Transcript Highlights:

• because they aren't civilly committed or because we have not provided appropriate access to supportive long-term
• with the law, where courts, attorneys, clinicians, they rely on OSH for evaluations, restoration, long-term
• psychiatric care, transition of that long-term psychiatric care to translate into community and public
• acute care system.
• , but they do need long-term ongoing support because they live with a serious and persistent mental illness

Keywords: 907, all

Summary: The joint Senate and House Behavioral Health committees held an informational meeting focused first on the Oregon State Hospital (OSH). OHA Director Sajal Hathi introduced the hospital’s incoming permanent superintendent, Sean Murphy, and praised interim superintendent Jim Deagle for stabilizing operations, restoring CMS compliance, and helping drive a culture change centered on safety, accountability, and transparency. Deagle and Chief Medical Officer Dr. Amit Bavon described OSH’s role as the state’s highest-level forensic psychiatric hospital, the patient populations it serves, its partnerships with courts, counties, jails, hospitals, and advocates, and recent leadership changes across the hospital. They also reported improved accreditation and regulatory status, including Joint Commission accreditation and CMS compliance, and said the hospital is now using daily safety huddles, incident review meetings, stronger escalation procedures, and revised seclusion/restraint practices to reduce risk and improve oversight. Members pressed hospital leaders on past seclusion practices, asking how prolonged seclusions could have occurred under federal standards. Leaders said they could not explain past decisions but emphasized that current leadership has changed processes, training, reporting, and oversight so that seclusion and restraint are reviewed in real time and cannot be normalized. Questions also covered staffing, falls, and future planning. OSH said it is generally staffed to budget, though it still has RN and mental health technician vacancies and is working on recruitment, training, and better staffing distribution. Hathi said the hospital is building a public dashboard with key performance and safety metrics, including workforce data, and described the long-term goal as a consistently safe, disciplined, high-functioning institution that responds quickly to mistakes and remains accountable to the public. The committee then shifted to an informational overview of civil commitment. Oregon Judicial Department representative Chanah Newell explained the civil commitment process, including who can initiate it, the role of community mental health providers and courts, the five-day timeline to hearing, and the standards for danger to self, danger to others, and inability to meet basic needs. She summarized changes made in House Bill 2005, including revised statutory language and new provisions allowing a second diversion period, but cautioned that the data are too early to show clear trends. Testimony from NAMI Oregon’s Chris Bonif and psychiatrist Dr. Stephanie Lopez argued that Oregon still relies too heavily on jails and state hospital commitments because the broader community system lacks enough treatment, housing, and less restrictive alternatives. They urged the legislature to focus on upstream services, supported housing, and possible outpatient commitment tools so people can receive treatment before reaching crisis. The meeting ended with acknowledgment that additional reports and follow-up discussions are expected, including on residential treatment capacity and related behavioral health system reforms.

Transcript Highlights:

• They lead to lost income, devastating medical bills, and long-term caregiving costs.
• , but at Boston Indicators we also wanted to look at how the law would impact the long-term financial
• into one's emergency savings can guard against long-term financial debt.
• Access to health insurance is a vital necessity that can guard against long-term financial ruin.
• , coherent, and long-term efforts, unquote, toward recruiting and retaining faculty and students from

Committee: Joint Joint Committee on Racial Equity, Civil Rights, and Inclusion

Summary: The Joint Committee on Racial Equity, Civil Rights, and Inclusion held a hearing on the impact of federal policy on the racial wealth gap in Massachusetts, with no bills heard. Chairs Bud Williams and Miranda opened by framing the issue as a structural, long-standing disparity affecting Black and brown communities, citing major gaps in wealth, income, housing, and opportunity. Members noted this was the fourth hearing in a series on federal impacts on racial equity, and public written testimony was invited by the posted deadline. Administration witnesses Secretary Lauren Jones, Secretary Kiami Mahania, and Assistant Secretary Juan Vega described how labor, health, and economic development policy intersect with wealth-building. Jones pointed to higher unemployment, wage gaps, and underemployment among Black and Latino workers, and highlighted ESOL, workforce training, MassHire, and skills-based hiring efforts. Mahania argued poverty drives poor health, linking medical debt, Medicaid instability, maternal health, and chronic disease to wealth loss, and said federal changes could worsen both health and wealth gaps. Vega focused on entrepreneurship and procurement, citing disparities in business ownership and revenue, and described state efforts such as small business technical assistance, founder pipelines, place-based grants, and the Business Front Door; members also pressed him on microbusiness definitions, supplier diversity, and whether state programs were reaching firms that had received prior grants. Nicole O’Bean of the Black Economic Council of Massachusetts testified that Black-owned businesses face a hostile environment due to tariffs, DEI rollbacks, immigration enforcement, capital barriers, and federal funding cuts that reduce contracts from education, health care, and nonprofit sectors. She emphasized that certification alone is not enough and called for stronger inclusive procurement outcomes, better data, and more support for microbusinesses. Dr. Melissa Colon and Dr. Fabian Torres-Dal of the Mauricio Gaston Institute testified on Latino wealth gaps, especially low homeownership, high rent burden, limited access to credit, and occupational segregation; they said structural racism, wage gaps, and education inequities are central drivers and urged housing, labor, and education reforms. Committee members repeatedly linked the hearing’s themes to redlining, medical debt, single-parent households, financial literacy, and the need for legislation and state programs to close the gap, but no votes or formal actions were taken.

Transcript Highlights:

• The in-home supportive services program, or IHSS, is a cornerstone of California's long-term supports
• The state's goal to keep more people and move more people off of long-term institutional care into IHSS
• It would have cost the system more. No one will ever care for our children the way we do.
• to wait too long because you don't want a computer system to get stale and then have to pay more money
• Furthermore, it eliminates long waiting lists and makes the system more efficient.

Summary: The subcommittee heard an overview of the governor’s IHSS budget proposals and extensive testimony from the Department of Social Services, Department of Finance, the Legislative Analyst’s Office, county representatives, labor, consumer advocates, and advocates for older adults and people with disabilities. The administration described IHSS as a large and growing program serving more than 900,000 recipients, and outlined three proposals: shifting the cost of growth in authorized hours per case to counties, eliminating the backup provider system, and aligning IHSS terminations with Medi-Cal terminations. The LAO said the overall budget estimates appeared reasonable but raised concerns about the hours-per-case proposal, including the lack of a comprehensive root-cause analysis, the limited control counties have over statewide cost growth, and uncertainty about how the baseline and savings would work. CWDA, SEIU, and consumer advocates strongly opposed the hours cost shift, arguing that counties use state-designed tools, that demographic changes and rising need explain much of the growth, and that the proposal would pressure counties to cut services and destabilize care. The chair and members repeatedly questioned the administration about the proposed baseline, the claimed savings, and whether the measure effectively circumvents the county maintenance-of-effort agreement. On the backup provider system, the administration said the statewide program is underutilized and administratively expensive, and proposed eliminating it to save about $3.5 million. The LAO suggested the Legislature consider whether administrative costs could be reduced while preserving some version of the program. County and consumer advocates opposed the cut, saying the system is a critical safety net when regular providers are unavailable, especially in rural areas and for people with complex needs. They argued that low utilization reflects the difficulty of finding emergency backup care, not lack of need, and that many counties already rely on local backup systems or other models. Committee members also pressed for better data on requests, fulfillment, and administrative costs, and discussed whether the state could support local alternatives instead of eliminating the program. The final topic was the proposal to align IHSS terminations with Medi-Cal terminations by automating the process when recipients fail to complete Medi-Cal redeterminations. The administration said this would reduce General Fund costs by about $86 million by preventing payment of IHSS in the residual program when recipients are no longer eligible for Medi-Cal, while also automating reinstatement when Medi-Cal is restored. The LAO noted the proposal has been rejected in prior years and suggested improved notice and communication to recipients as an alternative. CWDA and advocates warned that the change could create gaps in care, especially for people who lose Medi-Cal for procedural reasons, and urged additional safeguards such as better notices, faster reprocessing, and automatic reinstatement. Members questioned how many people would be affected, how the residual program currently works, and whether providers could go unpaid during the gap; the department said the automation is already built and would be activated if the proposal is approved. No votes were taken during the discussion, and the committee moved through public comment and questioning without final action on the proposals in the excerpt provided.

Transcript Highlights:

• costs the health care system more.
• That lack of coverage delays recovery, increases long-term health care costs, and reduces workforce participation
• institutional care. ...to their homes and to their communities rather than long-term institutional care
• That lack of coverage delays recovery, increases long-term health care costs, and reduces workforce participation
• system of care in Massachusetts.

Committee: Joint Joint Committee on Financial Services

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a lengthy public hearing with testimony on a wide range of health insurance and access-to-care bills. Early testimony focused on prescription drug pricing and pharmacy reimbursement, with supporters of H. 1326 arguing that pharmacy benefit managers and MassHealth managed care arrangements reimburse independent pharmacies too little, contributing to pharmacy closures and “pharmacy deserts.” The committee also heard repeated support for H. 1151/S. 742 on cognitive rehabilitation for acquired brain injury, H. 1288/S. 716 on telehealth parity for nutrition counseling, H. 1309/S. 761 on full-spectrum pregnancy care without cost-sharing, H. 1312 on insurance coverage for doula services, H. 309 on prompt access to health care by removing deductibles for certain services, H. 809/H. 1227 on biomarker testing, H. 1162/S. 810 on reducing inequities in access to medical procedures by limiting insurer cuts tied to Modifier 25, and S. 726 on insurance coverage for mobile integrated health. Testifiers included legislators, physicians, pharmacists, dietitians, emergency and rehabilitation clinicians, and patients and family members. Supporters of the brain injury bill said cognitive rehabilitation is medically necessary, improves long-term outcomes, and can reduce institutional care and public costs; they noted the bill has been heard repeatedly and has support from the Brain Injury Commission and prior favorable committee action. Supporters of the pregnancy care and doula bills described out-of-pocket costs as a barrier to maternal health and shared personal stories of high bills and unmet support needs. Biomarker testing advocates and cancer patients said coverage gaps deny patients access to precision treatment, can lead to avoidable suffering, and should be standardized across insurers; several speakers said insurers often deny claims despite clinical benefit. Dermatology witnesses said insurers’ use of Modifier 25 cuts reimbursement for same-day evaluation and procedure visits, forcing separate appointments and increasing patient burden. Mobile integrated health supporters described home-based care as a way to reduce emergency department use and hospital readmissions, especially for patients with transportation or mobility barriers. No votes or formal committee actions were taken during the hearing itself.

Transcript Highlights:

• need today in our health care system.
• need today in our health care system.
• need today in our health care system.
• need today in our health care system.
• need today in our health care system.

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• — shifts the long-term cost to emergency care, the county indigent health systems, and providers we
• $2,000 to $3,000 in health care costs in terms of prescriptions.
• system. ...strains on hospitals and the health care system.
• And it's short-term, how long can we get that exemption for?
• We also urge the legislature to consider long-term sustainable revenue solutions.

Summary: The Senate Budget and Fiscal Review Subcommittee held an oversight hearing on the impacts of H.R. 1 on California’s safety net, focusing on Medi-Cal and CalFresh. The chair and vice chair framed the issue as a major federal disruption that would reduce benefits and shift costs to the state, counties, hospitals, and other local systems. The first panel included the Legislative Analyst’s Office, the Department of Finance, the UC Berkeley Labor Center, and the Food Research and Action Center, each describing projected enrollment losses, higher state and county costs, and implementation challenges. The LAO outlined H.R. 1’s main changes: new and expanded work requirements, more frequent eligibility redeterminations, restrictions on certain non-citizen eligibility, and financing changes affecting provider taxes and federal matching rates. The LAO estimated that 1 to 2 million people could be disenrolled from Medi-Cal and more than 600,000 could lose CalFresh, with additional costs from reduced federal support and possible state and county administrative burdens. The Department of Finance said the Governor’s budget includes about $1.4 billion General Fund in 2026-27 to respond to H.R. 1, with larger out-year reductions in federal funds and projected Medi-Cal caseload losses of up to 2 million by 2029-30. The UC Berkeley Labor Center projected up to 3 million Californians could lose full-scope Medi-Cal by 2028 when H.R. 1 is combined with state budget changes, while noting the state could choose policies that would reduce some of those losses. The Food Research and Action Center warned that CalFresh cuts and time limits would increase hunger, worsen health outcomes, and strain local economies and emergency systems. Members questioned the witnesses about procedural disenrollments, regional variation, the overall growth in Medi-Cal spending, the future of the MCO tax, the CalFresh error rate, and the downstream effects on hospitals and county indigent care. Several senators argued that the federal law was driven by tax cuts for high-income earners and would disproportionately harm low-income Californians, immigrants, and communities of color. Administration witnesses said some impacts are still being analyzed, that counties and departments are working on implementation, and that the Legislature may need to use statute, reporting, and oversight tools as federal guidance develops. No votes or formal actions were taken during this portion of the hearing.

Transcript Highlights:

• We have a supervisor who... he's been in our system a lot of care... For a while.
• On page I'm not sure which page it is, but on the next page, potential long-term care.
• Now that we have to make decisions about today, so with regards to potential long-term impacts, Madam
• model of practice, can be implemented in their systems—in their behavioral health care systems.
• I will also, though, add that as somebody who's worked in this space for a long time, care management

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• ongoing care, not short-term fixes that end the moment someone appears stable.
• care, consent to treatment, maintain coverage, and navigate very complex systems.
• , whether it be the county behavioral health system or the managed care system, are hot-warm handoffs
• No more propping up the managed care plan systems for their, you know... ...stuff.
• And yet mobile crisis is foundational to our behavioral health care system.

Keywords: 988, house, all

Transcript Highlights:

• and supportive services to veterans at the long-term care and independent living facilities in Chelsea
• The home continues to set a high standard for veteran long-term care, utilizing innovative practices
• Our staff care for 231 veterans in both the long-term care and domiciliary program.
• with an average of 6.37 hours of direct patient care per day in our long-term care setting.
• Department of Veterans Affairs conducted its annual long-term care survey.

Committee: Joint Joint Committee on Ways and Means

Keywords: 995, all

Summary: The hearing opened with remarks from Senate Chair Robyn Kennedy and House Chair Chynah Tyler, who emphasized that the fiscal year 2026 hearing was focused on the Health and Human Services budget, asked members to keep questions budget-related, and noted that no public testimony would be taken. They also highlighted the choice of Doherty Memorial High School as the venue to showcase Worcester’s investment in career and technical education. Committee members then introduced themselves before the first panel, the Executive Office of Veterans Services and the state veterans homes, began testimony. Secretary John Santiago said the governor’s FY26 proposal would support implementation of the HERO Act, which he said is now about 95% implemented, including higher disabled veteran annuities, expanded behavioral health benefits, and other service expansions. He described efforts to reduce veteran homelessness, including nearly $20 million in ARPA-funded housing and outreach initiatives, and said the agency has delivered more than 100,000 supportive services to nearly 8,500 veterans. Leaders from the Chelsea and Holyoke veterans homes reported on staffing, quality measures, electronic medical records, and major construction projects at both facilities, including a new Chelsea campus and the new Holyoke home. Members asked about funding transfers, geographic equity in access to the homes, outreach to women veterans and veterans of color, suicide prevention, Gold Star family support, and the impact of federal uncertainty; Santiago said the homes are now licensed and certified, that the current budget is sufficient, and that the agency is expanding engagement and data collection. The second panel, the Office of the Veteran Advocate, testified that its FY26 request is about $3.3 million, up from the current $2 million, to cover staffing, a larger office, and higher technology costs. Veteran Advocate Bob Notch said the office is a new independent oversight agency created in 2022 to examine systems, coordinate with local veteran service officers, and investigate fatalities or serious harm involving veterans in state care. He said the office’s work depends on research, data, and collaboration with other agencies, and that current funding is only enough for minimum operations. In response to questions, Notch and Deputy Commissioner David O’Callaghan discussed the difficulty of tracking veteran suicides, the need for better data across agencies, and the office’s role as an oversight body rather than a direct service provider. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• long-term care coverage, preserves programs for senior care, preserves health care for people with disabilities
• While it may offer short-term savings, it jeopardizes the long-term sustainability of the service system
• While it may offer short-term savings, it jeopardizes the long-term sustainability of the service system
• While it may offer short-term savings, it jeopardizes the long-term sustainability of the service system
• While it may offer short-term savings, it jeopardizes the long-term susceptibility of the service system

Summary: The Assembly Budget Committee heard opening remarks on the 2025 Budget Act, which will be amended into AB 101 and SB 101 for floor consideration. Committee leaders described the budget as a difficult compromise shaped by a $12 billion deficit, federal funding uncertainty, wildfire impacts, and rising out-year costs, while emphasizing a balance between compassion and fiscal responsibility. Each budget subcommittee chair then summarized major actions in their areas, including health care, human services, education, climate and transportation, housing and state administration, public safety, and oversight/transparency. Key policy items included delaying or narrowing some of the Governor’s proposed cuts, especially in Medi-Cal and other safety-net programs; preserving funding for dental care, women’s health, family planning, hospice, long-term care, IHSS, and services for undocumented Californians; and maintaining or expanding child care, foster care, food banks, and CalWORKs-related supports. Education actions included additional Proposition 98 settle-up, reduced deferrals, support for TK-12, teacher recruitment, literacy, mental health, preschool slots, and restored funding for UC and CSU. Other major items included housing and homelessness investments, wildfire and disaster response funding, transit loans and greenhouse gas reduction fund support, Proposition 36 and VOCA-related public safety funding, and oversight measures on federal impacts and state efficiency. Department of Finance and Legislative Analyst staff said the package makes some of the same savings moves as the May Revision but relies more on internal borrowing and fewer reductions, leaving a smaller reserve than the administration’s plan but still maintaining roughly $11 billion in the rainy day fund. Members from both parties largely supported the package while raising concerns about long-term sustainability, Medi-Cal costs, reserve use, and the need for future revenue and program review. The committee adopted the subcommittee actions by roll call, 18-6, with the roll held open for absent members and additional comments continuing after the vote.

Transcript Highlights:

• transition to Harbor Heights now with the opening of that new facility, but that's not intended to be a long-term
• So it's really not intended to be a long-term placement.
• We do acknowledge and work to prevent further system involvement and guard against collateral or long-term
• So our care is increasing, the quality of care is increasing, and we think part of the number of Care
• and long-term benefits of early intervention and reduction in poverty as adults, ECAP is fully integrated

Summary: The committee began with a work session on juvenile rehabilitation institution capacity, services, and staffing. DCYF Assistant Secretary Jennifer Redmond described overcrowding at Green Hill School and Echo Glen, driven by longer adult-style sentences extending past age 25, limited community placements, and small facility sizes. She said Green Hill remains above safe operating capacity, but staffing, injuries, large-scale aggression, and use-of-force incidents have improved over the past year. She also discussed Harbor Heights, a new 46-bed flex facility that had opened with 22 youth and would expand once a medical trailer arrives, as well as community transition services, vocational programming, behavior management reforms, and a request for more resources for mental health-focused facilities and staffing. Members asked about success metrics, developmental disability screening and supports, college access at Echo Glen, Mission Creek planning, and gender-responsive programming; Redmond said JR uses assessments, family involvement, and specialized living units, and that some requested funding had already been secured for returning a girls’ program at Echo Glen. The committee then heard from Team Child and the Youth Action Coalition. Greta Schultz said youth perspectives should guide system reforms and identified key concerns: overuse of sentence extensions, underuse of community transition services, continued criminal referrals from Green Hill to Lewis County, limited family contact, inadequate mental health access, and unequal education opportunities, especially for young women at Echo Glen. Justella Gonzalez, a former system-involved youth, said her time in county and state facilities was harmful, with staff mistreatment, poor education, limited therapy access, and humiliating restraint practices; she also said girls at Echo Glen lacked the same college opportunities as boys at Green Hill. Committee members asked for follow-up on county versus state experiences and on telehealth mental health services. The next presentation covered county-level services for youth involved or at risk of involvement with the justice system, led by juvenile court administrators Christine Simon-Smeyer and Judge Rachel Anderson. They outlined the juvenile court continuum from prevention and truancy work through diversion, detention alternatives, community supervision, and disposition alternatives, emphasizing evidence-based, trauma-informed, and restorative practices. Clark County was used as an example of a court that partners closely with schools and community providers, uses risk assessments and wraparound behavioral health probation, and offers detention alternatives without electronic home monitoring. They said most courts do not use detention for status offenses, but instead use court involvement to connect youth to services. They also described funding, noting that courts rely on a mix of state block grant and local dollars, and that recent cuts to early intervention funding reduced programming and staff hours. Members asked about detention for truancy, developmental disability identification, restorative justice practices, and the juvenile block grant. Finally, DCYF Assistant Secretary Nicole Rose and Katie Warren of the Washington State Association of Head Start and ECAP discussed child care and early learning impacts from recent policy and budget changes. Rose said Fair Start for Kids investments had increased child care access, provider participation, and kindergarten readiness, with more than 60,000 children in Working Connections care and rising ECAP enrollment and provider capacity. She said recent reductions will raise most family copays in 2026, delay eligibility expansions, eliminate some expanded eligibility categories, reduce ECAP slots by about 3,000, delay entitlement timelines, and cut provider supports such as rate increases for centers, complex-needs grants, trauma-informed and dual-language incentives, and infant/early childhood mental health consultation. Warren emphasized ECAP’s role in family stability, workforce participation, and reducing poverty, and noted its two-generation approach to supporting both children and parents.

Transcript Highlights:

• At the same time, child care and long-term care costs consume large shares of family budgets, making
• versus long-term.
• system, with 64% of all voters saying that our health care system needs major reform.
• It would include medical, dental, hearing, vision, mental health, reproductive, and long-term care.
• We purchase with long-term contracts.

Committee: Senate Labor, Public Employment and Retirement

Summary: The Senate Labor and Public Employment Committee held an oversight hearing on federal policy impacts on California’s labor market. In opening remarks, the chair argued that federal actions, including immigration enforcement, tariffs, and cuts to safety-net programs, are harming workers, employers, and communities, and said the committee wanted to document impacts and identify state responses. The first panel featured economist Enrique Lopez Lira of UC Berkeley, who described slow job growth, wage pressures, high housing and care costs, and the large share of California workers in low-wage jobs. He said federal cuts to Medi-Cal and SNAP/CalFresh and increased immigration enforcement would worsen insecurity, especially in health care, retail, hospitality, agriculture, and care work. The chair asked about recession indicators, middle-wage stagnation, and which sectors rely most on safety-net programs, and Lopez Lira said worker organizing and unions were a source of hope. A second panel focused on federal immigration enforcement. UC Merced’s Edward Orozco Flores presented research finding that private-sector employment in enforcement-targeted states fell during escalated enforcement periods, with California experiencing unprecedented declines in 2025. He urged policymakers to consider wage-replacement or stimulus-style support for affected workers, including excluded workers who cannot access unemployment insurance. Shannon Sedgwick of the Los Angeles County Economic Development Corporation said undocumented workers are deeply embedded in the county economy, generating substantial economic activity and supporting over a million jobs. She reported that intensified enforcement in Los Angeles County was associated with business disruptions, reduced sales and customer traffic, workforce instability, lower transit ridership in vulnerable areas, and losses from the downtown curfew. Committee members asked about impacts on small businesses, tax revenue, and recovery, and witnesses pointed to local resiliency funds, business toolkits, and know-your-rights efforts as partial responses. The hearing then heard from worker representatives. Flore Melendres of the Clean Car Wash Worker Center said car washes have been heavily targeted by federal agents, with hundreds of workers taken from workplaces, many businesses disrupted or closed, and workers living in fear; she urged support for AB 2271 to provide financial benefits to families who lost income because of DHS activity. California Nurses Association president Michelle Gutierrez-Vos said H.R. 1’s Medi-Cal and Covered California cuts threaten hospital finances, jobs, and patient care, and she backed CalCare (AB 1900), a hospital closure moratorium, and more support for nursing education. UAW 4811 president Rafael Jaime said federal research cuts are putting UC research funding and postdoctoral jobs at risk and endorsed SB 895, a proposed bond measure for health and scientific research. AFGE representatives Wallace Wade and Kendrick Roberson described the strain on federal workers during shutdowns, unpaid work, staffing losses, and the effects on TSA, Social Security, VA services, and worker housing stability; they supported SB 1155 to protect federal workers from eviction. Committee members thanked the witnesses and said the testimony showed both the human and economic consequences of federal policy. In the final panel, employer groups began responding to the same federal pressures. California Retailers Association president Rachel Michelin said retail is a major private-sector employer and a key entry point for young workers, and that retailers are seeing the effects of rising costs, supply-chain shifts, and consumer pressure at the checkout counter. The hearing continued with additional employer testimony beyond the provided excerpt.

Transcript Highlights:

• MU Health Care, as a part of the university system, we generally... ...health care as a part of the university
• missions of the health care system.
• So we're not the largest health care system in the state.
• , which in the long run... ...or inadequately treated due to lack of access to care, which in the long
• Preserving access to care is therefore inseparable from preserving the long-term viability of the community

Committee: House Special Committee on Rural Issues

Summary: The committee first met in executive session on House Bill 1714, adopting an amendment that clarified the bill would not apply to hunting dogs or animals not under direct control of the hunter and would not affect a specified section of law. The committee then rolled the amendment into a House Committee Substitute and voted the substitute do pass, with the roll call showing passage. The committee then heard House Bill 317, which would authorize MU Health Care to collaborate with hospitals and providers in a 25-county area and seek state-action antitrust immunity for those transactions. The sponsor and MU Health Care testified that the bill is intended to help preserve rural hospitals and keep care local, citing multiple hospital closures in Missouri and examples from Alabama and other states. Supporters from MU Health Care, rural hospitals, and local business and health leaders described the bill as a way to stabilize struggling facilities, maintain emergency access, and protect rural economies. Opponents, including the Missouri Insurance Coalition and the Missouri Health Plan Association, warned that the bill could codify monopoly power, raise prices, and reduce competition, and argued that the language was too broad and not limited to distressed hospitals. Some committee members also raised concerns about antitrust immunity, facility fees, market share, and whether the bill should be tightened to ensure voluntary participation and clearer limits. No vote was taken on House Bill 317 before the hearing adjourned.

Transcript Highlights:

• We have now the Office of Ombudsman in Long-Term Care is here. Care is here.
• Our mission is to Long-Term Care.
• </c> Minnesotans receiving licensed long-term Minnesotans receiving licensed long-term care<00:18:18.280
• licensed long-term care setting, including<00:18:52.280><c> ICS.
• we</c><00:56:38.000><c> are</c> Long-Term Care just mentioned, we are Long-Term Care just mentioned,

Committee: Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• The last item I want to discuss is funding for the Health Care Connection System, also affectionately
• and move to an electronic health care system, which will improve quality and retention and all that.
• This funding will also strengthen respite care and expand access to education, information, and long-term
• care support, helping Florida's families care for their loved ones at home for as long as possible.
• They prioritize independence, dignity, ...emergency rooms you visit, long-term care settings in your

Summary: The Appropriations Committee on Health and Human Services heard a presentation on the governor’s proposed fiscal year 2026-27 budget for the health and human services silo, which totals $48.5 billion. Agency leaders outlined major requests for AHCA, APD, DCF, DOEA, DOH, and the Department of Veterans’ Affairs, including behavioral health redesign, Medicaid rate changes, developmental disability services, child welfare and opioid programs, senior services, cancer research, public health initiatives, and veterans’ facility and technology needs. The committee also received an overview of the overall state budget, which was described as $117.4 billion, up 1.1% from the current year. AHCA’s presentation focused on $71.6 million for a Medicaid behavioral health redesign, including funding for residential treatment, a serious mental illness waiver, and higher inpatient psychiatric rates for youth, plus $7.1 million to raise private duty nursing reimbursement in fee-for-service Medicaid, $2.5 million for the background screening clearinghouse, and $124.4 million for the Health Care Connection System (FX). APD requested funding to continue moving people off the pre-enrollment list and to support developmental disability centers, a new forensic facility, an electronic health record system, and higher operating costs. DCF highlighted $81.9 million for eligibility and system integrity, $187.5 million for opioid prevention and treatment, $35.5 million for community-based care lead agencies, and $72.7 million to expand behavioral health bed capacity, including 474 new beds at state hospitals. DOEA sought additional funding for Alzheimer’s services, home care, and community care for the elderly. DOH emphasized $278 million for cancer research and innovation, $5 million for food and product safety testing, $5 million for the Florida FIRST blood-on-ambulance initiative, and $5.7 million for a public lab feasibility study. Veterans Affairs requested funds for facility improvements, cybersecurity, and medication management equipment. Members asked detailed questions about several items, especially the proposed changes to the AIDS Drug Assistance Program (ADAP), which would reduce eligibility and the number of people served. Senators and public witnesses criticized the lack of transparency and urged the department to pause the changes and work with stakeholders; the Surgeon General said the issue was driven by funding constraints and federal changes, not a legal barrier, and that the agency was exploring alternatives. Questions also addressed the Office of Minority Health and Health Equity, the Kids Care/CHIP expansion implementation, the cancer research funding structure, and the timeline and cost of the FX system. Public testimony focused heavily on ADAP, with speakers warning that thousands could lose medication access and calling for community involvement and a review of the program’s finances. The committee adjourned after the presentations and questions, with no votes taken on the budget items during this meeting.

Transcript Highlights:

• , ALONG WITH THE ADDITIONAL MEDICAL AND LONG-TERM CARE SERVICES PROVIDED UNDER THE FLORIDA PROGRAM.
• WE CAN PROVIDE MEDICAL SERVICES, WE CAN PROVIDE LONG-TERM CARE SERVICES ANYWHERE IN THE STATE.
• HE WAS ENROLLED IN A LONG-TERM CARE PLAN FOR TWO YEARS, AND HE WAS ALSO ON THE PREENROLLMENT LIST FOR
• HIS CASE WAS NEVER DEEMED A CRISIS CASE AND IN THE LONG-TERM CARE PLAN, AND I WANT TO BE CAREFUL ABOUT
• IT IS HARD TO FIT THEM INTO THE LONG-TERM CARE MODEL AND SEND THEM TO A REGULAR ASSISTED FACILITY OR

Transcript Highlights:

• FOR THE SYSTEM OF CARE.
• PASCO PINELLAS REPORTING 67 TRANSITION TO A SAFE LONG-TERM PLACEMENT. 83% REDUCING AND 84 ENROLLED IN
• EVERYBODY IN THAT GROUP HAS HAD EXPERIENCE IN THE FOSTER CARE SYSTEM.
• GROWING UP IS CHALLENGING FOR ANY YOUNG PERSON AND FOR THOSE LEAVING CHILD CARE SYSTEM HAS MANY MORE
• CREATING A SUPPORTIVE ENVIRONMENT FOR THE YOUNG ADULTS TO HAVE LONG-TERM READINESS.

Keywords: 999, senate, all

Transcript Highlights:

• The largest workforce in long-term care is family caregivers.
• SEIU 775 is the union of long-term care workers.
• care, we are talking about, as you heard... ...long-term care.
• So, BHS Care needs in long-term care.
• Institutional long-term care.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• The last item I want to discuss is funding for the health care connection system, also affectionately
• This funding will also strengthen respite care and expand access to education, information, and long-term
• care support, helping Florida's families care for their loved ones at home for as long as possible.
• Think about the emergency rooms you visit, long-term care settings in your districts, the emergency rooms
• you visit, long-term care settings in your districts, the doctor's offices you frequent, and the families

Committee: Senate Appropriations Committee on Health and Human Services

Summary: The Appropriations Committee on Health and Human Services heard presentations on the governor’s proposed fiscal year 2026-2027 budget for the health and human services agencies. Kendall Kelly outlined the overall HHS budget at $48.5 billion, with AHCA accounting for the largest share, and agency heads then highlighted major proposals for Medicaid behavioral health redesign, APD waiver enrollment and facility needs, DCF child welfare, opioid, and mental health investments, DOEA funding for Alzheimer’s, home care, and community services, DOH funding for cancer research, public health initiatives, and lab capacity, and VA funding for facility improvements, cybersecurity, and medication management. Several members praised specific proposals, including increased reimbursement for private duty nursing, Alzheimer’s supports, and the Florida FIRST blood-in-ambulance initiative. Senators also questioned the proposed changes to the AIDS Drug Assistance Program (ADAP), with the Surgeon General explaining that the department expects a reduction in covered patients from about 30,000 to about 20,000 because of funding pressures tied to rebates, federal changes, and premium tax credit issues. Public testimony strongly criticized the ADAP changes, citing lack of transparency and warning that many patients could lose access to medications. Other questions focused on the Office of Minority Health and Health Equity, DCF’s substance abuse and mental health data dashboard, Kids Care/CHIP expansion implementation, APD bed and facility planning, and the FX Medicaid technology project. DCF said about $7 million is set aside for the dashboard system, and AHCA said the governor’s budget includes $124.4 million for FX maintenance and continued module development, with $13.5 million to begin claims processing work. The committee did not take a substantive vote on the budget presentations and adjourned after questions and public testimony.

Transcript Highlights:

• This bill provides a one-year extension of the skilled nursing facility quality assurance fee and long-term
• So long term, I think that's a solution—not just here, but across the board and so many things.
• is because it saves taxpayer money and because it makes the health care system better for everybody.
• We acknowledge a 2.01% increase in provider pay, but further immediate and long-term progress is needed
• We look forward to continuing with you on long-term revenue solutions that ensure corporations pay their

Summary: The Assembly Budget Committee met to consider the final three-party agreement for the 2026-27 state budget and 19 implementing bills, including two budget bill juniors and 17 trailer bills. Committee leadership and administration officials described the budget as a balanced plan that reduces out-year structural deficits, maintains large reserves, and makes major investments in health care, education, housing, child care, public safety, and other core services while also responding to expected federal cuts and fiscal uncertainty. The Department of Finance outlined the package’s major components, including Medi-Cal adjustments, education funding increases, higher education changes, child care and human services updates, housing and homelessness funding, energy and transportation provisions, and tax and general government changes. Members asked questions about several provisions, including CSU enrollment targets and turnaround plans, the Prop. 98 settle-up mechanism, the plastics market development payment program, housing accountability measures, NextGen 9-1-1 implementation, and veteran services. Staff and administration witnesses explained that the higher education language is intended to improve campus-by-campus reporting and oversight, that Prop. 98 settle-up would be finalized later through the statutory certification process, and that NextGen 9-1-1 now includes one-time funding, quarterly reporting, an independent technical review, and a state audit. Members also discussed the HAP homelessness funding increase to $900 million and the balance between accountability and timely distribution of funds. The most extended exchange centered on comparisons between funding for veterans and Medi-Cal/immigrant health coverage. Republican members argued the budget spends far more on undocumented immigrant services than on veterans, while Democratic members and Finance staff responded that the comparison was misleading because many veterans’ services are federally funded and the state budget also includes dedicated veteran support. The chair and other members emphasized that the budget reflects difficult tradeoffs and that the package protects vulnerable populations, preserves health care access, and advances affordability. No final vote was described in the excerpt, but members indicated support for the overall package and said they would support it on the floor.