Transcript Highlights:

• THE BODY HEALTH COVERS CANCER AND DEMENTIA BUT ON A CLINICAL LEVEL IT DISTINGUISHES IT FROM THE BRAIN
• THE CLINIC BECAME THE SIXTH CENTER OF EXCELLENCE IN THE STATE.
• IN ADDITION TO US AND MEMORIALS WE HAVE MEMBERS FROM US SCRIPTS, CLEVELAND CLINIC FLORIDA AND DELRAY
• IN TERMS OF THE DEMENTIA COMPONENTS I WAS TALKING ABOUT A CLINICAL OUTREACH COMING OUT OF I-HEALTH.
• PART OF THIS CLINICAL TRIAL, THE PATIENT WAS TREATED WITH FOCUSED ULTRASOUND BUT ONLY FOR ONE SIDE OF

Transcript Highlights:

• Issue number four is laboratory testing. Recommendations.
• Recommendations continue RIDR2 laboratory testing.
• We're going to start with the ectoparasite field identification laboratory, a request of $272,552.02
• That was the initial clinical sign along with a couple of other things that really keyed the Dairyman
• And clinics that could use that money to help out with low-cost spays and neuters.

Bills: SB1 , SB 1

Committee: Senate Finance

Bills: SCR12 , HB221 , HB509 , HCR58 , HB75 , HB1222 , SB121 , SB312 , SB348 , SB485 , SCR9 , SCR58 , SB65 , SB215 , SB249 , SB269 , SB282 , SB296 , SB323 , SB363 , SB369 , SB474 , SB490 , SB492 , SB500 , SB514 , HCR54 , HCR79 , HCR87 , HCR94 , HCR104 , HCR32 , HB944 , HB17 , HB41 , HB73 , HB223 , HB244 , HB410 , HB750 , HB759 , HB906 , HB966 , HB1006 , HB1009 , HB1086 , HB1107 , HB1112 , HB1215 , HB1242 , SB208 , SB217 , SB283 , SB387 , SB389 , SB401 , SB408 , SB469 , HB74 , HB119 , HB368 , HB414 , HB552 , HB732 , HB776 , HB848 , HB870 , HB953 , HB956 , HB1236 , SB29 , SB42 , SB43 , SB78 , SB149 , SB274 , SB300 , SB341 , SB382 , SB441 , SB449 , HB134 , HB210 , HB258 , HB359 , HB468 , HB784 , HB1117

Keywords: logging, recognition, John Keith, environment, safety, Mississippi River bridge, Trump Expressway, transportation, federal funding, Louisiana highways, injection wells, public hearing, geologic sequestration, environmental impact, public comment, Ascension Parish, state capitol, economic development, community partnership, celebration day

Transcript Highlights:

• Chairman, Representative Nelson, the clinical director for the Department of Health and Human Services
• The clinical director for the Department of Health and Human Services did appear in support of the bill
• You know, how much laboratory space, how much teaching space, how much office space.
• You know, how much laboratory space, how much teaching space, how much office space.
• You know, how much laboratory space, how much teaching space, how much office space.

Committee: House Appropriations

Summary: The committee first heard Senate Bill 2271, which would formally place adult residential facilities in code and rebase their Medicaid reimbursement rates. Sponsor Chairman Ruby and HHS staff explained that these facilities, often serving people with dementia or acquired brain injury, are reimbursed at a much lower rate than skilled nursing care and help reduce bottlenecks in higher-level facilities. Members questioned how the program differs from basic care and nursing facility memory care, and the bill was referred to the HR section for deeper review before possible action on Monday. The committee then took up Senate Bill 2396, as amended, which would authorize an independent third-party performance audit of the Department of Commerce and the North Dakota Development Fund, with findings shared with the state auditor. Sponsors said the proposal was prompted by concerns raised in testimony and that a private audit could begin faster than a state audit. The committee adopted an amendment adding an emergency clause and directing the report to the Legislative Audit and Fiscal Review Committee, then passed the bill 20-0 with 3 absent. Next, Representative Clemine presented Senate Bills 2226, 2036, and 2037. SB 2226 would presume an incarcerated person indigent at initial appearance so counsel can be provided at that critical stage; the commission said the appropriation would fund contract attorney hours, and the bill was sent to HR for further review. SB 2036 would create procedures for determining juvenile fitness to proceed in delinquency cases, with a $500,000 appropriation for mental health evaluations, and SB 2037 would begin a juvenile criminal code framework and include a $300,000 appropriation for fitness-to-proceed evaluations; both were also referred to HR, with some concern raised about staffing and overlapping functions. After a short break, the committee heard education-related appropriations bills. SB 2234 would replace expired ESSER funding for Choice Ready grants, but members noted the program was not included in the K-12 budget and sent it to E&E for comparison with existing appropriations. SB 2286, a University of North Dakota request for a new nursing school facility, drew extensive discussion about the age and condition of the current building and the size and scope of the project; the committee ultimately adopted a do-not-pass motion 22-0. SB 2213, the “science of mathematics” bill modeled on the science of reading initiative, would fund math professional development and implementation; it was also referred to E&E for further review. The committee then briefly passed the Racing Commission budget, SB 2023, and began discussion of the Trust Lands budget, SB 2013, including a proposed retention increase for investment-related positions.

Transcript Highlights:

• If there is not a drug on the PDL that is an acceptable clinical alternative; if the alternatives, if
• It makes sense fiscally, clinically, and compassionately.
• health care facilities, for nursing homes, for assisted living facilities, for hospitals, for laboratories
• It also requires years of clinical experience after our formative medical education is over.

Committee: Senate Health Policy

Summary: The Senate Committee on Health Policy met with a quorum and heard five bills. SB 126, on prescription hearing aids, would remove Florida’s prohibition on mailing hearing aids when required tele-audiology testing and procedures are completed before sale. The sponsor said the bill would improve access, especially for people with travel or geographic barriers. The Florida Academy of Audiologists expressed support in concept but said it was still working with the sponsor on an amendment for consumer safety. The committee voted the bill favorably. SB 152 would require hospitals and ambulatory surgical centers to adopt policies using smoke evacuation systems during certain surgical procedures. Supporters, including the Florida Nurses Association and several nurses, described surgical smoke as a workplace and patient safety hazard containing harmful chemicals, viruses, bacteria, and other contaminants, and said evacuation technology is available and already required in some settings. The committee voted the bill favorably. SB 264 would expand step-therapy exemptions for severe mental illness, including certain postpartum and pregnancy-related mental health conditions, so physicians would not have to require patients to fail preferred drugs in specified circumstances. Support came from Otsuka Pharmaceuticals, NAMI Florida, and several medical and pharmacy groups, who argued that delays in effective treatment can worsen crises and increase hospital and crisis-care costs. The committee voted the bill favorably. SB 342 would create a public-records exemption for current and former AHCA employees and certain family information, citing threats and harassment directed at inspectors and regulators. President Gaetz said he generally opposes such exemptions but supported this one because the employees are not elected officials and face real safety risks. The committee voted the bill favorably. SB 294 would limit the Board of Pharmacy’s ability to add heart failure, coronary heart disease, and cardiac rhythm disorders to the list of chronic conditions eligible for collaborative pharmacy practice, keeping those conditions under direct physician management. The Florida Society of Thoracic and Cardiovascular Surgeons, Florida Medical Association, and the Florida chapter of the American College of Cardiology supported the bill, while the Florida Society of Health System Pharmacists opposed it. The committee voted the bill favorably. Senator Trumbull asked to be recorded in support of SB 126 and SB 152, and the meeting adjourned without further business.

Transcript Highlights:

• Now it could do that, and if the conversation was to have a centralized laboratory to handle this, then
• built into that. conversation was to have a centralized conversation was to have a centralized laboratory
• to handle this then in that laboratory to handle this then in that conversation<00:17:32.799><c> our
• What we've seen is an expansion that has focused mostly less on the safety net clinics, more from those
• ,</c><00:31:51.279><c> more</c> less on the uh safety net clinics, more less on the uh safety net clinics

Committee: Senate Health and Human Services

Summary: The committee heard testimony on HB 302, which would expand access to medical cannabis by removing the in-person provider-patient relationship requirement and related restrictions. The Department of Health supported the bill, and multiple advocates and organizations testified in support, including the ACLU of Hawaii, Hawaii Alliance for Cannabis Reform, Marijuana Policy Project, and others. Supporters said the measure would improve access for patients, especially on outer islands, and some urged broader amendments allowing providers to certify cannabis for any medical condition and to speed registration and treat in-state and out-of-state patients equally. No opposition was heard, and the bill was left with no questions after testimony. The committee also heard HB 1052 HD1, which clarifies that the Public Utilities Commission may use universal service fund monies to provide free telecommunications access for individuals with print disabilities. Testimony was uniformly supportive from the DCCA Division of Consumer Advocacy, the State Council on Developmental Disabilities, the Department of Human Services, the Public Utilities Commission, and the National Federation of the Blind of Hawaii. Witnesses described the program as an important accessibility service that has been operating under prior appropriations and should continue under the universal service program. HB 1482, relating to controlled substances and hemp/synthetic cannabinoids, drew support from the Department of Law Enforcement, Department of Health, Honolulu Police Department, and others, with some comments from the Attorney General’s office. Supporters said the bill would clarify that delta-8 THC is a controlled substance and help enforcement against illegal hemp products and synthetic cannabinoids. Testimony and questioning focused on the need for better lab testing capacity, retail registry and age-gating, seizure authority, nuisance abatement, and possible use of special funds or appropriations to support enforcement. Members also discussed enforcement of illegal hemp businesses and whether additional funding or statutory changes would be needed. Finally, the committee took up HB 712, a 340B drug-discount measure affecting safety-net providers and contract pharmacies. Hospitals, health centers, and provider groups testified in support, saying the bill would protect access to discounted drugs and preserve funding for services such as chronic disease management, transportation, and specialty care. Pharmaceutical-industry representatives opposed the bill or sought amendments, arguing the 340B program has expanded beyond its original intent and lacks transparency, and they requested reporting or audit-like provisions to verify claims and revenues. Members questioned both sides about alleged abuse, the growth of contract pharmacies, and whether the bill should include transparency requirements before moving forward.

Transcript Highlights:

• excited to do patient care, and the work environment was so stressful that they found other jobs, in clinics
• orienting on the unit, I must further divide my focus so that the student isn't shortchanged of a clinical
• do you know of any efforts to either acquire And/or expand the number of beds and/or the number of clinics
• We send those vials to the lab, to the Scientific Laboratory Division, Department of Health in Albuquerque
• So that can be a nurse, laboratory technician.

Committee: House House Health & Human Services

Transcript Highlights:

• This program would place aspiring health care professionals in paid clinical positions in health care
• The program would place aspiring health care professionals in paid clinical positions in health care
• In fact, today's laboratory detection limits can analyze to one part per billion.

Committee: Senate Executive

Summary: The committee met in hybrid format, approved the June 24 and June 25, 2026 minutes, and then heard several bills and a joint resolution. On House Bill 382 with House Amendment 2, Senator Hoffer explained the measure as a technical correction to prior rental-car and peer-to-peer car-sharing law that would clarify when loss-of-use damages may be recovered while preserving recovery for intentional, willful, or criminal conduct. Avis Budget Group and Enterprise Mobility supported the bill, saying it resolved ambiguity and restored limited common-law recovery, while Allstate and Toro opposed it, arguing the bill could reintroduce unfair and unpredictable fees and leave too much discretion to rental companies. No vote was taken in the transcript, and Senator Townsend said he still had questions about how the bill would operate. The committee then considered House Bill 476, a Frederica charter change that would reduce town council meetings from twice monthly to monthly and make ordinances effective immediately unless otherwise stated. Representative Postles presented it as a simple, noncontroversial change, though members noted Senator Buckson, the Senate sponsor, was not present at the time. No public comment was offered on that bill. The committee also heard House Joint Resolution 13, which directs the Department of Labor to study a Delaware health care apprenticeship degree program and report recommendations; the Delaware Health Care Association supported the resolution and urged coordination with existing workforce efforts. Finally, the committee heard House Bill 458 with House Amendment 1 on backflow devices in low-hazard buildings. Senator Pardee said the bill would exempt residences and office-type buildings from costly backflow retrofits until regulations are updated, and DHSS said the current regulations do not clearly define low hazard but that the bill’s list of exempted buildings would not raise immediate public health concerns. The Delaware Association of Realtors supported the bill, arguing the regulations were overbroad and costly, while the Delaware Rural Water Association opposed it, warning that weakening backflow protections could threaten drinking water and aquifers. The committee then adjourned without any recorded votes on the substantive bills in the transcript.

Transcript Highlights:

• PREFERRED DRUG LIST IF FOR DIFFERENT CONDITIONS, IF THERE IS NOT A DRUG ON THE PDL THAT IS AN ACCEPTABLE CLINICAL
• REGULATORY AGENCY FOR OUR HEALTHCARE FACILITIES, FOR NURSING HOMES, ASSISTED LIVING FACILITIES, FOR LABORATORIES
• IT REQUIRES YEARS OF CLINICAL EXPERIENCE AFTER OUR FORMATIVE MEDICAL LITIGATION IS OVER INCLUDING ONGOING

Transcript Highlights:

• 10 are also intoxicating and they can induce psychosis as well, and this has been shown in human clinical
• 10 are also intoxicating and they can induce psychosis as well, and this has been shown in human clinical
• The states are the laboratory on this.
• The states are the laboratory on this.
• More recently, I've devoted most of my clinical work to treating teens with mental health and substance

Committee: Joint Joint Committee on Cannabis Policy

Summary: The Joint Committee on Cannabis Policy held a hearing on a broad set of cannabis and hemp bills, with the chairs opening by emphasizing unfinished work on equity, public health, safety, and market stability. The committee heard testimony on House Bill 146, which would create more efficient cannabis testing standards by increasing batch sizes, reducing or eliminating some environmental testing, standardizing lab reporting, and requiring annual scientific review and public data reporting. Industry witnesses, including a representative of the Massachusetts Cannabis Coalition, cultivators, and a testing lab owner, said current testing rules are overly burdensome, costly, and inconsistent, and argued the bill would lower compliance costs while preserving consumer safety. A testing lab witness also said some operators switch labs to obtain higher THC results or pass contaminated batches, and urged greater transparency and better sampling protocols. A major portion of the hearing focused on intoxicating hemp and related bills that would bring hemp-derived intoxicating products under a stronger regulatory framework. Legislators and industry witnesses described products sold in gas stations, smoke shops, and convenience stores as often untested, not age-gated, and sometimes mislabeled or far above the federal hemp THC threshold. Testimony from attorneys and cannabis business leaders said states can regulate these products more strictly under the Farm Bill’s non-preemption language, and pointed to New Jersey and other states as possible models. Some witnesses and committee members stressed that any new rules should avoid harming non-intoxicating CBD businesses or lawful hemp farmers, while others argued that the products are effectively cannabis and should be regulated like cannabis for licensing, testing, age limits, and taxation. The committee also heard extensive public-health testimony in support of bills S. 95, S. 96, S. 97 and their House counterparts H. 191, H. 192, and H. 193. Parents, advocates, and public health professionals urged stronger warning labels, THC potency caps, and improved data collection on cannabis-related harms, citing cannabis-induced psychosis, addiction, anxiety, and youth exposure to high-potency products. Several witnesses said Massachusetts has not done enough to track health outcomes or warn consumers, and referenced other jurisdictions such as Connecticut, Vermont, Colorado, Canada, and Quebec as examples of stronger limits or warnings. No votes or formal actions were taken during the hearing; the committee primarily received testimony and questions.

Bills: SB1421 , SB1427 , SB1484 , SB1503 , SB1553 , SB1557 , SB1564 , SB1566 , SB1567 , SB1591 , SB1642 , SB1794 , SB1837 , SB2044

Committee: Senate Health and Human Services

Keywords: mental health, nonphysical intervention, training, youth care, conflict resolution, staff training, pediatric screenings, type 1 diabetes, health care providers, parental consent, reimbursement, state funding, public health, medicolegal investigation, medical examiner, coroner, sudden infant death syndrome, SIDS, sudden unexpected infant death, SUID

Transcript Highlights:

• In Pfizer's own clinical trials, infants born to recipients showed a higher rate of health complications
• It maintains access for novel therapies under clinical trials for compassionate use.
• I retired last May, but I still volunteer at a clinic where I serve uninsured in our community.
• And it still allows for clinical trials.
• It talks about clinical trials.

Committee: Senate Health and Welfare

Transcript Highlights:

• pharmacists, to repeal Section 43-15-25.23 of the North Dakota Century Code, relating to approved laboratory
• My question is focused on how do we assess whether a pharmacist has sufficient clinical knowledge to
• and then the ability to do diagnostic and clinical assessments like stethoscope use, otoscope use, etc
• You know, does a pharmacist have the clinical skills to, you know, we spend a lot of effort training
• I've worked in rural clinics located in New Salem, Center, Hebron, Steele, and Richardson.

Bills: HB1621 , HB1624 , HB1623 , HB1622 , HB1625 , HB1626 , HB1627 , HCR3038

Summary: The North Dakota House convened in special session with prayer, roll call, and a quorum present, then took up several rural health-related bills. Senate Bill 2401, as amended, required physicians to complete one hour of continuing education in nutrition and metabolic health each renewal cycle and also added language allowing criminal history background checks for the Board of Occupational Therapy Practice. Supporters emphasized the role of nutrition in reducing chronic disease, and the bill passed 92-0. The House then considered Senate Bill 2402, which expanded pharmacists’ limited prescriptive and therapeutic substitution authority for certain low-acuity conditions and clarified related lab-test and communication requirements. Members discussed examples such as motion sickness, cold sores, lice, hypoglycemia, COVID and flu testing, emergency access to medications and supplies, and limits excluding certain drug classes; the bill passed 91-1. Senate Bill 2403 created a temporary medical facility emergency operating loan option through the Bank of North Dakota for qualifying rural hospitals facing severe financial distress, with extensive debate over the targeted nature of the aid, anti-gifting concerns, repayment terms, and the hospital’s turnaround plan; it passed 80-12. Senate Bill 2404 appropriated funds for NDIT to address federal digital accessibility requirements and for the Public Service Commission’s litigation efforts related to transmission costs, with a backup loan authorization available if needed; it passed 92-0. At the close of the session, leaders thanked members and staff for their work on the rural health transformation package, a committee notified the Governor and the Senate that the House had completed its business, absent members were excused, and the House adjourned sine die.

Transcript Highlights:

• sharing what I've learned with others, whether it be clipping a cow for someone, leading a showmanship clinic
• Whether it be clipping a cow for someone, leading a showmanship clinic, or speaking to groups about agriculture
• Our third goal is to invest in our three 4-H camps as year-round learning laboratories for agriculture
• 4-H Camp Cherry Lake is a prime location for an agriculture and workforce development learning laboratory

Committee: Senate Agriculture

Summary: The Committee on Agriculture met with a quorum present and first heard SB 1826 by Senator Martin, which would restrict ultra-processed foods served to public school students during the school day. Senator Martin said the bill is aimed only at government-purchased food in public schools, not parents’ lunches or after-school sales, and argued it is intended to protect children’s health and school performance. Members questioned the bill’s definition of ultra-processed food, its scope during the school day, and possible cost and compliance issues. Senator Rouson offered a friendly amendment extending the compliance date from July 1, 2025 to July 1, 2026, and the committee adopted it. Several industry groups and associations spoke against the bill, citing lack of a clear definition, FDA preemption concerns, costs, and the risk of a state-by-state patchwork; Moms for Liberty waived in support. Senator Martin then temporarily postponed the bill for further work. The committee next took up CS for SB 1132 by Senator Truenow on consumers’ right to repair certain equipment, including agricultural equipment and portable digital devices. An amendment by Senator Boyd was adopted to exclude security and life-safety systems and remove automobile-related provisions. Public testimony included opposition from TechNet, which said the bill is unnecessary because repair parts, tools, and manuals are already available and asked for changes to make the bill prospective and remove the private right of action. Agricultural equipment dealers and manufacturers testified against the bill, arguing that current repair resources and a memorandum of understanding with the Farm Bureau already address repair access, while warning that the bill could undermine dealer margins, parts inventory, training programs, safety, cybersecurity, and emissions compliance. Some members supported the concept but noted the bill still needed work. The committee voted 4-0 to report CS for SB 1132 favorably. The meeting concluded with a presentation from Florida 4-H youth leaders on the organization’s impact and goals. The presenters described 4-H’s role in leadership, agriculture, STEM, and healthy living, highlighted statewide participation and camp programs, and asked for continued support for camp improvements, especially the Camp Cherry Lake revitalization effort. Senators praised the students’ presentations and the value of 4-H before the committee adjourned.

Transcript Highlights:

• In fact, the land that his clinic is on was homesteaded by his great-great-grandfather, Charles Llewellyn
• Thomason's wife, Melissa, works alongside him in the clinic in their hometown of Hinton.
• Over the last hundred years, they've grown to over 80 locations, hospitals, and clinics in the Tulsa
• I know you said it would come from the federal government to bring a national laboratory to the state
• I visited the Pacific Northwest National Laboratory.

Bills: HB4104 , HB3722 , HB3787 , HB3700 , HB3701 , HB3310 , HB3404 , HB2964 , HB2398 , HB3024 , HB3499 , HB3278 , HB3279 , HB3645 , HB3649 , HB2293 , HB3260 , HB3176 , HB3177 , HB3114 , HB3172 , HB3322 , HB3323 , HB4248 , HB3720 , HB2210 , HB1322 , HB1937 , HB3301 , HB4107

Summary: The House convened, heard the prayer and Pledge of Allegiance, recognized the Doctor of the Day, and held several special presentations, including the Bethany Youth Council and a centennial recognition for Ascension St. John. The chamber then took up a long series of bills on second and third reading, with members asking questions on hospice care, broadband, funeral director continuing education, economic development, court reporters, DUI-related GPS monitoring, banking discrimination, statutory interpretation, electronic filings, intoxicating hemp beverages, homemade food production, youth apprenticeships, domestic violence, school communications with minors, firearms definitions, and outdoor warning sirens. Among the measures considered, House Bill 3645 on hospice referrals for patients without next of kin or a durable power of attorney passed 16-0. House Bill 3649, allowing proceeds from certain state property sales to remain in the mental health real estate trust, passed 15-0. House Bill 2293 extending the Oklahoma Broadband Office sunset to 2030 passed 84-10. House Bill 3216 adding the Oklahoma Funeral Directors Association to approved continuing education providers passed 94-0, and House Bill 3176 directing Commerce to pursue national lab and innovation opportunities passed 51-37 after extensive debate about its aspirational nature and cost. Other bills approved included HB 3177 on Corporation Commission court reporter pay and retention, HB 3114 removing DUI with great bodily harm from DOC GPS monitoring eligibility, HB 3172 restricting adverse banking actions by large financial institutions against lawful activity, HB 3322 on statutory interpretation, HB 3323 removing notarization requirements for electronic Service Oklahoma submissions, HB 4248 restricting certain intoxicating beverages to those 21 and older, HB 3720 expanding the Homemade Food Freedom Act, HB 2210 modernizing youth apprenticeships, HB 1322 creating a domestic violence offender registry, HB 1937 revising school communications with minors and receiving emergency passage, HB 3301 aligning state firearms definitions with federal law, and HB 4107 criminalizing hacking or unauthorized activation of outdoor warning sirens. Most bills passed with broad support, though some drew significant questioning over fiscal impact, public safety, and implementation details.

Transcript Highlights:

• So we've opened clinical trials that involve the Mayo Clinic for U.S.
• So we've opened clinical trials that involve the Mayo Clinic for U.S.
• So we've opened clinical trials that involve the Mayo Clinic for U.S.
• </c><00:56:57.400><c> trial</c> to ask if there's a clinical trial to ask if there's a clinical trial
• </c> answer to be no we don't do clinical answer to be no we don't do clinical trials<00:57:02.920><c

Committee: House Higher Education Finance and Policy

Transcript Highlights:

• , people who go to Cleveland Clinic, people who go to Cleveland Clinic,<00:45:24.480><c> people</c><00
• </c><00:58:17.040><c> trials</c> testing and access to clinical trials testing and access to clinical
• We also serve as the medical director of the laboratory.
• cancer tests. the laboratories can't operate without the laboratories can't operate without our<01:00
• And we patients with clinical trials.

Summary: The committee opened its sixth and final interim meeting with roll call, quorum confirmation, approval of the prior minutes, and a brief change in agenda order to preserve quorum and accommodate presenters’ schedules. Members then moved through several proposed health-related items with limited discussion, and the chair noted the committee would reconvene in January for further conversation. The first substantive item was a proposal relating to utilization controls for non-opioid analgesics in Medicaid. Senator Gerald Neal and Tara Hyde of People Advocating Recovery argued that pain parity is needed so patients can access non-opioid options without prior authorization or step therapy barriers, especially in acute pain situations and for people in recovery. Senator Berg supported the concept and suggested expanding the approach to other prescriptions by allowing physicians to explain why step therapy is inappropriate at the time of prescribing; another member cautioned against unintended cost increases if non-opioid drugs are used as add-ons to opioids. The committee then heard a proposal on physician assistants from Senator Scott and Andrew Rutherford of the Kentucky Academy of Physician Assistants. They described a shift from a supervisory to a collaborative practice model, with practice scope set at the practice level, limited Schedule II prescribing authority under guardrails, and permission for PAs to perform driver’s license vision testing. Supporters said the changes would improve rural access, reduce administrative burden, and align Kentucky with neighboring states; a question from Representative Bratcher focused on experience requirements and how the proposal compares with nurse practitioner rules. No vote was taken. Finally, Representative Nancy Tate, Adia Wuchner, and Representative Jason Nemes introduced a 2026 proposal aimed at “protecting vulnerable people.” They described a broad package focused on abortion pill trafficking, marketing to minors, commercial surrogacy, assisted suicide, and organ procurement safeguards, arguing that current law leaves gaps and that additional criminal and civil penalties are needed. The presentation was informational only, with no action taken before the meeting ended.

Transcript Highlights:

• clinic in Mexico.
• The urgent walk-in clinic in town also closed abruptly.
• In response, the remaining MU Health Care primary care clinics have extended our laboratory hours, added
• Twelve hospitals, maybe a few other clinics, right?
• Clinically, we've added services that we could not have done independently.

Committee: House Special Committee on Rural Issues

Summary: The committee first met in executive session on House Bill 1714, adopting an amendment that clarified the bill would not apply to hunting dogs or animals not under direct control of the hunter and would not affect a specified section of law. The committee then rolled the amendment into a House Committee Substitute and voted the substitute do pass, with the roll call showing passage. The committee then heard House Bill 317, which would authorize MU Health Care to collaborate with hospitals and providers in a 25-county area and seek state-action antitrust immunity for those transactions. The sponsor and MU Health Care testified that the bill is intended to help preserve rural hospitals and keep care local, citing multiple hospital closures in Missouri and examples from Alabama and other states. Supporters from MU Health Care, rural hospitals, and local business and health leaders described the bill as a way to stabilize struggling facilities, maintain emergency access, and protect rural economies. Opponents, including the Missouri Insurance Coalition and the Missouri Health Plan Association, warned that the bill could codify monopoly power, raise prices, and reduce competition, and argued that the language was too broad and not limited to distressed hospitals. Some committee members also raised concerns about antitrust immunity, facility fees, market share, and whether the bill should be tightened to ensure voluntary participation and clearer limits. No vote was taken on House Bill 317 before the hearing adjourned.

Transcript Highlights:

• I'm grateful for our emergency services or the quick clinic in Mexico.
• The urgent walk-in clinic in town also closed abruptly.
• In response, the remaining MU Health Care primary care clinics have extended our laboratory hours, added
• Twelve hospitals, maybe a few other clinics, right?
• Clinically, we've added services that we could not have done independently.

Committee: House Special Committee on Rural Issues

Transcript Highlights:

• Good morning, Olina Svetloff, President of the California Clinical Nurse Specialist.
• President of the California Clinical Nurse Specialist.
• Clinical practice requirements vary dramatically from state to state.
• I just wanted to ask CMA: You're talking about clinical experience differing across states.
• clinical hands-on training in infection control.

Committee: House Business and Professions