Video & Transcript : 'Arizona Long Term Care System' :
Page 416 of 500
WA
Washington 2025-2026 Regular Session
Senate Housing Jan 14th, 2026
Transcript Highlights:
- By way of background, smart access systems, also known as smart locks, are locking systems that use electronic
- or that operates the system.
- people who really care intensely.
- And in each of those cases, the church is making the land available for development through a long-term
- These tools together incentivize development while ensuring deep long-term affordability.
Summary:
The Senate Housing Committee heard public testimony on several bills. SB 5885 would expand affordable housing on property owned by religious organizations by lowering the density-bonus affordability threshold from 100% to 50% and adding a sales and use tax exemption for qualifying projects. The sponsor and supporters from Redmond, Tacoma, Spokane, faith organizations, and housing nonprofits said the current standard is too restrictive and that churches and other faith groups have underused land that could help meet the state’s housing shortage. A county planning representative raised concern about an unfunded mandate to update local development regulations, and one testifier said the bill should be paired with funding for county planning work.
The committee also heard SB 5884, which would expand a sales and use tax deferral program for redevelopment of underutilized property. The bill would broaden eligible land beyond surface parking lots to include vacant, partially used, or underutilized parcels, and would allow cities to approve projects with at least 50% affordable units, or 20% in designated residential targeted areas. Supporters from Spokane, Vancouver, Kent, Bellingham, and the Washington State Association of Counties said the current program is too narrow and should be available in more places, including counties and more cities. Construction industry groups supported redevelopment but objected to a provision tying eligibility to apprenticeship utilization, saying it could disadvantage nonunion contractors and create compliance burdens.
For SB 5937, the committee heard testimony on smart access systems in rental housing. The bill would require landlords, upon request, to offer a non-biometric, non-app-based alternative key and to provide privacy policies and limits on data collection for smart access systems. Tenant advocates supported the bill as a privacy and access protection, citing concerns about app-based locks, data tracking, lockouts, and retaliation. Landlord and multifamily housing groups said they were open to the concept but argued the bill was too broad and could impose burdens on small housing providers or simple keypad systems, and they asked for narrower definitions and clearer implementation language.
Finally, the committee took testimony on SB 5938, which would make technical changes to the foreclosure prevention fee created last year, including exempting certain reverse mortgages and chattel loans, preventing duplicate charges on some state-backed transactions, and directing Commerce to study a possible state homeowner assistance fund. Homeownership counselors, legal aid, HOA advocates, and equity organizations supported the bill, saying it would clarify fee collection, protect low- and moderate-income buyers from unnecessary costs, and help sustain foreclosure prevention services. No votes or final committee actions were taken in the transcript, and the meeting ended after public testimony.
MO
Missouri 2026 Regular Session
Professional Registration and Licensing Feb 4th, 2026 at 08:00 am
Professional Registration and Licensing
Transcript Highlights:
- House Bill 1623 simply adds massage therapists and chiropractors to the long list of health care professionals
- This allows us to have more people going forward and providing that type of health care.
- And, you know, really, if you turn to page three, they use a term in 13 there.
- Because that's what the term is, is defined in our state. You know, just provide some clarity.
- And, you know, really the, if you turn to page three, they use a term in 13 there.
CA
California 2025-2026 Regular Session
Joint Committee on the Arts May 14th, 2026
Joint Committee on the Arts
Transcript Highlights:
- The goal is to think more creatively and systematically about a wide array of long-term futures so that
- Systems change that outlasts any single short-term grant.
- Systems change that outlasts any single short-term grant.
- , behavioral health systems, and the aging services health care, behavioral health systems, and the aging
- This is an iterative and long-term process, and so we see a lot of moments of reflection, evaluation,
Committee:
House Joint Committee on the Arts
Summary:
The Joint Committee on the Arts held an informational hearing on California’s first sector-specific creative economy strategic plan, “California’s Future Is Creative,” developed under AB 127 and related legislation. Chair Allen framed the plan as a response to California’s large but vulnerable creative economy, citing workforce losses, federal funding headwinds, and the need to support artists, cultural organizations, public media, museums, cultural districts, and film/TV production. He also highlighted budget asks including support for California Humanities, museums, public media, cultural districts, a post-production incentive proposal (AB 2319), and funding to implement the strategic plan.
California Arts Council Director Danielle Brazel, Institute for the Future’s Rachel Hatch, CDE’s Allison Frenzel, and CWDB’s Michael Weoff described the planning process, which included a 30-plus-member work group, interagency coordination, and a phased approach from framework development to implementation and evaluation. They identified major forces shaping the sector over the next decade, including AI, climate disruption, affordability, access to capital, and social cohesion, and outlined six action areas: workforce preparation, business stabilization, cultural identity/tourism, cross-sector incentives, ROI/data tracking, and state capacity/infrastructure. Members and panelists repeatedly emphasized that the plan must be resourced and integrated across agencies rather than left siloed.
A second panel of practitioners and advocates focused on workforce pathways and local implementation. Ricarlo Handy described the Handy Foundation’s registered apprenticeship pipeline into film and TV jobs and argued that current data systems undercount gig, 1099, and LLC-based creative work. Joanna Reynolds discussed Arts for LA’s Creative Jobs Collective, which aims to create 10,000 living-wage creative jobs in Los Angeles County by 2030, while Alejandro Gutierrez Chavez urged embedding artists in health, aging, and behavioral health systems as community problem-solvers. Roxanne Messina Kaptur spoke about the need to normalize arts careers and expand residency and school-based models. Senator Rubio, who joined later, shared her own arts and teaching background, supported arts access in schools and small theaters, and raised concerns about AI, asking how schools and educators can adapt.
In the final panel, Rebecca Ratzkin reported on 26 statewide town halls with more than 1,100 attendees, which confirmed support for the plan but also highlighted needs for better information access, new financial models, stronger definitions and data, and more partnerships. Julie Baker of California for the Arts and California Arts Advocates urged sustained public funding, saying the plan is actionable only if the Legislature and administration provide resources, including increased California Arts Council funding and support for implementation. No formal votes were taken; the hearing was informational and concluded with calls for continued legislative and cross-agency collaboration.
NM
Transcript Highlights:
- Mexico that is more important than creating good jobs that provide not only the immediate needs but the long-term
- Child care and primary health care as well. We might just want to use the cordless mic, I think.
- In addition, she's a wonderful Chair in terms of meetings.
- The other two priorities this session are primary health care as a fund and behavioral health care as
- In terms of her science and her background, Dr.
Committee:
Senate Senate Rules
FL
Transcript Highlights:
- We think this should be a long-term plan rather than something that happens quickly like this session
- They revert back to the tort system and these families aren't taken care of immediately the way they
- community significance, but many of them struggle to find consistent funding for basic maintenance and long-term
- community significance, but many of them struggle to find consistent funding for basic maintenance and long-term
- used as a burial ground, the cemetery may choose to sell that land for the express purpose of funding long-term
Committee:
House Commerce Committee
Summary:
The committee first considered CS/HB 1263 on the Office of Insurance Regulation. The sponsor said the bill would strengthen OIR’s tools to oversee property insurance, including market conduct and solvency exams, claims handling oversight, mandatory discounts for certain mitigation measures, storage of mitigation inspection forms, and clearer authority over pharmacy benefit managers. An amendment narrowing fingerprinting requirements was adopted, and the bill passed favorably after supportive testimony from OIR and others.
Members then heard CS/HB 527, which would require a human review before an insurance claim can be denied or reduced when artificial intelligence or automated systems are used. After an amendment removing the term “algorithm” was adopted, the bill drew opposition from several insurance industry groups, while consumer and labor witnesses supported it. The sponsor argued the measure was needed after reports of AI-driven claim denials, and the bill passed favorably. The committee also approved CS/HB 637 on farm equipment “lemon law” protections, with an amendment clarifying who qualifies as a consumer, refund rights, repair timelines, and an effective date.
The committee next took up CS/HB 1007 on data centers, which would create a regulatory framework for siting and operating large data centers, limit NDAs in some circumstances, set PSC tariff requirements, and restrict certain locations near homes and schools. After an amendment narrowing the five-mile buffer to data centers over 50 megawatts and adding noise-study requirements, the bill drew mixed testimony from business, consumer, and local-government groups, with supporters emphasizing guardrails and opponents warning about competitiveness and site restrictions. The bill passed favorably despite several no votes.
Later, the committee approved CS/HB 1291 on the NICA birth-related neurological injury compensation program after a strike-all amendment revised reimbursement and assessment provisions; testimony included support from NICA and concerns from the Florida Justice Association and a family affected by the program. The committee also passed CS/HB 185 on a sales tax exemption for home-hardening products, CS/HB 425 on a historic African-American cemetery preservation program, CS/CS/CS/HB 1177 on Space Florida and spaceport operations, CS/CS/CS/HB 657 on community associations and HOA/condo reforms, and CS/CS/HB 1221, the DFS agency package. The final bill discussed was CS/HB 1001, which would restrict county and municipal DEI-related actions and contracting; the sponsor explained the strike-all, and members began questioning its definitions and exceptions, but the transcript cuts off before the bill’s final disposition.
CO
Colorado 2026 Regular Session
Colorado House 2026 Legislative Day 029 Feb 11th, 2026
Colorado House Floor Meeting
Transcript Highlights:
- Whether it's in DOC, whether it's in YOS, wherever it is, we need to figure out long-term sustainable
- for their own children so that we're not dealing long term as a society with all of these consequences
- for their own children so that we're not dealing long term as a society with all of these consequences
- for their own children so that we're not dealing long term as a society with all of these consequences
- for their own children so that we're not dealing long term as a society with all of these consequences
ND
North Dakota 2025-2026 Regular Session
Information Technology Committee Jul 8th, 2026
Transcript Highlights:
- And they're the first effort supporting this program of long-term modernization and mainframe retirement
- I would sure love to say that it's always easy to keep this in mind and keep that long-term thing in
- , while we investigate what better long-term solutions may be.
- It is a foundational step toward ensuring long-term operational excellence and high-quality service delivery
- And in terms of the state's financial system, we're farther away from that cliff, but there's things
Summary:
The committee approved the March 26 minutes and then received a quarterly update on major IT projects from NDIT. Staff reported the portfolio included 116 major projects totaling about $546 million, with the overall portfolio under budget but slightly behind schedule. They reviewed projects over the 20% variance threshold, including an Industrial Commission grants management system and DOT’s roadway pre-construction replacement, and then heard startup and closeout reports from HHS, OMB, DPI, and DOT. Several previously troubled projects were closed, including HHS bed management, vital records modernization, and DOT roadway capital planning; some projects finished under budget and ahead of schedule, while others were significantly behind schedule or over budget but were now closed or being remediated.
The committee also reviewed NDIT’s annual report, including service-fund financials, peer-state rate comparisons, records management, and customer satisfaction efforts. Members asked about how service-fund revenue and grant administrative charges are accounted for, how chargebacks work, and whether NDIT tracks customer satisfaction scores. NDIT said it does track CSAT-type measures in some service areas and has survey data, but it is not planning another customer survey this summer. Members encouraged more regular reporting of customer satisfaction, service-level metrics, and performance data to help guide future improvements.
A major portion of the meeting focused on the state’s mainframe modernization effort. NDIT said the overall effort is still targeting about 2030, with multiple HHS and DOT projects underway and a $15 million tech-debt appropriation already removing some components. Staff described the main obstacles as data cleanup, complex integrations, limited staff capacity, retirements, and vendor constraints, and said they are seeking a vendor with modernization support in the next contract cycle. Members pressed for clearer accountability and faster progress, and NDIT and HHS emphasized that they are working jointly but need continued support and better tools.
The committee then heard a cybersecurity update on NDIT’s statewide services and maturity assessments. NDIT explained that it provides vulnerability scanning, endpoint protection, security awareness training, threat briefings, and penetration testing, and that these services are tied to a cybersecurity maturity assessment based on CIS controls. Members questioned the sharp drop in participation since 2020 and whether the self-assessment should be mandatory or tied more strongly to StageNet access or insurance incentives. NDIT said participation is voluntary, but Enderf is now requiring annual assessments to keep a 4% insurance discount, and members discussed whether stronger requirements or audit authority may be needed. The meeting ended as the committee began a follow-up discussion on BEAD broadband connection costs and why some locations are much more expensive to connect than others.
TX
Transcript Highlights:
- We walked the city and county through the federal funding administration, their long-term recovery planning
- Well, that's not cost-effective and not sustainable long-term.
- What they've demonstrated is that if you want this to be sustainable in the long term, here are some
- It's a pretty long list.
- Grid systems.
Committee:
House State Affairs
HI
Transcript Highlights:
- Corporation operation as well as Systems Corporation operation as well as Aloha<01:04:27.839><c> care
- This bill came over from the Agriculture and Food Systems Committee and establishes short-term management
- one component information about crb and one component is<01:18:37.239><c> the</c><01:18:37.440><c> long-term
- c> management</c><01:18:38.719><c> we</c><01:18:38.880><c> want</c><01:18:39.120><c> to</c> is the long-term
- management we want to is the long-term management we want to initiate<01:18:40.320><c> research</c><
Committee:
House Higher Education
Summary:
The House Committee on Higher Education met at the University of Hawaiʻi’s Bachman Hall and heard testimony on several UH-related bills. HB 542 would expand the Hawaiʻi Promise Program to provide unmet-need scholarships at four-year UH campuses. UH system officials, the UH Student Caucus, and a Honolulu Community College student testified in support, emphasizing college affordability, student retention, and workforce needs. Committee members asked about current program data, eligibility, transfer patterns, and cost; UH said it had data available, noted about 10% of current Hawaiʻi Promise students transfer to four-year campuses, and estimated the full expansion would cost about $12 million. UH also suggested a possible alternative of focusing on transfer opportunities from two-year to four-year campuses.
The committee then heard HB 840, which concerns athletics appropriations for UH. UH Mānoa and UH Hilo supported the bill. UH officials said the funding would help cover recurring athletics operating costs, women’s sports travel and recruiting, Austin Awards, and a new nutrition fueling station, while Hilo said the money would help with travel, per diem, and conference-related costs. Members asked about the history of the athletics funding, the difference between Austin Awards and special talent waivers, NIL planning, and whether the appropriation should be restored to the base budget. UH explained that a $4 million athletics appropriation was originally made in 2018 or 2019, later removed from the base, and has been reappropriated annually since then.
Finally, the committee heard HB 842, which would fund three additional permanent mental health practitioner positions at UH Mānoa’s Counseling and Student Development Center. UH supported the bill, and Academic Labor United and a high school student testified in favor, citing student stress, overwork, and the need for more counseling access. In questions, members discussed the current counselor-to-student ratio, recruitment challenges in a tight labor market, and strategies for hiring, including looking at candidates on soft-money grants who may be seeking stable employment. No votes or final committee actions were taken during the portion of the meeting provided.
CA
California 2025-2026 Regular Session
Assembly Emergency Management Committee Feb 24th, 2026
Transcript Highlights:
- And these tools improve both immediate response and long-term accountability.
- And these tools improve both immediate response and long-term accountability.
- lives, where they literally say, I don't care.
- , also known as SEMS, and supporting long-term recovery for victim families and survivors.
- So it sounds like you went from an honor system to a trust-but-verify system where we really want to
Summary:
The committee held a hearing on active and mass shootings in California, focusing on prevention, response, training, communications, and gaps in preparedness across law enforcement, schools, campuses, fire, EMS, and state agencies. Opening remarks emphasized the frequency and impact of gun violence, the need for faster coordinated response, and the importance of learning from recent tragedies such as the Stockton-area mass shooting described by Sheriff Patrick Withrow. The first panel included representatives from police, sheriff, and campus public safety agencies, who discussed incident command, interoperable communications, next-generation 911, threat assessment, emergency notification systems, and the value of joint drills and cross-agency planning.
Witnesses also highlighted differences in training and authority across jurisdictions, especially for private university public safety departments versus public campus police. Campus representatives said they rely heavily on municipal law enforcement for armed response, while also using run-hide-fight protocols, text alerts, surveillance, and threat assessment teams. Members raised concerns about standardized training, after-action reviews, mental health resources, school resource officers, and whether campus safety plans and drills are sufficiently consistent or workable. Sheriff Withrow argued that early intervention and accountability are being weakened by well-intentioned laws, while other witnesses stressed prevention through relationships, diversion, and coordinated support services.
The second panel from Cal OES, the Department of Education, POST, and EMSA described statewide systems and standards. Cal OES outlined its Reduce the Risk initiative, gun violence restraining orders, mutual aid, unified command, after-action reporting, and nonprofit security grants. The Department of Education explained California’s statutory school safety framework, annual safety plans, regulated armed assailant drills, and local flexibility, while acknowledging compliance gaps and the need for more mental health support. POST described the new requirement for 16 hours of standardized active shooter training for recruits and ongoing local training options. EMSA explained its role in medical response and terrorism training standards. No votes or formal actions were taken during the hearing.
MN
Minnesota 2025-2026 Regular Session
House Fraud Prevention and State Agency Oversight Policy Committee 12/17/25
Fraud Prevention and State Agency Oversight Policy
Transcript Highlights:
- reviews verification items such as IRS forms, background studies, and the board of executives for long-term
- . system. system.
- Um, in addition to Medicaid funding, Medicaid is a significant payer of long-term services and supports
- in terms of supervision, care, assistance, and training activities are included.
- . care. care.
CA
California 2025-2026 Regular Session
Assembly Higher Education Committee Mar 17th, 2026
Higher Education
Transcript Highlights:
- But these short-term programs do have mixed results.
- Over the last two years, nearly 50% of our long-serving CSU presidents have retired.
- And AB 1829 moves us toward a system grounded in access, flexibility, and student success.
- They give students like me the chance to succeed and move toward long-term self-sufficiency.
- And those jobs were crucial to me. $36 cash in my pocket wasn't going to last very long.
Committee:
House Higher Education
FL
Florida 2025 Regular Session
Education Pre-K - 12 Feb 4th, 2025
Transcript Highlights:
- So your student information system, business information systems also want to highlight it and cybersecurity
- Ours about 21 pages long. It's functional.
- There was a term we use.
- And, you know, the term is compassion.
- I'll tell you, I think for a long, long time and public education, we had a captive audience and I believe
CA
California 2025-2026 Regular Session
Assembly Select Committee on Electric Vehicles and Charging Infrastructure Nov 20th, 2025
Transcript Highlights:
- CARB's regulatory program is the foundation for long-term, sector-wide emission reductions.
- And that's a long-term goal.
- And, you know, we have a long way to go in terms of meeting our charging capacity that we need.
- And, you know, we have a long way to go in terms of meeting our, you know, our charging capacity that
- So one of our asks here would be to have long-term dedicated funding allocations going forward.
Summary:
The joint informational hearing of the Select Committee on Electric Vehicles and Charging Infrastructure focused on California’s EV market, charging infrastructure, and the effects of recent federal actions. The chair opened by emphasizing California’s progress on EV adoption and charging reliability, but also noted ongoing challenges with affordability, access, interoperability, heavy-duty electrification, and federal headwinds. She highlighted interest in technologies such as inductive charging and thanked host organizations and staff before moving to the first panel.
State agency witnesses from Go-Biz, CARB, and the California Energy Commission described current programs and priorities. Go-Biz outlined its role in coordinating agencies, supporting permitting, and advancing the state’s ZEV market development strategy and equity action plan. CARB discussed federal attacks on its clean vehicle regulations, litigation to defend waiver authority, and the importance of incentives and regulatory programs such as Advanced Clean Trucks, Advanced Clean Fleets, Clean Truck Check, HVIP, and Clean Cars for All. The CEC detailed its funding and regulatory work on charging and fueling infrastructure, charger reliability, payment methods, roaming, and statewide planning, while stressing the need for more charging in multifamily housing and more public DC fast charging. All three agencies said federal rollbacks and permitting delays are major obstacles, but that California remains committed to expanding ZEV adoption.
The second panel featured advocates, local government, utility, and research perspectives. CalETC urged continuous state funding through the Greenhouse Gas Reduction Fund and emphasized the low-carbon fuel standard, multifamily charging, and managed charging. An EV advocacy group proposed a conquest-style state incentive for new and used EV buyers and argued that multifamily housing is a major untapped market, while also favoring Level 2 charging over Level 1 for most home and apartment settings. Los Angeles County and LADWP described large-scale local deployment of chargers, fleet electrification, workforce training, and the need for sustained funding, agency coordination, and streamlined permitting and grid interconnection. UCS recommended prioritizing replacement of older high-emitting vehicles, using fuel policy revenues to support cleaner cars, and expanding bidirectional charging. The chair closed by asking for more discussion on Level 1 versus Level 2 charging and noted the importance of education, affordability, and practical deployment strategies.
MO
Missouri 2026 Regular Session
Joint Committee on Administrative Rules Jun 12th, 2026
Joint Committee on Administrative Rules
Transcript Highlights:
- Part of clinical care. Routine clinical care.
- So if you're making, if you're checking the PDMP system as part of your continued care to assist in making
- Our health care system today is facing unprecedented challenges that come to us.
- behavioral health care—coordinate care to rehab placement, referrals to in-house nursing care, PT, OT
- And it seems to me, and, you know, I've been around for a long, long time.
Summary:
The Joint Committee on Administrative Rules met with a quorum and approved the minutes from the prior meeting. Members announced that two Department of Natural Resources rules had been withdrawn, leaving only the Missouri Prescription Drug Monitoring Program (PDMP) rule proposal for consideration. Public testimony focused on a proposed expansion of PDMP access to additional licensed behavioral health professionals, including licensed clinical social workers, licensed master social workers, marriage and family therapists, professional counselors, and psychologists, along with related clarifications to delegate access categories such as medical assistants and clinical nurse specialists.
Testimony from the PDMP director and supporters from Compass Health and the Department of Mental Health argued the changes would improve care coordination, medication reconciliation, and overdose prevention within multidisciplinary behavioral health teams, especially in CCBHC settings. They said access would remain limited to licensed Missouri professionals working under supervision or collaboration with a prescriber or dispenser, and that the system is intended for treatment-related, view-only use. Opponents and skeptical committee members raised concerns that the rule would expand access beyond the original statutory framework without legislative change, could create privacy risks or misuse in non-treatment contexts such as custody disputes, and might exceed the committee’s rulemaking authority. One public witness opposed the rule, warning it could deter patients from seeking counseling and arguing the change should be made, if at all, by statute.
After testimony, committee members debated whether the proposal was a permissible clarification or an impermissible substantive expansion of the law. Supporters of disapproval said the issue was legality, not the merits of PDMP access, and urged the department to seek a bill sponsor if it wanted the change enacted. A motion was made and seconded to disapprove Rule 1 CSR 60-1.010 on the grounds of lack of statutory authority, conflict with state law, and arbitrariness/capriciousness. The committee then took a roll-call vote and approved the motion by 7 ayes to 1 no, disapproving the rule and adjourning with no further business.
FL
Florida 2025 Regular Session
Appropriations Committee on Agriculture, Environment, and General Government Feb 5th, 2025
Transcript Highlights:
- THIS GRAPH DEPICTS THE NUMBER OF OPEN CASES BY COUNTY THAT WE CURRENTLY HAVE IN OUR SYSTEM.
- IN TERMS OF THE EFFECT ON PREMIUM DISCOUNTS, THAT WAS JULY 1.
- AND THEY DO JANITORIAL SERVICE, LAWN CARE SERVICES, AGAIN IT'S THE CARE AND FEEDING OF THE BUILDINGS,
- FIRE SYSTEMS AND THE REST FOR THE BUILDINGS OR ON THE PROPERTY.
- AND MONITOR BUILDING SYSTEMS.
DE
Delaware 2025-2026 Regular Session
House of Representatives Legislative Session - Session 2 - 42nd Legislative Day- REASSEMBLE Part 1 Jun 30th, 2026 at 02:00 pm
Delaware House Floor Meeting
Transcript Highlights:
- These costs are being driven by spending across the health care system, including hospitals, insurance
- , long-term care, and prescription drugs.
- improve health outcomes by reducing long-term costs for patients, employers, and taxpayers.
- So you may see 70%, but we don't know the long-term effects.
- And I, you know, ...see 70%, but we don't know the long-term effects.
NH
Transcript Highlights:
- It's well, as long as we understand that this is not just for the IEPs but is for the health care, medical
- Our current SAU system has been used for a very long time, and he had an idea that there would be a possibility
- School district system to a county school district system.
- </c> that make up our Public Library system that make up our Public Library system system<01:08:36.920
- That term is somewhat ill-defined, so we have to be careful in just letting one person decide that this
Committee:
Senate Education
MN
Minnesota 2025-2026 Regular Session
Press Conference: Governor Walz and Legislative Leaders Announce Bipartisan Budget Agreement May 16th, 2025
Transcript Highlights:
- We fulfilled our commitment to taking care of people in Minnesota in health and human services in terms
- care system especially in tenuous health care system especially in rural<00:18:54.960><c> facilities
- We are putting more of the responsibility back into the health care system as we do contain the costs
- and growth of costs in the health care system.
- The long-term 28-29 is half, and we're still funding the things. This was a savings area.
ND
North Dakota 2025-2026 Regular Session
Tribal and State Relations Committee Apr 13th, 2026
Transcript Highlights:
- So these are levels of care or settings of care where individuals with very high and complex needs receive
- of care and services.
- Similarly, care providers and primary care providers need more training to ensure direct connection to
- And one of the things I didn’t get to mention earlier was with CARES—” “With the CARES Act, the tribe
- There's a long list.
Summary:
The meeting focused heavily on behavioral health and substance use treatment, especially the IMD exclusion and whether North Dakota should pursue a Section 1115 waiver to allow Medicaid reimbursement for services in institutions for mental diseases for adults ages 21 to 64. Turtle Mountain representatives described major local needs, including limited access to care, high syphilis rates, and the importance of timely public health data. They also discussed the tribe’s recovery center, which opened the prior year, now operating five levels of care with 16 beds, and the desire to expand capacity, possibly through an IMD waiver or related policy changes. Committee members also raised related issues such as rural health transformation funding, telehealth, workforce retention, and the need for better coordination between tribal and state public health systems.
A central issue was Turtle Mountain Public Health’s long-running effort to secure a data use agreement with the state so it can receive surveillance data and respond directly to infectious disease cases among tribal members. Speakers said the tribe had a successful COVID-era agreement that allowed faster contact tracing and case management, but that agreement ended with the pandemic. They argued that current delays in sharing data, especially for sexually transmitted infections, leave the tribe unable to respond quickly, while the state and county epidemiology workload is too distant and stretched to be effective. Committee members expressed support and said they would look into the issue, noting that other tribes have secured similar agreements.
The committee also heard a detailed presentation from the National Health Law Program on the IMD exclusion. The presenter explained that federal Medicaid law generally bars payment for care in facilities with more than 16 beds, but that states can use other tools such as state plan amendments, managed care arrangements, telehealth, and community-based services. He said IMD waivers are administratively complex, time-limited, and have shown mixed results in other states, with some gains in residential treatment access but limited evidence of improved overdose outcomes or stronger community-based care. He urged the committee to consider broader continuum-of-care solutions and cautioned that waivers alone are not a cure-all.
No final vote was taken on the bill draft during the portion shown, but the committee discussed the proposal to appropriate $49,000 and one FTE to HHS to pursue an IMD waiver and report back in the next interim. Members also debated the policy rationale for the 16-bed limit, the role of the state versus tribal sovereignty, and whether the bill should move through the Health Care or Human Services committee in the future.