Transcript Highlights:

• </c><00:13:10.960><c> provider</c> of action for any health care provider of action for any health care
• </c> provide medical care. provide medical care.
• So, I welcome any questions. receive care. receive care.
• </c> jobs, and expand patient care. jobs, and expand patient care.
• </c> health care access. health care access.

Keywords: 1191, senate, all

Transcript Highlights:

• So we're trying to expand it for access to care. Correct.
• , and improve access and quality of care in Louisiana.
• What about wound care treatment? Y'all did wound care treatment?
• What about wound care treatment? Y'all did wound care treatment?
• Maybe they need more direction.

Summary: The committee first heard and favorably reported SB 255, which expands eligibility for psychosocial rehabilitation services by adding health sciences and therapeutic recreation degrees to the list of acceptable educational backgrounds. Supporters said the change would help address workforce shortages and improve access in rural areas. SB 314 was then reported favorably; it cleans up prior law so a limited scope certified social worker license can still be used for community psychiatric support and treatment services even if the application is filed after the CSW license has expired, rather than being barred by a timing restriction. The committee next took up several bills by Chairman McMath. SB 26, which repeals facility need review requirements for opioid treatment programs, was reported favorably after members and witnesses said Louisiana has too few OTPs and that removing the review would improve access, especially in rural areas. SB 29, requiring review and reporting of a child’s immunization records in certain unexpected death autopsies, was reported favorably despite questions about whether the bill should refer more broadly to medical records; supporters said the data could help evaluate vaccine-related concerns, while opponents raised concerns about singling out immunizations. SB 30, dealing with telehealth for obesity/weight management, was amended and reported favorably; the committee adopted technical amendments and a conceptual amendment replacing “metabolic condition” with “weight management services,” while witnesses debated patient safety, board authority, and whether the bill should limit agencies’ ability to restrict telehealth in the future. The committee also reported favorably SB 219, which creates an Office of Health and Nutrition within LDH. Supporters from the department, the Alzheimer’s Association, and Pennington Biomedical said the office would strengthen coordination on nutrition, physical activity, and brain health, and cited high Alzheimer’s costs and prevalence in Louisiana. SB 222, which streamlines Medicaid behavioral health administrative requirements and expands telehealth for psychosocial rehabilitation, was reported favorably with amendments after supporters described workforce and rural access barriers. SB 195, the “Danny’s Dose EMS Treatment Act,” was reported favorably; it would allow EMS personnel to administer a patient’s own prescribed time-critical medication in emergencies, and testimony from a parent and physician described life-threatening delays under current practice. The committee also adopted SCR 2, updating hospital architectural standards to the most recent Facility Guidelines Institute edition, and SCR 22, requesting a more detailed legislative auditor report on opioid settlement expenditures; members said they wanted clearer outcome data and planned to refine the language before floor debate. Finally, HB 1093 on naturopathic medicine was introduced and heavily amended, with the bill shifted under LSBME oversight and a large set of changes discussed, but no final action was taken in the portion provided.

Transcript Highlights:

• I'm here to present AB 2164, the Care Without Fear Act.
• Here to present 2164 the Care Without Fear Act.
• fragile reproductive health care system.
• I provide health care in California because I know my state will always protect health care access.
• AB 2164, the Care Without Fear Act, is the next step in protecting this care.

Summary: The committee heard several public safety bills and took action on multiple measures. AB 1662 by Assemblymember Wilson, which would require notice to the DMV when a defendant receives diversion in certain driving-related cases so points can still be assessed administratively, drew support from law enforcement, district attorneys, AAA, and road safety advocates, with opposition from the Western Center on Law and Poverty. The bill passed on a due pass motion to Transportation and was held on call. AB 1741 by Assemblymember Pacheco, as amended, would allow sexual battery committed during an unlawful residential intrusion to be charged as a wobbler; prosecutors and victim advocates supported it, while public defender organizations argued existing law already covers the conduct and warned the bill was overbroad. It passed due pass as amended to Appropriations and was held on call. AB 2760 by Assemblymember Sharp Collins would let counties with an Office of Inspector General expand that office’s oversight to probation and animal control departments. Supporters, including the author, an Ella Baker Center representative, and San Diego County Supervisor Monica Montgomery Steppe, said it would improve transparency and help counties lacking capacity. Probation officials and Fresno County opposed, citing existing oversight structures and concerns about conflicts, confidentiality, and duplication. The bill passed due pass to Local Government, with some no votes, and was held on call. AB 1753 by Assemblymember Wix, the Survivor Pathways to Safety Act, would strengthen firearm relinquishment and protection-order enforcement, expand firearm prohibitions for certain threats and violations, and broaden remote hearing and notification provisions. Support came from gun violence prevention, victim, medical, and law enforcement groups; gun rights organizations opposed on due process grounds. It passed due pass as amended to Judiciary and was held on call. The committee also heard AB 1743 by Assemblymember Wix, which would allow local governments and certain universities to request firearm trace data from DOJ for research and policy purposes. Supporters said the data would help identify trafficking patterns and inform evidence-based policy, while opponents warned about privacy, misuse, and stigmatizing lawful dealers. The bill passed due pass to Appropriations and was held on call. AB 2164, the Care Without Fear Act, would strengthen California’s shield-law protections for reproductive health care providers against extradition and related enforcement; supporters framed it as protecting lawful care in California, while opponents raised concerns about abortion and gender-affirming care and due process. It passed due pass to Judiciary and was held open. AB 2664, the Safe Worship Zone Act, would create a narrow buffer around houses of worship to prevent harassment of people entering or exiting; faith-based and anti-hate groups supported it, while civil liberties and some community groups opposed it as an unconstitutional speech restriction. The bill passed due pass to Appropriations and was held on call. The committee then began hearing AB 2122 by Assemblymember Kalra, which would prohibit bench warrants for Vehicle Code infractions and allow noncustodial warrants for other infractions, but the transcript cuts off before testimony or action on that bill.

Transcript Highlights:

• Sections 11 and 12 move the development of a health care directive by a mobile crisis team from the crisis
• health care.
• health care.
• health care.
• health care.

Keywords: 1187, senate, all

Transcript Highlights:

• Barr has chosen to direct her donation to support Gillette Children's.
• We add facility authority to include health care facilities in bonding.
• This increases access to eye care for patients and increases the availability of eye care doctors.
• The field of eye care faces significant workforce challenges.
• and LASIK care, all closely in harmony with ophthalmology.

Transcript Highlights:

• The entire membership extends its best wishes on this memorable occasion and directs this resolution
• Um that is no longer the abortion care.
• </c> to not provide emergency abortion care to not provide emergency abortion care previously<00:37:49.920
• Jackson, Maryland Health Care Commission membership, favorable, two amendments.
• </c> membership of the Maryland Healthc Care membership of the Maryland Healthc Care Commission<00:41

Keywords: Senate streaming session for Tuesday, February 10, 2026, 960, senate, all

Transcript Highlights:

• </c> in my opinion, of that cost of care. in my opinion, of that cost of care.
• </c> of care. of care.
• This is the direct care and treatment agency bill.
• This is the direct care<02:24:01.440><c> and</c><02:24:01.560><c> treatment</c><02:24:02.640><c> agency
• </c> health care system. health care system.

Keywords: 1187, senate, all

Transcript Highlights:

• is, because each warden has a different direction.
• I see that they really haven't had any direction, but also I really don't think that they care if they
• I see that they really haven't had any direction, but also I really don't think that they care if they
• I see that they really haven't had any direction, but also I really don't think that they care if they
• I see that they really haven't had any direction, but also I really don't think that they care if they

Keywords: 912, senate, all

Summary: The committees heard advice-and-consent testimony on several gubernatorial nominations, beginning with GM 644 for Steven Logan to serve as Adjutant General of the Department of Defense through December 7, 2026. Testimony from multiple state officials and others was strongly supportive, citing Logan’s military leadership, service during the COVID-19 period, and coordination during the fireworks-related patient transfer. Logan described his 44 years of military service, 22 years with the Honolulu Police Department, and his approach of “unity of effort,” including how he would help operationalize the Office of the State Fire Marshal by coordinating with county fire chiefs, the State Fire Council, and emergency management to pursue funding and implement recommendations. The committee then took up GM 621 and GM 623 for the Correctional Industries Advisory Committee. Shante Asuda of Hawaii Correctional Industries supported both nominees and said the board is important for evaluating private-sector joint ventures that can provide work skills for incarcerated people. Carla Kashiwa said she wanted to help improve outcomes through public-private partnerships and vocational rehabilitation opportunities for people reentering society. Lee Shinato, however, gave a less prepared presentation, offering broad ideas such as crafts, lunch wagons, and ukulele-making, and acknowledged he was not fully clear on the board’s scope or goals. Committee members expressed concern about the lack of preparation and clarity around the board’s mission, and the administrator later explained that the board’s role is to review business plans for viability, return on investment, sustainability, and whether they provide marketable skills for inmates. The final item discussed was GM 568 for Aris Banag to serve on the Advisory Board of Veteran Services. Supporters described him as community-minded and deeply committed to veterans. Banag said he has over 30 years of service, has worked as a mental health therapist and veterans resource coordinator at the University of Hawaiʻi Maui College, and helped create the first veteran service center there. In response to questions about federal VA cutbacks and veterans nearing retirement, he said the board must be a strong independent voice for veterans, advocate against reductions in benefits, and help service members plan for post-military life, including disability benefits, retirement, and financial planning. No votes or final committee actions were stated in the portion provided.

Transcript Highlights:

• These are direct emails from ASU.
• These are direct emails from ASU.
• So did they care? I don't think they cared.
• Colleton cares knowing Mr.
• I don't care. I'm not recognized.

Summary: The committee heard an extended presentation and discussion on Arizona higher education research security, focused heavily on Arizona State University’s foreign funding, international partnerships, and alleged ties to Chinese military-affiliated institutions. The presenter argued that ASU and the Arizona Board of Regents had not been transparent about foreign gifts, contracts, and research collaborations, especially those involving the Chinese “Seven Sons” universities, and said the committee would pursue a congressional referral and other federal review. A strike-everything amendment to SB 1060 was described but then withdrawn; the underlying SB 1327 was then taken up as a companion measure requiring ABOR to adopt university research security policies and submit annual reports on those policies and on foreign contributions over $250,000. The committee heard testimony in support from Marina Macklin, who said the bill would help protect dual-use and defense-relevant research from being funneled to China’s military ecosystem, and she answered questions about biosecurity, semiconductors, AI model theft, and election systems. After debate, SB 1327 was approved on a 4-2 vote, with Delos Santos and Marquez voting no and Colloden, Powell, and the chair voting yes; the chair stated his support was to keep missile, armor, guidance, and other technology safe from the Chinese government. The committee then heard SB 1803, a veterans’ consumer-protection bill regulating private companies that help veterans file disability claims. The bill would prohibit unaccredited persons from preparing, presenting, or prosecuting veterans’ benefits matters, require service agreements to be filed with the Attorney General, cap compensation, ban certain practices such as overseas call centers and in-house doctors, and create consumer-fraud enforcement authority. Sponsor Sen. Gallin said the measure was intended to add guardrails for veterans and prevent bad actors from taking excessive fees or misleading claimants. Testimony from Veterans Guardian representatives supported the bill as a way to create transparency and preserve veterans’ choice while regulating the industry; they said many veterans seek private help after unsuccessful attempts with free services and that the bill would not eliminate competition. Opponents and skeptical members questioned whether the bill would effectively legalize one business model while restricting others, whether the contingent-fee structure was consumer-friendly, and whether the companies were engaging in the unauthorized practice of law. The discussion also referenced prior federal and state litigation involving similar laws and the possibility of future federal accreditation reform. The transcript ends during continued questioning on SB 1803, before a final vote is shown.

Transcript Highlights:

• </c> in most cases are receiving direct in most cases are receiving direct appropriations.<00:14:15.440
• </c> intent um to u uh prohibit um direct intent um to u uh prohibit um direct appropriations<00:14:40.560
• </c> circumstances where direct circumstances where direct appropriations<00:15:01.360><c> are</c><00
• ,</c><00:46:28.960><c> any</c> employees uh for prenatal care, any employees uh for prenatal care, any
• Um, is it going in that direction, Mr. Elli, to voluntary compliance? >> Mr.

Bills: HF3707, HF3732, HF2581, HF3731

Keywords: unemployment insurance, judicial officials, paid leave, economic development, worker protections, workforce development, unemployment benefits, youth training, grants, job creation, grant funding, revolving loan, underserved communities, disadvantaged groups, electrical licensing, installation, Class A installer, regulations, labor and industry, 1183

Summary: The committee first adopted the minutes from February 26 and then heard House File 2581, authored by Representative Frazier, which sought $1 million for Fortis Capital, a nonprofit economic development lender. Frazier and Fortis CEO Brian Smith described Fortis as a gap-financing lender that helps underserved entrepreneurs who cannot meet traditional bank underwriting standards. They said the organization has made 37 loans totaling more than $4 million since 2021, leveraged another $29.5 million, and created 314 jobs. Smith said Fortis typically charges around 6.5% interest, has had two defaults, and uses a revolving loan fund model that recycles repayments; members discussed how the proposal fits with other state economic development programs and whether Fortis should instead be part of a competitive grant process. The chair laid HF 2581 over for possible inclusion in a budget bill. The committee then heard House File 3707, brought by Representative Berg, which would extend confidentiality protections to unemployment insurance and paid leave judges and related staff by adding them to the definition of judges for purposes of protecting personal information. Berg and testifiers from the Department of Economic Development and MAPE said the bill responds to harassment and safety concerns, including threats, doxxing, and an attack near an office, and is intended to protect people making sensitive determinations. MAPE supported the bill as an update to existing protections for similar workers. Members raised concerns that the bill’s language was too broad, especially the reference to the paid leave division, and questioned whether it should cover only judges or also call-center and other staff. Department and committee members agreed the language likely needed narrowing and discussed possible amendments and whether to move the bill to Judiciary and then revisit it. No final vote was taken on HF 3707 during the discussion, and the bill remained under consideration for further language work.

Transcript Highlights:

• We have a little bit of housekeeping to take care of. HB 123...
• We have a little bit of housekeeping to take care of.
• I spent much of my practice taking care of those with intellectual disabilities.
• And we need to be careful to have the correct definition.
• It is a process that requires stability, patience, and specialized care.

Bills: HB91, HB123, HB167, HB255, HB264, HB321, HB884, HB955, HB967, HB968, HB969, HB978, HB985, HB994, HB1005, HB1104, HB1107, HB1109, SCR3

Keywords: criminal procedure, disclosure, criminal records, witness protection, trial rights, electronic monitoring, GPS ankle monitor, ankle bracelet, pretrial release, post-conviction supervision, bail monitoring, house arrest, corrections, criminal justice, law enforcement, prosecuting authority, court reporting, provider registration, LCLE, Louisiana Commission on Law Enforcement and Administration of Criminal Justice

Transcript Highlights:

• It's people we see every single day: retail workers, child care professionals, home care assistants,
• It's people we see every single day: retail workers, child care professionals, home care assistants,
• It's people we see every single day, retail workers, child care professionals, home care assistance,
• So I think anything that improves on $7.25 is a step in the right direction.
• They want to be able to take care of their families.

Keywords: 974, senate, all

Transcript Highlights:

• </c> and I'm curious if a student is directed and I'm curious if a student is directed to<00:10:48.320
• </c> is um trending in a positive direction. is um trending in a positive direction.
• </c> the right care, it changes everything. the right care, it changes everything.
• student</c><01:21:17.040><c> support</c> We we received direct student support We we received direct
• </c> changes because we talked about directed changes because we talked about directed funding.<01:25

Keywords: 1187, senate, all

Transcript Highlights:

• </c><00:26:08.720><c> Directed</c> the back of the budget cut. Directed the back of the budget cut.
• That takes care of the Thank you.
• So that's 466 and 467 and taken care. Um So that's 466 and 467 and taken care.
• </c> direction. Okay. direction. Okay. All<07:30:32.478><c> right.
• </c> that would take care of it, I believe. that would take care of it, I believe.

Keywords: 10am HB 1 & HB 2, 928, house, all

Summary: The committee of conference for HB 1 and HB 2 reviewed the side-by-side budget comparison and began working through agreed and disputed items. Members first confirmed that grayed-out items were already settled and discussed a process for making later technical and intent changes, especially to true up abolished positions after additional decisions were made. They then moved through several budget sections, including judicial branch reductions, retirement systems, the Department of Justice, the Human Rights Commission, liquor enforcement, corrections, and the Department of Information Technology. Several items were agreed to or treated as settled package items, including the judicial branch position, the Department of Justice reduction, the Human Rights Commission item being held until related HB 2 language is finalized, the Housing Appeals Board being moved into the Board of Tax and Land Appeals, and the Office of Child Advocate. The committee also agreed to update the House bill language as needed based on HB 2 decisions, and to keep certain IT support rows in place unless related boards and commissions are eliminated. The effective date remained July 1, 2025, with no change. The main unresolved discussion centered on the retirement systems budget, where the Senate defended a large increase for deferred IT security and investment-function improvements, while the House argued the increase was too large and favored a back-of-the-budget cut. The Senate said the funds would support strategic IT and investment changes and would remain in the trust if cut, while the House emphasized the size of the increase and suggested a compromise. The committee ultimately retained the Senate position on retirement systems for the moment and said it would return to the issue later. On corrections and liquor enforcement, the committee described a negotiated back-of-the-budget cut structure, including a $10 million cut for corrections with some restoration of POS offices and administrative aides, and a liquor enforcement cut that was treated as part of a broader package. The Department of Safety item related to commercial enforcement and motor vehicle inspections was held for later discussion. The meeting ended with several items agreed, several held for coordination with HB 2, and some major budget questions still open.

Transcript Highlights:

• </c> governor's recommendation and uh directs governor's recommendation and uh directs the<00:38:25.599
• </c><00:41:05.440><c> of</c> department's review and uh direct of department's review and uh direct of
• </c> librarian are funded with a direct librarian are funded with a direct appropriation<00:58:52.559
• Our system of early care and education relies on family child care, center child care, Head Start, and
• It will have a direct student support.

Keywords: 1187, senate, all

Transcript Highlights:

• a... ...the most is that if we don't have guidance and direction, then it will create chaos.
• Would you care to speak to that?
• Ma'am, my question is directed to you.
• We have young parents in crisis, students who are unable to care for a child.
• We need to care for our young people. We need to provide them medically accurate information.

Bills: HCR26, HB113, HB380, HB392, HB476, HB513, HB608, HB682, HB905, HB987

Keywords: human growth, development education, prenatal education, state standards, biological science, grading scale, education reform, students, public schools, academic policy, community college, technical education, pilot program, driver training, transportation, Safe Haven Law, flyers, child safety, infant relinquishment, name image likeness

Transcript Highlights:

• Senator Luneau took care of it, Senator Abraham. Mr.
• Now, access to care matters, and that's why last year we raised Now, access to care matters.
• House Bill 557 by Representative DeWitt, long-term care; definition of long-term care pharmacy.
• House bill by representative DeWitt, long-term care, definition, defined long-term care, pharmacy, 557
• House Bill by Representative Manny Langer: Louisiana Pregnancy Baby Care Initiative; health care data

Summary: The House convened with a quorum, received and accepted multiple resignation notices from members representing Districts 37, 39, 60, 69, 97, and 100, and then recognized the election and qualification of the members-elect who filled those vacancies: Doyle Boudreau, Reese Broussard, Chasity Verrett-Martinez, and Edwin Murray. Each member-elect was sworn in, and the House also appointed committees to notify the Senate and the governor that it was ready to conduct business for the 2026 regular session. The chamber then handled a large number of procedural actions related to prefiled legislation. By motion and without objection, the House suspended rules to refer prefile bills to committee and introduced a broad slate of House bills and resolutions. Topics included the state budget and appropriations, retirement system changes, carbon capture and sequestration, criminal justice and bail, public safety, education, health care, local government matters, transportation, and several memorial or commemorative resolutions. Several resolutions and bills were noted as lying over, and some prefiled bills were withdrawn from the files. The House also received a Senate message that SCR 1 had been adopted, and the resolution was taken up without objection. The chamber then recessed for a joint session with the Senate to hear the governor’s address and a presentation honoring Technical Sergeant Adam W. Brister with the Distinguished Flying Cross. In his remarks, Governor Jeff Landry highlighted his administration’s priorities, including education, tax reform, workforce development, health and nutrition, insurance reform, transportation infrastructure, fiscal discipline, and criminal justice reform, while urging support for his agenda and several related bills and constitutional amendments.

Transcript Highlights:

• </c> that we're directing that we're directing services<00:14:30.839><c> to</c><00:14:31.240><c> those
• </c> overall minimum uh kapuna care overall minimum uh kapuna care eligibility<00:15:08.360><c> so</c
• No, it was Kupuna Care.
• care?
• care?

Keywords: 912, senate, all

Summary: The Committee on Health and Human Services held an informational briefing on Kupuna Care funding, distribution, utilization, and the status of program rules. The Office of Aging explained that state Kupuna Care funds are distributed using the same federally approved interstate funding formula used for Older Americans Act funds, with eight weighted factors tailored to Hawaii’s conditions: older adults, greatest economic need, low-income minority status, disability, language barriers, geographic isolation, inverse population density, and older adults living alone in poverty. The department said the formula is based on census and American Community Survey data, with current county shares listed as Kauai 7.45%, Honolulu 69.61%, Maui 11.7%, and Hawaii County 17.88%. Officials said the formula is being reviewed with current data and will need federal approval and then public hearing before final adoption. Members questioned how the program works in practice, noting that the statute and eligibility language can sound like direct individual benefits even though services are delivered through area agencies on aging, ADRCs, and contracted providers such as meal and adult day care programs. The Office of Aging said ADRCs determine eligibility and then refer clients to authorized providers, who must meet service standards in their contracts. The chair pressed repeatedly for long-delayed rules, saying the Legislature had expected them years earlier and that clear rules are needed to ensure funds are spent properly and to avoid conflicts of interest. The department acknowledged the delay, said draft rules were written in 2023 after earlier commitments to finish sooner, and said it paused while federal Older Americans Act rules were being updated; it now expects to send the rules to the Deputy Attorney General, then out for public hearing, with a goal of completion in 2025. The department also reported utilization data for the last two fiscal years. In 2023, it expended about 93% of its allocation and served 5,473 older adults at an average annual cost of $1,358; in 2024, it expended about 97% and served 5,520 older adults, with the average cost down by about $200, which officials said may indicate fewer services per person. Eligibility was described as age 60 or older, U.S. citizen or qualified alien, with cognitive impairment or disability and functional deficits, and the statewide profile showed many participants were homebound, living alone, or below poverty. The most-used services were transportation, case management, and home-delivered meals. The chair also asked about the former Kupuna caregiver program; officials said the programs are now combined under Kupuna Care, with most funding going to adult day care to provide respite for working caregivers. County representatives then described local conditions, especially on Hawaii Island. Hawaii County officials said the county covers about 5,000 square miles, has about 208,000 residents, and roughly 24% are age 65 or older. They identified three main challenges: staffing shortages and retention problems among providers, shortages within the county department itself, and the loss of adult day care capacity, with only one center remaining on the island and none on the west side. They said these constraints limit service delivery even as demand grows. At the same time, they highlighted successes such as serving people in the community before they need higher levels of care, providing caregiver counseling and training through adult day care, serving 467 individuals locally, and ensuring the Resource Center answers calls from caregivers seeking help.

Transcript Highlights:

• I have no, I don't care, actually.
• And so we want to be careful about that.
• I don't mind people being direct.
• You are on the wall taking care of us, taking care of this. the state and its citizens.
• HB 17 is a direct.

Bills: HB17, HB34, HB41, HB 118, HB 119, HB 127, HB 128, HB 129, HB 130, HB132, HB133, HB17, HB41, HB118, HB119, HB127, HB128, HB129, HB130, HB132, HB133

Keywords: foreign ownership, real estate, national security, designated countries, Texas property law, lobbying, foreign adversaries, compensation prohibition, transparency, civil penalties, higher education, foreign adversary, research security, trade secrets, academic partnerships, HB 128, sister city, sister-city agreement, international exchange, municipal diplomacy

Transcript Highlights:

• </c> managed care organizations, MCOs's. managed care organizations, MCOs's.
• taken care of.
• their health care cost after.
• In Dayton, emergency care costs.
• In 23 we were directed years.

Keywords: 958, all

Summary: The committee first approved the minutes and then approved an agency amendment to a health and family services regulation. The amendment reversed a prior change so that neonatal ICU beds would remain subject to regular review rather than nonsubstantive review. The remaining administrative regulations were then reviewed without objection. The main presentation was from State Auditor Allison Ball on a report finding $836 million in concurrent Medicaid capitation payments from 2019 through 2022, involving individuals enrolled in Kentucky and at least one other state. Ball said Kentucky relied on the PARIS system, which has limitations because it is updated quarterly and depends on voluntary state participation, while a better federal data source, T-MSIS, was not fully available to the state. She said the audit found weak internal controls, siloed processes, outdated guidance, and a low-priority attitude toward residency checks, all of which contributed to missed alerts and improper payments. She also said the report identified additional problems, including payments made after beneficiaries died and cases involving multiple states paying for the same person. Ball recommended better access to federal data, stronger MCO contract provisions, and more active oversight by the Department for Medicaid Services and managed care organizations. She said the contracts reviewed did not provide a clear way to recoup the improper payments, though she and her counsel suggested possible equitable legal theories might be explored. Members expressed concern about the scale of the waste and the lack of contract enforcement, and asked whether any money could be recovered. Ball said the audit did not identify a clear contractual path to recoup the funds.