Transcript Highlights:

• The Governor argues that disproportionate surges in population in a state that is surging in population
• Again, dealing with that premise, that we're dealing with race neutrality and population, population
• It assumes population changes beyond the 2020 census.
• They are subject to the same population shifts.
• 3% of the population—of where their shifts might be.

Summary: The Senate convened in special session and took up Senate Bill 8D / House Bill 1D, which would establish Florida’s congressional districts. The sponsor, Sen. Gates, explained that the Governor had transmitted a redistricting plan two days earlier and argued that mid-decade redistricting is legally permissible, citing population growth and the Governor’s view that race-based districting is unconstitutional. Much of the floor time was spent in extended questioning about the process, the lack of public hearings compared with prior redistricting cycles, the use of population estimates from the Census/EDR/ACS, compactness scores, and whether the Governor’s office used partisan data or outside consultants. Gates repeatedly said he was relaying the Governor’s proposal and legal theory rather than offering his own legal opinion, and he said any constitutional challenge would be for the courts. A major portion of the debate focused on the U.S. Supreme Court’s newly issued Calais decision and its implications for the Fair Districts Amendment and the Voting Rights Act. Senators questioned whether the decision struck down Section 2 of the Voting Rights Act, whether it affected Florida’s constitutional ban on partisan gerrymandering, and whether the Legislature should postpone action to review the ruling. A motion to temporarily postpone the bill failed by voice vote and then by recorded vote, 12 yeas to 23 nays. Senators also raised concerns that the proposed map cracked minority communities, including Latino and Black populations in Central Florida and Tampa Bay, and that it would produce a heavily Republican-leaning map despite the state’s voter registration mix. After debate on the Senate bill, the chamber substituted the identical House companion bill, read it a third time, and proceeded to final debate. Opponents argued the map was an illegal partisan gerrymander, was based on assumptions rather than verified data, and would likely lead to litigation. Supporters maintained that the Governor had authority to propose a congressional map, that the plan was race-neutral, and that the Legislature could accept, reject, or amend it. The transcript ends during continued debate on House Bill 1D, with no final vote shown in the excerpt.

Transcript Highlights:

• of a violent population.
• of a violent population.
• We're just monitoring population.
• That population today is about 3,000.
• Q Hwin: ...On page 4, we list the three main juvenile justice populations alongside its sub-populations

Bills: SB1

Keywords: campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards

Summary: The committee heard a Legislative Budget Board presentation and then testimony from the Department of Public Safety on the Article 5 public safety budget. LBB said DPS’s 2026-27 recommendation totals $3.7 billion, down from the prior base, while FTEs rise by 856.7. Major items included increased funding for driver license services and customer support, new trooper funding and recruit schools, crime lab operations, border security, and reductions tied to one-time facility, vehicle, and aircraft spending. The committee also discussed new riders, including one to lapse unused trooper funds and require reporting after recruit schools. Members focused heavily on driver license operations, questioning why prior staffing increases and a prior efficiency study had not solved long wait times, high call abandonment, and appointment delays. DPS and LBB said the agency receives about 22,000 calls per day, answers only about 9 percent, and is seeking more staff plus technology upgrades such as automation, kiosks, and better online processing. Senators also raised concerns about rural access, REAL ID document requirements, and whether the department should rethink its processes rather than simply add employees. DPS leadership then described needs for the Williamson County training academy, additional troopers, Capitol and Alamo security, border operations, aircraft and vehicle replacement, and regional headquarters in El Paso and San Antonio. Members asked about Operation Lone Star costs, overtime, pursuit safety, border crime, oilfield theft, and sexual assault kit and toxicology backlogs. DPS said border deployments remain focused on criminal threats, that overtime is partly driven by deployments and staffing shortages, and that the sexual assault kit backlog is down to 118 cases with a goal of zero by April. The committee later recessed and began the Texas Alcoholic Beverage Commission budget presentation, where LBB outlined a $115.1 million recommendation and noted ongoing costs for the AIMS technology project.

Transcript Highlights:

• So in Medicaid, for older population.
• As we've discussed, we population.
• population versus a 90%. population versus a 90%.
• assess the entire expansion population. assess the entire expansion population.
• Who do we know within that population Who do we know within that population already<01:32:38.320

Keywords: 1187, senate, all

Transcript Highlights:

• , patient population, and the business community.
• the most vulnerable population.
• So, so... ...population of nursing and other health care providers?
• This is about centering the patient population.
• The population at Pappas is a mostly non-ambulatory population, and lack of movement impacts their quality

Keywords: 995, all

Summary: The special legislative commission on the future of Pappas Rehabilitation Hospital for Children held a hybrid public hearing focused on the hospital’s future, admissions, staffing, infrastructure, and whether the facility should be preserved, expanded, or reimagined. Opening remarks from legislators, commissioners, parents, and union representatives emphasized that Pappas provides a unique combination of medical, rehabilitative, educational, and residential services for children with complex needs, and several speakers argued that the hospital is effectively being depopulated through reduced admissions and ongoing discharges despite public assurances that it remains open. Multiple speakers urged the commission to extend its authorization and continue its work before any closure or major change can occur. Testimony from labor leaders, including AFSCME, SEIU Local 509, and the Massachusetts Nurses Association, described a “silent closure” in practice, with staff reporting confusion about the hospital’s status, declining census numbers, blocked admissions, and uncertainty about the workforce’s future. They called for immediate action to stop admission denials and unnecessary discharges, and some proposed short-term solutions such as temporary modular structures to address infrastructure barriers and allow admissions to resume. Parents and former patients testified that Pappas provided life-changing independence, specialized therapy, and campus-based supports that they said could not be replicated elsewhere, and they criticized alternative placements as inadequate. Commissioner Robert Goldstein of the Department of Public Health said the administration supports keeping Pappas open and funded while the commission works, but he argued that admissions must comply with hospital-level-of-care rules and that the campus’s deteriorating infrastructure limits the kinds of children who can safely be served there. He said the department is continuing admissions for appropriate patients, working to expand outreach and services, and exploring long-term options, including broader statewide models of care. Commissioners pressed him on whether discharge status or lack of a clear discharge plan had been used as a barrier to admission, and requested de-identified data on patients recommended for admission but denied. No formal votes were taken during the hearing.

Transcript Highlights:

• It's very difficult with this population.
• What is the percentage of our population that is getting this... ...population who are eligible for that
• But we also have the challenge of a population that, particularly within our long-term population, don't
• It could be expanding to new populations.
• It could be expanding to new populations.

Summary: The subcommittee heard presentations from the Department of State Hospitals (DSH), the Commission for Behavioral Health, and the Department of Health Care Services (DHCS) on budget proposals and implementation updates. DSH outlined its proposed 2026-27 budget, including funding for patient operating expenses, IST solutions savings, conditional release program costs, LPS bed allocation changes, electrical infrastructure projects at Napa and Patton, SB 380 transitional housing feasibility work, and expanded dental services at Metropolitan and Patton. DSH also reported that it has met court-ordered IST treatment benchmarks in the Stiavedi v. Clinton case, with average time to initiate treatment down to about five days and pending placements reduced to roughly 250, while noting that Proposition 36 could increase referrals and SB 1323 may divert some individuals earlier into community-based treatment. Members asked about rising outside hospitalization costs, Medicare enrollment, the timing and structure of capital projects, and whether IST solution funds are being fully used; DSH said the savings reflect slower-than-expected ramp-up of community programs and that the Central California FACT replacement program is still on track for January 2027 activation. The Commission for Behavioral Health described its role under the Behavioral Health Services Act (BHSA), including data, evaluation, grantmaking, technical assistance, and transparency work. It highlighted the new statewide Innovation Partnership Fund, a five-year, $20 million-per-year program with small and large grant categories; the first RFA drew strong interest, with more than 400 questions and over 1,000 bidders’ conference participants. The Commission also discussed a proposed extension to spend down about $4.1 million remaining for the Alcove Youth Drop-in Center grants so sites can finish implementation and Stanford can complete the final evaluation. Members asked about grant duration, whether projects can be renewed, what qualifies as innovation, and whether the fund could support service delivery rather than awareness campaigns or training; the Commission said awards are expected to be three-year contracts and that proposals must be new or meaningfully expanded approaches that support BHSA priority populations. DHCS reviewed major behavioral health changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, updated specialty mental health access criteria, and new substance use treatment standards based on ASAM’s fourth edition. DHCS reported strong contingency management results, with more than 13,000 members served and 95% testing negative for stimulant use during treatment, and said 21 Indian health care providers have been approved to offer traditional health care practices. It also described BH Connect initiatives such as the $1.9 billion access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation by four counties, and transitional rent services. On BHSA implementation, DHCS said it is not tracking individual county contract cuts but is monitoring county plans and statewide outcomes, while stakeholders raised concerns about local prevention and service gaps. DHCS also outlined its H.R. 1 implementation strategy, including outreach, streamlined renewals, exemptions for disabled, substance use, and medically frail individuals, and proposed clinic navigator and outreach funding; it said it has not yet produced a focused estimate of H.R. 1 impacts on behavioral health populations. The discussion ended with DHCS noting that B-CHIP bond funding has supported 437 infrastructure projects, creating 546 new or expanded facilities and more than 9,500 residential beds across the state.

Transcript Highlights:

• And specifically we did it for the long-term care population.
• So the thought was, let's try it for a different population. Thank you.
• Let's try it for a different population.
• All of those services different than I-Budget for this population.
• A nurse or a social worker and experience with the IDD population.

Summary: The Health and Human Services Committee received an overview of Florida’s intellectual and developmental disabilities (IDD) managed care pilot, created by legislation in 2023 to test whether a managed care model could integrate Medicaid medical services with iBudget waiver home- and community-based services for adults in pre-enrollment categories. AHCA explained the existing system, the pilot’s scope in Regions D and I, and the rollout timeline, including federal approval, contract execution with Florida Community Care, and the October 2024 go-live. Officials reported that, as of early February, 370 individuals had been sent for onboarding and 168 more were in queue, with about $35.8 million of the appropriation remaining. APD also clarified the difference between the pre-enrollment categories and the waiver waitlist, and noted that crisis cases can be enrolled more quickly depending on eligibility and funding. Florida Community Care described the pilot as a comprehensive managed care model offering medical, long-term care, and iBudget services, plus enhanced benefits such as bed-hold days, caregiver transportation, and help with legal guardianship costs. The plan said it uses one care coordinator, a 1:18 coordinator ratio, a face-to-face assessment within five days of enrollment, and 180 days of continuity of care for existing providers. The company emphasized that it is recruiting providers by offering higher rates than some iBudget rates, lower administrative burden, and network adequacy incentives, while APD said it continues to monitor provider supply and demand and recruit across service types and regions. Members repeatedly questioned whether the pilot’s costs, provider rates, and service levels were truly comparable to the iBudget system, and AHCA and APD said it was too early to draw firm conclusions because claims data are still lagging. Committee members also raised concerns about communication, enrollment delays, provider shortages, and whether the pilot could scale statewide. APD said it has used letters, phone calls, texts, emails, and community meetings to reach eligible individuals, and that some delays stem from required assessments, Medicaid eligibility checks, and level-of-care determinations. Several members asked for more detailed comparisons of costs and provider reimbursement between the pilot and iBudget, and APD said it would provide additional data. Public testimony at the end was strongly critical of managed care, with a participant and his mother describing poor service, transportation failures, and loss of control under prior managed care arrangements, and urging the committee not to expand such a model without safeguards. No votes or formal committee action were taken before adjournment.

Transcript Highlights:

• Because you need to have, you know, one population needs to be in one wing, separate from another population
• We've got 19 in the portfolio, but only 12 of them have populations currently.
• We've talked a lot about the aging population.
• To get more insight into the female population, both state and county.
• into the female population, both state and county.

Keywords: 995, all

Summary: The Special Commission on Correctional Consolidation and Collaboration met on October 17 with members attending in person and virtually. The commission approved the September 15 minutes and then heard a detailed presentation from DCAM Commissioner Adam Bakey on the correctional facilities portfolio, including the age and condition of DOC and sheriff facilities, deferred maintenance, ADA compliance, decarbonization mandates, and how capital funding is allocated. Bakey said the correctional portfolio includes 36 facilities, with average ages over 50 years, and described how older, rapidly built facilities from the tough-on-crime era now face significant maintenance and replacement needs. He also explained the distinction between catch-up deferred maintenance and ongoing keep-up needs, and noted that construction costs and code thresholds have made projects more expensive. Commissioners and sheriffs asked about ADA requirements, aging and overcrowded facilities, hazardous materials, parts availability for obsolete systems, plumbing and health risks, and whether a newer, more modern correctional facility should be considered. Bakey said many projects trigger broader code upgrades, that some dormant facilities remain in the portfolio, and that health-care and correctional construction are among the most expensive building types. He outlined current funding, including annual deferred maintenance allocations for DOC and formula-based five-year commitments for sheriffs, plus a new competitive capital program for larger sheriff projects. He also explained the Designer Selection Board and “house doctor” process used to procure architects and engineers. The commission then shifted to planning its next steps, focusing on public input. Members agreed the next meeting should likely be a public hearing or include public testimony, with possible input from people with lived experience and consideration of facility tours, especially of women’s facilities such as Framingham. Members emphasized the need to define the commission’s scope clearly so testimony stays focused on structural and consolidation issues rather than all correctional policy topics. The meeting ended with plans for the co-chairs to coordinate the public process and a motion to adjourn, which passed without opposition.

Transcript Highlights:

• The Governor argues that disproportionate surges in population in a state that is surging in population
• Again, dealing with that premise that we're dealing with race neutrality and population, population being
• It assumes population changes beyond the 2020 census.
• It assumes population changes beyond the 2020 census.
• They are subject to the same population shifts.

Summary: The Senate convened in special session and took up Senate Bill 8D, later substituting identical House Bill 1D, to establish Florida’s congressional districts. The opening prayer and Pledge of Allegiance were followed by procedural remarks, then extensive floor discussion focused almost entirely on the redistricting proposal, its timing, and its legal basis. Senator Gaetz, explaining the bill, said the Governor had transmitted the map two days earlier, argued that mid-decade congressional redistricting is not prohibited by law, and said the Governor’s stated reasons were to address population growth and to draw race-neutral districts. He also said the legislature could accept, reject, or amend the proposal. Much of the debate centered on the U.S. Supreme Court’s recent Louisiana decision and whether it affected Florida’s Fair Districts Amendment and the Voting Rights Act. Senators Smith, Rouson, Sharief, Polsky, Arrington, Bracey Davis, Bernard, Nathan, and others questioned the short notice, lack of public hearings, the use of partisan data, the absence of sworn testimony, and whether the map diluted minority voting strength or fragmented communities of interest. Gaetz repeatedly said he was not offering legal opinions, that the Governor’s counsel believed the Fair Districts race-based provisions were inconsistent with federal law, and that any legal challenge would be for the courts. He also said the Governor’s mapmaker reported using census and demographic data, along with political data as one of many inputs, and claimed the map’s compactness was comparable to the current map. A motion by Senator Smith to temporarily postpone consideration of the bill failed on a 12-23 vote. After the Senate returned from a 30-minute break to review the new Supreme Court decision, debate continued. The chamber then substituted HB 1D for SB 8D, read the House bill, and advanced it to third reading. The transcript ends during debate on final passage, with Senators Rouson and Bernard speaking in opposition and arguing the map was procedurally rushed, legally vulnerable, and politically motivated.

Transcript Highlights:

• population The rising inmate population you just heard about at TDCJ, the monthly average population
• of a violent population.
• That population today is about 3,000.
• need to see within the inmate population.
• For the total number of referrals, while the other populations are projected for the average populations

Bills: SB 1

Keywords: campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards

Summary: The Senate Finance Committee heard a presentation from the Legislative Budget Board on the Texas Department of Public Safety’s Article 5 budget. LBB recommended $3.7 billion in all funds for 2026-27, a 5.2 percent decrease from the base, while FTEs would rise by 856.7. Major items included funding for driver license services, DPS facilities, troopers and recruit schools, crime labs, vehicle and aircraft operations, border security, and rider changes. The committee also reviewed DPS exceptional items not included in the recommendation, including additional staffing, technology, and facility requests. Members focused heavily on driver license operations, criticizing long wait times, call abandonment, and repeated staffing increases without clear process improvements. LBB said the agency’s call-answer rate was about 9 percent in fiscal 2024, with average hold times around 34 minutes, later reduced to roughly 22-25 minutes. Senators questioned whether more FTEs alone would solve the problem and urged a broader efficiency study and better use of technology. DPS officials said they were pursuing process changes, including appointment-system upgrades, online pre-population of forms, and remote issuance options, while noting that Real ID requirements and population growth continue to drive demand. DPS leadership then outlined the agency’s priorities: completion of the Williamson County training academy, recruitment and retention of troopers, capital needs for vehicles and aircraft, and expanded responsibilities at the Capitol complex and the Alamo. Officials said the new trooper funding would help address staffing shortages, public safety, and border operations, and that overtime and deployment patterns had been adjusted to reduce burnout and improve flexibility. They also discussed Operation Lone Star, saying DPS spending is largely overtime, travel, and fuel, and that the agency continues to coordinate with federal partners while awaiting clarity on possible federal reimbursement for border security costs. Senators also raised concerns about oilfield theft, cartel activity, high-speed pursuits, bilingual pay, and the Texas Ranger Hall of Fame and Museum, and DPS said it would follow up on some of those issues.

Transcript Highlights:

• The juvenile population at the top.
• Each community facility serves a unique population.
• Our population was at around 230. And July... Our population was at or around 230.
• Obviously, population growth.
• Detention is a population-based service.

Summary: The committee began with a work session on juvenile rehabilitation institution capacity, services, and staffing. DCYF Assistant Secretary Jennifer Redmond described overcrowding at Green Hill School and Echo Glen, driven by longer adult-style sentences extending past age 25, limited community placements, and small facility sizes. She said Green Hill remains above safe operating capacity, but staffing, injuries, large-scale aggression, and use-of-force incidents have improved over the past year. She also discussed Harbor Heights, a new 46-bed flex facility that had opened with 22 youth and would expand once a medical trailer arrives, as well as community transition services, vocational programming, behavior management reforms, and a request for more resources for mental health-focused facilities and staffing. Members asked about success metrics, developmental disability screening and supports, college access at Echo Glen, Mission Creek planning, and gender-responsive programming; Redmond said JR uses assessments, family involvement, and specialized living units, and that some requested funding had already been secured for returning a girls’ program at Echo Glen. The committee then heard from Team Child and the Youth Action Coalition. Greta Schultz said youth perspectives should guide system reforms and identified key concerns: overuse of sentence extensions, underuse of community transition services, continued criminal referrals from Green Hill to Lewis County, limited family contact, inadequate mental health access, and unequal education opportunities, especially for young women at Echo Glen. Justella Gonzalez, a former system-involved youth, said her time in county and state facilities was harmful, with staff mistreatment, poor education, limited therapy access, and humiliating restraint practices; she also said girls at Echo Glen lacked the same college opportunities as boys at Green Hill. Committee members asked for follow-up on county versus state experiences and on telehealth mental health services. The next presentation covered county-level services for youth involved or at risk of involvement with the justice system, led by juvenile court administrators Christine Simon-Smeyer and Judge Rachel Anderson. They outlined the juvenile court continuum from prevention and truancy work through diversion, detention alternatives, community supervision, and disposition alternatives, emphasizing evidence-based, trauma-informed, and restorative practices. Clark County was used as an example of a court that partners closely with schools and community providers, uses risk assessments and wraparound behavioral health probation, and offers detention alternatives without electronic home monitoring. They said most courts do not use detention for status offenses, but instead use court involvement to connect youth to services. They also described funding, noting that courts rely on a mix of state block grant and local dollars, and that recent cuts to early intervention funding reduced programming and staff hours. Members asked about detention for truancy, developmental disability identification, restorative justice practices, and the juvenile block grant. Finally, DCYF Assistant Secretary Nicole Rose and Katie Warren of the Washington State Association of Head Start and ECAP discussed child care and early learning impacts from recent policy and budget changes. Rose said Fair Start for Kids investments had increased child care access, provider participation, and kindergarten readiness, with more than 60,000 children in Working Connections care and rising ECAP enrollment and provider capacity. She said recent reductions will raise most family copays in 2026, delay eligibility expansions, eliminate some expanded eligibility categories, reduce ECAP slots by about 3,000, delay entitlement timelines, and cut provider supports such as rate increases for centers, complex-needs grants, trauma-informed and dual-language incentives, and infant/early childhood mental health consultation. Warren emphasized ECAP’s role in family stability, workforce participation, and reducing poverty, and noted its two-generation approach to supporting both children and parents.

Transcript Highlights:

• <00:08:44.399> would known as our expansion population would known as our expansion population
• <00:20:18.160> Um, in the MA expansion population. Um, in the MA expansion population.
• hard-to-reach populations. hard-to-reach populations.
• apply to that population? apply to that population?
• Um, one of the key population.

Keywords: 919, house, all

Summary: The Department of Human Services briefed the committee on how the federal HR1 law will affect Minnesota Medicaid and related programs. Budget Director Elise Bailey said the 900-page bill makes sweeping changes that will reduce coverage, increase administrative complexity for counties and tribal governments, raise uncompensated care for providers, and reduce federal funding. She reviewed current Medicaid spending and enrollment, emphasizing that the largest impacts will fall on the adult expansion group (adults ages 21-64 without children), which currently receives a 90% federal match. Bailey walked through several major provisions: work and community engagement requirements for the adult expansion group beginning January 1, 2027; six-month renewals for that same group; shorter retroactive coverage periods; new cost-sharing requirements for expansion enrollees above 100% of poverty; narrower Medicaid eligibility for certain lawful noncitizens; limits on provider taxes and state-directed payments; a reduced federal match for emergency medical assistance; and tighter federal rules on payment error penalties. She said many provisions require state law changes and additional federal guidance, and she cited research from Georgia suggesting work requirements increased administrative burden and caused coverage losses without increasing employment. The department estimated fiscal effects including reduced Medicaid spending in some areas but higher state costs in others, such as MinnesotaCare, emergency medical assistance, administrative systems, and provider uncompensated care. Bailey said the immigration-status changes would shift some people from Medical Assistance to MinnesotaCare, and that provider-tax and state-directed-payment changes could reduce future funding to hospitals and other providers. No votes or formal committee actions were taken in the portion provided; the presentation was informational and the department indicated it would return with proposed state-law language as needed.

Transcript Highlights:

• march towards being the largest population in the state of California.
• And will help provide services to our aging and disabled populations.
• This is a massive population.
• Recruitment will be a huge need in the future, as our population ages.
• Without Home Safe, we will add to the homeless population each year.

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• And we had 1.4% of our population, excuse me, 920,000 of our population on Medicaid.
• ,<00:04:19.680> excuse And we had 1.4 of our population, excuse And we had 1.4 of our population
• <00:04:21.440> on me, 920,000 of our population on me, 920,000 of our population on Medicaid
• ,<00:04:53.199> get improve the health of population, get improve the health of population
• improving the health population. improving the health population.

Keywords: 00:00 - Call to Order/Roll Call 01:38 - Discussion of 26RS SCR 9 22:00 - Roll Call Vote on 26RS SCR 9 23:15 - Discussion of 26RS SJR 23 33:20 - Roll Call Vote on 26RS SJR 23 35:18 - Adjournment, 958, all

Summary: The House Standing Committee on Health Services met with a quorum and first heard Senate Concurrent Resolution 9 from Sen. Steve Meredith. He argued that Kentucky’s Medicaid system is too costly and bureaucratic, saying spending has grown dramatically and that managed care organizations do not align with improving health outcomes. His proposal would create a feasibility study for a five-year pilot of an “accountable community healthcare organization” in three area development districts, with a locally owned, nonprofit, provider-driven model intended to reduce costs, address social determinants of health, and keep savings in the community. Members asked about how the model would differ from MCOs, administrative costs, eligibility changes, and implementation costs; Meredith said the model would eliminate preauthorization barriers, rely on provider and community risk-sharing, and could be funded initially through existing grant opportunities. The committee then voted unanimously to report SCR 9 favorably. The committee next took up Senate Joint Resolution 23, the “Food is Medicine” resolution, introduced by Sen. Shelley Funke Frommeyer and Dana Feldman of the Kentucky Department of Agriculture. They described the resolution as part of a broader wellness and rural prosperity effort, emphasizing that nutrition should be treated as part of health care and that Kentucky agriculture can support better health outcomes through local, healthy food. They said the effort grew out of task force work and regional listening sessions and is intended to build a foundation for continued collaboration between hospitals, agriculture, and state agencies. Members expressed support for the concept and the partnership approach, and the discussion highlighted using evaluation and shared learning to expand the initiative.

Transcript Highlights:

• which populations we were talking about. which populations we were talking about.
• . >> GP as in general population. >> I'm sorry, general population.
• risk to the population. risk to the population.
• That is not acceptable. separated from the population. And we do separated from the population.
• available to general population. available to general population.

Keywords: 912, senate, all

Summary: The working group on restrictive housing met with a quorum present, approved the August 21, 2025 minutes, and adopted a procedure to take public testimony on each agenda item with a two-minute limit per testifier, with some flexibility for follow-up questions. The main presentation came from the Department of Corrections and Rehabilitation on restrictive housing policies and a recent outside assessment of mental health care practices at HSCF and OOTC. DCR said the assessment found strengths such as consistent medication administration and staff commitment, but also identified major problems including outdated workflows, staffing shortages, inadequate physical plant conditions, overuse of suicide/safety watch for personal safety issues, and a need for more individualized treatment plans. DCR described several corrective steps already underway: filling a long-vacant high-level mental health administrator position, adjusting evening medication passes, working with DOH on transfer and referral workflows, planning a new electronic medical records system and revised screening tools, and pursuing additional training for ACOs and mental health staff. For OOTC, DCR said the facility is overcrowded and decrepit, needs a better screening tool, and requires more mental health-specific training and staffing. For HCF, DCR said the layout limits confidential assessments and provider access, and that the proposed consolidated healthcare unit would add 43 beds, private exam rooms, and a de-escalation room. DCR also said the new unit could serve acute and chronic suicide/safety watch needs and possibly some inmates with dementia, Alzheimer’s, or significant cognitive impairment. The discussion then focused on Act 292, which DCR said is difficult to implement as written. DCR said the bill aligns with DOJ, NCCHC, and ACA guidance in defining restrictive housing, limiting duration, requiring reviews, identifying vulnerable populations, and using step-down units, but raised two major concerns: a requirement to refer vulnerable people to DOH for confinement, and a requirement for clinical assessments every 12 hours by a provider. Members responded that the law should be matched with funding and staffing, and asked what resources are needed. DCR said it submitted a request for 35 positions at a cost of about $8.6 million, and also said funding may be needed for community-based beds and contracted medical services. Members also asked about the current MOA/MOU between DOH and DCR, the working group membership, and the timeline for revisions. DCR said the group includes DCR, DOH, and governor’s office medical advisors, that a first draft is complete, and that the revised agreement should be in place by the end of the year. On staffing, DCR said ACO recruitment classes increased from five to eight, vacancy rates dropped from 34% to 24%, but OOTC still faces a projected $7.1 million shortfall and heavy overtime costs, forcing post closures and program reductions. The meeting ended with continued discussion of screening tools, including DCR’s explanation that current broad questions may over-identify people with substance-use-related symptoms as having serious mental illness, and that a more discrete tool is needed to better identify those with acute needs.

Transcript Highlights:

• to the funding available and determine whether any populations are under-evaluated or underserved.
• Washington does not appear to under-identify any particular population for special education.
• Based on this work, we found little evidence to suggest any particular population was under-identified
• This means that if a district had more special education students than 16% of their student population
• So what would you say is the ability to draw conclusions about underserved populations in that regard

Summary: The JLARC I-900 Subcommittee heard a State Auditor’s Office performance audit on special education services, focused on comparing student needs, district identification practices, and funding. Auditors said Washington does not appear to under-identify any particular population for special education, though districts face ongoing challenges with identification, documentation, staffing shortages, and inconsistent referral tracking. They explained that their analysis used statistical models because the true prevalence of disabilities is unknown, and found Washington districts generally clustered near the national average, with little evidence that any demographic group was systematically under-identified. The audit also found that special education funding has historically been insufficient, with districts collectively covering about $500 million in costs not paid by state or federal sources, and that districts spent about 26% more per student than they received in funding. Auditors noted recent legislative changes that removed the special education enrollment cap and changed the safety net process, but said it was too soon to assess their effects. Their recommendations to OSPI included clarifying what counts as an official special education referral, requiring districts to report referral data even when no evaluation follows, and ensuring the new statewide data system is developed with district input, training, and possibly a mandate for uniform use. OSPI staff said they concurred with the report and appreciated the work of the auditor’s office and JLARC. During member questions, Representative Paulette raised concerns that the audit did not directly examine prevalence of specific disabilities, such as autism and dyslexia, in vulnerable populations or compare Washington’s identification practices to medical and peer-reviewed prevalence data. Auditors responded that medical prevalence is not known in a systematic way, that educational eligibility differs from medical diagnosis, and that the report’s conclusions should not be read as proving no populations are under- or over-identified. No public testimony was offered, and the meeting adjourned.

Transcript Highlights:

• the population that the jail population the population that with<00:30:32.640> us<00:30:32.799
• I’m talking about the pre-trial detaining population, male population.
• I’m talking about the pre-trial detaining population, male population.
• I’m talking about the pre-trial detaining population, male population.
• I’m talking about the pre-trial detaining population, male population.

Keywords: 910, house, all

Summary: The Public Safety Committee held a hearing on House Bill 433, which would appropriate $4 million for Department of Corrections and Rehabilitation re-entry services to connect offenders with community-based services. Director Tommy Johnson said the department supports the bill’s intent but noted the governor’s executive budget already includes $4 million for the same purpose and asked that the measure defer to that budget. Supporters, including the Hawaii Correctional System Oversight Commission, Community Alliance on Prisons, and the ACLU, backed the funding but urged that it be tied to a clear re-entry plan, performance measures, transparency, and regular reporting to the legislature. They emphasized that re-entry should begin at intake and involve community partnerships, housing, treatment, employment, and family reunification services. Committee members questioned the department about current re-entry services, pre-trial detainees, and how the new funds would be used. Johnson said the department’s current statewide re-entry budget is about $1.5 million to $1.7 million, separate from the larger Corrections Program Services Division budget for in-facility programs. He described the proposed $4 million as supporting a mix of services, including a pilot apprenticeship program, substance abuse treatment, navigator or warm-handoff services, and short-term transitional housing. He also said the department already tracks performance outcomes in its annual report and can provide a matrix showing the intake-to-discharge process, program contracts, and volunteer organizations. The discussion also covered pre-trial detainees, electronic monitoring, and mental health services. Johnson said the department has limited jurisdiction over pre-trial detainees but works with courts to seek supervised release when possible; he noted that many requests are denied, though electronic monitoring has improved release rates somewhat. On mental health, he said the jail is not an ideal therapeutic setting for people found unfit to proceed and suggested a secure community-based step-down facility run by the Department of Health for those needing care above what the jail can provide but below forensic-level treatment. No vote or final action on the bill was taken during the hearing.

Transcript Highlights:

• The population of Indiana is about six times New Hampshire's.
• So, the next section is the population served by long-term services report.
• change that to aging population. change that to aging population.
• I have in population served by LTSS. In the first paragraph, I’m missing a word.
• I have in population served by LTSS. In the first paragraph, I’m missing a word.

Keywords: 928, house, all

Summary: The committee approved the previous meeting minutes and then reviewed a draft preliminary report on long-term managed care. The chair explained the report is intended to frame issues and outline legislative options, not make a final recommendation, especially given unresolved questions about the federal One Big Beautiful Bill (OB3). The report’s key issues included the current financing of county and private nursing homes through Medicaid rates, ProShare, MQUIP, and related funding mechanisms, and the concern that those payments could be affected or eliminated under a managed care model. Members also discussed managed care organizations’ role in Medicaid and cited other states’ experiences, noting examples of savings in Florida and Tennessee but higher costs in California. One member raised Indiana as another important comparison, and the committee agreed to add it to the report’s state examples. The committee also reviewed sections on dual eligibility, D-SNP, PACE, and CFI waivers. The chair raised concerns about whether OB3 creates incentives for states to move toward D-SNP and whether federal changes could affect provider taxes, state-directed payments, and intergovernmental transfers. Henry Litman, the state Medicaid director, said he would confirm details on D-SNP incentives and explained that ProShare is based on certified public expenditure rather than an IGT, while county cap financing is the relevant intergovernmental transfer issue. He said IGTs are not going away and that the main risk is whether current financing mechanisms could be preserved if the state later changed course. Members discussed the possibility of a waiver not being granted or renewed and the high fiscal impact that could have on counties and property taxes. The committee then discussed the population that any long-term managed care model should cover. Members agreed that there is no appetite to move developmental disability or acquired brain disorder populations into long-term managed care at this time, and the chair changed the report’s terminology from “elderly” to “aging population.” The chair also noted that the status quo option should reflect the recent shift toward home and community-based services and reduced nursing home utilization since earlier county reports. The report’s four policy options were summarized as: maintain the status quo; pursue D-SNP for dual eligibles, with DHHS potentially submitting an application as early as 2027; adopt an HCBS carveout; or move fully to managed care for the aging population. No final policy recommendation was made, and the committee discussed making edits to the draft before circulation, including adding Indiana, clarifying OB3-related issues, and changing the report title from “final” to “preliminary” or “interim.”

Transcript Highlights:

• I'll describe this in a population.
• The the population population population CIDD<00:03:36.160> population,<00:03:37.000> these
• Medicaid money spent on this population Medicaid money spent on this population and<00:03:57.280
• and health care of the CIDD population and health care of the CIDD population than<00:03:58.960>
• So, this is about 0.3% of the U.S. population. It's about 1.6% of the Medicaid population.

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services met in person, approved the July 15 minutes, and heard a presentation from Dr. Matthew Holder and Dr. Henry Hood of the Lee Specialty Clinic in Louisville. The clinic serves people with complex intellectual and developmental disabilities through a transdisciplinary model that combines medical, dental, behavioral, psychiatric, therapy, and other services under one roof. The presenters argued that this population is large-cost but small in number, often receives little provider training, and is vulnerable to diagnostic overshadowing, overmedication, and missed medical or dental problems. The clinic reported that in Tennessee, payer data showed average costs of about $5,200 per member per month before clinic involvement, with a 44% reduction in overall health care spending after patients were seen, including lower emergency room use, inpatient admissions, and prescription use. They said those savings were measured by the payer, not the clinic, and that the savings accrued to Medicaid or managed care payers rather than the clinic itself. They also shared a case example of a patient who had been placed on hospice but improved after diagnosis and treatment at the clinic. Patient and parent satisfaction were described as very high, generally above 95%. The clinic asked for roughly $5 million to expand into Northern Kentucky, estimating 500 to 700 patients would use the new site and projecting annual savings of about $13 million to $19 million once mature. Members asked about the budget, startup and operating costs, where the savings go, and whether the clinic had considered taking full risk or another value-based model. Senator Meredith and others encouraged the clinic to explore an accountable care or risk-based arrangement, while the presenters said they were open to that discussion but had not pursued it yet. The exchange ended with follow-up questions about the clinic’s overall budget structure and public-private funding mix.

Transcript Highlights:

• So we see that's where we see the spikes in the population.
• and still have a population increase.
• So I don't want to hurt the bear population.
• Do we have the most up-to-date estimate on our Bear population.
• That means I would currently put the bear population around 2,500.

Bills: HB4128, HB3659, HB3270, HB3145

Keywords: wildlife conservation, hunting regulations, mountain lions, black bears, archery season, senior citizens, licensing fees, waterfowl, nonresidents, public lands, farmed cervidae, chronic wasting disease, genetic resistance, wildlife management, agriculture, wildlife tagging, Cervidae family, feral swine, exotic wildlife, conservation

Transcript Highlights:

• property and their jail population property and their jail population currently<00:21:37.840>
• effective population management.
• controls than in the general population. controls than in the general population.
• effective population management.
• population as called in act 282. population as called in act 282.

Keywords: 910, house, all