Transcript Highlights:

• The reform was in entirely bipartisan, just as President Trump and Secretary Kennedy's call to make America
• Senator, as you know, the FDA is not involved in Medicaid or coverage decisions. I understand that.
• We agreed that despite the need for reforms at the FDA, that the FDA is sort of the gold standard.
• and you said no there wasn't even though again you've got reforms you'd like to make here is a an issue
• I would welcome the opportunity to work with you on reforming. Thank you. I yield back.

Committee: Senate Health, Education, Labor, and Pensions Committee

Keywords: nominations, labor, health, veterans, Social Security, Elon Musk, transparency, government accountability

Summary: The meeting primarily focused on various executive nominations and their implications on labor and health affairs. Significant discussions surrounded the nomination of Mr. Sonderling as the Deputy Secretary of Labor, with members expressing concerns about workforce cuts affecting veterans and Social Security employees. There was also a debate led by a member regarding the authority and influence of private individuals, specifically citing Elon Musk's involvement in government decisions. Such discussions raised questions about transparency and accountability within governmental agencies, leading to a proposal for Mr. Musk to provide testimony before the committee.

Transcript Highlights:

• SB 1384, contributions, non-reformable expenses lobbying. Natural Resources.
• SB 1372, Medicaid dental benefit study committee.
• SB 1372, Medicaid dental benefit study committee.
• across Arizona, who are committed to educating children, and whereas the vital cause of education reform
• justice, supporting initiatives such as Migrant Health Start, middle school advocacy, just migration reform

Keywords: 1182, all

Transcript Highlights:

• So when we talk about waiver services and Medicaid funding, he's right there speaking up on behalf of
• So when we talk about waiver services and Medicaid funding, he's right there speaking up on behalf of
• </c> about waiver services and Medicaid about waiver services and Medicaid funding,<00:09:57.680><c>
• So just proposing some alternative options with how other states are looking at PBM reform.
• </c><00:27:10.159><c> I</c> states are looking at PBM reform. I states are looking at PBM reform.

Keywords: 912, senate, all

Summary: The committee first considered a series of Governor’s Message nominations, largely to the State Council on Developmental Disabilities and one to the Hawaii Advisory Commission on Drug Abuse and Controlled Substances. Testifiers and agencies spoke in strong support of the nominees, emphasizing their advocacy, community involvement, and lived experience. The committee heard from nominees and supporters for John Paul Moses III, Cynthia Fowler, Joshua Eay, Alicia Kim, Raymond Mamea, Maria Christina Valenzuela, Eden Watabayashi, Sierra Whiteside, and Brandy Lynn Macallani Hayen. After hearing testimony, the committee voted to advise and consent on each nomination, with the votes adopted by the members present. The committee then took up SR 53 / SCR 69, which asks the Department of Health to convene a pharmacy benefit manager working group to improve transparency, fairness, and drug affordability. Supporters included the Hawaii Pharmacist Association, the University of Hawaii system, and several individuals, while the Department of Health said the issue is complex and may require additional support or a different structure. Members discussed whether the Department of Health should lead the effort or whether another entity, such as SHIPA with an appropriation, might be more workable; the Department of Health suggested a $100,000 appropriation could be sufficient. Next, SR 56 / SCR 73 proposed a report on the developmental needs of children born during the COVID-19 pandemic. The Office of Wellness and Resilience supported the measure and asked for an extended deadline to the end of 2026, and several youth, mental health, and community organizations testified in support. The committee also heard SR 69 / STR 86 on creating an aeromedical services working group, with support from Air Methods, the Department of Health, and the Hawaii Medical Association, and SR 99 / STR 118 on studying the use of filtered catchment water for business activity, which drew support from the Plumbing and Mechanical Contractors Association and comments from the Department of Health that the issue is complicated and should include the Department of Agriculture. No final votes on the resolutions were taken in the portion of the meeting provided.

Transcript Highlights:

• The Juvenile Justice Policy and Data Board was created by the 2018 Criminal Justice Reform Bill and is
• Obviously, ...and for pre-reform, right?
• And so we certainly want to see the numbers lower than pre-reform, and you know, as you can sort of see
• Obviously, ...and for pre-reform, right?
• And so we certainly want to see the numbers lower than pre-reform, and you know, as you can sort of see

Committee: Senate Senate Committee on Juvenile and Emerging Adult Justice

Keywords: 1212, all

Transcript Highlights:

• And this is the exact thing that this reform is designed to change.
• This is why this reform matters.
• Delaying or fragmenting this reform doesn't just slow progress.
• Delaying or fragmenting this reform doesn't just slow progress.
• Part of it is all of the work going on with BH Connect reform right now.

Summary: The committee heard an extensive Department of Social Services presentation on child care budget issues, including the Governor’s proposed 2026-27 budget, federal CCDF changes, Prop. 64 revenue adjustments, and a one-time $11.5 million disaster-related infrastructure grant for licensed child care facilities affected by 2025 declared disasters. DSS said federal formula updates and lower Prop. 64 revenues would reduce funding and could result in about 4,176 CCTR slots being reduced, but the department said it was working to avoid impacts to currently enrolled children. The LAO supported aligning general child care funding with lower revenues and asked for more detail on the disaster grant. Members pressed DSS and Finance on why reductions were not being backfilled and why so many awarded slots remain uncontracted or unused; DSS said delays are largely due to providers building new infrastructure, licensing, staffing, and enrollment challenges, and that some unspent funds revert to the General Fund. The committee also discussed whether some contract dollars should be shifted to vouchers and whether more flexibility should be allowed for infrastructure and expansion costs. A second panel focused on the state’s commitment to expand child care and on rate reform. DSS reported that nearly 125,000 new slots have been awarded since 2021-22, but speakers from Stanislaus County Office of Education, Parent Voices California, and the California Budget and Policy Center argued that unmet need remains large and that the system still leaves many families without access. Stanislaus County described a large local shortage of infant and toddler care and said reimbursement disparities between child care programs and state preschool create disincentives for providers. Parent Voices gave testimony about the burdens and instability families face when trying to access care, especially for survivors and low-income parents, and called for a universal, publicly funded system. The Budget Center said only about 16% of eligible children were enrolled in 2024, urged expansion across the mixed delivery system rather than concentrating investment in TK, and called for faster rate reform and new revenue. LAO estimated that bringing certain CCTR adjustment factors up to CSPP levels would cost $88 million to $131 million ongoing. Members and witnesses discussed the single rate structure, automation needs, and the need for deadlines and a ramp-up plan; DSS said the goal is to eliminate disparities, but that policy decisions are still needed before automation can proceed. The committee then reviewed several trailer bill proposals. DSS outlined a 2026-27 COLA proposal that would apply a 2.41% increase through cost-of-care-plus payments, though the department said it had inadvertently excluded CalWORKs Child Care and the Emergency Child Care Bridge Program and would revise the proposal; LAO recommended making the COLA methodology uniform across programs. DSS also proposed replacing the market rate survey with the federally approved alternative methodology on a triennial schedule, limiting temporary absences in family child care homes to 20% of monthly hours, defining excessive unexplained absences as more than 30 days in a year, and aligning family fee deductions with new federal requirements so providers receive the full voucher value. Members generally supported the temporary absence change and asked about implementation timing for the family fee deduction, with DSS saying it was in contact with Riverside County. The committee also heard a brief update on the Early Childhood Policy Council reappropriation, which would extend unused funds through June 30, 2028 because prior costs came in higher than expected.

Transcript Highlights:

• fact that they are in our facilities, they would receive their federal Medicaid benefits.
• We were the first state to be given a waiver regarding Medicaid. This will apply.
• We were the forced state to be given a waiver regarding Medicaid. This will apply.
• Regarding Medicaid, this will apply.
• This office supports those bills and the important reforms to the campaign finance law.

Committee: Joint Joint Committee on Ways and Means

Keywords: 995, all

Summary: The Joint Committee on Ways and Means held its sixth public hearing on the Governor’s H-2 budget proposal for fiscal year 2026, focused on public safety and judiciary agencies, at the Foxborough Community Center. After opening remarks and local welcomes, the committee heard first from the Executive Office of Public Safety and Security, led by Secretary Gina Kwan, who outlined a $1.72 billion budget, up $69.8 million from FY26. She said the proposal emphasizes core operations, readiness, and partnerships with municipalities, and highlighted work on firearms-law implementation, State Police reform, DOC reentry efforts, hate-crimes prevention, emergency response, and planning for major events including the World Cup. Members also raised concerns about DNA backlog reporting, State Police academy boxing and training standards, ICE communication, disaster relief funding, crime lab staffing, EMS placement, and diversity in public safety leadership. Several exchanges focused on specific operational issues. Secretary Kwan and her team said the State Police are tracking the influx of forensic work from local sheriffs, that the boxing program remains suspended pending an IACP review and likely will not return in its prior form, and that EOPS has no direct communication with ICE but supports law-enforcement coordination where appropriate. On disaster preparedness, officials said the new disaster relief fund is being developed with MEMA and A&F, currently capitalized at $14 million with another $14 million expected, though members urged a more permanent funding source. On the crime lab, staff said the roughly $4.5 million increase is intended to cover core operations and a structural funding gap rather than expand services. The secretary also said EOPS is not ready to absorb OEMS from DPH at this time, though she would keep an open mind. The committee then heard from district attorneys, led by Suffolk County DA Kevin Hayden, who said the Massachusetts District Attorneys Association is seeking a 10% increase in operating budgets, including about $16.7 million for staffing salaries, to recruit and retain prosecutors, advocates, and support staff. He said the request reflects rising workload and the need to keep the criminal justice system functioning efficiently and fairly. The hearing was recessed briefly after the district attorneys’ opening remarks, with additional testimony expected to continue afterward.

Transcript Highlights:

• Senate Bill 1847 by Moore of the House and Green of the Senate, an act relating to Medicaid home and
• Senate Bill 1847 by Moore of the House and Green of the Senate, an act relating to Medicaid home and
• So this is going to be a great reform not only for reading but also for math.
• It's not reform. And it's not protection.
• No reform. And that's not respect, for sure.

Bills: SB1290 , SB1530 , SB1847 , HR1050 , SB169 , SB1377 , SB1990 , SB1991 , SB1778 , SB1579 , SB1992 , SB3 , SB2028 , SB1928 , SB2127 , SB2117 , SB1439 , SB1930 , SB330 , SB1191 , SB2110 , SB2134 , SB2069 , SB2095 , SB1613 , SB1246 , SB1976 , SB1346 , SB1509 , SB2071 , SB259 , SB1314

Keywords: 2-1-1 services, revolving fund, Department of Human Services, crisis pregnancy, abortion, legal funding, research funding, development rebate, Oklahoma Department of Commerce, tax incentives, higher education partnerships, Medicaid, ADvantage Waiver, home-based services, eligibility criteria, healthcare, senior services, Taiwan, Oklahoma, sister-state relationship

Transcript Highlights:

• If there were changes to those reforms, Mr. Chairman, I would consider that a downside risk.
• We're approaching K-12 is what we're doing in GROW for agencies through a reformed public ed reform fund
• Things like attendance improvement through the Public Education Reform Fund.
• Big increases in the budget as hospitals pay a new surcharge that will pay for enhanced Medicaid rates
• Plus percent of them would be on Medicaid, and other states pay it 80 percent of Medicare.

Committee: Senate Senate Finance

Transcript Highlights:

• I yield back. reforms that allow for competition and reforms that allow for competition and consumer<
• ,</c><00:25:45.200><c> and</c> Security, Medicare, Medicaid, and Security, Medicare, Medicaid, and Obamacare
• And just as those Medicare and Medicaid.
• ,</c> socialism, including Medicare, Medicaid, socialism, including Medicare, Medicaid, Social<01:08:
• ,</c> prioritized criminal justice reform, prioritized criminal justice reform, arts<02:05:36.960><c>

Keywords: U.S. House of Representatives Floor Proceedings on Friday, November 21, 2025, 1012, house, all

Transcript Highlights:

• Community First Choice Option, or SIFCO, is a federal Medicaid program within IHSS.
• Rate reform was a great investment, for example. We know we have a shared goal here.
• As shared in the agenda, the department underwent appeals reform in 2023, and since those reforms have
• We also know, based on the appeals reform, that we saw an increase.
• The final implementation of rate reform began on January 1, 2025.

Summary: The subcommittee heard an overview of the governor’s IHSS budget proposals and extensive testimony from the Department of Social Services, Department of Finance, the Legislative Analyst’s Office, county representatives, labor, consumer advocates, and advocates for older adults and people with disabilities. The administration described IHSS as a large and growing program serving more than 900,000 recipients, and outlined three proposals: shifting the cost of growth in authorized hours per case to counties, eliminating the backup provider system, and aligning IHSS terminations with Medi-Cal terminations. The LAO said the overall budget estimates appeared reasonable but raised concerns about the hours-per-case proposal, including the lack of a comprehensive root-cause analysis, the limited control counties have over statewide cost growth, and uncertainty about how the baseline and savings would work. CWDA, SEIU, and consumer advocates strongly opposed the hours cost shift, arguing that counties use state-designed tools, that demographic changes and rising need explain much of the growth, and that the proposal would pressure counties to cut services and destabilize care. The chair and members repeatedly questioned the administration about the proposed baseline, the claimed savings, and whether the measure effectively circumvents the county maintenance-of-effort agreement. On the backup provider system, the administration said the statewide program is underutilized and administratively expensive, and proposed eliminating it to save about $3.5 million. The LAO suggested the Legislature consider whether administrative costs could be reduced while preserving some version of the program. County and consumer advocates opposed the cut, saying the system is a critical safety net when regular providers are unavailable, especially in rural areas and for people with complex needs. They argued that low utilization reflects the difficulty of finding emergency backup care, not lack of need, and that many counties already rely on local backup systems or other models. Committee members also pressed for better data on requests, fulfillment, and administrative costs, and discussed whether the state could support local alternatives instead of eliminating the program. The final topic was the proposal to align IHSS terminations with Medi-Cal terminations by automating the process when recipients fail to complete Medi-Cal redeterminations. The administration said this would reduce General Fund costs by about $86 million by preventing payment of IHSS in the residual program when recipients are no longer eligible for Medi-Cal, while also automating reinstatement when Medi-Cal is restored. The LAO noted the proposal has been rejected in prior years and suggested improved notice and communication to recipients as an alternative. CWDA and advocates warned that the change could create gaps in care, especially for people who lose Medi-Cal for procedural reasons, and urged additional safeguards such as better notices, faster reprocessing, and automatic reinstatement. Members questioned how many people would be affected, how the residual program currently works, and whether providers could go unpaid during the gap; the department said the automation is already built and would be activated if the proposal is approved. No votes were taken during the discussion, and the committee moved through public comment and questioning without final action on the proposals in the excerpt provided.

Transcript Highlights:

• </c><01:07:31.000><c> funding</c> Um so under our Medicaid funding Um so under our Medicaid funding services
• in this area of law, and we called it day service reform.
• And through those reforms, we worked with the community, we worked with the providers...
• </c> um and we called it day service reform. um and we called it day service reform.
• ><c> we</c><01:43:19.800><c> worked</c> And through those reforms, we worked And through those reforms

Committee: Senate Labor

Keywords: 1187, senate, all

Transcript Highlights:

• funding needs, reimbursement structures, and licensed workforce models required to implement the reforms
• funding needs, reimbursement structures, and licensed workforce models required to implement the reforms
• This bill is a common-sense reform that reflects the will of the people.
• This bill is a common-sense reform that reflects the will of the people.
• So that means Medicare Advantage, Medicaid managed care, CHIP, and plans that are sold on the exchange

Committee: Senate Senate Health and Human Services COR

Summary: The committee approved the minutes and then took up a large agenda of health-related bills. SB 1214, the Arizona Stem Cell Therapy Act, drew extensive testimony from supporters who said it would create guardrails for regenerative medicine, protect patients, and encourage biotech investment, while opponents argued it was tied to abortion politics and imposed harsh penalties. The bill passed on a 4-3 vote. SB 1194, which would prohibit health professionals and institutions from denying care based on vaccination status, also passed 4-3 after testimony from supporters framing it as an access-to-care and religious-freedom measure and opponents warning it would interfere with private practice policies and parental choice. SB 1814, creating a study committee on substance use disorder treatment standards and oversight, passed unanimously 7-0. SB 1602, increasing stipends for kinship foster parents, passed as amended 7-0, and SB 1603, expanding child-only cash assistance eligibility, also passed as amended 7-0. The committee then considered several bills focused on gender-related care and public funding. SB 1177, which bars public monies from funding gender transition procedures and makes intentional violations a felony, passed 4-3 amid testimony that it protects taxpayers and counterarguments that it is discriminatory and unsupported by evidence. SB 1014, requiring insurance coverage for detransition procedures when transition care is covered and directing data reporting on transition and detransition, passed 4-3 after supporters said it would help detransitioners and collect needed data, while opponents argued it would chill providers and target transgender patients. SB 1094, creating civil liability for physicians who perform irreversible gender reassignment surgery on minors, was heard with testimony from supporters citing malpractice concerns and detransitioner harms and from opponents saying it would create a hostile environment for providers and treat trans patients differently; the transcript cuts off before the vote is shown. SB 1752, which classifies commercial harvesting or sale of mescaline as a felony while preserving bona fide religious use defenses, passed unanimously 7-0. Later, SB 1628, requiring insurers to report claims-denial and prior-authorization data and DIFI to publish standardized reports, passed unanimously 7-0 after supporters emphasized transparency and opponents called it redundant to federal reporting. SB 1629, requiring AHCCCS managed care organizations to give advance notice and network-adequacy documentation before terminating high-volume providers without cause, also passed 7-0; supporters said it would prevent patients from losing access to behavioral health care, while health plans and Access said existing oversight already covers much of this and warned the bill could slow necessary network changes. Throughout the meeting, the committee repeatedly adopted motions for due-pass recommendations and, where applicable, amendments, with several bills passing on party-line or near-party-line votes.

Transcript Highlights:

• Think your big three Social Security, Medicare, Medicaid.
• So, that's, that's why Medicaid is on the table.
• The majority of people on Medicaid are working.
• Entitlement reform.
• they may have Medicaid and healthcare in that system.

Committee: House Federal Funding Stabilization Subcommittee

Transcript Highlights:

• to revise provisions regarding Medicaid eligibility expansion.
• Medicaid members age 19 to 64 who are covered through the Affordable Care Act Medicaid expansion must
• Chair, I want to talk about Medicaid expansion.
• As you heard yesterday from the senator from 14, the Medicaid budget is not growing because of Medicaid
• The Medicaid expansion population actually has decreased, and those numbers have also, The Medicaid expansion

Keywords: 989, all

Transcript Highlights:

• So I think, and I know that, you know, you've heard me speak before about EMS reform.
• I think this is just another cog in that wheel of EMS reform in Massachusetts.
• True financial transparency is impossible without first reforming these insurance practices.
• With 75% of patients on Medicaid or Medicare and underpayment from commercial insurance, Boston relies
• Massachusetts long led the nation in health care reform and patient protection.

Committee: Joint Joint Committee on Financial Services

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a lengthy public hearing with more than 70 people signed up to testify, focusing mainly on health insurance and health care access bills. Early testimony centered on H.1257/S.712, which would require insurance coverage for medically necessary treatment of genetic craniofacial conditions. Supporters included legislators, dentists, and medical experts who said these conditions are not cosmetic, can severely affect eating, speech, pain, and social functioning, and often create major financial hardship because insurers deny coverage. A related dental bill, H.1262/S.676, drew technical testimony from the Life Insurance Association of Massachusetts about implementation issues with the 2022 dental loss-ratio law, while the Massachusetts Dental Society supported H.1306/S.696 on transparency in dental network leasing and opposed H.1262. Representative Gentile also testified for H.4013, which would ban for-profit acute care hospitals and for-profit health insurers in Massachusetts, arguing that profit incentives undermine patient care. A major portion of the hearing was devoted to H.1261/S.799, a bill to protect patients from surprise ambulance bills. Municipal fire chiefs, Boston EMS, nonprofit ambulance providers, and the bill’s Senate sponsor said the measure would require insurers to pay ambulance providers directly and promptly, cap patient out-of-pocket costs, and reduce confusion caused by out-of-network billing. Witnesses described ambulance services as essential public health infrastructure and said current billing practices can discourage people from calling 911 or leave municipalities and nonprofits unable to recover costs. Committee members asked about unpaid debt, municipal billing burdens, and how the bill would affect rates and reimbursement. No votes were taken during the hearing. The committee also heard extensive testimony on H.1249/S.805, which would require screening for PANS/PANDAS in medical and clinical settings. Legislators, clinicians, parents, a teen with the condition, and educators described PANS/PANDAS as an infection-triggered inflammatory illness that can present as sudden psychiatric symptoms and is often misdiagnosed as a mental health disorder. Supporters said routine screening at well visits, emergency rooms, and other clinical settings would help identify children earlier, reduce unnecessary psychiatric treatment and hospitalizations, and improve outcomes. Testifiers repeatedly urged favorable action, emphasizing the personal and financial toll on families and the potential for early treatment to prevent long-term harm. The hearing concluded with continued testimony on these bills; no committee action or votes were announced.

Transcript Highlights:

• Basic Medicaid is for pregnant women and children, as well as family Medicaid and Idaho's CHIP program
• the Medicaid.
• Medicaid estate recovery is the process...” “Used in the Division of Medicaid.
• Medicaid expansion repeal may make it possible to avoid this and protect the core Medicaid population
• And recall that before Medicaid expansion, there were no Medicaid supports, no Medicaid eligibility for

Keywords: 989, all

Summary: The committee heard a budget presentation on the Division of Medicaid within the Department of Health and Welfare, including an overview of the division’s five programs, staffing, spending trends, and the large share of the budget that goes to trust and benefit payments. Ms. Williamson explained the difference between ongoing and one-time enhancements, the role of population forecast adjustments, and why the fiscal year 2026 and 2027 numbers change significantly. Members asked about the growth in the budget, the FMAP match rate, the impact of provider rate changes, and the shift of some positions into Medicaid from other divisions after last year’s reorganization. A major topic was House Bill 345 and related budget changes, including the hospital assessment fund alignment, the 4% provider rate reduction, and the effect on Medicaid expansion and other populations. The committee discussed the decline in expansion enrollment, rising costs in traditional Medicaid populations, and the governor’s recommendation to offset part of the 2027 increase with additional reductions. Members raised concerns about access to care, especially for dental, behavioral health, developmental disability, and home- and community-based services, while the deputy director said the department is trying to contain costs through prior authorization, fraud and abuse work, and policy changes. The committee also focused on the MMIS replacement project, which is in year four of a five-year procurement and is funded through dedicated and federal dollars tied to milestones. Another significant item was estate recovery, where the department requested funding to replace an outdated case management system and add contractor support to address a backlog of roughly 20,000 cases; members questioned the return on investment and asked for more detail on the software and staffing split. The deputy director also explained the federally qualified health center reconciliation issue, saying the state had not been properly paying change-in-scope amounts and is now using a new process with interim payments and later reconciliation. In addition, lawmakers asked about program integrity staffing, the use of AI, and whether the department could better target fraud, waste, and abuse investigations. The deputy director said the department is reviewing AI use cautiously and sees opportunities for it in claims review and anomaly detection, but emphasized that the current request is for dedicated receipt authority rather than general funds. No formal votes were taken in the excerpt, but the committee received the presentation, asked extensive questions, and was told that some follow-up information would be provided later.

Transcript Highlights:

• Health insurance, Medicaid, the state, that's it.
• that we need to do this to prevent us from passing these costs along to the state in the form of Medicaid
• and revising the U.N. and what they did last year on tort reform and revising the U.M. statute as a
• And many states use NADAC-based reimbursement structures in their Medicaid programs.
• It's built primarily off of a definition from Centers for Medicare and Medicaid Services.

Committee: House Insurance

Keywords: 965, house, all

Transcript Highlights:

• of the appropriations that they received were related to Senate Bill 3, the Behavioral Health and Reform
• So if you recall, the Behavioral Health Reform and Investment Act was legislation you all passed last
• In addition, the Public Education Department requested a transfer into the Public Education Reform Fund
• In here, it is talking about maintaining health coverage for lawfully present Medicaid enrollees who
• lost Medicaid eligibility.

Keywords: 996, all

Transcript Highlights:

• Is this not available under Medicaid? No, not in state statute. Thank you for asking the question.
• that allows, law or in Medicaid or anything like this that allows us to assist those families who are
• Is this not available under Medicaid? No, not in state statute. Thank you for asking the question.
• And since then, meaningful progress has been made on the Medicaid side.
• So Medicaid, our Missouri HealthNet, has already allowed mothers to get this.

Committee: House Health and Mental Health

Keywords: 959, house, all

Transcript Highlights:

• Tyler Sadworth, State Medicaid Director. This is not a budget solution.
• plans or otherwise disproportionately burden Medicaid plans.
• Some of these resources are also... community supports and behavioral health reforms.
• The first is ensuring access to Medicaid services budget change proposal adjustment.
• The first is ensuring access to Medicaid services budget change proposal adjustment.

Summary: The committee first heard May Revision child care and human services items. The Department of Child Support Services described two technical adjustments, which the analyst supported. The Department of Social Services then walked through child care proposals, including a reduction in federal and Proposition 64 funding absorbed through a shift from General Child Care to the Alternative Payment program, a 2.01% child care COLA, disaster-related infrastructure grants, a new administrative support cost structure for Alternative Payment agencies, the removal of prospective pay funding after a federal rule change, a reappropriation for existing infrastructure grants, and estimates of unspent child care funds. The Legislative Analyst’s Office recommended asking for more justification for shifting reductions to CAP, supported the COLA reduction but wanted consistency across programs, recommended removing prospective pay funding, opposed the administrative cost shift, and suggested further review of disaster grant alignment. Members pressed the administration on why more slots would be cut for the same savings, why the COLA was reduced, and whether the administrative percentage would grow over time. The administration said the changes were intended to avoid disrupting currently enrolled families, reflect point-in-time relinquishments and unspent funds, and stabilize contractor operations. Public commenters, including providers, advocates, and county representatives, urged full COLA funding, rejection of child care slot reductions, preservation of prospective pay, and continued investment in child care infrastructure and access. The subcommittee then recessed before moving to health items. In Part B, the Department of State Hospitals presented its May Revision proposals, including a central utility plant replacement project at Metropolitan State Hospital, funding for a continuum electronic health record system, reduced county bed billing authority to reflect phase-in of additional LPS beds, limited contract exemption authority for online clinical subscription services, reversion of prior-year unspent operating funds, and a workforce development proposal to use Behavioral Health Services Act funds instead of General Fund for training programs. The department said the EHR would modernize records and improve continuity of care, and that the contract exemption would prevent delays in essential clinical information services. No votes were taken in the excerpt provided.