Transcript Highlights:

• We offer various services, and I would point out that many of these services are not covered by Medicare
• We offer various services, and many of these services are not covered by Medicare, nor are they covered
• </c> for providers offering specific Services for providers offering specific Services if<00:13:21.160
• through our state plan services.
• says if your services are services says if your services are covered<00:36:29.160><c> in</c><00:36:29.280

Summary: The Budget Review Subcommittee on Health and Family Services met with a quorum still coming together and first handled roll call and minutes. The main presentation came from the Department for Medicaid Services, with Commissioner Lisa Lee and CFO Steve Beckle giving an overview of Kentucky Medicaid, its federal-state financing structure, and the department’s 1915(c) home- and community-based waiver programs. They explained FMAP funding levels for traditional Medicaid, administration, IT, expansion adults, and CHIP, and noted the size of the program, including more than 600,000 Kentucky children eligible for Medicaid or CHIP, about 485,000 expansion adults, over 69,000 enrolled providers, and $18.5 billion in 2024 expenditures. A major focus was the waiver system, including the acquired brain injury waivers, model waiver, independence waiver, Michelle P. waiver, and Supports for Community Living waiver. The department said these waivers are intended to keep people with physical or developmental disabilities in home and community settings rather than facilities, and that many services are not covered by Medicare or commercial insurance. Officials described participant-directed services, interagency administration, and eligibility rules, including that some waiver programs use the child’s income only rather than family income. They also reported an unduplicated waiver wait list of 13,930 people and said the General Assembly had added waiver slots in the last budget, including 650 ABI slots and 1,275 more to be allocated July 1, 2025. The department also discussed a waiver rate study conducted by Guidehouse, explaining that CMS requires a defensible rate methodology because there is no Medicare or commercial benchmark for many waiver services. They said the study used cost and wage surveys, provider and stakeholder input, and aimed to improve transparency, provider stability, and rate parity. Officials reviewed prior COVID-era Appendix K rate increases and budget-driven increases, and said the budget ultimately funded rates at about 70% of the benchmark study, while preserving higher existing rates where needed so no provider would be cut. They highlighted larger differences in behavioral support and case management rates, and said a public report is available. Members asked several questions about the potential impact of federal FMAP changes, especially possible reductions in the enhanced match for expansion adults and Medicaid IT/admin activities. DMS said any FMAP reduction would require more state general fund dollars, estimating about $75 million for each 1% drop in the expansion match, while impacts on administrative IT funding would depend on the systems being built or implemented in a given year. Members also pressed for clarification on waiver wait-list procedures, funded versus filled slots, and what happens when someone on the wait list is later found ineligible. DMS said people on the wait list may not yet have been assessed, can be reevaluated if conditions change, and are still eligible for regular Medicaid state-plan services if they qualify, even if they are waiting for waiver services.

Transcript Highlights:

• keep providing the service.
• medical services?
• medical services?
• medical services?
• medical services?

Bills: HF729 , HF728

Committee: House Human Services Finance and Policy

Keywords: human services, provider enrollment, medical assistance, healthcare, housing stabilization, substance use disorder, vulnerable adults, fraud prevention, respite care, children, licensed settings, home and community-based services

Transcript Highlights:

• Business services supported residential services.
• for your phone service.
• , not just to voice service.
• service standards, right?
• or improve their service.

Committee: House Communications and Conveyance

Transcript Highlights:

• is that... ...services.
• We already see gaps between services authorized and services actually utilized.
• Families would receive fewer services instead of the services they truly need.
• services they need.
• services.

Summary: The Assembly Budget Subcommittee on Human Services held an informational hearing on several Department of Developmental Services proposals, with no votes taken. The first item focused on equitable access to intake and services for regional center clients, including standardizing eligibility assessments and modernizing the strengths-and-needs evaluation used to inform individual program plans. DDS said the changes would create a more consistent, equitable, and evidence-based process statewide, while the LAO explained the proposals as a response to disparities and inconsistent regional center practices. Advocates and regional center representatives were divided: Disability Rights California, the State Council on Developmental Disabilities, and some providers supported modernization but urged clearer safeguards, more community co-design, and stronger legislative review; others, including some regional center leaders and family advocates, warned against replacing the CEDER too quickly and stressed the need to preserve the person-centered IPP process. Committee members emphasized fair process, fidelity, and the need for a validated tool, while also noting that the proposals would not change eligibility definitions or replace IPPs. The second major item addressed state-operated transitional and rehabilitative services, including proposed time limits for stays at Porterville Developmental Center and Canyon Springs, plus the merger of the Community Placement Program and Community Resource Development Program. DDS argued that people should not remain in locked facilities for years and that the proposal would create urgency, clearer transition planning, a right of return, and a more efficient single program for community resource development. Supporters, including Disability Rights California, the State Council, the Public Defenders Association, and some service providers, said the proposals align with Olmstead and the Lanterman Act, reduce overreliance on institutions, and should be paired with stronger mental health supports, oversight, and notice to counsel. Opponents, including a district attorney representative, argued that a blanket 24-month limit could endanger public safety and that some individuals require longer, case-by-case commitments. Committee members said they wanted a more comprehensive plan showing that community placements and supports will be ready before people are moved, and they questioned whether an arbitrary timeline could work for such a complex population. Throughout the hearing, members repeatedly stressed that any implementation must be fair, transparent, and backed by valid tools, adequate community capacity, and public input. DDS said both sets of proposals would require legislative approval and that the department is still open to changes in trailer bill language and further stakeholder consultation. The hearing ended with the committee indicating it would continue reviewing the proposals and hear public comment, but no formal action was taken.

Transcript Highlights:

• We already see gaps between services authorized and services actually utilized. ...gaps between services
• Families would receive fewer services instead of the services they truly need.
• and covered with services.
• services they need.
• services they need.

Transcript Highlights:

• Who are receiving services.
• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.

Committee: All PUBLIC HEALTH- HOUSE HEALTH SERVICES SUBCOMMITTEE

Transcript Highlights:

• services.
• Services and life-sharing services new rate implementation.
• Services.
• services at all.
• The same services.

Bills: HF2434

Committee: House Human Services Finance and Policy

Transcript Highlights:

• Services, and the Bureau of Family-Centered Services.
• 15% for uh developmental Services 15% for uh developmental services<00:07:57.120><c> and</c> services
• </c><00:15:08.959><c> let</c> for services um funding for services let for services um funding for services
• services in the community.
• </c> those Services um the the major service those Services um the the major service types<01:37:17.119

Summary: The Division of Long-Term Supports and Services presented its budget and program overview as part of the Department of Health and Human Services operating budget review. Leadership described the division’s three bureaus—Aging and Adult Services, Developmental Services, and Family-Centered Services—and explained that the division provides guidance, technical assistance, quality monitoring, and contracted provider oversight across the lifespan. Members also discussed staffing, with reported vacancy rates of 4% in Aging and Adult Services, 15% in Developmental Services, and 6% in Family-Centered Services; the division said the higher BDS vacancy rate is partly due to the small number of authorized positions. The governor’s budget had left eight positions unfunded in the division, including three in Aging and Adult Services and five in BDS. A major topic was the division’s roadmap initiatives, especially building a system of care for healthy aging and strengthening developmental disabilities systems through a new reimbursement rate structure. The division said it contracted with an actuary to study DD service costs and found rates had not been reviewed since 2017 and were significantly below actual costs and other states’ rates, contributing to provider shortages even when services are authorized. Members asked about the impact on service delivery and whether rates would need to rise overall; the division said its strategy is to focus on lower-cost services that help people remain in the community. The division also reported waiver enrollment figures, including about 4,161 people on the Choices for Independence waiver, 3,688 average nursing facility residents, 5,061 people on the DD waiver, 228 on the acquired brain disorder waiver, and 488 children on the in-home support waiver, while noting there is no funding waitlist but provider availability remains a constraint. The division highlighted IT modernization as a major accomplishment, especially moving Adult Protective Services and Developmental Services into the New Heights system. Officials said these changes improve case-note access, data retrieval, service authorization tracking, and transparency for providers, and they asked for future oversight discussion focused on IT leverage. Members noted that New Heights maintenance is budgeted in the Office of the Commissioner under class 27 and suggested better transparency on system costs and benefits. The division also reported that it closed out a long-running CMS corrective action plan for BDS on July 1, 2023, and said it is now focused on strengthening the system rather than compliance alone. Other discussion covered the Aging and Adult Services bureau’s name change from Elderly and Adult Services to Adult and Aging Services, intended to avoid negative connotations and better reflect preventative services. The bureau described Adult Protective Services trends involving scams, financial exploitation, self-neglect, and isolation, and explained that it administers the CFI waiver, determines medical eligibility for nursing facility level of care, and braids funding from Medicaid, state funds, Older Americans Act money, Social Service Block Grants, and other grants. Members asked about waiver growth targets and federal consequences if enrollment remains below projections; the division said it would explain the shortfall in a future waiver amendment and did not anticipate a federal penalty. The meeting ended without any votes or formal actions taken.

Transcript Highlights:

• This service amounts to nearly 77% of Southwest Transit's local service.
• </c> service, as well. service, as well.
• , yet we were not receiving service, yet we were not receiving service. service. service.
• </c> Transportation Services. Transportation Services.
• That service coverage continuity that maintains substantially similar transit service routes and service

Transcript Highlights:

• Services, deviated Fix Route Services, complimentary Americans with Disabilities Act.
• They cannot be denied service. They must be meet delivered service, all trips.
• for ADA services.
• And a door-to-door service can really slow down the service and that actually time equals money.
• But the demand of services also do that. This is just typical service quality.

Transcript Highlights:

• So our Consumer Services Department... So our Consumer Services Department. Good morning.
• covers our transition services.
• We use the integrated service model. We use the integrated service model.
• The same services.
• We provided the same services.

Summary: The committee met to receive a detailed financial operations presentation from the South Carolina Vocational Rehabilitation (VR) agency, with staff walking members through funding sources, budgeting, accounts receivable, accounts payable, and grants management. Sabrina Walker explained VR’s blended funding structure, including federal grants, state appropriations, program income, and interagency contracts, and emphasized that state funds are essential to meeting the federal match and maintenance-of-effort requirements. Members asked repeatedly about transparency, audit controls, and the risk that state cuts could reduce federal drawdowns; staff responded that all reports reconcile back to the SCEIS accounting system, are subject to state audits and internal reviews, and that even modest state reductions could significantly reduce total available funding. The committee also discussed pre-employment transition services for students with disabilities, with staff confirming services are offered through school districts, charters, and private schools, and that contracts are monitored for performance and compliance. The presentation then shifted to budgeting and internal controls. Walker described a zero-based departmental budgeting process, monthly monitoring reports, contingency reserves for unexpected expenses, and a formal annual cycle that culminates in board approval. Members asked about facilities tracking, culture, and how the agency maintains accountability; staff said facilities staff inspect buildings and equipment, supervisors justify line-item requests, and the process has become smoother over time as departments learned the system. Cynthia Johnson followed with an accounts receivable overview, describing invoicing, receipting, aging, customer verification, year-end reporting, and the use of cross-training, shared email inboxes, and spreadsheets as checks and balances. She also explained work training center billing, interdepartmental transfers, and the revolving fund used to issue consumer checks more quickly than standard vendor payments. Olivia Perez presented accounts payable operations, including invoice processing through SCEIS and OnBase, the three-way match, travel reimbursements, revolving fund checks, State Treasury Office interactions, and handling of reversals, rejections, and levy notices. She reported that AP processed 67,723 SCEIS payments, 13,670 case management system invoices, 3,379 travel reimbursements, and 15,693 revolving fund checks in fiscal year 2025, with only 70 payment rejections. The final portion of the meeting covered Grants and Funds Management, where Walker explained federal reporting, drawdowns, payroll allocation, asset tracking, lease and IT contract reviews, cost allocation, and closing packages. She noted upcoming system changes such as S/4HANA, Workiva, and SC Pro, but said the agency is receiving training and feedback opportunities. No formal votes or legislative actions were taken during the presentation portion beyond approval of the prior minutes and a brief recess.

Transcript Highlights:

• </c> elderly disabled waiver Services elderly disabled waiver Services Alternative<00:04:58.120><c> Care
• But those services are tied to people who are using those services to stay on the planet, and as the
• ><c> Services</c> DHS Human Services DHS Human Services programs<00:32:09.080><c> chapter</c> programs
• </c><00:33:36.399><c> and</c> Services related to service planning and Services related to service planning
• uh the regional service centers Services uh the regional service centers and<00:35:31.760><c> the</c

Committee: House Human Services Finance and Policy

Transcript Highlights:

• They're very different services. Uh bus. They're very different services.
• Contracted services cost sometimes less than directly operated service.
• ><c> service</c><00:35:36.240><c> level</c><00:35:36.560><c> increased</c> the service the service level
• . service. service.
• mobility service service requires mobility service associated<00:46:56.319><c> with</c><00:46:56.480

Transcript Highlights:

• , CalFresh, CalWORKs, General Assistance, Adult Protective Services, In-Home Supportive Services, and
• We rely on CSBG funding services.
• for services for services CSBG.
• CSBG also allows us to offer support services and wraparound services to our enrolled customers.
• So we, because we run all of the social services, publicly funded social service programs, we really

Summary: The Senate and Assembly Human Services Committees held a special oversight hearing on California’s 2026-27 Community Services Block Grant (CSBG) state plan, focusing on how the federal anti-poverty funds are administered and used by local community action agencies. Department of Community Services and Development Director Jason Wimbley explained that CSBG is a flexible funding stream used to address housing, employment, education, food insecurity, health, transportation, and disaster response needs, with 60 organizations serving all 58 counties. He noted California received $68.4 million in federal fiscal year 2025 CSBG funds and that the program served about 1.5 million low-income Californians in 2023. He also described how CSBG helped with wildfire response and emphasized the risk posed by proposed federal elimination of the program, though he said federal staffing and program operations were currently stable. Representatives from CalCAPA and several funded agencies described CSBG as essential “braid” funding that supports staffing, leverages other grants, and fills gaps for people who do not qualify for other safety net programs. CalCAPA leaders stressed local flexibility, workforce development, partnerships, and the ROMA performance system, while agency witnesses from Contra Costa County, Northern California Indian Development Council, Proteus, and Sacred Heart Community Service gave examples of housing assistance, food distribution, employment training, utility aid, rural service delivery, tribal services, and disaster or emergency support. Several witnesses warned that federal cuts or elimination of CSBG would force service reductions, layoffs, and loss of leverage for other funding sources. The hearing also included discussion of CalAIM coordination, contingency planning for possible funding losses, and the limits of county ability to backfill federal reductions. During public comment, one speaker raised concerns about compliance and transparency issues involving community action agencies and asked the committees to ensure agencies follow California law. The chair thanked the witnesses and public commenters, reiterated the importance of CSBG in addressing poverty and homelessness, and adjourned the hearing after noting the need to sustain the investment and adapt services to changing statewide needs.

Transcript Highlights:

• APD will reimburse for the waiver services on a fee-for-service basis.
• APD will reimburse for the waiver services on a fee-for-service basis.
• service network.
• And those services can consist of medical services or long-term care kind of home health services or
• services, residential services, a variety of things.

Summary: The Health and Human Services Committee received an overview of Florida’s intellectual and developmental disabilities (IDD) managed care pilot, created by legislation in 2023 to test whether a managed care model could integrate Medicaid medical services with iBudget waiver home- and community-based services for adults in pre-enrollment categories. AHCA explained the existing system, the pilot’s scope in Regions D and I, and the rollout timeline, including federal approval, contract execution with Florida Community Care, and the October 2024 go-live. Officials reported that, as of early February, 370 individuals had been sent for onboarding and 168 more were in queue, with about $35.8 million of the appropriation remaining. APD also clarified the difference between the pre-enrollment categories and the waiver waitlist, and noted that crisis cases can be enrolled more quickly depending on eligibility and funding. Florida Community Care described the pilot as a comprehensive managed care model offering medical, long-term care, and iBudget services, plus enhanced benefits such as bed-hold days, caregiver transportation, and help with legal guardianship costs. The plan said it uses one care coordinator, a 1:18 coordinator ratio, a face-to-face assessment within five days of enrollment, and 180 days of continuity of care for existing providers. The company emphasized that it is recruiting providers by offering higher rates than some iBudget rates, lower administrative burden, and network adequacy incentives, while APD said it continues to monitor provider supply and demand and recruit across service types and regions. Members repeatedly questioned whether the pilot’s costs, provider rates, and service levels were truly comparable to the iBudget system, and AHCA and APD said it was too early to draw firm conclusions because claims data are still lagging. Committee members also raised concerns about communication, enrollment delays, provider shortages, and whether the pilot could scale statewide. APD said it has used letters, phone calls, texts, emails, and community meetings to reach eligible individuals, and that some delays stem from required assessments, Medicaid eligibility checks, and level-of-care determinations. Several members asked for more detailed comparisons of costs and provider reimbursement between the pilot and iBudget, and APD said it would provide additional data. Public testimony at the end was strongly critical of managed care, with a participant and his mother describing poor service, transportation failures, and loss of control under prior managed care arrangements, and urging the committee not to expand such a model without safeguards. No votes or formal committee action were taken before adjournment.

Transcript Highlights:

• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Services, Independent Living Services.
• Legal services. Administrative law judge services. Payment to risk management services.

Transcript Highlights:

• I'm the bureau chief of the Community Services Bureau, which includes services that are in-home service
• , or Home Health Services.
• PCCA services do not replace PDN services.
• So we created this service through our state plan benefit, ultimately preventative services, uh, service
• And we ultimately published the regulations for this service in July. comparable services.

Bills: HB2402 , HB2555 , HB2599 , HB2685

Committee: House Health Care & Wellness

Keywords: phthalates, medical equipment, healthcare regulation, intravenous therapy, toxic substances, Medicaid, healthcare, traditional practices, health insurance, coverage expansion, therapy, psychotherapy, mental health, regulation, professional standards, tribal data, data protection, privacy, sharing of information, Indigenous rights

Transcript Highlights:

• . services. services.
• </c> Services, right? Services, right?
• </c> services to people? services to people?
• . services. services.
• </c> episode of services. episode of services.

Committee: Senate Human Services

Transcript Highlights:

• Human services is calling me.
• And we really view our human services, our social services, should be work supports.
• So we're talking about human services because these services are work supports.
• It's about the services. It's about the services, not about the program they're applying for.
• or career services or training.

Committee: All ALC-HOSPITAL, MEDICAID, & DEVELOPMENTAL DISABILITIES STUDY SUBCOMMITTEE

Summary: The meeting focused on a presentation by the Alliance for Opportunity on its audit of Arkansas’s workforce and public assistance systems. Rachel Barkley, Mason Bishop, and Les Ford described a fragmented structure in which workforce programs, human services programs, and education/training programs operate in silos. They cited Arkansas data showing about 202,000 prime-age adults not engaged in the workforce, more than a million people on Medicaid/CHIP, and over 10% of the population on SNAP, while noting the state’s low labor force participation rate. They also said Arkansas has built some useful infrastructure, including integrated eligibility systems and data-sharing capacity, but argued that these tools are not yet being used to create a coordinated path to work. The presenters said local workforce boards administer only a small share of workforce dollars, mainly WIOA Title I funds, and argued that one-stop centers are funded largely by WIOA and Wagner-Peyser while other programs contribute little to service delivery. They said site visits showed frontline staff often had to “Google” community resources because they lacked referral tools, and that customers and employers alike must navigate multiple doors and agencies. They emphasized that administrative costs, duplicated staffing, separate buildings, and multiple case management systems reduce the amount of money reaching training and direct services. They also noted that most training dollars were going to limited offerings such as CDL training, and that human services employment-and-training funds were largely going to administration or subgrantees rather than direct participant support. As a solution, the presenters recommended a “one door to work” model built around three areas: a consolidated administrative structure, integrated service delivery, and integrated finances. They proposed creating a single state workforce agency that could include some public assistance functions, using a statewide eligibility and intake system, expanding case management through tools like Hope Hub, and adopting a unified cost-allocation model similar to Utah’s. They said these changes could be pursued through legislation, executive action, and federal waivers, and argued that savings would come mainly from reduced management, buildings, and duplicated systems rather than frontline layoffs. Committee members asked about costs, staffing, rural access, business engagement, and whether other states had adopted similar models. The presenters pointed to Utah, Louisiana, and Virginia as examples or partial examples, and said they would provide additional data, including a final report at the end of the month and follow-up information on Utah outcomes.

Transcript Highlights:

• But yet, we are denying them the services that I provide—the state services that I provide: housing,
• Public Health Service Commissioned Corps is the only uniformed public health service in the world and
• Public Health Service Commissioned Corps is the only uniformed service whose weapon is not a gun.
• We have an all-volunteer service today, regardless of what service you serve in.
• for your service.

Committee: Joint Joint Committee on Veterans and Federal Affairs

Summary: The Joint Committee on Veterans and Federal Affairs held its fourth public hearing of the 2025-26 session on recognitions, definitions, and designations related to veterans. Chairs John Velis and Joseph McGonagle opened the hybrid hearing with housekeeping rules and noted the committee’s reporting deadlines. The hearing focused on several bills honoring veterans and military-related service, including H. 3825 to include reserve components in flag half-staff recognition for service members killed in action, S. 2499 to place a State House marker honoring three Medal of Honor recipients from the war on terror, S. 2498 to add Merchant Marine recognition at veterans cemeteries and the State House and create a Massachusetts merchant mariner medal, and H. 2500/S. 2500 to have Massachusetts fly the Honor and Remember flag for Gold Star families and fallen service members. A major portion of the hearing centered on H. 3871 and S. 2467, which would update the Commonwealth’s definition of “veteran.” Testimony came from the Office of Veterans Services, veterans organizations, Public Health Service and NOAA representatives, National Guard and Reserve veterans, and Gold Star advocates. Witnesses argued the current state definition is inconsistent with federal law and excludes some service members who should be recognized, especially members of the U.S. Public Health Service Commissioned Corps, NOAA Commissioned Officer Corps, reservists, and some National Guard members. Supporters said the bills would improve fairness, consistency, and access to benefits and services, while several speakers emphasized that service in uniform should be honored regardless of branch. Some testimony also urged a broader moral recognition of all who raised their right hand, while others focused on aligning state law with federal definitions and closing gaps in eligibility. Committee members asked questions about the practical and fiscal effects of broadening the definition, including how the proposed language would interact with existing federal standards and state benefit programs. Witnesses explained that the bills would remove the current 180-day and 90-day active-service calculations and instead recognize certain active service and six-year reserve or Guard commitments, though some members noted that this could create a broader state standard than the federal one. No votes or formal actions were taken during the hearing, and the committee concluded after hearing from the final witness and adjourning.