Transcript Highlights:

• Investment in our health care system will also help prevent critical care from collapsing.
• Third, we need to expand funding for community-based organizations to provide direct services and act
• Third, we need to expand for community-based organizations to provide direct services to act as trusted
• This fund would ensure stability for essential services such as housing support, mental health care,
• , including direct case management and prevention services.

Summary: The Select Committee on Racism, Hate, and Xenophobia met to hear from Los Angeles County officials and community advocates about rising hate, discrimination, and xenophobia, with opening remarks emphasizing the need for stronger anti-hate infrastructure, community-based reporting, and state support. Assemblymember Lowenthal noted the broader economic and social impacts of discrimination, and the committee framed the hearing around understanding local conditions and identifying legislative responses. Los Angeles County Human Relations Commission Executive Director Robin Toma presented county hate-crime data showing record-high levels in 2024, with racial/ethnic hate crimes remaining the largest category and anti-Black hate crimes the most common. He also highlighted high levels of anti-Latino, anti-Jewish, anti-Muslim, anti-LGBTQ, and anti-transgender hate, the role of underreporting, and the county’s L.A. vs. Hate system for reporting and victim support. The Los Angeles County Sheriff’s Department said it uses hate-crime and hate-incident data to guide proactive patrols, community outreach, and training, and discussed the need to build trust amid immigration enforcement fears that discourage reporting. Community organizations described how current political rhetoric and federal immigration enforcement are intensifying fear and underreporting. LULAC called for multilingual, culturally competent reporting systems, prevention education, and stronger support for grassroots organizations. The Jewish Federation of Los Angeles described severe anti-Semitism, increased security costs, and the need for safe worship protections, security grants, and Holocaust education. The NAACP emphasized the continuing impact of anti-Black racism and the need for cross-community solidarity, while the Los Angeles LGBT Center highlighted rising anti-trans violence and urged funding for gender-affirming care, LGBTQ centers, and reauthorization of California vs. Hate. CHIRLA and CAIR California both described heightened fear among immigrants and Muslims, workplace discrimination, and the need for stronger civil-rights protections, data collection, and community-based reporting. No formal votes were taken. The discussion focused on policy ideas and funding priorities, including improved law-enforcement training, alternative sentencing or diversion for hate offenders, protections for houses of worship, and continued or expanded funding for California vs. Hate, Stop Hate, and related programs. Committee members and witnesses repeatedly stressed that hate is underreported, that words and leadership rhetoric matter, and that California should continue investing in prevention, response, and healing.

Transcript Highlights:

• Why were the gauges no longer in service?
• There is such a thing in a lot of regulatory structures—health care and various child care.
• language directing DHS.
• This legislature expects its direction.
• Agencies take direction from the legislature.

Keywords: 1185, senate, all

Transcript Highlights:

• I asked my two mayors in my district; they don’t care.
• Gentleman from 14, care to close the debate. I’ll make one point.
• We wanted to give clear direction to the courts and all parties.
• I don't know. the best direction for that child is achieved.
• We wanted to give clear direction to the courts and all parties.

Keywords: 989, all

Transcript Highlights:

• to improve access to care.
• I go out and talk to health care professionals.
• They're compelled to take care of these individuals.
• Do my constituents want health care? Do they want this rural health care funding?
• But it gives them the ability to take care of their own and also to take care of their own within their

Committee: Senate Health and Welfare

Keywords: 989, all

Transcript Highlights:

• The Office of Information Technology Services. We added that back in 2019.
• You see the unbilled services rate going down.
• to be reimbursed for those centralized services payments.
• And then the other part of that is the medical services contract.
• I'm a budget and policy analyst with Legislative Services.

Summary: The committee met as JFAC for a statewide budget overview and related process presentations. Keith Bybee of LSO walked members through the general fund outlook, emphasizing that projected revenues for FY 2026 and FY 2027 are below current budgeted spending, creating a structural imbalance that will require either budget reductions or use of one-time cash and reserve balances. He highlighted major statutory cost drivers over the last several years, including public defense, IT services, Medicaid expansion, public schools, and water resources, and reviewed cash reconciliation items, transfers, supplementals, rescissions, and the governor’s proposed use of various fund balances and interest earnings to help balance the budget. Members asked about the deficit, corrections costs, tax conformity timing, fire suppression deficiency funds, and whether stabilization funds should be used; Bybee stressed that the Legislature has options but must decide whether to rely on short-term money or make longer-term structural changes. Janet Jessup then explained the budget hearing process and the Legislative Budget Book, including historical summaries, fund analyses, organizational charts, five-year snapshots, performance measures, and enhancement/outcome reporting. Morgan Poloni followed with an overview of deficiency warrants and supplemental appropriations, explaining that deficiency warrants cover certain authorized expenses after they occur and are typically used for items like fire suppression or pest control, while supplementals adjust the current year appropriation and can apply to general, dedicated, or federal funds. She noted that deficiency warrant requests have grown in recent years, largely due to pest control, and that supplemental and rescission bills may require emergency clauses to take effect immediately. Francis Lippett presented on state health insurance costs, saying FY 2024 spending on health and dental insurance was $646.2 million and that costs are rising faster than in prior years. She explained how the state uses employee premiums, a sweep account, and reserve balances to stabilize the plan, and said the FY 2027 appropriation is expected to rise about 14 percent, with employee premiums projected to increase 7.3 percent to maintain the current 80/20 cost split. Members asked about why premiums are charged for benefit-eligible employees who decline coverage, how reserve targets are set, how school district employees fit into the state plan, and how the state selects its insurance carrier; the Division of Insurance administrator said the plan is administered by Regence under a multi-year contract and that the state will rebid the plan within the contract term.

Transcript Highlights:

• and authorized care for patients.
• Our member facilities employ LVNs to care for an elderly and disabled population, and these health care
• , major care disruptions, and unanticipated cost increases in health care, social service, and educational
• Amber King with LeadingAge California, representing nonprofit providers of care services and housing
• CCRCs could have LVNs providing care to nursing home-level residents in all three levels of their care

Committee: House Business and Professions

Keywords: 988, house, all

Transcript Highlights:

• or medical care to a child.
• It then goes on to say, including the right to direct the upbringing, education, health care, and mental
• With the acceptance, care because it says upbringing education, health care, and mental health of the
• So if they're directing the health care of the child free from government interference, are you saying
• We're talking about health care. We're not talking about health care.

Summary: The House began with prayer, the Pledge of Allegiance, and approval of the prior day’s journal by a 123-1 roll call vote. Members then spent time introducing guests, including physicians, sheriffs, students, interns, and school groups from several districts. The chamber also heard a personal privilege statement recognizing a member’s son’s birthday. On third reading, House Bill 1758, dealing with permanent daylight saving time in Missouri, drew debate over whether ending clock changes would improve convenience or create safety and health problems by leaving more commutes in darkness. Supporters argued it would align with public preference and reduce disruption, while opponents warned of circadian and safety concerns. The bill passed 107-31 with two present. The House then moved to perfection of House Bill 3329, which repeals expired or unused tax credits, and House Bill 3405, which reclassifies SALT/pass-through entity items as deductions rather than tax credits for reporting purposes; both were described as cleanup and efficiency measures and were perfected without opposition. The chamber then took up House Bill 2426, a broad parental rights bill covering medical, educational, privacy, and related decision-making for children, and a major amendment focused on individualized education plans (IEPs). Supporters said the bill and amendment strengthen parental involvement and require stricter judicial review, while opponents raised concerns about overbreadth, school district administration burdens, transparency requirements, and possible conflicts with existing law on truancy, medical care, and records. House Amendment 1 was adopted 98-25 with six present, and debate continued on the underlying bill with no final vote shown in the transcript excerpt.

Transcript Highlights:

• JFCS serves all communities, providing meals, mental health services, senior services, services to refugees
• Services to refugees, health care services, and so I tell these stories to highlight something critical
• The bill specifically aligns and modernizes the three advance planning tools: advance health care directives
• For small health care providers like community clinics to start providing or expand PrEP services.
• Licensed vocational nurses may perform limited respiratory care tasks and services and clarifies required

Summary: The Senate convened with prayer, the Pledge of Allegiance, guest recognitions, and several ceremonial presentations. Members welcomed Jack and Jill of America’s Far West Region and a large education bus trip from Senate District 15. The body also adopted SCR 151 designating May 2026 as ACL Injury Awareness Month, SR 105 declaring May as National Tennis Month, SCR 175 recognizing Behavioral Health Awareness Month, SCR 176 designating May as Small Business Month, and SCR 178 recognizing Jewish American Heritage Month. These resolutions drew broad support, with many senators speaking to the health, civic, economic, and cultural themes in the measures, as well as concerns about anti-Semitism, Islamophobia, and solidarity across communities. The Senate also confirmed three gubernatorial appointees unanimously: Siva Gunda to the California Energy Commission, Tony Sertich as Executive Director of the California Housing and Finance Agency, and Craig Snellings to the Workers’ Compensation Appeals Board. In addition, the chamber approved a motion to suspend Joint Rule 62(a) so the Committee on Local Government could hear AB 1768, after debate over the procedure and a roll call vote. On legislation, the Senate passed a series of bills on unanimous or near-unanimous votes, including SB 922 on local cost recovery for street damage from public service operations, SB 932 on litigation transparency, SB 1311 on updates to consumer affairs boards and licensing rules, SB 1143 on access to forensic interview recordings in child abuse cases, SB 1307 on clearing forged real estate documents, SB 1177 on high-speed rail reporting, SB 971 on community networks for older adults, SB 1400 on Alameda Health System governance, SB 1228 on existing outdoor advertising displays in former redevelopment areas, SB 997 on lien authority for a groundwater sustainability agency, SB 1115 on public cemetery district governance, SB 1088 on advance care planning forms, SB 1242 on family participation in CARE Court, SB 1364 on parental rights in rape-related custody cases, SB 993 on protecting mental health professionals’ identifying information, SB 1094 on prescription drug biosimilar use, SB 1117 on ADU fee calculations, SB 1244 on broker compensation disclosures for public agency health plans, SB 1315 on automated driving system software update reporting, and SB 1398 on recognizing Green Globes as an equivalent state building certification. Earlier, a motion by Senator Strickland to withdraw SB 1035 from committee failed on a 22-22 vote.

Transcript Highlights:

• background information, the Passport to Careers Program supports youth who experienced either foster care
• The Passport to Careers Program supports youth who experienced either foster care at the age of 13 or
• We also have scholarship and support services through Passport that are solely funded by the state.
• We also have scholarship and support services through Passport that are solely funded by the state.
• Like, no, we're using that to give direct cash grants to students. That's right.

Bills: SB5826 , SB5828 , SB5909 , SB5931 , SB5954 , SB5963 , SB6082 , SB6090

Committee: Senate Higher Education & Workforce Development

Keywords: medication abortion, public education, access, healthcare rights, postsecondary institutions, college grant, scholarships, higher education, private institutions, Washington State, undergraduate programs, enrollment, program review, public institutions, workforce education, accountability, oversight, administrative changes, investment, veterans

Transcript Highlights:

• The amendment defines direct patient care, generally meaning the provision of health care services directly
• The amendment provides certain other additional criteria for qualifying as direct patient care.
• patient care.
• patient care.
• from Smile Direct Club.

Summary: The Health Care and Wellness Committee heard executive action on seven bills, with discussion focused on prior authorization, the 340B drug pricing program, biosimilars, HIV drug coverage, exchange certification criteria, and hearing/speech board authority. Members also considered several amendments, including a date change to prior authorization reporting in SB 5395, a large striking amendment and multiple policy amendments on SB 5981, and market-criteria amendments on SB 6210. Testimony and debate centered on transparency, administrative costs, rural access, patient care spending, market stability, and the balance between state authority and federal law. SB 5395 on prior authorization received Amendment 247, which moved the carrier reporting deadline to the Office of Insurance Commissioner from January 1, 2027 to October 1, 2026, and was then reported out with a due pass recommendation. SB 5981 on 340B drug pricing adopted a striking amendment creating reporting and fee structures, but rejected amendments that would have removed filing fees, required 90% of revenues to go to direct patient care, limited additional contract pharmacies to rural or underserved areas, or delayed the bill’s effective date; the bill then passed out of committee 11-7. Supporters emphasized transparency and safety-net funding, while opponents raised concerns about federal preemption, litigation, costs, and administrative burden. SB 5594 on biosimilar substitution, SB 5877 on certified anesthesiology assistants and the physician health program, and SB 6183 on coverage of FDA-approved HIV antiviral drugs without utilization management all advanced with broad support and due pass recommendations. SB 6210 on health benefit exchange market factor criteria adopted a striking amendment but rejected amendments that would have limited updates to every two years, narrowly defined “meaningfully different,” or changed implementation timelines; it also passed 11-7. SB 6226 on the Board of Speech and Hearing adopted Amendment 313 to expand standards-of-care authority for hearing aid fitting and dispensing, then passed 17-1 after debate about patient safety, tele-audiology, and access to care.

Transcript Highlights:

• It's also our investments in the community, be it service to not-for-profit, service to research, service
• Not-for-profit, service to research, service to economic development.
• They don't care about you, and they sure don't care about me.
• This cut has a direct, immediate, and measurable impact on life-saving services for victims of domestic
• Just 10 full-time staff cover all direct services for a facility that operates... cover all direct services

Committee: House Budget

Keywords: 959, house, all

Transcript Highlights:

• </c> health care providers. health care providers.
• ' choices of who provides their medical care, including critically in rural areas where medical services
• </c><00:21:00.360><c> area</c> care services in any geographical area care services in any geographical
• </c> [clears throat] services. [clears throat] services.
• </c> service that we routinely use. service that we routinely use.

Keywords: 927, senate, all

Transcript Highlights:

• AB 1670, Arambula, Medi-Cal dental care, holding committee.
• AB 2470, Arambula, domestic violence services, holding committee.
• AB 1979, Bonta, AI and health care, do pass out on a B roll call.
• AB 2083, Jackson, child care special districts, held in committee.
• AB 2575, Ortega, AI and health care, do pass out on a B roll call.

Committee: House Appropriations

Keywords: 988, house, all

Transcript Highlights:

• Yes, sir, National Weather Service.
• Thank you for your service.
• But we have to be careful.
• Forest Service to the table on this.
• It's just setting up a standard of care, a clear standard of care for utilities.

Committee: House Water & Natural Resources Committee

Transcript Highlights:

• providers under the Arizona Department of Health Services.
• providers under the Arizona Department of Health Services.
• That is egregious, in my opinion, as a health care provider.
• This would exclude internet service providers, their affiliates, or cloud services from the responsibility
• This would exclude internet service providers, their affiliates, or cloud services from the responsibility

Summary: The meeting covered a very large number of bills across multiple committees, with most items presented on consent calendars and several sponsors explaining their measures. Education bills focused on moving statewide testing later in the school year, allowing paper testing by local choice, increasing transparency around district administrator pay, expanding religious excusal policies, creating a school fitness recognition program, and sending a resolution to voters to require sex-based designation of school sports teams and private spaces. Federalism and Government items included bans on foreign contributions to ballot-measure committees, a proposed ballot measure to eliminate voting centers and return to precinct-based voting, memorials urging withdrawal from the United Nations and the IMF, penalties for late agency financial reporting, restrictions on state contracts with China, and a bill limiting use of ADS-B aviation data for fee collection. Commerce bills addressed digital goods disclosure, child influencer trust accounts, liability for river outfitters, marketplace contractor termination rights, utility submetering charges, unemployment eligibility checks, and association-based health plans. Health and human services measures included lactation consultant certification and Medicaid breastfeeding support, a ban on gender transition procedures for minors, a requirement that chief medical officers hold active licenses, technical ambulance definitions, a SNAP waiver request to restrict non-eligible food purchases, hospital collection of patient immigration status, and enrollment verification for AHCCCS-related hospital presumptive eligibility. Judiciary bills included consent-verification requirements for online sexual material, a civil cause of action for DEI policy violations, hate-crime-style enhancements that also cover political affiliation, name-change disclosure rules for sex offenders, penalties for possession of falsified commercial driver’s licenses by unlawfully present persons, penalties for mailing abortion-inducing drugs, speed-inhibiting devices as an alternative to license suspension, longer transition services for inmates, stronger penalties for sexual extortion of minors, and legislative oversight of state shooting range closures. Natural resources and water bills dealt with brackish groundwater recovery and desalination studies, water augmentation authority financing, HOA drought-year watering restrictions, water-rate parity for customers outside city limits, and groundwater transportation from the McMullen Valley basin. Other topics included a ban on PFAS firefighting foam, restrictions on vaccine and mask mandates by governments and businesses, protections against employment or service discrimination based on medical interventions, elimination of long-vacant state positions, consumer protections against device disabling after owner modifications, and restrictions on Chinese-made critical infrastructure. The committee also heard a Space Commission update bill and a continuation of the Arizona Beef Council. Several bills were pulled from consent or flagged for amendments or legal concerns, including the testing-window bill, student directory information bill, river outfitter liability bill, ambulance bill, and others. No final floor votes were taken in the transcript, but many bills were advanced on third-read or consent calendars, while a few were set aside for amendments or further discussion.

Transcript Highlights:

• We will hear from representatives of EMERGE to discuss issues with health care services for juvenile
• /c><01:04:22.640><c> facilities</c><01:04:22.960><c> that</c> care services 247 at the facilities that
• care services 247 at the facilities that need<01:04:23.359><c> them.
• Right now we're being asked to provide health care services in the form of nurses, nurse practitioners—things
• Right now we're being asked to provide health care services in the form of nurses, nurse practitioners—things

Keywords: 958, all

Summary: The subcommittee heard presentations from the Legal Aid Network of Kentucky, including Legal Aid of the Bluegrass, Kentucky Legal Aid, AppalRed Legal Aid, and the Legal Aid Society in Louisville. The presenters explained that the four nonprofit programs provide civil legal services in all 120 counties, focusing on low-income clients and matters such as domestic violence, family law, housing, expungement, public benefits, and veterans’ issues. They emphasized that they do not handle criminal defense cases and described statewide efforts such as the kyjustice.org website and Project Renew, which helps people in recovery with legal issues that affect stability, employment, housing, and family reunification. Each organization highlighted regional service challenges and examples of casework. Legal Aid of the Bluegrass described its 33-county service area, its mobile “justice bus,” and expungement work for people in recovery. Kentucky Legal Aid focused on disaster response after the December 2021 tornadoes, including insurance disputes and contractor fraud, and said it has continued to handle repeated FEMA-declared disasters. AppalRed described serving 37 rural counties with limited attorneys, the shortage of lawyers in “rural legal deserts,” and its disaster-response work after flooding and tornadoes, including FEMA appeals clinics and volunteer attorney support. The Legal Aid Society described its Louisville-area veteran services, including Social Security and VA disability cases, veterans treatment court referrals, and homeless outreach. Committee members praised the organizations’ work and noted the importance of their services. In response to questions about funding, the presenters said their support comes from a mix of Legal Services Corporation funds, state appropriations, federal grants such as VOCA, VAWA, and HUD, United Way, and foundation funding. They stressed that many grants are restricted, while state funding is more flexible and useful for emergencies and day-to-day operations. The presenters said current funding does not fully meet demand and requested an increase in the General Assembly’s appropriation from $500,000 per year to $1 million per year, or $2 million over the biennium.

Transcript Highlights:

• Licensure Compact for EMS Services, which are Emergency Services. Personnel.
• The purpose of which is to help increase the access that people in New Mexico have to health care services
• Mexico have to health care services. In this case, it happens to be the emergency services.
• So that they're all the direct services are not Housed contracts or grant arrangements with non-profit
• All of our youth deserve certain levels of care, access to services, and such.

Committee: Senate Senate Health & Public Affairs

Keywords: 996, all

Transcript Highlights:

• The bill before you today directs OSPI and educational service districts to collaborate and coordinate
• I would say no, because they're directed to look at existing policies.
• and direct coaching to my faculty teams in public school since 2020.
• So it's really a good step in the right direction.
• How do we make sure that we're working together and not working in separate directions?

Summary: The committee held public hearings on three K-12 bills focused on behavioral health, literacy, and review of education mandates. On House Bill 1634, staff and Rep. Milin Tai described a framework for OSPI and educational service districts to coordinate with state and local partners on behavioral health technical assistance and training for schools, aligned with the Washington Thriving prenatal-to-25 plan. Testifiers, including students and education/behavioral health representatives, said the bill would improve coordination, early intervention, and access to supports for students and families. The bill was presented as having no fiscal note because it relies on existing funding, and testimony emphasized parent and student engagement in the framework. On House Bill 2636, staff and Rep. Skyler Rude explained that the bill creates a Public Education Review Steering Committee to identify existing policies and funding provisions for JLARC review, with the goal of determining whether they achieve intended outcomes, improve student performance, are cost-effective, and should be maintained, modified, or repealed. Supporters said the bill is intended to help reduce burdensome or ineffective requirements on school districts and free resources for students, while some members questioned how the committee would define policy and whether it could affect future mandates. A representative of the Washington State School Directors Association supported the concept as a meaningful review of unfunded mandates. The committee also heard House Bill 1295, which would require evidence-aligned literacy curriculum updates after 2027, require comprehensive K-4 literacy programs using structured literacy practices, direct PESB to revise literacy endorsement standards, require literacy-related continuing education, and direct OSPI to develop educator literacy training. Supporters, including parents, educators, students, dyslexia advocates, and district staff, argued that structured literacy is supported by research and would improve outcomes for struggling readers and students with dyslexia. One witness from the Washington Education Association supported the bill but raised concern about adding another continuing-education requirement. Testimony on the bill was extensive and largely in favor, with some discussion about whether the approach would address older students and how it would interact with existing district and ESD efforts. After public hearings, the committee moved into executive session and approved three gubernatorial appointments for confirmation recommendation. It adopted an amendment to House Bill 1796 and advanced the bill to Ways and Means, passed Engrossed House Bill 2317 to Rules, and adopted a striking amendment to Substitute House Bill 2594 before advancing it to Ways and Means. All actions were taken by voice vote, with no opposition recorded.

Transcript Highlights:

• She chose a life of service.
• </c> bill is to have clear clear direction bill is to have clear clear direction from<00:14:48.760><c
• </c> to take care of that at the beginning. to take care of that at the beginning.
• Can you give us the number of personnel in the Veterans Services, the Veteran Health Care, and then in
• ><c> Health</c><00:35:06.600><c> Care,</c> the Veteran Health Care, the Veteran Health Care, and<00:35

Keywords: 1187, senate, all

Summary: The Minnesota Senate Subcommittee on Veterans met on March 4, 2026, and began with a moment of silence honoring Sergeant First Class Nicole Amore of White Bear Lake, who was killed while serving in Kuwait. The committee then took up Senate File 3956, an MDVA policy bill giving the commissioner clearer authority to direct staff time and other non-monetary resources toward partnerships with organizations serving veterans, especially on food insecurity, homelessness, suicide prevention, and related efforts. MDVA and Disabled American Veterans testified that the bill would help them work more quickly and clearly with outside partners, including food pantry and outreach efforts, while remaining focused on non-monetary support. Senator Howe offered an A1 amendment narrowing the bill to the three named priorities and removing the broader “other critical issues” language; the amendment was adopted after discussion about whether the reporting language also needed adjustment. SF 3956, as amended, was laid over for further consideration. The committee then heard Senate File 3955, which would create a new procedure for temporary closure of a Minnesota veterans home if an involuntary termination notice requires it, bringing state law into closer alignment with federal expectations. MDVA emphasized that it had no intention of permanently closing any veterans homes and that the bill was intended only to establish a temporary closure plan to satisfy survey requirements. Senator Howe offered an A1 amendment clarifying that any closure would be temporary unless the legislature approved a permanent closure; MDVA and the Department of Health indicated the change was acceptable. The committee adopted the amendment and then voted to recommend SF 3955, as amended, to pass and refer it to the full committee. Finally, the committee began Senate File 4072, an MDVA cleanup and conformity bill. After adopting a technical A3 amendment, MDVA explained that the bill would reclassify the Chief of Staff/Deputy Chief of Staff role as Deputy Commissioner for Administration to better reflect the scope of the position, and would also repeal outdated statutes related to environmental hazards assistance and a data-collection requirement that the department said it could not implement. The bill was still being presented when the transcript ended, and no final committee action on SF 4072 was shown in the excerpt.

Transcript Highlights:

• So getting a taste of what it looks like to deliver health care services in rural Idaho.
• Improving health care access, quality, and outcomes through transformation of the health care delivery
• that there is a focus on innovative care, which will ensure that we have access to health care in rural
• expertise within the federal government in service of rural communities.
• , to rural health care entities.

Keywords: 989, all

Summary: The Rural Health Transformation Committee met with a quorum and approved the April 22 minutes. The main presentation came from Kate Sapra of CMS, who outlined the federal Rural Health Transformation Program, a $50 billion, five-year cooperative agreement for all 50 states. She emphasized CMS oversight, annual rescoring based first on implementation progress and later on outcomes, strict deadlines for obligating and spending funds, and the possibility of clawbacks if funds are not used on time or for approved purposes. She also described CMS’s Idaho site visit and the broader federal-state collaboration, including reporting requirements and technical assistance. Director Juliet Sharon of the Idaho Department of Health and Welfare then reviewed the state’s first round of planned sub-awards and solicitations. She explained the distinction between full RFPs, cooperative agreements, and smaller sub-grants, and said the first year will focus on building program structure, hiring support staff, data analysis, third-party administration, needs assessments, and initial service and infrastructure investments such as EMS, maternal and child health, behavioral health, chronic disease prevention, transportation, and technology. Committee members asked for more detail on KPIs, scoring metrics, and access to the actual RFP documents, and Sharon said those materials could be shared through SharePoint with confidentiality protections. Members also raised questions about reimbursement versus upfront funding, especially for tribes and other rural providers that may not have capital to start projects. CMS said upfront funding is allowable if consistent with state procurement rules and that RHTP funds cannot supplant existing funds or pay for projects already underway without a strong new-project rationale. Questions were also raised about multi-year construction or renovation projects, minor renovation definitions, and whether funds could be shifted between categories; CMS said budget revisions are possible but time-consuming, and year one changes would be difficult. The committee agreed to submit feedback on the first batch of opportunities by May 29 and scheduled the next meeting for July 15.