Transcript Highlights:

• Santa Ana was picked to have this facility on our lands just west of here.
• We want to ensure that this facility gets built.
• Or the tribe, sometimes if it's like an IHS facility or a BIE facility, the federal government has a
• So there are many healthcare facilities.
• It has 250,000 outpatient recorded, and then 5,800 inpatient admissions to this facility.

Transcript Highlights:

• IS THERE ANY TYPE OF OUTPATIENT INTERVENTION THAT WOULD BE PERMITTED UNDER YOUR BILL WITHOUT PARENT INVOLVEMENT
• WE'VE SPENT THOUSANDS OF HOURS IN HOSPITALS AND MEDICAL FACILITIES SINCE HER DIAGNOSIS IN 2013.

Transcript Highlights:

• They were only talking about outpatient prescriptions.
• A flexible endoscope that's processed in a health care facility can have up to 118 cleaning steps associated

Transcript Highlights:

• development on the site of the former Concord Naval Weapons Station, with housing, job-creating facilities
• lower-income households, up to 6.1 million square feet of commercial building space, community facilities
• such as school sites, neighborhood parks, and sports facilities, as well as approximately 2,500 acres
• into mixed-use, transit-oriented... ...form former naval weapons storage facilities into a mixed-use
• It means that, out of that situation, a lot of these facilities will not be approved, and so there needs

Summary: The committee heard a series of housing, local government, and governance bills, with most of the discussion focused on housing production, permitting, and local accountability. SB 1003, by Senator Grayson, would create an Infrastructure Partnership Financing Program to help local jurisdictions and developers jointly fund infill housing infrastructure; it drew support from housing advocates and senior housing groups, while Senator Seyarto questioned whether the state would actually fund another program. The bill was moved on a 3-1 vote and remained on call. SB 1014 would require local jurisdictions to provide good-faith estimates of on-site and off-site improvements within 30 business days of a preliminary application and limit later surprise requirements; Habitat for Humanity, SPUR, and other housing groups supported it, while the City of San Mateo and local government associations raised concerns about accuracy and timing. It passed 4-2 and remained on call. SB 1036, which would require credit under the Mitigation Fee Act for prior site uses when redeveloping a site, passed unanimously to the Senate floor. SB 1145 would streamline CEQA and federal reuse review for qualifying projects at the former Concord Naval Weapons Station; it drew broad labor and local support, but housing and legal advocates sought stronger affordability and enforceability provisions. The bill passed 6-0 to the Committee on Environmental Quality. The committee also considered SB 908, which would streamline permits for energy-code-compliant residential window replacements and limit local design restrictions and HOA barriers. Supporters said the bill would let homeowners and affordable housing providers reduce energy costs, while opponents argued it could override local design standards; it passed 3-1 and remained on call. SB 1172, the Local Tax Savings Act, would add guardrails and transparency to local tax-sharing and consultant agreements; it was supported by the City of Shafter and the League of California Cities and passed 4-0 to Revenue and Taxation, remaining on call. SB 1283 would expand ministerial approval for EV charging stations to include canopies and on-site energy storage systems and require local ordinance updates by 2027; EV industry groups supported it, while cities and counties warned about safety, liability, and local review. Members discussed battery storage safety and litigation concerns, and the bill passed 4-0 to Judiciary, remaining on call. The committee also heard SB 1379, which would separate the Riverside County Sheriff-Coroner offices and create an independent medical examiner in response to in-custody death concerns. Supporters cited high death rates, settlements, and the need for independent investigations, while the sheriff’s association and county representatives argued the change would be costly, duplicate services, and override local control. The bill passed 4-1 to Public Safety and remained on call. Finally, SB 1414 would create an independent redistricting commission for San Bernardino County; supporters said it would improve transparency and remove conflicts of interest, while the county opposed the estimated $2 million cost and noted its existing advisory commission. Members generally supported independent redistricting, and the bill was discussed but no final vote was recorded in the excerpt.

Transcript Highlights:

• locations. ...will help attract new investment and services, such as DoorDash's potential DashMart facility
• To be very clear, what would happen is these DoorDash drivers could stop at brick-and-mortar facilities
• They continue their duties to get merchandise to deliver from other facilities, but those employees inside
• And so if people unfamiliar with DashMarts, these are brick-and-mortar facilities that house items such
• He's trying to kind of maybe not stifle innovation and allow for some of these facilities to take place

Bills: LB815A, LB838A, LB912A, LB972A, LB1126A, LB962A, LB1114, LB921, LB937, LB803, LB803A, LB1032, LB1032A, LB1075, LB1075A, LB889, LB878, LB933, LB304, LB304A, LB1096, LB1096A, LB1165, LB1165A, LB958, LB958A, LB762, LB1187, LB966, LB929, LB962, LB753, LB788, LB913, LB1055, LB1195, LB429, LB721, LB722, LB727, LB743, LB745, LB749, LB778, LB787

Keywords: LB815A, LB815, appropriation, appropriations bill, Nebraska Department of Revenue, Motor Fuel Tax Enforcement and Collection Cash Fund, motor fuel tax, gas tax, fuel tax, tax enforcement, tax collection, cash fund, budget, state spending, per diem, salaries, fiscal year, enrollment and review, final reading, Nebraska

Transcript Highlights:

• district is when a child is a ward of the court, and the court places the child in a residential facility
• The child would need to be in a residential facility while the parents continue to reside in the original
• and quality to those... ...facilities designed to meet the needs of women and girls should be at least
• These facilities should not include men who claim to have female gender identities.
• Second, information relating to general descriptions of facilities, projects, budgets, or maintenance

Bills: LB815A, LB838A, LB912A, LB972A, LB1126A, LB962A, LB1114, LB921, LB937, LB803, LB803A, LB1032, LB1032A, LB1075, LB1075A, LB889, LB878, LB933, LB304, LB304A, LB1096, LB1096A, LB1165, LB1165A, LB958, LB958A, LB762, LB1187, LB966, LB929, LB962, LB753, LB788, LB913, LB1055, LB1195, LB429, LB721, LB722, LB727, LB743, LB745, LB749, LB778, LB787

Keywords: LB815A, LB815, appropriation, appropriations bill, Nebraska Department of Revenue, Motor Fuel Tax Enforcement and Collection Cash Fund, motor fuel tax, gas tax, fuel tax, tax enforcement, tax collection, cash fund, budget, state spending, per diem, salaries, fiscal year, enrollment and review, final reading, Nebraska

Transcript Highlights:

• To transportation facility designations. Debate? Representative Jacques in debate.
• It may not Sound too bad, folks, unless you live within a mile of one of these facilities.
• We recognize that these facilities are necessary.
• This facility burned down four years ago, and it burned for three weeks.
• They decide to open up into a facility and may have a performance-based agreement.

Bills: SB 5, SJR 3, HB 11, HJR 72, HB 48, HB 27, HB 144, HB 37, HB 1481, HB 581, HB 1696, HB 2216, HB 1035, HB 1633, HB 742, HB 754, HB 1689, HB 1690, HB 2669, HB 391, HB 517, HB 1775, HB 1024, HB 1607, HB 252, HB 1716, HB 1562, HB 4116, HB 1866, HB 1741, HB 2103, HB 2637, HB 2884, HB 3707, HB 503, HB 1089, HB 1757, HB 2986, HB 972, SB 365, SB 1786, SB 5, SJR 3, HB 14, HB 43, HB 36, HB 26, HB 149, HB 121, HB 206, HB 136, HB 3114, HB 2733, HB 1732, HB 3700, HB 467, HB 1130, HB 1846, HB 1442, HB 1147, HB 2176, HB 2701, HB 805, HB 2890, HB 1154, HB 1644, HB 2118, HB 1718, HB 2488, HB 2596, HB 2468, HB 484, HB 2578, HB 3204, HB 1041, HB 307, HB 685, HB 538, HB 2525, HB 3125, HB 2027, HB 2894, HB 3077, HB 106, HB 18, HB 11, HJR 72, HB 48, HB 27, HB 144, HB 37, HB 1481, HB 581, HB 1696, HB 2216, HB 1035, HB 1633, HB 742, HB 754, HB 1689, HB 1690, HB 2669, HB 391, HB 517, HB 1775, HB 1024, HB 1607, HB 252, HB 1716, HB 1562, HB 4116, HB 1866, HB 1741, HB 2103, HB 2637, HB 2884, HB 3707, HB 503, HB 1089, HB 1757, HB 2986, HB 972

Keywords: dementia, research institute, Alzheimer's disease, Parkinson's disease, funding, grants, state health initiatives, research funding, state budget, prevention, healthcare, medical research, Dementia Prevention and Research Institute, licensing, reciprocity, regulation, Texas Department of Licensing and Regulation, interstate agreements, tax exemption, intellectual disability

Transcript Highlights:

• This presentation will give us a little tutorial on what assisted outpatient treatment is and what civil

Transcript Highlights:

• There's been this focus on job training, drug court, inpatient drug treatment, outpatient drug treatment
• 53.440> inpatient<00:03:54.080> drug<00:03:54.319> treatment,<00:03:54.720> outpatient
• uh inpatient drug treatment, outpatient uh inpatient drug treatment, outpatient drug<00:03:55.440

Keywords: 958, all

Summary: The Senate Judiciary Committee heard Senate Bill 122, which would allow certain defendants who are caretakers of dependent children to ask a sentencing court to consider parenting classes and family counseling as part of an alternative sentence, alongside existing options like probation and treatment programs. Representative Nick Wilson, the House sponsor, said the bill was aimed at helping families affected by the opioid crisis, especially in Appalachia, and described it as a way to support parents who want to get clean and rebuild family stability. He emphasized that the bill would apply only on a defendant’s motion, would not be automatic, and would exclude violent offenders, domestic violence-related cases, child-victim cases, and cases where probation or similar relief is otherwise prohibited. Committee members raised concerns that the bill could create a two-tiered system of justice or add unnecessary procedure because judges already consider family circumstances through presentence investigations and sentencing discretion. One senator said he would support the bill but worried it privileged defendants with children over those without. Another member argued the bill was unnecessary because judges and prosecutors already have these options available and because it could add another hearing to an already overloaded court system. Supporters responded that the family unit should be given greater weight and that the bill would simply make that consideration more explicit. Judge Julie Ward, joined by Judge Jeremy Maddox, testified against the bill as written. She said judges already receive presentence reports, hear offender statements, and consider caregiving responsibilities, and that family court already addresses children’s needs when custody issues arise. Her main objections were that parenting services are not available in all communities, may cost money, and that the bill would require evidentiary hearings and potentially create equal protection problems by giving preferential treatment to caretakers. She urged the sponsors to work on revised language instead of passing the bill in its current form. Senator Wheeler said he would vote for the bill and noted that a floor amendment would be offered to address access to confidential juvenile “J cases” in presentence reports, since probation and parole do not have that access. He said the amendment was intended to make sure sentencing judges have the information they need. The discussion ended without a final committee vote in the transcript, but the bill remained under consideration with possible amendment and further revision.

Transcript Highlights:

• <02:05:41.360> quality and then the nursing facility quality and then the nursing facility
• 21 and this is when a lot of outpatient 21 and this is when a lot of outpatient services<02:09:20.239
• The next three pages, 43, 44, and 45, are for the nursing facility quality assessment.
• as a nursing facility.
• , then you would be subject to the nursing facility quality assessment.

Keywords: 928, house, all

Summary: The committee received an overview from Chris of the Legislative Budget Assistance Office on how it will estimate unrestricted revenues for the General Fund, Education Trust Fund, Highway Fund, and Fish and Game Fund. He explained that the committee’s work is based on current law, not pending bills, and that the estimates will feed into a House resolution and an amendment to House Bill 1, the operating budget. He also described the broader budget process, including how House and Senate estimates are reconciled, how surplus statements account for revenue changes from enacted bills, and how a committee of conference could resolve differences later in the session. No votes were taken. Members then asked about why the Education Trust Fund was running below plan. Chris said the shortfall appeared to be driven largely by business taxes, including differences in the BET/BPT split and improved tax-processing systems that better track where business tax payments belong. Representative Orr also asked about tobacco tax collections and out-of-state sales; Chris said tobacco revenue was likely overestimated in 2023 based on COVID-era patterns, with more people smoking at home, and noted that e-cigarette tax revenue goes to the General Fund while cigarette taxes are split between the General Fund and Education Trust Fund. He said he did not have a specific estimate for cross-border sales. Commissioner Lindsay St. Pierre of the Department of Revenue then began a deeper dive into the department’s role and the taxes it administers. She reviewed the department’s mission, organizational structure, taxpayer services, and the tax policy and legislative analysis staff who prepare fiscal notes and testify on bills. She noted that the department administers about $2.9 billion in revenue across major taxes such as business taxes, meals and rooms, and utility property tax, and that the figures being discussed were preliminary because the annual report had not yet been issued. The discussion was informational only, with no formal action taken.

Transcript Highlights:

• Florida's Directed Payment Program for Hospitals provides payments to hospitals for both inpatient and outpatient

Summary: The Legislative Budget Commission met with a quorum present and considered two Agency for Health Care Administration budget amendments related to Medicaid supplemental payments. The first amendment, EOGB 2026-0831, authorized $2.1 billion in budget authority for the Low-Income Pool to support safety-net providers with uncompensated charity care. Members asked about the timing of AHCA’s submission to CMS and whether the program addressed hospital shortfalls for insured patients and CHIP-related concerns. AHCA said approvals have generally been slower under the current federal review process, and the amendment was adopted without objection. The second amendment, EOGB 2026-0875, placed $7.9 billion in reserve for Florida’s Directed Payment Program for Hospitals pending final CMS approval. Senators and representatives questioned the role of hospital attestations regarding hold harmless agreements, whether any agreements had to be unwound, and how long final approval might take. AHCA said all hospitals had submitted attestations, no unwinding was known to be necessary, and approval was expected soon. Members also raised concerns about cancer hospitals, including Moffitt and the University of Miami, not participating in the directed payment program. AHCA responded that those institutions participate instead in a separate Florida Cancer Hospital supplemental payment program, which had already been approved. Both amendments were adopted without objection, and the commission then adjourned.

Transcript Highlights:

• This specifically applies to inpatient, outpatient hospital services, nursing facility services, and
• of things that that goes to work currently, but especially our nursing homes and assisted living facilities
• And it sounds like there's a variety of things that we use those funds for SNFs, skilled nursing facilities
• of things that that goes to work currently, but especially our nursing homes and assisted living facilities
• The typical state has hospitals, clinics, FQHCs, or other health care facilities approved by the board

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:

• They dealt with limited pool space, switching facilities all season, and still showed up and handled

Bills: HB2894, HB3418, HB3415, HB3413, HB3414, HB3416, HB3417, HB3419, HB3420, HB1739, HB1752, HB1979, HB2941, HB2992, HB3075, HB3086, HB3177, HB3269, HB3278, HB3279, HB3497, HB3644, HB4432, HB3720, HB3849, HB3882, HB3919, HB3941, HB4118, HB4141, HB4268, HB4342, HB4428, HB4429, HB4434

Keywords: HB2894, Oklahoma Rural Jobs Act, rural jobs, rural investment, tax credit, capital investment tax credit, state tax credits, economic development, rural fund, rural investor, qualified investment, eligible business, Department of Commerce, rural business, investment certification, tax liability, credit cap, workforce development, small business finance, rural development

Transcript Highlights:

• So, this bill requires large load data centers and crypto mining facilities to pay their portion.

Bills: HB2894, HB3418, HB3415, HB3413, HB3414, HB3416, HB3417, HB3419, HB3420, HB1739, HB1752, HB1979, HB2941, HB2992, HB3075, HB3086, HB3177, HB3269, HB3278, HB3279, HB3497, HB3644, HB4432, HB3720, HB3849, HB3882, HB3919, HB3941, HB4118, HB4141, HB4268, HB4342, HB4428, HB4429, HB4434

Keywords: HB2894, Oklahoma Rural Jobs Act, rural jobs, rural investment, tax credit, capital investment tax credit, state tax credits, economic development, rural fund, rural investor, qualified investment, eligible business, Department of Commerce, rural business, investment certification, tax liability, credit cap, workforce development, small business finance, rural development

Transcript Highlights:

• They dealt with limited pool space, switched facilities all season, and still showed up and handled business

Bills: HB2894, HB3418, HB3415, HB3413, HB3414, HB3416, HB3417, HB3419, HB3420, HB1739, HB1752, HB1979, HB2941, HB2992, HB3075, HB3086, HB3177, HB3269, HB3278, HB3279, HB3497, HB3644, HB4432, HB3720, HB3849, HB3882, HB3919, HB3941, HB4118, HB4141, HB4268, HB4342, HB4428, HB4429, HB4434

Keywords: HB2894, Oklahoma Rural Jobs Act, rural jobs, rural investment, tax credit, capital investment tax credit, state tax credits, economic development, rural fund, rural investor, qualified investment, eligible business, Department of Commerce, rural business, investment certification, tax liability, credit cap, workforce development, small business finance, rural development

Summary: The Senate began with ceremonial recognitions for several student groups and community visitors, including Carl Albert High School’s boys and girls swim teams, the Lady Titans basketball team, and the Choctaw High School speech and debate team. Senators and coaches highlighted the teams’ state championships, academic achievements, and perseverance, and the chamber also welcomed visiting groups from Aline, Owasso, and Tulsa County. After the presentations, the Senate returned to general order and took up a series of House bills. Among the measures considered, House Bill 3720 expanded the Local Food Freedom Act by raising the gross annual sales threshold for local food establishments from under $75,000 to $250,000; it passed 39-4. House Bill 3849 updated the Oklahoma mentoring children of incarcerated parents program and passed 42-1. House Bill 3882 created a revolving fund for industrial and lake access improvement projects and passed 33-9, then also passed the emergency clause 39-4. House Bill 3919 reduced county free fair association boards from nine members to five to address quorum problems and passed 45-0. House Bill 3941 codified a pay raise for a court secretary and passed 45-0, including its emergency clause. House Bill 4118 updated the family caregiver tax credit and passed 44-1. House Bill 4141 removed the sunset on the statewide sexual assault nurse examiner coordinator position and passed 45-0. The chamber also debated several policy bills more extensively. House Bill 4268 created a growth-based teacher compensation program using Oklahoma Teacher Empowerment Funds and restored a $5,000 stipend for national board-certified teachers; it passed 45-0 and its emergency clause also passed 45-0. House Bill 4342 allowed prior instances of domestic violence or abuse to be admitted as propensity evidence in court, with supporters saying it would help interrupt the cycle of abuse and opponents raising due process concerns; it passed after debate. House Bill 4428 required public pension plans to base proxy voting decisions solely on financial considerations, and House Bill 4429 required proxy advisors to disclose when recommendations were not based on financial analysis; both passed after debate, 35-8 and 37-7 respectively. Two Rule 7-9 motions to pull House Bills 4422 and 4423 from committee and place them on general order failed by recorded vote. The Senate then announced Denim Day for domestic violence and sexual assault awareness, noted a few final reminders, and adjourned until April 29, 2026, at 9:00 a.m.

Transcript Highlights:

• coordinator uh access to the facilities coordinator uh access to the facilities at<00:08:26.960>
• Donaldson Correction Facility. Donaldson Correction Facility.
• They come to the facility. You're right.
• have to come to the facility to unload. have to come to the facility to unload.
• in DHR homes or in DHR uh facilities in DHR homes or in DHR uh facilities that<01:02:46.480>

Bills: HB426, SB24, SB106, SB254, HB505, HB458, HB535, HB509, HB320, HB518, HB261, HB426, SB24, SB106, SB254, HB505, HB458, HB535, HB509, HB320, HB518, HB261, SB316, HB228, SB318, SB260, HB132, HB347, HB405, HB86, HB263, HB302, SB336

Keywords: Alabama Ad Valorem Advisory Committee, ad valorem taxes, property tax, real property, personal property, tax assessment, tax collection, county tax officials, Department of Revenue, Commissioner of Revenue, taxpayer representation, resident taxpayers, local government, property tax administration, Association of Alabama Tax Administrators, tax policy, advisory committee, public input, governance reform, body-worn camera

Transcript Highlights:

• subsection 6 is the one that assesses, or deducts from the fine, interest payments if a medical facility
• So that's for the hospitals and other facilities.
• we do support prevailing wage on public works, this bill would require it at permanent off-site facilities
• we do support prevailing wage on public works, this bill would require it at permanent off-site facilities

Bills: AB6, AB102, AB131, AB212, AB213, AB220, AB259, AB282, AB376, AB396, AB479, AB503, AB570, AB572, AB574, AB576, AB593, SB185, SB207, SB507, AB6

Keywords: fetal alcohol spectrum disorder, FASD, prenatal alcohol exposure, children's health, developmental disability, early intervention, treatment assistance, Aging and Disability Services Division, Department of Health and Human Services, Autism Treatment Assistance Program, public health, parent education, evidence-based treatment, Nevada NRS 427A, disability services, behavioral health, emergency medical services, ambulance, licensing, health district

Transcript Highlights:

• Hospitals are not allowed to do outpatient retail pharmacy, right? They can do it.
• They can do—” “To do outpatient retail pharmacy, right?
• We inspect facilities. We require training. We require insurance.
• Would they be allowed to sell the Delaware facility? Because they are not a Delaware organization.
• Would they be allowed to sell the Delaware facility? Because they are not a Delaware organization.

Summary: The House convened with Girl State participants presiding for part of the session, including introductions of the student leadership and a unanimous voice vote passing House Concurrent Resolution 152 honoring the young women participating in Delaware Girl State. The chamber also welcomed congressional interns and other guests, accepted the prior day’s minutes, and observed a moment of silence for Nathan Cynix and Kara Feeley before prayer and the Pledge of Allegiance. A major portion of the meeting was devoted to tributes for Representative Ron Gray, who was recognized for his 14 years of service and his work on issues such as bond bills, dredging, bike paths, small business, constituent service, and agriculture-related funding. Multiple members from both parties praised his humor, honesty, mentorship, and dedication to the House and his district. Gray responded with extended remarks reflecting on his family legacy, legislative service, and appreciation for colleagues and staff, and the chamber later sang “Take Me Out to the Ball Game” at his request. The House then received communications, including Senate messages returning several bills and informing the chamber of Senate passage of additional measures. Members were also told that the FY27 bond bill, House Bill 500, had been placed on desks as a gift for review. The House read in Consent Agenda S, which included House Bill 476, House Joint Resolution 13, Senate Substitute 1 for Senate Bill 168, Senate Bill 297, Senate Substitute 1 for Senate Bill 319, and Senate Joint Resolution 21, and began a roll call vote on the consent agenda.

Transcript Highlights:

• Would interns for these other facilities? Yeah, yes, interns.
• Would interns for these other facilities?
• For example, in my primary site in Wentzville, Missouri, I do outpatient clinics, substance use disorder

Summary: The Joint Committee on Administrative Rules met to consider a Missouri Prescription Drug Monitoring Program rule proposal after the Department of Natural Resources withdrew its items. The hearing focused on 1 CSR 60-1.010, which would expand delegate-level PDMP access to additional licensed behavioral health professionals, including licensed clinical social workers, licensed master social workers, marital and family therapists, professional counselors, and psychologists, while also correcting prior rule language involving medical assistants and clinical nurse specialists. Testimony from the PDMP executive director and supporters from Compass Health and the Department of Mental Health argued the change would improve care coordination, medication reconciliation, and safety in multidisciplinary behavioral health settings, especially CCBHCs. They said access would remain limited to licensed professionals working under a prescriber/dispenser relationship, with individual logins and penalties for misuse. Opponents and some committee members raised concerns that the rule would expand access beyond the original statutory framework without legislative change, could be used beyond treatment purposes, and should instead be addressed through statute rather than rulemaking. After public testimony, the committee debated whether the proposal exceeded statutory authority and whether the expansion was too substantive for rulemaking alone. A motion was made to disapprove the rule on grounds including lack of statutory authority, conflict with state law, and arbitrariness. The motion passed by a roll call vote of 7-1, and the committee disapproved Rule 1 CSR 60-1.010 before adjourning.

Transcript Highlights:

• psychiatric nurses in other states refer particularly complex cases to psychiatrists or inpatient care facilities
• Cases to psychiatrists or inpatient care facilities. And that's what they do today.
• mental health care in Florida continues to rank in the bottom third of the nation, with access to outpatient

Summary: The Health Professions and Programs Subcommittee heard and advanced several health care bills. HB 909, joining the Occupational Therapy Licensure Compact, was presented with a strike-all amendment and reported favorably as amended by a 13-0 vote. HB 911, the related public records exemption protecting certain biological information, was also adopted and reported favorably as amended by a 14-0 vote. CS for HB 597, allowing schools to procure and administer glucagon for students with diabetes under trained personnel, passed unanimously 14-0 after a technical amendment. HB 519, aligning state law with federal language on controlled substances administered by paramedics, passed as amended 14-0. The committee then took up HB 919 on nursing education programs. Sponsor Rep. Overdorf argued the bill would create accountability for underperforming nursing schools by requiring remediation, tuition refunds in the lowest-performing programs, and public reporting of passage rates. Supporters said it would improve quality and protect students from debt without licensure success, while opponents from private nursing schools warned it could close programs and reduce nurse supply. After extensive debate, the bill was reported favorably 15-0. HB 1553, which would require health care providers to submit identified uterine fibroid data so the Department of Health can implement the research database previously authorized by law, passed unanimously 15-0. The final bill, HB 883, would allow psychiatric mental health nurse practitioners to practice autonomously; supporters said it would expand access to mental health care, especially in rural and underserved areas, while opponents raised concerns about quality and physician oversight. After lengthy testimony and debate, the bill was reported favorably 14-3.