Transcript Highlights:

• When we set up the first program federally, it was a about a seven-figure investment in starting a waiver
• When we set up the first program federally, it was a about a seven-figure investment in starting a waiver
• Um waiver comes with getting a waiver.
• um has waiver in law. um has waiver in law.
• We want this program, but we're not asking anybody to submit a waiver.

Keywords: 1189, house, all

Transcript Highlights:

• Our disability waiver programs are incredibly complex, from their funding to the complex needs of the
• Our disability waiver programs are incredibly complex, from their funding to the complex needs of the
• Our disability waiver programs are incredibly complex, from their funding to the complex needs of the
• Our disability waiver programs are incredibly complex, from their funding to the complex needs of the
• especially in the area of waiver especially in the area of waiver programs<00:53:38.079> or

Keywords: 1183, house

Transcript Highlights:

• So that was the focus of our, quote unquote, welfare programming in Utah and why the TANF program, and
• I'll always maintain this, is a critical program to be part of your workforce... ...is a critical program
• They're not seen as workforce programs. ...being seen as welfare programs.
• And in Utah, 1991 is when our waiver program started.”
• If states take advantage of that waiver authority and those waivers are granted and you get well underway

Keywords: 1204, all

Summary: The meeting focused on the state’s “one door/no wrong door” workforce and social services modernization effort, with consultants Mason Bishop and Cameron Christie presenting recommendations. They argued that Arkansas should shift from fragmented programs and multiple access points to a more integrated system that promotes upward mobility, longer labor force attachment, better employer access to talent, greater efficiency, and faster adaptation to changes such as AI and economic shocks. They described the current system as overly siloed, with separate offices, portals, and funding streams that force job seekers and employers to navigate multiple doors and bureaucratic handoffs. The consultants emphasized that Arkansas should treat workforce and safety-net programs more like a coordinated franchise model, with a single point of access, one team, and integrated governance, service delivery, and financial administration. They discussed federal workforce waivers already submitted, a possible cost-allocation plan with the federal Office of Management and Budget, and a potential benefits-cliff pilot. They also said Arkansas Launch is a useful tool but not a full service-delivery system. Members asked how the proposal would affect DHS offices, local workforce boards, TANF, and disability-related services, and the consultants said TANF should be viewed as a workforce program and that Arkansas could consider co-locating or integrating staff, or even merging agencies as Utah did. Committee members repeatedly cited Utah as a model, noting its high workforce participation and lower reliance on Medicaid and SNAP, and asked whether Arkansas could use TANF and other programs to cross-train DHS workers and make county offices more work-focused. The consultants explained Utah’s 1990s reforms, later audits showing improved customer service, and the role of cost allocation in blending funds behind the scenes. They also addressed federal flexibility and said current waiver efforts are a fallback after a broader federal pilot proposal did not advance. The meeting ended with a request to continue examining case management, specifically whether Arkansas should case-manage people rather than programs, and the chair adjourned the meeting.

Transcript Highlights:

• . program. program.
• . program. program.
• Waiver Reimagine intersects with other major program integrity efforts.
• . waiver. waiver.
• Raymond, not right now, but tell me the gross expenditures in the programs that are affected by Waiver

Keywords: 1187, senate, all

Transcript Highlights:

• Review and update on the CalAIM and Home and Community-Based Alternative Waiver Program.
• The counties which had pilot programs from the prior Medi-Cal waiver generally had higher utilization
• Public comment: If you could direct your comment towards either CalAIM or the HCBA waiver programs and
• The HCBA waiver has been great, but it needs to be increased in order to keep these programs going.
• The waiver program has allowed me to transition from congregate living into living in the community.

Keywords: 988, house, all

Transcript Highlights:

• So that was the focus of our, quote-unquote, welfare programming in Utah and why the TANF program, and
• They're not seen as workforce programs. ...being seen as welfare programs.
• And in Utah, 1991 is when our waiver program started.
• And in Utah, 1991 is when our waiver program started.
• If states take advantage of that waiver authority and those waivers are granted and you get well underway

Summary: The committee met to hear an update from consultants Mason Bishop and Cameron Christie on Arkansas’s “one door” or “no wrong door” workforce and social services modernization effort. The discussion focused on moving the state toward a work-first system that better connects job seekers, employers, education, and public assistance programs, with goals of increasing upward mobility, improving labor force attachment, reducing inefficiencies, and adapting to changes such as AI and other economic disruptions. The consultants argued that Arkansas’s current system is fragmented across multiple offices, portals, agencies, and funding streams, and that people often have to navigate separate doors for workforce services, TANF, SNAP, Medicaid, and related supports. Bishop repeatedly pointed to Utah as the model, describing how that state integrated workforce and human services into a single department, used cost allocation to blend funding behind the scenes, and saw improved customer service and outcomes after reform. He said TANF should be treated as a workforce program, not just a benefits program, and suggested that Arkansas could use TANF and other tools to cross-train DHS staff, co-locate services, and create a more unified service delivery model. Members asked about federal flexibility, waivers, and whether the state could use one large waiver or a broader restructuring to simplify the system. Bishop explained that a federal pilot authority proposal failed in Congress, so the current approach relies on waivers, cost allocation plans, and possible state-level changes. The committee also discussed the relationship between DHS and workforce offices, the role of local workforce boards, how disability and vocational rehabilitation cases would be handled, and how the governor’s Restore Hope/Hope Hub and faith- and community-based initiatives might fit into the broader plan. Bishop said Arkansas already has rehabilitation services within the workforce department and emphasized that case managers should focus on people rather than programs. No votes were taken. The chair said the committee would revisit case management at its August meeting and adjourned the meeting after thanking the consultants.

Transcript Highlights:

• So athletic waivers make up about 4.5% to 4.7% of the total waiver dollars.
• And you'll see some of those here for the nursing programs, the business programs, the medical programs
• Our final program, the Family and Community Wellness Program, includes programming related to food and
• Our final program, the Family and Community Wellness Program, includes programming related to food and
• Program, and through the Renewable Energy Program.

Keywords: 908, all

Summary: The committee first reviewed the 2024-25 tuition waiver report for the North Dakota University System. Staff explained that waivers were reported for degree-seeking students and broken out by residency, institution, and waiver type. Members asked about partial versus full waivers, institutional discretion, athletic waivers, and whether campuses have published guardrails or transparency requirements. Staff said most waivers are set by institutions, with some statutory and board-required categories, and that athletic waivers are a small share of total waiver dollars. The report showed total gross tuition of $354.5 million, tuition waived of $38.9 million, and 11,193 of 42,040 students receiving some waiver. Members also discussed how waivers affect net tuition revenue, housing and food collections, and whether campuses are using waivers strategically compared with scholarships and other funding sources. The committee then heard a presentation on tuition rates by campus and State Board policy. Staff explained the board’s tuition factors for resident, Minnesota reciprocity, contiguous-state/U.S. nonresident, and international students, and noted that campuses often seek exceptions based on program-specific competition and enrollment goals. Members asked whether rates are based on cost or competition, and staff said campuses typically bring forward estimates and market comparisons when requesting special rates. The presentation also reviewed general fund appropriations versus net tuition revenue by campus, and members discussed how local tuition decisions and waivers do not directly affect the state funding formula, though they do affect institutional revenue and reserves. Questions were also raised about the Higher Learning Commission’s financial composite indicator and how it differs from the more intuitive reserve and revenue figures. The committee next received a broad overview of non-higher-education entities affiliated with the State Board of Higher Education, beginning with NDSU agriculture-related units. Dr. Greg Lardy described the State Board of Agricultural Research and Education, the NDSU Extension Service, the Agricultural Experiment Station, and the branch research centers, emphasizing their statewide role in crop and livestock research, extension education, and county-based outreach. He outlined funding mixes for extension, the experiment station, and branch stations, noting that grants and contracts support both research and education, while the agronomy seed farm is self-funded through seed sales. Members asked about the new and vacant FTE pool, R1 research status, matching requirements for grants, and whether state appropriations count toward research expenditures. Dr. Lardy also highlighted major research impacts, including crop varieties, virtual fencing, AI-assisted weed control, and NDAWN weather data. The Northern Crops Institute and the Upper Great Plains Transportation Institute also presented. NCI described its role in market development, technical services, and education for regional agriculture, its governance through the Northern Crops Council, and its funding from state appropriations, other states, and earned revenue. Members asked about the source of out-of-state funding, intellectual property, and the institute’s international reach. UGPTI then outlined its transportation research, federal and state funding structure, and work on road and bridge condition assessments, travel demand modeling, and workforce training. No votes were taken during the portion of the meeting reflected in the transcript.

Transcript Highlights:

• So that was the focus of our, quote unquote, welfare programming in Utah and why the TANF program, and
• I'll always maintain this, is a critical program to be part of your workforce... ...is a critical program
• They're not seen as workforce programs. ...being seen as welfare programs.
• And in Utah, 1991 is when our waiver program started.”
• And in Utah, 1991 is when our waiver program started.

Summary: The committee met to hear consultants Mason Bishop and Cameron Christie discuss Arkansas’s “one door/no wrong door” workforce and social services modernization effort. Bishop argued that the current system is fragmented across multiple agencies, offices, and portals, making it hard for job seekers and employers to access services efficiently. He said the goal is to create a more integrated system that promotes upward mobility, longer labor force attachment, better employer access to talent, greater efficiency, and faster adaptation to changes such as AI and other economic disruptions. Bishop repeatedly pointed to Utah as a model, describing how that state combined workforce and public assistance functions into a single agency, used statewide cost allocation to blend funding streams, and improved customer service and outcomes after reform. He said Arkansas should consider integrating governance, service delivery, and financing, including possible waivers, a statewide cost allocation plan, and a benefits-cliff pilot. He also said Arkansas’s current local workforce board structure creates duplication and weak coordination, and that Launch is a useful tool but not a full service-delivery system. Committee members asked how the proposal would work in practice, including whether TANF could be used to cross-train DHS workers, how federal waivers might be obtained, how local boards would be affected, and how disabled clients would be handled. Bishop said TANF should be treated as part of a workforce strategy, that federal pilot authority for workforce reform nearly passed but did not, and that waivers are now the practical path. He also said Arkansas could either merge functions more fully or at minimum co-locate workforce staff in DHS offices statewide. No votes were taken; the meeting ended with plans to continue the discussion in August, including a focus on case management and whether the state is managing programs or people.

Transcript Highlights:

• with waivers.
• with waivers.
• program?
• They do have to make— ...to short-term programs, including non-credit programs.
• Solutions programs or others?

Summary: The meeting focused on Arkansas’s proposed workforce system overhaul, including a combined WIOA/Perkins state plan and a package of federal waiver requests intended to consolidate workforce governance, reduce administrative costs, and redirect more funding to training and supportive services. Commerce officials said the plan would replace the current structure of 10 local workforce boards and more than 200 board members with a single statewide board and one administrative entity, while keeping local offices open and using regional business councils to preserve employer and local input. They said the state has already reduced Commerce headcount and operating costs, and that the changes would improve coordination with higher education, adult education, vocational rehabilitation, DHS, and Arkansas Industry Connect. Much of the discussion centered on the waiver package, especially the proposal to make the state board function as the local board, allow more flexible movement of funds across regions, eliminate the WIOA “last dollar” requirement for training and supportive services, create affiliate sites instead of requiring every area to maintain a comprehensive center, and relax the 14 youth program element requirement. Officials said the State Board of Workforce Development approved the waiver package 11-3 before it was submitted to the U.S. Department of Labor, and that implementation would begin only after federal approval and a closeout process, likely taking up to a year. They also described plans to streamline referrals and data sharing, expand mobile and virtual services, and use a more centralized model to improve customer service and employer engagement. Members raised repeated concerns about rural representation, local control, board composition, and whether jobs and relationships would be lost if local boards were eliminated. Commerce officials responded that local offices would remain open, some current staff could be rehired by the state, and regional business councils would help ensure local employer voice. Several members also questioned how the funding was being used, citing audit findings that only about $1.8 million to $1.9 million of roughly $14 million to $15 million in federal workforce funds had gone to training and supportive services. Officials said the reorganization could increase annual training spending to roughly $6 million to $7 million by reducing overhead, one-stop operator contracts, and board administration. The committee also discussed how the changes might support workforce training facilities, apprenticeships, child care and transportation assistance, and employer-driven training in fields such as manufacturing, health care, technology, and welding. The Division of Higher Education also briefed members on Workforce Pell. Officials explained that the new federal program would extend Pell eligibility to short-term programs, but only within narrow limits, such as 150 to 599 clock hours and 8 to 15 weeks of instruction, with additional completion and employment benchmarks. They said Arkansas is working with colleges and universities to identify programs that fit the criteria and that the governor has designated the Division of Higher Education to lead implementation. No votes were taken by the committee during this portion of the meeting.

Transcript Highlights:

• with waivers.
• program?
• It is a program that is a federal program, yet the state had a It is a program that is a federal program
• They'll have multiple programs.
• solution programs or others?

Keywords: 1204, all

Transcript Highlights:

• program from customized living facilities serving individuals on the CADI and BI waivers.
• program from customized living facilities serving individuals on the CADI and BI waivers.
• waiver program from that on the elderly waiver program from that from<00:42:51.359> customized
• <00:51:06.440> programs costs uh while Medicaid waiver programs costs uh while Medicaid waiver
• waiver programs fund the while Medicaid waiver programs fund the cost<00:52:56.640> of<00:52:56.760

Keywords: 1187, senate, all

Transcript Highlights:

• This bill relates to a small but very important program within the larger Medi-Cal program called the
• services overall with the waiver than we would without the waiver.
• As the Assemblymember mentioned, the waiver also supports As the Assemblymember mentioned, the waiver
• It's not just a program.
• that receives HCBA waivers.

Summary: The Assembly Health Committee met on March 25, 2025, with Chair Mia Bonta presiding and initially operating as a subcommittee until quorum was established. The committee heard several health-related bills, including AB 73 on creating a Black Mental Health Navigator certification, AB 499 on lowering the state reimbursement trigger for the Robert F. Kennedy Farm Workers Medical Plan, AB 843 on aligning California health insurance language-access rules with federal standards, AB 257 on a specialty care network using telehealth and virtual services for Medi-Cal and underserved communities, AB 64 on allowing diacritical marks on vital records, AB 315 on the Home and Community-Based Alternatives waiver, and AB 40 on clarifying that emergency services include reproductive health services such as abortion. Testimony generally emphasized disparities in access, culturally competent care, language access, rural provider shortages, and the importance of preserving or expanding programs that help vulnerable populations. Supporters included authors, state and local health organizations, advocacy groups, and affected individuals. AB 73 was backed as a way to address stigma, mistrust, and culturally competent mental health access for Black Californians. AB 499 was described as helping keep a self-insured farmworker health plan operational while maintaining a low-cost, labor-management model. AB 843 was supported as a way to prevent children and families from having to translate sensitive medical and insurance information and to protect limited-English-proficient Californians. AB 257 drew support as a demonstration project to improve specialty care access through California-based clinicians and virtual care, with examples of reduced wait times and costs. AB 64 received emotional testimony from the author, a child and his family, and others about the importance of accurately recording names with accents and other marks. AB 315 was presented as a cost-neutral or cost-saving way to expand home- and community-based care for medically fragile people, with strong support from disability, health, and provider groups. AB 40 drew support from reproductive health and medical organizations, while one opposition witness argued it could conflict with emergency care standards and overburden emergency departments. The committee took roll-call votes and advanced AB 499, AB 73, AB 843, AB 257, AB 64, AB 315, and AB 40 to Appropriations, with AB 40 receiving some no votes. The committee also adopted its 2025-26 rules and approved a consent calendar that included AB 225, AB 304, AB 403, AB 688, and AB 951. Several measures were initially placed on call and later lifted and recorded as passing out of committee before adjournment.

Transcript Highlights:

• well as our Medicaid waiver programs.
• So we do have people on both that program as well as our programs.
• services waivers.
• Um, we, the agency also had proposed that process for the medically dependent children program waiver
• Program integrity for these programs is, uh, is a three-legged stool.

Transcript Highlights:

• . waiver. waiver.
• So our second waiver is the in-home supports waiver. So that is our children's waiver.
• waiver or ABD<00:55:44.800> waiver.
• and internal programs. and internal programs.
• The Slurp program programs like Slurp.

Keywords: 928, house, all

Summary: The committee first handled roll call and approved the prior meeting minutes. Members discussed attendance and substitutions, then moved to the DHS commissioner’s update, which focused on New Hampshire’s Medicaid 1115 waiver and the new community re-entry initiative for people leaving correctional facilities. The presenter explained that the waiver lets the state cover certain services not normally covered under Medicaid, including substance use disorder treatment, serious mental illness services, adult dental benefits, and the new community re-entry component. She also noted that a separate youth re-entry component is federally required, with youth defined up to age 21 and foster-care-related coverage extending to age 26. The update described how the adult re-entry program works for incarcerated individuals with behavioral health needs, providing up to 45 days of pre-release services, care coordination with managed care organizations and DOC staff, telemedicine assessments, discharge prescriptions, insurance cards, and connections to community mental health, primary care, and substance use providers. For youth, the program includes more intensive case management, 30 days of pre-release services, and 30 days of post-release care coordination, with a stronger emphasis on screening, diagnosis, and holistic assessment. The presenter said New Hampshire received the adult waiver in July 2024, has implemented the program in state correctional facilities, and is beginning work at the youth center. Members and the presenter discussed why the program is structured as a waiver rather than a standard Medicaid benefit, with the explanation that CMS is allowing this as a newer policy area and that states generally pursue waivers for certain services. The chair and others emphasized the need for real cost and outcome data, and the presenter said an independent evaluator and evaluation plan are required under the 1115 waiver. Early results cited included 30 adults enrolled so far, 10 released, five youth enrolled with one released, and anecdotal early successes such as housing, employment, and better continuity of medication and treatment. The committee did not take any additional votes or formal actions beyond approving the minutes.

Transcript Highlights:

• Our elderly waiver program served 38,000, so that is a program that's serving people in their own home
• <00:14:59.079> program Services um our elderly waiver program Services um our elderly waiver
• <00:17:59.679> a<00:17:59.840> large waiver program so we're seeing a large waiver
• be a large cost driver in the waiver be a large cost driver in the waiver program<00:18:57.799><
• impacted elderly waiver program um that impacted elderly waiver program um that impacted provids<

Keywords: 1183, house

Transcript Highlights:

• with waivers.
• So based on this waiver...
• We have so many federal programs. We all know that. We have so many federal programs.
• program?
• programs.

Summary: The meeting focused on Arkansas’s workforce development reorganization and a set of federal waiver requests intended to consolidate and streamline the state’s WIOA system. Commerce officials said the department has already centralized shared services, split the old workforce agency into reemployment and Arkansas Workforce Connections, and submitted a combined WIOA/Perkins state plan. They described nine waiver requests, including replacing local workforce boards with a single statewide board, creating one planning and accountability structure, allowing more flexible movement of funds across regions, easing the “last-dollar” requirement for training and supportive services, reducing required youth program elements, and allowing affiliate sites instead of mandatory comprehensive centers. Officials said the goal is to reduce administrative costs and redirect more money to training, supportive services, and employer-driven programs. Legislators raised concerns about rural representation, local employer relationships, and whether local offices would close. Commerce officials said local offices would remain open, some current staff could be rehired, and regional business councils would preserve local employer input. They said the current system is fragmented and expensive, with roughly $14 million in federal workforce funds flowing through local boards but only about $1.9 million spent on training and supportive services last year; they argued the reorganization could raise training spending to about $6 million to $7 million annually. Questions also addressed board composition, performance accountability, and how funds could be shifted between regions when needs change. The State Board of Workforce Development had approved the waiver package 11-3 before it was submitted to the U.S. Department of Labor. Members also discussed workforce access for people with disabilities, child care and transportation supports, and the role of Arkansas Launch, apprenticeships, and career and technical education. Officials said vocational rehabilitation now has better access to the state job board and that referrals and data-sharing with DHS and other partners still need improvement. Several legislators emphasized the need for training to align more closely with employer demand, especially in manufacturing, technology, health care, and rural areas. The committee also heard a brief overview of Workforce Pell, with staff explaining that the new federal short-term Pell option has narrow eligibility rules and may not fit many existing programs, including some CDL and CNA programs.

Transcript Highlights:

• Um, they run the waiver programs. I'm gonna go through the waiver programs in detail.
• So they run the waiver programs that provide the services that support people living with DD who meet
• And so if you would be willing to flip to page 6 and 7, these are the waiver programs that we have under
• They are all in these waiver programs, they're also available under Turquoise Care Community benefits
• We have a waiver program that allows people who are, whose income is just a little too high to qual to

Transcript Highlights:

• So we operate this program through a federal program called a 1332 waiver, section 1332 of the Affordable
• Reinsurance program.
• That's the 1332 waiver.
• two parts to that waiver.
• program when we implemented this program program when we implemented this program every<01:20:30.800

Keywords: 1187, senate, all

Summary: The committee heard a reinsurance overview from Deputy Commissioner Julia Dryer of the Minnesota Department of Commerce on the Minnesota Premium Security Plan. She explained that reinsurance helps stabilize premiums in the individual market by reimbursing insurers for high-cost claims, and said Minnesota’s program has lowered premiums, preserved carrier participation, and helped maintain consumer choice. She warned that without continued funding, the program would be depleted and individual-market premiums could rise by about 25%, with potential losses in coverage and access to care. She also described the program’s structure under a federal 1332 waiver, the role of MCHA in administering the program, and the state’s receipt of more than $650 million in federal pass-through funds to date. Dryer said the current program is funded through the end of 2025, though the federal waiver authority runs through 2027. The governor’s proposal would create a new assessment on insurers, estimated at roughly 2% to 3%, to fund the state share of the program and avoid another full waiver submission. She noted that the proposal assumes MinnesotaCare funding would be held harmless and that the program would be reduced if federal basic health plan funding were negatively affected. She also said projected costs changed because individual-market enrollment has grown and enhanced federal subsidies were removed from the estimate. Members raised concerns about the proposal’s impact on premiums and the history of the fund. Senator Rasmusson argued the new assessment amounts to a large tax increase on health insurance and questioned who would be assessed and whether the surcharge would be capped. Dryer responded that the assessment would be based on annual claims experience and market conditions, with final amounts determined at the end of each year, not monthly. Senator Duckworth and Senator Frentz supported reinsurance as a way to keep premiums lower, while also questioning how the program should be financed. Senator Green asked about the mechanics of the assessment and the role of the department in setting it, and Senator H questioned why the fiscal note assumed 12% annual growth for program costs when general premium growth was lower. No vote or formal action was taken in the meeting.

Transcript Highlights:

• as our Medicaid Waivers.
• So we do have people on both that program as well as our programs.
• program.
• The agency also had proposed that process. process for the medically dependent children program waiver
• . program.

Keywords: 1184, house, all

Transcript Highlights:

• So it's not a general waiver ability.
• It's just for participants of the assisted living waiver program.
• So now we have the assisted living program.
• I think one of the components of the ALW program and also the assisted living transitions program, and
• Program for providers.

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