Transcript Highlights:

• We cannot wait. We have waited more than a decade, and enough is enough.
• We cannot wait. We have waited more than a decade, and enough is enough.
• We cannot wait. We have waited more than a decade, and enough is enough.
• She said they can't wait because their time might run out.
• She said they can't wait because their time might run out.

Transcript Highlights:

• </c> have minor children, they have to wait have minor children, they have to wait 60<00:02:18.480><c
• </c> that 60-day waiting period starts. that 60-day waiting period starts.
• They're losing half the time assets.
• </c> Kentucky, with only a 60-day waiting Kentucky, with only a 60-day waiting period<00:11:43.760><c
• It was a horrific time in my life.

Committee: House Families & Children

Transcript Highlights:

• lists and depriving many of timely support.
• lists and depriving many of timely support.
• Connecticut, a long time. Maine, Pennsylvania, New York, New Jersey, long time.
• At the same time, the demand for ABA services continues to increase, and At the same time, the demand
• This time has a cost.

Committee: Joint Joint Committee on Health Care Financing

Summary: The Joint Committee on Health Care Financing held a public hearing on a range of health care financing bills focused largely on autism services and kidney disease coverage. Committee chairs John Lawn and Cindy Friedman outlined hearing procedures and noted that written testimony would continue to be accepted until each bill is acted upon. They said the day’s bills addressed affordability and access to behavioral health services, provider reimbursement, Medicare coverage for vulnerable patients, and MassHealth eligibility asset exemptions. A major portion of the hearing concerned House Bill 4623, which would recognize board-certified assistant behavior analysts (BCABAs) in the MassHealth reimbursement framework to help address long wait lists for autism spectrum disorder services. Representative Lisa Field and several providers testified that Massachusetts families face long delays for ABA services and that adding BCABAs would expand workforce capacity, reduce costs, and improve access. Wakely actuary Annie Tasman Ewing said a three-tier model could reduce MassHealth costs by up to 6% annually, while Dr. Sandra Beaton and others described severe wait lists and said the bill would allow more families to be served sooner. The committee also heard extensive testimony on House Bill 4425 and Senate Bill 2737, which would allow people under 65 with end-stage renal disease to purchase Medigap coverage. Representative Stanley, Senator Gomez, and advocates from the American Kidney Fund and Dialysis Patient Citizens argued that current law unfairly excludes these patients, leaves them with high out-of-pocket costs, and can delay transplant eligibility because many centers require secondary insurance. Testifiers said the change would help about 846 residents, could cost insurers only a small premium increase, and might reduce Medicaid spending by avoiding asset spend-downs. Committee members asked questions about the existing statutory carve-out and the practical effects on transplant access. The hearing also included testimony on House Bill 4353 and Senate Bill 2587, which would require regular Medicaid rate reviews for ABA services. Providers and clinicians said current MassHealth rates no longer reflect the cost of delivering care, especially with new 2026 policy requirements, workforce shortages, and accreditation obligations. They emphasized that the bills would not mandate a rate increase but would create a data-driven, transparent review process. At the end of the hearing, the chairs thanked participants, invited additional written testimony, and the committee voted unanimously to adjourn the hearing.

Transcript Highlights:

• Of those on the waitlist, nearly 40% have waited over a decade. JJ waited 18 years.
• Thank you for your time.
• So there are time frames in there.
• You do need some time for that.
• You do need some time for that.

Committee: Senate Appropriations Committee on Health and Human Services

Summary: The committee took up a series of health and human services bills, beginning with CS/SB 1602, which would require emergency departments to have evidence-based pediatric care protocols, training, appropriate child-sized equipment and medications, a designated care coordinator, and participation in a pediatric readiness assessment. It was reported favorably. CS/SB 1224 followed, aligning Florida law with federal requirements so paramedics may administer controlled substances in the field under physician or nurse practitioner protocols; it also passed favorably after supportive testimony from fire chiefs. The committee then adopted a strike-all for SB 890, the Emily Adkins Family Protection Act, which addresses venous thromboembolism by creating a statewide registry, requiring screening and training in hospitals and long-term care settings, and adding assisted living facility response requirements. Assisted living representatives objected to the ALF provisions as unrealistic and potentially harmful, while supporters argued the bill would save lives; the bill was reported favorably. CS/SB 1182, requiring continuous glucose monitors to be covered as both durable medical equipment and a pharmacy benefit, also passed favorably with support from AARP. The committee next considered CS/SB 12, a claim bill for a child severely injured after a DCF home visit allegedly failed to meet standards, and it was reported favorably without opposition. CS/CS/SB 954, dealing with substance abuse treatment centers and recovery residences, drew substantial debate. The bill would limit local zoning restrictions on treatment facilities and allow larger recovery residences if staffing ratios are increased; a late-filed amendment reduced the maximum active patients from 500 to 300. Municipal and county representatives warned that the bill could override local reasonable-accommodation efforts and create institutional-scale facilities, while supporters said housing is essential to recovery and that clustering concerns are overstated. The committee ultimately reported the bill favorably. CS/SB 1050, expanding the developmental disabilities pilot program statewide and creating a statewide family care council, also passed after extensive testimony from families and advocates. Supporters emphasized the long waitlist and the need for more services, while some speakers opposed managed care and warned about provider shortages and loss of individualized supports. Later, CS/SB 614, requiring a public educational webpage about background screening clearinghouse and level two screening requirements, was reported favorably. CS/SB 1578, which would require coverage for mammograms and supplemental breast cancer screening in certain circumstances, was also reported favorably. CS/SB 1060 created a joint legislative oversight committee to review Medicaid operations and financing; members discussed the need for stronger oversight of large midyear spending adjustments, and the bill passed favorably. CS/SB 1240, a Department of Children and Families substance abuse and mental health bill, was amended to clarify Baker Act transfer timing and notification requirements after debate over whether facilities could hold patients too long; it was then reported favorably. Finally, Senator Harrell presented CS/SB 526, a major nursing education bill aimed at Florida’s low NCLEX passage rates. The bill would require nursing programs to use exit exams, remediation, reporting, and stricter oversight, and the strike-all would add graduate preceptorships for low-performing programs and temporary provisional licenses for graduates pending NCLEX passage. The transcript ended while that bill was still being explained, before final action was taken.

Transcript Highlights:

• Our average wait time is 254 days. The longest one that we know of is 531 days.
• Then they will start a wait list.
• We implemented the wait list, so it kept people from getting in the At any time.
• So the wait list grew. Yes, the wait list grew. We didn't have a wait list.
• And that's the most important time.

Committee: All EDUCATION- HOUSE EARLY CHILDHOOD SUBCOMMITTEE

Summary: The committee received an extensive update from the Office of Early Childhood on Arkansas child care and early learning funding streams, including CCDF/School Readiness Assistance (SRA), Arkansas Better Chance (ABC), Head Start/Early Head Start, EIDT, PDG B-5, and local school district funding. Staff explained how each stream is funded and administered, noted that federal SRA funding follows the family while ABC funds go to agencies, and reviewed current enrollment, provider counts, spending, and compliance data. They also reported that co-pays and tighter enrollment verification have stabilized SRA spending, that ABC allocations are now based more on demonstrated community need, and that a market rate survey and cost analysis are underway to inform future reimbursement decisions. Members asked about provider closures, wait lists, utilization rates, infant-toddler shortages, suspended licenses, workforce pay, and whether the state tracks outcomes for children who attend different early childhood settings. Staff said there are about 1,800 licensed providers, with recent net capacity gains but ongoing closures for reasons including financial strain, ownership changes, retirement, and relocation. The SRA wait list was reported at 2,364 families covering 3,428 children, with priority given to federally defined categories such as homelessness, foster care, special needs, teens, and TANF families. Officials also said they do not currently track average tuition, workforce turnover, or long-term child outcomes across all providers, though they do have some ABC readiness data and are exploring better data systems. The committee also heard from Forward Arkansas’s Center for Early Learning Solutions, which described a new statewide effort focused on early childhood systems improvement. The presentation highlighted a landscape analysis showing families’ difficulty finding infant-toddler care, providers’ administrative burden, and interest in shared services, better data systems, and quality supports. The center outlined projects on local lead networking, governance and finance analysis, tech-enabled child care management systems, and an open-source HQIM pilot. Members discussed the need for more funding, better coordination across agencies, and stronger data on child care access, affordability, and outcomes. No votes were taken beyond the initial motion to approve the minutes, and the meeting adjourned after the presentations and questions.

Transcript Highlights:

• At this time, the House will be at ease for a minute while we wait for those committees to return and
• It's that hurry up and wait time, and we appreciate your indulgence.
• Hurry up and wait time. And we appreciate your indulgence. With that, the House will be at ease.
• Together, we use one-time federal funds responsibly on one-time needs, not ongoing programs that will
• Wait. Wait. Wait. We're hit? Thank you. Thank you. Thank you. Thank you. Thank you. Thank you.

Transcript Highlights:

• But you tell us to wait. We got to wait.
• Not one time.
• Because we got to wait, because it takes a long time. It takes more than 12 years.
• . ...but you'll have to wait because everybody has to wait.
• There is no more time. We don't need to wait until June for another assessment.

Summary: The hearing focused on the long-delayed Southern California Veterans Cemetery project at Gypsum Canyon in Anaheim, with members of the Assembly, Senate, City of Anaheim, Orange County, CalVet, DGS, and veterans organizations discussing next steps. Chair Sharon Quirk-Silva reviewed the project’s history, including the earlier Irvine effort, the 2021 Anaheim support resolution, county and state funding commitments, and the recent federal determination that the site meets criteria for a state veterans cemetery. Speakers repeatedly emphasized the need for a local burial site for Orange County’s large veteran population and the burden on families who currently must travel to Riverside, San Diego, or Los Angeles. The first panel featured veterans advocates and Gold Star family members who strongly urged immediate action. The American Legion, Gold Star Mothers, and the Veterans Alliance of Orange County said the cemetery is overdue and stressed that older veterans and grieving families should not have to wait longer. Several speakers described personal losses and the hardship of long travel to existing cemeteries, while also calling for CalVet and state leaders to move faster and communicate more directly with veterans groups. Assembly and Senate members responded with support, noting the bipartisan nature of the effort and the importance of honoring veterans and their families. The second panel, with Orange County officials, described the county’s support and the unique shared-use arrangement with the Orange County Cemetery District. Supervisor Don Wagner said the county has dedicated land and $20 million, and county and district staff explained that the public cemetery and state veterans cemetery can share roads, utilities, grading, and other infrastructure to reduce costs. They said the county is ready to transfer property to CalVet when appropriate and that collaboration could save tens of millions of dollars. The third panel from DGS and CalVet explained that a 2023 feasibility study estimated the state’s portion at about $126 million under earlier assumptions, but that a revised concept plan is now being developed to lower costs and update the timeline. CalVet said it remains committed to the project, while legislators pressed for clearer answers on what is needed to begin construction and how budget action in the coming year could help. No formal vote was taken; the hearing ended with public comments, many of which echoed the call to begin construction immediately and criticized the pace of state action.

Transcript Highlights:

• But you tell us to wait. We got to wait.
• Not one time.
• Because we got to wait, because it takes a long time. It takes more than 12 years.
• Or do we have to wait? I won't know because... Or do we have to wait?
• There is no more time. We don't need to wait until June for another assessment.

Summary: The hearing focused on the long-delayed Southern California Veterans Cemetery project at Gypsum Canyon in Anaheim, with opening remarks from Assemblymember Sharon Quirk-Silva, Senator Tom Umberg, and Assemblymember Avelino Valencia emphasizing the project’s importance to Orange County veterans and families. Anaheim city leaders, including the mayor pro tem and council members, voiced strong support and described the city’s role in planning, utilities, and final approvals. Quirk-Silva reviewed the project history, including prior legislation, county and state funding commitments, and the recent federal determination that the site meets VA criteria for a state veterans cemetery. The first panel, representing the veterans community, included the American Legion, American Gold Star Mothers, and Valor. They argued that Orange County—home to a large veteran population—still lacks a local veterans cemetery, forcing families to travel long distances to Riverside or elsewhere. Testimony stressed the emotional and practical burden on aging veterans and grieving families, and called for immediate action and possession of the property. Some speakers were sharply critical of CalVet and the pace of the process, saying veterans have waited too long and that the project should move forward without further delay. The second panel, from Orange County, described the county’s and cemetery district’s support and the unique opportunity to develop a shared site for a public cemetery and a separate state veterans cemetery. County officials said the county has dedicated land and funding, and that shared infrastructure—roads, utilities, grading, and access—could reduce costs substantially if the two projects are coordinated. They also said the county is ready to transfer the property to CalVet when appropriate and that the project has already cleared major local approvals and litigation. The final panel from DGS and CalVet explained the state’s feasibility study and current planning work. DGS said the 2023 study estimated the state’s portion of phase one at about $126 million, largely driven by site work and grading, though that estimate may change as assumptions are updated. CalVet said it is working with DGS and the county on a revised concept plan to lower costs and refine the timeline, and that legislative budget action will be needed to authorize spending from the Southern California Veterans Cemetery fund. No formal vote was taken; the hearing was informational, and the main action was continued coordination among the state, county, city, and veterans groups, with public comment at the end overwhelmingly urging faster construction.

Transcript Highlights:

• Another key part of this bill is the minimum 72-hour waiting period between the time the background check
• <c> a</c><00:05:03.199><c> cooling</c> time waiting periods provide a cooling time waiting periods provide
• Needing to wait would have given him time to think about his decision.
• Needing to wait would have given him time to think about his decision.
• Needing to wait would have given him time to think about his decision.

Committee: House Criminal Justice and Public Safety

Transcript Highlights:

• Let the us on in time for dawn.
• </c><00:02:57.240><c> running</c> time is running time is running out out out for for for everyone.
• </c> at this time. at this time.
• Waite and his wife, Sergeant-at-Arms Administrative Assistant Donna Waite, for their dedicated state
• Mike Waite has been a part of the State House for 20 years, and in that time he had the bright idea of

Transcript Highlights:

• because I think that's a little... the wait list that we were speaking of last time, because I think
• wait list?
• One is just a refresher: What is the average wait time for the wait list, please?
• How accurate is the wait list?
• Are you purging it if people move, if people unfortunately pass away, or if there's a longer wait time

Summary: The Health Care Budget Subcommittee took up two bills and then continued oversight discussions with APD and AHCA. CS/HB 27, the Social Work Licensure Interstate Compact, was presented as a way to let Florida social workers practice in other compact states and vice versa; AARP, the Florida Chamber, and NASW Florida supported it, and the bill passed favorably. HB 1127, a child welfare bill, would create a treatment foster care pilot for children with high behavioral needs, improve DCF data collection on commercially sexually exploited children, and expand recruitment for protective investigators and case managers; the bill also passed favorably after brief supportive testimony. The committee then questioned APD at length about the iBudget waiver waitlist, enrollment pace, spending projections, and provider capacity. APD said it had sent more than 1,100 interest letters in categories 3, 4, and 5, enrolled 1,124 people so far this year, and expects to spend about 96.4% of its waiver appropriation, leaving roughly $82 million unspent. Members pressed APD on why prior discussions suggested more reserve was needed, how long the SANS process takes, whether category 6 could be expanded, and whether the agency has enough waiver support coordinators and direct support providers. APD said it has about 1,061 waiver support coordinators statewide, adequate capacity for current enrollees, but would need further analysis if the legislature directed a much larger enrollment increase. Members also asked about outreach, annual maintenance of the waitlist, portability for military families, and whether communication efforts should be privatized. Finally, AHCA walked the committee through the 2023 Achieved Savings Rebate (ASR) report for Aetna and explained how the report is used for financial monitoring, rebate calculations, and transparency. AHCA said the ASR is separate from the medical loss ratio (MLR) calculation, though both are reviewed, and that Florida uses the ASR mechanism rather than an MLR remittance requirement to recover funds from plans. Members asked about related-party disclosures, CVS/Caremark relationships, expanded benefits, encounter data, network adequacy penalties, denials and appeals reporting, interest earned on capitation payments, and whether rate increases were reaching providers. AHCA and the outside auditors said they review the plans’ reported data, reconcile it to underlying records, and can assess liquidated damages for network adequacy violations; several members requested follow-up data on rebates, interest, provider capacity, and related-party reporting.

Transcript Highlights:

• So what are those waiting times?
• So what are those waiting times?
• So what are those waiting times?
• So what are those waiting times?
• for waiting times.

Summary: The Medicaid Oversight and Advisory Board meeting began with a roll call and approval of the October 7 meeting minutes. The chair then reordered the agenda to hear the item on Medicaid reimbursement rates and network adequacy first because of scheduling issues. Dr. Steve Robertson of the Kentucky Dental Association was sworn in and testified at length about Kentucky’s dental Medicaid program, arguing that reimbursement rates are unsustainably low, have been largely flat for decades, and are often below the cost of providing care. He said Kentucky ranks near the bottom nationally in oral health, dental Medicaid rates are often 60% or less of commercial rates, and the program’s share of the Medicaid budget has effectively remained around 2% despite growth in enrollment and services. Dr. Robertson said the low rates are contributing to provider losses, rural access gaps, longer wait times, dental deserts, and greater use of emergency rooms for preventable dental problems. He cited examples of office costs exceeding reimbursement for basic procedures, noted that many dentists are small private businesses, and said the state is struggling to recruit and retain dentists because of low payment levels and high student debt. He also pointed to disparities with neighboring states and said recent increases in some oral surgery and cleaning codes were not enough to address the broader problem. His recommendations included completing the rebasing study, increasing dental reimbursement in the upcoming budget, tying future reviews to inflation and cost data, aligning benchmarks, and prioritizing preventive and restorative care to improve workforce stability and access. Board members asked about the size of the needed increase, the effect of private insurance on dental practice finances, and what a new dentist might expect to earn. Dr. Robertson said the association is working on an appropriations request and that private insurance pressures are part of the problem as well, since many plans are HMOs or PPOs with limited provider control over rates. He also said the association can no longer conduct reimbursement surveys because of FTC restrictions, but would try to obtain current ADA data. In response to questions about the future of the program, he warned that without significant changes it could become unsustainable and cited Ohio and Missouri as examples where higher reimbursement improved provider participation and access. The board then heard from Mr. Bowman of Baldwin Consulting, who discussed outpatient behavioral health providers, including ABA therapy and mental health/substance use disorder services. He said these providers face similar issues of rising costs, flat reimbursement, and access problems. He reviewed Kentucky’s network adequacy standards, including travel-time standards, 30-day appointment limits, and newer federal requirements that will require services within 10 business days by 2029. He said wait times for outpatient behavioral health, especially children’s services and ABA, have grown substantially, sometimes to more than a year, and emphasized that the Medicaid department must enforce these standards.

Transcript Highlights:

• We are waiting on our quarter two payment to come in.
• children are waiting, so you can see that there's a little over 3,000 children on our wait list.
• That was the last time that there was an increase.
• I would like to get some additional insight on the wait list. Are there caps on the wait list?
• For SRA, it is a statewide wait list.

Committee: All EDUCATION- HOUSE EARLY CHILDHOOD SUBCOMMITTEE

Transcript Highlights:

• children are waiting, so you can see that there's a little over 3,000 children on our wait list.
• That was the last time that there was an increase.
• That was the last time that there was an increase.
• I would like to get some additional insight on the wait list. Are there caps on the wait list?
• Okay, so for SRA, it is a statewide wait list.

Summary: The Early Childhood Committee met for an update from the Office of Early Childhood within the Department of Education. Members heard that the office’s goals under the LEARNS Act are to improve kindergarten readiness, support families, ensure quality providers, and expand affordable, accessible child care. Staff reviewed the local lead system, licensing, quality efforts such as CLASS and QRIS, and the two main funding streams: School Readiness Assistance (SRA), a federal CCDF-funded voucher program serving about 14,600 children with a wait list of a little over 3,000, and Arkansas Better Chance (ABC), a state-funded program serving about 21,000 children with authority recently increased to 24,000 slots. A major topic was the difference between market rate surveys and cost analysis studies. Officials said the department is procuring both through an RFP, hoping to begin by August and have results by late in the year. Members pressed for current reimbursement levels, the gap between ABC and SRA funding, and whether ABC funding should be increased to better match costs. Staff explained that SRA rates are set at 75% of the market rate, while ABC per-child funding is much lower, and that ABC slots are limited by the overall allocation. They also explained that some ABC slots were increased by moving children from a discontinued federal pre-K arrangement into ABC to preserve continuity of care. Committee members raised concerns about rural access, infant and toddler shortages, provider stability, workforce pay, and communication with families and providers. Officials said local leads are now helping identify underserved areas, that no county with absolutely no care is known, and that the department is trying to get a truer statewide count of children and providers. They also described efforts to improve communication through monthly provider calls, website postings, and direct case contacts with families. Members discussed possible funding increases, including ideas to reduce the SRA wait list and raise ABC funding, but no formal vote or action was taken beyond approving prior meeting minutes and receiving the update.

Transcript Highlights:

• lists and depriving many of timely support.
• I began dialysis as a young, first-time parent.
• Connecticut, a long time. Maine, Pennsylvania, New York, New Jersey, long time.
• At the same time, the demand for ABA services continues to increase, and At the same time, the demand
• This time has a cost.

Bills: H4353 , H4425 , H4453 , H4623 , H4770 , S2587 , S2737

Committee: Joint Joint Committee on Health Care Financing

Keywords: behavioral health, Medicaid, reimbursement rates, healthcare providers, service delivery, accreditation, Medicare, end-stage renal disease, healthcare access, patient coverage, renal failure, MassHealth, asset limit, personal vehicle exemption, vehicle value, healthcare, autism, ABA services, assistive technology, children

Transcript Highlights:

• Time is our friend.
• So it might be Leslie's time, might take a different amount of time than Carmen's time.
• c> Carmen's</c> different amount of time than Carmen's different amount of time than Carmen's time.<00
• So we broke out wait list by time frame.
• So this a few times.

Summary: The Medicaid Oversight Advisory Board’s fourth meeting focused primarily on a presentation from University of Kentucky and University of Louisville health leaders about the state university directed payment program. Mark Birdwhistle and Ken Marshall described the program as a long-running, value-based Medicaid arrangement that began in 2019, uses university-provided matching funds rather than provider taxes, and ties a portion of payments to quality outcomes. They said the program has improved measures such as tobacco cessation, diabetes control, depression screening, and cancer screening, while supporting access to specialty care, medical education, and workforce training. They also emphasized that Kentucky’s model is nationally notable and has helped improve health rankings and generate cost savings. A major topic was the federal reconciliation bill signed July 4, which the presenters said will reduce directed payments by 10% annually for 10 years beginning in 2028. UL Health estimated a first-year loss of about $75 million and a cumulative loss of about $600 million over the decade; UK estimated about $100 million in the first year, for a combined first-year impact of roughly $175 million. Both speakers warned the cuts could affect access to care, training capacity, and the sustainability of Kentucky’s value-based model, though they expressed hope that congressional action could alter or delay the changes. They also noted that 340B drug pricing changes could further strain already thin operating margins, but did not provide exact figures during the meeting. Committee members responded positively to the program’s reported outcomes and the institutions’ role in Kentucky health care. Senator Berg praised the quality of care and shared a personal example of being advised to stay at UofL for breast cancer treatment. Representative Moer highlighted Kentucky’s strong cancer-control score and asked for more explanation of the value-based payment structure; the presenters said the system is built around ongoing measurement, accountability, and collaboration with the Cabinet for Health and Family Services. No votes or formal actions were taken beyond approving the amended August 27 minutes by voice vote.

Transcript Highlights:

• close I'll wait wait wait close on the amendment all right I'll wait.
• She should be here playing and laughing and having a good time and being able to spend time with our
• Waite. Thanks.
• Waite. Thank you.
• I was hoping to save you all time by not having to wait for the rest of the bills be presented.

Bills: S0212 , S0656 , S0682 , S0810 , S0812 , S0890 , S0892 , S0900 , S0928 , S1084 , S1284

Committee: Senate Criminal Justice

Keywords: sexual offender, sexual predator, sex offender registry, child protection, residency restriction, loitering, proximity restriction, public swimming pool, school safety, child care facility, day care center, park, playground, conditional release, probation, community control, warrantless arrest, background check, registry screening, minor victims

Transcript Highlights:

• What is our average wait time for that service? So are we providing...
• We estimate that wait list right now will start somewhere in late summer, early fall time frame.
• So we estimate a wait list for residential services, likely the January time frame.
• So we estimate a wait list for residential services, likely the January time frame.
• What have we one-timed it every time or something?

Summary: The Budget Committee heard the Department of Mental Health’s FY 2027 budget presentation, with Director Valerie Hoon outlining a $4.4 billion department budget, including $1.7 billion in general revenue, and describing the department’s roles in substance use, behavioral health, and developmental disabilities services. Early questioning focused on marijuana-related mental health impacts, but the main discussion centered on the department’s new decision items, funding sources, and expected wait lists. The director explained several increases tied to Medicaid growth, mental health youth services, outpatient competency restoration, crisis residential services, developmental disability waivers, and provider tax adjustments, along with offsets such as reduced wraparound funding at the Kansas City Assessment and Triage Center and cuts to some youth and self-directed DD services. A major portion of the hearing focused on competency restoration for people found unfit to stand trial and currently held in county jails. Members pressed the department on the cost, effectiveness, and legal implications of keeping people in jail while awaiting services, noting a reported wait list of roughly 524 to 538 individuals and average holds of about 14 months. The department said it currently has eight outpatient competency restoration beds in the community, is seeking funding for 50 additional outpatient slots, and also operates jail-based restoration for about 40 people at a time. Members repeatedly asked for breakdowns of violent versus nonviolent cases, success rates, cost per person, and the split between state and federal funding, while the department explained that Medicaid can cover only the treatment portion, not residential housing or other non-billable costs. The committee also discussed broader capacity constraints in state hospitals and developmental disability services. Hoon said Fulton, Center for Behavioral Medicine, and FTC North are full, with 183 vacancies across the department, and that the department is working on a new Kansas City hospital that would add 150 beds, though completion is now expected closer to 2029 or 2030. In the developmental disabilities section, the department warned that the governor’s recommendation would create wait lists for in-home waiver services and crisis residential services, and members questioned proposed reductions to self-directed services rates and other provider payments. No votes were taken, and the committee recessed before finishing the presentation.

Transcript Highlights:

• And at the time, they had a waiting list, so we weren't really worried.
• And I said, what's the average length of time of waiting? And they said, maybe six months.
• We do not have the time to wait and must implement a solution that will help older adults, who often
• We do not have the time to wait and must implement a solution that will help older adults who often have
• The people living with ALS don't have time to wait. Their families don't have time to wait.

Summary: The committee heard testimony on several aging-related bills, with most speakers focusing on housing stability, home-based services, and care transitions. Representative Badger and a commissioner testified in support of H4039, which would create a universal breakfast and lunch program at senior centers funded through a new Senior Breakfast and Lunch Fund, arguing it would reduce food insecurity and social isolation among older adults. Representative Lipper-Garabedian and multiple providers then supported H780/S495, the hospital-to-home partnership program, describing how embedded aging-services liaisons help older patients transition safely from hospitals to home, reduce readmissions, and avoid nursing facility placement; witnesses from Mystic Valley Elder Services and Mass Aging Access cited pilot results, including hundreds of patients served and examples of substantial cost savings and successful discharge planning. The committee also took testimony on S478, which would require continuing care retirement communities to disclose entrance-fee refund policies more clearly at enrollment. Senator Lovely and LeadingAge Massachusetts said the bill would improve transparency for residents and families, while a consumer witness said her family experienced delays and confusion in getting a refund after her mother left a CCRC. Members noted the issue is also being examined by a special commission on CCRCs. A large portion of the hearing focused on S475, a statewide bridge subsidy program for older adults facing housing instability. Advocates from the Massachusetts Coalition for the Homeless, Western Massachusetts, Somerville, Northampton, East Hampton, Old Colony Elder Services, and Somerville’s Office of Housing Stability described rising senior homelessness, long waitlists for subsidized housing, and cases where short-term rental assistance kept older adults housed while they waited for permanent housing. Somerville witnesses said the pilot program helped nine households remain housed and that some participants have since moved into permanent housing. Members asked about wait times, program design, and how to prioritize applicants; witnesses emphasized flexibility, emergency risk, and the need for a statewide expansion. The hearing also included testimony on S465, an ALS bill that would expand home care access regardless of age and bar the use of quality-adjusted life-year metrics in coverage decisions, with the sponsor and ALS Association arguing the measure would reduce discriminatory treatment and better center patient care. No votes were taken during the hearing.

Transcript Highlights:

• So the three-day wait, we're allowing them to waive the three-day wait to purchase based on their experience
• They have greater than a lot of time in training, given...
• So the three-day wait, we're allowing them to waive the three-day wait to purchase based on their experience
• Well, you're going to have to wait for three days.
• So I support us, you know, removing this waiting period.

Committee: Senate Criminal Justice

Summary: The committee met and took up several criminal justice, public safety, and boating measures. It first heard SB 168, the Tristan Murphy Act, which would create mental health diversion options for eligible misdemeanor and felony defendants, expand mental health and substance abuse grant uses, require evaluations and treatment recommendations in certain cases, add Hillsborough County to a forensic diversion pilot list, and create a behavioral health data repository. After adopting a technical amendment, the bill received strong support from NAMI Florida, family advocates, sheriffs, and the Murphy family, and was reported favorably on a unanimous vote. The committee also approved SB 86, expanding peer support programs for certain law enforcement support personnel, and SB 472, allowing inmates who complete approved education in correctional facilities to receive credit toward professional licensure requirements. Both bills were amended and then reported favorably without opposition. SB 276, which increases penalties for unlawfully sheltering or aiding an unmarried minor and creates a defense for actions taken to protect a minor from danger, drew questions about runaway youth, LGBTQ youth, and the scope of the defense; the sponsor said he was open to further amendment, and the bill passed favorably. Members then approved SB 402, updating the unlawful use of uniforms, medals, or insignia statute to reference the armed forces by definition rather than by branch. SB 490, as amended, would let law enforcement, correctional, and correctional probation officers carry concealed off duty and exempt law enforcement officers, correctional officers, and active military service members from the three-day waiting period for rifle and shotgun purchases; it passed 8-1 after debate over the waiting period and equal treatment concerns. Finally, the committee passed SB 628, Lucy’s Law, to strengthen boating safety and penalties, after adopting an amendment that removed proposed changes to warrantless blood draws and boating education requirements; the bill was supported by the family of Lucy Fernandez and passed unanimously. The meeting then adjourned.