Transcript Highlights:

• They're going to be hit by reduced resources to provide care to home care consumers and to their patients
• ... ...cutting health care.
• , for housing, and health care.
• Our health care system is in trouble. Our health care system is in trouble.
• They will likely delay care, making conditions worse and more expensive to treat, or their care will

Committee: Joint Joint Committee on Revenue

Summary: The Joint Committee on Revenue, chaired by Senator James Eldridge and Representative Adrian Madaro, opened its hearing with a moment of silence for the late Lowell State Senator Ed Kennedy and reviewed hearing procedures and deadlines. The committee then took testimony on several corporate tax bills, including S. 2033/H. 3110 on offshore tax avoidance, H. 3248 on a manufacturing tax exemption, H. 3057 on a tiered corporate minimum tax, and S. 2041 on a corporate tax haven blacklist, along with a separate business interest deduction bill. No votes were taken during the hearing. Supporters of S. 2033/H. 3110, including labor unions, health care workers, educators, public health advocates, seniors, and several legislators, argued that Massachusetts needs new revenue to offset federal cuts to Medicaid, SNAP, health care, education, and other services. They said the bill would raise roughly $400 million annually by increasing the share of offshore profits included in the state tax base from 5% to 50%, and they framed it as a fairness measure that would require large multinational corporations to pay more while leaving most local businesses and workers unaffected. Testimony emphasized risks to MassHealth, PCA services, adult dental care, hospitals, schools, and public health programs if new revenue is not raised. Opponents, including the Mass Taxpayers Foundation and the Council on State Taxation, argued the proposal is poor tax policy and likely unconstitutional because it would tax foreign-source income without allowing foreign tax credits or a comparable apportionment method. They said Massachusetts should take a broader, coordinated approach to federal tax changes rather than a standalone bill, and warned of litigation risk and possible double taxation. Supporters such as MassBudget and former tax counsel Don Griswold countered that the bill is a reasonable rough-justice approach, consistent with federal and neighboring-state treatment, and that it would primarily affect a small number of very large multinationals. On S. 2041, the Global Business Alliance opposed the proposed tax haven blacklist, while supporting a separate bill allowing business interest deductibility.

Transcript Highlights:

• Every county in the state has a child care desert, and there is a need for child care throughout the
• Program and the Primary Care Facilities Program.
• Kicker: as a result, if you provide another 50% for expanded infant care and toddler care.
• The overnight care, the weekend care, and all the things that some laborers need are not really readily
• Child care is a desert.

Committee: House New Mexico Finance Authority Oversight Committee

Transcript Highlights:

• </c> twothirds of eye care across the state. twothirds of eye care across the state.
• I frankly don't care. But, well, fine, you may care, but I don't care.
• I frankly don't care. But, well, fine, you may care, but I don't care.
• I frankly don't care. But, well, fine, you may care, but I don't care.
• </c> infant health care in Minnesota. infant health care in Minnesota.

Committee: House Health Finance and Policy

Transcript Highlights:

• The personal care. Do you go into personal care? Yeah, why don't you? The personal care.
• Do you go into personal care?
• The personal care. Do you go into personal care? Yeah, why don't you? The personal care.
• Do you go into personal care?
• So there's New Mexico Care, and then what we see here on personal care services.

Committee: House House Appropriations & Finance

Transcript Highlights:

• </c> in our care. in our care.
• </c> care for their own children. care for their own children.
• We do need Minnesota Care. next week. We do need Minnesota Care.
• </c> care system in the state of Minnesota. care system in the state of Minnesota.
• The stress on our health care care care system.<03:40:19.439><c> Representative</c><03:40:20.080><c>

Transcript Highlights:

• So it will include veterans whose federal health care coverage. Compensated care grant program.
• Cannot obtain or provide abortion care.
• of that care.
• providing care for you, then this is an option to cover that abortion care, correct?
• So we're talking about people who need abortion care, getting abortion care that they need.

Summary: The Military and Veterans Affairs Committee heard presentations on several bills, beginning without a quorum and later taking up the measures once a quorum was established. AB 2531 by Assemblymember Irwin would expand California’s uncompensated care grant program so veterans whose federal health coverage does not include abortion services can access abortion care, and would require CalVet to link to abortion.ca.gov. Supporters, including Planned Parenthood Affiliates of California, Equality California, and Reproductive Freedom for All California, said the bill responds to federal restrictions on VA abortion care; opposition from the California Family Council argued it used taxpayer dollars to promote abortion and raised concerns about incomplete information and fraud. Committee members also questioned the bill’s use of “self-identify” for veteran status and the funding structure, with the author indicating openness to looking at proof-of-veteran options. AB 2054 by Assemblymember Gibson would update California’s paid family leave rules so relatives of military service members can qualify when those members are activated for state emergencies, disaster response, or other domestic duties, not just overseas deployment. The Department of Defense sponsored the bill, and Navy Region Southwest testified in support, saying it would improve stability for military families and reflect modern service demands. Members praised the bill and noted recent National Guard deployments for fires as an example of the gap it addresses. AB 2219, the Faster Service for Veterans Act, by Chair Schiavo, would require county veterans service officer vacancies to be filled within 12 months, set accreditation timelines, expand training and public awareness, create a statewide work queue, improve data collection, and require periodic reporting and a unified satisfaction survey. The California Association of County Veterans Service Officers supported the bill, saying it would improve timeliness, accountability, and resource planning. After discussion, the committee voted to pass all of the bills and move them to the next committees: the consent calendar bills AB 1702, AB 1765, AB 2203, and AB 2467 were approved 8-0; AB 2054 passed 8-0 and was re-referred to Insurance; AB 2219 passed 8-0 and was re-referred to Appropriations; and AB 2531 passed 6-2 and was re-referred to Appropriations.

Transcript Highlights:

• for the elderly and the home care for the elderly program.
• They're taking care of there. Thank you.
• the use of technical assistance offered by DCF to child care providers.
• The use of technical assistance offered by DCF to child care providers.
• child care to the children and families in our state.

Committee: Senate Appropriations Committee on Health and Human Services

Summary: The Health and Human Services Appropriations Committee met to review and advance the Senate’s fiscal year 2025-26 budget proposal for the committee’s portfolio. The presentation highlighted a $1.8 billion increase over the current base budget, including full funding for Medicaid and KidCare, investments in IT modernization, Medicaid provider rate increases, mental health and substance use services, opioid treatment, foster care and guardian assistance, elder care, veterans’ services, cancer research, school nurse staffing, and other public health initiatives. The committee adopted a motion allowing technical adjustments and then approved the budget proposal to be reported to the full Senate Appropriations Committee. The committee then heard and voted on several bills. SB 152 on surgical smoke protection required hospitals and ambulatory surgical centers to adopt smoke evacuation policies; nurses testified in support, citing workplace and patient safety risks, and the bill was reported favorably. CS/SB 958 on early detection of type 1 diabetes required the Department of Health to provide educational materials to schools and, by amendment, early learning coalitions; it was also reported favorably. CS/CS/SB 170 on nursing home oversight added consumer satisfaction surveys, reporting requirements, quality incentive changes, and financial reporting penalties, with an amendment exempting state-operated homes and directing a study of best practices; it passed after questions about dementia, language access, and retaliation protections. CS/SB 738 modernized child care regulation by streamlining DCF processes and reducing obsolete requirements, and was reported favorably without opposition. The committee also approved CS/SB 1356 creating the Florida Institute for Pediatric Rare Diseases at FSU and a Sunshine Genetics pilot to expand rare-disease screening and research, with support from members emphasizing early detection and data collection. SB 1370 separated ambulatory surgical centers into their own statute, with testimony that the change would better reflect the industry and help avoid burdensome regulation; it passed favorably. Finally, CS/CS/SB 1626 made a range of child welfare changes, including codifying DCF coordination with military installations, adjusting shelter certification, refining criminal-background exemptions, extending licensing compliance time, addressing room-and-board rate methodology, and clarifying missing-child procedures; after adopting three amendments and hearing both support and concerns, the bill was reported favorably. The committee also recorded a member’s affirmative vote on SB 958 before adjournment.

Transcript Highlights:

• care, data analytics, the collection... ...for medically necessary and appropriate care, data analytics
• And so are they going to deny care? They're not going to deny care.
• Is okay, so you mean regular medical care? It is. Okay. You mean regular medical care? Yes.
• That means Medicaid can pay for ongoing care in the community, not just short episodes of crisis care
• Care in the community, not just short episodes of crisis care.

Committee: Senate Senate Health and Human Services COR

Summary: The committee first approved the February 4 minutes, then heard Senate Bill 1086, which would require AHCCCS contractors to reimburse non-contracting providers for certain lab services when a member was referred by a contracting provider and would bar prior authorization for diagnostic services. The sponsor said the bill was intended to address unpaid claims and improve access, while Access testified neutral but warned the prior-authorization ban could increase utilization and create a fiscal impact. The committee adopted the Warner amendment limiting non-contracting reimbursement rates to no more than contracting rates, then passed SB 1086 as amended on a 4-2 vote. The committee then took up Senate Bill 1611, an emergency measure to require Access to contract with an administrative services organization for the American Indian Health Plan, while keeping Access ultimately responsible for administration. The chair’s amendment expanded ASO duties to include provider support, quality improvement, and data analytics, removed Access claims-payment authority, added tribal observers to the selection committee, and exempted IHS and tribal-facility services. The sponsor and tribal witnesses described the bill as a response to fraud, provider nonpayment, and harm to Native communities, while Access raised concerns about the fast timeline, tribal consultation requirements, possible duplication of program-integrity functions, and fiscal uncertainty. After debate over the emergency clause and tribal consultation, the committee adopted the amendment and passed SB 1611 as amended on a 5-2 vote. The committee also heard Senate Bill 1630, which would direct Access to seek federal approval for a Medicaid home- and community-based services program for adults with serious mental illness. Supporters said the bill would create a long-term community-care option for the sickest SMI members, reduce cycling through hospitals, jails, and homelessness, and potentially save state general fund dollars; family members and advocates testified in support. Access was neutral and said it was finalizing a fiscal estimate. The Angus amendment narrowed eligibility to long-term SMI, reduced the enrollment cap from 500 to 250, changed reporting to semiannual, and removed priority-order language; the committee adopted the amendment and passed SB 1630 as amended unanimously. Later, the committee passed Senate Bill 1193, which protects emergency medical care technicians’ personal identifying information from sale or disclosure by the Department of Health Services, after adopting a clarifying amendment expanding the protected information and addressing commercial requests. It then heard Senate Bill 1318, which repeals the state’s separate dense-breast notification requirement so Arizona law aligns with the FDA’s newer mammography notice standard; the sponsor and DHS said the change would reduce confusion from duplicate, slightly different notices, and the bill was moving forward with discussion of possible future amendment language.

Transcript Highlights:

• Children in the care of DCF, or in the continuing care of DCF and extended foster care, who are under
• would greatly restrict care for adults.
• However, most adults in our state lost access to care.
• We have the list of health care practitioners generally on page two.
• I did not have medical care, and I nearly became homeless.

Bills: S0560 , S0590 , S0778 , S1010

Committee: Senate Children, Families, and Elder Affairs

Summary: The Committee on Children, Families, and Elder Affairs considered four bills. SB 590, by Sen. Bradley, would toll the statute of limitations for failure to report suspected child abuse by mandatory reporters until the offense is known to law enforcement; an amendment clarified retroactive application for offenses not already time-barred by the bill’s effective date. Sen. Bradley said the bill is intended to ensure accountability in institutional abuse cases and not to change the reasonable-suspicion reporting standard. The committee adopted the amendment and reported the bill favorably. The committee also heard SB 778, by Sen. Simon, which would update the definition of forensic client so certain individuals with intellectual disabilities or autism whose charges were dismissed for incompetency can be housed with other Chapter 916 residents, reducing duplicative staffing and space needs at the Agency for Persons with Disabilities. Barney Bishop appeared in support, and the bill was reported favorably without amendment. SB 560, by Sen. Garcia, would streamline procedures for psychotropic medication prescriptions for children in DCF custody, reduce duplicative background checks and reporting, and simplify consent documentation. Amendments removed language allowing licensed clinical social workers and marriage and family therapists to serve as evaluators and narrowed changes to the Road to Independence Program’s postsecondary education services and supports, extending eligibility ages from 18 to 26 while keeping the five-year cap. Senators discussed the fiscal impact and funding blend for the education stipend. The committee adopted the amendments and reported the bill favorably. The committee then took up SB 1010, by Sen. Yarbrough, which adds criminal and civil enforcement for violations involving sex-reassignment prescriptions or procedures for minors and related parental-rights provisions. An amendment clarified that the civil action authority applies to minors and that damages benefit the affected minor. Public testimony was heavily divided, with supporters saying the bill enforces existing protections and opponents warning it would chill care, counseling, and school-based support for transgender youth. Senators Harrell, Sharief, and Rouson raised concerns about vagueness, standing, and impacts on teachers and health professionals; Sharief voted no, while the bill was still reported favorably.

Transcript Highlights:

• I have a long-time passion for patient care; I've taken care of 120,000 visits, which makes me feel really
• This bill is an access to care bill.
• Care by allowing providers to refuse care to Texans based on religious and personal beliefs.
• While this bill focuses on the right to refuse any type of care versus refusing care to a specific group
• We don't want a health care system. where children can be taken advantage of by health care providers

Bills: SB95 , SB268 , SB493 , SB619 , SB660 , SB922 , SB984 , SB1098 , SB1188 , SB1307 , SB1332 , SB1822

Committee: Senate Health & Human Services

Transcript Highlights:

• Direct care and treatment is a highly specialized behavioral health care system.
• DCT is similar in size to Central Care One of the state's larger health care systems.
• The health care workforce shortage is a critical concern, and direct care and treatment is not unique
• </c> hour and 45 minutes for the direct care hour and 45 minutes for the direct care and<00:00:50.399
• </c> director for direct care director for direct care treatment<00:01:22.119><c> and</c><00:01:22.280

Committee: House Human Services Finance and Policy

Transcript Highlights:

• First, it would formally define an abandoned endowed care cemetery.
• spending while maintaining high-quality patient care.
• And so I think this bill balances the need to save health care costs. ...the need to save health care
• The bill is about access to care and continuum of care for these patients while preserving existing safeguards
• Continuity of care is critical.

Summary: The committee heard several bills, beginning with SB 1312 by Senator Richardson on abandoned endowed-care cemeteries. Richardson described vandalism, theft, and neglect at abandoned cemeteries and said the bill would define abandonment, create a process for local governments to declare a cemetery abandoned, and allow the Bureau to act as conservator of endowment funds. Support came from Marin County, while county and special district groups opposed or had concerns, arguing the bill could shift burdens to local governments or public cemetery districts without enough safeguards. Members expressed general support but noted the need for further work; the bill was discussed but no final vote was taken in the excerpt. The committee then took up SB 758 by Senator Umberg, which would restrict retail sales of nitrous oxide to curb misuse. Supporters, including the League of California Cities, narcotic officers, counties, pediatricians, and other local governments and health groups, said easy access at smoke shops and convenience stores has fueled recreational abuse and health harms. There was no opposition testimony, and members voiced strong support for a statewide approach over city-by-city bans. The bill was well received, with the author closing in support. Dr. Weber-Pierson presented SB 1094, a health care affordability bill on biosimilars and biologic substitution. The bill would allow pharmacists to substitute biosimilars under certain conditions, require advance notice to providers and patients, and add reporting on savings; the author said amendments would strengthen provider notice and preserve the ability to mark prescriptions “do not substitute.” Supporters from health plans, insurers, pharmacies, labor, business, and some provider groups argued the bill would lower costs and expand access. Opponents, including dermatology and rheumatology groups and biotech interests, warned about non-medical switching, prior authorization delays, and patient harm. After extensive discussion, the committee voted 13-0 to pass SB 1094 to the Committee on Health. The committee also passed SB 849 by Dr. Weber-Pierson, which would bar reinstatement of physicians who surrendered their licenses while a sexual misconduct accusation was pending. The Medical Board and California Medical Association were generally supportive or neutral, and members praised the bill’s patient-protection focus. SB 993 by Senator Ochoa Bogh, which limits routine disclosure of identifying information for mental health professionals in correctional and psychiatric settings while preserving complaint processes, also passed unanimously to Appropriations. SB 1002 by Senator Niello, extending the David Hall Act to allow certain patients in remission to continue telehealth care with out-of-state specialists, drew strong patient support but opposition from the Medical Board and CMA over licensure and oversight concerns; the committee voted it out on a split roll with some members not voting. Finally, SB 1263 by Senator McGuire, aimed at protecting wildfire survivors and workers by requiring licensed, trained contractors for post-disaster residential debris removal, received support from labor and the Contractors State License Board, with contractors raising a narrower amendment concern about scope.

Transcript Highlights:

• Take care.
• The other is Cascade Care Savings.
• And then, of course, health care workforce needs.
• And we know what being uninsured means: not getting care, delayed access to care, uncompensated care
• That's how the health care system is structured.

Committee: Joint Joint Select Committee on Health Care and Behavioral Health Oversight

Summary: The committee first welcomed new DSHS Secretary Angela Ramirez, who introduced herself and described her background in public service, federal and state legislative work, and health and human services leadership. Members emphasized the importance of building strong relationships with her and noted her focus on protecting services, using strategic approaches in a tight budget environment, and improving partnerships with the Legislature. Ramirez said she wanted to keep communication open and that her priorities would be shaped by what she learns from lawmakers and agency partners. The next work session focused on the West Coast Health Alliance and the broader Governor’s Public Health Alliance. Department of Health and governor’s office staff said the West Coast alliance, involving Washington, Oregon, California, and Hawaii, was formed to coordinate science-based public health guidance, especially around vaccines, return-to-work guidance, and responses to federal changes. They said the alliance is intended to reduce confusion, counter misinformation, and preserve access to evidence-based recommendations, with early actions including vaccine guidance for COVID-19, flu, and RSV, a statement rejecting any vaccine-autism link, and preparation for possible ACIP changes. Members asked about workload and coordination with other regional alliances, and staff said there is informal coordination but no formal regular meetings. The committee then heard from the Washington State Health Benefit Exchange about open enrollment and the effects of federal policy changes. Exchange leaders said the expiration of enhanced premium tax credits, HR1 provisions, and immigration-related eligibility changes are affecting affordability and enrollment, with some customers facing large premium increases and some counties becoming harder to serve. They reported early open-enrollment traffic increases, nearly 10,000 new sign-ups, and nearly 12,000 active coverage drops so far, while noting that many more people may disenroll later if subsidies are not extended. They also described mitigation efforts such as silver loading, Cascade Care Savings, outreach through navigators and community partners, and planning for future HR1 requirements like ending auto-renewal and adding verification steps. In the final work session, staff from the Health Care Authority and Insurance Commissioner’s office reviewed Washington’s health reform history and the state’s current affordability and access efforts. They highlighted past ACA-related coverage gains, continued work on prescription drug affordability, PBM oversight, primary care and behavioral health access, and a pending legislative proposal to preserve access to preventive services. They also discussed federal changes affecting Medicaid and the exchange, including work requirements, six-month redeterminations, and the need to coordinate across agencies to implement new rules. Members raised concerns about network adequacy, provider access, and the complexity of the health care system, while staff said they are trying to mitigate harm, simplify administration, and keep coverage and access as stable as possible.

Transcript Highlights:

• Even with improved income stability, it is still difficult to access child care, health care, education
• He needed care.
• I've also seen folks who needed acute mental health care get that care and get to go in an ambulance
• It's something that I care about very deeply. It's something that I care about very deeply.
• So I'm proud of our child care And ultimately, the children that they're caring for.

Committee: House Human Services

Transcript Highlights:

• care needs, take care of themselves, get back to work, and lead productive, prosperous lives. have um
• </c> they don't have an established care they don't have an established care mechanism<00:05:36.039><
• c><00:05:44.240><c> themselves</c><00:05:45.199><c> get</c> care needs take care of themselves get care
• provider in order to continue their health care and move them either off to the specialty care that
• Health care. Where do they go?

Committee: Senate Health and Human Services

Transcript Highlights:

• needs would also be impacted. non-for-profit Health Care entity system non-for-profit Health Care entity
• </c><00:12:40.279><c> and</c> example I can get closer men care and example I can get closer men care
• care, containing health care costs and improving the quality of health care services to all Minnesotans
• care, containing health care costs and improving the quality of health care services to all Minnesotans
• 00:32:04.600><c> and</c> Care uh containing health care costs and Care uh containing health care costs

Committee: House Higher Education Finance and Policy

Transcript Highlights:

• Many health care mandates don't.
• And so I think, just as we talked about health care mandates and the cost of health care, that that's
• and not just health care mandates.
• And so I think just as we talked about health care mandates and the cost of health care, that that's
• and not just health care mandates. health care mandates.

Summary: The committee met to review the history and current treatment of North Dakota health insurance mandates, with presentations from Blue Cross Blue Shield of North Dakota, Sanford Health Plan, the Public Employees Retirement System (PERS), and the Insurance Department. The discussion focused on how mandates apply differently to fully insured, self-funded, ACA, Medicaid, and PERS plans; how the state’s benchmark plan and federal essential health benefits affect coverage; and how the existing process requires cost-benefit analysis and, for certain measures, a PERS pilot period before broader application. Presenters also reviewed the long list of existing state mandates, including provider, beneficiary, and coverage requirements, and noted that many were enacted decades ago and have not been revisited despite changes in medical evidence and treatment options. Witnesses from the carriers argued that mandates should be reviewed periodically because some are outdated, can create unintended costs, and may not align with current medical guidance. Examples cited included PSA screening, off-label drug coverage, prior authorization rules, step therapy, and cost-sharing provisions for mental health and substance use treatment. They emphasized that carriers often cover services without a mandate when supported by clinical evidence, and that mandates can shift costs to employers and employees, especially in the fully insured small-group market. They also suggested possible policy improvements such as clearer mandate definitions, better transparency around cost-benefit analyses, a regular 10-year review of mandates, and more timely submission of proposals through the interim process. PERS and the Insurance Department highlighted a recurring tension over what counts as a mandate and when a measure triggers the state’s defrayal obligation under federal law. PERS described its interim committee process, the April 1 deadline for fiscal-impact proposals, and the limited pilot program used for certain measures, noting that only a few bills have gone through the full pilot process. The Insurance Department explained that it views new benefit mandates through the lens of the ACA benchmark plan and essential health benefits, distinguishing true new benefits, such as infertility coverage, from changes to existing benefits, such as telehealth or insulin cost-sharing caps. No votes were taken on policy changes; the meeting was informational, with members asking questions about costs, applicability, transparency, and whether a periodic mandate review should be established.

Transcript Highlights:

• The health care team for income-eligible patients.
• They continue to tie our hands behind our back to provide the kind of care and health care that people
• Primary care providers have stated that their patients' psychiatric care improves when consulting with
• when you could have care in person.
• are going into these apps and online portals and virtual or remote care when you could have care in

Summary: The hearing opened with remarks from the chair and members about recent federal cuts to public health, mental health, family planning, and Title X funding, with strong concern about the impact on California programs and providers. The committee then turned to the Department of State Hospitals, which presented its 2025-26 budget proposal of $3.4 billion, including new positions, capital improvements, and funding tied to increased patient costs and incompetent-to-stand-trial services. DSH reported major progress in reducing the IST waitlist and wait times, said it had met the court’s 28-day treatment benchmark for those without extenuating circumstances, and described workforce recruitment and retention efforts such as residency programs, fellowships, outreach, and hiring streamlining. Members asked about future IST referral trends, SB 1323’s effect on diversion and community treatment, and workforce lessons in high-cost regions; public comment urged reconsideration of county IST growth cap methodology in light of new criminal justice initiatives. The committee next received an informational overview of Proposition 1 and its changes to behavioral health funding and governance. The Legislative Analyst’s Office explained that Prop. 1 restructured county MHSA funding buckets, expanded the Commission for Behavioral Health, shifted prevention and early intervention responsibilities, and authorized a $6.4 billion bond, including $4.4 billion for behavioral health facilities through BHCIP. DHCS said it had released guidance for county integrated plans and was receiving extensive public comment. Members focused on BHCIP application requirements, especially letters of support and tribal projects, and raised concerns about whether DHCS’s implementation matched statutory intent. DHCS said it had authority to set application requirements and that tribal entities were treated differently because of sovereignty and funding structure. DHCS then updated the committee on BHCIP, the Behavioral Health Bridge Housing Program, and related bond implementation. The department said BHCIP had awarded about $1.7 billion across five rounds, with more than 130 projects and 223 distinct facilities funded, and that it was preparing to award the new bond funds after receiving nearly $8 billion in applications. The LAO’s assessment found that more than half of awards served at least 80% Medi-Cal enrollees, but also raised concerns that the regional allocation model could reinforce inequities, that the program had not sufficiently addressed the highest-need regions such as the southern San Joaquin Valley, and that smaller counties and less launch-ready applicants faced barriers. For bridge housing, DHCS said more than $1.1 billion had been awarded, serving over 5,000 people and supporting more than 2,000 operational beds, but the Governor’s budget proposes to eliminate Round 4 funding as the administration weighs other statewide investments and Proposition 1 implementation workload. Public commenters and members urged more accountability, better regional equity, stronger labor and community involvement, and caution about funding for for-profit psychiatric facilities. Finally, the committee heard on the Children and Youth Behavioral Health Initiative. CalHHS and DHCS described CYBHI as a broad prevention- and equity-focused effort with more than 1,300 organizations funded, over $2.1 billion awarded, and multiple work streams spanning schools, community programs, workforce, and digital supports. DHCS highlighted school-based services, the fee schedule rollout, and digital platforms BrightLife Kids and Soluna, which it said are reaching users statewide and providing low-barrier access to coaching and support. Members and public commenters raised concerns about delays in school fee schedule implementation, the large share of funding going to digital tools, the need for more in-person services, and whether the initiative is sufficiently tracking outcomes and equity impacts. No formal votes were taken during the hearing.

Transcript Highlights:

• wait for us to pass that standard of care?
• Whereas my care and the surgical care I perform is technically regulated by the State Board for Registration
• We're going from medical care, which only 30% of optometrists perform currently, to surgical care in
• that care, I agree, but you're compromising.
• So it's going to be the Level of care.

Committee: House Professional Registration and Licensing

Summary: The committee first took up House Bill 3111, which concerns bail bonds oversight. Representative Phelps offered a committee substitute that moved bail bondsmen into the existing Board of Private Investigators, Private Fire Investigators, and Professional Surety Bail Bonds to avoid a fiscal note. An amendment was adopted to remove fee caps in the substitute, and the committee then adopted the revised substitute and voted it do pass 21-0. The committee then heard Senate Substitute No. 2 for Senate Bill 1233, the CPA licensure bill, along with related provisions for social work supervisors and speech pathologists. Senator Trent and supporters from the Missouri Society of CPAs, the speech-language association, the social work community, and the State Auditor’s Office said the bill would address CPA shortages by creating a new licensure path based more on experience, while preserving exam standards and adding reciprocity. No opposition was offered, and the hearing concluded without a vote. House Bill 2999 on optometry scope of practice drew extensive testimony and debate. The sponsor and ophthalmology witnesses described the bill as a negotiated compromise that would codify specific procedures optometrists may perform, while opponents from optometry argued it would freeze scope in statute, limit modernization, and require repeated legislative action as standards change. Witnesses disagreed sharply over whether the bill improved patient safety and access, whether the procedures were already within current practice, and whether surgical procedures such as lasers should be included. The bill was heard but no committee action was taken in the transcript. Finally, the committee heard House Bill 2957 on respiratory therapist licensure. Representative Castile and respiratory care witnesses said the bill would phase out the CRT as the entry credential for new applicants in favor of the higher RRT standard, while grandfathering current CRTs and adding renewal audits to confirm active credentials. Supporters said the change reflects current training standards and would raise patient-care quality without reducing workforce numbers. No opposition testimony was presented, and the hearing adjourned without a vote.

Transcript Highlights:

• We work day in and day out taking care of our individuals, loving them, caring for them, providing for
• We work day in and day out taking care of our individuals, loving them, caring for them, providing for
• These workers are home care aides, direct care staff, mental health, substance use, and disability service
• These workers are home care aides, direct care staff, mental health, substance use, and disability service
• Black and brown workers make up a disproportionate share of the home care and direct care workforce.

Committee: Joint Joint Committee on Labor and Workforce Development

Summary: The Joint Committee on Labor and Workforce Development held a hybrid hearing on legislation concerning unemployment insurance, non-compete agreements, prevailing wage, and minimum wage issues. Committee leaders outlined the hearing process, asked witnesses to keep oral testimony to three minutes, and invited written testimony through November 20. No votes were taken during the hearing; it ended with a motion to adjourn and notice of the next hearing on November 20. Much of the testimony focused on bills to expand unemployment insurance for striking workers, including H. 2168 and S. 1319. Labor leaders, union members, and legal advocates argued that workers who are out on strike for more than 30 days should be able to receive UI benefits, saying the policy would help workers and families meet basic expenses, reduce employers’ ability to “wait out” strikes, and encourage good-faith bargaining. Speakers cited recent strikes, including the Republic Services strike, and said the proposal would not meaningfully increase strike activity or strain the UI trust fund. Another major topic was minimum wage legislation, especially H. 2107/S. 1349 to raise the minimum wage to $20 by 2029 and index it to inflation, and H. 2191 to create a $25 enhanced care worker minimum wage. Supporters said current wages are not keeping pace with housing, food, and childcare costs, and that care workers, direct support staff, and human service employees face chronic vacancies, burnout, and turnover. Testimony also supported H. 2126 on prevailing wage by adding apprenticeship and training contributions to the wage calculation, and H. 2159 and S. 1363 on prevailing wage-related issues. One witness, Russell Beck, testified against S. 1336, which would ban non-competes, and against H. 2118, arguing Massachusetts’ current non-compete law is a balanced compromise that should not be disrupted.