Transcript Highlights:

• This particular idea was in the rural health transformation grant that AHS had, and it was approved by CMS
• and the senior vice president of policy and strategy for Vermont Association of ... was approved by CMS
• So was approved by CMS for that purpose.

Keywords: 926, house, all

Summary: The House took up S. 190, a health care cost-containment bill relating to the Green Mountain Care Board, reference-based pricing, and a study of a public employee health benefit authority. The House first suspended rules to take the bill from the notice calendar, then heard committee reports from Health Care, Ways and Means, and Appropriations. The Health Care committee chair described the bill as a strike-all amendment intended to carry out Act 68’s hospital reference-based pricing timeline, saying it would let the Green Mountain Care Board begin implementation for fiscal year 2027, expand reference-based pricing to qualified health plans and the Vermont Education Health Insurance program, and address hospital pricing transparency, outsourcing, and critical access hospital Medicare outpatient cost-sharing issues. Supporters argued the bill would lower insurance costs, help reduce property taxes, and improve hospital sustainability by reducing the need for hospitals to limit access as they approach revenue caps. The Ways and Means committee said the bill could reduce education spending by lowering health care costs for school employees and reported the bill favorably on a 7-4 vote. The Appropriations committee said it reviewed the bill and an amendment, and noted that much of the detailed language would be changed by the appropriations amendment; it also discussed a possible state innovation waiver under the Affordable Care Act. The Health Care committee reported its strike-all amendment favorably on a 10-0 vote. The bill’s provisions were described in detail, including requiring hospitals and insurers to express rates as a percentage of Medicare, setting a path toward national median hospital prices by 2030, limiting certain reimbursements for QHP and VHI plans, requiring a report on hospital outsourcing and provider tax impacts, and creating a public health system performance tool if funding is available. The speaker also noted that the bill would not affect critical access hospitals or Vermont’s Medicare-dependent hospital in the reimbursement cap provisions, and that critical access hospitals were already working with the Green Mountain Care Board on solutions to Medicare outpatient cost-sharing concerns.

Transcript Highlights:

• You're giving that responsibility<00:37:31.000> to<00:37:31.200> the<00:37:31.280> CMS
• c><00:37:32.200> to<00:37:32.360> the<00:37:32.840> case responsibility to the CMS
• to the case responsibility to the CMS to the case management<00:37:34.120> agency<00:37:34.560

Keywords: 1189, house, all

Summary: The committee first handled routine business, approving the minutes and consent calendar, then moved to the regular calendar of administrative rules. Department of Energy rule 25-220 was postponed until June at the sponsor’s request so stakeholders would have more time to review revised language. Several Department of Health and Human Services Medicaid-related rules were then considered, including 25-240, 25-265, and 26-33, each of which drew staff comments mainly about expired rule provisions and the agencies’ reliance on federal law, the Medicaid state plan, or other manuals. The committee approved those rules after brief questions, with the agencies stating they were already operating under the relevant federal or state-plan authority and, in one case, that rulemaking was underway to update an expired citation. The most extended discussion was on HHS Bureau of Aging rule 25-304, which had an amended conditional approval request. Staff explained the amendments clarified how case management agencies accept or deny cases, how telehealth participation is evaluated, and that the department sets the timing for accepting or denying cases under its existing authority. Staff also noted a separate issue about whether reimbursement rates must be in rule, but said the agency had long interpreted the statute to allow its approach and that any change would likely require legislation rather than committee objection. A provider representative testified against parts of the rule, arguing the case management agencies should not be required to accept referrals before contacting the participant, that telehealth decisions for other providers should remain with those providers, and that the quality-management section was duplicative and burdensome. Committee members questioned whether the telehealth language merely allowed case managers to say a service fit the client’s plan or instead gave them authority over another provider’s delivery method. The agency responded that case managers may determine what services an individual needs, but should not control how another licensed provider delivers those services. The discussion continued with no final action shown in the excerpt.

Transcript Highlights:

• Have to get the approval back from CMS on how we're going to spend the 203.4.
• So, either whatever the approval back from CMS on how we're approval back from CMS on how we're going

Keywords: 924, joint, all

Transcript Highlights:

• We have not gotten clearance from CMS to do that, but if we do get that training, we will be coming and
• We have not gotten clearance from CMS to do that, but if we do get that training, we will be coming and

Summary: The committee heard budget presentations and took executive recommendations on several Department of Human Services divisions, including Aging, Adult and Behavioral Health Services; Children and Family Services; County Operations; Developmental Disability Services; and Medical Services, with most divisions showing little or no significant change in total appropriations. Staff and agency witnesses repeatedly explained that many large appropriations are maintained for flexibility, federal matching requirements, or contingency needs, even when actual spending is much lower than the authorized amount. Members also raised concerns about staffing vacancies, long-vacant budgeted positions, and the use of excess appropriation authority across DHS. In Aging, Adult and Behavioral Health, members questioned federal funding levels for mental health and substance abuse grants, the status of senior centers and Meals on Wheels, the Medicaid tobacco settlement program, community alcohol safety grants, and the veterans mental health grant. Agency officials said federal block grants are largely committed, that senior center funding had been delayed by shutdown timing but was now back on track, that the tobacco settlement program had been moved internally within DHS, and that the veterans mental health appropriation remains unfunded. Senators also criticized the adequacy of support for seniors and asked for more detail on how transportation, meal services, and local contributions are funded. In Children and Family Services, members asked about rising appropriation levels, foster care and adoption subsidies, professional fees, the number of children in foster care, and the Children’s Trust Fund. DHS said increases reflect added flexibility for residential treatment, adoption subsidies, and prevention services, while the foster care population has remained fairly steady at about 3,400 children. The Children’s Trust Fund was described as supporting primary prevention programs such as Baby and Me and community schools, and members asked whether it could be administratively combined with other efforts. Questions also covered TANF subgrants, with DHS explaining that it had reduced outside subgrants after discovering over-obligation and was rebuilding reserves. In County Operations, members focused on the summer EBT program, SNAP employment and training, the farmer’s market program, and the state’s TANF reserve position. DHS said summer EBT is still being funded through temporary appropriations because it is a newer program, SNAP employment and training is largely federally funded and may expand under a pending policy change, and TANF reserves were drawn down after prior over-obligation but are now being stabilized. In Developmental Disability Services, members asked about vacancies, human development center staffing, facility construction funds, and the Booneville work program, and DHS said the program has reopened and staffing recruitment continues. In Medical Services, members asked about FMAP, the Our Kids B CHIP program, school-based Medicaid reimbursements, nursing home distress funds, and several large appropriation lines that far exceed actual spending; DHS said these are maintained for claims payment, nursing home receivership contingencies, and other flexibility needs. Each division reviewed was adopted by executive recommendation after questions concluded.

Transcript Highlights:

• you all are aware, there was a significant system update following our corrective action plan with CMS
• you all are aware, there was a significant system update following our corrective action plan with CMS

Keywords: 1189, house, all

Summary: The meeting opened without a quorum, so approval of the prior draft minutes was deferred until later. The committee then heard a DHS update from Commissioner Lori Weaver and COO David Weers, who described the recent flood at the Brown building and the relocation of nearly 400 DHS staff while operations are restored. They also outlined New Hampshire Care Connections, a privacy- and consent-focused closed-loop referral platform intended to improve referrals among providers, reduce duplication, and support continuity of care, with an Upper Valley implementation partnered with Dartmouth Health and an Epic integration already underway. Members asked whether the system would merge medical records or simply track referrals. DHS said it is not intended to store or transmit full medical records, but to integrate with providers’ electronic health record systems so referrals can be sent, received, and tracked, with consent controls limiting what information can be shared. Officials said the project will be tested over the coming months, with metrics, governance, and advisory committee oversight, and that it is tied to broader rural health transformation efforts and statewide implementation after the regional pilot. The committee also received the annual report from the Child Care Advisory Council. Maryanne Barter and Jessica Carver said the council worked with licensing to streamline the child care licensing rules, reducing the handbook by about 30%, and is now helping develop an informal dispute resolution process, revising the Granite Steps for Quality system, and creating a clearer handbook for providers handling state scholarship audits. They reported ongoing concern about child care closures and workforce shortages, said there is currently no wait list for child care assistance, and discussed questions about federal CCDF immunization requirements, which DHS said it would follow up on with federal technical assistance partners. After quorum was established, the committee moved to approve the minutes from the prior meeting.

Transcript Highlights:

• have it structured here, they would supply that information monthly, um, and we're actually working on—CMS
• have it structured here, they would supply that information monthly, um, and we're actually working on—CMS

Keywords: 1189, house, all

Transcript Highlights:

• You see it more in the design-build, and I assume probably the CM as well.
• You see it more in the design-build, and I assume probably the CM as well.

Keywords: 00:05 Call to Order and Roll Call 01:20 Road Projects 46:30 Approval of Minutes 46:50 Railroads 57:26 Adjournment, 958, all

Summary: The Budget Review Subcommittee on Transportation met without a quorum, so it could not approve the minutes. The chair announced an Eastern Kentucky University health forum later that day and then proceeded with testimony on alternative delivery methods for road projects. Jason Sawala of the Kentucky Transportation Cabinet and Chad Laroo of the Kentucky Association of Highway Contractors were sworn in and introduced themselves. Sawala explained KYTC’s use of alternative delivery tools, including design-build, construction manager/general contractor (CMGC), and public-private partnerships (P3s). He said the cabinet’s goal is to deliver the best value to taxpayers in terms of quality, cost, and time, and emphasized that alternative delivery is most useful on projects with special circumstances such as innovation needs, specialized technology, complex constructibility, schedule pressure, or early contractor input. He cited the cabinet’s wrong-way driving prevention project as an example where design-build helped evaluate technologies and coordinate with stakeholders such as EMS and first responders. He also outlined the main tradeoffs: alternative delivery can improve collaboration and sometimes accelerate schedules, but it also brings risks related to right-of-way acquisition, utility relocation, changing scope, and the need for dedicated staff and compressed decision-making. He stressed that these methods are not a cure-all and are not appropriate for every project, while noting that traditional design-bid-build remains effective for most of KYTC’s work. Representative Branscum responded favorably, saying early contractor involvement is valuable and consistent with his experience in the vertical construction world. No votes or formal actions were taken because the committee lacked a quorum.

Transcript Highlights:

• Could Medicaid reimbursement be jeopardized by the condition of the campus or the programming if CMS

Summary: The Health and Human Services Committee held an invited-testimony hearing on LR 425, which examines the Whitehall campus in Lincoln and possible long-term options for youth currently served there. Chair Brian Hardin explained that Whitehall houses two separate programs for adolescent males: a substance use program and a youth-who-sexually-harm program. Testimony from DHHS officials described Whitehall as a Joint Commission-accredited psychiatric residential treatment facility (PRTF) that provides about 40 hours of weekly programming, family involvement, school services, and community reintegration activities. Officials said the department is evaluating whether the programs should remain at Whitehall or move to another state-owned facility, with Hastings described as the department’s preferred alternative because it is more residential in design than a youth rehabilitation treatment center (YRTC).

Transcript Highlights:

• that Medicaid reimbursement could be jeopardized by the condition of the campus or the programming, if CMS

Keywords: 956, all

Transcript Highlights:

• between 225 and 250 certified home health agencies, also not licensed, but they are certified through CMS

Keywords: 995, all

Summary: The Joint Committee on Aging and Independence held a hearing on several bills, led by Chair Tom Stanley and Senate Chair Patricia Jehlen. The committee first heard testimony on H. 765/S. 487, an act relative to councils on aging, which would update outdated statutory language and allow directors of councils on aging to make staffing decisions when a council is structured as an advisory body. Representative Donahue and Betsy Connell of the Massachusetts Association of Councils on Aging said the change reflects how most councils now operate and would resolve conflicts like the one that arose in Sherborn. Members asked about whether the bill would affect town managers, volunteer roles, and whether the language should more clearly exempt informal volunteer help; supporters said the bill is aimed at municipal staffing structures, not unpaid volunteer assistance. The committee then took extensive testimony on H. 789/S. 470, an act to improve Massachusetts home care, which would create a statewide licensure system for non-medical home care agencies and entities. Julie Watt, Jay Krillovich, Betsy Krimmins, Lisa Gargoni, Tim Foley, and several providers and advocates supported the bill, arguing that licensure would establish baseline standards for background checks, training, service plans, insurance, complaint procedures, and labor-law compliance, while helping consumers identify legitimate providers and reducing fraud and abuse. Several witnesses described problems with unlicensed or poorly supervised providers, and family members and dementia advocates emphasized the need for dementia-specific training and better oversight for vulnerable clients. Tim Foley also raised concerns about private equity’s growing role in home care and said stronger regulation is needed to protect consumers and workers. Committee members focused on practical questions about the bill’s scope, including whether it would reach informal paid helpers, volunteers, or people doing occasional household tasks, and what agency would enforce the rules. Supporters said the bill is intended to cover entities advertising home care services, not unpaid volunteer help, though they acknowledged regulators would need to work out details. John Sneeth of Tribute Home Care offered a more cautious view, saying licensure should not unduly burden smaller providers or reduce competition, and that enforcement would be key. The hearing also included testimony from the Alzheimer’s Association and family caregivers, who strongly supported the bill’s dementia-training provisions and described how trained caregivers improved safety and quality of life for people living with Alzheimer’s and dementia. At the end of the hearing, the committee also heard support for H. 778/S. 473, regarding the Commission on LGBTQ Aging, with Lisa Krinsky urging funding for a full-time director and continued support for the commission’s strategic plan. After public testimony concluded, the committee adjourned the hearing by motion and voice vote.

Transcript Highlights:

• After that, CMS can redistribute the unspent funds to other states. We do not want that to happen.

Keywords: 993, senate, all

Summary: The Senate convened, approved the prior journal, and discharged several identical Assembly/Senate bills from committee so they could be substituted on the calendar. The chamber then took up and previously adopted two commemorative resolutions: one designating April 2026 as Sikh Heritage Month and another honoring Korean War veterans. Senators from both parties spoke in support of the Sikh resolution, emphasizing the community’s contributions, service, and the need for recognition and inclusion; the resolution was opened for co-sponsorship and the Sikh guests in the gallery were recognized. The Korean War resolution drew remarks from members recalling family service and the sacrifices of veterans, with repeated calls to preserve their stories and honor their legacy. The Senate then moved through the calendar, passing a series of bills. Among them were measures related to charter bus safety and seat belt awareness, coverage for doula services under insurance, social services/EBT-related changes, education, navigation, highway, public service, and hospital-closure reporting. Several bills passed unanimously or with only one dissenting vote; the social services bill drew the most opposition, with Senator Murray objecting that New York should first address EBT chip technology and skimming before adding new vendor requirements. One bill on the calendar was laid aside for the day. The chamber also adopted a supplemental bill authorizing the South Country Central School District to finance certain deficits, described by Senator Murray as a necessary rescue to keep the district operating and pay staff. Senators discussed the state budget impasse during debate on an extender bill, with the sponsor explaining it was a “clean extender” to keep government running through May 4 and cover payroll, health, education, and other essential payments. Senator Helming raised concerns about the lack of rural health transformation funding and the consequences of the delayed budget for schools, local governments, and hospitals. The extender passed, and the Senate adjourned until Monday, May 4, 2026.

Transcript Highlights:

• We've hidden any counts of users that are under 11 as part of what CMS recommends.

Transcript Highlights:

• started, to answer Senator Sears' question about the percentages, we're talking about 6.12% is what CMS

Bills: HB2048, HB2189, HB2248, HB2403, HB2728, HB2729, HB2730, HB2731, HB2906, HCR2058

Keywords: orders of protection, domestic violence, court procedures, legal guardian, enforcement, healthcare, licensed health aides, scope of practice, ventilator care, training standards, medical freedom, healthcare mandates, employment requirements, public health, government regulation, elderly, physical disabilities, Arizona Health Care Cost Containment System, home and community based services, funding increase

Summary: The committee first heard a presentation from Central Arizona Shelter Services (CASS) on homelessness in Maricopa County and CASS programs for single adults, families, and older adults. The witness described rising homelessness, especially among older adults, and said recent declines were linked to American Rescue Plan Act funding for shelters and flexible rental assistance. Members asked about CASS partnerships with mutual aid and service organizations; the witness described collaborations for food, banking, haircuts, digital access, and behavioral health. No vote was taken on this presentation. The committee then considered HB 2248, the Arizona Medical Freedom Act, which would bar businesses, schools, and government entities from denying services or employment based on medical interventions and limit employer medical requirements, with a school outbreak amendment adopted. Proponents framed the bill as protecting bodily autonomy and informed consent, while opponents argued it would weaken employers’ ability to control communicable diseases and protect public health. The committee adopted the amendment and advanced the bill on a 4-3 vote. It also advanced HB 2906, requiring one oral and maxillofacial surgeon on the State Board of Dental Examiners, and HB 2189, directing the Nursing Board to implement rules for licensed health aides performing routine ventilator care; both passed with amendments and strong support from sponsors and board representatives. Later, the committee approved HB 2403, appropriating $2.5 million in FY2027 for home- and community-based services providers serving elderly and physically disabled Arizonans. Supporters said the funding would help retain caregivers and reduce more expensive hospital or facility care. The committee also passed several continuation bills, including HB 2731 for the Physician Assistants Board, HB 2730 for the Occupational Therapy Board, and HB 2729 for the Nursing Board, all on largely party-line or near-unanimous votes after testimony from board staff emphasizing public protection and oversight. The committee then took up HB 2728, a DES continuation bill that also incorporated nine previously vetoed policy bills affecting SNAP, unemployment, and related benefits. Opponents argued it would make access to essential benefits harder and turn a routine continuation bill into a vehicle for controversial policy changes; supporters said it was needed for oversight and program integrity. The bill advanced on a 4-3 vote. Finally, the committee approved HB 2048, a strike-everything amendment requiring AHCCCS to treat a new non-opioid pain medication no more restrictively than opioids in utilization controls, and ACR 2058, which would require a comprehensive Medicaid claims audit funded by recoveries. Both measures drew support from sponsors and some personal testimony, while opponents warned about cost, duplication of oversight, and incentives that could bias audits; each advanced on 4-3 votes. The committee then adjourned.

Transcript Highlights:

• rural emergency hospital status, or REH status, it receives about $3.5 million per year in support from CMS

Bills: SB63, SB80, SB63, SB80

Keywords: immigration, law enforcement, fingerprints, DNA collection, illegal aliens, Alabama state law, SB80, Buddy Sharpless Education Institute, Alabama Local Government Training Institute, county commissioner training, local government training, ethics training, State Ethics Commission, county commissioners, Association of County Commissions of Alabama, local emergency management director, public officials, municipal officials, Alabama Code Title 11, Alabama Code Title 31

Transcript Highlights:

• CMS will review all state applications and announce awards by December 31, 2025, with funds distributed

Summary: The Senate Appropriations Committee met with a quorum present and took up two bills. The first, SB 250 on rural communities by Senator Simon, was described as a broad rural development package creating an Office of Rural Prosperity, a Renaissance grant program, housing and transportation investments, added funding for rural education consortiums, and health care initiatives for rural areas. Senator Harrell asked about overlap between road funding programs, and the sponsor explained that eligible counties could receive both SCRAP and FARM funding. Several organizations waived in support or spoke in support, and the bill was reported favorably by unanimous vote. The committee then heard SB 318, the committee substitute for educational scholarship programs by President Gates. The bill was presented as a response to Auditor General findings about the rapid growth and administration of Florida’s school choice and scholarship programs. It would separate Family Empowerment Scholarship funding from the FEFP, require more frequent student enrollment verification, lower scholarship funding organization administrative fees, require return of overpayments, create a student ID system, establish a $250 million stabilization fund, require annual audits, and direct DOE to recommend future program administration through competitive procurement. Gates also offered five amendments, including technical changes to eligibility documentation and a substantive amendment requiring a DOE report on future administration and competitive selection; all five amendments were adopted. During debate and public testimony, senators and witnesses discussed accountability, software solutions, reimbursement delays, monthly attestations, and impacts on public schools and families. Supporters and opponents alike raised concerns about bureaucracy, fraud prevention, special education services, and whether the bill would help or burden parents. Gates said the bill aimed to fix tracking and payment problems without capping the program, and he noted the IEP timeline would be aligned with public school timelines. After debate, the committee reported CS for SB 318 favorably by unanimous vote, and then adjourned.

Transcript Highlights:

• The only case that did, RM versus CM, was reversed.

Transcript Highlights:

• And CMS has determined that FACT accreditation is not necessary if providers are following.

Bills: HB345, HB721, HB2580, SB815, HB3057, HB4603, HB3233, SB495, HB3863, HB3914, HB4570, HB5099, HB5173, SB458

Keywords: insurance, appraisal process, disputed losses, residential property, policyholder rights, insurer obligations, natural disasters, appraisal expenses, umpire selection, policyholder, insurer, umpire, claims management, health care, cost disclosure, benefit plan, administrators, traumatic brain injury, health benefit plans, insurance coverage

Transcript Highlights:

• , and colon cancer combined, primarily due to the absence of a screening program up until 2015 when CMS

Bills: HB46

Keywords: local government spending cap, expenditure limit, political subdivision, property tax, ad valorem tax, budget cap, taxpayer protection, spending restraint, inflation adjustment, population growth, voter approval, supermajority vote, county budget, municipal budget, school district finance, junior college district, hospital district, special district, attorney general enforcement, local fiscal limits

Transcript Highlights:

• colon cancer combined, primarily due to the absence of a screening program up until now. 2015 when CMS

Bills: HB514, HB1652, HB2117, HB2298, HB3269, HB46, HB46

Keywords: maternal health, maternal care, pregnancy, labor and delivery, postpartum, doula, birth worker, midwife, obstetric care, women's health, rural health, health workforce, workforce development, trauma-informed care, public outreach campaign, health equity, minority health, underserved communities, Texas Department of State Health Services, HHSC

Transcript Highlights:

• And in Florida, Medicaid pay for the mandatory groups acquired by CMS are low-income children, pregnant

Keywords: 999, senate, all