Transcript Highlights:

• </c><00:44:23.600><c> in</c> to be taken for the for the patients in to be taken for the for the patients
• </c><01:09:07.040><c> not</c> and, you know, some of the patients not and, you know, some of the patients
• Um, and the patients are Medicaid-eligible patients, and there's a capitated rate.
• But for someone that uses it, patients for the utilization for that patient is high. Yeah.
• ,</c><01:42:16.440><c> accommodations</c> offer rides for patients, accommodations offer rides for patients

Summary: The Medicaid Oversight Advisory Board first approved the September 24 minutes and then heard a presentation from four certified community behavioral health clinic providers: Pathways, NorthKey, Seven Counties Services, and NewVista. The presenters explained the difference between traditional community mental health centers and CCBHCs, describing CCBHCs as an enhanced model that integrates behavioral health, primary care, wraparound services, and crisis response. They reviewed the federal history of the model, Kentucky’s entry into the Medicaid demonstration in 2022, and the scheduled end of the enhanced federal match on December 31, 2027. They also emphasized required services such as 24-hour mobile crisis, care coordination, and services for veterans, and described care coordination as a key feature that helps patients follow up after hospital or emergency discharge, manage medications, and connect to transportation and other supports. The presenters gave examples of improved outcomes, including a patient who was able to remain living independently because of coordinated home-based and telehealth support, and they argued that CCBHCs are helping Kentucky build a more responsive crisis system through 988, mobile crisis teams, and crisis stabilization units. They said the model is data-driven, uses performance metrics, and has led to stronger collaboration among community partners. One speaker said more than 100 agencies participated in a Jefferson County community health needs assessment and continued meeting afterward to reduce redundancies and barriers to care. They also said crisis call hub compliance and mobile crisis outreach compliance improved significantly over the past year. Members asked about how navigators and connectors fit into the model, how CCBHCs work with managed care organizations, and how the program could expand statewide. The presenters said navigators are not built into the CCBHC model but may be used through referrals, while the CCBHCs continue to bill MCOs the same way and receive a Medicaid wrap payment for the enhanced rate. They said the goal would be for all community mental health centers to become CCBHCs, but that a state plan amendment would be needed and could not be limited only to CMHCs if submitted to CMS. They estimated about $28 million would be needed statewide to continue the program in the next biennium, combining the loss of enhanced federal match and the state share of enhanced service costs. The board also discussed transportation, with one presenter explaining that their program arranges Medicaid transportation for eligible appointments, and members raised concerns about mental inquest warrant transport and whether sheriffs should remain involved. No votes were taken on the CCBHC or transportation items during the discussion.

Transcript Highlights:

• This is a hindrance to patient care slots because you can only treat one thing, and so patients have
• care... providers, we can only see a patient for providers, we can only see a patient for one<00:14:
• It requires multiple patient care thing. It requires multiple patient care slots. slots. slots.
• </c> we don't have enough patient care slots. we don't have enough patient care slots.
• </c><00:16:06.639><c> care</c> This is a hindrance to patient care This is a hindrance to patient care

Summary: The Medicaid Oversight Board met on March 9 with a quorum present and no minutes to approve. The chair reordered the agenda to hear House Bill 689 first. Representative Amy Neighbors presented HB 689, which would authorize Kentucky to seek CMS approval for a Medicaid state-directed payment program for physician and non-physician professional services delivered through qualifying hospital-affiliated groups, beginning January 1, 2026, with retroactive payments for that year. She said the bill is intended to improve access to care in rural and underserved areas, support workforce retention, and generate about $29 million annually in federal Medicaid funds without using general fund dollars. Representatives from Owensboro Health and St. Elizabeth Healthcare testified in support, describing staffing and subsidy pressures, lower Medicaid and Medicare reimbursement, and the importance of the program for maintaining access and quality in rural and safety-net settings. Committee members noted the bill had already passed the House Health Services Committee unanimously and discussed broader concerns about Kentucky’s low reimbursement rates and the need to consider other systems not covered by the proposal. The board then heard Senate Bill 2011 from Senator Donald Douglas and Cody Hunt of the Kentucky Medical Association. The bill would address a Medicaid coding issue by ensuring that coverage limits do not reduce payment to fewer than two evaluation and management service units per provider, per patient, per day. Douglas argued the current one-visit, one-issue limitation forces multiple visits, increases no-shows, and prevents providers from treating the whole patient. Hunt explained that the bill is meant to correct a longstanding regulation that limited E&M services to one per physician per recipient per date of service, which can prevent providers from coding additional medically necessary work during the same visit. He said DMS has already filed a regulatory amendment to fix the problem, but a statutory change is still needed to prevent the issue from returning. He also said the bill is not intended to change reimbursement policy, only coding rules, and that MCO payment practices vary. Members generally supported the concept. Senator Berg asked about fiscal impact and private-payer billing; Hunt said there should be no fiscal impact because the bill does not change payment policy, only coding. Representative Moore said the proposal could reduce costs and improve convenience by avoiding extra visits. Chairman Meredith said the bill illustrated problems with fee-for-service care and supported moving toward a more holistic delivery model. Dr. Schuster raised a drafting concern about the bill summary language, and Hunt responded that the regulatory amendment should address the issue generally for providers. No votes were taken on either bill during this portion of the meeting.

Transcript Highlights:

• We certainly prefer that.
• I was waiting my turn patiently. Oh, no, go ahead. Please. Thank you, Madam Chair.
• All right, then Spencer Camps, patiently over there, holding down the chair so it doesn't run away.
• There are several Passers agents that have been very patient in waiting in the audience.
• There are several passers agents that have been very patient in waiting in the audience.

Summary: The committee first considered the reappointment of Troy L. Campbell to the Arizona State Liquor Board. Campbell described his nearly 10 years of service, his role as chair since 2019, and his focus on fairness, public safety, and applying the law consistently. He answered questions about the board’s workload and authority, noting it hears roughly 40 to 50 cases a year and does not issue fines. With no public testimony, the committee voted 6-0 to recommend his confirmation to the full Senate. The committee then heard several liquor and consumer-related bills. SB 1478, an annual liquor-policy cleanup bill, made technical changes to liquor statutes, including conforming the definition of cider to federal tax law and clarifying other terminology. The bill drew support from industry stakeholders and neutral testimony from the Department of Liquor Licenses and Control; the committee adopted a clarifying amendment and recommended the bill do pass as amended. SB 1108 would require Swedish rounding of cash transactions when pennies are unavailable, with signage and enforcement provisions; an amendment removed an individual-item exemption and clarified tax calculations, and the bill passed as amended with support from business groups. SB 1205 would regulate private-property vehicle booting by setting signage, notice, fee, and recordkeeping requirements and making violations a misdemeanor; members raised concerns about appeals and signage on non-parking property, but the committee adopted a technical amendment and recommended the bill do pass as amended. The committee also took up SB 1241, which would allow private permitting providers to conduct plan reviews and inspections for single-trade residential projects without municipal or county approval. Supporters argued it would reduce delays and costs for homeowners and help cities focus on higher-priority work, while cities and counties opposed the bill on public-safety and local-control grounds, warning about private incentives and inspection quality. After adopting an amendment granting immunity to municipalities that rely on private providers, the committee recommended the bill do pass as amended by a 5-2 vote, with some members explaining their votes and asking for further stakeholder work. Finally, the committee heard SB 1366, which creates a Public Property Towing and Impound Practices Study Committee to review towing fees, standards, insurance, background checks, and related DPS policies, and to report recommendations by the end of 2026. Supporters said the study would help address inconsistent standards and consumer concerns before permanent changes are made. Some members objected that the study committee did not include minority-party appointments, but the sponsor said that could be addressed later. The committee adopted a strike-everything amendment and recommended the bill do pass as amended. The committee then began SB 1431, a housing-design bill limiting municipal design standards and restrictions on certain shared features, but the transcript cuts off during extended debate and no final action on that bill is shown.

Transcript Highlights:

• This would expand this, confusing patients and confusing that doctor-patient relationship.
• The compact is vital for cross-state practice, patient access, and workforce mobility.
• It increases patient access. It reduces regulatory burden, and it increases commerce.
• So that, again, is going to reduce patient access. In the end, ...have a license.
• So that, again, is going to reduce patient access.

Committee: Joint Business and Labor Interim Committee

Transcript Highlights:

• A patient must be seen and treated as a whole person.
• We see patients on our mobile unit.
• Patients have every say in the world when they go to...
• Where possible, I prefer free market solutions.
• Only 18% of our dentists serve the Medicaid patient.

Summary: The Health Professions and Programs Subcommittee heard and advanced three bills. HB 21 would create a new licensed profession of dental therapy under the Department of Health and Board of Dentistry, allowing trained dental therapists to provide a limited scope of care under a supervising Florida-licensed dentist through a collaborative management agreement. Sponsor Rep. Cheney argued the bill would help address severe dental shortages and improve access in underserved areas; opponents from the Florida Dental Association and oral surgery groups warned that the bill would allow irreversible procedures by less-educated providers and could compromise patient safety. Supporters, including dentists, hygienists, and community health center leaders, said dental therapists would expand access and free dentists to handle more complex care. An amendment was adopted to require proof of local anesthesia training, adverse-incident reporting, and updated background screening language. The bill was reported favorably as amended by a 14-1 vote. The committee then considered HB 27, which creates the Social Work Licensure Interstate Compact to allow licensed social workers to practice across member states, including through telehealth, and to help military families and address workforce shortages. Supporters from the National Association of Social Workers and other advocates said the compact would improve mobility, reduce administrative burdens, and expand access to mental health services, especially in underserved and rural areas. A technical amendment restoring model language and setting an effective date of July 1, 2025 was adopted, and the bill was reported favorably as amended on a 15-0 vote. Finally, the committee heard HB 29, the public-records companion to the social work compact, which creates exemptions needed for compact compliance and allows the compact commission or its committees to meet in closed session when discussing information exempt under law. After a technical amendment authorizing closed meetings for exempt matters was adopted, the bill was reported favorably as amended on a 15-0 vote. The meeting then adjourned.

Transcript Highlights:

• Prior authorization of medications takes time, costs money, aggravates the doctor, and delays patient
• And I also just want to speak to the piece about the cancer patients.
• And I also just want to speak to the piece about the cancer patients.
• You know, we heard our... ...want to speak to the piece about the cancer patients.
• I mean, I guess the way the bill is worded is you can't give a preference for that.

Bills: S0006 , S0026 , S0206 , S0532 , S0576 , S1012 , S1110 , S1178 , S1192 , S1758 , S1760 , S7046 , S7048

Committee: Senate Appropriations

Summary: The Appropriations Committee met and considered a large agenda of bills, reporting several measures favorably. Early action included SB 6, a settled claim bill involving the Department of Children and Families and the estate of Leila Estrada and Sapphire Williams, which was approved for $3.8 million. The committee also passed a cybersecurity internships bill creating a Department of Commerce program with Cyber Florida, and SB 532, which lets clerks of court retain the full amount of certain excess revenue and clarifies foreclosure-sale procedures. Veterans housing measures, CS for CS for SB 1602 and SB 1604, were approved to create a pilot program and a related trust fund for vacancy relief and risk mitigation for veteran housing. The committee also favorably reported SB 1110 on Medicaid and insurance coverage for orthotics and prosthetics, with emotional testimony from a student and family describing the high cost and importance of activity-specific prosthetics. Members also approved CS for CS for SB 1012 after adopting an amendment that removed inmate emergency and specialty medical service compensation provisions while retaining changes to the contractor-operated institutions inmate welfare trust fund. Another bill, CS for CS for SB 1614, was narrowed by a delete-all amendment to focus on limiting the use of excess fees for new building construction by local governments. All of these measures were reported favorably after brief debate, with some support testimony submitted in writing or waived. The most extensive discussion centered on CS for CS for SB 17, a major Medicaid and public assistance overhaul. The bill would create a Joint Legislative Committee on Medicaid Oversight, allow the Legislature to retain its own actuary, tighten Medicaid program oversight, update encounter-data reporting, set performance standards for managed care plans, revise pharmacy benefit manager rules, and require DCF to implement SNAP fraud-reduction and payment-accuracy reforms, including photo IDs on EBT cards and updated work requirements. It also would direct agencies to seek federal waivers for Medicaid work requirements for able-bodied adults and expanded behavioral health services. After lengthy questioning and testimony, the committee adopted amendments adding a transitional medical benefits glide path for people who gain employment and later lose Medicaid eligibility, and exempting hospice patients with six months or less to live. Supporters argued the bill would improve accountability, reduce fraud, and save money, while opponents warned it would create administrative burdens, increase paperwork, and cause eligible people to lose coverage or food assistance. The committee ultimately reported the bill favorably as amended.

Transcript Highlights:

• On average, private equity acquisitions have led to a 25% increase in patient adverse events, such as
• Despite the risk and harms caused to patients, Allina, which is the facility that I work at, deployed
• </c> leading to higher cost, loss of patient leading to higher cost, loss of patient access,<00:33:03.760
• because of patient care, not because<00:43:15.680><c> of</c><00:43:15.839><c> profits.
• and what this means for patients and the patient outcomes that this is bringing, and it's not what we

Committee: Senate Health and Human Services

Transcript Highlights:

• Our friends and families are caregivers as well as patients at that hospital.
• It is a public health concern with direct measurable consequences for patient safety.
• ratios, nurses experience burnout. ...mortality, and in hospitals with high patient-to-nurse ratios,
• nurses experience burnout and dissatisfaction, while patients experience higher mortality and failure-to-rescue
• It helps patients return more quickly to their daily lives.

Bills: HB359 , HB385 , HB165

Committee: Senate Health & Social Services

Summary: The Senate Health and Social Services Committee met with a quorum, approved the minutes from the prior two meetings, and briefly acknowledged the tragedy at Christiana Care before moving to legislation. The committee heard House Bill 385, which creates a statewide nurse preceptor grant program to expand clinical training placements for nursing students; testimony from nursing organizations, health care associations, and educators emphasized workforce shortages, the need for preceptor stipends and training, and the bill’s potential to help students complete programs and remain in Delaware. Members asked about eligibility and reporting, and several senators asked to be added as co-sponsors. Public comment was uniformly supportive, and the bill was advanced out of committee. The committee then considered House Bill 424, which repeals Delaware’s Autism Surveillance and Registration Program and requires DHSS to expunge protected health information collected through the registry. The sponsor and DHSS said the registry is no longer used for research or policy development and that repeal would reduce outdated reporting burdens; Autism Delaware, the Delaware Health Care Association, and the State Council for Persons with Disabilities support the change. A committee member raised the question of whether families would be notified before records are expunged, and DHSS said that process was not yet clear and would need further verification. Members discussed the issue, and the bill also moved forward. House Bill 419 was next, making children in foster care automatically eligible for the Purchase of Care child care subsidy and extending the same treatment to certain kinship and safety-plan placements through House Amendment 1. The Children’s Department and advocacy groups said the bill would provide immediate stability for children and caregivers, reduce delays from applications and income verification, and support working foster and kinship families. The committee also heard House Bill 359, which would allow cremation as an option for unclaimed and indigent remains when there is no family objection or next of kin cannot be found, addressing a shortage of burial plots and lowering costs; funeral industry testimony focused on preserving next-of-kin rights. Finally, the committee heard House Bill 475, creating a Delaware Nursing Advancement Fund financed by a $10 surcharge on nursing licenses and disciplinary fines to support workforce data collection and analysis through a nonprofit partner, and House Bill 165, authorizing physician associates, occupational therapists, and APRNs to perform dry needling under training and practice standards set by the Board of Medical Licensure and Discipline. All of the bills received supportive testimony, several members added their names as co-sponsors, and the committee adjourned after moving through the agenda.

Transcript Highlights:

• </c> patient visits. patient visits.
• </c> 268,000 unique patients. 268,000 unique patients.
• </c><00:12:44.480><c> is</c> The capacity to serve these patients is The capacity to serve these patients
• that are having their patients are that are having their patients are coming<00:19:48.160><c> from</c
• &gt;&gt; Uh I I prefer just to answer questions.

Summary: The committee first handled routine business, including a quorum call, approval of minutes, and informational items on school district financing and KCTCS equipment purchases. It then considered two KCTCS capital projects after initially rolling them together and later unrolling them: a Fire Commission Fire Academy maintenance building project that had grown from an original $2 million authorization to $4.7 million because of design changes, soil issues, and higher mechanical costs, and a $1.5 million renovation of the Blake Lee building at Somerset Community College for a health science simulation lab. Members questioned the large cost increase on the fire academy project and the adequacy of front-end due diligence, while KCTCS said the project was bid and ready to proceed and that a 15% contingency had been included. Both projects were approved by roll call vote, with the Blake Lee project ultimately approved after the committee unrolled the items and took them separately. The committee next heard and approved a University of Kentucky public-private partnership for the Hamburg East Medical Office Building, a five-story, 220,000-square-foot facility with a not-to-exceed budget of $275 million. UK said the project is intended to expand outpatient access, consolidate some services, and support projected growth in patient volume; the building will house multiple specialties, urgent care, therapy, imaging, and a retail pharmacy. Members asked about possible community uses, consolidation of services, and whether the project would free up other space, and UK said it hopes to consolidate some services and free campus space. The project was approved by roll call vote. The committee then approved three UK lease renegotiations: a specialty pharmacy and infusion services lease at Wellington Way in Lexington, a Department of Ophthalmology and Visual Sciences lease at Conte Terrace, and a College of Social Work lease at McGrath Park Way. Members asked about rising lease rates, occupancy, and whether space needs should be reduced; UK and the lessor’s representative said the pharmacy space remains busy, the ophthalmology lease was lower than before, and the social work lease had been negotiated down from a higher request. The committee also approved a Department of Military Affairs project amendment for a Mutual Field Maintenance Shop Restoration project, increasing federal funding by $1 million to $4.5 million because of higher construction costs, and approved a Kentucky State University Shanty Hall renovation project funded by bond and HBCU Title III funds. Finally, it approved a new lease for the Office of Mines and Minerals in Pike County, a new lease for the Cabinet for Health and Family Services in Pulaski County, and a lease renewal for the Cabinet for Health and Family Services in Kenton County after questions about rent increases and office utilization; the cabinet said the Kenton County space still has limited vacancy and remains in use by field staff. The meeting ended as the Kentucky Infrastructure Authority began presenting six sewer and water loans and six cleaner water program grant reallocations, with members agreeing to roll those items for later consideration.

Transcript Highlights:

• on each Medicade patient and what that<00:10:46.800><c> inevitably</c><00:10:47.480><c> results</c><
• </c><00:10:53.720><c> and</c> cost of caring for these patients and cost of caring for these patients
• </c><00:11:01.320><c> so</c><00:11:01.440><c> we</c> fewer and fewer Medicaid patients so we fewer and
• fewer Medicaid patients so we do<00:11:01.800><c> think</c><00:11:02.000><c> that</c><00:11:02.200><
• And I'm guessing it is your preference to keep that in.

Committee: House Human Services & Homelessness

Summary: The committee heard several Human Services measures focused on Medicaid access, long-term care benefits, home health reimbursement, SNAP administration, trauma-informed child welfare, and child abuse reporting. HP 702 would increase funding for Medicaid in-home services if federal matching funds are secured, and testimony from disability advocates supported the measure as needed to help people with disabilities cover medical expenses. HB 1477, described as a correction to a prior session’s mistake, would clarify that the monthly needs allowance for certain long-term care residents does not replace state supplemental payments and would raise the ceiling by $25 to fix the prior issue and by an additional $20 as a new benefit; DHS supported it with amendments, and the committee indicated it would amend accordingly. HB 713 would fund a DHS rate study for home health services, with the Healthcare Association of Hawaii strongly supporting it and describing rising labor costs, losses on Medicaid patients, and access concerns if agencies cannot keep serving Medicaid clients. HB 1099 would appropriate emergency funds to DHS after a USDA penalty tied to SNAP response times, with supporters including Catholic Charities Hawaii, Hawaii Public Health Institute, and others arguing the money should be reinvested in staffing and systems to improve access and avoid further penalties. HB 1079 would direct the Office of Wellness and Resilience and DHS to create trauma-informed assessments and training for Child Welfare Services staff; testimony from state offices and advocacy groups supported it, citing the Mālama ʻOhana Working Group, staff burnout, and the need for a sustainable train-the-trainer model. Finally, HB 239 would narrow when failure to provide a child’s needs constitutes abuse or neglect, but DHS raised concerns that the current wording could broaden abuse findings and leave families in poverty without a clear safety net, while the Honolulu prosecutor’s office opposed it, warning it could weaken mandatory reporting and hinder investigations of child abuse. No formal votes were taken in the portion provided, though the chair said HB 1477 would be amended and several measures were left open for further questions and testimony.

Transcript Highlights:

• Second, a patient story.
• </c><00:53:01.440><c> Kristen</c> Second, a patient story. Kristen Second, a patient story.
• New Hampshire patients and plan New Hampshire patients and plan sponsors.<02:00:10.639><c> And</c><02
• Patients deserve notice, clarity, and a Patients deserve notice, clarity, and a voice<02:11:31.040><c
• </c><05:18:53.760><c> Someone</c> We had a difficult patient. Someone We had a difficult patient.

Committee: Senate Health and Human Services

Transcript Highlights:

• And so it's a purely statistical question about what voters' preferences are.
• It's really about what is the preference of the group and whether they have a fair chance to exercise
• that voting preference.
• So thank you for being so patient.
• So thank you for being so patient.

Committee: House State Government & Tribal Relations

Summary: The committee held a work session on voting rights, beginning with testimony from Marissa Wright of Campaign Legal Center and David Montes of the ACLU of Washington. They described the federal Voting Rights Act’s main protections—preclearance, vote suppression, and vote dilution—and argued that Supreme Court decisions such as Shelby County and Brnovich have weakened those protections. They said state-level action is increasingly important, pointing to the Washington Voting Rights Act as a tool to address discriminatory election systems, with examples from Yakima, Sunnyside, and other parts of the Yakima Valley. Members asked about Washington’s history of discrimination, voter roll purges, noncitizen registration, remedies under the WVRA, ranked-choice voting, and how statistical evidence is used in vote dilution cases. No votes were taken. The committee then heard a joint presentation from the Office of Equity and several commissions, including the Hispanic Affairs Commission, Asian Pacific American Affairs Commission, and LGBTQ Commission. The panel described their role in advising state government, working with communities, and helping agencies improve equity and service delivery. They focused on the new immigration sub-cabinet created under Executive Order 2509, saying it is intended to coordinate across agencies, the legislature, the courts, and community organizations on issues such as data privacy, language access, communications, and protections for immigrant communities. Members asked about accountability under the Keep Washington Working Act, the use of NGOs, and the sub-cabinet’s goals. The panel said the effort is meant to make Washington residents feel safe, protected, and included. Next, researchers from the University of Washington presented findings from the Elections Database Project on vote-by-mail outcomes from 2020 to 2024. They reported that about 1.5% of ballots are signature-challenged in most elections, about 60% of those ballots are cured, and overall rejection rates are around 1% in general elections and 1.5% in primaries. They said younger voters and voters of color are more likely to have ballots rejected, and that cure rates do not fully eliminate those disparities. Committee members asked about tribal reservation data, turnout patterns, and access to election data. The researchers said they use publicly available data and will follow up with additional turnout information. The final panel featured Maria Fernandez and Vicki Frausto of EIA, who described voter education and leadership development work in Yakima County and Sunnyside. They said their organization helps residents understand ballot mechanics, language barriers, and misinformation, and they described harassment and intimidation tied to their civic engagement work. They supported stronger Washington Voting Rights Act protections and said at-large election systems continue to dilute Latino voting power in some jurisdictions. They also said turnout in Yakima County has risen modestly, which they attributed in part to community education and candidate recruitment. The committee thanked the presenters and adjourned the work session without taking action.

Transcript Highlights:

• I don't see that it would decrease access to patient care.
• We save time, with no remake costs and no frustrated patients.
• practice determines that the patient made an overpayment.
• , there's a Balance to the patient, to the Floridian, right now.
• It would require some degree of knowledge on behalf of the patients.

Transcript Highlights:

• And so, the patient is risking that they'll get a bill. Some patients don't take that risk.
• </c> patients had coverage. patients had coverage.
• >> [laughter] >> So I'm a patient. Are you a patient? Okay. >> To be a patient. Okay, right.
• Like, are the patients similar?
• They're not my preferred option.

Committee: House Commerce and Consumer Affairs

Summary: The committee held a public hearing on Senate Bill 562, which would create a home damage mitigation and resilience grant program aimed at helping homeowners make property improvements that could reduce insurance costs and non-renewals. Commissioner DJ Bettencourt of the New Hampshire Insurance Department explained that the program is modeled in part on Alabama’s safer homes program, but tailored for New Hampshire hazards such as floods, microbursts, heavy snow, ice, and falling trees. He said the grants would be limited to primary residences, subject to a means test, capped at $10,000, and intended to help homeowners make targeted improvements such as roof fortification or tree removal that could improve underwriting outcomes and lead to premium discounts. Bettencourt said the program would not use state taxpayer funds and would instead rely on philanthropic donations, possible federal or regional housing-bank funding, and other outside sources. He said the department would not need new staff, and that a current position could be reconfigured to help administer the program part-time. Committee members asked about the funding language, the meaning of “loans” in the bill, whether there were any other states using a similar no-state-funds model, and how many homeowners could be helped. Bettencourt said Rhode Island and Connecticut were moving forward in a similar way, and that the number of beneficiaries would depend on how much money is raised. Members also questioned how the grant program would actually lower premiums, whether savings would apply only to participants or more broadly, and how the IBHS evaluation process would work. Bettencourt and department staff said the direct benefit would be to the homeowner whose property is improved, though neighbors could also benefit in some cases. They explained that IBHS is a building-safety organization that certifies contractors and inspectors and that its standards can qualify homes for insurer discounts. Questions were also raised about confidentiality provisions, first-come-first-served grant awards, rollover of unused applications, and possible tax treatment of donations. The sponsor said those details would be addressed through rulemaking or existing tax rules, and no vote was taken during the hearing.

Transcript Highlights:

• I'm here to testify on Bill 2212, An Act to Patient Opioid Notification.
• Our patients' heads spin.
• Patients are getting healthier more quickly, preventing mental health On top of that, patients are getting
• for those patients.
• for those patients.

Committee: Joint Joint Committee on Mental Health, Substance Use and Recovery

Summary: The Joint Committee on Mental Health, Substance Use and Recovery held a public hearing on 14 bills focused on insurance, parity, opioids, behavioral health access, and mental health system reform. Chair Mindy Domb and Vice Chair Robyn Kennedy outlined hearing procedures and noted the committee would accept written testimony. The hearing featured testimony from legislators, providers, advocates, and behavioral health organizations, with most speakers urging favorable reports on the bills they addressed. A major topic was psychiatric collaborative care, including H. 222/S. 1390, which would raise reimbursement for collaborative care codes to at least Medicare levels and allow billing outside the MassHealth primary care subcapitation model. Supporters said the model improves access, outcomes, and cost savings by embedding behavioral health in primary care, and several witnesses described successful implementation in practices and schools. Committee members asked questions about how the model works, what specialties use it, barriers to adoption, and whether copays, deductibles, and subcapitation rules should be changed. Witnesses also supported related innovation legislation, including H. 2224, which would create a mental health innovation fund and support nontraditional trauma-healing approaches. Other bills discussed included H. 2212, which would require prescribers to discuss opioid and pain-medication risks, alternatives, and addiction/overdose concerns with patients or guardians; H. 2232 and H. 2233, which would address equitable payment and equitable access for behavioral health providers serving MassHealth patients; and S. 1406, which would add opioid maintenance treatment information to MassPAT and allow patient-authorized access to that information. Witnesses also strongly backed S. 1399, which would set targets to increase behavioral health spending within the overall health care cost benchmark, arguing that Massachusetts underinvests in behavioral health and that greater investment could reduce emergency, hospitalization, homelessness, and criminal justice costs. No votes were taken; the hearing concluded after testimony and committee questions.

Transcript Highlights:

• So it’s whatever you prefer here.
• So it’s whatever you prefer here.
• </c> and that they are charging patients and that they are charging patients facility<01:10:09.560><c
• </c> of patients. of patients.
• Um the the bill patient to pay it.

Committee: Senate Finance

Transcript Highlights:

• Whether one supported every provision or not, I believe we can all agree that certainty is preferable
• When Steward collapsed, Massachusetts physicians and providers didn't abandon their patients.
• Then TRACO failed too, and the same providers who had seamlessly maintained patient care through one
• That's better for patients, it's better for providers, and it's better for taxpayers.
• Taking care of patients has made me a better legislator.

Transcript Highlights:

• If the patient requests, the advance directive must be filed in the patient's electronic medical record
• As electronic medical record integration is ongoing, patients are encouraged to provide a copy of the
• I just like the idea, but how will patients know that this non-opioid advance directive is available?
• Because the health care provider did not know that they should not, or did not, or would not prefer not
• It will require each nursing home to conduct a patient safety culture survey at least biannually.

Committee: Senate Health Policy

Summary: The Committee on Health Policy met with a quorum and considered three bills. Senate Bill 526 on nursing education programs, sponsored by Senator Harrell, would tighten oversight of nursing schools by requiring admission criteria, exit exams, remediation plans, annual reporting, on-site inspections, and stronger action against programs with poor NCLEX results or adverse actions in other jurisdictions. After testimony from the sponsor and several committee questions, a late-filed amendment restored a two-year probation period instead of one year, and the bill was reported favorably. Senate Bill 714, also by Senator Harrell, would create a voluntary non-opioid advance directive allowing patients to document a wish not to receive opioids, including when incapacitated, with the form developed by the Department of Health and potentially included in electronic medical records. The sponsor said it would not prevent treatment discussions and would provide liability protection for providers who lack actual knowledge of the directive in emergencies. The bill drew no opposition in the meeting and was reported favorably. Senate Bill 170, sponsored by Senator Burton, would add nursing home quality and transparency measures, including consumer satisfaction surveys, patient safety culture surveys, electronic health record requirements, reporting to the Florida Health Information Exchange, a $10,000 fine for failure to submit required financial data, and reporting on Medicaid quality payments. An amendment clarified the fine’s application to both facilities and home offices. Testimony from AARP and the Florida Health Care Association supported the bill, and it was reported favorably after discussion about implementation and costs.

Transcript Highlights:

• That instability affects staffing, limits access to care, and ultimately impacts patients.
• She was recently notified that her health plan was withholding payment for current patient care due to
• It is fraudulent and it harms patients.
• For patients, these delays are not just inconvenient.
• If in the future you could focus on the specifics of the bill, that would be preferable.

Transcript Highlights:

• Senate Bill 1344 creates the insulin access affordability program at the Health Department to increase patient
• Senate Bill 1344 creates the insulin access affordability program at the Health Department to increase patient
• We can do it now, whichever you prefer. And would bring that amendment either on the floor.
• We can do it now, whichever you prefer.

Bills: SB1189 , SB1295 , SB1297 , SB1330 , SB1333 , SB1338 , SB1341 , SB1344 , SB1355 , SB1377 , SB1378 , SB1546 , SB1859 , SB1946 , SB1990 , SB1998

Committee: Senate Appropriations

Summary: The committee met in an appropriations setting and first laid over Senate Bill 1946. It then advanced Senate Bill 1344, creating an insulin access affordability program at the Health Department, on a 19-1 vote. Senate Bill 1295, establishing a Domestic Violence Fatality Review Board revolving fund and database, was amended to delete a section and then passed 21-0. Senate Bill 1355, creating a program for memorials and headstones for eligible National Guard veterans, also passed unanimously. Members then advanced several other measures, including Senate Bill 1998 to help smaller towns qualify for quality events incentives, Senate Bill 1330 raising Pardon and Parole Board salaries, Senate Bill 1297 creating a decennial census revolving fund to support outreach for the 2030 census, and Senate Bill 1189 extending the school security fund for three more years at $50 million annually. The committee also passed Senate Bill 1338 making the Heroes Literacy Instructional Team permanent, and Senate Bill 1546 increasing scholarship support for teacher preparation students. Additional bills passed included Senate Bill 1378 creating the Olympics and Oklahoma Revolving Fund, Senate Bill 1859 creating an OSBI cyber crime and fraud unit fund, Senate Bill 1341 creating a Career Counseling Revolving Fund, Senate Bill 1377 directing DHS to provide bags for foster children’s belongings, and Senate Bill 1990 broadening the Incentive Evaluation Commission’s comparative analysis of incentives. Several bills had appropriations stripped by amendment at the chair’s request before passage, and the committee repeatedly discussed fiscal impacts, local matching expectations, transparency, and whether programs should remain state-funded or rely on local or philanthropic support. The meeting ended with adjournment and notice of a meeting the following week.