Transcript Highlights:

• So be careful with it, everybody.
• Bernalillo has been my home since I immigrated to this country, so the welcoming, the sense of home,
• Bernalillo has been my home since I immigrated to this country, so the welcoming, the sense of home,
• I don't care.
• If they had that health care training.

Bills: HB111 , HB103 , HB109 , HB128 , HJM2 , HJM3 , HM7 , HM17 , HM4 , HM22 , HM23 , HM24 , HM26 , HM2 , HM16 , HM11 , HM14 , HM21 , HM34 , HM50 , HB49 , HB60 , HB108 , HB120 , HB124 , HB145 , HB154 , HB158 , HB164 , HB180 , HB291 , HJR6 , HJR7 , HR1 , HJM1 , HM13 , HM47

Keywords: water law, state engineer, civil penalty, compliance order, water rights, overdiversion, illegal diversion, groundwater storage and recovery, well license, permit violation, water enforcement, New Mexico water code, irrigation district, conservancy district, water diversion, unauthorized water sales, measuring device, district court appeal, water resources, water compliance

Transcript Highlights:

• the very best of the nursing profession through Her leadership experience and dedication to patient care
• So this is mainly for Title 19 and payback to the health care authority to cover the Medicaid expenses
• President, you started to talk a little bit about our uncompensated care.
• Would you talk about whether the supplemental gives any Percentage payment on uncompensated care from
• But then now we're not paying for that care.

Bills: SB1636 , SB1584 , SB1730 , SB1255 , SB1627 , SB137 , SB2062 , SB1470 , SB1284 , SB1632 , SB1594 , SB2045 , SB1251 , SB1884 , SB1250 , SB1630 , SB1262 , SB1374 , SB1292 , SB1432 , SB1199 , SB1790 , SB1481 , SB1614 , SB1734 , SB1437 , SB1489 , SB1718 , SB1778 , SB1327 , SB1372 , SB1403 , SB1937 , SB277 , SB2131 , SB1749 , SB1348 , SB1469 , SB2018 , SB1931 , SB1530 , SB2155 , SB2030 , SB1926 , SB2170 , SB2151 , SB2166 , SB1213 , SB1381 , SB1824 , SB1876 , SB1728 , SB1582 , SB1286 , SB1386 , SB1708 , SB1618 , SB2106 , SB1471 , SB2139 , SB2154 , SB1619 , SCR15 , HB2786 , HB2787 , SB1525 , SB2011 , SB2159

Keywords: cold case, unsolved homicide, violent crime, case file review, law enforcement, police records, victim family, immediate family member, designated person, forensic testing, witness reinterview, investigative leads, cold case unit, unsolved murder, public safety, Title 21, Oklahoma statutes, sexual assault, evidence kits, DNA testing

Transcript Highlights:

• care agencies for the protection of consumers, home care agencies, and home care professionals.
• as providing home care services in the home.
• home care market.
• care in their homes.
• care in their homes.

Summary: The Joint Committee on Aging and Independence held a hearing on several bills, led by Chair Tom Stanley and Senate Chair Patricia Jehlen. The committee first heard testimony on H. 765/S. 487, an act relative to councils on aging, which would update outdated statutory language and allow directors of councils on aging to make staffing decisions when a council is structured as an advisory body. Representative Donahue and Betsy Connell of the Massachusetts Association of Councils on Aging said the change reflects how most councils now operate and would resolve conflicts like the one that arose in Sherborn. Members asked about whether the bill would affect town managers, volunteer roles, and whether the language should more clearly exempt informal volunteer help; supporters said the bill is aimed at municipal staffing structures, not unpaid volunteer assistance. The committee then took extensive testimony on H. 789/S. 470, an act to improve Massachusetts home care, which would create a statewide licensure system for non-medical home care agencies and entities. Julie Watt, Jay Krillovich, Betsy Krimmins, Lisa Gargoni, Tim Foley, and several providers and advocates supported the bill, arguing that licensure would establish baseline standards for background checks, training, service plans, insurance, complaint procedures, and labor-law compliance, while helping consumers identify legitimate providers and reducing fraud and abuse. Several witnesses described problems with unlicensed or poorly supervised providers, and family members and dementia advocates emphasized the need for dementia-specific training and better oversight for vulnerable clients. Tim Foley also raised concerns about private equity’s growing role in home care and said stronger regulation is needed to protect consumers and workers. Committee members focused on practical questions about the bill’s scope, including whether it would reach informal paid helpers, volunteers, or people doing occasional household tasks, and what agency would enforce the rules. Supporters said the bill is intended to cover entities advertising home care services, not unpaid volunteer help, though they acknowledged regulators would need to work out details. John Sneeth of Tribute Home Care offered a more cautious view, saying licensure should not unduly burden smaller providers or reduce competition, and that enforcement would be key. The hearing also included testimony from the Alzheimer’s Association and family caregivers, who strongly supported the bill’s dementia-training provisions and described how trained caregivers improved safety and quality of life for people living with Alzheimer’s and dementia. At the end of the hearing, the committee also heard support for H. 778/S. 473, regarding the Commission on LGBTQ Aging, with Lisa Krinsky urging funding for a full-time director and continued support for the commission’s strategic plan. After public testimony concluded, the committee adjourned the hearing by motion and voice vote.

Transcript Highlights:

• care or nursing home care or those who are being served in a home or in a different capacity.
• care or nursing home care or those who are being served in a home or in a different capacity.
• Home care or nursing home care, or those who are being served in a home or in a different capacity.
• </c> care if they don't have access to Home care if they don't have access to Home Care Care Care Services
• visits</c><00:04:49.039><c> three</c> home care care evaluation visits three home care care evaluation

Transcript Highlights:

• only 1,700 certified foster homes. 4,671 kids in foster care in Louisiana, and only 1,700 certified
• foster homes.
• How will this affect surveillance of somebody at your home? You're exempted in your home. Huh?
• And I hope all of you'll be careful going home and enjoy the rest of the year.
• And I hope all of you'll be careful going home and enjoy the rest of the year.

Bills: HB410 , HR310 , HR314 , HR316 , HR317 , HR321 , HR275 , HR276 , HR279 , HR282 , HR286 , HR289 , HR292 , HR295 , HR302 , HR319 , HR307 , HR273 , SCR59 , SCR61 , SCR62 , SCR68 , SCR69 , SCR70 , SCR54 , SCR55 , SCR64 , SCR75 , HCR32 , HB776 , HB42 , HB119 , HB159 , HB302 , HB1017 , HB1028 , SB217 , SB283 , HB953 , SB208 , HR74 , HB998 , HB901 , HR20 , HCR65 , HCR71 , HCR98 , HB284 , HB306 , HB341 , HB366 , HB393 , HB458 , HB577 , HB603 , HB605 , HB614 , HB625 , HB646 , HB733 , HB752 , HB773 , HB798 , HB911 , HB955 , HB996 , HB1035 , HB1069 , HB1113 , HB1140 , HB1180 , HB1191 , HB1240 , HB1255 , SB82 , SB89 , SB97 , SB123 , SB237 , HB36 , HB74 , HB75 , HB258 , HB259 , HB414 , HB459 , HB784 , HB848 , HB956 , HB1095 , HB1220 , HB1252 , SB469 , SB479

Keywords: oil and gas, orphan wells, inactive wells, shut-in wells, marginal wells, plugging and abandonment, well decommissioning, site remediation, site restoration, Oilfield Site Restoration, OSR program, financial security, bonding, taxpayer liability, public liability, offshore wells, onshore wells, coastal erosion, Department of Conservation and Energy, natural resources

Transcript Highlights:

• health care and home services.
• health care and home services.
• I'm here today because our home care ...for home health care and home services.
• health care services and home care services.
• the Home Care Aid Council.

Committee: Joint Joint Committee on Health Care Financing

Summary: The Joint Committee on Health Care Financing held a public hearing focused on two broad sets of issues: home- and community-based care, and school-based Medicaid reimbursement. In the morning session, legislators and advocates testified on bills affecting children and disabled enrollees, including proposals to clarify rate-setting for home health and home care services (H. 767/S. 870), allow family members and spouses to be paid caregivers under MassHealth (H. 1394/S. 886 and related bills), extend MassHealth coverage for applied behavior analysis and other therapies beyond age 21 for adults with autism and developmental disabilities (H. 1351/S. 871), and protect medically fragile children by improving access to continuous skilled nursing. In the later portion of the hearing, testimony shifted to a bill to improve MassHealth reimbursement for schools (S. 862), with speakers describing the school mental health crisis and the need to reinvest Medicaid funds directly into school health services. Witnesses on the home care rate-setting bill said current reimbursement methods are opaque and outdated, contributing to workforce shortages, unfilled shifts, long waitlists, and patients remaining in hospitals longer than necessary. Home care providers and trade groups argued the bill would not set rates directly but would require more transparent methodology and fuller consideration of real costs such as wages, benefits, taxes, training, and technology. On caregiver bills, many family members and provider organizations described the financial and emotional strain of caring for disabled or medically fragile relatives, especially when parents, spouses, or guardians are barred from being paid caregivers. They argued the bills would recognize existing unpaid care, help families remain at home, and reduce reliance on more expensive institutional care. Advocates for adult ABA coverage said services remain medically necessary after age 21 and that ending coverage at that age creates an inequitable “cliff” for MassHealth members compared with those with private insurance. For the PACE/community care bill, elder law attorneys and PACE advocates said current MassHealth income rules force some older adults with modestly higher incomes to spend down to $542 per month, making community living unrealistic and pushing people toward nursing homes. They supported changing the eligibility structure to a premium-based approach that would allow more people to remain in the community. On the school Medicaid bill, advocates said schools are providing effective, preventive mental health care, but reimbursement currently flows to municipalities rather than directly back to school health budgets, limiting districts’ ability to hire and retain staff. No votes were taken during the hearing; the committee heard testimony and several witnesses requested favorable reports on the bills.

Transcript Highlights:

• are home care, assisted living residences, and nursing homes.
• Under the home care program, home care agencies that contract with aging services, Home care agencies
• There was a saying that people don't know about home care until they need home care.
• for the home care agency.
• care workers, home care agencies, and home care workers who are all dedicated to caring for the aging

Summary: The House opened with routine ceremonial business, including the Pledge of Allegiance and adoption of several resolutions, such as congratulations to the Williamsburg Grange on its 125th anniversary and to Fire Captain Melissa Blodgett on her retirement. The chamber also concurred in a Senate petition to establish a sick leave bank for a Bristol County Sheriff’s Department employee and suspended Joint Rule 12 to advance local petitions, including one involving the Dalton Fire District and another renaming a Chelmsford bridge. The main floor action centered on several Ways and Means bills. The House advanced a bill amending laws relative to individuals with disabilities, replacing outdated and offensive terminology in the General Laws with person-first language; members spoke at length in support, emphasizing dignity, inclusion, and the bill’s non-substantive nature. The bill was engrossed by a roll call vote, 152-0. The House also took up and engrossed a bill to improve Massachusetts home care, which would create a licensing and oversight framework for private-pay home care agencies, establish standards for contracts, background checks, training, insurance, and consumer protections, and create advisory committees to guide implementation. An amendment establishing a Family Caregiver Commission was adopted 154-0, and the bill itself was then engrossed 153-1. In addition, the House passed or engrossed several other measures, including a bill authorizing the Massachusetts Water Resources Authority to provide sewer services to land in Sharon, a sick leave bank bill for a Trial Court employee, a Marblehead parking fines bill, a Hingham municipal property bill for a center for active living, and a Taunton bill allowing continued employment of Police Chief Edward J. Walsh. The chamber also handled numerous calendar items, holding or passing over many while advancing a few. The session ended with a special adjournment in memory of former Representative George L. Sacco Jr., and the House adjourned to meet the next day at 11 a.m. in informal session.

Transcript Highlights:

• health and home care services.
• It's not just home care. It's all the continuum from home care to assisted living to nursing homes.
• It's all the continuum from home care to assisted living to nursing homes.
• homes, to... ...to get money to primary care, to group homes, to people who are taking care of those
• We represent home care workers, both personal care attendants, home care agency workers, hospital workers

Committee: Joint Joint Committee on Health Care Financing

Summary: The Joint Committee on Health Care Financing held a public hearing focused largely on senior long-term care issues, family caregiving, post-acute care access, and direct care workforce pay. Testimony strongly supported bills to raise the personal needs allowance for nursing home and rest home residents (including H. 1411, S. 482, and related bills), with speakers from Mass Senior Action, Dignity Alliance, nursing home residents, providers, and former state officials arguing that the current $72.80 monthly allowance has been unchanged since 2008 and is inadequate for basic items like clothing, toiletries, haircuts, and transportation. Witnesses also backed bills to increase MassHealth asset and income limits for seniors and to stop counting life insurance as cash, describing the current rules as outdated and harmful to low-income elders. The committee also heard testimony on bills allowing family members, including spouses and guardians, to be paid caregivers (H. 1394/S. 886), with supporters saying this would help families keep loved ones at home and reduce reliance on costly institutional care. Another set of bills (H. 1412/S. 903) drew support from a physician who said clearer MassHealth communication and improved post-acute care determination processes would help reduce delays and backlogs for patients awaiting skilled nursing, rehabilitation, or other post-acute placement. Several speakers emphasized that better home- and community-based care can prevent hospital readmissions and support independence. A major portion of the hearing focused on S. 877, which would establish an enhanced care worker minimum wage of $25 per hour, indexed to inflation, for certain home care and human services workers. Union representatives and direct care workers from SEIU Local 509, 1199 SEIU, and the AFL-CIO described severe staffing shortages, burnout, low wages, and high turnover across home care, mental health, disability services, and crisis response. They argued that higher pay is necessary to recruit and retain workers and to stabilize services for vulnerable residents. Committee members asked about costs, comparisons with other states, and whether non-wage incentives could help, but witnesses repeatedly said wages were the central issue. The hearing concluded after all registered testimony was heard, with the committee noting it would continue accepting written testimony and then adjourning.

Transcript Highlights:

• They have definitely progressed from the kind of long-term care round-the-clock care to more of the rehab-to-home
• transition from care, and what you often see is... ...care to more of the rehab-to-home transition from
• , where home health care will then continue to do therapies there at home.
• Home health needs us to have that two-week bridge for the round-the-clock care before they go home, and
• Sometimes for long-term care, there really is no home to go to.

Summary: The committee met with a quorum present and heard a presentation from Marty Wright, CEO of the West Virginia Healthcare Association, on the state’s long-term care system. He described the continuum from home care to assisted living to skilled nursing facilities, emphasizing that these settings increasingly serve short-term rehab-to-home patients as well as older adults needing round-the-clock care. He also outlined the number of facilities in West Virginia, the predominance of Medicaid as the payer for long-term nursing home care, the private-pay nature of assisted living, and the role of OFAC/CMS in regulation. A major focus of the presentation was workforce shortages and turnover, especially for CNAs, LPNs, and RNs, along with declining interest in nursing careers and the impact of regulatory burden and burnout. Wright said the system is also struggling to serve younger patients with substance use disorder, mental illness, or other behavioral needs, who are often not well suited for traditional nursing home placement but have limited alternatives. Senators raised concerns about where such patients are being housed, the long-term effects of opioid and behavioral health issues, and the gap between school-age special needs populations and adult care needs. Wright said Medicaid can cover long-term nursing home care for those who meet financial and medical eligibility requirements, but affordability and spend-down requirements remain major barriers. He also warned that Medicare Advantage can create confusion and shorter covered stays for rehab patients, and he urged early planning around long-term care insurance and estate planning. No votes were taken on the presentation, and the committee adjourned after questions and discussion.

Transcript Highlights:

• total care for Nick due to the shortage of group home attendants.
• I'm testifying today on behalf of the Texas Association for Home Care.
• But I also have host home companion care providers and other people in services.
• The care visibly deteriorated, and the homes fell into disarray.
• But I also have host home companion care providers and other services.

Bills: SB1 , SB 1

Committee: Senate Finance

Transcript Highlights:

• Not everyone has the financial means to hire at-home care.
• We've heard today the importance of care at home.
• state home care program.
• and the Massachusetts home care workforce.
• My name is Dionysia, and I am a home care worker for Latter Care.

Summary: The committee heard testimony on several aging-related bills, with most speakers focusing on housing stability, home-based services, and care transitions. Representative Badger and a commissioner testified in support of H4039, which would create a universal breakfast and lunch program at senior centers funded through a new Senior Breakfast and Lunch Fund, arguing it would reduce food insecurity and social isolation among older adults. Representative Lipper-Garabedian and multiple providers then supported H780/S495, the hospital-to-home partnership program, describing how embedded aging-services liaisons help older patients transition safely from hospitals to home, reduce readmissions, and avoid nursing facility placement; witnesses from Mystic Valley Elder Services and Mass Aging Access cited pilot results, including hundreds of patients served and examples of substantial cost savings and successful discharge planning. The committee also took testimony on S478, which would require continuing care retirement communities to disclose entrance-fee refund policies more clearly at enrollment. Senator Lovely and LeadingAge Massachusetts said the bill would improve transparency for residents and families, while a consumer witness said her family experienced delays and confusion in getting a refund after her mother left a CCRC. Members noted the issue is also being examined by a special commission on CCRCs. A large portion of the hearing focused on S475, a statewide bridge subsidy program for older adults facing housing instability. Advocates from the Massachusetts Coalition for the Homeless, Western Massachusetts, Somerville, Northampton, East Hampton, Old Colony Elder Services, and Somerville’s Office of Housing Stability described rising senior homelessness, long waitlists for subsidized housing, and cases where short-term rental assistance kept older adults housed while they waited for permanent housing. Somerville witnesses said the pilot program helped nine households remain housed and that some participants have since moved into permanent housing. Members asked about wait times, program design, and how to prioritize applicants; witnesses emphasized flexibility, emergency risk, and the need for a statewide expansion. The hearing also included testimony on S465, an ALS bill that would expand home care access regardless of age and bar the use of quality-adjusted life-year metrics in coverage decisions, with the sponsor and ALS Association arguing the measure would reduce discriminatory treatment and better center patient care. No votes were taken during the hearing.

Transcript Highlights:

• When we think about home care agencies, often we use the term home care, but within that there are three
• When we think about home care steps.
• </c> four different types of home care four different types of home care providers.<00:11:36.079><c>
• </c> home and community based care system. home and community based care system.
• </c> use of home and community based care use of home and community based care Indiana<01:06:04.160><

Summary: The committee to study long-term managed care met to approve the prior meeting minutes, with a clarification that “OB3” referred to the “one big beautiful bill.” The minutes were then approved. Chair Jim Kofalt outlined the day’s agenda, which included testimony from the Granite State Home Health and Hospice Association, the New Hampshire Association of Counties, and later DHHS. He also noted that future meetings were expected soon and that the meetings were being livestreamed on YouTube. Granite State Home Health and Hospice Association, represented by Kellyanne Totten and Amy Moore, urged inclusive planning and a cautious, phased approach if managed care is considered. They emphasized that home care providers are not uniform, with different licensing and service models, and said any pilot should include varied provider types, rural and southern regions, and agencies of different sizes. They warned that workforce shortages, inflation, and a possible 9% CMS cut to Medicare home health payments could force agencies to reduce service areas or service types. They also said the 2023 Medicaid CFI rate increase has begun to lose its effect. In response to questions, they said the rural health transformation fund may help with planning and telehealth but likely cannot be used directly for rates or recruitment/retention. They also described the New England Home Care Nurse Residency Program, a Department of Labor grant, as a way to bring new registered nurses into home care with added training and school partnerships. The New Hampshire Association of Counties, through county nursing home administrators Craig Labore and David Ross, revisited the earlier Step Two managed care discussions from 2016-2018. They said prior consultants found the long-term services and supports system was underfunded and needed investment to stabilize providers and expand community-based care. They argued the same concerns remain today and said a managed model would jeopardize the Medicaid quality incentive payment program and, for county nursing homes, the proportionate share payment program. Their testimony was generally opposed to moving forward with managed long-term services and supports without significant additional funding and safeguards.

Transcript Highlights:

• So, three of the four home and community-based care waivers.
• </c><01:07:52.160><c> based</c> care than home and community based care than home and community based
• longer so that they don't need that nursing home care.
• care, divert from nursing home care those who might otherwise be served in the community.
• </c><01:27:56.000><c> care,</c> extricate uh from nursing home care, extricate uh from nursing home care

Summary: The Committee to Study Long-Term Managed Care met to approve prior minutes and outline its schedule, with meetings set for September 24 and September 29 ahead of an October 1 report deadline. The chair said the committee would use the first two meetings to digest testimony, likely ask follow-up questions of DHS, and then work toward conclusions and a report format. The minutes from the previous meeting were approved unanimously. The main testimony came from Sharon Alexander of Amera Health, who argued in favor of moving from fee-for-service Medicaid long-term services and supports to a managed LTSS model. She described managed LTSS as a capitated, quality-driven system used in about 26 states, and said it can improve care coordination, accountability, access to home- and community-based services, and budget predictability. She cited Amera Health’s experience in Pennsylvania and Delaware, including care coordination, housing and transportation support, caregiver programs, and quality benchmarks tied to state oversight. She also said nursing facilities would remain an important option for people who need that level of care. Committee members asked about how the programs are administered, how rates are set, how care managers work, and how quality is measured. Alexander said states contract with managed care organizations at actuarially sound capitated rates, with annual contracts, reporting, and oversight. She explained that care managers typically conduct quarterly assessments and follow up after trigger events such as hospitalization, and that housing coordinators may assist with transitions to the community. On quality, she said states use CMS-related and HCBS benchmark measures covering service timeliness, care planning, transitions, and other outcomes, and that New Hampshire could build on existing metrics rather than starting from scratch. She also noted that rural areas face workforce and transportation challenges, which managed care plans try to address through technology and self-direction options.

Transcript Highlights:

• This is in part what brought them to the rest home level of care.
• Care, doing business as Anne's and Burgoyne Rest Home.
• This shift undermines the purpose of rest homes within the continuum of care and creates operational
• As such, rest home responsible persons are an integral part of the rest home care model.
• compared to other types of long-term care services like ALRs or nursing homes?

Committee: Joint Joint Committee on Aging and Independence

Summary: The Joint Committee on Aging and Independence heard testimony on Senate 3057/House 5376, a bill to create an Assisted Living Residence Trust Fund and implement recommendations from the Assisted Living Residence Commission. Supporters, including AARP and the state long-term care ombudsman, backed the trust fund for certification staffing, compliance reviews, investigations, ombudsman services, public reporting, and appeals. The assisted living industry, represented by MassALA, supported the affordability task force and certified medication aides, but asked for amendments to expand career paths and to remove or limit fines as a funding source, arguing fines should be capped and tied to health or safety risks. The ombudsman emphasized the need for more staffing and resources, noting the current caseload and travel burden across the state. The committee also took testimony on Senate 3056/House 5243 concerning medication administration in rest homes. Rest home operators, MARCH, and LeadingAge Massachusetts opposed proposed Department of Public Health changes that would replace the long-standing responsible person model with a MAP-based framework or require more licensed nursing staff. They argued the current model has been used for decades, is safe and affordable, and is better suited to rest homes than MAP, which they said was designed for different settings. They urged the committee to preserve responsible person medication administration while improving training and oversight, and several witnesses asked for a task force or substitute language to study best practices rather than impose immediate regulatory changes. Committee members asked questions about the history of the responsible person model, how medication administration works in practice, and whether other states use similar systems. Chair Stanley said the committee was still reviewing building code-related recommendations for assisted living and noted that those issues may require more time. No votes were taken during the hearing, and the committee adjourned after testimony concluded.

Transcript Highlights:

• > now</c> service and home care workers will now service and home care workers will now receive<00:04
• Paul, and I have worked in home care probably on and off for 15 years.
• Our health care system also has home care and direct care, and the certified direct support professional
• Our health care system also has home care and direct care, and the certified direct support professional
• Again, I believe that we all agreed that taking care of our nursing home workers, taking care of our

Bills: HF2367 , HF2319 , HF2523 , HF1742 , HF671 , HF2331 , HF2722 , HF2406 , HF1674

Committee: House Human Services Finance and Policy

Transcript Highlights:

• , such as paid in-home personal care, residential settings, and nursing homes.
• Residents, people who reside in licensed care homes.
• Long-term care homes have been using tech for many years.
• residents who are evicted from care homes.
• In home care, we know that home care is the preferred setting for clients.

Committee: Joint Joint Legislative Executive Committee on Planning for Aging and Disability Issues

Summary: The committee held what was described as its final meeting and began with introductions, then received updates on several long-term care and aging initiatives that originated from earlier J-LEC work. A presentation on the WA Cares Fund reviewed its development from a 2014 research project to implementation, including premium collection, expanded eligibility for near-retirees, portability, recent technical fixes, and the creation of a supplemental private insurance market. The presenter said the program is now largely in place and ready for future use, with benefits expected to go fully live next summer. The Dementia Action Collaborative also reported on its state plan, including Project ECHO dementia training, dementia-capable community pilots through area agencies on aging, and ongoing work on early detection, brain health, and caregiver support. Another DSHS presentation covered the Medicaid Transformation Project, including Medicaid Alternative Care, Tailored Supports for Older Adults, presumptive eligibility, and health-related social needs benefits such as rental assistance and nutrition support, with officials saying the waiver is likely secure until its 2028 renewal. The meeting then shifted to emerging issues from advocates and ombuds. The long-term care ombuds described persistent staffing shortages, concerns about low wages, the growing use of technology and surveillance in care settings, private equity ownership of facilities, and illegal or pressured discharges and evictions. The developmental disabilities ombuds focused on people with developmental disabilities who remain hospitalized without medical need, the need for better mental health and behavioral health access, and workforce training gaps for people serving this population. Disability Rights Washington urged more community-based supports to reduce repeated institutionalization, pointing to gaps in programs such as PACT, GOSH, and peer bridgers, and recommending those services be expanded and bundled at scale. Provider and workforce panels emphasized similar themes. Washington Health Care Association and LeadingAge Washington said assisted living and skilled nursing facilities face workforce shortages, Medicaid rates that lag behind costs, increasing client acuity, behavioral health needs, and discharge bottlenecks. They highlighted the need for more flexible care models, improved case management, and better reimbursement, including for complex behavioral health cases. Supported living providers reported high turnover, underfunding, and a successful pilot that used enhanced rates and added training to place 30 hard-to-serve individuals. SEIU 775 argued that the central problem across settings is the direct care workforce crisis, driven by low wages and inadequate benefits, and said rate increases must be tied more directly to worker compensation. DSHS closed by noting heavy reliance on federal Medicaid funding, ongoing pilots in training, transportation, remote caregiving, smart-home technology, and rental subsidies, and said future planning should shift toward a multi-sector state strategy after the committee sunsets.

Transcript Highlights:

• This is in part what brought them to the rest home level of care.
• Care, doing business as Anne's and Burgoyne Rest Home.
• This shift undermines the purpose of rest homes within the continuum of care and creates operational
• Responsible persons play an important role in the operation of a rest home and in caring for an aging
• As such, rest home responsible persons are an integral part of a rest home care model.

Committee: Joint Joint Committee on Aging and Independence

Summary: The Joint Committee on Aging and Independence held a hearing on two assisted living bills, Senate 3057 and House 5376, which would create an Assisted Living Residence Trust Fund to support certification staffing, compliance reviews, complaint investigations, ombudsman services, public reporting, appeals, and oversight. Testimony from MassALA, AARP, and the Long-Term Care Ombudsman generally supported the bills and the dedicated funding stream, but MassALA urged amendments to expand career pathways for staff through certified medication aides and to add guardrails on the use of fines as a funding source. The Ombudsman supported the fund and emphasized the need for additional staffing to better serve the state’s assisted living residents. Committee members asked for draft amendment language, and the chairs indicated they were open to further discussion, especially on fines and CMA language. The committee then heard testimony on Senate 3056 and House 5243 regarding medication administration in rest homes. Providers, including the Massachusetts Association of Residential Care Homes, LeadingAge Massachusetts, and several rest home operators, opposed proposed Department of Public Health changes that would eliminate the long-standing “responsible person” model and move rest homes toward the Medication Administration Program (MAP). Witnesses said the current model has been used for decades, is tailored to rest homes, and is essential to affordability, staffing stability, and resident continuity of care; they warned that replacing it with MAP or nurse-only administration would raise costs, worsen workforce shortages, and could force closures or resident displacement. They asked the committee to support legislation preserving responsible persons’ authority to administer medications while improving training and oversight. Committee members asked questions about the history of the responsible person model, how medication administration works day to day, whether other states use similar systems, and whether data exist comparing medication error rates under MAP and the current model. The chairs said they were still reviewing building-code-related recommendations raised in the assisted living discussion and noted that some issues might be better addressed through a task force. The hearing concluded after testimony and questions, and the committee voted to adjourn.

Transcript Highlights:

• </c><00:05:12.760><c> care</c> And the alternatives to home care And the alternatives to home care nursing
• Home health is short-term episodic care. Home health is short-term episodic care.
• uh with good home care.
• uh with good home care.
• </c> with good home care. with good home care.

Summary: Senators and House members held a press event in support of HF 4188, a bill addressing commercial insurance coverage for home care nursing for medically complex children who also receive medical assistance. Speakers said the issue arose after Medica and HealthPartners began imposing caps on coverage that had been provided for years under Minnesota law, and argued that the change would shift costs to Medicaid and taxpayers, create budget pressure, and force families to reduce other needed services. They emphasized that home care nursing is distinct from short-term home health visits and said the bill would prohibit quantity limits and clarify that insurers must continue covering authorized nursing care. Parents and family members described the impact on children who depend on continuous skilled nursing to remain safely at home, including one family whose child Nash has spent extensive time hospitalized and another speaker who said her niece Isabel’s care showed how many nurses, aides, and hospice workers are involved in these cases. Testimony stressed that the coverage caps could lead to more hospitalizations, ICU stays, and trauma for children and families, while costing more overall than home care. Several lawmakers, including Sen. Matt Klein and Rep. Robert Bierman, said the statute’s original intent was clear in 2010 and that the plans’ reinterpretation and the Commerce Department’s response should be corrected. Lawmakers said the Commerce and Consumer Protection Conference Committee has completed its work but is being kept open for the remaining days of session in hopes of resolving the issue this year. In response to questions, supporters said the bill is intended as a clarification rather than a new mandate, that it would simply bar caps on already-authorized home care nursing, and that they believe there is support to move it through the House and Senate before adjournment.

Transcript Highlights:

• So 0 to 5 population is about 40% of the children in out-of-home care, and 81% of our foster homes will
• So 0 to 5 population is about 40% of the children in out of home care and 81% of our foster homes will
• care that every one of those parents, or a majority... ...placements and out-of-home care that every
• care placement and the criteria and the rules that DCS is supposed to follow for out-of-home care placement
• Just out-of-home care is $360 million annually.

Committees: House Government , House House Government Committee of Reference

Transcript Highlights:

• So 0 to 5 population is about 40% of the children in out-of-home care, and 81% of our foster homes will
• So 0 to 5 population is about 40% of the children in out of home care and 81% of our foster homes will
• care placement and the criteria and the rules that DCS is supposed to follow for out-of-home care placement
• It's directed by 41, 25. ...follow for out-of-home care placement.
• Just out-of-home care is $360 million annually.

Committee: House House Government Committee of Reference

Summary: The Committee on Government met for a presentation-only hearing focused on the Arizona Department of Child Safety (DCS) and related child welfare system issues; no bills were heard or voted on. Chair Blackman opened by stressing that the hearing was for fact-finding and data, not personal attacks, and Director Catherine Patak then presented DCS data on hotline volume, investigations, reunifications, adoptions, guardianships, extended foster care, and placement patterns. She said DCS investigated more than 43,000 cases in 2025, kept the out-of-home population relatively steady, and emphasized that Arizona places a high share of children with kin. She also highlighted a mismatch between the age of children entering care and the availability of foster homes willing to take older youth, and said behavioral health capacity, not DCS alone, is a major constraint. Patak discussed kinship supports, foster care reimbursement increases, the Family First Prevention Services Act, missing youth, congregate care reduction, and the department’s procurement process for group home beds. Members asked about kinship caregiver support, behavioral health access, reunification services, parental-rights terminations, Auditor General findings on notices and documentation, licensing and reimbursement rates, and why some relatives are not approved as placements. Patak said DCS is working on policy guidance, supervisor training, and improved supports, but that provider capacity and other system partners limit what DCS can do. Representative Gillette then gave a lengthy presentation focused on system design, procurement, funding flows, and congregate care. He argued that DCS, DES, and Access are structurally intertwined, that DCS’s procurement carve-out and capitated funding model create incentives tied to bed space and volume, and that fragmented oversight diffuses accountability. He cited budget figures, contract amendments, and audit concerns to argue that the system is overreliant on congregate care and that decision-making, medical referrals, and placement processes are too vague or too centralized in ways that can harm children and families. Gillette said his findings were based on contracts, interviews, and public records, and he indicated some material would be referred to special counsel. He also raised concerns about placement decisions, due process, and demographic disparities in congregate care outcomes. The chair cut off further questioning of Gillette for time and announced the committee would move on to the next presenter, Vice Chair Fink, with attorneys and other speakers to follow.