Transcript Highlights:

• and Rachel Hetzner from the Michigan Council of Nurse Practitioners.
• I am here today representing the Michigan Council of Nurse Practitioners and nurse practitioners across
• I am a family nurse practitioner and an active member of A&A Michigan.
• So while the homes and the to that neighborhood that was destroyed.
• A lot of the homes that were demolished were never replaced with anything.

Committee: Senate Transportation and Infrastructure

Summary: The Senate Committee on Transportation and Infrastructure met with a quorum present and adopted the June 16, 2026 minutes. The committee first took up House Bill 5644, which would allow nurse practitioners, physical therapists, and occupational therapists to certify applications for disability windshield placards and disability license plates. The sponsor and witnesses from the nursing profession said the bill restores a practice that had worked for years, reduces delays and extra costs for patients, and improves access, especially in rural and underserved areas. A Department of State representative explained the issue arose after an Auditor General review found the statute was unclear. The bill was reported to the floor on a 10-0 vote. The committee then heard Senate Bill 791, which would designate a portion of I-475 in Genesee County as the St. John Street Community Memorial Highway. Senator Cherry and representatives of the St. John Street Historical Committee described the history of the St. John Street neighborhood in Flint, its displacement by urban renewal and highway construction, and the effort to memorialize the community’s cultural significance and trauma. No members asked questions, and the bill was reported to the floor unanimously, 10-0. House Bill 4415, previously heard by the committee, was also reported to the floor without further testimony. The committee then considered Senate Bill 959, which had a new S-2 substitute. Senator Klinefelt explained the substitute as a compromise that reorganizes rail detector regulations and changes distance and speed thresholds for Class 1, 2, and 3 rail lines. The substitute was adopted 10-0. After additional comments from Senator McBroom opposing the bill due to concerns about impacts on Upper Peninsula commerce and rail operations, the committee reported the S-2 version of Senate Bill 959 to the floor by a 6-4 vote. The committee then adjourned.

Transcript Highlights:

• So what happens if, like for Bedford Nursing Home or Hillsborough Nursing Home, they like the nurse,
• Bedford um nursing home a Hillsboro Bedford um nursing home a Hillsboro nursing<01:07:43.559><c> home
• </c><01:07:46.680><c> she</c> nursing home um they like the nurse she nursing home um they like the nurse
• </c> in a home or a hospital or a nursing in a home or a hospital or a nursing home<01:48:10.599><c>
• , prison, nursing home.

Committee: House Labor, Industrial and Rehabilitative Services

Transcript Highlights:

• Helen Haltersson with California Advocates for Nursing Home Reform in support. Thank you.
• Helen Haltersson with California Advocates for Nursing Home Reform in support. Thank you.
• Nursing homes provide vital housing and care to some of our state's most vulnerable population.
• CANHR receives calls daily from consumers facing issues related to nursing home evictions.
• California's nursing home residents deserve better.

Committee: House Health

Transcript Highlights:

• A licensed midwife may delegate specific tasks to a registered nurse or a licensed practical nurse.
• nurse specialists.
• licensed practical nurse submit nursing program transcripts to the Board.
• 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:

• county nursing homes only with another 60 to 70 million and private nursing homes with, um, the equip
• Then that leaves<00:24:21.760><c> nursing</c><00:24:22.159><c> homes,</c> leaves nursing homes, leaves
• c> um</c><00:24:30.960><c> the</c> and private nursing homes with um the and private nursing homes with
• However, for the county nursing homes, it's not a low risk.
• ><c> an</c> in nursing home utilization and an in nursing home utilization and an increase<00:35:19.599

Summary: The committee approved the previous meeting minutes and then reviewed a draft preliminary report on long-term managed care. The chair explained the report is intended to frame issues and outline legislative options, not make a final recommendation, especially given unresolved questions about the federal One Big Beautiful Bill (OB3). The report’s key issues included the current financing of county and private nursing homes through Medicaid rates, ProShare, MQUIP, and related funding mechanisms, and the concern that those payments could be affected or eliminated under a managed care model. Members also discussed managed care organizations’ role in Medicaid and cited other states’ experiences, noting examples of savings in Florida and Tennessee but higher costs in California. One member raised Indiana as another important comparison, and the committee agreed to add it to the report’s state examples. The committee also reviewed sections on dual eligibility, D-SNP, PACE, and CFI waivers. The chair raised concerns about whether OB3 creates incentives for states to move toward D-SNP and whether federal changes could affect provider taxes, state-directed payments, and intergovernmental transfers. Henry Litman, the state Medicaid director, said he would confirm details on D-SNP incentives and explained that ProShare is based on certified public expenditure rather than an IGT, while county cap financing is the relevant intergovernmental transfer issue. He said IGTs are not going away and that the main risk is whether current financing mechanisms could be preserved if the state later changed course. Members discussed the possibility of a waiver not being granted or renewed and the high fiscal impact that could have on counties and property taxes. The committee then discussed the population that any long-term managed care model should cover. Members agreed that there is no appetite to move developmental disability or acquired brain disorder populations into long-term managed care at this time, and the chair changed the report’s terminology from “elderly” to “aging population.” The chair also noted that the status quo option should reflect the recent shift toward home and community-based services and reduced nursing home utilization since earlier county reports. The report’s four policy options were summarized as: maintain the status quo; pursue D-SNP for dual eligibles, with DHHS potentially submitting an application as early as 2027; adopt an HCBS carveout; or move fully to managed care for the aging population. No final policy recommendation was made, and the committee discussed making edits to the draft before circulation, including adding Indiana, clarifying OB3-related issues, and changing the report title from “final” to “preliminary” or “interim.”

Transcript Highlights:

• These are not a nursing home setting. These are much lower care settings.
• </c> these are not a nursing home setting. these are not a nursing home setting.
• </c> residents really do not meet nursing residents really do not meet nursing home<00:05:29.520><c>
• nursing homes, or the homeless shelters, nursing homes, or the jail<00:09:41.040><c> system.
• </c> the person's coming from a nursing home. the person's coming from a nursing home.

Summary: The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses. The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness. Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.

Transcript Highlights:

• home eligibility is required nursing home eligibility is required 94%<00:09:12.120><c> of</c><00:09:
• </c><00:10:04.600><c> home</c> required in a similar nursing home required in a similar nursing home
• The intent was for it to be for a hospital, nursing home, assisted living, or disability home.
• </c> like a nursing home or an assisted like a nursing home or an assisted living<00:34:41.520><c> facility
• reduces</c><01:09:25.120><c> Rel</c> nursing home placements and reduces Rel nursing home placements

Bills: HF1937 , HF2407 , HF1678 , HF1477 , HF2040 , HF1840 , HF257

Committee: House Human Services Finance and Policy

Transcript Highlights:

• You all have a lot of nursing homes there.
• I've had a lot of conversations with the people in the nursing homes and with the nursing home administration
• I've had a lot of conversations with the people in the nursing homes and with the nursing home administration
• I built a brand new nursing home in Greensburg in 1984.
• homes south of I-10, but every nursing home in the state.

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

Summary: The House convened with a quorum, opened with a prayer, pledge, and national anthem, and spent much of the early portion of the day on recognitions and personal privileges. Members welcomed Reverend Dr. D. Edward Cheney, the Louisiana School Board Association, Southern University visitors for S.U. Day at the Capitol, former Representative Shirley Bowler, the mother of Caleb Wilson, a West Jefferson High School JAG group, the Louisiana Federation of Republican Women, and a Jeff Davis Parish delegation. The chamber also adopted a resolution honoring women legislators for Women’s History Month and observed a moment of silence for Caleb Wilson. The House received a large batch of Senate bills and referred them to committees, including measures on human trafficking, sexual assault kit reporting, bail schedules, environmental notice procedures, DOTD authority, judicial removal, school-zone and shoulder driving rules, workers’ compensation, kidney disease reporting, contractor licensing, public records exemptions, career-alignment dashboards, student health centers, sports wagering exclusions, gaming background checks, soybean promotion, and accessories-after-the-fact sentencing. Members also introduced numerous House resolutions and House bills, including measures on airport TSA loan assistance, Physical Therapy Day, Landscape Architecture Month, condolences, coastal protection, succession and paternity studies, and a long list of new bills covering taxes, education, health care, criminal justice, transportation, public records, and state operations. Several bills were debated and acted on. House Bill 69, concerning ignition interlock devices and penalties when used as a bail or probation condition, passed 82-18. House Bill 93, transferring Lincoln Parish jury commission functions to the clerk of court, passed 96-0. House Bill 199, extending the nursing home moratorium, drew substantial debate over nursing home capacity, competition, and patient care; an amendment requiring LDH to track occupancy and rejection reasons was adopted, and the bill passed 88-11. House Bill 201 creating a state seal of fine arts passed 98-0, and House Bill 202 requiring state civil service applicants to be notified when vacancies are filled or they are not selected also passed 98-0 after amendment. House Bill 218, requiring student questionnaires to include food insecurity questions, was introduced and amended technically, with debate beginning as the transcript ended.

Transcript Highlights:

• professions, including registered nurses and advanced practice registered nurses.
• I'm a tenured nursing faculty member of the Washington State Board of Nursing.
• in nursing practice and nursing education as we speak.
• I'm a nurse and I serve as executive director of the Washington State Nurses Association.
• Our nursing programs...

Summary: The Postsecondary Education & Workforce Committee held courtesy hearings on three bills before moving to executive session. House Bill 2443 would create an Armed Forces Reserve post-secondary education grant for members of the Armed Forces Reserve and their spouses or dependents, with repayment required unless the reservist serves one year for each year of benefit received. The prime sponsor said the bill is intended to extend educational support similar to what Washington National Guard members already receive. Testimony was generally supportive, emphasizing military readiness, recruitment, and fairness to reservists; one clarification was made that the bill applies to Armed Forces Reserve members broadly, not just the Army Reserve. House Bill 2567 would restore Washington College Grant and College Bound Scholarship award amounts for students attending four-year private, not-for-profit institutions. The sponsor and many students, school leaders, and private college representatives argued the 2025 cuts were inequitable, harmed low-income and first-generation students, and limited student choice. Supporters said the state’s dedicated financial aid account has grown and that the cuts disproportionately affected students at private institutions. Opponents, including representatives from public universities, argued state dollars should prioritize public institutions and questioned whether aid should be shifted away from state schools. Testimony was mixed but heavily pro, with sign-ins reported at 1,584 total, including 1,572 in support. House Bill 2498 would change nursing education oversight by limiting the Board of Nursing’s authority where programs are nationally accredited and by expediting approval for new programs. The sponsor and several community college leaders said the bill would reduce unnecessary barriers, speed program expansion, and help address the nursing shortage, especially in rural areas. The Board of Nursing, nursing educators, employers, and professional associations opposed the bill, arguing that state oversight is needed for public safety, Washington-specific workforce needs, and consistent standards, and that the board is already revising its rules through an open process. The committee then took executive action on two other bills: it passed Second Substitute House Bill 2363, allowing supervised music therapy practice for up to six months while exam results are verified, with an amendment delaying implementation to January 1, 2028; and it passed Substitute House Bill 2422, shifting private security guard license fees from applicants to employers and delaying implementation to November 1, 2026, by a 9-7 vote.

Transcript Highlights:

• facility and home criteria for nursing facility and home and<01:04:43.000><c> communitybased</c><01:
• They're ending up placed in nursing homes. They thrive in their homes.
• and I've been told I have more homes and I've been told I have more nursing<02:16:28.239><c> homes</
• homes in my district than any nursing homes in my district than any other<02:16:29.840><c> District<
• ><c> not</c> the nursing home communities they're not the nursing home communities they're not fooling

Committee: Senate Health and Human Services

Transcript Highlights:

• Helen Haltersson with California Advocates for Nursing Home Reform in support. Thank you.
• Nursing homes provide vital housing and care to some of our state's most vulnerable population.
• Nursing homes provide vital housing and care to some of our state's most vulnerable population.
• CANHR receives calls daily from consumers facing issues related to nursing home evictions.
• California's nursing home residents deserve better.

Summary: The committee heard several health-related bills. AB 1825 by Krell would clarify California’s offenders with mental health disorders program by tightening the standard for determining “substantial danger of physical harm,” improving exit planning, and expanding Medi-Cal access for people released after a successful challenge. Supporters, including psychiatrists, prosecutors, and medical groups, said the bill would close gaps in care and protect public safety; county behavioral health directors and Disability Rights California registered concerns. AB 1696 by Stephanie would state that nurse midwives do not need physician supervision when providing care within their existing scope, including EMTALA-related evaluation in labor and delivery settings. Nurse midwives and nursing groups supported the bill, while emergency physicians opposed it unless amended, arguing emergency department screening should remain under physician supervision; the author said she would keep working on the issue. AB 1949 by Lee would make acupuncture a separate Medi-Cal benefit and allow up to 24 visits per year. The author and supporters from acupuncture, health access, and integrative medicine groups said the current monthly cap is too restrictive and that acupuncture is an effective, cost-saving alternative for pain management and other conditions. There was no opposition. AB 2330 by Patterson would create a distinct regulatory category for cold spas, with standards for construction, operation, and disinfection. Fitness and wellness groups supported the bill, environmental health administrators had no formal position but thanked the author for amendments, and a committee member raised concerns about local officials interpreting the bill to require separate enclosures from saunas; the author said she would continue working on the language. AB 2000 by Aguirre-Curry would limit mid-year changes to prescription drug formularies and add notice, exceptions, reporting, and enforcement provisions. Family physicians, chronic care advocates, nurses, pharmacists, and patient groups supported the bill, citing non-medical switching and treatment disruptions; health plans and insurers opposed it, warning of higher costs, reduced flexibility, and premium increases. AB 1929 by Ortega would require health plans to disclose investments, including in private prisons and immigrant detention centers. Supporters framed it as a transparency measure tied to patient premiums and public values, while opponents argued the bill was duplicative, burdensome, and potentially harmful to investment confidentiality. AB 2746 by Schiavo would classify medical credit card debt as medical debt so it would not appear on credit reports. Consumer advocates and legal aid groups supported the bill, describing abusive marketing and housing harms; banks, debt collectors, and industry groups opposed it as unworkable and privacy-invasive. The committee took roll on AB 2746 and passed it on a due pass motion to Banking and Finance, with several members voting aye and a few no votes recorded.

Transcript Highlights:

• And so we would take in more surcharges from the nursing homes.
• And then we had a corresponding add-on rate for the nursing homes that would net even to the nursing
• And so we would take in more surcharges from the nursing homes.
• And then we had a corresponding add-on rate for the nursing homes that would net even to the nursing
• So, unfortunately, there are a number of individual nursing homes who are going to effectively see a

Committee: House Human Services Finance and Policy

Transcript Highlights:

• Texas has the second most number of nurses... homes in the United States, and unfortunately, we rank
• In 2022, we already knew that 99% of nursing homes... have a generator on site.
• This occurred in 2017 at a Dallas nursing... home when a constable illegally assisted mail-in voters,
• You know, this is a problem that we have really across the state in nursing homes.
• The nursing home facilitators are required by the code to help assist them in applying for a ballot.

Bills: SB397 , SB481 , SB596 , SB760 , SB855 , SB1195 , SB1196 , SB1233 , SB1257 , SB1318 , SB1368 , SB1388 , SB1398 , SB1524 , SB1558 , SB1589 , SB1677 , SB1792 , SB2034

Committee: Senate Health & Human Services

Transcript Highlights:

• homes, including the expansion of the dementia unit at the nursing home in Land O' Lakes.
• homes from the Florida Nursing Home Uniform Reporting System requirements.
• It also requires AHCA to impose a $10,000 fine against a nursing home or home office of a nursing home
• homes and the for-profit nursing homes alike?
• Nonprofit nursing homes and the for-profit nursing homes alike? It's going to cover both.

Committee: Senate Appropriations

Summary: The Appropriations Committee heard presentations on the Senate’s proposed 2025-2026 budget, SPB 25-200, totaling $117.4 billion. Chair Hooper and committee chairs highlighted major spending priorities including a 4% raise for state employees, continued health insurance contributions, investments in water quality, transportation, education infrastructure, and workforce development, along with reductions tied to long-vacant positions. Education funding was a major focus, with increases for K-12 public schools and scholarships, higher education workforce programs, nursing initiatives, tutoring, and university performance funding. Health and human services, criminal and civil justice, transportation/economic development, and agriculture/environment budgets were also outlined, including Medicaid, mental health, corrections staffing, affordable housing, beach restoration, citrus recovery, and water projects. Members then questioned several budget choices, especially K-12 funding. Senators Polsky and Smith raised concerns that the Senate’s AP and dual enrollment funding changes could disadvantage public schools, while Burgess argued the budget preserves the money in the FEFP and gives districts more flexibility rather than reducing support. Questions also addressed voucher availability, school stabilization funding, and the My Safe Florida Home program. The committee adopted 171 consent amendments and three late-file amendments, then approved SPB 2500 as a committee bill. It also favorably reported implementing and conforming bills for state employees, retirement, natural resources, judgeships, K-12 education, higher education, and health and human services, along with SB 7022 on Florida Retirement System contribution rates and elected-officer DROP options, CS/SB 1320 on the Resilient Florida Trust Fund, SB 7014 ending the Mediation and Arbitration Trust Fund, SB 7028 on cancer research, CS/CS/SB 170 on nursing home quality and oversight, CS/SB 168 on mental health diversion and behavioral health data, SB 114 creating an insurance and risk management research center at FSU, and SB 180 on emergency preparedness and post-storm recovery. Most bills were reported favorably with little or no opposition, though SB 180 drew discussion about local-government authority after storms and the need to balance recovery speed with local safety and planning concerns.

Transcript Highlights:

• I am honored to recognize nurse Karen Oskins, an obstetrics nurse at Hilo Benioff Medical Center.
• </c> during a routine newborn exam, nurse during a routine newborn exam, nurse Oscans<00:03:32.480><c
• Next, we recognize nurse Renee Kojima, a home infusion nurse with Pharmarmacare Hawaii.
• But under Nurse even impersonal.
• ,</c> parents informed as they raced home, parents informed as they raced home, ensuring<00:06:50.160

Transcript Highlights:

• Maura Gibney, California Advocates for Nursing Home Reform, in support.
• Maura Gibney, California Advocates for Nursing Home Reform, in support.
• With me today is Maura Gibney from Canter, California Advocates for Nursing Home Reform. Thank you.
• Medi-Cal managed care plans cover more than 60% of nursing home residents in California.
• County, for example, there are three different Medi-Cal plans and over 360 nursing homes.

Summary: The Assembly Health Committee heard several Senate bills focused on health care access, privacy, and public health data. SB 81 (Arreguín) would require health care facilities to create nonpublic areas and bar immigration enforcement from entering without a judicial warrant or court order, while also protecting disclosure of immigration-related information in medical records. The bill drew strong support from labor, immigrant-rights, health care, and patient advocacy groups, with committee members emphasizing patient safety and privacy; one member raised implementation concerns about how the restrictions would work in practice. The committee voted the bill out on a due pass motion to the Privacy and Consumer Protection Committee, with one no vote recorded. SB 250 (Ochoa Bogh) would add skilled nursing facilities to DHCS’s managed care provider directory so Medi-Cal beneficiaries can more easily identify covered facilities. Supporters said the change would help seniors and people with disabilities avoid confusion and rushed placement decisions, especially during hospital discharge, and would make existing information easier to use. The committee passed the bill to Appropriations on a unanimous vote. SB 717 (Richardson) would formally recognize California’s three regional cancer registries in state law to help preserve federal funding and support cancer surveillance data collection. The author and supporters said the measure would protect more than $15 million in annual federal support and strengthen cancer research and tracking; the committee approved it unanimously to Appropriations. SB 504 (Laird) would allow health care providers to disclose personally identifying information about previously reported HIV infections to state or local health officials when needed for disease control or care coordination. The author described the bill as a modernization of reporting and coordination practices, and supporters from the California Medical Association and Planned Parenthood backed it. The committee sent the bill out as amended to the Privacy and Consumer Protection Committee on a unanimous vote. The meeting also included routine consent-calendar action and multiple add-on votes, with the committee repeatedly holding the roll open to record additional members’ votes.

Transcript Highlights:

• We own and operate home health agencies, provide home delivery, We own and operate home health agencies
• For people that reside in an ALF or a nursing home, the health plans pay for services that they receive
• Florida Community Care works with our nursing home Florida Community Care works with our nursing home
• When a nursing home provider partner helps us transition our members safely into the community, we pay
• For us, it's been starting our nursing program and advancing our nursing programs.

Summary: The committee held a panel discussion focused on how Florida health care organizations are working to improve access, quality, and affordability. Panelists from Florida Community Care/Independent Living Systems, Sunshine Health, AdventHealth, UF Health, and Nemours described their approaches, including Medicaid managed care, value-based contracting, community partnerships, mobile screening units, smart-room technology, telehealth, and specialized programs for maternal health, children, and complex chronic conditions. Several speakers emphasized that managed care and coordinated care can improve outcomes while reducing unnecessary utilization and costs. Members asked about the impact of Medicare’s V28 changes, mobile cancer screening, urgent care versus emergency room billing, pediatric specialty access, complaint resolution, Black maternal mortality, provider shortages, network adequacy, and the use of AI in prior authorization. Witnesses said V28 has affected providers and revenue, UF Health’s mobile screening program is expanding beyond a few cancer types, and its urgent care model bills patients at the appropriate level rather than both urgent care and ER rates. Nemours said it reduced specialty wait times through scheduling changes, telemedicine, and registry tools, while AdventHealth described postpartum coordination and maternal heart programs to reduce maternal complications and mortality. On complaints and access problems, panelists said their organizations use patient/member advocates, care managers, call centers, and escalation processes to resolve issues, and Sunshine Health specifically discussed a transportation complaint that was addressed with its vendor and the family. Sunshine Health also said it is not using AI for prior authorization, though it is exploring responsible uses elsewhere, and Florida Community Care said it is not using AI in utilization management. In closing, panelists identified workforce shortages, provider burnout, and high-cost drugs as the biggest ongoing challenges. The meeting ended with thanks to the panel and adjournment after Representative Brackett moved to rise, without objection.

Transcript Highlights:

• That is up to the Board of Nursing.
• all nursing schools.
• The Florida Nurses Association supports the Board of Nursing in its critical role of ensuring nursing
• of the nursing profession.
• 52 percent of nurses.

Committee: Senate Appropriations Committee on Health and Human Services

Transcript Highlights:

• Our posthospitalization capacity planning and innovation, our nursing home bed restrictions, really need
• I'm a registered nurse by background.
• For those who might need a higher level of care, they're working with nursing care and nursing home systems
• Medicaid does offer a limited service for skilled nursing as well as home health services, but even with
• Next, we recommend extended private duty nursing hours.

Committee: House Public Health

Summary: The meeting focused on hospital “avoidable days” and the difficulty of discharging medically stable patients who still need post-acute placement or social services. Presenters from Saint Anthony Hospital Midtown, the Oklahoma Hospital Association, City Care, and OU Health described common barriers including lack of skilled nursing, rehab, long-term care, behavioral health, and hospice placements; insurance prior authorization delays; Medicaid and Social Security eligibility delays; guardianship and Adult Protective Services bottlenecks; limited home health and private duty nursing; and the challenge of placing unhoused, uninsured, or medically complex patients. Several speakers emphasized that these delays reduce bed availability, increase emergency department boarding, contribute to staff burnout, and expose patients to hospital-acquired conditions and other harms. The testimony included multiple examples of patients remaining in acute care for days, weeks, or even months after being medically ready for discharge, including patients awaiting guardianship, disability determinations, or placement in facilities willing to accept them. Speakers also highlighted special populations such as patients with behavioral health or substance use disorders, medically fragile children, patients with criminal histories, and unhoused individuals who need respite or hospice care. City Care described its planned 40-bed medical respite facility, set to open in 2027, as a way to provide clinical support and housing navigation for patients too sick to recover on the street or in shelters. Witnesses recommended policy and system changes such as standardizing preauthorization protocols, expanding rural swing-bed and home-based services, increasing public guardianship resources, improving data collection on homelessness, expanding private duty nursing hours, and creating more placement options for complex patients. They also suggested better coordination between hospitals, DHS, APS, the Health Department, and post-acute facilities, including a database of facility services to improve discharge planning and keep patients closer to home. No votes or formal committee actions were taken in the transcript, but the chair indicated the issue would require collaboration across multiple agencies and partners.

Transcript Highlights:

• It pays for half of all nursing home beds.
• Do you believe in a nursing home there should be a registered nurse?
• homes without nurses?
• We need a nurse in a nursing home. Not too complicated.
• I actually think we need a nurse who will work in a nursing home.

Committee: Senate Finance Committee

Keywords: Michael Falkender, Deputy Secretary of the Treasury, IRS, taxpayer privacy, nomination process, committee hearing

Summary: The committee convened to discuss critical issues surrounding the nomination of Michael Falkender for the position of Deputy Secretary of the Treasury. This meeting included a series of remarks from committee members who expressed divergent views on Falkender's qualifications and the implications of his appointment. Senator Wyden voiced strong opposition, arguing that Falkender represents harmful policies expected to be perpetuated under the current administration, especially concerning taxpayer privacy and IRS tactics. Meanwhile, other members defended Falkender, noting his extensive experience, including a commitment to transparency in government operations if confirmed.