Transcript Highlights:

• , CalFresh, CalWORKs, General Assistance, Adult Protective Services, In-Home Supportive Services, and
• , CalFresh, Cal Works, General Assistance, Adult Protective Services, In-Home Supportive Services, and
• We rely on CSBG funding services.
• in those services.
• CSBG also allows us to offer support services and wraparound services to our enrolled customers.

Summary: The Senate and Assembly Human Services Committees held a special oversight hearing on California’s 2026-27 Community Services Block Grant (CSBG) state plan, a federal anti-poverty funding stream. Committee members opened by citing statewide poverty and homelessness data and said the hearing was meant to review how CSBG dollars are used, how local agencies respond to community needs, and how the state is preparing for possible federal funding cuts. Jason Wimbley of the Department of Community Services and Development (CSD) explained that California’s CSBG network works through 60 organizations in 58 counties, serving about 1.5 million low-income Californians in 2023, and that the state received $68.4 million in federal CSBG funds in fiscal year 2025. He described the program as flexible funding used for housing, employment, education, food, health, transportation, and emergency response, and noted that the federal administration had proposed eliminating CSBG, though the Senate Appropriations Committee had voted to fully fund it for the coming year. Representatives from the California Community Action Partnership Association and several CSBG-funded agencies described how the program supports local anti-poverty work and leverages other funding. CalCAPA emphasized local flexibility, workforce development, partnerships, and data systems such as ROMA, while also warning that agencies are preparing for possible reductions by tightening budgets, planning staffing contingencies, and seeking private foundation support. Agency witnesses from Contra Costa County, Northern California Indian Development Council, Proteus, and Sacred Heart Community Service described services including housing assistance, food distribution, utility help, employment training, youth programs, and culturally specific services for Native communities and migrant farmworkers. They repeatedly said CSBG is essential because it funds staffing and infrastructure that allow them to braid other grants and serve people who do not qualify for standard safety-net programs. Members also asked about the impact of federal staffing changes and the Los Angeles fires. Wimbley said federal layoffs had affected some CSD programs but not CSBG administration, and that the department coordinated disaster response with state agencies and used CSBG-funded supply distribution, food, water, clothing, and documentation support during the fires. Witnesses said they were preparing for possible future cuts by diversifying funding, reducing expenses, and considering service changes, while county officials warned that state and federal reductions could not be backfilled locally. During public comment, one speaker urged stronger oversight of community action agencies and raised concerns about transparency and compliance with state law. The chair then thanked the witnesses, emphasized the importance of CSBG for low-income seniors, youth, and people with disabilities, and adjourned the hearing without any votes or formal action taken.

Transcript Highlights:

• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.
• They brought that service in.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to behavioral health as the main topic. Representatives Woodridge and Vaught described the work of the behavioral health working group, saying Arkansas needs a more proactive system that improves access, reduces red tape, and focuses on a few achievable policy changes for the 2027 session rather than many bills. Members discussed barriers such as low reimbursement, workforce shortages, licensing and credentialing hurdles, rural access problems, and the need to better use community providers, compacts, and step-down services. Director Paula Stone of DHS’s Office of Substance Abuse and Mental Health gave a detailed overview of the behavioral health system. She said Medicaid pays for more than 75% of behavioral health services in Arkansas and explained that when people are jailed or admitted to the state hospital, Medicaid generally stops, leaving state general revenue to cover care. She described current efforts including family-centered treatment for children, community reintegration group homes, a new adolescent substance use disorder residential unit, expanded community mental health center contracts, a secured restoration unit to reduce state hospital backlogs, and an IMD waiver to allow Medicaid payment for certain residential services. She also said DHS is working on crisis services, forensic evaluations, and provider rebidding in areas previously served by ERISA. Members asked about reimbursement for jail services, the lack of a statewide behavioral health dashboard, civil commitment options, crisis stabilization units, and whether Arkansas should expand step-down or long-term facilities for people who cannot safely return to the community. Stone said the state hospital backlog remains significant, average stays are still about 14 months, and crisis stabilization units have had mixed success, with Fort Smith and Jonesboro performing better than Fayetteville and Little Rock. The meeting ended with a commitment to continue the work, with more substantive discussion planned for August.

Transcript Highlights:

• Business services supported residential services.
• for your phone service.
• , not just to voice service.
• service standards, right?
• or improve their service.

Keywords: 988, house, all

Transcript Highlights:

• Services, and the Bureau of Family-Centered Services.
• 15% for uh developmental Services 15% for uh developmental services<00:07:57.120> and services
• <00:15:08.959> let for services um funding for services let for services um funding for services
• services in the community.
• those Services um the the major service those Services um the the major service types<01:37:17.119

Keywords: 928, house, all

Summary: The Division of Long-Term Supports and Services presented its budget and program overview as part of the Department of Health and Human Services operating budget review. Leadership described the division’s three bureaus—Aging and Adult Services, Developmental Services, and Family-Centered Services—and explained that the division provides guidance, technical assistance, quality monitoring, and contracted provider oversight across the lifespan. Members also discussed staffing, with reported vacancy rates of 4% in Aging and Adult Services, 15% in Developmental Services, and 6% in Family-Centered Services; the division said the higher BDS vacancy rate is partly due to the small number of authorized positions. The governor’s budget had left eight positions unfunded in the division, including three in Aging and Adult Services and five in BDS. A major topic was the division’s roadmap initiatives, especially building a system of care for healthy aging and strengthening developmental disabilities systems through a new reimbursement rate structure. The division said it contracted with an actuary to study DD service costs and found rates had not been reviewed since 2017 and were significantly below actual costs and other states’ rates, contributing to provider shortages even when services are authorized. Members asked about the impact on service delivery and whether rates would need to rise overall; the division said its strategy is to focus on lower-cost services that help people remain in the community. The division also reported waiver enrollment figures, including about 4,161 people on the Choices for Independence waiver, 3,688 average nursing facility residents, 5,061 people on the DD waiver, 228 on the acquired brain disorder waiver, and 488 children on the in-home support waiver, while noting there is no funding waitlist but provider availability remains a constraint. The division highlighted IT modernization as a major accomplishment, especially moving Adult Protective Services and Developmental Services into the New Heights system. Officials said these changes improve case-note access, data retrieval, service authorization tracking, and transparency for providers, and they asked for future oversight discussion focused on IT leverage. Members noted that New Heights maintenance is budgeted in the Office of the Commissioner under class 27 and suggested better transparency on system costs and benefits. The division also reported that it closed out a long-running CMS corrective action plan for BDS on July 1, 2023, and said it is now focused on strengthening the system rather than compliance alone. Other discussion covered the Aging and Adult Services bureau’s name change from Elderly and Adult Services to Adult and Aging Services, intended to avoid negative connotations and better reflect preventative services. The bureau described Adult Protective Services trends involving scams, financial exploitation, self-neglect, and isolation, and explained that it administers the CFI waiver, determines medical eligibility for nursing facility level of care, and braids funding from Medicaid, state funds, Older Americans Act money, Social Service Block Grants, and other grants. Members asked about waiver growth targets and federal consequences if enrollment remains below projections; the division said it would explain the shortfall in a future waiver amendment and did not anticipate a federal penalty. The meeting ended without any votes or formal actions taken.

Transcript Highlights:

• And so that's a step-down service.
• They provide a service called restoration, but then they also provide some services.
• So here are our adult services.
• So we'll be able to provide that service and pay for that service for individuals.
• services manual.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to a broad discussion of behavioral health policy, taking up work previously handled by a behavioral health working group. Representatives Wooldridge and Vaught described major gaps in Arkansas behavioral health care, emphasizing access problems, workforce shortages, rural service barriers, low reimbursement, and the need to move from a reactive crisis system to more proactive community-based care. Members discussed possible 2027-session priorities such as reducing red tape, improving provider licensing and supervision pathways, expanding billing codes and reimbursement structures, and considering interstate compacts and other workforce fixes. A major focus was the state’s crisis and forensic system, including long waits for competency evaluations, the backlog at the Arkansas State Hospital, and the use of county jails for people awaiting treatment. DHS Director Paula Stone explained that Medicaid pays for most behavioral health services, but cannot pay for services in jails or state hospitals because those individuals are treated as inmates of public institutions, leaving state general revenue to cover much of that cost. She outlined DHS efforts including secured restoration beds, therapeutic communities, community mental health center contracts for jail-based services, and plans for an institution-for-mental-disease waiver that could allow Medicaid payment for certain hospital-based services. Members also discussed crisis stabilization units, with DHS noting that Fort Smith and Jonesboro have been more successful than Fayetteville and Little Rock, largely because of location, partnerships, and law enforcement coordination. Questions covered reimbursement for county jails, step-down facilities, civil commitment options, non-emergency behavioral health transportation, and whether DHS should create a bed-availability dashboard similar to hospital systems. DHS said it does not currently have such a dashboard but is exploring the idea. The meeting ended with a commitment to continue the work, with more detailed discussion planned for August, and the subcommittee adjourned.

Transcript Highlights:

• Who are receiving services.
• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.

Keywords: 1204, all

Transcript Highlights:

• This service amounts to nearly 77% of Southwest Transit's local service.
• service, as well. service, as well.
• , yet we were not receiving service, yet we were not receiving service. service. service.
• Transportation Services. Transportation Services.
• That service coverage continuity that maintains substantially similar transit service routes and service

Keywords: 1183, house

Transcript Highlights:

• They're very different services. Uh bus. They're very different services.
• Contracted services cost sometimes less than directly operated service.
• > service<00:35:36.240> level<00:35:36.560> increased the service the service level
• . service. service.
• mobility service service requires mobility service associated<00:46:56.319> with<00:46:56.480

Keywords: 919, house, all

Summary: The committee heard a Met Council report from Charles Carlson on high-subsidy transit route analysis required by the transportation bill. Carlson explained that the study uses per-passenger operating subsidy, compares routes by type and service day, and is intended to help providers improve cost-effectiveness while recognizing transit’s importance for access, affordability, safety, and the region’s economy. He noted that routes more than 60% above peer averages are considered the highest-subsidy tier, and that the report also estimates the cost of Metro Mobility associated with those routes. Members asked several questions about why contracted service can cost less than directly operated service, whether contracting affects wages, union membership, or service quality, and why the Met Council targets about 20% of regular route service for contracting. Carlson said contracted service can be cheaper because of lower overhead and other market factors, that the council sets minimum wage and service-quality requirements in contracts, and that customers should not notice a quality difference. He also said the 20% target is meant to balance cost-effective service, geography, and a mix of providers, and that some routes may become more cost-effective with more frequent service depending on local demand. Carlson reported that in 2024, 206 of 264 routes met guidelines, 16 were in the lowest intervention tier, 14 in the middle tier, and 28 were in the highest-subsidy tier. He said the regional share of high-subsidy service was about 4.1%, but the share varied widely by provider, with some at 0% and others much higher. He estimated that discontinuing the highest-subsidy routes would save about $23 million annually and up to $72 million in capital costs. For Metro Mobility, he said the cost associated with trips tied to high-subsidy routes rose from about $368,000 in 2023 to about $6.1 million in 2024, largely because the mix of routes triggering federally mandated paratransit service changed, especially in the Shakopee area.

Transcript Highlights:

• elderly disabled waiver Services elderly disabled waiver Services Alternative<00:04:58.120> Care
• But those services are tied to people who are using those services to stay on the planet, and as the
• > Services DHS Human Services DHS Human Services programs<00:32:09.080> chapter programs
• <00:33:36.399> and Services related to service planning and Services related to service planning
• uh the regional service centers Services uh the regional service centers and<00:35:31.760> the

Keywords: 1183, house

Transcript Highlights:

• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Services, Independent Living Services.
• Legal services. Administrative law judge services. Payment to risk management services.

Keywords: 981, all

Transcript Highlights:

• Services, deviated Fix Route Services, complimentary Americans with Disabilities Act.
• They cannot be denied service. They must be meet delivered service, all trips.
• for ADA services.
• And a door-to-door service can really slow down the service and that actually time equals money.
• But the demand of services also do that. This is just typical service quality.

Keywords: 999, senate, all

Transcript Highlights:

• APD will reimburse for the waiver services on a fee-for-service basis.
• APD will reimburse for the waiver services on a fee-for-service basis.
• service network.
• And those services can consist of medical services or long-term care kind of home health services or
• services, residential services, a variety of things.

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:

• Services.
• . services. services.
• service permitted per day in the service service permitted per day in the service uh<00:39:59.440
• Human Services. Human Services.
• . services. services.

Keywords: 1183, house

Transcript Highlights:

• They are service providers, right?
• Service is awesome.
• Service is awesome.
• services.
• It does include congregate meal services, caregiver support services, etc.

Keywords: 912, senate, all

Summary: The Committee on Health and Human Services held an informational briefing on Kupuna Care funding, distribution, utilization, and the status of program rules. The Office of Aging explained that state Kupuna Care funds are distributed using the same federally approved interstate funding formula used for Older Americans Act funds, with eight weighted factors tailored to Hawaii’s conditions: older adults, greatest economic need, low-income minority status, disability, language barriers, geographic isolation, inverse population density, and older adults living alone in poverty. The department said the formula is based on census and American Community Survey data, with current county shares listed as Kauai 7.45%, Honolulu 69.61%, Maui 11.7%, and Hawaii County 17.88%. Officials said the formula is being reviewed with current data and will need federal approval and then public hearing before final adoption. Members questioned how the program works in practice, noting that the statute and eligibility language can sound like direct individual benefits even though services are delivered through area agencies on aging, ADRCs, and contracted providers such as meal and adult day care programs. The Office of Aging said ADRCs determine eligibility and then refer clients to authorized providers, who must meet service standards in their contracts. The chair pressed repeatedly for long-delayed rules, saying the Legislature had expected them years earlier and that clear rules are needed to ensure funds are spent properly and to avoid conflicts of interest. The department acknowledged the delay, said draft rules were written in 2023 after earlier commitments to finish sooner, and said it paused while federal Older Americans Act rules were being updated; it now expects to send the rules to the Deputy Attorney General, then out for public hearing, with a goal of completion in 2025. The department also reported utilization data for the last two fiscal years. In 2023, it expended about 93% of its allocation and served 5,473 older adults at an average annual cost of $1,358; in 2024, it expended about 97% and served 5,520 older adults, with the average cost down by about $200, which officials said may indicate fewer services per person. Eligibility was described as age 60 or older, U.S. citizen or qualified alien, with cognitive impairment or disability and functional deficits, and the statewide profile showed many participants were homebound, living alone, or below poverty. The most-used services were transportation, case management, and home-delivered meals. The chair also asked about the former Kupuna caregiver program; officials said the programs are now combined under Kupuna Care, with most funding going to adult day care to provide respite for working caregivers. County representatives then described local conditions, especially on Hawaii Island. Hawaii County officials said the county covers about 5,000 square miles, has about 208,000 residents, and roughly 24% are age 65 or older. They identified three main challenges: staffing shortages and retention problems among providers, shortages within the county department itself, and the loss of adult day care capacity, with only one center remaining on the island and none on the west side. They said these constraints limit service delivery even as demand grows. At the same time, they highlighted successes such as serving people in the community before they need higher levels of care, providing caregiver counseling and training through adult day care, serving 467 individuals locally, and ensuring the Resource Center answers calls from caregivers seeking help.

Transcript Highlights:

• So this is a state plan service.
• So this is a state plan service.
• So this is a state plan service.
• and other supportive services such as social work services.
• :28.040> we Services such as Social Work Services we Services such as Social Work Services we

Keywords: 1187, senate, all

Summary: The committee heard a presentation from DHS on its early intensive developmental and behavioral intervention (EIDBI) study and related licensing proposal. Christy Grom explained that EIDBI is a Medical Assistance state plan service for children and young adults under 21 with autism or related conditions, and that DHS’s multi-phase evaluation included standards review, community engagement, and a comparison with other states. She said the service is important but that DHS identified gaps in oversight, including stretched clinical supervision, providers affiliated with many centers, out-of-state providers, and rapid growth in enrollment that has outpaced current monitoring capacity. DHS’s main recommendation was to create a provisional license for EIDBI in Chapter 245A as an immediate step, with later work toward full licensing standards. The proposal would let DHS identify controlling individuals, disqualify ineligible people, investigate maltreatment, suspend or revoke licenses, require background studies and qualifications before service delivery, move EIDBI providers into a higher-risk category for revalidation, and make DHS the lead investigative agency for maltreatment. DHS also recommended statutory standards for supervision, caseloads, training, and documentation, while emphasizing the need to balance oversight with continued access to services. Grom said the provisional licensure proposal is part of the governor’s budget and that DHS hopes to begin implementation in 2025, with a possible full license start date in 2028. Testifiers then spoke in support of EIDBI while urging the committee to preserve access and include more community input. Ana Hagi Muhammad, a parent of three autistic children and a Somali community advocate, said EIDBI has been beneficial for her family and that community organizations serving Somali families have not been sufficiently engaged in DHS’s process. Ana Muhammad, a Black mother of a young autistic child, said ABA has helped her son with communication, self-regulation, and independence, and asked that discussions reflect the diversity of family experiences. Committee members asked testifiers to keep remarks brief and to identify which modality they use, and the chair indicated the committee would continue hearing from additional testifiers before further discussion.

Transcript Highlights:

• But yet, we are denying them the services that I provide—the state services that I provide: housing,
• Public Health Service Commissioned Corps is the only uniformed public health service in the world and
• Public Health Service Commissioned Corps is the only uniformed service whose weapon is not a gun.
• We have an all-volunteer service today, regardless of what service you serve in.
• for your service.

Keywords: 995, all

Summary: The Joint Committee on Veterans and Federal Affairs held its fourth public hearing of the 2025-26 session on recognitions, definitions, and designations related to veterans. Chairs John Velis and Joseph McGonagle opened the hybrid hearing with housekeeping rules and noted the committee’s reporting deadlines. The hearing focused on several bills honoring veterans and military-related service, including H. 3825 to include reserve components in flag half-staff recognition for service members killed in action, S. 2499 to place a State House marker honoring three Medal of Honor recipients from the war on terror, S. 2498 to add Merchant Marine recognition at veterans cemeteries and the State House and create a Massachusetts merchant mariner medal, and H. 2500/S. 2500 to have Massachusetts fly the Honor and Remember flag for Gold Star families and fallen service members. A major portion of the hearing centered on H. 3871 and S. 2467, which would update the Commonwealth’s definition of “veteran.” Testimony came from the Office of Veterans Services, veterans organizations, Public Health Service and NOAA representatives, National Guard and Reserve veterans, and Gold Star advocates. Witnesses argued the current state definition is inconsistent with federal law and excludes some service members who should be recognized, especially members of the U.S. Public Health Service Commissioned Corps, NOAA Commissioned Officer Corps, reservists, and some National Guard members. Supporters said the bills would improve fairness, consistency, and access to benefits and services, while several speakers emphasized that service in uniform should be honored regardless of branch. Some testimony also urged a broader moral recognition of all who raised their right hand, while others focused on aligning state law with federal definitions and closing gaps in eligibility. Committee members asked questions about the practical and fiscal effects of broadening the definition, including how the proposed language would interact with existing federal standards and state benefit programs. Witnesses explained that the bills would remove the current 180-day and 90-day active-service calculations and instead recognize certain active service and six-year reserve or Guard commitments, though some members noted that this could create a broader state standard than the federal one. No votes or formal actions were taken during the hearing, and the committee concluded after hearing from the final witness and adjourning.

Transcript Highlights:

• Thank you, first, for your service to our country and for your service now to the Commonwealth.
• the service provider.
• of services.
• determination services.
• The second service that we will provide is vocational rehabilitation services.

Keywords: 995, all

Summary: The hearing opened with remarks from Senate Chair Robyn Kennedy and House Chair Chynah Tyler, who emphasized that the fiscal year 2026 hearing was focused on the Health and Human Services budget, asked members to keep questions budget-related, and noted that no public testimony would be taken. They also highlighted the choice of Doherty Memorial High School as the venue to showcase Worcester’s investment in career and technical education. Committee members then introduced themselves before the first panel, the Executive Office of Veterans Services and the state veterans homes, began testimony. Secretary John Santiago said the governor’s FY26 proposal would support implementation of the HERO Act, which he said is now about 95% implemented, including higher disabled veteran annuities, expanded behavioral health benefits, and other service expansions. He described efforts to reduce veteran homelessness, including nearly $20 million in ARPA-funded housing and outreach initiatives, and said the agency has delivered more than 100,000 supportive services to nearly 8,500 veterans. Leaders from the Chelsea and Holyoke veterans homes reported on staffing, quality measures, electronic medical records, and major construction projects at both facilities, including a new Chelsea campus and the new Holyoke home. Members asked about funding transfers, geographic equity in access to the homes, outreach to women veterans and veterans of color, suicide prevention, Gold Star family support, and the impact of federal uncertainty; Santiago said the homes are now licensed and certified, that the current budget is sufficient, and that the agency is expanding engagement and data collection. The second panel, the Office of the Veteran Advocate, testified that its FY26 request is about $3.3 million, up from the current $2 million, to cover staffing, a larger office, and higher technology costs. Veteran Advocate Bob Notch said the office is a new independent oversight agency created in 2022 to examine systems, coordinate with local veteran service officers, and investigate fatalities or serious harm involving veterans in state care. He said the office’s work depends on research, data, and collaboration with other agencies, and that current funding is only enough for minimum operations. In response to questions, Notch and Deputy Commissioner David O’Callaghan discussed the difficulty of tracking veteran suicides, the need for better data across agencies, and the office’s role as an oversight body rather than a direct service provider. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• , Home Safety Services, Juvenile Services, Residential Treatment Services, and staff training.
• > home Services child protective services home Services child protective services home Safety<
• 00:05:03.240> Services Safety Services Safety Services juvenile<00:05:05.479> Services<
• Juvenile Services.
• c> that these Services these are services that these Services these are services that um<00:16:06.399

Keywords: Meeting Concurrently w/ (H) Families & Children, 958, all

Summary: The committee met to hear the 2025 Social Services Block Grant preliminary plan from the Department for Community Based Services. Commissioner Lisa Dennis and Executive Adviser Mary Carpenter described DCBS’s mission and explained that the federal block grant, about $21 million annually, supports Adult Protective Services, Child Protective Services, Home Safety Services, Juvenile Services, Residential Treatment Services, and staff training. They said most of the funding goes to staff and training, and that the department uses surveys, focus groups, program monitoring, funding availability, and historical data to set annual goals. They also noted that Kentucky uses the grant to fund direct services and that eligibility is generally limited to Kentucky residents or runaway juveniles based on need and available resources. Much of the discussion focused on child welfare data and the distinction between poverty and neglect. DCBS officials said Adult Protective Services investigates abuse, neglect, and exploitation of vulnerable adults, and that self-neglect cases have trended down in recent years, which they attributed in part to access to federal resources. For Child Protective Services, they reviewed intake and investigation numbers, noting that many calls screen out before meeting statutory criteria, while about 48,000 cases were assessed or investigated and about 8,000 were substantiated. Members raised concerns about how poverty can be mistaken for neglect, especially in rural areas, and DCBS said it has been working with the legislature, staff, and community partners to better define the difference and connect families to community supports when cases do not meet abuse or neglect criteria. Members also asked about the risk to federal funding and the impact on juvenile services. DCBS said it had not received notice that the $21 million block grant would be cut, but it is monitoring federal developments closely and would need to return to the General Assembly for a budget request if funding were lost. The department said about 30% of the federal share goes to juvenile services. Questions also covered the transition in staff training from Eastern Kentucky University to a broader statewide model, and the agency said it is expanding training opportunities and modernizing delivery. Officials discussed the MST pilot for youth, saying it is a successful evidence-based practice operating in three regions—Jefferson, Northern Bluegrass, and Central Kentucky—with positive outcomes and possible expansion. No votes were taken; the meeting was informational only.

Transcript Highlights:

• , assessments, lots of different outpatient services to treat behavioral health services and substance
• overview of Behavioral Health Services overview of Behavioral Health Services and<00:04:06.040><
• <00:04:33.759> this<00:04:33.880> is Services some of the services this is Services
• to treat Behavioral outpatient services to treat Behavioral Health<00:04:48.479> Services<00:
• We looked at services based on a paid date of service, and as we go forward we're going to show some

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services held its first meeting and received an overview from the Department for Medicaid Services on Medicaid’s behavioral health and substance use disorder services. Commissioner Lisa Lee and CFO Steve Beal said Kentucky Medicaid serves about 1.4 million members, including over half of Kentucky children, with 485,000 expansion members, more than 69,000 enrolled providers, and total fiscal year 2024 expenditures of $18.5 billion. They said Kentucky covers a broad range of behavioral health services, and behavioral health provider enrollment has grown from a little over 4,500 in 2019 to nearly 8,000 in 2024. They also described how Medicaid spending and utilization are tracked through claims and encounter data, with most members served through managed care organizations. Members focused on sharp increases in certain behavioral health billing codes, especially peer-to-peer services, and asked about reimbursement, utilization review, and whether the growth reflected increased need or expanded coverage. DMS said the rise was partly tied to combining facility and nonfacility behavioral health fee schedules in 2023, choosing the higher reimbursement rate to avoid cuts, and that the department has seen an uptick in peer-to-peer services. In response to concerns about overutilization, DMS said it mailed a letter to behavioral health providers, is considering limits and prior authorizations for some services, and plans to create a standardized monthly behavioral health report to monitor trends consistently and identify when controls may be needed. Lawmakers also asked whether the provider network is sufficient and whether access is adequate, especially for children. DMS said provider enrollment has expanded because behavioral health services were added to Medicaid in 2014 and because demand increased after COVID, but acknowledged studies showing children have less access than adults and said that would be an area of focus. The department said managed care organizations are required to ensure access to needed services and that current trends indicate access is available, though one member disagreed and said workforce shortages remain a major concern. Another member asked about non-emergency medical transportation spending, and DMS explained that it is handled through a capitated arrangement administered by the Transportation Cabinet rather than directly by the managed care organizations.

Transcript Highlights:

• Thank you. services.
• ; emergency services; surgical services provided by a doctor of dental medicine or dental surgery; services
• care coordination services would still be a part of the fee-for-service model?
• care coordination services would still be a part of the fee-for-service model?
• The FI for service, the coordination services that you talk about that would be available under the fee-for-service

Summary: The Assembly Budget Subcommittee on Health held a May Revision hearing covering several health-related budget proposals and broader concerns about the state’s budget structure. The Chair opened by praising some May Revision changes, such as added health IT funding, county administration support tied to Medi-Cal changes, a delay in Medi-Cal cuts for some lawfully present immigrants, and additional support for Covered California subsidies, while criticizing proposed increases in Medi-Cal premiums, changes to senior eligibility, the lack of a Medi-Cal dental solution, and other reductions affecting counties, mobile crisis units, workforce incentives, and physician shortages. The Legislative Analyst’s Office said the state’s budget condition remains weak despite progress on the structural deficit, and the Department of Finance said the May Revision uses a mix of reductions, reforms, revenue proposals, and fund shifts to cut out-year deficits. The committee first heard Department of State Hospitals proposals, including adjustments to county bed billing authority, contract exemption language for online clinical/pharmacy subscriptions, reversion of unspent funds, a revised Metro Central Utility Plant replacement project, electronic health record implementation, and workforce development funded partly through Behavioral Health Services Act resources. DSH also described savings and realignments in incompetent-to-stand-trial and conditional release programs, including extending the independent placement panel program and shifting funds to support additional bed capacity and a mental health rehab center. Members asked about the use of BHSA funds for workforce programs, and the department said the proposal would replace General Fund support with BHSA reimbursements. The Emergency Medical Services Authority proposed funding for statewide behavioral health crisis response guidance and for enterprise system development, and the Department of Managed Health Care proposed modernization of its complaint system and claims-settlement data system to improve oversight and comply with AB 3275. The largest discussion centered on the administration’s BHSA spending plan under Proposition 1, including state-directed prevention, workforce, and other uses, plus General Fund offsets for existing programs. The LAO questioned whether some proposed offsets fit Proposition 1’s non-supplant and eligible-use requirements, while the administration argued the uses were consistent with the measure and that the state-directed share can be adjusted annually. The Commission for Behavioral Health’s proposals drew the most public and member concern. The administration proposed cutting the commission’s Innovation Partnership Fund from $20 million to $10 million and reducing the Community Advocacy Program by $6.7 million, while redirecting BHSA dollars to other state purposes and direct services. Commissioners, advocates, and several members argued the cuts would weaken community voice, reduce support for underserved populations, and disrupt grants already in process; they also objected to using BHSA funds to backfill General Fund commitments. Public commenters, including youth, disability, behavioral health, LGBTQ, tribal, veteran, immigrant, and community-based organization representatives, overwhelmingly opposed the cuts and urged preservation of prevention, advocacy, mobile crisis, and innovation funding. No votes or final actions were taken during the hearing.