Transcript Highlights:

• services.
• Department of Health and Human Services has not directed its auditors to look at subrecipient monitoring
• The final rule also repeals the requirement for states to use some of its grants to provide direct services
• care space anymore, I believe.
• If they are not, they're going to a provider that is actually providing services for eligible child care

Committee: Joint Joint Legislative Audit Committee

Keywords: 1182, all

Transcript Highlights:

• The Department of Health and Human Services oversees our nation's largest health care programs, providing
• On other health care matters, from abortion to universal health care, Mr.
• care services.
• And you know, there's a move towards direct primary care systems that are growing across the country.
• We try to increase the use of those and direct primary care to continue transitioning into a value-based

Committee: Senate Finance Committee

Transcript Highlights:

• Every health care service contractor must have and maintain a minimum net worth equal to the greater
• care physicians to... ...is a consultation service that allows primary care physicians to consult with
• For example, CMS allows things like directing specific provider payments through managed care organizations
• It excludes from the definition of Apple Health employers localized service employers, consumer-directed
• care.

Summary: The committee opened with a public hearing on Senate Bill 5808, a proposal to require nonprofit health carriers with “excess surplus” to pay 10% of that surplus into the state health care affordability account for Cascade Care Savings. Committee staff said the bill could generate about $330 million one time in 2027, while the Office of Insurance Commissioner would have implementation costs. Supporters argued the bill would redirect consumer premium dollars to help people afford coverage, while opponents from health plans said reserves are needed for solvency, claims, and capital needs and warned the bill would destabilize nonprofit insurers. The committee also heard testimony on House Bill 2254, which would let the Partnership Access Line assessment cover administrative costs; HCA and Seattle Children’s supported it as a technical fix that saves general fund dollars, and a child psychiatrist asked that savings be reinvested in behavioral health services. House Bill 2385, which extends deadlines for the Medicaid Access Program because of federal restrictions on new provider taxes, also drew support from provider groups seeking future Medicaid rate increases. The committee then heard Substitute Senate Bill 6286, which would increase fines on private detention facilities that deny Department of Health inspections and dedicate the fines to an account for community repair and assistance to harmed individuals and families. Supporters, including Tacoma’s mayor and family members affected by detention, framed the bill as an accountability measure; fiscal staff estimated Department of Health costs of about $395,000 in the 2025-27 biennium. Senate Bill 6006 would exempt food banks from sales tax on certain services enacted last session, with food bank and tribal representatives saying the savings would go directly to food and operations. Senate Bill 6351 would create exemptions from the new sales tax on live presentations for before- and after-school care, arts and cultural nonprofit classes, and K-12 school purchases; school districts, arts groups, and PTA representatives supported it, while asking for clarifying language and broader nonprofit exemptions. Engrossed Substitute House Bill 1717 would let cities and counties create local sales tax remittance programs for affordable housing projects, and housing builders, Habitat affiliates, counties, and city officials supported it as a local tool to lower development costs. In executive session, the committee received briefings on several tax and spending bills and then voted to advance multiple measures. It adopted a substitute and passed Senate Bill 5949, which narrows a B&O tax exemption related to insurance premiums; a proposed retroactivity-removing amendment failed. It adopted a substitute and passed Senate Bill 6129 on cigarette, tobacco, and nicotine taxes after rejecting several amendments, including proposals to study the tax policy or replace the bill with illicit-market enforcement language. The committee also passed Senate Bill 6228 repealing a preferential B&O rate for prescription drug resellers, Senate Bill 6231 repealing data center sales tax exemptions, and Second Substitute Senate Bill 5965, which retained a bag-fee approach rather than a full ban after adopting an amendment. The committee then returned to public hearing and began testimony on Senate Bill 6353, a major Working Connections Child Care bill that would keep income eligibility at 60% of state median income, lower the provider rate target from the 85th to the 75th percentile, and make other program changes; the briefing was underway when the transcript ended.

Transcript Highlights:

• Over the years, we run in the mid-30s to mid-40% state employee rate in direct care.
• Obviously, we make up the difference with contract agency direct care personnel.
• Over the years, we run in the mid-30s to mid-40% state employee rate in direct care.
• Obviously, we make up the difference with contract agency direct care personnel.
• We run in the high 30s to low 40% state employee rate in direct care at our two facilities.

Committee: All ALC-REVIEW

Summary: The subcommittee reviewed multiple methods of finance and construction items, including projects for Arkansas State University, Black River Technical College, UAMS, the University of Arkansas at Pine Bluff, and UCA. The UAPB Allied Health and Sciences Building appeared both as a method of finance and as an alternative delivery construction project, with East Harding Construction selected and AMR Architects as designer. Members approved the methods of finance, the alternative delivery project, and several discretionary grants, including Department of Health grants for a heart attack center designation and community health worker training, and DHS grants related to homeless services, behavioral health transition support, and an enabling technology pilot. The committee then reviewed service contracts, including RFQs, construction-related contracts, intergovernmental agreements, and a large number of out-of-state and in-state contracts. Testimony focused heavily on DHS staffing and state hospital contracts, the Arkansas State Police seatbelt survey, AEDC’s lithium supply chain analysis, and Shared Administrative Services’ new SuccessFactors performance-management contract. Members asked detailed questions about contract nursing costs, turnover, hiring timelines, and whether some contracts were being renewed or amended beyond their original projected costs. DHS and Veterans Affairs officials explained staffing shortages, retention incentives, and the use of contract labor as a supplement to state employees. Several contracts drew scrutiny and were held for further review. Representative Wardlaw raised concerns about projected costs and repeated amendments on the Department of Education security contract and on DHS staffing contracts, arguing that some had exceeded their original projected totals. The committee voted to hold contracts 5, 7, and 8 until Friday, while adopting the remaining contracts. The meeting ended after informational reports on service contract amendments without material change, executed contracts, and emergency procurements were presented, with no further business before adjournment.

Transcript Highlights:

• The fire service, especially as it relates to the health care community, is very integrated.
• I am here today to provide a report on the progress of the North Dakota Stroke System of Care as directed
• I am here today to provide a report on the progress of the North Dakota Stroke System of Care as directed
• It begins with on-the-ground direct education and support for hospitals and health care providers.
• It begins with on-the-ground direct education and support for hospitals and health care providers.

Committee: Joint Health Care Committee

Summary: The committee first approved the minutes and then heard a detailed annual presentation from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and review findings. He explained the committee’s structure, the de-identified review process, and the distinction between pregnancy-associated and pregnancy-related deaths. He said national maternal mortality has declined from its 2021 peak, but mental health conditions, substance use, overdose, suicide, cardiovascular disease, hemorrhage, infection, and embolism remain major causes. He emphasized that many deaths are preventable, with especially high rates among non-Hispanic Black women and in the American Indian/Alaska Native population, and noted that a large share of deaths occur after 42 days postpartum. Committee members asked about suicide, domestic abuse, pregnancy testing in unexplained deaths, and the role of home births and midwife training. Dr. Arnold said the committee is adding a caseworker, exploring post-mortem pregnancy testing in suspicious cases, and working with coroners and forensic officials; he also said home births and untrained midwifery pose safety concerns and that better public education and facility-based care are important. The committee then heard from State Fire Marshal Dr. Matt Clark on cigarette ignition propensity standards and fire prevention. He recommended updating North Dakota’s cigarette ignition legislation to the current national standard and also considering legislation requiring fast-breakaway oxygen tubing, citing fatal fires involving smoking around home oxygen. He explained that his office verifies manufacturer testing and maintains certification for cigarettes sold in the state, but does not itself conduct the testing. Members asked about implementation, cost, and whether the standards apply in tribal communities; Clark said he would follow up with cost information and additional details, and that he had not seen evidence of a major issue on tribal lands but would look further. Christine Greff of the Department of Health and Human Services presented the North Dakota Stroke System of Care report. She described the statewide network of two comprehensive stroke centers, four primary stroke centers, and 30 acute stroke-ready hospitals, along with the stroke registry and quality-improvement efforts. She reported that most strokes are ischemic, that the median stroke patient age is 71.5, and that common risk factors include hypertension, dyslipidemia, obesity, and diabetes. She highlighted improvements in door-to-CT, thrombolytic treatment times, dysphagia screening, EMS pre-notification, and interfacility transfer performance, and said new priorities include hemorrhagic stroke quality measures and standardized EMS stroke screening tools. Members asked about the VA hospital’s participation, and Greff said she would pursue outreach. After a break, the committee heard testimony from Taha Khan of Vertex Pharmaceuticals as part of the prior authorization study, focused on non-opioid pain treatment. He argued that prior authorization can delay access to acute pain treatment and may push patients toward opioids, especially in the critical 24- to 72-hour post-discharge window. He cited data showing that even short opioid exposure can increase the risk of long-term use and said prior authorization is often a barrier for physicians and patients. Khan recommended open access with a quantity limit rather than prior authorization, suggesting a 14-day limit supported by the product’s data and an episode-of-care approach. Members asked about dental use, payer discussions, and cost; he said the product’s wholesale acquisition cost is about $16.10 per tablet, with patient assistance available, and that he would follow up on payer and comparison-cost questions.

Transcript Highlights:

• us to provide personal care services in us to provide personal care services in the<00:57:38.400><c>
• already, this was just—it actually may be a lesser cost in terms of the personal care services.
• care care services<00:59:37.280><c> so</c><00:59:37.480><c> so</c><00:59:37.640><c> a</c><00:59:37.799
• </c><01:54:08.599><c> services</c> earlier the the personal care services earlier the the personal care
• and Human Services, New Hampshire Granite Advantage Health Care Program premiums established.

Keywords: 1189, house, all

Summary: The House Finance Division 3 work session continued its review of the Department of Health and Human Services’ Medicaid budget and related policy issues, with CFO Nathan White and Medicaid Director Henry Litman presenting updated materials. The discussion focused on a crosswalk between the adjusted FY 2025 Medicaid budget and the governor’s FY 2026 recommendation, plus handouts showing service additions, eligibility changes, dental rates, and other Medicaid changes since 2019. The department also said it would provide a clearer breakdown of the pharmacy cost-sharing item by general, federal, and other funds. Members asked detailed questions about the Medicaid enhancement tax, the 80% plan, and how funds are allocated between hospital payments, directed payments, and DSH uncompensated care. The department explained that the MET is being used more toward rates and directed payments to better align with federal matching rules, while DSH remains important for uncompensated care. They also noted that a pending Senate Bill 249 would keep the 80% structure and move to Senate Finance. On the trigger law, the department identified the governing provision as Chapter 342:12, Laws of 2018, and explained that if the federal match for Medicaid expansion falls below 90%, the state must notify legislative leaders and participants and the program would sunset after 180 days unless the legislature acts. The committee also reviewed current Medicaid expansion enrollment and program trends. Officials said enrollment was just under 59,000 as of March 3, with about 87,000 people enrolled over the past year and more than a quarter-million residents having used the program over its lifetime. They said enrollment has fallen from a post-pandemic high of nearly 97,000 and may eventually settle in the low 50,000s. Finally, the department discussed federal DSH funding risk, saying New Hampshire could face a significant reduction if Congress does not extend current protections, which is part of why the state has shifted more funding toward payment rates and directed payments.

Transcript Highlights:

• TRC services help survivors stabilize housing, access medical care, navigate the legal system, and return
• ’ need for ongoing medical care, legal intervention, substance use services, and financial crisis support
• Compared to usual care, clients who receive TRC services experience a 56% increase in return to employment
• Core services are the traffic control, which direct vehicles based on verified addresses; the geographic
• Funding this proposal ensures continuity of care, prevents service disruptions, and positions the state

Keywords: 988, house, all

Transcript Highlights:

• The first is for the Agency for Health Care Administration.
• review by the Centers for Medicare and Medicaid Services.
• That's what this program here does; it covers uncompensated care.
• outpatient services to Medicaid-managed care enrollees.
• approval from the Centers for Medicare and Medicaid Services.

Keywords: 999, senate, all

Transcript Highlights:

• To receive case management services through extended foster care.
• And to be very clear, DFPS provides extended care services until the age of 21.
• To be very clear, DFPS provides extended care services until the age of 21.
• An organization that may have a more direct access to those services.
• I think it's one of the bills to specifically fund legal services for youth exiting care.

Committee: House Intergovernmental Affairs

Keywords: 1184, house, all

Transcript Highlights:

• On top of the payments for those direct services, it would also pay primary care providers a small monthly
• A couple other little provisions in the bill: one, we would be directing the Commissioner of Human Services
• members to support roughly 1 million low-income Minnesotans with access to needed health care services
• Was it in the managed care portion? How much was in the direct payment portion?
• Oh, that's only from the direct payment portion. Well, the vast majority of it is in managed care.

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• Psychiatric care, medical care, psychosocial treatment, skill building, et cetera, with our population
• I would also say, with respect to partnerships, in any hospital—I don't care if you're in an acute care
• And at the end of this month, we will be launching for the first time a care care care. Thank you.
• And at the end of this month, we will be launching for the first time and a care care care.
• Can we do it on the civil side where there's an actual health care outcome attached to that care?

Keywords: 907, all

Summary: The joint Senate and House Behavioral Health committees held an informational meeting focused first on the Oregon State Hospital (OSH). OHA Director Sajal Hathi introduced the hospital’s incoming permanent superintendent, Sean Murphy, and praised interim superintendent Jim Deagle for stabilizing operations, restoring CMS compliance, and helping drive a culture change centered on safety, accountability, and transparency. Deagle and Chief Medical Officer Dr. Amit Bavon described OSH’s role as the state’s highest-level forensic psychiatric hospital, the patient populations it serves, its partnerships with courts, counties, jails, hospitals, and advocates, and recent leadership changes across the hospital. They also reported improved accreditation and regulatory status, including Joint Commission accreditation and CMS compliance, and said the hospital is now using daily safety huddles, incident review meetings, stronger escalation procedures, and revised seclusion/restraint practices to reduce risk and improve oversight. Members pressed hospital leaders on past seclusion practices, asking how prolonged seclusions could have occurred under federal standards. Leaders said they could not explain past decisions but emphasized that current leadership has changed processes, training, reporting, and oversight so that seclusion and restraint are reviewed in real time and cannot be normalized. Questions also covered staffing, falls, and future planning. OSH said it is generally staffed to budget, though it still has RN and mental health technician vacancies and is working on recruitment, training, and better staffing distribution. Hathi said the hospital is building a public dashboard with key performance and safety metrics, including workforce data, and described the long-term goal as a consistently safe, disciplined, high-functioning institution that responds quickly to mistakes and remains accountable to the public. The committee then shifted to an informational overview of civil commitment. Oregon Judicial Department representative Chanah Newell explained the civil commitment process, including who can initiate it, the role of community mental health providers and courts, the five-day timeline to hearing, and the standards for danger to self, danger to others, and inability to meet basic needs. She summarized changes made in House Bill 2005, including revised statutory language and new provisions allowing a second diversion period, but cautioned that the data are too early to show clear trends. Testimony from NAMI Oregon’s Chris Bonif and psychiatrist Dr. Stephanie Lopez argued that Oregon still relies too heavily on jails and state hospital commitments because the broader community system lacks enough treatment, housing, and less restrictive alternatives. They urged the legislature to focus on upstream services, supported housing, and possible outpatient commitment tools so people can receive treatment before reaching crisis. The meeting ended with acknowledgment that additional reports and follow-up discussions are expected, including on residential treatment capacity and related behavioral health system reforms.

Transcript Highlights:

• The first one is for the Agency for Health Care Administration.
• review by the Centers for Medicare and Medicaid Services.
• That's what this program here does; it covers uncompensated care.
• outpatient services to Medicaid-managed care enrollees.
• approval from the Centers for Medicare and Medicaid Services.

Summary: The Legislative Budget Commission met with a quorum present and considered two Agency for Health Care Administration budget amendments related to Medicaid supplemental payments. The first amendment, EOGB 2026-0831, authorized $2.1 billion in budget authority for the Low-Income Pool to support safety-net providers with uncompensated charity care. Members asked about the timing of AHCA’s submission to CMS and whether the program addressed hospital shortfalls for insured patients and CHIP-related concerns. AHCA said approvals have generally been slower under the current federal review process, and the amendment was adopted without objection. The second amendment, EOGB 2026-0875, placed $7.9 billion in reserve for Florida’s Directed Payment Program for Hospitals pending final CMS approval. Senators and representatives questioned the role of hospital attestations regarding hold harmless agreements, whether any agreements had to be unwound, and how long final approval might take. AHCA said all hospitals had submitted attestations, no unwinding was known to be necessary, and approval was expected soon. Members also raised concerns about cancer hospitals, including Moffitt and the University of Miami, not participating in the directed payment program. AHCA responded that those institutions participate instead in a separate Florida Cancer Hospital supplemental payment program, which had already been approved. Both amendments were adopted without objection, and the commission then adjourned.

Transcript Highlights:

• Madam Chair and members, House Bill 2620, appropriation, homeless veteran shelter service, and unanimous
• Madam Chair and members, HB 2239 establishes the child care grant program to assist families in the state
• with child care.
• instruction fund that may be used only on direct instructional expenses and which is funded through
• instruction fund that may be used only on direct instructional expenses and which is funded through

Summary: The meeting was a caucus review of a long list of bills on Minority Caucus Calendars 8 and 9, with members briefly noting whether measures were unanimous, on consent, or had split votes. Topics included appropriations for homeless veteran shelter services (HB 2620), the Veterans Court Program grant fund (HB 2960), municipal improvement districts (HB 4064), a memorial measure (HB 2079), child care grants (HB 2239), midwife medication administration and advisory committee changes (HB 2251), home and community-based service provider funding (HB 2403), EMS reciprocity (HB 2437), prescription monitoring (HB 2434), electronic monitoring in health care facilities (HB 2914), pregnancy resource center funding and restrictions (HB 2229), limits on police transport of mental health patients (HB 2404), Access coverage for mild obstructive sleep apnea treatment (HB 2726), school district spending and teacher pay requirements referred to the ballot (HCR 2007), mobile home park operator training (HB 2199), local government investment pool oversight (HB 2344), task order contract website posting (HB 2445), tourism improvement areas (HB 2950), ambulance certificate reporting (HB 2402), short-term rental occupancy rules (HB 2429), ASRS retirement rules for elected officials (HB 2505), trespass penalties after eviction (HB 2047), post-nuptial agreement enforcement (HB 2861), civil rights board continuation (HB 2931), and utility replacement plant siting (HB 2389). Members also discussed child welfare and family law bills on Calendar 9, including kinship foster placement (HB 2035), neglect standards based on financial resources (HB 2041), family court evidence (HB 2968), DCS response to abuse reports (HB 4004), prostate cancer insurance cost-sharing (HB 2617), mental health hearing technology (SB 1242), optometrist prescriptions (SB 1023), behavior analyst regulation (SB 1145), assisted living occupants (SB 1247), manufactured home installer licensing and fingerprinting (HB 2868), supervised parenting time (HB 2615), unlawful entry involving vulnerable adults (HB 4136), uranium contamination monitoring funding (HB 2889), a gas and petroleum refinery study committee (HB 4025), and veteran state park fee exemptions (HB 2165). Several members raised policy concerns on bills involving privacy, rural transportation capacity, environmental review, pregnancy centers, and funding priorities, while others noted support or that amendments had addressed earlier issues. No formal roll-call votes were taken in the transcript itself; the chair mainly recorded whether bills were unanimous, consent, or split and whether any should be taken off consent or discussed further. The meeting ended with announcements about an upcoming CAP breakfast, a Latino Caucus meeting, and an Affordability Award presented to Representative Volk before adjournment.

Transcript Highlights:

• To be eligible, physicians must provide at least 32 hours of direct patient care per week...
• To be eligible, physicians must provide at least 32 hours of direct patient care per week in one of a
• professionals who provide primary care or dental services at an approved site located in one of the
• investments, whether it be at HCAI, Department of Public Health, or Department of Health Care Services
• investments, whether it be at H-Kai Department of Public Health or Department of Health Care Services

Summary: The Assembly Budget Subcommittee on Health held a hearing focused first on the impact of H.R. 1 on medical student financing and physician access, then on state residency-support programs. The chair framed the discussion around expected federal Medicaid and student loan changes, warning that higher borrowing barriers could reduce access to medical school for lower-income students and worsen physician shortages, especially in underserved regions. The LAO explained that H.R. 1 would cap federal loans for professional students, eliminate Grad PLUS for new borrowers, and likely shift more students toward private loans with less favorable terms; it said the bigger concern may be who can afford to attend medical school rather than a sharp drop in enrollment. HCAI described three physician loan repayment programs—the State Loan Repayment Program, the Stephen M. Thompson Physician Corps Loan Repayment Program, and the County Medical Services Program loan repayment program—and said retention data show many awardees remain in California and in underserved or safety-net settings after service obligations end. University of California and UCSF witnesses described California’s physician workforce shortages, especially on the Central Coast and in rural and agricultural communities, and said affordability, limited medical school capacity, and burnout are pushing some doctors into concierge practice or out of underserved areas. They emphasized that students from low-income backgrounds and underrepresented communities are more likely to be affected by loan limits and that residency location strongly influences where physicians ultimately practice. Members asked about medical school capacity, out-of-state students, residency retention, and whether the state could expand slots or better target aid to keep physicians in California and in high-need communities. Public commenters urged the Legislature to consider shortages in anesthesia, pediatric subspecialties, midwifery, and culturally concordant care, and to support broader workforce pathways and public-service loan programs. The second panel reviewed graduate medical education programs, especially CalMedForce, CalMedForce Plus, and Song-Brown. UC and HCAI said CalMedForce has supported new residency slots since 2018, while Song-Brown funds primary care residency training and has recently supported new programs in rural areas such as Del Norte County. The LAO said the state should decide whether residency support should remain a budget priority, whether these competitive grant programs are the best mechanism, and whether their structures are too rigid or duplicative. It noted that most awardees receive funding more than once and that the programs overlap substantially, suggesting possible coordination or consolidation. A family physician from the California Academy of Family Physicians argued that stable funding for primary care residencies is essential, that many California-trained physicians stay where they train, and that future funding should be more deliberately directed to primary care and high-need communities. The hearing ended with discussion of emergency room crowding, geographic inequities in residency distribution, and HCAI’s plan to develop supply-and-demand models to guide future funding decisions.

Transcript Highlights:

• and self-directed home care.
• for direct care incentivize wage growth for direct care workers<01:06:48.079><c> and</c><01:06:48.319
• This could limit access to essential care services well beyond To essential care services well beyond
• The long-term care service side.
• Um, this at direct care and treatment.

Committee: Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• care, in-home care, or TANF—would be in this area.
• health care costs change.
• services.
• , Department of Social and Health Services, higher education, K-12, and low-income health care and community
• So in the line-item appropriation from near general fund to DHS for long-term care services, the cost

Committee: Joint Joint Legislative-Executive Committee on Budget Transparency and Fiscal Sustainability

Summary: The committee held its first meeting, with co-chairs and members introducing themselves and staff outlining the committee’s statutory charge under the 2026 supplemental operating budget. Staff explained that the committee is tasked with studying budget transparency and fiscal sustainability in two phases: first, revenue growth, spending assumptions, statutory cost drivers, and carryforward/maintenance levels; and later, staffing, overhead, performance management, and public reporting tools. The committee also discussed its goals, with members emphasizing a shared factual understanding of Washington’s fiscal situation, the causes of projected structural deficits, and possible paths to a more sustainable operating budget. Staff then gave a detailed operating budget basics presentation. They reviewed the size and composition of the operating budget, explaining that most spending is concentrated in grants and client services, salaries and benefits, and goods and services, with K-12 education, DSHS, the Health Care Authority, DCYF, corrections, and higher education making up most NGFO spending. They also walked through the distinction between constitutional, federal, statutory, and discretionary spending; the role of caseload and per-capita forecasts; how maintenance level and policy level budgets are built; and how the four-year outlook works, including revenue forecasts, reversions, budget stabilization account reserves, and the official outlook adoption process. Members asked several questions about what is or is not included in the outlook, especially future collective bargaining agreements, health care inflation, court-ordered liabilities, and whether the budget could better separate mandatory from discretionary spending over time. Staff said some of those questions would require follow-up and noted the existence of an outlook accuracy report. The committee then heard from Josh Goodman of the Pew Charitable Trusts, who introduced Pew’s state fiscal work and its role as the nonprofit partner supporting the committee. He said Pew would help analyze long-term fiscal sustainability, reserve policies, recession preparedness, and practices from other states, and would draw on its 50-state data and subject-matter experts. No votes were taken and no formal actions were reported at this meeting.

Transcript Highlights:

• To be eligible, physicians must provide at least 32 hours of direct patient care per week in one of a
• professionals who provide primary care or dental services at an approved site located in one of the
• We manage chronic diseases, provide preventive services, coordinate specialty care, and serve as a first
• investments, whether it be at HCAI, Department of Public Health, or Department of Health Care Services
• investments, whether it be at H-Kai Department of Public Health or Department of Health Care Services

Keywords: 988, house, all

Transcript Highlights:

• It will focus on correctional health care and reentry, and medical and mental health services account
• On April 1, 2025, we went live with care management services.
• We continue our collaboration with the Department of Health Care Services, the managed care plans, and
• So admin, executive staff, really non-direct patient care.”
• “really non-direct patient care, and essentially as your kind of direct costs go up, this group of people

Summary: The committee heard an overview from the Office of the Inspector General and California Correctional Health Care Services on prison oversight, medical care, reentry, and related budget requests. The OIG requested $275,000 General Fund for two additional intake analysts, citing a sharp rise in complaints from 3,200 in 2022 to 7,860 in 2025 and explaining that the unit reviews and routes complaints, including PREA and staff misconduct allegations, within 30 days. Its medical inspection unit reported on cycle seven prison health inspections, noting generally adequate case-review performance but weak policy-compliance results, especially in medication management and health care environment indicators, and said it was beginning cycle eight with revised inspection methods. Members questioned the OIG about what kinds of complaints were driving the increase, whether the office tracks validity or systemic patterns, and how it distinguishes duplicative complaints from those already handled by CDCR. OIG said the largest categories were prison conditions and staff misconduct, that it does not determine whether complaints are “valid” in a statistical sense, and that it forwards issues to CDCR or other entities as appropriate. Senators also asked about the medical inspection findings, the remaining prisons not yet delegated back from federal receivership, and whether more detail should be provided in future reports. LAO and Department of Finance staff said they had no concerns with the OIG proposal. The committee then reviewed the correctional health care budget, including staffing, pharmacy, contract medical costs, and the state’s progress toward ending the Plata medical receivership. CDCR said it is trying to reduce vacancies through hiring events, social media outreach, new classifications, and more on-site care, while also using CalAIM to improve reentry services; CalAIM officials reported 89% Medi-Cal activation at release, 87% managed care assignment, 88% reentry care plans, and 59% warm handoffs, with about $14.7 million in reimbursements to date. Members pressed staff on the cost of receivership, the pace of delegation, whether more care could be consolidated into fewer facilities, and whether the state should seek more federal reimbursement or alternative staffing models. Finally, the committee discussed the new mental health receivership and a telemental health staffing proposal. The receiver’s office requested $33.9 million from the Mental Health Special Deposit Fund, including $8.2 million for the receiver’s office and $25.3 million to make court-ordered bonus payments permanent; CDCR also sought about $8.9 million for telemental health staffing, growing to $13 million ongoing. LAO recommended approving the action plan and portions of the telehealth request, but urged the Legislature to monitor progress, consider out-of-state recruitment and expanded telehealth, and avoid across-the-board salary increases; Finance cautioned that out-of-state licensure would require major statutory changes and that staffing-ratio changes would need receiver approval. Senators raised concerns about the high cost of receiverships, vacancy-driven fines, the need for more detailed benchmarks, and whether the state should consolidate mental health populations and better target recruitment to fill hard-to-staff positions.

Transcript Highlights:

• I would have asked about her service on the board.
• Public service is in my DNA, and I care deeply about the staff at ADHS, several of whom I've known and
• , we do not license the scope of services.
• ’s one of those services or something else, it could be another physical health service.
• care, which is one of the allegations.

Summary: The Committee on Director Nominations met with four members present and approved the prior minutes without objection. Chair Jay Kaufman outlined the committee’s role in reviewing executive nominations and explained the hearing process for three nominees: Mary Foote for the Office of Economic Opportunity, Debbie Johnston for the Department of Health Services, and Chuck Bassett. Foote did not appear for her hearing, and members discussed her absence and alleged omissions in her disclosure materials, including prior service with Planned Parenthood-related organizations. The committee then moved to reject her nomination, and the motion passed 3-2, recommending that the full Senate reject Mary Foote. Debbie Johnston, nominee to lead the Department of Health Services, appeared and gave an opening statement describing her Arizona background, prior Senate staff work, and more than 20 years with the Arizona Hospital and Health Care Association. She said her priorities at ADHS include rebuilding trust in public health licensing, improving stakeholder engagement, standardizing rulemaking communication, addressing alleged religious discrimination and retaliation concerns in licensing, and using technology and AI to improve efficiency. In questioning, senators pressed her on her management style, conflict-of-interest safeguards given her prior industry role, enforcement priorities, budget pressures, behavioral health and assisted living oversight, and the department’s response to COVID-19. Johnston said she would follow statutes, recuse herself from enforcement matters involving former contacts, and resign if directed to carry out an unlawful policy. She also said the department does not regulate therapy itself, only facilities, and that it would rely on legal counsel regarding the governor’s conversion-therapy executive order and related federal civil-rights allegations. Several senators focused on public health trust and the department’s pandemic response, with Johnston acknowledging concerns about closures, data collection, and communication during COVID-19 while saying she would review past after-action materials and be better prepared in the future. Public testimony from stakeholders in aging services and health care strongly supported her confirmation, praising her accessibility, responsiveness, and collaborative approach. After testimony, the vice chair moved to recommend Johnston’s confirmation to the full Senate. The roll call was underway when the transcript ended, with several members voting aye and one member expressing reservations about her not reviewing the pandemic after-action report before another crisis occurs.

Transcript Highlights:

• The division consists of four budgeted programs: physical health services, laboratory services, suicide
• The second is the Idaho Child Care Program, which funds a portion of child care costs for Idaho’s low-income
• The Idaho Child Care Program capacity is intended to find child care programs needing short-term investments
• you to proceed in that direction?
• and close family friends who step in to care for children, which can prevent entry into foster care.

Keywords: 989, all

Summary: The committee first approved a $3,700 dedicated-fund enhancement for the Endowment Fund Investment Board to replace a high-end laptop. It then took up several Department of Lands items. A $125,000 supplemental for Forest and Range Fire Protection to help stand up firefighters was rejected after concerns were raised that prior firefighter bonus money had gone largely to office staff rather than firefighters. The committee did approve a supplemental shifting 1.25 FTP and $160,000 from the Abandoned Mines Lands Fund to the Navigable Waterways Fund to align spending with statutory uses, and later approved a broader FY 2027 Department of Lands package including radio equipment, vehicle storage, a UTV, legal counsel fund shifts, Idaho Geological Survey support, replacement items, and OITS hardware. A proposed substitute that would have omitted the $140,500 general-fund restoration for eastern Idaho fire preparedness failed, but the original motion including that amount passed. The committee also adopted language for the Idaho Geological Survey and later approved Parks and Recreation FY 2027 enhancements for staffing, trail work, a mower, grant pass-throughs, staff housing, interpretive displays, Farragut entrance work, RV campsite development, and replacement items, after questions about federal replacement-item funding were answered by the director. A FY 2026 Parks and Recreation supplemental allowing program transfers above the 10% cap also passed. The committee then moved to the Department of Health and Welfare’s Division of Public Health Services. It approved FY 2027 funding for the Idaho Home Visiting Program, immunization assessment fund restoration, disaster planning and training, fee-for-service lab testing, ARPA multi-year grants, HIV prevention, hepatitis prevention, and a $19,000 suicide prevention restoration; a substitute motion that would have reduced the home-visiting restoration to $500,000 failed, and the original motion passed. The committee adopted reporting language for suicide prevention, HIV prevention, hepatitis prevention, and immunization assessment funds. It then considered the Division of Early Learning and Development, approving funding for Idaho Child Care Program capacity, replacement items, population forecast adjustments, and the transfer of the Idaho Home Visiting Program from Public Health; a separate motion to require an open competitive acquisition process for Idaho STARS was set aside and the committee instead held the language in committee for further work. The committee also adopted language for Idaho Home Visiting reporting, Idaho Child Care Program reappropriation, Idaho Child Care Capacity Grant restrictions, and a transfer-limitation exemption for the division. Finally, the committee began the Division of Family and Community Partnerships and heard a request for $180,000 in federal funds for kinship navigation services to help relatives and close family friends care for children and prevent foster care entry. The transcript cuts off before the vote on that item, so no final action on it is shown here.