Transcript Highlights:

• We don't administer that to a patient.
• Blood donor and patient safety is our top priority.
• Ultimately, this bill is about patient-physician autonomy.
• that that is what's best and right for this patient.
• The cost is passed on to the patient.

Committee: Senate Health and Welfare

Transcript Highlights:

• I'll be there this afternoon seeing 15 to 16 patients tonight.
• </c><00:53:44.400><c> for</c> being used to check in patients for being used to check in patients for
• or too many to have many patients or too many patients<00:58:20.599><c> um</c><00:58:21.520><c> also
• It becomes computer care instead of patient care.
• It becomes computer care instead of patient care.

Committee: Senate Labor

Transcript Highlights:

• I think patients in every two years.
• </c><00:09:14.320><c> to</c> rules, I think it would be preferable to rules, I think it would be preferable
• The requirement will support both access to care and patient safety.
• It does include the patient care records.
• </c> does include the patient care records. does include the patient care records.

Committee: Senate Executive Departments and Administration

Transcript Highlights:

• Patients don't suffer.
• I think we can all agree on patient privacy, patient safety.
• I think we can all agree on patient privacy, patient safety.
• I think we can all agree on patient privacy, patient safety.
• The patient protection piece, knowing that under law, patients are protected from co-pays, deductibles

Summary: The committee first took up House Bill 279, on a committee substitute that narrowed the bill to privacy and safety protections for reproductive and gender-affirming health care. The substitute would strengthen limits on disclosure of protected health information, restrict geofencing around care facilities with exceptions for security and research, clarify emergency stabilization obligations under state licensing law, and allow abortion-medication labels to omit a prescriber’s personal name and address. Supporters including ACOG, the ACLU, the League of Women Voters, the Health Care Authority, and advocacy groups said the bill protects patients and providers from surveillance, harassment, and out-of-state investigations. Some members raised concerns about HIPAA, research data, and whether the bill could go too far, but the substitute passed 6-2. The committee then approved House Memorial 1, which asks the Legislative Finance Committee to study whether a constitutional amendment should create an independent commission to manage CYFD. Supporters said the department needs a comprehensive structural review, while opponents argued New Mexico already has enough reports and should act on existing recommendations instead of commissioning another study. House Memorial 31 also passed; it directs the Health Care Authority to re-evaluate a rule limiting home health agencies to serving patients within 100 miles of their licensed locations, in light of access needs in remote areas such as the Navajo Nation and anticipated demand from uranium workers. House Bill 306, dealing with facility fees, was amended by substitute to prohibit such fees for certain preventive services, vaccinations, telehealth, and some services provided in vehicles, while exempting rural hospitals and requiring notice to patients. Hospital representatives opposed the bill, warning it would add financial pressure and could still be passed through to patients or premiums, while insurers, retiree advocates, and consumer groups supported it as a way to curb confusing and costly add-on charges. The committee also advanced House Memorial 36 to create an unfunded nursing shortage task force focused on graduation rates, retention, and barriers to training, and House Memorial 35, which would ask HCA to seek a Medicaid state plan amendment for pediatric palliative care. Supporters of the palliative care memorial described major access gaps for children with complex conditions, especially in rural areas, and the memorial passed after testimony from a rural pediatric hospice nurse and committee discussion about the small number of eligible children and the burden on families.

Transcript Highlights:

• </c> unconscious or anesthetized patient unconscious or anesthetized patient without<01:42:42.960><c>
• </c><01:42:55.840><c> is</c> obtained um if the patient is obtained um if the patient is unconscious<
• under anesthesia or unconscious patients under anesthesia or unconscious patients<01:43:11.239><c> should
• , requiring patients to give explicit informed consent prior to these educational exams.
• </c> for people doing bad things to patients for people doing bad things to patients this<01:50:15.400

Committee: Senate Health and Human Services

Transcript Highlights:

• Two minutes is preferred for testifiers as well.
• She was admired by patients and colleagues alike.
• We want to be able to do more for our patients, but we have so many more patients in line.
• How do you take care of patients safely?
• They really want to treat those patients.

Bills: HF2779 , HF1645 , HF1885 , HF1289 , HF1534 , HF2707 , HF1675 , HF3046

Committee: House Health Finance and Policy

Transcript Highlights:

• seeking care or trap patients in medical debt.
• Operationally, as a patient, it is terrible.
• Is it supposed to be a hospital against a patient?
• Patients need to be able to shop.
• They're often the first to greet patients seeking healthcare.

Bills: HB35 , HB138 , HB754 , HB1314 , HB1612 , HB2254 , HB2510 , HB2789 , HB3560 , HB3597 , HB4224 , HB4273 , HB4643 , HB4783 , HB138

Committee: Senate Health & Human Services

Transcript Highlights:

• So we'll go ahead then to our patient, Mr. Ward. Not our patient, as in medical patient.
• Our very patient individual. Not our patient, as in medical patient.
• It does not mandate preferences.
• This approach sadly misses opportunities to prevent patient harm.
• The bill would eliminate the most basic patient safety protection.

Summary: The committee heard testimony on several bills related to reproductive access, child safety online, immigration enforcement in schools, health privacy, location data, digital provenance, reparations, and age assurance. AB 54 would protect the medication abortion supply chain and shield providers and others from liability; AB 1137 would strengthen reporting and enforcement tools for child sexual abuse material on social media; AB 49 would limit ICE activity at California public schools; AB 82 would expand privacy and safety protections for gender-affirming care patients and providers; AB 1355 would restrict the collection, use, and sale of precise location data; AB 853 would expand provenance requirements for AI-generated and authentic content; AB 62 would create a pathway for restitution for racially biased eminent domain takings; and AB 1043 would create a device-based age assurance framework for online services. Supporters generally framed the bills as necessary responses to current harms: reproductive rights advocates emphasized California’s role as a safe haven; child safety witnesses described the persistence and re-victimization caused by CSAM online; immigrant rights and education advocates said schools should remain safe from immigration enforcement; health and LGBTQ+ advocates stressed privacy and safety risks tied to tracking and harassment; privacy and consumer groups backed limits on location data and stronger provenance tools; and reparations advocates said AB 62 would help address historic injustices. Opposition came from family policy, tech, business, law enforcement, and industry groups, who raised concerns about safety claims, constitutional issues, implementation burdens, transparency, law enforcement access, and the need to preserve existing privacy frameworks and voluntary standards. The committee members largely expressed support for the policy goals while noting implementation concerns on some measures. Several members asked for or were offered coauthor status on bills. AB 1137, AB 54, AB 49, AB 82, AB 1355, AB 853, and AB 62 all received do-pass votes to Appropriations, with some members voting no or not voting on certain bills. AB 1355 and AB 853 were advanced with amendments or ongoing work promised with opponents, and AB 1043 was presented with discussion of possible amendments on parental consent and age assurance details, though the transcript cuts off before final action on that bill.

Transcript Highlights:

• So there should be a guarantee of patient privacy. There should be no commercialization.
• So there should be a guarantee of patient privacy. There should be no commercialization.
• So there should be a guarantee of patient privacy. There should be no commercialization.
• So there should be a guarantee of patient privacy. There should be no commercialization.
• </c> you prefer. you prefer. &gt;&gt; Thank<01:15:08.320><c> you,</c><01:15:08.560><c> Chair.

Summary: The committee met with a quorum, approved the prior meeting minutes, and then heard testimony on the use of artificial intelligence in therapy and mental health settings. Representative Lisa Willner and Brenda Rosen of NASW Kentucky argued for “guard rails” on AI chatbots so they cannot present themselves as licensed therapists or replace school counselors, psychologists, or social workers. They said AI can support licensed professionals, but warned that chatbots cannot reliably recognize nonverbal cues, escalate crises, or provide accountable care, and they cited examples of harmful chatbot interactions, including a suicide case and a chatbot telling a user to “Please die.” The witnesses also raised concerns about data privacy, commercialization of sensitive mental health conversations, and the use of personal clinical content to train AI models. They said minors should require parental consent and suggested transparency about how a chatbot is trained and who created it. They distinguished between unvetted consumer chatbots and AI tools that have been scientifically validated or approved as digital therapeutics, noting that some evidence-based tools may be useful for specific conditions such as depression, anxiety, or eating disorders. Committee members asked whether regulation should be handled by the legislature or by professional boards, and whether a multi-state model would be preferable to 50 different state approaches. The witnesses generally favored expert-led standards and said a board or panel of experts could review and approve mental health chatbots, but members cautioned that boards can become too restrictive and that legislation should preserve flexibility and avoid discouraging children from seeking help. The discussion ended with a request for the witnesses to restate their proposed policy ideas, including privacy protections, bans on commercialization, limits on training AI with clinical content, transparency requirements, and informed consent.

Transcript Highlights:

• , along with about 170 ALS patients.
• We just want to say thank you for making this real as a patient and patient advocate.
• of our patients like family.
• of our patients like family.
• So right now, if you're a proposed patient, that means you're a Title 36 patient.

Summary: The committee heard House Bill 2433, which would require insurers offering Medicare supplement policies to people 65 and older to also offer them to Medicare beneficiaries under 65 with ALS or end-stage renal disease, with enrollment periods and premium protections tied to 65-year-old rates. Supporters, including dialysis and ALS advocates, said the bill would help a small population facing high out-of-pocket costs and could improve access to transplants and care; opponents argued it would shift costs onto older seniors and raise Medigap premiums. The committee recommended the bill do pass on a 12-0 vote. The committee also heard House Bill 2593, appropriating $1.5 million to the University of Arizona for the Arizona Perinatal Psychiatry Access Line. The sponsor and physicians testified that the line helps obstetric and pediatric providers quickly consult on perinatal depression, postpartum psychosis, suicidality, and other mental health crises, improving outcomes for mothers, children, and families and reducing costly emergency and crisis care. The bill received a do pass recommendation on a 10-1 vote. House Concurrent Resolution 2013, proclaiming June 2026 as Celebrate Life Month, drew emotional testimony from a young woman with spina bifida and another speaker supporting the sanctity of life. Some members objected that the state should focus on practical supports such as paid leave, child care, and health care access, while others supported the resolution as a statement of human dignity. The resolution passed the committee 7-5. The committee then approved House Bill 4010, creating a Board of Genetic Counselors and licensure standards, after testimony from genetic counselors and a patient advocate about the need for qualified counseling and better access; it passed 11-1. Later, the committee approved House Bill 2196, which would require pharmacy benefit managers to reimburse non-affiliated pharmacies at least their acquisition cost and pay a dispensing fee, and establish an appeals process. Independent pharmacists and their coalition said PBM practices are driving closures and unfairly favor affiliated pharmacies, while PBM and employer representatives warned of major cost increases and said the bill would interfere with private contracts; the bill passed 11-1. The committee also adopted a strike-everything amendment to House Bill 2182 requiring insurers and health plans to report claims denial and prior authorization data to DIFI, and then gave the amended bill a 12-0 do pass recommendation. Finally, the committee approved House Bill 2189, directing the Board of Nursing to update rules for licensed health aides and collect annual data, with the sponsor and board staff saying it would help implement routine ventilator care in the home; it passed 12-0. The committee then began hearing House Bill 2404, a strike-everything amendment on inter-facility transports for behavioral health patients, but the transcript cuts off before action on that bill.

Transcript Highlights:

• </c> the patient. the patient.
• </c> of premiums go directly toward patient of premiums go directly toward patient care.<00:53:30.800
• </c><00:53:57.520><c> if</c> and requires refunds to patients if and requires refunds to patients if
• Many rural dentist to patient ratios.
• </c> and ultimately hurts patients. and ultimately hurts patients.

Bills: SB170 , SB177 , SB207 , SB208 , SB215 , HB27 , SB219 , SB247 , SB232 , SB81 , SB170 , SB177 , SB207 , SB208 , SB215 , HB27 , SB219 , SB247 , SB232 , SB81

Committee: Senate Banking and Insurance

Keywords: health insurance, health savings account, high deductible plans, federal regulations, cost-sharing, insurance law, breast cancer, health coverage, deductible, copayment, insurance, captive insurance, captive insurer, captive insurers, insurance regulation, Alabama Department of Insurance, insurance commissioner, premium tax, capital requirements, surplus requirements

Transcript Highlights:

• </c><03:09:32.880><c> abuse</c><03:09:33.439><c> and</c> um patient abuse and um patient abuse and um
• Uh, I prefer just to talk about the CNU. Yeah, I want to withdraw it. Thank you.
• </c> I prefer just to talk about the CNU. I prefer just to talk about the CNU.
• We have direct care patients that the state is responsible for providing residential care.
• I was just going to chime in that it's whatever you prefer.

Summary: The committee met in Division 3 work session on HB 2 and began by noting a delayed start to allow the Legislative Budget Assistant to finish a large packet of updated amendments and revisions. The chair said the goal for the day was to move as many items as possible, with any cleanup deferred to a Friday follow-up. Members also discussed the process for handling public and department testimony on selected items before votes. Several early amendments were taken up and voted on. The committee unanimously recommended items dealing with repealing the liquor transfer to the alcohol fund and redirecting liquor-related revenue to the general fund, and it also approved an amendment revising Granite Advantage funding so there would be no automatic transfer from the liquor fund, instead using a general fund appropriation. Members then approved repealing the foster grandparent program by a 5-4 vote, and later approved an amendment requiring DHS contractors to comply with the patients’ bill of rights by a 9-0 vote. The committee also approved incorporating House Bill 94 on Medicaid coverage of circumcision by a 5-4 vote, while deferring the Wick Farmers Market Nutrition Program repeal for more discussion. The committee spent substantial time on the youth risk behavior survey amendment. Supporters said the change was intended to clarify opt-out procedures and ensure parents, guardians, and students are clearly notified that they may opt out without negative consequences. Some members raised privacy concerns and said the language could add administrative burden, but the amendment was ultimately recommended to Finance by a recorded vote of 8-1. Another amendment on civil rights and contractor standards for DHHS was discussed but not voted on after concerns were raised about vague enforcement language and possible penalties. The committee also struck amendment 1026 as redundant, with members noting related work in existing law and Senate Bill 134, and then moved on to other items, including a revised equity/access-related amendment that was postponed for later discussion.

Transcript Highlights:

• So there's not really a preferred list of vendors, but there are, like I said, it's open to anyone to
• </c><00:42:01.520><c> list</c><00:42:01.880><c> of</c> there's not really a preferred list of there's
• She added that the other item is for medical services for patients and residents.
• The witness explained that it is for residents or patients within the hospital who have to go outside
• </c><01:04:27.160><c> and</c> services for our patients and services for our patients and residents<01

Summary: Chairman Hart called the meeting to order, confirmed a quorum, welcomed Representative Rachel Roarx, and the committee approved the February 11 minutes. The committee then moved through its agenda of PSC and related contract items, including a motion to consider the reviewed contracts without objection. One Department of Highways item was deferred when the virtual representatives were not yet available. The committee first took up Kentucky Housing Corporation contracts. Members questioned outside legal services for foreclosures and bankruptcies, why the work was not handled entirely in-house, and how much of the workload and cost it represented. Witnesses said the agency’s need was largely geographic rather than a lack of expertise, that less than 1% of the loan portfolio is referred out for foreclosures, and that many fees are reimbursable through FHA. Both Kentucky Housing Corporation items were approved. The committee then considered a Department for Community Based Services contract tied to a protest and a temporary renewal with PCG. Witnesses said the contract increase was needed to bridge the gap while the protest and RFP process were unresolved, and that the initial vendor received no funds. The committee approved the item, with Senator Douglas explaining his vote as a preference for straightforward answers. The committee also heard a Northern Kentucky University contract for a Workday ERP replacement, including implementation consulting and separate license fees. University officials explained the move from SAP to Workday, the complexity of the systems, and the need for a consulting partner; they said the total effort would span 10 years and that the contract was priced below comparable institutions. After extensive questioning about cost, budget, and value, the vote ended 4-4 and the chair noted the contract would move forward through the Finance Committee if no disapproval motion was made. Finally, the Office of Inspector General presented a contract for culture change training in nursing facilities funded by civil monetary penalties; witnesses said the goal was to improve staff satisfaction, communication, and resident outcomes, and that the CMP fund balance was about $38 million. Discussion also covered survey backlogs and CMS restrictions on the funds, with the item still under review as the transcript ended.

Transcript Highlights:

• this extremely complex patient who’s very different than last year’s extremely complex patient.
• We're stuck with patients.
• So only 50% of Open Door's patients are Medi-Cal. The rest are Medicare or commercial patients.
• There's no benefit to patients.
• There's no benefit to patients.

Summary: The Assembly Health Committee met on April 22 and took up a special order of bills focused largely on prior authorization and utilization management in health care. The chair framed the discussion as part of a broader legislative effort to reduce delays and barriers to care, especially in behavioral health, chronic disease management, cancer treatment, and rehabilitation services. AB 384 by Assembly Member Connolly would prohibit prior authorization for inpatient mental health or substance use emergency admissions and related physician care; supporters said it would prevent dangerous delays in crisis care, while insurers and health plans warned about fraud, abuse, and ambiguity around residential treatment facilities. The bill was moved on a due pass as amended motion and passed the committee on a party-line style vote, with Republicans largely absent or not voting. The committee then heard AB 510 by Assembly Member Addis, which would require health plans, upon request, to provide a peer reviewer of the same or similar specialty when a treating provider appeals a prior authorization denial or modification. Supporters argued that specialty-matched review would make appeals fairer and more clinically informed; opponents said the requirement was too rigid and that timelines and electronic submission rules needed changes. After discussion about the need for timely, specialty-specific review, the bill was approved on a due pass as amended motion and placed on call. AB 539 by Assembly Member Schiavo would extend prior authorization approvals to one year or the duration of the physician’s prescribed treatment for chronic conditions; supporters cited repeated denials and treatment interruptions, while opponents raised concerns about overbreadth, fraud, and the need for shorter validity periods. The bill was also passed as amended and placed on call. The committee next considered AB 669 by Assembly Member Haney, which would bar concurrent and retrospective review for the first 28 days of medically necessary substance use disorder treatment and limit prior authorization for related outpatient medications. The bill was presented with a powerful personal story from Ryan Matlock’s mother about her son’s death after an insurer cut off treatment early; supporters said the measure would keep patients in care long enough to stabilize, while opponents argued it would reduce oversight and could allow lower-quality or non-evidence-based care. The bill was moved on a due pass as amended motion and placed on call. Finally, AB 512 by Assembly Member Harabedian would shorten prior authorization response times to 24 hours for urgent requests and 48 hours for non-urgent requests; supporters said delays can worsen outcomes, while opponents warned the timelines were unrealistic and could increase administrative burdens and safety issues. The bill was approved as amended and placed on call. AB 574 by Assembly Member Mark Gonzalez was then heard; it would allow up to 12 medically necessary physical therapy sessions for a new episode of care without prior authorization, with supporters emphasizing stroke and neurological recovery and opponents warning of reduced oversight and unnecessary care. The transcript ends during testimony on AB 574, before final action is shown.

Transcript Highlights:

• , along with about 170 ALS patients.
• , along with about 170 ALS patients.
• We just want to say thank you for making this real as a patient and patient advocate.
• of our patients like family.
• It simply expands patient choice.

Summary: The committee heard House Bill 2433, which would require insurers offering Medicare supplement policies to also offer them to people under 65 who qualify for Medicare because of ALS or end-stage renal disease, with enrollment periods and premium protections. Supporters, including patient advocates and an ALS patient, said the bill would improve access to needed coverage and transplant-related care and could have only a small premium impact. Opponents, including Blue Cross Blue Shield/AHIP, argued it would shift significant costs onto older seniors and shrink the Medigap risk pool. The bill was ultimately given a do-pass recommendation on a 12-0 vote. House Bill 2593 would appropriate $1.5 million to the University of Arizona for the Arizona Perinatal Psychiatry Access Line. The sponsor and physicians testified that the line helps providers quickly treat pregnant and postpartum patients with depression, psychosis, OCD, and suicide risk, and also supports pediatric mental health care. Supporters said it improves outcomes and reduces emergency and referral costs. The committee approved the bill with a do-pass recommendation by a 10-1 vote, with one member present. The committee also passed House Concurrent Resolution 2013, proclaiming June 2026 as Celebrate Life Month, after emotional testimony from a woman born with spina bifida and another supporter. Several members objected that the state should focus on concrete supports such as health care and family leave, but the resolution still received a 7-5 do-pass recommendation. House Bill 4010, creating a licensing and regulatory board for genetic counselors, also advanced 11-1 after testimony from genetic counselors and a cancer survivor who said licensure would protect patients and improve access. House Bill 2196, addressing pharmacy benefit manager reimbursement and dispensing fees, passed 11-1 despite opposition from PBMs and employers who warned of higher costs; independent pharmacies argued the bill would help them cover costs and stay open. The committee then adopted a strike-everything amendment to House Bill 2182 requiring insurers and health plans to report claims denial and prior authorization data to DIFI, which would publish aggregated information and hold a later stakeholder review. Supporters said Arizona needs state-specific transparency data, while opponents called it redundant to federal CMS reporting; the amended bill passed 12-0. House Bill 2189, directing the Board of Nursing to update rules for licensed health aides and collect annual data, also passed unanimously after the board said it was already working on curriculum and implementation. The committee held House Bill 2813 and 2725, and began discussion of House Bill 2404, as the transcript ended.

Transcript Highlights:

• While medical advancements have led to 87% of young adult cancer patients surviving their diagnosis,
• As a health care professional, we know that we have to approach patients in a very holistic manner.
• As a health care professional, we know that we have to approach patients in a very holistic manner.
• As I've said previously, my preference, and I believe the preference of the Senate, is to focus on a
• Actually, Senator Burton, I would prefer it if you could come over here so I can use you.

Summary: The Senate opened with prayer, the Pledge of Allegiance, and several recognitions, including guests from Miami Northwestern Senior High School, Clay County, and a moment of silence for Pope Francis. Members then moved to the special order calendar after adopting a motion to reconsider the earlier failed vote on CS/SB 1080, which was temporarily postponed. The chamber also temporarily postponed several bills during the day, including measures on social media use by minors, veterans’ nursing homes, Parkinson’s disease, mental health and substance use disorders, education, educator preparation, benefits for certain officers injured in the line of duty, Brownfields, and school social workers. The Senate passed a series of bills with little or no opposition, often substituting House companions for Senate bills. These included expedited DNA testing grants for law enforcement; additional aggravating factors in capital felony sentencing; fertility preservation coverage for cancer patients; commuter rail indemnification; disposition of migrant vessels; specialty license plates; an Alzheimer’s and dementia awareness campaign; relocation of the Council on the Social Status of Black Men and Boys to Florida Memorial University; charter school changes; registration rules for sexual predators and offenders; assault and battery penalties for utility workers; juvenile justice revisions; reporting of student mental health outcomes; foster home licensure transfers; water access facilities and boating-related funding; Florida Virtual School changes; school readiness program improvements; protections against lewd sexual images of children; age-related criminal offense provisions; tampering with electronic monitoring devices; certified recovery residences; and codification of the FSU Election Law Center. Most of these bills passed overwhelmingly, though the charter school bill and the aggravating factors bill drew more divided votes. One of the most debated measures was SB 820, codifying the Office of Faith and Community. Senator Polsky offered an amendment to bar political activity by office employees while on duty and using government resources, citing alleged election-related emails and concerns about mixing government and religious influence. Supporters argued the amendment was needed as a guardrail; opponents said existing law already covered the conduct and that the amendment could be confusing or overly broad. The amendment failed 13-23, and the underlying bill passed 27-9 after extended debate about faith, politics, and the office’s role. Another notable debate involved SB 954 on certified recovery residences, where senators emphasized the need for stable housing in addiction recovery and the bill passed unanimously after supportive remarks from members who had personal experience with recovery. The Senate also passed SB 674 on bonuses for county tax collector and property appraiser employees after questions about safeguards and the purpose of the bonuses.

Transcript Highlights:

• For instance, if a patient has been hospitalized for at least three days and For instance, if a patient
• Given these limitations, many patients may need long-term care beyond what Medicare can provide.
• Furthermore, Medicare does not cover home and community-based services that many individuals prefer as
• Services that many individuals prefer as alternatives to institutional care.
• Of the annual crises, and I prefer to fix things for a change, not just put a band-aid over them.

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• </c><00:41:02.440><c> be</c><00:41:02.520><c> able</c> patients and have your patients be able patients
• </c><00:42:11.319><c> and</c> patient the choice let's the patient and patient the choice let's the patient
• This should be a patient-and-provider, patient-and-nurse, patient-and-doctor-run health care system.
• This should be a patient-and-provider, patient-and-nurse, patient-and-doctor-run health care system.
• </c><00:47:23.680><c> in</c> provider patient in nurse patient in provider patient in nurse patient in

Committee: Senate Health and Human Services

Transcript Highlights:

• And when you put that into effect, the voters of our districts and the constituents have been very patient
• </c> very patient as this thing's unfolded. very patient as this thing's unfolded.
• I would prefer to see the fix to it in the process or would like to see it become up to a certain amount
• I would prefer to see the fix to it in the process or would like to see it become up to a certain amount
• I would prefer to see the fix to it in the process or would like to see it become up to a certain amount

Transcript Highlights:

• We prefer to get folks in the hospital as soon as we can. Okay.
• A lot of that higher cost is attributed to the type of patient, so forensic patients. which is about
• transition to the community. or our civil patients that are ready.
• Alito, patients can be forced to take medications. in state mental health facilities.
• That's one of the reasons when patients, especially those who. found incompetent to stand trial.

Committee: House Appropriations