Transcript Highlights:

• , or day services.
• , or day services.
• , or day services.
• , or day services.
• c> day</c> Services unit-based services or day Services unit-based services or day Services<00:37:20.520

Committee: Senate Human Services

Transcript Highlights:

• of Health Services, and the Department of Health and Human Services.
• . services, and adult protective services.
• item which is Strengthening Services for Adult Protective Services.
• They're providing services like functional- functional-based family services, therapy services, which
• Health Services.

Committee: House Appropriations - S/C on Article II

Transcript Highlights:

• Adults, and Behavioral Health Services.
• ASU requests ratification of services valued at $37,500 for services rendered prior to proper review.
• It's an mental health referral services.
• Is to make sure that a student that has been identified for needing services is getting those services
• This is new services; the ratification in M1 was for services that were already rendered.

Committee: All JBC-PEER REVIEW

Summary: The PEER Review Subcommittee met to consider a large agenda of appropriation, transfer, contract, and other review items. Members approved temporary appropriation requests in Sections B through F, including funding for prosecuting attorneys, education-related adjustments, school operating needs, labor licensing divisions, ARPA fund returns from Workforce Services, IIJA grants for state police CDL implementation and a forestry-related county grant, reserve fund transfers for teacher scholarships, school facilities, and economic development, and a Commerce reallocation tied to organizational realignment. Cash fund requests in Section G and budget classification transfers in Section H were also reviewed, along with pay plan requests in Section I, overtime requests in Section J, and multiple methods of finance in Section K. The committee also reviewed discretionary grants in Section L, including agriculture promotion board grants and DHS aging/adult behavioral health grants, plus RFQs, construction contracts, intergovernmental contracts, and out-of-state contracts in Sections M1 through M5. Several items drew questions from members. Workforce Services explained that $225,000 in TANF-related funds would be returned to the federal government because the two-year hold period for uncashed or moved checks had expired. Commerce officials described the $25 million site infrastructure grant program, saying it supports site development, due diligence, and infrastructure build-out at eligible sites of 30 acres or more, including rural communities, with grant agreements and matching requirements providing accountability. DHS and Education officials answered questions about the Care Solace mental health referral contract, saying it is a statewide concierge/referral service that helps schools connect students to Arkansas providers and follow up so students do not fall through the cracks; members asked for more information on provider selection, school-day scheduling, and Arkansas vendor participation. The committee held one item over: the DHS discretionary grant item for the RSVP retired senior volunteer program in L2, after concerns were raised about whether state general revenue was being used effectively and how much administrative overhead the providers retain. Members also questioned several contracts, including a DHS sole-source contract with EMSLink for document management software and a DHS bridge contract with Arkansas Foundation for Medical Care for Medicaid inspections of care reviews; in both cases, agency staff explained the need to avoid service disruption and said follow-up information would be provided. A Department of Corrections reentry center contract was discussed for its recidivism results, and ARDOT retirement-system investment contracts were briefly explained. The meeting ended after a lengthy discussion of the Medicaid Trust Fund balance, with DFA and DHS officials saying the state is expected to finish the fiscal year without exhausting the fund, that a restricted reserve of $100 million is available as a backstop, and that the larger question is what minimum balance should be maintained going forward.

Transcript Highlights:

• </c> providing Medicaid services. providing Medicaid services.
• The number of of people using the service. service. service.
• receiving the service, the type of service provided.
• of receiving the service, the type of service<00:57:35.040><c> provided.
• 50 hours of a community service, 50 hours of community<01:21:11.800><c> service,</c> community service

Committee: House Fraud Prevention and State Agency Oversight Policy

Transcript Highlights:

• </c> stabilization services. stabilization services.
• limits for housing stabilization service limits for housing stabilization services. services. services
• It's a medical service medical service.
• It's a service. It's not a PCA service. It's a medical<01:18:01.280><c> service.
• services.

Transcript Highlights:

• Then I took a shift in my career when I moved to state service in addiction services.
• , our IPV services, and our recovery services.
• Our caregiver services, but for today, we're really focusing on our adolescent services, which is on
• And the service is for 12- to 24-year-olds. And the service is for 12- to 24-year-olds.
• service regions.

Summary: The meeting opened with approval of the April minutes and brief administrative updates, including notice that House Bill 5447 had passed both chambers of the General Assembly. Speakers reflected on the bill’s key provisions, which include eating-disorder working groups, an evidence-based screening requirement for school-based health centers beginning July 1, 2027, and a DSS-led feasibility process to explore an inpatient psychiatric facility for young adults ages 14 to 21. New staff introductions were also made for the Behavioral Health Advocate’s office and the TCB team. A major portion of the meeting focused on marketing and outreach for urgent crisis centers (UCCs) and the broader youth crisis continuum. Daydream Communications presented research showing low public awareness of UCCs but strong interest once families learn about them, with parents wanting specialized, compassionate care, clear expectations, insurance clarity, and bilingual support. United Way described its parallel work on a statewide crisis continuum marketing toolkit, using the SAMHSA framework of “someone to talk to, someone to respond, and somewhere safe to go,” and outlined plans to distribute consistent messaging through websites, social media, flyers, and community venues. Members emphasized coordinating with existing platforms and ensuring the marketing reflects the actual experience at UCC sites. DCF then presented on adolescent substance use services, citing data showing high need and low treatment access among Connecticut youth. The department reviewed its ASAM-based continuum, SBIRT efforts in outpatient psychiatric clinics, medication-assisted treatment access, and statewide services such as MST, MST emerging adults, STRIDE, multidimensional family therapy, youth recovery supports, and the AIM matching tool. A new young people peer support program was highlighted, with referrals accepted from families, hospitals, community providers, DCF, youth diversion, and the judicial branch. Questions addressed parent consent, peer matching, and whether the AIM tool could be linked through 211. The meeting concluded with an update from the Connecticut Suicide Advisory Board and its regional boards and grant-funded initiatives. Presenters reviewed the state suicide prevention plan, regional coalition work, postvention response, lethal means safety efforts, and the 988 capacity improvement grant that supports Connecticut’s centralized 988 contact center at United Way. They also shared youth suicide risk data from the Connecticut Youth Risk Behavior Survey, noting recent declines in reported suicidal ideation and attempts, and provided resources for training and materials. No formal votes were taken beyond the approval of the April minutes.

Transcript Highlights:

• services, case management, and physical and occupational therapy services to children under age 21 with
• On being able to have the funding and support that they need for prevention services, frontline services
• I'm the State Medicaid Director at the Department of Health Care Services. of Health Care Services.
• Yet to integrate waiver services into managed care nor to determine which services should remain in fee-for-service
• for housing support services.

Transcript Highlights:

• not lower St Cay Valley but the service not lower St Cay Valley but the other<00:03:47.760><c> service
• and the St Louis County County Services and the St Louis County Services<00:07:05.639><c> to</c><00:
• </c><00:09:24.600><c> uh</c> money that would help uh Services uh money that would help uh Services uh
• /c><00:14:12.480><c> in</c><00:14:12.680><c> addition</c> Services the fire service um in addition Services
• primary service area ambulance services primary service area with<00:18:40.039><c> entities</c><00:18

Committee: Senate Health and Human Services

Transcript Highlights:

• </c><00:03:05.519><c> to</c> So there are a range of services to So there are a range of services to
• Some of these services are schools.
• The last service and support within schools is the School Link Behavioral Health Services.
• </c><00:35:27.280><c> Um,</c> outpatient service benefits. Um, outpatient service benefits.
• We need more of the services. We it. We need more of the services.

Transcript Highlights:

• This is due to the increase in statewide services such as legislative auditor fees, civil service fees
• Operating services are about 0.5% of the department budget. Professional services, 1.5%.
• services for young people?
• , 24-hour care for any behavioral health services, physical health services.
• services, they provide service.

Committee: House Appropriations

Transcript Highlights:

• My family and I have spent most of our lives in public service.
• I'm the executive director for Mystic Valley Elder Services.
• Home care services and those individuals who provide those services.
• The Secretary of Health and Human Services.
• So I needed those services, right?

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:

• which provide fixed-route and demand-response service, generally bus service, outside the MBTA service
• We are an organization that has regulatory responsibility for vehicle services, driver services, driver
• We have a very bare-bones Registry service center at the service plaza on the Pike, but they're very
• So our service model is on the license side of the house for license-related service, permits, license
• And we've shifted our service delivery model to focus on all-day service, a reflection of the post-pandemic

Committee: Joint Joint Committee on Transportation

Summary: The Joint Committee on Transportation held an informational hearing with invited testimony from MassDOT leadership, the MBTA, Massport, and the state’s Federal Funds and Infrastructure Office. MassDOT officials outlined work across highways, rail and transit, the Registry of Motor Vehicles, and aeronautics, emphasizing major capital spending, bridge and roadway programs, transit grants, rail expansion, airport safety, and modernization efforts. They highlighted Chapter 90 and municipal grant programs, the Compass Rail and West-East Rail efforts, RMV upgrades such as electronic titles and driver licensing systems, and aeronautics work on airport pavement, drones, and advanced air mobility. Committee members focused on safety, service access, and project implementation. Questions to MassDOT covered automated enforcement and rising roadway fatalities, the Allston multimodal project’s federal funding, Complete Streets access for rural communities, and South Coast Rail staffing and future electrification. The RMV was asked about the Work and Family Mobility Act, Real ID demand, and appointment access, especially in Metro West. Members also raised concerns about South Coast Rail operations, Keolis staffing, and whether the Stoughton route remains part of future plans; MassDOT and MBTA officials said they are working on staffing, service reliability, and long-term expansion, while noting that nothing is off the table for future rail improvements. MBTA General Manager Phil Eng reported progress including workforce growth, elimination of subway speed restrictions, expanded reduced-fare access, bus network redesign, South Coast Rail launch, and commuter rail signal upgrades. He said the agency is pursuing a new commuter rail operating contract designed to support future regional rail, electrification, and higher-frequency service, while maintaining service and workforce stability amid funding uncertainty. Members also asked about fare collection data privacy and the impact of state funding levels; Eng said the MBTA needs the governor’s proposed funding to preserve service and staffing, and that the fare system’s data are encrypted and handled through a secure vendor system. Massport CEO Rich Davey reported record activity at Logan, Worcester, and the cruise and maritime facilities, along with major capital and climate investments such as sustainable aviation fuel planning, shore power at Flynn Cruiseport, renewable diesel, and expanded ground transportation. He said Massport is planning for continued passenger growth and managing congestion through parking, HOV, and curbside changes, while monitoring federal policy, tariffs, and air traffic control staffing issues. Federal Funds Director Quentin Palfrey described the administration’s efforts to secure federal infrastructure dollars, citing about $9 billion in federal awards since the start of the administration, including major transportation grants for the Cape Cod Bridges, Allston, West-East Rail, North Station drawbridge replacement, roadway safety, and clean school buses. He warned that changing federal policies, grant delays, and possible future congressional actions create uncertainty, but said the office is working case-by-case with municipalities and agencies to protect awarded funds and find alternative financing where needed.

Transcript Highlights:

• One, identify all needed hospitals and services.
• The most frustrating part of this is that many of these services were labeled essential services by the
• Yet I've watched services deteriorate and services close over the years.
• Of wasteful hospital services.
• We can expand access to services quickly and safely.

Committee: Joint Joint Committee on Public Health

Summary: The committee hearing covered a wide range of public health bills, with much of the testimony focused on two major themes: expanding access to care and stabilizing health-related workforces and services. On House 2364, an act relative to medical health and fitness facilities, representatives from Dedham Health and Athletic Club argued for a pilot program recognizing supervised exercise as medicine, saying it could improve outcomes for chronic disease, fall prevention, and mental health while reducing costs. On House/Senate bills concerning community health workers (H. 359/S. 251), multiple witnesses from MACHW, Health Care for All, MHA, Cambridge Health Alliance, Mass General Brigham, Boston Children’s Hospital, Asian Women for Health, and the City of Somerville described CHWs as essential for navigation, trust-building, language access, and addressing social needs, and urged reimbursement by MassHealth, the GIC, and private insurers, along with workforce development measures. One pediatric neurologist also told the committee that losing grant-funded CHW support led to more avoidable ER visits and threatened clinic operations. The committee also heard extensive testimony on hospital closures and essential services. Witnesses including Dr. Alan Sager, MNA President Katie Murphy, nurses from Brockton Hospital and Providence Behavioral Health, and local officials and legislators from Norwood described the loss of hospitals and service lines, especially maternity, pediatric, and behavioral health care, and argued current closure processes are too weak to protect communities. They supported bills such as H. 2460/S. 1503 and H. 2534/S. 1574, which would require earlier notice, community input, stronger state oversight, possible receivership, and limits on reopening or expanding after closures. Testimony emphasized the impact of Steward’s bankruptcy, the closures of Carney and Neshoba Valley, and the need to preserve access to essential services in underserved areas. Several end-of-life and professional regulation bills were also discussed. On H. 2436, Representative Omar Gomez and funeral industry witnesses supported eliminating Office of the Chief Medical Examiner fees for the removal of a child’s body in cases involving children five and under, describing the bill as a small but important relief for grieving families. On H. 2444 and related Senate bills, cemetery and consumer advocates supported legalizing alkaline hydrolysis and natural organic reduction as environmentally friendly after-death options, while cemetery representatives opposed H. 2360, which would allow funeral establishments to operate crematories, arguing cemeteries should retain that role. The committee also heard support for H. 2382, which would exempt dentists and oral surgeons from a new office-based surgical center framework, and for H. 2461, which would create hospital efficiency standards; employers and retailers backed that bill as a way to address rising health care costs. Finally, the committee heard testimony on autism services and hospital governance. On S. 1414, behavior analysts and school representatives said Massachusetts already licenses assistant-level ABA providers but MassHealth does not reimburse them, causing long waitlists and limiting school and family access; an actuary testified that a three-tier ABA reimbursement model could reduce MassHealth costs by up to 6% per child served. Senator Lovely also testified in support of S. 1572, which would require at least one registered nurse on each acute care hospital governing board, arguing nurses’ frontline perspective would improve quality and retention. No votes were taken in the hearing excerpt, but many witnesses urged favorable reports on their respective bills.

Transcript Highlights:

• </c><00:02:18.599><c> compound</c> for Access of basic Services compound for Access of basic Services
• Services would add disability waiver Services would add approximately<00:03:08.319><c> $1</c><00:03:
• </c> much increased demands for our service much increased demands for our service and<00:03:50.959><
• </c><00:04:57.639><c> uh</c> for other important County Services uh for other important County Services
• </c> infrastructure and Emergency Services infrastructure and Emergency Services Klay<00:05:02.880><c

Transcript Highlights:

• Some examples of VR services: In short, whatever services are necessary to help that individual achieve
• services.
• We provide services to adults, some who are looking for vocational services, and actually one of our
• of the services are complete.
• Service hours for the Medallion, 75 service hours, or Academic 100 service hours, or, for either particular

Summary: The Higher Education Budget Subcommittee met for an introductory overview of the higher education programs under its jurisdiction. After roll call and member introductions, Chair Busatta outlined that the subcommittee oversees programs in the Department of Education and the State University System, including vocational rehabilitation, blind services, private postsecondary licensure, student financial aid, career and adult education, the Florida College System, and the Board of Governors. The chair and staff also noted that these areas represent roughly $9 billion in current-year funding. Officials from the Department of Education presented on several programs. Vocational Rehabilitation Director Kelly Rogers described services for adults and youth with disabilities, including pre-employment transition services, job coaching, assistive technology, and employer support; she said the program served more than 55,000 people last year, has no wait list, and reported a return of $7.61 to the economy for every $1 invested. Division of Blind Services Director Robert Doyle explained services from birth through older adulthood, including early intervention, school-age support, vocational rehabilitation, independent living, the Business Enterprise Program for blind vendors, and the Braille and Talking Book Library; he said the division serves about 12,000 people annually and also has no wait list, though some community rehab providers may have one. Tiffany Hurst of the Commission for Independent Education described licensure and consumer protection for independent postsecondary institutions, reporting oversight of about 1,100 institutions and 721 non-degree schools, along with enforcement actions against unlicensed operators. Sean Haskin of Student Financial Assistance reviewed 22 scholarship and grant programs totaling about $1 billion for more than 200,000 students, including Bright Futures, Benacquisto, need-based grants, EASE, EASE Plus, veterans’ scholarships, dual enrollment reimbursement, first responder scholarships, and the Ocoee and Rosewood scholarships. Members asked about surplus funds, marketing, Bright Futures eligibility requirements, and whether EASE awards had changed; Haskin said any unused funds are reverted to the Legislature, that the department markets through schools and the Florida Lottery, and that EASE remained at $3,500 per FTE for the last two fiscal years. Several members raised concerns that students and parents may not learn about aid programs early enough, especially in economically disadvantaged communities. Chancellor Kevin O’Farrell then presented on Career and Adult Education, highlighting record participation in career and technical education, adult education, and apprenticeship. He said about 800,000 secondary students and 480,000 postsecondary students are in CTE, adult education serves about 183,000 learners, and apprenticeship/pre-apprenticeship programs include more than 22,000 participants. He also described the workforce development fund, Perkins, WIOA Title II, the Pathways to Career Opportunities Grant, workforce capitalization grants, CAPE performance funding, and the Pipeline nursing initiative, noting strong NCLEX outcomes and expanded outreach through the Get There, Your Way, Future of Work Florida, and Zello platforms. Kathy Hebda began the Florida College System presentation by emphasizing open access, workforce preparation, statewide reach, and strong enrollment and completion growth, including more than 672,000 students, over 131,000 degrees and certificates, and significant dual enrollment savings for students and families.

Transcript Highlights:

• Thank you for your service. Thank you for what you've done.
• Veterans Service Officers.
• Veterans Service Officers.
• called to service alongside them.
• called to service alongside them.

Committee: Senate Military and Veterans Affairs

Transcript Highlights:

• services, which includes home health aide, rehab therapy, skilled nursing visit services, as well as
• home care nursing services.
• services, which includes home health aide, rehab therapy, skilled nursing visit services, as well as
• home care nursing services.
• Home health agency services include home health aide, rehab therapy, skilled nursing visit services,

Transcript Highlights:

• </c> the 14 high-risk services. the 14 high-risk services.
• </c> stabilization services. stabilization services.
• </c> recovery support services. recovery support services.
• </c> recovery support services. recovery support services.
• We are housing, treatment services, housing, treatment services, community-based<00:53:58.240><c> services

Committees: Senate Health and Human Services , Senate Human Services

Transcript Highlights:

• > we</c> those services and what services we those services and what services we offer<00:11:50.240><
• And if I may, this provider... these services? these services?
• </c> services um so the demand for services services um so the demand for services is<00:34:04.320><c
• </c> services in our Eastern Mountain service services in our Eastern Mountain service region.<00:34:
• </c> services, we may have too many services services, we may have too many services and<01:33:01.199

Summary: The Government Contracts Committee met with a quorum and approved the July 8 minutes. It then deferred several items from the July agenda, including a Kentucky Education Television contract because the vendor was not yet registered with the Secretary of State, and a University of Louisville contract at the university’s request. The committee also deferred a behavioral health memorandum of agreement and later a Department of Community Based Services contract after questions were raised about the scope of services and the need for additional information. The most extensive discussion involved the Seven Counties Services contract with the Department for Behavioral Health, Developmental, and Intellectual Disabilities. Committee members questioned why the state continues to contract with Seven Counties despite its bankruptcy and pension-related liabilities, how the funding split was determined, whether the services are statutorily required, and whether the state or another provider could deliver the services more efficiently. Agency representatives said Seven Counties is the sole provider of core community mental health services in its region, serves about 24,500 people, and that service needs and acuity remain high even as the number served has declined. A cabinet attorney said the bankruptcy dispute is ongoing and involves roughly $20 million in contested retirement contributions, though members suggested the amount may be higher. Members also raised broader concerns about whether local governments, especially Metro Louisville, should contribute more toward services tied to social determinants of health, and whether the contract includes services beyond what statute requires. The committee requested additional information on the contract scope and possible offsets or recovery of unfunded liabilities, and then voted to defer the Seven Counties contract to the next meeting. The committee also heard a separate DCBS presentation on the Youth Villages Intercept program, where staff explained it was selected because it is an approved evidence-based Family First prevention service, provides intensive in-home and foster care stabilization services, and is headquartered in Tennessee but operates across Kentucky; members asked for clarification on Medicaid billing and additional funding needs.

Transcript Highlights:

• We have the Bureau of Drug and Alcohol Services and the Bureau of Homeless Services.
• Services.
• can get into that um service level of can get into that um service level of service<02:50:34.399><c>
• um the services by the Services um the services by the Community<02:55:26.040><c> Mental</c><02:55:26.439
• </c><05:18:53.280><c> that</c><05:18:53.400><c> are</c> services that are the services that are services

Summary: The House Finance Committee’s Division 3 held a public work session on the Behavioral Health budget on February 27, 2025. The chair opened by explaining the schedule, materials, and deadlines for the budget process, and noted there would be no motions or votes in the division that day. Division of Behavioral Health Director Ktia Fox and DHHS CFO Nathan White then walked the committee through the division’s mission, structure, and budget materials, describing the division’s four bureaus: Mental Health Services, Children’s Behavioral Health, Drug and Alcohol Services, and Homeless Services, along with the policy unit. They emphasized the division’s role in oversight, technical assistance, quality assurance, contracting, and the continuum of care from prevention and early intervention through crisis and residential services. Much of the discussion focused on major programs and funding lines, including the 988 Lifeline contract with Headrest, a technical assistance contract with UNH, Medicaid pass-through payments to New Hampshire Hospital and Glencliff, crisis response services, cold-weather homeless responses, housing supports, and the children’s system of care. Members asked about the UNH contract, the 988 program, crisis stabilization centers, and the peer certification program; Fox explained that the peer certification is a training-and-credentialing pathway for people with lived experience to enter community-based behavioral health work, not a volunteer program. The committee also discussed the “Choose Love” program, which Fox said was created after the Sandy Hook tragedy to build resilience and strength-based emotional regulation in schools and communities. On the children’s side, Fox described the system of care account as the place where many contracted services are budgeted, including community mental health centers, care management entities, rapid response services, and residential programs. Members asked about temporary staffing, and Fox said roughly $500,000 in temporary staff costs shown in the current year would not be spent next year because the money came from a nonlapsing appropriation in HB 1573 for oversight of children’s residential services. She also said provider rate increases were a prioritized need but were not funded in the governor’s current budget, and that the Children’s Behavioral Health Resource Center was not funded, resulting in about a $1 million reduction. The session ended while the division was still moving through the children’s behavioral health slides, including questions about the Fast Forward high-fidelity wraparound program and medication management.