Transcript Highlights:

• I'm just services. So, why why cap it at two? I services. So, why why cap it at two?
• </c> Department of Health and Human Services. Department of Health and Human Services.
• My name is Public Health Services.
• </c> clinical contractor providing services. clinical contractor providing services.
• </c> Department of Health and Human Services. Department of Health and Human Services.

Keywords: 1189, house, all

Transcript Highlights:

• </c> is to provide the investment services is to provide the investment services for<00:03:05.680><c>
• service service they<00:53:54.800><c> performed.
• . services. services.
• So, we look at years of service, right? So, we look at years of service, okay?
• </c> service um and so thank you. service um and so thank you.

Keywords: 1187, senate, all

Transcript Highlights:

• We don't have strong prevention support services.
• In statute, it simply says to be used for foundational health services.
• Consumer by the service provider and remitted to the Department of Revenue.
• Medical Plan, those services are subject to B&O.
• These are birth-to-death services.

Summary: The committee heard briefings, sponsor presentations, and public testimony on several finance bills. HB 2038 would impose an additional B&O tax on businesses operating social media platforms beginning in 2027 and create a youth behavioral health account funded by the tax. The sponsor argued the bill would help address youth mental health harms linked to social media and support implementation of the Washington Thriving plan. Supporters in testimony, including youth advocates and some public health voices, said social media contributes to youth anxiety and addiction and that the revenue should be used for behavioral health services. Opponents, including technology and business groups, argued the tax unfairly singles out one sector, could be passed on to consumers, and may violate federal internet tax law. The hearing on HB 2038 was suspended and later reopened for public testimony; no vote was taken. HB 2297 would create tax incentives for grocery stores in underserved communities, including local B&O preferences, a sales tax exemption for security services, a 30-year property tax exemption program, a B&O tax credit, and a B&O exemption for certain locally owned or employee-owned stores. The sponsor and supporters said the bill is intended to preserve and attract grocery stores in food deserts, especially after recent store closures, and to help communities with limited transportation and access to healthy food. County representatives supported the goal but raised concern about the bill’s sales tax exemption and its effect on local revenues. Public testimony was largely supportive, with advocates, local officials, grocers, and residents describing grocery stores as essential community infrastructure. No action was taken. HB 2382 would raise cigarette taxes by $2 per pack, restructure vapor and other tobacco product taxes, and dedicate portions of the revenue to a time-sensitive emergency system, tobacco enforcement, and the foundational public health services account. The sponsor said the bill would generate needed revenue, support cancer research funding, and strengthen public health and enforcement. Supporters said higher tobacco taxes reduce use and help cover long-term health costs, while some public health witnesses supported the revenue but suggested directing more funds to existing tobacco prevention accounts. Opponents from retail and industry groups argued the proposal is regressive, could increase illicit sales and cross-border purchasing, and would hurt small businesses and low-income consumers. The committee also heard HB 2487, a Department of Revenue request bill that would narrow the B&O exemption for insurers to clarify that it applies only to premium income subject to insurance premium tax, and apply the change retroactively to 2019. The sponsor and supporters said the bill closes a loophole created by a recent Supreme Court ruling and preserves tax equity, while insurers and business groups objected to the retroactive application, warning of higher premiums and unfair taxation. Finally, HB 2018 would increase the solid waste tax by 0.5% per year for five years and direct the new revenue to a local government solid waste assistance account for county and city waste management plans. County officials supported the bill as a way to stabilize funding for solid waste systems, and testimony emphasized rising disposal and infrastructure costs. No votes were taken on any of the bills during the hearing.

Transcript Highlights:

• In the years since, these services have continued to grow.
• But public transit service ended at midnight.
• I know you all provided a tremendous service.
• who were impacted to use your service at no cost.
• You're providing a service.

Summary: The hearing focused on transportation network companies in California, with the chair framing it as an informational hearing on the history, regulation, safety, climate, accessibility, and data issues surrounding Uber, Lyft, and smaller or autonomous TNC services. The CPUC described its decade-long regulatory role, including safety rules, background checks, insurance requirements, reporting obligations, and two major legislative programs from 2018: the Clean Miles Standard and the Access for All program. Members asked about complaint trends, data collection and disclosure, program implementation, and how the CPUC uses annual reports for policymaking, compliance, and program oversight. Uber and Lyft said the statewide framework has supported growth while providing safety and access benefits, but both companies emphasized that insurance is a major cost driver and argued that California’s UM/UIM requirement is unusually high compared with other vehicles. They said the Clean Miles Standard is pushing electrification but faces headwinds from EV affordability and charging infrastructure, while Access for All has expanded wheelchair-accessible service but still needs continued support. They also discussed transit partnerships, wildfire response, and the potential role of autonomous vehicles, with both companies saying human drivers will remain important and that future regulation should account for new technology. The final panel, including the San Francisco County Transportation Authority and UC Berkeley researchers, presented evidence that TNCs have increased congestion and reduced transit ridership, especially in dense urban areas. They described prior research showing TNCs contributed to congestion growth in San Francisco and noted that this work helped spur local taxes on ride-hailing trips to fund safety and transit improvements. The panel also discussed the CPUC’s evolving data-disclosure decisions, arguing that public access to TNC trip data is important for understanding transportation impacts and informing local policy.

Transcript Highlights:

• Forest Service and U.S.
• Forest Service and U.S.
• Forest Service and U.S.
• Forest Service and U.S.
• </c> Service and US fish and wildlife service Service and US fish and wildlife service to<03:25:01.359

Keywords: U.S. House of Representatives Floor Proceedings on Tuesday, January 21, 2025, 1012, house, all

Transcript Highlights:

• Medicaid waiver services. So that's Medicaid waiver services.
• </c> cabinet for health and family services cabinet for health and family services and<00:08:04.800><
• </c> services to Medicaid enrolles. services to Medicaid enrolles.
• So non-service non-benefit stuff.
• </c> care services are covered by Medicaid. care services are covered by Medicaid.

Keywords: Call to Order and Roll Call – 00:00:00 Introduction of Board Members – 00:02:04 Overview of the Purpose and Goals of the Medicaid Oversight and Advisory Board – 00:12:46 Medicaid Legislative Update - 00:20:26 Discussion of Next Steps and Future Meeting Dates – 01:04:06 Adjournment – 01:06:37, 958, all

Summary: The first meeting of the Medicaid Oversight Advisory Board opened with Chair Ken Fleming and Co-Chair Rocky Adams welcoming members, explaining the board’s purpose, and introducing the diverse membership of legislators, providers, advocates, and state officials. Fleming said the board would meet monthly, allow public comment at the end of meetings, and operate transparently with materials posted online and distributed in advance. Both chairs emphasized that the board’s work would focus on improving Medicaid outcomes, efficiency, and oversight, while preparing for possible federal changes and avoiding premature assumptions about what Congress may do. Members then gave brief introductions describing their backgrounds in medicine, nursing, hospital administration, behavioral health, insurance, budgeting, pharmacy, and Medicaid administration. Several noted direct experience with Medicaid populations or managed care, including the Department for Medicaid Services commissioner, health plan representatives, hospital and clinic leaders, and legislators with health care backgrounds. The board also heard from Stephanie Bates of the LRC Office of Health Data Analytics, who said her office supports the General Assembly with health-related data, policy, and research and would serve as a resource to the board. Bates then began a presentation on Medicaid basics, explaining that House Bill 695 created the board and that the presentation would cover eligibility, enrollment, covered benefits, waivers, managed care, the budget, and the federal reconciliation bill. She described Medicaid eligibility as complex, noted that Kentucky had more than 1.4 million enrollees, and explained enrollment churn and the unwinding of pandemic-era continuous coverage. She also outlined mandatory and optional Medicaid benefits, the requirement that services be medically necessary and provided by enrolled providers, and the main waiver types used in Kentucky, including 1115, 1915(b), and 1915(c) waivers. No votes or formal actions were taken at this meeting beyond organizational setup and receiving the initial informational presentation.

Transcript Highlights:

• For shared technology services and telecom, cost of services is estimated, and it's based on customer
• And, oh, I forgot the last one, Amazon Web Services. Which was the last one? Amazon Web Services.
• through our shared technology services.
• of our budget that we are utilizing those outside service providers to deliver private cloud services
• , public cloud services, Texan communication services, so as agencies need telecommunication services

Bills: SB 1

Keywords: campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards

Summary: The committee first heard the Legislative Budget Board and Secretary of State Jane Nelson on the Secretary of State budget. LBB said the recommendation would reduce the agency’s appropriation by about $40.3 million overall, with major changes including removing federal HAVA funding and one-time business system replacement money, adjusting the agency’s base request, deleting an outdated Interstate Crosscheck rider, and directing HAVA funds to be drawn down first. Secretary Nelson and staff defended the agency’s needs, emphasizing election security, business filings, international protocol, and the Texas Register, and requested additional staff, a new website, digitization of records, IT and cybersecurity upgrades, and renovation of the Rudder Building. Senators discussed voter-roll maintenance, cross-checking data, call-center response times, and the need for online voter registration and more efficient election administration. No votes were taken. The committee then took up the Office of the Governor and trustee programs. LBB outlined a $2.4 million decrease for the office proper and a much larger decrease in trustee programs, driven by unexpended balances and the removal of one-time federal and border-security items, while noting continued funding for disaster response, victim assistance, and $2.9 billion for border security at roughly the prior level. Governor’s staff said Texas remains focused on border security, economic development, and public safety, and discussed efforts to seek federal reimbursement for prior border spending. Members asked about the National Guard’s status, possible federal assumption of border costs, the music incubator program, the Semiconductor Innovation Consortium, the Governor’s University Research Initiative, defense economic adjustment grants, and a new $5 million nonprofit security grant proposal. Staff said the semiconductor program has 12 approved projects totaling about 948 jobs and $17 billion in capital investment, and that the nonprofit security request was added late to address threats to houses of worship and other nonprofits. No formal action was taken. Finally, the committee heard the Texas Facilities Commission and lease-payment recommendations. LBB said the Facilities Commission recommendation would reduce appropriations by about $2.0 billion, mainly by removing border wall construction funding and capital complex bond funding, while adding money for higher utility costs, Rudder Building refurbishment, and additional staff. The lease-payment recommendation would decrease general revenue by $9.3 million. LBB also noted new riders related to completing the State Library and Archives building, tenant communication during disruptions, and a space-utilization report. In agency testimony, members asked about border wall maintenance responsibility, total facilities-related debt, and the status of capital complex construction. The Rudder Building renovation and related security needs were repeatedly discussed as important one-time infrastructure investments.

Transcript Highlights:

• </c> and immigrants come to hap for services and immigrants come to hap for services it<00:43:02.359>
• Supportive Services to make sure we are Supportive Services to make sure we are wrapping<00:50:41.680
• or service capacity.
• And perhaps most importantly, IPS integrates employment services with mental health services.
• </c> Services with mental health services Services with mental health services maybe<01:16:07.159><c>

Keywords: 1187, senate, all

Transcript Highlights:

• Almost every service has air traffic controllers.
• So I want to be clear: thank you for your service. Thank you for your honorable service.
• Thank you for your service.
• Minnesota, and their service is ongoing to their communities. So thank you for your service.
• for that service.

Transcript Highlights:

• </c> is the veteran committee Based Services is the veteran committee Based Services some<00:01:54.040
• We will be partnered with our programs and services, with our supervisor from the Medical Care Service
• > veter</c> with our service members our veter with our service members our veter friends<00:20:28.880
• That to our Lutheran Social Services core benefit, along with that array of services that we have for
• </c><00:29:03.760><c> I</c> uh children Youth and Family Services I uh children Youth and Family Services

Keywords: 1187, senate, all

Transcript Highlights:

• </c> choosing service. choosing service.
• </c> history of service in the US military. history of service in the US military.
• </c> ceaseless gratitude for your service. ceaseless gratitude for your service.
• </c> all service members. all service members.
• Development services supports this. Development services support<03:25:01.760><c> this.

Keywords: 981, all

Transcript Highlights:

• SB 1012, Judiciary; Health and Human Services and Appropriations.
• SB 1012, Judiciary; Health and Human Services and Appropriations.
• SB 1012, Judiciary; Health and Human Services and Appropriations.
• SB 1620, Obesity; Health and Human Services. SB 1632, Health and Human Services.
• SB 1776, Juvenile Services and Appropriations. SB 1803, Veterans.

Summary: The House convened, opened with prayer and the Pledge of Allegiance, approved the journal, and recognized the Doctor of the Day, Dr. Jasleen Chatwal. Members also introduced a number of guests and visiting groups, including Irish dignitaries for St. Patrick’s Day recognition, labor organizations such as AFSCME and CWA, the Arizona Farm Bureau, the Arizona chapter of the American College of Surgeons for Stop the Bleed training, and advocates for rare skeletal conditions. A proclamation recognizing St. Patrick’s Day was read, and the House later heard a proclamation honoring AFSCME Arizona. On the floor, the House took up several procedural motions, including requests to have the Senate return HB 4027 and HB 2444 for reconsideration, and received multiple Senate bills on first and second reading. The chamber then moved into Committee of the Whole and approved HB 2750 with a friendly floor amendment, sending it forward as amended. The House also sent HB 2999 to an additional Committee of the Whole, adopted a floor amendment, and advanced it as amended for engrossing. During third reading, HB 2197, relating to water access and camping near water sources, failed on reconsideration after members debated whether it imposed unnecessary criminal penalties and enforcement concerns. HB 2429, relating to vacation and short-term rentals, passed after supporters said it restored local control to cities and towns. HB 2950, creating special districts for tourism improvement areas, passed after amendments made participation voluntary and added notice requirements. HB 4001, relating to nicotine products, also passed after debate over youth vaping, enforcement authority, and whether the bill struck the right balance between regulation and parental responsibility. The House then made committee announcements and adjourned until Tuesday, March 17, 2026.

Transcript Highlights:

• I'm the director of the Florida Forest Service and the Florida Forest Services Division under the Florida
• So overview of the Florida Forest Service, we manage 38 state for us.
• They're also an calculated benefits and ecosystem services.
• And we do partner with the Forest Service on offer hunting on quite a few forest service lands as well
• the park service or the Fish and Wildlife Conservation Commission.

Transcript Highlights:

• The first page on our outline will just give you a brief overview of ACA and the services that they offer
• So, you know, obviously this is very interesting to me as being the chair of Human Services.
• So, you know, obviously this is very interesting to me as being the chair of Human Services.
• , providing service, and quite frankly was not providing service for a long time, and our state was aware
• I was looking at the Florida Department of Management Services.

Summary: The Health Care Budget Subcommittee met to review agency budgets, vacant positions, and possible efficiencies across several health and human services agencies. Members were asked to identify savings and potential areas for increased funding, and the discussion repeatedly focused on whether long-vacant FTEs, reversion of funds, and staffing shortages reflect true operational needs or broader budgeting and recruitment problems. The chair and members emphasized that the exercise was intended to help the committee make more informed budget decisions and to identify structural issues that may require legislative action. For the Agency for Persons with Disabilities, members highlighted a large waiting list, including individuals in crisis and children, and discussed whether vacant positions and unspent funds could be redirected to services. Several members raised concerns about delays in crisis applications, the use of paper applications, and whether the issue is staffing, process, or both. For the Department of Children and Families, the presenters discussed vacant positions, the use of staff augmentation in state hospitals, support for expanding behavioral qualified residential treatment program beds, and concerns raised by audits of the managing entities, which showed procurement and financial management problems. They recommended continued oversight, reporting requirements on Medicaid enrollees receiving mental health services through managing entities, and support for the governor’s proposed funding items. Other agencies reviewed included Elder Affairs, where members questioned the need for multiple divisions, CARES assessments, and supervisory overhead; the Department of Health, where vacancies, turnover, pay gaps, and units of rate were discussed as barriers to recruitment and retention; and the Department of Veterans’ Affairs, where the presenters said vacancies were tied to new nursing homes and recommended shifting a major priority into general revenue rather than trust funds. Throughout the meeting, members generally agreed that the vacancy review was eye-opening and suggested deeper, possibly separate, reviews of agency staffing, pay parity, and fund reversion practices. No formal votes were taken during the transcript.

Transcript Highlights:

• services are not covered?
• </c> human services budget. human services budget.
• </c> health services? Commissioner? health services? Commissioner?
• It lists private duty nursing as completely different services than home health care services.
• different services than home health<00:19:07.840><c> care</c><00:19:08.240><c> services.

Keywords: 919, house, all

Summary: The conference committee on House File 4188 met on May 16, 2026, with a quorum present and indicated it was intended to be the final meeting. The main issue discussed was an amendment to the 62J language concerning home care nursing services for children with complex medical needs. Chair O'Driscoll said the amendment would direct the Departments of Commerce and Health and Human Services to review the fiscal impact on the state, families, and health plans, and to develop possible legislation for 2027. Supporters described the proposal as a pause to allow more review, while also acknowledging it was not a complete solution. Senator Bolden and others testified strongly against allowing the coverage changes to stand, saying the issue affects roughly 200 to 250 families statewide, many of them children who need hospital-level care at home. They warned that capping or denying private coverage would shift costs to Medicaid waivers, strain family waiver budgets, increase state costs, and potentially force more children into hospitals, reducing critical care capacity. Committee members also questioned Commerce Commissioner Grace Arnold and department staff about the distinction between home care nursing and home health services, statutory definitions, billing units, essential health benefits, waiver budgets, and the effect of enforcement actions involving HealthPartners. The committee adopted the A30 amendment by voice vote, and the motion prevailed. Members then took up another provision, described by staff as the meat raffle/paddle wheel language, and adopted an amendment to add the game of Haus und Pfeffer before approving the provision as amended. In final remarks, members from both chambers praised the committee’s work and professionalism, but several expressed regret that the home care nursing issue was not resolved in the conference report and said it would need further work next session. They also noted other items that did not make it into the bill, including reinsurance and certain other policy provisions.

Transcript Highlights:

• Julia Hannigan, Dependency Legal Services, proud co-sponsor.
• First Prevention Services Program.
• County's Department of Children and Family Services.
• There's no services to offer.
• Public benefit programs provide life-saving health care services and supportive services that keep older

Summary: The Assembly Committee on Human Services heard a long agenda of bills focused largely on child welfare, foster care, child care, CalWORKs, mandated reporting, and public benefits. Early items included AB 890, which would ease county transfer rules for nonminor dependents in extended foster care; AB 461, which would replace punitive truancy-related penalties with supportive services for families; and AB 753, which would create an interim associate teacher pathway to help address the child care workforce shortage. Testimony on these bills emphasized barriers faced by foster youth, low-income families, and child care providers, and members expressed support for the general policy direction. The committee also heard AB 926 on foster care visitation, AB 563 on early childhood planning and reporting, AB 601 on standardized mandated reporter training, AB 1074 on CalWORKs reunification aid, AB 822 extending the Commission on the State of Hate, AB 970 creating a Los Angeles County mandated reporter pilot, AB 1161 protecting public benefits during disasters, AB 1172 allowing trained staff to administer emergency seizure medication in community care settings, and AB 363 expanding CalWORKs student supports and work-study. Witnesses generally supported these measures as ways to reduce trauma, improve reunification, modernize reporting and training, and expand access to services. County welfare and child welfare groups, advocacy organizations, and providers largely testified in support, while some bills drew concerns from county representatives about implementation or needed amendments. Several bills were voted out of committee, often unanimously and sometimes as amended, including AB 926, AB 563, AB 601, AB 1074, AB 822, AB 970, AB 1161, and AB 1172; AB 1172 was reported on call. The committee also took up consent items and later voted on subcommittee-held bills AB 461, AB 753, and AB 890, leaving them on call. At the end of the hearing, the committee heard AB 1211, which would protect CalFresh benefits from federal cuts and require a feasibility study on increasing benefits and eligibility; testimony stressed rising food insecurity and the economic importance of food assistance, but the transcript ends before a final vote on that bill.

Transcript Highlights:

• security services as well.
• How you use your back. to improve processing times and customer service.
• Customer service is paramount.
• It's a services org that has to have a high degree of quality and accuracy.
• And we know that service and wait times and backlogs have existed.

Keywords: Social Security, Medicaid, Frank Bisignano, Elon Musk, benefit processing, office closures, public testimony, administration policies, health care, vulnerable populations

Summary: The committee meeting focused heavily on the nomination of Frank Bisignano as the Commissioner of the Social Security Administration, with intense discussions around the current state of Social Security and its management under the current administration. Members voiced significant concerns regarding potential changes to Social Security and Medicaid, specifically addressing issues such as office closures, delays in benefit processing, and the perceived policies from Elon Musk's association with the administration. Public testimonies highlighted fears that these changes would severely impact the accessibility of benefits for seniors and vulnerable individuals, resulting in a chaotic environment at the SSA. Members expressed a unified opposition to the notion of dismantling these critical programs, emphasizing the long-term implications on their constituents' well-being.

Transcript Highlights:

• </c> passenger corridor rail service passenger corridor rail service throughout<00:04:27.680><c> the<
• </c><00:04:54.400><c> in</c> and fairbox recovery for services in and fairbox recovery for services in
• Current Amtrak Empire Builder service in this corridor.
• So, it would still be Amtrak, we just get more service.
• And so, there would be a service.

Keywords: 1183, house

Transcript Highlights:

• For shared technology services and telecom, cost of services is estimated, and it's based on customer
• through our shared technology services.
• of our budget that we are utilizing those outside service providers to deliver... ...private cloud services
• , public cloud services, Texan communication services, so as agencies need telecommunication services
• You know what a particular service is going to cost.

Bills: SB 1

Keywords: campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards

Summary: The committee began with Article I budget items for the Secretary of State. LBB staff outlined recommendations that would reduce the agency’s appropriation by about $40.3 million, including changes to HAVA funding, removal of one-time business system replacement money, and a rider directing the agency to use Fund 5095 first. Secretary Jane Nelson and staff then defended several exceptional items, especially additional staffing for elections and business filings, a new website, digitization of records, cybersecurity tools, and renovation of the James Earl Rudder Building. Members focused heavily on election administration, cross-checking voter rolls, Harris County complaints, call-center response times, and whether online voter registration should be expanded. No votes were taken; the discussion was informational and budget-focused. The committee then heard the Office of the Governor and trustee programs. LBB presented a recommended $2.4 million decrease for the governor’s office proper and a much larger decrease in trustee programs driven by one-time funding and unexpended balances, while still preserving major border security funding and victim assistance funding. Governor’s staff emphasized Texas’ economic growth, the importance of border security, and efforts to seek federal reimbursement for the roughly $11 billion Texas has spent on border operations. Members discussed whether shifting National Guard deployment to federal control could reduce state costs, and they also reviewed the music incubator program, the Governor’s University Research Initiative, and the semiconductor innovation consortium. Staff highlighted a $5 million late-added request for grants to protect nonprofits from violence and terrorism. Again, the exchange was largely explanatory, with no formal action. Finally, the committee took up the Texas Facilities Commission and lease payments for revenue bonds. LBB recommended major reductions overall, including removal of border wall construction funding and capital complex bond funding, but added money for higher utility costs, renovation of the Rudder Building, and additional facilities staff. George Purcell also noted stable maintenance-and-renewal funding and new riders related to the Texas State Library and Archives Commission building, tenant communications, and space utilization. For lease payments, LBB recommended a smaller appropriation tied to revenue-bond costs allocated across agencies. The discussion was informational, with members asking about the Rudder Building renovation, border wall progress, and capital complex construction timelines; no votes were recorded.

Transcript Highlights:

• And 83% of what fire service agencies do now is respond to EMS, emergency medical calls for service.
• A study on dental services that was reviewed by the Interim Health Services Committee, chaired by Senator
• Resources and Services Administration.
• Tribes pay a better rate for services than IHS.
• So for the FQCs, our Medicaid rate is not fee-for-service.

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