Transcript Highlights:

• Sections 1 through 3 limit the cabinet's authority to make changes to the Medicaid Program on new waivers
• <00:10:07.000> on<00:10:07.160> new<00:10:07.399> waivers to the Medicaid Program
• on new waivers to the Medicaid Program on new waivers state<00:10:08.120> plan<00:10:08.399><
• Section 6 requires the cabinet to inform the LRC of application waiver applications, waiver amendments
• <00:12:47.880> and looking to go into these programs and looking to go into these programs

Keywords: Meeting start 00:00:00 Roll Call 00:00:15 HB 537 Discussion 00:01:30 HB 537 Vote 00:05:15 HB 695 Discussion 00:07:00 HB 695 Vote 00:23:15 HJR 31 Discussion 00:27:40 HJR 31 Vote 00:29:55, 958, all

Summary: The committee first took up House Bill 537, as amended by PHS 1, which was described as a technical measure needed to ensure Kentucky can receive opioid settlement funds despite changes in bankruptcy court orders. The sponsor and Attorney General’s office explained that the bill does not change the settlement formula or substantive terms, but adjusts the mechanism for receiving the money. After brief discussion, the committee adopted PHS 1 and then passed HB 537 out favorably on a 17-0 vote, with one member recording attendance after arriving late. The committee then considered House Bill 695, also amended by PHS 1, a Medicaid stabilization bill. The sponsor said the measure is intended to hold the program steady while the legislature gathers more information and awaits work by a future Medicaid Oversight and Advisory Board. The bill would limit new waivers, state plan amendments, and coverage expansions; require reporting and record retention; create a Kentucky Medicaid Pharmaceutical Rebate Fund; direct certain behavioral health and managed care changes; and include an emergency clause. Members raised questions about the rebate fund, work requirements, and whether the bill could affect coverage or funding, while supporters emphasized transparency, data collection, and preventing new expansions until oversight is in place. Several members spoke in favor of the bill’s goals but expressed caution about micromanaging a complex program and about possible unintended consequences for beneficiaries. Representative Fleming stressed the need for stronger oversight and noted the potential fiscal impact of federal Medicaid changes. Representative Stevenson voted pass, saying the committee should let the new oversight board handle the issue, and Representative Gentry also passed, citing concern about overreach and the burden of data collection. The committee ultimately reported HB 695 favorably on a 16-1 vote with three pass votes. Afterward, members recorded additional yes votes on HB 537 for the record.

Transcript Highlights:

• It is to contract creating a supplemental nutrition assistance program waiver compliance solution.
• Whenever we've got this program, you've got this program, and it's my understanding... ...that is contingent
• For example, the WIC program, school lunch program, and other programs have more nutritional requirements
• And this waiver is a step in the direction of increasing the nutritional value of that program.
• This is a two-year waiver, and so we have been able to find that.

Summary: The committee reviewed three DHS out-of-state service contracts: a $690,000-plus sole-source contract for DCFS with Evident Change for maintenance and operation of the Child Welfare Structured Decision-Making practice hub; a $1.2 million sole-source contract for County Operations with Sifter Solutions to support a SNAP waiver compliance solution; and a $156,000 contract for Developmental Disabilities with Samaritan Integrative Services for psychiatric services at the Southeast Arkansas Human Development Center. The chair and staff explained the contracts and noted that the Evident Change and Sifter contracts were sole-source due to the proprietary nature of the systems or services involved. Most of the discussion focused on the Evident Change contract. Members questioned DCFS about long-term dependence on the vendor, the lack of a competitive bid, the absence of a clear off-ramp, and whether the state was paying more overall as the work was split into multiple contracts. DCFS said the contract before the committee was only for maintenance and operations of a web-based platform used daily for safety assessments and case planning, while a separate Evident Change contract covers case reviews, CQI work, and data management. The vendor said it was continuing to reduce its role and had begun off-ramp discussions, but members remained concerned that the state was too reliant on the vendor. Staff said the contract had to be approved by May 31 or the system could be turned off. The committee also discussed the Sifter Solutions contract, which supports Arkansas’s SNAP waiver pilot by providing a dynamic list of excluded products and a consumer app that scans barcodes and provides nutrition information. DHS said the waiver is intended to improve the nutritional value of SNAP benefits, that the contract is funded with remaining federal SNAP Nutrition Education dollars that would otherwise be returned, and that the University of Pennsylvania will conduct the evaluation at no cost. Members asked about the benefit to Arkansas, whether the app would include nutrition and budgeting information, and whether the state would own the application or need future renewals. DHS said the two-year term was intentionally aligned with the waiver period and that future procurement options could change. After discussion, the committee noted the items as reviewed and adjourned without objections or votes recorded in the transcript.

Transcript Highlights:

• the Medicaid waiver programs, which includes iBudget and the long-term care, by July 1, 2026.
• I want to make sure to note that this program and this participation in the pilot program is completely
• The pilot program, there is limited data on the pilot program.
• The pilot program is a voluntary program to allow people to get the much-needed services that some of
• If they don't like the program, they can come off the program, go back on the wait list, and wait for

Summary: The committee met with a quorum present and heard six bills, all of which were reported favorably. HB 1567, relating to insulin administration by direct support professionals, was amended to clarify the type of insulin that may be administered and to allow supervision of self-administration of an insulin pen. Supporters described the bill as a way to keep people with developmental disabilities in group homes rather than forcing institutional placement; the amendment and bill both passed unanimously, 17-0. PCS for HB 1103, on services for persons with disabilities, would expand the APD managed care pilot statewide in phases, require more transparency on waitlist data, create a statewide family care council, and address transition services for young adults leaving foster care. Testimony was mixed: supporters emphasized the long APD waitlist and the need for a voluntary option, while some witnesses and members raised concerns about the accelerated rollout, limited data, and preserving consumer-directed care. The committee adopted the bill 17-0. CS for HB 127, on exceptional student education, would create micro-credentials and coordinate with the Florida Center for Students with Unique Abilities and OSHA to support students with disabilities transitioning to work; it passed 17-0 after testimony from a parent and advocates. HB 989, concerning licensure of family foster homes, was amended to streamline license transfers for foster parents moving within Florida while maintaining oversight and directing DCF rulemaking. A teacher and other supporters said the bill would reduce bureaucracy and help children remain in stable homes; it passed 17-0. PCS for HB 1091, on substance abuse and mental health care, updates processes related to the 988 crisis line, methadone treatment needs assessments, and forensic evaluators, and adds data/reporting requirements for DCF managing entities. After one amendment and testimony from supporters and one opponent, it passed 16-0. Finally, HB 633, on behavioral health managing entities, was amended and then approved 17-0; it requires more structured data and reporting from managing entities to increase accountability and transparency in the behavioral health system.

Transcript Highlights:

• For supported decision-making programs.
• advisory task force on Waiver Reimagined: the Waiver Reimagined Advisory Committee.
• , including PCA Choice, the CFSS program.
• First, an amendment to apply it only to new waiver applicants; otherwise, existing waiver recipients
• are likely to lose their waivers.

Bills: HF2434

Keywords: healthcare, personal care assistance, worker retention, disability services, state funding

Transcript Highlights:

• Florida's<00:10:18.959> programming<00:10:19.839> program<00:10:20.320> achieving
• > Florida's programming program achieving Florida's programming program achieving uh<00:10:21.600>
• That's authorized under a waiver program.
• That's authorized under a waiver That's authorized under a waiver program.<00:24:14.080> If
• If that waiver were not not program.

Keywords: 928, house, all

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:

• And the waiver changed that. But the waiver only works when support coordination works.
• program.
• We represent a very, very large program, nurses, programs all around the country.
• We represent a very large program, nurses, programs all around the country.
• , all nursing programs.

Summary: The Appropriations Committee on Health and Human Services met with a quorum present and took up several health-related bills. CS/SB 1110, covering Medicaid and insurance coverage for medically necessary orthotics and prosthetics, including activity-specific devices without lifetime or continuous-use caps, received emotional testimony from families and athletes describing high costs and the importance of access for children and adults with disabilities. Members voiced strong support, and the bill was reported favorably. The committee also heard SB 1574, which would add biliary atresia screening to the newborn screening program using the existing birth blood specimen. The sponsor and a parent testified that earlier detection could prevent severe liver damage, transplants, and deaths, and the bill was reported favorably. CS/SB 794, dealing with background screening for employees at residential facilities and day training programs for people with developmental disabilities and a review of waiver support coordination, was amended to align with the House companion and then reported favorably after testimony emphasizing the importance of strong support coordinators for APD waiver families. Members then considered SB 162, requiring hospitals and ambulatory surgical centers to adopt policies for smoke evacuation systems during procedures that generate surgical smoke. Nurses and other supporters described surgical smoke as a serious occupational hazard, while the Florida Hospital Association said hospitals are already regulated in this area and the bill was somewhat prescriptive; an amendment was adopted and the bill was reported favorably. CS/SB 254, which tightens oversight of nursing education programs, adds preceptorship and provisional licensure pathways for graduates awaiting NCLEX results, and increases transparency and accountability for low-performing programs, drew support from nursing advocates and opposition from private nursing schools concerned about workforce impacts; after amendment, it was reported favorably. Finally, SB 688 to reestablish licensure and regulation of naturopathic doctors in Florida was heard with testimony both supporting expanded health care choices and opposing the bill over safety and scope concerns, and it too was reported favorably. The committee then adjourned.

Transcript Highlights:

• Tant: in the waiver, long-term care managed-care programs for individuals with developmental disabilities
• As you have heard this program is vital for Laura Antonello: those of us on the waiver that work.
• But the program itself is vital.
• Especially as of right now the program itself does cover just those on the waiver and there's a lot of
• program.

Transcript Highlights:

• phase that they come for those waivers.
• That totals the amount of that program.
• If you've programmed everything you need and you're programming at least to the minimums for your core
• So if they wouldn't be getting rid of their entire waiver, it would just be a waiver on the expanded
• I think if they get a waiver, they get a waiver for allowing them to increase the gross square footage

Transcript Highlights:

• Within our traditional Medicaid program, we have our health system value-based program that operates
• into that program.
• Chair, that is because these rates are used by our SPED program and our expanded SPED program, which
• We would also anticipate that individuals would shift from our DD waiver to this new waiver as well.
• Way to administer this program, or the right federal authority to administer the program under.

Keywords: 908, all

Summary: The Senate Appropriations HR Division met with all members present to review the medical services portion of the HHS budget. Sarah Aker, Executive Director of Medical Services, walked the committee through several budget items, including HCBS cost-to-continue adjustments, the DD bed assessment, expansion of value-based purchasing, targeted rate increases for home health and QSP services, and the cross-disability waiver. Members generally supported the targeted increases for home health and QSP, and Aker explained that the cross-disability waiver funding would support startup work, service design, and infrastructure ahead of a planned July 1, 2028 implementation. The committee spent significant time on rate-setting and provider payment issues. Members discussed ambulance rate rebasing, with several senators expressing concern that the proposed increase was too high relative to peer states; the committee ultimately moved toward reducing that item to $1 million rather than zero so it could be revisited in conference committee. They also discussed a House-added critical access hospital networking grant and similarly leaned toward reducing it to $1 million. Aker explained the department’s value-based purchasing plans, including use of a vendor selected through RFP, and clarified how the department’s existing Medicaid managed care and hospital value-based programs work. A major portion of the meeting focused on long-term care and basic care payments, including a House-added extension of the $5 per day basic care add-on and a proposed shift in nursing facility incentive grants toward a withhold-based model. Senator Mathern indicated he would bring an amendment to delay or modify the withhold change, and Aker said the department would prefer language that directly addresses whether a withhold may be implemented. Members also discussed 1915(i) services, FMAP changes, the Medicaid legacy system modernization carryover, and a House-added legislative intent section on medical assistance. The committee adjourned for the morning with plans to return later to continue Human Services budget work and revisit unresolved items in conference committee.

Transcript Highlights:

• It is to contract creating a supplemental nutrition assistance program waiver compliance solution.
• Whenever we've got this program, you've got this program, and it's my understanding that is contingent
• Whenever we've got this program, you've got this program, and it's my understanding that is contingent
• For example, the WIC program, school lunch program, and other programs have more nutritional requirements
• And this waiver is a step in the direction of increasing the nutritional value of that program.

Summary: The committee reviewed three DHS service contracts: a $690,000-plus sole-source contract for DCFS with Evident Change for maintenance and operation of the Child Welfare Structured Decision-Making Assessment tools; a $1.2 million contract with Sifter Solutions for a SNAP waiver compliance solution and related app; and a $156,000 contract with Samaritan Integrative Services for psychiatric services at the Southeast Arkansas Human Development Center. Staff said the Evident Change contract was needed to keep daily safety risk assessments, case planning, and reunification tools functioning, and that the vendor’s proprietary system made it sole source. Members questioned DHS about reliance on the vendor, the lack of an off-ramp, whether the state was paying more or less annually, and why the contracts were not aligned on the same cycle. DHS and the vendor said the new Evident Change contract was limited to maintenance and operations, that no additional services or employees were being added, and that the broader CQI/review contract would come up separately later. For the SNAP waiver contract, DHS explained that the waiver is intended to exclude certain unhealthy foods from SNAP purchases to improve nutritional value, and that Sifter Solutions would provide a dynamic list for retailers and an app for clients to check products by barcode. DHS said the contract is sole source because it is tied to the waiver implementation and because the vendor can provide the needed dynamic list and education features. Staff said the contract would be funded with remaining federal SNAP Nutrition Education dollars that would otherwise revert to the federal government, and that the University of Pennsylvania would conduct the evaluation at no cost. Members asked about the public benefit, future renewals, and whether the state would own the application; DHS said the two-year term was designed to match the waiver period and allow time to reassess future procurement options. Members also asked about the nutrition education component, and DHS said it is developing videos with a nutritionist on preparing budget-friendly healthy meals and plans to link them to the app and website. After discussion, no objections were raised, and the items were reported as reviewed. The meeting then adjourned.

Transcript Highlights:

• These are niche waivers service waivers.
• program.
• cost of the program. cost of the program.
• . program. program.
• program like ATRIP. program like ATRIP.

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.

Transcript Highlights:

• and this program is transitioning the old PCA program into this new program.
• c><00:08:34.479> one PCA program into this new program one PCA program into this new program one
• in the waiver.
• in the waiver.
• The A36 amendment would add the WIC program to the excluded programs.

Keywords: 1187, senate, all

Transcript Highlights:

• WAIVER PROGRAM INCLUDING EYE BUDGET AND LONG TERM CARE BY JULY 1st 2026.
• ENROLLMENT IS VOLUNTARY AND CLIENTS CAN GO TO THE PILOT AND RETURN TO THE BUDGET WAIVER PROGRAM.
• HAD A WAIVER YEARS AGO CALLED FSI WAIVER REFERRED TO AS A LITTLE WAIVER AND IT WAS KIND OF THE SAME
• LIKEWISE ON THE MANAGED CARE PILOT PROGRAM THERE WAIVER OF SUPPORT COORDINATES OR EQUIVALENTS AND NURSES
• TO BE IN THIS PROGRAM.

Keywords: 999, senate, all

Transcript Highlights:

• There's no retroactive eligibility in a waiver.
• Well, what about the waiver? Is that a viable... were we emphatic?
• It takes 18 months to get a waiver?”
• Let's deal with a waiver on special needs later. So yes, sir.
• When y'all were talking about the waiver and how many people are in the waiver, I am finding that there

Summary: The Administrative Rules Subcommittee of the Arkansas Legislative Council reviewed several agency rules and requests. It approved without objection an Insurance Department amendment implementing Act 261’s holding company system requirements, two State Board of Election Commissioners rules on poll watchers/provisional voting and certified election monitors, and a Treasurer of State rule removing DEI-related membership requirements to comply with Act 938. The committee also held over for a month a Department of Education request related to excluding a rule from reporting requirements so it could be discussed further with the Department of Commerce. A major portion of the meeting focused on the Department of Human Services’ request to be excluded from rulemaking for Acts 567, 568, 967, and 1025. DHS said federal CMS guidance created comparability and other issues for the Medicaid-related dental and diagnostic lab provisions, making it difficult to implement the acts as written by their effective dates. DHS outlined possible paths, including broader adult dental coverage, waivers, or splitting the dental rate increase from the special-needs cap increase. The Arkansas State Dental Association disputed DHS’s approach, arguing Act 1025 is workable, that the pediatric rate increase should move forward separately, and that DHS should continue pursuing the law rather than stop rulemaking. Committee members questioned both sides extensively about CMS correspondence, waiver timelines, fiscal impact, and whether the acts could be severed. After testimony from DHS, the Dental Association, and a public commenter, the committee adopted a motion not to exclude DHS from reporting requirements for Acts 567, 568, 967, and 1025, meaning DHS must continue the normal rulemaking/reporting process. The committee then accepted the Division of Higher Education’s report, which recommended repealing three of its 32 rules and keeping the remaining 29 in effect. It also received routine written updates on older and newer rulemaking items and filed the monthly updates without further action.

Transcript Highlights:

• for developmentally disabled Floridians who receive support through Medicaid waiver programs.
• adults with developmental disabilities in a Medicaid waiver program be automatically enrolled.
• Eligible adults with developmental disabilities in a Medicaid waiver program be automatically enrolled
• And my only question is, is this going to require a specific waiver for ACA to get a waiver to do this
• As of now, there is no way for us to formally enroll in the program.

Bills: S1002, S1016, S1030, S1594, S1630

Keywords: child welfare, substance abuse, neglect, parental rights, drug exposure, Medicaid, disabilities, employment, healthcare access, income eligibility, veteran benefits, minor clients, financial assistance, education services, Department of Children and Families, Department of Health, aging services, disability assistance, long-term care, Alzheimer's support

Summary: The committee considered several bills affecting children, disability services, aging, recovery residences, and foster youth benefits. SB 1016 codified the working people with disabilities program for Medicaid waiver recipients, with amendments removing automatic enrollment and improving information sharing between agencies; advocates testified that the program helps people with developmental disabilities work while keeping needed care, though they raised implementation and training concerns. The bill was reported favorably. SB 1002, as amended, clarified that evidence of acute or chronic parental drug abuse can constitute harm or neglect in child welfare cases and allow court intervention and treatment requirements; it was also reported favorably. SB 1594 would preserve veterans’ benefits for foster youth for postsecondary education or aftercare rather than using them as reimbursement to the agency, and it passed favorably. SB 1630 modernized aging and long-term care statutes, expanded emergency service authority, updated oversight of area agencies on aging and guardianship, and permanently established the Florida Alzheimer’s Center of Excellence; after two amendments, it was reported favorably. SB 1030, on recovery residences/substance abuse services, was amended with a substitute that narrowed transfer definitions, sped licensure for existing providers adding levels of care, and limited credentialing entities’ access to resident records; members noted it remained a work in progress, but it was reported favorably. The committee also held confirmation hearings. Robert Astellos, nominated as Director of the Agency for Persons with Disabilities, described efforts to reduce the pre-enrollment list, improve transparency and customer service, expand family involvement, and streamline agency processes; multiple advocacy groups appeared in support, and the committee recommended his confirmation. The committee then unanimously recommended confirmation of the appointees on tabs 7 through 10. The meeting concluded with adjournment.

Transcript Highlights:

• waiver waiver 1915c<00:54:37.839> program<00:54:38.839> which<00:54:39.000> as<
• covers the true cost of delivering services through the Medicaid waiver program.
• covers the true cost of delivering services through the Medicaid waiver program.
• covers the true cost of delivering services through the Medicaid waiver program.
• of delivering services through the Medicaid waiver program, so in addition to all of the bills that

Keywords: 912, senate, all

Summary: The Committee on Health and Human Services held an informational briefing on the Developmental Disabilities Council and related agencies. The Hawaii State Council on Developmental Disabilities outlined its 2025 legislative priorities, including a pilot project for guardian ad litem and capacity evaluations in guardianship/conservatorship cases, a supported decision-making bill, a health disparities study for people with disabilities, an ABLE savings outreach/staffing measure, a Medicaid buy-in proposal, an adult changing tables equity bill, and a resolution on fetal alcohol spectrum disorder. Council representatives emphasized that supported decision-making would complement tools like powers of attorney and medical releases, and that the health disparities study would help identify unmet needs by ZIP code and improve state data on the intellectual and developmental disability population. The Center on Disability Studies at the University of Hawaii described its role as the research and training arm within the DD system, working with the DD Council and the Hawaii Disability Rights Center. It reported activities such as interdisciplinary training, community education, technical assistance, research collaborations, the Pacific Rim International Conference on Disability and Diversity, publications, telehealth, ECHO Autism, and counseling for Maui fire survivors. The center said it leveraged about $16 million in outside funding last year and highlighted goals focused on workforce development, community capacity, research with direct participation from people with disabilities, and accessible dissemination of information. The Hawaii Disability Rights Center, the state’s protection and advocacy agency, supported the Council’s priorities, especially supported decision-making, which it said could help some people avoid guardianship while preserving liberty and reducing state resource use. The center also raised concerns about the DD system budget and urged legislators to review whether the Developmental Disabilities Division is requesting enough funding, noting possible backsliding in services and eligibility. The Developmental Disabilities Division of the Department of Health then outlined its statewide waiver program serving just over 3,500 people, its service array, and its budget request for increased waiver funding, a federal initiatives coordinator, and IT upgrades to comply with the new HCBS access rule; no votes or formal actions were taken during the briefing.

Transcript Highlights:

• Additional major cost drivers are the KidCare program, the iBudget waiver program at APD, and the child
• welfare program at DCF.
• Care Plus program.
• services. programs.
• So that's another program. So that's another program that I wanted to highlight.

Summary: The Health Care Budget Subcommittee met to organize the new term, take roll, and hear introductory presentations from the six agencies under its jurisdiction: the Agency for Health Care Administration, Agency for Persons with Disabilities, Department of Children and Families, Department of Elder Affairs, Department of Health, and Department of Veterans’ Affairs. The chair outlined the committee process, including assigning members to review agencies and make budget recommendations. Each agency head gave a high-level overview of their budget, staffing, major programs, and priorities, with recurring themes including Medicaid, long-term care, disability services, child welfare, mental health, aging services, public health, and veterans’ health care. Several agency leaders highlighted recent initiatives and funding priorities. AHCA emphasized Medicaid managed care, provider regulation, Hope Florida, hospital-at-home, and cancer-related efforts; APD discussed iBudget services, Hope Florida, a managed-care pilot, online applications, and forensic care costs; DCF focused on child protection, foster care, adult protective services, food/cash/medical assistance, mental health, and opioid treatment; Elder Affairs highlighted Alzheimer’s services, community-based senior care, guardianship, ombudsman services, and disaster outreach; DOH covered cancer innovation, maternal telehealth, cybersecurity, HIV/hepatitis/syphilis screening, and school nursing; and Veterans Affairs described benefits and health care access for veterans, long-term care, and federal reimbursement. Several speakers also raised concerns about rising costs, provider rates, disaster response, and access to services. The committee heard two public comments from disability advocates about Medicaid redeterminations affecting iBudget waiver recipients and provider payment delays. In response, AHCA and APD said they were coordinating on data sharing, early outreach, escalation processes, and efforts to reduce disenrollments and make recertification smoother. Members then asked questions about provider rates, opioid settlement spending, managed care quality measures, pediatric rare disease grants, group home transparency, senior outreach, ABA services moving into managed care, annual Medicaid recertification, veterans’ service utilization, waiting lists for elder services, and prevention spending. No formal votes were taken during the meeting.

Transcript Highlights:

• This bill also replaces the existing unauthorized alien transport program with a new program where the
• And along those lines on tuition waivers, do we not have a program for tuition waiver for grandchildren
• When you're identifying students with tuition waivers, they would be among those who have tuition waivers
• When you're identifying students with tuition waivers, they would be among those who have tuition waivers
• Your daycare program. So what does he do?

Summary: The Senate Appropriations Committee met to hear SB 2-C, a major immigration enforcement bill sponsored by Senator Gruters and co-introduced by Senator Fine. The sponsor described the bill as a response to federal immigration priorities and said it replaces a single immigration officer with a State Board of Immigration Enforcement, expands local-federal cooperation, increases penalties for crimes committed by unauthorized immigrants, requires detention in certain cases, broadens information sharing, funds detention-bed expansion and law-enforcement training, and ends in-state tuition waivers for undocumented students. The bill also includes provisions related to sanctuary policies, voter fraud, transport of unauthorized aliens, and driver’s license-related offenses. The sponsor said the bill appropriates roughly $300 million overall, including $250 million for grants and $48 million for the Department of Agriculture and Consumer Services for interdiction and border-related enforcement work. Committee members questioned the bill’s scope, costs, and implementation. Senators focused heavily on the tuition-waiver repeal, asking how many students would be affected and whether the bill would harm students who have long lived in Florida. They also pressed on whether the bill should include stronger E-Verify provisions, how sanctuary-policy enforcement would work, whether local officials could be penalized for policy choices, and how immigration status would be verified in court and jail settings. The sponsor and Senator Fine said the tuition waiver would be removed for undocumented students, that the bill does not address E-Verify, and that the measure is intended to make immigration status a factor in detention and sentencing. Questions also addressed detention-bed capacity, reimbursement rates, and whether corrections staff would receive bonuses or salary increases; sponsors said bonuses are included for participating law enforcement, while broader salary issues would be handled in the regular budget process. Public testimony was sharply divided. Supporters and information-only witnesses, including Sheriff Bob Gualtieri and former officials, said the bill would help Florida coordinate with federal authorities, expand bed space, and close loopholes in existing immigration enforcement. Opponents from the Southern Poverty Law Center, ACLU of Florida, Florida Policy Institute, labor groups, and immigrant advocates argued the bill is unconstitutional, likely to trigger litigation, and harmful to families, schools, and the economy. They warned that the pretrial detention provisions could lead to wrongful detentions and that the tuition changes would reduce access to higher education and cost the state tuition revenue. No final vote is reflected in the transcript excerpt, but the committee continued through public comment and extended the meeting to complete the agenda.

Transcript Highlights:

• waiver.
• Per waiver requirement Waiver requirements residents are responsible for paying for their room and board
• So it's not a general waiver ability.
• It's just for participants of the Assisted Living Waiver Program.
• What are the components of the ALW program and also the assisted living transitions program and they

Keywords: 988, house, all

Transcript Highlights:

• for your program.
• Work with John Valdez to ensure that the programming spaces... all of the educational programs.
• Initially, it was a full waiver, but now it's a partial waiver.
• what they need regarding moving some of these programs forward, especially CTE programs.
• programmed to the space.