Transcript Highlights:

• <00:19:02.919> that in our and there were 23 facilities that in our and there were 23 facilities
• , an assisted living facility, a veterans home, a group home, etc.
• , an assisted living facility, a veterans home, a group home, etc.
• I'm assuming you have some Canadians that come down to your facility.
• inpatient and outpatient inpatient and outpatient services<01:19:08.120> the<01:19:08.199

Keywords: 1183, house

Summary: The Health Finance and Policy Committee heard testimony from the Minnesota Hospital Association and several hospital leaders about the financial strain facing hospitals across Minnesota. The association’s CEO said hospitals are essential 24/7 safety-net providers, but rising labor, supply, technology, and drug costs are outpacing reimbursement from Medicaid, Medicare, and commercial payers. He warned that many not-for-profit hospitals are struggling, that workforce shortages remain significant, and that the committee should consider help on Medicaid rates, discharge/boarding problems, mental health services, workforce development, protecting the 340B drug discount program, and avoiding new mandates that add costs. Relle Schultz of Winona Health described a community hospital with a 49-bed facility and long-term care services that has faced years of losses, including a $17 million loss in 2023 and $12 million in losses the following year. She said government payers now make up about 65% of the hospital’s mix, and each 1% increase in that mix costs about $1 million. She highlighted the difficulty of sustaining services such as dialysis, which was nearly closed until a local donor provided $3 million to keep it open for three years, and she emphasized the importance of 340B savings and the need for higher Medicaid payments. Carrie Mulski of Riverview Health in Crookston said critical access hospitals are also under pressure despite their federal designation. She explained that federal support has eroded, that Medicaid and other public programs do not cover full costs, and that her hospital’s 340B savings help keep the doors open. She said Riverview opened a new hospital in 2020 but was hit by the pandemic and inflation, leading to annual losses of $5 million to $6 million and a negative operating margin of 9% to 10%. She also described bond covenant problems, low cash on hand, the prior closure of the nursing home, and the need for rapid state action to stabilize rural hospitals and preserve access to care.

Transcript Highlights:

• There was an unintended consequence that has rippled through our behavioral health facilities now.
• It's rippled through our behavioral health facilities now.
• And our solution to keep people safe in the community is this court-ordered outpatient treatment.
• He is precisely why we have judges ordering mandatory medications and outpatient treatment.
• Or who physically enter an assisted living facility or home for the purpose of making referrals.

Bills: SB1113, SB1115, SB1122, SB1123, SB1125, SB1165, SB1188, SB1193, SB1243, SB1318, SB1477

Keywords: mental health, involuntary evaluation, service of process, court-ordered treatment, evaluation agencies, AHCCCS, remote work, state agency, employment, public health, healthcare, behavioral health, prior authorization, American Indian health program, medicaid, medical examiner, death investigation, body disposal, autopsy, veteran burial

Summary: The committee heard and advanced a series of health and human services bills, with most receiving unanimous or near-unanimous support. SB 1113 would allow screening or evaluation agency employees, under contract with a county, to personally serve court documents in involuntary mental health proceedings instead of requiring police officers; supporters said it would reduce burdens on law enforcement and be less disruptive for patients. An amendment clarifying county contracts and reimbursement was adopted, and the bill passed 12-0. SB 1122 would limit AHCCCS from imposing over-100% prepayment review on certain behavioral health providers serving American Indian Health Program members unless a corrective action plan is in place; AHCCCS was neutral and said it could implement the bill with additional staffing, and it passed 12-0. SB 1123 would remove a board-certification requirement so trained, licensed forensic pathologists can supervise pathology trainees during the period before board exam results are available; Maricopa County supported it as a workforce and efficiency measure, and it passed 12-0. SB 1125 would require DCS to make annual efforts to enter MOUs with Arizona tribes and improve communication on tribal children in state care; DCS said it was already working on several pending MOUs, and the bill passed 12-0. The committee also approved several bills related to cancer screening and mental health. SB 1165 would prohibit cost-sharing for diagnostic and supplemental breast cancer screening services in the commercial market; the sponsor and advocates said it would remove financial barriers that delay diagnosis, and it passed 12-0 amid personal testimony from members and the chair. SB 1243 would require notice to a patient’s guardian before discharge from court-ordered treatment and allow guardians to seek continuation of treatment; supporters said it closes dangerous gaps when treatment orders expire, and it passed 10-0 with two absent. SB 1318 would repeal a state breast-density notice requirement that now overlaps with a federal FDA standard; ADHS said the change would reduce confusion and duplicate notices, and it passed 11-0 with one absent. SB 1188 would align Arizona controlled-substance schedules with federal FDA/DEA scheduling changes; supporters said it would speed access to new treatments, while one member voted no over concerns about relying on federal review, and it passed 8-2. Additional bills addressed privacy and assisted-living referrals. SB 1193 would bar DHS from selling or disclosing EMT personal identifying information for commercial purposes without consent, while still allowing de-identified data; the sponsor’s representative said the bill arose after DHS said vendor access to licensee data was not prohibited, and members discussed whether broader privacy protections should apply to other workers as well. It passed 10-0 with two absent. SB 1477 would require referral agencies serving assisted living facilities or homes to verify background-screening practices, maintain insurance, and provide documentation regarding APS registry status; the bill’s supporters said it raises standards for senior placement services, a technical amendment was adopted, and the bill passed 10-0 with two absent.

Transcript Highlights:

• But it's a unique facility.
• this facility.
• Develop mental health treatment facilities on campus.
• Develop mental health treatment facilities on campus.
• He was transferred to a residential facility.

Keywords: 995, all

Summary: The special legislative commission on the future of Pappas Rehabilitation Hospital for Children held a hybrid public hearing focused on the hospital’s future, admissions, staffing, infrastructure, and whether the facility should be preserved, expanded, or reimagined. Opening remarks from legislators, commissioners, parents, and union representatives emphasized that Pappas provides a unique combination of medical, rehabilitative, educational, and residential services for children with complex needs, and several speakers argued that the hospital is effectively being depopulated through reduced admissions and ongoing discharges despite public assurances that it remains open. Multiple speakers urged the commission to extend its authorization and continue its work before any closure or major change can occur. Testimony from labor leaders, including AFSCME, SEIU Local 509, and the Massachusetts Nurses Association, described a “silent closure” in practice, with staff reporting confusion about the hospital’s status, declining census numbers, blocked admissions, and uncertainty about the workforce’s future. They called for immediate action to stop admission denials and unnecessary discharges, and some proposed short-term solutions such as temporary modular structures to address infrastructure barriers and allow admissions to resume. Parents and former patients testified that Pappas provided life-changing independence, specialized therapy, and campus-based supports that they said could not be replicated elsewhere, and they criticized alternative placements as inadequate. Commissioner Robert Goldstein of the Department of Public Health said the administration supports keeping Pappas open and funded while the commission works, but he argued that admissions must comply with hospital-level-of-care rules and that the campus’s deteriorating infrastructure limits the kinds of children who can safely be served there. He said the department is continuing admissions for appropriate patients, working to expand outreach and services, and exploring long-term options, including broader statewide models of care. Commissioners pressed him on whether discharge status or lack of a clear discharge plan had been used as a barrier to admission, and requested de-identified data on patients recommended for admission but denied. No formal votes were taken during the hearing.

Transcript Highlights:

• There's a lot of facility types that do not want to take Medi-Cal.
• , treatment facilities, now we're moving into housing.
• Some of our applications are... ...just for one type of facility type.
• We get a lot of outpatient facility requests in rural areas because, like I mentioned earlier, they may
• not be able to sustain a full residential facility.

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

Transcript Highlights:

• Some facilities do, so insurance doesn't pay for it.
• House Bill 5147 allows these treatments to be provided more settings, including outpatient facilities
• Well, we are talking about these level two... facilities.
• So it will be outpatient facilities that have anesthesia capabilities, meaning they have a robust medical
• Yeah, and so that would extend to the outpatient facilities, potentially commercializing and giving them

Bills: HB1106, HB3284, HB541, HB713, HB1403, HB1586, HB1942, HB2070, HB2844, HB2851, HB3151, HB3749, HB3940, HB3963, HB4454, HB4466, HB4795, HB5154, HB5394, SB1357, HB1052, HB4099, HB4638, HB5147

Keywords: child abuse, neglect, gender identity, sexual orientation, child welfare, marriage, family, Texas Commission, family welfare, marriage support, stability, premarital education, child development, strong families, direct patient care, healthcare, physicians, medical services, insurance regulation, maternal health

Transcript Highlights:

• providers, outpatient physical therapy, and birthing centers.
• providers, outpatient physical therapy, and birthing centers.
• eight community facilities, and community transition services.
• the facility?
• We do intend to be looking at individual facilities and characteristics associated with those facilities

Summary: At the May 14, 2025 JLARC meeting, members approved the January 9 minutes and adopted the 2025–27 biennial work plan with a minor typo correction. Staff reviewed the new work plan studies, including a drug take-back program fee/expenditure review due in December 2025 and a state energy performance standard compliance review due in June 2027, and noted JLARC’s recent session activity, including several bills passed related to JLARC work and recommendations. The committee then heard a preliminary cannabis market study showing Washington businesses likely produced two to three times more cannabis than retailers sold in 2023. Staff and RAND said LCB’s data systems are incomplete and unreliable, limiting regulation, tax verification, and diversion tracking; they recommended that LCB submit a plan by year-end for collecting accurate data by the end of 2026. Members and LCB discussed the long timeline for a new traceability system, the causes of missing sales and weight data, overproduction, diversion, and the social equity program’s effect on producer licenses. JLARC also presented a preliminary hospital oversight report concluding that the Department of Health is late on many hospital inspections, does not verify third-party inspection standards, does not review adverse health event correction plans, and could make hospital data more accessible. The committee discussed fee funding, language access, and inspection timing, and DOH said it would work on a strategic plan and continue coordinating with JLARC. Members also heard a preliminary report on the public records survivor exemption, which found agencies are using it but need more guidance; JLARC recommended keeping the exemption and having the Attorney General provide additional training. Finally, the committee approved the DDA processes and staffing final report for distribution, which recommended performance metrics, stronger data quality controls, and workforce planning; DDA concurred. JLARC also introduced proposed study questions for a future DCYF juvenile rehabilitation review focused on safety, security, programs, staffing, education, and contraband, and the meeting adjourned after members asked about scope and facility conditions.

Transcript Highlights:

• It emphasizes the need for community-based outpatient treatment as opposed to hospitalization, which
• So, those outpatient community mental health centers who are doing those outpatient services as well
• <00:42:27.200> So,<00:42:27.359> those<00:42:27.599> outpatient<00:42:28.240
• So, those outpatient the guard rails.
• We need to fund building and staffing facilities for individuals who fall under the 202C statute.

Keywords: 00:00:06 - Call to Order/Roll Call 00:01:23 - Review of Referred Administrative Regulations 00:02:00 - Discussion of 26RS HB 485 01:00:40 - Roll Call Vote on 26RS HB 485 01:03:25 - Adjournment, 958, all

Summary: The House Standing Committee on Health Services met with a quorum and took up House Bill 485, a major mental health measure addressing both KRS 202C and KRS 202A. The committee first adopted a committee substitute and then approved a committee amendment correcting misspellings in the bill. Members and witnesses described the bill as the product of years of work with judges, prosecutors, defense attorneys, mental health professionals, advocates, and the Kentucky Judicial Commission on Mental Health. Testimony on the 202C portion focused on individuals charged with serious violent offenses who are found incompetent to stand trial. Witnesses, including a circuit judge and a family member whose mother was killed by her mentally ill brother, argued that current timelines require repeated evidentiary hearings and impose unnecessary trauma on victims’ families and strain on courts and KCPC. Supporters said the bill would lengthen review intervals, clarify the role and payment of guardians ad litem, and reduce repeated relitigation while preserving due process and public safety. They noted that 202C cases are few in number but consume a significant share of KCPC bed space. The committee then turned to the 202A portion, which covers civil mental health commitments for people who may not have committed a crime. Supporters said current law leaves courts with only two choices—hospitalization or release—and that the bill would create a third option by allowing court-ordered outpatient treatment and other guardrails such as medication compliance and follow-up care. Witnesses emphasized that the bill defines terms such as “benefit” and “serious mental illness,” expands the definition of danger, and aims to provide a least restrictive alternative to inpatient hospitalization. No final vote on the bill itself was taken during the portion of the meeting provided, but the substitute and amendment were adopted and testimony continued in support of the measure.

Transcript Highlights:

• The topic of xylazine and especially to ensure that our facilities that treat substance use disorder
• revelation that there has already been so much going on, and me being insulated in my inpatient facilities
• And so I think figuring out, you know, I know this group is really focused on the outpatient kind of
• And I think standardizing some of the care protocols in the outpatient settings and providing more support
• One other comment, too, is, you know, we think a lot about outpatient and inpatient as kind of these

Keywords: 995, all

Summary: The Working Group on Outreach and Treatment of the Special Commission on Xylazine held its first meeting, chaired by Gabe Adams-Cain in Senator John Villis’s absence. Members introduced themselves and described priorities such as improving education about xylazine, expanding first responder and clinical training, and ensuring patients and providers know how to respond to xylazine-related wounds and complications. Several participants emphasized that outreach should reach both people who have not been exposed and those already affected, and that stigma is a major barrier for patients and families. Discussion focused on the main challenges to treatment and outreach, including limited awareness, inconsistent wound care access, gaps in geographic coverage, cost of supplies, and the need for better training in both outpatient and inpatient settings. Dr. Kimmel noted that harm reduction and outreach programs are already providing much of the care, but often lack specialized staff, sufficient supplies, and standardized protocols. He also said xylazine can complicate withdrawal and make it harder for people to engage in substance use treatment. Members discussed the value of non-stigmatizing, consensus messaging, family support organizations, and existing resources such as PARI, StreetCheck, and state-funded syringe service and naloxone networks. The group also reviewed the commission timeline and next steps. Staff said materials for the December 11 full commission meeting should be submitted by December 2, with draft presentation materials to be shared by December 4 and reviewed by December 9. Members agreed to do additional follow-up research on topics including the cost-effectiveness and contents of self-care wound kits, outreach to family and recovery organizations, incarcerated populations, and geographic access gaps. The meeting ended with agreement to use a PowerPoint-style presentation and to continue compiling research through a shared folder, followed by adjournment at 9:55 a.m.

Transcript Highlights:

• If you do, UT Dallas is requesting support for a facility to sustain our rapid research advancement,
• Outpatient rather than inpatient. therapy.
• We have a request for $100 million. and CCAP support for our biosciences research facility.
• This is a state-of-the-art bivarium, an animal care facility, an animal care facility. research facility
• So we have the largest patient facility thanks to you.

Keywords: 1184, house, all

Transcript Highlights:

• staff more say in when juveniles are released from a state facility.
• Facility coordination gaps: receiving facility administrators may not have been involved in treatment
• What's happening is they're not abiding by their outpatient.
• What's happening is they're not abiding by their outpatient.
• They receive the highest level of mental health outpatient services.

Bills: HB47, HB171, HB285, HB305, HB449, HB908, HB 1024, HB 1306, HB1443, HB1445, HB1741, HB1866, HB1902, HB2001, HB2282, HB2355, HB2492, HB2637, HB2697, HB3464, HB4263, HB4996, HB5667

Keywords: sexual assault, victim rights, forensic examination, medical care, trauma-informed care, crime victims compensation, evidence retention, chemical dependency, court-ordered treatment, mental health, health care, treatment facility, juvenile justice, criminal justice reform, animal cruelty, nonlivestock, prosecution, veterinary defense, animal welfare, pretrial hearings

Summary: The Senate Committee on Criminal Justice met with a quorum and heard a long agenda of bills on criminal justice, public safety, mental health, victims’ rights, and related administrative issues. Early bills included HB 47, the omnibus sexual assault survivors bill, which would expand post-assault care, require courts to consider delays for adult survivors, bar sex offenders from rideshare driving, allow lease termination regardless of where an assault occurred, and require more reporting from sexual assault response teams. Testimony was generally supportive, though one witness raised concern that the bill’s reporting requirements could jeopardize county grant funding. HB 171, the Annel Borrego Act, would set a minimum period for court-ordered chemical dependency treatment; NAMI Texas supported it. HB 908 would require missing children reports to be sent to the National Center for Missing and Exploited Children within two hours, and HB 1443 would criminalize possession and promotion of childlike sex dolls; both drew supportive testimony and were left pending. HB 567, changing juvenile board chair selection in Parker County, and HB 4263, a TJJD workforce retention bill, were also heard and left pending after brief discussion and adoption of committee substitutes where applicable. The committee also heard several bills focused on jail and prison safety, court process, and victim protection. HB 2282 would raise the arrest warrant fee from $50 to $75; constables supported it as a cost-recovery measure, while the Texas Fair Defense Project opposed it as a regressive fee that burdens low-income defendants. HB 3464 would increase penalties for correctional employees who bring drugs or alcohol into prisons, with support from Harris County jail officials and a formerly incarcerated advocate who described the dangers of contraband and retaliation. HB 285, “Poncho’s Law,” would add criminal negligence to non-livestock animal cruelty offenses; animal welfare advocates said it would close a loophole that lets pet service businesses avoid accountability, and the bill was left pending. HB 2355 would keep certain Crime Victims Compensation records confidential when held by the Attorney General, and HB 2637 would standardize jury exemption ages and clean up jury disqualification reporting; both were left pending after limited testimony. Mental health and competency-related bills received significant attention. HB 305 would require a pretrial hearing within 14 days after a defendant is restored to competency, aimed at reducing repeated decompensation and the forensic waitlist; NAMI Texas supported it. HB 1741 would tighten procedures for not-guilty-by-reason-of-insanity outpatient commitments by requiring a stronger nexus to the receiving county and clearer supervision authority; law enforcement and mental health witnesses said it would improve public safety and treatment success. HB 2492 would make the four-hour family-violence post-bond cooling-off period mandatory rather than discretionary, and HB 1445 would allow a managed assigned counsel director to designate someone to approve certain payments for indigent defense attorneys; both were left pending. HB 1024 would require prompt execution of warrants for parole violators on superintensive supervision, and HB 1306 would extend first-responder-style benefits to death investigation professionals; neither drew opposition in the hearing. The committee also heard a series of public integrity and technology bills. HB 449 would expand the deepfake sexual content statute to include sexually explicit images, with Public Citizen supporting the change as necessary to address a rapidly growing problem. HB 1902 would create a new offense for “jugging,” or following bank or ATM customers to rob them; the Texas Bankers Association supported it. HB 2697 would require sureties to notify prosecutors before surrendering a felony defendant’s bond, and HB 2001 would sharply increase penalties for misuse of public information for financial gain and related coercion, with prosecutors and Texas Rangers describing bid-rigging and public corruption investigations as difficult to prove under current law because of short limitations periods and limited penalties. HB 1866 would grant Texas peace officer authority to National Park Service rangers within Texas park boundaries, and HB 4996 would increase penalties for fraudulent liens filed against public servants. Throughout the hearing, most bills were left pending after testimony, and several committee substitutes were adopted without objection.

Transcript Highlights:

• There is no long-term care facility.
• There is no long-term care facility.
• There is no long-term care facility.
• There is no long-term care facility.
• There is no long-term care facility.

Keywords: 1187, senate, all

Transcript Highlights:

• > to<00:03:29.599> provide assisted living facilities to provide assisted living facilities
• I took my concerns to care facilities.
• They did have elderly at this facility?
• :29.360> which<00:21:29.679> are as these um facilities, which are as these um facilities
• believe that more and more facilities believe that more and more facilities are<00:32:06.240>

Bills: HF2216, HF1978, HF2354, HF1963, HF1994, HF1995, HF1894

Keywords: assisted living, nursing home, long-term care, guardian, conservator, resident rights, arbitration, mandatory arbitration, consumer protection, fee increase, rate increase, price hike, private pay, public funds, Medicaid, waiver services, elderly, seniors, older adults, disability rights

Transcript Highlights:

• So facilities were transferring them... ...So facilities were transferring them somewhere else as soon
• Services, but the same exact service that you're paying hospital outpatient services for if you were
• Actually do the physician or the facility fee in their clinic. >> Yeah. Thank you.
• Uh, if you're meaning within the health department and our five facilities that we operate, this is..
• . ...five facilities that we operate, this is a term everybody knows that operates healthcare facilities

Keywords: 916, all

Transcript Highlights:

• <00:22:47.600> that we do have a mainland facility that we do have a mainland facility that
• , um to a separate facility, um to a separate facility, then then then you<00:30:00.320> will<
• says shall not be held in a facility says shall not be held in a facility controlled<00:34:42.159
• Have you folks thought of a separate facility somewhere, some an intermediate facility? Okay.
• somewhere some an intermediate facility? somewhere some an intermediate facility?

Keywords: 912, senate, all

Summary: The briefing focused on the Hawaii State Hospital’s overcrowding, construction defects in the new addition, and how Act 26 and related court-ordered processes are affecting admissions and discharges. The chair said the hospital has become increasingly forensic-focused, has lost beds after the closure of Kahimohala, and may face further costs and possible litigation over the defective addition. Hospital and Department of Health officials said they are working with the attorney general and contractors on repairs, and that the hospital is currently using all 292 licensed beds, including 13 waiver beds, while average daily census last fiscal year was 376. Officials explained that the high census is driven by both increased admissions and discharge barriers. They said the loss of Kahimohala returned patients to the state hospital, and that Act 26-related petty misdemeanor cases are contributing to admissions. They also said limited lower-level placement options delay discharges. Hospital staff reported that many patients are repeat admissions, about 22% were unhoused before admission, and a significant share are in categories such as fitness-to-proceed evaluations and conditional-release violations. They said these groups could potentially be reduced if evaluations were done elsewhere and if more community or supportive housing were available. The chair and senators questioned whether some fitness-to-proceed detainees need to be held at the state hospital at all, and whether the Clark consent order requires transfer to the hospital. The attorney general’s office said the Clark injunction does not govern unfitness-to-proceed cases; instead, the requirement comes from state statute, and the statute could be changed. Director Johnson said DCR cannot keep such detainees because the court orders them into the custody of the Department of Health, and the department cannot provide the needed therapeutic level of care in a correctional setting. The discussion also emphasized co-occurring substance use and mental illness, especially among petty misdemeanor defendants, and the need for supportive housing and a decompression plan to reduce readmissions and free beds for civil commitments.

Transcript Highlights:

• It's amazing to me some of the procedures that are done in outpatient settings nowadays anyway.
• We take anesthesia in the outpatient setting extremely seriously.
• We train four to six years after dental school in hospital and outpatient-based settings.
• We train four to six years after dental school in hospital and outpatient-based settings.
• Thank you. “...of the committee for conscious sedation in the outpatient setting?”

Bills: HB2048, HB2189, HB2248, HB2403, HB2728, HB2729, HB2730, HB2731, HB2906, HCR2058

Keywords: orders of protection, domestic violence, court procedures, legal guardian, enforcement, healthcare, licensed health aides, scope of practice, ventilator care, training standards, medical freedom, healthcare mandates, employment requirements, public health, government regulation, elderly, physical disabilities, Arizona Health Care Cost Containment System, home and community based services, funding increase

Summary: The committee first heard a presentation from Central Arizona Shelter Services (CASS) on homelessness in Maricopa County and CASS programs for single adults, families, and older adults. The witness described rising homelessness, especially among older adults, and said recent declines were linked to American Rescue Plan Act funding for shelters and flexible rental assistance. Members asked about CASS partnerships with mutual aid and service organizations; the witness described collaborations for food, banking, haircuts, digital access, and behavioral health. No vote was taken on this presentation. The committee then considered HB 2248, the Arizona Medical Freedom Act, which would bar businesses, schools, and government entities from denying services or employment based on medical interventions and limit employer medical requirements, with a school outbreak amendment adopted. Proponents framed the bill as protecting bodily autonomy and informed consent, while opponents argued it would weaken employers’ ability to control communicable diseases and protect public health. The committee adopted the amendment and advanced the bill on a 4-3 vote. It also advanced HB 2906, requiring one oral and maxillofacial surgeon on the State Board of Dental Examiners, and HB 2189, directing the Nursing Board to implement rules for licensed health aides performing routine ventilator care; both passed with amendments and strong support from sponsors and board representatives. Later, the committee approved HB 2403, appropriating $2.5 million in FY2027 for home- and community-based services providers serving elderly and physically disabled Arizonans. Supporters said the funding would help retain caregivers and reduce more expensive hospital or facility care. The committee also passed several continuation bills, including HB 2731 for the Physician Assistants Board, HB 2730 for the Occupational Therapy Board, and HB 2729 for the Nursing Board, all on largely party-line or near-unanimous votes after testimony from board staff emphasizing public protection and oversight. The committee then took up HB 2728, a DES continuation bill that also incorporated nine previously vetoed policy bills affecting SNAP, unemployment, and related benefits. Opponents argued it would make access to essential benefits harder and turn a routine continuation bill into a vehicle for controversial policy changes; supporters said it was needed for oversight and program integrity. The bill advanced on a 4-3 vote. Finally, the committee approved HB 2048, a strike-everything amendment requiring AHCCCS to treat a new non-opioid pain medication no more restrictively than opioids in utilization controls, and ACR 2058, which would require a comprehensive Medicaid claims audit funded by recoveries. Both measures drew support from sponsors and some personal testimony, while opponents warned about cost, duplication of oversight, and incentives that could bias audits; each advanced on 4-3 votes. The committee then adjourned.

Transcript Highlights:

• That was a $4 million grant from the Attorney General's office that allowed us to open our outpatient
• allowed us to open our outpatient allowed us to open our outpatient behavioral<00:32:39.279>
• Today, we serve any month throughout the 15 to 600 kids in our outpatient behavioral health program.
• The biggest growth we've had over the last few years is in outpatient.
• The biggest growth we've had over the last few years is in outpatient.

Keywords: 958, all

Summary: The Joint Committee on Families and Children met with a quorum, approved the August minutes, and received an update that the number of children in out-of-home care with active placements was 8,647 as of September 7, 2025. The first presentation was from Isaiah 117 House, a nonprofit that provides a home-like setting for children on removal day so they do not have to wait in a state office. Speakers described the mission as reducing trauma for children, lightening the burden on case workers, and easing transitions to foster or kinship placements. They said the Kentucky home in Logan County opened on August 15 and had already served 10 children in its first six days. Committee members asked about logistics, including whether children placed with kinship caregivers would still come to the house, how long children can stay, who remains responsible for them, and how volunteers are screened. The presenters said children are brought to the house regardless of whether they are headed to kinship or foster placement, that 72 hours is not a hard cutoff, and that a case worker remains in charge at all times while volunteers provide support. They also said volunteers undergo background checks, trauma-informed training, confidentiality instruction, and annual continuing education. In response to questions about funding and expansion, they said Isaiah 117 House is community-funded without state or federal money, and that new homes are opened only when fully funded, with construction costs typically ranging from $80,000 to $150,000 and first-year budgets around $180,000. The committee then heard a presentation from Remy Eastep Homes on its Family Centered Integrated Healthcare and related services. Leaders described the organization’s history from its origins as separate orphanages in Boyd County to residential treatment, treatment foster care, prevention services, and outpatient behavioral health. They said the organization shifted about 15 years ago toward engaging families more directly because family involvement improves outcomes and helps keep children safely at home when possible. The presentation continued into program details, but no votes or formal actions were taken on either presentation.

Transcript Highlights:

• We are familiar with the housing facility utilized by the state of Washington that has been cited as
• to house multiple individuals in one facility would not be easier and likely would be more difficult
• If individuals could be placed in transitional facilities in alternate counties, any county identified
• the placement of the facility into their county and against housing individuals designated as an SVP
• facility for the reasons that I presented in my opening comments, as Assembly Member DeMaio mentioned

Summary: The Joint Legislative Audit Committee held an oversight hearing on the state auditor’s October 2024 report on California’s Forensic Conditional Release Program (CONREP) for sexually violent predators. Members and witnesses discussed public safety, the long delays in finding community housing, the role of local housing committees, and the Department of State Hospitals’ oversight of Liberty Healthcare, which operates much of the program. Several legislators from rural and high-desert districts said their communities have been disproportionately affected by placements and questioned why many placements end up in remote areas. State Auditor Grant Parks said the audit found that CONREP participants were convicted of new offenses less often than sexually violent predators who were unconditionally released, but that 18 of 56 participants had been revoked and returned to state hospitals for noncompliance. He said it took an average of 17 months to place current participants in the community, with 20 additional people awaiting placement for an average of 20 months, and that the program incurred significant pre-placement costs. Parks also said local officials were often unclear about their role, DSH had not given clear guidance at the time of the audit, and California lacks a transitional housing option used in some other states. He reported that DSH had implemented four of the five audit recommendations, while declining the recommendation to explore state-owned transitional housing. DSH Director Stephanie Clendendon and Liberty representative Ken Carabello defended the program as a court-ordered, highly supervised treatment model intended to reduce reoffending and support reintegration. They said DSH is actively involved in placement review, that Liberty searches countywide under statutory restrictions, and that community feedback and court approval are part of the process. DSH said it has now implemented guidance for housing committee designees, formal program reviews, an outcome tracker, and an analysis of whether to separate some Liberty services into different contracts. DSH continued to oppose transitional housing, arguing it would not solve the core siting and statutory problems and would add cost. Several members remained critical, arguing the program is broken, costly, and unfairly concentrated in certain communities, and some called for major statutory changes or suspension of the program.

Transcript Highlights:

• They do aneurysms as an outpatient there.
• Physician fee and facility fee, all-inclusive.
• ; they get to charge a facility fee.
• Reducing those types of facility fees could be substantial.
• I think outpatient prescription drug costs are higher.

Keywords: 1184, house, all

Transcript Highlights:

• treatment facility.
• And then I would transition to outpatient, where I'd have intensive cardiac rehab there.
• I would transition to outpatient where I'd have intensive cardiac rehab there.
• We’ve got outpatient substance use.
• And it looks like you're just seeing them, provider recommended intensive outpatient programming.

Summary: The task force meeting opened with new leadership announcements, including Senator Nick Schroer thanking outgoing chair Representative John Black and naming Representative Del Taylor as vice chair. After some initial technical difficulties with audio and Zoom, members reviewed the task force’s statutory charge under Missouri law: to hold hearings on substance use, explore solutions, draft or modify legislation, and produce recommendations for prevention and treatment. The chair said the goal for this year is to develop concrete legislative ideas for the next session, with hearings focused first on field experts and later on alternative therapies and the Department of Mental Health. Dr. Rachel Winograd gave the first major presentation, describing Missouri’s overdose crisis as increasingly complex and driven primarily by fentanyl, now compounded by xylazine and metatomidine. She said overdose deaths have declined for a third straight year, with preliminary 2025 data around 1,200 deaths, and attributed the decline to a smaller fentanyl supply, wider naloxone availability, and fewer young people entering use. Her main recommendations were to focus on reducing harm rather than trying to eliminate drug use, expand evidence-based medications for opioid use disorder—especially methadone and buprenorphine—improve access to naloxone, and loosen methadone regulations, including take-home doses, the federal 72-hour rule, and broader methadone units. She also emphasized that peer support, housing, transportation, and other practical supports matter, and noted that naloxone can still reverse fentanyl overdoses even when tranquilizers are present. Dr. Heidi Miller, the state medical director, followed with two recommendations: integrate substance use disorder care into whole-person health care and follow the science when considering substance-related legislation. She argued that primary care, maternal health, workforce training, EMS, public health, and methadone access should all be part of a coordinated model, and said reimbursement should support teams rather than isolated providers. She also urged stronger enforcement of parity between behavioral health/SUD and physical health coverage, and highlighted tobacco and alcohol as major, under-addressed causes of death in Missouri. Dr. Doug Burgess then reinforced the need for a coordinated continuum of care, comparing substance use treatment to the seamless system used for heart attacks, and said patients should have standardized assessment, discharge planning from day one, transition coordinators, peer recovery coaches, and better information-sharing between levels of care. Members asked questions about relapse, treatment court, EMS referral barriers, reimbursement, and whether buprenorphine can be started in the field; no votes were taken, and the meeting ended with plans to continue hearing testimony and use it to shape future policy recommendations.

Transcript Highlights:

• Whole facility types on their projects.
• Before, we were talking about facilities and treatment facilities; now we're moving into housing.
• Of facility type.
• We receive many outpatient facility requests in rural areas because, as I mentioned earlier, they may
• not be able to sustain a full residential facility.

Keywords: 988, house, all