Transcript Highlights:

• Second reading of bills: SB 1014, insurance, gender surgeries; 1016, employees, medical products; 1017

Keywords: 1182, all

Summary: The House opened with prayer, the Pledge of Allegiance, approval of the prior journal, and several recognitions and proclamations, including a doctor of the day introduction, a thank-you to members who supported care packages for deployed troops, a visit from Mom’s Demand Action, and a proclamation honoring the 205th anniversary of Greek Independence Day. The chamber also announced committee substitutions, bill referrals, and the day’s calendar, then moved into Committee of the Whole to consider measures on the calendar. In Committee of the Whole, the House recommended do pass on Senate Bill 1125, which was described as a response to child welfare and tribal communication issues raised after the Emily Pike tragedy; members noted the Department of Child Safety supported the bill. The committee also adopted an agreed floor amendment to Senate Bill 1193 and recommended it do pass as amended; discussion focused on protecting EMTs and paramedics from disclosure of private information sold through vendors. Senate Bill 1448 was also amended and recommended do pass; the bill would add certain utility, telecommunications, and video service workers to aggravated assault protections when they are engaged in work duties, and members debated whether the protection was appropriately limited to on-duty work situations. The House then adopted the Committee of the Whole report and referred the amended bills to engrossing. In open session, Senate Bill 1023 passed 43-10 and Senate Bill 1211 passed 53-0. The House also received announcements about upcoming committee meetings and a personal privilege proclamation designating April 26 to May 2, 2026, as Arizona Water Professionals Week. The chamber adjourned until 1:15 p.m. on Wednesday, March 25, 2026.

Transcript Highlights:

• I recently had surgery and was unable to travel. And so, for each of you, I'm sorry I missed that.

Keywords: 1182, all

Summary: The Senate opened with prayer, the Pledge of Allegiance, attendance, and routine business, including guest introductions and committee announcements. The President Pro Tem also reported several temporary committee substitutions and a referral change for Senate Bill 1267. The chamber then moved through third-reading votes on a consent calendar of bills and one memorial, with several measures relating to mental health services, special license plates, optometrists, private postsecondary education institutions, Department of Revenue matters, attorney general authority, and a technical cleanup bill on conflicting legislative text. On the consent calendar, Senate Bill 1112 failed, while Senate Bills 1153, 1242, 1023, 1097, 1210, 1401, 1430, 1452, and 1613 all passed. Senate Concurrent Memorial 1003, urging Congress to amend the Constitution to allow states to regulate and limit campaign finance, also passed after brief remarks supporting campaign finance reform and criticizing the influence of money in politics. The chamber then received House Concurrent Resolution 2060, a death resolution for former lawmaker and University of Arizona administrator George Cunningham, adopted it unanimously, and observed a moment of silence. After recess, senators and family members offered tributes to Cunningham, highlighting his public service, budget expertise, work at the University of Arizona, role in state government, and co-founding of the Grand Canyon Institute. The Senate also heard a legislative proclamation honoring Reverend Jesse Jackson Sr. Finally, the body announced upcoming committee meetings, noted that some committees would not meet Monday, and adjourned until Monday, February 23, 2026, at 11 a.m.

Transcript Highlights:

• You have a lot of, you know, for instance, I know there are surgeries and sometimes things are ...paid

Summary: The Health Professions and Programs Subcommittee met with a quorum and considered several health-related bills. HB 887, reducing medical marijuana registry card fees to $15 for honorably discharged veterans, drew support from veterans’ advocates and cannabis groups as a way to lower a financial barrier to care; it passed 18-0 and was reported favorably. HB 733, a Department of Health bill covering medical marijuana treatment center setbacks, physician certification renewals, low-THC/cannabis definitions, emergency license suspension for certain murder-related arrests, dental loan repayment area definitions, Early Steps policy cleanup, and autism microcredential eligibility, received mixed testimony from cannabis advocates who objected to some marijuana-related changes and zoning impacts; it also passed 18-0. HB 259, removing the $1,500 cap on pre-treatment funds held in trust by chiropractic physicians, was described as a free-market change supported by chiropractic groups and passed 18-0. The committee also approved PCS for HB 1443, creating a statewide Parkinson’s Disease Registry within the existing Parkinson’s Disease Research Institute and adding appointments to the consortium board, with USF support and no opposition; it passed 18-0. HB 1445, the related public records exemption for the registry, adopted an amendment adding the required public necessity statement and sunset date of October 2, 2031, then passed 18-0. HB 1309, which would standardize and speed patient access to medical records and align nursing home timelines with federal requirements, drew opposition from an information systems group concerned about data mining and portal access, while supporters argued it would improve patient access and care coordination; it passed 17-1 and was reported favorably. The meeting then adjourned.

Transcript Highlights:

• there some kind of benefits outlined that tells them like, for example, they have to have emergency surgery

Keywords: 999, senate, all

Transcript Highlights:

• While I was incarcerated, I underwent surgery. I was handcuffed throughout the entire procedure.
• When someone is medically fragile, recovering from surgery, elderly, or seriously ill, the prison environment
• While I was incarcerated, I underwent surgery. I was handcuffed throughout the entire procedure.
• While I was incarcerated, I underwent surgery. I was handcuffed throughout the entire procedure.
• While I was incarcerated, I underwent surgery. I was handcuffed throughout the entire procedure.

Keywords: 910, house, all

Summary: The House Committee on Judiciary and Hawaiian Affairs heard testimony on two immigration-enforcement bills: HB 1886 HD1 and HB 2540 HD1. HB 1886 would limit state and federal collaboration in immigration enforcement, require visible identification and restrictions on facial coverings for law enforcement officers, and create offenses for improper masking, lack of identification, and unauthorized civil immigration interrogation, arrest, or detention. HB 2540 would also limit state and federal collaboration, require law enforcement agencies to adopt and publicly post written civil immigration enforcement policies, prohibit stops or arrests based solely on immigration status, and restrict state and county participation in civil immigration enforcement in certain places. Most testimony supported both measures. The Office of Hawaiian Affairs, the Office of the Public Defender, the ACLU of Hawaii, the Hawaii Coalition for Immigrant Rights, the Legal Clinic, and several private individuals said the bills would increase transparency, accountability, and community trust, and would help protect constitutional rights and reduce fear among immigrants and other community members. Several testifiers emphasized Hawaii’s history and the need to keep local law enforcement separate from federal immigration enforcement, while others said the bills would help people feel safer going to court, school, work, or public protests. A retired police officer also supported visible identification and uniform standards for officers, including federal agents operating in Hawaii. A few testifiers opposed the use of masked or unidentified officers and argued that local police should not be diverted from ordinary public safety duties to immigration enforcement. One ACLU witness noted that the federal government has increasingly used local and state agencies to expand immigration enforcement, and said the task-force provisions in the bills are important to prevent blurred lines between agencies. The committee did not take a final vote in the portion of the meeting provided, but it recorded very large numbers of supportive testimonies for both bills, with only a small number in opposition.

Transcript Highlights:

• significant medical event within one month of being discharged that required extended hospital stays and surgery
• She has had some big-time health issues and many surgeries, including spending months in a full body
• What happens if she injures her back, gets sick, or needs emergency surgery?

Keywords: 995, all

Summary: The special legislative commission on the future of Pappas Rehabilitation Hospital for Children held a hybrid public hearing focused on the hospital’s future, admissions, staffing, infrastructure, and whether the facility should be preserved, expanded, or reimagined. Opening remarks from legislators, commissioners, parents, and union representatives emphasized that Pappas provides a unique combination of medical, rehabilitative, educational, and residential services for children with complex needs, and several speakers argued that the hospital is effectively being depopulated through reduced admissions and ongoing discharges despite public assurances that it remains open. Multiple speakers urged the commission to extend its authorization and continue its work before any closure or major change can occur. Testimony from labor leaders, including AFSCME, SEIU Local 509, and the Massachusetts Nurses Association, described a “silent closure” in practice, with staff reporting confusion about the hospital’s status, declining census numbers, blocked admissions, and uncertainty about the workforce’s future. They called for immediate action to stop admission denials and unnecessary discharges, and some proposed short-term solutions such as temporary modular structures to address infrastructure barriers and allow admissions to resume. Parents and former patients testified that Pappas provided life-changing independence, specialized therapy, and campus-based supports that they said could not be replicated elsewhere, and they criticized alternative placements as inadequate. Commissioner Robert Goldstein of the Department of Public Health said the administration supports keeping Pappas open and funded while the commission works, but he argued that admissions must comply with hospital-level-of-care rules and that the campus’s deteriorating infrastructure limits the kinds of children who can safely be served there. He said the department is continuing admissions for appropriate patients, working to expand outreach and services, and exploring long-term options, including broader statewide models of care. Commissioners pressed him on whether discharge status or lack of a clear discharge plan had been used as a barrier to admission, and requested de-identified data on patients recommended for admission but denied. No formal votes were taken during the hearing.

Transcript Highlights:

• hypothetically, had that perfect childhood, had DCS become involved in my family when my father had open-heart surgery
• And say that my mother, when she had surgery very recently, my brothers and I had been separated a long
• When she had surgery very recently, my brothers and I had been separated a long time ago, society would

Keywords: 1182, all

Summary: The committee met for a presentation-only hearing on the Arizona Department of Child Safety, with no bills on the agenda. Chair Blackman opened by emphasizing that the hearing was intended to be data-focused and respectful, and that personal attacks or false accusations would not be tolerated. Director Catherine Patak then presented DCS data on hotline volume, investigations, reunifications, adoptions, guardianships, foster care entries and exits, kinship placement, congregate care, missing youth, and extended foster care. She said the department investigated more than 43,000 cases in 2025, kept the out-of-home care population relatively steady, and had reunified about 3,000 children with parents, while also noting that older youth and behavioral-health-driven removals are creating a mismatch with available foster homes. She also described kinship supports, foster parent recruitment, and the impact of Family First on funding, saying DCS lost federal drawdown for congregate care while waiting on approval for prevention programs. Members questioned the director about kinship caregivers, behavioral health access, reunification services, parental rights terminations, notice and documentation practices, and the effect of increased reimbursement rates. Patak said unlicensed kin can receive support through the kinship supports contract, that behavioral health assessments are done quickly at the welcome center or within 24 hours for kin placements, and that provider capacity remains a major constraint outside DCS control. She explained reunification conditions and services, said the department is working on documentation and notice issues flagged by the Auditor General, and noted that kinship reimbursement increases have helped some families step forward. She also said DCS procurement for group homes is handled internally through an RFP process and that about 10% of kinship caregivers become licensed. Representative Gillette then delivered a lengthy presentation arguing that the child welfare, Medicaid, and disability systems are structurally intertwined and that procurement and funding rules create incentives for volume and congregate care use. He criticized DCS, DES, and AHCCCS/Access oversight structures, argued that the system diffuses accountability, and said the committee’s work and related materials would be referred to special counsel. He also raised concerns about documentation, placement decisions, and the cost of congregate care, while asserting that the system over-relies on large providers and that reforms should focus on structural and financial incentives. Vice Chair Fink followed with a brief slide noting that congregate care costs far more per child than foster or kinship care, reinforcing the committee’s concern about placement costs and the need to shift children toward family-based care when possible.

Transcript Highlights:

• designates the Executive Director of the Arizona Board of Osteopathic Examiners and Medicine and Surgery
• One recent case involved a young woman who was incorrectly told she needed proactive surgery to remove
• During the workup for my surgery, I underwent a breast MRI and was discovered to have an early but aggressive

Keywords: 1182, all

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:

• Kelly is home recovering from surgery and couldn't be here, but I want to bring her voice to you.
• Kelly is home recovering from surgery and couldn't be here, but I want to bring her voice to you.
• Kelly is home recovering from surgery and couldn't be here, but I want to bring her voice to you.

Keywords: 00:00:06 - Call to Order/Roll Call 00:01:23 - Review of Referred Administrative Regulations 00:02:00 - Discussion of 26RS HB 485 01:00:40 - Roll Call Vote on 26RS HB 485 01:03:25 - Adjournment, 958, all

Summary: The House Standing Committee on Health Services met with a quorum and took up House Bill 485, a major mental health measure addressing both KRS 202C and KRS 202A. The committee first adopted a committee substitute and then approved a committee amendment correcting misspellings in the bill. Members and witnesses described the bill as the product of years of work with judges, prosecutors, defense attorneys, mental health professionals, advocates, and the Kentucky Judicial Commission on Mental Health. Testimony on the 202C portion focused on individuals charged with serious violent offenses who are found incompetent to stand trial. Witnesses, including a circuit judge and a family member whose mother was killed by her mentally ill brother, argued that current timelines require repeated evidentiary hearings and impose unnecessary trauma on victims’ families and strain on courts and KCPC. Supporters said the bill would lengthen review intervals, clarify the role and payment of guardians ad litem, and reduce repeated relitigation while preserving due process and public safety. They noted that 202C cases are few in number but consume a significant share of KCPC bed space. The committee then turned to the 202A portion, which covers civil mental health commitments for people who may not have committed a crime. Supporters said current law leaves courts with only two choices—hospitalization or release—and that the bill would create a third option by allowing court-ordered outpatient treatment and other guardrails such as medication compliance and follow-up care. Witnesses emphasized that the bill defines terms such as “benefit” and “serious mental illness,” expands the definition of danger, and aims to provide a least restrictive alternative to inpatient hospitalization. No final vote on the bill itself was taken during the portion of the meeting provided, but the substitute and amendment were adopted and testimony continued in support of the measure.

Transcript Highlights:

• He's had three brain surgeries since 2009, and he had a serious... spinal fluid leak again, and so he
• now has to have a fourth brain surgery.
• It took over three months to get into a neurosurgeon and a specialist to schedule the surgery, which

Transcript Highlights:

• I had surgery and thought I was okay, and a year later it metastasized to my brain and my liver.
• I had some more surgery and ended up doing chemo and radiation in my brain. I am really lucky.
• the way that my treatment was delivered, and by 2015 that cancer was completely eradicated with no surgery

Transcript Highlights:

• And I’m also a patient; when I was a child, I had many surgeries at Children’s.

Keywords: 995, all

Summary: The Massachusetts Commission on the Status of Persons with Disabilities subcommittee on Disability Employment approved the prior meeting minutes, welcomed new commission member Victoria Gill, and heard an opening quote on leadership before moving to presentations and planning. The main presentation was from Kristen Grip and Katie McCarthy of Boston Children’s Hospital’s Disability Alliance employee-led group, which described its mission to build an inclusive workplace through education, community-building, and advocacy. They discussed monthly disability-awareness programming, intersectional events, accommodation and accessibility efforts, internal ableism, universal design, and BCH’s recognition in the 2025 Disability Equality Index. They also described their own lived experience and emphasized that employees with disabilities should lead disability-related workplace efforts. Committee members asked how to start a disability employee resource group and what external partnerships might help. The presenters said BCH’s HR diversity team helped launch the group over about a year, and members noted related resources, including a Work Without Limits guide and possible connections with Spalding Rehabilitation and other hospitals. The committee also discussed BCH’s continued support for disability inclusion work despite broader political pressure, and members praised the hospital’s efforts and offered to share additional contacts and resources. The subcommittee then turned to possible collaboration with SEED, the State Exchange on Employment and Disability, on Massachusetts as a model employer and benefit cliff analysis work. Members agreed SEED could help with policy framing, comparative data, stakeholder education, and youth disability employment efforts, and they approved inviting SEED to brief the subcommittee in January or February. The group also discussed possible links to CAPE-Youth, Commonwealth HR and DEI offices, and a future partnership with the Office of the Veterans Advocate. The meeting ended with a motion to adjourn, which was seconded and approved.

Transcript Highlights:

• She's worked at the bedside in surgery.

Bills: HJR1032, SB1314, SB1257, SB1326, SB1365, SB1932, SB169, SB1991, SB1992, SB1204, SB1339, SB182, SB1847, SB1360, SB1346

Keywords: HJR1032, House Joint Resolution 1032, Service Oklahoma, administrative rules, rule repeal, joint resolution, Oklahoma Administrative Code, OAC 670:15-1-10, OAC 670:15-1-14, agency regulation, legislative oversight, Secretary of State, Oklahoma Register, rulemaking, permanent rules, administrative code, groundwater, indemnity fund, well drilling, pollution prevention

Transcript Highlights:

• If something was caught sooner, I'd— I would not have been forced to have surgery in March.

Bills: HB123, HB5606, HB549, HB2757, HB4359, HB5381, HB1939, HB123

Keywords: HB 123, kindergarten readiness, early literacy, early numeracy, reading screening, math screening, foundational literacy, foundational numeracy, dyslexia screening, reading intervention, math intervention, teacher academy, literacy academy, mathematics academy, interventionist academy, K-3 assessments, school readiness, prekindergarten, tutoring grant, parent-directed tutoring

Transcript Highlights:

• NEC is a life-threatening disease where bacteria attacks the intestines, often requiring surgery.

Bills: SB2959, HB3096, HCR29, HCR56, HCR12, HCR55, HCR74, HCR78, HCR116, HCR117, HCR6, HCR50, HCR107, HCR80, HCR58, HCR70, HCR71, HCR72, HCR75, HCR93, HCR12, HCR6

Keywords: firearm safety, awareness month, public safety, responsible ownership, storage, recreational use, profound autism, awareness day, caregiver, disabilities, support, counseling, mental health, awareness, support services, community health, necrotizing enterocolitis, premature infants, breastfeeding, health awareness

Transcript Highlights:

• Um and I'll just for some of our subspecialties, trauma surgery, neurosurgery, interventional radiology
• subspecialties, for some of our subspecialties, for some of our subspecialties, trauma<01:04:08.040> surgery
• ,<01:04:08.480> neurosurgery, trauma surgery, neurosurgery, trauma surgery, neurosurgery,

Transcript Highlights:

• Wayne Wasloski, Assistant Commissioner for the Department of Administration, and I had rotator cuff surgery
• 00:03:16.120> cuff Administration and had rotator cuff Administration and had rotator cuff surgery
• 17.360> is<00:03:17.640> I'm<00:03:17.800> right-handed,<00:03:18.280> so surgery
• Uh this is I'm right-handed, so surgery.

Keywords: 1187, senate, all

Transcript Highlights:

• Physical therapy helps restore movement and function over illness or injury and avoid unnecessary surgeries
• and function over illness or injury and avoid<00:03:36.000> unnecessary<00:03:36.720> surgeries
• , avoid unnecessary surgeries, avoid unnecessary surgeries, which<00:03:38.520> reduces<00

Keywords: 926, house, all

Summary: The House began with routine business, including referral of Senate Bill 211 on motor vehicle inspections to the Transportation Committee and Senate Bill 298 creating the Vermont Voting Rights Act to the Committee on Government Operations and Military Affairs. The chamber also referred House bills reported by Ways and Means to Appropriations, including H. 211 on data brokers and personal information and H. 931 on miscellaneous education law changes. JRH9, a joint resolution urging the American Speech-Language-Hearing Association to reconsider its opposition to rapid prompting method communication instruction for students with apraxia of speech or autism, was read and referred to Human Services. Several announcements followed, including a welcome to members of the Vermont chapter of the American Physical Therapy Association, a reminder about an education reform meeting, and a correction regarding a prior reference to S. 138 of 2023 and the working group on student protections from harassment and discrimination in schools. The House also recognized guests in the gallery, including Donnie Kanovsky, who was described as a proponent of JRH9. The Speaker announced that H. 606 on firearms procedures, H. 642 on youthful offender proceedings, and later H. 585 would be bumped to later in the calendar. The House then took up H. 537, the right to grow vegetable gardens. The committee explained the bill would protect vegetable gardening in common interest communities and rental housing, while allowing reasonable restrictions and landlord or association oversight; witnesses included a South Burlington resident, HOA and landlord representatives, and legislative counsel. The committee reported an 8-0-0 vote, the House adopted the committee amendment, and ordered third reading. The chamber then passed H. 171 on Attorney General investigations into a law enforcement officer’s use of a firearm and H. 519 allowing Randolph police officers to enroll in Group C of the state retirement system. The House also passed H. 536 on toxic heavy metals in baby food products after extended debate over whether infant formula should be included. Supporters said the bill would help parents make informed choices and noted the amendment was intended to align with federal action; opponents argued formula-specific federal work was still underway and urged waiting. The chamber then passed H. 550 on gender equity in correctional facilities, H. 733 on franchise agreements, H. 775 on housing production tools, H. 887 on crime victim status under the Fair Employment Practices Act, H. 917 on military affairs, and H. 921 on alcoholic beverages. Action on H. 930 addressing chronic absenteeism was postponed one legislative day, and H. 942 on miscellaneous agricultural subjects began second reading with the committee outlining sections on water quality training, non-sewage waste management, and unit pricing.

Transcript Highlights:

• He said sterilization programs must be able to return community cats to their territory after surgery
• the be able to return community cats to the territory<00:27:36.080> after<00:27:36.440> surgery
• to<00:27:37.480> scale<00:27:37.880> to<00:27:38.000> the territory after surgery
• to scale to the territory after surgery to scale to the level<00:27:38.360> needed<00:27:38.720

Bills: HB1736, HB1620, HB1695

Keywords: animal control, spay and neuter, pet overpopulation, sterilization, counties funding, tax designation, veterinary care, electric vehicles, charging infrastructure, energy policy, rebate program, environmental impact, renewable fuels, sustainable aviation fuel, tax credit, greenhouse gas emissions, local production, energy resilience, agricultural innovation, job creation

Summary: The committee heard testimony on HB 1737, which clarifies allowable uses in agricultural districts for farm dwellings and farm employee housing, and HB 1604 HD2, which creates an agricultural workforce housing working group within the Department of Agriculture and Biosecurity. Testimony on HB 1737 was overwhelmingly supportive, with county agriculture officials, the Hawaii Farm Bureau, and Hawaii Farmers Union backing the measure; one witness asked for a definition of “affordable” to guard against misuse of farm housing. For HB 1604, the Department of Agriculture, Hawaii Farm Bureau, Housing Hawaii’s Future, Hawaii Farmers Union, and the Office of Hawaiian Affairs supported the bill, with OHA requesting disaggregated data and a seat on the working group. Committee discussion focused on housing shortages, possible misuse, affordability, and whether innovative housing models such as modular, tiny, and container homes should be considered. The committee then took action on both measures. HB 1737 HD3 was recommended to pass with amendments that would limit farm employee housing to agricultural employees and their immediate family members actively engaged in the farm operation, add a grandfathering provision for existing permitted housing, preserve county zoning authority, clarify that ag tourism must be secondary and not occur in employee housing, delete a square-footage-per-acre ratio, and defer the effective date to July 1, 2050. HB 1604 HD2 was also recommended to pass with amendments adding OHA and a housing-shortage organization to the working group, expanding its scope to include modular, tiny, and container homes and permitting/zoning streamlining, and deferring the effective date to July 1, 2050. Both motions were adopted unanimously by the members present. The joint hearing then moved to HB 1736, which would establish a spay and neuter special fund and require sterilization and declaration provisions for cats, with some discussion of dogs. DLNR and the Hawaiian Humane Society supported the bill, while Pacific Pet Alliance objected to the broader requirements and the inclusion of dogs; the Hawaiian Humane Society and American Bird Conservancy supported cat-focused sterilization and the special fund, while some testifiers opposed mandatory sterilization as too costly or intrusive. Members raised questions about toxoplasmosis, trap-neuter-release, enforcement, neighbor-island access, and funding needs, and DLNR indicated additional funding and third-party contracting would likely be needed. The transcript then began HB 1620 HD2 on energy, which would increase the environmental response energy and food security tax and shift funds from the hydrogen fueling subaccount to EV charging infrastructure; state agencies generally stood on written testimony in support, while the Tax Foundation objected to special fund earmarks and noted the bill raises only one part of the barrel tax structure.

Transcript Highlights:

• They increase the patient's likelihood of joint deterioration and future joint replacement surgery, a
• Then finally, surgery, the path that inevitably ends with high-cost, highly invasive surgeries that could
• something like physical therapy is associated with a total medical cost 75% lower than starting with surgery

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well. Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk. Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.