Transcript Highlights:

• I'm Hagar Dickman, Director of California LTSS Advocacy for Justice in Aging.

Summary: The Assembly Aging and Long-Term Care Committee met on June 24 with a substitute chair presiding and considered three measures. SB 352 by Senator Reyes was placed on the consent calendar and approved unanimously, 7-0, to be re-referred to the Committee on Emergency Management. SB 433 by Senator Wahab, presented on behalf of Senator Stern, was heard next and focused on room-and-board protections for participants in the assisted living waiver and CalAIM assisted living transition community support programs. Supporters, including Justice in Aging, CANHR, the Western Center on Law and Poverty, the California Commission on Aging, and the Long-Term Care Ombudsman Association, argued the bill would prevent low-income Medi-Cal residents from being charged unaffordable rates and losing their housing. Opponents, including the California Assisted Living Association, LeadingAge California, and Six B’s, said they remained concerned about the bill’s rent-control implications and statutory scope, though they acknowledged recent amendments addressed some eligibility issues. After committee discussion, SB 433 was approved 5-1 with one abstention and re-referred to the Committee on Human Services. The committee also heard SB 582 by Senator Stern, presented by Senator Wahab, which would allow state departments to issue disaster suspensions of active licenses for facilities rendered inoperable by declared emergencies, waive some licensing fees, and provide temporary flexibility for community-based adult services, child care, and evacuation planning requirements for skilled nursing and residential care facilities. Support came from the California Assisted Living Association, LeadingAge California, the California Commission on Aging, the Long-Term Care Ombudsman Association, CANHR, and a child care resource center, all describing the bill as helpful for rebuilding and continuity of services after disasters. There was no recorded opposition, and SB 582 passed unanimously, 7-0, to the Committee on Health. The meeting then adjourned.

Transcript Highlights:

• Whether an organization already has experience providing LTSS services and working with its population
• organization already has experience organization already has experience providing<00:13:41.440> ltss
• services<00:13:42.480> and<00:13:42.600> working<00:13:42.839> with providing ltss
• services and working with providing ltss services and working with its<00:13:43.199> population
• smoother process, and our goal is to try to make eligibility similar across PACE and other Medicaid LTSS

Keywords: 1183, house

Transcript Highlights:

• lever that could be utilized by legislators would be to increase the long-term services and supports, LTSS
• lever that could be utilized by legislators would be to increase the long-term services and supports, LTSS
• lever that could be utilized by legislators would be to increase the long-term services and supports, LTSS
• lever that could be utilized by legislators would be to increase the long-term services and supports, LTSS

Keywords: 1187, senate, all

Transcript Highlights:

• My name is Mohammed Rashid, and I am from the LTSS Coalition.
• I'm from the LTSS for All Coalition, and I would like to thank the legislature for rejecting the governor's

Keywords: 987, senate, all

Summary: The Senate Budget and Fiscal Review Committee heard AB 109, the Budget Act of 2026, and related discussion of the legislative budget agreement. Committee staff and the Department of Finance described a two-year balanced plan with about $253 billion in General Fund spending, roughly $5.5 billion in higher assumed revenues than the May Revision, and about $36.5 billion in combined reserves. They said the package preserves or expands funding for schools and community colleges, child care, IHSS, Medi-Cal-related county administration, housing and homelessness programs, public hospitals, courthouse construction, and some criminal justice and prison-closure savings, while delaying or modifying several prior health care reductions and some Medi-Cal changes. Much of the member discussion focused on Medi-Cal, H.R. 1, and the impact on low-income and immigrant Californians. Several Democrats argued the budget protects vulnerable residents by delaying some cuts, funding county eligibility work, indigent care, public hospitals, and food banks, and rejecting the Governor’s IHSS cuts and asset-limit proposal. Republicans criticized the budget for assuming future revenues, relying on new taxes, and not doing enough to address the structural deficit or improve accountability. Members also raised concerns and support around homelessness funding, Prop. 36, judgeships and courthouse funding, transit and GGRF allocations, local journalism, Caltrans fleet spending, and a proposed “fair share” revenue measure that was not yet before the committee. Public testimony was largely supportive of the budget’s health and human services provisions, especially the rejection of IHSS cuts and the asset-limit proposal, and the inclusion of funding for child care, sickle cell centers, domestic violence services, trauma recovery centers, distressed hospitals, county eligibility work, and transit programs. Some witnesses representing hospitals and health plans cautioned about the effects of moving certain Medi-Cal populations to fee-for-service and about proposed tax changes affecting health care providers. The chair said revenue trailer bills were still being finalized and would likely come back later in the week; the committee then moved to public comment, with the chair limiting speakers to about one minute each.

Transcript Highlights:

• are inviting someone from MassHealth, they could do comparison statistics of people utilizing the LTSS

Keywords: 995, all

Summary: The Long-Term Services and Supports and Health Equity Subcommittee met with a presentation from Housing Navigator Massachusetts. Staff described the nonprofit’s mission to improve access to affordable housing through a free, 24/7 search tool and public data dashboards. They explained how the site distinguishes between rent-based-on-income units and fixed below-market rent units, how mobile vouchers such as AHVP and Section 8 interact with those listings, and what types of housing are included or excluded from the database. They also reviewed accessibility filters, supportive housing resources, and related state programs such as EOHLC resources and RAFT. Committee members asked about the organization’s funding, the availability of voucher programs, and whether the site tracks demand for accessible units or wait lists over time. Housing Navigator said it is primarily supported through the state, works closely with the Executive Office of Housing and Livable Communities, and does not collect personal application data because it is not part of the application process. Staff said accessible units appear to be in high demand, but they do not have direct data on how many people are waiting or how many applications result from site visits. They also said they are working to improve data sharing, more frequent updates, and future research tools. Members discussed ways to increase public awareness of Housing Navigator, including sharing a one-page fact sheet or infographic through disability organizations, local disability commissions, independent living centers, and the Massachusetts Office on Disability. The subcommittee also briefly discussed future goals, including inviting MassHealth to a January meeting, seeking regular updates on federal Medicare and Medicaid developments, reviewing the annual report’s recommendations, and possibly planning a future health equity event. The meeting ended with the introduction of new commission member Victoria Gill and a motion to adjourn, which was approved unanimously.

Transcript Highlights:

• I'm Hagar Dickman, Director of California LTSS Advocacy for Justice in Aging.

Summary: The Assembly Committee on Human Services heard several homelessness, public benefits, and aging-related bills. SB 748 would expand Encampment Resolution Funding to support safe parking sites for people living in cars or RVs, require quarterly reporting from HCD on outcomes, and direct LAO evaluation; supporters said it would help local governments reduce RV encampments while connecting people to housing and services. SB 290 would repeal the CalWORKs immunization sanction that reduces aid when parents cannot provide acceptable proof of a child’s vaccination; supporters argued the penalty unfairly harms families already in poverty and can worsen instability, while no opposition testified. SB 606 would define “functional zero” for overall and unsheltered homelessness and require local jurisdictions to plan for and report on the housing and interim shelter needed to reach that goal; supporters said it would add accountability and focus on reducing unsheltered homelessness, and one group moved from opposition to neutral after amendments. SB 433 would create an income-based room-and-board cap and personal needs allowance for all Medi-Cal assisted living participants in residential care facilities for the elderly, not just SSI recipients; supporters said it would prevent eviction and homelessness among low-income seniors and people with disabilities, and facility groups withdrew opposition or moved to neutral after amendments. SB 761 would require students applying for Cal Grants to be notified that they may be eligible for CalFresh and given information on how to apply; supporters said it would address widespread student food insecurity and low enrollment among eligible students. The committee accepted amendments on the bills, and all of the measures discussed were reported out on 7-0 or similar unanimous votes to the Assembly Appropriations Committee, with the consent calendar also approved unanimously.

Transcript Highlights:

• to, you know, the presentation earlier, I think, about the workforce and supports issue, actually LTSS

Keywords: 995, all

Summary: The Massachusetts Permanent Commission on the Status of Persons with Disabilities held its quarterly virtual meeting and approved the September minutes. Chair Denise Garlick opened with updates on the commission’s first “Meeting the Moment” community forum in Needham, reporting strong attendance, a large resource fair, and mostly positive survey feedback. Commissioners said the event was valuable for connecting advocates, providers, and people with disabilities, while also noting lessons learned about accessibility, timing, and the need for more networking time and advance materials. The chair said the commission is planning future forums in other regions, including possible sites in Lowell, Northampton, and the South Shore. A major item was the new advisory council. Oz Osmondahar and Eman described the outreach and screening process, which drew roughly 60 nominations and emphasized lived experience, sector expertise, geographic diversity, and connections to broader networks. The council will serve as strategic advisors and thought partners, meet twice a year, and hold its first in-person orientation on January 30 at the State House Members Lounge. Commissioners were encouraged to stay engaged with the council and use it to strengthen commission and subcommittee work. Subcommittee reports covered employment, workforce supports, and long-term services and supports/health equity. The Disability Employment Subcommittee reported collaboration with SEED, a presentation at the Employment Matters Conference, a discussion with a disability employee resource group, and upcoming work with CED and veterans advocates. The Workforce Supports Subcommittee heard from the MassHealth Policy Commission’s Behavioral Health Workforce Center about workforce data gaps and an upcoming needs assessment, and plans to host ADDP on 2025 workforce metrics. The long-term services and supports committee discussed the Housing Navigator program, barriers to accessible housing, and concerns about how federal cuts could affect disability services and health equity. The commission also heard from DDS Deputy General Counsel Erin Brown and Associate Commissioner Chris Klaskin on a new law expanding access to records from former state institutions, including new notification and privacy procedures and a forthcoming regulatory process with public input. Commissioners welcomed the law as a step toward transparency and dignity. Amen gave an executive director update on the annual report, recent collaboration with the Greater Boston Chamber of Commerce, the Office of the Veteran Advocate, a national state-employer practice group, and the IDD/Autism Alliance working group. The meeting also included a moment of reflection for disability activist Alice Wong, a commissioner announcement about Work Without Limits’ virtual career fair, and adjournment after a motion and second were approved unanimously.

Transcript Highlights:

• related, but because it was such a big item on your spreadsheet, I thought I would notate it: the LTSS
• <00:54:13.119> the<00:54:13.440> LTSS I thought I would notate it. the LTSS I thought
• I would notate it. the LTSS advisory<00:54:14.800> committee.

Keywords: 1187, senate, all

Transcript Highlights:

• I would want to recommend that, you know, this was a discussion I think about 12 years ago, having LTSS
• I think it got pretty far, but did not produce LTSS in managed care.
• :58:01.880> um<01:58:02.880> you<01:58:03.000> know I think, you know, having LTSS
• and managed care, it got pretty far, but did not produce LTSS in managed care.

Keywords: 928, house, all

Summary: The Division of Long-Term Supports and Services presented its budget and program overview as part of the Department of Health and Human Services operating budget review. Leadership described the division’s three bureaus—Aging and Adult Services, Developmental Services, and Family-Centered Services—and explained that the division provides guidance, technical assistance, quality monitoring, and contracted provider oversight across the lifespan. Members also discussed staffing, with reported vacancy rates of 4% in Aging and Adult Services, 15% in Developmental Services, and 6% in Family-Centered Services; the division said the higher BDS vacancy rate is partly due to the small number of authorized positions. The governor’s budget had left eight positions unfunded in the division, including three in Aging and Adult Services and five in BDS. A major topic was the division’s roadmap initiatives, especially building a system of care for healthy aging and strengthening developmental disabilities systems through a new reimbursement rate structure. The division said it contracted with an actuary to study DD service costs and found rates had not been reviewed since 2017 and were significantly below actual costs and other states’ rates, contributing to provider shortages even when services are authorized. Members asked about the impact on service delivery and whether rates would need to rise overall; the division said its strategy is to focus on lower-cost services that help people remain in the community. The division also reported waiver enrollment figures, including about 4,161 people on the Choices for Independence waiver, 3,688 average nursing facility residents, 5,061 people on the DD waiver, 228 on the acquired brain disorder waiver, and 488 children on the in-home support waiver, while noting there is no funding waitlist but provider availability remains a constraint. The division highlighted IT modernization as a major accomplishment, especially moving Adult Protective Services and Developmental Services into the New Heights system. Officials said these changes improve case-note access, data retrieval, service authorization tracking, and transparency for providers, and they asked for future oversight discussion focused on IT leverage. Members noted that New Heights maintenance is budgeted in the Office of the Commissioner under class 27 and suggested better transparency on system costs and benefits. The division also reported that it closed out a long-running CMS corrective action plan for BDS on July 1, 2023, and said it is now focused on strengthening the system rather than compliance alone. Other discussion covered the Aging and Adult Services bureau’s name change from Elderly and Adult Services to Adult and Aging Services, intended to avoid negative connotations and better reflect preventative services. The bureau described Adult Protective Services trends involving scams, financial exploitation, self-neglect, and isolation, and explained that it administers the CFI waiver, determines medical eligibility for nursing facility level of care, and braids funding from Medicaid, state funds, Older Americans Act money, Social Service Block Grants, and other grants. Members asked about waiver growth targets and federal consequences if enrollment remains below projections; the division said it would explain the shortfall in a future waiver amendment and did not anticipate a federal penalty. The meeting ended without any votes or formal actions taken.

Transcript Highlights:

• I'm from Oakland, and I'm here representing LTSS for All. I'm a Medi-Cal and IHSS recipient.
• I'm with Caring Across Generations, also a member of the LTSS for All Grassroots Coalition.
• I'm with Caring Across Generations, also a member of the LTSS for All Grassroots Coalition.

Summary: The hearing began with opening remarks on the Governor’s May Revision for child care and human services, with committee members and advocates stressing that the budget should not be balanced on the backs of low-income families, children, and providers. Legislative members and public witnesses strongly opposed the proposed suspension of the child care COLA, reductions to the Emergency Child Care Bridge Program, and the lack of codified rate reform tied to the alternative methodology. Several speakers also urged more support for providers affected by the Eaton fire and other disasters, and called for child care to be funded at the true cost of care and for additional slots to be restored. Administration, LAO, and Department of Education staff described the child care proposal as maintaining existing funding levels while adding administrative resources to prepare for federally required prospective payment changes and single-rate reform. The administration said the May Revision would suspend the 2025–26 COLA and reduce Bridge Program funding to align with utilization, while the LAO raised questions about the size and purpose of the proposed rate-reform and prospective-payment funding and recommended rejecting a Department of Technology exemption. CDE supported continued early education investments but said it would need additional resources if prospective pay were extended to state preschool, and it objected to a proposed reallocation of preschool funds for inclusive education grants. The committee then moved to the IHSS portion of the May Revision. DSS outlined five major proposals: capping provider work hours at 50 per week, eliminating IHSS for undocumented adults age 19 and older, shifting certain Community First Choice reassessment penalties to counties, reinstating the Medi-Cal asset test as a conforming IHSS reduction, and automating the termination of IHSS when Medi-Cal eligibility ends. DSS also discussed funding to implement a federal HCBS access rule and a separate reassessment of IHSS administrative methodology that found counties would need additional administrative funding. Finance said the proposals were intended to slow program growth and improve sustainability, while the LAO said it was still analyzing the package and raised concerns about implementation, county workload, and the potential loss of services. Committee members and public commenters criticized the IHSS cuts, especially the overtime cap and the elimination of services for undocumented adults and people affected by the asset test. Advocates argued that IHSS workers and recipients depend on these services, that county administration is already underfunded, and that the proposals could destabilize vulnerable consumers. The chair closed by saying the committee would continue to fight for child care and would not pause on child care, and the meeting recessed before moving on to the remaining May Revision items.

Transcript Highlights:

• the changes in subdivision two would change any revenue for the Board of Executives for long-term LTSS
• for the Board of Executives for for the Board of Executives for long-term long-term long-term LTSS
• LTSS. LTSS.

Keywords: 1187, senate, all

Transcript Highlights:

• threatened by the recent passage of H.R. 1, which drastically... ...reduces Medicaid because Texas' LTSS

Keywords: 1185, senate, all

Transcript Highlights:

• control disability waiver growth and proposed disability waivers caution shifts according to the state's LTSS
• control disability waiver growth and proposed disability waivers caution shifts according to the state's LTSS
• Hennepin County's LTSS demographic dashboard has increased the number of people accessing all home and

Keywords: 1187, senate, all

Transcript Highlights:

• For the traditional population, which includes many of the children and parent caretakers, For our LTSS

Transcript Highlights:

• Our division with LTSS promotes the health and well-being of people and their families throughout the
• that we provide to children, youth, adults, and people who are aging. services um our division with ltss
• services um our division with ltss promotes<01:44:48.000> the<01:44:48.119> health<01:

Keywords: 1189, house, all

Bills: SB667, SB904, SB1344, SB1380, SB1423, SB1425, SB1484, SB1500, SB1502, SB1503, SB1555, SB1561, SB1562, SB1565, SB1572, SB1644, SB1749, SB1833, SB2007, SB2044, SB2074

Keywords: chiropractic, licensure, animal chiropractic, Board of Chiropractic Examiners, licensing requirements, gender transition, gender-affirming care, transgender, puberty blockers, cross-sex hormones, hormone therapy, sex reassignment, transition surgery, Medicaid, public funds, state facilities, state hospital, Oklahoma, intersex, DSD

Transcript Highlights:

• community connector units, placing soft caps on certain HCBS hours, delaying the implementation of LTSS
• 16:15.440> the<02:16:15.679> implementation<02:16:16.320> of<02:16:16.639> LTSS
• um delaying the implementation of LTSS um delaying the implementation of LTSS presumptive<02:16:

Keywords: 981, all

Summary: The House convened, led the pledge of allegiance, and established a quorum before approving the corrected journal. The Majority Leader then moved a long list of bills—House Bills 1150 through 1179—to be made special orders for February 11, 2026 at 9:15 a.m., and the chamber agreed without objection. The committee then took up House Bill 1150, a supplemental appropriation for the Department of Agriculture. Representative Serna explained it included technical adjustments tied to other agencies, plus a pilot program to test a biocontrol strategy for the mountain pine beetle infestation in Colorado’s ponderosa pine forests. After brief opposition from a member who said he would vote no on spending measures generally, the bill passed. House Bill 1151, the supplemental appropriation for the Department of Corrections, generated extensive debate. Supporters said the bill was necessary to cover major costs such as medical case loads, outside medical and mental health contracts, local jail payments, prison case load, private prison utilization, and food services, while also addressing staffing and parole/community corrections coordination. Opponents argued the state keeps funding more beds instead of investing in services that reduce incarceration, criticized DOC management and delays, and said the legislature should demand better accountability and efficiency. Supporters countered that DOC does not control the parole board or community corrections, that the prison population is aging, and that the state must pay for required custody and care. The transcript ends amid continued debate over the corrections supplemental, with no final vote on House Bill 1151 shown in the excerpt.

Transcript Highlights:

• the right people to be able to look at managed care, the potential transition of managed care for LTSS
• managed<00:54:31.839> care<00:54:32.800> um<00:54:32.880> for<00:54:33.720> LTSS
• <00:54:34.880> My<00:54:35.359> concern of managed care um for LTSS.
• My concern of managed care um for LTSS.

Keywords: 928, house, all

Summary: The Division 3 work session focused largely on amendment 1176 to HB 2, which would have incorporated the substance of HB 548FN, a House-passed bill creating a direct-pay or membership-based model for health care facilities. Representative Mlan described the proposal as a way to increase competition in health care by extending the direct-care model used in primary care to facilities, arguing it could encourage innovation and that concerns about widespread harm to critical access hospitals were overstated. He pointed to Oklahoma’s long-standing Surgical Center model as evidence that the approach had not spread broadly or displaced hospitals there. Several members and witnesses raised concerns. Representative Stringham questioned whether the model would shift profitable services and patients away from existing hospitals, potentially worsening their finances and affecting Medicaid-related funding. David Ross, speaking for county nursing homes, opposed the language because it also removed moratoriums on nursing home, skilled nursing, inpatient rehabilitation, and self-pay beds, warning that it could increase pressure on Medicaid rates and undermine community-based care. Ben Bradley of the New Hampshire Hospital Association said the proposal appeared to create a separate regulatory framework for direct-pay facilities and raised concerns about patient safety, CMS participation rules, and a separate patient bill of rights. The chair concluded that, because HB 548 was already moving through the Senate, the HB 2 process was not the best vehicle for the policy and that the issue should be left to the Senate’s more deliberative committee process. Representative Ferski moved to not accept or remove amendment 1176 from the agenda, and the committee approved the motion by roll call, 9-0, withdrawing the item from HB 2.

Transcript Highlights:

• And this does not include the LTSS spend.

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services met in person, approved the July 15 minutes, and heard a presentation from Dr. Matthew Holder and Dr. Henry Hood of the Lee Specialty Clinic in Louisville. The clinic serves people with complex intellectual and developmental disabilities through a transdisciplinary model that combines medical, dental, behavioral, psychiatric, therapy, and other services under one roof. The presenters argued that this population is large-cost but small in number, often receives little provider training, and is vulnerable to diagnostic overshadowing, overmedication, and missed medical or dental problems. The clinic reported that in Tennessee, payer data showed average costs of about $5,200 per member per month before clinic involvement, with a 44% reduction in overall health care spending after patients were seen, including lower emergency room use, inpatient admissions, and prescription use. They said those savings were measured by the payer, not the clinic, and that the savings accrued to Medicaid or managed care payers rather than the clinic itself. They also shared a case example of a patient who had been placed on hospice but improved after diagnosis and treatment at the clinic. Patient and parent satisfaction were described as very high, generally above 95%. The clinic asked for roughly $5 million to expand into Northern Kentucky, estimating 500 to 700 patients would use the new site and projecting annual savings of about $13 million to $19 million once mature. Members asked about the budget, startup and operating costs, where the savings go, and whether the clinic had considered taking full risk or another value-based model. Senator Meredith and others encouraged the clinic to explore an accountable care or risk-based arrangement, while the presenters said they were open to that discussion but had not pursued it yet. The exchange ended with follow-up questions about the clinic’s overall budget structure and public-private funding mix.

Transcript Highlights:

• I'm with Caring Across Generations, also a member of the LTSS for all. Food Coalition.

Keywords: 988, house, all