Transcript Highlights:

• With Medicare not covering long-term care, few individuals with dementia have sufficient resources to
• Today, our Medicaid long-term care spending is split: 24% for people who want to live at home and 76%
• Seventy percent of those individuals will need some type of long-term care.
• Andrew talked about the disparity in that we spend about 24% of our money on our long-term care budget
• And there is no path to long-term community safety. So I am asking you to complete the system.

Committee: House Appropriations

Summary: The committee heard public testimony on several budget requests tied to health and human services. Louisiana Children’s Advocacy Centers asked for continued support and a supplemental appropriation of $1.173 million for infrastructure and standardization, explaining that the money would expand use of the Guardify digital evidence system, improve chain of custody, and reduce reliance on DVDs. Baton Rouge and statewide CAC leaders said prior funding helped eliminate a therapy wait list and speed services for abused children. Members asked detailed questions about the digital system, MDT coordination, and how the request related to SB 237, which would strengthen multidisciplinary review of child abuse cases. The Alzheimer’s Association sought $824,000 to sustain the dementia care specialist program, saying it helps families navigate services, keep loved ones at home longer, and reduce Medicaid costs. AARP and the Live at Home Coalition also testified for 750 additional Community Choice waiver slots at a state cost of $3.3 million, arguing that home- and community-based care is cheaper than nursing homes and that the current wait list is more than 11,000 people. Legislators discussed the size of the need, the state’s long-term care spending mix, and whether more support should go to family caregivers and community-based options. Testimony also focused on disability support services, substance use treatment, and developmental disability provider rates. A parent and direct support worker described the Children’s Choice waiver’s 20-hour cap and low pay, saying it makes it hard to retain caregivers and meet the needs of medically fragile children. Odyssey House and O’Brien House asked for higher Medicaid reimbursement rates under ASAM 4, warned that removal of room-and-board payments and weak Medicaid eligibility pathways are reducing access, and called for more oversight of sober living homes; members questioned outcomes data, length of stay, and links to homelessness. Finally, the Arc of Louisiana said the LDH rate study confirmed underfunding and supported a $53.6 million increase in state general funds, with local ARC leaders describing the services they provide and the need for higher direct support professional wages.

Transcript Highlights:

• In the year 2000, there were 108,000 children in the foster care system.
• level of need of the individual child, creating the level of care system.
• This is putting an unsustainable strain on resources, and a long-term solution is needed.
• With respect to AB 2906—be careful. You made too long of a pause. Yeah, that was staining.
• foster care system and the child welfare system.

Summary: The Assembly Budget Subcommittee on Human Services held an informational hearing on child welfare, foster care, child support, and related prevention efforts. The chair opened by emphasizing mandated reporting reform, foster care system improvements, and community-based prevention, and noted that no votes would be taken. Public testimony focused first on mandated reporting, where a lived-experience advocate and several organizations argued that the current system overreports families, especially Black, Native, and Latino families, causes trauma, and should be reformed through standardized training, clearer thresholds, and stronger community supports rather than more hotline referrals. Casey Family Programs cited data showing nearly 90% of reports are unsubstantiated, while CDSS said it is already forming a Mandated Reporting Advisory Committee, updating training, and exploring community pathways and possible changes to the list of mandated reporters. CWDA and SEIU supported training and alternative response concepts but stressed child safety, county capacity, funding, and the need for careful implementation and accountability. The committee then discussed a proposal to create a foster care multi-agency office within the California Health and Human Services Agency, led by a chief foster youth advocate with authority to coordinate across departments. Advocates said foster youth often need services from education, health, housing, and behavioral health systems that do not coordinate well, and argued that a central office with real authority could improve placement stability and access to services. CDSS responded that existing structures already provide coordination, including AB 2083 interagency teams, the Child Welfare Council, complex care steering committees, and the foster care ombudsperson, but said it was open to technical assistance. Members raised concerns about whether the new office would have enough authority and funding to avoid becoming another layer of bureaucracy, and the chair emphasized the need for real “teeth” and better interagency action. The final major topic was the continuation and expansion of Promise Neighborhoods. A community leader described strong early results from the state-funded neighborhoods, including improved kindergarten readiness, reduced chronic absenteeism, higher graduation rates, food access, housing supports, and mental health services, but warned that current funding sunsets in June 2025 and that a fiscal cliff could jeopardize staff and services. CDSS said the four funded neighborhoods have reported positive outcomes and valuable flexibility, but also noted challenges with one-time funding, student mental health, and long-term planning. Assemblymember Mia Bonta urged continued investment, saying the place-based model is difficult to rebuild once lost, and the chair asked LAO to help identify the minimum funding needed to preserve the existing infrastructure while evaluation results are still pending.

Transcript Highlights:

• It cuts the long-term structural deficit in half.
• Additionally, in the long-term care space, specifically skilled nursing facilities, looking for that
• Additionally, in the long-term care space, specifically skilled nursing facilities, looking for that
• Additionally, in the long-term care space, specifically skilled nursing facilities, looking for that
• Additionally, in the long-term care space, specifically skilled nursing facilities, looking for that

Committee: Senate Budget and Fiscal Review

Keywords: 987, senate, all

Transcript Highlights:

• care ombudsman services in Sonoma County and also the California Long-Term Care Ombudsman Association
• I'm the director of the California Long-Term Care Ombudsman Association.
• to improve needed transparency in long-term care facilities.
• I'm the director of the California Long-Term Care Ombudsman Association.
• to improve needed transparency in long-term care facilities.

Committee: Senate Human Services

Keywords: 987, senate, all

Transcript Highlights:

• Our claims staff focus most of their time on the short-term compensable and long-term disability claims
• with the goal of preventing long-term disability.
• , with the goal of preventing long-term disability.
• Our claim staff focus most of their time on the short-term compensable and long-term disability claims
• with the goal of preventing long-term disability.

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

Transcript Highlights:

• And I will say I've broken it out where manage medical assistance focus, then a long-term care focus
• long-term care programs.
• Standardized performance measures for long-term care are relatively new.
• An update measures the percentage of long-term care Persis Pence who have documentation of in a long-term
• care program in 2014, about 40% of long-term care and release for in the community.

Transcript Highlights:

• of people that work in the health care system.
• So primary care is the foundation of a functional health care system.
• term while also addressing long-term workforce needs.
• cost-effective health care system.
• health care system.

Summary: The Assembly Budget Subcommittee on Health held a hearing focused first on the impact of H.R. 1 on medical student financing and physician access, then on state residency-support programs. The chair framed the discussion around expected federal Medicaid and student loan changes, warning that higher borrowing barriers could reduce access to medical school for lower-income students and worsen physician shortages, especially in underserved regions. The LAO explained that H.R. 1 would cap federal loans for professional students, eliminate Grad PLUS for new borrowers, and likely shift more students toward private loans with less favorable terms; it said the bigger concern may be who can afford to attend medical school rather than a sharp drop in enrollment. HCAI described three physician loan repayment programs—the State Loan Repayment Program, the Stephen M. Thompson Physician Corps Loan Repayment Program, and the County Medical Services Program loan repayment program—and said retention data show many awardees remain in California and in underserved or safety-net settings after service obligations end. University of California and UCSF witnesses described California’s physician workforce shortages, especially on the Central Coast and in rural and agricultural communities, and said affordability, limited medical school capacity, and burnout are pushing some doctors into concierge practice or out of underserved areas. They emphasized that students from low-income backgrounds and underrepresented communities are more likely to be affected by loan limits and that residency location strongly influences where physicians ultimately practice. Members asked about medical school capacity, out-of-state students, residency retention, and whether the state could expand slots or better target aid to keep physicians in California and in high-need communities. Public commenters urged the Legislature to consider shortages in anesthesia, pediatric subspecialties, midwifery, and culturally concordant care, and to support broader workforce pathways and public-service loan programs. The second panel reviewed graduate medical education programs, especially CalMedForce, CalMedForce Plus, and Song-Brown. UC and HCAI said CalMedForce has supported new residency slots since 2018, while Song-Brown funds primary care residency training and has recently supported new programs in rural areas such as Del Norte County. The LAO said the state should decide whether residency support should remain a budget priority, whether these competitive grant programs are the best mechanism, and whether their structures are too rigid or duplicative. It noted that most awardees receive funding more than once and that the programs overlap substantially, suggesting possible coordination or consolidation. A family physician from the California Academy of Family Physicians argued that stable funding for primary care residencies is essential, that many California-trained physicians stay where they train, and that future funding should be more deliberately directed to primary care and high-need communities. The hearing ended with discussion of emergency room crowding, geographic inequities in residency distribution, and HCAI’s plan to develop supply-and-demand models to guide future funding decisions.

Transcript Highlights:

• care now—I'm not talking about respite, I know that's another conversation—but on long-term care, the
• The Department of Public Health admits that not a single new long-term care patient has been admitted
• I'm at Franciscan Children's, which, as you know, is long-term acute care, and we have a lot of very
• health care system.
• acute care or waiting for long-term community-based programs to open up.

Summary: The hearing focused on the future of the Pappas Rehabilitation Hospital for Children and the work of the special legislative commission studying whether and how the facility should continue. Senators and representatives said the Legislature has continued funding Pappas, that the hospital cannot be closed before the commission reports, and that they are seeking to extend the commission’s deadline. Multiple commissioners and witnesses described Pappas as a unique setting combining inpatient medical care, residential programming, special education, therapy, and campus-based activities for children with complex medical needs. Union leaders, staff, parents, and local officials argued that Pappas is being quietly depopulated through blocked admissions and continued discharges despite the formal pause on closure. They said the hospital’s integrated model cannot be replicated elsewhere, that families and staff are being left in limbo, and that the state should invest in repairs, modernization, and possibly temporary modular space to reopen admissions. Several witnesses emphasized the impact on children who have benefited from Pappas and on workers who fear losing a specialized workforce built over decades. Department of Public Health Commissioner Robert Goldstein said the state is committed to keeping Pappas open and stable while the commission works, but that admissions must meet hospital-level-of-care standards and the current infrastructure limits who can safely be served. He said the administration has been expanding outreach, hiring staff, and exploring ways to broaden services, including outpatient and therapy programs over time. Commissioners pressed him on why admissions remain so limited and whether the facility is being effectively depopulated, while Goldstein maintained that the restrictions reflect legal and safety requirements rather than an effort to close the hospital.

Transcript Highlights:

• METS handles most people, but people with disabilities and people in long-term care are still in ACCESS
• And so if someone becomes disabled or starts needing long-term care again, we need to close out the METS
• METS handles most people, but people with disabilities and people in long-term care are still in ACCESS
• If you have a long-term care worker leave, that's a very difficult position to replace because of the
• We have long-term systems replacement needs.

Committee: House Ways and Means

Keywords: 1183, house

Transcript Highlights:

• In terms of CalWORKs Child Care,...
• Individuals receiving long-term care in a nursing facility, individuals receiving pregnancy-related services
• Individuals receiving long-term care in a...
• Funds from a health care tax should be reinvested into the health care system to protect patient access
• improves outcomes and reduces long-term costs across the health system.

Summary: The committee first heard May Revision child care and human services items. The Department of Child Support Services described two technical adjustments, which the analyst supported. The Department of Social Services then walked through child care proposals, including a reduction in federal and Proposition 64 funding absorbed through a shift from General Child Care to the Alternative Payment program, a 2.01% child care COLA, disaster-related infrastructure grants, a new administrative support cost structure for Alternative Payment agencies, the removal of prospective pay funding after a federal rule change, a reappropriation for existing infrastructure grants, and estimates of unspent child care funds. The Legislative Analyst’s Office recommended asking for more justification for shifting reductions to CAP, supported the COLA reduction but wanted consistency across programs, recommended removing prospective pay funding, opposed the administrative cost shift, and suggested further review of disaster grant alignment. Members pressed the administration on why more slots would be cut for the same savings, why the COLA was reduced, and whether the administrative percentage would grow over time. The administration said the changes were intended to avoid disrupting currently enrolled families, reflect point-in-time relinquishments and unspent funds, and stabilize contractor operations. Public commenters, including providers, advocates, and county representatives, urged full COLA funding, rejection of child care slot reductions, preservation of prospective pay, and continued investment in child care infrastructure and access. The subcommittee then recessed before moving to health items. In Part B, the Department of State Hospitals presented its May Revision proposals, including a central utility plant replacement project at Metropolitan State Hospital, funding for a continuum electronic health record system, reduced county bed billing authority to reflect phase-in of additional LPS beds, limited contract exemption authority for online clinical subscription services, reversion of prior-year unspent operating funds, and a workforce development proposal to use Behavioral Health Services Act funds instead of General Fund for training programs. The department said the EHR would modernize records and improve continuity of care, and that the contract exemption would prevent delays in essential clinical information services. No votes were taken in the excerpt provided.

Transcript Highlights:

• A lot long... ...about things in the short term and longer term.
• Things like system of care reform from the child welfare system, the California Youth Behavioral Health
• Things like system of care reform from the child welfare system.
• For a long time, we were operating under rate freezes and... ...precedent in our system for a long time
• term so there is a of thinking more about quality incentives in the long term so there is chaptered

Summary: The Assembly Budget Subcommittee on Human Services held a hearing on developmental services, rehabilitation, and related supports, with no votes taken. The first major topic was the Master Plan for Developmental Services. Administration officials described a year-long, community-driven process that included a steering committee, work groups, and statewide engagement sessions, and said the final draft would be released that Friday with about 170 recommendations. The Department of Developmental Services said the plan would inform future work, but did not offer a detailed implementation roadmap. The LAO said the plan contains significant policy and budget implications, may require statutory changes, and needs further analysis to turn recommendations into actionable proposals. Advocates and regional center representatives urged the Legislature and administration to avoid letting the plan sit on a shelf, called for prioritization and ongoing stakeholder oversight, and emphasized the need to address equity, workforce, service coordination, and cross-system collaboration. The chair said he wanted to work with the LAO on trailer bill language and future reporting to create a clearer path forward. The second topic was the Office of Employment First and competitive integrated employment. Administration witnesses said California has ended subminimum wage under SB 639, but that moving people into competitive integrated employment remains a major priority. They described existing efforts such as DDS’s coordinated career pathways pilot, paid internships, job development services, benefits counseling, and DOR’s career counseling and referral services, along with pilot projects in San Diego and Orange County. The State Council on Developmental Disabilities and advocates argued that employment outcomes have remained stuck at roughly 15% and that a dedicated Employment First Office is needed to coordinate across agencies, align goals, and improve outcomes. The LAO recommended regular legislative oversight on people transitioning out of subminimum wage and asked for technical assistance on coordinated career pathways. The chair criticized the administration’s decision to effectively eliminate funding for the office, requested a detailed implementation timeline and quarterly transition reports, and said the committee would continue pressing for the office to be implemented. The final issue was respite services, utilization trends, and access. DDS reported that in-home respite use and spending have risen sharply over several years, with about 150,000 people using respite in 2023-24 and expenditures reaching about $1 billion. Officials said access depends on families knowing the service exists, service coordinators identifying need, and having enough providers, especially in rural and linguistically diverse communities. The San Diego Regional Center said utilization generally mirrors statewide trends, but access is stronger in some areas, such as Imperial County, where families often prefer family-directed or agency-supported models that allow them to hire trusted workers. Committee members emphasized the importance of respite for family health and caregiver well-being, asked whether service coordinators are asking practical questions about sleep and stress, and discussed the need for better identification of complex behavioral and medical needs. DDS said a standardized family support tool and updated IPP process are intended to improve consistency, transparency, and person-centered assessment for respite and related services.

Transcript Highlights:

• The second item with the Department of Social Health Care Authority is related to continuing long-term
• Thank you for continued support for long-term care. Thank you. John Lemus.
• Who will otherwise lose long-term care.
• It shifts costs to emergency systems, hospitals, and long-term care at a far greater expense.
• This budget makes cuts at the Health Care Authority, DCYF, early learning, DSHS long-term care, and in

Bills: SB5998

Committee: Senate Ways & Means

Keywords: fiscal appropriations, budget, state funding, financial management, operating expenses, 904, all

Transcript Highlights:

• system, including increasing investment in primary care and changing the way care is paid for to really
• system, including increasing investment in primary care and changing the way care is paid for to really
• Issue number four: the long-term care payment transparency staffing.
• coverage waiting periods from health facilities, including clinics, hospitals, and long-term care facilities
• within a stable health care delivery system.

Keywords: 987, senate, all

Transcript Highlights:

• So, in long-term care, we get about a 50% match from the federal government.
• Um, in the next bar is the long-term care waiver and home care service set of services.
• And these are the traditional health care services excluding long-term care to that population.
• care waiver and bar is the long-term care waiver and home<00:04:19.519><c> care</c><00:04:20.079><c>
• care to that excluding long-term care to that population.<00:04:57.360><c> Again,</c><00:04:57.680><c

Keywords: 1183, house

Transcript Highlights:

• And as Chair Bernowski shared, I am the current chair of the Senate Health and Long-Term Care Committee
• I am the current chair of the Senate Health and Long-Term Care Committee, and I'm really pleased to co-chair
• , but the other is also the health care delivery system.
• but the other is also the health care delivery system.
• recruiting and training community workforce, embedding long-term care worker training and testing sites

Committee: Joint Joint Select Committee on Health Care and Behavioral Health Oversight

Summary: The committee met to hear introductory briefings from the Department of Health and the Health Care Authority on agency priorities, federal changes, and implementation challenges. Secretary of Health Dennis Worsham said his department’s listening tour is focused on strengthening governmental public health, improving health care quality and access, and responding to federal funding disruptions and the shutdown’s effects on programs such as WIC. HCA Director Ryan Moran said the agency is prioritizing coverage preservation, oversight of major contracts, affordability, behavioral health integration, rural health transformation, and internal agency operations. Members asked about licensure delays; Worsham said the backlog had been reduced from about four months to six weeks and should be caught up by January 1, with possible further process changes if needed. A major portion of the meeting focused on H.R. 1 and its Medicaid-related implementation. Governor’s health policy advisor Caitlin Stafford, HCA staff, and interim Medicaid Director Trinity Wilson said the state is working with DSHS, the Health Benefit Exchange, tribes, and other partners to prepare for eligibility changes, work requirements, and six-month redeterminations. They said the state expects up to 30,000 Apple Health enrollees could lose coverage under the law’s non-citizen eligibility changes, and that the work requirement/redetermination provisions could affect about 620,000 adults, with roughly 80,000 also enrolled in SNAP. HCA said it hopes to automate most verification, but about 15% to 20% of cases may require manual review, with technology costs estimated at up to $30 million. Staff also said they are trying to keep H.R. 1 implementation mostly in budget language rather than statute, and that communication and navigator support will be important to minimize confusion and coverage loss. The committee also received an update on the Rural Health Transformation Program created in H.R. 1. HCA said Washington submitted its application to CMS on November 5 after extensive stakeholder engagement, including more than 310 written comments, webinars, and tribal consultation. The application centers on six initiatives: rural hospital innovation, community care and prevention, tribal investments, technology and data, workforce development, and rural behavioral health. HCA said the state is likely to receive less than the full $200 million annual amount assumed in the federal program, and that an advisory committee may be created to help guide spending over the five-year program. Members asked about palliative care, small business impacts, and communication with enrollees; HCA said it expects to share outreach toolkits and that no 2026 statutory changes are currently anticipated, though that could change. The final panels covered organ donation and transplant services. Department of Health staff explained the 2023 “Lights and Sirens” law for organ transport vehicles, including licensing, driver qualifications, insurance requirements, and use of emergency lanes and traffic preemption; the department said one company is currently licensed and there have been no complaints. LifeCenter Northwest described the organ procurement process, the legal framework under the Uniform Anatomical Gift Act, and the rarity and complexity of deceased donation, noting Washington has seen strong growth in donation and transplants over the past decade. University of Washington Medical Center staff then outlined its transplant programs for kidney, liver, heart, lung, pancreas, and multi-organ transplants, describing the multidisciplinary evaluation and waitlist process and the coordination required with donor organizations and hospitals.

Transcript Highlights:

• First, H.R. 1 creates a new home equity limit for long-term care recipients.
• H.R. 1 creates a new home equity limit for long-term care recipients.
• and long-term care systems.
• Ultimately, costs would shift to acute care, shelters, or long-term care facilities rather than being
• , hospitals, and long-term care settings.

Summary: The joint informational hearing focused on the impact of H.R. 1 on older Californians and related county administration issues. Chair Jackson and Chair Addis opened by emphasizing California’s rapidly aging population and the need to protect seniors’ access to food, health care, housing, and in-home support services. Testimony from the Department of Social Services, Department of Health Care Services, and Department of Aging described how H.R. 1 would expand work and reporting requirements in CalFresh and Medi-Cal, increase redeterminations, and create new eligibility barriers. Witnesses and advocates warned that these changes could lead to large coverage losses, especially for adults ages 55 to 64, people experiencing homelessness, caregivers, and some immigrant groups, while also increasing administrative burden on counties. The LAO noted that many provisions do not directly apply to Californians 65 and older, but highlighted indirect effects and some direct impacts, including a new home equity limit for certain long-term care recipients and narrower immigration eligibility rules. Committee members pressed the administration and counties on how exemptions would be identified and implemented, whether data systems could automatically protect eligible people, and how outreach would reach older adults, women, LGBTQ seniors, and people with limited digital access. DHCS and CDSS said they are working to use existing data, cross-program information sharing, and human-centered communications to maximize exemptions and reduce churn, including text outreach, print and radio campaigns, and navigator support. Members also raised concerns about the need for legal aid and county eligibility workers to help people navigate complex rules, and requested updated analyses on the number of people likely to lose both Medi-Cal and CalFresh and the broader human and system impacts. No votes were taken. The second major topic was the administration’s proposal to shift some future IHSS costs to counties by establishing a statewide baseline for average authorized hours per case. CDSS said the proposal is intended to improve consistency in assessments and not reduce services, while counties and labor groups strongly opposed it, arguing that rising hours reflect real increases in need, an aging and higher-acuity caseload, and state-mandated assessment tools rather than county error. County representatives said the proposal would strain already limited local revenues, worsen the effects of H.R. 1, and could force cuts to other safety-net services. Committee members questioned the proposal’s timing and impact, but the hearing ended without action, with the chairs asking for continued updates, additional analysis, and more information before May Revision.

Transcript Highlights:

• It is a lifeline for the communities we serve, providing vital access to medical, dental, long-term care
• and long-term impact.
• Primary care is essential for a functional health care system.
• I think it's hard to quantify the long term because if you don't get preventive care, you just end up
• quality of our health care system.

Committee: House Health

Keywords: 988, house, all

Transcript Highlights:

• In the end, we were able to work with Gary to find him a long-term nursing facility placement.
• In the end, we were able to work with Gary to find him a long-term nursing facility placement.
• care in our health care system here in our state.
• And they are a key to preventing long-term hospitalization and higher-cost institutions.
• , and food insecurity these long-term survivors face.

Keywords: 995, all

Summary: The committee heard testimony on several aging-related bills, with most speakers focusing on housing stability, home-based services, and care transitions. Representative Badger and a commissioner testified in support of H4039, which would create a universal breakfast and lunch program at senior centers funded through a new Senior Breakfast and Lunch Fund, arguing it would reduce food insecurity and social isolation among older adults. Representative Lipper-Garabedian and multiple providers then supported H780/S495, the hospital-to-home partnership program, describing how embedded aging-services liaisons help older patients transition safely from hospitals to home, reduce readmissions, and avoid nursing facility placement; witnesses from Mystic Valley Elder Services and Mass Aging Access cited pilot results, including hundreds of patients served and examples of substantial cost savings and successful discharge planning. The committee also took testimony on S478, which would require continuing care retirement communities to disclose entrance-fee refund policies more clearly at enrollment. Senator Lovely and LeadingAge Massachusetts said the bill would improve transparency for residents and families, while a consumer witness said her family experienced delays and confusion in getting a refund after her mother left a CCRC. Members noted the issue is also being examined by a special commission on CCRCs. A large portion of the hearing focused on S475, a statewide bridge subsidy program for older adults facing housing instability. Advocates from the Massachusetts Coalition for the Homeless, Western Massachusetts, Somerville, Northampton, East Hampton, Old Colony Elder Services, and Somerville’s Office of Housing Stability described rising senior homelessness, long waitlists for subsidized housing, and cases where short-term rental assistance kept older adults housed while they waited for permanent housing. Somerville witnesses said the pilot program helped nine households remain housed and that some participants have since moved into permanent housing. Members asked about wait times, program design, and how to prioritize applicants; witnesses emphasized flexibility, emergency risk, and the need for a statewide expansion. The hearing also included testimony on S465, an ALS bill that would expand home care access regardless of age and bar the use of quality-adjusted life-year metrics in coverage decisions, with the sponsor and ALS Association arguing the measure would reduce discriminatory treatment and better center patient care. No votes were taken during the hearing.

Transcript Highlights:

• With Medicare not covering long-term care, few individuals with dementia have sufficient resources to
• Today, our Medicaid long-term care spending is split: 24% for people who want to live at home and 76%
• Seventy percent of those individuals will need some type of long-term care.
• Andrew talked about the disparity in that we spend about 24% of our money on our long-term care budget
• They also reduce long-term public cost.

Committee: House Appropriations

Keywords: 965, house, all

Transcript Highlights:

• Infrastructure: we're talking about small businesses that shape long-term outcomes, not short-term fixes
• Stable, nurturing child care programs reduce the likelihood of later crisis and lower long-term public
• The investment builds a system once, scales responsibly, and reduces long-term reliance on public dollars
• system for the long term.
• system for the long term.

Summary: The committee met to hear presentations on proposed uses of temporary Millennium Fund money for youth- and family-focused prevention programs. The chair opened by emphasizing that the funds are one-time and not ongoing, and that the committee would not make decisions at this meeting. Minutes from the prior meeting were approved before testimony began. Roger Sherman of the Idaho Children's Trust Fund described the fund’s statutory role in preventing child abuse and neglect and requested $682,000 for mid-sized grants to community organizations for child sexual abuse prevention, abusive head trauma education, parenting programs, family resource centers, and school-based family supports. Royal Lockhart of The Children’s Bridge proposed $3.5 million over four years for a shared-services model to stabilize child care businesses through software, coaching, bookkeeping, purchasing, and benefits access, arguing that stronger child care infrastructure supports prevention and family stability. Nancy Windmill of the Idaho Safety Assessment Center Coalition requested $1 million for 12 youth assessment centers, citing diversion and early intervention outcomes for youth facing substance use, behavioral, or mental health crises. Sonia Howerton of the Idaho Network of Children’s Advocacy Centers asked for $3 million in bridge funding for 10 children’s advocacy centers, explaining that declining federal funds and prior one-time state support created a sustainability gap. Ross Edmunds of the Department of Health and Welfare requested $150,000 for a 10th recovery community center, the Upper River Youth Leadership Council in Kamiah, noting that the department now serves as the pass-through and accountability entity for existing recovery centers under prior intent language. Representative Jordan Redmond also presented a proposed $5 million statewide drug-use awareness campaign through the Office of Drug Policy, with research, survey work, and multi-platform media buys to test and refine messaging. Members asked about grant criteria, referral networks, sustainability, oversight, and coordination with state agencies; presenters generally described extensive application processes, multidisciplinary collaboration, and plans to transition toward earned revenue or state oversight. The chair closed by reiterating that the Governor’s recommendation already includes $150,000 for recovery centers and that the Governor has proposed $25 million from the Millennium Fund, limiting available funds, and said the committee would reconvene later for further discussion.