Transcript Highlights:

• They really are to replace the skilled nursing facility at Holderman."
• I'm not sure what the waiting list is for skilled nursing at Yountville.
• to be more and more nurses that want to be in that particular space of being a traveling nurse.
• Using some rooms for nursing, kind of like the traveling nurses, and maybe that's not even a model that
• being a traveling nurse.

Transcript Highlights:

• Nurses, optometrists, chiropractors.
• I practice at the Texas Nurses Association and am a registered nurse here in Texas.
• Nurses, optometrists, pharmacists, and other healthcare practitioners are often regulated by their own
• revoke a nursing license.
• How would you regulate? to regulate this type of licensing.

Bills: SB2024 , SB227 , SB268 , SB1467 , SB1580 , HB5537 , SB1313 , SB1677 , SB918 , SB331 , SB2207 , SB2721

Committee: House Public Health

Transcript Highlights:

• Budget neutrality requires the state to cut spending to nursing homes as nursing home costs rise.
• ,</c><00:43:01.520><c> which</c> nursing on nursing home care, which nursing on nursing home care, which
• </c> still struggled for LNAS for nurses still struggled for LNAS for nurses um<00:46:37.359><c> to</
• </c> regulated. Uh they are not transparent. regulated. Uh they are not transparent.
• </c> regulator, uh we have to fight for it. regulator, uh we have to fight for it.

Committee: Senate Finance

Transcript Highlights:

• In their guidance, the Board of Nursing stated that their reason for this change is because the Nurse
• Thank you, I'm sorry, who appoints the nursing board?
• I'm a nationally certified school nurse and the executive director of the Texas School Nurses Organization
• So in 2006, there was a Q&A in the Board of Nursing bulletin about whether nurses need a prescription
• If they don't, there's no regulation.

Bills: HB178 , HB178 , HB1551 , HB1939 , HB2040 , HB2354 , HB2674 , HB3029 , HB3460 , HB3631 , HB3662 , HB5201 , HB5381

Committee: House Public Education

Transcript Highlights:

• highly regulated cannabis, we should be clear about the impact.
• CAs do not replace nurse anesthetists nor anesthesiologists.
• JP Hanna with the California Nurses Association.
• . of Nurse Anesthesiology.
• Those who would be regulated by this bill may state that we are cutting out highly regulated USDA licensed

Committee: House Business and Professions

Transcript Highlights:

• </c> it prohibits residents, I assume nursing it prohibits residents, I assume nursing home,<00:25:25.840
• </c> of customers who've been in nursing of customers who've been in nursing homes,<00:25:58.960><c>
• </c><00:38:00.000><c> homes</c> in nursing homes in nursing homes uh uh uh that<00:38:02.760><c> have
• Uh, Senator Dibble's bill, regulation and notice related to the purchase of nonprofit nursing homes and
• </c> purchase of nonprofit nursing homes and purchase of nonprofit nursing homes and assisted<00:40:00.120

Committee: Senate Human Services

Transcript Highlights:

• I mean, we got shortages of nurses.
• I'm a registered nurse, and I work as a nursing practice specialist at the Minnesota Nurses Association
• at Minnesota nursing practice specialist at Minnesota Nurses<00:57:05.400><c> Association</c><00:57:
• </c> job cuts by replacing skilled nurses job cuts by replacing skilled nurses with<00:57:48.400><c>
• </c> guidelines into actual regulations guidelines into actual regulations establishing<01:14:08.199>

Committee: Senate Labor

Transcript Highlights:

• This conclusion is echoed by the Journal of Nursing Regulation, the official journal of the counts, briefly
• This conclusion is echoed by the Journal of Nursing Regulation, the official journal of the counts, Echoed
• by the Journal of Nursing Regulation, the official journal of the National Council of State Boards of
• Nursing, in a 2022 study examining nurse practitioner preparation for emergency department practice.
• That is what we regulate.

Committee: House Professional Registration and Licensing

Summary: The committee first completed action on House Bill 3009, adopting an amendment, rolling the bill into a House Committee Substitute, and then voting do pass on the substitute by a 20-0 roll call vote. The meeting then moved into public hearing on House Bill 1963, which would reduce from five years to three years the amount of licensed practice required before certain social workers may supervise others. Representative Tara Peters said the change would help address Missouri’s behavioral health workforce shortage, especially in rural areas, and testimony from the National Association of Social Workers and Burrell Behavioral Health supported the bill as a way to remove a bottleneck without changing education or supervision-hour requirements. There was no opposition testimony on HB 1963. The committee then heard House Bill 2557, which would require a physician to be physically present in an emergency department during all hours of operation. Representative George Hruza argued the bill would improve patient safety and standardize emergency care, while noting possible telehealth accommodations for low-volume critical access hospitals. Supporters, including physicians and medical associations, said patients expect physician-led emergency care and that physician presence is the gold standard. Opponents, led by the Missouri Hospital Association and several rural hospital administrators, argued the mandate is not realistic given physician shortages, could force rural ER closures, and would reduce access to care; they emphasized that current hospital models rely on teams, telehealth, and transfer protocols. The bill drew extensive discussion but no vote was taken. Finally, the committee heard House Bill 311, which would modernize Missouri’s bail bond laws by creating a professional board and tightening training, oversight, and recovery procedures. Representative Brandon Phelps said the industry itself wants clearer standards and that he may revise the bill in committee substitute form to merge the new board with an existing board to reduce costs. A bail bond industry representative testified in support, saying the profession wants higher standards and accountability. The chair then adjourned the meeting after testimony concluded.

Transcript Highlights:

• </c> when we have placed a 4% cap on nursing when we have placed a 4% cap on nursing homes?
• A registered nurse must serve as a charge nurse on each shift.
• nursing homes.
• </c> nursing home workforce standards board. nursing home workforce standards board.
• </c> financial viability of nursing homes. financial viability of nursing homes.

Committees: Senate Health and Human Services , Senate Human Services

Transcript Highlights:

• Texas Nurse Partners, and herself. Well, thanks for being here today, Holly.
• I'm a board-certified family nurse practitioner as well as a psychiatric mental health nurse practitioner
• It excludes commercial insurance plans regulated by the state.
• However, when it comes to the regulation of healthcare for nurse practitioners, we really fall behind
• And the ones who suffer are really the nurse practitioner owners, like myself.

Bills: HB139 , HB1818 , HB1942 , HB1959 , HB2221 , HB2254 , HB2563 , HB2067 , HB2275 , HB3211 , HB139

Committee: House Insurance

Transcript Highlights:

• </c> for the Kentucky Nurses Association. for the Kentucky Nurses Association.
• I was it was I was a nurse. I had I had. I was it was I was a nurse.
• </c> them to have a school nurse. them to have a school nurse.
• Nurses Association School Nurse Kentucky Nurses Association School Nurse Committee<00:30:24.799><c>
• </c> the nurses in the building. the nurses in the building.

Summary: The Medicaid Oversight Board met on March 9 with a quorum present and no minutes to approve. The chair reordered the agenda to hear House Bill 689 first. Representative Amy Neighbors presented HB 689, which would authorize Kentucky to seek CMS approval for a Medicaid state-directed payment program for physician and non-physician professional services delivered through qualifying hospital-affiliated groups, beginning January 1, 2026, with retroactive payments for that year. She said the bill is intended to improve access to care in rural and underserved areas, support workforce retention, and generate about $29 million annually in federal Medicaid funds without using general fund dollars. Representatives from Owensboro Health and St. Elizabeth Healthcare testified in support, describing staffing and subsidy pressures, lower Medicaid and Medicare reimbursement, and the importance of the program for maintaining access and quality in rural and safety-net settings. Committee members noted the bill had already passed the House Health Services Committee unanimously and discussed broader concerns about Kentucky’s low reimbursement rates and the need to consider other systems not covered by the proposal. The board then heard Senate Bill 2011 from Senator Donald Douglas and Cody Hunt of the Kentucky Medical Association. The bill would address a Medicaid coding issue by ensuring that coverage limits do not reduce payment to fewer than two evaluation and management service units per provider, per patient, per day. Douglas argued the current one-visit, one-issue limitation forces multiple visits, increases no-shows, and prevents providers from treating the whole patient. Hunt explained that the bill is meant to correct a longstanding regulation that limited E&M services to one per physician per recipient per date of service, which can prevent providers from coding additional medically necessary work during the same visit. He said DMS has already filed a regulatory amendment to fix the problem, but a statutory change is still needed to prevent the issue from returning. He also said the bill is not intended to change reimbursement policy, only coding rules, and that MCO payment practices vary. Members generally supported the concept. Senator Berg asked about fiscal impact and private-payer billing; Hunt said there should be no fiscal impact because the bill does not change payment policy, only coding. Representative Moore said the proposal could reduce costs and improve convenience by avoiding extra visits. Chairman Meredith said the bill illustrated problems with fee-for-service care and supported moving toward a more holistic delivery model. Dr. Schuster raised a drafting concern about the bill summary language, and Hunt responded that the regulatory amendment should address the issue generally for providers. No votes were taken on either bill during this portion of the meeting.

Transcript Highlights:

• Nurse practitioners, certified nurse midwives, and physician assistants, also known as advanced practice
• This bill would allow nurse practitioners, certified nurse midwives, and physician assistants to perform
• This bill would allow nurse practitioners, certified nurse midwives, and physician assistants to perform
• This bill would allow nurse practitioners certified nurse midwives and physician assistants to perform
• Exactly the population this regulated system is meant to serve.

Committee: Senate Business, Professions and Economic Development

Transcript Highlights:

• regulate their behavior.
• I'm a registered nurse and a member of the United Nurses Associations of California, Union of Healthcare
• I've been a nurse for more than 20 years, and I can't remember a time when nurse-patient ratios have
• You know, nurses that I talk to, we know nurses are leaving the profession, and this is one of the huge
• As a member, this doesn't change the amount of hours a nurse works, the amount of shifts a nurse will

Summary: The Assembly Health Committee heard several bills focused on health care access, oversight, and affordability. The first major item was SB 306 by Senator Becker, a prior authorization reform bill. Becker and supporters, including the California Medical Association and California Hospital Association, argued that prior authorization delays care, adds administrative burden, and can lead to serious patient harm. The bill was substantially amended late in the process to have DMHC and CDI identify services and drugs to exempt from prior authorization based on utilization data, with safeguards for fraud, waste, abuse, and patient safety. Health plans and insurers opposed the measure as written, saying prior authorization remains an important utilization-management tool and raising concerns about the 90% threshold, drug inclusion, and how modifications are counted. The committee also heard SB 35 by Senator Umberg, which would let cities or counties inspect unlicensed sober living homes if DHCS does not act promptly on complaints. Supporters said the bill would address weak enforcement and protect residents, while one behavioral health directors group opposed it unless amended. Members generally supported the measure, citing problems with unlicensed facilities and the need for local enforcement backup. The committee then heard SB 62, which would codify California’s updated essential health benefits benchmark if approved by the federal government. Senator Wiener said the package would add hearing aids, durable medical equipment, and infertility treatment including IVF, acknowledging that premiums could rise but arguing the benefits were worth it. Health Access California and other advocates supported the bill, while the California Family Council opposed it. The committee also took up SB 596 by Senator Menjivar, which would tighten the rules for hospitals claiming an on-call list as a defense to nurse staffing ratio penalties. Supporters, including nurses and SEIU, said hospitals have used vague or ineffective on-call practices to avoid accountability and that the bill would improve enforcement and patient safety. Hospital groups opposed it, arguing that staffing is highly dynamic, that hospitals need flexibility to manage acuity and emergencies, and that the bill could increase costs and interfere with collective bargaining arrangements. Finally, the committee heard SB 40 by Senator Wiener, the Insulin Affordability Act, which would cap insulin copays at $35 for a 30-day supply and restrict step therapy unless a plan covers at least one insulin in each drug type. Supporters, including physicians, diabetes advocates, nurses, students, and patient groups, said insulin is life-saving and too often unaffordable, forcing patients to ration or choose between medication and basic needs. There was no formal opposition testimony, though one member questioned why insulin remains so expensive. The committee also began discussion of SB 363, but the transcript cuts off before that bill’s full presentation or any action on the measures. No votes are recorded in the portion provided, and several bills were noted as consent items earlier in the hearing.

Transcript Highlights:

• </c> covering the cost of home care nursing covering the cost of home care nursing services. services
• ,</c> with my son, Nash, and his nurse, with my son, Nash, and his nurse, Maddie,<01:09:10.839><c> in
• </c> our community depends on home nursing our community depends on home nursing care.<01:09:19.200><
• </c> nursing denials. nursing denials.
• Social plus games are regulated.

Committee: Senate Commerce and Consumer Protection

Transcript Highlights:

• Hospitals do that on regulated entities.
• Cannot tell a nurse to just do an ultrasound.
• Had licensing and regulation.
• People don't know what entity regulates these bodies.
• Because we’re already under regulation.” “What regulation?

Bills: HB611 , HB897 , HB902 , HB931 , HB1030 , HB1092 , HB1100 , HB1118 , HB1138 , HB1143 , HB1160 , HB1185 , HB1216

Committee: House Health and Welfare

Transcript Highlights:

• They really are to replace the skilled nursing facility at Holderman.
• They really are to replace the skilled nursing facility at Holderman.
• ...which is the level below skilled nursing.
• I know we heard that nurses... ...out there.
• to be more and more nurses that want to be in that particular space of being a traveling nurse.

Summary: The Assembly Budget Subcommittee on State Administration heard several CalVet budget updates first. CalVet reported progress on the Southern California Veterans Cemetery at Gypsum Canyon, explaining that DGS is revising the earlier feasibility study to reflect a smaller footprint and lower grading costs, with updated numbers expected by the end of April. Members and public commenters emphasized the project’s importance and asked whether additional budget authority or trailer bill language was needed; CalVet said it may need more spending authority but wanted to return after the revised study is complete. The committee also reviewed the Yountville skilled nursing facility replacement project, where CalVet said construction is nearing completion, a certificate of occupancy was received, and the new 240-bed facility will replace Holderman Hospital while older buildings will be repurposed for lower levels of care. CalVet also defended eliminating about 178 vacant positions at Yountville and West Los Angeles as a fiscal and staffing efficiency measure, saying current care levels can still be met and that retention and hiring efforts are improving. The committee then took up the Department of Cannabis Control’s enforcement and legal affairs proposal. DCC described the size of the illicit cannabis market, said enforcement alone cannot solve the problem, and asked for additional sworn staff, a new Redding-area field office, and more analysts to focus on distribution networks, organized crime, environmental harms, and high-priority public safety cases. Finance supported the proposal as a targeted investment, while the LAO had no additional comment. Members asked about funding impacts and local co-location options, and DCC said the request would be funded from cannabis excise tax revenues and could help shift sales into the legal market. Public testimony from the cannabis industry strongly supported more enforcement against illicit retail and said it would help legal operators compete. DCC also presented its hemp enforcement and regulation proposal tied to AB 8. The department said the law closes loopholes around intoxicating hemp products, strengthens enforcement across agencies, and prepares for hemp to enter the cannabis regulatory framework in 2028. DCC requested staff for a civil enforcement unit, field-testing equipment, lab capacity to detect synthetic cannabinoids, a track-and-trace specialist, and a policy specialist. Members asked about enforcement in informal retail settings and consumer confusion, and DCC said the biggest problems have been smoke shops and online sales. Public commenters from the legal cannabis industry supported the proposal, saying intoxicating hemp has harmed the regulated market and created public safety risks. The Cannabis Control Appeals Panel then requested ongoing funding of $3.4 million to support 12 positions and its quasi-judicial appeals function. The panel said that with provisional licenses largely phased out, more annual licensees now have appeal rights and the workload is beginning to increase, with two cases currently on the docket. The LAO recommended limiting funding to three years and requiring a workload and comparative analysis before making the funding permanent, while Finance supported ongoing funding as consistent with the panel’s permanent statutory role. Members questioned the panel’s compensation and workload, noting that the five-member body is paid at a high statutory rate despite historically meeting only quarterly, though panel staff said the work now includes substantial case preparation and monthly hearings. Finally, the Department of Consumer Affairs introduced two proposals: $2 million ongoing for the Contractors State License Board’s IT needs and $251,000 plus one limited-term position for the Board of Pharmacy to implement Proposition 34-related licensing policy and reduce barriers to licensure.

Transcript Highlights:

• For us, you have to have independent living and skilled nursing.
• A lot of the CCRCs that are being developed now, they don't have skilled nursing.
• For us, you have to have independent living and skilled nursing.
• They closed the skilled nursing and terminated the life care contract.
• They closed the skilled nursing and terminated the life care contract.

Summary: The commission met at Brookhaven at Lexington to continue discussing continuing care retirement communities (CCRCs), with a focus on financial viability, entrance fees, refund policies, and how the industry is evolving. Speakers explained that nonprofit CCRCs have shifted away from building entirely new campuses since the 2008 financial crisis, and now more often grow through expansions, affiliations, mergers, or added home- and community-based services. They also noted that many newer CCRCs, especially nationwide, are being built without on-campus skilled nursing, relying instead on assisted living, memory care, or off-site arrangements, and that zoning and local approval can affect expansion plans. A substantial portion of the discussion centered on financial health and consumer protection. Panelists said the most important indicators of a strong CCRC are high occupancy, strong liquidity, and reinvestment in the property, with low occupancy and declining days cash on hand cited as warning signs. They described how actuarial reviews are used to estimate health care utilization and set pricing, and said staffing shortages are often a bigger financial pressure than resident care utilization itself. On refunds, speakers said entrance-fee refunds are generally paid when a unit is resold and the new entrance fee is received, and that resident refunds are usually protected even in bankruptcy, though residents are unsecured creditors. Massachusetts examples such as Reed’s Landing and the Groves were cited as cases where residents remained in place and refunds were ultimately protected. The group also discussed a pending disclosure bill on Beacon Hill related to entrance fees and refund transparency. LeadingAge Massachusetts said it supports clearer disclosure so residents understand refund provisions, and reported that among surveyed member CCRCs, the average time to provide an entrance-fee refund over the past two years was about 117 days. Participants emphasized the need to balance consumer protection with preserving the financial stability of the communities. The commission also reviewed upcoming dates: a virtual public hearing/listening session on June 16, the next commission meeting on June 23, and a later discussion planned on consumer rights, protections, and advertising practices. The meeting concluded with introductions of commission members and an invitation for attendees to tour the Brookhaven campus.

Transcript Highlights:

• , advanced registered nurse practitioner, or licensed practical nurse, including posting any supporting
• And so now what happened is the nursing assistants came under the Board of Nursing, and so we need them
• They make even less than nurses.
• and a registered nurse by training.
• The nurses who go on transport would be the nurses who are already caring for the patient and familiar

Summary: The Senate Health and Long-Term Care Committee held public hearings on several House bills and later took executive action on two others. The committee heard testimony on House Bill 2242, which would let the Department of Health issue immunization recommendations and tie preventive-service coverage to federal recommendations as of June 30, 2025, while preserving access to vaccines and other preventive services. Supporters, including the Governor’s office and the Insurance Commissioner, said the bill would protect access, affordability, and stable vaccine purchasing; opponents argued it politicizes vaccine policy and gives too much influence to state agencies and outside groups. The committee also heard testimony on House Bill 2152, allowing terminally ill patients in hospitals, nursing homes, and hospice facilities to use medical cannabis under facility policies, with supporters emphasizing dignity, symptom relief, and safeguards, and House Bill 2088, joining the dietitian licensure compact, which supporters said would help military spouses, telehealth, and workforce shortages. House Bill 2110, on ambulance inter-facility specialty care transports, drew support from rural hospitals seeking more staffing flexibility and opposition from nurses and EMS personnel concerned about training, accountability, and patient safety. House Bill 2247, on veterinarian-client-patient relationships and telemedicine, drew support from the sponsor and some stakeholders as a workforce and access measure, but also criticism from the state veterinarian and others who said it could conflict with federal VCPR requirements and public health protections. House Bill 2340, expanding substance use disorder monitoring program eligibility to nursing assistants and stipend support, was presented as a way to help low-wage health workers stay in the workforce; there were no in-person testifiers against it. In executive session, the committee considered House Bill 2155, concerning the use of nursing titles, and House Bill 2531, aligning the ambulance transport fund quality assurance fee with federal regulations. Both bills received do-pass recommendations and were sent to the Rules Committee. For the public hearings, no final committee votes were taken on the other bills in this transcript, and testimony concluded on each measure after the committee heard from sponsors, agency officials, advocates, and opponents.

Transcript Highlights:

• I'm also the vice president of the Massachusetts Nurses Association.
• It's not good for patients and not good for nurses.
• Certified registered nurse anesthetist remains the legal title for nurse anesthetists in Massachusetts
• But again, the nurse is not able to accept the psychologist's order.
• I am a registered nurse, a hospice nurse at MGH.

Committee: Joint Joint Committee on Public Health

Summary: The Joint Committee on Public Health held a hearing to take testimony on a wide range of bills involving professional licensure, clinical practice, and public health-related workforce issues. The chair explained that no votes would be taken at the hearing and that the purpose was to gather public input. Early testimony focused on Marnie’s Law, with supporters describing the bill as a no-cost, preventive measure to require nursing education on inflammatory breast cancer after a family tragedy and arguing it could reduce misdiagnosis and save lives. A major portion of the hearing centered on bills affecting clinical decision-making and licensure compacts. Supporters of the physician ownership/clinical autonomy bills argued they would protect independent practices from corporate interference after the Steward collapse, while supporters of EMS, dental, psychology, physical therapy, and physician assistant compacts said the measures would improve workforce mobility, reduce delays, and expand access to care, especially for rural patients, military families, and telehealth users. Several witnesses emphasized that the compacts would not reduce standards and would strengthen public protection through shared disciplinary databases and streamlined credentialing. There was also testimony on bills to ensure safe medication administration and to protect the independence of complementary and alternative health care practitioners. Nursing representatives urged that only licensed professionals administer medications in hospitals, hospices, and home care settings, warning that delegation to unlicensed staff could endanger patients and nurses’ licenses. A complementary and alternative care witness supported consumer access with mandatory disclosures and limits on reserved medical acts. On the dental compact, witnesses were split: some supported portability and workforce flexibility, while others warned the compact lacked a hands-on skills exam and could weaken Massachusetts’ regulatory authority and patient safety. The hearing concluded with continued testimony on the psychology compact, physical therapy compact, and physician assistant bills, with most speakers favoring expanded interstate practice and reduced administrative barriers.

Transcript Highlights:

• Requires ACA to impose a $10,000 fine against the home office of a nursing home, or the nursing home
• that a nursing home, if a nursing home maintains an electronic health record system, it might be a patient
• safety culture survey, at least bi-annually, provides that a nursing home, if, excuse me, if a nursing
• nursing home, actually, because we did amend that, of a nursing home that fails to submit financial
• I can't hire nurses for less than what a hospital does.

Summary: The Appropriations Committee on Health and Human Services first heard and adopted the proposed fiscal year 2025-26 budget for the committee, which was presented as a $1.8 billion increase over the current base budget. The budget emphasized Medicaid and KidCare funding, IT modernization, workforce reductions tied to unfilled or augmented positions, provider rate increases, mental health and substance use funding, opioid treatment, elder care, veterans’ services, cancer research, and school nurse staffing. The committee approved technical adjustments and then adopted the budget proposal for submission to the full Senate Appropriations Committee. The committee then considered several bills, most of which were reported favorably. SB 152 on surgical smoke required hospitals and ambulatory surgical centers to adopt smoke evacuation policies; it drew strong support from nurses and other health care workers describing workplace and patient safety risks. CS/SB 958 on early detection of type 1 diabetes required the Department of Health to develop informational materials for schools and, by amendment, early learning coalitions. CS/CS/SB 170 on nursing homes required consumer satisfaction surveys, patient safety culture surveys, reporting to the health information exchange, financial reporting penalties, and Medicaid quality incentive reporting; an amendment exempted state-operated homes, including veterans’ facilities, and directed a study of quality incentive systems. CS/SB 738 updated and streamlined child care regulation, and CS/SB 1356 created the Florida Institute for Pediatric Rare Diseases at Florida State University and a related pediatric rare disease screening pilot. The committee also passed SB 1370, which reorganized ambulatory surgical centers into their own statutory framework, with testimony emphasizing their lower costs compared with hospitals. Finally, the committee considered CS/CS/SB 1626 on child welfare and related issues. After adopting multiple amendments that removed references to unaccompanied alien children and special immigrant visas, changed language on child abuse definitions, and required DCF to set room-and-board rates by methodology rather than fee schedule, the bill was explained as strengthening child welfare protections, codifying military-family coordination, improving domestic violence shelter certification, adjusting children’s services council appointments, clarifying missing-child procedures, and updating licensing and compliance provisions. The bill drew both support and opposition, particularly over missing-child jurisdiction and immigration-related concerns, and was ultimately reported favorably. A final motion to record a vote on SB 958 was also adopted.