Transcript Highlights:

• therapy departments, a retail pharmacy, and an assisted living facility.
• Imagine a patient traveling for over an hour to the closest facility with obstetric services.
• Well, if there is, if you're having to hold a patient, then there's at least a facility there.
• The three years of pediatric residency experience can't be replicated in an outpatient practice.
• I see those complications in my clinic, and often they're in the outpatient sphere.

Bills: SB1888, SB3003, SB2417, SB2459, SB3055, HB1393, HB2884, SB2943

Keywords: grand jury, jury qualifications, jury wheel, small counties, Texas legislation, age verification, obscene devices, online sales, juvenile protection, penalties, antitrust, attorney general, Texas Free Enterprise, business regulations, legal confidentiality, personal identifying information, data brokers, judicial safety, civil rights, data privacy

Transcript Highlights:

• It is hard to say if facilities are the right place, right?
• They also provide outpatient services.
• establish a facility like that? establish a facility like that?
• private child caring facilities. private child caring facilities.
• <01:22:31.400> and kids end up going to facilities and kids end up going to facilities and

Keywords: Roll Call - 00:10 Discussion on SCR 61 – 01:46 Vote on SCR 61 – 11:33 Discussion on SR 18 – 12:30 Vote on SR 18 - 30:01 Discussion on Ky Residential Autism Services – 32:34 Questions & Comments – 56:56, 958, all

Summary: The committee met with a quorum and first considered Senate Concurrent Resolution 61, sponsored by Senator Shelley Funke Frommeyer and Representative Matt Lockett. The resolution, as amended by committee substitute, would create a legislative task force tied to the MAHA (Make America Healthy Again) framework to study Kentucky health policy, including Medicaid drug approvals, preventive and alternative therapies, holistic health education, oversight and transparency in health care, and research into integrative approaches. Supporters said the goal was to address chronic disease and reduce over-medication, while emphasizing the effort was not intended as an attack on agriculture or the pharmaceutical industry. The resolution received favorable expression and passed the committee 9-0. The committee then heard Senate Resolution 18 from Senator Neal, urging Kentucky to maximize participation in the federal SNAP Employment and Training (SNAP E&T) program. Testimony from Jessica Klein of the Kentucky Center for Economic Policy and Secretary Eric Friedlander explained that SNAP E&T provides job training, education, and support services for SNAP participants, and that the program is federally matched and does not require additional General Assembly funding in the normal course. Members discussed how the program works, whether it could create new state costs, and how it fits with efforts to connect food assistance, workforce development, and local agriculture. Questions also focused on whether SNAP spending can be steered toward healthier foods and farmers markets, including Kentucky’s Double Dollars program, which was described as helping participants buy produce, meat, and dairy at participating markets and some retailers. Several members expressed support for the workforce goals but asked for more information on fiscal impacts and purchasing data. Secretary Friedlander said the SNAP E&T funds are separate from nutrition benefits, and that the state match generally comes from employer, university, or workforce partner contributions rather than new state appropriations. Senator Herron explained her vote in favor by saying the program could help people gain education and employment and reduce reliance on SNAP over time. Senate Resolution 18 was then adopted by the committee.

Transcript Highlights:

• especially in our safety net facilities especially in our safety net facilities um<00:12:36.160>
• capital construction for new facilities capital construction for new facilities or<00:23:16.480>
• We are a safety net facility.
• Um so we try to be flexible uh facility.
• That's those are the types of facility.

Bills: SF0010, SF0005

Keywords: mental health, detention, competency evaluation, treatment, contractual agreements, bankruptcy, hospital, county, healthcare, financial stability, 916, all

Transcript Highlights:

• Changing outpatient reimbursement from percent of billed charges to a fixed fee.
• Changing outpatient reimbursement from Changing outpatient reimbursement from percent<00:41:39.920><
• <00:53:38.680> And<00:53:38.800> the our urban facilities as well.
• And the our urban facilities as well.
• over the last 3 years in outpatient over the last 3 years in outpatient behavioral<01:25:01.960>

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board received a presentation from Dr. Stack and Commissioner Langfeld on Kentucky’s application for a federal Medicaid-related funding opportunity tied to House Resolution 1. They described a compressed six-week stakeholder process that produced more than 50 responses and letters of support, and said the application was organized around five broad priorities: maternal health, behavioral health and substance use disorder, oral health, EMS/trauma response, and chronic disease. They emphasized that the proposal was designed to align with CMS goals, use allowable funding categories, and focus on sustainability rather than a short-term grant. Commissioner Langfeld outlined five core initiatives: rural community hubs for chronic care innovation, beginning with obesity and diabetes; a maternal and infant health effort called POWER; a behavioral health and substance use model called IMPATH; an oral health initiative called Rooted in Health; and an integrated crisis-to-care EMS and trauma response effort. He said the chronic disease work would include prevention, food-as-medicine concepts, and technology tools, while the maternal health effort would expand team-based care around mothers and infants using community health workers and doulas. The behavioral health proposal would build on existing crisis intervention models, oral health would address workforce and access gaps through training, mobile vans, and telehealth, and the EMS proposal would better connect emergency response with home-based and community care. Several senators questioned whether the proposal would meaningfully address rural hospital closures or the broader rural health care crisis. Senator Meredith said the plan was not transformational and would not save rural hospitals, while Senator Berg asked how success would be measured. In response, the presenters said they would use both lagging and leading indicators, with an emphasis on rapid-cycle feedback and data use that is more actionable in real time. They also said the work could help existing models that already show promise, such as behavioral health units and dental workforce expansion, even if it would not solve the larger funding gap created by HR1. Senator Douglas asked how the proposals would motivate patients to participate in their own health care. The presenters responded that the chronic disease prevention work would focus on obesity, diabetes prevention, nutrition, and consumer-facing technology tools to help people engage in their own care, and that EMS-community health worker partnerships could identify unmet needs in the home and reduce preventable problems. The board then moved on to its next agenda item, Medicaid managed care delivery models, with Tom Stevens, Katherine North, and Dr. Patel scheduled to present.

Transcript Highlights:

• Is it the ethics committee of the health facility?
• Ethics Committee of the health facility Ethics Committee of the health facility has<00:15:30.959
• <00:25:47.320> I'm clinic or a particular facility I'm clinic or a particular facility I'm
• , even if the facility knew the patient needed care.
• Kean we also have a number of outpatient Kean we also have a number of outpatient clinics<01:03:

Keywords: 928, house, all

Summary: The committee heard testimony on House Bill 232, which would protect health care workers’ conscience rights in connection with certain procedures, especially abortion and sterilization, and also referenced contraception. The prime sponsor, Rep. Mark Pearson, said the bill is meant to prevent medical professionals from being forced to participate in procedures that violate their beliefs, while still prohibiting discrimination against patients based on protected characteristics. He said the measure was intended to help retain health care workers in New Hampshire and noted he had added an amendment to address concerns about people taking jobs only to later refuse duties, as well as emergency situations where a provider is the only one available. Committee members raised concerns about how broadly the bill and amendment were written. Questions focused on whether the protections could apply to non-physician staff such as schedulers, receptionists, or pharmacy employees; whether a provider could refuse to schedule, refer, or otherwise assist with services; and how “emergency” would be determined in practice. Several members also questioned whether the bill could affect access to contraception, including pharmacy sales and procedures such as tubal ligation, and whether the language was clear enough to prevent confusion or unintended refusals of care. Pearson said the bill was not intended to allow refusal of emergency care or general patient discrimination, and he acknowledged some language could be tweaked. Rep. Paige Boerman, a maternal-child health nurse, testified in opposition, saying she had seen pharmacists question prescriptions related to miscarriage care and that the bill could create barriers to contraception and other reproductive health services. She warned that the lack of a disclosure requirement and the broad definitions could create risks, especially in rural areas with limited providers. She also pointed to problems she said had occurred in other states, arguing the bill could lead to delayed care in emergencies. The hearing ended after questions and discussion; no vote or final action was taken in the portion provided.

Transcript Highlights:

• in a district's long-term facilities in a district's long-term facilities maintenance<00:05:20.800
• provide additional long-term facilities provide additional long-term facilities maintenance<00:29
• And I'm I prohibition of facility fees.
• Do you prohibition on facilities fees.
• The bill that would prohibit facility fees.

Keywords: 1187, senate, all

Transcript Highlights:

• Senate Bill 1577 by Parker relaying the temporary sale of alcoholic beverages at certain Racing Facilities
• issuance the Texas Commission of Environmental Quality of permits for certain wastewater treatment facilities
• to physical examination a nation requirements for patients admitted to an inpatient mental health facility

Bills: SJR60, SJR62, SJR65, SJR66, SJR67, SJR68, SCR27, SCR28, SCR29, SB1576, SB1577, SB1578, SB1579, SB1580, SB1581, SB1582, SB1583, SB1584, SB1585, SB1586, SB1587, SB1588, SB1589, SB1590, SB1591, SB1592, SB1593, SB1594, SB1595, SB1596, SB1597, SB1598, SB1599, SB1600, SB1601, SB1602, SB1603, SB1604, SB1605, SB1606, SB1607, SB1608, SB1609, SB1610, SB1611, SB1612, SB1613, SB1614, SB1615, SB1616, SB1618, SB1619, SB1620, SB1622, SB1623, SB1624, SB1625, SJR60, SJR62, SJR65, SJR66, SJR67, SJR68, SCR27, SCR28, SCR29, SB1576, SB1577, SB1578, SB1579, SB1580, SB1581, SB1582, SB1583, SB1584, SB1585, SB1586, SB1587, SB1588, SB1589, SB1590, SB1591, SB1592, SB1593, SB1594, SB1595, SB1596, SB1597, SB1598, SB1599, SB1600, SB1601, SB1602, SB1603, SB1604, SB1605, SB1606, SB1607, SB1608, SB1609, SB1610, SB1611, SB1612, SB1613, SB1614, SB1615, SB1616, SB1618, SB1619, SB1620, SB1622, SB1623, SB1624, SB1625

Keywords: SJR 60, Texas constitutional amendment, property tax exemption, ad valorem taxation, rainwater harvesting, graywater system, water conservation, water reuse, residential tax incentive, local government finance, county commissioners court, appraisal value, environmental incentive, November 2025 ballot, Article VIII, tax relief, healthcare workforce, education funding, higher education, economic growth

Transcript Highlights:

• The waivers would maximize the 100% FMAP for tribal and IHS facilities received for services provided
• facilities only, making health care harder for folks in rural areas of the country.
• Ajene, if you could explain House Bill 2195, nursing facilities, records, surveys, and timeliness.
• This disconnect delays corrective action and creates unnecessary inefficiencies, even when facilities
• It improves efficiency, aligns Arizona with federal standards already in place, and helps facilities

Bills: HB2049, HB2050, HB2051, HB2072, HB2082, HB2085, HB2177, HB2178, HB2179, HB2183, HB2195

Keywords: radiation therapy, particle accelerator, critical access hospitals, patient care, rural healthcare, AHCCCS, lactation care, breastfeeding, health services, healthcare access, Cesar Chavez, public holiday, state law, holiday repeal, Arizona Revised Statutes, childhood cancer, rare diseases, research funding, healthcare, clinical trials

Summary: The committee opened with attendance and member introductions, then heard a series of health-related bills, many focused on access to care in rural and underserved communities. HB 2049 would allow particle accelerators for radiation therapy in critical access hospitals and counties under 400,000 population under general supervision; sponsors and rural oncology witnesses said it would reduce travel burdens for cancer patients while maintaining safety protocols. HB 2050 updated radiologic technologist statutes to align with current national standards, adjust accreditation and clinical-hour requirements, and allow radiologist assistants to work under supervision rather than direct supervision; an amendment also added registered nurses to the list of professionals not needing a separate license to use diagnostic X-ray machines. Both bills were supported by testimony about workforce shortages and access, though one member voted no on HB 2050 over concerns about oversight and board authority. Both measures received do-pass recommendations, with HB 2050 amended. The committee then unanimously advanced HB 2082, which creates a Childhood Cancer and Rare Childhood Disease Research Commission to award grants for phase-one pediatric cancer and rare disease trials. Testimony came from families affected by pediatric brain cancer, including a parent who described traveling internationally for treatment and a college student currently undergoing treatment who urged the state to invest in research. Members expressed strong sympathy and support, and the bill passed 12-0. Next, HB 2015 would require Access to cover breastfeeding and lactation services in multiple settings; the sponsor and medical witnesses described breastfeeding as preventive care with benefits for infants and mothers, while Access testified neutral and noted a fiscal estimate was being developed and that the amendment would protect the state if CMS does not approve the services. The bill, as amended, also received a unanimous do-pass recommendation. The committee also approved HB 2177, which directs Access to seek CMS waivers so tribal and Indian Health Service facilities can be reimbursed for certain covered services, including dental care, for American Indian and Alaska Native members. The sponsor and a Sage Memorial Hospital representative said the bill would help rural tribal facilities keep services local and maximize federal matching funds; it passed unanimously as amended. HB 2178, requiring a state agency medical chief officer to hold an active medical or osteopathic license, was described as a cleanup measure after a lapse in licensure exposed a statutory gap, and it also passed unanimously. HB 2179, which clarifies definitions separating air ambulance from ground ambulance regulation, was supported as a technical clarification to avoid unintended consequences and likewise received unanimous approval. Finally, the committee advanced HB 2183, which creates an emergency medicine study committee to examine Arizona’s EMS system, including rural and urban capacity, workforce burnout, uncompensated care, and emergency department utilization. The sponsor said the study would help the state understand system pressures and identify policy solutions; firefighters, health care advocates, and an emergency medicine nurse practitioner testified in support, emphasizing the ER’s role as the safety net and the strain from staffing shortages, rural closures, and high volumes. The bill was still under discussion at the end of the transcript, with testimony continuing after the initial supporters spoke.

Transcript Highlights:

• Institutional medical is inpatient and outpatient hospital care.
• We now can also prosecute neglect in long-term care facilities.
• We can prosecute abuse in long-term care facilities.
• These include any sort of nursing home, any boarding care facility.
• These include any sort of nursing home, any boarding care facility.

Summary: The Medicaid Subcommittee of the Legislative Joint Auditing Committee met to adopt the November 2018 minutes and receive a primer on the subcommittee’s role and Medicaid oversight in Arkansas. Legislative audit staff reviewed the subcommittee’s history and explained that Medicaid is audited annually through the statewide single audit because it is a high-risk federal program. Staff summarized recent audit findings, including weaknesses in eligibility and data-matching controls, improper use of Medicaid funds for partially non-Medicaid work, issues with incarcerated juveniles’ coverage, the absence of a Medicaid recovery audit contractor program exception request, reporting problems involving MFCU recoveries, and provider eligibility documentation concerns. Staff also noted a DHS departmental audit finding involving employees who improperly received benefits, which was referred for further action. The Department of Human Services gave an overview of Medicaid’s structure, eligibility, delivery systems, and budget. DHS described Arkansas Medicaid as covering about 850,000 people through fee-for-service, managed care, and premium assistance for the expansion population, and outlined major spending categories such as institutional care, long-term services, pharmacy, capitated payments, and supplemental payments. DHS also explained the difference between state plan amendments and waivers, and said it has a beneficiary-fraud unit that refers cases to local prosecutors. The Office of Medicaid Inspector General described its role in detecting and preventing fraud, waste, and abuse, distinguishing between suspensions for credible allegations of fraud and recovery actions for mistakes or overpayments. OMIG said it works with DHS and law enforcement, issues quarterly and annual reports, and has increased recoveries in recent years. The Attorney General’s Medicaid Fraud Control Unit explained that it prosecutes provider fraud criminally and civilly, can also handle long-term care neglect, abuse, and exploitation cases, and works with local prosecutors as special deputies. Committee members asked about court venue, provider suspensions, beneficiary fraud, education of providers, and the status of Medicaid expansion work requirements; DHS said it is preparing to implement community engagement requirements under HR 1 and will begin with a soft launch before full enforcement. No formal votes were taken beyond adoption of the minutes, and the meeting adjourned after questions were answered.

Transcript Highlights:

• Had been moved into a residential care facility, so she was in a residential facility.
• And in fact, the nursing facility, as I understand it, the nursing home facility is on the hook for this
• We're on a roll here. with uh you know a nursing facility in with uh you know a nursing facility in in
• problem for many if not all facilities problem for many if not all facilities at<02:33:03.040>
• The facility has to pay the money back to the fund, and even if it is denied again, the facility has

Keywords: 1191, senate, all

Transcript Highlights:

• will see a need for prior authorization based on rules are inpatient hospitalizations, certain outpatient
• They look at certain selected outpatient surgeries, more than actually, I think, 18 visits of PT and
• And then for things like MRIs, we have gold card facilities who are exempted from the utilization...
• These levels of acuity simply cannot be safely managed in an outpatient setting.
• Thank you." levels of acuity simply cannot be safely managed in an outpatient setting, and without the

Summary: The committee first received an update from the Attorney General’s office on a new workers’ rights unit and two request bills. The office said the unit will focus on wage theft and civil rights enforcement, using existing resources for a small staff. It also described a bill to expand civil investigative demand authority for labor, wage theft, prevailing wage, and discrimination investigations, and an Immigrant Worker Protection Act that would require employer notice when federal immigration authorities request employee records, limit access to nonpublic work areas without a warrant, and restrict disclosure of employee data without proper legal process. Senators asked about costs, funding sources, and the scope of the proposed authority, and the office said it would follow up with more detail. The committee then heard a detailed presentation on Washington’s workers’ compensation system from Labor and Industries, including how claims are filed, how the medical provider network works, and how treatment authorizations and utilization review are handled. L&I said the network was created to improve care quality and return workers to work, and explained that most routine care is automatically authorized while certain procedures require prior approval or review. A question from Senator Conway focused on the role of the medical director and the appeals process; L&I said decisions can be protested and reconsidered, with exceptions reviewed through a complex treatment unit and medical staff. An experience panel followed with testimony from labor representatives, physicians, and an injured-worker attorney, who argued that the medical provider network and treatment guidelines can delay or deny needed care, especially in complex cases such as PTSD, brain injuries, and serious orthopedic injuries. They described long appeals, utilization review barriers, provider shortages, and the impact on injured workers and families, while L&I’s presentation emphasized the system’s structure and review safeguards. The committee then heard a report from the Underground Economy Task Force in the construction industry. L&I summarized the task force’s findings on worker misclassification, unregistered contractors, and unpaid taxes and premiums, and outlined consensus and majority recommendations, including better interagency communication, stronger penalties for repeat offenders, more authority to address successorship, possible contractor notice requirements, and further study of cash payments. The Attorney General’s office, labor, and business representatives generally supported the report’s goals but differed on some recommendations, especially those affecting independent contractors, contractor liability, and administrative burdens. The chair and Senator Conway thanked participants and said the report would inform future legislation.

Bills: HB4028, HB4075, HB4077, HB4074, HB4076, SB1221, SB1921, SB2118, SB1932, SB2134, HCR1025, SB1432, HCR1024, HCR1022, SB1122, HB4029, HB4063, HB4073, HB4078, SB1936, SB44, SB237, SB248, SB1360, SB985, SB1204, SB1239, SB1307, SB2143, SB1428, SB1390, SB1400, SB1405, SB1732, SB1832, SB1859, SB1989, SB2018, SB1427

Keywords: tax deduction, venture capital, economic development, Oklahoma, investment, water resources, appropriations, funding, state treasury, infrastructure projects, emergency act, emergency management, disaster relief, pandemic response, state appropriations, HB4074, Health Care Workforce Training Commission, Health Care Workforce Revolving Fund, health workforce, health care workforce

Bills: HB4028, HB4075, HB4077, HB4074, HB4076, SB1221, SB1921, SB2118, SB1932, SB2134, HCR1025, SB1432, HCR1024, HCR1022, SB1122, HB4029, HB4063, HB4073, HB4078, SB1936, SB44, SB237, SB248, SB1360, SB985, SB1204, SB1239, SB1307, SB2143, SB1428, SB1390, SB1400, SB1405, SB1732, SB1832, SB1859, SB1989, SB2018, SB1427

Keywords: tax deduction, venture capital, economic development, Oklahoma, investment, water resources, appropriations, funding, state treasury, infrastructure projects, emergency act, emergency management, disaster relief, pandemic response, state appropriations, HB4074, Health Care Workforce Training Commission, Health Care Workforce Revolving Fund, health workforce, health care workforce

Transcript Highlights:

• Institutional medical is inpatient and outpatient hospital.
• Medicaid services for rehab include our autism waiver, our EIDT, our ADDT, outpatient behavioral health
• We now can also prosecute neglect in long-term care facilities.
• We can prosecute abuse in long-term care facilities.
• These include any sort of nursing home, any boarding care facility.

Summary: The Medicaid Subcommittee of the Legislative Joint Auditing Committee met to receive a primer on the subcommittee’s history and on how Medicaid oversight works in Arkansas. Legislative audit staff reviewed the subcommittee’s origins in response to earlier Medicaid audit concerns and explained that Medicaid is audited every year in the statewide single audit because it is a high-risk, large federal program. Staff summarized recent audit findings, including issues with eligibility controls, data matching, contractor charging, incarcerated juveniles’ coverage handling, provider eligibility support, and the state’s Medicaid recovery audit contractor exception request. They also noted a DHS departmental audit finding involving employees who improperly received benefits, which was referred for possible prosecution. The Department of Human Services gave an overview of the Medicaid program, describing eligibility groups, delivery systems (fee-for-service, managed care/PASSE, and premium assistance for expansion adults), the size of the program, and the agency’s budget and provider base. DHS also outlined the difference between state plan amendments and waivers and said other committee materials would be sent to members. The Office of Medicaid Inspector General described its role in detecting and preventing fraud, waste, and abuse, explaining that it investigates suspected intentional fraud, suspends providers when there is a credible allegation of fraud, recovers improper payments in mistake cases, and recommends policy changes when trends are identified. The Attorney General’s Medicaid Fraud Control Unit explained that it prosecutes provider fraud criminally and civilly, handles neglect, abuse, and exploitation cases in long-term care settings, and works with DHS, OMIG, and federal partners. Members asked about where cases are filed, how provider suspensions work, whether beneficiary fraud is investigated, and how education is provided to providers. DHS confirmed that beneficiary fraud cases are referred to local prosecutors and said the expansion population will move toward community engagement/work requirements under federal changes, with a soft launch planned before full implementation. The meeting ended with no formal votes beyond adoption of the prior minutes and no other committee actions.

Transcript Highlights:

• <00:23:22.320> are identify which medical facilities are identify which medical facilities
• So this is a little facility.
• fact that this is the medical facility fact that this is the medical facility is<00:50:56.480>
• how good these facilities are.
• <01:04:22.480> uh<01:04:23.119> just a facility uh just a facility uh just recently

Keywords: 1189, house, all

Transcript Highlights:

• On a state facility or on state land, it's a 50-50 proposition.
• Providing occupational therapy and outpatient psychotherapy.
• And my site in particular is the only site without a residential facility.
• And my site in particular is the only site without a residential facility.
• Less staff and more patients means there will be Veteran care that VA facilities provide.

Summary: The Assembly Committee on Military and Veteran Affairs held an informational hearing focused on the effects of federal budget cuts and policy changes on veterans, military readiness, and California’s veteran support systems. The chair and members emphasized that federal reductions to the VA, Medicaid/Medi-Cal, SNAP, and the federal workforce are disproportionately harming veterans by threatening health care, employment, housing, crisis lines, and suicide prevention services. The chair also highlighted California’s progress on veteran homelessness and the importance of preserving state programs that leverage federal dollars. Major General Matthew Beavers of the California Military Department described the department’s structure, its response to the Los Angeles fire emergency, and concerns that federal cuts could reduce readiness through less training, older equipment, and fewer resources. He also discussed state programs such as Work for Warriors, STARBASE, youth and community schools, and the counterdrug task force, saying they are valuable but vulnerable if funding is redirected away from readiness. Members asked about the impact of federal changes on the Guard and how the Legislature could help, and Beavers said the state should advocate for recapitalized equipment and continued support for key programs. A second panel focused on veterans’ benefits and claims support. CalVet, Los Angeles County, and Swords to Plowshares testified that county veteran service officers, legal aid, and community-based partnerships are essential to helping veterans access VA benefits, especially after the PACT Act expanded eligibility and increased claims volume. Witnesses said these services bring substantial federal dollars back to California, but county offices and legal providers are underfunded and overburdened. Members discussed data sharing, staffing shortages, and the need for more resources to reach veterans who are not connected to VA care. In the final panel on mental health and suicide prevention, CalVet and nonprofit providers described state-funded programs such as the Veterans Support Self-Reliance program and the California Veterans Health Initiative, which place services in permanent supportive housing and provide no-cost counseling statewide. Witnesses said these programs are showing measurable improvements in health, medication adherence, and emergency room use, but they depend on sustained funding and are vulnerable to step-down grants and federal instability. Committee members expressed support for the programs and raised questions about access, staffing, and the role of non-veteran family members in Vet Center services.

Transcript Highlights:

• In FY 26, we are actually licensing more facilities than we licensed in Y25.
• Accreditation numbers, so in the end of 2024, we had 1,300 five-star facilities.
• So we went from having I don't know 20 or 25 cameras throughout that facility to over 100.
• In July, we moved our first group of residents to one of the new facilities.
• clinic on our campus. 14,000 square foot outpatient clinic that clinic has been built.

Keywords: 914, all

Transcript Highlights:

• a level four facility a level four facility is<01:24:39.240> the<01:24:39.440> local
• > the<01:24:47.760> safety These facilities truly are the safety These facilities truly
• inpatient services and will do outpatient emergency facilities, emergency services kind of things.
• <01:39:01.680> that of the 85, I believe, facilities that of the 85, I believe, facilities
• and they will do outpatient emergency uh facilities,<01:39:24.120> emergency<01:39:24.520>

Keywords: 958, all

Summary: The committee opened its sixth and final interim meeting with roll call, quorum confirmation, approval of the prior minutes, and a brief change in agenda order to preserve quorum and accommodate presenters’ schedules. Members then moved through several proposed health-related items with limited discussion, and the chair noted the committee would reconvene in January for further conversation. The first substantive item was a proposal relating to utilization controls for non-opioid analgesics in Medicaid. Senator Gerald Neal and Tara Hyde of People Advocating Recovery argued that pain parity is needed so patients can access non-opioid options without prior authorization or step therapy barriers, especially in acute pain situations and for people in recovery. Senator Berg supported the concept and suggested expanding the approach to other prescriptions by allowing physicians to explain why step therapy is inappropriate at the time of prescribing; another member cautioned against unintended cost increases if non-opioid drugs are used as add-ons to opioids. The committee then heard a proposal on physician assistants from Senator Scott and Andrew Rutherford of the Kentucky Academy of Physician Assistants. They described a shift from a supervisory to a collaborative practice model, with practice scope set at the practice level, limited Schedule II prescribing authority under guardrails, and permission for PAs to perform driver’s license vision testing. Supporters said the changes would improve rural access, reduce administrative burden, and align Kentucky with neighboring states; a question from Representative Bratcher focused on experience requirements and how the proposal compares with nurse practitioner rules. No vote was taken. Finally, Representative Nancy Tate, Adia Wuchner, and Representative Jason Nemes introduced a 2026 proposal aimed at “protecting vulnerable people.” They described a broad package focused on abortion pill trafficking, marketing to minors, commercial surrogacy, assisted suicide, and organ procurement safeguards, arguing that current law leaves gaps and that additional criminal and civil penalties are needed. The presentation was informational only, with no action taken before the meeting ended.

Transcript Highlights:

• Nursing facilities and intermediate care facilities for intellectual and developmental disabilities are
• Nursing facilities and sense.
• > for intermediate care facilities for intermediate care facilities for intellectual<00:26:42.880
• terms of just rural hospital facilities terms of just rural hospital facilities or<00:56:31.280>
• rate for both inpatient and outpatient rate for both inpatient and outpatient Medicaid<01:05:28.319

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.

Transcript Highlights:

• We have several of our lawyers embedded in children's health care facilities, so we regularly train,
• you're talking about PT, OT, and BCBA, all three services are very difficult to offer within an outpatient
• So there are real barriers to outpatient delivery unless you're specializing in that.
• So there's like there are real barriers to outpatient delivery unless you're specializing in that.

Keywords: 962, all

Summary: The meeting began with approval of the May minutes and then moved into administrative updates on several 2025 legislative workstreams. Staff reported progress on two marketing efforts tied to the youth mental health crisis: one focused on increasing awareness and use of urgent crisis centers, and another broader crisis-continuum campaign led by United Way. Both projects are refining materials based on working-group feedback and aim to have materials ready before the start of the school year. Updates were also given on the UCC private insurance review and the crisis continuum review, both of which are gathering data and reconvening working groups over the summer. The main discussion centered on a Civic Solutions Group update on Medicaid school billing. The contractor explained that the project is examining why Connecticut schools are not billing for behavioral health and related services, with the goal of maximizing federal reimbursement. Members clarified that the study is about schools billing for services, not private providers billing in schools. Questions focused on whether Medicaid has caps or authorization issues when students receive services both in school and in the community, and whether recent federal or state changes affect billing. The contractor said the work is still in data collection and analysis, and that some issues, such as reauthorization procedures, were outside his scope. Participants also raised concerns about perceived barriers, fee-for-service limitations, and the need to distinguish school-based billing from provider billing. A second major presentation came from Disability Rights Connecticut on a separate legislative study concerning behavioral health issues affecting students receiving special education. The subgroup is examining the feasibility and impact of requiring evidence-based interventions, especially for challenging behaviors that can lead to restraint and seclusion, and is also looking at monitoring and random audits of restraint and seclusion practices. The team described its project plan, including literature reviews, interviews, focus groups, surveys, and data requests from the State Department of Education and other stakeholders. Members emphasized that the work is aimed primarily at private providers under the statute, but may have broader relevance. Questions from the group focused on whether the study would include public schools, how evidence-based practices apply to students with intellectual disabilities and autism, and whether caregivers or parents would be interviewed; the presenters said caregiver input is not currently part of the charge. The meeting ended with reminders about the July 15 meeting, which will include a Solnit briefing, and a note that August TCB meetings will not be held, though a workshop on the Connecticut Children’s Behavioral Health Provider Survey is being planned for late July or early August.