-term care kind of home health services or
• The pilot program covers medical care, long-term care, and all of the services that are included in the
• If the goal of managed care was to make disability services so difficult, If the goal of managed care

Summary: The Health and Human Services Committee received an overview of Florida’s intellectual and developmental disabilities (IDD) managed care pilot, created by legislation in 2023 to test whether a managed care model could integrate Medicaid medical services with iBudget waiver home- and community-based services for adults in pre-enrollment categories. AHCA explained the existing system, the pilot’s scope in Regions D and I, and the rollout timeline, including federal approval, contract execution with Florida Community Care, and the October 2024 go-live. Officials reported that, as of early February, 370 individuals had been sent for onboarding and 168 more were in queue, with about $35.8 million of the appropriation remaining. APD also clarified the difference between the pre-enrollment categories and the waiver waitlist, and noted that crisis cases can be enrolled more quickly depending on eligibility and funding. Florida Community Care described the pilot as a comprehensive managed care model offering medical, long-term care, and iBudget services, plus enhanced benefits such as bed-hold days, caregiver transportation, and help with legal guardianship costs. The plan said it uses one care coordinator, a 1:18 coordinator ratio, a face-to-face assessment within five days of enrollment, and 180 days of continuity of care for existing providers. The company emphasized that it is recruiting providers by offering higher rates than some iBudget rates, lower administrative burden, and network adequacy incentives, while APD said it continues to monitor provider supply and demand and recruit across service types and regions. Members repeatedly questioned whether the pilot’s costs, provider rates, and service levels were truly comparable to the iBudget system, and AHCA and APD said it was too early to draw firm conclusions because claims data are still lagging. Committee members also raised concerns about communication, enrollment delays, provider shortages, and whether the pilot could scale statewide. APD said it has used letters, phone calls, texts, emails, and community meetings to reach eligible individuals, and that some delays stem from required assessments, Medicaid eligibility checks, and level-of-care determinations. Several members asked for more detailed comparisons of costs and provider reimbursement between the pilot and iBudget, and APD said it would provide additional data. Public testimony at the end was strongly critical of managed care, with a participant and his mother describing poor service, transportation failures, and loss of control under prior managed care arrangements, and urging the committee not to expand such a model without safeguards. No votes or formal committee action were taken before adjournment.

Transcript Highlights:

• protective services, senior programs, and the long-term care ombudsman.
• It can be self-direction or consumer-directed services, where the participant is responsible for hiring
• It can be self-direction or consumer-directed services, where the participant is responsible for hiring
• , training, and directing ...or consumer-directed services, where the participant is responsible for
• , or in-home care, where a participant selects a provider agency who then sends a trained direct service

Committee: House Budget

Summary: The committee heard the Missouri Department of Health and Senior Services present its FY 2027 budget request, with Director Sarah Wilson and budget staff describing the department’s mission, major divisions, and the impact of federal funding shifts, especially the FMAP change that will shift costs to general revenue. Wilson emphasized prevention, public health infrastructure, workforce capacity, and data modernization, while several members praised the department’s responsiveness and cost-cutting efforts. The discussion repeatedly focused on lapses, excess authority, and the department’s stated practice of spending federal and other funds before general revenue where possible. Members asked detailed questions about local public health agency support, nutrition programs, rural health and primary care, newborn screening, the state public health lab, and the department’s use of flexibility and reallocations. There was extended discussion of substance use disorder funding: the department explained that some funding is being reduced in its own budget because transfer authority is being added for the Department of Mental Health and the Department of Corrections, while some other SUD-related lines are actual reductions. Members also questioned tobacco prevention and cessation cuts, maternal and infant health programs, fetal infant mortality review, and minority health initiatives, with staff explaining program purposes and noting that some reductions were tied to excess authority or to moving programs to other departments. The committee also reviewed specific operational items such as the Health Initiatives Fund transfer, debt offset escrow for loan repayment defaults, donated funds authority, emergency preparedness, environmental health, health informatics, HIV/STI/hepatitis services, local public health incentives, and the COVID/ARPA authority reductions. Several members requested follow-up information on vacancies, lapse trends, grant spending plans, and program details. No final vote or formal action was taken in the portion provided; the chair recessed briefly and the hearing continued with additional budget testimony.

Transcript Highlights:

• Recently, in response to the board's feedback and direction, the Office of Health Care Affordability
• Health care claims data is regularly used in health services research and policy analysis.
• payers, including commercial health plans, as well as insurers and the Department of Health Care Services
• Services and HCAI's own Office of Health Care Affordability with critical data and analysis necessary
• AB 3275 changed the time frames for reimbursing, contesting, and denying claims for health care services

Keywords: 988, house, all

Transcript Highlights:

• gender-affirming care services.
• Aging services, HIV care, primary care, behavioral, Aging services, HIV care, primary care, behavioral
• The Medi-Cal waiver program provides comprehensive case management and direct care services to persons
• The Medi-Cal waiver program provides comprehensive case management and direct care services to persons
• Through our community-based research and direct service work, we have learned that gaps in care are not

Summary: The committee held an inaugural hearing on the health care and support needs of older LGBTQ Californians, with members and witnesses emphasizing that this population has made major gains in rights and longevity but still faces discrimination, isolation, economic insecurity, and gaps in services. Opening remarks highlighted concerns about older LGBTQ people entering nursing homes and feeling forced back into the closet, as well as the growing number of Californians aging with HIV. The hearing was structured into three panels, with public testimony considered if time allowed. The first panel focused on the overall health and support landscape. Justice in Aging described survey findings showing discrimination, poor health, difficulty with errands, and economic insecurity among older LGBTQ Californians, and warned that federal Medicaid cuts and broader federal actions could worsen access to home- and community-based services and culturally competent care. CalHHS and the Department of Aging described the Master Plan for Aging, the first statewide LGBTQIA older adult survey, and efforts to support gender-affirming care, PACE, care management, and community supports. Witnesses stressed the need for better outreach, data collection, and a “no wrong door” approach so people can more easily find and access services. The chair and senators pressed the departments on how survey findings are being translated into concrete action and how state agencies are coordinating across silos. The second panel addressed health care for seniors living with HIV. A longtime survivor described severe financial and benefits consequences from a federal clawback and argued that California needs stronger legal, navigation, and housing supports, including HIV-specific housing funding. The Department of Aging reported on implementation of SB 258, saying it has educated area agencies on aging, added HIV data to planning tools, and found that 20 of 33 area agencies identified HIV as a target population, with 16 including specific strategies. The Office of AIDS outlined Project Cornerstone, Ryan White, ADAP, HOPWA, a Medi-Cal waiver, and PrEP-AP, noting these programs serve thousands of older clients and that local case managers are expected to coordinate whole-person care. Case managers and advocates said housing, food, transportation, mental health, and premium assistance remain major needs, and senators asked whether future ADAP rebate funds could support navigation, housing, and other gap-filling services. The final panel turned to transgender, gender nonconforming, and intersex seniors. The Department of Social Services described protections under SB 219, including nondiscrimination notices, resident rights postings, required records for preferred names and pronouns, and annual inspections of licensed facilities. The Department of Public Health and a TransLatin Coalition leader were introduced to discuss additional supports for TGI seniors. Across the hearing, members repeatedly returned to the themes of visibility, coordination, and implementation, asking departments to follow up on how they will better connect services, improve outreach, and ensure that existing laws and programs are actually reaching the people they are meant to serve.

Transcript Highlights:

• It provides a collaborative care approach, which is a way that we can provide mental health services
• They're not supposed to be using exceptions to pay for anything except for direct care for the one.
• I support the DC&T, the direct care and treatment process.
• We transferred 10 individuals from the hospitals to direct care and treatment. That was progress.
• That responsibility is to make sure that every individual who needs services is taken care of.

Transcript Highlights:

• is take care of those veterans that are being denied the dental care.
• Our focus includes dental care services and access, emergency financial assistance, transportation for
• Our focus includes dental care services and access, emergency financial assistance, transportation for
• These are the services that are directed to us under 295.22, the Florida Vets program.
• sign-ups for our services.

Committee: Senate Military and Veterans Affairs, Space, and Domestic Security

Summary: The Committee on Military Veterans Affairs, Space, and Domestic Security met to consider SB 96, which originally proposed a new veterans dental care program but was amended to expand the existing Veterans Dental Care Grant Program. The amendment raised eligibility from 300% to 400% of the federal poverty level and added a recurring $500,000 general revenue appropriation. Members discussed whether expanding eligibility without guaranteed additional funding could dilute services for veterans already being served, while supporters argued it would help veterans currently turned away for dental care. The committee adopted the amendment and then reported CS/SB 96 favorably by roll call vote, with Chair Wright voting no. The committee also approved two committee bills continuing public records exemptions: SPB 7000, covering the address and telephone number of people staying in public emergency shelters during storms or catastrophic events, and SPB 7002, covering certain Department of Military Affairs records stored in or transmitted through Department of Defense systems or related to military cyber operations. Both were moved as committee bills without objection and were favorably reported. Members then received presentations from Dr. Pia Woodley of the Florida Veterans Foundation and Joe Marino of Veterans Florida. Dr. Woodley outlined the foundation’s dental initiatives, emergency assistance, transportation support, benefits guide distribution, new programs for state veterans’ homes and community grants, and recent audits with no findings. Marino described Veterans Florida’s SkillBridge, entrepreneur, and workforce programs, including outreach and federal partnerships, and noted legislative priorities to allow stipends for training at UF IFAS AGVets facilities and to rename a program in statute for clarity. The meeting concluded with no further business and adjournment.

Transcript Highlights:

• to assist children and their families, including child care, perinatal support services, before-school
• Counties are instrumental in funding local health ability to provide direct services such as mobile clinics
• Our services address health concerns early, preventing expensive emergency care and hospitalizations,
• company, HMO, or health care service contractor from interfering with, controlling, or otherwise directing
• increase the administrative burden on physicians, pulling them further away from direct patient care

Summary: The Ways and Means Committee held a public hearing on multiple bills, beginning with a motion to suspend the five-day notice rule for a long list of Senate bills, which passed on a voice vote. The committee first heard Substitute Senate Bill 6026, a governor-request housing bill that would require cities and counties over 30,000 population to allow residential uses in commercial and mixed-use zones, limit mixed-use/ground-floor commercial requirements in some areas, and allow added height where such requirements are imposed. The lieutenant governor testified strongly in support, arguing the bill would add needed housing capacity without requiring ground-floor retail burdens. The hearing on SB 6026 was then suspended so the committee could move through the agenda. The committee then heard Senate Bill 6294, a broad local government finance measure with eight parts, including expanded uses for certain REET revenues, a new county public utility tax, a new local sales tax for children and family services, expanded housing-related tax uses, changes to county levy structure, longer lid lift periods, and expanded use of rental car tax revenue. Local government, housing, and public health witnesses largely supported the bill, emphasizing flexibility for affordable housing, rental assistance, children’s services, and county fiscal stability. Opponents, including wireless industry, water/sewer district, auto dealer, realtors, energy, and cannabis representatives, objected to specific tax provisions as regressive, costly, or likely to raise consumer prices. Several witnesses requested amendments, including adding public health clinic funding and flood recovery language from House bills. The committee also heard Substitute Senate Bill 5400 on local news sustainability, which would create a state grant program funded by a surcharge on large search engines and social media platforms to support journalism jobs and the Murrow Fellowship program. News organizations, the League of Women Voters, open government advocates, and local journalism supporters testified in favor, saying local news is essential to civic life and that the bill would help sustain reporting without using general fund dollars. Technology industry representatives opposed the bill, arguing it unfairly singles out tech companies and could face legal challenges. The committee then heard Senate Bill 6211, which would let opt-in GMA jurisdictions impose REET-2 without voter approval; cities and counties supported it as a parity and infrastructure funding measure, while Realtors opposed the loss of voter approval. Senate Bill 5650, authorizing local cannabis excise taxes, drew support from some local officials but strong opposition from cannabis businesses, which argued Washington’s cannabis taxes are already too high and drive sales to the illicit market. Senate Bill 6033, waiving penalties and interest for taxpayers who failed to collect new sales tax on certain services, was supported by NFIB as a compliance and fairness measure. Senate Bill 6297, exempting temporary staffing services for nonprofit behavioral health providers from sales tax, drew strong support from behavioral health organizations citing workforce shortages and unsustainable costs. Finally, Senate Bill 6343, extending and expanding tax relief for disaster-damaged property and repairs, was presented as aid for flood recovery; local officials testified in support. No final committee votes on the bills were taken in the portion of the meeting provided.

Transcript Highlights:

• care.
• The other part of MA is paid for via fee-for-service, where we don't use a managed care organization.
• , not just long-term care.
• , not just long-term care.
• , not just long-term care.

Committee: House Human Services Finance and Policy

Keywords: 1183, house

Transcript Highlights:

• So whether we talk about transportation, housing, health care services, education, there's lots of work
• Service coordination is the first service.
• One option that is a combination of directed and agency participant-directed services is utilized by
• services.
• When people have stable and consistent services with direct support professionals who are well-trained

Keywords: 988, house, all