Transcript Highlights:

• So the department has made that request and is in the process of seeking input from CMS.
• 44:50.960> from potential uh guidance we may need from potential uh guidance we may need from CMS
• CMS on how to reconcile these policies. CMS on how to reconcile these policies.
• of seeking uh and is in the process of seeking uh input<01:44:59.280> from<01:44:59.520> CMS
• input from CMS. input from CMS. >> Questions?

Keywords: 1191, senate, all

Transcript Highlights:

• programs, the single largest source is the direct funding that comes from the federal government through CMS
• Miner, we certainly are concerned, especially at the national funding and the GME programs from CMS.
• Miner, we certainly are concerned, especially at the national funding and the GME programs from CMS.
• We certainly are concerned, especially at the national funding and the GME programs from CMS.
• We certainly are concerned, especially at the national funding and the GME programs from CMS.

Keywords: 1183, house

Transcript Highlights:

• One, MQD—our abbreviation; I might say MQD, it’s MedQuest—but we were allowed by CMS, our regulators,
• :18:18.640> take<01:18:18.800> a<01:18:19.040> 3mon<01:18:19.600> pause CMS
• our regulators to take a 3mon pause CMS our regulators to take a 3mon pause to<01:18:20.320> make
• We actually also have to, um, uh, CMS has been giving us, like, hints of we think we're we think cannot
• has been giving us uh CMS has been giving us like<01:49:01.520> hints<01:49:02.239> of

Keywords: 910, house, all

Summary: The House Committee on Human Services held an informational briefing on the impacts of federal funding cuts, inflation, labor shortages, and chronic underfunding on Hawaii’s nonprofit social safety net. Hawaii Community Foundation opened with a story about a federal worker family relying on food pantry support, then described a “perfect storm” facing human services nonprofits: historically high demand, rising costs, staffing challenges, federal cuts, and state and county contracts that do not cover true service costs. The foundation said it has reactivated its Hawaii Resilience Fund, launched strengthened service grants, and is tracking policy changes and data to help nonprofits respond. Trey Gordner of UHERO presented research on the vulnerability of Hawaii’s nonprofit sector, explaining a framework that assessed political, financial, and structural risk. He said about 8,200 501(c)(3) nonprofits are active in Hawaii, but only about 200 receive direct federal funds; 74 grants to 59 organizations were flagged as politically at risk, totaling about $126 million in unpaid obligations. He said about 68 of the direct-funding recipients rely on federal funds for more than 20% of annual revenue, and that human services nonprofits are among the most exposed subsectors because they serve vulnerable populations and depend heavily on federal support. Catholic Charities Hawaii and the Hawaii True Cost Coalition said community-based organizations were already under strain before the current crisis, with most contracts not covering full costs and many groups depending on private philanthropy to fill gaps. They reported that half of surveyed organizations expect to reduce programs, more than a third may decline future contracts, and some are waiting months for reimbursements. Examples included reduced shelter admissions, fewer case management hours, and cutbacks in kūpuna services. The coalition urged higher contract rates, regular inflation and cost-of-living reviews, and timely reimbursement; no votes or formal actions were taken. Partners in Development Foundation described the loss of Native Hawaiian education funding as especially damaging, saying the federal Department of Education has zeroed out support that creates a roughly $46 million gap, including about $20 million for early childhood programs. The speaker shared a family story from the Nā Pono program to illustrate how early learning services support both children and parents, and warned that the organization’s federal funds make up 72% of its budget. The briefing ended with a call for continued emergency funding and longer-term structural changes to sustain nonprofits statewide.

Bills: HB235, HB236, HB565, HB237, HB238, HB239, HB240, HB241, HB242, HB235, HB236, HB565, HB237, HB238, HB239, HB240, HB241, HB242

Keywords: social media, age verification, minors, under 16, children online safety, online privacy, platform regulation, deceptive trade practice, Attorney General, civil penalties, punitive damages, consumer protection, account creation, algorithmic feeds, internet safety, youth social media, HB236, Baldwin County, Board of Equalization, per diem

Transcript Highlights:

• pilot through our 9817 funds, the money we got around the American Rescue Act that came straight from CMS
• CMS will only let us use the money until September 30th.

Summary: The ALC-Review Subcommittee reviewed seven methods of finance, including university projects at ASU Jonesboro and Mountain Home, Black River Technical College deferred maintenance, UA Batesville’s Farm Project Gateway Center, UAMS PET cyclotron equipment, a new allied health building at UAPB funded by a federal grant, and UCA’s multi-purpose arena design work. The committee also approved an alternative delivery construction project for UAPB’s Allied Health and Sciences Building, with East Harding Construction selected and AMR Architects as designer. Members then approved discretionary grants from the Department of Health and DHS, including support for a heart attack center designation, community health worker training, homeless services funding corrections, behavioral health transition support, and an enabling technology pilot. In the contracts section, the committee reviewed RFQs, construction-related contracts, intergovernmental contracts, and a large slate of out-of-state and in-state contracts covering topics such as seatbelt survey data collection, Medicaid and DHS systems, state hospital staffing and services, veterans’ services, education assessments, and state IT and procurement projects. Several contracts drew extended questioning. Senators and representatives pressed DHS and the Department of Veterans Affairs about heavy reliance on contract nursing and staffing costs, and officials said they were using pay incentives and recruitment efforts to increase state employee staffing. Members also questioned AEDC’s lithium supply chain study and the Department of Education’s security contract, with concerns about projected costs and repeated amendments. The committee held three in-state contracts—Department of Education security services and two DHS staffing contracts—until Friday, then adopted the remaining contracts and received informational reports on contract amendments, executed contracts, and emergency procurements before adjourning.

Transcript Highlights:

• My numbers are coming right from the billing of CMS. Representative Hart, you're recognized.
• CMS said patients were in immediate jeopardy because of problems with multiple poor outcomes from patients

Summary: The Health and Human Services Committee heard a lengthy agenda of health care and public health bills. The first major item was HB 649, which would remove the paper supervision protocol for certified registered nurse anesthetists (CRNAs) and allow autonomous practice. The sponsor and supporters argued it would improve access, especially in rural areas, address workforce shortages, and reduce costs, while opponents from the medical community raised patient safety concerns and argued it would weaken physician oversight. After extensive testimony and debate, the committee reported the bill favorably by a vote of 18-7. The committee then unanimously advanced several other measures. HB 259, creating a special observance for fentanyl awareness and education, passed 23-0. HB 791, which codifies infant safety devices as an option for surrendering newborns and amends safe-haven law, passed as amended 25-0. HB 355, allowing schools to use FDA-approved emergency opioid antagonists rather than only naloxone, passed 26-0. HB 1119, requiring hospitals with emergency departments to adopt pediatric readiness policies, training, coordination, and assessment requirements, also passed 26-0 after two amendments. HB 431, changing the date for level-two background screening of athletic coaches to July 1, 2026, passed 26-0. Later, the committee approved CS for HB 907, the Florida Institute for Pediatric Rare Diseases or “Sunshine Genetics Act,” which would establish an opt-in newborn genome sequencing program at FSU and a statewide consortium for rare disease research; supporters emphasized earlier diagnosis and cost savings, and the bill passed 25-0. CS for HB 519, aligning state law with federal law on controlled substances for paramedics, passed 25-0. Finally, CS for HB 723, requiring the Department of Health to provide early-detection materials for type 1 diabetes to families of young schoolchildren, passed as amended 26-0. The meeting adjourned after all bills were reported favorably.

Transcript Highlights:

• In 2014, we became CMS back to 2013.
• This data is from the CMS website. Okay, it is based on payroll journal entries.
• This data is from the CMS website. Okay, it is based on payroll journal entries.
• This data is from the CMS website. Okay, it is based on payroll journal entries.
• This data is from the CMS website. Okay, it is based on payroll journal entries.

Keywords: Call to Order and Roll Call- 00:00:14 Staff Report on the Firefighter Commission Minimum Training Standards and Administrative Spending- 00:02:02 Response from the Kentucky Fire Commission-00:32:06 Judge Testimony on Child Removal-00:42:47 Update on Child Removal and Reunification-01:11:19 Staffing at Kentucky Veteran Centers-01:40:15 Adjournment-02:05:55, 958, all

Summary: The Legislative Oversight and Investigation Committee met without a quorum, so no votes were taken. Staff presented a study of the Kentucky Fire Commission focused on firefighter minimum training standards and administrative spending. The presentation explained that Kentucky’s training standards are built from NFPA guidelines, that the commission currently requires 115 hours for volunteer firefighters and 300 hours for paid firefighters, and that those reduced hours were adopted by removing electives and other non-NFPA content. Staff also said the commission’s IFSAC certification testing for firefighter 1 and firefighter 2 aligns with NFPA standards, but the commission cannot require local departments to train or certify firefighters. Staff recommended that the commission formally promulgate regulations establishing the reduced training hours and work with KCTCS to better separate administrative costs for certain programs so compliance with the statute can be demonstrated. The finance portion of the report said the commission is funded by general fund appropriations for State Fire Rescue Training and by an insurance premium surcharge that supports the Firefighter Foundation Program Fund. Staff reported that the commission stayed within the 5% administrative cap tied to the overall surcharge allotment, but could not confirm compliance with a separate 5% cap for specific programs because KCTCS accounting does not break out those costs in enough detail. Staff suggested the General Assembly may want to clarify what counts as administrative cost in statute. Members asked about investment returns, local fire department funding, and whether training documentation is required; staff said some of those topics were outside the study scope and that IFSAC testing relies on chief certification that a candidate is ready to test. Representatives from the Fire Commission then responded, saying they agreed with the report’s recommendations and would work to clarify the 5% issue with legislators and KCTCS. They explained that the reduction in training hours was intended to remove electives, better align with NFPA standards, and address the difficulty volunteer departments have in getting members to complete lengthy training. Commission officials said training is documented through rosters and annual compliance reviews, and that IFSAC-certified firefighter testing is based on demonstrated skills rather than a required number of training hours. They also said the difficulty in tracking the second 5% cap stems from the way KCTCS’s PeopleSoft system records reimbursements as single transactions, making it hard to isolate administrative costs by program.

Transcript Highlights:

• One is that the rates are set in accordance with the approved plan, you know, but by CMS and so there's
• you know,<01:45:24.960> but<01:45:25.240> but<01:45:25.440> by<01:45:25.640> CMS
• <01:45:26.200> and<01:45:26.400> so<01:45:26.520> there's know, but but by CMS
• and so there's know, but but by CMS and so there's strict<01:45:27.040> guidance<01:45:27.440
• 01:46:06.640> rules<01:46:07.400> that<01:46:07.840> that ...federally approved CMS

Keywords: 1189, house, all

Summary: Division Three of the Finance Committee met in work session on April 20, 2026, to consider Senate Bills 481, 603, and 663, with the discussion focused primarily on SB 481, relative to the sale of the Sununu Youth Services Center property. The chair explained that the bill was advisory only and that the committee’s recommendations would go to full Finance on April 27. For SB 481, members reviewed conflicting provisions in the prior budget law about whether sale proceeds should go to the general fund or the Youth Development Center Claims and Administration Settlement Fund, and the bill was described as a compromise that would direct proceeds to the general fund before June 30, 2027, and to the settlement fund after that date. It was noted that the settlement fund had originally received about $20 million and had roughly $10 million remaining. The committee also received an extensive update from DCYF Director Marie Noonan on the new Youth Development Center in Hampstead. She reported that construction remained on schedule, with major structural and interior work complete, substantial completion expected in late summer or early fall 2026, and occupancy anticipated in early 2027. The presentation highlighted the facility’s design features, including single-occupancy bedrooms, sensory rooms, an education wing, medical and clinical suites, visitation space, a gym, and multiple outdoor courtyards, all intended to support a trauma-informed setting. Members asked about the facility’s funding, square footage, fencing, and scanner; staff said the building is about 34,000 square feet, funded entirely with federal ARPA state recovery funds to date, and that the scanner is on site but not yet operational pending policy and staff training. Committee members also raised concerns about the facility’s design and security. In response, DCYF said some concrete walls are required for structural and safety reasons, but they are being painted to maintain a brighter environment, and that the fencing will be about 15 feet high with privacy netting because the campus is shared with Hampstead. Officials said the new facility is legislatively limited to a maximum of 12 youth, while the current center can house 12 to 18, and emphasized that courts ultimately determine placements. No votes or final actions were taken during the work session.

Transcript Highlights:

• CMS requires all states to submit managed care program annual reports, which are often referred to as
• to CMS.
• presentations, there are allusions to required periodic reports from the MCOs to the agency and to CMS
• <01:15:11.680> related<01:15:12.240> to MCOs to the agency and to CMS related to MCOs
• to the agency and to CMS related to suspected<01:15:13.200> fraud.

Keywords: 1183, house

Transcript Highlights:

• respectfully that it will be everything that the bill proposes to do would have to be contingent upon CMS
• <00:48:33.520> be<00:48:33.640> contingent<00:48:34.240> upon<00:48:34.680> CMS
• would have to be contingent upon CMS would have to be contingent upon CMS approval<00:48:36.320>
• you're hopeful that language would be inserted that this solely goes into effect if we receive the CMS
• That is exactly the process, and really the length of time that goes into a CMS review is largely based

Bills: SB709, SB2089, SB2090, SB2108, SB2211, SB2250, SB2325, SB2803, SB2866, SB3245

Keywords: mental health, crisis intervention, assisted community treatment, treatment orders, law enforcement training, public safety, court-ordered treatment, Medicaid, healthcare access, unlicensed professionals, supervised services, workforce development, mental health equity, child custody, evaluations, licensed counselors, family court, juvenile justice, waiver of jurisdiction, transfer to adult court

Summary: The committee heard SB 709 SD2, which would require the Department of Health to respond to reports involving persons with severe mental illness, assess eligibility for assisted community treatment, and coordinate treatment when appropriate. Testimony from the Department of Human Services and the Department of Health supported the measure, with DOH saying it generally supported the bill but had comments on one section it viewed as unnecessary. The Department of Law Enforcement later explained that the bill would shift certification and standards for crisis intervention officer training from DOH to DLE, while still involving DOH in the training process. Opposition came from the Hawaii Disability Rights Center and an individual testifier, both of whom argued the bill expands state authority over people with mental illness and could worsen forced treatment practices. The Disability Rights Center also raised procedural concerns, saying the bill was effectively moved from a prior administration measure that had not been heard this session, and questioned whether the bill’s changes to assisted community treatment, blood tests, urinalysis, and living arrangements went beyond current law. The individual testifier argued the bill would further entrench harmful psychiatric drugging and urged the committee to defer it. Committee members questioned the administration about the bill’s process, the role of the Attorney General in treatment-over-objection proceedings, and the practical effects of moving CIT certification to DLE. The Attorney General’s office said the bill was intended to fill a gap by allowing it to assist with treatment proceedings, while public defenders would continue to represent respondents and due process protections would remain in place. DLE and DOH said the change would better align certification with law enforcement training needs, improve speed in crisis response, and still keep DOH involved; members also discussed whether WAM counted as a hearing and whether the bill should more explicitly preserve DOH’s role. No vote or final action was taken in the portion provided.

Transcript Highlights:

• we are in health care with health outcomes to federal reimbursements in some capacity through state CMS
• we are in health care with health outcomes to federal reimbursements in some capacity through state CMS
• we are in health care with health outcomes to federal reimbursements in some capacity through state CMS
• > would I think the number one thing that we would be looking for is making sure that Medicaid, CMS
• sure that u be looking for is making sure that u Medicaid<00:52:51.680> uh<00:52:51.839> CMS

Keywords: 958, all

Summary: The Make America Healthy Kentucky Task Force met with a quorum, approved the minutes, and then heard a presentation on the state’s “food is medicine” efforts. Chair Funky Fromm opened by describing a recent foot injury from a road hazard and used it to emphasize the importance of infrastructure, nutrition, sleep, and activity as part of a broader wellness culture. The main witnesses were Kentucky Commissioner of Agriculture Jonathan Shell, Holly Harris of Appalachian Regional Health Care (ARH), and Jim Muser of the Kentucky Hospital Association. Shell and Harris described a partnership between the Department of Agriculture, the Kentucky Hospital Association, and hospitals such as ARH to connect local farmers with hospital cafeterias, farmers markets, CSA-style subscription food boxes, and medically tailored meals. Harris said ARH serves a large region with 14 hospitals, more than 95 clinics, about 6,700 employees, and 1,300 medical staff, and that the system began by improving employee food options because hospital workers often have limited access to healthy meals during shifts. They reported examples such as a local-protein burger, parking-lot farmers markets, subsidized CSA boxes for employees, and plans for container gardens at some hospitals. The witnesses said the program is intended to improve health outcomes, reduce readmissions, support chronic disease management, and also increase rural prosperity by expanding demand for Kentucky farm products. Shell said more than 40 hospitals had already been onboarded into the food-is-medicine program, with measurable outcomes being studied through pilots such as one at Russell County Hospital. He also noted that some systems, including CHI St. Joseph Health, Taylor Regional, and UK King’s Daughters, have formally embedded food-as-medicine goals into strategic plans. Members and witnesses also discussed barriers, especially the lack of reimbursement, fragmented short-term funding, and regulatory or purchasing hurdles that make it difficult for small farmers to participate. Shell said the goal is to make the model scalable and easier for hospitals and farmers to navigate, while Harris emphasized that ARH has been funding its efforts without reimbursement because of its mission. No votes or formal policy actions were taken beyond approving the minutes.

Transcript Highlights:

• It aligns with current CMS rules that have not been updated since the 1980s and are not adjusted for
• CMS studies published on this have summaries from every single state.
• CMS<00:42:44.560> studies<00:42:44.840> published<00:42:45.200> on<00:42:45.280>
• this<00:42:45.440> have CMS studies published on this have CMS studies published on this
• It was brought up about funding, and, as she understood it, the Department of Health and CMS did stable

Keywords: 916, all

Summary: The committee opened by explaining it would work through a long list of interim topics one at a time and asked members to complete a selection form at the end. The first topic, long-term care, drew testimony from AARP Wyoming and the Wyoming Long-Term Care Association. AARP emphasized Wyoming’s aging population, the state’s roughly $200 million annual Medicaid spending on long-term care, and the need to examine whether more support for home-based care could reduce nursing home use and costs. The association agreed with supporting people at home as long as possible, but asked that any study also consider increased support for nursing homes and assisted living when home care is no longer feasible. Committee discussion also touched on adult day care and PACE-like services, with Mr. Laycock noting prior Department of Health discussion and limited adult day availability due to reimbursement concerns. The committee then heard proposals for neonatal intensive care unit family leave, expanded midwifery scope, and a modification to workers’ compensation law. The NICU leave idea, presented by the Wyoming Women’s Foundation, would explore leave options for families with premature infants in intensive care, potentially paid or unpaid, while considering business size and the burden on families who may need out-of-state care. The midwifery topic was framed as a way to address rural maternity and women’s health gaps by allowing midwives to practice to the full extent of their training. On workers’ compensation, the Wyoming Association of Municipalities sought to classify dispatch personnel as first responders so they could receive mental health coverage under workers’ compensation; the Department of Workforce Services explained that current law covers dispatchers under workers’ compensation generally, but the first responder mental health provision added in 2018 applies to law enforcement and firefighters and does not currently include dispatchers. Other topics included problematic gaming and program funding, breast cancer diagnostic and supplemental exams, prescription drug coverage for advanced metastatic cancer, SNAP education, behavioral health workforce clinical training site shortages, CPR in schools, and broader midwifery oversight. The behavioral health workforce proposal, brought by a WICHE commissioner, focused on increasing psychology internship slots in Wyoming, noting that the state currently has only three and that expanding placements could improve recruitment and retention. The CPR in schools topic drew strong support from the American Heart Association, which argued that CPR training in high school could improve bystander response in a rural state with long EMS response times; committee members asked about cost and curriculum fit, and the witnesses said hands-only CPR could be taught by school staff rather than requiring expensive certification. The midwifery discussion later broadened into concerns about oversight and standards after a representative described a constituent’s pregnancy loss and said complaints involving midwifery practice and staffing delays in investigations warranted a deeper review. No votes were taken during the portion provided, and most topics were simply introduced, discussed, and left open for further testimony or later committee selection.

Transcript Highlights:

• 4th of last year to September of last year is when the Centers for Medicare and Medicaid Services, or CMS
• to January, right as the legislative session was getting ready to kick off, negotiations began with CMS
• Because of quite a bit of legal discussion, Quite a bit of legal discussion, productive discussions with CMS
• The second component was discussions that we had with CMS around the amount of dollars that the legislature

Keywords: 916, all

Transcript Highlights:

• My comment is that the RVU system was identified by people from DHS as actually coming from CMS.
• It is not a CMS entity; it is a committee from the American Medical Association that serves, and it's
• My comment is that the RVU system was identified by people from DHS as actually coming from CMS.
• It is not a CMS entity; it is a committee from the American Medical Association that serves, and it's

Keywords: 919, house, all

Summary: House File 105 was presented by Representatives Beerman and Baker and then laid over for possible inclusion in a future omnibus bill. The bill would implement the remaining mental health and physician service recommendations from DHS’s rate study, including raising certain Medicaid reimbursement rates to at least 100% of Medicare where a Medicare equivalent exists, increasing community-based children’s and adult mental health rates and behavioral health home rates, and phasing in additional increases over three years. The authors said the proposal also addresses master’s-level clinician reimbursement and fee-for-service hospital inpatient mental health services, and they emphasized that the changes are intended to improve access, transparency, and provider stability. Both authors argued that low MA reimbursement rates are driving access problems across Minnesota, especially for children, families, and rural communities. They said providers are struggling to hire and retain staff, clinics are closing or shrinking, and patients are facing long waits, boarding in hospitals, or delayed care. Representative Baker said the issue is personal and described the bill as a phased, long-term approach because of state budget limits and the size of the cost, which he said is in the hundreds of millions but still awaiting a fiscal note. Public testimony was strongly supportive overall. A family physician said higher rates would improve access, keep clinics open, and help patients avoid emergency care, while a Children’s Minnesota mental health leader described more than 1,200 pediatric boarding episodes in 2024 and said outpatient investment is needed to reduce pressure on emergency and inpatient services. A rural provider said her organization had to close an in-home children’s mental health program because of insufficient reimbursement, harming access in underserved counties. A psychologist testifying for the Minnesota Psychological Association supported the bill’s general direction but objected to repealing the pay differential for doctoral-level psychologists, arguing that doctoral training is more extensive and that eliminating the differential could worsen workforce shortages. After testimony and member questions about the bill’s scope and cost, public testimony was closed and the bill was laid over.

Transcript Highlights:

• CMS allows fully insured large groups to implement these programs, but current state law prohibits us
• This has been turned around in a CMS rule, which CMS has failed to enforce.

Summary: The Senate Committee on Insurance met on May 6, 2026, and first reported HB 1241 favorably. That bill, by Chairman Furman, requires insurers to check with DCFS before paying certain insurance settlements to determine whether the recipient owes delinquent child support, and to withhold and remit arrears if found. DCFS explained that Louisiana already has intercepts and other collection tools, but no current mechanism for insurance settlements. Senators raised concerns about notice to obligors and about liability if insurers fail to withhold, but the bill was advanced without objection. The committee then heard HB 870, which would require health insurers and PBMs to cover lower-cost generic or biosimilar drugs when available and to use utilization management no more restrictively on those drugs. Supporters said the bill would improve access and lower patient costs by using wholesale acquisition cost as the comparison point. Opponents, including Louisiana Blue and the AFL-CIO, argued that WAC ignores rebates and net cost, could force plans to cover higher-cost biosimilars first, and could increase premiums and disrupt ERISA and fully insured plan design. The committee adopted a technical amendment set and then a second amendment set that added notice and reporting requirements tied to net cost calculations, and HB 870 was reported favorably as amended. Several other bills were moved with little or no opposition. HB 1176, concerning Medicare Advantage coverage for integrative cancer treatments such as cold cap therapy, cryotherapy, and acupuncture, was amended to change the effective date and then reported favorably. HB 1196, dealing with colorectal cancer screening follow-up colonoscopies, was also amended and reported favorably. HB 1162, a consumer protection bill requiring DOI to verify that a contractor named on a first-party property damage check is licensed in Louisiana, was amended and reported favorably. HB 826, which modernizes insurance referral rules to allow referrals by email or website address, was reported favorably. The committee also heard HB 1151 on insurer investment limits and solvency protections, and HB 1236 on pharmacy reimbursement and copay maximizer programs; both drew substantial testimony and concern, especially over retroactivity, PBM cost allocation, and whether copay maximizers shift costs to patients, but the transcript cuts off before final action on HB 1236.

Transcript Highlights:

• Other states under the Biden administration, CMS rules were still allowed to take people off the rolls
• Other states under the Biden administration, CMS rules were still allowed to take people off the rolls
• CMS rules were still allowed to take people off the rolls for death, for dual enrollment in other states

Keywords: 1183, house

Transcript Highlights:

• From a financing standpoint, we are looking at what Medicare revenues can be drawn down using CMS funding
• We're waiting on OHCA, which has told us that they have not gotten the final approval from CMS, but have

Keywords: 914, all

Transcript Highlights:

• they're admitted, it's like a privately run operation, and our reimbursements come from the VA and CMS
• they're admitted, it's like a privately run operation, and our reimbursements come from the VA and CMS
• they're admitted, it's like a privately run operation, and our reimbursements come from the VA and CMS
• but<00:22:17.039> there's<00:22:17.360> no<00:22:17.600> additional um and CMS
• , but there's no additional um and CMS, but there's no additional funding<00:22:18.320> for<00

Bills: HB1531

Keywords: emergency announcements, American Sign Language, accessibility, public safety, broadcast media, 910, house, all

Summary: The committee heard testimony on House Bill 1913, which would create a mental health coordinator position within the Office of Veteran Services for the Daniel K. Akaka State Veterans Home and appropriate funds for it. Supporters said veterans, especially on the neighbor islands, need more mental health access and coordination. Several witnesses, including Sean Sonatada and Tom Driscoll, supported the intent but urged amendments to broaden the position beyond one facility and make it a statewide resource. Committee members questioned whether the bill would duplicate existing services at the veterans home and whether the position would be reimbursable through federal VA funding; testimony indicated the state would appropriate the money, while existing home services are already covered through current staff and federal reimbursement structures. The committee also heard testimony on House Bill 9, which would designate Hawaii as a Purple Heart state. Testifiers generally supported the measure as a way to honor wounded veterans and their families, though one member asked what benefits the designation would confer. Witnesses clarified that the bill was mainly symbolic and did not appear to create new benefits, and one testifier noted Honolulu County had already adopted a similar Purple Heart designation. The committee then took up House Bill 1628, which would establish a compassionate release protocol for certain seriously ill or debilitated incarcerated persons. The Department of Corrections and Rehabilitation and the Hawaii Paroling Authority opposed the bill, arguing that an existing administrative process already works, that the bill could improperly extend eligibility to people serving life without parole or mandatory minimum sentences, and that it lacked victim and family input and sufficient resources. In contrast, the Hawaii Correctional System Oversight Commission strongly supported the bill, saying it would reduce the high cost of incarcerating people with complex medical needs, ease burdens on staff and the prison population, and better reflect human dignity. The commission described having seen severe suffering and deaths in custody and said compassionate release is warranted in some cases. No votes or final actions were taken in the portion of the meeting provided.

Transcript Highlights:

• So we can move from compliance and CMS and, you know, looking at those regulations every day to really
• > worked really hard to gain compliance worked really hard to gain compliance with<00:16:54.839> CMS
• and give us the nice uh letter with CMS and give us the nice uh letter that<00:16:58.480> that
• know move from move towards you know move from compliance<00:17:04.640> and<00:17:04.839> CMS
• <00:17:05.720> you<00:17:05.799> know<00:17:06.000> looking compliance and CMS

Keywords: 928, house, all

Summary: The Division of Long-Term Supports and Services presented its budget and program overview as part of the Department of Health and Human Services operating budget review. Leadership described the division’s three bureaus—Aging and Adult Services, Developmental Services, and Family-Centered Services—and explained that the division provides guidance, technical assistance, quality monitoring, and contracted provider oversight across the lifespan. Members also discussed staffing, with reported vacancy rates of 4% in Aging and Adult Services, 15% in Developmental Services, and 6% in Family-Centered Services; the division said the higher BDS vacancy rate is partly due to the small number of authorized positions. The governor’s budget had left eight positions unfunded in the division, including three in Aging and Adult Services and five in BDS. A major topic was the division’s roadmap initiatives, especially building a system of care for healthy aging and strengthening developmental disabilities systems through a new reimbursement rate structure. The division said it contracted with an actuary to study DD service costs and found rates had not been reviewed since 2017 and were significantly below actual costs and other states’ rates, contributing to provider shortages even when services are authorized. Members asked about the impact on service delivery and whether rates would need to rise overall; the division said its strategy is to focus on lower-cost services that help people remain in the community. The division also reported waiver enrollment figures, including about 4,161 people on the Choices for Independence waiver, 3,688 average nursing facility residents, 5,061 people on the DD waiver, 228 on the acquired brain disorder waiver, and 488 children on the in-home support waiver, while noting there is no funding waitlist but provider availability remains a constraint. The division highlighted IT modernization as a major accomplishment, especially moving Adult Protective Services and Developmental Services into the New Heights system. Officials said these changes improve case-note access, data retrieval, service authorization tracking, and transparency for providers, and they asked for future oversight discussion focused on IT leverage. Members noted that New Heights maintenance is budgeted in the Office of the Commissioner under class 27 and suggested better transparency on system costs and benefits. The division also reported that it closed out a long-running CMS corrective action plan for BDS on July 1, 2023, and said it is now focused on strengthening the system rather than compliance alone. Other discussion covered the Aging and Adult Services bureau’s name change from Elderly and Adult Services to Adult and Aging Services, intended to avoid negative connotations and better reflect preventative services. The bureau described Adult Protective Services trends involving scams, financial exploitation, self-neglect, and isolation, and explained that it administers the CFI waiver, determines medical eligibility for nursing facility level of care, and braids funding from Medicaid, state funds, Older Americans Act money, Social Service Block Grants, and other grants. Members asked about waiver growth targets and federal consequences if enrollment remains below projections; the division said it would explain the shortfall in a future waiver amendment and did not anticipate a federal penalty. The meeting ended without any votes or formal actions taken.

Transcript Highlights:

• <01:34:35.600> we<01:34:35.760> concur<01:34:36.239> with<01:34:36.440> CMS
• <01:34:37.199> the access to care we concur with CMS the access to care we concur with CMS
• I just want to note for the committee that there are actually CMS requirements that are being required
• I just want to note for the committee that there are actually CMS requirements that are being required
• Under these new CMS requirements, PA timelines will be important, further helping to reduce the burden

Keywords: 910, house, all

Summary: The committees heard testimony on several transportation and consumer-related bills. HB 496, relating to mamaki tea labeling, drew support from the Department of Agriculture, the Department of Weights and Measures, and the Hawaii Farm Bureau, which said the bill would help protect a culturally important crop and the Hawaii brand. Members questioned Agriculture about staffing and whether the bill was being used to reopen a package-labeling inspection branch; the department said it currently has no Oahu inspectors for that function but has a place for an additional inspector. No opposition was registered on the measure. HB 978, relating to electric utilities, and HB 1316, relating to DLNR/park reservations, were also heard. HB 1316 received support from State Parks, and members discussed where reservation fees would go and whether the statewide reservation system for three parks would cover its costs; the committee indicated a change would be made so fees go to the special fund. HB 914, relating to water carriers, drew support or comments from the PUC, Department of Agriculture, Department of Transportation, Young Brothers, and the Hawaii Harbor Users Group. The main discussion focused on the proposed automatic rate-adjustment mechanism tied to the GDP price index, with members asking for alternative index ideas and questioning whether the PUC already had authority to adopt such a mechanism. Young Brothers said the measure would provide clarity and help recover inflationary costs, while the chair raised concerns about repeated rate increases and asked for further testimony on possible alternative indices. HB 1161, relating to transportation and road usage charges, received support from the Insurance Division, DOT, and the State Energy Office, with comments from the Tax Foundation of Hawaii and the Hawaii Food Industry Association. Members asked whether counties need state authorization to adopt mileage-based charges and why the bill included funding for implementation; DOT said it is helping counties build the data collection and billing system and that Honolulu is handling much of the collection work. A question was also raised about whether plug-in hybrids would be covered, and DOT said vehicles under the federal electric-vehicle definition would be included. HB 1301, relating to transportation network companies, drew opposition from the Hawaii Association for Justice, Lyft, and Uber, all arguing that classifying TNCs as common carriers and changing liability rules would raise costs, reduce access, and disrupt the current statewide framework. No votes or final committee actions were taken in the portion of the meeting provided.