Transcript Highlights:

• So that’s what the data sharing is about in terms of transparency and looking at benchmarks and those
• benchmarks and those sorts of things. benchmarks and those sorts of things.
• is exempt because that's a behavioral health service, but her biopsy, surgery, weekly chemo, blood tests
• heart disease or diabetes would be required to pay $20 for most of their specialist visits, their tests
• is exempt because that's a behavioral health service, but her biopsy, surgery, weekly chemo, blood tests

Keywords: Meeting Start 00:00:00 Roll Call 00:00:15 HB 1 Discussion 00:02:00 HB 1 Vote 00:15:05 HB 2 Discussion 00:17:20 HB 2 Vote 01:13:20, 958, all

Summary: The committee met on House Bill 1, which would implement Kentucky’s participation in the federal education freedom tax credit program. Sponsors said the bill would allow donors to receive a federal dollar-for-dollar tax credit for contributions to scholarship granting organizations, with no state dollars involved, and that public school districts could potentially create their own SGOs. Members asked about the removal of state tax language in the committee substitute, the meaning of the 11th Amendment waiver, whether SGOs could serve only public school students, and whether data collection could be added. The sponsors said the state tax language was unnecessary because the credit is federal, the waiver would allow federal-court litigation over the act, and a district could establish an SGO if it met federal requirements. The committee adopted the substitute and then reported HB 1 favorably with 16 yes votes, one nay, three pass votes, and one abstention. The committee then took up House Bill 2, an act relating to Medicaid and making an appropriation. The sponsor described the bill as a response to federal HR 1 and to concerns raised by the Medicaid oversight board, saying it would address program integrity, eligibility redeterminations, cost sharing, and managed care organization contracts. He said the bill would require periodic eligibility verification for expansion Medicaid enrollees, add modest cost-sharing for some services to encourage use of primary care over emergency rooms, and strengthen enforcement of MCO contracts, with penalties going into a restricted compliance fund. Members asked about the committee amendment, and the sponsor explained it restored flexibility on the number of MCOs in future procurement rather than locking in a reduction. Members also asked whether the bill had gone before the Medicaid oversight advisory board and whether a fiscal note was available; the sponsor said the board’s recommendations were incorporated and fiscal notes were included in the packet. After discussion, the committee adopted committee amendment one to PHS2 and then adopted PHS2 as amended for consideration. The sponsor continued outlining the bill’s provisions, emphasizing that it applied to the expansion population and was intended to align Kentucky law with federal requirements while improving oversight and accountability.

Transcript Highlights:

• There were no objective tests; it was going to be by diagnosis, which is subjective, when the physician
• Adam, can you test that? Microphone, real quick. Yes, sir. Okay, do not touch that microphone.
• Like, for me at least, I have a balancing test.
• He paid $284 per scan, $568 total, four days before his test.
• And now you've got something established as a benchmark for those are going to be established in the

Bills: HB4806

Keywords: civil action, damages, health care services, noneconomic damages, negligence, legal standards, 1184, house, all

Transcript Highlights:

• And what we are finding out is there's a huge need to do massive scaled testing.
• A lot of places have those test facilities, but they're all providing power or generation.
• To things they can't disconnect from to test the EMP process, right? Right.
• So Gurley was a Texas MBA, went off to Silicon Valley, Benchmark Capital.
• The first thing that we noticed was Frank only had one testing center. It was in Wakefield.

Bills: SB1, SB 1

Keywords: appropriations, budget, state funding, education, healthcare, infrastructure, campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards, 1185, senate, all

Transcript Highlights:

• This bill severely limits what a jury can see by only presenting an arbitrary benchmark of 300% of Medicare
• act out in ways that would mask our mental issues to help get us through. for us without any proper testing
• last 10 years with all the personal injury cases is extremely robust background checks, MVRs, drug testing
• But if they want to see any specialists or want to get any testing, they have to go through the LOP system
• And don't just teach them to pass a CDL test, but to save lives. Sorry for your loss.

Bills: HB4806

Keywords: civil action, damages, health care services, noneconomic damages, negligence, legal standards, 1184, house, all

Transcript Highlights:

• That funding is provided for healthcare services such as birth control, cancer screening, and STI testing
• The court set a deadline and interim benchmarks for DSH to meet the 28 days, and these were subsequently
• extenuating circumstances beyond DSH's control received services within the final court compliance benchmark
• They were testing the system. They're learning.
• And so they've submitted test claims. They've been paid.

Keywords: 988, house, all

Transcript Highlights:

• won't read them to you, um, but they, you know, are tracked here through, um, objectives and then benchmarks
• little bit hard to see at the bottom, um, but we have created, um, for each goal, we have created a benchmark
• multi-family programs, um, and I, you know, again, I don't need to read these to you, but these benchmarks
• They test our processes.
• They test the internal controls and the risks that the organization is susceptible to or not, and those

Transcript Highlights:

• And so some of those benchmarks that they mentioned included things like operational benchmarks, the
• I am going to go back to the benchmarks. I'm going to go back to the benchmarks.
• necessarily gone away from benchmarks necessarily gone away from benchmarks entirely.<00:50:37.280
• And so I think some of these benchmarks And so I think some of these benchmarks at<00:51:36.559>
• The next section is the benchmarks.

Keywords: 916, all

Transcript Highlights:

• We're going to get rid of the star test, and we're going to have debate about reforming the A-F system
• The predominant way is the star test, which I heard may be going the way of the dodo.
• Student A gets modified tests, has a one-on-one aid. group testing and a behavioral intervention plan
• on that test.
• that test your state content standards.

Keywords: 1184, house, all

Transcript Highlights:

• Just to give you a benchmark, as that government payer increases, for every 1% increase that we have
• Just to give you a benchmark, as that government payer increases, for every 1% increase that we have
• as that government payer benchmark as that government payer increases<00:15:58.560> for<00:15
• We planned, studied, and did a stress test on the cash flow of that project very diligently. hospitals
• and services that they need to tests and services that they need to continue<00:46:34.960> their<

Keywords: 1183, house

Summary: The Health Finance and Policy Committee heard testimony from the Minnesota Hospital Association and several hospital leaders about the financial strain facing hospitals across Minnesota. The association’s CEO said hospitals are essential 24/7 safety-net providers, but rising labor, supply, technology, and drug costs are outpacing reimbursement from Medicaid, Medicare, and commercial payers. He warned that many not-for-profit hospitals are struggling, that workforce shortages remain significant, and that the committee should consider help on Medicaid rates, discharge/boarding problems, mental health services, workforce development, protecting the 340B drug discount program, and avoiding new mandates that add costs. Relle Schultz of Winona Health described a community hospital with a 49-bed facility and long-term care services that has faced years of losses, including a $17 million loss in 2023 and $12 million in losses the following year. She said government payers now make up about 65% of the hospital’s mix, and each 1% increase in that mix costs about $1 million. She highlighted the difficulty of sustaining services such as dialysis, which was nearly closed until a local donor provided $3 million to keep it open for three years, and she emphasized the importance of 340B savings and the need for higher Medicaid payments. Carrie Mulski of Riverview Health in Crookston said critical access hospitals are also under pressure despite their federal designation. She explained that federal support has eroded, that Medicaid and other public programs do not cover full costs, and that her hospital’s 340B savings help keep the doors open. She said Riverview opened a new hospital in 2020 but was hit by the pandemic and inflation, leading to annual losses of $5 million to $6 million and a negative operating margin of 9% to 10%. She also described bond covenant problems, low cash on hand, the prior closure of the nursing home, and the need for rapid state action to stabilize rural hospitals and preserve access to care.

Transcript Highlights:

• >> then yes I would say that by your test >> then yes I would say that by your test
• No, no, so they'll give us some test. >> Yes.
• I did diagnostic testing in the Boston school system.
• I did diagnostic testing in the Boston school system.
• I did diagnostic testing in the Boston school system.

Keywords: 1189, house, all

Transcript Highlights:

• That's why the vaccination, the testing, the microchip identification.
• ,<00:33:03.040> the why the vaccination, the testing, the why the vaccination, the testing
• ,<00:33:22.200> microchip vaccination, testing, microchip vaccination, testing, microchip
• But we need benchmarks yearly to figure out where we at. Yeah, I agree.
• out where we benchmarks yearly to figure out where we at. at. at.

Keywords: 912, senate, all

Transcript Highlights:

• At the time, you saw that educational rankings and benchmark scores were very low and remained low.
• There was still That educational rankings and benchmark scores were very low and remained low.
• There's also the standards included in the state's testing system.
• that the General Assembly took in 1983: establishing standards of accreditation, requiring yearly testing
• that the General Assembly took in 1983, establishing standards of accreditation, requiring yearly testing

Summary: The meeting began with approval of the previous minutes and then focused on an update from the Department of Education on early childhood programs, especially the state-funded Arkansas Better Chance (ABC) program. Secretary Jacob Oliva and Deputy Commissioner Stacey Smith said Arkansas had received a federal Preschool Development Grant and described ongoing work to review ABC slots, which have been flat for years at about 23,800 slots and roughly $114 million. They said about 1,000 slots statewide are currently unfilled despite a waiting list of more than 2,000 families, and the department is shifting toward paying based on enrollment rather than guaranteed slots. Members asked about school choice, income eligibility, year-round access, curriculum flexibility, transportation, and whether funding should be increased or rebalanced; the department said it is collecting data, may survey providers more formally, and is considering whether to modernize income thresholds, daily rates, and other program rules. The committee agreed to form an early childhood subcommittee and asked the Bureau of Legislative Research to help gather historical information on income limits and other program details. The second major portion of the meeting was a legal presentation on the framework for Arkansas school adequacy by BLR education attorney Taylor Lloyd. She reviewed the constitutional basis for a “general, suitable, and efficient” public school system, the Dupree and Lake View cases, and the principle that adequacy and equity are different but related: adequacy asks what resources are needed, while equity asks whether those resources are distributed fairly. She explained that the General Assembly must define adequacy, study it, and react to evidence over time, and that the current adequacy definition includes curriculum and career/technical frameworks, the 38 mandatory Carnegie units, state testing standards, and sufficient funding. She also described the matrix as a funding tool, not a spending mandate, and noted that categorical funds are separate from the matrix. BLR’s Elizabeth Bynum then gave the historical framework, tracing legislative responses from Dupree through Lake View and into the present. She highlighted major changes such as the creation of equalization funding, fiscal distress and academic distress laws, the adequacy study process, the Educational Adequacy Fund, facilities and transportation changes, declining enrollment and student growth funding, and later adjustments to teacher salaries, isolated funding, and categorical programs. She explained that the adequacy study has evolved through committee hearings, surveys, site visits, and outside consultants, and that recent changes include updates to accountability references and the addition or removal of certain funding categories. Members asked follow-up questions about how the matrix is used, whether homeschool or private-school funding raises comparable issues, whether stakeholders include private and homeschool participants, whether school board members should be surveyed, and whether the state should revisit average daily membership versus attendance-based funding. No votes were taken on the adequacy presentations, but the committee did agree to continue the early childhood discussion in a future subcommittee meeting.

Transcript Highlights:

• He said the test to become a licensed engineer does not deal with software; it deals with structures
• He said the test to become a licensed engineer does not deal with software; it deals with structures
• He said the test to become a licensed engineer does not deal with software; it deals with structures
• to prevent black people taxes and tests to prevent black people from<01:20:29.040> voting<01:
• “So I do think giving people three hours off is a good benchmark.

Keywords: 928, house, all

Summary: The hearing opened on House Bill 192, which concerns the Joint Committee on Employee Classification process for state employee positions. Representative Peter Schmidt explained that the bill is a procedural step to send already-reviewed classifications to Korn Ferry and then into statute and the budget. Department of Corrections staff and Commissioner Helen Hanks testified that one Deputy Director of Medical Services position had been omitted from the bill by mistake even though it had already gone through the JCEC process, and they asked for an amendment to add it. Hanks clarified that the position is an existing classified job being converted to unclassified status, not a new position. The committee discussed how the amendment would work and the quorum requirements for the JCEC, then closed the hearing on HB 192 after no further testimony. The committee then heard House Bill 435, sponsored by Representative Don McFarland, which would clarify professional engineering licensure law. McFarland said the bill is intended to make clear that work in IT security, electronics, digital systems, computing, and software is not the practice of engineering requiring a professional engineer license, while preserving licensure requirements for fields such as civil, structural, and building-related engineering. He said he had consulted with the American Council of Engineering Companies and that the bill is meant to remove ambiguity and legal risk, not deregulate engineering. Several members with engineering backgrounds spoke in support, describing the distinction between licensed PE work and other technical fields, and one member noted that software development and regulated software work typically do not require a PE license. The committee voted ought to pass on HB 435 by a roll call of 16-0 and placed it on consent. Finally, the committee opened House Bill 210, which would create a commission to study the New Hampshire state flag. Representative Tom Corman argued that the current flag is a generic “state seal on a blue bedsheet” and does not meet common vexillological design principles such as simplicity, meaningful symbolism, limited colors, and distinctiveness. He said the proposed commission would include legislative members plus representatives of the New Hampshire Historical Society and the New England Vexillological Association, and would review the flag’s history and recommend whether to redesign it and how to do so. He also indicated he intended to add language to avoid costs, but the bill discussion was not completed in the portion provided.

Transcript Highlights:

• They have income and asset tests. The asset limit is $2,000. These are needs-based benefits.
• They have income and asset tests.
• The ASWB found that Black and Latino test takers, multilingual folks, and folks who are multicultural
• are failing that test 52% of the time.
• The state benchmark for human services direct care staff median wage is just $20.79 an hour, while the

Keywords: 995, all

Summary: The Joint Committee on Children, Families, and Persons with Disabilities heard testimony on a wide range of bills affecting foster youth, child welfare oversight, homelessness services, juvenile justice, social work licensure, and human services workforce supports. Committee co-chairs Senator Robyn Kennedy and Representative Jay Livingstone opened the hybrid hearing by outlining testimony procedures and accessibility measures. Several members and legislators participated throughout the day, and many witnesses were invited to submit additional written testimony after speaking. A major portion of the hearing focused on House 227/Senate 105, which would protect federal benefits owed to children in foster care. Supporters, including advocates from Hopewell, the Disability Law Center, CPCS, the Children’s Law Center, More Than Words, Friends of Children, and youth witness Onyx Rosario, said DCF had already ended the practice of taking most Social Security and SSI benefits and now conserves them in accounts for youth, but argued the policy should be codified to prevent future reversals. Witnesses described how conserved benefits help with basic needs, housing, education, transportation, and transition to adulthood, and several noted the bill also adds financial literacy and transparency requirements. Senator Joan Comerford and others said the change would protect vulnerable youth, especially children of color, LGBTQ youth, and youth with disabilities. The committee also heard testimony on House 225, which would expand the grandparents-raising-grandchildren commission by adding appointments and helping with quorum and representation. The committee also took testimony on Senate 136, which would improve emergency housing assistance for families experiencing homelessness by easing documentation requirements, allowing use of existing state data to verify eligibility, requiring notice before benefit reductions, and creating an ombudsperson. Senator Adam Gomez and other supporters said the bill would reduce barriers for families in crisis. On House 262/Senate 148, an omnibus child welfare bill, witnesses supported provisions on data reporting, education coordination, and Office of the Child Advocate reforms, while CPCS raised concerns about expanded access to sensitive records and the OCA’s role in certain proceedings. The Office of the Child Advocate supported codifying current practices and also backed child fatality review changes in House 234/Senate 133. The committee additionally heard support for Senate 108, which would require attorneys and audio/video recording during juvenile custodial interrogations, and for House 247/Senate 116, which would update the Juvenile Justice Policy and Data Board to add supported lived-experience seats. Finally, the committee heard competing testimony on Senate 135, a bill to ensure parity in social work licensure. SEIU Local 509 and supporters argued the current exam requirement disproportionately harms Black, Latino, multilingual, and multicultural applicants and worsens workforce shortages, while the Association of Social Work Boards opposed the bill, saying the exam is a necessary public-protection measure and that removing it would conflict with interstate compact efforts. The hearing also included testimony in support of a loan repayment program for human service workers, with providers and workers describing low wages, high student debt, and the need to retain staff in essential services. No votes or final committee actions were taken during the hearing itself.

Transcript Highlights:

• for each of the and benchmarks for each of the improvement<00:51:53.200> areas,<00:51:54.079>
• Funding to be distributed to the university based on goals and benchmarks included in the plan.
• Um, we benchmarked administrative positions to peer institutions, and the board has received all the
• <00:56:14.319> Um<00:56:14.640> we<00:56:14.799> benchmarked organizational
• Um we benchmarked organizational chart.

Keywords: 958, all

Summary: The committee met with a full quorum and approved the prior minutes. Members offered introductions of guests and family members, then heard a presentation from University of Louisville President Thomas Jared Bradley, who was sworn in before testifying. He described his background and outlined U of L’s strategic priorities: student success, access and affordability, workforce development, community engagement, and research. Bradley highlighted enrollment growth, increases in first-generation and Pell-eligible students, strong transfer pathways with KCTCS, and support programs such as the Cardinal Commitment Grant, 15-to-Finish, Comeback Cards, tutoring, mentoring, and mental health services. Bradley also emphasized U of L’s statewide and regional impact through UofL Health, rural outreach, the Bullitt County rural cancer education and research center, nursing expansion, and the Kentucky Manufacturing Extension Partnership program. He noted major institutional distinctions, including R1 status, a new Carnegie Opportunity College and University designation, and community-engaged classification. He said the university is one of only 10 public universities nationwide with all three designations and reported record enrollment, improved retention, and strong research expenditures. He also thanked lawmakers for significant capital and operating support, including funding for the simulation center, health science center, asset preservation, and the MEP program. During questions, members praised the university’s public service role and asked about first-generation enrollment, retention, graduation rates, and post-graduation outcomes. Bradley said the university is working to improve completion by expanding academic support, early alerts, incentives for tutoring, and faculty/advisor mentoring, especially for first-generation and high-need students. He acknowledged that post-graduation employment data is difficult to collect but said the new Carnegie classification reflects positive outcomes. No votes were taken beyond approving the minutes, and no formal actions were taken on legislation in this portion of the meeting.

Transcript Highlights:

• , track and respond all and drug testing, track and respond all complaints,<00:10:45.440> uh<00
• So there's a lot of checks and balances each month as well as our year. >> And do you have benchmarks
• We're currently in the process of doing a multi-site clinical trial to test how effective this is.
• We're currently in the process of doing a multi-site clinical trial to test how effective this is.
• <01:04:32.880> We've test how effective this is. We've test how effective this is.

Keywords: 958, all

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.

Transcript Highlights:

• Uh, you know, white powder, powdery substances, anything like that that get tested through the lab.
• <00:09:55.040> through<00:09:55.200> the like that that get tested through the like
• Our first benchmark, if you will, is September 30. That's the end of the federal fiscal year.
• has tested clean and we're basically among the unaffected states and remain so at this time.
• um and traceability and testing um and traceability and sampling.

Keywords: 958, all

Summary: The committee met to adopt the minutes of the second meeting by voice vote, then heard an update focused on disaster preparedness, resiliency, response, and coordination among state agencies and partners. The chair emphasized avoiding duplication of resources and highlighted the importance of agriculture-related response issues, including animal evacuation, feed distribution, and the role of extension services during disasters. The Department for Public Health was invited to explain its role in emergency planning and response. Public Health described its Emergency Preparedness and Response Branch as the lead coordinating agency for Emergency Support Function 8, covering health and medical services under Kentucky’s emergency operations framework. Testimony outlined its broad responsibilities, including support for hospitals, morgues, local health departments, behavioral health, crisis counseling, suspicious package testing, disease outbreaks, and coordination with emergency management, EMS, transportation, and nonprofit and private partners. Officials also described the agency’s risk-assessment process, training and exercise programs, and deployed assets such as PPE caches, deployable communications, a federal medical station, a mobile treatment center, and alternate care support used in events like the eastern Kentucky floods and COVID-19. The agency also discussed funding through federal cooperative agreements for public health emergency preparedness and hospital preparedness, noting that these programs have evolved since 9/11 and have been shaped by major disasters and emerging threats. Officials said Kentucky’s funding has declined over time and that current awards are partially funded for the first time in the program’s history. They expressed support for efficiency if federal programs are consolidated, but cautioned that combining programs could risk further funding losses.

Transcript Highlights:

• You couldn't have an objective test. It was going to be by diagnosis, which is subjective.
• Adam, can you test that microphone real quick? Yes sir. OK. Can you hear me?
• Do not test that microphone. Yes, yes, perfect.presentative Flores.
• We should all be like for me, at least I have a balancing test.
• He paid $284 per scan, $568 total, four days before his test.

Transcript Highlights:

• Following testing, motivation was often diminished, while end-of-the-year benchmarking helps sustain
• I’ve administered every state test since 1991, including the Ames Test, AZM2, AASA, and the AzELLA test
• test.
• day of the test or during the test.
• and computer testing.

Keywords: 1182, all

Summary: The committee first heard House Bill 2266, which would change school district and charter governing board policy from permissive to mandatory for excusing students for religious instruction during the school day. The sponsor and supporters framed it as a parental-choice and religious-liberty measure that preserves release-time programs, while opponents argued it would reduce local control, take students out of core instruction, create peer pressure and bullying, and raise constitutional concerns. After testimony from Secular AZ, a LifeWise Academy board member, and a school board president, the committee voted 7-5 to give HB 2266 a do pass recommendation. The committee then took up House Bill 2193, a cleanup measure related to student directory information and parent organizations such as PTOs/PTAs/APTs. Supporters said the bill would restore parent-to-parent communication that had been unintentionally limited by prior privacy legislation, while some members raised concerns about how the information could be used and suggested narrowing the language to prevent political or lobbying uses. The bill advanced on a 10-1 vote, with members generally supporting school-community communication but asking for possible amendments. Finally, the committee heard House Bill 2075, which requires public school districts to submit superintendent and other top administrator contracts or attestations to ADE and have the information posted in a searchable database. The sponsor and Goldwater Institute supporters said the bill is a transparency measure because base salary reports do not show total compensation, benefits, or allowances; opponents from school administrator groups and rural districts argued the bill singles out districts while ignoring charters and other publicly funded education providers, and they said superintendent pay is already publicly available in other forms. Discussion also touched on whether the bill should be expanded to charters and private schools. The sponsor closed by emphasizing transparency and the committee continued discussion of the measure.

Transcript Highlights:

• It revealed serious blockage, and she needed a stress test.
• Finally, her test was scheduled.
• Testing one. Check one. Check one. All right. All right. I apologize, everybody. I... Check one.
• Testing one. Check one. Check one. All right. All right. I apologize everybody. I Testing one?
• Just give a quick audio test. Check one. Okay, so you're on mute? Yep. Perfect, okay.

Keywords: 995, all

Summary: The committee held a public hearing with testimony on several health care bills, with most of the discussion focused on primary care access, community health center reimbursement, midwifery and birth centers, telehealth, hospital-at-home, direct primary care, and trans-inclusive health care access. Chair Feeney and Chair Murphy opened by noting the large number of signups and asking testifiers to keep remarks brief because of time constraints. Legislators and witnesses repeatedly emphasized that Massachusetts’ primary care system is under strain and that federal policy changes and reimbursement gaps are worsening financial pressure on providers. On community health centers, Representative Blay, Senator Lovely, Michael Curry, Bethany Keeley, Jag Deep Trevetti, Sean Cahill, and Christina Severin all supported H. 1096/S. 711, which would require commercial insurers to pay federally qualified health centers at least the MassHealth prospective payment system rate. They argued that commercial plans currently reimburse health centers below Medicaid rates, threatening sustainability, staffing, and access, especially as federal cuts and coverage losses could increase uncompensated care. Testifiers said the bill would stabilize health centers, protect primary care access, and not cost the state money. A second major topic was H. 1117/S. 784 on sustaining birth centers and the midwifery workforce. Senator Lovely, Senator Miranda, Emily Anesta, Rebecca Orden, Catherine Rushworth, Nishira Burrill, Joel Sutherland, Rachel Blessington, Joelle Ward, and others described the 2024 maternal health omnibus as an important first step, but said birth centers and midwives still face low reimbursement, workforce shortages, and financial instability. They urged reimbursement parity, a workforce development fund, and support for freestanding birth centers, citing improved outcomes, lower C-section rates, better patient experience, and racial equity in maternal health. Several speakers shared personal birth stories and said the bill would help preserve and expand birth options in communities like Roxbury, Worcester, and the North Shore. The committee also heard support for H. 1343 on direct primary care from Dr. Garofalo, Dr. Altman, Dr. Nair, Stephanie Cameron, Dr. Haley Moke-Blessed, and others, who said current insurance rules force patients to use a separate in-network primary care doctor for referrals and sometimes prevent physicians from dispensing medications. They argued the bill would reduce delays, administrative burden, and costs while improving continuity of care. In addition, Dr. Miklides and Sue Stempeck supported H. 1141 on hospital-at-home parity, saying the model has strong outcomes and should be reimbursed at the same rate as brick-and-mortar hospital care. Heather Myers and Katrina Cook testified on telehealth and digital health equity, urging broader coverage for asynchronous care, remote monitoring, interpreter services, and digital literacy supports. SEIU Local 509 supported H. 1188/S. 681 on trans-inclusive health care access, saying it would remove arbitrary insurance barriers to gender-affirming care. No votes or committee actions were taken during the hearing.