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

Transcript Highlights:

• </c> the service, but who can do the service the service, but who can do the service and<00:01:27.360
• As a result, providers must divert already limited direct care dollars to new compliance infrastructure
• </c><00:21:46.320><c> and</c><00:21:46.640><c> service</c> community-based services and service community-based
• services and service disrespands regulatory<00:21:54.080><c> requirements.
• </c> receives services. receives services.

Keywords: 1183, house

Transcript Highlights:

• health care.
• services.
• We come before you today as a provider of health care services, as a partner, as a thought leader, and
• And so we're trying to bring those types of services into our community through the Rural Health Care
• They can take that opportunity to expand their services and try to bring in primary care doctors, and

Committee: House Federal Funding Stabilization Subcommittee

Transcript Highlights:

• care.
• That commitment continues under universal child care. Universal Child Care.
• What we show below is child care.
• That's why building the child care sector is so important to bring health care professionals.
• Of child care assistance. I mean, where are we really going to get service?

Committee: Senate Senate Finance

Keywords: 996, all

Transcript Highlights:

• LEVEL OF SERVICE.
• FROM CIVIL LIABILITY AND CRIMINAL PENALTIES FOR GROUP HOMES DIRECT SERVICE PROVIDERS AND RELATIVES TO
• SERVICE PROFESSIONAL SELF ADMINISTRATION ADVICES AND ALLOWS UNLICENSED DIRECT SERVICE PROFESSIONAL DIVIDERS
• AND THE SUCCESS RATE OF TRANSITIONING PATIENTS FROM ACUTE CARE TO COMMUNITY BASED SERVICES.
• BUT IT IS A STEP IN THE RIGHT DIRECTION TO ENSURE THAT WE DON'T HAVE BREAKS IN CARE FOR FLORIDA'S MOST

Keywords: 999, senate, all

Transcript Highlights:

• No, whatever service that they're providing, this is allowing them as a health care professional to do
• So we're not necessarily talking about direct access or autonomous care in that capacity.
• the health care facilities will say, I can't bill for your services, and that's it.
• the health care facilities will say, I can't bill for your services, and that's it.
• system because the health care system will say, I can't bill for your services.

Committee: House Health and Mental Health

Keywords: 959, house, all

Transcript Highlights:

• And may increase costs of charity care.
• appropriate competencies to care for the patient.
• to staff and provide these services with nurses.
• and hospitals on specialty care patients such as neonatal intensive care.
• Physicians to provide direct supervision of virtual, direct, real-time interactive audio and video technology

Summary: The House Health Care and Wellness Committee held public hearings on several bills. HB 2152 would allow terminally ill qualifying patients to use medical cannabis in hospitals, nursing homes, and hospice facilities under facility policies that prohibit smoking/vaping, require patient self-administration and secure storage, and allow facilities to suspend compliance if federal enforcement arises. The prime sponsor and supporters, including family members, cannabis advocates, nurses, and hospital-related groups, described the bill as a compassionate end-of-life measure based on California’s Ryan’s Law; the Washington State Hospital Association asked for clarifying amendments to limit the bill to inpatient beds and to bar staff from retrieving cannabis as well as administering it. HB 2122 would require hospitals, starting in 2027 and during flu season, to offer influenza vaccines to inpatients age 65 and older and to inpatients with chronic health conditions when not contraindicated. The sponsor and supporters from diabetes, infectious disease, AARP, and public health emphasized rising flu deaths, the benefits for high-risk patients, and the chance to reduce severe illness and costs. The Washington State Hospital Association supported the goal but said the bill would create an unfunded mandate and requested amendments related to vaccine availability, emergency declarations, and operational flexibility. One witness from Informed Choice Washington opposed the bill but suggested adding vaccine information statements to strengthen informed consent. HB 2110 would change staffing rules for inter-facility specialty care ambulance transports so a registered nurse without EMT certification could satisfy the personnel requirement when no paramedic or EMT-certified nurse is available, provided an EMT-certified EMS provider is in the ambulance and the nurse has appropriate competencies. Rural hospitals and ambulance providers said the current rule delays transfers and can force long waits or air transport, while the Washington State Nurses Association supported the concept but raised concerns about standardized training, medical oversight, and staffing impacts on hospitals. HB 2113 would update radiologic technologist supervision rules for IV contrast and other procedures, allowing virtual direct supervision for contrast procedures and supervision by physicians, APRNs, or PAs in some cases; supporters said it aligns with current practice and improves rural access, while radiology groups asked for a distance/proximity requirement for virtual physician supervision. HB 2168 would require the Department of Health to rapidly share overdose data from the state EMS information system to ODMAP within 24 hours, with privacy protections and limits on law-enforcement use. Supporters from Yakima County, public health, and the poison center said near-real-time overdose mapping would improve spike alerts, prevention, and response, and could save lives; the Washington Poison Center asked that its data be included and that the bill clarify language around opioid versus other overdoses. No votes or final committee actions were taken in the hearing; the meeting ended after public testimony on HB 2168.

Transcript Highlights:

• So coverage is provided for acute care services.
• We have managed care and fee for service.
• of of our managed care service delivery model.
• direct care. services for children in foster care, and I'll explain a little bit more about that.
• Um, and then also, the rate methodology really aligns the cost of- care to quality foster care services

Committee: House Appropriations

Keywords: 1184, house, all

Transcript Highlights:

• urgent medical... $653,000 for specialized services, including urgent medical and mental care and expanded
• They have services somewhere else.
• Next, Senator Chair Trumbull, health care. Chair Trumbull, health care.
• Next, Senator Chair Trumbull, Health Care. Chair Trumbull, health care.
• Senator Trumbull, health care?

Summary: The Senate convened with prayer and the Pledge of Allegiance, then moved to the conference report on House Bill 501E, the General Appropriations Act for fiscal year 2026-27. Budget chairs presented the major spending areas, describing a $114.5 billion overall budget that they said was fiscally responsible and below the prior year’s spending. Highlights included pay increases and retirement adjustments for public safety employees, education funding for K-12, higher education, health and human services, criminal justice, transportation, environmental programs, and agriculture/regulatory agencies. Members then questioned chairs on several items. In education, senators discussed K-12 declining enrollment funding, teacher salary set-asides, private school scholarship spending, mental health funding, preeminence funding for universities, the Hamilton Center at UF, and charter school PICO funding. In health and human services, questions focused on the iBudget waiver waitlist, provider rates, ADAP/HIV funding and the return of Biktarvy to the formulary, KidCare, rural health funding, SNAP-related IT and error reduction efforts, and the IDD managed care program. In criminal justice, senators asked about correctional officer pay, prison staffing and infrastructure, air conditioning in prisons, juvenile justice facilities, law enforcement recruitment, and court system funding. Environmental and transportation questions covered Florida Forever, water quality, state parks, water projects, housing, elections funding, and emergency management. Several specific actions and explanations were given during debate: the budget includes $8.8 million for state attorney competitive area differentials but no funding for public defender CAD requests; assistant state attorneys will start at $70,000 and assistant public defenders at $65,000; the battery disposal issue was described as a temporary study/preemption approach; and the Senate said the budget does not fund Medicaid expansion, preeminence funding, or the SunBucks Summer EBT state share. Senators also noted that some proposals discussed in committee did not make it into the final budget. The transcript ends with debate statements from members praising the budget process and Chair Hooper, while also expressing concerns about public schools, health care access, affordability, and the lack of funding for certain priorities.

Transcript Highlights:

• Efforts to dismantle health care, undermine reproductive health services, and strip away critical protections
• Efforts to dismantle health care, undermine reproductive health services, and strip away critical protections
• Efforts to dismantle health care, undermine reproductive health services, and strip away critical protections
• to quality, affordable care.
• to quality, affordable care.

Keywords: U.S. House of Representatives Floor Proceedings on Monday, April 20, 2026, 1012, house, all

Transcript Highlights:

• The structure of health care delivery, one that would include current services and facilities offered
• and uh that that stop that um service and uh that that stop that um directive<00:29:35.360><c> on</c
• That's the child care services division, child safety and services division, child safety and permanency
• and child foster care settings and the program integrity units for the children and family services
• </c> transferring um that's the child care transferring um that's the child care services<01:40:44.560

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• This means a lot less money going to direct care and more spent on paperwork.
• This means a lot less money going to direct care and more spent on paperwork.
• A lot less money going to direct care and more spent on paperwork.
• as adult health care services and not having that respite care, as well as the cognitive connections
• This threat to staffing, service delivery, and long-term sustainability of care is serious.

Summary: The Assembly Budget Subcommittee on Accountability and Oversight held its fifth hearing of the year to examine the newly enacted federal H.R. 1 and its effects on California. Members and the chair described the law as a major threat to state health, food, education, and climate programs, and emphasized that California would not be able to fully backfill the federal cuts. Several members also highlighted the bill’s tax provisions, including temporary deductions for tips, overtime, seniors, and auto loan interest, while warning that the largest benefits flow to higher-income taxpayers and that major cuts to Medi-Cal, CalFresh, and clean-energy incentives are delayed or phased in over time. The Legislative Analyst’s Office and the Department of Finance presented detailed overviews of the bill’s likely impacts and implementation timelines. They identified the main affected areas as health care coverage and financing, food assistance, higher education, personal income taxes, and clean-energy/electric-vehicle credits. They explained that H.R. 1 limits provider taxes used to finance Medi-Cal, adds work and redetermination requirements, restricts CalFresh eligibility and increases state costs, changes student loan and Pell Grant rules, extends and modifies federal tax provisions, and phases out many clean-energy credits. Finance also noted major rescissions of Inflation Reduction Act funds, new border and immigration enforcement spending, and the possibility of PAYGO sequestration if Congress does not act to offset the deficit increase. During member questions, the committee focused on likely enrollment losses, administrative burdens, and fiscal exposure for the state and counties. Witnesses said many details still depend on federal guidance, but they estimated significant impacts on Medi-Cal, CalFresh, and graduate/professional student borrowing, and noted that California’s high CalFresh error rate could increase state costs. UC testified that the elimination of Graduate PLUS loans would affect thousands of professional students, especially in health, law, and other high-cost programs. Members asked for follow-up data on county, health, and tax impacts, and staff agreed to provide additional tables and estimates as implementation guidance becomes clearer. Public commenters from counties, early childhood advocates, health coalitions, disability rights groups, immigrant-rights organizations, and other stakeholders urged the Legislature to mitigate the law’s effects. They warned of higher county costs, reduced access to health care and food assistance, increased administrative burdens, and harm to children, immigrants, people with disabilities, and low-income families. Several urged new state revenue solutions and stronger protections for Medi-Cal, CalFresh, child care, and home- and community-based services. No votes were taken; the hearing was informational and ended with a commitment to continue monitoring federal guidance and to work on state responses in the budget process.

Transcript Highlights:

• It depends on the mix of services they offer, how much uncompensated care they have, and their patient
• It depends on the mix of services they offer, how much uncompensated care they have, and their patient
• It depends on the mix of services they offer, how much uncompensated care they have, and their patient
• c> payment</c> directed an additional directed payment directed an additional directed payment pool<00
• </c> help rural Health Care help rural Health Care Services<02:07:11.639><c> okay</c><02:07:12.360><c

Committee: Senate Finance

Keywords: 1191, senate, all

Transcript Highlights:

• The first service is individual directed goods and service. This is a relatively small cut.
• The third item is a reduction of self-directed service. That we will be removing from the waiver.
• sit on the rate range compared to other services and the direct support wage that is being paid for
• sit on the rate range compared to other services and the direct support wage that is being paid for
• That act requires states to implement EVV for all personal care services and home health care services

Summary: The Budget Committee heard the Department of Mental Health’s FY 2027 budget presentation, with Director Valerie Hoon outlining a $4.4 billion department budget, including $1.7 billion in general revenue, and describing the department’s roles in substance use, behavioral health, and developmental disabilities services. Early questioning focused on marijuana-related mental health impacts, but the main discussion centered on the department’s new decision items, funding sources, and expected wait lists. The director explained several increases tied to Medicaid growth, mental health youth services, outpatient competency restoration, crisis residential services, developmental disability waivers, and provider tax adjustments, along with offsets such as reduced wraparound funding at the Kansas City Assessment and Triage Center and cuts to some youth and self-directed DD services. A major portion of the hearing focused on competency restoration for people found unfit to stand trial and currently held in county jails. Members pressed the department on the cost, effectiveness, and legal implications of keeping people in jail while awaiting services, noting a reported wait list of roughly 524 to 538 individuals and average holds of about 14 months. The department said it currently has eight outpatient competency restoration beds in the community, is seeking funding for 50 additional outpatient slots, and also operates jail-based restoration for about 40 people at a time. Members repeatedly asked for breakdowns of violent versus nonviolent cases, success rates, cost per person, and the split between state and federal funding, while the department explained that Medicaid can cover only the treatment portion, not residential housing or other non-billable costs. The committee also discussed broader capacity constraints in state hospitals and developmental disability services. Hoon said Fulton, Center for Behavioral Medicine, and FTC North are full, with 183 vacancies across the department, and that the department is working on a new Kansas City hospital that would add 150 beds, though completion is now expected closer to 2029 or 2030. In the developmental disabilities section, the department warned that the governor’s recommendation would create wait lists for in-home waiver services and crisis residential services, and members questioned proposed reductions to self-directed services rates and other provider payments. No votes were taken, and the committee recessed before finishing the presentation.

Transcript Highlights:

• And there is a pathway to care.
• </c> And there is a pathway to care. And there is a pathway to care.
• We also are expanding the services.
• Our goal is to move life of service.
• </c><00:09:44.959><c> right</c> getting these guys the services right getting these guys the services

Keywords: 1183, house

Transcript Highlights:

• to, Medicaid and child care service programs.
• So again, across fee for service and your managed care.
• So again, across fee for service and your managed care.
• is that service is in managed care.
• You all are consumer directed and fee for. Service directive.

Committee: Senate Health & Human Services

Summary: The Senate Committee on Health and Human Services convened to discuss interim charges regarding fraud, waste, and abuse in Texas human services, particularly focusing on Medicaid and childcare programs. The meeting highlighted the importance of preventing misuse of taxpayer funds, with testimony from various stakeholders emphasizing the need for increased oversight and accountability in these programs. Key points included the alarming rise in healthcare fraud in other states, the necessity for Texas to enhance its fraud prevention measures, and the potential financial repercussions of failing to meet federal compliance standards. Several committee members expressed concerns about the impact of fraud on vulnerable populations, particularly those relying on Medicaid services. Testimonies from experts underscored the effectiveness of Texas's Office of Inspector General (OIG) in combating fraud, yet pointed out existing vulnerabilities, such as inconsistent enforcement and the need for better data sharing among agencies. The discussion also touched on the challenges faced by hospice care providers, with a significant increase in the number of hospices in Texas raising concerns about quality and oversight. The committee heard from various witnesses, including representatives from health plans and advocacy organizations, who provided insights into the complexities of managing Medicaid and the importance of maintaining program integrity. The meeting concluded with a commitment to further explore legislative solutions to enhance oversight and ensure that resources are directed to those in genuine need.

Transcript Highlights:

• Section 1 of Senate Bill 2249 directed this study of historical health care mandates.
• services, including oral and vision care.
• Consumer direct-to-consumer modalities for health care is growing.
• Medication, consumer direct-to-consumer modalities for health care is growing.
• You will see that for dental care... ...services in dark blue, broken down by age group.

Keywords: 908, all

Summary: The committee met to review the history and current treatment of North Dakota health insurance mandates, with presentations from Blue Cross Blue Shield of North Dakota, Sanford Health Plan, the Public Employees Retirement System (PERS), and the Insurance Department. The discussion focused on how mandates apply differently to fully insured, self-funded, ACA, Medicaid, and PERS plans; how the state’s benchmark plan and federal essential health benefits affect coverage; and how the existing process requires cost-benefit analysis and, for certain measures, a PERS pilot period before broader application. Presenters also reviewed the long list of existing state mandates, including provider, beneficiary, and coverage requirements, and noted that many were enacted decades ago and have not been revisited despite changes in medical evidence and treatment options. Witnesses from the carriers argued that mandates should be reviewed periodically because some are outdated, can create unintended costs, and may not align with current medical guidance. Examples cited included PSA screening, off-label drug coverage, prior authorization rules, step therapy, and cost-sharing provisions for mental health and substance use treatment. They emphasized that carriers often cover services without a mandate when supported by clinical evidence, and that mandates can shift costs to employers and employees, especially in the fully insured small-group market. They also suggested possible policy improvements such as clearer mandate definitions, better transparency around cost-benefit analyses, a regular 10-year review of mandates, and more timely submission of proposals through the interim process. PERS and the Insurance Department highlighted a recurring tension over what counts as a mandate and when a measure triggers the state’s defrayal obligation under federal law. PERS described its interim committee process, the April 1 deadline for fiscal-impact proposals, and the limited pilot program used for certain measures, noting that only a few bills have gone through the full pilot process. The Insurance Department explained that it views new benefit mandates through the lens of the ACA benchmark plan and essential health benefits, distinguishing true new benefits, such as infertility coverage, from changes to existing benefits, such as telehealth or insulin cost-sharing caps. No votes were taken on policy changes; the meeting was informational, with members asking questions about costs, applicability, transparency, and whether a periodic mandate review should be established.

Transcript Highlights:

• No, whatever service that they're providing, this is allowing them as a health care professional to allow
• So we're not necessarily talking about direct access or autonomous care in that capacity.
• But I believe CMS, the Center for Medicare Services, will say, "We don't direct independent insurance
• system because the health care system will say, I can't bill for your services.
• would be providing that care and able to bill for the services that they are allowed to bill for because

Committee: House Health and Mental Health

Summary: The committee first heard House Bills 2365, 2490, and 2249, a bipartisan version of Elijah’s Law, which would require child care facilities to receive training and guidance on recognizing and responding to food allergies and anaphylaxis. Sponsors described the bill as a response to the death of Elijah, whose daycare did not administer epinephrine quickly enough after a food exposure. Witnesses in support, including a parent and food allergy advocate, said the measure would improve preparedness and save lives. Committee members asked about whether the bill should use broader epinephrine terminology, whether the requirements could also be handled through child care licensing rules, and whether the bill was already included in a larger measure. No opposition was presented, and the hearing on those bills was closed. The committee then heard House Bill 1965, which would require insurers to reimburse athletic trainers for covered services and add athletic trainers to the practitioner definition for billing purposes. The sponsor and athletic training witnesses said the bill would recognize athletic trainers as licensed health care providers, improve access in rural and underserved areas, and allow reimbursement when trainers work in clinics, hospitals, or other non-school settings. Committee members raised repeated questions about the difference between athletic trainers and physical therapists, whether school-based services were already paid through contracts, whether the bill would increase costs or create double payment, and how diagnosis and billing would work under the current scope of practice. Opponents from Blue Cross and Blue Shield of Kansas City and the Missouri Insurance Coalition argued the bill would create a mandate, increase costs, and expand billing before clarifying the underlying scope of practice. No vote was taken in public hearing. The committee then moved into executive session and voted several bills do pass. A substitute was adopted for House Bill 1826 and the committee substitute for House Bills 1826, 2560, 2349, and 2194 passed 17-0. House Bill 1783 also passed 17-0. House Bill 2372, which incorporated multiple related provisions including changes to epinephrine terminology and other committee items, passed 17-1 after a substitute and amendment were adopted. House Bill 1827, the occupational therapy bill related to disabled placards and license plates, passed 18-0. The committee then returned to public hearing and heard House Bills 1941 and 2279, which would prohibit copay accumulator programs for fully insured plans so that third-party assistance counts toward a patient’s deductible and out-of-pocket maximum. Sponsors and a rheumatologist testified that the bills would prevent patients with serious illnesses from being forced to pay the same deductible twice and said similar laws have been enacted in many other states. Opponents from America’s Health Insurance Plans argued the measure would affect only a minority of plans, raise costs in the individual and small-group market, and could worsen affordability for remaining enrollees. The hearing ended without a vote on those bills.

Transcript Highlights:

• Um the first direct care and treatment.
• at some direct care and clients at some direct care facilities.<00:34:28.720><c> that</c><00:34:29.119
• Um so there's direct care and treatment.
• and</c><00:59:05.680><c> the</c> direct care staff retention and the direct care staff retention and
• It's not a child care based service.

Keywords: 1187, senate, all

Transcript Highlights:

• This only deals with the foster care youth.
• direct donor blood.
• direct donor is a blood relative.
• donor blood, and every individual deserves the right to direct their medical care to the furthest extent
• about or a person they really care about.

Summary: The Senate Health and Welfare Committee began with introductions of three new Senate pages, who briefly described their backgrounds and interests. The committee then approved the minutes from February 3rd by voice vote. The first bill heard was House Bill 558, which would codify protections for foster youth’s Social Security survivor benefits so those funds remain with the child rather than being used by the state. The sponsor and committee members discussed that the bill would align state law with an existing executive order, clarify that it applies only to foster youth, and help young people transition out of foster care. After questions about fiscal impact and how the benefits work, the committee voted to send HB 558 to the floor with a due pass recommendation. The committee then took up House Bill 528, dealing with directed and autologous blood donations. Supporters said the bill would clarify Idaho law, protect patient choice, and address reported barriers to obtaining directed donations for planned procedures. Opponents, including Red Cross and blood center representatives, argued the bill was unnecessary because such donations are already allowed, could create confusion, add cost, and imply the general blood supply is unsafe. After extensive testimony from medical professionals, patients, and advocacy groups on both sides, the committee voted to send HB 528 to the floor with a due pass recommendation, with one member requesting to be recorded as opposed.