Transcript Highlights:

• navigation, counseling, and a referral navigation, counseling, and a referral system<00:46:08.079
• There's a lot that goes on regarding transportation, processing, cold storage.
• ,<01:09:07.679> cold transportation, processing, cold transportation, processing, cold storage
• Staff systems and processes are in place.
• federal funding freezes, new referrals federal funding freezes, new referrals are<02:10:13.599><

Keywords: 912, senate, all

Summary: This joint informational briefing focused on Act 310 grants and aid, with committee members hearing one-minute testimony from organizations first in person and then by Zoom. At the outset, the chairs explained there would be no Q&A during the briefing and asked testifiers to focus on how federal cuts were affecting their work. The meeting was organized by registration number and included both neighbor island and Oʻahu applicants. Testimony centered on organizations seeking state support to offset federal funding losses or anticipated reductions. Health and social service providers described impacts from Medicaid, SNAP, ACA subsidy, Title X, and other federal changes, including Aloha Care, Community Clinic of Maui, Healthy Mothers Healthy Babies, West Hawaiʻi Community Health Center, Hawaiʻi Disability Rights Center, Hawaiʻi Youth Services Network, Alcoholic Rehabilitation Services of Hawaiʻi, and Kokua Kalihi Valley. Other groups highlighted losses affecting food security, housing, disaster preparedness, and climate resilience, including the Kohala Center, Feeding Hawaiʻi Together, Hawaiian Lending and Investments, Dynamic Community Solutions, and the Pacific Tsunami Museum. Several arts, youth, and education organizations also testified, including Hawaiʻi Literacy, Hawaiʻi Youth Symphony, Honolulu Theatre for the Youth, Sounding Joy Music Therapy, Big Brothers Big Sisters Hawaiʻi, Girl Scouts of Hawaiʻi, Kids Hurt Too Hawaiʻi, and US Vets, each requesting funding to preserve programs and staffing. No votes or formal committee actions were taken during the briefing. The only action was procedural: the chairs moved through the applicant list, limited testimony time, and then transitioned from neighbor island in-person testimony to Oʻahu and later Zoom participants.

Transcript Highlights:

• over 16 bills and that's not<00:01:08.720> doing<00:01:09.000> the<00:01:09.240> process
• fairly<00:01:10.920> we<00:01:11.040> want<00:01:11.159> to not doing the process
• fairly we want to not doing the process fairly we want to make<00:01:11.400> sure<00:01:11.600
• We are a regional rural referral center and support an 11-county region of Northeastern Kentucky.
• We are a regional rural referral center and support an 11-county region of Northeastern Kentucky.

Keywords: 00:00 Introductions 02:46 Roll Call 03:35 Discussion on SB 14 46:13 Vote on SB 14 48:07 Discussion on SB 17 50:38 Vote on SB 17, 958, all

Summary: The Senate Standing Committee on Health Services opened with the chair welcoming several new members and outlining session rules: hearings would start and end on time, the committee would limit the number of bills heard each meeting, prioritize bills heard during the interim, and generally avoid using the consent calendar except in extreme circumstances. The committee then briefly considered administrative regulations, which were treated as approved if members had no questions. The main item was Senate Bill 14, a measure addressing the 340B drug discount program. The chair said the bill had already passed the Senate in a prior session and had been heard in interim, so he did not present it again. He described the bill as prohibiting drug manufacturers from discriminating against 340B covered entities by refusing 340B pricing when the same drug is offered at that price in the state. He also said the committee would not debate the federal 340B program itself, but would hear testimony on the bill. Hospital leaders and Kentucky Hospital Association representatives testified in support, arguing that 340B savings are essential to rural hospitals, oncology services, transportation support, chronic care, addiction recovery, and new service lines such as chemotherapy and hepatitis treatment. They said the program helps keep care close to home and that manufacturer restrictions on contract pharmacies have reduced access and cost hospitals millions. Opponents from BIO Kentucky and the National Alliance of Healthcare Purchaser Coalitions argued the bill would expand federal law beyond Congress’s intent, create administrative burdens, and not lower patient out-of-pocket costs. The chair repeatedly pressed opponents to address why Kentucky should be denied the same 340B pricing available in other states. No vote on the bill was taken in the portion provided.

Transcript Highlights:

• After reading referral bills into the end of today's business, is there an objection?
• A mentor in this process taught me that if you don't care about the people you work with, you will never
• And that's the way this process works. You don't lose the friendships; you make new friendships.
• The Senate amendments remove the timelines and processes that this body voted out in regards to when
• And I'm hopeful that with this, we begin the process of doing that here in the state.

Bills: HB5560, HB2, HB24, HB3233, HB1397, HB2067, HB3133, HB5696, HB5680, HB2885, HB3966, HB3556, HB3595, HB144, HB26, HB2038, HB521, HB4, HB 1178, HB42, HB 1211, HB783, HB3963, HB2240, HB1690, HB 1234, HB3372, HB27, HB4211, HB2243, HB2853, HB4638, HJR7, HB 100, HB 126, HB3783, HB5138, HB2512, HB5616, HB4751, SB17, SB1637, SB1833, SB2155, SB21, SB2778, SB260, SB8, SB12, SB37, SB379, SB441, SB1566, SB2878, HB4112, HB3866, HB4749, HB2844, HB150

Keywords: groundwater, civil penalties, water conservation, drought contingency, environmental protection, public education, teacher compensation, certification, funding, school finance, educator rights, education funding, charter schools, staff compensation, state aid, retention allotment, zoning, public notice, local government, residential development

Transcript Highlights:

• So bringing someone on who can really help us through the process of making the choices of what to upgrade
• Um, the way that our procurement works, the way that our hiring processes work, all of those are much
• Yeah, because we have House session and it could—we could get a referral this way. >> Right.
• We could get a referral this way.
• We could get a referral this way. >> right. We could get a referral this way.

Keywords: 1189, house, all

Summary: The committee held a work session on House Bill 592, which concerns regional conservation and energy resources planning for habitat strongholds and wildlife corridors, and a commission to study transferring ownership of the Winnipesaukee River Basin Program to another authority. Jason Stock of the New Hampshire Timberland Owners Association said his group was fine with the bill as printed, especially after Senate language clarified that habitat stronghold designations are for information gathering and not regulatory purposes. Ted Diers of the Department of Environmental Services strongly supported the bill’s Winnipesaukee River Basin provisions, saying the state’s role in operating the wastewater system is outdated and that the communities are now capable of taking more control; he also supported creating a higher-level engineering/director position to oversee aging infrastructure and help manage a possible transition. Committee members asked about the facility’s location, capacity, costs, staffing, the possibility of private operation, the commission’s membership, and whether the six-month study timeline was realistic. Diers said there would be no state savings beyond administrative time, that the communities already pay the costs, and that a report in six months should provide useful next steps even if it would not resolve everything. The chair closed the work session on HB 592 and announced a brief recess before later action, while a member indicated interest in proposing an amendment to change the commission’s membership.

Transcript Highlights:

• Communication No. 450 transmits House Concurrent Resolution No. 104, which was adopted in the House for referral
• Communication No. 450 transmits House Concurrent Resolution No. 104, which was adopted in the House for referral
• ><00:03:44.000> for which was adopted in the House for which was adopted in the House for referral
• referral to committee. So ordered. referral to committee. So ordered.
• Referrals and re-referrals are made in accordance with the supplemental orders of the day that may be

Keywords: 912, senate, all

Transcript Highlights:

• Governor's Message Nos. 771 to 785 are referred in accordance with the referrals on the order of the
• Referrals and re-referrals are made in accordance with the supplemental orders of the day that may be
• Miscellaneous business: waiver of referral for Senate Concurrent Resolutions Nos. 3, 4, 5, Senate Draft
• to 14 on the order of the day. miscellaneous business waiver of miscellaneous business waiver of referral
• <00:11:38.240> for<00:11:38.480> Senate<00:11:38.800> concurrent referral for Senate

Keywords: 912, senate, all

Summary: The Senate convened with 24 members present and one excused, approved the previous day’s Journal, and heard several introductions. Senator Hashimoto welcomed a visiting Kukui Fellowship Program cohort from Maui, and Senator Chang delivered a tribute honoring the late University of Hawaii Professor Daniel W. Kwak, highlighting his scholarship in Asian studies, his teaching career, and the journalism fellowship and China seminar he founded. A late introduction also recognized retired UH communications professor Gerald Kato for his work in journalism policy. The chamber then processed messages and communications, including Governor’s nominations to boards and commissions, House communications returning Senate bills, and a Judiciary communication transmitting the nomination of Sonia H. Toma to the Family Court of the Second Circuit. The Senate adopted Standing Committee Reports Nos. 1369 and 1370, agreed to disagree with House amendments to Senate Bill 108, and received notice that conferees would be named later. House concurrent resolutions transmitted from the House were referred to committee. On third reading, the Senate passed House Bill 994, HD1, relating to promoting pornography to minors, and House Bill 1175, relating to tax appeal procedures, both by unanimous consent with 24 ayes and no reservations. The Senate also granted a waiver of referral for a list of Senate concurrent resolutions and Senate resolutions so they could meet an upcoming deadline. The President thanked staff for the job fair and noted its value for employees whose service would end at adjournment. The Senate then adjourned until 11:30 a.m. on Monday, March 31st.

Transcript Highlights:

• Governor's Message No. 666 to 668 are referred in accordance with the referrals listed on the Order of
• Governor's Message No. 666 to 668 are referred in accordance with the referrals listed on the Order of
• Referrals and re-referrals are made in accordance with the Order of the Day and the supplemental orders
• Referrals and re-referrals are made in accordance with the Order of the Day and the supplemental orders
• Referrals and re-referrals are made in accordance with the Order of the Day and the supplemental orders

Keywords: 912, senate, all

Summary: The Senate convened with a quorum present, approved the previous day’s journal, and opened with a moment of contemplation honoring Bob Marley. Several senators spoke about Marley’s life, music, and activism, emphasizing his messages of peace, justice, unity, and resistance. One senator highlighted Marley’s 1979 visit to Hawaii and his influence on Hawaiian and “Jawaiian” music, while another introduced members of the Marley family and recognized their continuing musical work and cultural legacy. The Senate also recognized staff members from one senator’s office during the introductions. After the contemplative remarks and guest introductions, the presiding officer asked for a few minutes for photographs. The chamber then processed Governor’s Message No. 665, withdrawing a nomination to the Campaign Spending Commission, and Governor’s Messages Nos. 666 to 668, transmitting nominations to various boards and commissions. Those messages were referred according to the Order of the Day, and Standing Committee Reports Nos. 480 to 674 were adopted by motion without objection. In announcements, the presiding officer thanked the SMA team and legislative staff for efficient work on a record number of bills during the first lateral, noted the upcoming three-day weekend, and extended birthday wishes to Clerk Carol Taniguchi. The Senate then adjourned by motion until 11:30 a.m. on Tuesday, February 18th.

Transcript Highlights:

• At my location alone, we had what I know to be true is 325 potential referrals for home care services
• At my location alone, we had what I know to be true is 325 potential referrals for home care services
• At my location alone, we had what I know to be true is 325 potential referrals for home care services
• Greater Minnesota lane for this, and so I don't know who would answer the question, but in this grant process
• Greater Minnesota lane for this, and so I don't know who would answer the question, but in this grant process

Keywords: 1183, house

Transcript Highlights:

• That might not require the same payroll processing.
• That might not require the same payroll processing.
• Not an excuse, the appropriations process moves fast.
• These would process advocacy claims in the proposal.
• I'm not sure I understand the thought process.

Keywords: 988, house, all

Summary: The subcommittee met to review May Revision proposals for several departments and emphasized that no votes would be taken that day. The Legislative Analyst’s Office opened with a warning that the state budget is balanced only through one-time resources and still has structural deficits, recommending that the Legislature avoid new ongoing spending and instead preserve reserves and other solutions. The Judicial Council then presented proposals for language access and interpreter services, appellate court security, a backfill to the state court facilities construction fund, and an extension of the lactation-room mandate; Finance supported the language access item with reporting language and supported keeping the court facilities backfill. Members raised concerns about judicial pay freezes, judge vacancies, and uneven judge allocations across counties, and also asked about the cost and completion of courthouse lactation rooms and remote-hearing infrastructure. The Board of State and Community Corrections items focused on $10 million one-time grants for missing and murdered Indigenous people and for a human trafficking vertical prosecution program. The LAO suggested the Legislature consider whether the Tribal Nations Grant Fund could support the MMIP work, while Finance said it preferred General Fund support and wanted more review before any fund swap. On the human trafficking grant, Finance said the need was clear based on reported cases and California’s share of hotline reports. Members strongly supported MMIP funding and discussed whether ongoing funding would be needed beyond the one-time proposal, while also debating whether BSEC or OES should administer the prosecution grants. The Department of Justice presented antitrust litigation funding, Medi-Cal fraud and elder abuse staffing, organized retail criminal enterprise case completion, and a continuous appropriation for the Victims of Consumer Fraud Restitution Fund. The LAO raised concerns about the Unfair Competition Law Fund’s solvency and recommended rejecting that portion unless DOJ could show the fund could support it without General Fund repayment, and it opposed the continuous appropriation in favor of more legislative oversight. Finance said the fund would remain solvent under current projections and defended the continuous appropriation as necessary to pay victims promptly. Members also clarified that the Medi-Cal fraud unit targets providers, not beneficiaries, and asked about delays in restitution payments. A lengthy portion of the hearing covered CDCR’s May Revision package and the Boston Consulting Group cost-savings effort. CDCR described revised savings from workforce optimization, workers’ compensation, and procurement, but members repeatedly expressed frustration that the promised savings had fallen far short of earlier estimates. The LAO recommended deeper cuts to some parole positions, more detail on proposed eliminations and contract changes, and caution about counting unallocated future savings. CDCR also presented population projections showing continued declines and the LAO again urged the administration to close a prison to reduce ongoing costs. The committee also heard proposals on workers’ compensation, Corcoran honor housing, incarcerated firefighter pay, agricultural food purchasing requirements, menopause care, mental health receiver staffing, resource teams, crisis intervention teams, medical classification staffing, and AI note-taking in electronic health records, with the LAO generally recommending limited-term approvals and reporting requirements while Finance defended ongoing funding and said it was open to additional reporting language.

Transcript Highlights:

• This bill would create a streamlined referral process for Care Court. Care Court is our...
• This bill would create a streamlined referral process for Care Court.
• to process more quickly.
• I mean, that's a complicated, long process. I get that.
• So it's an honor to be involved in the process as well.

Summary: The committee heard several bills focused on civil rights, housing, public safety, and administrative process. Early items included SB 46, which would authorize the Secretary of State to remove constitutionally ineligible presidential and vice presidential candidates from California ballots; SB 1078, requiring notice to the Civil Rights Department when court filings involve civil rights violations; SB 989, expanding access to Care Court by letting first responders refer cases through county behavioral health agencies; SB 998, clarifying and expanding discrimination prevention coordinators in the new Office of Civil Rights; SB 1146, requiring disclosure for AI-generated health advertisements and giving physicians a limited private right of action; SB 1164, a California Voting Rights Act expansion responding to federal voting-rights rulings; SB 1256, a housing bill aimed at limiting repeated litigation over the Harmony Grove Village South project; SB 1267, addressing HOA liability and indemnification for EV charger installations; and SB 1425, authorizing an encroachment permit program for high-speed rail right-of-way management. The committee also later heard SB 873, restricting ICE arrests near courthouses, and SB 1160, requiring eviction data reporting by zip code. Most bills drew support from sponsors, advocacy groups, labor organizations, or local officials, while opposition centered on concerns about county workload, due process, fire safety, civil liberties, or the scope of the policy changes. Members generally expressed support for the bills while noting unresolved issues and the need for amendments or further stakeholder work, especially on SB 1164, SB 1256, SB 1267, SB 1425, and SB 1160. The Judicial Council opposed SB 1160 because of the burden of adding zip-code reporting to court systems, while the author and supporters argued the data would help target eviction-prevention efforts. SB 873 drew strong support from public defenders, immigrant-rights groups, and court-related stakeholders, with the San Bernardino County Sheriff’s Department opposing. SB 989 drew support from firefighters and family advocates, while Disability Rights California opposed, arguing Care Court is too costly and diverts resources from community-based services. SB 1164 received broad civil-rights and voting-rights support, with cities opposing unless amended over definitions, cure periods, and litigation risk. SB 1256 drew support from housing and labor interests and opposition from local residents and environmental groups concerned about fire safety and evacuation. SB 1267 was supported by the HOA and utility stakeholders after amendments addressing liability concerns. After quorum was established, the committee voted to pass a consent calendar and then approved the listed bills, sending them to the appropriate committees or to Appropriations, including SB 46, SB 873, SB 989, SB 998, SB 1078, SB 1146, SB 1164, SB 1256, SB 1267, and SB 1425. The transcript ends with SB 1160 still under discussion, with members indicating support for the bill’s goals but acknowledging the Judicial Council’s implementation concerns and the need for further work.

Transcript Highlights:

• This bill would create a streamlined referral process for Care Court. Care Court is our...
• This bill would create a streamlined referral process for Care Court.
• to process more quickly.
• I mean, that's a complicated, long process. I get that.
• So it's an honor to be involved in the process as well.

Keywords: 988, house, all

Transcript Highlights:

• And I know there's a process where you can automate automatically people automatically be reenrolled.
• to job assistance or a referral to an entity that will help them possibly find a job.
• to job to um job assistance or referral to job to um job assistance or um<00:45:49.359> like<
• 00:45:49.599> a<00:45:49.920> referral<00:45:50.319> to<00:45:51.359> um<
• 00:45:51.440> I<00:45:51.680> forgot<00:45:51.920> if um like a referral to um I

Keywords: Call to Order and Roll Call – 00:00:00 Introduction of Board Members – 00:02:04 Overview of the Purpose and Goals of the Medicaid Oversight and Advisory Board – 00:12:46 Medicaid Legislative Update - 00:20:26 Discussion of Next Steps and Future Meeting Dates – 01:04:06 Adjournment – 01:06:37, 958, all

Summary: The first meeting of the Medicaid Oversight Advisory Board opened with Chair Ken Fleming and Co-Chair Rocky Adams welcoming members, explaining the board’s purpose, and introducing the diverse membership of legislators, providers, advocates, and state officials. Fleming said the board would meet monthly, allow public comment at the end of meetings, and operate transparently with materials posted online and distributed in advance. Both chairs emphasized that the board’s work would focus on improving Medicaid outcomes, efficiency, and oversight, while preparing for possible federal changes and avoiding premature assumptions about what Congress may do. Members then gave brief introductions describing their backgrounds in medicine, nursing, hospital administration, behavioral health, insurance, budgeting, pharmacy, and Medicaid administration. Several noted direct experience with Medicaid populations or managed care, including the Department for Medicaid Services commissioner, health plan representatives, hospital and clinic leaders, and legislators with health care backgrounds. The board also heard from Stephanie Bates of the LRC Office of Health Data Analytics, who said her office supports the General Assembly with health-related data, policy, and research and would serve as a resource to the board. Bates then began a presentation on Medicaid basics, explaining that House Bill 695 created the board and that the presentation would cover eligibility, enrollment, covered benefits, waivers, managed care, the budget, and the federal reconciliation bill. She described Medicaid eligibility as complex, noted that Kentucky had more than 1.4 million enrollees, and explained enrollment churn and the unwinding of pandemic-era continuous coverage. She also outlined mandatory and optional Medicaid benefits, the requirement that services be medically necessary and provided by enrolled providers, and the main waiver types used in Kentucky, including 1115, 1915(b), and 1915(c) waivers. No votes or formal actions were taken at this meeting beyond organizational setup and receiving the initial informational presentation.

Transcript Highlights:

• Attention was being paid to DHS being asked to process applications for providers faster.
• That process is underway, as we discussed.
• . until law enforcement accepted a referral.
• That process, as I said, takes a long time.
• But, you know, if we want to see subs into a process on... On tightening this stuff the way Mr.

Transcript Highlights:

• for referrals of suspected abuse and neglect.
• And Secretary Sandoval provided an overview of The screening process at CYFD, including referrals, the
• It is a process. I will admit to that, and it's not always a very fast process. We could do better.
• And so, I've been leading a process, a weekly process, with our permanency team to move those.
• and to have to wait that process out.

Keywords: 996, all

Transcript Highlights:

• I would like you to imagine that you just went through the life-saving process of getting an ostomy.
• And lastly, I just want to mention that I'm not alone in this process, and this bill will improve the
• MassHealth still requires a physician referral for a patient to access chiropractic care.
• We urge consideration of language to remove the outdated referral requirement.
• An athletic trainer's intervention could prevent a death and, with appropriate treatment and referral

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a public hearing on a wide range of bills, with testimony first focused on H. 1315/S. 824, which would require insurance coverage for pain management options during IUD insertion. Representative Sabadosa, Planned Parenthood clinicians, and policy advocates said sedation can reduce fear and trauma, improve access to effective contraception, and should be reimbursed so providers can continue offering it. A Tufts OB-GYN resident also testified that pain control should be standard care for intrauterine procedures. No votes were taken during the hearing. The committee then heard extensive testimony on firefighter health bills, especially H. 1230/S. 690 requiring insurance coverage for cancer screenings for firefighters. Professional Fire Fighters of Massachusetts leaders, a Dana-Farber oncologist, and firefighters themselves described occupational exposure to carcinogens and personal stories of late-stage cancer detection, arguing that early screening can save lives and reduce long-term costs. Representative Crichton and Representative Howitt also spoke in support, and Representative Ayers testified for H. 4012, which would require neurological disorder screenings for firefighters. Committee members expressed support and sympathy, but no action was taken. The hearing also covered H. 3946/S. 756 on hearing aid coverage, with testimony from students, adults with hearing loss, disability advocates, and HLAA representatives describing the educational, social, and financial barriers caused by lack of coverage and urging broader insurance mandates. Later, Representative Donahue and Representative Vargas testified for H. 1337 to expand insurance coverage for opioid antagonists and related medications, including naloxone dispensed at discharge. The committee additionally heard testimony on H. 1134 to improve chronic pain care coordination and non-opioid access, and H. 4162 to improve ostomy supply coverage and access to certified ostomy care, with patients and clinicians describing denials, quantity limits, and non-medical switching. The transcript ends while testimony on H. 1315/S. 824 is still ongoing; no votes or formal committee actions are recorded in the excerpt.

Transcript Highlights:

• dyslexia itself, but just as an overview, dyslexia is a learning disability that disrupts how the brain processes
• I'm going to give you guys a little bit of a background on dyslexia today. processes written language
• processes written language um<00:01:30.880> this<00:01:31.119> makes<00:01:31.439>
• <00:04:50.120> instructions<00:04:51.120> spelling<00:04:52.120> writing processing
• instructions spelling writing processing instructions spelling writing and<00:04:53.000> behavior

Keywords: 1187, senate, all

Transcript Highlights:

• and people that may or may not be there in agencies that may or may not have the same processes.
• you talk about community support workers, as you get done with treatment with people, are there referrals
• I’m not an expert in that process and how it’s done.
• But that's a really intensive process. It requires a lot of coordination.
• and do transportation work to help people get their medical treatment. ...open and do referrals and

Keywords: 959, house, all

Transcript Highlights:

• Public health has the majority of staff, and they're going to continue the certificate of need process
• And they're going to continue the certificate of need process.
• Only getting referrals based on a lottery. Yeah, for who, what, for a referral?
• Sometimes in some years when there's more money in the state budget, the center will process more cases
• But essentially, the nursing homes will... ...will process more cases, but essentially the nursing homes

Keywords: 962, all

Summary: The Complex Care Committee meeting focused first on a new Diabetes Caucus launched at the Capitol. Rep. Johnson described the caucus as a forum to educate people about type 1 and type 2 diabetes, genetic risk, early testing, pregnancy-related diabetes, and ways Medicaid policy might improve prevention and lower long-term costs. Members agreed the caucus could intersect with care management, and Carolyn Grandell of CHNCT offered to share information about current diabetes-related care management services at a future meeting. The committee then heard a detailed presentation from Alex Rigger of the Office of Health Strategy, who is moving to the Office of Policy and Management. He reviewed Connecticut health care benchmark data, including total health care expenditures, medical spending, and market-by-market trends. He said 2023 to 2024 per-capita spending grew more than 8.5% statewide and 14% in Medicaid, with long-term care accounting for about 46% of Medicaid spending and retail pharmacy also identified as a major cost driver. Members asked about enrollment changes, dual-eligible populations, Medicare Savings Program members, 340B drug pricing, and value-based payment models. Rigger explained that his office tracks alternate payment models and quality benchmarks, but does not separately capture 340B data. Discussion then shifted to Medicare Advantage, dual eligibles, and hospital discharge planning. Members said they want better data on how many Medicaid members are in Medicare Advantage plans and whether those plans shift costs back to Medicaid or affect access to care, especially for complex-care patients. Staff noted DSS does have some Medicare Advantage indicators and that CMS is developing encounter-data rules for states. Kathy Holt and others raised concerns about denials, nursing home stays, and the need to compare Medicaid spending for dual eligibles in Medicare Advantage versus traditional Medicare. The meeting ended with plans for follow-up data sharing, including Alex Rigger’s slides, the diabetes caucus materials, and a future discussion with DSS and other agencies; no formal votes were taken.

Transcript Highlights:

• It's a slow process, and that's even at the CDC level nationally.
• A lot of the referrals made for these complications occur in those centers.
• We were part of a competitive bid process with the Department of Health and Human Services.
• I think it's helpful to kind of look at our process.
• I think it's helpful to kind of look at our process, too.

Summary: The committee first approved the previous meeting minutes and then heard a detailed annual report from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and policy issues. He explained the committee’s review process, confidentiality protections, and national and North Dakota data showing that most maternal deaths are preventable and that mental health conditions, substance use, cardiovascular issues, infection, hemorrhage, and embolism are the leading causes. Members asked about suicide, domestic violence, midwife training, home births, and whether pregnancy testing at death scenes should be expanded; Dr. Arnold said better coroner education, more investigation of unexplained deaths, and possible post-mortem pregnancy testing could improve case identification, especially in rural areas. He also noted that deaths often occur well after 42 days postpartum and that mental health-related deaths remain a major concern. The committee then heard from State Fire Marshal Dr. Matthew Clark on cigarette reduced-ignition-propensity standards and related fire prevention issues. He recommended updating the state’s cigarette propensity law to current national standards and also raised a separate recommendation to require fast-breakaway oxygen tubing for home oxygen users, citing fatal fires linked to smoking around oxygen. Members asked about implementation, cost, insurance coverage, and whether the standards apply in tribal communities; Dr. Clark said he would provide follow-up information and was willing to help with any legislation, but no agency bill had yet been planned. Next, Christine Greff of the Department of Health and Human Services reported on the North Dakota Stroke System of Care. She described the statewide network of stroke-ready hospitals, registry-based quality improvement, and performance data showing continued improvement in stroke recognition, imaging, thrombolytic treatment, transfers, and EMS pre-notification. She highlighted new quality measures for inter-facility transfers and intracerebral hemorrhage care, and said the system remains strong but depends on continued legislative and hospital support. Committee members asked about participation by the VA hospital and were encouraged to consider outreach to include it more fully in the stroke system. Finally, the committee began a presentation on prior authorization and non-opioid pain treatment from Taha Khan of Vertex Pharmaceuticals. He argued that prior authorization can delay access to non-opioid acute pain medications, especially in the 24- to 72-hour post-discharge window when pain is most severe, and said delays can push patients toward opioids. He emphasized that prior authorization has a role in utilization management but should not create barriers in acute pain care, and he noted that current use of the company’s non-opioid product remains very low. The discussion was still underway when the transcript ended.

Transcript Highlights:

• <01:42:35.520> with necessary through the rules process with necessary through the rules process
• You're not this stage in the process.
• So we just remove the referral for... So we just remove the referral for...
• referral for u. referral for u.
• essential biological processes. essential biological processes.

Keywords: 12:30pm HB 421 2:00pm HB 701 3:00pm HB 377 4:00pm HB 712, 928, house, all

Summary: The committee of conference first took up House Bill 421FN, concerning notice of tax-exempt status filing procedures by town officials. Members reviewed the Senate changes and focused on whether the amended language would require multiple mailings to charitable organizations. House conferees said the Senate wording appeared to create more than one mailing and asked for clarification; Senate members explained the intent was to reduce clerk workload by posting forms and sending a follow-up notice only to organizations that failed to file after the deadline. After a brief caucus, the House concluded there were too many unresolved changes to work out in conference and moved to non-concur with the Senate amendment. The House motion to non-concur passed unanimously, 4-0, and the committee agreed to place the conference report on the House consent calendar. The chair then closed the committee of conference on House Bill 421FN. The transcript then shifted to a separate committee of conference on another bill, where members discussed revisions involving direct supervision at an eligible facility, federalwide assurance requirements, and immunity language. Testimony focused on whether the bill should require supervision at a specific facility or allow broader supervision arrangements, whether rulemaking should define direct supervision, and whether the immunity provision should cover reckless as well as willful misconduct. No final vote or action on that second bill was reached in the portion provided.