Transcript Highlights:

• Direct client Services, sorry. Direct client services were streamlined into HHSC.
• things like, um, acute care, so doctor, hospital, x-ray, long-term care services like nursing facility
• So the majority of people in Medicaid are receiving services through what we call managed care.
• Um, the legislature directed this agency to move away from fee for service and into the managed care
• These, um, I've already talked a little bit about those service delivery models, some in managed care

Committee: House Human Services

Transcript Highlights:

• care, in-home care, or TANF—would be in this area.
• Other agencies with large field service operations include DCYF. Next is goods and services.
• services.
• But the health care inflation or projected health care inflation is not included.
• 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

Keywords: 904, all

Transcript Highlights:

• needs, substance abuse services, mental health services, immunization, women and children's health services
• at the direction..."
• "OMB is the managerial agent that directs at the direction of the president.
• OMB directs the cabinet agencies.
• To Health and Human Services?

Bills: SB825

Committee: Senate Border Security

Keywords: illegal immigration, economic impact, environmental impact, financial impact, annual study, Texas, government report

Summary: The Senate Committee on Border Security heard testimony on Senate Bill 825 by Senator Middleton, as substituted, which would require an annual or biennial study of the economic, environmental, and financial impacts of illegal immigration in Texas. Middleton said the bill is intended to provide lawmakers with comprehensive data on costs to law enforcement, health care, education, infrastructure, and taxpayers, and to support possible federal reimbursement claims. Several senators, including Hinojosa and Eckhardt, agreed that a study is needed but raised concerns about bias, the scope of the study, and whether the Comptroller’s Office rather than the governor’s office should conduct it. Middleton argued the governor’s office was the best coordinating entity because it could direct multiple agencies to provide data, while Hinojosa and others emphasized the Comptroller’s expertise and prior 2006 study. Public testimony was generally supportive of the idea of a study but critical of the bill’s framing. Sarah Cruz of the ACLU of Texas said the study should be a full cost-benefit analysis and warned that focusing only on costs could create an anti-immigrant narrative. Danny Woodward of the Texas Civil Rights Project also supported the concept but recommended moving the study to the Comptroller or, alternatively, creating a neutral commission. Jaime Pointe of Every Texan likewise supported updating the 2006 analysis and said state agencies should be able to cooperate with a governor-led study. Resource witnesses from the governor’s office, HHSC, TEA, OCA, TDCJ, and DPS explained that data collection would be uneven across agencies. HHSC and TEA said they often do not collect immigration status and, in TEA’s case, federal law limits schools from requesting such information; OCA and TDCJ said they could provide only partial or indirect data unless new reporting requirements were added. DPS said it already has Operation Lone Star data but would need to collect additional information if tasked with the broader study. The chair asked the governor’s office to provide a follow-up answer on separation-of-powers and related authority questions by the following Tuesday, and the committee recessed subject to the call of the chair without taking a vote on the bill.

Transcript Highlights:

• The Hope Florida Foundation, which was established in 2023 as DCF's direct service organization, was
• And, you know, what I think about service is service is just love.
• You know, what I think about service is service is just love.
• care.
• Moving them to direct dispense also means they're losing access to their health care and access to their

Keywords: 998, house, all

Transcript Highlights:

• Providing rapid transit service to Roslindale Square would benefit Providing rapid transit service to
• This directs the MBTA to begin year-round commuter service within 12 months of the effective passage
• But there's so many different services, and there's so many different ways of obtaining those services
• But there's so many different services and there's so many different ways of obtaining those services
• I'll take care of this time. I'll take care of this time. Nice to see you. How are you doing?

Committee: Joint Joint Committee on Transportation

Keywords: 995, all

Summary: The committee heard testimony on a wide range of transportation bills focused on rural microtransit, commuter rail fares and service, rail electrification, climate alignment, and safety. Several speakers supported H. 4054 and related microtransit proposals, arguing that rural communities need stable, permanent funding for services like the Tri-Town Connector and Quaboag Connector, which have strong ridership, high satisfaction, and measurable economic and health benefits. Testimony also supported a commission bill to study microtransit funding and definitions, with witnesses emphasizing that current grant programs are helpful but short-term and insufficient for long-term service planning. A major theme was commuter rail equity and expansion. Boston-area officials and advocates backed bills to make all Boston commuter rail stations Zone 1A, citing large fare disparities between nearby stations in Hyde Park, Roslindale, and Readville. Related testimony supported studying an Orange Line extension from Forest Hills to Roslindale Square and expanding The Ride to Foxborough, as well as restoring commuter rail service to Cape Cod via Middleborough to Buzzards Bay and beyond. Speakers said these projects would improve access, reduce car dependence, and better serve neighborhoods and regions that currently face limited rapid transit options. Multiple panels urged action on electrification and climate-focused transportation planning, including H. 3726, the Freedom to Move Act, and bills to electrify commuter rail, buses, school buses, and public fleets. Advocates from environmental, transit, and public health groups said transportation is the state’s largest emissions source and argued that statutory goals, coordinated planning, and streamlined permitting are needed to speed decarbonization while improving safety, affordability, and reliability. The committee also heard support for a bill to streamline rail electrification permitting, a bill to exempt certain transit projects from MEPA review, and a bill to improve commuter rail pedestrian safety with gates, fencing, and warning devices at at-grade crossings. No votes were taken during the hearing.

Transcript Highlights:

• , as well as community care licensing and the Department of Child Support Services.
• It's unclear how these programs, like intensive services for foster care, will continue.
• I think that's partly a question for my colleagues at the Department of Health Care Services.
• Adult and senior care, children's residential, child care, and home care services programs have each
• For home care services, that's a specific target of mine.

Summary: The Assembly Budget Subcommittee on Human Services heard an informational hearing on child welfare, foster care, community care licensing, child support, and related budget issues. CDSS described the Governor’s proposed child and family services budget, emphasized a family-centered and kin-first approach, and reported that foster care entries and congregate care placements have declined over the past decade. Witnesses also highlighted the importance of extended foster care to age 21, while noting persistent racial disparities for Native American and Black children and the need for stronger prevention, family finding, and community-based supports. A major focus was the proposed tiered rate structure (TRS), which CDSS said would shift funding from placement-based rates to child-centered supports, including care and supervision, strength-building dollars, and immediate needs funding paired with high-fidelity wraparound services. CDSS and county representatives said implementation is on track, with foundational policy guidance expected by the end of the year, CANS/CFT timeliness targeted by year-end, and the CWS CARES system nearing go-live in October 2026. Counties and providers raised concerns about whether the rate model and wraparound capacity will be sufficient, especially for higher-acuity youth, and asked for more data, clearer guidance, and continued collaboration. County Welfare Directors Association representatives also requested continued emergency response funding and an extension of flexible family supports, arguing both are needed to stabilize front-end child welfare work and bridge to TRS. Providers from FFAs and STRTPs warned that insurance costs, provider closures, and the transition to TRS could threaten service capacity unless the state addresses long-term insurance and reimbursement issues. LAO noted the Governor’s budget contains no new child welfare augmentations and said the main General Fund change reflects the expiration of one-time funding. No votes were taken; members instead asked for follow-up data, technical assistance, and possible future legislative or trailer bill solutions, including on insurance and implementation timelines.

Transcript Highlights:

• Nursing home services are critical in our community, and it's time to put dignity in long-term care.
• As someone who receives home and community-based services for all my personal care and daily living needs
• Cuts to Medicaid, even when intended as cost savings, undermine access to essential primary care services
• Regional Markets is the only state program dedicated to the economic viability of small and direct-service
• Regional Markets is the only state program dedicated to the economic viability of small and direct-service

Summary: The committee held a public hearing on the Senate operating budget proposal, beginning with a staff briefing from James Kettle. He described the budget as built on relatively flat revenue after multiple forecast updates, with substantial mandatory cost growth, especially in Health Care Authority, DSHS, and DCYF. He highlighted major policy-level additions and savings, including large tort liability costs, continued support for long-term services, reductions tied to child care and K-12 items, several assumed revenue bills, and major transfers from reserves and other accounts. Kettle also noted the four-year outlook remained positive overall, with about $1 billion ending fund balance in the final year and roughly $3 billion in total reserves. A committee member asked about a diagram showing the loss of federal funds, and staff said they would follow up. Public testimony then focused first on K-12 education, where school leaders, teachers, OSPI, PTA, and rural district representatives largely opposed the proposed cuts to local effort assistance, transition to kindergarten, bus depreciation, and related school funding items. Many argued the reductions would disproportionately harm rural and property-poor districts and weaken early learning access, while several students and educators spoke in favor of career and technical education and IT Academy funding. The committee also heard support for wildfire prevention funding from the Commissioner of Public Lands, who thanked the Senate for restoring those dollars but raised concerns about recreation program reductions. Higher education testimony was mixed but generally supportive of the Senate proposal compared with the governor’s budget. Community and technical college leaders warned that the budget still shifts compensation costs to tuition and reduces Running Start funding, while university representatives from Western, Eastern, Central, WSU, and UW thanked the committee for avoiding deeper cuts. Private vocational college students and administrators urged extension of Washington College Grant eligibility for students already enrolled, and others asked to preserve IT Academy and related certification funding. In early learning, child care and advocacy groups praised the decision not to cap Working Connections Child Care but warned that child care and transition to kindergarten still bear a disproportionate share of cuts; they also requested continued support for Dolly Parton Imagination Library and Pierce County early childhood programs, including Family Connects. The hearing continued with testimony on employee compensation, mental health, and human services. State employee and retiree groups supported the budget’s COLA and wildfire funding but objected to cuts in retiree health benefits. Behavioral health and public safety advocates supported mentoring, Trueblood-related funding, crisis stabilization, and the Recovery Navigator Program, while others opposed reductions to those programs and to community-based recovery services. In human services, witnesses thanked the committee for funding victim services, child welfare supports, health homes, adult day care, community health centers, energy assistance, and disability services, while urging the committee to avoid further reductions to skilled nursing, case management, and recovery navigation. No votes were taken during the hearing.

Transcript Highlights:

• the direction of an anesthesiologist as part of a larger care team.
• , charity care to our community, as well as operating some services at a loss.
• Stories like this happen every day across diabetes care, behavioral health, homeless services, and more
• services.
• We need to take care of this crisis, and here's a service that can help out in this crisis.

Bills: SB5877 , SB5904 , SB5988

Committee: House Health Care & Wellness

Keywords: anesthesiology, medical personnel, surcharges, licensing, healthcare regulations, nursing titles, licensure, healthcare professionals, patient safety, professional standards, opioid treatment, accreditation, health department, fee authority, substance abuse, 904, all

Transcript Highlights:

• Care. the provision of services.
• This includes Medi-Cal primary care, mental health services, psychiatry, and supportive services.
• This includes Medi-Cal primary care, mental health services, psychiatry, and supportive services.
• services while keeping the health care system strong.
• services while keeping the health care.

Committee: House Health

Keywords: 988, house, all

Transcript Highlights:

• </c> council is to provide direct services. council is to provide direct services.
• Parents cannot direct health care if they're kept in the dark.
• They can offer a wide variety of services such as primary care, mental health services, sexual health
• , sexual care, mental health services, sexual health<02:07:06.560><c> services,</c><02:07:07.440><c>
• services, all within primary care services, all within schools.<02:22:55.840><c> Regardless</c><02:22

Committee: Senate Health and Human Services

Keywords: 1191, senate, all

Transcript Highlights:

• Patient care, research, and student financial aid.
• , food assistance, and other services.
• California cares about its residents.
• California understands that when we care about one person, we care about all of us.
• It's about attacking our basic ability. to provide human services and healthcare services to Californians

Keywords: 988, house, all

Transcript Highlights:

• Bless his decisions, his service, and the example he sets, and may your hand direct every step of his
• You don't care about the Constitution. You care about keeping a certain group of people in power.
• the very best of public service.
• Cantella, Secretary, by the Health and Human Services Committee, Health Care Budget Subcommittee, Health
• And much to Representative Hunschofsky's point, what I care more about is... ...what I care more about

Summary: The House met with a quorum present, heard prayers and ceremonial remarks, and then took up a series of returning messages from the Senate. The first major item was CS/CS/HB 1503 on computer science education and certification. Members explained that the House concurred in a Senate amendment that restored teacher certificate language, kept computer science and AI-related content in the bill, and delayed implementation to give the Department of Education time to develop curriculum. The House adopted the amendment and then passed the bill 105-0. The House also considered CS/CS/HB 1085 on local government cybersecurity. Members adopted a House amendment allowing local governments to buy into the cyber grant program even if they do not receive a grant, adding a five-year sunset and reporting provisions. The House then concurred in the Senate amendment shifting grant administration from a university to the Florida Digital Service, and passed the bill 104-1. Several other returning messages were rejected or sent back to the Senate. The House refused to concur in Senate amendments to CS/HB 351 on concurrent legislative jurisdiction over military installations and HB 6011 on reporting gifts or honoraria, as well as CS/HB 851 on professional learning for instructional and school administrative personnel. The most contentious debate came on CS/CS/HB 1471, which concerns systems of law and terrorist organizations; the Senate amendment defined “promote,” refined notice and timeline requirements, and retained references to Sharia law. Opponents argued the bill was overbroad, lacked due process and evidentiary standards, and threatened First Amendment rights, while supporters said it targeted conduct, not speech, and protected against terrorist support. The House adopted the amendment and passed the bill 80-25. The House then took up a related public records bill, CS/CS/HB 1473, which made a technical conforming change to align with HB 1471; debate focused on transparency and due process concerns.

Transcript Highlights:

• Rural emergency hospitals provide rural emergency services and other care that do not require treatment
• How are we as a state integrating behavioral health services into kid care? You recognize.
• Just behavioral health service. Yes. Just behavioral health service and kid care in general.
• entities to implement new health care screening or service programs, or to expand existing programs
• Pharmacy to ensure that patients have access to primary care services.

Committee: Senate Health Policy

Summary: The committee opened with roll call, welcomed members back for the first committee weeks, and heard brief personal updates from several senators before moving into agency implementation updates on recently enacted health care laws. The Agency for Health Care Administration reported on Senate Bill 64 creating rural emergency hospitals, explaining that AHCA adopted the required rules effective June 1, 2025, but that no hospitals have yet been designated. Members asked about possible hospital conversions, accreditation and survey responsibilities, and whether Florida would apply for federal rural health transformation funding; AHCA said it intends to apply and has already been working on the issue with federal officials. AHCA also reviewed the non-emergent care access plan requirement under Senate Bill 7016. The agency said hospitals with emergency departments must submit plans that help redirect non-emergent patients to appropriate care settings while complying with EMTALA, and that 83 plans had been received and 63 approved as of September 30. Members asked about data collection, managed care coordination, and the state’s health information exchange; AHCA said it has moved to a new HIE vendor and will continue monitoring implementation and possible care gaps. AHCA then updated the committee on the TEACH program, saying $6.8 million was spent in 2024-25 across 59 parent organizations and 229 facilities, with more than 1,800 students and nearly 380,000 clinical hours reimbursed. The agency said rulemaking is nearly complete, a new nursing student category and expanded facility eligibility were added, and a federal 1115 workforce waiver remains stalled after CMS signaled it will not approve new workforce demonstrations. AHCA also reviewed House Bill 121 on KidCare eligibility, explaining that implementation of the 300% poverty-level expansion remains blocked by federal litigation and waiver issues tied to premium nonpayment rules; members and public speakers urged action to close the coverage gap. Public testimony on AHCA’s presentation came from representatives of health centers and advocacy groups, who said the non-emergent care access plan has improved hospital-health center coordination and reduced repeat emergency use, and who urged implementation of KidCare expansion for children in the coverage gap. The Department of Health then presented updates on FRAM, the Sanadi screening grant program, the Health Care Innovation Revolving Loan Program, telehealth maternity care, swimming lesson vouchers, and House Bill 159 on pharmacist dispensing of HIV post-exposure prophylaxis. DOH reported strong participation in FRAM and the telehealth maternity program, 24 Sanadi grant awards in 42 counties, 4,945 swimming lesson vouchers issued last year and 2,371 so far this year, and three approved certification courses with five pharmacist certifications issued under HB 159. Committee members asked about recruitment of dentists and other providers, telehealth maternity outcomes, and why participation in the maternity program remains below expected levels; DOH said outreach and regional referral networks are expanding and more detailed outcome data will be included in the upcoming legislative report.

Transcript Highlights:

• services.
• Access to Health Care Act, allowing cosmetologists to provide aesthetic body contouring services without
• services.
• Access to Health Care Act, allowing cosmetologists to provide aesthetic body contouring services without
• Definition of careful and prudent matter for a right turns on. from the Senate bill, definition of careful

Summary: The Senate convened with a quorum, opening with prayer, the Pledge of Allegiance, and a series of recognitions for interns, staff, and guests. Members also honored a retiring Senate staffer and a wounded veteran, then moved into returning House messages and special order bills. Several measures were taken up and either concurred in or sent back to the House, with multiple unanimous or near-unanimous votes on noncontroversial bills. Among the bills addressed were SB 118 on recreational vehicle park assessments, SB 572 on ethics for public officers and employees, and HB 991 on election integrity. SB 118 and SB 572 were amended to reflect House changes and passed 38-0. HB 991 drew extensive debate over voter registration and identification requirements, with opponents arguing it would burden students, seniors, disabled voters, and others, while supporters said it would strengthen election security and streamline verification; it passed 27-12. The chamber also approved bills on historic cemeteries, chickee regulation, habitual traffic offender designation, military affairs, and a Department of Health package. The Department of Health bill (SB 902/HB 733) was the subject of detailed amendment work, including changes to medical marijuana rules, NICU educational materials, Early Steps, dental loan repayment, and pediatric trauma center designation. The Senate adopted an amendment to the amendment and then passed the bill 37-0. Other measures included a funeral services bill, which the Senate refused to concur in because the House strike-all would redefine cremation to include composting, and a veterans-related bill that was temporarily postponed. The Senate also recessed briefly, then returned to continue the calendar and additional recognitions.

Transcript Highlights:

• It's based on a solid infrastructure and resource for consistent services to child care providers.
• In reality, the work of the program includes significant direct client services to families, including
• I'm the Executive Director of Long-Term Care Ombudsman Services of San Luis Obispo County.
• care ombudsman services in Sonoma County and also the California Long-Term Care Ombudsman Association
• Senior Advocacy Services provides long-term care ombudsman services in Sonoma County and also the California

Summary: The committee heard several bills focused on disability services, food security, veterans, aging services, and child care. SB 969 by Senator Reyes would make permanent the option for Californians with intellectual and developmental disabilities to receive certain regional center services remotely; supporters said remote services improve access, continuity, safety, and choice, and there was no opposition. The committee initially lacked a quorum, so action on the bill was delayed until later in the hearing, when it was moved on a 4-0 vote to Appropriations. SB 1025 by Senator Hurtado would create an Office of Food Security and Affordability to coordinate state food programs, improve CalFresh enrollment, reduce duplication, and support a 24-hour hunger hotline; supporters framed it as a coordination and strategic-planning measure, while some members questioned whether existing programs should be evaluated first and whether the bill needed stronger reporting and accountability. It passed 3-0 to Governmental Organization. The committee also heard SB 1052 by Senator Gonzalez, which would allow the State Council on Developmental Disabilities to appoint contingent authorized representatives so people with developmental disabilities are not left without support if a parent or other primary helper becomes unavailable. Supporters, including families and disability advocates, described emergencies, immigration enforcement fears, and service interruptions as reasons for the bill; members asked about the current approval and renewal process and whether the annual renewal requirement could be streamlined. The bill passed 3-0 to Appropriations. SB 1077, also by Senator Gonzalez, would require the Department of Social Services to prepare for future federal shutdowns by creating a communications and contingency plan for CalFresh disruptions and a state-backed emergency benefits mechanism; supporters cited the 43-day federal shutdown and delays in benefits, and the bill passed 4-0 to Appropriations. Other measures discussed included SB 1201 by Senator McNerney, the No Hungry Heroes Act, which would seek waivers and direct referrals to protect veterans from federal SNAP changes and job-search-related income calculations; it passed 3-0 to Military and Veterans Affairs. SB 1261 by Senator Laird would let aging and disability resource connections continue operating during partner transitions so people do not lose access to “no wrong door” services; it passed 3-0 to Appropriations. SB 1110 by Senator Becker would update child care subsidy funding and reimbursement structures to better reflect direct family services and stabilize providers; the author said a provision tied to the budget would be removed, and the bill passed 4-0 to Education. Finally, SB 991 by Senator Menjivar was presented to improve how abuse and neglect findings in residential care facilities for the elderly are categorized in the licensing database, so serious abuse is not lumped together with lesser violations; testimony described examples of sexual assault and restraint being recorded as generic residents’ rights violations.

Transcript Highlights:

• Today we will be discussing the Governor's May Revise proposal in Child Care and Human Services.
• First, I want to appreciate that this May Revision doesn't cut child care rates or services.
• My assignment also includes the Department of Health Care Services.
• How are those in need of services expected to continue receiving care?
• We've protected the Lanterman Act entitlement, direct services, including direct services to young children

Summary: The hearing began with opening remarks on the Governor’s May Revision for child care and human services, with committee members and advocates stressing that the budget should not be balanced on the backs of low-income families, children, and providers. Legislative members and public witnesses strongly opposed the proposed suspension of the child care COLA, reductions to the Emergency Child Care Bridge Program, and the lack of codified rate reform tied to the alternative methodology. Several speakers also urged more support for providers affected by the Eaton fire and other disasters, and called for child care to be funded at the true cost of care and for additional slots to be restored. Administration, LAO, and Department of Education staff described the child care proposal as maintaining existing funding levels while adding administrative resources to prepare for federally required prospective payment changes and single-rate reform. The administration said the May Revision would suspend the 2025–26 COLA and reduce Bridge Program funding to align with utilization, while the LAO raised questions about the size and purpose of the proposed rate-reform and prospective-payment funding and recommended rejecting a Department of Technology exemption. CDE supported continued early education investments but said it would need additional resources if prospective pay were extended to state preschool, and it objected to a proposed reallocation of preschool funds for inclusive education grants. The committee then moved to the IHSS portion of the May Revision. DSS outlined five major proposals: capping provider work hours at 50 per week, eliminating IHSS for undocumented adults age 19 and older, shifting certain Community First Choice reassessment penalties to counties, reinstating the Medi-Cal asset test as a conforming IHSS reduction, and automating the termination of IHSS when Medi-Cal eligibility ends. DSS also discussed funding to implement a federal HCBS access rule and a separate reassessment of IHSS administrative methodology that found counties would need additional administrative funding. Finance said the proposals were intended to slow program growth and improve sustainability, while the LAO said it was still analyzing the package and raised concerns about implementation, county workload, and the potential loss of services. Committee members and public commenters criticized the IHSS cuts, especially the overtime cap and the elimination of services for undocumented adults and people affected by the asset test. Advocates argued that IHSS workers and recipients depend on these services, that county administration is already underfunded, and that the proposals could destabilize vulnerable consumers. The chair closed by saying the committee would continue to fight for child care and would not pause on child care, and the meeting recessed before moving on to the remaining May Revision items.

Transcript Highlights:

• With the expansion of other health care options, this would shorten the coverage of SUD services from
• And then lastly, I'm going to go over very quickly our proposals around direct care and treatment.
• </c><00:36:23.160><c> Care</c><00:36:23.359><c> and</c> proposals around Direct Care and proposals around
• </c><00:36:39.280><c> care</c><00:36:39.440><c> and</c> operating adjustment to direct care and operating
• </c><00:37:43.319><c> during</c><00:37:43.599><c> the</c> direct care and treatment so during the direct

Committee: Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• Nearly 800 staff deliver care across health, housing, social services, cultural services, education,
• Nearly 800 staff deliver care across health, housing, social services, cultural services, education,
• This includes Medi-Cal primary care, mental health services, psychiatry, and supportive services. 56%
• s ability to deliver health care services to our communities.
• services for all. ...reduce access to prenatal, reproductive, and women's health care services for all

Summary: The Assembly Health Committee held an informational hearing on the impact of federal H.R. 1 and related state budget actions on California’s health care system. Opening remarks framed the federal changes as a major threat to Medi-Cal, Covered California, hospitals, clinics, and the broader safety net, with warnings that millions could lose coverage and that costs would shift to providers, counties, and consumers. Testimony from the California Health Care Foundation and the Legislative Analyst’s Office focused on implementation challenges, the administrative burden of work requirements and more frequent renewals, the loss of federal funding, and the need for California to consider long-term structural changes to Medi-Cal, county safety-net programs, and cost containment. A Covered California enrollee, Chas Franklin, described sharply rising premiums for his family after losing subsidies, illustrating the personal impact of federal policy changes. Committee members raised concerns about whether premium increases were driven by H.R. 1 or insurer pricing, the cost of rebuilding county-based indigent care systems, and the need to account for the cost of inaction. Dr. Hernandez pointed to pre-ACA models such as Healthy San Francisco as examples of coordinated local safety-net care, while also emphasizing the importance of primary care, data interoperability, and the Office of Health Care Affordability in reducing waste and improving access. Department of Health Care Services officials then outlined the state’s implementation plan for H.R. 1, including work requirements, six-month redeterminations, reduced retroactive coverage, cost-sharing, and immigration-related eligibility changes. They said the department would try to automate eligibility checks, expand outreach, and train counties and partners, but estimated up to 2 million Californians could lose coverage over time. Covered California reported that the expiration of enhanced federal premium tax credits and new federal marketplace rules are already raising costs and reducing enrollment, with an estimated 400,000 enrollees at risk of dropping coverage. County, hospital, and safety-net representatives warned that coverage losses will increase uncompensated care and strain local systems, while one coalition proposed a temporary state-funded coverage option as a bridge if full-scope Medi-Cal cannot be maintained. The hearing concluded with a policy analyst urging stakeholder engagement, immigrant protections, and new state revenue options to preserve coverage and offset federal cuts.

Transcript Highlights:

• She's finally retiring after a long career in public service.
• services.
• Access to Health Care Act, allowing cosmetologists to provide aesthetic body contouring services without
• Access to Health Care Act, allowing cosmetologists to provide aesthetic body contouring services without
• and access to care with patient safety.

Keywords: 999, senate, all

Transcript Highlights:

• But specifically, the coalitions, while we contract with the providers for the direct services of these
• SR provides child care services for children birth through age 13 who are economically disadvantaged,
• We are seeing an uptick in to continue receiving an additional 12 months of child care services using
• Sorry, do they work for child care providers in their service area, or do they work for parents?
• , right, for full direct service and provision of services to children and families.

Summary: The Pre-K through 12 Budget Subcommittee met with a quorum and focused on School Readiness, specifically the new provider reimbursement rates and the School Readiness Plus program. The chair gave an overview of how School Readiness is funded and administered, noting that the Legislature now sets county-based reimbursement rates using market and cost data, and that School Readiness Plus was created to help families who would otherwise fall off the subsidy “cliff” at 85% of state median income by extending assistance up to 100% of state median income. Panelists from the Children’s Forum, the Association of Early Learning Coalitions, and the Division of Early Learning described the programs as major workforce and family-support tools that help parents stay employed and help providers recruit and retain qualified staff. Testimony emphasized that higher reimbursement rates increase parental choice, help providers cover rising child care costs, and support better staffing and lower turnover. The panel also said School Readiness Plus is easing the pressure on families to turn down raises or promotions for fear of losing child care assistance, though uptake is still early because the program only began in late 2024 and is only available to current School Readiness families at redetermination. The Division of Early Learning reported about 275 children enrolled in School Readiness Plus as of March 10, with expenditures of about $161,420 through January 2025, and said participation is increasing. Members asked about the federal-state funding split, wait lists, reverted funds, coalition accountability, county-based rate differences, and whether the entrance eligibility threshold should be raised or shifted to state median income. The panel said roughly 70% of School Readiness funding is federal, about 4% has typically reverted in recent years, and the wait list is around 12,000 children, with reasons including income ineligibility, lack of available seats, and funding limits. They argued that raising the entrance threshold would expand access but would require additional funding, and they also discussed the need to reduce workforce barriers such as in-person testing and training requirements. The meeting ended with no formal action beyond the presentation and member discussion, and the subcommittee adjourned.