Transcript Highlights:

• And so I'll explain what their practice is.
• One is to try to request full scope of practice.
• types are practicing.
• all provider types are practicing.
• In addition to private practice, chiropractors are increasingly being integrated into medical practices

Summary: The joint Assembly and Senate Business and Professions sunset oversight hearing focused first on the Board of Registered Nursing (BRN), with opening remarks emphasizing legislative oversight, consumer protection, workforce access, and the need to evaluate whether licensing boards are efficient and effective. BRN leaders reported progress since the last review, including faster licensing timelines, streamlined enforcement, improved consumer satisfaction, expanded nursing program enrollment, and new statewide data collection on faculty. Committee members then questioned the board about nurse practitioner scope and supervision, international licensure, English proficiency, online nursing education and clinical placements, military and veteran pathways, workforce shortages, diversity in nursing, the LVN-to-RN 30-unit option, and the role of the board’s RN executive officer. The board explained California’s tiered APRN system, the NCLEX and national certification requirements, the 500-hour direct patient care clinical requirement, and its use of nursing education consultants and board-approved programs to oversee schools and placements. Members also discussed retention problems, especially for new graduates, and the board said shortages are often driven by burnout, lack of support, and employers’ reduced use of new-grad training programs. Public comment largely centered on proposed BRN sunset issues affecting advanced practice nursing, education oversight, and workforce development. Nurse practitioner, nurse midwife, and nurse anesthesiology groups generally supported the BRN sunset report but asked for clearer implementation of AB 890, support for APRN-to-RN delegation authority, streamlined renewals for nurse midwives, and protection of the current population-focus model. The California Medical Association raised concerns about out-of-state nurse practitioners practicing independently without California transition-to-practice requirements, specialty delegation, ratios, and data collection. Higher education representatives from UC, CSU, private nonprofit colleges, and nursing associations urged the board to reduce duplicative documentation, modernize clinical placement rules, improve parity between in-state and out-of-state programs, and address bottlenecks in securing clinical sites. An online nursing school argued that California should create a pathway for distance-learning programs so students can complete clinicals in-state rather than traveling out of state. Several speakers also highlighted the need to expand access for rural and underserved communities, support diverse and nontraditional students, and preserve affordable pathways into nursing.

Transcript Highlights:

• </c> authorizing this as a scope of practice authorizing this as a scope of practice for<00:08:00.240
• </c><00:18:37.360><c> happen</c> changes in the scope of practice happen changes in the scope of practice
• </c> injection in school and practiced injection in school and practiced really<00:25:31.039><c> you<
• practice practice I<00:25:59.640><c> I</c><00:25:59.720><c> just</c><00:25:59.840><c> don't</c><00:26
• </c><00:34:48.960><c> when</c> operate in their scope of practice when operate in their scope of practice

Transcript Highlights:

• Both providers came from new practice sites and two from current PCMH practices.
• We had 103 engaged PCMH practices, which was an increase of 12 practices from 2024.
• more practices.
• This is internal medicine practices. Family practices. Family practices and pediatric practices.
• They're practice-owned, large practice-owned.

Summary: The Care Management Meeting opened with a DSS update on the PCMH program. Staff reported the program remained steady at 124 practices, 553 sites, and 2,548 providers, with some month-to-month fluctuation driven by practice consolidation, retirements, and a few practices leaving the program because NCQA requirements were burdensome. Members asked about declining provider and site counts, member attribution trends, and whether PCMH practices overlap with behavioral health homes; DSS said attribution changes are largely due to members becoming ineligible, moving, or getting other insurance, and that PCMH and behavioral health homes are separate programs that coordinate informally. The committee also discussed why some smaller practices leave the program and whether the requirements could be made easier to support retention. The committee then resumed a detailed presentation on the Husky Dental program. The presenter described the dental benefit’s history, the importance of preventive oral health, workforce and consolidation pressures in dentistry, and the lack of interoperability between dental and medical records. Network data showed year-over-year declines in enrolled dental practitioners and service locations, with access gaps concentrated in rural and eastern parts of the state. Appointment availability surveys showed average waits of 38 days for adults and 23 days for children, but much longer waits at FQHCs than private fee-for-service practices. The presenter said Connecticut remains above the national median on CMS pediatric dental quality measures, though sealant rates remain a concern, and noted that preventive care is associated with lower per-member costs. Members raised concerns about provider participation, large practices dropping Medicaid, mobile dental care, and whether the public directory accurately reflects which dentists are actually accepting new patients. The presenter said the plan uses secret-shopper calls, tracks appointment availability, and has begun using place-of-service coding to better identify school-based dental care. She also noted a new MOU with 20 Head Start programs to share data and provide oral health literacy and navigation support. The final major topic was implementation planning for HR1. DSS said CMS guidance was expected in early June and proposed using upcoming meetings to cover medical frailty, communication strategy, and data integration/ex parte verification. Committee members urged the department to create a dashboard to track disenrollments and other impacts of HR1, to build a process for complaints and problem resolution, and to think through cost-sharing, caregiver verification, exemptions, and notices. Members also asked about using existing eligibility structures such as the working-disabled program as a model. The committee agreed to move the next meeting to June 10 by Zoom, with the agenda to be circulated in advance and any PCMH Plus quality data shared if available.

Transcript Highlights:

• And so I'll explain what their practice is.
• One is to request full scope of practice.
• One is to try to request full scope of practice.
• types are practicing.
• In addition to private practice, chiropractors are increasingly being integrated into medical practices

Transcript Highlights:

• So PAs are educated as practice.
• /c> practiced as an MA in that practice up practiced as an MA in that practice up in<00:16:02.959><c>
• </c> product and he knows she's practic product and he knows she's practic practicing<00:22:18.799><c
• We're practicing standards. We're practicing evidence-based<00:27:33.679><c> medicine.
• </c> who's been practicing for three years. who's been practicing for three years.

Bills: HB31 , HB31

Committee: House Health

Keywords: absentee voting, disabled, blind, voter assistance, voting rights, SNAP, public assistance, nutritional standards, waiver, food regulation

Transcript Highlights:

• And so I'll explain what their practice is.
• types are practicing.
• As a practicing physical therapist, I do believe that the relationship As a practicing physical therapist
• In addition to private practice, chiropractors are increasingly being integrated into medical practices
• Standards of practice and professional conduct.

Summary: The joint Assembly and Senate Business and Professions sunset oversight hearing focused first on the Board of Registered Nursing (BRN), with committee chairs emphasizing oversight, consumer protection, workforce access, and economic mobility. BRN leaders reported improvements since the last review, including faster licensing timelines, streamlined enforcement, higher consumer satisfaction, growth in pre-licensure enrollment, and expanded data collection. Members questioned the board about nurse practitioner scope and supervision, international and military pathways to licensure, online nursing education and clinical requirements, rural workforce shortages, and the 30-unit LVN-to-RN option. BRN staff explained California’s tiered advanced practice system, the NCLEX and certification requirements, English proficiency rules, clinical hour standards, and the board’s role in approving programs and supporting schools through nursing education consultants. Several members and the board president also discussed the need to retain new graduates, improve diversity in the workforce, and better support nontraditional students and rural placements. Public comment on the BRN sunset review was extensive and largely supportive of the board, while also urging policy changes. Nurse practitioner, nurse anesthetist, nurse midwife, and nursing education groups generally supported the BRN report and especially backed clarification of APRN-to-RN delegation authority under issue 13. Other commenters asked for clearer implementation of AB 890, more flexibility for clinical nurse specialists, streamlined renewals for nurse midwives, and changes to federal loan limits affecting graduate nursing education. Higher education representatives and private nursing schools raised concerns about duplicative BRN documentation, clinical placement bottlenecks, and barriers faced by out-of-state and online programs seeking to serve California students. The California Medical Association and some physician groups opposed easing transition-to-practice requirements for out-of-state nurse practitioners and cautioned against changes to specialty and delegation rules, while the California Nurses Association and others stressed the importance of community college pathways, new graduate support, and workforce retention. The hearing then moved to the Physical Therapy Board of California. Board leadership reported that the board oversees more than 41,000 active licensees, has seen about 15% growth since 2021, and continues to maintain high exam pass rates among California physical therapy and physical therapist assistant programs. The board described its mission as consumer protection through licensing, enforcement, continuing competency oversight, and stakeholder engagement. The vice president’s remote testimony encountered technical problems, so the executive officer continued with a brief overview of the board’s work and its commitment to efficient service and public protection. No votes or formal actions were taken in the portion of the meeting provided.

Transcript Highlights:

• And so I'll explain what their practice is.
• One is to try to request full scope of practice.
• types are practicing.
• Actually became part of the Practice Act.
• In addition to private practice, chiropractors are increasingly being integrated into medical practices

Transcript Highlights:

• I've also been a practicing optometrist for 24 years. and a practice owner.
• Minnesota optometrists are forced to practice outdated practices, therefore leaving our citizens at a
• I practice and live in Moorhead, Minnesota, but also practice in Wadena, Minnesota, and my partners in
• It essentially sets out the scope of practice.
• Yes, HF 1913 offers a practical forward This bill offers a practical solution to Minnesota's physician

Committee: House Health Finance and Policy

Transcript Highlights:

• practices.
• practices then we protect our practice practices then we just<01:09:25.560><c> become</c><01:09:25.880
• </c> practices um the these are practices practices um the these are practices that<01:42:18.080><c>
• <c> a</c> practicing these practices without a practicing these practices without a license<02:59:24.040
• practices performed by healing practice practices performed by traditional<03:02:49.960><c> Hawaiian

Summary: The joint House Committee on Health and Committee on Consumer Protection and Commerce heard two midwifery bills, with testimony focused primarily on HB 1194. Committee chairs opened the hearing with rules for Zoom testimony and noted the bills relate to midwives. The Department of Commerce and Consumer Affairs said it supported the intent of HB 1194 and offered comments. Supporters of the bill, including the Midwives Alliance of Hawaii, argued that midwifery should remain subject to mandatory licensure to protect consumer safety, citing the state’s regulatory licensing standards and a 2025 state auditor sunset analysis. They said the bill would strengthen educational standards and public protection, and some offered clarifying amendments. Opponents argued HB 1194 would restrict access to care and fail to protect traditional, cultural, and community-based birth practices. Testifiers from the Hawaii Home Birth Task Force, the Hawaii Home Birth Collective, the Libertarian Party of Hawaii, the Center for Reproductive Rights, Pacific Birth Collective, and Papa Ola Lōkahi said the bill would limit licensure pathways, reduce access in rural and underserved areas, and burden Native Hawaiian and traditional practitioners. Several speakers said the measure could worsen Hawaii’s maternal health shortages, especially on Maui, and urged lawmakers to defer HB 1194 or instead advance HB 1328, which they said better protects practitioner access and cultural practices. The Hawaii affiliate of the American College of Nurse-Midwives said it opposed HB 1194 because it did not align with national or state standards for certified midwives and could create conflicts with Medicaid reimbursement and prescriptive authority. The ACLU also opposed the measure, emphasizing reproductive rights, privacy, and the need to preserve apprenticeship pathways to licensure. No vote or final committee action was taken during the portion of the hearing reflected in the transcript.

Transcript Highlights:

• the scope of practice.
• So your bill is more about who can practice and not what they can practice? Correct. Thank you.
• She doesn't practice anymore, she just, she still keeps her license. She has a practice.
• T&B would have to approve their renewal for another two years of practice. practicing under a provisional
• in our practice group.

Bills: HB713 , HB827 , HB932 , HB499 , HB510 , HB163 , HB296 , HB879 , HB913 , HB163 , HB296

Committee: House Public Health

Keywords: healthcare, maternal health, reporting requirements, Texas Maternal Mortality and Morbidity Review Committee, health provider immunity, workplace violence, nurses, grant program, healthcare facilities, safety measures, safety, nursing, grants, healthcare safety, verbal abuse, physical abuse, nurse empowerment, occupational therapy, licensure, interstate practice

Transcript Highlights:

• Peters is here from the Forest Practices Board.
• None of us sit on Forest Practices, so I think we're trying to understand.
• The rule when it comes to forest practices will go into effect in August.
• The rule when it comes to forest practices will go into effect in August.
• The rule when it comes to forest practices will go into effect in August.

Summary: The House Agriculture and Natural Resources Committee heard public testimony on House Bill 2598, which would create a Salmon Advisory Commission made up of tribal leaders, state agencies, legislators, and local governments to develop recommendations on salmon and steelhead recovery. Prime sponsor Rep. Lekanoff described the bill as a way to bring executive, legislative, and tribal leaders together on salmon recovery and treaty obligations. Staff noted a fiscal note of roughly $35,000 in out years. Supporters emphasized salmon’s cultural and treaty importance and the need for coordinated leadership, while the lone public testifier, Todd Myers of Washington Policy Center, opposed the bill as another statewide layer of bureaucracy and argued that recovery efforts should focus more on local, watershed-level action. The committee noted 10 signed in pro, 886 con, and one other, but no vote was taken on the bill in the hearing. The committee then heard House Bill 2620, which would repeal the recently adopted Forest Practices Board rule expanding riparian buffers on non-fish-bearing streams and impose new standards for future riparian buffer rulemaking, including an economic viability standard for the timber industry and additional consensus and alternative-analysis requirements. Rep. Dent said the bill was intended to restore communication and collaboration in the forest practices process. Testimony was sharply divided. Tribal representatives and environmental advocates said the rule was the product of a long, science-based adaptive management process under the Forest and Fish framework and was needed to protect water quality, salmon habitat, and treaty rights; they argued the bill would undermine that process and conflict with Clean Water Act compliance. Forest industry and small forest landowner witnesses supported the bill, saying the process had lost trust, ignored alternatives, and imposed significant economic harm on rural communities and family tree farms. DNR and Ecology testified in opposition, saying the rule was based on science and that the bill would weaken water-quality protections and jeopardize HCP compliance. The committee recorded 592 signed in pro, 489 con, and one other, with no vote taken during the hearing. After the public hearings, the committee moved into executive session on five bills. Staff briefly described House Bill 2104, which would make permanent the Aviation Assurance Funding Program for wildfire response; House Bill 2348, a DNR request bill on land and material sales advertising; House Bill 2544, which would require an adjudication process for the Upper Columbia River with a proposed substitute; House Bill 2554, which would repeal Initiative 456 concerning state declarations on tribal natural resource management; and House Joint Memorial 4009, urging federal action on wildland firefighting consolidation. The committee then recessed briefly for caucus and began executive action, starting with a motion to report House Bill 2104 out of committee with a do pass recommendation.

Transcript Highlights:

• The practice that they implement on farms, we are all doing the same practices.
• The practice that they implement on farms, we are all doing the same practices.
• The practice that they implement on farms, we are all doing the same practices.
• The practice that they implement on farms, we are all doing the same practices.
• The practice that they implement on farms, we are all doing the same practices.

Transcript Highlights:

• In this illustrative example, in a platform practice of three physicians in one practice, depending on
• of a practice with two physicians, add-on acquisition of practice B of a solo practitioner, and add-on
• ><c> practice</c><00:03:51.599><c> medicine</c><00:03:52.000><c> doctrine,</c> corporate of practice
• </c><00:04:08.959><c> is</c> three physicians in one practice is three physicians in one practice is
• </c> practice C with four physicians. practice C with four physicians.

Transcript Highlights:

• I've also been a practicing optometrist for 24 years and a practice owner.
• I practice and live in Moorhead, Minnesota, but also practice in Wadena, Minnesota.
• or do practice County that have practice or do practice also<00:40:34.560><c> in</c><00:40:34.800><c
• </c> practice are. Thank you. Thank you Dr. practice are. Thank you. Thank you Dr.
• </c> full license to practice in Minnesota. full license to practice in Minnesota.

Committee: House Health Finance and Policy

Transcript Highlights:

• As you can see, the schools we reviewed adopted most of these practices.
• We would like to go through three of the practices in more detail: Practice one, small groups, because
• We would like to go through three of the practices in more detail.
• Practice one, small groups because it's a straightforward example to describe.
• Two of the practices that stand out to me that I've seen firsthand.

Summary: The committee first heard a presentation from the State Auditor’s Office on its current performance audit work plan. The auditor described how topics are selected from a large pool of ideas and coordinated with JLARC to avoid duplication. Four ongoing audits were highlighted: Liquor and Cannabis Board operations, oversight of authorized entities serving students with disabilities, the long-term care provisions of Initiative 1163, and Medicaid managed care versus fee-for-service costs. Other planned topics included housing commission tenant ownership follow-up, DSHS vendor payment growth, implementation of the Since Time Memorial curriculum, and Washington State Ferries operations. Members asked about coordination with JLARC, and the auditor said the office regularly exchanges work plans and monthly updates with JLARC staff. The committee then received the State Auditor’s report on how charter schools identify and support at-risk students. Auditors reviewed four schools—Catalyst Public Schools, Innovation High School, Pinnacles Prep, and Rainier Prep—and focused on English language learners, homeless students, and special education students. The audit found that the schools met nearly all legal requirements reviewed and used many leading practices, including small-group instruction, culturally responsive environments, family engagement, and multi-tiered systems of support. The main recommendations were to improve documentation and written procedures so staff can apply practices more consistently. One area of partial compliance involved language access planning, and MTSS implementation varied across schools. Committee members asked why those four schools were selected, how the sample compared with district and statewide student populations, and whether the audit examined K-2 MTSS requirements. The auditor explained the schools were chosen for student need, geographic diversity, and authorizer representation, and that K-2 MTSS was not evaluated because only one school served those grades. Representatives from the Charter School Commission and charter school advocates responded positively, saying the report reflected strong practices and could help spread effective approaches. Public testimony from the Washington State Charter Schools Association and Excellent Schools Washington also supported the report and urged continued sharing of best practices across schools.

Transcript Highlights:

• Autonomous practice by Representative Shoaf.
• Advanced practice, registered nurses to engage an autonomous practice to provide mental health services
• Do not have a practicing psychiatrist.
• Let me briefly share an example from my practice.
• So they're not practicing outside the scope. They're still they're just not practice it.

Transcript Highlights:

• </c> balanced approach to the data Practices balanced approach to the data Practices Act<00:02:09.200
• </c> central premise of the data Practices central premise of the data Practices Act<00:26:57.919><c>
• The Data Practices Act exists.
• The Data Practices Act exists.
• The Data Practices Act exists.

Transcript Highlights:

• supervised practice they can get in the supervised practice they can get in the workforce<00:05:57.960
• No, there's no scope of practice changes. There's no changes to the practice of physical therapy.
• </c><00:09:04.600><c> is</c> in and their supervised practice is in and their supervised practice is
• </c><00:09:18.120><c> statute</c> so the supervised practice statute so the supervised practice statute
• </c><00:09:28.839><c> and</c> six months of supervised practice and six months of supervised practice

Summary: The Senate Standing Committee on Licensing and Occupations met on March 27, 2025, with a quorum present and first took up House Bill 255, relating to physical therapy. The bill sponsor and representatives of the Kentucky Board of Physical Therapy and APTA Kentucky said the measure is mainly a cleanup and modernization bill that updates outdated statutory language, changes PTAs from “certified” to “licensed,” gives the board authority to purchase liability insurance, moves fee and fine caps into regulation without changing current fees, renames temporary permits as provisional licenses, and creates a pathway to more easily recognize some internationally trained physical therapists already practicing in other states. Senators asked whether the bill changed training, scope of practice, Medicaid, or supervised practice standards; witnesses said it did not, and that supervised practice requirements remain in place with out-of-state practice accepted only when equivalent or more stringent. The committee approved HB 255 with favorable expression. The committee then considered House Bill 618, an alcoholic beverages measure with a Senate committee substitute. The bill was described as having three parts: allowing restaurants to buy limited quantities of alcohol from retail outlets to meet customer demand while keeping the three-tier system intact and requiring quarterly reporting; creating a temporary auctioneer license to auction previously retail-sold alcohol in original packaging, such as estate or bourbon collections; and giving quota bar license holders the same opportunity restaurants already have to sell barrel picks by the bottle. Testimony supported the bill as a way to help restaurants, auctioneers, and bars, while a senator raised a question about sales tax on auction sales and another noted that nonprofit or church-related alcohol auctions already require permits under existing law. One senator suggested future guardrails to encourage local purchasing, but no amendment was adopted. The committee passed HB 618 with favorable expression.

Transcript Highlights:

• </c><00:02:40.920><c> Act</c> uh meaning of the uh data Practices Act uh meaning of the uh data Practices
• ><c> puts</c><00:03:09.400><c> a</c> Act uh the data Practices Act uh puts a Act uh the data Practices
• </c> particular section of the data Practices particular section of the data Practices Act<00:10:45.839
• </c> number of sections in the data Practice number of sections in the data Practice Act<00:14:48.320
• </c> central premise of the data Practices central premise of the data Practices Act<00:27:55.519><c>

Committee: House Judiciary Finance and Civil Law

Transcript Highlights:

• He returned to Danville, where he’s been practicing in private practice ever since.
• He has a wide practice experience. He brings to the table. He has a wide practice experience.
• So I've been practicing— So I've been practicing now for almost 23 years.
• Again, it's not the area I practice in, so we don't practice against each other.
• I could practice here.

Committee: House Courts of Justice