Video & Transcript : 'DFPS budget' :
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KY
Kentucky 2026 Regular Session
Legislative Ethics Commission (3-9-26)
Transcript Highlights:
- Um, so first we'll have Lori just mention the budget to you. >> Yeah.
- for the budget to be approved. there.
- </c> the the budget to you. the the budget to you.
- parameters of the budget and we will<00:05:14.400><c> need</c><00:05:14.720><c> to</c><00:05:15.039>
- </c> the budget the budget to<00:05:20.000><c> be</c><00:05:20.720><c> approved.
Summary:
The Kentucky Legislative Ethics Commission met on March 9, 2026, with a quorum present in person and one commissioner participating from Florida. The meeting began with the swearing-in of new commissioner Joe Palumbo, who briefly introduced himself and his family and business background. The commission then approved the February 2, 2026 minutes and approved the staff budget report, with staff noting the office remained within spending parameters.
Staff gave an update on the heavy workload from re-registration and reporting season, saying roughly 4,500 re-registrations and about 10,000 total forms had been processed. They credited the new online payment portal with reducing manual work and discussed ongoing LRC technology work to build a new system for desktop use, online re-registration, payment processing, and a searchable register. Commissioners asked about the timeline and current paper-based process; staff said the system is being built from scratch and that, for now, forms are still often downloaded, completed, emailed or mailed, and manually entered by staff.
The commission also reviewed financial disclosure processing. Staff said all required disclosures had been received except one outstanding candidate filing, and that the candidate was still officially running, so notice was being sent by certified mail under the statute. Staff explained that their review is for completeness rather than audit-level accuracy, and that disclosures from legislators, candidates, and certain upper-management/LRC officials are posted for public access. The commission then discussed its informal advisory opinions, including how staff tracks and organizes them, and praised staff for quick turnaround before voting to enter executive session to discuss confidential complaints and informal opinions.
FL
Florida 2026 5th Special Session
Appropriations Committee on Health and Human Services Feb 25th, 2026
Transcript Highlights:
- I know it's going to have an impact on the state budget through Medicaid.
- Two of my boys receive services through the APDI budget waiver.
- a budget issue arises or when a child or in my case children are in crisis.
- to support our budget waiver, as well as the support coordinators.
- to support our budget waiver, as well as the support coordinators.
Summary:
The Appropriations Committee on Health and Human Services met with a quorum present and took up several health-related bills. CS/SB 1110, covering Medicaid and insurance coverage for medically necessary orthotics and prosthetics, including activity-specific devices without lifetime or continuous-use caps, received emotional testimony from families and athletes describing high costs and the importance of access for children and adults with disabilities. Members voiced strong support, and the bill was reported favorably.
The committee also heard SB 1574, which would add biliary atresia screening to the newborn screening program using the existing birth blood specimen. The sponsor and a parent testified that earlier detection could prevent severe liver damage, transplants, and deaths, and the bill was reported favorably. CS/SB 794, dealing with background screening for employees at residential facilities and day training programs for people with developmental disabilities and a review of waiver support coordination, was amended to align with the House companion and then reported favorably after testimony emphasizing the importance of strong support coordinators for APD waiver families.
Members then considered SB 162, requiring hospitals and ambulatory surgical centers to adopt policies for smoke evacuation systems during procedures that generate surgical smoke. Nurses and other supporters described surgical smoke as a serious occupational hazard, while the Florida Hospital Association said hospitals are already regulated in this area and the bill was somewhat prescriptive; an amendment was adopted and the bill was reported favorably. CS/SB 254, which tightens oversight of nursing education programs, adds preceptorship and provisional licensure pathways for graduates awaiting NCLEX results, and increases transparency and accountability for low-performing programs, drew support from nursing advocates and opposition from private nursing schools concerned about workforce impacts; after amendment, it was reported favorably. Finally, SB 688 to reestablish licensure and regulation of naturopathic doctors in Florida was heard with testimony both supporting expanded health care choices and opposing the bill over safety and scope concerns, and it too was reported favorably. The committee then adjourned.
OK
Oklahoma 2026 Regular Session
Appropriations and Budget 2nd Revision: Oklahoma Department of Transportation will present at 10:30 a.m.
Appropriations and Budget
Transcript Highlights:
- I get questions all the time about, especially during our budget hearings, what does the Department of
- That's just like putting money back in our budget if we're not trying to fund, and quite frankly, in
- First, is there a budget line item for that work as broken out on state property?
- There are, you know, how we budget our maintenance efforts.
- It's more than just how many miles you have. and that's a percent of the budget you get.
OK
Oklahoma 2026 Regular Session
Appr/Sub-Natural Resources REVISED Jan 8th, 2026 at 09:00 am
Transcript Highlights:
- You guys are not asking for any budget increases, which is why we got snacks.
- So, when we met a couple of weeks ago, obviously, you all had seen the budget requests.
- Well, first of all, the big thing is we're asking for a flat budget this year, no increase in budget.
- It's proceeding on budget, kind of ahead of timeline.
- For comparison, the state of Arkansas's travel promotion budget is $31 million.
NH
New Hampshire 2025 Regular Session
House Executive Departments and Administration (04/02/2025)
Transcript Highlights:
- .<00:05:32.479><c> Um,</c><00:05:33.039><c> so</c> budget.
- Um, so budget.
- And on Thursday, we are in session with the last of the budget bills. Okay.
- We have there is a presentation budget.
- </c> the with the last of the of the budget the with the last of the of the budget bills. bills. bills
Summary:
The committee first heard House Bill 538, a Liquor Commission cleanup bill. Chair Joseph Mica and CFO Tina Deir explained that the bill updates outdated statutory titles and positions after the commission’s 2014 restructuring, deleting references to the former commissioner and COO roles, adding a director of administration and a director of finance and audit, and keeping the new positions at the same labor grade pending review by the Joint Committee on Employee Classification (JCEC). Members discussed the proper sequence for JCEC review, but generally treated the bill as housekeeping. The committee then voted ought to pass, and the roll call was unanimous, 16-0.
The committee next took up House Bill 493, which would require continuing education related to child abuse/ACE recognition for physicians and other providers. Testimony and committee discussion focused on whether the bill was too vague, whether it improperly intruded on the Board of Medicine’s authority to set professional education requirements, and whether it would effectively mandate a narrow training course that is currently voluntary and free. Supporters argued the bill addressed a real problem and cited testimony about missed abuse cases, while opponents said the board should handle the issue through its own rules and that the bill was poorly drafted. A motion of inexpedient to legislate passed 9-7, and the committee noted a minority report would be needed.
The meeting ended with procedural and scheduling announcements, including that the committee would be dealing with budget hearings the following week and had a large number of Senate bills scheduled for later in the month.
MA
Massachusetts 2025-2026 Regular Session
Formal House Session 33 Jun 21st, 2026 at 11:00 am
Massachusetts House Floor Meeting
Transcript Highlights:
- Due to this uncertainty, we decided to be conservative in our approach for the first year and budgeted
- The reason for that imbalance in favor of transportation is that the last two budgets have seen more
- education and transportation sectors, we will build off the work we have done in the last several budget
- several years it will be doubtful we will be able to spend an amount like this outside of our annual budget
- Furthermore, I acknowledge that this bill before us is only one piece of the budget funding that we will
Summary:
The House opened with the Pledge of Allegiance and adopted two ceremonial resolutions: one commemorating the dedication of the Woburn Battle Road Memorial as part of the Massachusetts 250th celebration, and another recognizing May 1-7 as Elks National Youth Week. The chamber then took up House Bill 4005, a fiscal year 2025 supplemental appropriations bill using FY24 Fair Share surtax surplus funds, and ordered it to a third reading before later considering it for passage to be engrossed.
During debate on the bill, the House heard a lengthy presentation in support of the proposal, which would direct about $828 million to transportation and $353 million to education. The transportation spending was described as primarily supporting the MBTA, including workforce and safety funding, reserve replenishment, station and infrastructure improvements, reduced fares, and reimbursement for tunnel closure costs, along with smaller amounts for regional transit authorities and unpaved roads. The education side included additional special education circuit breaker funding, vocational school capital, early education workforce supports, early literacy, universal school meals, higher education endowment matches, Green School Works, and ESOL waitlist reduction, with the Inspector General directed to review circuit breaker cost controls.
Members then debated several amendments. One amendment related to a school athletics policy was modified by a further amendment calling for DESE analysis before implementation; both the further amendment and the underlying amendment as amended were adopted. A transportation amendment to shift $50 million from MBTA funding to Chapter 90 municipal roads was supported by members emphasizing rural road needs but was rejected on a roll call, 25-120. Another transportation amendment adding at least $300,000 for Route 93 mitigation costs in Medford was adopted, 133-20. The bill itself then passed to be engrossed on a roll call, 140-14. The House also observed moments of silence for former First Lady Kitty Dukakis and for victims of the Santo Domingo nightclub collapse, and later adopted an order to meet the next day at 11 a.m. before adjourning in memory of former Representative Philip W. Johnston.
AR
Transcript Highlights:
- When education funding falls short, it's not just a budget issue.
- Our state's private school voucher spending now makes up 6% of our state's budget.
- We are experiencing a perfect storm of economic pressure on the state budget.
- Many more are unable to balance their budgets.
- Their dignity and their health are less important than a line item in a budget.
AR
Transcript Highlights:
- of Joint Budget, then they would adopt those same rules.
- And that is the main difference from the governor's balanced budget proposal. Mr.
- And that is the main difference from the governor's balanced budget proposal. Mr.
- This is a Joint Budget Committee meeting Tuesday, but we will only be taking up peer issues.
- So it's functionally a peer meeting for the Joint Budget Committee.
Summary:
The committee first reviewed a long list of House and Senate bills that were ready to be passed out, then heard a special language subcommittee report. The report recommended do pass on six bills, including SB 63, SB 67, SB 73, HB 1089, HB 1090, and HB 1093, and amendments on 11 others. A motion to pull HB 107 out for separate consideration failed, and the special language report was adopted.
The committee then took up the Revenue Stabilization Law and schedule. Staff explained the schedule’s differences from the governor’s balanced budget proposal and described several fund transfers, including $100 million for Medicaid sustainability, $70 million for the Arkansas Children’s Educational Freedom account, $43.7 million for the general discretionary majority vote set-aside, $5 million for the motor vehicle set-aside, and two $150 million transfers related to the Quick Action Closing Fund and public highway improvements. Members asked for clarification on allocations, and the committee adopted the amendment and passed both House Bill 1100 and Senate Bill 75 as amended.
Representative McClendon then presented a bill to support expansion of the Bella Vista Veterans Wall of Honor, but withdrew it, saying he would seek other funding sources. The committee then moved through the remaining captioned bills, including House Bills 105, 107, 1008, 1022, 1035, 1036, 1037, 1051, 1052, 1064, 1066, 1068, 1089, 1090, and 1093, and Senate Bills 3, 4, 7, 8, 15, 20, 21, 30, 31, 36, 41, 43, 58, 63, 67, and 77, generally passing them with little or no discussion, some as amended. The chair announced that all prior holds had been released and said the next Joint Budget Committee meeting would be Tuesday for peer issues only, then adjourned the meeting.
AR
Transcript Highlights:
- Members will now go to the yellow budget calendar. Invite Representative Johnson.
- Representative Johnson, you are recognized to present the budget calendar. Thank you, Mr. Speaker.
- This is to amend the budget for state turnbacks for counties.
- This is to amend the budget for state turnbacks for counties.
- And then tomorrow at 9:00 a.m., Joint Budget will meet in Big Mac A.
Summary:
The House convened with prayer and the Pledge of Allegiance, established a quorum, granted several leaves, and received a gubernatorial communication noting approval of House Bill 1002 (Act 1). The chamber also recognized guests, including state troopers, a nurse of the day, students, a cheer team, Entergy representatives, and a representative-elect, before moving to the calendar.
Members passed House Bill 1003, the Arkansas House Representative Staff appropriation, by 94-0 with the emergency clause. On the budget calendar, the House considered a series of appropriation amendments and bills affecting agencies and institutions including the Labor and Licensing Board, University of Arkansas Community College at Rich Mountain, the State Treasurer, DFA, county turnbacks, career technical education, Northwest Arkansas Community College, and the Fort Chaffee appropriation. Several amendments were adopted by voice vote, and the House then batched and passed multiple appropriation bills, while some were pulled out for separate votes.
In separate roll-call votes, House Bills 1021, 1027, 1029, 1049, 1056, 1061, 1074, 1075, and 1079 passed, while House Bills 1014, 1060, and 1062 failed. The chamber also adopted House Resolutions 1004 and 1005, which were described as necessary to introduce a non-appropriation bill. The meeting ended with adjournment set for 11:00 a.m. the next day, and committee announcements noted upcoming House Rules, Special Language, and Joint Budget meetings.
ID
Idaho 2026 Regular Session
Agenda Jan 15th, 2026
Transcript Highlights:
- I'm a budget and policy analyst with Legislative Services Office.
- I just don’t want to be having to cut that much out of our budgets; that really concerns me.
- I know we might have to cut our budget, and, you know, guess what?
- We're, everybody's cutting their budget. To cut our budget. And, you know, guess what?
- We're, everybody's cutting their budget right now. They can't afford the inflation.
Summary:
The Economic Outlook and Revenue Assessment Committee met to finalize general fund revenue projections for fiscal years 2026 and 2027, using updated worksheet results after a spreadsheet formula error was corrected. Staff explained the committee’s homework submissions, the average and median estimates, and how the corrected numbers affected the spread only slightly. Members discussed whether to use a lower, average, or median projection, with several noting uncertainty around possible tax conformity impacts, the state’s economic outlook, and the desire to avoid overestimating revenues.
A motion to adopt the committee median was ultimately approved over alternatives. The committee voted 10-8 to set the general fund revenue projection at $5,665.1 million for FY 2026 and $5,816.6 million for FY 2027. Members who supported the lower estimate said they preferred to err on the side of caution, while others argued the projections should reflect expected revenues without assuming future conformity reductions.
After the revenue numbers were set, the committee reviewed a draft letter/report to JFAC that incorporated the adopted projections. A motion to adopt the report language passed 17-1. The committee thanked staff for the quick turnaround and adjourned, with the co-chairs planning to present the recommendation to JFAC the next morning.
VT
Transcript Highlights:
- JRS 33, joint resolution to provide for a joint assembly to hear the budget message of the governor.
- houses meet in joint assembly on Tuesday, January 20, 2026, at 1:00 in the afternoon to receive the budget
- </c> joint assembly to hear the budget joint assembly to hear the budget message<00:07:18.160><c> of<
- </c><00:07:36.080><c> message</c><00:07:36.319><c> of</c><00:07:36.479><c> the</c> receive the budget
- message of the receive the budget message of the governor. governor. governor.
WA
Washington 2025-2026 Regular Session
Senate Opening Ceremonies Jan 12th, 2026
Transcript Highlights:
- And democracy is hard, particularly so during budget challenges.
- And democracy is hard, particularly so during budget challenges.
- And when we have budget issues and we don't prioritize the budget first in a session, it sets us up to
- not properly budget.
- I really think, though, that both chambers need to take a hard look at how we budget in this state.
Summary:
The Senate convened for the opening day of the 2026 session with roll call, presentation of colors by the Washington State Patrol Honor Guard, the Pledge of Allegiance, a signed national anthem by River Ridge High School ASL students, and an invocation. The President welcomed new Senator Victoria Hunt and noted the 250th anniversary of the Declaration of Independence, emphasizing the challenges of democracy and the need for grace and respect. The Senate then received certification of the November 2025 election results and administered the oath of office to newly elected Senators Emily Alvarado, Victoria Hunt, Deborah Krishnadasan, Tina Orwall, and Vandana Slatter.
The chamber adopted Senate Resolution 8660 to notify the Governor that the Senate was organized and ready for business, confirmed the committee appointed to deliver that message, and adopted Senate Resolution 8663 making minor rule changes. The President also confirmed the 2026 Senate standing committee memberships. During first reading and referral, several bills and measures were introduced and sent to committees, including bills on toxicology testing, supplemental leave benefits for public employees, crime victims and witnesses, and fire code administration, along with Senate Concurrent Resolution 8407 establishing cutoff dates.
Senate Concurrent Resolution 8407 was debated, with support arguing it set the session’s schedule for efficient work and opposition criticizing the traditional budget-and-policy sequence and calling for budget-first reform. The resolution passed. The Senate then received House Concurrent Resolutions 4406 and 4407, adopted both, and heard messages from the Governor’s office, the Secretary of State, and the Secretary of the Senate, including provisional certifications of initiatives and transmitted bills. The session concluded with notice of an upcoming joint session and committee meeting, and the Senate adjourned until the next legislative day.
TX
Texas 89th Regular
Appropriations - S/C on Articles VI, VII, & VIII Feb 26th, 2025
Appropriations - S/C on Articles VI, VII, & VIII
Transcript Highlights:
- The chair calls Jeb Bell with the Legislative Budget Board. Mr. Bell.
- previous budget cycle as a result of those efforts. Thank you. Thank you for the question.
- Total budget? Our total budget is $65 billion for the biennium.
- Are there any areas in your budget that y'all have cut from last biennium to this biennium?
- No, our baseline budget remains the same. OK. You're asking a lot in your.
TX
Transcript Highlights:
- I believe that our budget conferees should fight to ensure these amendments make it into the final budget
- And if you're really digging the budget, there's a lot of things in the budget that are great, right?
- We all looked at the budget. Some voted yes, some voted no.
- They spent a lot of time putting that budget together.
- It’s going to be paid for with the budget you didn’t vote for.
Summary:
The House convened with prayer, pledges, and several ceremonial recognitions, including Wilson County Day, San Antonio Mission Indian Descendants Day, and Blue Ribbon Lobby Day, along with acknowledgments of visiting groups and a birthday greeting. The chamber also announced committee meetings and then moved into floor business, including conference committee action on Senate Bill 1, the state budget.
A series of motions to instruct House conferees on SB 1 were debated and voted on. One motion sought to restore salary for Attorney General Ken Paxton after his impeachment-related suspension; it passed 88-56. Another, from Rep. Olcott, directed conferees to support amendments requiring data collection on the costs of undocumented immigrants in hospitals and prisons; after extended debate and a failed amendment from Rep. Martinez Fischer to also study immigrants’ economic contributions, the motion passed 86-61. The House also adopted instructions to eliminate Texas Lottery Commission funding, to support amendments restricting public education institutions from affirming gender identities inconsistent with biological sex, and to seek an additional $4 billion in property tax relief, with each motion passing on recorded votes.
The House then took up a supplemental calendar and passed several bills, including HB 39 on veteran death data, HB 102 on priority registration for certain students entering military service, HB 126 on student-athlete compensation and representation, HB 290 on tuition and fee assistance for members of the Texas military forces, HB 300 on Texas Armed Services Scholarship Program updates, and HB 2143 naming a highway in honor of Army Specialist Joey Lins. The chamber also postponed consideration of HJR 2 and HJR 6.
Later, the House considered HB 120 on career and technology education pathways and HB 20 on applied science pathway programs for high school students. HB 120 received a perfecting amendment and was advanced after discussion about workforce preparation. HB 20 prompted extensive questioning about transportation, costs, and how students would access partner campuses such as community colleges and TSTC sites; debate continued as the transcript ended, with members examining how the program would operate and whether approval authority would rest with TEA.
MN
Transcript Highlights:
- Senator Nelson, so I will say that this proposal, while it is not included in the Governor's budget,
- Senator Nelson, so I will say that this proposal, while it is not included in the Governor's budget,
- Senator Nelson, so I will say that this proposal, while it is not included in the Governor's budget,
- </c><00:30:19.320><c> he</c> not have this in his proposed budget he not have this in his proposed budget
- to balance a budget that now went<00:30:21.760><c> from</c><00:30:21.919><c> a5.1</c><00:30:22.880><
MN
Minnesota 2025-2026 Regular Session
Legislative Commission on Pensions and Retirement - 04/08/25
Minnesota Senate Floor Meeting
Transcript Highlights:
- </c> closely match the governor's budget closely match the governor's budget proposal.<00:04:21.199><
- I made the pain of going through uh ... budgeting to me, if you do zero-based budgeting, and I wasn't
- But once I went through zero-based budgeting, I realized how much of my budget I could I was paying and
- to me, if you do zerobased budgeting to me, if you do zerobased budgeting,<01:41:48.480><c> and</c><
- , I realized how much of my budgeting, I realized how much of my budget<01:41:57.679><c> I</c><01:41:
AZ
Arizona 2026 Regular Session
05/06/2026 - Joint Legislative Budget Committee
Joint Legislative Budget Committee
Transcript Highlights:
- The Joint Legislative Budget Committee is called to order. Will the Secretary please note the roll?
- The FY 2026 budget appropriated $10 million from those opioid settlement revenues to the Attorney General
- Pursuant to the enacted budget, the Attorney General's expenditure plan distributes those monies accordingly
- The committee... ...than budgeted Attorney General risk management contracted legal costs.
- time when we need to move these monies around for these different funds after it goes through the budget
Summary:
The Joint Legislative Budget Committee approved the minutes from its March 5, 2026 meeting and then entered executive session, where it approved a recommended settlement. After returning to open session, the committee took up the Attorney General’s opioid settlement expenditure plan. Staff explained that Arizona will receive opioid settlement funds over many years and that the FY 2026 budget appropriated $10 million for distribution to five counties. The plan would allocate $2 million each to Coconino, Mohave, Navajo, Pinal, and Yavapai counties. Members expressed support, noting the funds would continue programs they viewed as effective, and the committee gave the plan a favorable review.
The committee also considered an Arizona Department of Administration request to transfer $7 million within the risk management revolving fund. Of that amount, $5 million would go to workers’ compensation losses and premiums to cover higher program costs, and $2 million would go to administrative expenses for higher-than-budgeted Attorney General contracted legal costs. Members described the transfer as a routine budget adjustment, and the committee approved it.
Before adjournment, members asked staff about recent revenue trends, including April numbers and sports betting revenue. Staff said April data were still being analyzed and no definitive figures were available yet. On sports betting, staff said Arizona’s tax rate is in the range of other states but tends to be on the lower end. The committee then adjourned.
FL
Transcript Highlights:
- It is less than 0.2% of the preeminence annual budget.
- And I know we’ll have a budget.
- And it's not smart budgeting.
- and future budgets.
- and future budgets.
Summary:
The House convened with prayer, a moment of silence for former member Chester Clem, the Pledge of Allegiance, and quorum confirmation. Members then adopted the special order report and a rules report amending House Rule 15.3 to allow fundraising under certain circumstances during extended or special sessions. The chamber also heard several recognitions and a farewell speech from Representative Nixon, who reflected on constituent service and her legislative priorities.
On the floor, HB 1405, relating to a statewide project for missing persons with special needs, passed unanimously. The House then took up CS/CS/CS/SB 290, the Department of Agriculture and Consumer Services bill, which drew questions about the handling of surplus conservation lands and agricultural uses; it passed 94-10. CS/CS/CS/HB 905, the “Fire Act” on foreign influence, was explained as a broad package restricting foreign-country influence in government, procurement, gifts, cultural agreements, and related areas. An amendment adding restrictions on surrogacy and adoption involving citizens or residents of foreign countries of concern was adopted after debate over possible impacts on families and adoption practices, and the bill then passed 80-20.
The House also passed CS/CS/HB 1197, a bill to modernize state information technology procurement and contracting, unanimously after debate about improving oversight of large IT projects. HB 1103, allowing local governments to fast-track action on derelict vessels, also passed unanimously. The chamber then considered CS/CS/CS/HB 399 on land use development and development regulations, including limits on development fees, changes to local voting thresholds for comprehensive plan and boundary actions, manufactured homes in RV parks, and resort-related provisions. Several amendments were debated, including one on local control and rural boundaries that failed and another strike-all amendment ruled out of order; the bill ultimately passed 71-38. The final item reached before the transcript ended was a local bill for the Pace Fire Rescue District in Santa Rosa County, described as adjusting its assessment formula to provide tax relief.
KY
Kentucky 2025 Regular Session
Budget Review Subcommittee on Health and Family Service (11-5-25)
Transcript Highlights:
- </c> and I may misinterpret you budgeted and I may misinterpret you budgeted about<00:26:27.279><c> $180
- ,</c><00:41:31.359><c> Stacy</c> of office management and budget, Stacy of office management and budget
- We've tightened our budgets.
- We're in the tightened our budgets.
- </c> been received for the NE next budget been received for the NE next budget cycle.<01:06:50.880><c
Summary:
The Budget Review Subcommittee on Health and Family Services met in person, approved the October 15 minutes, and began with a moment of silence following a Louisville UPS plane explosion that was described as a local tragedy affecting many families and first responders. The main presentation was an overview of Kentucky’s Medicaid non-emergency medical transportation (NMT) program from the Department for Medicaid Services and the Transportation Cabinet. Witnesses explained that NMT is a federally required Medicaid benefit, administered by the Transportation Cabinet under a risk-based capitated model, with eligibility limited to Medicaid members traveling to medically necessary, Medicaid-covered services and who lack access to other transportation. They also described exclusions, including certain KCHIP, QMB, and PACE members, and outlined the brokered regional structure, call center operations, scheduling rules, vehicle and driver oversight, complaint handling, and rider surveys.
The presenters reported that NMT handled more than 3.1 million trips in state fiscal year 2024, with over 1.38 million trips already recorded in October, and said customer satisfaction surveys were high. They said the FY 2025-26 contract total is about $360.6 million, with monthly per-member capitation rates set by region through an actuarial process and approved by CMS. They emphasized that payments are tied to monthly Medicaid enrollment and that the state draws down federal funds for the exact amount paid, with no leftover balance. They also said most NMT use comes from adult day centers and rehabilitative care such as dialysis.
Members questioned the witnesses about how quality metrics and contract standards are set, whether the state had explored alternatives such as Uber Health or other integrated models, and how utilization was calculated. The witnesses said contract requirements are developed collaboratively by Medicaid Services, the Transportation Cabinet, and other agencies, and that studies of other models generally found higher costs and lower approval ratings, with additional research on a hybrid model expected by the end of the year. They clarified that one figure reflected the share of Medicaid members with registered vehicles, while another reflected actual NMT users, and they defended the capitated structure as shifting financial risk to brokers rather than the state. Representative Fleming also raised concerns about oversight, reporting, and the apparent gap between budgeted and contracted amounts, asking whether any unused funds would return to general funds; the discussion ended before a final answer was given.
KY
Kentucky 2025 Regular Session
Medicaid Oversight and Advisory Board (9-24-25)
Transcript Highlights:
- </c> comparison is completed for budget comparison is completed for budget neutrality.<00:10:19.360><
- </c> that go into um budget neutrality. that go into um budget neutrality.
- </c> advocacy going into the 2024 budget advocacy going into the 2024 budget session<00:26:49.320><c>
- </c> Balanced Budget Act of 1997. Balanced Budget Act of 1997.
- </c> understanding the budget. understanding the budget.
Summary:
The Medicaid Oversight and Advisory Board met on September 24, 2025, approved the minutes from the September 9 meeting, and then continued its discussion of Medicaid waivers with Leslie Hoffman and Carmen Hancock from the Department for Medicaid Services. Members asked for updates on the 2024 waiver waitlist management assessment recommendations, including aligning waiver policies, standardizing applications and waitlist placement, and modernizing data systems. DMS said that work is being done jointly with Aging and Independent Living and Behavioral Health/Developmental and Intellectual Disabilities through task forces, that ARPA spending delayed action, and that implementation timelines extend through March 2027.
The board also reviewed per-member waiver cost averages for fiscal years 2023 through 2025 for ABI, ABI long-term care, HCBS, Model II, Michelle P, and SCL. DMS emphasized these figures were benefit-only averages based on paid claims, not full waiver costs, and explained that true budget neutrality is calculated on an aggregate basis against institutional care comparisons approved by CMS. DMS said all six waivers remain in compliance with budget neutrality and that the most recent 18-month lag review for FY 2022 and FY 2023 found costs at or below institutional care. Members also asked about unused waiver slots; DMS said slots generally cannot be reallocated mid-year if they have been used, except in cases such as death or reserved capacity, because CMS treats participants as unduplicated for the waiver year.
A major portion of the meeting focused on the new child waiver created under House Bill 6. Legislators questioned whether the waiver’s design, including the exclusion of participant-directed services and the emphasis on high-acuity children with behavioral health, DCBS, or juvenile justice involvement, matched the bill’s intent to keep children at home. DMS said it used the $14.7 million appropriated for FY 2026 to develop the program, that there is no priority list, and that the waiver is intended to serve the highest-acuity children while also addressing residential needs for those sleeping in offices or placed out of state. Members also raised concerns about the rapid growth of the HCBS waiting list and asked for more detail on age and timing patterns, which DMS said it would provide later. Finally, DMS gave average processing times from application to eligibility determination and from approval to service start, and said the overall average from application to services beginning was about 80 days, while members requested follow-up information on the Carewise assessment contract and related costs.