Transcript Highlights:

• And I think it'll grow just like the cancer facility did.
• In my experience because I also teach in those facilities it just depends on the facility but most of
• And this bill doesn't do anything to limit facilities or a physician's personal choice.
• So, all this bill does is require a facility to have a policy. That's requiring smoke evacuation.
• Now, some facilities are gangbusters and are. Big believers, and they use them in every case.

Bills: HB5, HJR3, HB155, HB513, HB5, HB155

Keywords: dementia, research, health care, Texas Institute, grants, medical breakthroughs, oversight, prevention, funding, healthcare, Texas, autopsy, confidentiality, public records, medical examiner, law enforcement, HB 513, surgical smoke, surgical plume, smoke evacuation

Transcript Highlights:

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

Keywords: 1187, senate, all

Transcript Highlights:

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

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

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

Transcript Highlights:

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

Keywords: 916, all

Transcript Highlights:

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

Keywords: 912, senate, all

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

Transcript Highlights:

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

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

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

Transcript Highlights:

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

Keywords: 958, all

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

Transcript Highlights:

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

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

Transcript Highlights:

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

Keywords: 1184, house, all

Transcript Highlights:

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

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

Transcript Highlights:

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

Keywords: 988, house, all

Transcript Highlights:

• And then on top of that, actually, we had the Venture Global LNG facility, right?
• And I have never been outpatient in the hospital and went home.
• To 50 percent for outpatient procedures. Now, I have a couple of things to review.
• You have a facility fee, an anesthesia fee...
• You have three charges: a facility fee, an anesthesia fee, and a professional fee.

Summary: The Finance Committee met on May 27, 2026, with six members present and took up a series of House bills, most of them dealing with education funding, criminal justice staffing, transportation, health care access, and economic development. HB 325 was reported favorably after testimony that it would expand TOPS eligibility by allowing dual-enrollment credits to satisfy eligibility criteria and by making part-time students eligible for TOPS Tech, with supporters saying the program has been underused and the change would help working students. HB 719 was amended and reported favorably to increase assistant district attorney positions in various judicial districts; the Louisiana District Attorneys Association said the changes were based on workload data and local input, and members discussed the need to coordinate any expansion with public defender funding. The committee also reported HB 749 favorably, which would move Louisiana’s 529 savings accounts to a more secure online platform after a cyber incident, and HB 1028 favorably, which concerns transportation reimbursement for providers and was described as already subject to appropriation. Several bills focused on food access and local economic development. HB 1222, the Grocery Initiative Act, was reported favorably to let LED use existing grant resources to map food deserts and develop a program, with members noting it could return for funding later if needed. HB 1194 was amended and reported favorably to define food deserts and direct the LSU AgCenter and the Department of Agriculture and Forestry to identify and map them, with authors emphasizing it was a study and not a government-run grocery program. HB 755, which would create IDIQ contracting for architects and engineers on smaller state projects, was reported favorably with no fiscal impact. HB 823, a local diversion pilot for Orleans Parish, was also reported favorably after the fiscal note was revised to remove state impact and reflect only local costs. The committee spent substantial time on HB 488, a proposal from Plaquemines Parish to use severance-tax revenue to help buy out a private toll concession on the parish’s bridge. The author and local officials described severe toll burdens, economic harm to local businesses, and what they called an unfair contract, but members noted the bill was not funded and ultimately deferred it without a motion. HB 797, the Bayou Gold/Louisiana Sound Money Act, was amended to make implementation subject to appropriation and then reported favorably. The committee also took up HB 198, which would raise Medicaid reimbursement for ambulatory surgery centers for certain outpatient procedures; after extensive discussion about fiscal notes, access to care, and potential long-term savings, the bill was amended to narrow its scope and make implementation subject to appropriation, then reported favorably as amended. The meeting ended with the chair noting it would be the committee’s last meeting and asking members to spread the word.

Transcript Highlights:

• Assisted outpatient treatment is court-ordered mental health care provided in the community and not in
• Creates a legal process for courts to order assisted outpatient treatment for adults with serious mental
• Assisted outpatient treatment is court-ordered mental health care provided in the community and not in
• Entities could include skilled nursing facilities, residential care facilities, anyone that provides
• Sometimes whenever we get constituent requests, it is on the facility and not a specific employee.

Keywords: 959, house, all

Summary: The Committee on Health and Mental Health met with a quorum and first voted in executive session to give House Bills 2370, 3278, and 1638 due pass, with recorded votes of 13-9, 15-0, and 17-0 respectively. The committee then moved to public testimony on Senate Bill 1015, which would create a court process for assisted outpatient treatment for adults with serious mental illness who cannot voluntarily engage in care and are at risk of deterioration, hospitalization, or harm. Senator Maggie Nuremberg and supporters from the Missouri Behavioral Health Council and the Missouri Association of Public Administrators said the bill would help people stay stable in the community, reduce hospitalization and incarceration, and save costs; there was no opposition testimony. The committee also heard a presentation on the STARS program from SSM Health, which was described as a Missouri-based emergency planning system for medically complex children. Witnesses explained that STARS provides physician-approved, electronic emergency care plans for EMS and emergency departments, with education and quality improvement components, and that it is funded by participating children’s hospitals rather than families or EMS agencies. Members asked about costs, access, and how the program differs from the bill previously discussed by Representative Burns; the witness emphasized that STARS is an EMS program and not the same as the proposed hospital-flagging requirement. House Bill 2903, sponsored by Representative Don Mayhew, would change rules for county and district hospitals to make them more competitive with private hospitals by narrowing Sunshine Law exposure for sensitive business information, adjusting board qualifications, and aligning financial reporting deadlines. Supporters from Phelps Health said the bill would reduce administrative burdens and protect proprietary information, while still preserving public transparency for core financial information. Finally, House Bill 3379, sponsored by Representative David Dolan, would expand and strengthen the employee disqualification list and mandated reporting rules for abuse, neglect, and financial exploitation of vulnerable adults, including adding certain bank personnel and first responders as reporters and creating penalties for failure to report. DHSS supported the bill, while the Missouri Bankers Association supported the goal but raised concerns about mandatory reporting obligations for bank staff when customer participation in adult day programs may be unknown; the committee took no final action on the public testimony bills before adjournment.

Transcript Highlights:

• Shifting over to the skilled nursing facilities, nursing homes, there are 124 facilities in West Virginia
• As of the recent sale of the four state facilities, the state still maintains one long-term care facility
• Outside of that one facility, the state no longer operates any long-term care facilities.
• Some are taken into facilities, long-term care facilities, and then some historically used to go to some
• Some of the state facilities had specialized wings.

Keywords: 994, senate, all

Summary: The committee met with a quorum present and heard a presentation from Marty Wright, CEO of the West Virginia Healthcare Association, on the state’s long-term care system. He described the continuum from home care to assisted living to skilled nursing facilities, emphasizing that these settings increasingly serve short-term rehab-to-home patients as well as older adults needing round-the-clock care. He also outlined the number of facilities in West Virginia, the predominance of Medicaid as the payer for long-term nursing home care, the private-pay nature of assisted living, and the role of OFAC/CMS in regulation. A major focus of the presentation was workforce shortages and turnover, especially for CNAs, LPNs, and RNs, along with declining interest in nursing careers and the impact of regulatory burden and burnout. Wright said the system is also struggling to serve younger patients with substance use disorder, mental illness, or other behavioral needs, who are often not well suited for traditional nursing home placement but have limited alternatives. Senators raised concerns about where such patients are being housed, the long-term effects of opioid and behavioral health issues, and the gap between school-age special needs populations and adult care needs. Wright said Medicaid can cover long-term nursing home care for those who meet financial and medical eligibility requirements, but affordability and spend-down requirements remain major barriers. He also warned that Medicare Advantage can create confusion and shorter covered stays for rehab patients, and he urged early planning around long-term care insurance and estate planning. No votes were taken on the presentation, and the committee adjourned after questions and discussion.

Transcript Highlights:

• He is working with outpatient programs. He is happy, and he is living with me.
• He is working with outpatient programs. He is happy, and he is living with me.
• In correctional facilities. Many people with anosognosia, where did I treat them?
• But assisted outpatient treatment, the black robe effect, showed that it was working.
• This would specifically impact six SUD treatment facilities among more than 1,000 facilities that are

Summary: The hearing focused first on behavioral health, especially serious mental illness and anosognosia, a condition described by witnesses as a neurological symptom that prevents people from recognizing they are ill. The chair framed the issue around families cycling through emergency rooms, jails, conservatorships, and short-term stabilization without lasting treatment, and warned that federal changes under H.R. 1 could reduce Medi-Cal funding and worsen access. Dawn Marie Anderson gave a personal account of her son’s long history of psychosis, homelessness, arrests, repeated jail and state hospital stays, and eventual stability when he received sustained medication and coordinated support. She argued that the system often treats the problem as criminal rather than medical and that voluntary programs and short-term services are not enough for people who lack insight into their illness. Other panelists, including representatives from the California Behavioral Health Association, Santa Barbara County Behavioral Health, and the County Behavioral Health Directors Association, agreed that anosognosia is not denial or noncompliance and said the system needs long-term, coordinated care, including assertive community treatment, mobile crisis, supportive housing, medication support, and stronger handoffs between county and managed care systems. They said CalAIM and other reforms have improved some coordination, but significant gaps remain, especially for people with serious mental illness, for those in jail or locked settings, and for people with private insurance, which witnesses said often offers little meaningful coverage for early psychosis or intensive behavioral health services. Several witnesses urged the Legislature to protect Medi-Cal, shore up county safety-net services, and invest in training and family engagement. The committee then turned to the Children and Youth Behavioral Health Initiative, with a focus on the virtual services platforms BrightLife Kids and Soluna and the CYBHI fee schedule. DHCS reported strong growth in app registrations, coaching sessions, referrals, and positive user outcomes, saying the platforms provide free, culturally responsive, early-intervention support statewide and help connect users to higher levels of care when needed. On the fee schedule, DHCS said more than 500 LEAs, colleges, universities, and school-linked providers are participating, 181 LEAs have submitted claims, and $9.6 million has been reimbursed to date, with 41,556 students represented in claims. The chair and several members criticized the pace of implementation and the amount of money spent relative to reimbursement levels, saying the Legislature had requested data earlier and that the return on investment still appeared low. DHCS responded that many claims are still being submitted, that 70% of denials are correctable, that $400 million in capacity grants has been distributed locally, and that reimbursement is increasing rapidly as more districts come online. Public comment included a rural county behavioral health director who said private insurance denials leave counties with significant uncompensated work, especially for unlicensed staff providing case management and mobile crisis services.

Transcript Highlights:

• in outpatient services and in teleaalth. in outpatient services and in teleaalth.
• <00:40:09.359> services in outpatient services in outpatient services and<00:40:11.359>
• And so the bathrooms in our facilities are now psychiatric hospital-grade facilities that you would find
• The kids would sometimes facilities.
• > psychiatric facilities are now psychiatric facilities are now psychiatric hospital-grade<00:

Keywords: 958, all

Summary: The meeting opened with roll call, approval of the September 17 minutes, and an introduction of Sarah Rome to the committee. The chair also noted that the committee would stay on schedule and then moved to presentations. Representative Amy Neighbors and Taylor Williams of the Kentucky Pharmacists Association presented a refiled “pharmacy parity” proposal, formerly House Bill 3, to require Medicaid reimbursement for pharmacist clinical services already authorized under current scope of practice. They said the bill would not expand Medicaid or pharmacist scope, but would align Medicaid with commercial insurance, improve access and outcomes, and likely save money; they cited a Cabinet report under Senate Joint Resolution 26, which found similar laws in other states were producing savings or trending toward savings and would require only modest administrative updates. No member questions were raised after that presentation. The committee then heard an update on the Kentucky Colon Cancer Screening Program from Senator Stephen Meredith, Dr. Whitney Jones, Melissa Carrier, and Representative Neighbors. They described the program’s goals of increasing screening, reducing deaths through earlier detection, and preventing cancers by finding polyps, saying it has produced substantial savings and improved outcomes. Speakers emphasized Kentucky’s high colorectal cancer burden, especially in younger adults, and said the program helps uninsured and underinsured Kentuckians access stool-based screening and follow-up colonoscopies through a network of partners including the Department for Public Health, Kentucky Cancer Link, and university cancer programs. They requested an increase in funding from $500,000 to $1.25 million annually, or $2.5 million over the biennium, to expand services, fill geographic gaps, and support education and navigation. Members asked whether the colon cancer screening was already covered by Medicaid, and the presenters replied that Medicaid does cover it, but the program serves people who are not on Medicaid or who fall into a separate eligibility category based on income and insurance status. A member also clarified the requested funding increase. The committee then moved on to the next agenda item, an update from the Children’s Home of Northern Kentucky, where board member Sal Santoro and CHNK Behavioral Health leaders began a presentation describing the organization’s broader behavioral health work and its request, but the transcript cuts off before that presentation concludes or any action is taken.

Transcript Highlights:

• residential and seven outpatient residential and seven outpatient programs<00:26:24.039> from
• In 2024, a survey of MJDA facilities showed that on June 1st, 20% of the youth in our facilities were
• in 2024 a survey of detention facilities in 2024 a survey of mjda<01:56:36.320> facilities<01
• <01:56:40.560> were 20% of the youth in our facilities were 20% of the youth in our facilities
• themselves in a correctional facility themselves in a correctional facility with<01:57:25.159>

Keywords: 1187, senate, all

Transcript Highlights:

• Many of the facilities that call home.
• <00:16:09.519> on an example, in one of our facilities on an example, in one of our facilities
• I assume you facilities in Kentucky.
• Um they do do individualized facility.
• So that's going operated u facilities.

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses. The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness. Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.

Transcript Highlights:

• Ray at another facility that was then acquired by a second doctor.
• Just gives that facility the ability to have another choice.
• It just gives options to the rural facilities, the facilities that are struggling financially, to have
• The facility bylaws and policies... always supersede the state law. Thank you.
• living facility.

Bills: HB35, HB4490, HB4454, HB2188, HB3078, HB4743, HB2556, HB46, HB5342, HB4783, HB3785, HB5278, HB1639, HB2581, HB4224, HB4070, HB4099, HB4882, HB3794, HB46

Keywords: peer support, first responders, mental health, confidentiality, emergency services, disclosure, next of kin, public information, deceased persons, privacy rights, patient solicitation, marketing practices, healthcare regulation, task force, deceptive advertising, nurse aide, certification, Texas Board of Nursing, healthcare workforce, nursing standards

Transcript Highlights:

• Hayes, for presenting their outpatient rate study.
• Children need outpatient mental health services.
• list and why most of our outpatient list and why most of our outpatient services<00:18:07.480>
• <00:19:28.080> services programming and outpatient services programming and outpatient services
• or take I don't know but this outpatient or take I don't know but this outpatient services<00:42

Keywords: 919, house, all

Summary: House File 105 was presented by Representatives Beerman and Baker and then laid over for possible inclusion in a future omnibus bill. The bill would implement the remaining mental health and physician service recommendations from DHS’s rate study, including raising certain Medicaid reimbursement rates to at least 100% of Medicare where a Medicare equivalent exists, increasing community-based children’s and adult mental health rates and behavioral health home rates, and phasing in additional increases over three years. The authors said the proposal also addresses master’s-level clinician reimbursement and fee-for-service hospital inpatient mental health services, and they emphasized that the changes are intended to improve access, transparency, and provider stability. Both authors argued that low MA reimbursement rates are driving access problems across Minnesota, especially for children, families, and rural communities. They said providers are struggling to hire and retain staff, clinics are closing or shrinking, and patients are facing long waits, boarding in hospitals, or delayed care. Representative Baker said the issue is personal and described the bill as a phased, long-term approach because of state budget limits and the size of the cost, which he said is in the hundreds of millions but still awaiting a fiscal note. Public testimony was strongly supportive overall. A family physician said higher rates would improve access, keep clinics open, and help patients avoid emergency care, while a Children’s Minnesota mental health leader described more than 1,200 pediatric boarding episodes in 2024 and said outpatient investment is needed to reduce pressure on emergency and inpatient services. A rural provider said her organization had to close an in-home children’s mental health program because of insufficient reimbursement, harming access in underserved counties. A psychologist testifying for the Minnesota Psychological Association supported the bill’s general direction but objected to repealing the pay differential for doctoral-level psychologists, arguing that doctoral training is more extensive and that eliminating the differential could worsen workforce shortages. After testimony and member questions about the bill’s scope and cost, public testimony was closed and the bill was laid over.