Transcript Highlights:

• And I carry that trauma every day of my life.
• And I carry that trauma every day of my life.
• This will exacerbate the trauma impact on our foster youth.
• in licensed facilities.
• Five facilities were destroyed. One, four, I'm sorry, four.

Summary: The Assembly Budget Subcommittee on Human Services held an informational hearing on child welfare, foster care, child support, and related prevention efforts. The chair opened by emphasizing mandated reporting reform, foster care system improvements, and community-based prevention, and noted that no votes would be taken. Public testimony focused first on mandated reporting, where a lived-experience advocate and several organizations argued that the current system overreports families, especially Black, Native, and Latino families, causes trauma, and should be reformed through standardized training, clearer thresholds, and stronger community supports rather than more hotline referrals. Casey Family Programs cited data showing nearly 90% of reports are unsubstantiated, while CDSS said it is already forming a Mandated Reporting Advisory Committee, updating training, and exploring community pathways and possible changes to the list of mandated reporters. CWDA and SEIU supported training and alternative response concepts but stressed child safety, county capacity, funding, and the need for careful implementation and accountability. The committee then discussed a proposal to create a foster care multi-agency office within the California Health and Human Services Agency, led by a chief foster youth advocate with authority to coordinate across departments. Advocates said foster youth often need services from education, health, housing, and behavioral health systems that do not coordinate well, and argued that a central office with real authority could improve placement stability and access to services. CDSS responded that existing structures already provide coordination, including AB 2083 interagency teams, the Child Welfare Council, complex care steering committees, and the foster care ombudsperson, but said it was open to technical assistance. Members raised concerns about whether the new office would have enough authority and funding to avoid becoming another layer of bureaucracy, and the chair emphasized the need for real “teeth” and better interagency action. The final major topic was the continuation and expansion of Promise Neighborhoods. A community leader described strong early results from the state-funded neighborhoods, including improved kindergarten readiness, reduced chronic absenteeism, higher graduation rates, food access, housing supports, and mental health services, but warned that current funding sunsets in June 2025 and that a fiscal cliff could jeopardize staff and services. CDSS said the four funded neighborhoods have reported positive outcomes and valuable flexibility, but also noted challenges with one-time funding, student mental health, and long-term planning. Assemblymember Mia Bonta urged continued investment, saying the place-based model is difficult to rebuild once lost, and the chair asked LAO to help identify the minimum funding needed to preserve the existing infrastructure while evaluation results are still pending.

Transcript Highlights:

• They act out behaviorally oftentimes because of the trauma that they've experienced, and that is not
• </c><00:33:47.360><c> that</c> oftentimes because of the trauma that oftentimes because of the trauma
• </c><00:34:00.720><c> informed</c> them accountable in a trauma informed them accountable in a trauma
• Adult facilities do not provide the developmentally appropriate rehabilitative services youth require
• We, as public defenders, are in these facilities daily, weekly. I've been there twice this week.

Committee: House Judiciary & Hawaiian Affairs

Summary: The committee heard several measures, beginning with Senate Bill 869 on community outreach boards. The Office of Information Practices said the bill was now clear and raised no concerns after clarification that it applies to Hawaii County community development action plan committees under the Sunshine Law. Written support was received from several individuals, and one testifier initially opposed the bill but withdrew opposition after hearing OIP’s explanation. No vote was taken in the excerpt. The committee then heard Senate Bill 405 on neighborhood board meetings, which would let boards receive and discuss reports from government officials that were not on a noticed agenda, with final action deferred to a later noticed meeting. OIP said the bill was a policy choice but warned it would give boards more flexibility at the cost of less public notice. Support came from the Wke neighborhood board and Jacob Weinek, while Natalie Iwasa and Greg Mian opposed it, arguing it could lead to unclear agenda items and deeper discussion without adequate public notice. No vote was taken. The committee also heard Senate Bill 903 on a claims review working group in the Office of Hawaiian Affairs, with the Department of Hawaiian Home Lands asking for the measure to be deferred because it believed a complete inventory and audit of the public lands trust should come first. Members asked about the status of related House Bill 1358. The committee then heard tax measures: Senate Bill 1469, which would suspend the collection statute of limitations while tax assessments are on appeal, and Senate Bill 1467, which would clarify that county tax appeals do not need to be served on the Director of Taxation. The Tax Department supported both bills, and the Tax Foundation’s witness generally agreed but suggested a possible amendment to SB 1469 regarding insurance premium tax language. The committee then moved to Senate Bill 544 on sentencing of minor defendants, which would require courts to consider youth-related factors and allow departures from mandatory minimums; OHA, the Public Defender, Human Rights for Kids, and others supported it, citing trauma, diminished culpability, and national trends, and no opposition was noted in the excerpt. Finally, the committee heard Senate Bill 691 on family courts, which would set a minimum age of 12 for adjudication of law violations. The Public Defender and Human Rights for Kids supported the bill, saying very young children should not be treated as law violators and can still receive services through other family court mechanisms. The Attorney General’s office and the Honolulu Prosecutor’s Office opposed the measure, arguing it could limit court jurisdiction and services for younger children and might have unintended consequences, including recruitment of children into criminal activity. Members asked whether amendments could preserve the bill’s intent while addressing those concerns; no final action is shown in the excerpt.

Transcript Highlights:

• We, too, have concerns about the present facility, but the facility is what it is, and people inside
• similar trauma on others.
• I have lived experience with mental health and trauma and DMH-funded facilities.
• Estelle Collins: There was sexual trauma.
• , and fines for facilities that have repeated violations.

Committee: Joint Joint Committee on Mental Health, Substance Use and Recovery

Summary: The committee held a public hearing on a broad set of mental health, substance use, recovery, and patients’ rights bills. Early testimony focused on H. 2227, which would replace stigmatizing substance use terminology in the General Laws, and H. 3950, which would support parents in recovery involved with DCF by requiring more individualized recovery plans, clearer benchmarks for parenting time, access to recovery coaches or counselors, family counseling after sustained recovery, and staff training on addiction and lived experience. Speakers described the bills as ways to reduce stigma, increase accountability, and improve reunification outcomes for families. A major portion of the hearing centered on S. 1386, which would transfer Bridgewater State Hospital from the Department of Correction to the Department of Mental Health. Advocates, family members, and disability groups testified that Bridgewater functions like a prison rather than a hospital, with excessive restraint, seclusion, involuntary medication, poor conditions, and racial disparities, and argued DMH should oversee a treatment setting. One DMH occupational therapist and MNA member opposed the transfer, saying the real issue is mixing forensic and continuing-care patients and that DMH should instead create designated forensic units under bills H. 228/S. 1408. Committee members asked about Bridgewater’s population, the history of DOC control, capacity, staffing, and how a transfer might be implemented. The committee also heard testimony on modernizing the six fundamental rights for psychiatric inpatients, including expanding communication options, clarifying visitation and advocacy definitions, and improving access to gender-appropriate and culturally relevant items. Another bill, H. 2216, would require stronger oversight before antipsychotic medication is prescribed in nursing homes, prompted by concerns about inappropriate use. Finally, testimony supported H. 2240 and H. 2239 on sober homes, with supporters saying discharge and relocation policies are needed when a resident returns to active use or becomes unsafe, while preserving the recovery environment and resident rights. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• ><c> remain</c><00:04:27.840><c> safe</c> hospital facilities must remain safe hospital facilities must
• There is trauma and moral injury.
• The trauma triggered a medical crisis.
• </c> to go to the healthcare facilities? to go to the healthcare facilities?
• There is trauma and moral injury.

Summary: At this meeting, Senator Matt Klein and a group of Minnesota physicians and medical organizations described what they said was escalating ICE activity in and around hospitals and clinics, and argued it is deterring patients from seeking care and interfering with medical work. Speakers from emergency medicine, pediatrics, the Minnesota Medical Association, obstetrics/gynecology, and family medicine said patients are avoiding appointments, missing follow-up care, and in some cases suffering serious harm because of fear of detention or family separation. They emphasized that emergency departments and other health care settings should remain safe spaces where care is based on medical need, not immigration status. Several speakers gave examples they said showed actual patient harm, including missed prenatal and pediatric visits, delayed treatment leading to sepsis, perforated colon, burst appendix, and a patient with cancer who was detained and moved without medications. Pediatric and OB/GYN speakers focused on trauma to children and families, including fear of bringing children to appointments, requests for home births, and patients refusing transfer for higher-level care. Family medicine and emergency physicians also said staff morale is low, some workers are afraid to come in, and the situation is affecting diverse health care teams across the state. The discussion also touched on legal and policy questions. Speakers said they have tried calling police, hospital administration, and security to remove ICE agents from private patient areas, but reported that agents refused to leave. They said ICE may be allowed in public spaces but should not be in patient rooms or during private exams, and suggested there may be a role for legislation to codify best practices for law enforcement interactions in health care settings. No votes were taken; the meeting consisted of testimony, questions from reporters, and calls for collaboration and for ICE to stop enforcement activity in health care settings.

Transcript Highlights:

• You see, Madam President, 5/14 Was not a stand-alone trauma for my community. It was a retrauma.
• Again, not as a trauma, but as a Retrauma.
• And no one can deny the continuous trauma that ensued, especially after that day.
• Residents in the historic community, and an entrepreneur is putting a battery energy storage facility
• He could reach across his driveway and touch the walls of the facility.

Summary: The Senate opened with routine proceedings, approved the prior journal, and processed several messages from the Assembly, including motions to discharge and substitute identical Senate bills for Assembly bills on the calendars. The chamber also reconsidered and restored Senate Print 1788, an act amending the Real Property Tax Law, to the third reading calendar. The Rules Committee reported Senate Print 10324, the state budget appropriations bill, directly to third reading, and the Senate accepted the message of necessity and laid the bill aside before taking it up on the controversial calendar as a budget extender. A lengthy debate followed on the budget extender, with Senator O’Mara and others criticizing the continued delay in finalizing the state budget, the lack of public details, and the absence of a schedule for joint budget committee meetings. Senator Serrano responded that the extender was necessary to keep state government operating while final budget negotiations continued, but could not provide specifics on policy items such as Tier 6 pension changes, New York City aid, local government support, or school aid. The extender was ultimately passed 56-2, with Senators Rhoads and Weik voting no. The Senate then adopted several previously adopted resolutions, including a memorial resolution for former Congressman Eliot Engel and a resolution marking the fourth anniversary of the Tops Friendly Markets mass shooting in Buffalo. The Buffalo resolution prompted extensive remarks from multiple senators about racism, gun violence, community trauma, and the need for policy responses; it was adopted with broad support. The chamber also passed a series of bills on the third reading calendar covering highway, municipal, environmental, banking, veterans, education, public health, and public service matters, with most passing overwhelmingly and a few drawing minority opposition. Notable floor debate occurred on a study bill regarding battery energy storage systems, where senators raised concerns about fire safety and siting; the bill passed 45-13. The Senate adjourned to reconvene on Monday, May 18 at 11:00 a.m.

Transcript Highlights:

• WE PROVIDE TRAUMA INFORMED SERVICES IN PLACE OF SURVIVORS WITH HUMAN TRAFFICKING AND EDUCATION.
• WE KNOW THAT THE INDICATORS BEING THE TRAUMA ITSELF ABOUT TREATMENT AND WHAT THEY HAVE EXPERIENCED WITH
• WE KNOW THE TRAUMA.
• WE HAVE IDENTIFIED WHAT KIND OF TRAUMA THEY HAVE EXPERIENCED LIKE SEXUAL ABUSE, EXTREME CHRONIC WE HAVE
• WHILE THE STATUTE REQUIRED ONLY A ONE HOUR TRAUMA INFORMED TRAINING, WE RECOGNIZE THE NEED FOR A MORE

Transcript Highlights:

• ,</c> accommodations in all state facilities, accommodations in all state facilities, state<00:12:40.480
• So, I'm in full support of this and do appreciate kind of highlighting that trauma and trauma-informed
• </c> look at all of our bathroom facilities look at all of our bathroom facilities so<00:23:50.559><c
• </c><00:24:14.320><c> and</c> and look at all of their facilities and and look at all of their facilities
• </c><00:24:20.480><c> compared</c> matrix of highused facilities compared matrix of highused facilities

Committee: House Human Services & Homelessness

Summary: The committee heard STR 73 SD1, which requests the Office of Wellness and Resilience to develop a report on the developmental needs of children born during the COVID-19 pandemic. The Office of Wellness and Resilience testified in support, saying it was eager to work with local researchers on evidence-based, community-informed recommendations. Support also came from a Zoom testifier, the Department of Education, and the Hawaii Community Foundation. The testifier emphasized the need for trauma-informed supports for children who were ages zero to five during COVID, especially in communities also affected by the Kilauea eruption and the Maui wildfires. Members discussed the long-term impacts of the pandemic and natural disasters on children, and one member said they would support the measure but vote with reservations because they wanted the phrase “climate crisis” changed to “natural disasters.” The committee adopted the chair’s recommendation to pass the resolution as is, with some members noting reservations. The committee then took up SCR 239 SD1, which asks DAGS, DLNR, and the City and County of Honolulu Department of Parks and Recreation to provide universal changing accommodations in state and county facilities and parks. DAGS submitted comments, DLNR State Parks testified that it supported the intent but raised concerns about the cost and feasibility of retrofitting existing facilities, noting it has 73 comfort stations statewide, ongoing vandalism and maintenance issues, and possible ADA space conflicts. The Hawaii State Council on Developmental Disabilities and the Hawaii Disability Rights Center supported the measure, with testimony stressing that accessible changing facilities are important for independence and equity for people with disabilities. In response to questions, DLNR said it had not received complaints about the lack of such infrastructure and that any future installations should be considered in new designs rather than existing facilities. After discussion, the chair moved to defer the resolution, citing budget and implementation concerns and suggesting the issue be revisited in the future with a revised approach and possible needs assessment. The committee agreed to defer SCR 239 SD1 and then adjourned.

Transcript Highlights:

• And sensory rooms, our districts are making great use of those kinds of facilities and de-escalation
• They need support to build skills and process trauma.
• They need support to build skills and process trauma.
• I do extensive research on neurodiversity-affirming, trauma-informed strategies and share what helps
• No matter the training without the tools of mental health facilities, we cannot ensure the safety for

Committee: Senate Early Learning & K-12 Education

Transcript Highlights:

• And this did not just occur within the IHS facilities, but anybody that provided health care to those
• the United States of America, causing Native women to bear the heaviest burden of the historical trauma
• The unspoken trauma caused marriages to dissolve, alcohol and drug abuse, and living with shame and guilt
• Unfortunately, I bled for nine months straight, and no matter what IHS facility and IHS facility, Unfortunately
• , with the... ...of what occurs after such a trauma, with the significant cost of trying to just, you

Summary: The Senate Indian, Rural and Cultural Affairs Committee heard Senate Memorial 14, which calls on the Indian Affairs Department and the Commission on the Status of Women to conduct a comprehensive study of the history, scope, and continuing impacts of forced and coerced sterilization of Indigenous women and women of color. Sponsors and advocates said the memorial is intended to document harms that occurred not only in Indian Health Service facilities but also through other health providers, while being culturally sensitive and respectful of tribal sovereignty. Supporters described the issue as a reproductive justice, human rights, and Indigenous rights matter, and said the study could help lead to acknowledgment, healing, and possible reparative action. Several witnesses gave personal testimony. Representative Caballero shared a personal experience in which she nearly underwent a hysterectomy after a miscarriage due to forms she was asked to sign while sedated, and said that experience motivated her support. Jean Whitehorse, a Navajo Nation member and daughter of a Navajo code talker, described being sterilized in 1972 after treatment at Gallup Indian Health Service and said the practice caused lasting trauma to Native families. Other speakers, including Elena Giacchi, Keeley Badger, Jennifer Raphael Gatz, Rachel Lorenzo, Alicia Carese Lobbius, Nasserian Olamako, Deanna Warren, and Kat Sanchez, supported the memorial and emphasized the need for survivor testimony, historical records, data gathering, informed consent protections, and culturally grounded healing. Committee members asked about the difficulty of obtaining records and whether the information exists or is being blocked. Witnesses said access is limited, requests often need to come from official state or federal bodies, and many records may be sealed or difficult to retrieve. The Commission on the Status of Women said it could serve as the organizing entity for a three-phase process: gathering data, holding discussions with subject matter experts and survivors, and contracting with an Indigenous organization to prepare the report. After public comment and questions, the committee voted 4-0 to give Senate Memorial 14 a do pass recommendation, and the chair then recessed the meeting.

Transcript Highlights:

• Epping has one tax-exempt facility. Derry has seven tax-exempt facilities.
• Exit only has one facility. I years ago. Exit only has one facility.
• </c> facility until that process is done. facility until that process is done.
• </c> facility to a a nonpartner hospital. facility to a a nonpartner hospital.
• > uh</c><05:52:42.320><c> but</c> facility to outside facilities uh but facility to outside facilities

Committee: House Health, Human Services and Elderly Affairs

Transcript Highlights:

• One, Anissa De La Cruz, Warden, Central California Women's Facility, CDCR.
• We recognize that women incarcerated in California prisons are often victims of past trauma including
• CIW is a medically licensed facility.
• I was released in 2020 from the Central California Women's Facility.
• I was sharing about my causative factors, my trauma, and he was right there staring me down.

Transcript Highlights:

• In trauma, early stabilization prevents secondary injury.
• In trauma, early stabilization prevents secondary injury.
• In trauma, early stabilization prevents secondary injury.
• In trauma, early stabilization prevents secondary injury.
• In trauma, early stabilization prevents secondary injury.

Bills: HCR92 , HCR46 , HCR172 , HCR147 , HCR112 , HCR100 , HR84 , HR42 , HR139 , HR104 , HR92

Committee: House Labor

Transcript Highlights:

• </c><00:48:06.880><c> needs,</c> assess program facility needs, assess program facility needs, investigate
• Back in 1999 when we responded to trauma Back in 1999 when we responded to trauma calls,<01:43:02.719
• </c> trauma. Just read the news every day. trauma. Just read the news every day.
• ><c> committee</c> The trauma medical review committee The trauma medical review committee should<01:
• It expands the trauma patient care.

Transcript Highlights:

• for using the dollars that come to them for keeping up the facilities, the actual buildings in which
• for using the dollars that come to them for keeping up the facilities, the actual buildings in which
• for using the dollars that come to them for keeping up the facilities, the actual buildings in which
• And North Memorial, which is a level one trauma center for adult health care.
• Facilities, the upkeep of facilities, and this bill, as opposed to the bill we passed yesterday, gives

Committee: Senate Taxes

Transcript Highlights:

• ,</c><00:30:31.520><c> limit</c> 503b compounding facilities, limit 503b compounding facilities, limit
• , FDA-approved compounding facility.
• , FDA-approved compounding facility.
• , FDA-approved compounding facility.
• , FDA-approved compounding facility.

Committee: Senate Health and Human Services

Summary: The joint HHS and LBT meeting opened with accessibility concerns, as several blind attendees arrived after the general public had already been seated. The chair apologized and said future hearings would try to seat blind members earlier. The committee also announced the hearing was being streamed on YouTube, testimony would be limited to one minute, and written testimony was available online. The first bill heard was SB 2281, relating to the use of artificial intelligence in healthcare. The Department of Health supported transparency for patients but preferred disclosure through provider websites and office signage rather than a new regulatory program. The Hawaii Medical Association and Healthcare Association of Hawaii generally supported the bill’s intent but raised concerns about administrative burden and suggested a working group or model policies. Hawaii Pacific Health said it already uses AI for note-taking and patient portal functions and worried that written notice requirements could create too much consumer information. In response, the chair emphasized that patients should be informed when AI is used, especially if it affects diagnosis or consequential decisions, and said AI should not be making medical decisions. The committee later voted to recommend SB 2281 pass with amendments, including narrowing the definition of consequential decisions, removing certain language requested by DOH, adding a two-year implementation period, and setting a far-future defective date for further discussion; both committees adopted the recommendation, with the chair voting aye and the vice chair voting with reservations. The second major bill was SB 2852, a civil rights measure focused on digital access for people with disabilities. The Hawaii State Council on Developmental Disabilities, Hawaii Civil Rights Commission, Hawaii Disability Rights Center, and the National Federation of the Blind of Hawaii all supported the bill, arguing that existing law clearly protects physical access but should also make digital access explicit. Blind testifiers described how accessible technology, such as VoiceOver on iPhones, allows them to participate independently in public processes and warned that inaccessible digital systems can create barriers for thousands of blind residents. One testifier, an attorney with disability-law experience, supported the bill’s intent but said the draft had flaws, including no exceptions for archived materials, no distinction between small and large businesses, and concerns about the timing and choice of accessibility standards; he suggested delegating regulatory authority to the Hawaii Civil Rights Commission. The bill’s sponsor said he supported DAB’s proposed amendments, and the committee indicated those amendments would address many of the concerns raised. No final vote on SB 2852 was taken in the portion provided. The committee then took up SB 2751, which defines compounded prescription drugs for workers’ compensation purposes. The Department of Labor and Industrial Relations supported the bill but requested clarifying amendments to keep pharmacists as the primary professionals authorized to compound in licensed pharmacies and to limit any physician compounding authority to the physician’s own patient. Supporters included the Work Injury Medical Association of Hawaii, while Solera Integrated Medical Solutions opposed the measure, arguing the current definition was already broad enough and warning about cost inflation, especially with 503B bulk compounding facilities and physician dispensing. In questioning, members asked about rural access, reimbursement for 503B products, and late testimony suggesting definitions for 503A and 503B facilities, limits on physician dispensing to 30 days post-injury, and pre-approval for non-FDA-approved drugs. DLIR said not every rural community has licensed pharmacists available, that products with a national drug code are reimbursed at 140%, and that 503B facilities raise concerns because they are bulk manufacturers rather than patient-specific compounding operations. The meeting then moved into decision-making on SB 2281; the chair’s pass-with-amendments recommendation was adopted by both committees, with the vice chair voting with reservations.

Transcript Highlights:

• Well, I don't know anything about sanitation facilities.
• They have inspectors already that go into facilities.
• Inspectors already go into facilities.
• There are no minimum standards for these facilities statewide.
• We recognize the trauma. We want to get ahead of that.

Committee: House Appropriations

Summary: The House Appropriations Committee met on April 27 and first took up House Bill 175 and its companion House Bill 165, both dealing with lottery proceeds for veterans. HB 175 was amended to create a Veterans Service Grant Board within the Department of Veterans Affairs and direct $500,000 annually from Louisiana Lottery net proceeds into a Veterans Service Grant Fund, with unused money returned to the lottery proceeds fund that supports the MFP. Supporters, including the bill sponsor, The Boot Louisiana, LDVA Secretary Charlton McGinley, and Bastion Veterans Organization, argued the grants would help veteran services, workforce placement, mental health, housing, entrepreneurship, and retention of veterans in Louisiana. Members raised concerns about drawing from lottery proceeds that traditionally support education, but the committee adopted amendments and reported HB 175 favorably as amended. HB 165, the constitutional amendment companion, was also amended for technical and ballot-language changes and then reported favorably as amended for voter consideration. The committee then considered House Bill 457, which would authorize the Louisiana Department of Health and the State Fire Marshal to set minimum housing standards for homeless shelters, group homes, and halfway homes. The sponsor said the bill responded to a state auditor recommendation and to unsafe conditions in some facilities; he also explained an amendment changing the Fire Marshal’s duties from mandatory to permissive to reduce fiscal impact and allow agencies flexibility. Some members questioned whether local standards already existed and how enforcement and funding would work, while others supported the need for statewide minimum standards for human housing. The committee adopted the amendment and reported HB 457 favorably as amended. House Bill 488, by Representative Brough, sought to create a Belle Chasse Bridge Merit-Based Special Fund using recurring severance tax revenues from Plaquemines Parish to help buy out the Belle Chasse toll bridge and end what the sponsor described as excessive tolls and fees. He and several local witnesses, including business owners, a YMCA representative, and a parish council member, testified that the tolling arrangement had harmed access, businesses, and quality of life. The committee adopted a technical amendment clarifying the revenue source and then reported HB 488 favorably as amended. House Bill 566, which would prohibit state funds from supporting net-zero greenhouse gas initiatives tied to the 2022 Louisiana Climate Action Plan, drew significant debate over whether it would interfere with agency funding and economic development efforts; the sponsor argued the plan lacked legislative approval and should be repudiated, while members urged caution and suggested hearing from affected agencies. The sponsor agreed to consider deferring the bill, and the committee did not advance it at that time. House Bill 603, a constitutional amendment authorizing investment of state funds in digital assets and precious metals, was discussed as a way to hedge inflation and preserve value; members asked about limits and safeguards, and the bill was reported favorably. The committee then began hearing House Bill 763, a transparency measure creating a public database for settlement agreements involving state agencies.

Transcript Highlights:

• And this is for acute days and weeks after the trauma.
• Climate traumas, climate disasters are ACEs, adverse childhood events.
• The daily reports include impacts on facilities and clinics as well as member impacts.
• for behavioral health facilities.
• So hospital facility flexibilities are not within our purview.

Summary: The Assembly Health Committee held an informational hearing on the health impacts of wildfires and the effects on health care systems and access to care. The first panel focused on public health consequences, with testimony from UCLA and UCSF physicians, a community organizer, and an Altadena recovery leader. Witnesses described acute and long-term physical harms from wildfire smoke and ash, including asthma and COPD exacerbations, cardiovascular and stroke risks, pregnancy impacts, infection risk, and possible added hazards from lithium-ion battery fires. They also emphasized mental health effects such as anxiety, depression, PTSD, “firebrain,” and the need for psychological first aid, trauma-informed community networks, and youth-focused resilience programs. Community advocates stressed that Latine, Indigenous, undocumented, and Black communities face disproportionate harm because of language barriers, unsafe work conditions, lack of insurance, and exclusion from disaster aid, and they called for stronger language access, worker protections, permanent disaster relief, and better outreach. Committee members asked about air monitoring, masks, wind events, lithium-ion batteries, and how to reach communities with translation and emergency information. Panelists said AQI is useful but incomplete, that N95s help for smoke but P100 masks are needed for ash/asbestos exposure, and that communities should be warned to stay indoors and avoid windy dust-ups after fires. They also discussed the importance of building relationships during non-emergency periods, using text alerts and trusted community organizations, and providing culturally and linguistically appropriate information. Several members and witnesses highlighted the need for more research on long-term health effects, especially for people with chronic lung disease, workers who cannot stay indoors, and residents exposed to repeated disasters. The second panel addressed health care system response and access to care. DHCS and DMHC described emergency flexibilities used during the Southern California fires, including federal waivers, extended Medi-Cal renewal deadlines, reinstated coverage for some disenrolled members, suspension of prior authorization and prescription refill barriers, out-of-network access at in-network cost-sharing, and communication through websites, toll-free numbers, and social media. Hospital and community health center leaders described major operational strain: emergency room surges, canceled surgeries, dialysis disruptions, staff displacement, temporary housing needs, and financial losses. Huntington Health and AltaMed reported using incident command systems, temporary care spaces, bilingual and culturally tailored services, mobile clinics, infection control measures, and community health workers to keep care going. Members and witnesses also discussed the need for better disaster staffing pools, more flexible facility rules, stronger mental health coverage, child care planning, and statewide coordination for future emergencies; no formal votes were taken.

Transcript Highlights:

• It includes cardiac, stroke, and trauma events.
• So we welcome ongoing conversations with stakeholders... ...as well as trauma.
• Similarly, trauma accounts for a large and growing burden of premature death in Washington State.
• As demonstrated by our already robust trauma system, it's through data collection that hospitals and
• EMS and hospital guidelines, much like we do for trauma, in order to help hospitals produce their own

Bills: HB1812 , HB2232 , HB2250 , HB2340 , HB2577

Committee: House Health Care & Wellness

Keywords: anesthesia services, healthcare access, reimbursement, patient care, equitable treatment, emergency services, healthcare outcomes, health infrastructure, system improvement, charity care, residency requirements, medical assistance, low-income, HB 2340, nursing assistants, nurse aide, substance use disorder monitoring program, monitoring program, credentialing, licensure

Transcript Highlights:

• It includes cardiac, stroke, and trauma events.
• Similarly, trauma accounts for a large and growing burden of premature death in Washington State.
• As demonstrated by our already robust trauma system, it's through data collection that hospitals and
• And like the trauma system, these rules would help ensure that the patient goes to the right hospital
• This issue is important to me, as I have been chair of the EMS and trauma steering committee and the

Summary: The House Health Care & Wellness Committee held public hearings on several bills. House Bill 2232 would create a Department of Health-operated time-sensitive emergency data repository covering trauma, cardiac, and stroke events, with quality improvement reporting and support for rural facilities; it drew strong support from emergency physicians, nurses, and the Department of Health, while the Washington State Hospital Association said hospitals support the goal but lack the resources to absorb the added requirements. House Bill 1812, as a proposed substitute, would bar insurers and public plans from imposing anesthesia time limits or related reimbursement caps; the sponsor and anesthesia providers said it protects patient safety and fair payment, and the Washington State Society of Anesthesiologists asked for a clarifying amendment on physical status modifiers. House Bill 2250 would limit hospital charity care to Washington residents, while preserving emergency care access; supporters from rural hospitals and the Washington State Hospital Association said the change would help border hospitals facing rising nonresident charity care, and opponents from legal aid, patient advocacy, and LGBTQ groups warned it would create barriers, chill access for immigrants and other vulnerable patients, and conflict with Washington’s safety-net values. The committee also heard House Bill 2340, which would extend existing substance-use monitoring program protections and stipend eligibility to nursing assistants under the Board of Nursing’s CARES program. The sponsor described it as a simple equity measure, and the Board of Nursing supported it, saying it would improve access and reduce stigma; members asked where the stipend funding comes from, and staff and the board said it is currently general-fund supported at about $25,000 annually. House Bill 2577 would change hospital inspection law by requiring acute care hospital inspections every 18 months rather than on average, allowing some accredited inspections to satisfy the requirement every 36 months, and clarifying fire-protection reinspection standards; the sponsor and Department of Health said it responds to a JLARC audit and provides needed clarity, while DOH said it is still working to catch up from inspection delays caused by the public health emergency. The meeting ended after public testimony on the bills was closed and the committee adjourned.

Transcript Highlights:

• It creates risk, and trauma does not wait.
• And trauma does not wait.
• , and trauma-informed evidence-based counseling services for children in need.
• , and trauma-informed evidence-based counseling services for children in need.
• Any bad actors are weeded out of child care facilities.

Committee: House Children and Families