Transcript Highlights:

• looking at the Health Care Affordability Fund, and I'd bring this up, I was just in Washington at the CMS
• I'm happy to help you in putting connections with people, CMS, if you want to discuss that.

Transcript Highlights:

• And lastly, the bill directs APD, alongside ACCA, to seek the appropriate CMS federal approval for a
• has been a huge issue for us, especially when they age out of the Medicaid program and working with CMS

Summary: The committee heard and advanced several bills related to children, families, elder affairs, mental health, disability services, and child care. SB 1050 on the Agency for Persons with Disabilities was amended and reported favorably after discussion of expanding the voluntary IDD managed care pilot statewide, improving transparency on the APD wait list, creating a statewide family care council, addressing transition services for youth leaving foster care, and seeking federal approval for an adult pathways waiver. Testimony from providers and a parent emphasized workforce capacity, county-level identification of clients, Medicaid delays, and the importance of keeping the pilot voluntary; the bill passed with support and some discussion about possible future clarifications on services and Medicaid eligibility. The committee also passed SB 1310, which directs OPPAGA to evaluate student mental health outcomes tied to school mental health assistance funding, and members discussed the need for better data, coordination with managing entities, and avoiding duplication of services. SB 976 on court-appointed social investigators was amended and approved, with the sponsor describing due process protections and fee-shifting provisions for parents challenging court-appointed psychologists. SB 886, creating a crisis care coordination team pilot in Volusia and Polk counties to reduce Baker Act recidivism and improve follow-up care, was reported favorably after the sponsor described its law enforcement and community provider partnerships and an independent evaluation requirement. Later, SB 614 on child care facility and program background screening requirements was amended and passed; the bill requires a public educational webpage explaining Level 2 screening, the clearinghouse, disqualifying offenses, exemptions, and related job listings and timelines. Finally, SB 276 on sheltering or aiding unmarried minors was approved; it increases the offense from a first-degree misdemeanor to a third-degree felony, creates a presumption regarding knowledge of the minor’s age, and adds a defense when the conduct was necessary to protect the minor from danger. All bills considered were reported favorably, and the committee adjourned at the end of the meeting.

Transcript Highlights:

• > government, under rules from the federal government, under rules from the federal government, CMS
• , CMS, CMS, the<00:43:25.880> rates<00:43:26.800> are<00:43:26.960> supposed<00:
• MCOs are highly regulated by DHS and CMS, and we have submitted a letter to the committee that lists
• MCOs are highly regulated by DHS and CMS, and we have submitted a letter to the committee that lists
• MCOs are highly regulated by DHS and CMS, and we have submitted a letter to the committee that lists

Keywords: 919, house, all

Summary: The committee first took up House File 3939, a bill to support a Helping Paws service-dog litter named in honor of Gilbert and the Hortman family. Testimony from Helping Paws and service-dog graduate Angie Foley described the organization’s work, the significance of the “Guided by Gilbert” litter, and how the funding would help train dogs that provide independence and support to people with disabilities, veterans, and others. Members from both parties spoke warmly about Speaker Hortman’s connection to the organization and Gilbert, and the bill was laid over for possible inclusion. The committee then considered House File 3769, the Department of Corrections’ technical omnibus bill, with an A1 amendment adopted to clarify tuberculosis testing language. The bill updates TB screening procedures in correctional facilities, including how refusals are handled, and adds Quantiferon Gold Plus testing as an option alongside existing methods. Members discussed whether the bill would create costs for counties and jails, with some noting added testing and segregation costs and others arguing the changes would improve accuracy and reduce time in restrictive housing. The bill, as amended, was recommended to the general register. House File 3978 was next, a technical cleanup bill for a provider wellness program created last year. The bill expands eligibility and confidentiality protections from physicians to all health care providers, while supporters said the program is meant to address burnout and mental health strain in the workforce and does not require new money. Some members questioned whether the change was redundant or would broaden the program without additional funding, but the Minnesota Medical Association testified that the program is separate from insurance and was intended to serve all providers. The bill was recommended to the general register. Finally, the committee began House File 3476, which Rep. Liebling described as a cleanup bill related to Minnesota’s Medicaid managed care system and public program oversight. She argued that the state spends billions through managed care organizations and that the system has never been proven better than direct payment, setting up a broader discussion of the bill’s purpose and the state’s oversight of public health care spending.

Transcript Highlights:

• So, we have several comparisons for CMS. Remember, these are alternatives to facility care, right?
• So, we have several comparisons<01:08:12.680> for<01:08:12.800> CMS.
• <01:08:13.760> Remember,<01:08:14.200> these<01:08:14.480> are comparisons for CMS
• Remember, these are comparisons for CMS.
• approval as to which comparison get CMS approval as to which comparison we're<01:08:54.640> going

Keywords: 958, all

Transcript Highlights:

• we put as much program integrity as possible into this bill, and we get some of that language from CMS
• So my amendment makes sure that the bill language aligns with the language from CMS, which is good, but
• we put as much program integrity as possible into this bill, and we get some of that language from CMS
• So my amendment makes sure that the bill language aligns with the language from CMS, which is good, but
• CMS.

Keywords: 919, house, all

Summary: The House took up Senate File 4476, described as the human services program integrity package, and first adopted a motion declaring urgency so the bill could move quickly to conference committee before the end of session. The House then adopted a DE amendment to insert House language, followed by a technical A7 amendment clarifying that prepayment review would apply to all fee-for-service systems. Members then debated the A5 amendment, which would have removed a sunset on the periodic data matching reporting requirement tied to eligibility checks for medical assistance and MinnesotaCare. Supporters argued the report is essential for fraud prevention, accountability, and ensuring only eligible recipients receive benefits, citing missed or delayed reports and claiming the process can save the state money. Opponents said the report had been received, that federal HR1 changes would require different data-matching procedures, and that the amendment was not the right vehicle. After roll call, the A5 amendment failed, 63-67. The House next debated the A6 amendment, which would require DHS reporting on homelessness programs, including outcomes, costs, and participant movement, and would allow recoupment of funds if reporting was not provided. Supporters said the state spends tens of millions on homelessness without clear results and needs better data to guide policy; opponents said homelessness reporting and stakeholder work are already underway and objected to the amendment’s approach. Debate continued with questions about the amendment’s details and stakeholder consultation, but the transcript ends before a final vote on A6.

Transcript Highlights:

• This item is required from our federal requirements that we're working on with CMS at the moment.
• we're working federal requirements that we're working on<00:36:18.560> with<00:36:18.720> CMS
• :58:04.680> with required of us as we are working with required of us as we are working with CMS
• CMS for the approval of the 1115 waiver. CMS for the approval of the 1115 waiver.
• In May 2024, CMS published this Medicaid access rule with the goal of increasing access to care, quality

Keywords: 1183, house

Transcript Highlights:

• the Department of Human Services sent a request to the Centers for Medicare and Medicaid Services, CMS
• CMS agreed on Halloween last year to have this program stopped.
• Medicaid Medicaid, Medicare and Medicaid Medicaid, Medicare and Medicaid Services,<00:10:34.880> CMS
• CMS agreed on Halloween last stopped.
• CMS agreed on Halloween last year<00:10:59.440> to<00:11:00.000> have<00:11:00.160>

Keywords: 1183, house

Transcript Highlights:

• CMS estimated that point-of-sale rebates would cause a 15% decline in rebates.
• The Center for Medicare and Medicaid CMS The Center for Medicare and Medicaid CMS Office<01:08:06.799
• <01:08:17.120> CMS<01:08:17.679> estimated raising the cost of drugs.
• CMS estimated raising the cost of drugs.
• CMS estimated that<01:08:18.400> point<01:08:18.560> of<01:08:18.799> sale<01:08

Keywords: 1187, senate, all

Transcript Highlights:

• There were some concerns expressed from CMS that when California went this route, they were violating
• There were some concerns expressed from CMS that when California went this route, they were violating
• 36:50.000> um we're using was approved by Congress um we're using was approved by Congress um CMS
• in the past has raised some concerns CMS in the past has raised some concerns with<00:36:52.839>
• And we need 50 more of these to slide through and a very flexible CMS, and we actually can make it.

Keywords: 1187, senate, all

Transcript Highlights:

• I just want to say that, you know, as much as CMS does sort of move the ball on people, move the cheese
• know<00:25:20.640> as<00:25:20.880> much<00:25:21.039> as<00:25:21.200> CMS
• <00:25:22.320> does know the you know as much as CMS does know the you know as much as CMS

Keywords: 928, house, all

Summary: The committee approved the previous meeting minutes and then reviewed a draft preliminary report on long-term managed care. The chair explained the report is intended to frame issues and outline legislative options, not make a final recommendation, especially given unresolved questions about the federal One Big Beautiful Bill (OB3). The report’s key issues included the current financing of county and private nursing homes through Medicaid rates, ProShare, MQUIP, and related funding mechanisms, and the concern that those payments could be affected or eliminated under a managed care model. Members also discussed managed care organizations’ role in Medicaid and cited other states’ experiences, noting examples of savings in Florida and Tennessee but higher costs in California. One member raised Indiana as another important comparison, and the committee agreed to add it to the report’s state examples. The committee also reviewed sections on dual eligibility, D-SNP, PACE, and CFI waivers. The chair raised concerns about whether OB3 creates incentives for states to move toward D-SNP and whether federal changes could affect provider taxes, state-directed payments, and intergovernmental transfers. Henry Litman, the state Medicaid director, said he would confirm details on D-SNP incentives and explained that ProShare is based on certified public expenditure rather than an IGT, while county cap financing is the relevant intergovernmental transfer issue. He said IGTs are not going away and that the main risk is whether current financing mechanisms could be preserved if the state later changed course. Members discussed the possibility of a waiver not being granted or renewed and the high fiscal impact that could have on counties and property taxes. The committee then discussed the population that any long-term managed care model should cover. Members agreed that there is no appetite to move developmental disability or acquired brain disorder populations into long-term managed care at this time, and the chair changed the report’s terminology from “elderly” to “aging population.” The chair also noted that the status quo option should reflect the recent shift toward home and community-based services and reduced nursing home utilization since earlier county reports. The report’s four policy options were summarized as: maintain the status quo; pursue D-SNP for dual eligibles, with DHHS potentially submitting an application as early as 2027; adopt an HCBS carveout; or move fully to managed care for the aging population. No final policy recommendation was made, and the committee discussed making edits to the draft before circulation, including adding Indiana, clarifying OB3-related issues, and changing the report title from “final” to “preliminary” or “interim.”

Transcript Highlights:

• So they set up, um, Congress asked CMS to set up a 15-person panel or committee, the ground ambulance
• So they set up um Cong Congress<03:17:12.160> asked<03:17:12.399> CMS<03:17:12.880>
• c> up<03:17:13.359> a<03:17:13.600> 15<03:17:14.439> person Congress asked CMS
• to set up a 15 person Congress asked CMS to set up a 15 person panel<03:17:15.840> or<03:17:16.080

Keywords: 928, house, all

Summary: The committee first took up several liquor-related bills. Senate Bill 24, allowing students under 21 to taste wine in educational settings, drew no opposition or amendment and was reported out 6-0. Senate Bill 79, authorizing self-pour automated systems under the liquor commission, also faced no opposition and was voted ought to pass 6-0. Senate Bill 80, shifting licensing, auditing, and enforcement for wholesale and retail e-cigarette sales to the liquor commission, prompted discussion about whether the change would add cost; members heard that the liquor commission already handles similar enforcement and that the change was meant to address nonreporting. It was voted ought to pass 6-0. The committee then discussed Senate Bill 87, concerning alcohol service in salons, barbershops, and spas. Members and staff focused on how to limit the amount served, whether to require recordkeeping, and privacy concerns about tracking what patrons drank. The discussion settled on removing references to alcohol type and quantity and keeping only patron records, with the understanding that the agency would set the details by rule. The bill was not formally amended at the meeting, but members agreed an amendment would be drafted for the following week; the bill itself was reported ought to pass with that amendment to be determined. Finally, the committee heard testimony on Senate Bill 245, the EMS No Surprises Act and System Stabilization Act. The sponsor, Senator Suprena, said the bill would prohibit balance billing for emergency ambulance calls and unscheduled transfers, while setting reimbursement at either locally set public rates or 325% of Medicare. She explained that the proposal was based on national work on ground ambulance billing and was intended to stabilize struggling EMS providers. Committee members sought clarification that the bill did not eliminate balance billing for non-emergency transfers, and the sponsor confirmed it did not. A second witness, Jerry Stringham, testified in support, citing his reimbursement background.

Transcript Highlights:

• CM request. Uh, Vice Chair for vote. Chair votes aye. Senator Fukunaga excused. Senator Kim aye.
• committee on economic development Chair committee on economic development tourism.<01:04:20.079> CM
• CM request. Uh vice chair for tourism. CM request.

Keywords: 912, senate, all

Summary: The joint Health, Human Services, and Higher Education hearing took up HB 441 HD2, a measure to increase cigarette taxes and dedicate the revenue to the University of Hawaii Cancer Center. The Department of Taxation said it had no substantive objection but requested an effective date of January 1, 2026 if tax rates change so it can order new stamps. The Department of Health, the Deputy Attorney General/tobacco enforcement, the University of Hawaii Cancer Center, the Hawaii Public Health Institute, the American Cancer Society, the Hawaii Medical Association, and several other health organizations and youth advocates supported the bill, arguing that higher cigarette prices reduce youth initiation, encourage cessation, and help fund cancer research and care. Several supporters asked for a larger increase, including at least $1 per pack, while opponents from retail, wholesale, and tobacco-related groups argued the tax would be regressive, burden low-income smokers, and drive sales to the illicit market. The Tax Foundation and other opponents also criticized reliance on sin taxes and said smoking rates are already at historic lows. After testimony and questions, members discussed how the revenue should be used and whether higher taxes change smoker behavior or push people toward vaping or other alternatives. The chairs announced they would pass HB 441 HD2 with amendments, replacing the contents with SB 528 SD1 except for changes reflecting the Department of Taxation’s request and a provision directing all proceeds from the tax increase to the Hawaii Cancer Center’s debt reduction, with an effective date of December 31, 2025. The House Health, Human Services, and Higher Education committees then voted to adopt the recommendation; the Health, Human Services committee vote was adopted with Chair and several members voting aye and one member voting no in the Higher Education committee vote. The hearing also briefly covered HB 1334 on meat donation, which drew support from the Department of Agriculture, Hawaii Farm Bureau, food industry, and community groups, though no action was taken in the excerpt. The committee then heard HB 1098 on crimes against protective services workers. The Honolulu Prosecutor’s Office and Honolulu Police Department supported the bill, saying assaults on protective services workers can have chilling effects and deserve stronger deterrence; a committee question raised whether the bill should instead be part of a broader, more proactive approach to assault statutes. The Department of Human Services also described safety steps such as panic buttons and phone apps for social workers. The excerpt ends before any final vote on HB 1098.

Transcript Highlights:

• highlighted that the proposed changes would align state rules around ambulatory surgical centers with CMS
• :32:22.720> by surgical centers with those updated by surgical centers with those updated by CMS
• <00:32:23.480> in CMS in CMS in 2019<00:32:25.240> um<00:32:25.360> and<00:32:25.480

Keywords: 910, house, all

Summary: The House Committee on Health heard testimony on several measures. On HB 1233 relating to storm water management, the Attorney General’s office said the state may need to share costs with counties for any new inspection or regulatory program. Testifiers strongly supported the bill, including the Hawaiian Lifeguard Association and a community member who described her daughter’s death in a poorly maintained detention pond and urged statewide inspections and a comprehensive approach. A member asked the Attorney General about the cost-sharing issue, and the office said state appropriations would be needed if counties are required to take on new duties. The committee then heard HB 245 on student heat exposure safety. The Department of Education, Department of Health, and the Hawaii State Council on Developmental Disabilities supported the measure. A physician testifying for the Climate Change and Health Working Group described children’s vulnerability to heat and cited examples from other states that adopted stronger heat guidelines after school heat deaths. The Department of Education said it could do the feasibility study without additional funding and preferred to wait for the study before deciding on equipment needs. The Attorney General’s office later testified on HB 903, authorizing schools to maintain bronchodilators, supporting the concept but warning that the bill’s definition of school was broad and that DOE may not have jurisdiction over all covered entities; it suggested changing “protocol” to “guidelines” and involving the Public Charter School Commission. On HB 1314 relating to youth mental health, the Department of Education testified in opposition, though no additional testimony was offered. The committee also heard HB 1334 on meat donation, with DLNR and the Hawaii Farm Bureau supporting the measure. HB 799 on health care drew support from HMSA and the Hawaii Association of Health Plans, while the Department of Health said it supported the intent but wanted amendments, including limiting the bill to Maui, adding a sunset, and requiring a study of quality and access impacts. On HB 952 relating to Parkinson’s disease research, the Department of Health said the proposal would require additional appropriations and staffing and suggested a public-private partnership approach; the Hawaii Parkinson Association, Queen’s clinicians, and other supporters testified that a registry would help identify the number of patients and improve care. Finally, SHPDA strongly supported HB 1431 establishing an oral health task force, saying the state lacks sufficient dental oversight and that both keiki and kūpuna need better access to services.

Transcript Highlights:

• Services with Guidehouse Incorporated, is Amendment Nine to an existing contract, and this is for the CMS-required
• This is Amendment 9 to an existing contract, and this is for the CMS required closeout conditions for

Summary: The subcommittee first considered a used tire program contract for Arkansas District 4, an $88,000 one-year contract with LTR Intermediate Holdings. Senators raised concerns that the tire district’s revised business plan had not yet been approved and that the contract could leave the district unable to pay. Questions also focused on solicitation language that excluded bidders under corrective action plans. On motion, the committee held the contract until next month and encouraged the tire board to appear. Members then reviewed and, without objection, moved forward a series of methods of finance, alternative delivery projects, and discretionary grants. These included multiple university and college projects such as renovations, roof replacements, a new UCA multipurpose arena, and a revised financing package for UA Fayetteville’s Maple Hill residence hall. The committee also reviewed DHS and Department of Health grants for aging services, substance abuse prevention, mental health, nutrition outreach, hearing-loss follow-up, HIV services, maternal health, and rural hospital quality improvement. The committee next handled contract items, including a UAMS ratification for FMLA Source after an amendment was not submitted for review and payments continued past expiration; UAMS said it had retrained staff and would review for other missed contracts. Members also reviewed numerous construction, intergovernmental, out-of-state, and in-state contracts across state agencies and universities. Questions were raised about an out-of-state aeronautics study, a U of A Fayetteville parking guidance system, and a Veterans Affairs nursing contract. Most items were reviewed without objection, and the meeting adjourned after informational reports on contract amendments and minor contracts.

Transcript Highlights:

• The rules and regulations, and there's tons of them, are set by the federal government, by the CMS.
• CMS contracts with OFAC to do surveys and oversight.

Keywords: 994, senate, all

Summary: The committee met with a quorum present and heard a presentation from Marty Wright, CEO of the West Virginia Healthcare Association, on the state’s long-term care system. He described the continuum from home care to assisted living to skilled nursing facilities, emphasizing that these settings increasingly serve short-term rehab-to-home patients as well as older adults needing round-the-clock care. He also outlined the number of facilities in West Virginia, the predominance of Medicaid as the payer for long-term nursing home care, the private-pay nature of assisted living, and the role of OFAC/CMS in regulation. A major focus of the presentation was workforce shortages and turnover, especially for CNAs, LPNs, and RNs, along with declining interest in nursing careers and the impact of regulatory burden and burnout. Wright said the system is also struggling to serve younger patients with substance use disorder, mental illness, or other behavioral needs, who are often not well suited for traditional nursing home placement but have limited alternatives. Senators raised concerns about where such patients are being housed, the long-term effects of opioid and behavioral health issues, and the gap between school-age special needs populations and adult care needs. Wright said Medicaid can cover long-term nursing home care for those who meet financial and medical eligibility requirements, but affordability and spend-down requirements remain major barriers. He also warned that Medicare Advantage can create confusion and shorter covered stays for rehab patients, and he urged early planning around long-term care insurance and estate planning. No votes were taken on the presentation, and the committee adjourned after questions and discussion.

Transcript Highlights:

• And so they had a one-page directive to see if CMS could basically try to root out waste, fraud, and
• So, the primary care ones in particular, if CMS were to come back and say, as part of implementing this
• We've done this in phases, and I guess CMS has been behind on the official approval process, but say

Transcript Highlights:

• therapy and the clarification there is really more for what's already established and set up through CMS
• Do you know if other states have submitted to CMS for in lieu of service approval for nutritional counseling
• Yes, there are 3 other states that have submitted to CMS and have in lieu of, in lieu of services counseling

Bills: HB 26, HB 140, HB 141, HB 142, HB 215

Keywords: Medicaid, nutrition support, maternal health, chronic conditions, pilot program, DFPS, Department of Family and Protective Services, child protective services, child abuse investigations, child neglect, child exploitation, advisory committee, Family and Protective Services Council, council abolition, foster care, due process, investigative procedures, child welfare, parental rights, family preservation services

Transcript Highlights:

• So we have standing data user agreement with CMS for Medicare data and with ARCA for Medicaid data.
• CMS has a one-year delay for Medicare. The Medicaid data rolls in on a quarterly basis.
• CMS has a one-year delay for Medicare. So doing anything fast, no.

Summary: The Health Professions and Program Subcommittee met to receive oversight briefings on Florida’s medical marijuana program from the Department of Health’s Office of Medical Marijuana Use (OMMU) and from the University of Florida’s Consortium for Medical Marijuana Clinical Outcomes Research. OMMU Director Christopher Kimball outlined the program’s structure, including more than 900,000 active patients, nearly 7,000 caregivers, 27 MMTC licensees, 706 dispensing locations, and nine certified testing labs. He described the state’s pre-approval process for products and advertising, plain packaging requirements, seed-to-sale tracking, registry operations, and compliance efforts such as background checks, inspections, complaint investigations, and lab desk audits. He also said the Bureau of Public Health Laboratories in Jacksonville had been accredited to begin supporting testing. Members asked about telehealth, patient growth, product safety, advertising to children, inspections, and the status of MMTC licensure; Kimball said recertifications by telehealth now make up more than half of recertifications, that patient growth has slowed, and that ongoing litigation is delaying issuance of 22 new MMTC licenses. Kimball also discussed implementation of recent legislation and licensure changes, including licenses issued under HB 387 and SB 1582 to applicants from the original Pigford-related pool, with additional cure opportunities still ongoing. He said the department is monitoring diversion, inversion, and unapproved products, and that it coordinates with law enforcement when needed but does not itself have sworn authority. In response to questions, he said the department does not regulate physicians directly, but may refer concerns to the Division of Medical Quality Assurance, and that caregiver and physician participation requirements are set by statute. Members raised concerns about edibles, child access, and continued use of child-attractive branding; Kimball said the department tries to catch issues through pre-approval and enforcement, and that complaints involving children are treated as serious and investigated using available records and camera footage. Dr. Almond Winterstein then presented the consortium’s research overview. He explained that the consortium was created by statute in 2019, includes 10 universities, and is funded by annual state appropriations. He said its work includes grants, a research repository, a clinical core, outreach, and evidence synthesis, including a recent FDA-supported review of cannabis evidence. He emphasized that the current evidence base is limited and often low quality, with the strongest signals for symptom relief in PTSD-related symptoms, nausea, and some pain outcomes, but with many studies inconclusive or mixed. He also described the consortium’s use of registry data linked to Medicaid, Medicare, death, fetal death, and birth records to study safety and outcomes, including children, pregnancy, driving safety, opioid-sparing effects, and adverse events. Winterstein said adverse event reporting is sparse and likely underreported, with most reports mild but some serious events noted, and he expressed concern about use among young adults because of uncertain benefit-risk and possible effects on the developing brain. The committee discussed the need for better surveillance, more robust adverse event reporting, and the possibility of using linked data to identify harms more quickly. At the end of the meeting, the committee rose without objection.

Transcript Highlights:

• We've been working with CMS to understand... Household incomes above 255% of poverty for children.
• We've been working with CMS to understand...
• federal requirement to cover children 12 months of continuous coverage, so we've been working with CMS
• And so, we've been working through that issue with CMS.
• with CMS. with CMS.

Keywords: 1189, house, all

Summary: The committee met on May 29 and approved the draft minutes. DHHS Commissioner Weaver then opened the department update by asking Medicaid Director Henry Litman to brief members on federal and state Medicaid changes, and later turned to DHHS Chief Operating Officer David Weathers for an update on data governance. Members also asked that acronyms be spelled out in future materials and requested a follow-up on the federal Medicaid rule once it is published. Litman reviewed several federal Medicaid provisions tied to HR 1/"OBBA" and related state implementation issues. He said the first major change would be restrictions on certain non-citizens’ Medicaid coverage, affecting about 400 people in New Hampshire, with notices likely 30 to 60 days before the effective date. He also discussed new work requirements/community engagement rules, saying New Hampshire is on track to implement them and will likely need a state plan amendment rather than an 1115 waiver. Other changes included shorter retroactive coverage periods, a new state option for certain community-based services with an estimated $740,000 in implementation support, a freeze and phased-down reduction in the Medicaid enhancement tax beginning in state fiscal year 2029, and limits on directed payments to hospitals after a grandfathering period. He also noted that Medicaid enrollment has fallen from pandemic-era levels, with about 167,000 people covered as of May 1, and that the department is working with CMS on child premiums and other cost-sharing changes approved in HB 2. Committee members asked how the department could plan for the 2029 changes given the number of elections before then, and Litman said federal rules may be adjusted over time as states and stakeholders raise concerns. He emphasized planning for the worst while hoping for the best, and said rural health care transformation funding would help the state prepare. In the second presentation, Weathers explained that data governance is now embedded in DHHS operations to control access, manage reporting, and respond to risk. He defined it as managing what data is collected, how it is used, who can access it, and what laws apply, and said DHHS has moved from governance as a committee to governance as an operational process. He described privacy impact assessments for new systems going into production, monthly privacy and security training, and ongoing review of access controls and data-sharing rules.

Transcript Highlights:

• And does it take into account the enhanced funding that the department gets right now from CMS in order
• that 28 million. >> And then just for the record, um, if a state plan was created and submitted to CMS
• ,<00:23:43.440> we<00:23:43.600> could created and submitted to CMS, we could created
• and submitted to CMS, we could not<00:23:44.200> limit<00:23:45.040> the<00:23:45.640>
• So, I went back and I pulled the application that CHFS made to CMS for the waiver.

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board first approved the September 24 minutes and then heard a presentation from four certified community behavioral health clinic providers: Pathways, NorthKey, Seven Counties Services, and NewVista. The presenters explained the difference between traditional community mental health centers and CCBHCs, describing CCBHCs as an enhanced model that integrates behavioral health, primary care, wraparound services, and crisis response. They reviewed the federal history of the model, Kentucky’s entry into the Medicaid demonstration in 2022, and the scheduled end of the enhanced federal match on December 31, 2027. They also emphasized required services such as 24-hour mobile crisis, care coordination, and services for veterans, and described care coordination as a key feature that helps patients follow up after hospital or emergency discharge, manage medications, and connect to transportation and other supports. The presenters gave examples of improved outcomes, including a patient who was able to remain living independently because of coordinated home-based and telehealth support, and they argued that CCBHCs are helping Kentucky build a more responsive crisis system through 988, mobile crisis teams, and crisis stabilization units. They said the model is data-driven, uses performance metrics, and has led to stronger collaboration among community partners. One speaker said more than 100 agencies participated in a Jefferson County community health needs assessment and continued meeting afterward to reduce redundancies and barriers to care. They also said crisis call hub compliance and mobile crisis outreach compliance improved significantly over the past year. Members asked about how navigators and connectors fit into the model, how CCBHCs work with managed care organizations, and how the program could expand statewide. The presenters said navigators are not built into the CCBHC model but may be used through referrals, while the CCBHCs continue to bill MCOs the same way and receive a Medicaid wrap payment for the enhanced rate. They said the goal would be for all community mental health centers to become CCBHCs, but that a state plan amendment would be needed and could not be limited only to CMHCs if submitted to CMS. They estimated about $28 million would be needed statewide to continue the program in the next biennium, combining the loss of enhanced federal match and the state share of enhanced service costs. The board also discussed transportation, with one presenter explaining that their program arranges Medicaid transportation for eligible appointments, and members raised concerns about mental inquest warrant transport and whether sheriffs should remain involved. No votes were taken on the CCBHC or transportation items during the discussion.