Transcript Highlights:

• Is there a preference the AG office has when it comes to that?
• Yes, I believe we would prefer to stay at the campus where we are, and we would prefer the site where
• Not only is fraud our focus, but also patient safety.
• We do patient abuse and neglect cases as well.
• All the other things listed deter future fraud and patient abuse.

Summary: The committee met to review the Attorney General’s budget and related agency operations, beginning with Legislative Council staff walking members through compliance reports and a blue-sheet base budget document. Staff highlighted current-biennium items such as FTE changes, one-time appropriations, litigation funding, opioid settlement receipts, continuing appropriations, and major special and federal funds. Members asked for clarification on items including the Missing Indigenous People Grant Fund, the Internet Crimes Investigation Fund, and the Medicaid Fraud Control Unit grant funding. Assistant Attorney General Clare Ness then gave an overview of the office’s structure, staffing, and budget pressures. She emphasized the office’s broad statutory duties, the value of its legal services to state and local government, and concerns about attorney pay lagging behind other agencies. Members discussed whether attorney compensation should be benchmarked more consistently across state government and whether some legal work could be consolidated within the AG’s office. Ness also addressed questions about AG opinion turnaround times, boards-and-commissions training, the new-and-vacant FTE pool, operating expense cuts, office leases, and the state’s criminal justice information systems. The crime lab presentation drew significant attention. Director Jennifer Penner described severe space, safety, and infrastructure problems at the current lab, including cramped work areas, glycol leaks, outdated fire and burglar alarms, air-handling limits, and equipment failures that have delayed toxicology work. She said the 2024 study projected a much larger facility would be needed and that the preferred location would be near the current health department site, but in a new building. Members asked about possible evidence risks, backlog status, and whether the proposed building would solve the current problems; Penner said it would and noted backlogs have improved overall, though some delays remain. The committee also heard from the new Medicaid Fraud Control Unit director, who described the unit’s civil and criminal work, federal-state funding split, and examples of fraud such as billing for services not provided or upcoding. The gaming division reported continued growth in charitable gaming and e-tabs, with members expressing concern about large trust-account balances, site competition, and possible misuse of proceeds. Finally, BCI outlined its caseload, cybercrime work, missing Indigenous persons task force, and the surge in CSAM cyber tips; members asked about AI-generated CSAM, and the AG’s office noted that last session’s law increased penalties and expressly allowed AI-generated CSAM to be prosecuted like other CSAM. No formal votes or actions were taken beyond approval of the minutes.

Transcript Highlights:

• This care requires multiple patient visits and relationships, but so many of those patients also need
• Louis prefer the care of my organization.
• They prefer to wait for us.
• So we give you X amount per year for caring for any number of patients that, you know, X per patient.
• I go down and see patients there.

Committee: House Substance Abuse Prevention and Treatment Task Force

Transcript Highlights:

• This care requires multiple patient visits and relationships, but so many of those patients also need
• Many of these patients, and my patients, will never step foot in an SUD treatment agency until it's too
• They prefer to wait for us.
• So we give you X amount per year for caring for any number of patients, you know, X per patient.
• I go down and see patients there.

Committee: House Substance Abuse Prevention and Treatment Task Force

Summary: The task force meeting opened with a brief organizational update, including new leadership, roll call, and an explanation of the task force’s statutory duties: to study current and future drug and substance use in Missouri, explore solutions, draft or modify legislation, and report recommendations on prevention and treatment. The chair outlined the summer hearing plan, which would feature field experts, with future sessions expected to cover alternative therapies such as psilocybin and ibogaine and testimony from the Department of Mental Health. Members were encouraged to think about legislative ideas and policy recommendations for the upcoming session. The first major testimony came from Dr. Rachel Winograd, who described Missouri’s overdose crisis as evolving into a “fourth wave” marked by fentanyl mixed with animal tranquilizers such as xylazine and medetomidine, along with methamphetamine and other synthetic drugs. She said overdose deaths have declined for a third straight year, with preliminary 2025 data around 1,200 deaths, but emphasized that the crisis remains severe. Her main recommendations were to focus on demand reduction rather than repeated supply crackdowns, expand evidence-based treatment—especially methadone and buprenorphine—broaden naloxone access, and improve practical supports like housing, transportation, and case management. She also said peer services are valuable but should not be used as a substitute for clinical care, and noted that Missouri Medicaid generally covers evidence-based treatment but reimbursement for peer recovery services remains a gap. Dr. Heidi Miller, the state medical director at the Department of Health and Senior Services, reinforced the call for integrating substance use disorder care into whole-person health care. She highlighted the state naloxone standing order, which supports more than 11,000 Medicaid naloxone prescriptions annually, and urged five best practices: integrating SUD treatment into primary care, maternal health, general medical training, EMS initiation of buprenorphine after overdose, and expanded methadone access. She also argued for team-based reimbursement, stronger parity enforcement between behavioral health/SUD and physical health, and caution in regulating emerging substances so policy does not outrun the science. Dr. Doug Burgess of University Health in Kansas City echoed the integration theme, arguing that Missouri’s system is too fragmented and that patients are often stabilized and then left to coordinate their own next steps. He compared ideal SUD care to the coordinated response used for heart attacks, with seamless transitions from emergency care to inpatient treatment, rehab, and outpatient follow-up. He said treatment courts can be effective when they are well coordinated and informed by addiction science, and he stressed the importance of discharge planning, peer recovery coaches, information-sharing, and maintaining Medicaid coverage during justice involvement. No formal votes or committee actions were taken during this portion of the meeting.

Transcript Highlights:

• Senator Hicks, you have been waiting patiently. You are recognized for a question. Thank you, Mr.
• I can do the question if you prefer. Okay. So anyway, prefer. Okay.
• And I want to thank all of the people that have come to my office in particular and been patient with
• And I do understand the relationship between patient and client.
• That doesn't help the patient laying there.

Bills: HB3239 , HB3391 , HB3557 , HB4128

Committee: Senate Agriculture and Wildlife

Summary: The Agriculture Committee first considered two executive nominations and approved both unanimously. Rebecca Hartfield was re-nominated to the State Board of Veterinary Medical Examiners, where she described her rural mixed-animal veterinary work and efforts to encourage future veterinarians. James Harrell was then nominated to the Oklahoma State University Veterinary Medical Authority; supporters emphasized his commitment to rural Oklahoma and addressing the shortage of large-animal veterinarians, and he discussed efforts to improve veterinary education and recruit more Oklahoma students. Both nominations passed 13-0. The committee then took up House Bill 3391, which would add improper advertising as a basis for revoking a commercial pet breeder license and define advertising to include digital and social media. Members asked about the definition and scope of commercial pet breeders. The bill passed on a 9-4 vote. House Bill 4128, dealing with black bear hunting season and harvest limits, drew extensive debate. An amendment to move the opener to September 21, expand counties, and let the Wildlife Commission set quotas failed 6-7. The underlying bill, which would have kept the September 15 opener and a 200-bear limit, also failed 3-9 after testimony and debate focused on bear population data, nuisance complaints, and concerns about out-of-state hunters and impacts on female bears. House Bill 3557, which would keep locally raised county extension funds in separate accounts so they are not swept into state accounts, passed 10-2 after questions about how local, state, and federal funds would be handled. Finally, House Bill 3239 on veterinary telemedicine passed 9-3. The bill defines the veterinarian-client relationship needed before telemedicine can be used, with supporters saying it would provide needed structure while preserving access for rural livestock care; opponents worried it could restrict access in emergencies. The committee then adjourned.

Transcript Highlights:

• receives prescriptions uh for a patient receives prescriptions uh for a medication<00:32:36.120><c>
• A few years ago, the state embarked on a preferred incontinence program because of the potential cost
• </c> Minnesota and not go directly to Patient Minnesota and not go directly to Patient Care<00:48:03.440
• </c><00:48:09.800><c> care</c> DHS would better serve patient care DHS would better serve patient care
• </c> access to Equitable care for patients access to Equitable care for patients with<00:49:09.440><c

Committee: House Human Services Finance and Policy

Transcript Highlights:

• Just like we have in the Medicaid program, you may have preferred drugs and non-preferred drugs based
• It could be 15 to 20 patients a day. 15 to 20 patients a day.
• Though she's also seeing patients.
• Then what does a patient get, right?
• Of mental health patients, I don't think it...

Bills: SB128 , SB640 , SB672 , SB904 , SB1141 , SB1263 , SB1525 , SB1528 , SB2041 , SB2306 , SB2308 , SB2357 , SB2446 , SB2695 , SB2857 , SB2891 , SB2583

Committee: Senate Health & Human Services

Transcript Highlights:

• </c> um is just not good patient care. um is just not good patient care.
• </c> apply direct patient care. apply direct patient care.
• . prefer. prefer.
• So we do teach; we spend time with our patients. We see fewer patients daily.
• We spend time with our patients. We see fewer patients daily.

Committee: Senate Health and Human Services

Transcript Highlights:

• There was a national movement to not institutionalize patients, right?
• To offer and push patients to home health, to more at-home care.
• Keep a patient in their home.
• I think that sometimes it's about patients' pay or source.
• I think that sometimes it's about patients' pay or source.

Bills: HR84 , HR85 , HR86 , HR87 , HR88 , HR89 , HR90 , HCR42 , HCR43 , HB1087 , HB1088 , HB1089 , HB1090 , HB1091 , HB1092 , HB1093 , HB1094 , HB1095 , HB1096 , HB1097 , HB1098 , HB1099 , HB1100 , HB1101 , HB1102 , HB1103 , HB1104 , HB1105 , HB1106 , HB1107 , HB1108 , HB1109 , HB1110 , HB1111 , HB1112 , HB1113 , HB1114 , HB1115 , HB1116 , HB1117 , HB1118 , HB1119 , HB1120 , HB1121 , HB1122 , HB1123 , HB1124 , HB1125 , HB1126 , HB1127 , HB1128 , HB1129 , HB1130 , HB1131 , HB1132 , HB1133 , HB1134 , HB1135 , HB1136 , HB1137 , HB1138 , HB1139 , HB1140 , HB1141 , HB1142 , HB1143 , HB1144 , HB1145 , HB1146 , HB1147 , HB1148 , HB1149 , HB1150 , HB1151 , HB1153 , HB1154 , HB1155 , HB1156 , HB1157 , HB1158 , HB1159 , HB1160 , HB1161 , HB1162 , HB1163 , HB1164 , HB1165 , HB1166 , HB1167 , HB1169 , HB1170 , HB1171 , HB1172 , HB1173 , HB1174 , HB1175 , HB1176 , HB1177 , HB1178 , HB1179 , HB1180 , HB1181 , HB1182 , HB1183 , HB1184 , HB1185 , HB1186 , HB1187 , HB1188 , HB1189 , HB1190 , HB1192 , HB1193 , HB1194 , HB1195 , HB1196 , HB1197 , HB1198 , HB1199 , HB1200 , HB1201 , HB1202 , HB1203 , HB1204 , HB1205 , HB1206 , HB1207 , HB1208 , HB1209 , HB1210 , HB1211 , HB1212 , HB1213 , HB1214 , HB1215 , HB1216 , HB1217 , HB1218 , HB1219 , HB1220 , HB1221 , HB1222 , HB1223 , HB1224 , HB1225 , HB1226 , HB1227 , HB1228 , HB1229 , HB1230 , HB1231 , HR73 , HR74 , HR75 , HR77 , HR78 , HR79 , HR80 , HR81 , HR83 , HCR36 , HCR37 , HCR38 , HCR39 , HCR40 , HCR41 , HB368 , HB433 , HB1017 , HB1018 , HB1019 , HB1020 , HB1021 , HB1022 , HB1023 , HB1024 , HB1025 , HB1026 , HB1027 , HB1028 , HB1029 , HB1030 , HB1031 , HB1032 , HB1033 , HB1034 , HB1035 , HB1036 , HB1037 , HB1038 , HB1039 , HB1040 , HB1041 , HB1042 , HB1043 , HB1044 , HB1045 , HB1046 , HB1047 , HB1048 , HB1049 , HB1050 , HB1051 , HB1052 , HB1053 , HB1054 , HB1055 , HB1056 , HB1057 , HB1058 , HB1059 , HB1060 , HB1061 , HB1062 , HB1063 , HB1064 , HB1065 , HB1066 , HB1067 , HB1068 , HB1069 , HB1070 , HB1071 , HB1072 , HB1073 , HB1074 , HB1075 , HB1076 , HB1077 , HB1078 , HB1079 , HB1080 , HB1081 , HB1082 , HB1083 , HB1084 , SB111 , SB122 , SB195 , SB221 , SB404 , HR1 , HCR6 , HCR19 , HB27 , HB81 , HB134 , HB154 , HB163 , HB170 , HB194 , HB214 , HB217 , HB220 , HB254 , HB259 , HB290 , HB308 , HB311 , HB360 , HB382 , HB401 , HB410 , HB417 , HB463 , HB514 , HB575 , HB592 , HB718 , HB723 , HB750 , HB755 , HB776 , HB812 , HB830 , HB838 , HB844 , HB882 , HB885 , HB888 , HB950 , HB961 , HB966 , HB980 , HR15 , HR20 , HCR14 , HB58 , HB69 , HB93 , HB166 , HB199 , HB201 , HB202 , HB218 , HB223 , HB224 , HB231 , HB235 , HB246 , HB338 , HB349 , HB352 , HB379 , HB405 , HB429 , HB535 , HB547 , HB577 , HB588 , HB626 , HB636 , HB652 , HB653 , HB669 , HB688 , HB691 , HB721 , HB738 , HB806 , HB851 , HB857 , HB861 , HB889 , HB904 , HB907 , HB908 , HB929 , HB1009 , HB13 , HB23 , HB25 , HB32 , HB41 , HB90 , HB120 , HB121 , HB122 , HB127 , HB138 , HB139 , HB141 , HB179 , HB187 , HB213 , HB247 , HB286 , HB332 , HB344 , HB357

Keywords: physical therapy, healthcare, prevention, wellness, education, Louisiana, landscape architecture, environment, public health, economic development, infrastructure, condolences, memorial resolution, tribute, Roger D. Boudreaux, Church Point, mayor, Louisiana House of Representatives, community service, local government

Transcript Highlights:

• what we call direct primary care, where providers can enter into an agreement directly with their patients
• If a chiropractor tried to enter into an agreement with a patient to do a membership program, I don't
• therapists to participate in direct primary care agreements with patients.
• She concluded that it creates scope confusion for patients and said she would stand against it.
• And of course, he didn't give us what he preferred.

Committee: House Health and Welfare

Transcript Highlights:

• And that means that those patients are not getting care.
• So we would prefer that. We want to ensure, first and foremost, patient safety.
• information or patient access.
• But they were also intimidating our patients by parking right outside of the hospitals, and patients
• But they were also intimidating our patients by parking right outside of the hospitals, and patients

Committee: House House Health & Human Services Committee of Reference

Summary: The committee began with a presentation from the Alzheimer’s Association Desert Southwest Chapter and Dr. Anna Burke of Barrow Neurological Institute on the growing impact of Alzheimer’s and dementia in Arizona, the need for earlier diagnosis, better provider education, caregiver support, and continued research funding. They described current gaps in training and access to specialists, but also highlighted new therapies, lifestyle interventions, and Arizona-based research efforts. Members expressed support and optimism, but no action was taken on the presentation. The committee then heard HB 2202, which appropriates $300,000 from the general fund over fiscal years 2027 through 2029 for a dementia care tele-mentoring grant program through the Department of Health Services. Supporters, including the Alzheimer’s Association, a dementia specialist, and a patient advocate, said the program would help primary care providers diagnose dementia earlier and improve care. The bill was passed out of committee on an 11-0 vote. Next, the committee took up HB 2251, the midwifery bill, which would authorize certain licensed midwives to dispense and administer specified medications and devices, require liability insurance disclosure and annual reporting, and create a Midwifery Advisory Committee. A committee amendment removed some medications and renamed the bill the Jordan and MacTerry Act. ACOG and the Arizona Osteopathic Medical Association opposed the bill as drafted, citing concerns about oversight, peer review, and the medication list, while licensed midwives and other supporters argued the bill would improve safety, transparency, and alignment with national standards. The bill was held for further stakeholder work, with members indicating more amendments were likely. The committee then heard HB 2252, which would allow certified nurse midwives, certified professional midwives, or licensed midwives to accompany a patient in a ground ambulance during an out-of-hospital birth if approved by medical direction. Supporters described cases where continued midwife involvement during transport helped newborns and mothers, while firefighters and EMS representatives opposed the bill as written, saying it created ambiguity about command and scene control and could raise safety concerns. The chair said the bill would be held for further stakeholder meetings and possible language changes. After a recess, the committee reconvened for presentations on federal Medicaid and rural health funding impacts, beginning with JLBC’s overview of H.R. 1’s Medicaid provisions and the rural health transformation grant program.

Bills: SR146 , SCR12 , HB378 , HB509 , HB1090 , HB221 , HCR85 , HCR100 , HCR105 , HCR107 , HCR114 , HCR58 , HB723 , SB4 , SB52 , SB57 , SB83 , SB131 , SB143 , SB145 , SB152 , SB194 , SB251 , SB254 , SB279 , SB283 , SB333 , SB353 , SB367 , SB384 , SB389 , SB398 , SB408 , SB431 , SB448 , SB450 , SB465 , SB468 , SB469 , SB484 , SB495 , SB496 , SB509 , SB56 , SCR9 , SCR58 , SB35 , SB65 , SB215 , SB246 , SB249 , SB269 , SB282 , SB296 , SB323 , SB363 , SB369 , SB474 , SB490 , SB492 , SB500 , SB514 , HCR32 , HB59 , HB89 , HB153 , HB243 , HB335 , HB342 , HB407 , HB451 , HB513 , HB595 , HB682 , HB688 , HB690 , HB730 , HB762 , HB802 , HB816 , HB940 , HB1003 , HB1011 , HB1029 , HB1053 , HB1058 , HB1062 , HB1064 , HB1079 , HB1084 , HB1098 , HB1161 , HB1189 , HB1203 , HB1215 , HB1247 , HB1248 , HB1251 , HB1253 , HB1257 , HB1258 , HB17 , HB27 , HB36 , HB41 , HB73 , HB140 , HB166 , HB181 , HB205 , HB211 , HB223 , HB226 , HB259 , HB271 , HB308 , HB337 , HB399 , HB410 , HB487 , HB626 , HB712 , HB740 , HB750 , HB759 , HB775 , HB812 , HB844 , HB906 , HB966 , HB968 , HB979 , HB1006 , HB1009 , HB1018 , HB1036 , HB1038 , HB1081 , HB1086 , HB1107 , HB1112 , HB1155 , HB1220 , HB1242 , HB1252 , HB1256 , SB42 , SB208 , SB217 , SB274 , SB300 , SB341 , SB379 , SB382 , SB387 , SB401 , SB449 , SB487 , HB74 , HB119 , HB134 , HB210 , HB258 , HB468 , HB784 , HB870 , HB953 , HB956 , HB1117 , HB1236 , SB29 , SB43 , SB78 , SB149 , SB441 , HB359

Keywords: SR146, Senate Resolution 146, Louis Thomas Nelson, Thomas Nelson, condolences, memorial resolution, tribute, obituary, public service, St. Martinville, Cade, St. Martin Parish, police juror, mayor, community center, water system, school bus driver, school board, Louisiana Senate, sympathy

Transcript Highlights:

• Members, this bill just extends the current policy in Collin County for health care for indigent patients
• Members, this bill is the one that informs consumers and patients about how to request their health care
• facility told the parents that because he didn't want to be admitted, they couldn't accept him as a patient
• Members, House Bill 5147 improves access to investigational adult stem cell treatments for patients with
• This bill allows them to be provided in more settings, giving patients more flexibility.

Bills: HB1535 , HB 123 , HB 111 , HB180 , HB342 , HB 1027 , HB 1178 , HB610 , HB 1277 , HB1615 , HB1620 , HB5342 , HB4885 , HB4751 , HB4689 , HB4530 , HB4488 , HB2149 , HB2041 , HB2071 , HB1813 , HB2282 , HB2248 , HB2243 , HB2522 , HB2310 , HB2513 , HB2300 , HB1902 , HB3719 , HB4284 , HB4327 , HB3743 , HB3778 , HB3801 , HB5153 , HB5147 , HB4877 , HB4850 , HB3158 , HB3261 , HB3005 , HB3033 , HB3138 , HB3099 , HB2849 , HB2967 , HB3488 , HB3477 , HB3466 , HB3396 , HB3469 , HB2594 , HB2776 , HB2564 , HB2298 , HB5331 , HB5646 , HB5247 , HB5323 , HB2015 , HB4384 , HB3896 , HB4014 , HB3627 , HB3594 , HB2524 , HB510 , HB561 , HB5111 , HB5446 , HB 1181 , HB3963 , HB2785 , HB1661 , HB2460 , HB24 , HJR138 , HB3800 , HB42 , HB 129 , HB677 , HB668 , HB2128 , HB2038 , HB2316 , HB3686 , HB2563 , HB 1160 , HB3883 , HB2788 , HB2663 , HB3305 , HB3474 , HB 1105 , HB3490 , HB3597 , HB 1295 , HB3512 , HB3783 , HB2017 , HB3010 , HB3112 , HB4215 , HB3223 , HB3464 , HB3120 , HB4214 , HB4081 , HB4783 , HB4063 , HB2783 , HB5085 , HB2510 , HB3426 , HB4361 , HB 1169 , HB2516 , HB4700 , HB3560 , HB3860 , HB3146 , HB184 , HB198 , HB247 , HB367 , HB449 , HB1778 , HB514 , HB632 , HB2582 , HB766 , HB2715 , HB2712 , HB3069 , HB3505 , HB 1269 , HB4224 , HB5032 , HB2240 , HB5180 , HB3348 , HB4668 , HB4665 , HB3395 , HB3157 , HB4395 , HB4325 , HB4386 , HB4273 , HB2760 , HB2820 , HB1828 , HB1579 , SB2349 , SB1268 , SB610 , SB1577 , SB1369 , SB2032 , SB2034 , SB1057 , SB1044 , SB922 , SB1759 , SB1143 , SB1506 , SB1403 , SB2361 , SB870 , SB372 , SB72 , SB1583 , SB2314 , SB1267 , SB1273 , SB765 , SB552 , HB2145 , HJR112 , HB1804 , HJR110 , HB 1194 , HB1531 , HB5008 , HB3421 , SCR27 , HB5398 , HB1407 , HB426 , HB1535 , HB 123 , HB1773 , HB1871 , HB2035 , HB2448 , HB2492 , HB1411 , HB4753 , HB4666 , HB4529 , HB1499 , HB1610 , HB2028 , HB1506 , HB886 , HB3546 , HB796 , HB223 , HB1475 , HB3556 , HB4638 , HB 111 , HB180 , HB342 , HB 1027 , HB 1178 , HB610 , HB 1277 , HB1615 , HB1620 , HB5342 , HB4885 , HB4751 , HB4689 , HB4530 , HB4488 , HB2149 , HB2041 , HB2071 , HB1813 , HB2282 , HB2248 , HB2243 , HB2522 , HB2310 , HB2513 , HB2300 , HB1902 , HB3719 , HB4284 , HB4327 , HB3743 , HB3778 , HB3801 , HB5153 , HB5147 , HB4877 , HB4850 , HB3158 , HB3261 , HB3005 , HB3033 , HB3138 , HB3099 , HB2849 , HB2967 , HB3488 , HB3477 , HB3466 , HB3396 , HB3469 , HB2594 , HB2776 , HB2564 , HB2298 , HB5331 , HB5646 , HB5247 , HB5323 , HB2015 , HB4384 , HB3896 , HB4014 , HB3627 , HB3594 , HB2524 , HB510 , HB561 , HB5111 , HB5446 , HB 1181 , HB3963 , HB2785 , HB1661 , HB2460 , HCR98 , HCR92 , HCR126

Keywords: Trinity River Authority, river authority, Sunset Advisory Commission, Texas Sunset Act, board of directors, governor appointment, public water authority, regional water authority, water resources, local government, natural resources, board training, ethics, open meetings, public information, conflict of interest, complaint procedures, public comment, director removal, governance reform

Summary: The House convened with a quorum present, heard an invocation and pledges, received Senate messages, and adopted several procedural motions allowing committees to meet during the session and postponing or scheduling certain committee hearings. Members also observed a memorial recognition for Wood County Deputy Sheriff Melissa Pollard, who died in the line of duty, and adopted a resolution honoring her service. The chamber then adopted House Resolution 897 recognizing May 6, 2025 as Golf Day in Texas and House Resolution 1063 recognizing Dallas Housing Coalition Advocacy Day; additional recognitions highlighted Mental Health Awareness Month and tardive dyskinesia awareness, The Woodlands’ 50th anniversary, Alzheimer’s advocacy, student athlete Gator Young, an intern in Rep. Leo-Wilson’s office, and educator Jessica Lopez. The House spent much of the day on third-reading consideration of a long calendar of bills. Among the measures passed were HB 24 on zoning protest procedures, HB 3800 creating a health care workforce advisory board, HB 42 on higher education appropriations, HB 129 restricting contracts with foreign adversary companies, HB 677 on county elections administrator political activity, HB 668 on license-to-carry renewal procedures, HB 2128 directing a rural firefighting study, HB 2038 expanding physician licensing options, HB 2316 on election result reporting, HB 3686 on retired peace officer ID cards, HB 2563 creating a prescribed burn manager self-insurance pool, HB 1160 increasing penalties for assaults on utility workers, HB 3883 on major events funding, HB 2788 protecting fraud-detection information, HB 2663 on inactive well plugging extensions, HB 3305 extending a county health provider participation program, HB 3474 on pension reporting, HB 1105 expanding tuition exemptions for certain paramedics, HB 3490 on closed meetings with internal auditors, HB 3597 on child care facility notice thresholds, HB 1295 on health literacy planning, HB 3512 on AI training for government employees, HB 3783 on court-ordered counseling, HB 2017 on intoxication manslaughter penalties, HB 3010 on rural disaster recovery, HB 3112 on cybersecurity-related public information and meetings, HB 4215 on delivery network companies, HB 3223 on construction claims limitation periods, HB 3464 on controlled substances in correctional facilities, HB 3120 on residential child detention facilities, HB 4214 on public information, HB 481 on trade secret sealing, HB 4783 on opioid antagonist program reporting, HB 4063 on unilateral memoranda of contract, HB 2783 on county employee deferred compensation, HB 5085 on seed banks, HB 2510 on assisted living facility operations, HB 3426 on digital driver’s licenses, HB 4361 on emergency notifications at higher education institutions, HB 1169 on oil and gas infrastructure protection, HB 2516 on Medicare supplement eligibility for Texans under 65, HB 3560 on hospital staff background checks, HB 3860 on occupational licenses for inmates, HB 3146 on SOAH hearings, HB 184 on loan repayment for border prosecution attorneys, HB 198 on firefighter cancer screenings, HB 247 on border security infrastructure taxation, HB 367 on excused absences for students with severe illnesses, HB 449 on deepfake sexually explicit images, HB 1778 on human trafficking and related offenses, HB 514 on maternal health workforce outreach, HB 632 on pharmacy regulation, HB 2582 on victim parole information, HB 766 on precinct chair ballot applications, HB 2715 on suspension/removal of officials, HB 2712 on water and sewer utility test years, HB 3069 on transmission projects, HB 3505 on health provider participation districts, HB 1269 on plant disease and pest prevention grants, HB 4224 on access to health care records, HB 5032 on historical documents in the Capitol complex, HB 2240 on void marriages, HB 5180 on diploma designation, HB 3348 on health provider participation programs, HB 4668 on PUC authority to retain assistance, HB 4665 on child care training providers, HB 3395 on beneficiary designation for manufactured homes, HB 3157 on interim electric utility rates, HB 4395 on electronic submission of public securities records, HB 4325 on bribery civil penalties, HB 4386 on annuity replacement transactions, HB 4273 on Medicaid fraud-related unlawful acts, HB 2760 on judicial review of unemployment decisions, HB 2820 on charitable bingo operating capital, HB 1828 on legislative leave for correctional officers, and a series of Senate bills including SB 2349, SB 1268, SB 610, SB 1577, SB 1369, SB 2032, SB 1057, SB 1044, SB 922, SB 1759, SB 1143, SB 1506, SB 1403, SB 2361, SB 870, SB 372, and SB 72. Several bills drew debate or amendments, including HB 24, where a germane point of order was sustained against an amendment, and HB 198, HB 3348, and SB 2361, which were amended before passage. Most measures passed by wide margins, though some drew notable opposition, including HB 3883, HB 514, HB 1295, HB 184, SB 1143, and others. The House also postponed further consideration of HB 4700 until the end of the day and HB 24 until 1 p.m., and it granted permission for committees to meet during the House session and for the Calendars Committee to meet that morning.

Transcript Highlights:

• four physicians have reported that prior authorizations have led to a serious adverse event for a patient
• For the patient, this means delays in care and treatment, abandonment, and can even force the patient
• Overall, this bill is going to allow patients to lead productive lives while managing their illnesses
• On behalf of thousands of frustrated patients, pharmacists, and doctors, I move final passage of the
• He adds that he knows Senator West would probably prefer that this bill be included in that category,

Bills: HJR98 , HB142 , HB912 , HB2525 , SCR19 , SB66 , SB128 , SB209 , SB250 , SB317 , SB383 , SB393 , SB397 , SB517 , SB571 , SB612 , SB614 , SB715 , SB731 , SB801 , SB865 , SB867 , SB872 , SB905 , SB913 , SB945 , SB946 , SB986 , SB1013 , SB1015 , SB1071 , SB1086 , SB1087 , SB1113 , SB1117 , SB1181 , SB1212 , SB1241 , SB1250 , SB1263 , SB1278 , SB1285 , SB1444 , SB1483 , SB1525 , SB1528 , SB1553 , SB1556 , SB1588 , SB1660 , SB1708 , SB1802 , SB1833 , SB1844 , SB1854 , SB1957 , SB1965 , SB1999 , SB2056 , SB2082 , SB2119 , SB2133 , SB2138 , SB2203 , SB2221 , SB2337 , SB2340 , SB2373 , SB2419 , SB2422 , SB2452 , SB2477 , SB2487 , SB2501 , SB2533 , SB2586 , SB2587 , SB2615 , SB2622 , SB2633 , SB2675 , SB2681 , SB2690 , SB2713 , SB2717 , SB2753 , SB2781 , SB2782 , SB2835 , SB2841 , SB2857 , SB2891 , SB2929 , SB2933 , SB2994 , SB3016 , SJR3 , SB5 , SB29 , SB72 , SB326 , SB494 , SB509 , SB530 , SB616 , SB769 , SB783 , SB963 , SB985 , SB1143 , SB1172 , SB1238 , SB1267 , SB1271 , SB1273 , SB1506 , SB1759 , SB1786 , SB1967 , SB2312 , SB2361 , SB1 , SB260 , SB1506 , SB1637 , HJR98 , HJR99 , HJR2 , HJR1 , HB 1109 , HB1392 , HB22 , HB2525 , HB3093 , HB517 , HB912 , HB 1130 , HB142 , HB1689 , HB2018 , HB136 , HB2884 , HB1393 , HB2730 , HB1399 , HB 1244 , HB467 , HB331 , HB2559 , HB29 , HB26 , HB166 , HB353 , HB2000 , HB2756 , HB3248 , HB3513 , HB3204 , HB3135 , HB3012 , HB2763 , HB2523 , HB2457 , HB2415 , HB2198 , HB2143 , HB1708 , HB1672 , HB767 , HB1327 , HB2723 , HB451 , HB140 , HB 109 , HB3096 , HCR6 , HCR12 , HCR29 , HCR50 , HCR55 , HCR56 , HCR58 , HCR70 , HCR71 , HCR74 , HCR78 , HCR80 , HCR107 , HCR116 , HCR117 , SJR36 , SJR50 , SJR63 , SJR59 , SCR12 , SCR39 , SCR48 , SCR19 , SB2023 , SB1844 , SB2533 , SB62 , SB666 , SB847 , SB284 , SB854 , SB1073 , SB810 , SB1505 , SB583 , SB507 , SB1434 , SB1772 , SB2016 , SB1163 , SB1122 , SB731 , SB397 , SB508 , SB1436 , SB287 , SB261 , SB1882 , SB393 , SB1791 , SB209 , SB2429 , SB1999 , SB511 , SB2309 , SB510 , SB1085 , SB1975 , SB2717 , SB1262 , SB636 , SB2056 , SB884 , SB517 , SB1200 , SB1845 , SB2681 , SB2458 , SB801 , SB3014 , SB3013 , SB758 , SB1013 , SB2797 , SB2076 , SB2876 , SB2929 , SB715 , SB1640 , SB2538 , SB1449 , SB986 , SB1181 , SB1359 , SB410 , SB1234 , SB2926 , SB2138 , SB2615 , SB2972 , SB2841 , SB3016 , SB1856 , SB1528 , SB1373 , SB672 , SB2891 , SB1854 , SB317 , SB2539 , SB2532 , SB1250 , SB2082 , SB2203 , SB1285 , SB1454 , SB2520 , SB1237 , SB1586 , SB2819 , SB629 , SB2342 , SB2903 , SB2477 , SB3029 , SB1957 , SB375 , SB250 , SB777 , SB2367 , SB2703 , SB2608 , SB2965 , SB2521 , SB865 , SB2165 , SB2501 , SB2675 , SB2452 , SB2835 , SB872 , SB1212 , SB1278 , SB1588 , SB1602 , SB1704 , SB1723 , SB1833 , SB1858 , SB1946 , SB2009 , SB2177 , SB2460 , SB2785 , SB2373 , SB1660 , SB614 , SB867 , SB1608 , SB1525 , SB905 , SB640 , SB2487 , SB1698 , SB383 , SB705 , SB748 , SB1113 , SB1117 , SB1802 , SB2340 , SB2586 , SB2680 , SB2690 , SB2994 , SB2747 , SB1950 , SB913 , SB1071 , SB1086 , SB1087 , SB1483 , SB1444 , SB1553 , SB1556 , SB1703 , SB2133 , SB2297 , SB2298 , SB2622 , SB2955 , SB3059 , SB2782 , SB2781 , SB2637 , SB2633 , SB2337 , SB2334 , SB1861 , SB2043 , SB1367 , SB946 , SB945 , SB2857 , SB128 , SB571 , SB1263 , SB3058 , SB612 , SB2221 , SB2587 , SB2044 , SB2363 , SB2713 , SB2311 , SB1986 , SB2565 , SB2943 , SB1888 , SB2417 , SB3048 , SB3052 , SB3053 , SB3036 , SB3057 , SB3056 , SB3043 , SB3037 , SB3050 , SB3063 , SB3047 , SB3035 , SB2446 , SB466 , SB2611 , SB2794 , SB2105 , SB2017 , SB1790 , SB1778 , SB1730 , SB2995 , SB2847 , SB205 , SB2619 , SB1903 , SB203 , SB3061 , SB1581 , SB2600 , SB2799 , SB2790 , SB2688 , SB2515 , SB1230 , SB876 , SB2522 , SB2639 , SB2137 , SB2519 , SB2403 , SB2459 , SB3051 , SB2655 , SB2251 , SB2764 , SB2878 , SB1884 , SB111 , SB582 , SB2617 , SB1835 , SB2751 , SB2959 , SB250 , SB614 , SB865 , SB872 , SB905 , SB986 , SB1113 , SB1212 , SB1278 , SB1525 , SB1588 , SB1660 , SB1802 , SB1833 , SB2487 , SB2586 , SB2675 , SB2690 , SB2929 , HB912 , HB2525 , SB1844 , SB2533 , SB1957 , SB1999 , SB2138 , SB2615 , SB3016 , SR469 , SB29 , SB326 , SB494 , SB530 , SB769 , SB783 , SB1238 , SB1967 , SB2312 , SB1506 , HJR34 , HB42 , HB198 , HB247 , HB367 , HB449 , HB632 , HB668 , HB677 , HB766 , HB 1105 , HB 1160 , HB 1169 , HB1592 , HB1778 , HB1781 , HB1868 , HB2017 , HB2038 , HB2128 , HB2240 , HB2316 , HB2510 , HB2516 , HB2563 , HB2582 , HB2663 , HB2712 , HB2715 , HB2760 , HB2788 , HB3010 , HB3069 , HB3112 , HB3120 , HB3146 , HB3157 , HB3305 , HB3348 , HB3464 , HB3474 , HB3505 , HB3512 , HB3560 , HB3597 , HB3686 , HB3783 , HB3860 , HB4063 , HB4081 , HB4214 , HB4215 , HB4224 , HB4273 , HB4325 , HB4361 , HB4386 , HB4395 , HB4665 , HB4783 , HB5032 , HB5180 , HJR34 , HB42 , HB198 , HB247 , HB367 , HB449 , HB632 , HB668 , HB677 , HB766 , HB 1105 , HB 1160 , HB 1169 , HB1592 , HB1778 , HB1781 , HB1868 , HB2017 , HB2038 , HB2128 , HB2240 , HB2316 , HB2510 , HB2516 , HB2563 , HB2582 , HB2663 , HB2712 , HB2715 , HB2760 , HB2788 , HB3010 , HB3069 , HB3112 , HB3120 , HB3146 , HB3157 , HB3305 , HB3348 , HB3464 , HB3474 , HB3505 , HB3512 , HB3560 , HB3597 , HB3686 , HB3783 , HB3860 , HB4063 , HB4081 , HB4214 , HB4215 , HB4224 , HB4273 , HB4325 , HB4361 , HB4386 , HB4395 , HB4665 , HB4783 , HB5032 , HB5180

Summary: The Senate convened with a quorum present, heard an invocation, adopted the prior day’s journal, received House messages, and adopted several resolutions and recognitions, including Senate Resolution 496 honoring Leadership Garland and resolutions 503 and 504. The chamber also recognized guests, including a North Dakota senator and the Doctor of the Day, and received gubernatorial nominations for the Texas Economic Development Corporation Board and the Nueces River Authority Board. The Senate then took up and passed a series of bills, often by suspending the regular order and the constitutional three-day rule. Measures approved included SB 614 on Texas Forensic Science Commission referrals to the Office of Capital and Forensic Writs; SB 250 on municipal annexation across railroad rights-of-way; SB 1660 on toxicological evidence retention and destruction procedures; SB 2586 requiring property owners associations to file governing documents with the Texas Real Estate Commission; SB 1588 increasing penalties for certain failures to report child sexual abuse; HB 912 on compensation for distributed renewable generation outside ERCOT; SB 1957 setting eligibility standards for civilian oversight boards; HB 2525 clarifying a charitable property tax exemption; SB 1525 limiting repeated prior authorization for neurodegenerative disease drugs; SB 865 requiring CPR/AED training and cardiac emergency response planning in schools; SB 1212 elevating human trafficking penalties; SB 2690 on solicitations for Secretary of State documents; SB 1802 on landlord repair duties for ramps, elevators, and handrails; SB 905 on licensing rules for speech-language pathologists and audiologists; SB 2929 allowing removal of disruptive spectators at school athletic events; SB 2675 creating a narrow McAllen-specific parkland conveyance exception; SB 872 increasing punishment for burglary of a vehicle involving firearm theft; and SB 1113 clarifying sales rules for certain converter-license holders. Several bills drew extended debate. SB 2487, dealing with crisis and mental health services for homelessness, was amended to make the county model permissive rather than mandatory and to remove state funding/assistance requirements before passing 28-3. SB 2138, barring higher education funds from contracting with firms that boycott fossil fuels through ESG policies, also passed after questions about fiscal effects and First Amendment concerns. SB 2615, restricting remote work at public institutions of higher education, advanced 22-9. The Senate also began consideration of SB 3016, which would expand enforcement tools against local governments that fail to comply with state law, but the transcript cuts off before action on that bill is completed.

Transcript Highlights:

• They play a very key role in patient care.
• They play a very key role in patient care.
• Ketamine does not work for all patients.
• With a maximum of 1,000 patients. Maximum of 50 providers.
• This is important so we have a record of exactly what the patient is receiving.

Bills: HF3454 , HF3917 , HF2906 , HF3832 , HF3769

Committee: House Health Finance and Policy

Transcript Highlights:

• An exemption from a tax preference performance statement, JLARC review, and the 10-year expiration is
• And then part five of the bill creates the tax preference performance...
• And then part five of the bill creates the tax preference performance statement, the 10-year expiration
• My name's Jim Freiburg, pro on House Bill 2487, on behalf of the Patient Coalition of Washington.
• We unite 18 of the state's leading patient groups to have one voice for better health care.

Bills: HB2038 , HB2297 , HB2382 , HB2487 , HB2018

Committee: House Finance

Keywords: HB2038, Washington, B&O tax, business and occupation tax, social media tax, platform tax, youth behavioral health, mental health, adolescent mental health, children's mental health, telebehavioral health, behavioral health account, state treasury, digital services tax, internet platform, social media companies, youth services, depression, anxiety, public health funding

Transcript Highlights:

• The physician and patient relationship is built on trust.
• And if you have a preference, you are sent to that shop of preference.
• We honor preference, period. It's against the law. It's a best practice.
• Or if I were to be asked, do I have a preference? I have no idea unless I do research.
• What's the next step if they say I have no preference? Go ahead. Sure.

Committee: Senate Judiciary

Summary: The committee heard several bills, with testimony largely focused on child safety, immigrant community transparency, agricultural land security, consumer protection, estate transfers, detention commissary pricing, and public works wage enforcement. SB 1234 would require fentanyl to be included in drug tests ordered by juvenile courts for parents or guardians in dependency cases; the author said it was a narrow child-safety measure, and there was no opposition. SB 1257 would require the Attorney General to publish annual reports on immigration enforcement incidents at designated safe locations; supporters said it would improve accountability and document fear in immigrant communities, while questions centered on how the data would be collected and concerns were raised about sanctuary policies. SB 1176 would bar foreign adversary entities from buying or controlling California agricultural land; supporters framed it as a national security measure, while committee members pressed the author on enforcement, who would verify buyers, and possible discriminatory application. The bill was moved on a 2-4 vote and placed on call after the author said he would work on clarifying responsibility and nondiscrimination concerns. The committee also heard SB 1146, which would require clear disclosure when AI-generated or altered images, audio, or video are used in health-related advertisements depicting health care providers. The California Medical Association and California Dental Association supported the bill, saying it would curb deceptive deepfake ads and protect consumers; it passed unanimously, 7-0. SB 988 would restrict assignment of benefits in auto glass claims, require claim numbers and itemized estimates, and update repair disclosure rules to curb overbilling and steering; supporters said it would protect consumers and stabilize insurance costs, while independent glass shop concerns about steering and market concentration were discussed. The bill passed 7-0, with one member abstaining because of a conflict. SB 1288, presented on behalf of Senator Laird, would require financial institutions to make good-faith efforts to notify beneficiaries of non-probate assets and would simplify access requirements, especially for nonprofits. Supporters described long delays and burdensome account-opening requirements; SIFMA and the California Bankers Association opposed the bill unless amended, citing conflicts with federal and industry obligations and concerns about retroactive burdens. The bill passed 8-0. SB 941 would cap commissary markups in private immigration detention facilities at 35% above vendor cost; supporters said detainees often pay excessive prices for basic necessities, and the bill passed 8-0. Finally, SB 909 would raise and index public works contractor fees and penalties and dedicate more penalty revenue to enforcement; labor supporters said stronger funding is needed to address wage theft and backlogs, while contractors warned of uncapped costs and reduced transparency. The discussion continued with questions about enforcement and whether stronger penalties or license restrictions would better deter repeat violators.

Transcript Highlights:

• We think that where there's an opportunity to support families and keep them together, that is preferable
• So, for example, this summer patients at Eastern State Hospital, are we trying to do moving forward?
• So for example, this summer patients at Eastern State Hospital, So, for example, this summer patients
• And part of the reimagined helped us do was we’ve successfully discharged quite a few patients out of
• So there's really nothing that is, we've already removed the ability for new patients.

Committee: House Early Learning & Human Services

Summary: The committee heard an update on Washington’s child welfare system from Casey Family Programs and then from DCYF. Dr. David Sanders presented national and state trends showing fewer children entering and remaining in out-of-home care, more kinship placements, and relatively low use of group homes, but he also flagged concerns about children lingering in care for years and an increase in repeat maltreatment and child fatalities. He urged stronger focus on infants and young children, better coordination among child protection, health care, and law enforcement, and more proactive review and decision-making practices. Members asked for disaggregated data on children remaining in care, fatalities, and the role of fentanyl and other factors. DCYF said Washington has increased relative placements and guardianships, citing prior legislative changes such as HB 1747, HB 1227, and SB 6109. Officials reported a rise in critical incidents in 2025, especially near-fatalities involving children age three and under, many tied to opioid exposure, and described responses including safe child consults, hotspot identification, more training on neglect and medically complex cases, updated safety tools, and expanded community supports and peer services. Members pressed DCYF on cross-agency collaboration, preventive services, and whether a broader commission on child abuse prevention should be created; DCYF said it would be open to discussing that and noted existing work with health and legal partners. The committee then received a DSHS update on the agency’s “Reimagined” reorganization. Secretary Angela Ramirez said the restructuring consolidates administrations to reduce silos, improve customer experience, and better coordinate services across behavioral health, habilitation, aging, long-term support, technology, and analytics. She said DSHS will seek statutory alignment and CMS approval and is also redesigning its website. Members asked about federal HR1 impacts, SNAP, and whether DSHS has a team tracking federal changes; Ramirez said the agency is monitoring developments and will coordinate with legislators. Finally, DSHS provided an update on residential habilitation centers and implementation of SB 5393, which phases out new long-term admissions at Rainier School and closes it by June 30, 2027. Officials reported current census and capacity figures for the state’s RHCs, described recent resident transitions from Rainier, and said emergency and permanent rulemaking are underway. They also disclosed that a recent CMS survey found Rainier out of compliance with the active treatment condition of participation, prompting corrective action plans and a 90-day window to return to compliance. Members questioned the meaning of active treatment, the lack of available capacity, the consequences of noncompliance, and whether Rainier could be repurposed for other services; DSHS said it is working to correct the deficiencies and is open to future uses if directed and funded by the legislature.

Transcript Highlights:

• We think that where there's an opportunity to support families and keep them together, that is preferable
• So for example, this summer patients at Eastern State Hospital, So, for example, this summer patients
• It's resulted in much better patient care.
• Part of the reimagined effort helped us do was we've successfully discharged quite a few patients out
• So there's really nothing that is—we've already removed the ability for new patients. Am I?

Summary: The committee heard a lengthy update on Washington child welfare from Casey Family Programs and DCYF. Dr. David Sanders said Washington has sharply reduced out-of-home care and increased kinship placements, but he flagged concerns about low screening-in rates, long stays in foster care for many children, and a recent rise in repeat maltreatment and child fatalities, especially among infants. He urged more focus on infants and young children, better coordination among child protection, health care, and law enforcement, and more proactive review and investigation practices. Members asked for disaggregated data on children lingering in care, fatalities, and causes such as fentanyl exposure. DCYF said it has increased relative placements and guardianships, but also reported a concerning rise in 2025 critical incidents, mostly near-fatalities involving children age three and under, many opioid-related. The department described responses including safe child consults for opioid cases, more training, hotspot analysis, and proposed investments in peer support, public health nurses, community referrals, and an updated safety framework. Members also discussed whether a broader commission on child abuse prevention would be useful, and DCYF said it was open to that idea. The committee then received a DSHS reorganization update from Secretary Angela Ramirez, who described the “Reimagined” plan to consolidate four administrations into three new ones, with the stated goals of reducing silos, improving customer experience, and making transitions between services smoother. She said the agency is seeking statutory changes and CMS approval to align the new structure, and members asked about preparing for federal HR1 impacts, especially SNAP. Ramirez said DSHS is monitoring those impacts closely and emphasized the need for accurate data and cross-agency coordination. Finally, DSHS’s Behavioral Health and Habilitation Administration updated the committee on residential habilitation centers and implementation of Substitute Senate Bill 5393, which phases out Rainier School by June 30, 2027 and limits new admissions. Officials reported current census and staffing levels at the state’s RHCs, said Rainier has had some residents transition to supported living or adult family homes, and explained that emergency and permanent rulemaking was needed to implement the law. They also said Rainier was recently cited by federal surveyors for not meeting the active treatment requirement for two residents, and that the facility has 90 days to return to compliance before possible payment penalties or further remedies. Members pressed for details on the citation, the meaning of active treatment, the assessment process for admissions, and whether Rainier could be repurposed for other services; DSHS said it is working on corrective action and will follow up in writing.

Transcript Highlights:

• for remaining in their homes preferences for remaining in their homes and<00:13:01.120><c> communities
• </c><01:02:26.799><c> to</c> out of four Americans would prefer to out of four Americans would prefer
• </c><01:12:51.920><c> and</c> of those two theoretical patients and of those two theoretical patients
• specifically uh for nursing home patient specifically uh for an<01:18:37.679><c> insurance</c><01:18
• all the uh patients are discharged into<01:23:36.400><c> the</c><01:23:36.639><c> community.

Summary: The Committee to Study Long-Term Managed Care met to approve prior minutes and outline its schedule, with meetings set for September 24 and September 29 ahead of an October 1 report deadline. The chair said the committee would use the first two meetings to digest testimony, likely ask follow-up questions of DHS, and then work toward conclusions and a report format. The minutes from the previous meeting were approved unanimously. The main testimony came from Sharon Alexander of Amera Health, who argued in favor of moving from fee-for-service Medicaid long-term services and supports to a managed LTSS model. She described managed LTSS as a capitated, quality-driven system used in about 26 states, and said it can improve care coordination, accountability, access to home- and community-based services, and budget predictability. She cited Amera Health’s experience in Pennsylvania and Delaware, including care coordination, housing and transportation support, caregiver programs, and quality benchmarks tied to state oversight. She also said nursing facilities would remain an important option for people who need that level of care. Committee members asked about how the programs are administered, how rates are set, how care managers work, and how quality is measured. Alexander said states contract with managed care organizations at actuarially sound capitated rates, with annual contracts, reporting, and oversight. She explained that care managers typically conduct quarterly assessments and follow up after trigger events such as hospitalization, and that housing coordinators may assist with transitions to the community. On quality, she said states use CMS-related and HCBS benchmark measures covering service timeliness, care planning, transitions, and other outcomes, and that New Hampshire could build on existing metrics rather than starting from scratch. She also noted that rural areas face workforce and transportation challenges, which managed care plans try to address through technology and self-direction options.

Transcript Highlights:

• So we give it a little preference slider, is what we call it.
• I think patient safety ought to be non-negotiable.
• We're blinded to patient names and things like that, so we're 100% HIPAA compliant.
• We're blinded to patient name and things like that. So we're 100% HIPAA compliant.
• And evidence-based guidance really protects patient safety and helps preserve public trust.

Summary: The Senate Health and Long-Term Care Committee opened its 2026 session with a work session focused on the committee’s priorities of access, quality, and affordability. Health Care Authority staff Michelle Needham and Ross Florey reviewed the Health Care Cost Transparency Board’s work, noting Washington’s uninsured rate has fallen from 15% in 2010 to 5%, but health care spending growth remains above the benchmark. They said 2023 spending grew 6.2% versus a 3.2% target, with prescription drugs, hospital outpatient care, professional services, and non-claims spending driving growth. They highlighted ongoing work on market transparency, hospital spending, primary care, and federal policy changes that could reduce coverage and increase uncompensated care. Dr. Drew Oliva of the Washington Health Alliance added quality and safety data, saying many measures remain below top national performance, primary care attachment is weak, hospital pricing varies widely, and behavioral health data are limited. He urged stronger primary care investment, more transparency, and better patient safety oversight. Committee members then introduced themselves and staff before moving to public hearings. The committee first heard Senate Bill 5877, a technical fix expanding the physician health program surcharge to certified anesthesiologist assistants so they can participate in the Washington Physicians Health Program and related educational resources. The bill sponsor and witnesses from the Washington Medical Commission, the Washington Academy of Anesthesiologist Assistants, and the Washington Physicians Health Program all supported the measure, describing it as a consistency and access fix for a newly licensed profession. The bill drew 12 pro, 2 con, and 0 other sign-ins. The committee then heard Senate Bill 5967, which would preserve access to preventive services by allowing the Department of Health to issue immunization recommendations based on multiple expert sources and by freezing state insurance coverage protections for preventive services and vaccines as of mid-2025, with OIC rulemaking authority to keep coverage at least as favorable. The sponsor, Insurance Commissioner Patty Kuderer, Secretary of Health Dennis Worsham, and Governor’s office staff said the bill is intended to protect existing coverage, not create new vaccine mandates, and to keep recommendations grounded in science amid federal uncertainty. Supporters included Dr. Helen Chu, Dr. Beth Harvey, Dr. Maria Huang, Dr. J. Miller, and Dr. Matt LaGalbo, who emphasized vaccine safety, rising vaccine-preventable diseases, and the importance of no-cost preventive care. Opponents, including Bob Runnels and Natalie Chavez, argued the bill politicizes vaccines, reduces transparency, and expands state authority without adequate fiscal detail. The hearing continued with additional testimony after the excerpt ended.