Transcript Highlights:

• There will be an increase in uninsured individuals, and that will likely lead to higher acuity, higher
• So, no, they do very well, but they're very associative with visually.
• , and you draw a fence, for example, in an area with something permanent that they can associate visually
• to overcome in The future if you want to remove that virtual fence because they're associating the visual

Transcript Highlights:

• And that even their acuity after the fact is greatly improved.
• And that even their acuity after the fact is greatly improved.
• "And that even their acuity after the fact is greatly improved.
• You can visually see when students are in need of expending it; their movements become somewhat erratic
• You can visually see when students are in need of expending it; their movements become somewhat erratic

Keywords: 1191, senate, all

Transcript Highlights:

• I was having a hard time visualizing how that was going to work.
• An increase in acuity is the main issue they're seeing at Hospital Galveston recently.
• And the increasing acuity of these populations can be seen in your handouts on slide 5.
• And so the same thing with my highest acuity, I have essentially an inpatient psychiatry unit, and those
• Visualizing, we would probably be Tyler. Is there one in Tyler? Yes, sir. Okay.

Summary: The Senate Finance Committee heard the Legislative Budget Board’s overview of the Texas Department of Public Safety’s 2026-27 budget, followed by extensive testimony from DPS leadership. The LBB presentation covered funding and staffing changes across driver license services, facilities, troopers and recruit schools, crime labs, vehicle and aircraft operations, and border security. The recommendations included added support for customer service staffing and trooper hiring, but did not include several DPS exceptional items such as major driver license staffing and technology requests, new regional headquarters in El Paso and San Antonio, and other capital projects. Members also discussed proposed rider changes, including a new rider to lapse unused trooper funding and require reporting after recruit schools. Much of the committee’s questioning focused on driver license operations, where senators criticized long call wait times, low call-answer rates, appointment delays, and what they viewed as an overreliance on adding staff rather than improving processes. DPS and LBB witnesses said the agency is pursuing some technology upgrades, including automation, online pre-population of applications, and appointment-system improvements, but acknowledged that the driver license division remains a major problem area. Senators also raised concerns about whether the 2019 efficiency study led to meaningful changes and whether the agency should consider broader process redesign or even a different administrative structure. Colonel Freeman and other DPS officials then defended the agency’s broader law enforcement and border-security work, emphasizing the need for the Williamson County training academy, the 500 additional troopers funded in prior sessions, and continued support for Operation Lone Star. They described DPS’s role in border interdiction, threat-to-life investigations, oilfield theft cases, Capitol and Alamo security, and highway safety, and said the agency is stretched thin by deployments and overtime. Members asked about border reimbursement possibilities, regional staffing differences, pursuit safety, fleet and aircraft replacement needs, and the Texas Ranger Hall of Fame museum. No votes or formal actions were taken in the portion provided.

Transcript Highlights:

• problems where we have more high acuity problems where we have more high acuity youth<00:05:04.080
• We know that the high acuity before.
• So for the high acuity >> That's okay.
• ,<00:32:27.760> not juveniles that are not high acuity, not juveniles that are not high acuity
• Right now, the high acuity treatment.

Keywords: 958, all

Summary: The Senate Judiciary Committee met with a quorum and took up Senate Bill 125, sponsored by Sen. Danny Carroll, which would create a structure for evaluating and placing juveniles with acute mental illness, including a continuum of care and a process for resolving placement disputes between the Justice Cabinet and Juvenile Justice Cabinet through a judge. The committee adopted a committee substitute before hearing the bill. Carroll described several changes in the substitute, including removing language that would have made juvenile information nonconfidential in certain lawsuits, requiring public escape information to be removed once a juvenile is returned to custody, clarifying escape charges for juveniles absent without leave, and revising language about when hospitals may discharge high-acuity youth until a new facility is built. Carroll and Justice Cabinet officials Mona Wamik and Dr. Clark Lester argued that Kentucky needs a secure high-acuity mental health facility for violent juveniles because detention centers are not equipped to provide psychiatric treatment, private hospitals often refuse these youth, and current staff cannot administer the level of care needed, including intramuscular medication. They also said the bill would support two new female detention centers to help return DJJ to a regional detention model. Carroll cited prior juvenile detention crises, ongoing lawsuits, and a Department of Justice investigation, saying the bill could affect whether Kentucky faces a consent decree. Wamik said the proposed high-acuity facility would serve youth clinically assessed as needing secure treatment and would be designed to balance security with clinical care. Senators asked about how the bill would apply to a violent 14-year-old, whether the facility would simply isolate dangerous youth, what clinical care DJJ can currently provide, and staffing and cost estimates. Carroll said the bill would not change criminal accountability but would apply only if a youth were found to be severely mentally ill and need treatment placement. Dr. Lester said DJJ currently can provide only oral psychiatric medication and cannot administer intramuscular injections or the physical holds needed for acute psychiatric treatment. Cabinet staff said staffing would need to be higher than in a standard detention setting and estimated annual operating costs for the high-acuity facility at about $12 million, compared with about $8 million for a regular juvenile detention facility. No vote on final passage was taken during the portion of the meeting provided.

Transcript Highlights:

• In section one, it also provides for a process for high-acuity youth to move to a lower continuum of
• In section one, it also provides for a process for high-acuity youth to move to a lower continuum of
• In section one, it also provides for a process for high-acuity youth to move to a lower continuum of
• In section one, it also provides for a process for high-acuity youth to move to a lower continuum of
• Acuity Youth Detention Center that would be the highest level of care for these high-acuity violent children

Keywords: Meeting Start: 00:00:00 Roll Call: 00:00:04 SB 02: 00:01:37 Discussion in Opposition to SB 02: 00:09:49 SB 84: 00:22:19 SB 111: 00:30:35, 958, all

Summary: The committee first considered Senate Bill 2, sponsored by Senator Mike Wilson, which would prohibit incarcerated people from receiving cross-sex hormones or gender-affirming surgeries, while allowing a tapering period if stopping an existing treatment would cause physical harm. Wilson said the bill was needed to prevent the Department of Corrections from providing such care by memo or policy rather than statute, and he argued the care was elective and not medically necessary. Senators Thomas, Neal, Nemes, Styers, and others questioned whether any gender-affirming surgeries had actually occurred in Kentucky, whether the hormone treatments were physician-prescribed, and whether the bill would override medical judgment; Wilson said the department reported no surgeries, that 67 incarcerated people were receiving cross-sex hormone therapy, and that he would only support treatment if it fit the bill’s narrow medical-harm exception. Public testimony on SB 2 was strongly opposed. Chris Hartman of the Fairness Campaign said the bill would deny medically necessary care, violate the Eighth Amendment, and target a very small and vulnerable incarcerated population. Dr. Jack Skilles testified that gender-affirming care is medically necessary and supported by major medical organizations, warning that denying it could worsen mental health and lead to suicidality. Hannah Callahan, a transgender woman, described being denied hormone therapy while incarcerated and said the interruption caused severe physical and mental harm, including suicidal thoughts. Emma Curtis, Lexington’s Fourth District councilwoman, also urged a no vote, framing the issue as a matter of compassion and religious duty. The committee then voted on SB 2. Senator Neal explained his no vote by saying he was not medically trained and deferred to doctors; Senator Nemes said he wanted clarification that the bill would not stop ongoing treatment; and Senator Styers argued the bill was a poor priority and noted there was no fiscal note and that only 67 people were affected. Senator Wheeler moved the bill, Senator Reed seconded, and the committee reported Senate Bill 2 favorably. Afterward, the committee began hearing Senate Bill 84, sponsored by Senator Steve Rawlings, which would limit judicial deference to state agency interpretations and require courts, not agencies, to interpret ambiguous laws, citing the U.S. Supreme Court’s 2024 Loper Bright decision overturning Chevron deference.

Transcript Highlights:

• we've also seen an expansion in the number of individuals with the diagnosis of autism and increased acuity
• We're seeing increased acuity across the board, and so we've made a number of changes over the past year
• We're seeing increased acuity across the board, and so we've made a number of changes over the past year
• in full alignment with our Secretary's core commitments to supporting high-need, high-risk, high-acuity
• training at the Carroll Center for the Blind and the Massachusetts Association for the Blind and Visually

Keywords: 995, all

Summary: The hearing opened with remarks from Senate Chair Robyn Kennedy and House Chair Chynah Tyler, who emphasized that the fiscal year 2026 hearing was focused on the Health and Human Services budget, asked members to keep questions budget-related, and noted that no public testimony would be taken. They also highlighted the choice of Doherty Memorial High School as the venue to showcase Worcester’s investment in career and technical education. Committee members then introduced themselves before the first panel, the Executive Office of Veterans Services and the state veterans homes, began testimony. Secretary John Santiago said the governor’s FY26 proposal would support implementation of the HERO Act, which he said is now about 95% implemented, including higher disabled veteran annuities, expanded behavioral health benefits, and other service expansions. He described efforts to reduce veteran homelessness, including nearly $20 million in ARPA-funded housing and outreach initiatives, and said the agency has delivered more than 100,000 supportive services to nearly 8,500 veterans. Leaders from the Chelsea and Holyoke veterans homes reported on staffing, quality measures, electronic medical records, and major construction projects at both facilities, including a new Chelsea campus and the new Holyoke home. Members asked about funding transfers, geographic equity in access to the homes, outreach to women veterans and veterans of color, suicide prevention, Gold Star family support, and the impact of federal uncertainty; Santiago said the homes are now licensed and certified, that the current budget is sufficient, and that the agency is expanding engagement and data collection. The second panel, the Office of the Veteran Advocate, testified that its FY26 request is about $3.3 million, up from the current $2 million, to cover staffing, a larger office, and higher technology costs. Veteran Advocate Bob Notch said the office is a new independent oversight agency created in 2022 to examine systems, coordinate with local veteran service officers, and investigate fatalities or serious harm involving veterans in state care. He said the office’s work depends on research, data, and collaboration with other agencies, and that current funding is only enough for minimum operations. In response to questions, Notch and Deputy Commissioner David O’Callaghan discussed the difficulty of tracking veteran suicides, the need for better data across agencies, and the office’s role as an oversight body rather than a direct service provider. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• grab that is that data indicator to give us acuity level indicators.
• So we’re already capturing the high acuity cost.”
• So we’re already capturing the high acuity cost.
• If you're paying for high acuity now, it is capturing the high acuity.
• We eventually would like to have high acuity have its own actuarial adjustment.

Bills: S0042, S0578, S0624, S7018

Keywords: child protection, medical records, investigation, abuse, neglect, healthcare, Child Protection Team, diagnosis, Alzheimer's disease, Alzheimers, dementia, related dementias, brain health, early detection, caregiver support, elderly affairs, Department of Elderly Affairs, Department of Health, public health outreach, memory loss

Summary: The committee met with a quorum and first heard SB 624, which would codify DCF’s current practice of allowing batterers intervention programs to offer supplemental faith-based activities so long as participation is voluntary. The bill drew support from faith-based and family organizations, which argued it would restore access to effective rehabilitation options and remove discriminatory barriers. SB 624 was reported favorably after a roll call vote. The committee then heard SB 42, which would require child protective investigators and child protection teams to rely on qualified medical professionals when a child has a documented pre-existing diagnosis or when a parent requests an exam, and would require clearer notice to parents and custodians at the start of an investigation. Testimony overwhelmingly came from parents, advocates, and disability rights representatives describing cases in which medically complex children were allegedly misdiagnosed as abuse victims and families were separated unnecessarily. Members expressed sympathy and support, and SB 42 was reported favorably. Next, the committee considered CS/SB 578, creating an Alzheimer’s disease awareness initiative within the Department of Elder Affairs to promote early detection, brain health education, research updates, and clinical trial awareness, with outreach focused on older adults and at-risk populations. An amendment was adopted to place the campaign within the Alzheimer’s Disease Initiative. A caregiver testified about the need for public education and early diagnosis, and the bill was reported favorably. The committee also took up SPB 7018, a committee bill on child welfare that would extend the definition of “visitor” for foster homes to reduce repeated background checks, make the Step Into Success foster youth workforce pilot permanent and statewide, and create a program through the Florida Institute for Child Welfare to catalog best practices among community-based care lead agencies. The bill was approved as a committee bill and reported favorably. Finally, the Department of Children and Families presented its 2025-26 final funding methodology and rates report for community-based care. Members questioned the proposed tiered model, including insurance costs, risk corridors, prevention funding, performance measures, and regional funding disparities. No vote was taken on the presentation, but members discussed the possible need for follow-up legislation and additional stakeholder input.

Transcript Highlights:

• There is a tremendous need for providers who serve higher-acuity youth.
• But there are some youth who their acuity you like.
• But I will tell you, on that higher acuity level, now there is a continuum.
• I will tell you that for those higher acuity youth, ...the significant gaps.
• Just a quick follow-up on the high-acuity cases.

Summary: The Human Services Subcommittee held its first meeting of the term and heard introductory remarks from the chair, vice chair, ranking member, and members, who broadly described their interest in child welfare, mental health, aging services, homelessness, and agency accountability. The chair then outlined the subcommittee’s jurisdiction, including child welfare, mental health and substance abuse safety net services, domestic violence, developmental disabilities, elder services, and child support, and introduced the Department of Children and Families (DCF) as the first agency panel for the term. DCF presented an implementation update on HB 7089, a 2024 law aimed at increasing accountability and transparency for community-based care (CBC) lead agencies that deliver most child welfare services under contract. The department said the bill was prompted by forensic examinations that found problems such as noncompetitive procurement, related-party transactions, excessive executive compensation, and weak financial oversight. DCF described new contract requirements and monitoring tools covering board governance and annual training, conflict-of-interest disclosures, financial penalties for noncompliance, fidelity bond requirements, limits on direct service provision by lead agencies, related-party procurement rules, procurement thresholds, real-property approvals, compensation caps, expanded public reporting, and a new Future of Child Protection and Funding Work Group. DCF reported that some lead agencies had completed required board training, others were still on schedule, and two agencies exceeding the direct-service threshold had been referred to the Auditor General. Members asked DCF about the reasons for the bill, the impact on children, the work group’s regional representation, aging-out youth, the Embrace Families transition, board training requirements, and whether enforcement actions had been taken. DCF said the bill was intended to protect funds for children and families and improve oversight, and clarified that the Central Florida lead agency contract was awarded through competitive procurement rather than an absorption. DCF also said the board training was designed to be meaningful but not overly burdensome, with timing left partly to lead agencies as they implement the new requirements. The committee then heard from two CBC leaders, who generally supported the accountability goals of HB 7089 and said their agencies had already addressed most of the new governance and disclosure requirements. They reported that board training had been completed or was being scheduled, but both agencies said the fidelity bond requirement has been difficult or impossible to obtain in the market as written, though they were able to secure the separate performance bond. The CBC witnesses also warned that recruiting providers is increasingly difficult, especially for higher-acuity children and group-home placements, due to limited provider supply, regulatory burden, insurance costs, and rising risk. They said these pressures are contributing to budget deficits in some areas and urged lawmakers to consider the funding model, insurance and indemnification issues, and the risk of overregulation reducing provider participation.

Transcript Highlights:

• So this one consistently evolves annually based on the changing population, the acuity, and the needs
• And if the acuity of your kids goes up, there needs to be a lever for any, you know, unavoidable... .
• And so they require a higher level of acuity. They get reimbursed at a higher rate.
• And so they require a higher level of acuity. They get reimbursed at a higher rate.
• There's a lot of acuity in there.

Summary: The committee heard a presentation from Dr. Kelly O’Dare on first responder behavioral health access, peer support, and suicide prevention. She described UCF Restores, the Second Alarm Project, and related partnerships that provide culturally competent treatment, peer training, clinician education, disaster response support, and behavioral health navigation. She cited survey and state data showing significant rates of sleep problems, anxiety, depression, substance use, and suicide among Florida first responders, and said evidence-based treatment has helped many patients recover, including a reported 76% who no longer met PTSD diagnostic criteria after treatment. Senators asked about measuring outcomes, peer support standards, and whether the state should create more consistent statewide requirements; O’Dare said peer support training must be specialized, linked to higher levels of care, and supported by sustainable funding and statewide coordination. The committee also heard from a public commenter who supported the work and emphasized the need for adequate resources and peer support infrastructure. The committee then received a Department of Children and Families presentation from Casey Penn on the proposed funding methodology for community-based care lead agencies under HB 7089. Penn explained that the new model is intended to be actuarially based, reimbursement-oriented, and more transparent than prior funding approaches, using historical expenditures, standardized reporting, and two main tiers: Tier 1 for largely fixed administrative and operational costs, and Tier 2 for direct child-serving costs based on per-child-per-month blended rates. He said the model includes a 2% risk corridor for Tier 2, hold-harmless funding in the first year, and optional Tier 3 performance incentives, with an estimated additional state appropriation need after offsets. Senators raised concerns about prevention, historical inequities, reasonableness of costs, administrative overhead, blended state and federal funds, adoption subsidies, high-acuity placements, and disaster-related disruptions. Penn said some of those issues could be addressed in future iterations as the child welfare information system is modernized, and he agreed to provide written responses to committee questions. Representatives of the Florida Coalition for Children and CBCs responded that the model is a major improvement but urged additional safeguards, including an administrative cap, clearer separation of direct and indirect costs, and better treatment of federal and pass-through funds. They argued that the system already has oversight and that deficits reflect insufficient appropriations rather than excess spending, while also noting that higher-acuity children and regional differences can drive costs. No votes were taken on either topic, and the meeting ended with committee staff introductions and adjournment.

Transcript Highlights:

• built specifically for high acuity built specifically for high acuity acuity<00:26:06.720> mental
• DJJ advocates for a high acuity mental DJJ advocates for a high acuity mental health<00:41:33.119>
• <00:43:02.960> youth The majority of the high acuity youth The majority of the high acuity
• <00:58:39.599> I they're not the high acuity youth. I they're not the high acuity youth.
• Uh that housing high acuity youth.

Keywords: Meeting Start: 00:00:00 Roll Call: 00:00:05 25 RS HB 534 - AN ACT relating to actions for forcible entry and detainer: 00:01:45 25 RS SB 111 - AN ACT relating to juvenile justice: 00:23:46 Children's Advocacy Centers of Kentucky: 01:13:26 Opioid Use Disorder (OUD) Treatment in State and County Correctional Facilities: 01:25:28, 958, all

Summary: The committee approved the September 18 minutes and then heard testimony on House Bill 534, which would automatically seal dismissed eviction filings and protect youth from public disclosure in forcible detainer cases. Rep. Susan Tyler Whitten and George Ecklan of the Coalition for the Homeless said the bill is aimed at reducing housing barriers for Kentuckians, especially those with dismissed cases, while preserving landlords’ rights to pursue rent, collections, damages, and other legal remedies. They said the proposal was developed with input from landlords, clerks, judges, AOC, and service providers, and noted that similar laws exist in other states. Several members, including Sen. Neimes, Rep. Deetsz, Rep. Cole Carney, and Sen. Thomas, expressed support while emphasizing that the bill is narrowly tailored to dismissed cases and should not affect legitimate landlord claims; Sen. Wheeler raised concerns about cases involving settlements or delays and whether future landlords should know about them. The sponsors responded that the bill only covers dismissed actions, that dismissals require a judge’s order, and that the goal is to remove barriers created by records that remain publicly visible even when a case is resolved. The committee then took up Senate Bill 111 on juvenile justice. Commissioner Randy White, Kentucky Hospital Association President Nancy Galvanny, and Dr. Clark Lester of the University of Kentucky said the bill would require a secure state-run facility for youth with high-acuity mental health needs in detention and, until that is built, create a process with incentives for private hospitals to provide inpatient treatment with safeguards and increased compensation. They argued that detention is not an appropriate setting for severely mentally ill, violent youth and that private psychiatric hospitals often refuse these referrals or discharge them early. Dr. Lester cited recent referral data showing high denial rates for juvenile justice youth in private hospitals in August and September, often due to aggression, and described a case in which repeated placement attempts failed because of violent and self-harming behavior. The presenters said the bill is intended to fill a service gap and improve safety and outcomes for youth, staff, and hospitals, but no vote or final action on the bill was taken in the portion of the meeting provided.

Transcript Highlights:

• Secondly, this deals with increased acuity and placement array.
• In the past, we have had specific homes that deal with children such as the high-acuity levels.
• Now, also the training, what would be expected of the foster parent that has this high-acuity child,
• In the past, we have had specific homes that deal with children such as the high acuity levels.
• You have the emerging child there who's been bouncing around in the system or has high-acuity mental

Summary: The Committee on Children, Families, and Elder Affairs met with a quorum and first took up SB 398, which would create a statewide public health awareness campaign through the Department of Elder Affairs on Alzheimer’s disease and related dementias. Senator Burgess said the campaign would focus on early detection, brain health, risk reduction, clinical trial access, and community resources. The committee heard supportive testimony from a caregiver, AARP, the Alzheimer’s Association, and others, with members discussing the need for culturally responsive outreach and continued funding. SB 398 was reported favorably by roll call vote. The committee then heard SB 106, which would strengthen Florida’s exploitation injunction law for vulnerable adults by allowing service of an unascertainable exploiter through the same communication method used to contact the victim, such as text, Facebook Messenger, or WhatsApp. Senator Martin explained the bill as a way to close a loophole that lets scammers evade traditional service, and witnesses from the Florida Bankers Association and the Florida Bar’s Elder Law Section supported it, describing how the bill could stop ongoing thefts more quickly while preserving due process. Members asked about gift card scams, clerk workload, and the definition of an unascertainable respondent. SB 106 was reported favorably. The Department of Children and Families then presented an update on the Adoption Benefits for Qualifying Adoptive Employees Program, describing its expansion over time and the current one-time lump-sum benefit structure for eligible adoptive parents. The presentation covered eligibility rules, open enrollment, funding history, and the program’s impact on adoption placements, with members asking why tax collectors were included but other constitutional offices were not, and whether foster relatives could qualify. Finally, the committee considered SPB 7012, a committee bill addressing child welfare workforce shortages, treatment foster care for high-acuity children, and improved data collection on commercially sexually exploited children. The bill would direct DCF to recruit former public safety workers for CPI and case manager roles, create a treatment foster care pilot in two judicial circuits, and require more detailed, analyzable data and capacity studies. The bill drew support from child welfare advocates, with some members urging DCF to return with a more developed framework; it was adopted as a committee bill and reported favorably.

Transcript Highlights:

• And as before, We have provided a table below if it's easier to use a table than it is the visualization
• to the public and deploy a new version of the dashboard with those new analytics and those new visualizations
• And given the acuity of who we take, meaning if you go to the psych hospitals across the state, your

Transcript Highlights:

• So this one consistently evolved annually based on the changing population, the acuity and the needs
• I had a higher acuity of kids coming into care that required additional services that cost more money
• There's 3 kind of opportunities that we are providing resources for a higher acuity child.
• But if you factor in the acuity, what it would cost to send them to a day care because remember, they
• And so they require high-level acuity. They get reimbursed at a higher rate.

Keywords: 999, senate, all

Transcript Highlights:

• We focus on our staffing ratios dependent on the acuity of our patients, and that acuity system allows
• Patient diagnoses and acuity, and can you point me to that?
• So, acuities are Divided up that way as well.
• I personally, in the ER, we are not necessarily assigned patients per acuity.
• So we're not necessarily assigned patients per acuity.

Transcript Highlights:

• AND THE HIGHER ACUITY KIDS OUTCOMES OF EXPENDITURES ARE BEING CAPTURED IN THE MODEL ONE OF THE THINGS
• WE HAVE BEEN DISCUSSING IS WHETHER OR NOT HOW DO YOU ACCOUNT FOR THE HIGHER COST KIDS OR ACUITY FOR
• SO, WHEN I SPOKE ABOUT WHETHER OR NOT FUTURE SEAMLESS MODERNIZATION CAN CAPTURE THINGS LIKE ACUITY IF
• THEY CANNOT CONTROL THEIR ACUITY OR WHAT COMES INTO THE FRONT DOOR SO BY DEFAULT IT IS EASY FOR CBC TO
• GO FROM A BALANCED BUDGET TO ALL THE SUDDEN A IN HIGH ACUITY KIDS AND THIS THROWS THEM RIGHT INTO A

Transcript Highlights:

• Detention Center project, the Lyon facility project, Medical Services contract, an update on the high-acuity
• Detention Center project, the Lyon facility project, the Medical Services contract, an update on the high-acuity
• Now I'd like to talk about the High Acuity juvenile mental health treatment facility.
• juvenile mental health High Acuity juvenile mental health treatment treatment treatment facility<00:
• "Investing in a high acuity mental health facility or justice-involved youth in Kentucky is necessary

Keywords: 958, all

Summary: The committee heard an overview from Department of Juvenile Justice Commissioner Randy White on the state’s juvenile detention network and several facility projects. He identified the currently operating detention centers as Boyd County for females, Breathitt County for low-risk males, Fayette County for high-risk males, Adair County for high-risk youth from Jefferson and surrounding counties, Warren County for high-risk males, and McCracken County for low-risk males. Members asked about capacity and staffing; White said Boyd County houses 33 and is usually near full, Breathitt County is about half full, Fayette County runs about 80-90% full, Campbell County’s operational limit is about 25 due to staffing, Adair County can hold 60 and has hit capacity several times this year, Warren County holds 43 and usually runs near capacity, and McCracken County holds 43 and is not currently full. He said staffing is generally harder in higher-risk facilities and in metropolitan areas because of wages and housing costs. White then updated the committee on the Louisville Detention Center downtown renovation and the Lyon facility project. For the Louisville downtown facility, he said schematic design and design development are complete, construction documents are expected by late February or early March, bids are anticipated in April, and completion is projected for March 2027. He explained the delay is due to extensive renovation work needed to bring the building up to current building, life-safety, ACA, and PREA standards, including security, mechanical, electrical, plumbing, food service, and roof work. The project is designed for 64 beds for high-risk Jefferson County boys, with the facility currently vacant and those youth being housed in Adair County and Campbell County. For the Lyon project, he said the contract was issued November 21, 2024, demolition is underway, completion is expected June 14, 2026, and the facility will have 34 beds in four pods for low-risk offenders; he said the project appears to be on time and on budget within the $4.5 million authorization. The committee also discussed the medical services contract. DJJ officials said they are reviewing whether to continue with the current state contract provider, Wellpath, or pursue an RFP, while retaining current merit staff and continuing oversight through four nurse program administrators. They said DJJ uses a state master agreement to staff nurses, APRNs, and the chief medical officer, and that the current contract is about $20 million per year. Members asked about Wellpath’s bankruptcy filing; officials said they were aware of it, asked questions, and were told it would not affect Kentucky service delivery or contracting, though they could not recall the bankruptcy type and offered to provide more detail later. They also said DJJ is working with the Cabinet for Health and Family Services to become a Medicaid provider, and any future contractual partner will need to be a Medicaid provider. Finally, White described the proposed high-acuity juvenile mental health treatment facility. He said DJJ must accept court-ordered youth even when they have severe mental illness, but detention centers are not equipped to treat those youth and private psychiatric hospitals often refuse them or discharge them early. He argued that a dedicated secure treatment facility is needed for a small number of highly violent, high-need youth who require intensive psychiatric care and are disruptive in detention. The facility would provide behavioral and psychiatric treatment, reduce delays caused by lack of beds or outside placements, and serve youth determined by clinical assessment to need a secure treatment environment. No votes were taken during the discussion.

Transcript Highlights:

• Senate Bill 125 requires that a facility be built specifically for high acuity mental health needs for
• Um, if she with these high acuity needs.
• And that concludes our part of the presentation on the high acuity mental health facility.
• caring for these particular high acuity caring for these particular high acuity youth<00:14:40.800
• <00:16:27.680> youth process to remove a high acuity youth process to remove a high acuity

Keywords: Meeting Start: 00:00:00 Agency Updates: 00:01:45 26RS SB 125: 00:02:10 26RS SB 101: 01:14:58, 958, all

Summary: The Juvenile Justice Oversight Council met on February 6, 2026, took roll, approved a motion to convene, and heard agency updates from materials in the packet. The council then took up Senate Bill 125 out of order because Senator Carol was present. The bill was presented as a collaborative effort focused on creating a secure, state-run high-acuity mental health facility for justice-involved youth who need specialized psychiatric care and cannot be appropriately served in detention or by private hospitals. Speakers said the facility would fill a gap in services, improve safety and treatment outcomes, and be designed with trauma-informed, medically equipped spaces rather than a jail-like setting. The presenters also outlined other parts of the bill, including a placement process in which DJJ and CHFS would evaluate youth and provide recommendations before the judge makes the final decision, with certain hospital-declination provisions to be delayed until the new facility is operating. They described payment incentives for hospitals treating high-acuity youth, confidentiality and escape-related disclosure provisions, and contracts with a public teaching university for clinical services. The proposed facility was described as a 24-bed center at Central State, with staffing to include mental health professionals and juvenile detention staff receiving enhanced training. Dr. Clark Lester said staffing needs would vary by youth and could include one-to-one supervision for some patients. The bill also addressed female juvenile detention capacity. Speakers said the number of detained girls has risen sharply since 2024, peaking at 51 in 2025, and that current facilities cannot meet the separation requirements for boys and girls or high- and low-level youth. The proposal would build two female detention centers, with possible locations discussed in central Kentucky and western Kentucky, and a third or fourth center could be added if population data show the need. Members asked about hospital placement authority, staffing, and average length of stay for girls; the presenters said the current court-order process would remain until the new facility is built and that they would provide additional data later. No vote was taken during the portion of the meeting provided.

Transcript Highlights:

• KAR 12120 establishes visual acuity and visual field testing requirements for driver's licensing.

Keywords: 0:22 – Roll Call 0:30 – Approval of minutes 1:04 – Department of Veterans Affairs 2:06 – Board of Pharmacy 3:20 – Board of Optometric Examiners 39:26 – Board of Nursing 40:07 – Board of Emergency Medical Services 41:52 – Department of Fish & Wildlife Resources 44:36 – Transportation Cabinet: Department of Vehicle Registration 45:36 – Department of Alcoholic Beverage Control 47:00 – Cabinet for Health & Family Services: Department for Medicaid Services 49:59 – Cabinet for Health & Family Services: Department for Community-Based Services, 958, all

Summary: The subcommittee approved the minutes from the previous meeting and then took up several regulations. The first was a Department of Veterans Affairs regulation, with a staff amendment, to allow nurse practitioners to apply for the Veterans Affairs nurse loan repayment program year-round and to make technical drafting changes. The committee heard from the Office of Kentucky Veteran Centers, then adopted the staff amendment and approved the regulation without objection. The main item of the meeting was the Board of Optometric Examiners’ proposed amendment to 201 KAR 5:010, which would allow applicants to use the Optometry Examining Board of Canada written exam in place of part one of the National Board of Examiners in Optometry exam for licensure. The board said the change would improve access to care, provide an additional pathway for Canadian-trained candidates, and still require applicants to pass the remaining national board parts. Opponents, including NBEO officials, ARBO, Pearson VUE, and several optometrists, argued the Canadian exam is not equivalent, does not test the same biomedical science content, is not validated for U.S. scope of practice, and raises concerns about test security, transparency, and portability across states. They urged the committee to find the amendment deficient or vote no. Committee members questioned both sides about prior communication with the board, whether Kentucky would be the first state to adopt such a change, the rationale for the proposal, and the cost difference between the exams. Supporters said the board had received some written comments and one phone call, and that the proposal was driven by access concerns and the presence of Canadian students. Opponents said they had not had direct discussions with the Kentucky board before the hearing. No final vote on the optometry regulation is reflected in the transcript excerpt, but the committee heard extensive testimony and rebuttal before moving on.

Transcript Highlights:

• And sometimes that can be difficult, especially with different acuity levels.
• Might have to move in that direction. ...on acuity in behavioral health, and that can be challenging
• Vice Chair Deal, I think the one... ...on acuity in behavioral health, and that can be challenging as
• We have huge issues in high-acuity care.
• And so increased acuity equates to a higher per-member cost and greater volatility.

Keywords: 907, all

Summary: The committee held an informational hearing focused first on Oregon Medicaid coordinated care organization (CCO) finances and rate setting. Oregon Health Authority staff explained how 2025 CCO financial results will inform 2027 capitation rates, including reserve requirements, subcapitation arrangements, and major cost drivers such as behavioral health, pharmacy, rural hospital costs, and dental directed payments. They said the Legislature’s added 2025 funding materially improved CCO margins and that, without it, the program would have been negative overall. Members asked about retained earnings, subcapitation, behavioral health utilization, ABA therapy, and whether outcomes are being evaluated; OHA said rate setting is actuarial and that CCOs, OHA, and other partners all play roles in monitoring efficacy and access. OHA also reviewed House Bill 4039 changes intended to increase transparency and give CCOs earlier access to rate information and reconciliation exhibits. CCO representatives then testified that the system is under significant financial pressure and that behavioral health state-directed payments, benefit changes, and federal uncertainty from H.R. 1 are reducing flexibility. CareOregon said it has lost more than $500 million over the last couple of years and is now making provider terminations and other network changes to align spending with available funding, while emphasizing that CCOs must make hard decisions about which services and providers can be sustained. Eastern Oregon CCO said rural and frontier factors, cost-based hospitals, air ambulance needs, and statewide efficiency adjustments are not fully reflected in rates, and that dental funding is especially strained. Trillium similarly warned that state-directed payments and benefit expansion pressures are constraining the global budget model and that H.R. 1 could worsen acuity and volatility. Members pressed the witnesses on who is responsible for evaluating treatment effectiveness, especially for ABA and psychotherapy, and on how utilization limits and reimbursement changes are being used to control costs. The committee then shifted to an overview of the Affordable Care Act and Oregon’s commercial insurance market. Department of Consumer and Business Services staff explained actuarial value, metal tiers, premium tax credits, medical loss ratio rules, and the main drivers of premium rates: cost trend, utilization trend, and administrative costs. They said mandates have likely added only a limited amount to premiums over the past decade, though the exact effect is difficult to isolate, and they gave examples of how high-cost, low-volume services versus broad, high-utilization services can affect rates differently. Staff also noted that Providence Health Plan and PacificSource Health Plans are withdrawing from the individual market, though consumers should still have at least three insurer options in every county and may have four in many counties. The division said it is in the middle of reviewing proposed 2027 rates and will continue its public rate review process, including hearings and written comment.

Transcript Highlights:

• commercial sexual exploitation, launch a treatment foster care pilot program for children with high-acuity
• This pilot is intended to support Florida's placement array for children with higher-acuity needs and
• To identify the two judicial circuits, we conducted a statewide analysis of high-acuity trends, utilizing
• The review focused on five indicators known to signal the need and high-acuity indicators, including
• We took information based on quantifiable high-acuity data indicators, which included frequency of placement

Summary: The subcommittee heard two Department of Children and Families implementation updates on measures passed in prior sessions. First, DCF reviewed House Bill 633, which increased oversight of behavioral health managing entities through biennial independent audits, standardized claims-based reporting, and new monthly outcome dashboards. The department said it had awarded the inaugural audit to Ernst & Young, found no significant waste, fraud, or abuse, but identified process risks involving financial controls, claims validation, data access, and system access controls. DCF also described its transition to standardized behavioral health coding and said the new public dashboard of 11 measures is posted on its website, though members asked for easier access and for hard copies of the audit report. Members asked about how the department distinguishes Medicaid-covered services from department-funded services, how duplicate payment risks are being addressed, and whether the new reporting and audit requirements would improve oversight without disrupting services. DCF said it is the payer of last resort for uninsured or underinsured individuals, that some overlap with Medicaid is expected because Medicaid does not cover all behavioral health services, and that new claims edits and cross-checks are being built into the system. The department also said it had not found significant negative feedback from providers and that the new requirements are intended to improve transparency and accountability. DCF then updated the committee on Senate Bill 7012, covering human trafficking data collection, domestic violence center certification, limited background-screening exemptions, expanded recruitment for child welfare staff, subcontractor liability protections, a four-year treatment foster care pilot, case management efficiency recommendations, and a statewide study of residential bed capacity for child victims of commercial sexual exploitation. The department said several items are already complete or underway, including limited exemptions in the screening clearinghouse, while others are in procurement or rulemaking. It identified Circuits 4 and 12 as the treatment foster care pilot sites and said the pilot will launch in January 2026. Members questioned recruitment metrics, pilot timing, and report deadlines; the department said final reports are expected by January and that some dates were flexible because of procurement and implementation timelines. The meeting ended after the presentations and questions, and the subcommittee adjourned.