Transcript Highlights:

• I'm a fourth-generation Idahoan and married to a fourth-generation Idahoan.
• Because you can have a generic that might be at a lower cost, but then... ...a generic that might be
• So the youth that are put in the facility... ...into the facility, and the kids will get it as well.
• There are applications for facilities. Facilities have to accept your child.
• There are applications for facilities. Facilities have to accept your child.

Committee: House Health and Welfare

Keywords: 989, all

Transcript Highlights:

• and Florida is that we are a state-owned facility.
• Facilities in, let's say, Ohio and Florida is that we are a state-owned facility.
• Uh first, we are a multi-use facility.
• Uh first, we are a multi-use facility.
• Uh first, we are a multi-use facility.

Committee: Senate State & Local Government

Keywords: Meeting Start: 00:07 Attendance Roll Call: 00:14 SB 68 Discussion 01:21 SB 68 Vote 04:40 SB 20 Discussion 05:34 SB 20 Vote 08:12 Adjournment: 09:15, 958, all

Transcript Highlights:

• </c> facilities and some mandated reports. facilities and some mandated reports.
• ,</c> morning, we had the inspector general, morning, we had the inspector general, uh,<00:03:07.760>
• </c> the facility and elope and the facility the facility and elope and the facility doesn't<00:14:55.360
• </c> &gt;&gt; At state facilities. &gt;&gt; At state facilities.
• </c> to do a full facility survey for us. to do a full facility survey for us.

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Human Services met to review budget items carved out in the prior session budget, including long-term care surveyor contracts, funding for local health departments, and expansion of the central laboratory. The committee approved the June 4 minutes and then heard an update from the Office of Inspector General’s Division of Health Care on long-term care certification surveys and complaint investigations. Officials said the $1 million annual appropriation for contracted survey work, along with salary increases and other resources, helped the state reduce its backlog. They reported that Kentucky completed 101 long-term care certification surveys in fiscal year 2024, up from 28 in fiscal year 2023, and had completed 186 surveys by July 7, 2025, with a goal of 40 to 50 more before the end of fiscal year 2025. Outstanding complaints fell from 1,565 at the end of fiscal year 2024 to 695 by July 7, 2025, and outstanding priority-one or immediate-jeopardy complaints were reduced to zero. Members asked about the definition of priority-one cases, survey timing, the number of facilities still overdue, vacancy rates, federal funding reliance, and the use of contract surveyors. Officials said priority-one cases involve serious harm or high risk of harm, that surveys are required within a 12- to 15.7-month window, and that the agency now has 40 contract surveyors and an outside team option. Several members praised the progress but warned that delays in surveys can endanger residents and urged continued funding and monitoring. The committee then began hearing from Mike Tuggle of the Department of Public Health on the Public Health Transformation Initiative, with Tuggle noting the legislation’s importance to public health financing. The transcript cuts off as he began his remarks.

Transcript Highlights:

• Contraband in correctional facilities is not new.
• , depending on the market of the facility.
• Also, as a reminder, our Windham School District has a robust general library on every facility, new
• Is it the Office of Inspector General?
• And if he wants to run in on a facility...

Committee: Senate Criminal Justice

Keywords: 1185, senate, all

Transcript Highlights:

• to generate $130 million in revenue for the company.
• to generate $130 million in revenue for the company.
• These are federal facilities.
• facilities, and this gets to the opponent's point of view, that you shut down the private facilities
• And he passed away due to the lack of facility.

Summary: The Assembly Committee on Revenue and Taxation heard several bills, most of them referred to the suspense file because of their fiscal impact. AB 2465 and AB 1675 would deny state grants, loans, tax credits, or other benefits to companies doing business with ICE or related immigration-enforcement agencies; both drew strong support from immigrant-rights, labor, and community groups, and opposition from CalChamber and industry groups that argued the bills were overly broad and could affect unrelated federal contracts. AB 1633 would impose a 50% gross receipts tax on for-profit private immigration detention facilities, with supporters saying it would hold companies accountable for dangerous conditions and opponents warning it was punitive and could disrupt detention operations. The committee also heard AB 2089, which would streamline the welfare property tax exemption process for affordable housing, and AB 2250, a cleanup bill to clarify hemp enforcement laws; both were supported by affected industry and advocacy groups, while county assessors and tax collectors opposed AB 2089 unless amended over workload and implementation concerns. AB 2172, which would allow counties to use a single-member assessment appeals commissioner for complex property tax appeals, was the only bill taken up for a vote during the meeting. Supporters, including Los Angeles County Assessor Jeffrey Prang, said the change would reduce a large backlog and speed resolution of appeals; the committee adopted amendments and passed the bill 4-0 to the Assembly Committee on Appropriations. The committee also heard AB 2319, creating a proposed post-production tax credit to keep film and television post-production work in California, with support from labor and industry representatives who said jobs and spending were leaving the state; the author said the bill still needed work on labor standards and the annual credit cap. Finally, AB 2403 was presented to create a commercial production tax credit to keep commercial shoots in California. The author and supporters said commercial production has declined sharply in the state and that other states are winning work through targeted incentives, while labor-backed witnesses argued the bill would protect middle-class jobs and local spending. The transcript ends during the presentation of AB 2403, before any vote or final action on that measure.

Transcript Highlights:

• So, you know, really carving in skilled nursing facilities and sub-acute facilities into managed care
• In skilled nursing facilities and sub-acute facilities into managed care for the first time, so working
• I've been working at a facility for 15 years.
• We are a family-owned and operated facility.
• serve as a general fund backfill.

Summary: The subcommittee heard a lengthy Department of Health Care Services presentation on the governor’s Medi-Cal budget, including a $229.1 billion total-funds proposal, projected Medi-Cal enrollment declines as redeterminations continue, and several major cost drivers such as managed care growth, Medicare-related costs, pharmacy spending, and changes tied to federal policy. Members focused heavily on the elimination of Prop. 56 dental supplemental payments beginning July 1, 2026, questioning the likely impact on provider participation and utilization. DHCS said it is completing the required rate reduction/access analysis for CMS, has been holding stakeholder meetings and issuing provider bulletins, but could not yet quantify the real-world effect. The committee also discussed a $50 million savings proposal tied to new hospice utilization management authority and asked about possible effects on emergency dental care and provider participation. The hearing then moved through the November 2025 family health estimate and several county and program administration issues, including CCS, GHPP, and Every Woman Counts. DHCS said family health costs are rising despite slight caseload declines because of higher utilization and medical costs, and members raised concerns about CCS website accessibility, county administrative funding, and the transition of youth aging out of CCS. The department said most CCS beneficiaries are also on Medi-Cal, that counties have long raised funding concerns, and that it had clarified use of maintenance-and-operations dollars to address some county workload issues. Members also asked about Every Woman Counts potentially seeing higher demand as Medi-Cal changes take effect; DHCS said that is possible and that the program has multiple funding sources including General Fund. A major portion of the hearing focused on provider taxes and federal changes under H.R. 1, especially the Medi-Cal managed care organization tax and the hospital quality assurance fee. DHCS explained that H.R. 1 restricts new or increased health care-related taxes, phases down allowable tax levels over time, and tightens “generally redistributive” rules, which could sharply reduce the state’s ability to use the MCO tax for Medi-Cal financing. Members asked whether the Legislature could amend Prop. 35 or whether voters would need to act; DHCS said a three-fourths legislative amendment may be possible if it aligns with the measure’s purpose, but the department is still evaluating options. The committee also discussed hospital financing, with DHCS describing recent increases in state-directed payments and the effect of H.R. 1 in capping those payments at Medicare levels, and the LAO noting the tradeoff between preserving provider taxes and maintaining Medi-Cal funding. The subcommittee also reviewed a series of DHCS budget change proposals and trailer bill items, including managed care final-rule implementation, managed care operations, a hospital value strategy, a one-year extension of skilled nursing facility financing, long-term care payment transparency, and interoperability/prior authorization requirements. Members repeatedly questioned the use of limited-term versus permanent positions, the overlap among proposals, and the timing of new financing reforms. DHCS said the SNF extension would preserve current workforce standards, sanctions, growth limits, and the SNF quality assurance fee while the department develops a broader 2027-28 redesign. No votes were taken; items were repeatedly held open for later action. Covered California then presented on the expiration of the federal enhanced premium tax credit and the resulting affordability crisis. The agency said Californians will lose about $2.5 billion in premium assistance for 2026, average premiums could nearly double for many enrollees, and as many as 400,000 people could eventually leave marketplace coverage. Open enrollment ended with 1.9 million sign-ups, down 3% from the prior year, with especially steep declines among middle-income consumers and increased movement into bronze plans. Covered California said the state’s $190 million affordability subsidy is helping lower-income enrollees retain coverage, but cannot fully replace the lost federal assistance. Members also asked about the Health Care Affordability Reserve Fund, repayment of loans from that fund, the status of federal review of California’s essential health benefits benchmark, and implementation of the new gender-affirming care benefit under AB 144.

Transcript Highlights:

• Proceeds will be used to convert a work release facility into a full security facility.
• Proceeds will fund facility improvements and related equipment.
• school bonds, Series 2021, with tax-exempt bonds to generate savings.
• The documents do require a first-fill covenant for the proposed facilities.
• “Okay, because generally those are before. So I’m just confused.”

Keywords: 974, senate, all

Summary: The State Bond Commission met on May 21 with a quorum present and approved the April 16 minutes. The commission then reviewed and approved a large slate of local government and public authority financing requests, including election propositions for the November ballot, water and sewer infrastructure projects, fire protection and recreation district bonds, school board financing, and several refunding transactions. Most items were found to meet technical requirements and were approved on motions by Speaker DeVillier and seconded by Senator Talbot. Among the more notable items were the East Baton Rouge City-Parish refunding bonds for the Greater Baton Rouge Airport District, the City of Kenner’s retroactive approval request tied to a convention center agreement with GMB Basketball LLC, a Louisiana Housing Corporation financing increase for the Federal City Building 10 affordable housing project, and preliminary approval for the Northwest Louisiana Finance Authority’s Petro Tower redevelopment in Shreveport. The commission also approved financing for Southern University’s Scott’s Bluff student housing project and the Crescent City Schools/Harriet Tubman Charter School project. The Crescent City Schools item prompted questions about how MFP funds are used; staff explained that lease payments would support the bonds and that MFP funds are generally split between educational expenses and facilities-related costs. The commission received six monthly cost-of-issuance reports, which required no action, and a status update on the state debt schedule. It also approved Resolution No. 2 authorizing up to $425 million in general obligation refunding bonds to refund the Series 2016 bonds and tender other outstanding bonds for savings, with pricing tentatively set for June 16 and closing for June 30. During other business, New Orleans City Council President J.P. Morel thanked the commission for its role in helping address the city’s fiscal crisis and for approving a charter amendment election item aimed at strengthening budget oversight. The meeting adjourned after no further business.

Transcript Highlights:

• I'm a fourth-generation Idahoan and married to a fourth-generation Idahoan.
• Because you can have a generic that might be at a lower cost, but then A generic that might be at a lower
• First off, as I hope it was made clear, when a generic medication is made available, the generic medication
• So the facility could just do their thing, and I'm not picking on any one facility, but it's happened
• There's applications for facilities. Facilities have to accept your child.

Summary: The committee first introduced RS 33403, a follow-on podiatry bill that would merge podiatry with the Board of Medicine and move certain rules into statute. Representative Ehlers explained it was a replacement for prior legislation, and the committee voted to introduce it without objection. The committee then heard House Bill 713 on copay accumulator policies. Representative Cannon and co-sponsor Representative Furman argued the bill would stop insurers from refusing to count third-party copay assistance toward deductibles and out-of-pocket maximums, especially for patients with expensive specialty drugs. Supporters, including patients and advocates, described serious financial hardship and treatment adherence problems caused by accumulators. Opponents, including the Idaho Association of Health Plans, argued the bill would raise costs and premiums, could conflict with Idaho’s anti-kickback law, and might interfere with private plan design. After debate, the committee voted 7-8 against the motion to send HB 713 to the floor, so the bill was held in committee. Next, the committee took up House Bill 655 and its related RS 33527, a pilot program to incentivize preceptorships by giving certain Medicaid providers a 12-month exemption from prior authorization requirements. The sponsor said the goal was to reduce administrative burden and increase training opportunities in rural areas and in family practice, psychiatry, and OB-GYN, with caps on participation and expansion to advanced practice providers and PAs in the RS. The committee first voted to hold HB 655 in committee, then approved RS 33527 for introduction and second reading. Finally, the committee heard House Bill 723 on children’s residential facilities. Representative Erickson said the bill would add quality-of-care oversight, annual unannounced inspections, resident and staff interviews, a youth bill of rights, and critical incident reporting, based on an OPE study and prior testimony about abuse and gaps in oversight. Testifiers, including parents and former residents, described abuse, isolation, and lack of reporting mechanisms in facilities and supported the bill. The committee discussed whether the bill created enforceable rights, but the sponsor said existing child protection and corrective action processes would apply. The bill was moved to the floor with a due pass recommendation.

Transcript Highlights:

• facility being built.
• </c> facility space in September of 2028. facility space in September of 2028.
• </c> that are required of these facilities. that are required of these facilities.
• </c> generate those credits. generate those credits.
• </c> future generations. future generations.

Bills: HF3599 , HF3761 , HF3523 , HF3515 , HF573

Committee: House Capital Investment

Keywords: water treatment, infrastructure, municipal funding, bond issuance, Becker, sewer improvements, sanitation, Hibbing, state bonds, infrastructure funding, capital investment, safety improvements, mobility, U.S. Highway 12, bonds, transportation funding, trails, Prior Lake, bond funding, recreational improvements

Transcript Highlights:

• We have Major General. General Thomas Schuessler, General, welcome. And Brigadier General.
• Brigadier General Moni Ulis. Did I say that correct, sir? Yes, sir. Welcome, General.
• That is General Ulis and General Camacho will come and talk to you, the Air and Army National Guard.
• So I'm going to call up now General Andrew Camacho. He's the Adjutant General for the Air side.
• They are all in VA facilities, county facilities, military installations, or a U.S. military facility

Committee: House S/C on Defense & Veterans' Affairs

Keywords: 1184, house, all

Transcript Highlights:

• </c> Facility Prison. Facility Prison.
• </c> controls than in the general population. controls than in the general population.
• facility.
• . facilities. facilities.
• Minimum-security facilities.

Keywords: 910, house, all

Transcript Highlights:

• So, you know, really carving in skilled nursing facilities and sub-acute facilities into managed care
• In skilled nursing facilities and sub-acute facilities into managed care for the first time, so working
• I've been working at a facility for 15 years.
• W-QIP is critical in helping facilities rebuild the workforce and W-QIP is critical in helping facilities
• serve as a General Fund backfill.

Summary: The subcommittee heard an overview of the Department of Health Care Services’ proposed budget, including a $229.1 billion total-funds budget and projected Medi-Cal enrollment decline as redeterminations continue. Members focused heavily on the fiscal and programmatic effects of prior budget solutions and federal changes, especially the elimination of General Fund-supported Prop. 56 dental supplemental payments beginning July 1, 2026, the hospice utilization-management change, and the impact of reduced caseloads alongside rising health care costs. DHCS said it is still completing required access and rate-reduction analyses for the dental cuts and has been engaging stakeholders, but could not yet quantify the real-world effect on utilization or provider participation. The committee also reviewed the November 2025 Medi-Cal local assistance estimate, which shows higher General Fund spending despite lower enrollment, driven by managed care rate growth, Medicare cost growth, state-only claiming, and federal policy changes. The hearing then turned to provider taxes and federal H.R. 1 constraints, with extensive discussion of the MCO tax, the hospital quality assurance fee, and other health care-related taxes. DHCS explained that H.R. 1 phases down allowable tax levels and tightens “generally redistributive” rules, making the current MCO tax structure and the proposed higher hospital fee levels difficult or impossible to renew as originally designed. Staff and the LAO described the tradeoff between preserving Medi-Cal funding and avoiding higher costs on private providers and consumers. Members asked about options for preserving revenue, including possible amendments to Prop. 35 or returning to voters, and were told the department is still evaluating approaches while federal guidance remains in flux. The committee also reviewed hospital payment increases already implemented through state-directed payments, with DHCS noting that H.R. 1 will force those payments down to Medicare levels over time. Several budget change proposals were discussed and left open, including requests tied to the managed care final rule, managed care operations, hospital value strategy, long-term care payment transparency, and interoperability requirements. The committee also heard about a one-year trailer bill extension for skilled nursing facility financing, including continuation of the SNF workforce standards program, the SNF quality assurance fee, and annual rate growth, while the department develops a longer-term financing redesign for 2027-28. Members expressed skepticism about repeated rate reform efforts and questioned whether a one-year extension of the eliminated workforce quality incentive program should be restored during the transition. Finally, Covered California presented its budget and enrollment update, reporting that the expiration of the federal enhanced premium tax credit is expected to reduce affordability significantly, with average premiums roughly doubling for many enrollees and as many as 400,000 Californians potentially losing marketplace coverage over time. The exchange said California’s $190 million subsidy program is helping lower-income enrollees, but not enough to offset the federal loss, and it is also implementing a new gender-affirming care benefit and awaiting federal action on benchmark plan changes.

Transcript Highlights:

• to generate $130 million in revenue for the company.
• to generate $130 million in revenue for the company.
• These are federal facilities.
• Your intent is to shut down the ICE detention facilities.
• Your intent is to shut down the ICE detention facilities.

Committee: House Revenue and Taxation

Keywords: 988, house, all

Transcript Highlights:

• The bill requires facility operators to grant The bill requires facility operators to grant reasonable
• First, it is neutral and generally applicable law.
• . safety for all of our detention facilities.
• of detention facility, particularly, I think, the youth facilities are important and are vital.
• Detention facilities didn't apply to secure youth treatment facilities?

Summary: The Assembly Health Committee heard several bills focused on mental health access, preventive care, health care costs, detention oversight, and daylight saving time. SB 989 would streamline Care Court referrals by allowing first responders to ask county behavioral health agencies to review and file petitions; supporters, especially firefighters and families, said the current process is too burdensome, while Disability Rights California and other opponents argued Care Court is coercive and unproven. SB 1089, as amended, would direct CalRx/HHS to help distribute GLP-1 medications more broadly and more affordably; the author described her own experience with the drugs, and the bill drew support from medical and life sciences groups with no opposition. SB 1309 would eliminate out-of-pocket costs for medically appropriate lung cancer screening follow-up care; cancer advocates and survivors strongly supported it, while health plans and insurers opposed it as costly and said the bigger problem is low initial screening rates. The committee also heard SB 1284, which would require DHCS to report large employers whose workers are enrolled in Medi-Cal and estimate taxpayer costs, framed by supporters as a transparency measure about corporate reliance on public coverage. SCR 7, urging permanent standard time for health reasons, passed with support from medical groups and no opposition. SB 995, the Masuma Khan Justice Act, would create statewide inspection and enforcement standards for large involuntary residential facilities, including private immigration detention centers and certain youth facilities; supporters cited unsafe and inhumane conditions, while county probation officials objected to duplicative oversight for secure youth treatment facilities. The committee took votes on each measure, and the bills and resolution advanced, with SB 1309 and SB 1284 moving on amended and the others also reported out; the consent calendar was approved as well.

Transcript Highlights:

• House Bill 398, an act relating to decommissioning costs for electric generating units.
• 57.840><c> Brandon</c> Whereas Brigadier General Billy Brandon Whereas Brigadier General Billy Brandon
• ><01:05:19.440><c> Morgan</c> Brigadier General Billy Brandon Morgan Brigadier General Billy Brandon
• 14.120><c> Brandon</c> Whereas Brigadier General Billy Brandon Whereas Brigadier General Billy Brandon
• </c> General, but I knew him as coach. General, but I knew him as coach.

Keywords: 958, all

Transcript Highlights:

• Barbara Dickens, general Controller. Barbara Dickens, general counsel. counsel. counsel.
• Um, so I'm the general this contract?
• Matt Wingham, general counsel. Thanks for having us.
• :27:22.639><c> counsel</c> Allison Smith, associate general counsel Allison Smith, associate general
• I'm Sam Thorner, general record, please. I'm Sam Thorner, general counsel. counsel. counsel.

Keywords: 958, all

Summary: The Government Contract Committee met with a quorum, observed a moment of silence for Representative McCool after the death of his sister, and approved the April 14 minutes. The committee then reviewed a large agenda of contracts and amendments, beginning with a deferred Office of the Controller procurement involving broker services. Members questioned why a contract that had previously been handled for about $300,000 annually was now priced at about $1 million, and why the procurement was limited to one year. Office of the Controller staff said the prior vendor had held the work for more than 20 years, the work had previously been treated as not practical to bid, and the new RFP was intended to increase competition. They said the technical evaluation was scored before cost was considered, that past performance was not scored because it was seen as unreliable, and that AON received the highest technical score despite not being the lowest bidder. After discussion, the committee voted to take no action and let the contract proceed to the Finance Cabinet, with members noting continuing concerns about the pricing and process. The committee next considered a DCBS memorandum of agreement amendment for language services. DCBS representatives said the additional funding did not come from a new cut elsewhere, but from reduced spending on interpreter services because commonly used forms had been translated into other languages, freeing up funds for the contract. The committee approved the item unanimously. The final major item discussed was an initial contract for the Board of Hairdressers and Cosmetologists for legal services. Board staff said the board had been without a permanent general counsel since March 2024 and had relied on special and conflict counsel because of unusually heavy litigation, including 11 active cases, plus broader disciplinary and licensing changes tied to recent legislation and an oversight report. They said the contract was a not-to-exceed amount funded entirely by agency fees and that the board was currently running a surplus. Senator Thomas urged support, citing prior legislation and oversight findings about problems at the board and saying the contract was needed to help the board address ongoing litigation and corrective work. The committee approved the contract and then approved the remaining agenda items without objection, sending them forward.

Transcript Highlights:

• goes on with the facilities.
• In fact, the Inspector General of Homeland Security called for this facility, and this facility alone
• Do we know in the facilities, the three facilities, the three facilities...
• So at the Otero County Facility and other facilities, what are they waiting for them?
• facility.

Committee: House House Consumer & Public Affairs

Keywords: 996, all

Transcript Highlights:

• Today I'm no longer part of the newest generation of employees.
• , where we, despite our efforts to access those facilities to ensure their general health and welfare
• Additionally, the facility itself is leased from the state.
• "Are you speaking specifically to juvenile detention facilities?"
• the adult or other private detention facilities.

Summary: The House Finance Committee held public hearings on two bills. HB 2730 would clarify how JLARC evaluates the effectiveness of existing aerospace tax preferences by requiring a rolling five-year comparison of Washington aerospace employment with other states and asking JLARC to consider broader aerospace-sector changes and economic conditions. The prime sponsor and labor testifiers said the bill would add needed clarity and accountability for major tax investments supporting aerospace jobs. A committee question raised whether JLARC would be directed to make recommendations for improving the incentive, and staff and the sponsor said the bill does not specifically require that. HB 2713 would impose a 1% B&O tax surcharge, beginning July 1, 2026, on operators of private detention facilities with more than $1 million in annual Washington gross receipts. The sponsor said the bill is intended to respond to harms associated with private detention and to help fund services and legal support for affected families and communities. A remote testifier urged a much higher surtax on GEO Group, which operates the Northwest Detention Center, while county representatives testified that the bill as written could unintentionally apply to Martin Hall, a juvenile facility in Spokane County that is publicly governed and operated day-to-day by a nonprofit contractor. They asked for an exemption for Martin Hall, and the sponsor said that inclusion of nonprofits was not intended and that she would work with them on amendments. No votes were taken on either bill. The committee closed testimony on HB 2730 and HB 2713 and then adjourned.

Transcript Highlights:

• And if it's Medi-Cal, by long-term care, if it's like a skilled nursing facility or a subacute facility
• This care is generally less intense than that provided in a general acute care hospital, but more intense
• I have 18 beds, three facilities, and a lot of patients that come to us,” “I have 18 beds, three facilities
• And those are mostly, you know, non-General Fund.
• To save $300 million General Fund.

Summary: The Assembly Budget Subcommittee on Health began with a hearing on the impacts of H.R. 1 on California health programs, focusing first on reproductive health state investments. HCAI outlined five state-funded reproductive health programs created after Dobbs, including uncompensated care, practical support, capital and clinical infrastructure, and workforce programs. Essential Access Health and Planned Parenthood testified that these funds have served hundreds of thousands of patients, but warned that the uncompensated care program is fully awarded and needs renewal, and that Title X and Medicaid-related federal uncertainty continues to threaten access. Members questioned who the uncompensated care program serves, why Medi-Cal covers a large share of abortions, and whether Planned Parenthood could expand prenatal services; public commenters urged continued support for reproductive health access. The committee then took up long-term care services and supports, starting with the HCBA and Assisted Living Waiver programs. DHCS reported large wait lists for both programs and said enrollment is limited by workforce and provider capacity, while LAO noted that increasing slots alone may not increase access without additional programmatic changes. Members pressed the department on whether more slots should be added given the lower cost of home- and community-based care compared with skilled nursing facilities, and public testimony argued that the wait lists should be reduced and that staffing concerns do not fully explain unused capacity. The committee also heard testimony on congregate living health facilities, where providers and a patient family described the homes as critical, lower-cost alternatives to nursing facilities for younger, medically complex people. Witnesses requested short-term bridge funding, while DHCS said it is proposing to transition CLFs into a managed care benefit by January 1, 2028, which would remove caps and expand access statewide. The final long-term care topic was PACE. DHCS explained that it has paused new PACE applications and service expansions for at least two years to reassess oversight capacity and develop a statewide strategic growth framework, while existing programs continue operating. CalPACE supported the pause as a planning measure but asked for four additional state nurse positions to reduce delays in level-of-care determinations and speed enrollment for frail older adults. Members shared personal stories about how PACE has helped family members and asked how the state will meet growing demand; DHCS said stakeholder engagement will begin later in the year and that some existing applications already in process will continue. Public commenters broadly supported PACE, HCBA, and CLF funding requests. The hearing then moved to the Department of Health Care Services’ 2026-27 Medi-Cal budget and related trailer bills. DHCS said Medi-Cal spending has grown due to coverage expansions, higher acuity, rising utilization, and especially pharmacy costs, and it described proposals to extend the current skilled nursing facility financing framework for one year while the state develops a new value-based payment strategy. LAO said most recent Medi-Cal spending growth has been driven more by higher per-enrollee costs than by caseload growth, with pharmacy spending growing especially quickly, and recommended better and more timely data to analyze the drivers. Members expressed concern about the rapid rise in Medi-Cal spending and asked for more detail on the largest cost increases.

Transcript Highlights:

• And if it's Medi-Cal, by long-term care, if it's like a skilled nursing facility or a subacute facility
• This care is generally less intense than that provided in a general acute care hospital, but more intense
• than that provided in a skilled nursing facility.
• With DHS, other than just seeing some of the general increase, other than just seeing some of the general
• To save $300 million General Fund.

Keywords: 988, house, all