Transcript Highlights:

• This will not only prohibit behavior we are seeing in the marketplace right now, with chatbots claiming
• to be doctors, nurses, or psychologists, but also hopefully deter future bad behavior by establishing
• Malik Bynum with the County Behavioral Health Directors Association, in strong support. Thank you.
• The second piece in this, I think, is also appropriately called out in the analysis: the need to make
• And again, a great committee analysis. We cannot thank you enough. Mr. Chair, I move the bill.

Summary: The Assembly Business and Professions Committee held its first regular bill hearing of 2025 and considered a wide range of measures on health care access, professional regulation, animal welfare, and consumer protection. Early in the hearing, the committee adopted its rules and then approved a consent calendar of several bills, including measures by Chen, Caloza, Carrillo, Arreguín, Berman, and Flora. The committee also took up AB 1082, which would allow California nursing students enrolled in out-of-state programs to complete clinical training in California; supporters said it would help address the nursing shortage and keep students closer to home, while opponents warned it could worsen already limited clinical placement capacity and reduce oversight. The bill passed on a do pass recommendation to Appropriations after a quorum was established. The committee then heard and advanced several health-related bills. AB 50, by Assembly Member Bonta, would ease Medi-Cal access to over-the-counter hormonal contraception by removing the need for a prescription for coverage purposes; pharmacists, reproductive health advocates, and medical groups supported the bill, and it passed unanimously to the Committee on Health. AB 489, also by Bonta, would prohibit AI systems from misrepresenting themselves as licensed health professionals; supporters from medical, psychiatric, behavioral health, and other professional groups said the bill would protect patients from misleading chatbot advice, and it passed to Privacy and Consumer Protection. AB 481, by Assembly Member Rubio, would expand the tasks that federally qualified lab personnel can perform under CLIA supervision to help address lab staffing shortages; labor groups raised concerns about training, certification, and supervision, but the bill passed to Appropriations with an amended do pass recommendation. The committee also considered animal welfare and access-to-care measures. AB 631, by Assembly Member Lee, would require animal shelters to post intake and outcome data online; supporters said the reporting would improve policy and resource allocation, while members discussed how the requirement would work for shelters without websites, and the bill passed to Appropriations. AB 867, also by Lee, would prohibit cat declawing except when medically necessary for the animal; animal welfare groups strongly supported the bill, while the veterinary association opposed it as an improper legislative regulation of veterinary surgery, and the bill passed to Appropriations. Finally, AB 1307 would create a pilot program allowing a limited number of qualified dentists trained in Mexico to practice in underserved California areas; supporters framed it as a cost-neutral way to address major dental access gaps, the California Dental Association remained opposed unless amended, and the bill passed to Appropriations. Several members later added their votes on the various items after the hearing, and the committee kept the hearing open briefly to allow additional add-ons.

Transcript Highlights:

• And they were approaching that as a rate cut and requiring an access analysis that triggered the access
• rule and an analysis, which was the first time we had triggered that type of requirement.
• As we were working toward providing the extensive analysis that's required under that, the administration
• How are we as a state integrating behavioral health services into kid care? You recognize.
• Just behavioral health service. Yes. Just behavioral health service and kid care in general.

Summary: The committee opened with roll call, welcomed members back for the first committee weeks, and heard brief personal updates from several senators before moving into agency implementation updates on recently enacted health care laws. The Agency for Health Care Administration reported on Senate Bill 64 creating rural emergency hospitals, explaining that AHCA adopted the required rules effective June 1, 2025, but that no hospitals have yet been designated. Members asked about possible hospital conversions, accreditation and survey responsibilities, and whether Florida would apply for federal rural health transformation funding; AHCA said it intends to apply and has already been working on the issue with federal officials. AHCA also reviewed the non-emergent care access plan requirement under Senate Bill 7016. The agency said hospitals with emergency departments must submit plans that help redirect non-emergent patients to appropriate care settings while complying with EMTALA, and that 83 plans had been received and 63 approved as of September 30. Members asked about data collection, managed care coordination, and the state’s health information exchange; AHCA said it has moved to a new HIE vendor and will continue monitoring implementation and possible care gaps. AHCA then updated the committee on the TEACH program, saying $6.8 million was spent in 2024-25 across 59 parent organizations and 229 facilities, with more than 1,800 students and nearly 380,000 clinical hours reimbursed. The agency said rulemaking is nearly complete, a new nursing student category and expanded facility eligibility were added, and a federal 1115 workforce waiver remains stalled after CMS signaled it will not approve new workforce demonstrations. AHCA also reviewed House Bill 121 on KidCare eligibility, explaining that implementation of the 300% poverty-level expansion remains blocked by federal litigation and waiver issues tied to premium nonpayment rules; members and public speakers urged action to close the coverage gap. Public testimony on AHCA’s presentation came from representatives of health centers and advocacy groups, who said the non-emergent care access plan has improved hospital-health center coordination and reduced repeat emergency use, and who urged implementation of KidCare expansion for children in the coverage gap. The Department of Health then presented updates on FRAM, the Sanadi screening grant program, the Health Care Innovation Revolving Loan Program, telehealth maternity care, swimming lesson vouchers, and House Bill 159 on pharmacist dispensing of HIV post-exposure prophylaxis. DOH reported strong participation in FRAM and the telehealth maternity program, 24 Sanadi grant awards in 42 counties, 4,945 swimming lesson vouchers issued last year and 2,371 so far this year, and three approved certification courses with five pharmacist certifications issued under HB 159. Committee members asked about recruitment of dentists and other providers, telehealth maternity outcomes, and why participation in the maternity program remains below expected levels; DOH said outreach and regional referral networks are expanding and more detailed outcome data will be included in the upcoming legislative report.

Transcript Highlights:

• But these six papers that we published look at and do a deep analysis.
• And we also are meant to promulgate rules governing data sharing network and data analysis.
• Our LOPI analysis goes through that case law with a fine-tooth comb.
• Chavez-Cook on her exhaustive technical detail and sharp analysis.
• ... ...broadens this in a way that might be sweeping up misdemeanor behavior with a felony charge.

Bills: SB100

Keywords: burglary, aggravated burglary, dwelling, criminal law, property rights, 996, all

Transcript Highlights:

• Can I ask, is it criminal behavior for the platform?”
• “Can I ask, is it criminal behavior for the platforms to be facilitating?
• You read the analysis. You get a gold star. Oh, my God, thank you.
• While that behavior calls into question their intent, serious privacy concerns.
• I did read through the analysis, and I appreciate a lot of the amendments that are laid out.

Summary: The committee heard several bills focused on artificial intelligence, child safety, mental health, and privacy. SB 574 by Senator Umberg would require transparency and human oversight when attorneys, judges, and court neutrals use AI; it drew support from privacy advocates and committee members, with no opposition. SB 1276, the End Child Exploitation Act, would update child sexual exploitation laws to cover live-streamed and AI-generated abuse material and clarify that viewing such content can be criminally punishable; prosecutors, child advocacy groups, and others supported it, while no one appeared in opposition despite opposition on file. SB 813 would create a California AI standards and safety commission and a voluntary two-tier certification framework for AI safety standards; supporters said it would create scalable, independent oversight, while TechNet and CalChamber opposed it as duplicative, under-defined, and likely to create a de facto mandate. The committee discussed market pressure, federal preemption concerns, and the role of voluntary standards, but no final vote was taken in the excerpt. Senator Padilla also presented SB 300, which would strengthen protections for minors from sexually explicit chatbot content by moving from a reasonableness standard to an affirmative duty to prevent such exposure and to prohibit facilitation. Supporters said new evidence showed greater risks and that companies can and should build stronger safeguards; opponents, including TechNet and CCIA, argued the bill was premature because SB 243 had only recently taken effect and warned it could create strict-liability-like exposure. Padilla then presented SB 903, which would bar AI chatbots from being advertised as therapists, require licensed clinician oversight and informed consent for AI use in psychotherapy, and protect patient confidentiality; it received broad support from mental health professionals and labor groups, while industry and health associations were opposed unless amended over triage and crisis-detection language. The committee members emphasized the need for human judgment in mental health care and noted ongoing negotiations on amendments. The committee also heard SB 1119, a companion to AB 2020, which would require annual risk assessments, crisis-response protocols, default child settings, parental controls, limits on data use, public incident reporting, and third-party audits for chatbots used by children. Supporters argued the bill would address documented harms and improve transparency, while industry groups objected to ambiguous standards, liability exposure, and the private right of action. A roll call vote was taken on SB 1119 after quorum was established; the motion to pass to Appropriations succeeded on a 5-1 vote, with one no vote and the measure left on call for absent members. Finally, SB 354, a privacy bill for insurance consumers, would modernize outdated insurance privacy rules, bar sale of personal information, and expand consumer rights to know, correct, and delete data. Supporters said it would implement Proposition 24’s privacy mandate, while a large coalition of insurers, agents, brokers, and related businesses opposed unless amended, mainly seeking a small-business exemption and narrower treatment of publicly available information; members and the author said negotiations were ongoing and the bill had already been substantially revised.

Transcript Highlights:

• We will not accept disruptive behavior or behavior that incites or threatens violence.
• I'd like to start by accepting the amendments in the committee analysis and thanking the chair and the
• The analysis does a good job of showing how many there are.
• The second-tier partners are the 6,000-plus that's mentioned in the analysis.
• It is my understanding. against gross negligence, recklessness, or intentional behavior.

Summary: The committee heard and advanced several transportation-related bills, beginning with AB 431 on advanced air mobility. The author and supporters from AUVSI, Joby Aviation, United Airlines, Wisk Aero, the City of Long Beach, and Archer said the bill would create a statewide plan and technical framework for eVTOL/advanced air mobility infrastructure, public outreach, and local implementation. No opposition testified, and the bill passed the committee as amended to Appropriations on a unanimous roll call. Members then took up AB 630 on abandoned or hazardous RVs. The author and supporters, including Los Angeles Mayor Karen Bass’s office, argued the bill would curb a cycle in which inoperable RVs are towed, auctioned cheaply, and returned to the streets by predatory buyers, while adding notice, recovery, and reporting requirements. Opponents from Western Center on Law and Poverty and ACLU California Action warned the bill would destroy RVs that serve as shelter for unhoused residents and could worsen homelessness. After discussion about the bill’s focus on dismantling rather than towing, the committee passed AB 630 as amended to Appropriations. The committee also approved AB 314, which would support transit-oriented development around planned and existing high-speed rail stations; AB 1223, which gives Sacramento County communities more flexibility to use local transportation revenues for related infrastructure supporting infill development; AB 1111, which adds flexibility to the zero-emission school bus transition for rural and disadvantaged districts; AB 1190, which caps fees charged by DMV business partners and requires clearer disclosure of the official DMV site; AB 987, which limits unreasonable towing fees and related charges; and AB 911, which creates a narrow exemption from Advanced Clean Fleets rules for telecommunications bucket trucks and sail-on-wheels used in emergencies. Most bills drew support from local governments, industry, or consumer groups, while AB 1111 and AB 911 drew opposition from clean transportation and environmental advocates concerned about weakening emissions goals. All of the bills were reported out as amended to the Committee on Appropriations, with recorded roll-call votes and several members adding their names as co-authors or supporters.

Transcript Highlights:

• On the behavioral health side, we're also about two years into the behavioral health roadmap, where we've
• For instance, the intersection of behavioral health and the educational system, the intersection of behavioral
• Health Help Line, which is part of the roadmap for behavioral health reform.
• Health Help Line, which is part of the roadmap for behavioral health reform.
• MAP represents 13 health plans and one behavioral health organization.

Keywords: 995, all

Summary: The Joint Committee on Public Health held an introductory informational hearing for the new session, with Chairs Marjorie Decker and Senator Michael Driscoll outlining the committee’s scope and emphasizing the impact of the federal landscape on Massachusetts public health. They noted the hearing would focus on testimony from agencies and advocates, with short testimony limits due to the hybrid format. No votes were taken; the meeting was for briefing and discussion of priorities. Commissioner Robbie Goldstein of the Department of Public Health described the department’s budget and federal funding, warning that recent CDC grant terminations could cut nearly $100 million and affect lab testing, surveillance, vaccines, and community engagement. He highlighted DPH priorities including racial equity, maternal health, substance use and child welfare coordination, emergency preparedness, data transparency, and public hospital quality. MassHealth Assistant Secretary Michael Levine discussed MassHealth’s role covering about 2 million residents and its priorities in health equity, behavioral health, primary care, member independence, and customer service, while noting the agency relies heavily on federal Medicaid dollars and would face major strain from federal cuts. Several advocacy and provider groups focused on reproductive health and maternal health. Planned Parenthood warned of threats to Title X, 340B savings, and other federal funding, and supported a bill to eliminate parental consent and judicial bypass for abortion care for young people. Reproductive Equity Now urged stronger shield-law protections and changes to Massachusetts’ later-abortion framework. Dr. Indyamaka Anugaka called for full implementation of the maternal health law, better reimbursement for doulas and midwives, stronger data collection, and support for full-spectrum pregnancy care coverage. The Health Policy Commission said new maternal health and primary care task forces would begin work soon. Mental health and health system access were also major themes. The Mass Medical Society urged action on vaccine hesitancy, removal of non-medical school vaccine exemptions, and primary care reform. The Massachusetts Association for Mental Health and the Children’s Mental Health Campaign opposed proposed cuts to DMH and substance use services, called for more school-based supports, and raised concerns about inpatient capacity, including a unit serving LGBTQ youth. The Massachusetts Nurses Association and 1199 SEIU warned that staffing shortages, low wages, workplace violence, hospital closures, and possible Medicaid cuts threaten patient care and the health care workforce. The Betsy Lehman Center also urged investment in automated patient-safety monitoring to reduce harm and costs.

Transcript Highlights:

• for your analysis? for your analysis?
• involved in their analysis. involved in their analysis.
• , or we could do a sua sponte analysis, or we could do a sua sponte analysis, but<00:36:59.760>
• substitute for Hawaii-specific analysis substitute for Hawaii-specific analysis and<01:23:33.600
• Losing 88 behavioral health said, "Yes."

Keywords: 910, house, all

Transcript Highlights:

• Instead, there is increasing evidence that interventions based on applied behavioral analysis and behavior
• Changing behavior doesn't mean suppressing behavior.
• Changing behavior doesn't mean suppressing behavior.
• This conclusion is supported by official research conducted by the Association for Behavior Analysis
• With the help of a functional behavioral analysis, or FBA, we learned what triggers Luke's distress and

Keywords: 995, all

Summary: The committee held a hybrid hearing on a range of bills affecting children, families, disability rights, homelessness, and social services. Early testimony focused on H.215, which would support children experiencing homelessness by speeding access to child care vouchers and early intervention screenings. Boston officials, Horizons for Homeless Children, Head Start, pediatric and early education advocates, and families described delays in child care and early intervention, the developmental risks of homelessness, and the need for automatic referrals and faster access to services. Testimony also supported H.216, which would improve emergency housing assistance by restoring presumptive eligibility, reducing documentation barriers, extending shelter stays from six to nine months, and creating an ombudsperson; providers and legal advocates said current rules leave families sleeping in cars or outside and create unnecessary administrative hurdles. The committee also heard strong support for H.210, which would repeal the “Learn Fair” school attendance sanction that cuts cash assistance to families when children miss school. Advocates from legal aid, education, and anti-poverty organizations argued the policy is punitive, burdensome, and ineffective, disproportionately affecting low-income, disabled, and Hispanic/Latino families. Several speakers said chronic absenteeism should be addressed through supports such as family outreach, wraparound services, and school engagement rather than benefit cuts. Legislators and school officials from Salem also testified that their districts reduced absenteeism through supportive strategies, not sanctions. Additional testimony addressed children’s vision bills H.202 and H.166, with optometrists and researchers urging better screening, data systems, and treatment access to close achievement gaps caused by untreated vision problems. Senator Lovely also presented S.2714, proposing a study of discrimination in public accommodations for people with service animals. Later, testimony on H.279 supported changing social work licensure rules to remove exam requirements that speakers said disproportionately exclude multilingual candidates and candidates of color. The hearing also included testimony on bills related to the Judge Rotenberg Center and electric shock devices, with disability rights advocates opposing continued use of the devices and urging the committee to reject licensing or authorization for them. No votes or committee actions were taken during the hearing.

Transcript Highlights:

• Senators please take up Tab. 2 SB 1350, for behavioral health, managing entities by Senator Trumbull
• This bill is aimed at approving for does behavioral health system.
• The bill will include increase transparency, accountability and efficiency and how we manage behavioral
• The commission was broken down into 4 subcommittees strategy and planning data analysis, dual diagnosis
• They should also develop and routinely and analyze the Behavioral Health Workforce survey with monitoring

Keywords: 999, senate, all

Transcript Highlights:

• Entrusted with economic analysis, workforce development, and the impartial execution of Arizona law.
• That would fall under the Board of Behavioral Health Examiners.
• I’m not a behavioral health practitioner, and I just don’t. Okay.
• Do you do cost-benefit analysis of regulations on the industry? Mr.
• But yeah, we should definitely do cost-benefit analysis.

Summary: The Committee on Director Nominations met with four members present and approved the prior minutes without objection. Chair Jay Kaufman outlined the committee’s role in reviewing executive nominations and explained the hearing process for three nominees: Mary Foote for the Office of Economic Opportunity, Debbie Johnston for the Department of Health Services, and Chuck Bassett. Foote did not appear for her hearing, and members discussed her absence and alleged omissions in her disclosure materials, including prior service with Planned Parenthood-related organizations. The committee then moved to reject her nomination, and the motion passed 3-2, recommending that the full Senate reject Mary Foote. Debbie Johnston, nominee to lead the Department of Health Services, appeared and gave an opening statement describing her Arizona background, prior Senate staff work, and more than 20 years with the Arizona Hospital and Health Care Association. She said her priorities at ADHS include rebuilding trust in public health licensing, improving stakeholder engagement, standardizing rulemaking communication, addressing alleged religious discrimination and retaliation concerns in licensing, and using technology and AI to improve efficiency. In questioning, senators pressed her on her management style, conflict-of-interest safeguards given her prior industry role, enforcement priorities, budget pressures, behavioral health and assisted living oversight, and the department’s response to COVID-19. Johnston said she would follow statutes, recuse herself from enforcement matters involving former contacts, and resign if directed to carry out an unlawful policy. She also said the department does not regulate therapy itself, only facilities, and that it would rely on legal counsel regarding the governor’s conversion-therapy executive order and related federal civil-rights allegations. Several senators focused on public health trust and the department’s pandemic response, with Johnston acknowledging concerns about closures, data collection, and communication during COVID-19 while saying she would review past after-action materials and be better prepared in the future. Public testimony from stakeholders in aging services and health care strongly supported her confirmation, praising her accessibility, responsiveness, and collaborative approach. After testimony, the vice chair moved to recommend Johnston’s confirmation to the full Senate. The roll call was underway when the transcript ended, with several members voting aye and one member expressing reservations about her not reviewing the pandemic after-action report before another crisis occurs.

Transcript Highlights:

• housing, continuous eligibility for children under 6 years old, home visiting, and evidence-based behavioral
• Your Medicaid expansion for behavioral health is about 3%, and then your long-term care is about 23%
• There's also exemptions in there for people with substance use disorder, behavioral health issues, and
• Our behavioral health and physical rehab and long-term acute care is into this program as well.
• Jeffrey Tager, General Counsel of PED, have the privilege of presenting our comprehensive analysis of

Transcript Highlights:

• I'M EXPECTING THE TOP BAR TO GRAB YOUR ATTENTION AND IT LOOKS LIKE THAT ARE A SMALL NUMBER FOR BEHAVIORAL
• ANALYSIS PROVIDERS AND I WANT TO EXPLAIN THAT.
• FIRST OF ALL, BEHAVIOR ANALYSIS IS A STATEWIDE MEDICAID PLAN SERVICE FOR CHILDREN UP TO AGE 21.
• WE HAVE SOME 3500 BEHAVIORAL ANALYSIS PROVIDERS INCLUDED IN THAT NETWORK FOR CHILDREN.
• ANALYSIS SERVICES, WE ENTER INTO A CONTINUITY OF CARE ARRANGEMENT.

Transcript Highlights:

• They're not in this analysis because they weren't present in every year of the data.
• And it's kind of messy to try to statistically model human behavior.
• So there was a meta-analysis, a study of a lot of other studies.
• And a meta-analysis looked at all those, and they found that, yes, it changes knowledge and behavior,
• There's learned attitudes and behaviors, the 22% increase in reports from teachers.

Summary: The committee met to approve prior minutes and then heard a presentation from Dr. Ramona Danielson on adverse childhood experiences (ACEs), focusing on the economic and public-system impacts in North Dakota. She explained that ACEs are a population-level measure, not a diagnostic tool for individuals, and said higher ACE exposure is consistently associated with more chronic illness, mental health challenges, child welfare involvement, justice-system contact, and reduced workforce participation. She emphasized that precise dollar estimates are difficult because of the many interacting factors across a person’s life course, but said the direction of the impact is clear and that evidence-based prevention and protective factors can reduce harm. Members asked about definitions of a “healthy family,” same-sex couples, divorce, substance abuse, historical trends in ACEs, and the role of positive childhood experiences and home visiting. The committee then heard from Allison Mahoney and Missy Barranco about evidence-based home visiting programs in North Dakota, including Healthy Families, Early Head Start, Nurse-Family Partnership, and Parents as Teachers. They described home visiting as voluntary, relationship-based, and tailored to family needs, with referrals coming from hospitals, WIC, human service zones, pregnancy navigators, self-referrals, and other community sources. A parent, Abby, shared that home visiting helped her family after premature births and NICU stays by providing support with postpartum mental health, breastfeeding, developmental screenings, referrals, and parenting guidance. The presenters said the programs are funded through a mix of federal MIECHV/Title IV-E dollars, Medicaid targeted case management, state and tribal funds, philanthropy, charitable gaming, and grants, and they noted that current funding is fragmented and insufficient to serve all eligible families statewide. Members discussed whether the state should expand or better fund these services and how to improve outreach and referrals. Later, the committee received a memorandum on artificial intelligence and sexual exploitation, followed by a presentation from a BCI special agent on how AI is already affecting child exploitation investigations in North Dakota. The memo and testimony described AI-generated child sexual abuse material, deepfakes, sextortion, and risks posed by chatbots, along with relevant federal and state law and recent executive orders. The agent said North Dakota saw 2,698 cyber tips in 2025, the highest on record, and that investigators are increasingly encountering AI-assisted exploitation that is harder to detect and verify. Members discussed the need for child-safety protections, the limits of executive orders, and broader concerns about AI undermining critical thinking and spreading misinformation. No votes were taken on the AI materials during the portion provided, and the committee recessed briefly after the report.

Transcript Highlights:

• So, I'll pass it out, and I do believe that both analysts received a copy of it, so there's an analysis
• You've heard me before around this in terms of behavioral health, and I'm back again on this particular
• And there are many situations And stories of individuals needing some real behavioral health help not
• But I know with behavioral health, we do have a need.
• Even in here, on our analysis, it looks. At and talks about regulation, right?

Keywords: 996, all

Transcript Highlights:

• So based on that analysis, here are our recommendations.
• So I will share some findings from our revenue and expenditure analysis.
• Okay, now I'll provide a summary of our funding gap analysis.
• other neighborhoods, and what did it do to change the behavior?
• did it benefit other neighborhoods and what did it do to change the behavior?

Keywords: 904, all

Transcript Highlights:

• In the staff analysis, the bill analysis, sorry. Thank you very...
• In the staff analysis, the bill analysis, sorry, it says at the bottom an A is 65% or greater.
• Yeah, the one at the bottom of the first page of the bill analysis.
• In the bill analysis, if you notice, if you notice the year 26, 27, the bill analysis, if you notice
• Now the teachers are also now, you know, trying to assist with behavior... Assist.

Summary: The Student Academic Success Subcommittee met with a quorum and considered two bills. The first, PCS for HB 1565, would expand permitted purchases under the Personalized Education Program scholarship to include digital devices, clarify statutory terms, and distinguish between parent-directed part-time programs and full-time instructor-led programs. Rep. Hinson questioned oversight and misuse safeguards, while the sponsor said existing statutory and SFO oversight already applies. Public testimony included support from the James Madison Institute, and the bill was reported favorably by a 12-1 vote. The committee then heard PCS for HB 1483, the SCORE Act, which would gradually align Florida’s school grading scale with the familiar A-F scale used for students over a 10-year transition. The sponsor argued that current school grades are inflated and confusing to parents, and said the bill would also expand early support identification from pre-K through 8th grade. Members raised concerns about the impact on public and charter schools, low-income communities, teacher workload, resources, property values, and whether the bill should be paired with funding and professional development. Public testimony included an ESE teacher asking about funding and class size, one opponent from Orange County teachers, and a proponent from Florida Citizens Alliance. After extensive debate, the committee voted 12-5 to report PCS for HB 1483 favorably. Supporters said the bill would improve transparency and accountability for parents and create pressure to raise standards, while opponents warned it could sharply increase lower-rated schools without sufficient resources and could mislead the public about school performance during the transition.

Transcript Highlights:

• We're looking at our analysis.
• In fact, we are related behavior.
• can have health conditions, behavioral can have health conditions, behavioral mental<00:29:58.240
• grades, absence, behavioral Slipping grades, absence, behavioral problems,<00:30:23.120> uh<00
• Um, my name is Nicole Hokoana, and I’m the CEO of Maui Behavioral Health Resources, overseeing Aloha

Bills: HCR18, HCR32, HCR35, HCR105, HCR173

Keywords: hospice, health care, aging population, regulations, Medicare, working group, fraud prevention, quality of care, mental health, recidivism, civil commitment, Hawaii State Hospital, justice system, shelter, treatment pathways, biomarker testing, health insurance, precision medicine, healthcare access, medical necessity

Summary: The committee heard testimony on SCR 21 SD1, which asks Hawaii Health Systems Corporation’s East Hawaii Regional Health Care System to study the feasibility of a rural health clinic or similar access point for the Volcano community. Testimony in strong support came from HHSC representatives, Volcano residents, the Volcano Health Collaborative, the Rotary Club of Volcano, and others, who said the area has a clear need and that local primary and urgent care would align with regional plans. HHSC said it had already looked at the area, found no suitable temporary buildings, and would need a longer-term, capital-intensive solution, but that the study could help accelerate next steps. The committee then took up SCR 50 SD1, proposing a Hawaii Health Plan Working Group to design a basic affordable health plan for residents. Dr. Jack Lewin of SHIPTA said the state faces a growing uninsured population and argued for a short-term, lower-cost plan focused on preventive and primary care, drawing on the old State Health Insurance Plan as a possible model. Members asked about whether that prior program still exists and whether the working group should include the Hawaii Medical Association and Hawaii Primary Care Association; Dr. Lewin said the statute still exists but is unfunded, and that the group should be inclusive. The Department of Labor and other organizations also provided comments. For SCR 75 SD1, which urges a coordinated interdepartmental effort to reduce fetal alcohol spectrum disorder, Dr. Lewin and others said prevention, prenatal screening, and early intervention are needed because FASD is often hidden until later problems appear. Amanda from Hawaii FASD Action Group said current implementation under Act 192 is still largely a landscape analysis and that Hawaii lacks the infrastructure and specialists for a full system. Darlene Chance Govor urged adding the judiciary as a partner so juvenile justice and probation staff can be trained and referral pathways improved, while the Department of Health said it supports prevention but prefers a broader, systems-based approach focused on child needs and upstream care. The Disability Rights Center supported the resolution and asked for an earlier reporting date. The committee also heard SCR 149 SD1, which seeks an informal working group to address complex patients with multiple diagnoses involving substance use, mental health, or chronic physical illness. The Hawaii Substance Abuse Coalition and Ke Nui Malo strongly supported the measure, saying current siloed systems leave people bouncing between medical, mental health, and substance use providers without coordinated care, often ending up in crisis, emergency rooms, or the justice system. They said integrated residential care and a coordinated working group could improve outcomes and align with federal funding opportunities. The transcript ended before any final vote or action on the measures was announced, and SCR 109 was noted as withdrawn from the agenda.

Transcript Highlights:

• We also have the provider tax assessment report, which is in progress, and a behavioral health trend
• budget analysis uh on a quarterly basis. budget analysis uh on a quarterly basis.
• health trend report that is behavioral health trend report that is in<00:07:23.160> progress<
• all behavioral health prior authorizations<00:08:05.600> for<00:08:05.720> services<00
• And I would have additional information on that for you from the Department for Behavioral Health.

Keywords: 958, all

Summary: The Budget Review Subcommittee for Health and Family Services met for its first meeting, established quorum, and heard a presentation from Department for Medicaid Services Commissioner Lisa Lee and CFO Steve Becktold. The department reviewed its compliance with House Bill 695, which requires legislative approval before certain Medicaid eligibility, service, benefit, or waiver changes, along with fiscal impact reporting to the Legislative Research Commission. They described current waivers, including home and community-based waivers, managed care and transportation waivers, and the 1115 re-entry waiver, and said the community engagement waiver is in public comment and on track for submission to CMS. They also said required reports and other HB 695 tasks, including a pharmacy rebate fund, budget analyses, expenditure reports, and a behavioral health scorecard, are underway or completed as required. The CFO outlined Medicaid’s budget, saying the department has two appropriation units and projecting near-full use of state funds while leaving some federal funds unspent because of matching-rate differences. They reported roughly 211 filled positions and 11 vacancies. Members asked about the vacancy makeup, the behavioral health scorecard, and whether a provider involved in quality metrics could have a conflict if used in the scorecard process; the department said it would follow up. Members also asked about the community engagement waiver and its interaction with federal policy, and the department said CMS guidance is still pending and that it will proceed under HB 695. A substantial portion of the discussion focused on federal Medicaid policy changes under a reconciliation bill, including possible limits on provider taxes, directed payments, cost-sharing, and community engagement requirements. Department officials said the final federal impact is still uncertain because the Senate bill is not finalized, but they have modeled several scenarios and warned that any reduction in federal support or benefits would be harmful, especially for hospitals and rural hospitals. They estimated Medicaid benefits are funded about 80% federal and 20% state overall, with expansion populations closer to 90% federal funding, and said administrative costs would also rise if federal requirements change. Members also asked about work requirements and eligibility. The department said the community engagement waiver would mainly affect the expansion population, which they estimated at about 450,000 people out of roughly 1.5 million total Medicaid enrollees, and that many groups are exempt, including children, the aged, blind, disabled, and people in substance use disorder treatment. Officials said they can provide data on how many enrollees are working or work-ready and explained that their eligibility system is designed to prevent duplication by automatically placing people in the correct category and correcting errors quickly. They also noted a federal proposal to require expansion eligibility reviews every six months, compared with current annual renewals.

Transcript Highlights:

• Their incomes range in our analysis between $25,000 and $101,000 a year.
• That analysis is available on our website.
• That is an analysis.
• that analysis to the Legislature by May 14, 2025.
• George Cruz with the California Behavioral Health Association.

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• First will be a presentation and discussion focused on behavioral health programs for first responders
• The Second Alarm Project focuses on enhancing the behavioral health and resilience of first responders
• Behavioral health services for first responders depend on diverse state, local, university, nonprofit
• The behavioral health... ...access program framework provides tools and resources to build proactive,
• And things of that nature and do that analysis to ensure that it meets the changes in HB 7089.

Summary: The committee heard a presentation from Dr. Kelly O’Dare on first responder behavioral health access, peer support, and suicide prevention. She described UCF Restores, the Second Alarm Project, and related partnerships that provide culturally competent treatment, peer training, clinician education, disaster response support, and behavioral health navigation. She cited survey and state data showing significant rates of sleep problems, anxiety, depression, substance use, and suicide among Florida first responders, and said evidence-based treatment has helped many patients recover, including a reported 76% who no longer met PTSD diagnostic criteria after treatment. Senators asked about measuring outcomes, peer support standards, and whether the state should create more consistent statewide requirements; O’Dare said peer support training must be specialized, linked to higher levels of care, and supported by sustainable funding and statewide coordination. The committee also heard from a public commenter who supported the work and emphasized the need for adequate resources and peer support infrastructure. The committee then received a Department of Children and Families presentation from Casey Penn on the proposed funding methodology for community-based care lead agencies under HB 7089. Penn explained that the new model is intended to be actuarially based, reimbursement-oriented, and more transparent than prior funding approaches, using historical expenditures, standardized reporting, and two main tiers: Tier 1 for largely fixed administrative and operational costs, and Tier 2 for direct child-serving costs based on per-child-per-month blended rates. He said the model includes a 2% risk corridor for Tier 2, hold-harmless funding in the first year, and optional Tier 3 performance incentives, with an estimated additional state appropriation need after offsets. Senators raised concerns about prevention, historical inequities, reasonableness of costs, administrative overhead, blended state and federal funds, adoption subsidies, high-acuity placements, and disaster-related disruptions. Penn said some of those issues could be addressed in future iterations as the child welfare information system is modernized, and he agreed to provide written responses to committee questions. Representatives of the Florida Coalition for Children and CBCs responded that the model is a major improvement but urged additional safeguards, including an administrative cap, clearer separation of direct and indirect costs, and better treatment of federal and pass-through funds. They argued that the system already has oversight and that deficits reflect insufficient appropriations rather than excess spending, while also noting that higher-acuity children and regional differences can drive costs. No votes were taken on either topic, and the meeting ended with committee staff introductions and adjournment.