Transcript Highlights:

• We cover several state agencies: the Agency for Health Care Administration, often referred to as AHCA
• So, as noted, HB 391 directed the agency to allow for a new type of home health agency worker, which
• It directed the agency to conduct an annual assessment of the new program, and it required the agency
• So essentially the agency created a new Medicaid fee schedule for the home health agencies employing
• So then what the home health agency pays... ...to the home health agency.

Summary: The subcommittee held its first meeting of the 2025-2026 term, took attendance, confirmed a quorum, and heard introductory remarks from members and staff. Chair Anderson outlined the subcommittee’s jurisdiction over access and affordability issues, including health facility regulation, insurance, Medicaid, CHIP, and state employee health coverage. The main agenda item was an update on implementation of HB 391, which created a family home health aide program for medically fragile children. Representative Tramont, the bill sponsor, explained that the law was intended to let trained family caregivers be paid through Medicaid to care for their children, reduce reliance on private duty nursing, and relieve families. He and several members expressed frustration that implementation had taken nearly two years and that families still faced barriers. Deputy Secretary Brian Meyer of AHCA and Bridget Royce of DCF said the program was implemented October 1, 2024, with billing available, but no home health agencies had yet launched the required 80-hour training program and no claims had been paid. They described the program’s requirements, including agency employment, background screening, training, a $25-per-hour Medicaid rate paid to the agency, and an annual assessment report. A major issue discussed was that income earned by family caregivers counts toward Medicaid eligibility and could cause families to lose coverage. AHCA and DCF outlined two possible fixes that would require CMS approval: disregarding the income for eligibility purposes or treating the child as a family of one. Members and public witnesses strongly urged changes to avoid forcing families to choose between income and coverage. Several providers said they had begun preparing training programs, but asked for clearer approval processes and more patient-specific training requirements. The committee then heard extensive public testimony from parents and caregivers of medically fragile children, who described the financial, emotional, and logistical strain of caring for children with severe disabilities and argued that the bill should be expanded to include Florida KidCare families and others in the coverage gap. They also raised concerns about the eight-hour-per-day limit, low pay, and the need for simpler rules and direct support. Home health providers and associations supported the concept but asked for modifications, including more targeted training and clearer implementation guidance. The meeting then shifted to a second agenda item on the Andrew John Anderson Rapid Whole Genome Sequencing Program, which was funded in the 2023 budget. Deputy Secretary Meyer said the program has been implemented since January 1, 2024, but utilization has been lower than expected, with only about 60 claims paid and many denials occurring through managed care. Public testimony from a lab, a hospital, and a pediatric rare disease expert said the program is clinically valuable and cost-saving, but managed care billing barriers, prior authorization issues, and DRG-related denials are limiting access; they urged direct billing to Medicaid and possible expansion to all newborns.

Transcript Highlights:

• , and the SPI could make recommendations on how to address those key challenges.
• And how does that potentially create challenges then? Thank you for the question.
• The GovOps and NCRD agencies that are dealing with education back home as well.
• And on my far left, I see that you're really challenged with it.
• Those are the challenges that we have. I spoke earlier about UTK.

Keywords: 987, senate, all

Transcript Highlights:

• We have to be a strong regulatory agency doing hallmark regulatory agency work so we can have a strong
• You mentioned CDFW and other agencies.
• , working with all the control agencies.
• The CDCR role was definitely challenging.
• You know, it’s a challenge. It could be a challenge.

Keywords: 987, senate, all

Transcript Highlights:

• , and that report identified permitting as one of those challenges.
• , and that report identified permitting as one of those challenges.
• , and that report identified permitting as one of those challenges.
• We have a number of challenges, and that report identified permitting as one of those challenges.
• </c> permits were required of state agencies permits were required of state agencies DNR<00:46:49.400

Keywords: 1183, house

Transcript Highlights:

• Agency Summary - Senate.
• A&M University System Agency.
• agencies.
• That is our biggest challenge.
• TTI is a world-renowned research agency dedicated to solving transportation challenges through collaboration

Bills: SB1, SB 1

Keywords: appropriations, budget, state funding, education, healthcare, infrastructure, campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards, 1185, senate, all

Transcript Highlights:

• financial assistance and other relevant agency activities, while the agency, OMB, reviewed whether those
• of Health and Human Services and to prevent reductions in force across federal agencies.
• Within hours of that memo going out, we contacted our state agencies. To draw down money?
• We are in constant Communication with our state agencies about what they are seeing.
• Like, and we check in We check in with our state agencies; other states do the same.

Transcript Highlights:

• </c> so we work with uh the ratings agencies so we work with uh the ratings agencies Moody<00:07:38.120
• </c> things that a a Housing Finance Agency things that a a Housing Finance Agency that's<00:08:41.320
• </c> that's just a standard loan agency that's just a standard loan agency without<00:08:43.120><c> a
• </c><00:10:02.279><c> or</c> like some public housing agencies or like some public housing agencies or
• </c> program when I uh think about our agency program when I uh think about our agency I<00:10:38.880

Keywords: 1183, house

Transcript Highlights:

• What to report, which agency to report certain types of incidents to, and what each agency does in its
• Agency routing: should there be a more formal process in place for cross-reporting to other agencies?
• agency only wants to do things in person.
• Already given one to another state agency.
• There are lots of state agencies that have investigative units that have that same caseload challenge

Keywords: 907, all

Transcript Highlights:

• Some very tough challenges ahead of us.
• Natural Resources Agency and Environmental Protection Agency.
• And I'm so proud of the 26,000 women and men across our agency that kept moving on all of these challenges
• So the water agencies...
• Very specifically in your agency, what federal actions has your agency or its boards, departments, or

Keywords: 987, senate, all

Transcript Highlights:

• But we still have huge major challenges, and the biggest challenges lie ahead.
• I suspect it's not because we have other agencies that have certainly had their challenges... ...because
• we have other agencies that have certainly had their challenges in trying to add positions or even fill
• That is one of the big challenges.
• Nielsen really appreciate the challenge of her.

Summary: The Joint Committee on Fisheries and Aquaculture held its annual State of the Fishery forum, focusing on salmon, Dungeness crab, kelp, ocean conditions, and related aquaculture and committee reports. Opening remarks from committee leadership emphasized climate impacts, reduced federal NOAA support, state investments through Proposition 4, coastal resilience funding, and the importance of fisheries to rural economies and tribal communities. Secretary of Natural Resources Wade Crowfoot described a decade of drought and climate stress, highlighted progress such as Klamath River dam removal, wetland restoration, and the state’s salmon strategy, and warned that federal funding uncertainty and staffing cuts could undermine restoration and fishery recovery efforts. Senator Cortese raised concerns about illegal cannabis cultivation damaging riparian habitat and water flows, and both Crowfoot and Fish and Wildlife Director Bonham said enforcement against illicit grows remains a major environmental priority but is constrained by resources. Director Bonham provided a broad update on California fisheries, reporting encouraging signs for salmon after several difficult years, including improved ocean conditions, stronger returns in some runs, and successful short recreational openings in 2025. He also noted major challenges, including reduced federal hatchery production at Nimbus, ongoing uncertainty around winter-run and spring-run recovery, and the need for continued habitat restoration, monitoring, and hatchery investment. On Dungeness crab, Bonham said the fishery remained valuable but constrained by whale entanglement risk, warming ocean conditions, and domoic acid concerns; he described new marked-line distribution, ropeless and alternative gear trials, and ongoing aerial and vessel monitoring. He also said the department’s unified cannabis enforcement task force had served numerous warrants and seized large amounts of illegal cannabis, but more funding is needed for sustained operations. In the salmon panel, Yurok Tribe fisheries director McCovey said the Klamath still faces low run sizes, climate-driven warming, wildfire impacts, and federal uncertainty, but he pointed to dam removal, restoration work, and AB 263’s river-flow protections as major advances. PCFFA president Bradshaw stressed that the three consecutive salmon closures have devastated coastal communities and argued for major reinvestment in aging Central Valley hatchery infrastructure and better broodstock management at Fall Creek. CalTrout’s Schneider said salmon remain at risk statewide, but cited Prop 4, habitat reconnection, floodplain restoration, improved water management, and monitoring as the main tools for recovery. In the crab panel, CDFW’s Schumann reported that the 2024–25 season produced record prices per pound and about $55 million in value despite delays and trap reductions, but he warned that three confirmed whale entanglements and elevated whale presence could force a conservative opener for 2025–26. PCFFA’s Domrash supported marked line, alternative gear, and a new gear-recovery network, while also criticizing the current ramp system as a response to a problem not fully grounded in science.

Transcript Highlights:

• The Northern California Power Agency is a not-for-profit joint powers agency that represents and helps
• Is there unique challenges for them?
• Yeah, so at least eight agencies, plus some other agencies that they work with.
• So that probably simplified the project because whenever you have eight agencies, and in each agency,
• And what that means is one agency needs to be a coordinating agency.

Summary: The Select Committee on Climate Innovation and Infrastructure held a hearing focused on emerging technologies for climate resilience and infrastructure. The first panel discussed the Calistoga Resiliency Center, a utility-driven microgrid that keeps the city powered during public safety power shutoffs using hydrogen fuel cells, lithium-ion batteries, and liquid hydrogen storage. PG&E described microgrids as a resilience tool but emphasized that cost remains the main barrier to wider deployment. Energy Vault explained the project’s design, its ability to provide at least 48 hours of backup power on a small parcel of land, and its use of green hydrogen and battery storage to improve efficiency and reduce emissions. A Calistoga councilmember and NCPA representative also discussed the Lodi Energy Center hydrogen project, saying it could help decarbonize power generation and transportation, but that federal and state funding changes, tax credit timing, and other policy shifts have made the project difficult to advance. The Green Hydrogen Coalition supported the Calistoga model as a blueprint and urged policy changes to create demand and reduce barriers for renewable hydrogen, including addressing behind-the-meter rules and recognizing hydrogen in state energy planning. The second panel focused on water resilience and desalination, with the California Desal Association and Oneka Technologies discussing wave-powered desalination for the City of Fort Bragg. Cal Desal said California’s changing hydrology, reduced snowpack, and drought conditions make local water supply options increasingly important, but noted that conventional desalination is expensive and slow to permit. Oneka described its offshore, wave-powered system as a zero-electricity desalination technology that produces drinking water without greenhouse gas emissions and with limited land use, and said the Fort Bragg pilot is intended to demonstrate the technology under California conditions. The company and Cal Desal both stressed that permitting is a major obstacle, with the project requiring multiple agencies and a timeline far longer than in other jurisdictions. They also said the technology’s autonomous operation could improve water resilience because it does not depend on the electrical grid. The final panel featured the Climate Foundation’s marine permaculture proposal, which aims to restore kelp forests and support carbon removal and coastal food systems. The presenter said warming oceans and nutrient loss have devastated kelp forests along the California coast and argued that offshore platforms that raise and lower seaweed to access nutrients and sunlight could help regenerate ecosystems while producing food, feed, fertilizer, and carbon benefits. He said the technology has shown strong growth rates and storm resilience in other regions, but that California permitting remains a major hurdle, involving 17 state and federal agencies. He proposed a streamlined, code-based permitting approach for smaller projects and said the group is seeking matching funds to complete a first California pilot. Throughout the hearing, members and witnesses repeatedly highlighted the tension between innovation and the high cost, complexity, and length of California’s permitting and funding processes.

Transcript Highlights:

• , and other agencies in the implementation of its program.
• This has been a challenge from a resource limitation standpoint, but we both in the... ...challenge from
• , challenging things coming from the federal government.
• It has been a challenge.
• The withdrawn ACF waiver does make this more challenging, but we are up for the challenge.

Summary: The committee hearing focused heavily on CARB’s broad trailer bill request for regulatory fee authority. Finance and CARB argued the proposal would let CARB develop fees to recover reasonable costs for implementing and enforcing regulations, while the LAO recommended rejection because the authority was too broad, could apply to an entire division of code, and would delegate core legislative taxing/fee-setting power without enough guardrails. Members from both parties raised concerns about the breadth of the authority, accountability, affordability impacts, and whether the Legislature would be put in an up-or-down position after CARB had already developed regulations. CARB responded that fees would still go through a budget change proposal and legislative approval before collection, and cited existing examples such as transport refrigeration units and commercial harborcraft fees. The committee then reviewed CARB’s request for permanent resources to implement SB 905 on carbon capture, utilization, storage, and carbon dioxide removal. CARB said the Legislature had previously authorized limited-term positions and funding, but it had struggled to recruit and retain staff with specialized regulatory and technical expertise, and that the work had included pre-rulemaking contracts, technology review, and permit-related preparation. Members questioned the pace of work, the use of limited-term positions, and whether additional permitting authority would be needed. CARB said it hoped to begin rulemaking later in the year if permanent resources were approved. Members also discussed the cap-and-trade spending plan, noting lower-than-expected auction revenues but higher interest earnings, and the need to monitor the Greenhouse Gas Reduction Fund and possible May Revision changes. The committee then heard overviews of the zero-emission vehicle package, the Community Air Protection Program, demand-side grid support, and e-bike incentives. CARB described ongoing investments in community-based transportation equity, drayage trucks, harbor craft, and other clean technology demonstrations, while members pressed on affordability, program duplication, and whether enough funding was being directed to incentive programs. No formal votes were taken during the portion provided, and the chair repeatedly indicated that the hearing was intended to surface concerns for later budget negotiations.

Transcript Highlights:

• So that can take some finagling from the agency side, um, but that's I think that's a challenging question
• side um but that's I think that's agency side um but that's I think that's a<04:01:23.520><c> challenging
• So that granted pretty broad latitude to agencies and disempowered those who would challenge agency rules
• :18:44.319><c> challenge</c><04:18:44.800><c> agency</c><04:18:45.680><c> rules.
• agency they're an agency they're not the agency they're an agency but<04:38:05.520><c> they're</c><04

Keywords: 1189, house, all

Transcript Highlights:

• That creates a challenge for consistent staffing for the agencies.
• Medicaid agency.
• And then on getting hired by an agency, it has been more or less challenging for members.
• One of the challenges could be around availability for supervision if an agency doesn't have the staff
• Challenges could be around availability for supervision if an agency doesn't have the staff to be able

Bills: HB2402, HB2555, HB2599, HB2685

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:

• There is so much expertise across all of our agencies.
• And lead agencies, I'm trying to remember what the lead agency is in your district. I'm sorry.
• But this does give us the first step in identifying where those challenges...
• So before we start talking about those challenges, because Molly and I will go over some of those challenges
• Now I'll move on to a couple of our challenges.

Summary: The House Agriculture and Natural Resources Committee held a work session on food systems and food security, with no public testimony. The first panel focused on household food security and data. Marie Spiker of the University of Washington explained what food insecurity means, its health impacts, and the importance of reliable measurement, warning that the federal Census food security data is being terminated and that there is no true replacement. She described Washington’s WaFOOD surveys as a useful complement, not a substitute, and noted that they show food insecurity affects households at a range of income levels. Katie Raines of WSDA described the state’s food systems work, the need for shared data and dashboards, and the role of agriculture in both food production and the hunger safety net. Committee members asked about the $2.2 million state food assistance allocation, the scale of the SNAP gap, and how household size, housing costs, and other factors intersect with food insecurity. The committee then heard from Tracy Roof of the University of Richmond on the history of SNAP and its relationship to agriculture. She traced the program from Depression-era commodity distribution through the modern farm bill, emphasizing that food assistance has long functioned both as anti-hunger policy and as an agricultural and economic stabilizer. She highlighted how SNAP expands during recessions, supports retailers and farmers, and has become more important since the Great Recession because participation stayed high even as the economy recovered. Roof also noted that Washington has relatively high SNAP participation and low payment error rates, but that recent federal changes could reduce eligibility and shift more costs to states. Members asked how Washington compares to other states and why the program is structured as it is. A later panel featured the Washington State Food Policy Forum and a joint systems presentation from the Washington Farm Bureau, Washington Retail Association, and Washington Food Industry Association. The Food Policy Forum described its consensus-based recommendations on food insecurity, climate and water, regional food infrastructure, farmland protection, and farm viability, including more support for producer purchasing, water planning, and farmland conservation. The industry groups presented a systems map showing how agriculture, processing, retail, and transportation are interconnected, and argued that rising costs, regulations, labor and fuel expenses, retail theft, and thin margins make it harder to keep farms and stores viable. They said food security depends on store viability and local agricultural profitability, and promised to provide a more detailed list of policy recommendations. The final panel included state agency staff from DSHS, DOH, and WSDA. Bryce Montgomery said the Basic Food program serves about 920,000 Washingtonians monthly and warned that H.R. 1 could require Washington to pay up to 15% of SNAP benefits, broaden work requirements, and restrict immigrant eligibility. Karen Mullen described DOH nutrition programs, including WIC, farmers market nutrition benefits, fruit and vegetable incentives, and a fruit-and-vegetable prescription program, while noting funding instability and the end of SNAP-Ed. WSDA’s Katie Raines began describing ongoing food assistance and farmer support challenges, including farmer mental health and the need to address food insecurity across both producers and consumers.

Transcript Highlights:

• That creates a challenge for consistent staffing for the agencies.
• And then on getting hired by an agency, it has been more or less challenging for members.
• One of the challenges could be around availability for supervision if an agency doesn't have the staff
• Okay. challenges could be around availability for supervision if an agency doesn't have the staff to
• agencies and across the board rather than a different agency agencies.

Summary: The House Health Care and Wellness Committee met at policy cutoff and first took up executive session on four bills. It considered a proposed substitute for HB 1589 on health carrier contracting practices, which would require carriers to provide providers advance notice and clean copies of contract changes and payment methodologies, and would also add notice requirements for significant payer contract modifications. The committee also considered HB 2402 on phthalates in IV solution containers and tubing, with a substitute delaying implementation dates and creating shortage and FDA-related exemptions. HB 2555, concerning Medicaid coverage of traditional health care practices, and HB 2685, concerning tribal data and disease reporting to tribal health jurisdictions, were also before the committee. HB 2599 was deferred. The committee reported HB 1589, HB 2402, HB 2555, and HB 2685 out of committee with do pass recommendations, with recorded votes showing some members voting no or no without recommendation on the more contested bills. The committee then held a work session on private duty nursing in the Medically Intensive Children’s Program. Health Care Authority and DSHS staff described how the program serves children with complex medical needs through managed care and fee-for-service pathways, the role of prior authorization and medical necessity review, and the ongoing shortage of nursing staff. They said many approved hours are not filled, especially in rural areas, and that family members often provide unpaid care to fill gaps. Committee members asked about the structure of the children’s and adult PDN programs and about how many authorized hours are actually being served. The committee also heard testimony from a home care agency representative and a parent caregiver, both of whom described severe staffing shortages and the burden on families when nursing shifts go unfilled. They supported models that would allow trusted family caregivers to be paid for some of the skilled care they already provide. The committee then heard examples from Montana and Massachusetts of similar family caregiver or complex care assistant programs. Montana described its pediatric complex care assistant model as a gap-filling service with prior authorization and a set hourly rate, while Massachusetts outlined its complex care assistant program, including training, supervision, wage pass-through requirements, and early growth in participation. The meeting concluded after the work session.

Transcript Highlights:

• dialogue around cross-agency collaboration challenges.
• It's been almost a year since I've returned to the agency... ...agency collaboration challenges.
• So that is one of the things that is challenging.
• I hear their struggles and challenges.
• multiple agencies, multiple systems.

Keywords: 999, senate, all

Transcript Highlights:

• 20 million for cabinet agencies.
• for all agencies.
• And yes, we want from my experience agencies, different agencies approach it differently.
• But I've also seen or some challenges where agency might say, you know, we're not gonna get the budget
• Does it come from the agency?

Transcript Highlights:

• So I was asked, what are our top challenges?
• California agencies if that comes to pass.
• So there's engineering challenges to overcome.
• So there's engineering challenges to overcome.
• But I kind of am seeing these agencies kind of move the goalposts.

Summary: The Assembly Select Committee on Biotechnology and Medical Technology held an informational hearing on the role of biotechnology industries in wastewater treatment, hosted at Bakar Labs on the UC Berkeley campus. Opening remarks emphasized California’s water scarcity, the rising cost of wastewater infrastructure, and the need to reuse and clean contaminated water. Committee members framed the hearing as a look at both current treatment challenges and emerging technologies that could improve water quality, affordability, and resilience over time. The first panel focused on statewide wastewater challenges. BACWA Executive Director Laurie Fono described wastewater plants as part of a broader circular economy, noting their roles in recycled water, environmental enhancement, biosolids management, carbon sequestration, and renewable energy generation. She highlighted major challenges including aging 1970s-era infrastructure, nutrient reduction mandates, sea level rise, evolving regulations, and PFAS source control. She said Bay Area agencies face about $11 billion in nutrient reduction costs, with rate increases, state revolving funds, WIFIA loans, and bonds as the main financing tools. Members asked about regional differences, energy revenue opportunities, smaller decentralized plants, and agricultural collaboration. The second panel featured researchers and lab experts discussing biotechnology solutions. Lawrence Berkeley National Lab’s Dr. Romine Chakarvati described using microbial communities and machine learning to help break down PFAS and treat produced water. CEL Analytical’s Dr. Yigi Dearborn explained pathogen testing for direct potable reuse, wastewater monitoring, and the need for larger sample volumes and more funding to validate methods for viruses and protozoa. Stanford’s Dr. Chunhung-Shin presented an anaerobic membrane system that turns domestic wastewater into clean water and energy with less biosolids and lower operating costs. Committee members asked about AI, assay development, scaling technologies, and funding priorities. Public comment from the California Association of Sanitation Agencies stressed the need to balance scalability, reliability, and affordability, and the hearing adjourned without any formal vote or action.

Transcript Highlights:

• as an agency in FY27.
• as an agency in FY27.
• Challenge number one is around cost growth.
• One of the challenges that we see for a subset of individuals, particularly One of the challenges that
• As I said earlier, the only agency of its kind.

Keywords: 995, all

Summary: The Joint Committee on Ways and Means held a Health and Human Services budget hearing in Clinton, with opening remarks from Chairs Meg Kilcoyne and Robin Kennedy, local officials, and many House and Senate members introducing themselves. The hearing focused on Governor Healey’s FY27 EOHHS and MassHealth budgets, with repeated themes of rising health care costs, federal funding uncertainty, workforce shortages, and access to care in underserved regions. Members also raised concerns about primary care shortages, rural and regional disparities, behavioral health access, maternal health, food insecurity, and the impact of federal policy changes on Massachusetts programs. EOHHS Secretary Kiame Mahaniah said the FY27 EOHHS budget totals $33.7 billion, reflecting mostly non-discretionary growth from health care costs, labor costs, caseload increases, and provider rate pressures. He highlighted targeted investments in foster care, family resource centers, maternal health, youth services, nutrition programs, immigrant legal services, and human service workforce rates, while warning that federal actions could strip roughly $3.5 billion annually from the state’s health care funding. In response to questions, he defended the administration’s cooperation with federal audits and program integrity efforts, discussed the primary care crisis, and said the state is trying to preserve core services while preparing for a more difficult FY28 budget cycle. MassHealth Undersecretary Mike Levine then described two major FY27 challenges: double-digit cost growth and the expected effects of the federal One Big Beautiful Bill Act. He said MassHealth’s proposed $22.7 billion gross budget includes a 7.5% increase and relies on a moratorium on new expansions plus targeted reductions, including a $1,000 annual adult dental cap, ending GLP-1 coverage for weight loss only, reducing care management to peer-state levels, and work groups to slow growth in PCA, adult foster care, and adult day health spending. Members questioned the impact on Boston Health Care for the Homeless, preventive care, and regional access; Levine said the changes are meant to preserve sustainability, that children and certain disabled populations remain protected, and that the administration will continue working with providers, advocates, and the Legislature on implementation and longer-term reforms.