Transcript Highlights:

• I saw a lot of girls, a lot of boys get mistreated by staff.
• to really hurt a lot of young people.
• We do a 45-day meal and a lot of stuff.
• I won’t spend a lot of time on this.
• I've got lots of time for you. Thank you so much. Meet. I've got lots of time for you.

Summary: The committee began with a work session on juvenile rehabilitation institution capacity, services, and staffing. DCYF Assistant Secretary Jennifer Redmond described overcrowding at Green Hill School and Echo Glen, driven by longer adult-style sentences extending past age 25, limited community placements, and small facility sizes. She said Green Hill remains above safe operating capacity, but staffing, injuries, large-scale aggression, and use-of-force incidents have improved over the past year. She also discussed Harbor Heights, a new 46-bed flex facility that had opened with 22 youth and would expand once a medical trailer arrives, as well as community transition services, vocational programming, behavior management reforms, and a request for more resources for mental health-focused facilities and staffing. Members asked about success metrics, developmental disability screening and supports, college access at Echo Glen, Mission Creek planning, and gender-responsive programming; Redmond said JR uses assessments, family involvement, and specialized living units, and that some requested funding had already been secured for returning a girls’ program at Echo Glen. The committee then heard from Team Child and the Youth Action Coalition. Greta Schultz said youth perspectives should guide system reforms and identified key concerns: overuse of sentence extensions, underuse of community transition services, continued criminal referrals from Green Hill to Lewis County, limited family contact, inadequate mental health access, and unequal education opportunities, especially for young women at Echo Glen. Justella Gonzalez, a former system-involved youth, said her time in county and state facilities was harmful, with staff mistreatment, poor education, limited therapy access, and humiliating restraint practices; she also said girls at Echo Glen lacked the same college opportunities as boys at Green Hill. Committee members asked for follow-up on county versus state experiences and on telehealth mental health services. The next presentation covered county-level services for youth involved or at risk of involvement with the justice system, led by juvenile court administrators Christine Simon-Smeyer and Judge Rachel Anderson. They outlined the juvenile court continuum from prevention and truancy work through diversion, detention alternatives, community supervision, and disposition alternatives, emphasizing evidence-based, trauma-informed, and restorative practices. Clark County was used as an example of a court that partners closely with schools and community providers, uses risk assessments and wraparound behavioral health probation, and offers detention alternatives without electronic home monitoring. They said most courts do not use detention for status offenses, but instead use court involvement to connect youth to services. They also described funding, noting that courts rely on a mix of state block grant and local dollars, and that recent cuts to early intervention funding reduced programming and staff hours. Members asked about detention for truancy, developmental disability identification, restorative justice practices, and the juvenile block grant. Finally, DCYF Assistant Secretary Nicole Rose and Katie Warren of the Washington State Association of Head Start and ECAP discussed child care and early learning impacts from recent policy and budget changes. Rose said Fair Start for Kids investments had increased child care access, provider participation, and kindergarten readiness, with more than 60,000 children in Working Connections care and rising ECAP enrollment and provider capacity. She said recent reductions will raise most family copays in 2026, delay eligibility expansions, eliminate some expanded eligibility categories, reduce ECAP slots by about 3,000, delay entitlement timelines, and cut provider supports such as rate increases for centers, complex-needs grants, trauma-informed and dual-language incentives, and infant/early childhood mental health consultation. Warren emphasized ECAP’s role in family stability, workforce participation, and reducing poverty, and noted its two-generation approach to supporting both children and parents.

Transcript Highlights:

• So that really opens up a lot of opportunities.
• There's a lot of legwork.
• So we've made a lot of great work.
• We use that term intermediary in a lot of ways.
• We use that term intermediary in a lot of ways.

Summary: The committee first approved the November 3 minutes, then received an extensive update from Arkansas Division of Higher Education and Division of Career and Technical Education officials on LEARNS and ACCESS implementation. Witnesses said the state’s goal is for students to graduate employed, enrolled, or enlisted, and described expanded career pathways, student success plans, merit and distinction diplomas, and school accountability measures tied to pathway completion and tangible credentials. They reported increases in K-12 CTE enrollment and concurrent enrollment, and explained that some secondary career center programs were reduced or eliminated because they no longer aligned with state workforce demand. Members asked detailed questions about how merit/distinction affects school letter grades, how AP, concurrent credit, CTE completers, apprenticeships, and work-based learning fit into the system, and whether homeschool and private school students can access the same opportunities. Officials said multiple pathways can satisfy the requirements, including AP Scholar, concurrent credit, technical certificates, and apprenticeships, and that counselors are being trained to advise students. They also discussed scholarship changes: ACCESS broadened eligibility for the Arkansas Academic Challenge and Governor’s Scholar awards, with diploma of merit or distinction now qualifying students for additional aid, while the Governor’s Distinguished Scholarship itself remained unchanged. Questions were raised about whether homeschool and private school students can meet the new diploma-of-distinction criteria; officials said the intent is to make them eligible if they meet the same standards, and that guidance is being finalized. The discussion also covered workforce scholarships and grants. Officials said the Workforce Challenge was expanded to include vocational-technical schools and increased funding, and that the Division is reworking policy around “professional skills training” to support shorter-term, stackable programs. They reviewed the new federal Workforce Pell Grant, noting its narrow hour and duration limits and the need for programs to meet completion, placement, and earnings thresholds. Members also asked about the state lottery scholarship fund balance and whether more aid should be directed to students; officials said the fund remains healthy and that ACCESS has already increased awards and expanded eligibility, with more implementation data still to come. The final presentation came from the Director of Workforce Connections on a $35.8 million U.S. Department of Labor cooperative agreement for the American Manufacturing Apprenticeship Incentive Fund. Arkansas will administer the national fund, which is aimed at expanding advanced manufacturing registered apprenticeships across the country through a pay-for-performance model. Officials said the program will support occupations in aerospace, automotive, biotech, maritime, nuclear, semiconductors, supply chain, and automation, and that applications will open soon. Members asked who can apply and how the money will be distributed; the answer was that registered apprenticeship sponsors—sometimes companies, sometimes colleges, sometimes intermediaries—will apply, with Arkansas setting eligibility criteria, vendor requirements, and outreach efforts.

Transcript Highlights:

• There was also a lot of debate.
• There's a lot of uncertainty. You're right.
• In fiscal year 25, we were focused on, and that's a lot of work, but we were able to do a lot of work
• The federal treasury on a lot of these grants is now requiring a lot of that information up front at
• Chairman, it takes a lot of control away from them.

Transcript Highlights:

• We have a lot of things to get to.
• I appreciate a lot of what's been said on the other side of the aisle today about this, but a lot of
• A lot of businesses love the relationship.
• The other thing is, you know, we have heard—and we hear this a lot—a lot of hyperbole without much data
• Also, in our committee, Earlier this year, we heard a lot from our schools and we heard a lot from our

Transcript Highlights:

• I have a lot of friends that are middle class and they have to take out lots of loans and work full-time
• Yeah, something that a lot of students, and I found, is that a lot of internships are unpaid.
• a lot of bills, right?
• I think it was just a lot of money.
• And so a lot of the bills that came before my committee cost a lot of money and further exacerbated our

Summary: The Assembly Committee on Economic Development, Growth, and Household Impact held an informational hearing in Paramount as part of its “Pocketbook Tour,” focused on affordability, cost pressures, and household impacts in Los Angeles County. The first panel centered on workers and learners, with testimony from the UCLA Labor Center and the Southeast Los Angeles County Workforce Development Board. Speakers described how rising living costs, tuition, and low wages force many students to work long hours, often in unrelated, low-wage jobs, while struggling with food, rent, bills, anxiety, and limited financial aid. Recommendations included expanding state-funded work study, creating a statewide internship tax credit for small businesses, improving financial aid formulas to reflect regional cost of living, increasing flexibility for students, and strengthening worker-rights education and career pathways. The second panel focused on microbusinesses and small business affordability. Testimony from microenterprise advocates, the Los Angeles Regional Small Business Development Center Network, and local business owners described rising commercial rents, labor costs, tariffs, supply chain disruptions, insurance, utilities, and disaster-related pressures as major threats to small businesses. Witnesses emphasized that small businesses are central to local economies and asked the state to expand technical assistance, low-interest financing, disaster support, supply-chain development, and community-based outreach. They also urged more intentional support for microbusinesses and home-based entrepreneurs, including networks that connect them to resources and help them build collective buying power. Committee members asked about possible state actions, including tax credits for hiring local workers or interns, support for trades and apprenticeships, and ways to partner more closely with SBDCs and chambers of commerce. Public comment echoed the hearing themes, with speakers highlighting student hardship, nonprofit mental health funding, renewable energy jobs and internships, and the need for state support for clean-energy incentives. No formal votes were taken; the hearing concluded with closing remarks and adjournment at 11:05 a.m.

Transcript Highlights:

• I have a lot of roots here in San Miguel County.
• Um, so we have a lot of stuff going on, a lot of irons in the fire, but one of our biggest projects right
• And it's causing a lot of problems.
• get bogged down with a lot of the...
• A lot of our land grants can learn from you all.

Transcript Highlights:

• There’s a lot to coordinate.
• It's just going to be a lot of work.
• It's just a lot to coordinate.
• They did a lot of other things.
• I'll just say, you know, we've done a lot and we pass a lot of legislation on human trafficking and I

Bills: HB33, HB45, HB48, HB1261, HB1465, HB1778, HB2596, HB5238, SB2969, HB45, HB48

Keywords: HB 48, oilfield theft, organized theft, petroleum products, oil and gas equipment, DPS, Department of Public Safety, Texas, Railroad Commission, criminal justice, energy resources, theft prevention, organized crime, border region, El Paso, law enforcement task force, asset recovery, pipeline theft, drilling equipment, equipment theft

Transcript Highlights:

• There's a lot of process issues.
• Staffing is a big issue for a lot of us.
• And we've got a lot of people that are on fixed incomes.
• I'm learning a lot. Also I do represent Madison County.
• There's a lot of policies. You know, the state building official has a lot of power.

Transcript Highlights:

• We also do lots and lots of really great things we don't tell you about: disaster preparedness, public
• There is a lot of hospitals on here.
• There is a lot of hospitals on here.
• Yes, we say that a lot. Medicaid might be... And okay, yes, we say that a lot.
• they have a lot more members of index have a lot more population, which means they have a lot more members

Summary: The subcommittee met to review Arkansas DHS hospital spending and reimbursement methods, with Secretary Janet Mann and Deputy Secretary Misty Eubanks explaining Medicaid hospital payments. They described fee-for-service per diem payments, cost settlements, and the upper payment limit (UPL) program, noting that SFY 2025 hospital payments included $688 million in inpatient/outpatient claims, $473 million in UPL payments, $248 million in cost settlements, and about $47 million in other payments such as graduate medical education and disproportionate share hospital funds. Members asked about why per diem rates vary, how cost settlements work, why UPL applies mainly to private hospitals, and how assessment fees are structured and funded. DHS said the hospital assessment fee is broad-based and uniform, used as the state share to draw federal funds, and that supplemental hospital payments after federal match totaled $548 million with no general revenue used. The Arkansas Hospital Association’s Jody Ann Tritt then gave a broader overview of the hospital landscape, explaining the different hospital types in the state, including critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals. She said Arkansas hospitals face financial strain, citing a negative 5.18% patient service margin statewide and lower reimbursement than surrounding states. She argued that Arkansas hospitals are paid less than hospitals in neighboring states for similar services, that commercial payer rates and administrative burdens are a major problem, and that Medicaid and Medicare rates remain below cost even with UPL support. She also said hospitals are the backbone of community care, provide emergency and public health functions, and are looking for ways to invest in technology and telehealth but often lack the revenue to do so. Members pressed for clearer data on hospital finances, reimbursement adequacy, and the impact of commercial insurers. Tritt said the association had just authorized a statewide survey to gather updated financial information from hospitals, which she said would take about a year to complete. She also explained that Medicaid pays weekly, Medicare and commercial plans can involve delays and denials, and that hospitals often spend significant resources on revenue cycle work. The discussion ended with a brief update on assisted living reimbursement: DHS said one facility, The Pillars of the Community in Crossett, had announced closure, nine Living Choices waiver clients were being transitioned, and the updated rate study would be available after cost reports are collected, likely before the end of the fiscal year. The meeting then adjourned.

Transcript Highlights:

• There's a lot of questions.
• Now it goes to a lot of different things, a lot of different entities.
• There's a, there's a lot on there, um.
• And I, I, I do think the legislature here, this body has done a lot to try to get Um, our funding a lot
• Um, a lot of people are falling off, if a lot of people are losing care through the coverage through

Transcript Highlights:

• be submitting a lot more of these estimates to FDLE.
• So in the amendment, we gutted a lot of the bill, right?
• A lot of the teeth, right, to hold some of these guys accountable. Gutted a lot of the bill, right?
• We have a lot of ground. Thank you very much, Chair.
• I worked on a lot of state criminal laws.

Summary: The committee considered and reported favorably several bills, most of them sponsored by Senator Rodriguez. CS/SB 164 on vessel accountability was presented as a measure to help law enforcement identify vessel owners, create a free long-term anchoring permit program, increase penalties for derelict vessel violations, and authorize grants for local governments in FWC’s prevention program; it passed without amendment. SB 388, dealing with FWC trust funds, was also reported favorably after Senator Berman asked whether non-game wildlife funds would support immigration enforcement; Senator Rodriguez said they would not. CS/SB 1320 was amended to recreate the Resilient Florida Trust Fund and then passed favorably. CS/CS/SB 344 modernizing the Telecommunications Access System was amended to define new terms and reduce the maximum surcharge from 25 cents to 15 cents, then reported favorably. CS/SB 86 on peer support for first responders expanded eligibility to support personnel and passed with broad support from law enforcement and related groups. The committee also took up CS/CS/SB 92, a hit-and-run accountability bill by Senator Gruters. The adopted amendment added a front license plate requirement, lowered the damage threshold from $5,000 to $2,500, and retained reporting requirements for repair shops. NFIB testified in opposition to parts of the bill, citing concerns about the lower threshold, short reporting deadlines, and potential license revocation, while supporters argued the bill would improve accountability and help solve hit-and-run cases. The bill was reported favorably after debate. The final and most contentious measure was CS/SB 56 by Senator Garcia, which would prohibit geoengineering and weather modification activities in Florida, repeal older weather-modification statutes, create a public reporting system at DEP, and impose penalties for violations. Supporters, including individuals identifying with weather-watch and anti-geoengineering concerns, argued that the bill would address public fears and environmental risks. A cloud-seeding company representative testified that cloud seeding is distinct from solar radiation management and said permitting should exist for responsible weather modification, while warning the bill could hinder beneficial precipitation enhancement. Despite skepticism from some members about the bill’s premise and scope, the committee reported it favorably. The meeting then concluded after members recorded missed votes and the committee adjourned.

Transcript Highlights:

• I'm seeing a lot of faces that's been in a lot of prisons for a long time and knows a lot about our system
• And so a lot of good things to come, I think.
• I know there's a lot of new ideas.
• I think we'll offset a lot of the technology, a lot of the staffing needs, or enhance it at least, with
• And you’ll be seeing a lot of me.

Summary: The Senate Criminal Justice Committee met with Vice Chair Smith presiding in Chair Martin’s excused absence. After opening remarks from several senators, the committee heard a presentation from Department of Corrections Secretary Ricky Dixon on the state’s incentivized prisons program and related population-management efforts. Dixon said the department now operates eight incentivized prisons, which use enhanced privileges and programming for well-behaved inmates, and reported major reductions in disciplinary reports, staff assaults, inmate-on-inmate assaults, and uses of force compared with average institutions. He also described administrative management units for more disruptive inmates, short-sentence correctional institutions for those with less than a year to serve, and a reentry strategy that places inmates closer to home within 18 months of release. Dixon said Florida’s recidivism rate has fallen to about 21 percent, among the lowest in the nation, and emphasized that staffing, programming, and facility repairs remain ongoing needs. Committee members asked about access to education and workforce training, staffing levels, contraband, technology upgrades, heating and air-conditioning maintenance, and whether incentivized prisons could be expanded. Dixon said educational access is improving but remains limited by eligibility and staffing, that the incentivized facilities are at capacity, and that expansion depends on adding more administrative management unit beds. He also said the department is increasing use of technology, improving maintenance oversight, and continuing efforts to reduce contraband and improve staff recruitment and retention. Several senators praised the department’s work and urged more funding for prison infrastructure and officer pay. Public testimony largely supported the incentivized prisons model while calling for more seats, better staffing, and broader reforms. Family members of incarcerated people said the facilities were safer, more stable, and better for rehabilitation, though they asked for more programming, better treatment by staff, and clearer access to education and release-related opportunities. A Florida PBA representative emphasized that programs can only succeed with safe staffing levels and better pay and retention for correctional officers. No formal committee vote or bill action was taken, and the meeting ended after public testimony and closing remarks.

Transcript Highlights:

• They make a lot of money.
• So there are a lot of unknowns and there's a lot of data... unknowns there.
• A lot of that cost.
• We hear a lot.
• A lot of it is silica, too.

Bills: SB458, SB819, SB1238, SB1642, SB1643, SB1644, SB1791, SB1810, SB1824, SB1825, SB758, SB1455, SB1706

Keywords: insurance appraisal, property insurance, auto insurance, homeowners insurance, residential property, disputed loss, loss valuation, appraisal clause, appraiser, umpire, Texas Department of Insurance, TDI, insurance dispute resolution, claims adjustment, total loss, windstorm insurance, FAIR Plan, surplus lines insurance, policyholder, insurer

Transcript Highlights:

• on a lot of things.
• They haven't developed a lot of the comorbidities.
• So I'm going to reference a lot back to a lot of their presentations, but I will try to provide enough
• So there was a lot of good information.
• A lot of it was the paperwork part of it.

Summary: The committee first approved the previous meeting minutes and then heard a detailed annual report from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and policy issues. He explained the committee’s review process, confidentiality protections, and national and North Dakota data showing that most maternal deaths are preventable and that mental health conditions, substance use, cardiovascular issues, infection, hemorrhage, and embolism are the leading causes. Members asked about suicide, domestic violence, midwife training, home births, and whether pregnancy testing at death scenes should be expanded; Dr. Arnold said better coroner education, more investigation of unexplained deaths, and possible post-mortem pregnancy testing could improve case identification, especially in rural areas. He also noted that deaths often occur well after 42 days postpartum and that mental health-related deaths remain a major concern. The committee then heard from State Fire Marshal Dr. Matthew Clark on cigarette reduced-ignition-propensity standards and related fire prevention issues. He recommended updating the state’s cigarette propensity law to current national standards and also raised a separate recommendation to require fast-breakaway oxygen tubing for home oxygen users, citing fatal fires linked to smoking around oxygen. Members asked about implementation, cost, insurance coverage, and whether the standards apply in tribal communities; Dr. Clark said he would provide follow-up information and was willing to help with any legislation, but no agency bill had yet been planned. Next, Christine Greff of the Department of Health and Human Services reported on the North Dakota Stroke System of Care. She described the statewide network of stroke-ready hospitals, registry-based quality improvement, and performance data showing continued improvement in stroke recognition, imaging, thrombolytic treatment, transfers, and EMS pre-notification. She highlighted new quality measures for inter-facility transfers and intracerebral hemorrhage care, and said the system remains strong but depends on continued legislative and hospital support. Committee members asked about participation by the VA hospital and were encouraged to consider outreach to include it more fully in the stroke system. Finally, the committee began a presentation on prior authorization and non-opioid pain treatment from Taha Khan of Vertex Pharmaceuticals. He argued that prior authorization can delay access to non-opioid acute pain medications, especially in the 24- to 72-hour post-discharge window when pain is most severe, and said delays can push patients toward opioids. He emphasized that prior authorization has a role in utilization management but should not create barriers in acute pain care, and he noted that current use of the company’s non-opioid product remains very low. The discussion was still underway when the transcript ended.

Transcript Highlights:

• We would start doing a lot more of that.
• <00:03:38.720> of Kong and then Taiwan a lot of Kong and then Taiwan a lot of activities.<
• We would start doing a lot and things.
• So there's a lot that's really involved.
• So there's a lot that's small print. So there's a lot that's really<00:43:59.760> involved.

Keywords: 912, senate, all

Summary: The joint committees on Transportation and Culture and the Arts and Economic Development and Tourism heard three measures. HB 450, which would transfer the State Foundation on Culture and the Arts to the Department of Business, Economic Development, and Tourism, drew support from DBEDT, the State Foundation, the Hawaii Arts Alliance, DAGs, and individuals. Members asked about the bill’s purpose and the relationship between arts administration and international/cultural considerations. The committees voted to pass HB 450 with amendments, including a housekeeping change allowing specific legislative direction in narrow cases; the measure was adopted with unanimous or near-unanimous votes. HB 437, relating to out-of-state offices, received testimony in support from DBEDT and representatives of the Filipino Chamber of Commerce and another individual. The discussion focused on whether an overseas office in the Philippines was the best use of funds, given existing offices and trade relationships in places like Beijing and Taiwan. Members questioned the return on investment, fiscal priorities, and whether DBEDT had a broader strategic plan for selecting markets. The committees ultimately passed HB 437 with a Senate Draft 1 and technical amendments, with some members voting with reservations. HB 1391, relating to trade and creating a Hawaii-Ireland trade commission, also advanced after a lengthy discussion. DBEDT said it offered comments rather than a firm recommendation and explained that the bill appeared intended to build economic ties with Europe through Ireland, but members questioned why a commission was needed, how it would be structured, and whether similar efforts should focus on other countries. DBEDT said it would provide reports on sister-state relationships and office performance, and noted that trade initiatives would likely require private-sector participation. The committees passed HB 1391 with amendments and reservations from some members.

Transcript Highlights:

• of kids, a lot of kids, but sorry, six is a lot.
• And I summarized a lot of it.
• So, they had a lot of success.
• . lot of choice. don't last long.
• We've had a lot of testimony today.

Bills: HB3, HB3

Keywords: education savings account, educational expenses, certified educational assistance organization, school choice, funding, special education, tuition reimbursement, emergency communication, public safety, interoperability, Texas Interoperability Council, grant program, emergency communications, public safety radio, first responders, radio system, dispatch, 911, emergency management, Texas Division of Emergency Management

Transcript Highlights:

• There are lots of public meetings that happen.
• And I know there's a lot of those housing bills. Those ones cause me a lot of concern.
• It's going to create a lot of affordable units.
• of different, a lot of different places.
• There's obviously a lot of variables in here.

Keywords: 996, all

Transcript Highlights:

• A lot of head nods. We like that.
• It was a lot. It was all hands on deck.
• That's a lot of people. It's a lot, a lot. But it's not 100%.
• We've seen over the years there's a lot of funding going to a lot of different entities, a lot through
• And Indian River Lagoon is one area where we have a lot of data, a lot of historic data.

Summary: The committee meeting began with quorum, member introductions, and an overview of the Agriculture, Environment, and General Government budget process. The chair emphasized using the committee resource book and performance metrics to review the base budget and invited members to identify areas of interest for later discussion. Members were also reminded about appearance forms and speaking procedures. Wes Gregory of the Department of Agriculture and Consumer Services presented on agricultural best management practices and water policy. He said the office had updated all nine commodity BMP manuals and added a manual for small farms and livestock, expanded enrollment by 742 producers covering 677,000 acres, and used GIS and data analysis to target areas such as the Indian River Lagoon. He also described cost-share projects, a new field application for enrollment and inspections, cross-training staff, and a request for $20 million for regional water quality projects. Members asked about BMP enrollment, compliance, and enforcement; Gregory said noncompliance is uncommon and cases can be referred to DEP. Adam Blaylock of DEP reviewed environmental grant programs, saying the state has appropriated $2.9 billion since 2018 for water quality projects, with about 1,100 projects reducing nitrogen and phosphorus statewide. He described the Water Quality Improvement Grant, Indian River Lagoon, Biscayne Bay, Springs, Alternative Water Supply, and Resilient Florida programs, including a planned public dashboard and a water-quality monitoring portal. Senators asked about the application window, award timing, and the high cost of septic-to-sewer conversions, with Blaylock estimating a blended average of about $35,000 per home. Chief Conservation Officer George Worthing of the Fish and Wildlife Conservation Commission then presented on invasive animal control. He discussed prevention, risk screening, law enforcement at ports, public outreach programs such as the Python Challenge, Lionfish Challenge, and Exotic Pet Amnesty Program, and early detection tools like the Ive Got One reporting system. He also described control efforts for Burmese pythons, tegus, and lionfish, along with research and partner coordination. Members asked about the most harmful invasive species and whether iguanas may be taken; Worthing said iguanas are open for take, subject to other laws. The meeting ended after members briefly identified priorities such as water quality, recreation water quality, sustainability, sea level rise, and septic-to-sewer infrastructure, and the committee adjourned without any formal votes.

Transcript Highlights:

• on a lot of things.
• They haven't developed a lot of the comorbidities. They're having a lot of the babies.
• So I'm going to reference a lot of back to a lot of their presentations, but I will try to provide enough
• And so there was a lot of good information.
• A lot of it was the paperwork part of it.

Summary: The committee first approved the minutes and then heard a detailed annual presentation from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and review findings. He explained the committee’s structure, the de-identified review process, and the distinction between pregnancy-associated and pregnancy-related deaths. He said national maternal mortality has declined from its 2021 peak, but mental health conditions, substance use, overdose, suicide, cardiovascular disease, hemorrhage, infection, and embolism remain major causes. He emphasized that many deaths are preventable, with especially high rates among non-Hispanic Black women and in the American Indian/Alaska Native population, and noted that a large share of deaths occur after 42 days postpartum. Committee members asked about suicide, domestic abuse, pregnancy testing in unexplained deaths, and the role of home births and midwife training. Dr. Arnold said the committee is adding a caseworker, exploring post-mortem pregnancy testing in suspicious cases, and working with coroners and forensic officials; he also said home births and untrained midwifery pose safety concerns and that better public education and facility-based care are important. The committee then heard from State Fire Marshal Dr. Matt Clark on cigarette ignition propensity standards and fire prevention. He recommended updating North Dakota’s cigarette ignition legislation to the current national standard and also considering legislation requiring fast-breakaway oxygen tubing, citing fatal fires involving smoking around home oxygen. He explained that his office verifies manufacturer testing and maintains certification for cigarettes sold in the state, but does not itself conduct the testing. Members asked about implementation, cost, and whether the standards apply in tribal communities; Clark said he would follow up with cost information and additional details, and that he had not seen evidence of a major issue on tribal lands but would look further. Christine Greff of the Department of Health and Human Services presented the North Dakota Stroke System of Care report. She described the statewide network of two comprehensive stroke centers, four primary stroke centers, and 30 acute stroke-ready hospitals, along with the stroke registry and quality-improvement efforts. She reported that most strokes are ischemic, that the median stroke patient age is 71.5, and that common risk factors include hypertension, dyslipidemia, obesity, and diabetes. She highlighted improvements in door-to-CT, thrombolytic treatment times, dysphagia screening, EMS pre-notification, and interfacility transfer performance, and said new priorities include hemorrhagic stroke quality measures and standardized EMS stroke screening tools. Members asked about the VA hospital’s participation, and Greff said she would pursue outreach. After a break, the committee heard testimony from Taha Khan of Vertex Pharmaceuticals as part of the prior authorization study, focused on non-opioid pain treatment. He argued that prior authorization can delay access to acute pain treatment and may push patients toward opioids, especially in the critical 24- to 72-hour post-discharge window. He cited data showing that even short opioid exposure can increase the risk of long-term use and said prior authorization is often a barrier for physicians and patients. Khan recommended open access with a quantity limit rather than prior authorization, suggesting a 14-day limit supported by the product’s data and an episode-of-care approach. Members asked about dental use, payer discussions, and cost; he said the product’s wholesale acquisition cost is about $16.10 per tablet, with patient assistance available, and that he would follow up on payer and comparison-cost questions.

Transcript Highlights:

• I've actually always thought that, and it was sort of a lot of, you know, a lot of people were interested
• It's driven up lot rents. It's increased some evictions.
• A lot of families, very close to me, I have a number of mobile home parks, a lot of families, working
• So a lot of private entities do, thank you, a lot of private entities do some level of analysis before
• can be a lot.

Keywords: 988, house, all