Transcript Highlights:

• We stand on our written testimony, but in full support of this EA, which improves the environment of
• We stand on our written testimony, but in full support of this emergency appropriation, which improves
• I will just mention that we do support efforts to improve access to health care services.
• <02:26:58.680> in automation of future PA improvements in automation of future PA improvements
• prescription ion drug costs and improve prescription ion drug costs and improve transparency<02:

Keywords: 910, house, all

Summary: The committee first took up SB 1494 on hearing aids. Testimony was generally supportive of expanding hearing-aid coverage, with the Insurance Division raising concern about possible federal defrayment issues, SHPDA supporting the goal of hearing augmentation, DCAB strongly supporting the bill as an important access issue, and health plans and insurers asking for amendments. Kaiser Permanente and the Hawaii Association of Health Plans requested changes to add a medical-necessity standard and clarify annual notice language, while HMSA suggested the proposal should be studied by the auditor. The chair noted concerns about federal preemption and the lack of an audit, and deferred the bill in favor of a related resolution calling for a study. The committee then heard SB 1448, an emergency appropriation for the Hawaii State Hospital. DAGS and the Department of Health supported the measure, with the hospital administrator saying the funding would improve the environment of care, support cleaning, and allow a third-party review of the building. Committee members questioned the size of the request and the status of litigation against the design-builder. Administration witnesses said they were pursuing a comprehensive study involving destructive testing, had made a demand on the design-builder to fund the study, and were using different processes than before. They also said the roof work would be handled through a separate CIP request. No final action was taken in the portion provided. The committee next heard SB 1432, relating to the future responsibilities of the Department of Health and land issues at Kalaupapa after the last patient dies. DOH supported the bill in part but said its long-term role would be limited mainly to environmental cleanup, with operations expected to continue under the National Park Service and land-use decisions left to DHHL and beneficiary consultation. DHHL asked that the measure reflect that any land-use or zoning changes on homeland lands require commission approval and beneficiary consultation. Testifiers from Kalaupapa and Maui County, including Degra Vanderbilt-Papa and Council Member Keani Rollins-Fernandez, supported deferring the bill, saying there had been no meaningful community discussion about provisions affecting Kalaupapa’s future management and possible transfer of responsibilities to Maui County. The committee also read into the record written testimony from Gloria Marks emphasizing that Kalaupapa stakeholders must be included in future discussions. Finally, the committee heard SB 955 on fitness-to-proceed examinations. The Judiciary and the Public Defender’s Office both supported raising pay and standardizing expectations for private examiners, but opposed reducing felony fitness evaluations from three examiners to one and opposed expanding use of expedited reports. They argued that a single examiner would reduce reliability, create a more adversarial process, and likely increase costs and contested hearings, while expedited reports do not contain enough information for a proper fitness determination. The Department of Health also supported the bill’s intent but asked to preserve a three-examiner framework and said the goal was to reduce the number of people sent to the State Hospital, where admissions have reportedly risen about 20% year over year since Act 26. The bill remained under discussion in the excerpt, with no final vote shown.

Transcript Highlights:

• under a quality rating and improvement system that the bureau administers and manages.
• Where should we focus our efforts in making any particular improvements?
• Where should we focus our efforts in making any particular improvements?
• they did in order for us to improve they did in order for us to improve programs<01:39:36.480>
• eligibility system and any improvements eligibility system and any improvements to<02:57:25.000>

Keywords: 928, house, all

Summary: The committee held a Division 3 budget work session focused on the Department of Health and Human Services’ Division of Economic Stability. Karen Hebert, the division director, and Nathan White, DHHS chief financial officer, walked members through the governor’s operating budget pages and a briefing book, explaining that the division was consolidated in 2018 and serves programs aimed at financial stability, poverty reduction, child care access, and related supports. Members repeatedly asked for clearer breakdowns of general fund spending, historical growth since consolidation, and how the division’s broad mission areas map onto specific budget lines. A major portion of the discussion centered on the Bureau of Child Development and Head Start collaboration and the child care subsidy program. Hebert said the child care scholarship/subsidy helps low- and moderate-income families access daycare so parents can work, attend school, or receive treatment, and that eligibility is based on state median income up to 85%. She reported a 45% increase in utilization, 4,032 children receiving daycare support as of the end of January, and about 15% of eligible children being served. She also described the quality improvement system “Granite Steps for Quality,” with 160 providers enrolled out of 717 licensed programs, and noted that 1,200 child care professionals added credentials in the last year. Members pressed for cost-benefit information, asking for data on how much the state pays, how many providers and children are served, and whether the department could quantify unmet need. The witnesses said some projects were funded with short-term ARPA child care dollars and that detailed cost data for specific examples, such as the Gorm Community Learning Center expansion, would need to be looked up. They also explained that the child care fund is a federal block grant with required spending set-asides of 9% for quality, 3% for infants and toddlers, and up to 5% for administration, and that unused funds remain available. The committee also reviewed slide 10’s accounting units, including that the Child Care Workforce Fund is 100% general funds and was created as a priority item under HB 2 from the 2024 session, while some other child care-related units are 100% federal funds.

Transcript Highlights:

• more room, I guess, for improved compliance across...
• We have put into place certain improvement plans.
• So there can be improvement, but we need to have the staff to be able to do that.
• So there can be improvement, but we need to have the staff to be able to do that.
• an opportunity we have to improve an opportunity we have to improve electronic<05:45:31.478>

Keywords: 910, house, all

Summary: The Committee on Finance held an informational briefing with the Department of Labor and Industrial Relations on its budget, staffing, and operations. The director reviewed department leadership and reported on recruitment and retention efforts, including a 14% vacancy rate, a 10.5% workforce increase from filling 189 positions, and the Hela Imua internship program, which has placed 516 interns since inception and led to 62 permanent hires. The department also described modernization efforts, including the UI Huakai project and the Disability Compensation Division’s electronic case management system, and said the unemployment compensation trust fund exceeded $71.5 million, triggering Schedule C for calendar year 2025. The department’s main budget requests included $2.9 million for fiscal year 2026 to support maintenance and operations of the electronic case management system, plus restoration of two enforcement specialist positions. Officials said those positions are needed to address a decline in investigators from 11 to six since 2009, improve compliance, and handle Hawaii Compliance Express certificate work. Additional requests included two human resources specialists to address recruitment backlogs, two labor enforcement specialists to reduce a backlog of Chapter 104 prevailing wage and wage cases, and two positions for the Office of Community Services to expand immigrant services and access centers. The department also discussed federal funding for unemployment insurance and workforce programs, including National Dislocated Worker Grants and Workforce Innovation and Opportunity Act funds, and said some funding is received in increments and may require extensions. Members asked about Kauai inspection coverage, federal funding uncertainty, the size of the special unemployment insurance fund, and whether the department could ramp up staffing during a future crisis. Officials said Kauai is currently served by inspectors from Honolulu and there are no plans to open a permanent island position because of staffing constraints. They said the department is meeting federal guidelines and is not in jeopardy, and that the special unemployment insurance fund has about $10 million, with current UI operations funded at a little over $15 million, meaning the fund may need to cover roughly $5 million if federal support declines. The director said the department would use the special fund to supplement shortfalls, but noted that federal funding cuts and the loss of ARPA support have already affected operations.

Transcript Highlights:

• We will also be able to improve our pharmacy drug list, in which physicians and other providers do their
• our our Pharmacy drug list in improve our our Pharmacy drug list in which<00:06:17.479> Physicians
• “Do you see any improvement that can be made?” “Sorry, what was that?”
• “Do you see any improvement that can be made?”
• <02:28:00.040> the lot of thoughts on how to improve the lot of thoughts on how to improve

Keywords: 1191, senate, all

Transcript Highlights:

• home study program law to improve home study program law to improve oversight<00:36:27.760> and
• Assessment and Continuous Improvement Assessment and Continuous Improvement Agency<00:36:48.240>
• They are called revenue improvement.
• the current Vermont Housing Improvement the current Vermont Housing Improvement Program<02:13:01.720
• <02:13:11.760> Currently, make other improvements. Currently, make other improvements.

Keywords: 926, house, all

Summary: The House resumed consideration of H.606 on firearm procedures and first took up Section 3 and its effective dates. A member from Northfield spoke at length in support, arguing the provision is narrowly tailored, based on actual dangerousness rather than mental illness alone, and is more limited than federal law because it applies only to specific court findings and is temporary, with rights restorable upon recovery. The House then approved Section 3 and its effective dates, approved the remainder of the Judiciary Committee report, and ordered third reading. The chamber then moved through third readings and passed H.385 on remedies and protections for victims of coerced debt, H.556 on exceptions to the state minimum wage, H.559 on the parole board, H.723 on posting of land, and H.757 on manufactured homes and limited equity cooperatives. On H.814, relating to neurological rights and AI in health and human services, the House adopted an amendment offered by the member from Burlington that required the advisory council to include proposed definitions for neurotechnology, artificial intelligence, and related terms in its report; the House Health Care Committee reported the amendment favorable 11-0-0, and the bill then passed. H.816, regulating the use of artificial intelligence in the provision of mental health services, also passed, as did H.927, technical corrections for the 2026 session. The House then took up H.930 on chronic absenteeism. The committee member from Manchester described the bill as an AOE proposal responding to high post-pandemic absenteeism rates and their impact on learning, and outlined provisions adding definitions, updating compulsory attendance language, requiring a state model policy, strengthening notification and truancy procedures, and preserving existing penalties. The member said the Education Committee heard from a wide range of education and child welfare witnesses and passed the bill 11-0. After a brief clarification on the absences section, the House proceeded toward third reading of H.930.

Transcript Highlights:

• program and that we release improvements every week.
• . improve. improve.
• improvements every week. improvements every week.
• <00:30:56.000> it ways that we might be able to improve it ways that we might be able to improve
• this program in the how to improve this program in the future?

Keywords: 1183, house

Transcript Highlights:

• conversation from our hearing earlier this session about the person-centered policy and how we can improve
• We made some modest improvements in transparency last year, and that work did matter.
• We licensed assisted living in 2021 with the hope that regulation would improve care.
• We licensed assisted living in 2021 with the hope that regulation would improve care.
• We licensed assisted living in 2021 with the hope that regulation would improve care.

Keywords: 1187, senate, all

Transcript Highlights:

• benefit from a sustained and improved benefit from a sustained and improved outdoor<00:26:48.320
• It's something that you need to continue to develop over time and track and improve.
• That is just an area where we need to improve, and I think we're open to that and we're making improvements
• That is just an area where we need to improve, and I think we're open to that and we're making improvements
• That is just an area where we need to improve, and I think we're open to that and we're making improvements

Keywords: 1187, senate, all

Transcript Highlights:

• People with mental illnesses are languishing, and costs are skyrocketing without improved outcomes.
• But boards of supervisors have no direct authority to improve jail practices.
• They cannot condition jail funding on improvements.
• But there's still room for improvement.
• This bill improves adherence to prison rules.

Keywords: 987, senate, all

Transcript Highlights:

• Let's support them in those efforts and give them the staff they need to keep improving.
• . improving. improving.
• It does save cost and it improves access.
• does save cost and it improves access. does save cost and it improves access.
• <01:34:20.960> in in which showed reported improvements in in which showed reported improvements

Keywords: 1191, senate, all

Transcript Highlights:

• For example, the DNR itself said improvement of marked routes greatly reduces off-trail riding.
• <01:29:00.880> future actually improve current and future actually improve current and future
• others to find common ground and improve others to find common ground and improve this<01:42:31.440
• :51:12.960> our we're talking about improving our we're talking about improving our environment
• <01:53:56.080> I Use without improving outcomes.

Keywords: 1187, senate, all

Transcript Highlights:

• I have this saying that says there's always room for improvement.
• I see that happening. notion of improving uh ourselves. notion of improving uh ourselves.
• So, I like always room for improvement.
• in order to improve our conditions here. in order to improve our conditions here.
• now and uh that can improve. now and uh that can improve.

Keywords: 1187, senate, all

Transcript Highlights:

• called the hospital rate improvement called the hospital rate improvement program,<01:04:55.440>
• ATRIP, we've seen major improvements in ATRIP, we've seen major improvements in the<01:06:27.119>
• hospitals need to improve. hospitals need to improve.
• Um, the good news in all of this is that there is opportunity to improve.
• [laughter] opportunity to improve. So, um, our opportunity to improve.

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.

Transcript Highlights:

• <00:08:44.519> the<00:08:44.680> current<00:08:45.040> care support improving
• the current care support improving the current care options<00:08:46.440> as<00:08:46.600>
• We'll see improved health outcomes, reduced cost, and increased efficiency in our health care system.
• We'll see improved health outcomes, reduced cost, and increased efficiency in our health care system.
• to youth, families, and single adults, to improve accessibility statewide.

Keywords: 1183, house

Transcript Highlights:

• Our current health care system is moving at hyperspeed, but it has room for improvement. nationally are
• The goal is to improve patient outcomes, reduce costs, and empower patients and their families.
• <00:14:23.519> patient significant success in improving patient significant success in improving
• So you can get a sense of the leverage and how it improves access.
• So you can get a sense of the leverage and how it improves access.

Keywords: 1183, house

Transcript Highlights:

• And this is an opportunity that we have to improve the consequence.
• When I say improve, address the consequence with meaning, with real meaning.
• SB 1203 will not improve public safety.
• AB 46 makes an important improvement. which the governor did sign yesterday.
• And this committee has really improved. And this committee is really improved. It's more fair.

Keywords: 988, house, all

Transcript Highlights:

• So, we've tried to improve the bill um and have, you know, little sympathy for people who might get caught
• bill<00:09:01.920> um<00:09:02.160> and<00:09:02.480> have, tried to improve
• the bill um and have, tried to improve the bill um and have, you<00:09:03.600> know,<00:09:03.839
• whether you know you think they improve whether you know you think they improve outcomes<01:08:05.520
• The truth is that New Hampshire has done a lot in the last decade and a half to improve the outcomes

Keywords: 1189, house, all

Transcript Highlights:

• improve its operations or its business. improve its operations or its business.
• But we do recognize that there's always room to improve.
• . improve. improve.
• I mean, a survey is look at improving.
• their anonymity and that we can improve their anonymity and that we can improve the<01:15:16.040

Bills: HB1984, HB1593, HB2423, HB1691, HB2283, HB2386, HB1824, HB1697, HB2164, HB2165

Keywords: renewable energy, solar energy, self-certification, building permits, environmental regulations, HB1593, affordable housing, pet-inclusive housing, pet friendly housing, rental housing, affordable rental housing, HHFDC, Hawaii Housing Finance and Development Corporation, tenant pets, companion animals, dogs, cats, landlord-tenant law, security deposit, pet deposit

Summary: The committee heard testimony on HB 1984 HD2, which would require government entities issuing building permits to create a self-certification process for certain behind-the-meter rooftop solar and energy storage systems, allowing approved applicants to proceed without waiting for standard permit review. The Public Utilities Commission and DLNR offered comments, and the Hawaii Solar Energy Association, Holoholo Energy, Photon Works Engineering, Malama Solar, RevoluSun, and others testified in strong support. Supporters said the bill would reduce permitting delays, lower costs, and help meet Hawaii’s renewable energy goals while still relying on licensed engineers, electricians, and county inspections for safety. Committee members asked about risk, existing county pilot programs, and whether self-certification had been used before; witnesses said the professional liability remains with licensed signers and that current automated review systems often flag minor issues that slow projects. The committee also noted 16 additional written testimonies in support. The committee then took up HB 1593 HD1, which would require HHFDC-financed affordable rental housing projects to allow residents to own or keep common household pets. The Hawaiian Humane Society testified that the bill is a top priority because housing restrictions are a major reason pets are surrendered and because many unhoused residents with pets avoid housing that does not allow animals. In response to questions, the Humane Society said concerns about pet-related damage are overstated, suggested pet behavior screening as a safeguard, and said it would be willing to work on broader private-market pet-friendly housing policies. Members raised concerns about whether allowing pets in public housing could create problems for residents who later transition to the private market, and the witness said California has a similar law and no major negative effects had been identified. Finally, the committee heard HB 2423 HD2, which would require that by January 1, 2028, diesel fuel sold in Hawaii for on-highway vehicles contain at least 5% biodiesel by volume. The Hawaii State Energy Office offered comments, and Hawaii Transportation Association and Pacific Biodiesel Technologies testified in support. Pacific Biodiesel argued the mandate would improve energy security, stabilize fuel prices amid global supply disruptions, and support local clean-fuel production. In response to questions, the company said its nameplate capacity is 5.5 million gallons per year and it has produced over 6 million gallons annually, but much of its output is tied up in standby generator contracts that can fluctuate. Witnesses said the mandate would provide a stable market signal and could support future investment in expanded local biodiesel production, including agricultural feedstock development and a possible second refinery. No votes or final actions were taken during the portion of the meeting provided.

Transcript Highlights:

• Our R&D teams are working to further reduce this by improved genetic and management.
• Our R&D teams are working to further reduce this by improved genetic and management.
• Our R&D teams are working to further reduce this by improved genetic and management.
• Using it improves forest health, increases climate resilience, improves visual quality after a timber
• Using it improves forest health, increases climate resilience, improves visual quality after a timber

Keywords: 1187, senate, all

Transcript Highlights:

• But as we saw over time, it doesn't really make sense especially as technology has improved and cloud
• computing has improved to have 60 copies of similar technology at 60 times the cost.
• computing has improved to have 60 copies of similar technology at 60 times the cost.
• especially as technology has improved especially as technology has improved and<00:05:05.840>
• So I think improving um uh healthcare.

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.