Transcript Highlights:

• </c> school funding of of uh of services. school funding of of uh of services.
• </c> a medically necessary covered services a medically necessary covered services service<00:55:23.280
• </c> receive a related service like speech. receive a related service like speech.
• They have an obligation to provide the services, and they have no one to provide the services.
• services? services? &gt;&gt; I'm<01:23:21.280><c> sorry.

Keywords: 1189, house, all

Summary: The commission to study special education costs under SB 57 met for its second meeting, with members introducing themselves and reviewing background materials on New Hampshire special education identification rates, NAEP results, and a Wall Street Journal article about the rise in autism diagnoses. The chair explained that the commission is examining special education aid formulas, including how New Hampshire’s current catastrophic aid threshold works and how changes to that threshold might affect school districts, but noted that the needed data on how many students would shift into the aid system at lower thresholds is not yet available. The main testimony came from Henry Litman of HHS on Medicaid reimbursement in schools. He explained that school-based Medicaid funding is tied to health-related services, not all special education services, and that federal rules are changing in state fiscal year 2027. Under the new approach, schools will move away from an in-kind methodology to a certified public expenditure model that may also allow recovery of some overhead costs, such as support staff time. He said the state won a federal grant to help build the new system, hired a vendor, and is setting up training and a help center for districts. Members asked about why Medicaid claims have declined and whether districts are leaving money on the table. Litman said claims are down about 25% from pre-pandemic levels, with declines tied to federal and state rule changes, documentation requirements, provider qualification rules, and the end of temporary pandemic flexibilities. He said some districts adapted better than others depending on local medical-provider access and administrative capacity. He also said the new federal legislation does not directly affect schools, while New Hampshire’s return to pre-pandemic eligibility rules has reduced enrollment somewhat. No votes were taken, and the discussion ended with agreement that the commission needs better data to determine how much special education spending is truly Medicaid-eligible and whether additional legislation is needed.

Transcript Highlights:

• fee-for-service rate.
• fee-for-service rate.
• fee-for-service rate.
• . services. services.
• </c> services OB. services OB.

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.

Transcript Highlights:

• </c> their they their services are based their they their services are based premised<00:26:00.080><c
• </c> provide services there. provide services there.
• </c><00:51:59.280><c> The</c> Who delivers the service? The Who delivers the service?
• service? service?
• </c> forward for placement services etc. forward for placement services etc.

Keywords: 928, house, all

Summary: The commission met to continue its study of the cost of special education, with the chair emphasizing that the group needs to narrow its focus over the coming year toward specific cost drivers, including the IEP process, Medicaid, charter schools, and EFAs. Members reviewed a draft first report due November 1 and agreed it would be a brief synopsis of prior meetings, with minutes attached. The September 30, 2025 minutes were amended to correct the number of federally funded department staff from 234 to 23, and to revise language about Senator Sullivan’s comments so they reflected concerns about IEP advocates and fees charged to families rather than support for the concept. The amended minutes were then approved unanimously, with abstentions noted for members who were absent. The main presentation focused on how special education costs are handled for students attending charter schools. The DOE representative said there are 804 students with disabilities in charter schools across 88 of the state’s 176 districts, and that the district of residence remains responsible for all services and costs. She explained that students must meet IDEA criteria through district evaluation and parent consent, and that services are determined through individual IEP meetings rather than by a blanket charter-school decision. Members asked how those costs are tracked, whether any students are merely “monitored,” and whether districts separately identify charter-school special education expenses; the answer was that most districts fold those costs into their overall special education budget, though some may break them out as a line item. The discussion then turned to transportation and mileage costs for staff providing services at charter schools. Testimony indicated that districts may use their own staff, contract staff, or contract with a charter school for certified services, and that travel costs are often either built into contracts or absorbed as part of staff time rather than separately reimbursed. Members questioned whether mileage is reimbursed when staff travel to distant charter schools and whether those costs can be isolated in district budgets; the response was that practices vary by district and are not usually broken out by special education function. Several members argued this makes it difficult to determine the true cost of delivering special education, especially given New Hampshire’s model in which the district of residence pays regardless of where the charter school is located. The chair noted the complexity of the system and compared it to the state’s separate tuition and transportation approach for career and technical education centers.

Transcript Highlights:

• These services include overseeing the state's annual purchasing of $3.7 billion in goods and services
• </c> capital and veteran services capital and veteran services organization<00:19:02.200><c> space</c
• services, cybersecurity services, and connectivity-type services.
• disrupt services in government.
• connectivity type services but services connectivity type services but really<00:32:51.720><c> the</

Keywords: 1187, senate, all

Transcript Highlights:

• Alcohol and drug counselors provide counseling services to persons seeking services to address substance
• </c> including the administrative Services including the administrative Services Unit<00:04:03.120><c
• Services Services Program<00:04:08.480><c> it</c><00:04:08.599><c> is</c><00:04:08.799><c> important
• ><c> address</c><00:04:54.080><c> substance</c> seeking services to address substance seeking services
• </c> importance of mental health services importance of mental health services which<00:10:29.480><c>

Keywords: 1183, house

Transcript Highlights:

• residential services, that Medicaid reimburses.
• We reimburse for psychiatric services, mental health services, and in psychiatric hospitals or in psychiatric
• A specific provider type for substance use disorder services for adolescents, for residential services
• We reimburse for psychiatric services, mental health services, and in psychiatric hospitals or in psychiatric
• It is a way in which we verify the services, the start date, start time, end time, date, place of service

Keywords: 1204, all

Transcript Highlights:

• Regarding service centers, this calendar year the RMV will be moving three service center locations to
• The RMV also services business customers at our service centers through a drop-off service.
• hours, weekend services, and route expansions continuing across RTA service areas.
• We've also launched permanent extended service on all service lines and eight frequent bus routes on
• the expanded service hours.

Keywords: 995, all

Summary: The Joint Committee on Ways and Means held a hearing at UMass Amherst on Governor Healey’s fiscal year 2027 budget, focusing on energy/environment-related transportation issues and the Massachusetts Department of Transportation. The chairs and members opened with thanks to UMass, university leadership, court officers, and legislative staff, and Chancellor Javier Reyes highlighted UMass Amherst’s research, workforce, sustainability, and transportation contributions, including energy research, transit operations, and partnerships with MassDOT. The hearing then moved to MassDOT and MBTA testimony on the administration’s transportation funding package, including House 2, the FY26 Fair Share supplemental, and a proposed four-year Chapter 90 authorization. MassDOT officials described the budget as part of a broader multi-year transportation investment strategy, citing funding for operations, snow and ice removal, regional transit authorities, the MBTA, the Merit Rating Board, sustainable aviation fuel credits, micro-transit and last-mile grants, unpaved road improvements, bridge and pavement work, and housing-related transportation infrastructure. They emphasized workforce expansion, capital delivery capacity, safety improvements, and local aid, including the new lane-mile-based Chapter 90 formula intended to benefit rural communities. Officials also discussed major projects and programs such as Grant Central, culvert and unpaved road grants, work zone speed cameras, congestion hotspot fixes, the Sagamore and Bourne Bridge projects, and MBTA operating support and safety upgrades. Testimony from the MBTA and rail/transit staff focused on improved ridership, service frequency, accessibility, and safety, including progress on the Green Line Train Protection System, reduced delays, expanded bus and commuter rail service, and the South Coast rail extension. Regional transit authorities reported increased ridership and described new fare-free, connectivity, and community transit grants. Aeronautics testimony covered airport capital work, drone and data programs, sustainable aviation fuel efforts, and workforce development in aviation maintenance. Committee members then asked questions, especially about Western Massachusetts priorities, Chapter 90 funding, bridge repairs, snow and ice costs, Cape Cod bridges, Buzzard’s Bay rail, and Compass Rail/West-East Rail. Officials said several federal rail grants were moving forward, that Sagamore Bridge procurement would begin soon, and that the administration remained committed to pursuing federal funding and multi-year transportation investments.

Transcript Highlights:

• All of the services provided through Seven Counties are outpatient services.
• But for substance use services, the services are offered across the continuum.
• So, we're talking about different types of treatment services, recovery services, harm reduction services
• But for substance use services, the services are offered across the continuum.
• So, we're talking about different types of treatment services, recovery services, harm reduction services

Keywords: 958, all

Summary: The committee first approved the August 12 minutes and then handled a large agenda of 355 contracts totaling about $278.7 million. It agreed to defer three Office of Energy Policy items to the October 2025 meeting and reviewed a deferred Kentucky Educational Television contract without objection. The main substantive discussion centered on two University of Louisville legal services PSC amendments and a Seven Counties Services MOA item. For the University of Louisville items, members questioned a large increase in hourly rates and the scope of the legal services, especially complex litigation work and a Colorado estate matter. University officials said the contracts followed an RFP, involved specialized litigation, included local counsel where required, and were expected to be offset by savings in other PSCs and by a potential financial recovery in the Colorado matter. The committee also discussed whether the $125 hourly rate was a statutory requirement or committee policy; the chair later said staff would verify whether it was an executive-branch regulation or statutory rate. Both University of Louisville items were ultimately approved, though Senator Meredith voted no on one and Senator Douglas explained his support while urging future adjustments and more information sharing. The Seven Counties Services contract drew questions about how the $18.7 million would be used and whether federal changes could affect future funding. Cabinet officials described 988 crisis response, outpatient mental health and substance use treatment, prevention, recovery, and harm-reduction services, and said they were monitoring federal developments daily. Representative Petrie and Senator Thomas pressed the cabinet on the long-running Seven Counties bankruptcy and the need to push for resolution; officials said the matter was pending on a motion for reconsideration and that they would try to help move it along. The contract was approved. At the end of the meeting, the committee approved the remaining agenda items as reviewed without objection, but Senator Meredith voted no on the blanket approval motion because of numerous retroactive contract requests and what she said were insufficient explanations such as administrative error or staff being on conference. She said retroactive approvals should be rare and supported stronger internal controls.

Transcript Highlights:

• And the last way that the department provides these services is through direct service provision at the
• If the member needed other medical services provided by Hartview's physician, for example, those services
• This slide shows Medicaid payments for residential services and outpatient services over the past five
• We've increased payments for residential services by over 1,700% and payments for outpatient services
• For outpatient services by about 84%.

Summary: The committee met at Spirit Lake Tribe and first heard welcoming remarks and introductions from tribal leaders and program directors. Chairwoman Street and other tribal representatives outlined a range of concerns and requests for state action, including taxation of reservation lands, support for non-beneficiary students at the tribal school, homelessness funding, Indian-managed health care, gaming and e-tabs, Feather Alert improvements, industrial farming near waterways, tourism, and better state-tribal consultation. Committee members responded that the meeting was intended to improve understanding and communication, and several members suggested future legislation or resolutions could be used to advance some of the issues. The tribe also offered to provide training on treaties, IHS 638, and compact services to legislators and staff. A major portion of the discussion focused on Spirit Lake fish and wildlife jurisdiction and the lake boundary. Tribal representatives asked for an MOU or co-stewardship agreement with the state to clarify hunting and fishing rights, recognize tribal licenses, and reduce recurring disputes over “gray areas” on the reservation and lake. Committee members discussed whether to draft a bill or resolution directing the executive branch and state agencies to negotiate such an agreement, and asked that North Dakota Game and Fish be invited to a future meeting. Related concerns included aquatic nuisance species prevention, with both sides agreeing that more aggressive boat inspection and cleaning measures would be beneficial. The committee also discussed taxation and county relations. Tribal leaders raised concerns about county resistance to fee-to-trust transfers and about property and vehicle taxation affecting members living on or near reservation lands. Committee members and tribal counsel reviewed federal treaty principles and court cases, and one member noted that the committee had previously taken no formal action on similar issues. Later, Benson County’s tax equalization director explained how the county values taxable land, handles inundated land applications, and tracks land coming off the tax rolls when the tribe repurchases acreage. The discussion ended with a presentation from the president of Sisseton Wahpeton College, who described the college’s programs, economic impact, and funding needs, followed by an HHS presentation on 1115 Medicaid waivers and the IMD exclusion as the committee moved to its next topic.

Transcript Highlights:

• </c><00:09:56.320><c> in</c> a hospital ER and medical services in a hospital ER and medical services
• Our mission is to advance equity by addressing the lack of social service services in our communities
• Your support of our GIA request... services to our state holders these services to our state holders
• </c> not present the alcohol rehab Services not present the alcohol rehab Services of of of Hawaii<01
• The first is our shelter services.

Keywords: 912, senate, all

Summary: The joint Ways and Means and Finance informational briefing on grants and aids was held February 14 and was organized as a high-volume public testimony session with strict procedures: no Q&A, one representative per applicant, one minute per testimony, in-person testimony first, and then Zoom participants. The chairs also announced a recess at 11:00 a.m. for floor sessions and a reconvening at 1:00 p.m. Testimony was heard first from neighbor island applicants, then Oʻahu applicants, with members repeatedly directing speakers to line up and keep remarks brief. Neighbor island testimony focused on a wide range of capital and operating requests. Health and community projects included Hawaii Island Community Health Center’s workforce housing in Kau, Wuli Hawaiian Homestead Association’s learning center and predevelopment work, Rescue Tube Foundation’s beach rescue tube expansion, Puna Community Medical Center’s planned hospital/ER campus, Maui Humane Society’s free veterinary care after the wildfires, Hawaiʻi Care Choices’ palliative care readiness, and the Lyman Museum’s HVAC replacement. Other requests included the Maui Advanced Manufacturing Alliance’s Pāʻia Mill redevelopment, Laua 2020’s preschool and learning lab, Mālama Aina’s USDA-compliant meat processing facility, the Hawaiian Lifeguard Association’s water safety programs, Kaha P Organization’s agriculture education support, Ohana Arts’ youth performance project, Friends of the Children’s Justice Center’s emergency closet, EOA Pacific’s Marshall Islands teacher training, and the Central Pacific Youth Athletic Club’s new facility. Oʻahu testimony included the YWCA Oʻahu/Pythink Center’s renovation of Juliet M. Atherton Hall and its community kitchen, West Oʻahu Community Health Center’s wildfire protection and security needs, the Early School’s playground improvements, Surfing the Nations’ food distribution center expansion, and Sounding Joy Music Therapy’s weekly services for people with disabilities. Speakers generally emphasized community benefit, workforce development, health access, food security, disaster recovery, and support for children, seniors, and underserved populations. No votes or formal committee actions were taken during the briefing.

Transcript Highlights:

• This is a core for human services staff.
• , fleet, and food service.
• This is the core for reentry services.
• It depends on which service provider they're using.
• One of the providers is RePath, or eHawk Services, and the other one is Total Court Services, or TCS.

Keywords: 959, house, all

Transcript Highlights:

• . services to our citizens.
• Who was providing that service?
• There's simply not enough legal service providers to meet the needs.
• Emelyn Shabbard with the California Disability Services Association.
• Name and affiliation, please. services in the Inland Empire.

Keywords: 988, house, all

Transcript Highlights:

• </c><00:10:50.720><c> that</c> operation like for example services that operation like for example services
• We provide funds to Social Services, transfer funds to the Social Services Grant, and then of course
• We provide funds to Social Services, transfer funds to the Social Services Grant, and then of course
• </c> of the services of the services provided<01:29:28.679><c> uh</c><01:29:28.800><c> it's</c><01:29
• Contracts for program services. I'm sorry. Yes, you have zero in services. I'm sorry.

Keywords: 928, house, all

Summary: The committee held a Division 3 budget work session focused on the Department of Health and Human Services’ Division of Economic Stability. Karen Hebert, the division director, and Nathan White, DHHS chief financial officer, walked members through the governor’s operating budget pages and a briefing book, explaining that the division was consolidated in 2018 and serves programs aimed at financial stability, poverty reduction, child care access, and related supports. Members repeatedly asked for clearer breakdowns of general fund spending, historical growth since consolidation, and how the division’s broad mission areas map onto specific budget lines. A major portion of the discussion centered on the Bureau of Child Development and Head Start collaboration and the child care subsidy program. Hebert said the child care scholarship/subsidy helps low- and moderate-income families access daycare so parents can work, attend school, or receive treatment, and that eligibility is based on state median income up to 85%. She reported a 45% increase in utilization, 4,032 children receiving daycare support as of the end of January, and about 15% of eligible children being served. She also described the quality improvement system “Granite Steps for Quality,” with 160 providers enrolled out of 717 licensed programs, and noted that 1,200 child care professionals added credentials in the last year. Members pressed for cost-benefit information, asking for data on how much the state pays, how many providers and children are served, and whether the department could quantify unmet need. The witnesses said some projects were funded with short-term ARPA child care dollars and that detailed cost data for specific examples, such as the Gorm Community Learning Center expansion, would need to be looked up. They also explained that the child care fund is a federal block grant with required spending set-asides of 9% for quality, 3% for infants and toddlers, and up to 5% for administration, and that unused funds remain available. The committee also reviewed slide 10’s accounting units, including that the Child Care Workforce Fund is 100% general funds and was created as a priority item under HB 2 from the 2024 session, while some other child care-related units are 100% federal funds.

Transcript Highlights:

• These include certain items and services recommended by the United States Preventive Services Task Force
• For the items, services, and screenings recommended by the United States Preventive Services Task Force
• Services Task Force and by the United States Health Resources and Services Administration, the applicable
• Preventive Services Task Force. However... ...U.S. Preventive Services Task Force.
• Postal Service, common carriers, express companies, and interactive computer services.

Summary: The committee heard testimony on three health care bills. HB 1496 would cap charges for electronically stored medical records at $50 for patients and certain authorized recipients, while removing a free-copy provision tied to SSI/SSDI appeals and changing attorney fee language to “prevailing patient.” Supporters, including patient advocates, attorneys, and injured workers, said current record fees can reach thousands of dollars and block access to justice; opponents, including hospitals, home care providers, and records vendors, argued the bill would not cover the labor and HIPAA compliance work involved in large third-party requests and could shift costs to providers and patients. The bill remained in hearing with testimony continuing after the committee moved through other bills. HB 2182 would change how the Department of Corrections distributes its stockpile of mifepristone and misoprostol, removing the requirement that the medications be sold at cost plus a $5 fee and instead allowing, but not requiring, payment while directing DOC and the Department of Health to coordinate distribution to providers and facilities. The prime sponsor and supporters said the bill is needed so the state’s stockpile does not go unused or expire and to remove barriers to access for abortion and miscarriage care; opponents argued the bill subsidizes abortion, raises legal and taxpayer concerns, and should be rejected. Public testimony on HB 2182 was closed after hearing from both supporters and opponents. HB 2196 would require certain fully insured health plans to cover IVIG for PANS and PANDAS, with initial and medically necessary follow-up courses, and would bar denials based on prior treatment, age, out-of-state care when unavailable in Washington, or treatment guidelines that only address psychiatric symptoms. The sponsor, families, and physicians described severe, sudden-onset symptoms in children and said IVIG can be life-changing after other treatments fail, while insurers warned the mandate could add to already rising premiums and noted the treatment can be very expensive. HB 2242 would shift vaccine and preventive-service recommendation authority from federal bodies to the Department of Health, while preserving no-cost coverage for preventive services and updating the reference date for protected services; the governor, insurance commissioner, public health officials, and many physicians supported it as a way to preserve access amid federal instability and rising vaccine-preventable disease, while questions focused on whether the bill would change school or daycare requirements, which staff said it would not.

Transcript Highlights:

• That House Health and Human Services is too long.
• This bill is only addressing facility fees for specific services, and those services are listed in the
• So the bill is only addressing facility fees for specific services, and those services are listed in
• Those services are listed in the legislation, so they are preventive health care services, including
• services that are provided in a patient's vehicle, vaccination services, and telehealth services.

Keywords: 996, all

Transcript Highlights:

• And FATA became the services arm so that our legacy contracts are under that services arm, including
• So help me to understand: how do you perform these services?
• And then lastly, protective services.
• FDLE's services cover the entire state in certain disciplines and all of our additional services, while
• FDLE's services cover the entire state in certain disciplines and all of our additional services, while

Summary: The Appropriations Committee on Criminal and Civil Justice met to continue its review of performance measurement in the criminal justice system. The first presentation, from State Courts Administrator Eric McClure, described how the court system uses multiple data sources to track filings, dispositions, clearance rates, workload, and support services, and how those data inform judge need, budget requests, resource allocation, and court administration. He also discussed ongoing efforts to improve case-level reporting, the use of case management systems in trial and appellate courts, and performance efforts in problem-solving courts and civil case management. McClure noted that the legislature provides dedicated funding for problem-solving courts and for medication-assisted treatment, and that the courts are required to report outcomes and monitor compliance with contract requirements. Melanie Brown-Whor of the Florida Behavioral Health Association then reviewed the medication-assisted treatment program funded through the courts budget. She said the program combines medication with counseling and behavioral supports, serves people involved in or at risk of criminal justice involvement, and has expanded over time to include additional medications and more counties. She reported improved engagement and retention, with more than 10,000 people screened over five years, about 9,200 receiving medication, and over 6,600 successfully discharged. Senators asked about racial and ethnic demographics, hospital referrals, and how services are delivered; Brown-Whor explained that local community providers deliver treatment under contract and that the program is working to improve data reporting and consistency. The Department of Law Enforcement then presented on investigations, forensics, and criminal justice information services. Deputy Commissioner Vaden Pollard outlined FDLE’s strategic plan and major investigative priorities, including cybercrime, targeted violence, crimes against children, mutual aid, and the SAFE fentanyl eradication program. He said SAFE has led to major seizures, arrests, and a reported decline in fentanyl deaths. Director Jason Bundy described FDLE’s forensic laboratory operations, DNA and rapid DNA capabilities, cold case and missing persons work, and the staffing and turnaround-time challenges tied to complex evidence testing. Director Lucy Saunders reviewed FDLE’s criminal history, biometric, incident-based crime reporting, and criminal justice transparency systems, noting that Florida is still transitioning agencies from summary reporting to incident-based reporting. The committee raised questions about Rapid DNA deployment, cold case coordination, and the slow pace of NIBRS/FIBRS adoption. No votes were taken, and the meeting adjourned after the presentations and questions.

Transcript Highlights:

• fees and in-state services preferences, and clarify requirements for each type of service.
• fees and in-state services preferences, and clarify requirements for each type of service. >> If you
• on sleep disorder service.
• </c><00:20:36.240><c> What</c> services on sleep disorder service.
• What services on sleep disorder service.

Keywords: 958, all

Summary: The committee met with a quorum, approved the prior meeting’s minutes, and then reviewed a series of administrative regulations from multiple agencies. Most of the regulations were presented as technical updates or policy clarifications, and in each case the committee approved staff-suggested amendments without objection. The Department of Revenue regulation would delete a section on tax credits for trusts and estates to align with statute. The Kentucky Public Pensions Authority package updated definitions, sick leave credit rules, hazardous/non-hazardous employment participation, refund procedures, contribution limits, mortality table references, and incorporated federal tax references. The Board of Medical Licensure regulations addressed renewal and activation of inactive physician-assistant licenses and renewal/reinstatement timelines for athletic trainer licenses. The Fish and Wildlife regulations revised rules for Otter Creek and Peabody areas by deleting definitions and creating shooting-range permit exemptions. The committee also heard emergency vocational rehabilitation regulations that would clarify definitions, due process rights, federal compliance, service fees, in-state service preferences, and service-specific requirements; a workforce insurance regulation updating contribution/reporting rules for professional employer organizations; and a horse racing regulation adding license categories for allied animal health professionals, animal chiropractors, and equine dental providers, while updating fees, application timing, and special events licensing. Members asked questions about the horse racing licensure changes, and the agency explained they were responding to prior session changes and adding guardrails, including veterinarian sign-off for equine therapist licensure on the back side of a racetrack. The Department for Public Health package made several personnel and salary-related changes for local health departments, including salary ranges for new hires, probation and evaluation rules, salary increases after probation, and limits on certain leave payouts for employees who separate without proper notice or are dismissed for cause. The Office of Inspector General regulation added electronic prescription references and removed authority to create a new prescription number for partial dispensing of Schedule II prescriptions. The Department for Medicaid Services regulations updated provider group definitions, removed some service limits, required prior authorization for all genetic testing for non-MCO recipients, changed physician fee schedule updates from quarterly to annually, and added reimbursement for department-approved vaccines. Members asked detailed questions about genetic testing prior authorization and sleep disorder coverage; the agency said prior authorization is intended to take two to five days and that sleep disorder services generally involve sleep apnea-related treatments such as CPAP machines and sleep studies. The committee then adjourned and announced its next meeting for Tuesday, May 12 at 1:00 p.m.

Transcript Highlights:

• I mean, that would be huge for our senior services.
• And it's a great service.
• So these local services are helping to bridge the gap.
• We're entertaining this for disability services.
• We're saying we're cutting services for seniors.

Keywords: 959, house, all

Transcript Highlights:

• We started with Children and Family Services. We did county operations.
• through the fee-for-service.
• through the fee-for-service.
• They're an emergency department that has a lot of outpatient services.
• They're an emergency department that has a lot of outpatient services.

Summary: The subcommittee met to review Arkansas DHS hospital spending and reimbursement methods, with Secretary Janet Mann and Deputy Secretary Misty Eubanks explaining Medicaid hospital payments. They described fee-for-service per diem payments, cost settlements, and the upper payment limit (UPL) program, noting that SFY 2025 hospital payments included $688 million in inpatient/outpatient claims, $473 million in UPL payments, $248 million in cost settlements, and about $47 million in other payments such as graduate medical education and disproportionate share hospital funds. Members asked about why per diem rates vary, how cost settlements work, why UPL applies mainly to private hospitals, and how assessment fees are structured and funded. DHS said the hospital assessment fee is broad-based and uniform, used as the state share to draw federal funds, and that supplemental hospital payments after federal match totaled $548 million with no general revenue used. The Arkansas Hospital Association’s Jody Ann Tritt then gave a broader overview of the hospital landscape, explaining the different hospital types in the state, including critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals. She said Arkansas hospitals face financial strain, citing a negative 5.18% patient service margin statewide and lower reimbursement than surrounding states. She argued that Arkansas hospitals are paid less than hospitals in neighboring states for similar services, that commercial payer rates and administrative burdens are a major problem, and that Medicaid and Medicare rates remain below cost even with UPL support. She also said hospitals are the backbone of community care, provide emergency and public health functions, and are looking for ways to invest in technology and telehealth but often lack the revenue to do so. Members pressed for clearer data on hospital finances, reimbursement adequacy, and the impact of commercial insurers. Tritt said the association had just authorized a statewide survey to gather updated financial information from hospitals, which she said would take about a year to complete. She also explained that Medicaid pays weekly, Medicare and commercial plans can involve delays and denials, and that hospitals often spend significant resources on revenue cycle work. The discussion ended with a brief update on assisted living reimbursement: DHS said one facility, The Pillars of the Community in Crossett, had announced closure, nine Living Choices waiver clients were being transitioned, and the updated rate study would be available after cost reports are collected, likely before the end of the fiscal year. The meeting then adjourned.

Transcript Highlights:

• Districts and public charter schools participating in and buying services through these regional service
• You'd come forward and you would say, as a school district, I'm looking to buy into this service.
• instead of some online contracted service with someone that you never meet.
• It would strengthen services to students with disabilities and reduce... Okay.
• It would strengthen services to students with disabilities, reduce, It would strengthen services to students

Keywords: 989, all