Transcript Highlights:

• A lot of times when EMS service providers are contacted, they show up and the patient has a low-acuity
• low acuity injury, something like that. low acuity injury, something like that.
• If<00:24:18.720> it's<00:24:18.799> a<00:24:18.960> low<00:24:19.120> acuity<
• ><00:24:19.520> patient,<00:24:19.919> they<00:24:20.159> can, If it's a low acuity
• holders by not having to take low acuity holders by not having to take low acuity patients<00:24

Bills: SB294, HB296, HB300, SB269

Keywords: public officers, bonding, risk management, notification, delinquency, consumer protection, rental home, marketplace guarantees, insurance, commissioner of insurance, healthcare, breast cancer screening, insurance coverage, deductible, copayment, emergency medical services, ambulance reimbursement, health care insurers, balance billing, provider networks

Transcript Highlights:

• . >> Senator Grall: THIS BILL DEALS WITH CHILD WELFARE WORKFORCE ISSUES, INCREASED ACUITY OF CHILDREN
• WITH REGARD TO INCREASED ACUITY AND PLACEMENT ARRAY IN RECENT YEARS THERE HAS BEEN A DECREASE IN THE
• THE SECOND ARTICLE SERVES CHILDREN WITH HIGH ACUITY PARTICULARLY FAMILY LIKE SETTINGS.
• TREATMENT FOSTER CARE PILOT PROGRAM THAT WILL INCREASE FAMILY LIKE PLACEMENT FOR CHILDREN WITH HIGH ACUITY
• WE SEE IN OUR COMMUNITIES ANY TIME WE MEET WITH OUR LEAD AGENCIES THE COST FOR REPLACING HIGH ACUITY

Keywords: 999, senate, all

Transcript Highlights:

• Well, these kids are high acuity. They're called high acuity kids.
• Of a high-acuity kid, and there's also not in statute a way for the agencies to collaborate information
• I have actually, in my county, several high-acuity individuals.
• DCF gave us a heat map, and this area is the red zone for high acuity.
• We did a national high-acuity summit here in the panhandle last year, and that's where this came from

Transcript Highlights:

• think it was a question, but he thought he heard that they would not want there to be tight bands of acuity
• So this is a kind of a visual representation of that same vision.
• So this is a kind of a visual representation of that same vision.
• So this is a kind of a visual representation of that same vision.
• The visual representation of that same vision was actually developed from the Acute Care Transitions

Keywords: 1183, house

Transcript Highlights:

• It doesn't take into account the changing acuity that happens with kids.
• So how do we ensure that if the acuity of kids in care goes up, that the CBCs have a buffer, right, to
• But for Tier 2, if you're estimated to serve 1,000 kids and you serve 1,000 kids, but the acuity of some
• So how do we ensure that if the acuity of kids in care go up, that the CBCs have a buffer, right, to
• Different kids also have different costs, you know, based on medical needs, acuity.

Summary: The Human Services Subcommittee met with a quorum present and took up a presentation from the Department of Children and Families on HB 7089, which revises how Florida’s community-based care (CBC) lead agencies for child welfare are funded. Representative McFarland described the bill’s background, arguing that the prior formula relied too heavily on outdated, static factors and produced inequities among CBCs. She emphasized that the new approach is intended to provide a more stable, transparent, and statute-based funding method that better supports prevention, case management, and family services while reducing year-to-year political uncertainty. DCF Chief of Staff Casey Penn explained that HB 7089 required an actuarially sound, reimbursement-based formula developed with CBC and provider input. The new model uses a cost-based structure with three tiers: Tier 1 for operational and administrative costs, Tier 2 for per-child/per-month service costs, and a possible Tier 3 incentive component for performance measures if the Legislature chooses to fund it. The model includes regional growth factors, inflation adjustments, a 2% risk corridor for Tier 2, a hold-harmless provision for agencies that would otherwise receive less than prior funding, and the ability for CBCs to retain some state general revenue savings. DCF said the model produced a total budget need of about $1.392 billion, roughly $28.6 million above the prior year after offsets, and that the department is also updating its child welfare case management system to improve data quality and future modeling. Members asked about whether prevention spending is captured, how Tier 3 incentives would work and how much they might cost, how the formula accounts for insurance, hurricanes, child acuity, and staffing costs, and whether CBC executives’ compensation is capped. DCF said prevention is included in the model but is not yet separately broken out due to data limitations, Tier 3 is optional and not yet costed, and the formula can incorporate additional growth factors if needed. On executive pay, DCF explained that compensation is limited by statute for CBC contracts, but multiple contracts and non-state funding sources can affect total compensation; staff later clarified that CBC CEOs with multiple contracts had been reviewed for compliance. The meeting ended after questions, and Representative Miller moved to adjourn; the subcommittee adjourned without any vote on the bill.

Transcript Highlights:

• <01:32:00.400> mental facilities and one high acuity mental facilities and one high acuity
• and also the high acuity and also the high acuity um<01:41:00.960> treatment<01:41:01.520
• <01:42:48.320> mental or female, that have high acuity mental or female, that have high acuity
• Uh, as far as high acuity, and I'll move on to the high-acuity facility.
• and I'll move on to the high high acuity and I'll move on to the high acuity<01:43:50.639> facility

Keywords: Call to Order and Roll Call- 00:00:03 Approve Minutes from July 10, 2025- 00:02:41 Statewide Emergency Responder Voice System Testimony- 00:03:38 Investment of State Funds- 00:46:13 Department of Juvenile Justice Update- 1:11:34 Adjournment- 1:54:08, 958, all

Summary: The committee opened with roll call, welcomed a new member, approved the July meeting minutes, and then took up testimony on the statewide emergency responder voice system, also described as the state police radio system replacement project. John Hicks, secretary of the governor’s executive cabinet and state budget director, testified that the project is unusually complex because it combines multiple IT replacements, land acquisition, and tower construction. He said the existing system dates to the early 1970s and that the administration is treating the project as a priority, with work proceeding in phases and weekly coordination among the Justice Cabinet, Kentucky State Police, and Finance and Administration Cabinet. Hicks said the project has already spent about $110 million, with nearly 1,900 portable radios acquired, microwave replacement completed at 56 sites and underway at 76 more, and routers, switches, and network upgrades addressed. He explained that because the State Police are not set up to handle real property work, the administration brought in outside real property consulting vendors through an RFP, and three vendors are now qualified to help identify and negotiate sites. He said the goal is to speed up land acquisition and tower construction while the State Police continue the technology work, and he emphasized that the project is intended to close coverage gaps for state police first and later benefit local governments and other first responders. Members of the committee expressed concern about the project’s cost and pace. Representative Petri noted that about $218.8 million has been authorized since 2018 and questioned whether the project could stretch into 2030 or later, asking what more the General Assembly could do to help. Representative Blandon also raised concerns about the long timeline and the risk of the project becoming another costly, delayed infrastructure effort, while asking when the vendor RFP was completed and whether any sites had been acquired since then. Representative Sharp asked whether there was a detailed plan and timeline, and Hicks responded that the technology side is well defined but the property acquisition side must proceed site by site because each location depends on ownership, access, power, and other factors. Hicks said the west-to-east phasing has been a smart approach and that the executive branch should improve performance to beat the current timeline expectations.

Transcript Highlights:

• This bill deals with three distinct areas: child welfare workforce issues, increased acuity of the children
• With regard to increased acuity and placement array, in recent years there has been a decrease in the
• Unfortunately, there are simply not enough placements that can adequately serve children with high acuity
• treatment foster care pilot program that will increase family-like placements for children with high-acuity
• we all see in our communities, anytime we meet with our lead agencies, the cost for placing high-acuity

Summary: The Committee on Fiscal Policy met and first considered CS/SB 7012 on child welfare, presented by Senator Graal. The bill addressed three areas: child welfare workforce shortages, higher-acuity children in out-of-home care, and services/data for commercially sexually exploited children. It would create a CPI and case manager recruitment program aimed at former public safety and service workers, convene a workforce work group, establish a four-year treatment foster care pilot in two judicial circuits identified by DCF based on removal and placement data, and require more detailed, extractable child-level data on commercially sexually exploited children along with a bed capacity study and service gap analysis. Two amendments were adopted: one clarified record retention for redacted assessments, and another attached the appropriation. The committee then heard CS/SB 110 on rural communities from Senator Simon. The bill proposed a broad rural development package, including a state office of rural prosperity, a Renaissance grant program for counties with declining populations, increased housing support, major rural road funding, school consortium funding, and additional health care resources for rural facilities and training. A delete-all amendment was adopted that expanded and refined several provisions, including local sales tax trust fund distributions, county connectivity projects, agritourism marketing support, disaster-impacted rural infrastructure eligibility, insurance and provider eligibility changes, and increased funding for critical access hospitals and rural medical education reimbursement. Both bills drew broad support from local government, education, health care, housing, and rural advocacy representatives. Supporters said the rural bill was especially comprehensive and would help small counties, schools, roads, housing, and health care, while one witness cautioned that road expansion should be balanced with protection of agricultural and natural lands. Senator Bradley and Senator Simon emphasized local control and the importance of strengthening rural Florida without imposing mandates. CS/SB 7012 and CS/SB 110 were both reported favorably, and the committee then adjourned.

Transcript Highlights:

• Last year we hosted a national summit in the Panhandle for high acuity children. Rep.
• mental health, physical, disabled, there is a wide variety of things that cause them to be in the high acuity
• Whenever you talk about high acuity children in foster care, which is what this bill is about, you have
• will mandate weekly inter-agency data sharing protocol to expedite out of home placements for high acuity
• must assess interagency coordination as it relates to finding appropriate care settings for high acuity

Transcript Highlights:

• it should be based on looking at Acuity it should be based on looking at Acuity uh<00:31:01.639>
• One of them is the acuity of the patient.
• Then you can need to be out of flux based on acuity.
• So again, that goes back to acuity. Same with oncology.
• I don't understand why, because... to Acuity same with oncology um oncology to Acuity same with oncology

Keywords: 910, house, all

Summary: The House Committees on Health and Labor heard testimony on HB 1244, a measure relating to labor standards at health care facilities and nursing staff ratios. Committee members opened by explaining hearing procedures, including a suggested two-minute testimony limit and Zoom rules. The bill drew extensive testimony from hospitals, nursing organizations, unions, and individual nurses, with the central debate focusing on whether staffing ratios should be set by statute or left to collective bargaining and unit-level staffing decisions. Opponents included the Department of Labor and Industrial Relations, the Healthcare Association of Hawaii, Straub Benioff Medical Center, Hawaii Pacific Health, Kapiolani Medical Center, and Queen’s Health Systems. They argued that fixed ratios are too rigid for the changing conditions of hospital care, could worsen workforce shortages, and should be handled through labor negotiations, staffing committees, and existing agreements. Several also pointed to investments in nursing education, loan repayment, and workforce development as better solutions. Queen’s said it had recently reached an agreement with nurses after more than 40 meetings that included a staffing framework, and Kapiolani and others emphasized the need for flexibility in emergencies and specialty care. Supporters, including the Hawaii State Center for Nursing, Pride at Work Hawaii, the Hawaii Nurses Association/American Nurses Association chapter, Hawaii Nurses Association Local 50, UNAC/UHCP, and individual nurses, said unsafe staffing levels contribute to burnout, turnover, errors, and patient harm. Testifiers described chronic short staffing, emotionally and physically exhausting workloads, and situations in which nurses were responsible for too many patients at once. Supporters argued that safe ratios are necessary to protect both patients and nurses, and that collective bargaining has not been enough to ensure safe conditions statewide, especially in facilities without unions. No vote or final committee action was announced in the portion provided.

Transcript Highlights:

• investments necessary to keep pace with expanded responsibilities, growing populations, increased acuity
• well-documented, is that in the case of artificial... official food dyes, the food is much more visually
• However, there's no functional reason. for artificial food dyes, other than to make it more visually

Bills: HB367, HB497, HB549, HB983, HB 1188, HB 1290, HB1368, HB2243, HB2310, HB2849, HB3099, HB3546, HB3629, HB3627

Keywords: education, absences, severe illness, life-threatening, school policy, verification, healthcare, insurance, affordability, coverage, patient rights, school health, respiratory distress, airway clearance devices, medication training, public health, HB 983, Texas Education Agency, TEA, educator privacy

Transcript Highlights:

• It's an amendment of a previously approved contract with Acuity Asset Verification Services, Inc.
• Acuity provides the federally required asset verifications for the applications the agency receives.
• It'll be a one-year. approved contract with Acuity Asset approved contract with Acuity Asset Verification
• <00:13:05.200> uh<00:13:05.360> Acuity Verification Services, Inc. uh Acuity Verification
• Services, Inc. uh Acuity provides<00:13:06.720> the<00:13:07.360> uh<00:13:07.519>

Keywords: 924, joint, all

Transcript Highlights:

• And we fund $45 million for a female detention center and $35 million for a high acuity mental health
• requiring a report on the high acuity requiring a report on the high acuity juvenile<00:21:17.240
• million<00:21:25.280> for<00:21:25.480> a<00:21:25.520> high<00:21:25.760> acuity
• <00:21:26.600> mental<00:21:27.160> health million for a high acuity mental health
• million for a high acuity mental health facility.

Keywords: Meeting Start 00:00:00 Roll Call 00:00:23 HB 503 Discussion 00:01:00 HB 503 Vote 00:02:17 HB 504 Discussion 00:02:53 HB 504 Vote 00:04:48 HB 500 Discussion 00:05:19 HB 500 Vote 00:29:18 HB 900 Discussion 00:32:02 HB 900 Vote 00:33:00, 958, all

Summary: The Kentucky Senate Appropriations and Revenue Committee met with a quorum and first took up House Bill 503, the legislative branch budget, adopting a committee substitute and reporting it favorably. The chair said the Senate version fully funds defined calculations, provides 2% raises in each fiscal year for legislative employees, removes a paragraph on operating expense reductions, and includes $1 million in the first year for a judicial branch salary study. House Bill 504, the judicial branch budget, was then amended and reported favorably; changes included 2% annual raises for judicial employees, revised operating expense language, $1 million each year for county current services, retention of Boyle County fit-up language, reporting requirements for smaller capital projects, full funding for nine judges added in 2022, and removal of furlough prohibitions and certain budget implementation language. Both bills passed the committee unanimously with favorable expressions to the floor. The committee then considered House Bill 500, the executive branch budget, adopting a committee substitute before hearing a lengthy summary of major spending and policy changes. The chair described statewide 2% annual employee raises, agency base reductions with many exemptions, increased school safety and 911 funding, veterans and military funding, local government and severance-related changes, attorney general and auditor funding, pension and retirement system support, education funding changes including SEEK, postsecondary and scholarship provisions, public safety and corrections funding, and multiple capital projects. The chair also highlighted Medicaid-related provisions, including added waiver slots, increased state-directed payments, a 2.5% reduction in managed care vendor payments for plan years 2027 and 2028 with savings redirected to fee-for-service rates, and additional funding for behavioral health and public health programs. The bill was reported favorably after members explained their votes, with several noting they had only recently received the full 228-page bill and wanted more time for detailed review. Finally, the committee adopted a committee substitute for House Bill 900, an appropriation measure for government agencies, and reported it favorably. The chair said the bill remains a work in progress and that one-time funding requests from across the Commonwealth and across party lines would continue to be addressed as the process moves forward. All measures considered during the meeting passed the committee with unanimous or near-unanimous favorable votes, and the meeting adjourned after no further business.

Transcript Highlights:

• Acuity based model. Yes, sir. Yeah.
• Acuity based model. Yes, sir. Yeah.
• So, you know, with this ask, are you going to be able to serve a higher acuity of patients?
• Uh, when you look at the overall acuity level of the population today compared to before redeterminations
• Uh, when you look at the overall acuity level of the population today compared to before redeterminations

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses. The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness. Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.

Transcript Highlights:

• And so the overall acuity levels for individuals will go up, but with less ability to pay because either
• And so the overall acuity levels for individuals will go up, but with less ability to pay because either
• And then this is a visual graphic. Sorry, next slide. Sorry, we haven't been [laughter]. Thank you.
• And so um we know that people will delay care um and conditions will worsen um whether that's acuity,
• ,<01:11:12.640> whether<01:11:13.120> folks um whether that's acuity, whether folks

Keywords: 912, senate, all

Summary: The joint informational briefing by the Health and Human Services and Commerce and Consumer Protection committees focused on projected impacts to Hawaii consumers from federal changes affecting Med-QUEST and the ACA marketplace, including the loss of ACA premium tax credits, OBVA/HR1-related Medicaid changes, immigrant eligibility restrictions, and new Medicaid work/community engagement requirements. Committee members noted the meeting was being streamed live and emphasized the need to explain potential coverage losses affecting a significant share of the state population. Med-QUEST administrators reported current enrollment at 390,766, about 27% of Hawaii’s population, and broke that down into major groups including roughly 128,000 ACA expansion adults and about 52,000 parent/caretaker relatives. They said the expansion adult population would be most affected by the new federal requirements, which will shorten renewal periods from 12 months to 6 months and impose community engagement rules beginning in late 2026 and 2027. They described the work requirement as 80 hours per month of work, community service, work program participation, or half-time education, with an income-based pathway tied to $580 per month at the federal minimum wage; they also noted a long list of exemptions, but said many details are still awaiting federal guidance and rulemaking. The administrators said federal changes to immigrant eligibility would eliminate Medicaid coverage for certain noncitizen categories, with an estimated 1,200 to 2,400 people affected, though about 200 may remain covered through a state-funded program for otherwise eligible individuals. They also said marketplace subsidies would no longer be available for some immigrants under 100% of the federal poverty level starting January 1, 2026, with further restrictions expected in 2027. For Hawaii overall, they estimated the new Medicaid work and renewal rules could push an additional 19,000 to 38,000 people into uninsured status, with another estimated 6,000 at risk from the six-month renewal process alone. Members asked about how exemptions would be determined, especially for medically frail and seriously mentally ill individuals, and administrators said they were still awaiting detailed federal rules and were working on data-matching and verification processes to reduce coverage losses.

Transcript Highlights:

• I think the state of Oregon has long underinvested in high-acuity capacity.
• I think the state of Oregon has long underinvested in high acuity capacity.
• I think that trend has reversed over the last few years, high acuity capacity.
• Because of the acuity of the individuals that we're talking about, most often that's going to be in a
• But folks can move down as their acuity lessens into a lower level of care as is appropriate.

Keywords: 907, all

Summary: The joint Senate and House Behavioral Health committees held an informational meeting focused first on the Oregon State Hospital (OSH). OHA Director Sajal Hathi introduced the hospital’s incoming permanent superintendent, Sean Murphy, and praised interim superintendent Jim Deagle for stabilizing operations, restoring CMS compliance, and helping drive a culture change centered on safety, accountability, and transparency. Deagle and Chief Medical Officer Dr. Amit Bavon described OSH’s role as the state’s highest-level forensic psychiatric hospital, the patient populations it serves, its partnerships with courts, counties, jails, hospitals, and advocates, and recent leadership changes across the hospital. They also reported improved accreditation and regulatory status, including Joint Commission accreditation and CMS compliance, and said the hospital is now using daily safety huddles, incident review meetings, stronger escalation procedures, and revised seclusion/restraint practices to reduce risk and improve oversight. Members pressed hospital leaders on past seclusion practices, asking how prolonged seclusions could have occurred under federal standards. Leaders said they could not explain past decisions but emphasized that current leadership has changed processes, training, reporting, and oversight so that seclusion and restraint are reviewed in real time and cannot be normalized. Questions also covered staffing, falls, and future planning. OSH said it is generally staffed to budget, though it still has RN and mental health technician vacancies and is working on recruitment, training, and better staffing distribution. Hathi said the hospital is building a public dashboard with key performance and safety metrics, including workforce data, and described the long-term goal as a consistently safe, disciplined, high-functioning institution that responds quickly to mistakes and remains accountable to the public. The committee then shifted to an informational overview of civil commitment. Oregon Judicial Department representative Chanah Newell explained the civil commitment process, including who can initiate it, the role of community mental health providers and courts, the five-day timeline to hearing, and the standards for danger to self, danger to others, and inability to meet basic needs. She summarized changes made in House Bill 2005, including revised statutory language and new provisions allowing a second diversion period, but cautioned that the data are too early to show clear trends. Testimony from NAMI Oregon’s Chris Bonif and psychiatrist Dr. Stephanie Lopez argued that Oregon still relies too heavily on jails and state hospital commitments because the broader community system lacks enough treatment, housing, and less restrictive alternatives. They urged the legislature to focus on upstream services, supported housing, and possible outpatient commitment tools so people can receive treatment before reaching crisis. The meeting ended with acknowledgment that additional reports and follow-up discussions are expected, including on residential treatment capacity and related behavioral health system reforms.

Transcript Highlights:

• payments to managed care orgs and the fee-for-service portion based on updated claims and level of acuity
• <00:09:07.519> and<00:09:07.760> level<00:09:08.040> of<00:09:08.240> Acuity
• <00:09:08.880> now updated claims and level of Acuity now updated claims and level of Acuity
• We have had to amend our capitation payments with our managed care organizations due to increased acuity
• <01:21:30.560> and Care payments according to Acuity and Care payments according to Acuity

Keywords: 1183, house

Transcript Highlights:

• Incidentally, we don't have a strong definition of what high acuity means, but we can look into some
• 16 177 yearold males who uh High Acuity 16 177 yearold males who uh perhaps<00:24:33.120> have
• When you get into higher acuity, uh, that becomes more of an issue.
• When you get into higher acuity, uh, that becomes more of an issue.
• When you get into higher acuity, uh, that becomes more of an issue.

Keywords: 00:00:00 Introductions 00:00:22 Roll Call 00:01:56 Discussion on SB 85 00:14:03 Vote on SB 85 00:16:15 Explanation of Agency Amendment 00:19:04 Voice Vote on Amendment 00:19:33 Discussion on Kentucky Foster Children Housing, 958, all

Summary: The committee first took up Senate Bill 85, sponsored by Senator Meredith, which would move the Office of the Ombudsman from the Cabinet for Health and Family Services to the State Auditor’s office and make related cleanup changes. Meredith said the bill grew out of a prior task force and a two-year transition from Senate Bill 48, and he argued the move would create independence, improve access to the ITWIST database, ensure complaints are not lost in the handoff, and add confidentiality protections for whistleblowers. Auditor Allison Ball and her staff said the bill would codify access and procedures after earlier disputes and a court-mediated settlement, and they described the measure as necessary to make the new structure work effectively. Members asked how the Ombudsman would handle complaints and verify services in cases involving waiver recipients and other cabinet services. Ball and her staff said the Ombudsman would investigate complaints, make inquiries, and provide accountability outside the cabinet structure, with timelines and procedures similar to the Auditor’s office. The committee also discussed staffing and whether the office would need more personnel; Ball said the office already had about 100 people but could use more. The bill passed 10-0 with favorable expression. The committee then approved an agency amendment to administrative regulation 922 KAR 1:001490 concerning foster parent background checks. Cabinet staff explained the amendment corrected a drafting error by removing references to civil determinations in a second section of the regulation because the system cannot search those determinations, while still allowing the required checks under state and federal law. Senator Herron asked what a civil determination meant, and staff said it could involve a court finding in a custody or abuse case, though such findings are now typically handled through the child abuse and neglect registry. The amendment was adopted. Afterward, the committee began a discussion on Kentucky foster children housing and related issues. Ball and Ombudsman staff presented a preliminary assessment of children placed in office buildings, saying the review covered 49 children placed over a four-month period and showed a different picture than the public narrative of only older, high-acuity youth. They reported that some children had no documented behavioral or disability issues, many came directly from home, the average age was 13, the average stay was four nights, and placements were spread across several regions rather than centered only in Louisville. Members raised concerns about the lack of formal policies and procedures, staff safety, and how to ensure children are treated appropriately, and Ball said the Ombudsman was continuing a deeper review. No final action was taken on that discussion in the portion provided.

Transcript Highlights:

• 02:10.560> or impairment, hearing loss, blindness or impairment, hearing loss, blindness or visual
• , autism spectrum visual impairment, autism spectrum disorder,<01:02:13.320> TBI,<01:02:14.080
• It's just a visual indicator on their license plate that this person has an invisible disability. >>
• It's just a visual indicator on their license plate that this person has an invisible disability. >>
• that I have, the little bit that acuity that I have, the little bit that I<01:51:53.800> have.

Keywords: 1136, house, all

Transcript Highlights:

• <00:14:40.959> and<00:14:41.120> cost depending on the acuity and cost depending on
• the acuity and cost expectations. expectations. expectations.
• A peer support, depending on the acuity of the patients, and you'd have to stratify that in order to
• A peer support, depending on the acuity of the patients, and you'd have to stratify that in order to
• A peer support, depending on the acuity of the patients, and you'd have to stratify that in order to

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well. Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk. Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.

Transcript Highlights:

• , acuity entails a lot of things.
• or if you're talking about acuity as ADLs.
• lot talk about acuity acuity entails a lot talk about acuity acuity entails a lot of<01:59:16.000
• Uh we don't make about acuity as ADLs.
• Uh we do evaluate acuity, low ADL level.

Keywords: Call to Order and Roll Call- 00:00:14 Staff Report on the Firefighter Commission Minimum Training Standards and Administrative Spending- 00:02:02 Response from the Kentucky Fire Commission-00:32:06 Judge Testimony on Child Removal-00:42:47 Update on Child Removal and Reunification-01:11:19 Staffing at Kentucky Veteran Centers-01:40:15 Adjournment-02:05:55, 958, all

Summary: The Legislative Oversight and Investigation Committee met without a quorum, so no votes were taken. Staff presented a study of the Kentucky Fire Commission focused on firefighter minimum training standards and administrative spending. The presentation explained that Kentucky’s training standards are built from NFPA guidelines, that the commission currently requires 115 hours for volunteer firefighters and 300 hours for paid firefighters, and that those reduced hours were adopted by removing electives and other non-NFPA content. Staff also said the commission’s IFSAC certification testing for firefighter 1 and firefighter 2 aligns with NFPA standards, but the commission cannot require local departments to train or certify firefighters. Staff recommended that the commission formally promulgate regulations establishing the reduced training hours and work with KCTCS to better separate administrative costs for certain programs so compliance with the statute can be demonstrated. The finance portion of the report said the commission is funded by general fund appropriations for State Fire Rescue Training and by an insurance premium surcharge that supports the Firefighter Foundation Program Fund. Staff reported that the commission stayed within the 5% administrative cap tied to the overall surcharge allotment, but could not confirm compliance with a separate 5% cap for specific programs because KCTCS accounting does not break out those costs in enough detail. Staff suggested the General Assembly may want to clarify what counts as administrative cost in statute. Members asked about investment returns, local fire department funding, and whether training documentation is required; staff said some of those topics were outside the study scope and that IFSAC testing relies on chief certification that a candidate is ready to test. Representatives from the Fire Commission then responded, saying they agreed with the report’s recommendations and would work to clarify the 5% issue with legislators and KCTCS. They explained that the reduction in training hours was intended to remove electives, better align with NFPA standards, and address the difficulty volunteer departments have in getting members to complete lengthy training. Commission officials said training is documented through rosters and annual compliance reviews, and that IFSAC-certified firefighter testing is based on demonstrated skills rather than a required number of training hours. They also said the difficulty in tracking the second 5% cap stems from the way KCTCS’s PeopleSoft system records reimbursements as single transactions, making it hard to isolate administrative costs by program.