Transcript Highlights:

• remember that licensure of these services will license provider home care agencies, regardless of payer
• Defining these roles and responsibilities is a primary part of these bills.
• It shouldn't matter what the payer is, if it's from private pay or from Medicaid or Medicare; the consumer
• It shouldn't matter what the payer is, whether it's private pay or Medicaid or Medicare; the consumer

Keywords: 995, all

Summary: The Joint Committee on Aging and Independence held a hearing on several bills, led by Chair Tom Stanley and Senate Chair Patricia Jehlen. The committee first heard testimony on H. 765/S. 487, an act relative to councils on aging, which would update outdated statutory language and allow directors of councils on aging to make staffing decisions when a council is structured as an advisory body. Representative Donahue and Betsy Connell of the Massachusetts Association of Councils on Aging said the change reflects how most councils now operate and would resolve conflicts like the one that arose in Sherborn. Members asked about whether the bill would affect town managers, volunteer roles, and whether the language should more clearly exempt informal volunteer help; supporters said the bill is aimed at municipal staffing structures, not unpaid volunteer assistance. The committee then took extensive testimony on H. 789/S. 470, an act to improve Massachusetts home care, which would create a statewide licensure system for non-medical home care agencies and entities. Julie Watt, Jay Krillovich, Betsy Krimmins, Lisa Gargoni, Tim Foley, and several providers and advocates supported the bill, arguing that licensure would establish baseline standards for background checks, training, service plans, insurance, complaint procedures, and labor-law compliance, while helping consumers identify legitimate providers and reducing fraud and abuse. Several witnesses described problems with unlicensed or poorly supervised providers, and family members and dementia advocates emphasized the need for dementia-specific training and better oversight for vulnerable clients. Tim Foley also raised concerns about private equity’s growing role in home care and said stronger regulation is needed to protect consumers and workers. Committee members focused on practical questions about the bill’s scope, including whether it would reach informal paid helpers, volunteers, or people doing occasional household tasks, and what agency would enforce the rules. Supporters said the bill is intended to cover entities advertising home care services, not unpaid volunteer help, though they acknowledged regulators would need to work out details. John Sneeth of Tribute Home Care offered a more cautious view, saying licensure should not unduly burden smaller providers or reduce competition, and that enforcement would be key. The hearing also included testimony from the Alzheimer’s Association and family caregivers, who strongly supported the bill’s dementia-training provisions and described how trained caregivers improved safety and quality of life for people living with Alzheimer’s and dementia. At the end of the hearing, the committee also heard support for H. 778/S. 473, regarding the Commission on LGBTQ Aging, with Lisa Krinsky urging funding for a full-time director and continued support for the commission’s strategic plan. After public testimony concluded, the committee adjourned the hearing by motion and voice vote.

Transcript Highlights:

• This is not just a collaboration between primary care and behavioral health.
• Those are the three primary spend areas. You gave us six.
• Those are the three primary spend areas. Those are the three primary spend areas.
• And then in 2015 it was approved for coverage in Medicaid, Medicare, and all commercial payers.
• Uh and so but yet we commercial payers.

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:

• Um, drinking contaminated water is a primary pathway to getting exposed to this.
• Um, drinking contaminated water is<00:24:12.799> a<00:24:13.039> primary<00:24:13.600><
• pathway to getting exposed is a primary pathway to getting exposed to<00:24:15.760> this.
• need to be some system where polluters are held accountable because I don't think your taxpayers payers
• want to be think your taxpayers payers want to be held<00:32:42.000> accountable<00:32:42.480

Keywords: 1183, house

Summary: The meeting was a PFAS-focused hearing of the Capital Investment Committee, with members informally discussing the scale of PFAS cleanup costs, possible Minnesota-made removal technology, and even committee birthday treats before the testimony began. No formal votes or motions were taken in the portion provided. The chair also noted the committee was waiting on a computer/cable issue before starting the presentation. The main testimony came from Sandy Wyn, co-chair of the Great Lakes PFAS Action Network, who described how PFAS contamination affected her Michigan community. She recounted that her private well tested at extremely high PFAS levels after a state visit, linked the contamination to Wolverine Worldwide’s historic dumping practices, and said the pollution spread through groundwater and municipal systems. She emphasized that PFAS are widespread in consumer products, firefighting foam, wastewater biosolids, and agriculture, and argued that the chemicals’ persistence makes them difficult to manage once released. Wyn said PFAS exposure is associated with health problems including cholesterol issues, liver and thyroid damage, kidney cancer, low birth weight, and reduced vaccine response in children. She told members she had her own blood tested, later developed thyroid cancer, and said a local child had very high PFAS levels and vaccine complications. Members asked for supporting studies, and she referenced the C8 study and other research. She urged stronger product restrictions, labeling, blood and water testing support, caution around biosolids, and continued efforts to reduce PFAS use, while acknowledging some limited uses may still be necessary in critical applications like military firefighting foam or medical devices.

Transcript Highlights:

• I always talk about the payer mix at the local hospitals, and when you look at the payer mix of our flagship
• center, which is Baystate Medical Center, in the decade plus that I've been in the legislature, their payer
• mix has gone from like 60/40 private... ...that I've been in the legislature, their payer mix has gone
• It houses our education department's lab classroom, shared P-20 resources, and the primary performance
• that we have been looking at with regard to our learning resource center and our student center are primary

Keywords: 995, all

Summary: The committee heard testimony on the BRIGHT Act, a higher education capital bill that would use Fair Share surtax revenue to fund major repairs, modernization, and decarbonization projects across UMass, state universities, and community colleges. UMass leadership described a $4.8 billion deferred maintenance backlog, aging buildings, and the need to modernize facilities, improve accessibility, and reduce emissions. Administration officials said the bill would authorize $2.5 billion in capital funding, split roughly 50-50 between UMass and the rest of public higher education, plus additional targeted funding for housing planning, smaller modernization projects, campus master plans, and workforce skills grants. They emphasized that the financing structure is modeled on the Commonwealth Transportation Fund and would not raise student costs, while also supporting affordability through financial aid and free community college. Members raised questions about regional equity, the distribution of funds among the five UMass campuses and the 24 state university/community college campuses, project labor agreements, whether the bill would unlock private or federal matching funds, and how the system is preparing for AI and changing workforce needs. UMass officials said project selection is data-driven, based on deferred maintenance, safety, accessibility, sustainability, and programmatic needs, and that the flagship campus in Western Massachusetts would likely receive a large share because of its size and needs. They also said UMass Boston would receive its own share and would not be shortchanged by the Bayside project. On labor, they said PLAs are commonly used and they would follow existing board and building authority policies. On affordability, they said the university has shifted hundreds of millions into need-based aid and that the state’s recent support has helped keep tuition low for many students. DCAMM and higher education officials said the state’s public campuses account for a large share of state-owned building space and a disproportionate share of operational carbon emissions, making decarbonization a major driver of the bill. They said the legislation would allow larger, more comprehensive projects that can address deferred maintenance, energy efficiency, and program needs at the same time, while also making some projects shovel-ready through the Fair Share supplemental funding already appropriated. A later panel from the State Universities Council of Presidents argued the bill’s authorization is still too small to meet long-term needs and urged the committee to increase the bond cap and ensure a more equitable distribution among segments. No votes or final actions were taken in the portion of the meeting provided.

Transcript Highlights:

• That is the primary fuel for the next generation of reactors, and it is enriched to a higher level.
• That is the primary fuel for the next generation of reactors, and it is enriched to a higher level.
• Um, but the primary concern, you know, I won't go through the explanation of the bill.
• Um, but the primary concern, you know, I won't go through the explanation of the bill.
• to make sure that when these rate payers to make sure that when these rate payers see<00:46:03.040

Keywords: Meeting Start 00:00 Attendance Roll Call 03:09 SB 57 Discussion 04:03 SB 57 Roll Call Vote 38:37 SB 172 Discussion 41:27 SB 172 Roll Call Vote 50:23, 958, all

Summary: The committee first handled routine business, including a prayer, the pledge, recognition of an Energy and Environment Cabinet leadership academy group, a roll call establishing quorum, and approval of the previous meeting’s minutes. The main item was Senator Danny Carroll’s presentation of legislation to create a nuclear-ready site readiness pilot program in Kentucky. He said the bill is intended to help build a nuclear ecosystem in the Commonwealth by supporting early site permits, construction permits, or combined licenses, with the state contributing up to $25 million per project and a total of $75 million for up to three projects. He emphasized safeguards such as refundable funding if conditions are not met, legislative rather than authority-only selection of projects, and oversight by the Kentucky Nuclear Energy Development Authority (NIDTA). He also described related provisions on cost recovery through the Public Service Commission, tax incentive eligibility for nuclear ecosystem projects, training and consultant support for the authority, and eligibility for fusion projects. Carroll and Rodney Andrews said the proposal is meant to attract utilities, developers, and large industrial users such as data centers, and to spread projects geographically, with particular attention to Eastern Kentucky and other rural areas. They said selection criteria would include site suitability, prior site use, regional economic need and impact, geographic diversity, additional investment, federal funding status, and whether a community has applied to be designated nuclear-ready. They stressed that communities would not be forced to host reactors and could choose which parts of the nuclear ecosystem to participate in. Carroll also said the bill could help Kentucky compete with states like Texas and Tennessee, and Andrews said industry contacts viewed the proposal as a signal that Kentucky is open to investment. Members generally expressed support for the bill and its goals, while asking about taxpayer exposure, site size, permitting, grid needs, national security, and reactor technology. Carroll said the state’s direct commitment would be capped at $75 million, with any additional cost recovery depending on PSC approval and project specifics. He said small modular reactor sites would be much smaller than traditional plants, and described a model in which a utility partners with a developer and a data center, with power contracts helping offset costs over decades. On security and technology, Carroll and Andrews said newer reactors would still be subject to the same standards as larger units, and Andrews explained that next-generation designs may use different fuels and materials such as TRISO and high-assay low-enriched uranium. No vote on the bill was taken in the portion provided, and the chair noted time limits and that additional members still had questions, including one witness expected to speak against the measure.

Transcript Highlights:

• A primary example of the punitive measures is that several of these operators are being seen.
• A primary example of the punitive measures is that several of these operators are being sent straight
• licensed, how is it that this volume of unlicensed activity affecting DHS's ability to carry out its primary
• This is a core operational metric for any payer, and its absence is evidence that DFSM is not adequately
• Access cannot monitor whether key levels of care are being authorized timely, even though Access is the payer

Keywords: 1182, all

Summary: The Senate Committee on Health and Human Services held a fourth hearing in its ongoing review of alleged fraud, waste, and abuse involving AHCCCS/Access and DHS, with a major focus on Medicaid eligibility verification for the aged, blind, and disabled (ABD) population, behavioral health and sober living oversight, and payment delays to providers. Senator Shamp presented findings she said showed major gaps in ABD asset verification, including claims that only a fraction of enrollees were checked and that many ineligible members may remain on the rolls. She urged referrals to law enforcement, tighter verification requirements, better PARIS data sharing, and legislative changes to close what she described as a compliance and taxpayer-risk gap. Reva Stewart also testified that patient brokering and fraudulent recruitment of vulnerable people, including Native Americans, continues through social media and other channels, and she called for stronger enforcement and transparency. Heather Dukes, representing behavioral health and sober living operators, argued that the state’s response to fraud has become overly punitive toward legitimate providers. She said ADHS often sends technical paperwork deficiencies straight to enforcement instead of allowing plans of correction, that zoning approvals are being questioned despite not being within ADHS authority, and that long Access approval timelines are creating licensing and billing delays. ADHS Deputy Assistant Director Tiffany Slater said the department has seen a large volume of unlicensed complaints, that it is trying to improve staffing and data systems, and that some enforcement tools have been expanded for sober living homes. She also said many sober living operators are in recovery themselves and provide low-cost housing and support rather than direct billing to Access. Access Director Virginia Roundtree said the agency is trying to balance fraud prevention with support for legitimate providers. She reported steps such as daily internal huddles, live dashboards, added project management support, an outside review of the Division of Fee-for-Service Management, and a new external claims vendor to help reduce backlogs. Senators pressed her on a specific provider’s long-delayed payments and prepayment review, and she said the agency would provide answers early the following week. Access staff also described provider resolution roundtables and said unadjudicated claims had been reduced to zero, though members questioned whether that was due to denials rather than resolution. The hearing ended with the chair announcing legislation to preserve the American Indian Health Plan as a fee-for-service option while requiring Access to contract administrative and care management functions to another entity, citing structural failures in Access’s ability to operate the plan safely and effectively.

Transcript Highlights:

• this, we have all heard a lot from providers about how complicated it is to deal with 15 different payers
• How complicated it is to deal with 15 different payers and 15 different programs, and everybody's got
• Continuing, of course, to support our primary care and behavioral health access, focusing on how we might
• of those things, and when we talk about trying to bolster the behavioral health workforce and the primary
• of those things, and when we talk about trying to bolster the behavioral health workforce and the primary

Summary: The committee first welcomed new DSHS Secretary Angela Ramirez, who introduced herself and described her background in public service, federal and state legislative work, and health and human services leadership. Members emphasized the importance of building strong relationships with her and noted her focus on protecting services, using strategic approaches in a tight budget environment, and improving partnerships with the Legislature. Ramirez said she wanted to keep communication open and that her priorities would be shaped by what she learns from lawmakers and agency partners. The next work session focused on the West Coast Health Alliance and the broader Governor’s Public Health Alliance. Department of Health and governor’s office staff said the West Coast alliance, involving Washington, Oregon, California, and Hawaii, was formed to coordinate science-based public health guidance, especially around vaccines, return-to-work guidance, and responses to federal changes. They said the alliance is intended to reduce confusion, counter misinformation, and preserve access to evidence-based recommendations, with early actions including vaccine guidance for COVID-19, flu, and RSV, a statement rejecting any vaccine-autism link, and preparation for possible ACIP changes. Members asked about workload and coordination with other regional alliances, and staff said there is informal coordination but no formal regular meetings. The committee then heard from the Washington State Health Benefit Exchange about open enrollment and the effects of federal policy changes. Exchange leaders said the expiration of enhanced premium tax credits, HR1 provisions, and immigration-related eligibility changes are affecting affordability and enrollment, with some customers facing large premium increases and some counties becoming harder to serve. They reported early open-enrollment traffic increases, nearly 10,000 new sign-ups, and nearly 12,000 active coverage drops so far, while noting that many more people may disenroll later if subsidies are not extended. They also described mitigation efforts such as silver loading, Cascade Care Savings, outreach through navigators and community partners, and planning for future HR1 requirements like ending auto-renewal and adding verification steps. In the final work session, staff from the Health Care Authority and Insurance Commissioner’s office reviewed Washington’s health reform history and the state’s current affordability and access efforts. They highlighted past ACA-related coverage gains, continued work on prescription drug affordability, PBM oversight, primary care and behavioral health access, and a pending legislative proposal to preserve access to preventive services. They also discussed federal changes affecting Medicaid and the exchange, including work requirements, six-month redeterminations, and the need to coordinate across agencies to implement new rules. Members raised concerns about network adequacy, provider access, and the complexity of the health care system, while staff said they are trying to mitigate harm, simplify administration, and keep coverage and access as stable as possible.

Transcript Highlights:

• Payers who are facing rates that keep going up for the recycling of waste.
• including expanding our agency's data collection and increasing outreach and communications to fee payers
• This has been tremendously successful in clarifying and helping our fee payers understand what to pay
• So last fall, we did send a letter with CDTFA's assistance to notify all of our fee payers with more
• DPR's primary funding source has long been the mill assessment that comes from the first sale of a pesticide

Keywords: 988, house, all

Transcript Highlights:

• I do primary care, so to answer your question of what we do, we can do primary care, and I've been a
• primary care provider for 15 years.
• So, we are trained as primary care.
• payers payers as<03:40:00.960> part<03:40:01.200> of<03:40:01.280> that.
• and it always depends on who the payer and it always depends on who the payer is,<04:08:25.160><

Keywords: 928, house, all

Summary: The committee held a public hearing on Senate Bill 562, which would create a home damage mitigation and resilience grant program aimed at helping homeowners make property improvements that could reduce insurance costs and non-renewals. Commissioner DJ Bettencourt of the New Hampshire Insurance Department explained that the program is modeled in part on Alabama’s safer homes program, but tailored for New Hampshire hazards such as floods, microbursts, heavy snow, ice, and falling trees. He said the grants would be limited to primary residences, subject to a means test, capped at $10,000, and intended to help homeowners make targeted improvements such as roof fortification or tree removal that could improve underwriting outcomes and lead to premium discounts. Bettencourt said the program would not use state taxpayer funds and would instead rely on philanthropic donations, possible federal or regional housing-bank funding, and other outside sources. He said the department would not need new staff, and that a current position could be reconfigured to help administer the program part-time. Committee members asked about the funding language, the meaning of “loans” in the bill, whether there were any other states using a similar no-state-funds model, and how many homeowners could be helped. Bettencourt said Rhode Island and Connecticut were moving forward in a similar way, and that the number of beneficiaries would depend on how much money is raised. Members also questioned how the grant program would actually lower premiums, whether savings would apply only to participants or more broadly, and how the IBHS evaluation process would work. Bettencourt and department staff said the direct benefit would be to the homeowner whose property is improved, though neighbors could also benefit in some cases. They explained that IBHS is a building-safety organization that certifies contractors and inspectors and that its standards can qualify homes for insurer discounts. Questions were also raised about confidentiality provisions, first-come-first-served grant awards, rollover of unused applications, and possible tax treatment of donations. The sponsor said those details would be addressed through rulemaking or existing tax rules, and no vote was taken during the hearing.

Transcript Highlights:

• in the medium term low rates rate payers in the medium term low rates help<00:15:17.000> attract<
• use of CO2 from these pipelines primary use of CO2 from these pipelines is<00:26:30.279> for<
• With this bill, we run the risk of supporting such industry plans whose primary goal is not to reduce
• With this bill, we run the risk of supporting such industry plans whose primary goal is not to reduce
• With this bill, we run the risk of supporting such industry plans whose primary goal is not to reduce

Keywords: 1183, house

Transcript Highlights:

• One of the primary concerns is direct shipment of alcohol moving into the hands of minors.
• Well, I think the wholesalers' primary revenue base is the large brands, right?
• Well, I think the wholesalers' primary revenue base is the large brands, right?
• And that's our primary concern.
• , payers, payers, and<01:21:53.360> for<01:21:53.600> the<01:21:53.760> whole and

Keywords: 912, senate, all

Summary: The joint Senate committees heard HB 108 HD2, which would allow direct shipment of beer and distilled spirits by certain licensees and require liquor commissions to adopt rules. Most testimony came from craft brewers and distillers in support, who said the bill would help small and fragile producers reach customers, move limited or specialty products that wholesalers do not carry, and maintain relationships with visitors after they leave Hawaii. Supporters also argued that direct-to-consumer shipping would not meaningfully increase underage access because common carriers age-gate deliveries and require adult signatures, and that the measure would supplement rather than replace the three-tier system. Opposition came from the Hawaii Food Industry Association and the Hawaii Liquor Wholesalers Association, which said the bill could create problems with minor access and tax revenue and would allow out-of-state manufacturers to ship directly to Hawaii households. Supporters responded that similar concerns were raised when wine direct shipping was adopted and said the existing shipping and reporting systems can track and tax these sales. Several witnesses, including Maui Brewing, Ola Brew, Koloa Rum, Hana Rum, Koulana Rumworks, Koval Distillery, and the Brewers Association, described their small-batch operations, limited distribution options, and the potential for direct shipping to expand sales and jobs. Committee members questioned witnesses about underage access, tax collection, and the impact on the three-tier system. One witness discussed efforts to protect and potentially scale the Hawaiian spirit Okolehao through geographic and sourcing rules. The transcript does not show a final vote or disposition on HB 108 HD2 in the excerpt provided.

Transcript Highlights:

• For primary residence statements, it required them to include the primary residence credit amount and
• So when you all started or passed the primary residence credit, we read the statute.
• Therefore, your primary residence credit is the remainder after that.
• But could we get rid of the discount for primary residence credit recipients?
• I benefit way more from the 5% discount than I do from the $1,600 primary residence credit.

Summary: The subcommittee of the Tax Reform and Relief Committee met to begin its study of the feasibility and desirability of revising the content of the real estate tax statement to improve property tax transparency. Legislative Council staff reviewed the study directive under House Bill 1176 and the statutory requirements for tax statements, including required line items such as true and full value, mill levy, legislative tax relief, primary residence credit, and the Legacy Fund portion of that credit. The Tax Department then explained how the current uniform statement is prescribed and approved, and noted that changes are typically driven by statute and implemented collaboratively with counties and vendors. County officials from the North Dakota Association of Counties described the full annual tax cycle, from county budgeting and valuation notices to budget hearing notices, levy certification, cap calculations, and final tax statement mailing. They emphasized that counties and auditors do extensive coordination with taxing districts and neighboring counties, and that the process is labor-intensive and often manual. Members discussed the limited public response to budget notices and tax statements, the difficulty of explaining the legislative tax relief line, the 3% cap and valuation issues, and whether more frequent assessments or different timing would improve understanding. Several members and witnesses noted that many taxpayers only engage when they receive their final bill, and that clarity may be more important than adding more detail. NDACO also presented a rough cost survey from eight counties, estimating an average tax statement cost of about 74 cents and a statewide total near $600,000 for printing and mailing tax statements alone, with outsourcing generally cheaper than in-house printing. Witnesses noted that House Bill 1176 added other mailings and notices, increasing county workload and cost beyond the statement itself. The committee then heard from software vendors, who explained how their systems handle tax billing, budget notices, valuation notices, primary residence credit processing, and tax levy calculations, and they identified the 1600/1685 primary residence credit and discount interaction as a current programming challenge. No votes were taken; the meeting was informational and focused on gathering testimony and identifying issues for possible future recommendations or bill drafts.

Transcript Highlights:

• For primary residence statements, it required it to include the primary residence credit amount and the
• So when you all started or passed the primary residence credit, we read the statute...
• And therefore, your primary residence credit is the remainder after that.
• But could we get rid of the discount for primary residence credit recipients?
• I benefit way more from the 5% discount than I do from the $1,600 primary residence credit.

Summary: The subcommittee of the Tax Reform and Relief Advisory Committee met to begin its study of whether the content of the real estate tax statement should be revised to improve transparency. Legislative Council staff reviewed the study directive from HB 1176 and the statutory requirements for tax statements, including required line items such as true and full value, mill levy, legislative tax relief, primary residence credit, legacy fund share, discounts for early payment, and special assessments. The Tax Department then explained how the current uniform statewide statement is prescribed and approved, and noted that changes are typically driven by statute and implemented collaboratively with counties and vendors. County officials from NDACO, including auditors from McKenzie and Richland counties, described the full annual property tax timeline from budgeting through mailing final statements. They explained how counties gather budgets, calculate levies, verify taxable values, handle centrally assessed property, and prepare required notices and statements. They also said public attendance at budget hearings is generally very low, though the notices and statements generate some calls, mostly about whether attendance is required or why taxes are changing. Several members questioned the usefulness of the legislative tax relief line and the complexity of the 5% discount calculation, and county officials said the current process can be confusing and depends on manual data entry and coordination among counties, vendors, and taxing districts. The committee also discussed assessment frequency, valuation equalization, the 3% cap, and whether more frequent reassessment would reduce large jumps in taxable value. County officials said they try to use rotating reassessments and sales-ratio reviews to keep values within statutory tolerance, but staffing, training, and local market changes make the work difficult. NDACO staff estimated, based on a small county survey, that tax statement preparation and mailing costs average about 74 cents per statement, with outsourcing generally cheaper than in-house printing, and said HB 1176 added some mailing and administrative costs even if the tax statement itself did not change dramatically. Software vendors from CPT and Tyler then began presentations showing how their systems handle budgeting, valuation notices, tax statement generation, primary residence credit processing, and levy worksheets, emphasizing that many of the required calculations and reports are still manually entered or verified by county staff.

Transcript Highlights:

• When your payer mix is anywhere from 60 to 75% government, you're losing money.
• <01:52:24.159> anywhere<01:52:24.639> from<01:52:25.119> 60 When your payer
• mix is anywhere from 60 When your payer mix is anywhere from 60 to<01:52:25.760> 75% to 75% to
• mix, the Medicaid provider their payer mix, the Medicaid provider rate<01:55:31.920> is<01:55
• portable qualified senior primary portable qualified senior primary residents<03:48:28.319> benefit

Keywords: 981, all

Summary: The Senate convened with a quorum, approved the February 18, 2026 journal, and received several committee and House messages. Judiciary reported juvenile parole board appointments to the consent calendar for confirmation, and Transportation and Energy reported Senate Bills 28 and 25 along with other measures. The House transmitted multiple bills to the Reviser of Statutes, and the Senate later agreed to take up a large group of House bills on special order and consent calendar. A major portion of the meeting was devoted to personal-privilege remarks recognizing visiting groups, including the Mad Moms and Mad Dads advocating for people with serious mental illness, and the Colorado Gifted and Talented Association. Members spoke about stigma and the need for mental health legislation, and about supporting gifted students and their families. These remarks were welcomed by the chair and other senators. The Senate then considered a package of supplemental appropriation bills, including House Bills 1150 through 1179, covering agency budgets, school finance adjustments, education fund uses, and capital construction transfers. The committee of the whole adopted the package on second reading, and the full Senate later adopted the committee report by a vote of 33 ayes, with one excused and one vacant seat. The bills were ordered placed on the calendar for third reading and final passage. House Bill 1151, a supplemental appropriation to the Department of Corrections, drew extended debate. Supporters argued the bill was needed to cover existing obligations, avoid more costly jail backlogs, and prevent unsafe conditions, while critics said the department’s population management failures and broader sentencing policies were driving unnecessary costs and called for accountability and structural reform before more funding. Despite the debate, the bill was included in the adopted second-reading package.

Transcript Highlights:

• Instead, you have primary care physicians who largely have no idea that these benefits even exist under
• This is a multi-payer effort that includes private insurance, commercial health plans regulated under
• And notably, our laws for payers are aligned.
• So this level of detoxification-only services going forward will also be something that payers will not
• Our primary tools are data and policy research, program evaluation, grantmaking, technical assistance

Keywords: 988, house, all

Summary: The hearing focused first on behavioral health, especially hard-to-treat serious mental illness through the lens of anosognosia, and the impact of potential federal Medi-Cal reductions under H.R. 1. A family member, Dawn Marie Anderson, described her son’s long cycle of psychosis, homelessness, arrests, jail-based stabilization, and repeated relapse when treatment ended, arguing that anosognosia is a symptom of illness rather than refusal of care. She and other witnesses urged more consistent, long-term treatment, family involvement, medication support, and stronger county and state coordination. County and provider representatives said the current system still relies too heavily on crisis response and leaves people with serious mental illness falling through gaps between managed care, county specialty care, housing, and justice systems. Testimony from the California Behavioral Health Association, Santa Barbara County Behavioral Health, and the County Behavioral Health Directors Association emphasized that people with anosognosia often cannot self-navigate care, making a “no wrong door” system essential. They said H.R. 1 could destabilize coverage and shift costs to counties, while existing private insurance coverage is inadequate for early psychosis and related services. Witnesses highlighted CalAIM, jail in-reach, assertive community treatment, mobile crisis, supportive housing, and LEAP-style family training as promising tools, but said counties still need more resources and that the state should strengthen both Medi-Cal and private insurance behavioral health coverage. A public commenter from Lake County said private insurers denied most claims, especially for unlicensed staff providing case management and mobile crisis services. The committee then heard an update on the Children and Youth Behavioral Health Initiative, including the virtual services platforms BrightLife Kids and Soluna and the CYBHI fee schedule program. DHCS reported strong growth in app registrations, coaching sessions, referrals, and positive user outcomes, and said the platforms are serving children and youth statewide, including many who had never previously accessed care. For the fee schedule, DHCS said 72% of school districts and 50 of 58 county offices of education are participating across six cohorts, with $9.6 million reimbursed to date and 41,556 students represented in claims. Members pressed the department on the program’s roughly $69.3 million administrative cost, the slow pace of reimbursement relative to the investment, and the late delivery of requested data. DHCS responded that many claims are still being submitted, most denials are correctable, and local implementation is still scaling up through technical assistance and capacity grants.

Transcript Highlights:

• So that means we have a lot of Medicaid payers in our practice. >> Okay.
• Um on Medicaid payers in our practice.
• Many of our children have commercial primary; they have Medicaid secondary.
• When you bill commercial primary, you can't change rules, right?
• When you bill commercial primary, you can't change rules, right?

Keywords: 958, all

Summary: The Senate Standing Committee on Health Services heard Senate Bill 18, a bill described by the sponsor and podiatry witnesses as a modernization of Kentucky’s podiatry laws. The bill would recognize and regulate podiatric assistants, podiatric residents, and supervising podiatrists; allow podiatrists to supervise physician assistants in podiatry practices with approval from the relevant licensing boards; require new podiatrists licensed after January 1, 2027 to complete at least two years of residency; and extend disciplinary authority to the new categories. Witnesses said the measure would improve access to foot and ankle care, especially in rural areas, without expanding scope of practice. The Kentucky Medical Association was said to be neutral after working on the language with the sponsors. Committee members raised concerns about the meaning of “supervision,” whether it required direct or indirect oversight, and whether the bill could broaden billing or coding privileges. Dr. Roberts said supervision could mean direct supervision or indirect supervision, including being available by telephone, and noted the bill mirrors language used in allopathic PA supervision. He also said the bill would not change office staff billing roles and that podiatric assistants would not bill separately. Several senators said they supported moving the bill forward but remained concerned about workforce, cost, and scope creep. The committee adopted a committee substitute, then voted on the bill. The motion passed unanimously with favorable expression. After the vote, the committee moved on to a presentation on outpatient pediatric therapies, where providers described Medicaid reimbursement pressures, workforce turnover, and long waiting lists for children’s therapy services, but no action was taken on that presentation in the portion provided.

Transcript Highlights:

• That primary language. And so it may miss that block of text.
• And the payer, if they're using some sort of AI, is reviewing clinical documents.
• We’re also dealing with primary care, clinics, CBOs.”
• And this is something I'm very familiar with as a primary care physician.
• In the safety net setting, one of the ways we primarily care for patients is primary care.

Summary: The joint informational hearing of the Assembly Health and Privacy Committees focused on generative AI in health care, with opening remarks emphasizing both its potential to improve care and its risks around privacy, bias, liability, workforce impacts, and unequal access. Chair Bauer-Kahan and Chair Bonta framed the discussion around how California can encourage beneficial innovation while protecting patients, especially given the sensitivity of health data and the possibility that AI could worsen existing disparities if not carefully governed. The first panel featured representatives from Cedars-Sinai, Kaiser Permanente, Penguin AI, and Google, who described current uses of AI such as ambient clinical scribes, nursing documentation tools, imaging triage, maternal-fetal risk prediction, and administrative automation. Speakers said these tools can reduce clinician burden, improve patient experience, speed treatment, and in some cases improve outcomes, including a reported mortality benefit from a Kaiser predictive model and faster thrombectomy times at Cedars-Sinai. Members raised concerns about accuracy with accents and multilingual visits, whether predictive tools could reinforce bias or lead to more interventions such as C-sections, and how to ensure a human remains in the loop for important decisions. The second panel, including representatives from the California Health Care Foundation, UC Berkeley, and Stanford, focused on policy and governance challenges. Testimony highlighted examples of AI supporting homelessness outreach and community health work, but also warned that biased algorithms can encode inequities, especially when trained on data that reflect under-treatment of Black, rural, or low-income patients. Witnesses urged clearer standards for trustworthy AI, stronger monitoring and governance structures, better data access for accountability, and attention to the safety net’s limited resources. Several speakers argued that states should require health systems to have AI governance processes, clarify liability between developers and deployers, and regulate downstream uses of AI while preserving access to data for lifesaving research and oversight.

Transcript Highlights:

• As a primary care physician, I would still see my patient for those refills.
• anytime we see changes that have The prospect of increasing premiums, it's of concern for the premium payer
• So it just recommends and evaluates six specific areas: First, the primary drivers for premium increases
• This committee has been really focused on cost drivers over the last several years, but we feel that payers

Bills: SB101, SB21, HM52, HB132, SB14, SB20

Keywords: SB 101, Health Care Delivery and Access Act, repeal of repeal, sunset repeal, delayed repeal, health care, healthcare, access to care, medical services, provider regulation, state health law, New Mexico, SB 21, Medicare supplement, Medigap, open enrollment, guaranteed issue, birthday month enrollment, health insurance, insurance regulation

Transcript Highlights:

• Payers may have different rules than providers.
• Payers may have different with whom.
• Payers may have different rules<00:12:38.240> than<00:12:38.480> providers.
• <00:27:04.400> care linked back to the lack of primary care linked back to the lack of primary
• Looking at optimized installed resources that the state already has and KHI being the primary one.

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:20 CRISP Shared Services 00:01:39 Rural Health Transformation Plan 00:30:55, 958, all

Summary: The Budget Review Subcommittee on Health and Family Services opened its first meeting of the 2026 interim session, took roll, and moved directly into presentations. The main presentation was from Ryan Bramble of Crisp Shared Services, who described the organization’s health information exchange and health data utility model in Kentucky and other states. He emphasized that Crisp is a nonprofit, that data ownership remains with providers, and that governance is local. He also outlined the technical infrastructure, including a master patient index, cloud-based data lake, support for modern standards like FHIR and USCDI as well as older formats, and data quality tools used to normalize and standardize information. Bramble said the model is intended to reduce duplication, lower costs, and support rural providers and future use cases such as reporting, analytics, and AI-enabled decision support. Members asked how the state can ensure the data is actually used and who should drive priorities for health care improvement. Bramble said Crisp can provide tools, expertise, and examples from other states, but local teams such as KHI and state stakeholders must tailor and lead utilization efforts. In response to questions about ownership and coordination, he stressed that successful HIE governance requires a multistakeholder body that includes hospitals, health plans, government, and other interests, with a unified approach rather than multiple competing directives. He also said the Commonwealth has an opportunity to convene those stakeholders and set clear priorities. A senator raised concerns that responsibility for Medicaid and broader health policy has become fragmented and suggested a stronger central role for the state, possibly through the Department of Public Health, to coordinate health priorities. Bramble agreed that a single convening authority and multistakeholder governance are important, and noted that local governance should determine what data is shared and how it is used. No votes or formal actions were taken during this portion of the meeting. After Bramble’s presentation and questions, the committee was told that Secretary Stack from the cabinet would testify next on the rural health transformation plan.

Transcript Highlights:

• DeCegile: YES, I BELIEVE THE RUNOFF ELECTION PIECE THAT WILL BE MOVED TO THE PRIMARY ELECTION DATE IN
• Chair Gaetz: GO AHEAD SENATOR. >> Vice Chair Bernard: SO THE ELECTION WOULD BE DURING THE AUGUST PRIMARY
• TREMENDOUS COST SAVINGS, ONE OF MY BIGGER CITIES WOULD SAVE MORE THAN HALF $1 MILLION JUST ON THE PRIMARY
• AS CHAIR I HAVE TWO PRIMARY PRIORITIES.
• OFFICE OF PUBLIC COUNSEL OBVIOUSLY IS A PRIMARY, SEES WHAT THAT IS BUT OBVIOUSLY IT IS CONCEALED FOR

Keywords: 999, senate, all