Transcript Highlights:

• make it harder for a lot of independent pharmacies to be able to deliver specialty drugs to their consumers
• I appreciate this committee's ...to their consumers, many of whom they have served for literally decades
• The 340B program involves manufacturer discounts, not insurer or employer payments or dollars.
• It even could prevent consumers from accessing health care.
• Low-income and vulnerable patients receiving lower payments overall.

Keywords: 995, all

Summary: The committee held a lengthy hearing on a large docket of pharmacy and drug-pricing bills, with most testimony focused on PBM reform, 340B drug discount program protections, specialty medication access, and medication adherence. Chair James Murphy and Senator Paul Feeney opened the hearing and took testimony from legislators, patient advocates, pharmacists, health center leaders, industry representatives, and policy groups. Several speakers described delays, denials, high out-of-pocket costs, and pharmacy closures tied to PBM practices, while others emphasized the importance of community health centers and independent pharmacies in serving patients. On the 340B program, supporters including Senator Eldridge, Senator Payano, Community Care Cooperative, Fenway Health, the Massachusetts League of Community Health Centers, and several community health center leaders argued that bills such as H. 1107 and S. 819 would stop discriminatory PBM and manufacturer practices, preserve contract pharmacy access, and protect safety-net providers that say they reinvest savings into care, pharmacy expansion, interpreter services, behavioral health, and other services. Opponents including PhRMA, the Community Liver Alliance, and a public policy analyst argued the program lacks transparency and accountability, has grown beyond its original purpose, and may benefit large hospitals and for-profit entities more than low-income patients. They urged more reporting and oversight rather than expanding protections. On PBM reform, testimony supported bills including H. 1157, H. 1234, S. 724, S. 831, and related measures that would require rebate pass-through, ban spread pricing, limit steering to PBM-owned pharmacies, and improve reimbursement for community pharmacies. Independent pharmacists and patients said current PBM practices raise costs, create administrative burdens, and threaten access to local pharmacies. PCMA, representing PBMs, opposed the reforms, arguing PBMs lower costs, that plan sponsors choose to contract with them, and that the Health Policy Commission and CHIA should complete their ongoing study before new mandates are adopted. The committee also heard support for H. 1322 and S. 734 on specialty medications, and for H. 781 and H. 1305 on medication synchronization to improve adherence. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• There are both premium and out-of-pocket savings for consumers resulting from this measure.
• And I'll just say, you know, in my nearly 20 years with the... ...consumers resulting from this measure
• This means the Sharp pharmacy team must undertake additional time-consuming steps, including multiple
• SB 1314 strives to ensure commercial spaces near our schools are not consumed by smoke shops, and those
• This includes payments made by a consumer, but also payments made on their behalf in California.

Keywords: 987, senate, all

Transcript Highlights:

• diverting market activity and consumer diverting market activity and consumer spending<01:01:31.960
• c> no consistent consumer protections, no consistent consumer protections, no guaranteed<01:17:21.920
• up to three months of deferred payments up to three months of deferred payments on<01:39:28.320>
• We saw applications<02:35:39.040> and<02:35:39.280> payments applications and payments
• > for For frontline workers payment for For frontline workers payment for workers<03:53:56.200

Keywords: 918, senate, all

Summary: The Senate was called to order, a quorum was established, and remote voting was authorized for several members. The body adopted committee reports except those related to Senate Concurrent Resolution 6, gave Senate File 4067 a second reading, and referred newly introduced bills as listed on the agenda. It also adopted a motion to strike and re-refer House File 3379 to the Committee on Finance, and then moved into special orders and floor debate. The main floor action was on House File 2358, a public safety bill providing enhanced criminal penalties for certain coercion offenses. Senator Lang described it as creating a Minnesota crime targeting sexual extortion of children, including online extortion. Senator Maye Quade supported the bill and spoke about the tragic constituent story behind it. The Senate took a roll call and passed the bill 67-0, with its title agreed to. The Senate then began debate on Senate File 4511, which would clarify Minnesota gambling law to prohibit prediction-market style betting disguised as futures contracts. Senator Marty argued the bill was needed to stop companies such as Kalshi and Polymarket from using futures-contract language to evade state gambling restrictions and to protect existing regulated gambling businesses. Senator Johnson initially offered the A10 amendment to delay action until federal jurisdiction issues are resolved, but withdrew it after debate. He then offered the A8 amendment to preserve longer-term weather-related hedging contracts, which Senator Marty supported as a distinction from short-term, manipulable bets; the A8 amendment was adopted. Debate continued with questions about the bill’s scope, including whether it would reach election-related or financial contracts.

Transcript Highlights:

• <00:15:43.920> the the vendor and the and the consumer the the vendor and the and the consumer
• <00:43:45.280> when continue receiving federal payments when continue receiving federal payments
• I think that will be good for all consumers for that.
• I think that will be good for all consumers for that.
• I think that will be good for all consumers for that.

Keywords: Call to Order and Roll Call- 00:00:00 Approve Minutes from November 13, 2025- 00:00:55 RiverLink Tolling Operations for Louisville Bridges-Quarterhill Testimony- 00:01:48 Staff Report on Veterans’ Centers- 00:26:45 Kentucky Department of Veterans Affairs Response to Staff Report- 0:58:53 Adjournment- 1:18:00, 958, all

Summary: The committee first approved the minutes from the November 13, 2025 meeting and then heard testimony from Quarter Hill, the tolling subcontractor for RiverLink on the Indiana-Kentucky bridge system. Quarter Hill described its role in back-office support and call center operations for the Lincoln, Kennedy, and Lewis and Clark bridges, and said the contract began in 2021 with go-live in September 2023. The company reported that revenue has increased since it took over, customer service response times have improved, and it has been operating at a loss because the contract was based on outdated transaction estimates and did not account for higher-than-expected volume and added support costs. Members questioned Quarter Hill about the role of consultants, the low reported collection rate, and why the company was leaving the contract. Quarter Hill said a single large consulting engineering firm had been hired to help shape the RFP and contract, but argued that consultants and overly detailed requirements can create disputes and hinder efficient service. On collection rates, the company said the reported 85% rate reflects the absence of registration holds and other enforcement tools, and that the remaining unpaid tolls are the hardest to collect. The company also said it had lost significant money on the contract and had reached a change order and termination agreement, while emphasizing that the system itself was functioning well. The committee then received a staff report on Kentucky veterans centers. Staff said quality of care is generally high and staffing has improved, but reported occupancy figures are misleading because they are based on certified beds rather than functional capacity after conversions to single-occupancy rooms and capital projects. The report said actual occupancy is closer to 85% than the commonly reported 56%, and that increasing occupancy would not necessarily increase revenue because the state’s cost of care exceeds reimbursement and private-pay revenue. Recommendations included adopting functional occupancy reporting, continuing the move to single-occupancy rooms, reviewing modernization needs at Thompson Hood, including Eastern Kentucky in planning, and referring the Radcliffe HVAC procurement and installation to the Auditor of Public Accounts and Attorney General for review.

Transcript Highlights:

• under Kentucky consumer protection law. under Kentucky consumer protection law.
• > Data consumer the Kentucky Consumer Data consumer the Kentucky Consumer Data Protection<00:20:30.280
• That continuation of protecting consumer That continuation of protecting consumer data<00:20:59.720
• There one of those consumer protections.
• It requires consumers to operators.

Keywords: 958, all

Transcript Highlights:

• Current procurement and grant-making processes are needlessly complex, and payments.
• Procurement and grant-making processes are needlessly complex, and payments for services are often delayed
• Opening more pathways for wineries to connect face-to-face with consumers is critical for supporting
• Opening more pathways for wineries to connect face-to-face with consumers is critical for supporting
• They're connected to the consumers through the farmers' market.

Keywords: 988, house, all

Transcript Highlights:

• AS THE SLIDE SHOWS FOR STATUE FOR THE RELEASE OF THE SECOND QUARTER PAYMENT THE PAYMENT FILE FOR CROSSCHECKING
• PAYMENT FILE.
• , WERE THERE ANY STUDENTS ON THE SECOND QUARTER PAYMENT FILE NOT ON THE FIRST QUARTER PAYMENT FILE FOR
• PAYMENT TO BE RECEIVED?
• ALL INVOICES OUT THE FORM OF PAYMENT, JUST A LITTLE BECAUSE NOT ALL INVOICES OUT THE FORM OF PAYMENT

Transcript Highlights:

• Tier two are your per-child, per-month payments.
• And then that led into the final development of the Tier 1 and Tier 2 payments.
• The payment for these would be a standard equal payment monthly. CBCs can count on this coming in.
• Tier 2 is the per-child, per-month payment.
• to you, like what your actual cost would be based on what your payment would be.

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

Transcript Highlights:

• But they're still getting, for example, in DSGS a payment just for being in the program.
• ELRP customers don't get a payment Getting, for example, in DSGS a payment just for being in the program
• ELRP customers don't get a payment just for being in the program.
• Your NBT is just screwed over the consumers who had solar, and they're getting less credits.
• that consumer affairs branch.

Keywords: 988, house, all

Transcript Highlights:

• The conference report also adds consumer protections by requiring disclosures to the purchaser when warranty
• The more plumbers you have in any business, the more it is going to drive the cost down to help consumers
• Many have invested their own resources into direct-to-consumer sales, on-farm processing, and new markets

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: recording, privacy, notification, direct conversation, law enforcement, first responder, penalties, 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

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: recording, privacy, notification, direct conversation, law enforcement, first responder, penalties, 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

Summary: The House convened with a quorum, opened with prayer, the pledge, and a national anthem performance, then moved through several personal privileges and recognitions. Members welcomed a student cancer survivor and entrepreneur, Bella of Brave Bella Bead Company, and also recognized a new legislative assistant, a page leaving for college, and a resolution honoring National Mississippi River Day. The chamber also received conference committee reports and enrollment reports, and returned some previously failed measures to the calendar, including H.R. 119 and H.B. 410. The main floor action centered on a series of Senate concurrent resolutions, most of which were adopted overwhelmingly. These included SCR 59 on re-evaluating flood maps and insurance rates tied to the Comite River Diversion Canal, SCR 61 urging higher reimbursement for behavioral health crisis centers, SCR 62 calling for review of school-zone safety and speed limits, SCR 68 creating a blockchain and digital innovation task force, SCR 69 encouraging continued research to reduce sugarcane burning, SCR 70 supporting the Major Richard Star Act for medically retired combat-wounded veterans, SCR 54 supporting the Mississippi River Basin Fishery Commission Act, SCR 55 designating the Peggy Martin Rose as the official state rose, SCR 64 creating a construction manager-at-risk task force, SCR 75 studying a Louisiana maneuvers museum and trail, and SCR 80 creating a task force on the minimum foundation program and long-term teacher pay funding. Most passed with little or no opposition, with SCR 84 on earthquake seismic activity in several parishes amended to adjust task force membership before final adoption. The House also heard a personal privilege statement honoring the late Ponder P.C. Clinton Jr., a noted Black farmer, cattleman, and community leader in Shreveport’s Cedar Grove neighborhood, and expressed condolences to his family. Later, members received a hurricane-season reminder from Rep. Jay Galle about disaster response procedures and the need to work through parish emergency offices. The transcript ends as the House moves into additional concurrent resolutions returned from the Senate with amendments.

Transcript Highlights:

• and consumers.
• This new value needs coverage, which results in bigger consumer bills.
• The Consumer Protection Division helps consumers with complaints against their insurance company, their
• We have consumer resources.
• We do a fairly extensive consumer education program, like TDI.

Keywords: 1184, house, all

Transcript Highlights:

• The act set forth requirements for the payments made by these processors to the producers and put in
• This is a model that we are participating in through CMS that allows us to enter into value-based payment
• And so these are favorable payment models for the state that will hopefully result in some savings and
• An untrained inspector affects the consumer, affects the business, and it can cost both of them money
• And that saves the consumers' money because you're not going to have to bring out full electricians.

Keywords: 1204, all

Transcript Highlights:

• [clears throat] Michael Angelo, consumer advocate with the Division of Consumer Advocacy.
• Michael Angelo, consumer advocate with a Michael Angelo, consumer advocate with a division<00:16:20.720
• Dwight division of consumer advocacy.
• director of the Office of Consumer director of the Office of Consumer Protection.<00:16:49.519><
• <00:18:40.559> advocacy the division of consumer advocacy the division of consumer advocacy

Keywords: 910, house, all

Transcript Highlights:

• Do we just stop making payments for people who need medication for diabetes, medication for MS?
• , than my son can access PCA or AOC payments easily.
• This makes it unclear why these provider payment rates often do not adjust in sync with key economic
• across the Commonwealth to go without life-saving consumer.
• Rates have forced many workers to leave the industry, leaving consumers across the Commonwealth without

Keywords: 995, all

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:

• This bill is intended to function as a landowner consumer protection measure.
• But, of course, many of the provisions cannot be waived or it wouldn’t be a true consumer protection
• <00:02:33.360> protection wouldn't be a true consumer protection wouldn't be a true consumer
• The next one is the Consumer Freedom of Choice Act.
• <00:19:04.480> from the system through window payments from the system through window payments

Keywords: Energy - Room 210, 2 February, 2026; 4:15 PM, 925, all

Summary: The committee took up several energy, utility, and infrastructure bills. Bill 2527 on solar decommissioning was presented as a landowner consumer-protection measure that would set statewide baseline requirements for solar lease agreements, preserve some freedom of contract, preempt duplicative local rules, and protect landowners from reclamation costs; after no questions, it was moved and passed. The committee also discussed changes to the Gulf Coast Regional Utility Act in HB 2058 and HB 2309, including new first-right-of-refusal language, prohibitions on unauthorized service, civil penalties and enforcement tools, and legislative intent language aimed at preventing duplication and protecting public investment; both were adopted as committee substitutes and passed. HB 2018 was amended to extend similar oversight to water systems, and it was reported after questions about the scope of the change. Several bills focused on water and wastewater oversight. SB 2311 and SB 2312 would create statewide A-to-F grading systems for drinking water and wastewater systems, require annual public reporting, and direct the health and environmental agencies to adopt objective scoring rules; both were passed. SB 2526 would create a Mississippi Rural Water Oversight Committee, require rate studies, capacity studies, and asset management plans for water associations, and provide staffing and funding support from existing revolving-fund resources; it was adopted as a committee substitute and reported, with supporters saying it would help identify and assist troubled associations. The committee also heard a bill creating the Metro Jackson Water Authority, allowing a lease of city system assets, special revenue bonds to refinance legacy debt, and supplemental revenue sources such as sanitation fees and possibly sales tax revenues; the sponsor said no general fund money would be used, and the bill was reported. The committee also advanced HB 2641, which was stripped down to a study committee on wind turbine facilities, grandfathered existing projects, and imposed a moratorium on new construction until the study is completed; members asked about existing projects and were told current projects under construction would not be penalized, and the committee substitute passed. SB 2783 would make targeted definition changes to BEAD-related broadband grant programs so remaining federal funds could support other state initiatives, including AI workforce training, and it was reported after questions about future federal guidance. Finally, HB 2787 would add propane to the school gas-leak testing statute; the sponsor said the inspections would not require additional state funding because propane dealers and the State Fire Marshal’s office already handle the checks, and the bill passed.

Transcript Highlights:

• The few dollars of margin that might exist are quickly consumed by overtime, mortgage payments, or unexpected
• That is due to directed payments, the growth in state-directed payments, the additional directed payments
• We've just paid one quarter's payment. We've just paid one quarter's payment.
• <00:53:20.880> So quarters worth of that payment. So quarters worth of that payment.
• We've expanded directed payments.

Keywords: 958, all

Summary: The Health and Family Services committee heard an informational presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults, often with serious mental illness, who do not meet nursing home criteria but need structured supervision, medication assistance, meals, and daily support. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and are supported largely through state supplementation payments and residents’ SSI income. The presenters argued that the current reimbursement rate of about $50.70 per day is no longer sufficient to cover staffing, food, insurance, utilities, maintenance, and other costs, and said the sector has shrunk significantly over time. They cited figures showing a decline from 64 to 34 homes serving the seriously mentally ill since 2002, with 30 closures over 23 years, and said the loss of beds contributes to homelessness, hospital overcrowding, and longer psychiatric stays. They also gave examples of residents who had spent many months in hospitals before being successfully placed in personal care homes, which they said can prevent more costly institutional care. Committee members asked about staffing credentials, fraud controls, referral processes, and how reimbursement works in other states. The presenters said Kentucky does not require licensed or certified staff in these facilities, though some homes use certified medication technicians or an LPN, and they described a county case-manager-based assessment process used to set individualized rates in other states such as Minnesota. Members expressed support for the work but emphasized the need for documentation of savings and budget offsets. The presenters said they are seeking an incremental reimbursement increase over two years, roughly 25% to 50% in the first year and another 50% after that, and urged the committee to support the homes to prevent further closures.

Transcript Highlights:

• this does is make it clear that all that can be charged for installment fees will be installment payment
• So currently we spend $1.4 billion to hospital payments through DHS, and Arkansas Children's receives
• The practice of pushing the processing fee to the consumer is relatively new.
• That's not a today we're going to write the check for; there's quarterly payments made on that.
• , certain payment due in December, or something like that, yes.

Keywords: 1204, all

Transcript Highlights:

• The few dollars of margin that might exist are quickly consumed by overtime, mortgage payments, or unexpected
• The few dollars of margin that might exist are quickly consumed by overtime, mortgage payments, or unexpected
• The few dollars of margin that might exist are quickly consumed by overtime, mortgage payments, or unexpected
• The few dollars of margin that might exist are quickly consumed by overtime, mortgage payments, or unexpected
• payments.

Keywords: 958, all

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

Transcript Highlights:

• payment breakdowns. payment breakdowns.
• <00:34:37.280> protection this was under the consumer protection this was under the consumer
• should not use valuebased payment should not use valuebased payment structures<00:43:17.200>
• and I think that is from a consumer and I think that is from a consumer perspective<01:03:26.160
• <01:38:12.320> and labor intensive uh time consuming and labor intensive uh time consuming

Keywords: 1189, house, all