Transcript Highlights:

• PAYMENTS.
• TO TEST THE TIMELINESS WE THE 27 FCC SCHOLARSHIP PAYMENTS AND 11 FSPO PAYMENTS.
• AND WE FOUND THREE OF THE FTC TUITION PAYMENTS WERE PROCESSED FROM 15 TO 35 DAYS AFTER RECEIVING PAYMENT
• LINE NUMBER TWO WAS FOR UNTIMELY SCHOLARSHIP REIMBURSEMENTS.
• FSUA REIMBURSEMENTS AND WE FOUND THAT EIGHT OF THE FTC SCHOLARSHIPS AND SEL REIMBURSEMENTS WERE PAID

Transcript Highlights:

• We can make our federal payments until you make your payments, and we'll just hold this.
• It has to do with funding reimbursements that are delayed.
• One is the payment in lieu of taxes, and that sort of starts on page 11.
• Snap payments are mandatory programs, are they not?
• The first is the detention reimbursement fund.

Committee: House Federal Funding Stabilization Subcommittee

Transcript Highlights:

• talking a little bit about provider payment.
• And three, that payments and billing are correct.
• And three, that payments and billing are correct.
• And then there’s a tiered reimbursement, or an increased percentage of payment, associated with that.
• And then there's a tiered reimbursement or an increased percentage of payment associated with that.

Bills: SB5952 , SB5961 , SB5969 , SB5841 , SB5943

Committee: Senate Early Learning & K-12 Education

Keywords: physical education, school districts, student requirements, education policy, high school, early literacy, childhood literacy, book distribution, Imagination Library, Dolly Parton Imagination Library, preschool, pre-K, reading readiness, school readiness, birth to age five, young children, nonprofit contract, OSPI, Office of Superintendent of Public Instruction, DCYF

Transcript Highlights:

• So before payment can even occur, a family must be— So before payment can even occur, a family must be
• And then payment is available after the provider provides care.
• talking a little bit about provider payment.
• And then there's a tiered reimbursement, or an increased percentage of payment, associated with that.
• And then there's a tiered reimbursement or an increased percentage of payment associated with that.

Summary: The committee began with a work session on Washington’s child care oversight and subsidy system, focusing on Working Connections Child Care, licensing, audits, and fraud prevention. DCYF officials said the program serves over 63,000 eligible families, with about 6,600 licensed providers and roughly 2,200 license-exempt family, friend, and neighbor providers. They described annual unannounced licensing visits, complaint investigations, attendance tracking, eligibility verification, random and focused audits, and referrals to the Office of Fraud and Accountability or Office of Financial Recovery when needed. Senators asked about voucher amounts, visit frequency, and what happens when children are not present; officials said the average subsidy is about $2,200 per month, providers are paid directly, and repeated failed visits can lead to license closure. Child Care Aware and provider testimony emphasized the quality system, Early Achievers, and a virtual provider described the practical realities of home-based care and unannounced inspections. The committee then heard Senate Bill 5952, which would standardize the process for waiving high school physical education requirements. The bill’s sponsor said the goal was to make PE waiver decisions consistent across districts so students who move schools are not disadvantaged, especially in six-period schedules with limited room for electives. Student supporters said a uniform process would improve fairness and help students fit in AP, career, or other coursework. Opponents, including PE teachers and the Washington Association of School Principals, argued that PE is a core academic subject, that athletics is not interchangeable with PE, and that local flexibility should remain. The State Board of Education supported the bill, saying current district policies vary widely and a standardized process would improve equity and transparency. Next, the committee took testimony on Senate Bill 5961, which would transfer the Imagination Library of Washington from DCYF to OSPI. The sponsor called it a simple administrative move to align the book-gifting program with early literacy and K-12 education, noting the program serves about 120,000 children in all 39 counties. OSPI and program representatives supported the transfer, saying it better fits the birth-to-grade-three literacy continuum and strengthens accountability. Testifiers highlighted the program’s role in school readiness, early brain development, and access to physical books for young children. Finally, the committee opened Senate Bill 5969, which would allow a student’s IEP transition plan to satisfy high school and beyond plan requirements if the IEP team chooses. The sponsor, a special education teacher, said the bill would reduce duplication and better support students with disabilities as they transition to postsecondary life. The committee then began hearing testimony on the proposal.

Transcript Highlights:

• for reimbursement.
• Those drove the state's payment error rate higher.
• We are working very hard on bringing that payment error rate down. New Mexico.
• The payment error rate is always calculated on a look-back period.
• Then we may have some financial liability related to the payment error rate.

Committee: Senate Senate Finance

Transcript Highlights:

• ambulance providers enhanced payments, or if you will, directed payments, and those have to be approved
• We do have some payment programs.
• or if you will or enhanced payments or if you will or directed<00:04:07.800><c> payments</c> directed
• payments directed payments and<00:04:09.440><c> those</c><00:04:09.800><c> have</c><00:04:10.000><c>
• </c> limitation on our directed payments. limitation on our directed payments.

Keywords: 958, all

Summary: The Budget Review Subcommittee for Health and Family Services met for its first meeting, established quorum, and heard a presentation from Department for Medicaid Services Commissioner Lisa Lee and CFO Steve Becktold. The department reviewed its compliance with House Bill 695, which requires legislative approval before certain Medicaid eligibility, service, benefit, or waiver changes, along with fiscal impact reporting to the Legislative Research Commission. They described current waivers, including home and community-based waivers, managed care and transportation waivers, and the 1115 re-entry waiver, and said the community engagement waiver is in public comment and on track for submission to CMS. They also said required reports and other HB 695 tasks, including a pharmacy rebate fund, budget analyses, expenditure reports, and a behavioral health scorecard, are underway or completed as required. The CFO outlined Medicaid’s budget, saying the department has two appropriation units and projecting near-full use of state funds while leaving some federal funds unspent because of matching-rate differences. They reported roughly 211 filled positions and 11 vacancies. Members asked about the vacancy makeup, the behavioral health scorecard, and whether a provider involved in quality metrics could have a conflict if used in the scorecard process; the department said it would follow up. Members also asked about the community engagement waiver and its interaction with federal policy, and the department said CMS guidance is still pending and that it will proceed under HB 695. A substantial portion of the discussion focused on federal Medicaid policy changes under a reconciliation bill, including possible limits on provider taxes, directed payments, cost-sharing, and community engagement requirements. Department officials said the final federal impact is still uncertain because the Senate bill is not finalized, but they have modeled several scenarios and warned that any reduction in federal support or benefits would be harmful, especially for hospitals and rural hospitals. They estimated Medicaid benefits are funded about 80% federal and 20% state overall, with expansion populations closer to 90% federal funding, and said administrative costs would also rise if federal requirements change. Members also asked about work requirements and eligibility. The department said the community engagement waiver would mainly affect the expansion population, which they estimated at about 450,000 people out of roughly 1.5 million total Medicaid enrollees, and that many groups are exempt, including children, the aged, blind, disabled, and people in substance use disorder treatment. Officials said they can provide data on how many enrollees are working or work-ready and explained that their eligibility system is designed to prevent duplication by automatically placing people in the correct category and correcting errors quickly. They also noted a federal proposal to require expansion eligibility reviews every six months, compared with current annual renewals.

Transcript Highlights:

• The loans are not reimbursable by the state, by the way—the interest on them is not reimbursable.
• The Prompt Payment Act was meant to address these sorts of payment delays, but the law only applies to
• So are we talking about paper checks, the checks, payments that go from, in your case, payments that
• The checks, payments that go from, in your case, payments that go from nonprofits to the state versus
• payments that go from the state to the nonprofits.

Summary: The joint Senate and Assembly Select Committee on the nonprofit sector held a hearing focused on the importance of California’s nonprofit sector and how state systems can better support it. Chair and co-chair remarks emphasized that nonprofits are essential to the state’s economy and public services, especially as federal cuts and administrative burdens increase pressure on organizations that deliver health care, food assistance, homelessness services, disaster response, and other safety-net functions. CalNonprofits CEO Jeff Green described the sector’s size and complexity, citing roughly 110,000 nonprofits in California, about 1.4 to 1.5 million nonprofit workers, and major concerns about funding uncertainty, delayed reimbursements, and federal threats to nonprofit funding and nonpartisanship. He said many organizations are being forced to use reserves, reduce services, or take out loans while waiting for state payments. The Little Hoover Commission presented findings from its study of state grant and contract administration, arguing that nonprofits often subsidize state services because of late payments, insufficient advance funding, and inadequate reimbursement for overhead. The commission recommended requiring advance payments, expanding prompt-payment protections, matching federal indirect-cost rates, standardizing emergency contract amendments, creating an Office of Nonprofit Empowerment, reducing duplicative reporting, moving to electronic payments, improving feedback to unsuccessful applicants, and using longer grant periods. Committee members expressed support for these ideas and discussed shifting state contracting culture toward outcomes and better coordination. The commission also noted that SB 1240, which would create the Office of Nonprofit Empowerment, and SB 1366, related to payment delays, align with its recommendations. The Attorney General’s Charitable Trusts Section then outlined its rollout of a new online filing system for charities and charitable fundraisers. Elizabeth Kim said the system, launched in stages beginning in 2024, is intended to replace paper filings, reduce incomplete submissions and bounced checks, and speed processing; the final phase is expected to cover renewals, delinquency, raffles, professional fundraisers, dissolution, and complaints. Committee members asked about staffing impacts and complaint handling, and DOJ explained that complaints are reviewed based on allegations, public filings, and, when needed, requests for additional information. A final panel featured Matt Gonzalez of Nonprofit New York, who described New York City’s Mayor’s Office of Nonprofit Services as a model for reducing contract backlogs, increasing advance payments, and improving coordination through ombudsman-style support and chief nonprofit officers. Public commenters from the California Alliance of Child and Family Services, SEIU, and CalNonprofits urged support for stronger state-nonprofit partnerships, transparency, and modernization of contracting systems. No formal vote was taken; the hearing concluded after testimony and public comment.

Transcript Highlights:

• And before the payment goes out by no later than September 15, 2026.
• So this is the percentage that we should reimburse.
• rather than the specified per-pupil payment amount.
• And looking forward to being able to reimburse our volunteers.
• And I'm looking forward to being able to reimburse our volunteers.

Committee: Joint Joint Committee on Finance

Keywords: 970, all

Transcript Highlights:

• What happens then with respect to the payments and the retroactive payments that were discussed earlier
• AND THE RETROACTIVE&nbsp; PAYMENTS THAT WERE DISCUSSED EARLIER?
• Not so much the payment side, but the reimbursement to the agency.
• 909 NOT SO MUCH THE PAYMENT SIDE BUT THE REIMBURSEMENT TO THE AGENCY.
• AND THE MEDICAID PAYMENT IS STILL $25 AN HOUR.

Summary: The Health Facilities Subcommittee met to receive implementation updates from the Agency for Health Care Administration on three bills passed in prior sessions. First, Deputy Secretary Brian Meyer reported on the transfer of the Children’s Medical Services managed care plan from the Department of Health to AHCA under HB 1085. He said the move was administrative only, with no change to enrollment, providers, services, or clinical eligibility functions, and that it was intended to create efficiencies by aligning procurement and shifting staff resources between agencies. Members then questioned AHCA about reports of reductions in private duty nursing and therapy services for medically fragile children, including concerns about appeals, provider credentialing, and whether families were losing services or being transitioned appropriately. AHCA said it was reviewing denials, monitoring the plan, and using contractual remedies while focusing on maintaining access for members. The committee also reviewed implementation of a bill creating permanent Medicaid eligibility for individuals with permanent disabilities. AHCA staff explained that the agency had submitted a federal 1115 waiver request after public comment and stakeholder meetings, but CMS had indicated it did not anticipate approving the requested authority. Members pressed AHCA on why the waiver was submitted later than the bill’s directive date and on whether the delay was avoidable. AHCA said the waiver was complex and required review, drafting, and public input, and noted that DCF already has a specialized unit to help with redeterminations while the agencies work on operational changes. The committee discussed the practical impact on families who struggle with annual eligibility renewals and the need for clearer communication and faster follow-up from the agency. Finally, AHCA presented on the home health aide program for medically fragile children and related Medicaid eligibility changes. The agency described the 2023 law that created a family caregiver provider type and the 2025 changes that increased the hourly rate, expanded hours, reduced training requirements, and removed caregiver earnings from Medicaid eligibility calculations, subject to federal approval. AHCA said it had completed state public comment, submitted the waiver amendment to CMS, and was awaiting federal action. Members raised concerns that some families may have enrolled or begun work before the eligibility fix was in place and may have lost benefits, especially in Broward County. AHCA said it would work with affected families and plans, review outreach through DCF and the health plans, and continue rulemaking, system updates, and provider training. The meeting ended with the chair noting that the committee had received the updates and adjourned without objection.

Transcript Highlights:

• And that’s a form that’s used relative to making the reimbursement, or the payment to the company, using
• And that’s a form that’s used relative to making the reimbursement, or the payment to the company, using
• And that’s a form that’s used relative to making the reimbursement, or the payment to the company, using
• And that’s a form that’s used relative to making the reimbursement, or the payment to the company, using
• And that’s a form that’s used relative to making the reimbursement, or the payment to the company, using

Keywords: 958, all

Summary: The speaker outlined Kentucky’s economic development strategy and how the cabinet evaluates and awards incentives. He emphasized using national benchmarks such as Site Selection and Area Development magazines, focusing on real data, competitiveness, and performance-based incentives. He said the state is performing well nationally in investment rankings, and credited the legislature with providing tools that help attract and retain jobs, especially through speed to market, site readiness, transportation, and workforce coordination. A major portion of the remarks described the “anatomy” of an incentive package: first improving sites and infrastructure such as water, sewer, roads, and rail spurs; then using sales tax benefits for construction materials and equipment; then training support through the Bluegrass State Skills Corporation; and finally the Kentucky Business Incentive (KBI) program, which reimburses qualifying expenses from incremental tax revenue. He said incentives are negotiated, data-driven, and targeted toward companies with strong wage levels, training plans, growth potential, and, in some cases, agricultural benefits or industry leadership. He also noted special treatment for heritage communities and said the state has expanded KBI beyond heavy manufacturing to include R&D, headquarters, and service businesses. The speaker also described compliance and oversight. Incentive agreements are written with job, wage, investment, and community-benefit terms, and companies must file regular reports and invoices. Cash incentives can be clawed back if commitments are not met, while tax credits are tied to actual investment and job creation. He said the Revenue Cabinet and Environment and Energy Cabinet play important monitoring roles, and that projects go through application review and preliminary approval by the Kentucky Economic Development Finance Authority before final approval and payment. He closed by thanking legislators for their support and for allowing more flexible, capped, and data-driven incentive tools.

Transcript Highlights:

• What's the formula for determining reimbursement rates?
• payment structures with, you know, if we're looking at... ...payment structures to quality, not just
• That has impacted our reimbursement rates in this grant and will also impact reimbursement rates in a
• And meanwhile, we've got to make payments to providers.
• Like, when we look at projected fund balance and reserves, we're payment to payment.

Committee: All EDUCATION- HOUSE EARLY CHILDHOOD SUBCOMMITTEE

Keywords: 1204, all

Transcript Highlights:

• payments.
• So, while all fraud payments are by definition improper payments, not all improper payments are fraud
• payments.
• So, while all fraud payments are by definition improper payments, not all improper payments are fraud
• . reimbursement. reimbursement.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board reconvened and heard a presentation from the Attorney General’s Office Medicaid Fraud and Abuse Control unit. AG staff described the unit’s structure and work: it investigates and prosecutes Medicaid provider fraud, and also handles abuse, neglect, and exploitation cases involving vulnerable adults in facility settings when asked to assist. They said the office has prosecutors, detectives, auditors, and support staff, works with federal partners, Commonwealth’s attorneys, CHFS, DMS, OIG, and MCOs, and uses a hotline and referral line for complaints. They also explained the MCO referral process, including monthly meetings, stand-down lists, and review of referrals for a “credible allegation of fraud” before the AG office decides whether to open a criminal or civil investigation. The presentation focused heavily on current fraud trends. Staff said behavioral health is a major concern, along with participant-directed waiver services, medically assisted treatment, cash billing for services, controlled-substance billing, and vision and dental fraud. They gave examples such as duplicate time sheets for family caregivers, questionable Suboxone counseling and urine drug screening practices, and a prior optometry case involving false claims for children’s glasses. They also discussed CMS’s estimate that about 5% of Medicaid payments are improper, noted that most improper payments are at the fee-for-service level, and said there is no reliable overall fraud-rate estimate. They highlighted a sharp shift in behavioral health billing after the cabinet’s November 1, 2024 policy changes, saying individual psychotherapy spending dropped while group billing increased, suggesting providers may have moved billing to different codes. Members asked about the scale and timing of cases, how MCO referrals are screened, and whether the data reflected more people being served or just higher spending. The AG office said investigations can take years, with some federal cases still awaiting sentencing from 2018 and 2019 matters, and that they currently had nine individuals awaiting sentencing in federal court. They also reported 58 hotline reports during the referenced period, six cases opened from MCO referrals, and four additional MCO referrals not accepted for active cases. Several members raised concerns about home-based services and the risk of abuse or fraud when family members are reimbursed, and asked whether the process could be streamlined; the AG office said it had no immediate recommendations but would be willing to return with suggestions after further review.

Transcript Highlights:

• So what are those lease payments? How much have we paid in lease since April of 2025?
• It also depends on some quarterly payments that will be made.
• It also depends on some quarterly payments that will be made and some end-of-the-year payments.
• But the insurance only reimbursed us for $1.8 million.
• But the insurance only reimbursed us for $1.8.

Committee: All ALC-PEER

Summary: The committee considered a series of appropriation, fund transfer, and reserve requests across multiple agencies. Section B temporary appropriations included funding for state technology upgrades, personnel management staffing and IT skills assessment, court reporters and interpreters, crime victim claims, juvenile sex offender assessments, radiation lab testing, and higher education workforce grants and credentialing pathways. Additional items covered an ARPA grant for the University of Arkansas Fort Smith LPN program, an IIJA grant for the Oil and Gas Commission’s critical minerals work, a restricted reserve transfer for State Police vehicle purchases, a transfer to the Arkansas Heroes Program, and cash fund requests for the Real Estate Commission’s AV system and HVAC work. Most of these items were approved by voice vote. One budget classification transfer request from the Commissioner of State Lands drew extended questioning and was ultimately not approved. Members questioned the $250,000 transfer to operating expenses tied to the purchase of a West Little Rock office building, the ongoing lease costs at the prior location, and whether the agency had adequately planned for building-related expenses. After discussion, the motion failed, and members told the agency to tighten spending and return if needed. The committee then took up 15 pay plan appropriation requests totaling $25.7 million and approved them after discussion with DFA, DHS, Corrections, and the State Board of Election Commissioners. Members focused heavily on DHS staffing shortages at human development centers, where officials said vacancies and turnover were driven by overtime and burnout rather than pay alone; one member asked DHS to submit a written plan to address the issue. Corrections reported the pay plan had improved hiring and retention. The committee also approved overtime appropriations for Emergency Management and Military. Reports on reserve funds, the Budget Stabilization Trust Fund, tobacco settlement, State Central Services, Education Adequacy, Medicaid Trust, IIJA, and revenue transfer activity were received. The Medicaid Trust Fund report prompted significant concern about February’s $90 million draw; DHS said the month was unusually high because of cash-flow timing and that the fund should end the year with a balance between $150 million and $200 million, while lawmakers noted a second $100 million set-aside is planned for FY27. The final discussion centered on DHS’s state hospital damage claim and reconstruction funding, where members expressed disappointment that insurance reimbursement would likely return only about $1.8 million now and possibly about $97,000 more later, far less than the roughly $5 million initially expected. DHS explained the policy was based on actual cash value and depreciation for old buildings, and said the work would proceed on Unit 3 for secured restoration because it was the most cost-effective option.

Transcript Highlights:

• Reimbursement rates are a key factor.
• These payments are provided on a per-member-per-visit basis.
• It's just a challenge to increase reimbursement rates in general.
• It was a one-time payment. In Colorado, they created a Take 5 program.
• And just as the dual reimbursement is changing the trajectory of birth outcomes, CHW and Reimbursement

Committee: Joint Joint Committee on Health Care Financing

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing on a large docket of bills focused on MassHealth benefits and reimbursement, health equity, behavioral health, public health, dental access, 340B drug pricing, tobacco cessation, and coverage for children. The chairs emphasized rising health care costs, provider shortages, administrative burdens, and persistent inequities by income, race, geography, and immigration status. Much of the testimony centered on H.1416/S.901, an act to advance health equity, with legislators and members of the Health Equity Compact arguing for statewide benchmarks, stronger health equity leadership, reimbursement for interpreter services, community health workers and patient navigation, Medicaid graduate medical education support, and a health equity zone trust fund. Witnesses described disparities in life expectancy, maternal mortality, access to primary care, and the impact of federal Medicaid and social service cuts, and urged the committee to report the bill favorably. The committee also heard strong support for H.1368/S.847 on rapid whole genome sequencing for critically ill MassHealth children. Testifiers from industry, academia, hospitals, and families said early sequencing can end long diagnostic odysseys, improve treatment decisions, shorten hospital stays, and save money, while also providing emotional relief and information for families. The hearing then moved to H.1407 on MassHealth rate parity for inpatient behavioral health providers, where Rep. Scanlan and the Massachusetts Association of Behavioral Health Systems said the bill would codify existing administrative parity so managed care plans cannot pay less than the MassHealth fee-for-service rate. On H.1392/S.853 to preserve and protect public health, witnesses supported higher vaccine administration fees to improve provider participation and immunization rates. The committee also heard testimony on H.770/845 to protect 340B providers in MassHealth, and on S.848 to require reporting and transparency around 340B revenues and outside administrative costs. Additional bills drew testimony on tobacco cessation coverage for MassHealth members, with advocates supporting broader access to counseling and medications through medical, behavioral health, and dental providers. On H.1409, a nursing home operator asked for more flexibility in a MassHealth staffing-related penalty tied to patient days per resident. On H.1401/S.888, supporters of the “Take 10” dental access proposal said adult MassHealth dental coverage is underused because too few dentists accept MassHealth, leading to long travel times and avoidable emergency room visits; they urged incentive payments for dentists serving new adult MassHealth patients. Finally, on H.1403/S.855, “Cover All Kids,” advocates and immigrant community members urged removal of immigration status as a barrier to full MassHealth coverage for children, while also backing a related bill to ensure 12 months of continuous coverage for children. No votes were taken during the hearing; the committee primarily received testimony and asked questions on costs, reimbursement levels, and implementation details.

Transcript Highlights:

• In fact, we know that instead of driving down... the national debt, public and non-public payments have
• It caps the total state directed payment amounts for inpatient hospital and nursing facility services
• at 100% of Medicare payment rates.
• It simplifies the payment plans by and large.
• payment error rate.

Keywords: 988, house, all

Transcript Highlights:

• It restricts state-directed payments from exceeding Medicare payment rates.
• January 2027 it restricts state new state directed payments from exceeding Medicare payment rates that's
• There are no new state-directed payments that can exceed the Medicare payment levels.
• And it requires existing state-directed payments... The Medicare payment levels.
• And it requires existing state-directed payments.

Summary: The committee first received an update on the effects of HR1 and related federal Medicaid and marketplace changes from Governor’s Office and Health Care Authority staff. Presenters said the most immediate coverage losses are expected in the individual market beginning in January, with premium increases and an estimated 80,000 people potentially unable to afford coverage. They warned that larger Medicaid impacts will follow over the next year and beyond, including tighter eligibility checks, work requirements, reduced retroactive coverage, limits on state-directed payments and provider taxes, new cost-sharing, and changes affecting certain non-citizen adults. They also said the state plans to seek a waiver or extension for work requirements and will continue to analyze impacts, including on rural providers and Planned Parenthood-related services. Members asked about the effect on nursing homes, rural hospitals, and how the state can help providers and enrollees navigate the new requirements; staff said timelines and a state-specific implementation chart are being developed. The committee then heard a report on the International Medical Graduate Work Group and Washington’s efforts to create pathways for internationally trained physicians. Testimony described the clinical experience license, the clinical evaluation assessment tool, grant funding for IMG support organizations, and a new hardship waiver process enacted this year. National presenters said many states have adopted similar pathways because of physician shortages, but Washington and Tennessee are among the few states that have actually issued licenses so far. They recommended clear guardrails, an employment offer before application, ECFMG certification, supervised practice, and data collection to avoid exploitation and protect patients. Members asked about state-to-state variation, retention of IMGs, and whether Washington should pursue dedicated residency or preceptorship options; presenters said the key next step is moving successful participants from supervised experience to a durable long-term license. The final topic was implementation of Washington’s Apple Health doula benefit and the statewide doula hub and referral system. Senator T’wina Nobles highlighted the state’s $3,500 per-birth Medicaid reimbursement rate for doulas and the importance of the hub for referrals, training, and billing. Health Care Authority staff said the benefit launched January 1, 2025, and covers prenatal intake, labor and delivery, postpartum visits, and telehealth-supported services. They reported 336 state-certified doulas, 134 enrolled in Apple Health, 287 unique clients served, and 641 claims paid so far. Testimony emphasized doulas’ role in improving birth outcomes, reducing unnecessary interventions, and addressing racial disparities in maternal health, while noting that implementation is still early and ongoing.

Transcript Highlights:

• a few cases, affect a provider's current reimbursement rate.
• So infant toddler bonus payments...
• Well, the payment goes to the provider. Provider. I know.
• We're going to hear DD Payment System Steering Committee.
• We're going to hear DD Payment System Steering Committee. Reimbursement Project on Development Act.

Summary: The committee first heard an update on North Dakota’s Interagency Council on Homelessness and Continuum of Care funding. Jennifer Henderson of the North Dakota Housing Finance Agency reported that homelessness remains driven by tight housing markets, low incomes, rising rents, and barriers to rental assistance, public benefits, and disability determinations. She said the state’s one-time North Dakota Homeless Grant is serving all regions but reaches far fewer households than the former Rent Help program, and that aging homelessness, shelter staffing shortages, and limited affordable units are growing concerns. Members discussed the need for more housing supply, better coordination with Health and Human Services, landlord engagement, reentry housing, and possible continued one-time funding for the $10 million Homeless Grant and $25 million Housing Incentive Fund. Henderson also warned that federal Continuum of Care funding is uncertain, with HUD expected to issue a new notice June 1 and possible shifts away from permanent supportive housing toward transitional housing and other models. The committee then took testimony on accessibility of government services for people who are blind, visually impaired, deaf, or hard of hearing. Paul Olson of North Dakota Vision Services School for the Blind described the school’s services for infants, children, and adults, including screenings, mobility training, assistive technology, and outreach across the state. He said the agency works closely with Vocational Rehabilitation and is also involved in improving website and document accessibility, especially for PDF materials. Public testimony highlighted barriers such as inaccessible CAPTCHA systems, online forms, driver’s license requirements on job applications, and limited transportation in rural areas. A deaf resident urged broader use of video remote interpreting and video relay services, along with training so people know how to use them effectively. Finally, Kay Larson presented the final report on the child care provider licensing study. The report recommended streamlining North Dakota’s child care licensing structure into three provider types plus a preschool designation, while preserving health and safety standards and maintaining eligibility for child care assistance. The committee discussed simplifying training and qualification rules, revising ratio and group-size requirements, and adjusting age bands for infants and toddlers. The report also noted that some changes would require statutory amendments and later administrative rule changes, with a transition period likely extending through 2029. No formal votes were taken in the transcript, but the committee accepted the updates and scheduled follow-up presentations for a later meeting.

Transcript Highlights:

• </c> do is it has the state funding payments do is it has the state funding payments oh<00:29:04.760>
• So there are payments that are scholarship payments that are not taxable under federal law.
• So there are payments that are scholarship payments that are not taxable under federal law.
• </c> questions about whether those payments questions about whether those payments would<00:34:46.119
• </c> receives the benefit of the EFA payment receives the benefit of the EFA payment can<00:42:53.559

Keywords: 928, house, all

Summary: The committee opened a public hearing on HB 402, a bill dealing with whether Education Freedom Account (EFA) payments should be described in state law as not constituting taxable income. The bill sponsor argued that the current statute is misleading because New Hampshire should not imply a federal tax result, and said the bill would remove that language and could also be amended to clarify that families should consult tax advisors. He emphasized that the measure was not intended to impose a state tax on EFAs, but to avoid giving inaccurate advice about possible federal tax liability. Testimony was divided. A retired representative and a tax preparer both opposed the bill, saying EFA payments are already treated consistently with IRS rules and that the bill would create confusion, administrative burden, and possible tax consequences for low- and moderate-income families. They argued the bill is a solution in search of a problem and warned that requiring 1099s could add costs for the scholarship organization and recipients. A tax attorney supported the bill’s repeal of the state language, saying New Hampshire should not put tax advice into statute and that the current wording is inaccurate because federal law, not state law, controls taxability. He cited IRS Section 117 and Publication 970, explaining that only some scholarship-like payments are tax-free and that many EFA-eligible expenses may not qualify for federal exemption. Members asked questions about what would be misleading, whether the bill was trying to tax EFAs, and the cost of issuing 1099s. The sponsor and witnesses repeatedly said the bill was not a state tax on voucher payments, but a clarification about federal tax treatment. No vote or final committee action was taken in the portion provided.

Transcript Highlights:

• We continue to serve them, but we lose the payment for reimbursement for these services.
• Protect PPS reimbursement.
• We didn't always give this payment. So this, it's PPS for the UIS population.
• Okay, so for about 10 years, they've had this payment.
• Okay, so for about 10 years, they've had this payment.

Summary: The subcommittee heard an extended briefing on the impacts of H.R. 1 on Medi-Cal and CalFresh, followed by testimony from the Legislative Analyst’s Office and county officials. DHCS described major Medi-Cal changes in H.R. 1, including work/community engagement requirements, six-month redeterminations, reduced federal matching for some emergency services, narrower immigrant eligibility, reduced retroactive coverage, and limits on provider taxes and directed payments. CDSS outlined CalFresh changes, especially the expanded able-bodied adults without dependents time limit, reduced exemptions and waivers, and the new federal-state-county administrative cost split. Both departments emphasized implementation plans, automation, outreach, and county coordination, while acknowledging significant expected coverage losses and administrative burden. The LAO and an independent policy expert discussed how H.R. 1 could increase demand on county indigent care systems and public hospitals as people lose Medi-Cal. They reviewed the history of county indigent care, 1991 realignment, and AB 85, explaining that counties already rely on a patchwork of funding and that current realignment revenues are often used for public health rather than indigent care. They warned that counties may face large increases in uninsured residents, with wide variation in how counties respond, and raised concerns about equity, financing, and whether a more standardized state-county program should be created. Committee members pressed witnesses on county funding, exemptions, homelessness, older adults, undocumented residents, and the effect of administrative burden versus true ineligibility. County representatives from Los Angeles, Santa Clara, Tulare, and San Bernardino described the expected local impacts and asked for additional state support. They said H.R. 1 would drive major losses in Medi-Cal and CalFresh enrollment, increase uncompensated care, strain eligibility staff, and worsen homelessness and food insecurity. Several counties urged the Legislature to fund eligibility workers, preserve enrollment, and consider a CalFresh match waiver; Santa Clara and San Bernardino also cited local tax measures and staffing reductions already underway. No formal vote or committee action was taken in the portion provided.

Transcript Highlights:

• And finally, contracts must clearly spell out the terms for reimbursement by clearly defining reimbursement
• , what documentation is required to recover payment, and how payments will be processed.
• Because the reimbursement terms were inadequate, Commerce issued $10.7 million in payments without sufficient
• Once Commerce began reviewing reimbursement requests more closely, subgrantees stated experiencing payment
• In another case, staff requested reimbursement documentation before issuing additional payments.

Summary: The Joint Legislative Audit and Review Committee subcommittee heard three State Auditor’s Office performance audits: implementation of the Law Enforcement Training and Community Safety Act, Washington’s digital equity planning, and the Department of Commerce’s Digital Navigator Program. In the law enforcement training audit, the State Auditor found the Criminal Justice Training Commission had developed most required training content but had not developed all required topics, lacked a systematic project management approach, and had weak tools to ensure participation and compliance. Auditors said most officers had not completed the required 40 hours, patrol tactics training was a major bottleneck, and the Commission’s reporting did not clearly show statewide compliance. The Commission said it generally agreed with the recommendations and had begun implementing some changes. Committee members raised concerns about staffing, liability, incentives, and whether the law had enough enforcement “teeth.” In the digital equity audit, auditors said Washington lacked a comprehensive, unified statewide plan, a designated leader, and reliable funding for digital equity efforts. They said existing plans were fragmented, with the NTIA-approved plan the most complete but no longer fully funded after federal changes. The State Auditor recommended the legislature establish oversight authority and require a lead organization to coordinate and evaluate statewide digital equity efforts and develop a unified plan. The Department of Commerce and Office of Equity agreed with the need for clearer leadership and coordination, and a public witness described ongoing coalition and local planning work. Committee members asked about best practices from other states and whether the auditor could provide additional research on coordination models. In the Digital Navigator Program audit, the State Auditor concluded Commerce did not consistently follow core grant-management practices, including competitive award processes, vetting of grantees, clear contracts, performance monitoring, and reimbursement controls. Auditors said Commerce expanded grants without a new competition, lacked adequate documentation and reporting, and paid out millions without sufficient support; they also cited management decisions that overrode staff concerns. Commerce said it had already begun major contract-management reforms, created a new contracts and compliance structure, and was working on risk assessments, documentation standards, and staff training. Members pressed Commerce on accountability, possible recoupment of improper payments, ethics issues, and whether the agency had clear performance metrics for the program. No votes were taken, and the hearing ended after public testimony and committee discussion.