Transcript Highlights:

• Two are primary-care-driven, so you, like ERS, have to see a primary care provider, get referrals to
• But the primary care provider controls a lot, so we're looking for primary care providers who are steering
• We do have direct primary care.
• primary care practitioner they can know and trust.
• market, a new payer.

Keywords: 1184, house, all

Transcript Highlights:

• <00:09:22.320> claims and of course the all payer claims and of course the all payer claims
• Hennepin HealthCare's biggest payer. Hennepin HealthCare's biggest payer.
• So, for people to lose their payer.
• , the payer landscape Additionally, the payer landscape continues<00:58:36.520> to<00:58:36.600
• <01:04:00.240> care, including dentistry, primary care, including dentistry, primary care,

Bills: HF4343

Keywords: sales tax, use tax, advertising tax, taxable services, digital advertising, online marketing, marketing services, search engine marketing, lead generation, internet advertising, ad agency, media buying, campaign planning, Minnesota tax law, service tax, broadening tax base, web advertising, promotional services, 1183, house

Transcript Highlights:

• Um, and then we can also get estimates of how many primary care, uh, FTEs.
• For this, um, The all claims payer date all.
• I kind of building on this all claims payer database.
• Sorry, Madam Chair, these are just primary care physicians as well as, as, um.
• Um, and can you remind us, Madam Chair, who IPRA, the all-payers claim data?

Transcript Highlights:

• So now your primary care physician and advanced practice nurses are able to order that.
• Finally, this The processing times for prior authorization requests are broken out across payer types
• It's a process by which payers want to ensure that the provider they're contracting with has all the
• Can you state kind of specific, give examples of the quality criteria used by the payers?
• But as we saw when we looked at developing a single-payer model in New Mexico, the jurisdiction...

Transcript Highlights:

• I was the primary care provider there. I worked in the hospital there.
• benchmark as that government payer benchmark as that government payer increases<00:15:58.560>
• Okay, thank you. would be all government payers so that would be all government payers so that would<
• <00:46:23.319> around<00:46:23.800> prior insurance payers around prior insurance payers
• years so uh when government payers years so uh when government payers chronically<01:16:07.560><

Keywords: 1183, house

Summary: The Health Finance and Policy Committee heard testimony from the Minnesota Hospital Association and several hospital leaders about the financial strain facing hospitals across Minnesota. The association’s CEO said hospitals are essential 24/7 safety-net providers, but rising labor, supply, technology, and drug costs are outpacing reimbursement from Medicaid, Medicare, and commercial payers. He warned that many not-for-profit hospitals are struggling, that workforce shortages remain significant, and that the committee should consider help on Medicaid rates, discharge/boarding problems, mental health services, workforce development, protecting the 340B drug discount program, and avoiding new mandates that add costs. Relle Schultz of Winona Health described a community hospital with a 49-bed facility and long-term care services that has faced years of losses, including a $17 million loss in 2023 and $12 million in losses the following year. She said government payers now make up about 65% of the hospital’s mix, and each 1% increase in that mix costs about $1 million. She highlighted the difficulty of sustaining services such as dialysis, which was nearly closed until a local donor provided $3 million to keep it open for three years, and she emphasized the importance of 340B savings and the need for higher Medicaid payments. Carrie Mulski of Riverview Health in Crookston said critical access hospitals are also under pressure despite their federal designation. She explained that federal support has eroded, that Medicaid and other public programs do not cover full costs, and that her hospital’s 340B savings help keep the doors open. She said Riverview opened a new hospital in 2020 but was hit by the pandemic and inflation, leading to annual losses of $5 million to $6 million and a negative operating margin of 9% to 10%. She also described bond covenant problems, low cash on hand, the prior closure of the nursing home, and the need for rapid state action to stabilize rural hospitals and preserve access to care.

Transcript Highlights:

• So the model really has three primary care team members.
• <00:08:26.720> care providing resources to the primary care providing resources to the primary
• And it expands the care capacity of the primary care doctor.
• The capacity of the primary care doctor.
• <00:13:03.920> care, the internal medicine, the primary care, the internal medicine, the primary

Keywords: 00:00 - Call to Order/Roll Call 02:05 - Discussion of 26RS HB 178 14:05 - Roll Call Vote on 26RS HB 178 15:05 - Discussion of 26RS HB 280 20:00 - Roll Call Vote on 26RS HB 280 22:00 - Discussion of 26RS HJR 24 24:30 - Roll Call Vote on 26RS HJR 24 26:00 - Adjournment, 958, all

Summary: The Health Services Committee met for the first time in the 2026 session and established a quorum before taking up three measures. House Bill 178, sponsored by Rep. Kim Moser with support from the Kentucky Psychiatric Medical Association, was presented as a budget-neutral collaborative care model to improve access to mental health treatment in primary care settings. Testimony emphasized workforce shortages, long wait times, stigma, and the potential for the model to reduce costs and improve outcomes by having primary care providers work with behavioral health care managers and psychiatric consultants. The bill received a favorable recommendation by roll call vote. The committee then considered House Bill 280, also sponsored by Rep. Moser. The bill and committee amendment were described as cleanup and policy updates affecting Kentucky Board of Nursing licensure standards, including restoring language related to abuse, neglect, and exploitation in the central registry, preserving the board’s ability to investigate out-of-state applicants, and adding an emergency provision. The bill also updated school medication provisions to allow certain prescribed rescue medications, including bronchodilator inhalers, nebulizers, glucagon, Solu-Cortef, and updated epinephrine delivery. The committee adopted the amendment, approved the bill with favorable expression, and then approved a motion to roll the committee amendment into the House committee substitute. Finally, the committee took up House Joint Resolution 24, sponsored by Rep. Ken Fleming, with a committee substitute adopted first. The resolution was explained as a request for the cabinet to withdraw a previously submitted Medicaid-related waiver application so it could be resubmitted under new requirements tied to House Resolution 1. The committee approved the resolution with favorable expression and also adopted a title amendment. The meeting concluded with notice that the next committee meeting would be Thursday, January 22nd at noon.

Transcript Highlights:

• In this team-based approach, primary In this team-based approach, primary care<00:33:05.320>
• source of comfort within that primary source of comfort within that primary care<00:36:22.600>
• status with a specific payer. status with a specific payer.
• Uh when I asked the specific payer Uh when I asked the specific payer how<00:59:13.880> they<
• uh premium payer and the doctor. uh premium payer and the doctor.

Keywords: 1187, senate, all

Transcript Highlights:

• Like, what did they pay for their primary care physicians or their...?
• Prior authorization is one of the root causes driving the current crisis in primary care.
• It's unsustainable for our primary care workforce.
• care and stay in primary care.
• Section 19 establishes spending targets for primary care and behavioral health.

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing on a large docket of bills focused on MassHealth benefits and reimbursement, health equity, behavioral health, public health, dental access, 340B drug pricing, tobacco cessation, and coverage for children. The chairs emphasized rising health care costs, provider shortages, administrative burdens, and persistent inequities by income, race, geography, and immigration status. Much of the testimony centered on H.1416/S.901, an act to advance health equity, with legislators and members of the Health Equity Compact arguing for statewide benchmarks, stronger health equity leadership, reimbursement for interpreter services, community health workers and patient navigation, Medicaid graduate medical education support, and a health equity zone trust fund. Witnesses described disparities in life expectancy, maternal mortality, access to primary care, and the impact of federal Medicaid and social service cuts, and urged the committee to report the bill favorably. The committee also heard strong support for H.1368/S.847 on rapid whole genome sequencing for critically ill MassHealth children. Testifiers from industry, academia, hospitals, and families said early sequencing can end long diagnostic odysseys, improve treatment decisions, shorten hospital stays, and save money, while also providing emotional relief and information for families. The hearing then moved to H.1407 on MassHealth rate parity for inpatient behavioral health providers, where Rep. Scanlan and the Massachusetts Association of Behavioral Health Systems said the bill would codify existing administrative parity so managed care plans cannot pay less than the MassHealth fee-for-service rate. On H.1392/S.853 to preserve and protect public health, witnesses supported higher vaccine administration fees to improve provider participation and immunization rates. The committee also heard testimony on H.770/845 to protect 340B providers in MassHealth, and on S.848 to require reporting and transparency around 340B revenues and outside administrative costs. Additional bills drew testimony on tobacco cessation coverage for MassHealth members, with advocates supporting broader access to counseling and medications through medical, behavioral health, and dental providers. On H.1409, a nursing home operator asked for more flexibility in a MassHealth staffing-related penalty tied to patient days per resident. On H.1401/S.888, supporters of the “Take 10” dental access proposal said adult MassHealth dental coverage is underused because too few dentists accept MassHealth, leading to long travel times and avoidable emergency room visits; they urged incentive payments for dentists serving new adult MassHealth patients. Finally, on H.1403/S.855, “Cover All Kids,” advocates and immigrant community members urged removal of immigration status as a barrier to full MassHealth coverage for children, while also backing a related bill to ensure 12 months of continuous coverage for children. No votes were taken during the hearing; the committee primarily received testimony and asked questions on costs, reimbursement levels, and implementation details.

Transcript Highlights:

• Outside of primary care.
• Imagine if all of primary care were...
• So this is special and applies to all of your primary care.
• It can be incorporated by commercial payers in a less...
• That's a payer-provider relationship. Do they pay?

Bills: HB46, HB35, HB4490, HB4454, HB2188, HB3078, HB4743, HB2556, HB46, HB5342, HB4783, HB3785, HB5278, HB1639, HB2581, HB4224, HB4070, HB4099, HB4882, HB3794

Keywords: local government spending cap, expenditure limit, political subdivision, property tax, ad valorem tax, budget cap, taxpayer protection, spending restraint, inflation adjustment, population growth, voter approval, supermajority vote, county budget, municipal budget, school district finance, junior college district, hospital district, special district, attorney general enforcement, local fiscal limits

Transcript Highlights:

• One of those is the all payer care.
• That is not being payer claims database.
• Another one of our key focus areas is how do we expand the reach of primary care?
• And wanting to leverage what primary care providers can do and how to support them.
• consultation to primary care providers. consultation to primary care providers.

Bills: HB20, HB276, HB644, HB812, HB816, HB916, HB1131, HB1247, HB1518, HB1525, HB1537, HB1541, HB1546, HB1553, HB1562, HB1565, HB1566, HB1576, HB1577, HB1591, HB1605, HB1612, HB1613, HB1614, HB1618, HB1620, HB1650, HB1656, HB1658, HB1661, HB1664, HB1668, HB1676, HB1707, HB1711, HB1713, HB1715, HB1718, HB1727, HB1749, HB1756, HB1774, HB1776, HB1801, HB1802, HB1805, HB1813, HB1815, HB1831, HB1838, HB1853, HB1854, HB1859, HB1863, HB1871, HB1872, HB1918, HB1920, HB1952, HB1965, HB1966, HB1967, HB1969, HB1972, HB1973, HB1974, HB1975, HB1980, HB1985, HB2005, HB2023, HB2031, HB2033, HB2062, HB2113, HB2114, HB2116, HB2138, HB2139, HB2156, HB2158, HB2159, HB2171, HB2208, HB2268, HB2270, HB2272, HB2273, HB2276, HB2289, HB2310, HB2315, HB2335, HB2338, HB2339, HB2340, HB2343, HB2361, HB2384, HB2387, SB2338, SB2431, SB2438, SB2593, SB2907, SB2671, SB2321, SB3084, SB2401, SB3033, SB2972, SB3032, SB2806, SB3014, SB2108, SB2981, SB2973, SB2423, SB2078, SB2322, SB2397, SB2896, SB2088, SB2347, SB2408, SB2970, SB2851, SB2713, SB2697, SB2312, SB2192, SB2363, SB2530, SB3028, SB2024, SB3007, SB2599, SB2596, SB2662, SB2930, SB3334, SB2378, SB3019, SB3231, SB2240, SB2372, SB2175, SB2046, SB2298, SB2922, SB2835, SB3263, SB2174, SB2128, SB2006, SB2489, SB3134, SB2982, SB2425, SB2849, SB2797, SB2795, SB2575, SB2521, SB2765, SB2386, SB2852, SB2022, SB2117, SB2277, SB2387, SB2688, SB2885, SB3132, SB3219, SB2169, SB2591, SB2090, SB2983, SB888, SB3249, SB2611, SB2429, SB2463, SB3154, SB3131, SB3152, SB3315, SB2448, SB2054, SB2140, SB2520, SB2377, SB2986, SB2010, SB2189, SB2026, SB3010, SB2818, SB2002

Keywords: lava insurance, homeowners, insurance market, subsidy, Hawaii, condominiums, annual report, filing fee, real estate, developer, residency, property regime, PFAS, single-use plastics, environmental health, food ware, pollution reduction, local produce, agriculture, Hawaii Revised Statutes

Transcript Highlights:

• direct primary care is not insurance. direct primary care is not insurance.
• primary care. primary care.
• c> direct<01:23:13.640> primary Direct primary care and direct primary Direct primary care
• primary care. primary care.
• <01:29:51.880> care<01:29:52.680> can primary care and good primary care can primary

Bills: HF4493, HF3133, HF4595, HF4143, HF4142, HF3756, HF4289, HF1724, HF2291, HF4568, HF4547

Keywords: opioid use disorder, OUD, medication-assisted treatment, MAT, pharmacist prescribing, pharmacy practice, controlled substances, Schedule III, Schedule IV, Schedule V, DEA registration, Board of Pharmacy, substance use disorder, addiction treatment, buprenorphine, naltrexone, harm reduction, prescription authority, pharmacist intern, Minnesota pharmacy law

Transcript Highlights:

• We provide the only access to primary care and mental health care in those counties.
• This bill allows for these contracts only for primary care physicians or primary care physician groups
• So this is, one of the easy ways to think about this in primary care; it's kind of like direct primary
• Texas Primary Care Consortium.
• I'm a local practicing physician with a Direct Primary Care Clinic.

Bills: HB139, HB1818, HB1942, HB1959, HB2221, HB2254, HB2563, HB2067, HB2275, HB3211, HB139

Keywords: HB 1818, Texas Insurance Code, Texas Department of Insurance, commissioner of insurance, health maintenance organization, HMO, insurer, utilization review, preauthorization, prior authorization, medical necessity review, health care services, medical care, insurance regulation, insurance examination, regulatory oversight, confidential records, public information exception, Chapter 843, Chapter 1301

Transcript Highlights:

• No, I'm not going to say it, but anyway—but they’ll still have their... primary care doc.
• taxpayer burden that comes. from that eventually gets transferred out of insurance to the taxpayer payers

Bills: HB139, HB1818, HB1942, HB1959, HB2221, HB2254, HB2563, HB2067, HB2275, HB3211, HB139

Keywords: HB 1818, Texas Insurance Code, Texas Department of Insurance, commissioner of insurance, health maintenance organization, HMO, insurer, utilization review, preauthorization, prior authorization, medical necessity review, health care services, medical care, insurance regulation, insurance examination, regulatory oversight, confidential records, public information exception, Chapter 843, Chapter 1301

Transcript Highlights:

• versus a primary candidate forum, which would be in a primary all-one poll? party?
• And only one part, so I'm thinking about in a primary, for example. specifically.
• This bill ensures that if a candidate to advance from a primary election to the runoff then withdraw
• Let's say there are three candidates running in. primary, Republican or Democrat, or what other party
• might have a primary in Texas. candidate receives 50 percent of the vote.

Bills: SB29, SB406, SB447, SB875, SB893, SB1033, SB1346, SB1362, SB1539, SCR22, SB 29

Keywords: business organization, internal management, corporate governance, partnerships, liability reduction, birth certificate, biological sex, gender identity, health and safety, sex assignment, SB 875, Texas, independent school district, ISD, school board trustee, superintendent, campus administrator, electioneering, political signs, early voting

Transcript Highlights:

• <00:31:03.159> and Efficiency for the rate payers and Efficiency for the rate payers and that's
• <01:27:23.480> are otherwise would then rate payers are otherwise would then rate payers are
• <01:35:06.760> as<01:35:07.600> the payers as the payers as the OCA<01:35:09.560> position
• on behalf of residential rate payers on behalf of residential rate payers this<01:35:34.080>
• represent the voice of the rate payer represent the voice of the rate payer throughout<01:46:13.679

Keywords: 928, house, all

Summary: The hearing focused on House Bill 610, which would fold the Office of the Consumer Advocate into the Department of Energy rather than fully eliminate consumer advocacy functions. The prime sponsor argued the current office is small, funded by a special assessment on ratepayers, and duplicative of DOE work. He said moving the function to DOE would streamline energy policy review, reduce bureaucracy, and better focus the larger agency on lowering residential energy costs. He also disputed claims that the Consumer Advocate is independent, saying the office is appointed through a political process similar to DOE leadership. Committee members and the sponsor discussed whether the bill would actually relocate existing positions or replace them, and whether the Department of Energy would absorb the cost of the transferred staff. The sponsor said the fiscal note shows roughly a million-dollar reduction in both revenue assessment and spending, and that the bill would effectively reduce the office from five positions to three. He also defended his cost estimates for energy-code-related housing impacts and said the Consumer Advocate has sometimes supported policies he считает increase costs, such as energy-efficiency measures and building code changes. He argued the office should focus more on energy supply and generation, including natural gas and nuclear, rather than efficiency alone. Representative Wendy Thomas testified in opposition, saying the Consumer Advocate is an important, fair, and impartial voice for ratepayers and warning that the bill was fiscally irresponsible because the incumbent could still be owed salary and benefits if the office were repealed. She also said the bill’s drafting was confusing and that the Consumer Advocate’s role is to push back on utilities on behalf of consumers. Other members raised questions about whether the DOE would simply inherit the same political appointment structure and whether the bill would meaningfully lower bills. No vote was taken in the excerpt; the chair indicated additional testimony would follow, and the Department of Energy was present to answer questions.

Transcript Highlights:

• Talking about all-payer claims databases in particular, Maryland was the first state to establish one
• Two of the more recent policies that have been enacted relate to hospital and payer transparency and
• A number of programs that exist in the state, I think we regularly think about our state's all-payer
• The source of the data is a hospital's chargemaster and hospitals' negotiated rates with payers.
• The source of the data is a hospital's chargemaster and hospitals' negotiated rates with payers.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• As a reminder, primary witnesses and support must be those accompanying the author.
• We'll now hear from any primary witnesses in opposition. Please come forward.
• Any primary witnesses in opposition, please come forward to the table here.
• Are there any primary witnesses in opposition in the room? Move the bill.
• Are there any primary witnesses in opposition to this bill? I'm so sorry.

Summary: The committee heard several health-related measures. SB 27 by Senator Umberg would revise and expand California’s CARE Court by limiting the expansion to people with bipolar I disorder with psychotic features, clarifying the definition of “clinically stabilized,” and narrowing the role of nurse practitioners and physician assistants. Supporters, including behavioral health officials and family members, said the bill would reduce dismissals and better serve people with severe illness; opponents warned the expansion would strain county staffing and housing resources and could undermine voluntary engagement. The bill passed on a do pass motion to the Committee on Public Safety. SB 503 by Senator Weber Pierson would require AI tools used in health care facilities to be identified, monitored, and mitigated for bias when used in clinical decision-making or resource allocation. The author and supporters from Kaiser Permanente and the California Medical Association said the bill would help prevent discriminatory outcomes and improve trust and safety. The committee discussed the need to clarify developer and deployer responsibilities, and the bill passed as amended to Privacy and Consumer Protection. SB 68 by Senator Menjivar would require restaurants to provide written allergen information for the top nine food allergens, with tiered flexibility for smaller establishments. The bill was supported by patients, families, nurses, and allergy organizations, who described severe reactions and the difficulty of relying on verbal disclosures alone. The California Restaurant Association opposed unless amended, seeking broader use of the national model food code and additional liability language. The bill passed as amended to Appropriations. The committee also heard SB 403 by Senator Blakespear, which would remove the sunset from the End of Life Option Act; supporters described the law as a compassionate, well-functioning option for terminally ill patients, while faith-based groups opposed it. The bill passed to Judiciary. Later, SB 41 by Senator Wiener was introduced to rein in pharmacy benefit manager practices that steer patients to mail-order pharmacies and reimburse community pharmacies below cost; community pharmacists and several health organizations testified in support, describing pharmacy closures and patient access problems.

Transcript Highlights:

• I'm trying to get a picture of exactly what the All-Payer Claims Database is.
• What are the primary cost drivers behind this disproportionate growth?
• So that's why the All-Payer Claims Database is harder because there's...
• Required to be reported to the All-Payer Claims Database.
• It utilizes what it can from an All Payer Claims Database.

Transcript Highlights:

• One common thing is they'll get referred back to primary care.
• Everyone goes to their primary care doctor. You can see a therapist right there.
• And they also don't know how to navigate when they go from one payer to another.
• Because they are the best deliverers, but it’s not their primary goal.
• Because they are the best deliverers, but it’s not their primary goal.

Summary: The hearing focused on youth mental health and treatment access in California, with opening remarks emphasizing that youth distress, self-harm-related emergency visits, and difficulty obtaining care remain elevated, while workforce shortages and reliance on one-time funding continue to limit access. Assemblymember Lori Davies echoed concerns about unstable funding and said lawmakers need to hear directly from providers and families as they prepare for the budget and legislation. The chair framed the hearing as a chance to hear from county, school, provider, and student perspectives, especially in San Diego County, where needs are high and investments have not always matched demand. County and school officials described the current system and recent state initiatives, including the Children and Youth Behavioral Health Initiative, school-linked fee schedules, payment reform, and the Behavioral Health Services Act transition. San Diego County Behavioral Health said it serves Medi-Cal youth with specialty mental health needs through a broad continuum of care, including outpatient clinics, school-based services, crisis response, residential treatment, and new crisis and residential facilities. San Diego County Office of Education and San Marcos Unified School District described efforts to expand school-based services and reimbursement through CYBHI, but said implementation is slowed by complex billing rules, insurance-data collection concerns from families, administrative burden, and uncertainty about sustaining staff positions funded by grants or soft money. School counselor testimony highlighted reduced stigma through campus outreach and clubs, but also noted that counselor-to-student ratios remain well above national standards and that budget cuts threaten supports. Provider testimony stressed that the system remains fragmented and that youth often move between emergency rooms, inpatient care, outpatient therapy, schools, and county programs without smooth handoffs. A child psychiatrist described crisis cases in which the main choices are brief hospitalization or discharge with limited follow-up, and argued for stronger warm handoffs, more outpatient and intensive outpatient options, better school-clinic coordination, and broader use of mobile crisis and 988. Rady Children’s Hospital and Aurora Behavioral Health described large increases in behavioral health demand, expansion of integrated care, and major barriers tied to low reimbursement rates, delayed payments, and administrative complexity. Across the panel, witnesses called for more stable funding, clearer reimbursement rules, better parent education on warning signs, and stronger collaboration among schools, counties, hospitals, and community providers to reduce stigma and improve timely care for youth.

Transcript Highlights:

• with 37 States already commercial payers with 37 States already offering<00:09:00.079> it<00:
• care settings and it decreases primary care settings and it decreases total<00:10:16.560> costs
• Services are often siloed from primary Services are often siloed from primary care<00:10:58.000>
• Primary care providers collaborate directly with experts on their own team.
• <00:12:16.680> care then given back to the primary care then given back to the primary care

Bills: HF958, HF688, HF702

Keywords: mental health, behavioral health, psychiatric care, collaborative care model, healthcare funding, service dog, service animal, service dog in training, assistance dog, guide dog, disability rights, housing accommodations, fair housing, landlord, rental housing, homeowners association, HOA, Minnesota human services, accessible housing, reasonable accommodation