Transcript Highlights:

• ><c> program</c><00:08:54.920><c> and</c> the federal Medicare program and the federal Medicare program
• One program that we looked at was the dialysis program.
• programming.
• programming.
• programming.

Committee: House Health Finance and Policy

Transcript Highlights:

• We wanted to share a brief presentation and update on our nursing program at NTU. So our program...
• We have a 78-credit program, which has a few more credits than some of the other associate nursing programs
• the updates of our nursing program with you all.
• And then I have a curiosity about the success pathway of the nursing program students.
• But I appreciate you sharing your advocacy for the local nursing program.

Committee: House House Government, Elections & Indian Affairs

Transcript Highlights:

• They started a nursing program with 13 nurses in 2017.
• So if the state had some kind of program that says, hey, we need more teachers and more nurses, we can
• And you mentioned the new nursing program in the Miami area, and it's on trajectory.
• There's a new, brand-new nursing program at St. Leo that just started last year. St.
• But asking for some program funding for new nursing programs.

Summary: The Higher Education Budget Subcommittee heard and advanced House Bill 1145, which clarifies that public charter schools may participate in the CAP Grant Fund. The bill’s amendment expanded a separate “money-back guarantee” concept for state colleges, requiring participating institutions to offer six eligible programs and refund tuition if graduates do not find qualifying employment within six months under standardized job-search requirements. Members asked about refund rates, student notification, fiscal impact, and whether the proposal accounted for disability or out-of-state job searches. Public testimony on the amendment and bill was in support from Nathan Hoffman of the Foundation for Florida’s Future, and the committee adopted the amendment and reported the bill favorably as a committee substitute by a 16-1 vote, with Representative Aristide voting no over the charter school issue. The committee then received presentations on the William L. Boyd IV Effective Access to Student Education (EASE) Grant and the private nonprofit college sector. Department of Education staff explained that EASE, created in 1979, provides tuition assistance to eligible full-time undergraduates at participating private institutions, with a 2024-25 maximum award of $3,500 and an additional EASE Plus incentive of up to $850 for students in high-demand fields. The department reviewed the program’s funding history, disbursement process, and accountability metrics, including access, affordability, graduation, retention, and postgraduate employment/continuing education. Members asked about award proration, eligibility for other aid, religious-program restrictions, and why some institutions had low or unavailable graduation-rate data. ICUF President Robert Boyd argued that EASE is a strong return on investment and described ICUF institutions as not-for-profit, four-year schools serving many Pell-eligible, adult, military, and minority students. He said the sector produces a significant share of Florida’s bachelor’s, graduate, nursing, and education degrees, and highlighted ICUF’s dashboard with additional transparency metrics, program earnings data, and net price calculators. Boyd and members discussed graduation and completion rates, NCLEX passage rates, affordability, institutional flexibility, and whether schools with lower graduation rates should be compared differently because of their student populations. The presentations ended with no further business, and the meeting adjourned.

Transcript Highlights:

• WABON, the Washington Board of Nursing, has moved certified nursing assistant testing into training programs
• in nursing homes.
• All state behavioral health funding programs have the goal of enabling nursing facilities to safely admit
• Success of these programs requires behavioral health providers to help equip nursing home staff to be
• These programs really do work and have a focus on outcomes that positively impact the lives of nursing

Committee: Senate Health & Long-Term Care

Summary: The committee held a work session on the long-term care workforce, hearing first from DSHS Assistant Secretary B. Rector and then from representatives of Washington Health Care Association, SEIU 775, and Behavioral Health Solutions. Presenters described rapid growth in the 85-and-older population, increasing demand for home- and community-based services, and persistent shortages in direct care, nursing, and behavioral health staff. They cited low wages, unstable hours, benefits, certification and testing delays, immigration-related workforce concerns, and burnout as major barriers to recruitment and retention. DSHS highlighted recruitment and retention initiatives funded with federal dollars, including high school training programs, a retention toolkit, transportation support, workforce navigators, tribal partnerships, and remote caregiving pilots. Industry and labor witnesses urged higher reimbursement and compensation, better training pathways, and more worker voice; they also noted that Washington ranks highly nationally on some workforce measures but still faces shortages and turnover. Behavioral Health Solutions added that credentialing delays and mental health staffing gaps are affecting nursing home behavioral care, and that its programs aim to reduce hospital transfers and improve resident outcomes. No votes were taken. The committee then received an overview from the Office of the Insurance Commissioner on the palliative care benefit work group created by 2024 legislation. OIC explained that the work group, with actuarial analysis from Milliman and input from multiple stakeholder organizations, studied a proposed palliative care benefit for commercial plans, Medicaid, PEBB, and SEBB. The report concluded that a new benefit would likely increase costs, estimating about 28 cents per member per month overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. OIC said the evidence was insufficient to conclude that palliative care would produce offsetting savings, though several provider members disagreed and submitted response letters. Members asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said the issue remains unsettled and that additional data may emerge as other states implement similar benefits. Finally, the Health Care Authority provided a broad overview of health care price transparency tools in Washington and federally. Staff described federal hospital and health plan transparency rules, the state all-payer claims database, consumer-facing price and quality tools, prescription drug price transparency reporting, the Health Care Cost Transparency Board, and the Prescription Drug Affordability Board. They emphasized that these tools provide useful but incomplete information because of data lags, proprietary restrictions, limited self-insured employer participation, and the complexity of machine-readable files. The committee also discussed the role of AI in making transparency data more usable and the limits of current tools in helping consumers afford care. No formal action or vote was taken on any item.

Transcript Highlights:

• House Bill 2340 relates to substance use monitoring programs for nursing assistants.
• House Bill 2340 relates to substance use monitoring programs for nursing assistants.
• Additionally, nursing assistants are made eligible for the Board of Nursing stipend program.
• And this bill honestly just allows nursing assistants to utilize the program now because nursing assistants
• And this bill honestly just allows nursing assistants to utilize the program now because nursing assistants

Summary: The House Health Care & Wellness Committee held public hearings on several bills. House Bill 2232 would create a Department of Health-operated time-sensitive emergency data repository covering trauma, cardiac, and stroke events, with quality improvement reporting and support for rural facilities; it drew strong support from emergency physicians, nurses, and the Department of Health, while the Washington State Hospital Association said hospitals support the goal but lack the resources to absorb the added requirements. House Bill 1812, as a proposed substitute, would bar insurers and public plans from imposing anesthesia time limits or related reimbursement caps; the sponsor and anesthesia providers said it protects patient safety and fair payment, and the Washington State Society of Anesthesiologists asked for a clarifying amendment on physical status modifiers. House Bill 2250 would limit hospital charity care to Washington residents, while preserving emergency care access; supporters from rural hospitals and the Washington State Hospital Association said the change would help border hospitals facing rising nonresident charity care, and opponents from legal aid, patient advocacy, and LGBTQ groups warned it would create barriers, chill access for immigrants and other vulnerable patients, and conflict with Washington’s safety-net values. The committee also heard House Bill 2340, which would extend existing substance-use monitoring program protections and stipend eligibility to nursing assistants under the Board of Nursing’s CARES program. The sponsor described it as a simple equity measure, and the Board of Nursing supported it, saying it would improve access and reduce stigma; members asked where the stipend funding comes from, and staff and the board said it is currently general-fund supported at about $25,000 annually. House Bill 2577 would change hospital inspection law by requiring acute care hospital inspections every 18 months rather than on average, allowing some accredited inspections to satisfy the requirement every 36 months, and clarifying fire-protection reinspection standards; the sponsor and Department of Health said it responds to a JLARC audit and provides needed clarity, while DOH said it is still working to catch up from inspection delays caused by the public health emergency. The meeting ended after public testimony on the bills was closed and the committee adjourned.

Transcript Highlights:

• nurse specialists.
• licensed practical nurse submit nursing program transcripts to the Board.
• ...place just to make sure that applicants are actually graduates of an accredited nursing program.
• But that does not reflect the fact that there are nurse midwives, nurse anesthetists, and clinical nurse
• But that does not reflect the fact that there are nurse midwives, nurse anesthetists, and clinical nurse

Summary: The committee heard public hearings on several health-related bills. House Bill 1904 would prohibit cat declawing except for therapeutic purposes, with staff explaining definitions, fines, recordkeeping, and reporting requirements. The prime sponsor and animal welfare advocates described declawing as cruel and linked it to pain and behavior problems, while the Washington State Veterinary Medical Association supported the substance of the bill but asked to remove the added reporting and disciplinary provisions as redundant and burdensome. House Bill 2211 would provide guidance for medically tailored meals under existing Medicaid-related nutrition supports, including standards for Washington-based nonprofit providers where possible, menu review, and nutrition requirements. The sponsor said it would clarify implementation without expanding the program, and supporters from meal providers, food distributors, and local farms said it would improve health outcomes, keep dollars local, and support Washington jobs and agriculture. House Bill 2329 would allow licensed midwives to delegate certain tasks to medical assistants and to supervise medical assistants, with the sponsor and birth center operators saying it would fix an omission in current law and help rural and under-resourced birth centers operate more efficiently. Supporters said it would improve staffing and financial stability, while the sponsor indicated the lactation consultant language would likely be removed because those consultants are not regulated by the Department of Health. The committee then returned to House Bill 1904 for additional testimony from humane organizations, veterinarians, shelter leaders, and local officials, all supporting a ban on declawing and emphasizing animal pain, shelter impacts, and available alternatives. House Bill 2247 would expand and clarify veterinary telehealth and veterinarian-client-patient relationship rules, allowing a VCPR to be established in certain telehealth circumstances and setting guardrails for consent, practice standards, and when in-person exams are still required. Supporters from shelters, animal welfare groups, mobile clinics, and veterinarians said telehealth would improve access in rural and underserved areas, reduce shelter intake, and help animals receive care sooner; the veterinary association supported the bill with amendments to clarify recordkeeping and access-to-care findings. House Bill 2339 would update nursing license terminology and processes for advanced registered nurse practitioners, including title changes, controlled substance rules for CRNAs, transcript submission, and interim permits. Nursing board and ARNP representatives supported the technical updates, while the hospital association and medical association raised concerns about title language for clinical nurse specialists and the deletion of a reference to the medical profession. Finally, House Bill 2106 would require health carriers to give 90 days’ notice of significant mid-contract payer modifications and provide the actual modification language, with the sponsor and hospital and provider representatives saying insurers are increasingly making unilateral changes that affect payment, services, and patient access. UW Medicine and a rural hospital district described examples where insurers changed imaging or preventive service coverage mid-contract, causing financial losses and forcing difficult choices about network participation. Carriers were noted as opposing the bill, while providers and facilities argued it would improve transparency and prevent one-sided contract changes that disrupt care.

Transcript Highlights:

• of oversight for registered nurses.
• nursing education programs, setting standards for maintaining competence, and disciplining nurses for
• nurses right now.
• who are nurses who apply to become nurses that have positive criminal backgrounds.
• And some areas that we are looking at is with our nurses in our alternative-to-discipline program.

Committee: All ALC-OCCUPATIONAL LICENSING REVIEW SUBCOMMITTEE

Summary: The Occupational Licensing Review Subcommittee met to review two occupational licensing reports: the Arkansas State Board of Nursing and the State Board of Registration for Professional Soil Classifiers. For nursing, board officials described the board’s history, scope, and licensure categories, noting it regulates about 72,000 nurses and oversees RNs, LPNs, advanced practice nurses, medication assistants, and a new dialysis patient care technician registry. Members asked about workforce shortages, complaint types, and the board’s finances; the board said Arkansas has enough licensed nurses overall but has vacancy issues in some areas, complaints commonly involve criminal backgrounds, fraud, misrepresentation, drug abuse, and misappropriation, and the average case length is 191 days though some cases remain open much longer while awaiting criminal adjudication. Officials also said they are working on efficiency improvements and have added help positions with Department of Health support. The report was accepted without objection. The committee then reviewed the soil classifier program, now housed under the Natural Resources Commission after the former board was abolished in 2023. Agriculture Department officials explained that soil classifiers are a small, specialized profession requiring a four-year degree with coursework in biological, earth, and soil sciences, and that the state currently has 29 registered soil classifiers. Members asked whether that number is sufficient, what the work involves, and how the program’s finances are used. Officials said the profession is mainly used for septic system design, wetland determinations, nutrient management, and other soil-related work, and that current staffing appears adequate. They also noted the program has about $20,000 in reserves, above the statutory three-year balance, and discussed possible uses such as training, curriculum upgrades, and expanded administrative funding. The report was also accepted without objection, and the meeting adjourned with the next meeting scheduled for February 19 at 1:30 p.m.

Transcript Highlights:

• THE NURSING HOME PATIENT SAFETY CULTURE SURVEY IN THE NURSING HOME CONSUMER SATISFACTION SURVEY.
• RESPONSES FROM NURSING HOME FACILITIES EVERY TWO YEARS.
• AND IT WILL ALSO BE USED FOR CALCULATING THE QUALITY INCENTIVE PROGRAM PAYMENTS AS A MEASURE OF NURSING
• JUMPED ON THE NEW FROM COMPARING NURSING HOMES.
• NEXT OF HEALTHY BEHAVIORS PROGRAMS.

Transcript Highlights:

• practical nurse.
• practical nurse, nurse practitioner, advanced registered nurse practitioner, or advanced practice registered
• the program is a program 340B program would increase costs to employers and workers.
• the program is a program 340B program would increase costs to employers and workers.
• BIO supports the federal 340B program. It's a good program, but even good programs can be abused.

Summary: The Senate Health and Long-Term Care Committee held a hearing on several bills. SB 5904 would prohibit non-human entities from using nursing titles; the sponsor and nursing groups said it is meant to increase transparency around AI and ensure patients know when they are interacting with a real nurse. SB 5915 would change Health Technology Assessment Program review criteria and timelines, with supporters arguing it would better account for Medicare coverage and national guidelines, especially for rare and life-threatening conditions. SB 6025 would update the definition of fetal death to allow gestational age to be determined by the best clinically accurate method rather than last menstrual period, and medical professionals and the sponsor said this would reduce emotional, financial, and legal burdens on grieving families. SB 5933 would require near real-time sharing of overdose data into ODMAP; public health, local government, and recovery advocates said it would improve overdose response, while one witness asked that poison center data be included and clarified separately. SB 5990 would allow APRNs and physician assistants to serve as local health officers in counties under 100,000 population; rural county officials supported the added flexibility, while public health groups and naturopathic physicians raised concerns about qualifications and asked that naturopathic doctors be included as well. SB 5981 would restrict drug manufacturers from limiting 340B drug access through contract pharmacies or requiring data as a condition of discounts; safety-net hospitals, community health centers, pharmacies, and patients said it protects access and reinvestment in care, while manufacturers, employer groups, and industry representatives argued it increases costs, lacks transparency, and may not ensure savings reach patients. No votes or final committee actions were taken in the transcript; each bill was heard and testimony was closed. Sign-in counts were reported for several bills, including strong pro support for SB 5904, SB 5915, SB 5933, and SB 5981, and mixed or substantial opposition on SB 6025 and SB 5990.

Transcript Highlights:

• , advanced registered nurse practitioners, or licensed practical nurses.
• These titles are registered nurse, nurse, or RN; advanced registered nurse practitioner, ARNP, or NP;
• The bill amends the Nurse Practice Act, which governs nursing practice and title protection for nurses
• for nurses.
• The bill amends the Nurse Practice Act, which governs nursing practice and title protection for nurses

Summary: The committee heard public testimony on several health-related bills. SB 5904 would restrict nursing titles such as RN, NP/ARNP, and LPN to licensed human people and prohibit non-human entities, including AI chatbots, from using those titles. The sponsor and nursing advocates said the bill is meant to prevent confusion and protect public trust, while preserving the use of AI as a support tool. SB 5877 would add a $70 surcharge for certified anesthesiologist assistants so they can participate in the Washington Physicians Health Program and access HealWA resources; supporters said it closes a technical gap and aligns CAAs with other medical professions. SB 5185 would create a pilot pathway for certain international medical graduates with clinical experience licenses to obtain full primary care licensure; supporters from the medical commission, physicians, and IMG advocates said the program has worked well, has shown no patient safety issues, and could help address workforce shortages. The committee also heard extensive testimony on ESSB 6210, which would let the Health Benefit Exchange adopt additional market-factor certification criteria for exchange plans, including standards aimed at preserving access and affordability in underserved counties. Supporters, including the exchange, OIC, consumer advocates, tribal representatives, and patient groups, said the bill is needed to respond to federal policy changes, rising premiums, and disappearing coverage in places like San Juan County. Opponents from carriers and employer groups argued the timeline is too fast, the criteria are too discretionary, and the bill could reduce competition and raise costs. The committee then heard SB 5981, which would strengthen protections and reporting requirements for the federal 340B drug pricing program and limit manufacturer restrictions on contract pharmacies and data requests. Hospitals, clinics, and patient advocates said the bill protects safety-net care and rural access, while manufacturers, employers, and business groups argued it would expand a program that already raises costs and lacks transparency. In executive session, the committee took action on SB 5917, related to Department of Corrections distribution of abortion medications, rejecting five proposed amendments and then advancing the bill on a 10-6 vote with three excused. The committee also advanced SB 5988, which concerns Department of Health opioid treatment program accrediting activities, on a do-pass recommendation after brief discussion.

Transcript Highlights:

• In 2024, the legislature made the program portable, meaning that if workers pay into the program for
• So it makes the program, it fulfills the promise of the program, such that anyone who pays into WAC CARES
• Similarly, the second program I want to mention is gosh. gosh The second program I want to mention is
• The third program is peer bridgers.
• Complex wound care is often accomplished in skilled nursing facilities, bowel and bladder programs, oxygen

Committee: Joint Joint Legislative Executive Committee on Planning for Aging and Disability Issues

Summary: The committee held what was described as its final meeting and began with introductions, then received updates on several long-term care and aging initiatives that originated from earlier J-LEC work. A presentation on the WA Cares Fund reviewed its development from a 2014 research project to implementation, including premium collection, expanded eligibility for near-retirees, portability, recent technical fixes, and the creation of a supplemental private insurance market. The presenter said the program is now largely in place and ready for future use, with benefits expected to go fully live next summer. The Dementia Action Collaborative also reported on its state plan, including Project ECHO dementia training, dementia-capable community pilots through area agencies on aging, and ongoing work on early detection, brain health, and caregiver support. Another DSHS presentation covered the Medicaid Transformation Project, including Medicaid Alternative Care, Tailored Supports for Older Adults, presumptive eligibility, and health-related social needs benefits such as rental assistance and nutrition support, with officials saying the waiver is likely secure until its 2028 renewal. The meeting then shifted to emerging issues from advocates and ombuds. The long-term care ombuds described persistent staffing shortages, concerns about low wages, the growing use of technology and surveillance in care settings, private equity ownership of facilities, and illegal or pressured discharges and evictions. The developmental disabilities ombuds focused on people with developmental disabilities who remain hospitalized without medical need, the need for better mental health and behavioral health access, and workforce training gaps for people serving this population. Disability Rights Washington urged more community-based supports to reduce repeated institutionalization, pointing to gaps in programs such as PACT, GOSH, and peer bridgers, and recommending those services be expanded and bundled at scale. Provider and workforce panels emphasized similar themes. Washington Health Care Association and LeadingAge Washington said assisted living and skilled nursing facilities face workforce shortages, Medicaid rates that lag behind costs, increasing client acuity, behavioral health needs, and discharge bottlenecks. They highlighted the need for more flexible care models, improved case management, and better reimbursement, including for complex behavioral health cases. Supported living providers reported high turnover, underfunding, and a successful pilot that used enhanced rates and added training to place 30 hard-to-serve individuals. SEIU 775 argued that the central problem across settings is the direct care workforce crisis, driven by low wages and inadequate benefits, and said rate increases must be tied more directly to worker compensation. DSHS closed by noting heavy reliance on federal Medicaid funding, ongoing pilots in training, transportation, remote caregiving, smart-home technology, and rental subsidies, and said future planning should shift toward a multi-sector state strategy after the committee sunsets.

Transcript Highlights:

• In 2024, the legislature made the program portable, meaning that if workers pay into the program for
• So it makes the program, it fulfills the promise of the program, such that anyone who pays into WAC Cares
• The third program is peer bridgers.
• That means that if an individual has nursing needs, they have access to nursing care, medications assistance
• Complex wound care is often accomplished in skilled nursing facilities, bowel and bladder programs, oxygen

Committee: Joint Joint Legislative Executive Committee on Planning for Aging and Disability Issues

Summary: The committee met for what was described as its final meeting, with members and staff reflecting on the work of the Joint Legislative Executive Committee on Aging and Long-Term Care and noting that future work would likely shift to standing health and wellness committees. The meeting began with introductions and then moved into updates on major initiatives that originated from the committee, including Washington Cares, the Dementia Action Collaborative, and Medicaid long-term care programs. Presenters emphasized that these efforts were developed through long-term legislative-executive collaboration and were intended to help Washington prepare for the state’s aging population. On Washington Cares, DSHS described the program’s development from a 2014 research effort to its 2019 enactment, premium collection beginning in 2023, portability improvements in 2024, and 2025 changes including a grandfathered opt-out fix and a framework for supplemental private long-term care insurance. The agency said benefits are expected to go fully live next summer, with a pilot of up to 400 applicants planned for next January. On dementia policy, the Dementia Action Collaborative reported on the state dementia plan, Project ECHO training for providers, and pilot dementia-capable community programs at area agencies on aging, citing preliminary results that about 85% of family caregivers said services helped people remain at home. DSHS also reviewed Medicaid Transformation Project initiatives, including Medicaid Alternative Care, Tailored Supports for Older Adults, presumptive eligibility, and health-related social needs benefits such as rental assistance, nutrition support, and home modifications. The committee then heard an emerging issues panel from ombuds and disability advocates. Patricia Hunter of the long-term care ombuds program raised concerns about staffing shortages, resident rights, surveillance technology, private equity ownership of facilities, and illegal discharges or evictions. Betty Sweeterman of the Developmental Disabilities Ombuds discussed people stuck in hospitals without medical need, gaps in behavioral health services for people with developmental disabilities, and the need for better workforce training. Todd Carlyle of Disability Rights Washington urged expansion and bundling of community supports such as PACT, GOSH, and peer bridgers to reduce repeated institutionalization and support discharge from inpatient psychiatric settings. Provider and labor panels followed, with nursing home, assisted living, supported living, and union representatives all emphasizing workforce shortages, low wages, Medicaid rate inadequacy, case management bottlenecks, behavioral health complexity, and the need for more flexible care models and stronger accountability for rate increases. No formal votes were taken; the meeting ended with public comment on manufactured housing and closing remarks thanking staff and participants for the committee’s work.

Transcript Highlights:

• The New Hampshire Board of Nursing defines a school nurse as a school nurse should have a broad working
• :32.199><c> nurse</c> Board of Nursing defines a school nurse Board of Nursing defines a school nurse
• </c> pediatric nurses or not pediatric nurses pediatric nurses or not pediatric nurses but<02:02:29.079
• nurse that nurse is or 504 they need a nurse that nurse is not<02:06:07.679><c> a</c><02:06:07.840><c
• </c> the Nurses Association the school Nurses the Nurses Association the school Nurses Association<02

Committee: Senate Education

Transcript Highlights:

• WABON, the Washington Board of Nursing, has moved CNA testing to training programs to similar results
• in nursing homes.
• All state behavioral health funding programs have the goal to enable nursing facilities to safely admit
• Success of these programs requires behavioral health providers to help equip nursing home staff to be
• These programs really do work and have a focus on outcomes that positively impact the lives of nursing

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

Transcript Highlights:

• Okay, our next presenters this morning are going to be sexual assault nurse examiners, the SANE programs
• Our program is a little bit different than what Tammy had stated as her program.
• She is my human trafficking nurse leader. So she is my nurse leader in my program.
• She's a nurse. She's a SANE nurse.
• So our programs both are 24/7, 365 days a year crisis programs.

Summary: The first meeting of the Human Trafficking and Emergency Department Task Force focused on implementing Act 267 of 2025, which created the body to develop a statewide human trafficking protocol to be incorporated into regional sexual assault response plans. Chair Rep. Kelly Hennessy Dickerson and Office of Human Trafficking Prevention Director Mary Kate Andrepont outlined the task force’s goal of producing a practical, transferable protocol for hospitals and emergency departments across Louisiana, with help from Heal Trafficking. Members and presenters repeatedly emphasized that the protocol should be trauma-informed, survivor-centered, multidisciplinary, and adaptable to different regions and health systems. Hospital, SANE, and advocacy presenters described current practices and gaps. Ochsner LSU Health Shreveport’s Operation Rahab and FMOLHS’s policies highlighted staff education, badge buddies, private screening, reporting pathways, and coordination with the National Human Trafficking Hotline, law enforcement, DCFS, and local advocates. SANE nurses and forensic staff stressed that most trafficking victims pass through emergency departments and that subtle behavioral indicators, rapport-building, and broad staff education are critical. LaFASA described statewide sexual assault advocacy services, emphasizing 24-hour crisis response, legal support, and the role of advocates in helping survivors understand options and regain control. Child and youth trafficking specialists from DCFS-contracted programs, including Unbound Now and BCFS/Common Thread, explained Louisiana’s Act 662 response for minors, which routes reports into coordinated advocacy and care coordination. They said their teams respond statewide within 90 minutes, provide crisis support, and work with CACs, hospitals, and law enforcement. Members raised concerns about major service gaps, especially for adults, transportation, safe housing, and specialized placements for survivors with disabilities. Presenters also noted that male survivor housing remains limited, though Eden Centers now offers some beds. The task force also reviewed a needs assessment showing many hospitals lack mandatory trafficking training, screening practices, written protocols, and confidence in identifying victims. Members discussed expanding education beyond ED staff to residents, nursing schools, student health, mental health, housekeeping, maintenance, and law enforcement. No formal votes were taken, but the chair said the survey results and testimony would be used to draft a protocol before the next meeting, with a final draft to follow after further review and feedback.

Transcript Highlights:

• Secondly, we have serious concerns that the 340B program is being misconstrued as a patient program.
• fee programs.
• To practice nursing in Washington, a person must be licensed by the Washington State Board of Nursing
• nurses.
• registered nurse practitioner, nurse, or APRN, or licensed practical nurse, or LPN.

Summary: The committee first heard House Bill 2437, which would put the Department of Health’s authority to accredit opioid treatment programs into statute and allow the department to set a fee to cover the cost of those services. The prime sponsor and DOH said the bill would preserve a service that is especially important to tribal and rural providers and would be self-sustaining rather than supported by the general fund. Members asked about the relationship between DOH and HCA and whether the bill would duplicate existing authority; staff and the department said DOH already performs the accrediting role and the bill mainly formalizes that authority and fee-setting power. Public testimony on the bill was then closed. The committee then held an extensive work session on the federal 340B drug pricing program and later opened public testimony on House Bill 2145, which would prohibit manufacturers, distributors, and third-party logistics providers from restricting 340B drug acquisition or delivery and from requiring claims or utilization data as a condition of access. Committee staff and NCSL gave background on how 340B works, recent growth in the program, contract pharmacy issues, and state efforts in other jurisdictions. Testimony on HB 2145 was sharply divided: hospitals, community health centers, tribal representatives, contract pharmacies, and labor groups said the bill would protect safety-net providers, rural access, HIV and behavioral health services, and tribal programs from manufacturer restrictions; business groups, pharmaceutical companies, and employer coalitions argued the program has expanded beyond its original intent, lacks transparency, shifts costs to employers and taxpayers, and should be addressed through federal reform instead. No vote was taken in the excerpt. Finally, the committee heard House Bill 2155, which would bar non-human entities from using nursing titles such as RN, APRN, or LPN or otherwise implying they are licensed nurses. The prime sponsor said the bill is intended to protect patients from being misled by AI systems and to preserve transparency and public safety as health care technology expands. The Washington State Nurses Association testified in support, saying AI can be useful but should not replace nurses or be presented as a licensed professional. A member asked about enforcement and liability, and staff said they would follow up on those details.

Transcript Highlights:

• program.
• The Crossroads Program is the substance use prevention program that APS uses.
• That's going to help school nurses recruit school nurses.
• The program for uninsured residents is called the coverage expansion program and is a flexible program
• The nursing home, quality surcharge program is another one where the nursing homes pay the state of New

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• </c> The CNEE is Minnesota's Nursing The CNEE is Minnesota's Nursing Workforce<00:03:41.160><c> Center
• </c> serious nursing workforce shortages. serious nursing workforce shortages.
• </c> fact, almost half of the state's Nursing fact, almost half of the state's Nursing Workforce<00:04
• apprenticeship program.
• ,</c><00:10:31.200><c> and</c> uh that are focusing on nursing, and uh that are focusing on nursing,

Transcript Highlights:

• practical nurses.
• the programs include Home Care programs the programs include PCA<00:18:01.559><c> Choice</c><00:18:02.360
• This program works.
• nursing homes.
• nursing homes.

Committees: Senate Health and Human Services , Senate Human Services

Transcript Highlights:

• health aide program.
• , or graduate from an accredited pre-licensure nursing education program, and also successfully pass
• to as the SMMC program.
• program to an opt-out.
• If our nurses are allowed to work 8 to 16 hours a day and under the CDC Plus program under IHSS, a parent

Summary: The subcommittee held its first meeting of the 2025-2026 term, took attendance, confirmed a quorum, and heard introductory remarks from members and staff. Chair Anderson outlined the subcommittee’s jurisdiction over access and affordability issues, including health facility regulation, insurance, Medicaid, CHIP, and state employee health coverage. The main agenda item was an update on implementation of HB 391, which created a family home health aide program for medically fragile children. Representative Tramont, the bill sponsor, explained that the law was intended to let trained family caregivers be paid through Medicaid to care for their children, reduce reliance on private duty nursing, and relieve families. He and several members expressed frustration that implementation had taken nearly two years and that families still faced barriers. Deputy Secretary Brian Meyer of AHCA and Bridget Royce of DCF said the program was implemented October 1, 2024, with billing available, but no home health agencies had yet launched the required 80-hour training program and no claims had been paid. They described the program’s requirements, including agency employment, background screening, training, a $25-per-hour Medicaid rate paid to the agency, and an annual assessment report. A major issue discussed was that income earned by family caregivers counts toward Medicaid eligibility and could cause families to lose coverage. AHCA and DCF outlined two possible fixes that would require CMS approval: disregarding the income for eligibility purposes or treating the child as a family of one. Members and public witnesses strongly urged changes to avoid forcing families to choose between income and coverage. Several providers said they had begun preparing training programs, but asked for clearer approval processes and more patient-specific training requirements. The committee then heard extensive public testimony from parents and caregivers of medically fragile children, who described the financial, emotional, and logistical strain of caring for children with severe disabilities and argued that the bill should be expanded to include Florida KidCare families and others in the coverage gap. They also raised concerns about the eight-hour-per-day limit, low pay, and the need for simpler rules and direct support. Home health providers and associations supported the concept but asked for modifications, including more targeted training and clearer implementation guidance. The meeting then shifted to a second agenda item on the Andrew John Anderson Rapid Whole Genome Sequencing Program, which was funded in the 2023 budget. Deputy Secretary Meyer said the program has been implemented since January 1, 2024, but utilization has been lower than expected, with only about 60 claims paid and many denials occurring through managed care. Public testimony from a lab, a hospital, and a pediatric rare disease expert said the program is clinically valuable and cost-saving, but managed care billing barriers, prior authorization issues, and DRG-related denials are limiting access; they urged direct billing to Medicaid and possible expansion to all newborns.