Transcript Highlights:

• our demand for programs goes up at DHS, the administrative costs to not.
• The next slide goes over our forecasted programs.
• But the waiver amendment savings items that you passed into law for disability waivers, we typically
• The administrative costs have not kept pace with the demand for programs.
• Alright, Johnson, similar programs has a significant bias toward a one-to-one ratio in separate programming

Keywords: 1183, house

Transcript Highlights:

• So while Secretary Rubio has told us that there are waivers, we know that of the 5,400 or so programs
• These programs are being reviewed. Waivers are being granted in particular circumstances.
• your staff to make sure that if the secretary grants a waiver, that waiver is actually going through
• There is a waiver process.
• Let me understand, in your view, are programs that counter human trafficking, programs that help families

Transcript Highlights:

• You can ask the department this, but that waiver was a great waiver.
• The substance abuse waiver that we got, the IMD waiver, I don't think any of those waivers went to the
• <03:51:34.239> The that waiver was a great waiver. The that waiver was a great waiver.
• waiver and then CMS withdrew the waiver waiver and then CMS withdrew the waiver that<04:17:50.960
• but have not yet either received the waiver or have not yet stood up their program?

Keywords: 1189, house, all

Transcript Highlights:

• the a high school auto program the a high school auto program instructor<00:02:36.040> Ethan<
• The waiver is granted. Senator Enoi: Thank you, Mr. President.
• The waiver is granted. Senator Kidani: Thank you.
• The waiver is granted. Senator San Buenaventura: Thank you.
• c><00:18:28.760> Ed filing deadline the waiver is GR Ed filing deadline the waiver is GR Ed Senator

Keywords: 912, senate, all

Transcript Highlights:

• For the record, forecasted programs represent programs where eligibility rules are set in statute, benefit
• <00:02:07.719> where programs represent uh are programs where programs represent uh are programs
• <00:02:19.080> itself rates are in statute the program itself rates are in statute the program
• waiver programs and in in the disability waiver programs and in this<00:09:56.240> forecast<00
• , and the PCA program.

Keywords: 1183, house

Transcript Highlights:

• CASA programs cultivate programs.
• States that submit waivers for the Medicaid programs could be up for congressional review under this
• States that submit waivers for the Medicaid programs could be up for congressional review under this
• programs to address these very issues. programs to address these very issues.
• programs if market conditions change. programs if market conditions change.

Keywords: U.S. House of Representatives Floor Proceedings on Wednesday, April 30, 2025, 1012, house, all

Transcript Highlights:

• That is a waiver section.
• actual program rules.
• back to the waiver, saying, “Oh, by the way, you can use this waiver process.”
• two programs. two programs.
• waiver process. waiver process.

Keywords: 928, house, all

Summary: The committee began with routine business, including the Pledge of Allegiance, approval of the minutes, seating of an alternate member, and approval of the consent agenda. It then took up Department of Health and Human Services Rule 25188 on New Hampshire Early Childhood and Out-of-School Time Credentials. Staff explained that the rule adopts two new parts to implement RSA 170E:50, which had long required rules. The main issue was an unclear comment created by changes in the department’s amended conditional approval request: language defining out-of-school-time basics and a requirement tied to the New Hampshire Professional Registry training transcript had been removed, creating a mismatch between the form and the rule text. The department said it revised the language so the form and rule now match. A member also asked about the fee schedule, and the department said the fees are sufficient and supported in part by federal funds. The committee then approved Rule 25188 as amended, with oral edits, on a voice vote. The committee next considered Department of Environmental Services Rule 25206, dealing with subsurface wastewater rules and an administrative fine schedule. Staff said most comments had been addressed, but one remaining issue concerned the fine schedule because the prior interim rule had expired years ago. Staff also noted public concerns about septic tank replacement sizes, but pointed to waiver provisions and replacement-in-kind language that would still allow smaller existing systems to be replaced under certain conditions. DES officials explained that the rule package adds the fine schedule into the program rules and that no fines have been brought under these expired provisions for many years. They also described the waiver and grandfathering provisions as intended to protect existing systems and seasonal campgrounds from unnecessary upgrades. A public witness, Christopher Albert, testified that two sections of the rule would harm manufactured home parks and cooperatives. He argued that the new “two people per bedroom” assumption and the minimum bedroom threshold for using water-meter data would inflate design flows, make water-meter data unusable, and increase costs for low-income residents. Committee members questioned both the witness and the agency about the assumptions. DES staff responded that the two-person-per-bedroom standard is meant for individual on-site system design, not citywide planning, and that water-meter data is only useful in larger or unusual facilities. They said the rule still allows flexibility through waivers and grandfathering for existing uses, and that the drinking-water rule cited by the witness was not the correct comparison. No final vote on Rule 25206 was taken in the portion of the meeting provided.

Transcript Highlights:

• But I thought we had a moving expenses for folks clearly within the waiver case management program as
• But I thought we had a moving expenses for folks clearly within the waiver case management program as
• She was at the nursing program.
• I recruited her from the nursing program into the PACE program, and ever since she stayed in the program
• > page her from the nurs program into the page her from the nurs program into the page program

Keywords: 1187, senate, all

Transcript Highlights:

• . program. program.
• It's something to do with the consultation, knowing that individuals who are in the waiver program and
• also in the PC CFSS program, that the waiver process, the care plan, and other provisions, and I think
• <01:34:59.440> program<01:34:59.760> and<01:35:00.080> also who are in the waiver
• program and also who are in the waiver program and also in<01:35:00.480> the<01:35:01.120>

Keywords: 1187, senate, all

Summary: Members met to review a budget bill agreement using a nonpartisan spreadsheet and summary materials. Chairs and members thanked fiscal, research, revisers, and agency staff for the collaborative process, noting the bill had been difficult and that the final product reflected compromise. The chair also said only minor technical changes were expected before final enactment, and the spreadsheet walkthrough was then turned over to fiscal staff. Fiscal staff explained that the agreement met the overall budget target and walked through major human services provisions. Key items included nursing facility payment changes, including a phased PDPM change, APS inflation, modified single-bed incentives, and a CPI-U capped payment cap; a nursing facility surcharge; workforce standards board rule costs; continuation of certain nursing facility property tax rates; regulation of for-profit acquisitions of nursing homes and assisted living facilities; repurposing assisted living special project funds; funding the SEIU self-directed worker agreement; CFSS reimbursement in acute care hospital settings; and multiple disability waiver rate and authorization changes, including CPI-U inflation caps, waiver authorization reforms, and a waiver reimagined advisory task force. The agreement also included family residential service rate increases, a temporary extension of customized living disproportionate share payments, tribal eligibility for targeted case management, positive supports training changes, out-of-home respite modifications, swimming lessons as an allowable service for certain children with disabilities, a provisional EID provider license, and program integrity services funded by licensing fee increases. Additional provisions covered MinnChoices studies and assumed savings, behavioral health fund changes, substance use disorder treatment billing and rate changes, supportive recovery housing, housing support supplemental rates for specific providers, disability determinations, enteral nutrition payment timing, temporary funding for Boundary Waters Care Center, several one-time human services grants, senior nutrition funding, and grant reductions and extensions. No formal vote was described in the transcript; the discussion focused on explaining the agreement and its fiscal effects.

Transcript Highlights:

• waiver, and the acquired brain disorder waiver that the Bureau of Developmental Services administers
• ,<00:54:34.880> the developmental disabilities waiver, the developmental disabilities waiver
• waiver, and the acquired brain<00:54:37.760> disorder<00:54:38.160> waiver<00:54:38.960
• As you know, all of these three waivers are Medicaid waiver services.
• waiver? waiver? >> Seeing<00:58:45.440> none. >> Seeing none.

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:

• Members, the Children's Health Insurance Program is a joint federal and state program.
• Members, the Children's Health Insurance Program is a joint federal and state program that provides a
• program began in 1998.
• So both Medicaid programs and CHIP programs will vary state by state.
• Both for Medicaid programs and also CHIP programs will vary state by state.

Summary: The committee received a briefing from AHCA Deputy Secretary Brian Meyer and Florida Healthy Kids CMO Ashley Carr on implementation of HB 121, which was enacted in 2023 to expand Florida’s KidCare/CHIP eligibility from 200% to 300% of the federal poverty level and replace the sharp premium “benefits cliff” with a tiered premium glide path. Sponsor Rep. Bartleman described the bill as a bipartisan effort to help working families keep children insured while moving toward economic self-sufficiency. The presenters explained that the program remains a joint federal-state structure, with Medicaid unchanged and the bill affecting only the CHIP-related portions of KidCare. AHCA said implementation has been delayed by federal CMS actions. The agency reported that CMS first rejected a state plan amendment approach, then required revisions to the premium tiers under a new maintenance-of-effort interpretation, and later issued a new interpretation of continuous 12-month eligibility that would prevent disenrollment for nonpayment of premiums. AHCA said it submitted an 1115 waiver, but negotiations over special terms and conditions reached an impasse, and the state has filed litigation challenging CMS’s interpretation. Members asked about the cost of litigation, the effect on future bills, the review process for CMS documents, disenrollment and reenrollment rules, and whether any additional legislative action is needed; AHCA said no further state action is needed at this time and that the key issue is the pending federal litigation. Several members and the sponsor emphasized the need for immediate implementation and asked about possible interim relief. AHCA said current coverage remains in place under the preexisting program, that there is a 30-day grace period for premium payment, and that reenrollment does not require a penalty or back payment, though coverage is not active during lapsed periods. The committee also heard public comment from Nicholas Hessing of the Children’s Services Council of Broward County and the Florida Alliance of Children’s Councils and Trusts, who supported HB 121 and said the expansion could make about 17,600 additional children eligible in Broward County alone. The meeting ended with Rep. Bartleman thanking staff and expressing hope that the new federal administration would allow the program to move forward, and the chair adjourned the meeting.

Transcript Highlights:

• it would be possibly easy to get a waiver or that you could get a waiver every year, and that is not
• And that's why I'm saying unless a waiver is granted... ...unless a waiver is granted, like I said, I
• They don’t have to use the universal program. They can go into the first program.
• Program today.
• people who already have the program.

Summary: The committee met to review and adopt Legislative Council ballot measure analyses, with members repeatedly reminded that the hearing was limited to the accuracy, clarity, and impartiality of the summaries and not the merits of the underlying proposals. Steve Premack explained the statutory role of the analyses in the publicity pamphlet, and staff presented draft language for several measures. The committee considered and voted on multiple amendments, often debating whether proposed wording was clearer or instead crossed into advocacy or added unnecessary legal detail. For SCR 1004, members debated amendments to more closely mirror the measure’s text and to add language about electric vehicles and mileage, but several proposed changes were rejected. The analysis was ultimately adopted by an 8-6 roll call. HCR 2021 was then adopted without amendment by the same 8-6 margin. For HCR 2055, members debated whether the summary should say the Department of Homeland Security must “do everything” or “use all lawful means available,” and whether to add language about cartels acting “individually or collectively”; both amendments were rejected and the analysis was adopted 8-6. The committee next took up SCR 1004 on photo enforcement systems, where members proposed amendments to clarify that the measure would apply to red light cameras, to add “thereafter” regarding recurring voter approval, and to specify that approval would occur at the general election; those amendments failed, and the analysis was adopted 8-6. On SCR 1032, dealing with instructional expenses and classroom site fund reductions, members debated adding a definition of the Classroom Site Fund and spelling out the waiver process in more detail; both amendments failed, and the analysis was adopted 8-6. Finally, on HCR 2001 regarding citizenship identification and early voting, members rejected amendments that would have added background on current law, clarified that mail voting would be affected, added severability and revenue-source language, and struck the measure’s short title; the discussion was lengthy and at times contentious, but the transcript ends before a final roll-call vote on that measure is shown.

Transcript Highlights:

• <00:17:29.360> For program and continuum of care. For program and continuum of care.
• of this program?
• service programs that they offer. service programs that they offer.
• >> the oh of the the waiver services. >> the oh of the the waiver services.
• <00:46:56.079> all<00:46:56.319> waiver >> I think that the waiver all waiver

Keywords: 928, house, all

Summary: The Committee to Study Long-Term Managed Care met to approve prior minutes and outline its schedule, with meetings set for September 24 and September 29 ahead of an October 1 report deadline. The chair said the committee would use the first two meetings to digest testimony, likely ask follow-up questions of DHS, and then work toward conclusions and a report format. The minutes from the previous meeting were approved unanimously. The main testimony came from Sharon Alexander of Amera Health, who argued in favor of moving from fee-for-service Medicaid long-term services and supports to a managed LTSS model. She described managed LTSS as a capitated, quality-driven system used in about 26 states, and said it can improve care coordination, accountability, access to home- and community-based services, and budget predictability. She cited Amera Health’s experience in Pennsylvania and Delaware, including care coordination, housing and transportation support, caregiver programs, and quality benchmarks tied to state oversight. She also said nursing facilities would remain an important option for people who need that level of care. Committee members asked about how the programs are administered, how rates are set, how care managers work, and how quality is measured. Alexander said states contract with managed care organizations at actuarially sound capitated rates, with annual contracts, reporting, and oversight. She explained that care managers typically conduct quarterly assessments and follow up after trigger events such as hospitalization, and that housing coordinators may assist with transitions to the community. On quality, she said states use CMS-related and HCBS benchmark measures covering service timeliness, care planning, transitions, and other outcomes, and that New Hampshire could build on existing metrics rather than starting from scratch. She also noted that rural areas face workforce and transportation challenges, which managed care plans try to address through technology and self-direction options.

Transcript Highlights:

• This bill also replaces the existing unauthorized alien transport program with a new program where the
• from the waiver because they are illegal immigrants.
• And along those lines on tuition waivers, do we not have a program for a tuition waiver for grandchildren
• those who have tuition waivers.
• waiver for students and Senator Berman.

Keywords: 999, senate, all

Transcript Highlights:

• program.
• , the overall size of the program is less than the overall size of the reinsurance program.
• program. So this isn't completely new. program. So this isn't completely new.
• program and the current<01:10:55.360> reinsurance<01:10:56.040> program.
• reinsurance program to the individual. reinsurance program to the individual.

Keywords: 1187, senate, all

Transcript Highlights:

• functions of the program. program. program.
• fee-for-service program. fee-for-service program.
• So, the disproportionate share program is a program on the EW program where if a person has low needs
• . program. program.
• So, we are seeking to eliminate that<01:04:46.920> program that program that program and<01:04

Keywords: 1183, house

Transcript Highlights:

• G program is a federal program. And right now, it only applies to these detention facilities.
• cannot continue in the program?
• Can they sign up for one program but not necessarily another type of program?
• You have the jail program, you have the warrant program.
• right now have the jail program.

Summary: The Senate opened with a prayer, the Pledge of Allegiance, and the reading of an amended joint proclamation expanding the Legislature’s immigration agenda. The proclamation added items calling for financial penalties for government officials, enhanced criminal penalties for offenses committed by illegal aliens, and programs and appropriations to support law enforcement in enforcing federal immigration law. The chamber then took up the special order calendar, beginning with Committee Substitute for Senate Bill 2B, the immigration bill. Most of the meeting was devoted to debate and questions on the strike-all amendment to SB 2B. Sponsor Senator Gruters described the bill as a broad immigration enforcement package aligned with President Trump’s agenda. He said it would require greater cooperation with federal immigration authorities, strengthen participation in the 287(g) program, create a chief immigration officer and council, authorize financial penalties for noncompliance, provide bonuses for officers assisting ICE, and direct information-sharing with federal agencies. He also said the bill would bar DHSMV from issuing licenses or ID cards to unauthorized aliens and would end in-state tuition waivers for undocumented students. Senators Polsky, Pizzo, Smith, Jones, Berman, Osgood, and others questioned the scope of the bill, whether it would affect schools, churches, cities, nonprofits, and green-card holders, and how the 287(g) provisions would work in practice. Gruters repeatedly said the operational focus was on jails and detention facilities, not street-level enforcement. A major point of controversy was the bill’s proposed mandatory death penalty for unauthorized aliens convicted of certain capital offenses. Senator Fine said the covered crimes were the most serious capital felonies, including murder, child sexual battery, destructive-device offenses causing death, and certain trafficking offenses, and argued the provision was intended to withstand constitutional challenge. Senator Pizzo raised Eighth Amendment concerns and questioned whether the bill could mandate death sentences. The tuition waiver provisions also drew extended debate: Fine said the state would save about $41 million by ending discounted tuition for undocumented students, while Democrats argued the savings would not return to general revenue and that the policy would harm students who are already enrolled. Fine and Gruters said green-card holders would not be affected and that the bill targeted only students in the country illegally. The discussion also covered appropriations and implementation. Senator Smith asked about the bill’s large funding levels, and Fine broke down the spending as including $375 million for the chief immigration officer, $100 million in grants to local law enforcement, $29 million for the new Office of State Immigration Enforcement, and $10 million for an unauthorized-alien transport program. Gruters said the funds would reimburse local governments and help address staffing shortages, while critics questioned the lack of benchmarks and the fiscal impact. No final vote or disposition on the bill appears in the transcript excerpt.

Transcript Highlights:

• within the waiver process. within the waiver process.
• So, what I'm so proud about this program is that this is a proven program.
• program has meant to his district. program has meant to his district.
• through this program. through this program.
• leadership program. leadership program.

Keywords: 958, all

Summary: The committee first heard Senate Bill 2, sponsored by Senator Julie Rocky Adams, which would prohibit school administrators from receiving a percentage pay increase greater than the average percentage increase given to classroom teachers in the same district. Supporters said the bill is intended to keep teacher pay from falling behind, promote fairness and transparency, and preserve local control through existing waiver options. Senators Thomas, Higdon, Givens, Neal, Williams, and others generally supported the bill, while Senator Meredith raised concerns about unintended consequences for rural districts and the ability to retain principals and other talent quickly enough through the waiver process. The sponsor and others responded that the waiver process is standardized and expedited, and that normal raises would not be affected. SB 2 was adopted unanimously with favorable expression. The committee then took up Senate Bill 4 on school leadership, with a committee substitute changing a reference from the Kentucky Chamber of Commerce to the Kentucky Chamber Foundation. Senator West explained that the bill is designed to create a coordinated five-year principal leadership pipeline, based on research suggesting that school leadership is a major factor in teacher retention and school success. The first two years would be KDE-run foundational training and mentorship, followed by a gap year, then a public-private partnership year with the Chamber/Truist program, and finally a fifth year of advanced training through approved providers such as Western Kentucky University or KASA. West said the goal is to extend principals’ tenure and improve leadership quality statewide. Ashley Watts of the Kentucky Chamber of Commerce testified that the Chamber Foundation has run the Leadership Institute for School Principals since 2011, sending 641 principals from 112 counties through the program at a business-funded cost of more than $4.4 million. She said the program has reached about 3 million students and produces measurable school improvement. Henderson County Superintendent Bob Lawson said the program has been valuable in his district and emphasized the heavy workload and leadership demands placed on principals. The discussion continued with testimony about the importance of principal leadership and the need to invest in it, but no final vote on SB 4 was reached in the portion provided.

Transcript Highlights:

• than five graduates in graduate programs at the master's and doctoral level. ...graduate programs at
• If you think about every program was a row in an Excel spreadsheet, 2,000 programs.
• So that would be post-baccalaureate degree programs, excluding those professional programs of law, OT
• But we have, and so the waivers that we have are more teaching waivers.
• But we have, and so the waivers that we have are more teaching waivers.

Summary: The committee met to discuss higher education funding and capital building policy. Members first heard an update from NDUS Deputy Commissioner Lisa Johnson on low-producing academic programs. She described a proposed board policy using a five-year rolling window and thresholds of fewer than 10 undergraduate graduates or fewer than 5 graduate graduates, with programs flagged for three consecutive review periods going to the board. Possible outcomes would include continuation, continuation with modifications, inactivation, or termination. Members asked about how the review would account for program costs, service to other students, workforce demand, and the difference between inactivation and termination. Johnson said the board would consider broader factors and that campuses already do detailed program analysis. Several members also asked about cost savings and staffing impacts from program terminations, and Johnson said the board would try to provide more information later. The committee then received a report on the Capital Building Fund from Jamie Wilkie. He reviewed the program’s history, matching requirements, and recent uses, noting that about $334 million in state and matching dollars has been invested overall, with most going to deferred maintenance and extraordinary repairs. Members discussed whether the program is reducing deferred maintenance and requested updated systemwide data on deferred maintenance and campus space utilization. Wilkie said the board is considering a new study to update deferred maintenance figures, which are based on information more than 12 years old. He also reported that several institutions have used current biennium funds for projects such as residence hall renovations, health sciences housing, generators, and building repairs. Later, the committee began a detailed walkthrough of a draft bill that would replace the current higher education funding formula with an FTE-based model and also revise the capital building fund structure. The draft would use fall enrollment FTEs, add completion incentives for degrees in in-demand fields, and create a separate research funding component for UND and NDSU tied to doctoral completions and external research expenditures. Members raised concerns about the use of older data in the formula, the treatment of waivers, the weighting of professional and health sciences programs, and the use of CIP codes to define CTE and education incentives. The bill draft would also combine capital building fund tiers, broaden eligible uses for deferred maintenance and legislatively authorized projects, change matching requirements, repeal the old formula chapter and the capital pool, and transfer funds from the Strategic Investment and Improvements Fund into the capital building fund. No final votes were taken during the portion provided; the meeting was primarily discussion and review.

Transcript Highlights:

• The second one is adult day program.
• program.
• And like I said, and like was already spoken about, those programs like the CES waiver are the ones that
• And like I said, and like was already spoken about, those programs like the CES waiver, and like was
• already spoken about, those programs, like the CES waiver, like it had already been mentioned, are the

Summary: The Arkansas Legislative Autism Task Force approved the April 1, 2026 meeting minutes and then reviewed several vacant membership slots on the task force, including appointments from the Arkansas Psychology Board, Arkansas Blue Cross Blue Shield, UAMS, and parent or guardian positions. Members discussed trying to fill those vacancies before the next meeting, and noted that if they remain open they may be addressed in the task force’s legislative report and through possible statutory changes in the next General Assembly. Representatives from the Developmental Disabilities Provider Association (DDPA) and Civitan Services presented on DDPA’s role serving children and adults with intellectual and developmental disabilities across Arkansas. They said DDPA now represents 80 providers serving more than 13,000 individuals in 75 counties, with services including early intervention, adult day programs, supported employment, intermediate care facilities, work activities, and community/residential waiver services. They also shared survey data on older clients and said these services remain available to seniors with IDD, including people with autism. The task force then heard a proposal to amend Act 656 of 2021 to include licensed psychological practitioners as qualified providers for autism waiver-related evaluations. The presenter argued this would reduce wait times, avoid duplicate assessments, and help families access services sooner, while still maintaining quality standards. Members asked about training, licensure, and whether other professionals such as speech-language pathologists or audiologists should be included; Dr. Scott noted that current practice already relies on a two-provider model and that speech-language pathologists play a role because autism diagnosis considers communication, cognitive ability, and language. The discussion also touched on the need for proper testing standards and board oversight. No vote was taken on the amendment, and the meeting ended with plans to return to fraud-related discussion and to begin prioritizing recommendations for the 2027 session before adjourning.