Transcript Highlights:

• the cost savings that Programs are providing the cost savings that these programs are providing and
• , and provider orientations.
• and providers, managing health benefits for eligible providers, and giving consumers a voice in how
• and providers, managing health benefits for eligible providers, and giving can be. for consumers and
• providers, managing health benefits for eligible providers, and giving consumers a voice in how IHS

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

Transcript Highlights:

• We need to broaden the spectrum and allow providers to provide services.
• to provide that service. ...need for providers to step out, get the credentialing required to provide
• So we have to allow a model in which these providers can provide a service.
• We have a number of providers that have started providing that service.
• So they provide a service... ...evaluation and provide some services.

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to behavioral health as the main topic. Representatives Woodridge and Vaught described the work of the behavioral health working group, saying Arkansas needs a more proactive system that improves access, reduces red tape, and focuses on a few achievable policy changes for the 2027 session rather than many bills. Members discussed barriers such as low reimbursement, workforce shortages, licensing and credentialing hurdles, rural access problems, and the need to better use community providers, compacts, and step-down services. Director Paula Stone of DHS’s Office of Substance Abuse and Mental Health gave a detailed overview of the behavioral health system. She said Medicaid pays for more than 75% of behavioral health services in Arkansas and explained that when people are jailed or admitted to the state hospital, Medicaid generally stops, leaving state general revenue to cover care. She described current efforts including family-centered treatment for children, community reintegration group homes, a new adolescent substance use disorder residential unit, expanded community mental health center contracts, a secured restoration unit to reduce state hospital backlogs, and an IMD waiver to allow Medicaid payment for certain residential services. She also said DHS is working on crisis services, forensic evaluations, and provider rebidding in areas previously served by ERISA. Members asked about reimbursement for jail services, the lack of a statewide behavioral health dashboard, civil commitment options, crisis stabilization units, and whether Arkansas should expand step-down or long-term facilities for people who cannot safely return to the community. Stone said the state hospital backlog remains significant, average stays are still about 14 months, and crisis stabilization units have had mixed success, with Fort Smith and Jonesboro performing better than Fayetteville and Little Rock. The meeting ended with a commitment to continue the work, with more substantive discussion planned for August.

Transcript Highlights:

• and partnering with providers, managing provider networks, providing services, and performing various
• the previously long-term care providers, ...providers that come into that system, maybe some of the
• provided.
• allocated to the providers in order for you to be able to retain those good providers to provide the
• We provide...

Summary: The Health and Human Services Committee received an overview of Florida’s intellectual and developmental disabilities (IDD) managed care pilot, created by legislation in 2023 to test whether a managed care model could integrate Medicaid medical services with iBudget waiver home- and community-based services for adults in pre-enrollment categories. AHCA explained the existing system, the pilot’s scope in Regions D and I, and the rollout timeline, including federal approval, contract execution with Florida Community Care, and the October 2024 go-live. Officials reported that, as of early February, 370 individuals had been sent for onboarding and 168 more were in queue, with about $35.8 million of the appropriation remaining. APD also clarified the difference between the pre-enrollment categories and the waiver waitlist, and noted that crisis cases can be enrolled more quickly depending on eligibility and funding. Florida Community Care described the pilot as a comprehensive managed care model offering medical, long-term care, and iBudget services, plus enhanced benefits such as bed-hold days, caregiver transportation, and help with legal guardianship costs. The plan said it uses one care coordinator, a 1:18 coordinator ratio, a face-to-face assessment within five days of enrollment, and 180 days of continuity of care for existing providers. The company emphasized that it is recruiting providers by offering higher rates than some iBudget rates, lower administrative burden, and network adequacy incentives, while APD said it continues to monitor provider supply and demand and recruit across service types and regions. Members repeatedly questioned whether the pilot’s costs, provider rates, and service levels were truly comparable to the iBudget system, and AHCA and APD said it was too early to draw firm conclusions because claims data are still lagging. Committee members also raised concerns about communication, enrollment delays, provider shortages, and whether the pilot could scale statewide. APD said it has used letters, phone calls, texts, emails, and community meetings to reach eligible individuals, and that some delays stem from required assessments, Medicaid eligibility checks, and level-of-care determinations. Several members asked for more detailed comparisons of costs and provider reimbursement between the pilot and iBudget, and APD said it would provide additional data. Public testimony at the end was strongly critical of managed care, with a participant and his mother describing poor service, transportation failures, and loss of control under prior managed care arrangements, and urging the committee not to expand such a model without safeguards. No votes or formal committee action were taken before adjournment.

Transcript Highlights:

• are providing to our Medi-Cal members.
• If a family or a child provides a complaint, we want to be able to track that and provide some information
• Providers.
• provider.
• We are both a PACE provider and an HCBA waiver agency provider, and we serve Alameda and Contra Costa

Keywords: 988, house, all

Transcript Highlights:

• is the federal block grant that provides is the federal block grant that provides states<00:03:32.879
• Who gets taxed by the provider tax? Health care providers.
• <00:07:48.360> tax uh in 2024 the the the provider tax uh in 2024 the the the provider tax
• Then those providers bill DHS directly for the services provided, and then DHS reimburses those providers
• providers.

Keywords: 1183, house

Summary: The meeting was an informational walkthrough for the Health Finance and Policy Working Group, focused on committee structure, budget basics, and major health-related accounts and programs. Staff explained the roles of House Research and House Fiscal, then reviewed key funds used by the committee, including the general fund, government special revenue fund, federal funds, the health care access fund, remediation account, and drinking water revolving fund. They also outlined the committee’s main budget areas, noting that medical assistance is the largest general fund item and that the Department of Health is a substantial agency funded by a mix of federal, general fund, and special revenue dollars. A major portion of the presentation covered subsidized health coverage programs. Staff described Medical Assistance (Minnesota’s Medicaid program) as an entitlement for eligible Minnesotans, with no premiums or cost sharing, and explained its managed care and fee-for-service delivery systems. MinnesotaCare was presented as a separate federal-state basic health program for people who are not eligible for MA, with income limits, premiums for adults age 21 and older, and cost-sharing requirements; staff noted that federal premium tax credit changes affect MinnesotaCare premium ranges. The presentation also summarized MNsure’s role in the individual market and in determining eligibility for premium tax credits, cost-sharing reductions, MinnesotaCare, and MA. The committee also received an overview of health-related licensing boards and occupational regulation. Staff said Minnesota has 16 health-related licensing boards, funded mainly through the state government special revenue fund and subject to legislative appropriation, and explained that health occupations may be regulated by the Department of Health, the Office of Emergency Medical Services, or the boards under chapter 214. Interstate licensure compacts were briefly noted as a way to ease practice across states. No bills were debated and no votes or formal actions were taken during the meeting.

Transcript Highlights:

• So, you know, if a family or a child provides a complaint, we want to be able to track that and provide
• The provider rate increases will support the inpatient and outpatient care we provide to Medi-Cal patients
• on managed care providers.
• We are both a PACE provider and an HCBA waiver agency provider, and we serve Alameda and Contra Costa
• Once payment suspension is lifted, the funds are returned to the provider, less any provider liabilities

Summary: The committee heard a budget oversight hearing on the Department of Health Care Services, focusing first on the overall Medi-Cal budget and a March General Fund loan to cover a current-year shortfall. DHCS said the 2025-26 budget proposal totals $193.4 billion, with Medi-Cal projected at $188.1 billion total funds and $42.1 billion General Fund, driven by higher enrollment, pharmacy costs, managed care growth, and costs tied to eligibility expansions and the COVID-era redetermination unwinding. The department said the $3.44 billion loan was needed to manage cash flow and ensure timely payments to providers and plans, while the LAO noted Medi-Cal’s cash-basis budgeting creates volatility and that more detailed estimates would come with the May Revision. Members discussed federal Medicaid threats, the need for transparency on cost drivers, and the impact of pharmacy spending, long-term care, and immigration-related coverage expansions. The second major topic was family health programs, including California Children’s Services, the continuous coverage unwinding, and opioid settlement fund spending. DHCS described CCS funding methodology changes, ongoing county stakeholder work, and a delayed rollout of CCS monitoring and oversight until July 1, 2025, while county representatives and advocates argued the program is underfunded and asked for more technical assistance and a delay in implementation. On the unwinding, the department explained that federal redetermination flexibilities helped maintain coverage after the pandemic, but the Governor’s budget proposes ending them at the end of June 2025; advocates urged making the flexibilities permanent to avoid coverage losses. For opioid settlement funds, DHCS and Finance said the budget increases funding for naloxone distribution while reducing other harm-reduction spending based on updated settlement revenues, prompting criticism from members and public commenters who argued the change would weaken effective harm-reduction programs. The hearing also included an update on Proposition 35 implementation. DHCS said the voter-approved measure continuously appropriates MCO tax revenues beginning in 2025, with up to $4.6 billion annually available for specified Medi-Cal and provider investments in 2025 and 2026, but implementation depends on consultation with the required stakeholder advisory committee. The department and LAO noted uncertainty about future federal rules affecting the MCO tax after 2026. Public testimony largely supported maintaining Medi-Cal expansions, protecting immigrant coverage, preserving harm-reduction funding, and increasing support for community health workers, pediatric dental care, and CCS county administration. No votes were taken during the portion of the hearing provided.

Transcript Highlights:

• When you see an HSS provider committing fraud, they may also share ownership with an autism provider,
• I've seen providers lacking documentation to support services that were provided.
• We will Be working to provide providers, counties, and our partners with resources that people can be
• We are also looking at our provider networks and data related to our provider networks to ensure that
• I think this is most important: we have a provider vetting problem with unqualified providers gaining

Transcript Highlights:

• for providers to provide these services. for providers to provide these services.
• that there are a lot of providers of color, immigrant providers, new first generation American providers
• that there are a lot of providers of color, immigrant providers, new first generation American providers
• that there are a lot of providers of color, immigrant providers, new first generation American providers
• Small providers that there are a lot of providers of color, immigrant providers, new first generation

Keywords: 1187, senate, all

Transcript Highlights:

• <00:37:24.880> to<00:37:25.160> provide centers though yes to provide to provide centers
• Different providers on island will provide the service.
• > different providers on island will different providers on island will provide<00:47:17.520> the<
• And so, yes, that's a provider that also provides health services.
• a provider na pu and they also provide a provider na pu and they also provide adult<00:53:20.000

Keywords: 912, senate, all

Summary: The Committee on Health and Human Services held an informational briefing on Kupuna Care funding, distribution, utilization, and the status of program rules. The Office of Aging explained that state Kupuna Care funds are distributed using the same federally approved interstate funding formula used for Older Americans Act funds, with eight weighted factors tailored to Hawaii’s conditions: older adults, greatest economic need, low-income minority status, disability, language barriers, geographic isolation, inverse population density, and older adults living alone in poverty. The department said the formula is based on census and American Community Survey data, with current county shares listed as Kauai 7.45%, Honolulu 69.61%, Maui 11.7%, and Hawaii County 17.88%. Officials said the formula is being reviewed with current data and will need federal approval and then public hearing before final adoption. Members questioned how the program works in practice, noting that the statute and eligibility language can sound like direct individual benefits even though services are delivered through area agencies on aging, ADRCs, and contracted providers such as meal and adult day care programs. The Office of Aging said ADRCs determine eligibility and then refer clients to authorized providers, who must meet service standards in their contracts. The chair pressed repeatedly for long-delayed rules, saying the Legislature had expected them years earlier and that clear rules are needed to ensure funds are spent properly and to avoid conflicts of interest. The department acknowledged the delay, said draft rules were written in 2023 after earlier commitments to finish sooner, and said it paused while federal Older Americans Act rules were being updated; it now expects to send the rules to the Deputy Attorney General, then out for public hearing, with a goal of completion in 2025. The department also reported utilization data for the last two fiscal years. In 2023, it expended about 93% of its allocation and served 5,473 older adults at an average annual cost of $1,358; in 2024, it expended about 97% and served 5,520 older adults, with the average cost down by about $200, which officials said may indicate fewer services per person. Eligibility was described as age 60 or older, U.S. citizen or qualified alien, with cognitive impairment or disability and functional deficits, and the statewide profile showed many participants were homebound, living alone, or below poverty. The most-used services were transportation, case management, and home-delivered meals. The chair also asked about the former Kupuna caregiver program; officials said the programs are now combined under Kupuna Care, with most funding going to adult day care to provide respite for working caregivers. County representatives then described local conditions, especially on Hawaii Island. Hawaii County officials said the county covers about 5,000 square miles, has about 208,000 residents, and roughly 24% are age 65 or older. They identified three main challenges: staffing shortages and retention problems among providers, shortages within the county department itself, and the loss of adult day care capacity, with only one center remaining on the island and none on the west side. They said these constraints limit service delivery even as demand grows. At the same time, they highlighted successes such as serving people in the community before they need higher levels of care, providing caregiver counseling and training through adult day care, serving 467 individuals locally, and ensuring the Resource Center answers calls from caregivers seeking help.

Transcript Highlights:

• payments to providers directly.
• We're going to conduct targeted provider outreach to those providers that are plan network providers,
• new providers.
• So they provide the services, they provide the care coordination. So why is the rate different?
• in a medical provider.

Keywords: 987, senate, all

Transcript Highlights:

• many providers have setting uh today many providers have been<00:04:09.879> waiting<00:04:10.159
• :04:51.840> provider<00:04:52.199> members<00:04:52.520> and roughly 200 provider
• the ongoing issues that small providers the ongoing issues that small providers have<00:05:09.080
• Today, providers who are actively transitioning to providing IC services are facing months or, at this
• Today, providers who are actively transitioning to providing IC services are facing months or, at this

Keywords: 1187, senate, all

Transcript Highlights:

• We have over 69,000 enrolled providers who treat and provide care to Medicaid members in state fiscal
• 69,000 enroll providers who treat and<00:03:46.560> U<00:03:46.760> provide<00:03:47.239
• <00:05:05.919> who had a little over 4,500 providers who had a little over 4,500 providers
• <00:05:14.440> delivering almost 8,000 providers delivering almost 8,000 providers delivering
• membership this is a a spin by provider membership this is a a spin by provider type<00:10:39.240

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services held its first meeting and received an overview from the Department for Medicaid Services on Medicaid’s behavioral health and substance use disorder services. Commissioner Lisa Lee and CFO Steve Beal said Kentucky Medicaid serves about 1.4 million members, including over half of Kentucky children, with 485,000 expansion members, more than 69,000 enrolled providers, and total fiscal year 2024 expenditures of $18.5 billion. They said Kentucky covers a broad range of behavioral health services, and behavioral health provider enrollment has grown from a little over 4,500 in 2019 to nearly 8,000 in 2024. They also described how Medicaid spending and utilization are tracked through claims and encounter data, with most members served through managed care organizations. Members focused on sharp increases in certain behavioral health billing codes, especially peer-to-peer services, and asked about reimbursement, utilization review, and whether the growth reflected increased need or expanded coverage. DMS said the rise was partly tied to combining facility and nonfacility behavioral health fee schedules in 2023, choosing the higher reimbursement rate to avoid cuts, and that the department has seen an uptick in peer-to-peer services. In response to concerns about overutilization, DMS said it mailed a letter to behavioral health providers, is considering limits and prior authorizations for some services, and plans to create a standardized monthly behavioral health report to monitor trends consistently and identify when controls may be needed. Lawmakers also asked whether the provider network is sufficient and whether access is adequate, especially for children. DMS said provider enrollment has expanded because behavioral health services were added to Medicaid in 2014 and because demand increased after COVID, but acknowledged studies showing children have less access than adults and said that would be an area of focus. The department said managed care organizations are required to ensure access to needed services and that current trends indicate access is available, though one member disagreed and said workforce shortages remain a major concern. Another member asked about non-emergency medical transportation spending, and DMS explained that it is handled through a capitated arrangement administered by the Transportation Cabinet rather than directly by the managed care organizations.

Transcript Highlights:

• providers who are not providing providers who are not providing services. services. services.
• or provider capacity excess of providers or provider capacity relative<00:51:51.920> to<00:51
• providers? providers?
• . providers. providers.
• providers. Um so that that's my opinion. providers.

Keywords: 1183, house

Transcript Highlights:

• provider.
• And these are providers who are specifically able to provide personal care services.
• IHSS provides...
• She is an IHSS provider.
• provides services to.

Keywords: 987, senate, all

Transcript Highlights:

• for definitions, to provide for written notice, to provide for method of delivery, to provide for the
• rights of customers, to provide for enforcement, to provide for authority, to provide for rulemaking
• , to provide for applicability, to provide for an effective date, and to provide for related matters.
• rights of customers, to provide for enforcement, to provide for authority, to provide for rulemaking
• , to provide for applicability, to provide for an effective date, and to provide for related matters.

Summary: The House Committee on Commerce met on Wednesday, April 22, with a quorum present and heard several bills. HB 1195, relating to the Louisiana State Athletic Commission, was amended with technical changes and a fee-related amendment tied to student athlete agents, then reported favorably. Members asked about criminal penalties and whether the bill would affect prison athletic events; the author said he would follow up on those questions. HB 798, the Broadband and Cable Price Notice Act, was amended to clarify definitions, federal compliance, notice requirements, and severability, then reported favorably after extensive debate over whether providers already give adequate notice, whether a separate notice is necessary, and whether the bill would be preempted by federal law. Charter Communications testified in opposition, saying the bill was duplicative and would add costs, while the author argued it was needed to ensure clear, conspicuous notice of price increases and cancellation rights.

Transcript Highlights:

• We have initiated opportunities to provide additional funding to providers that are part of that program
• We have initiated opportunities to provide additional funding to providers that are part of that program
• When the Council of Human Service Providers asked me to participate in a meeting with providers who are
• When the Council of Human Service Providers asked me to participate in a meeting with providers who were
• providers they regulate.

Keywords: 1182, all

Transcript Highlights:

• DO WE HAVE ENOUGH PROVIDERS OUT THERE PROVIDING THESE SERVICES?
• WE ARE WORKING ON PROVIDER ADVISORIES TO ENSURE THAT ALL PROVIDERS ARE AWARE AND WE ARE WORKING WITH
• >> THE ISSUE IS THE PROVIDER ENTITY NOT NECESSARILY THE WORKERS THAT SUPPORT THE PROVIDER ENTITY. >>
• NOW THAT THE PROVIDER COMMUNITY HAS PUT OUT A GET FROM THE PROVIDERS THROUGH THE FIRST SURVEY.
• WE DO NOT HAVE A PROVIDER WE ARE WORKING WITH THIS WE DO HAVE A PROVIDER WE ARE WORKING WITH.

Transcript Highlights:

• guidance to the counties to provide notice to recipients and providers.
• The care that they need if the providers are not able to help them because the providers The providers
• I'm here as a provider.
• IHSS care provider. I've been providing care for over 50 years.
• I'm a parent provider, before becoming a provider for my daughter, I was a provider for my mother.

Keywords: 988, house, all

Transcript Highlights:

• FFN providers get the minimum wage.
• I'm also a member of BWA, Brockton Workers Alliance, and I'm also a provider, like many providers in
• So I'm going to provide, to stabilize the providers who know and confirm...
• But of course, there are many, many FFN providers providing care to families with vouchers.
• From 6 o'clock until 8 or 8:30, the time they go to provider if someone has a provider.

Keywords: 995, all

Summary: The Joint Committee on Education held its sixth public hearing and took testimony on a large slate of bills, with the chair moving H. 542/S. 341 on family, friend, and neighbor (FFN) child care to the top of the agenda so young constituents would not have to wait. Witnesses from labor, community organizations, and FFN providers strongly supported the bill, saying FFN care fills critical gaps for families working nonstandard hours, especially in low-income, immigrant, and BIPOC communities. Testimony emphasized that FFN providers are currently underpaid, often receive only about $24 per child per day, and should be guaranteed at least the state minimum wage. Witnesses also backed changes to the voucher system to allow families to combine formal and FFN care more flexibly, and they supported creating an FFN advisory council. Committee members asked about the difference between FFN and center-based care, registration requirements, fingerprinting/background checks, EEC’s ongoing study group, and the fiscal impact; witnesses said the current annual cost is about $1.8 million and could rise to about $6 million if all current FFN providers were paid minimum wage, still under 1% of the EEC budget. The committee then closed testimony on that bill. The committee next heard testimony on several preschool and universal pre-K bills, including H. 707 on public preschool facilities, H. 687/S. 339 on universal pre-K and mixed delivery, and related bills such as H. 606, H. 523, H. 618, H. 522, H. 510, and H. 615, many of which were later closed without additional witnesses. A Lowell school official testified that space and facilities funding are major barriers to expanding preschool and that the city has hundreds of children on voucher waitlists. Other witnesses and organizations, including the Early Care and Education Consortium and AFT Massachusetts, supported mixed-delivery universal pre-K and warned that public-school expansion should not undermine community-based providers, whose preschool tuition helps subsidize infant and toddler care. Several witnesses also urged stronger standards for preschool teachers, better staffing ratios, and more integrated special education and support services. The committee accepted written testimony on some bills and closed testimony on the others when no one else came forward. A major portion of the hearing focused on H. 541/S. 373, which would ban school exclusion in pre-K through third grade. Advocates from Massachusetts Advocates for Children, Mass Appleseed, Citizens for Juvenile Justice, AFT Massachusetts, and the Mental Health Legal Advisors Committee argued that suspensions and expulsions at young ages harm learning, worsen inequities, and contribute to the school-to-prison pipeline. They cited data showing disproportionate impacts on Black and Latinx students, students with disabilities, and low-income children, and described personal stories of children whose behavior improved when schools kept them in class and addressed underlying needs. Committee members asked for updated data on the number of students and districts affected, and witnesses said they would provide more detailed written information. After testimony on this and a few other bills, including S. 372, S. 357, and H. 275/S. 133, the committee closed testimony and adjourned.

Transcript Highlights:

• This provides for a rotation of leadership positions, so there's a total of six leaders being provided
• <00:03:09.760> some mentioned uh just provides some mentioned uh just provides some additional
• <00:03:50.200> the leaders um being provided the leaders um being provided the supplemental
• Item 13 starting on 1.12 provides new standards for committee and floor procedure. 13.1 provides that
• Item 13 starting on 1.12 provides new standards for committee and floor procedure. 13.1 provides that

Keywords: 1183, house