Transcript Highlights:

• millions of licensees while ensuring access to quality care. ...and service to the millions of California
• to services.
• to increased access to care.
• and access-to-care standpoint.
• PT services. worked beautifully to allow PTs and veterinarians to collaborate and expand access to PT

Summary: The joint Assembly and Senate Business and Professions sunset oversight hearing focused first on the Board of Registered Nursing (BRN), with chairs emphasizing oversight, consumer protection, workforce access, and the need to evaluate whether licensing boards are functioning efficiently. BRN leadership reported major process improvements since the last sunset review, including faster license processing, streamlined enforcement, improved consumer satisfaction, and growth in nursing education enrollment. Members questioned the board extensively about nurse practitioner scope and supervision, international licensure, online nursing programs and clinical placements, military pathways, the 30-unit LVN-to-RN option, workforce shortages, diversity in nursing, and retention of new graduates. The board explained California’s tiered APRN system, the NCLEX and national certification requirements, clinical hour standards, and its role in approving programs and assigning nursing education consultants. Public testimony on the BRN was mixed: nurse practitioner, nurse midwife, and nurse anesthetist groups largely supported the sunset report and especially the proposed APRN-to-RN delegation language, while physician and hospital stakeholders raised concerns about out-of-state NP practice, specialty delegation, ratios, and the need for regulatory parity and clearer standards. Higher education representatives urged reduced duplication in documentation, more flexible clinical placement rules, and better coordination to address bottlenecks in placements and faculty hiring. The committee did not take a vote during the excerpted BRN discussion. The hearing then moved to the Physical Therapy Board of California, where the board’s president began an overview of the board’s mission, structure, vacancies, and public-protection role under the Physical Therapy Practice Act. The transcript excerpt ends before substantive questioning, testimony, or any action on the physical therapy item is shown.

Transcript Highlights:

• able to maintain access to disciplines across campus.
• so that we engender some trust among our campus community members to access our services should they
• lack of access to university programs.
• promote access to a CSU degree.
• expand access to higher education.

Summary: The Assembly Budget Subcommittee on Education Finance met to review CSU and State Library budget issues, enrollment trends, the Capital Fellows program, and a Title IX update. Chair David Alvarez opened by stressing that CSU faces serious financial pressure, including a systemwide deficit and proposed cuts that he and several members said were too large and likely to harm access, course offerings, and student services. Public comment focused heavily on the Braille Institute Library, with patrons, staff, veterans, and advocates urging restoration of funding and warning that the proposed cut would severely affect blind and visually impaired Californians across Southern California. Several CSU faculty, staff, and union representatives also opposed the proposed reductions and warned of larger class sizes, fewer sections, and layoffs. On the CSU core operations item, the Department of Finance explained the Governor’s proposal to reduce ongoing General Fund support by about $375 million and defer a 5% base increase, while the LAO said CSU core funding would be roughly flat once tuition and targeted augmentations were considered, but warned that rising costs and prior shortfalls would still force campuses to cut spending. CSU’s Chancellor’s Office said the proposed cut would deepen existing problems, citing prior-year budget gaps, job losses, reduced course sections, and student-service reductions. Members pressed Finance and the LAO on whether cuts could be made more surgically, especially at the Chancellor’s Office or in institutional support rather than in instruction, and the LAO said the Legislature has flexibility to target cuts more specifically. CSU also described ongoing consolidation efforts, including shared services among campuses and the planned Cal Maritime/Cal Poly San Luis Obispo integration, while cautioning that savings are not yet fully known. The committee then discussed CSU enrollment. The LAO recommended holding enrollment targets flat because the budget does not add new funding, while CSU reported strong recent growth, including more California residents, record first-year enrollment, and expanded direct admissions and transfer pathways. Members questioned why some campuses with high demand turn away many applicants while others continue to lose enrollment, and CSU said it is shifting resources from campuses with sustained declines to those with demand, using a 10% below-target threshold. The committee also discussed whether enrollment declines mirror local population trends, how to improve marketing and program alignment, and whether lessons from Cal Poly Humboldt’s conversion could inform other campuses such as Sonoma State. The Capital Fellows item drew a Finance proposal for a salary increase and an LAO counterproposal for a smaller raise plus future COLA language; the committee kept the item open. Finally, CSU reported progress on Title IX compliance, saying it has completed most State Auditor recommendations, expanded civil rights staffing, and increased training, prevention, and case-management efforts, though members asked how proposed budget cuts might affect those services.

Transcript Highlights:

• to services.
• to increased access to care.
• and access-to-care standpoint.
• For us, access and access to care and safety are number one.
• PT services. worked beautifully to allow PTs and veterinarians to collaborate and expand access to PT

Keywords: 987, senate, all

Transcript Highlights:

• Do you think it would be safer and better for somebody to have access to a year's worth of contraception
• do with a lack of access to contraception.
• providing services, to be able to work together.
• The role of adult protective services, what I like to say, ...to have to support.
• get comprehensive services to address those root issues.

Keywords: 959, house, all

Transcript Highlights:

• In addition, older adult Medi-Cal members have access to a wide range of care management services directly
• to access and find the services in a streamlined way.
• of a no wrong door approach to help people access services in a more streamlined way.
• We need to educate the people who are accessing the services, right?
• safely connected to services.

Summary: The Select Committee on Older LGBTQ Californians held an inaugural hearing focused on the health care and support landscape for older LGBTQ Californians, including people aging with HIV and transgender, gender non-conforming, and intersex seniors. Opening remarks emphasized the long history of discrimination faced by older LGBTQ adults, the growth of the aging LGBTQ population, and the need to translate existing state commitments into concrete services. Senators highlighted concerns about nursing home vulnerability, the aging of people living with HIV, and the impact of federal actions and Medicaid cuts on California’s safety net. The first panel featured Justice in Aging, CalHHS, the Department of Aging, and the Aging and HIV Institute. Testimony described widespread inequities, including discrimination, social isolation, economic insecurity, and gaps in culturally competent care. State officials outlined the Master Plan for Aging, the first statewide survey of LGBTQIA older adults, gender-affirming care protections in Medi-Cal, and efforts to improve coordination across departments. Advocates argued the state has been too slow to respond to federal threats and that services are often hard to find or fragmented. Committee members pressed the departments on how survey findings are being turned into action, how rural and underserved communities are being reached, and whether more formal stakeholder coordination or “no wrong door” access systems are needed. The second panel focused on seniors living with HIV. A long-term survivor gave emotional testimony about the “survivorship penalty,” loss of benefits, housing insecurity, and the need for legal and navigation support, housing assistance, and protection from outdated disability standards. The Department of Aging reported on implementation of SB 258, which added HIV status to the definition of greatest social need for area agencies on aging; it said 20 of 33 area plans now identify HIV as a target population and many include specific strategies, such as LGBTQIA mental health connections programs. The Office of AIDS described Project Cornerstone, Ryan White, ADAP, HOPWA, the Medi-Cal waiver, and PrEP-AP, noting these programs serve thousands of older clients and rely on whole-person case management. Case management testimony underscored persistent needs for medication subsidies, transportation, food, and housing. Committee members questioned how ADAP rebate funds might be used, how SB 258 is enforced across local agencies, and how to reduce administrative barriers and auto-connect eligible people to benefits. The final panel began with the Department of Social Services outlining protections for TGI seniors in licensed care facilities, including SB 219’s nondiscrimination requirements and related provider notices and resident rights materials. The hearing remained focused on identifying service gaps, improving coordination across aging, health, and social service systems, and ensuring state programs better reflect the lived experience of older LGBTQ Californians.

Transcript Highlights:

• continue to do access.
• cost of delivering care, which would also increase access to those services and lessen the need for
• of delivering care, which would also increase access to those services and lessen the need for them
• You're going to have either limited lines of service or the entire access point. Okay.
• So we need to provide 24-hour wraparound services to ensure that the patient receives the care, has access

Keywords: 1185, senate, all

Transcript Highlights:

• But she had access to lactation consultant services through her insurance.
• HB 2015 allows Access to reimburse lactation services, enabling early intervention, reducing avoidable
• Access to reimbursed lactation services would enable early intervention, reduce avoidable hospitalization
• Because he's covered under Access, we were able to bill for services he urgently needed, including preventive
• access to medical and mental health services.

Summary: The committee began with two radiology-related bills focused on rural access and workforce shortages. HB 2049 would allow particle accelerators for cancer treatment in critical access hospitals and counties under 400,000 population under general supervision, with rural providers testifying that the change would let patients receive care closer to home while maintaining safety protocols. The bill passed on an 11-0 vote. HB 2050 updated outdated radiologic technologist statutes, revised school accreditation and clinical-hour standards, and allowed radiologist assistants to work under supervision rather than direct supervision; an amendment also added registered nurses to the list of professionals not needing an additional license to use diagnostic X-ray machines. Testimony centered on staffing shortages, national standards, and whether the change would preserve oversight. The committee adopted the amendment and passed the bill 10-2, with some members citing the need for more vetting and concern about oversight of dangerous equipment. The committee then heard HB 2082, which creates a Childhood Cancer and Rare Childhood Disease Research Commission to award grants for phase-one pediatric cancer and rare disease trials using existing license-plate funds and other sources. Parents and patients gave emotional testimony about pediatric brain cancer diagnoses, the lack of effective treatments, and the need for Arizona to support local research; the bill passed unanimously 12-0. HB 2015 required Access to cover breastfeeding and lactation services, and an amendment made the coverage subject to CMS approval. Supporters described breastfeeding as preventive care with benefits for infants and mothers, while Access said it was neutral but appreciated the amendment’s fiscal safeguard. The bill passed 12-0 as amended. Next, HB 2177 directed Access to seek CMS waivers to restore Medicaid payments for certain services provided to American Indian and Alaska Native members by IHS and tribal facilities, including dental, diagnostic, therapeutic, and preventive services. The sponsor and a Sage Memorial Hospital witness said the bill would help tribal facilities draw down federal funds and keep services local; it passed 12-0 as amended. HB 2178 required state agency chief medical officers to hold an active medical or osteopathic license and passed without opposition. HB 2179 clarified statutory definitions separating air ambulance from ground ambulance regulation, with industry testimony saying it was a cleanup measure that would avoid unintended consequences; it also passed 12-0. Finally, HB 2183 created an 11-member emergency medicine study committee to examine EMS system sustainability, rural and urban capacity, workforce burnout, and uncompensated care. Firefighters, health care advocates, and an emergency nurse practitioner supported the study as a way to gather data and make recommendations; it passed 12-0. The committee then returned to HB 2072, which establishes an optional state certification for lactation care providers under ADHS, along with rulemaking, fees, discipline, and an advisory committee; the sponsor said the credential was needed so Access could reimburse the service, and the bill was introduced for further consideration.

Transcript Highlights:

• hopefully access to more local resources related to substance abuse.
• hopefully access to more local resources related to substance abuse.
• hopefully access to more local resources related to substance abuse.
• </c> were able to update the health services were able to update the health services and<00:20:05.520
• improve language access to our population.

Keywords: 912, senate, all

Summary: The joint hearing began with SB 59 on prescription drugs, which drew extensive testimony from insurers, pharmacies, patient advocates, and health organizations. Supporters argued the bill would address PBM practices such as spread pricing, unclear reimbursement, and patient steering, and would help independent pharmacies and lower patient costs by passing rebates through to consumers. Opponents from health plans and PBM-related groups raised concerns, while Walgreens supported the measure and suggested amendments to establish a reimbursement floor. After questions, the committee accepted the Hawaii Pharmacist Association’s proposed amendments, added technical changes and a defective date of December 31, 2050, and voted to pass SB 59 with amendments. The remainder of the hearing focused on a series of nominations and reappointments to health, aging, disability, mental health, juvenile justice, and advisory boards. Nominees and agency representatives generally described their backgrounds and interest in serving, with support testimony emphasizing experience, continuity, and the value of volunteer service. Several nominees highlighted issues such as mental health access, substance abuse treatment, elder services, language access, disability access, and rehabilitation services. The Department of Health, SHPDA, DHS, and other organizations largely testified in support of the nominees. No votes were taken on the nominations during the transcript excerpt, and the chair repeatedly thanked the nominees for their service and testimony. The hearing also included brief procedural remarks about time limits, Zoom testimony, and a possible reconvening date in case of technical difficulties.

Transcript Highlights:

• There is a huge need for access to behavioral health services.
• you're having to creatively try to figure out, ...services.
• And if there are ways that we can expand that access or different codes to allow them to service other
• Do they have access to services and people that are trained to provide substance use disorder services
• We're in big trouble with access to services, and we'll never get that back.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to behavioral health as the main topic. Representatives Woodridge and Vaught described the work of the behavioral health working group, saying Arkansas needs a more proactive system that improves access, reduces red tape, and focuses on a few achievable policy changes for the 2027 session rather than many bills. Members discussed barriers such as low reimbursement, workforce shortages, licensing and credentialing hurdles, rural access problems, and the need to better use community providers, compacts, and step-down services. Director Paula Stone of DHS’s Office of Substance Abuse and Mental Health gave a detailed overview of the behavioral health system. She said Medicaid pays for more than 75% of behavioral health services in Arkansas and explained that when people are jailed or admitted to the state hospital, Medicaid generally stops, leaving state general revenue to cover care. She described current efforts including family-centered treatment for children, community reintegration group homes, a new adolescent substance use disorder residential unit, expanded community mental health center contracts, a secured restoration unit to reduce state hospital backlogs, and an IMD waiver to allow Medicaid payment for certain residential services. She also said DHS is working on crisis services, forensic evaluations, and provider rebidding in areas previously served by ERISA. Members asked about reimbursement for jail services, the lack of a statewide behavioral health dashboard, civil commitment options, crisis stabilization units, and whether Arkansas should expand step-down or long-term facilities for people who cannot safely return to the community. Stone said the state hospital backlog remains significant, average stays are still about 14 months, and crisis stabilization units have had mixed success, with Fort Smith and Jonesboro performing better than Fayetteville and Little Rock. The meeting ended with a commitment to continue the work, with more substantive discussion planned for August.

Transcript Highlights:

• access services and care.
• HCBS is not a regional service where you have to leave your family or community to get access to services
• We've cuts to HCBS service.
• They don't reflect how long it takes to get access to a service or whether or not the authorized services
• He will no longer have access to that day service and will remain home with his grandmother, both of

Summary: The committee heard testimony on the effects of H.R. 1 on Washington’s Medicaid, developmental disability, long-term care, and food assistance systems, followed by a separate discussion of juvenile rehabilitation caseloads and placement capacity. DSHS officials said HR1 could affect home equity rules, immigration-related eligibility, work requirements for some expansion-population enrollees, and provider taxes, while also creating a future opportunity for a new 1915(c) waiver. Advocates and providers warned that any state response that cuts home and community-based services would worsen already thin provider networks, increase waiting lists, push more people into hospitals or out-of-state placements, and strain families and workers. A pediatric behavioral health expert and a supported living provider said Medicaid reimbursement is already too low and further reductions would threaten outpatient, residential, and inpatient services for people with intellectual and developmental disabilities and severe behavioral needs. The committee then turned to SNAP and the state food assistance program. DSHS said HR1 would tighten work requirements and exemptions, end some immigrant eligibility for the federal program, eliminate the SNAP education program, raise state administrative costs, and eventually require Washington to share in benefit costs based on its error rate. Officials estimated large numbers of residents could lose or see reduced benefits, with significant added state costs. Anti-hunger advocates, a food bank director, and a SNAP recipient described the program as essential for low-income families, seniors, and people with disabilities, and said the changes would increase paperwork, reduce benefits, and worsen food insecurity while also harming local food economies. Testimony emphasized that food banks cannot replace SNAP and that work requirements may be difficult to meet for caregivers, people with disabilities, and those facing child care or transportation barriers. In the juvenile justice portion, the Caseload Forecast Council presented the JR forecast, which is currently mostly flat through the end of the biennium but expected to grow modestly over the longer term. Members discussed how policy choices, including the 2019 JR-25 law, have increased lengths of stay for adult-sentenced youth in JR, while diversion and other reforms have affected regular JR trends. A court researcher explained the data available to help forecast admissions and noted ongoing efforts to improve data sharing with JR, AOC, and county systems, though staffing and system-lag issues limit how quickly data can be produced. Juvenile court administrators and DCYF officials described the community-based juvenile justice continuum, rising complexity in the JR population, overcrowding at Green Hill and placement constraints at Echo Glen and Harbor Heights, and the need for more flexible community transition and mental health capacity. No votes were taken.

Transcript Highlights:

• There is a huge need for access to behavioral health services.
• And if there are ways that we can expand that access or different codes to allow them to service other
• Do they have access to services and people that are trained to provide substance use disorder services
• do to allow access is trying to get people on Medicaid to make sure that they can access those services
• And you guys supported us because we said, if you do that, then we're in big trouble with access to services

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to a broad discussion of behavioral health policy, taking up work previously handled by a behavioral health working group. Representatives Wooldridge and Vaught described major gaps in Arkansas behavioral health care, emphasizing access problems, workforce shortages, rural service barriers, low reimbursement, and the need to move from a reactive crisis system to more proactive community-based care. Members discussed possible 2027-session priorities such as reducing red tape, improving provider licensing and supervision pathways, expanding billing codes and reimbursement structures, and considering interstate compacts and other workforce fixes. A major focus was the state’s crisis and forensic system, including long waits for competency evaluations, the backlog at the Arkansas State Hospital, and the use of county jails for people awaiting treatment. DHS Director Paula Stone explained that Medicaid pays for most behavioral health services, but cannot pay for services in jails or state hospitals because those individuals are treated as inmates of public institutions, leaving state general revenue to cover much of that cost. She outlined DHS efforts including secured restoration beds, therapeutic communities, community mental health center contracts for jail-based services, and plans for an institution-for-mental-disease waiver that could allow Medicaid payment for certain hospital-based services. Members also discussed crisis stabilization units, with DHS noting that Fort Smith and Jonesboro have been more successful than Fayetteville and Little Rock, largely because of location, partnerships, and law enforcement coordination. Questions covered reimbursement for county jails, step-down facilities, civil commitment options, non-emergency behavioral health transportation, and whether DHS should create a bed-availability dashboard similar to hospital systems. DHS said it does not currently have such a dashboard but is exploring the idea. The meeting ended with a commitment to continue the work, with more detailed discussion planned for August, and the subcommittee adjourned.

Transcript Highlights:

• All Californians deserve access to critical health care services without fear.
• All Californians deserve access to critical health care services without fear.
• Many Californians struggle to access behavioral health services.
• AB 2540 will expand equitable access to medication abortion services for students attending community
• Access to equitable health care also includes access to reproductive health care.

Summary: The Assembly Health Committee heard a long agenda of health-related bills, beginning with AB 2651 by Bonta, which would require schools to notify parents when school vaccination rates fall below herd immunity thresholds. Supporters, including family physicians, PTA representatives, and medical groups, said the bill would improve transparency and help parents protect children and vulnerable family members. Opponents argued the data could be misleading, could identify medically exempt or conditional students, and might lead to stigma or discrimination. The bill was later moved out of committee on a due-pass-as-amended motion, with one no vote recorded on the roll call. The committee also heard AB 2123 by Aguirre-Curry on medical debt relief, AB 1570 by Wilson to eliminate out-of-pocket costs for medically necessary breast diagnostic and supplemental imaging, AB 2201 by Berner to restore Medi-Cal eligibility and renewal flexibilities, AB 2448 by Berman to strengthen privacy protections for reproductive and gender-affirming care records, AB 2034 by Addis on food additive safety and transparency, and AB 2598 by Krell to require better notification of next of kin when a patient dies in a hospital. Each bill drew strong support from authors, advocates, and affected individuals, while some drew opposition from insurers, industry groups, or transparency critics who raised concerns about cost, duplication, implementation, or unintended harm. Several bills were moved forward on due-pass-as-amended motions, including AB 2123, AB 2201, AB 2448, AB 2034, and AB 2598. The committee also heard AB 2551 by Elhawary, which would require health plans to collect and publish data on how often enrollees must go out of network for behavioral health care and why. Supporters said the measure would expose access barriers and high out-of-pocket costs, especially for communities of color and people with language access needs; opponents said it would add another reporting mandate and might not solve provider shortage problems. Members generally expressed support for the bill’s goals and several described personal or district-level experiences with behavioral health access problems. The bill was then moved out of committee on a due-pass motion. The committee also took up consent items and other procedural motions, with multiple bills reported out and some placed on call.

Transcript Highlights:

• There is a huge need for access to behavioral health services.
• to creatively try to figure out services.
• And if there are ways that we can expand that access or different codes to allow them to service other
• Do they have access to services and people that are trained to provide substance use disorder services
• We're in big trouble with access to services, and we'll never get that back.

Keywords: 1204, all

Transcript Highlights:

• to access to veterinary care.
• access to care.
• access to in-network benefits.
• or patient access to care.
• access to care.

Summary: The committee heard public hearings on several health-related bills. House Bill 1904 would prohibit cat declawing except for therapeutic purposes, with staff explaining definitions, fines, recordkeeping, and reporting requirements. The prime sponsor and animal welfare advocates described declawing as cruel and linked it to pain and behavior problems, while the Washington State Veterinary Medical Association supported the substance of the bill but asked to remove the added reporting and disciplinary provisions as redundant and burdensome. House Bill 2211 would provide guidance for medically tailored meals under existing Medicaid-related nutrition supports, including standards for Washington-based nonprofit providers where possible, menu review, and nutrition requirements. The sponsor said it would clarify implementation without expanding the program, and supporters from meal providers, food distributors, and local farms said it would improve health outcomes, keep dollars local, and support Washington jobs and agriculture. House Bill 2329 would allow licensed midwives to delegate certain tasks to medical assistants and to supervise medical assistants, with the sponsor and birth center operators saying it would fix an omission in current law and help rural and under-resourced birth centers operate more efficiently. Supporters said it would improve staffing and financial stability, while the sponsor indicated the lactation consultant language would likely be removed because those consultants are not regulated by the Department of Health. The committee then returned to House Bill 1904 for additional testimony from humane organizations, veterinarians, shelter leaders, and local officials, all supporting a ban on declawing and emphasizing animal pain, shelter impacts, and available alternatives. House Bill 2247 would expand and clarify veterinary telehealth and veterinarian-client-patient relationship rules, allowing a VCPR to be established in certain telehealth circumstances and setting guardrails for consent, practice standards, and when in-person exams are still required. Supporters from shelters, animal welfare groups, mobile clinics, and veterinarians said telehealth would improve access in rural and underserved areas, reduce shelter intake, and help animals receive care sooner; the veterinary association supported the bill with amendments to clarify recordkeeping and access-to-care findings. House Bill 2339 would update nursing license terminology and processes for advanced registered nurse practitioners, including title changes, controlled substance rules for CRNAs, transcript submission, and interim permits. Nursing board and ARNP representatives supported the technical updates, while the hospital association and medical association raised concerns about title language for clinical nurse specialists and the deletion of a reference to the medical profession. Finally, House Bill 2106 would require health carriers to give 90 days’ notice of significant mid-contract payer modifications and provide the actual modification language, with the sponsor and hospital and provider representatives saying insurers are increasingly making unilateral changes that affect payment, services, and patient access. UW Medicine and a rural hospital district described examples where insurers changed imaging or preventive service coverage mid-contract, causing financial losses and forcing difficult choices about network participation. Carriers were noted as opposing the bill, while providers and facilities argued it would improve transparency and prevent one-sided contract changes that disrupt care.

Transcript Highlights:

• access as a result of the freeze due to H.R. 1.
• go to pay for abortion services, correct?
• be able to access preventative care, for them to be able to go.
• I do not want to see those services closed down.
• life-saving services to people all over California.

Summary: The Senate Budget and Fiscal Review Committee heard AB 106, an early-action budget bill providing $90 million one-time General Fund to support reproductive health providers affected by the federal H.R. 1 Medicaid funding prohibition. Department of Finance staff explained that the money would be administered as grants by the Department of Health Care Access and Information because affected providers can no longer bill Medi-Cal during the federal restriction, which runs through July 4, 2026. The Legislative Analyst’s Office had no additional comments. Members also discussed related budget context, including the broader estimated loss to California providers, the use of grant funding rather than loans, and provisions exempting some contract and records information from public disclosure. Committee debate focused on whether the funding was an appropriate priority amid other budget pressures. Supporters argued the bill is an emergency response to a targeted federal attack on Planned Parenthood and other family planning providers, emphasizing that the clinics provide broader primary care services such as cancer screenings, STI testing, contraception, and prenatal care, and that the funding is not for abortion services because federal Medicaid dollars cannot be used for abortion. Opponents questioned the size of the appropriation, the use of General Fund dollars, the transparency exemptions, and why similar aid was not being directed to rural hospitals, disability services, Proposition 36, or other budget needs. Public testimony was overwhelmingly in support from reproductive health, medical, and health equity organizations, with some unrelated comments urging funding for dental care, disability services, housing, and county health systems. After public comment, the committee voted on AB 106 and passed it on a 12-4 vote. The bill was reported out of committee.

Transcript Highlights:

• to services.
• to increased access to care.
• and access-to-care standpoint.
• For us, access and access to care and safety are number one.
• allow PTs and veterinarians to collaborate and expand access to PT services.

Summary: The joint Assembly and Senate Business and Professions sunset oversight hearing focused first on the Board of Registered Nursing (BRN), with opening remarks emphasizing legislative oversight, consumer protection, workforce access, and the need to evaluate whether licensing boards are efficient and effective. BRN leaders reported progress since the last review, including faster licensing timelines, streamlined enforcement, improved consumer satisfaction, expanded nursing program enrollment, and new statewide data collection on faculty. Committee members then questioned the board about nurse practitioner scope and supervision, international licensure, English proficiency, online nursing education and clinical placements, military and veteran pathways, workforce shortages, diversity in nursing, the LVN-to-RN 30-unit option, and the role of the board’s RN executive officer. The board explained California’s tiered APRN system, the NCLEX and national certification requirements, the 500-hour direct patient care clinical requirement, and its use of nursing education consultants and board-approved programs to oversee schools and placements. Members also discussed retention problems, especially for new graduates, and the board said shortages are often driven by burnout, lack of support, and employers’ reduced use of new-grad training programs. Public comment largely centered on proposed BRN sunset issues affecting advanced practice nursing, education oversight, and workforce development. Nurse practitioner, nurse midwife, and nurse anesthesiology groups generally supported the BRN sunset report but asked for clearer implementation of AB 890, support for APRN-to-RN delegation authority, streamlined renewals for nurse midwives, and protection of the current population-focus model. The California Medical Association raised concerns about out-of-state nurse practitioners practicing independently without California transition-to-practice requirements, specialty delegation, ratios, and data collection. Higher education representatives from UC, CSU, private nonprofit colleges, and nursing associations urged the board to reduce duplicative documentation, modernize clinical placement rules, improve parity between in-state and out-of-state programs, and address bottlenecks in securing clinical sites. An online nursing school argued that California should create a pathway for distance-learning programs so students can complete clinicals in-state rather than traveling out of state. Several speakers also highlighted the need to expand access for rural and underserved communities, support diverse and nontraditional students, and preserve affordable pathways into nursing.

Transcript Highlights:

• But if they don't have access to services, then they won't get the support they need to make their lives
• And in cutting our fleet, that means that people may not get access to the services they need.
• to this service.
• And that CCAP funding is going to allow more children to get access to quality care, access to that education
• One thing I want to highlight is access: access to information, to updates, to understanding your case

Summary: The committee heard public testimony on several budget requests tied to health and human services. Louisiana Children’s Advocacy Centers asked for continued support and a supplemental appropriation of $1.173 million for infrastructure and standardization, explaining that the money would expand use of the Guardify digital evidence system, improve chain of custody, and reduce reliance on DVDs. Baton Rouge and statewide CAC leaders said prior funding helped eliminate a therapy wait list and speed services for abused children. Members asked detailed questions about the digital system, MDT coordination, and how the request related to SB 237, which would strengthen multidisciplinary review of child abuse cases. The Alzheimer’s Association sought $824,000 to sustain the dementia care specialist program, saying it helps families navigate services, keep loved ones at home longer, and reduce Medicaid costs. AARP and the Live at Home Coalition also testified for 750 additional Community Choice waiver slots at a state cost of $3.3 million, arguing that home- and community-based care is cheaper than nursing homes and that the current wait list is more than 11,000 people. Legislators discussed the size of the need, the state’s long-term care spending mix, and whether more support should go to family caregivers and community-based options. Testimony also focused on disability support services, substance use treatment, and developmental disability provider rates. A parent and direct support worker described the Children’s Choice waiver’s 20-hour cap and low pay, saying it makes it hard to retain caregivers and meet the needs of medically fragile children. Odyssey House and O’Brien House asked for higher Medicaid reimbursement rates under ASAM 4, warned that removal of room-and-board payments and weak Medicaid eligibility pathways are reducing access, and called for more oversight of sober living homes; members questioned outcomes data, length of stay, and links to homelessness. Finally, the Arc of Louisiana said the LDH rate study confirmed underfunding and supported a $53.6 million increase in state general funds, with local ARC leaders describing the services they provide and the need for higher direct support professional wages.

Transcript Highlights:

• access to legal services who can help them navigate these processes.
• accessing the services necessary to allow them to remain living in their homes.
• to provide services.
• Gray's to get services. We want others like you to get services.
• , from what age to what age, right, and the different services that should be able to be accessed based

Summary: The joint informational hearing focused on the impact of H.R. 1 on older Californians and related county administration issues. Chair Jackson and Chair Addis opened by emphasizing California’s rapidly aging population and the need to protect seniors’ access to food, health care, housing, and in-home support services. Testimony from the Department of Social Services, Department of Health Care Services, and Department of Aging described how H.R. 1 would expand work and reporting requirements in CalFresh and Medi-Cal, increase redeterminations, and create new eligibility barriers. Witnesses and advocates warned that these changes could lead to large coverage losses, especially for adults ages 55 to 64, people experiencing homelessness, caregivers, and some immigrant groups, while also increasing administrative burden on counties. The LAO noted that many provisions do not directly apply to Californians 65 and older, but highlighted indirect effects and some direct impacts, including a new home equity limit for certain long-term care recipients and narrower immigration eligibility rules. Committee members pressed the administration and counties on how exemptions would be identified and implemented, whether data systems could automatically protect eligible people, and how outreach would reach older adults, women, LGBTQ seniors, and people with limited digital access. DHCS and CDSS said they are working to use existing data, cross-program information sharing, and human-centered communications to maximize exemptions and reduce churn, including text outreach, print and radio campaigns, and navigator support. Members also raised concerns about the need for legal aid and county eligibility workers to help people navigate complex rules, and requested updated analyses on the number of people likely to lose both Medi-Cal and CalFresh and the broader human and system impacts. No votes were taken. The second major topic was the administration’s proposal to shift some future IHSS costs to counties by establishing a statewide baseline for average authorized hours per case. CDSS said the proposal is intended to improve consistency in assessments and not reduce services, while counties and labor groups strongly opposed it, arguing that rising hours reflect real increases in need, an aging and higher-acuity caseload, and state-mandated assessment tools rather than county error. County representatives said the proposal would strain already limited local revenues, worsen the effects of H.R. 1, and could force cuts to other safety-net services. Committee members questioned the proposal’s timing and impact, but the hearing ended without action, with the chairs asking for continued updates, additional analysis, and more information before May Revision.

Transcript Highlights:

• But if they don't have access to services, then they won't get the support they need to make their lives
• to this service.
• And that CCAP funding is going to allow more children to get access to quality care, access to that education
• And that CCAP funding is going to allow more children to get access to quality care, access to that education
• One thing I want to highlight is access: access to information, to updates, to understanding your case

Keywords: 965, house, all

Transcript Highlights:

• ability to access care.
• use of members receiving these services, and not lose access to other care.
• use of members receiving these services, and not lose access to other care.
• explore ways to ensure that beneficiaries have access to home and community-based services as an alternative
• With abortion access under attack across the country, California has made efforts to expand the services

Summary: The Assembly Budget Subcommittee on Health held the first of several hearings on the Governor’s May Revision for health care, with opening remarks focused on the state’s projected $12 billion deficit, looming federal Medicaid changes, and the potential impact on Medi-Cal, public health, reproductive health, and safety-net providers. Several members criticized the proposal as balancing the budget on vulnerable Californians, while others defended the need for cost containment and questioned the administration’s assumptions. The chair set ground rules for respectful, focused questioning and outlined three topics: the Medi-Cal proposals, Proposition 35, and Proposition 56. DHCS Director Michelle Baas presented the May Revision’s Medi-Cal package, saying the department’s budget totals $200.6 billion overall, including $45.2 billion General Fund, and that the proposals are intended to address rising caseloads, pharmacy costs, and managed care spending. She described proposed changes for adults with unsatisfactory immigration status, including a freeze on new full-scope enrollment for those 19 and older, $100 monthly premiums beginning in 2027, elimination of adult dental and long-term care coverage, removal of PPS/RAP payments to FQHCs and rural health clinics for that population, and a pharmacy rebate aggregator. Other proposals included eliminating certain OTC drug classes, removing GLP-1 coverage for weight loss, prior authorization and step therapy changes, reinstating the Medi-Cal asset test, eliminating acupuncture as an optional benefit, allowing utilization management for hospice, raising the managed care minimum medical loss ratio to 90%, reducing PACE capitation rates toward the midpoint of the actuarial range, eliminating the skilled nursing facility workforce and quality incentive program, and suspending the SNF backup power requirement. The LAO said the revised Medi-Cal spending estimate is about $2.5 billion higher than the Governor’s Budget in the budget year, and that the increase appears driven more by higher per-enrollee costs than by caseload alone. The LAO said the budget solutions are concentrated in a few areas, are largely ongoing, and should be considered in light of federal uncertainty, but suggested the Legislature could explore alternatives such as more targeted income thresholds for the undocumented expansion and simpler asset-test rules. Department of Finance officials said the proposals are difficult but necessary to address a third consecutive deficit and rising Medi-Cal costs. Members then pressed the administration on the methodology and impacts of the proposals, especially the enrollment freeze, premiums, asset test, hospice controls, PACE reductions, and the elimination of benefits and provider payments. No votes or formal actions were taken at this hearing.