Transcript Highlights:

• The support Medicaid, home and community-based services, hcbs waiver programs and related services.

Transcript Highlights:

• And then sections 24 and 25 relate to clarifying some technical items in HCBS.
• 01:16:20.320> technical<01:16:20.800> items<01:16:21.920> in<01:16:22.520> HCBS
• clarifying some technical items in HCBS. clarifying some technical items in HCBS.

Keywords: 1187, senate, all

Transcript Highlights:

• transition to a location of their choice, whether that be another assisted living, back to another HCBS

Keywords: 1204, all

Transcript Highlights:

• Section 7, also from the governor's budget bill, contains technical changes and requires unlicensed HCBS

Bills: HF2434

Keywords: healthcare, personal care assistance, worker retention, disability services, state funding

Transcript Highlights:

• People discharged from the state hospital to the HCBS AMH program, those numbers are on the second line
• encounters, decrease in use of inpatient hospitalizations, and decrease in arrests for folks who get HCBS
• Hospitalizations and decrease in arrests for folks who get HCBS AMH.

Keywords: 1185, senate, all

Transcript Highlights:

• For them, EVV fits, but for the vast majority of HCBS services, that is not the case.
• HCBS services do not function this way. HCBS services do not function this way.

Bills: HF3423, HF2354, HF3634

Keywords: healthcare, provider enrollment, medical assistance, legislation, state funds, fraud prevention, subpoena authority, criminal penalties, consumer protection, service verification, Medicaid, human services, electronic documentation, 1183, house

Transcript Highlights:

• This prohibits HCBS providers regulated by chapter 245D from requiring a client to have or acquire a
• Chair, Senator Abeler, um, the HCBS setting rule does have language in it about proximity of settings
• Chair, Senator Abeler, um, the HCBS setting rule does have language in it about proximity of settings
• Chair, Senator Abeler, um, the HCBS setting rule does have language in it about proximity of settings
• Chair, Senator Abeler, um, the HCBS setting rule does have language in it about proximity of settings

Keywords: 1187, senate, all

Transcript Highlights:

• survey to its vendors to collect data on the state of the direct support professional workforce for HCBS

Bills: SB1001, SB1011, SB1016, SB1052, SB1072, SB1100, SB1112, SB1113, SB1116, SB1118, SB1120, SB1121, SB1122, SB1123, SB1124, SB1125

Keywords: appropriation, economic security, blind individuals, older adults, state funding, medical examiners, sudden infant death, autopsy protocols, forensic pathology, public health, religious exemption, employment practices, COVID-19 vaccination, accommodation, discrimination, assisted living, health care, hyperbaric oxygen therapy, physician orders, informed consent

Transcript Highlights:

• the denials or the issues with denials again had to do around the majority of them were around the HCBS
• 00:58:49.520> the the majority of them were around the the majority of them were around the HCBS
• 51.839> like<00:58:52.000> the<00:58:52.240> providers<00:58:52.799> those HCBS
• services like the providers those HCBS services like the providers those were<00:58:53.119> the

Keywords: 1187, senate, all

Transcript Highlights:

• of a third party to pay for drugs, reducing community connector units, placing soft caps on certain HCBS
• 12.000> certain units, placing soft caps on uh certain units, placing soft caps on uh certain HCBS
• <02:16:13.360> hours, HCBS hours, HCBS hours, um<02:16:14.960> delaying<02:16:15.440>
• What they found is that HCBS is actually runs on a very low administrative cost. 95% of the dollars are
• What we're talking about still, though, is HCBS service limits.

Keywords: 981, all

Transcript Highlights:

• and executive director of 29 Acres, a supported living community in Denton County, and a provider of HCBS
• My son is extraordinarily happy in an HCBS. ...us at 29 Acres, and he's 30 minutes literally from me,

Bills: SB1, SB 1

Keywords: appropriations, budget, state funding, education, healthcare, infrastructure, campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards, 1185, senate, all

Transcript Highlights:

• requests for a 915c waiver demonstrate it will not increase the average amount of time that people who HCBS

Keywords: 988, house, all

Transcript Highlights:

• So if they already have Medicaid established and we're able to connect with them quickly on that HCBS

Summary: The Health Care Budget Subcommittee took up two bills and then continued oversight discussions with APD and AHCA. CS/HB 27, the Social Work Licensure Interstate Compact, was presented as a way to let Florida social workers practice in other compact states and vice versa; AARP, the Florida Chamber, and NASW Florida supported it, and the bill passed favorably. HB 1127, a child welfare bill, would create a treatment foster care pilot for children with high behavioral needs, improve DCF data collection on commercially sexually exploited children, and expand recruitment for protective investigators and case managers; the bill also passed favorably after brief supportive testimony. The committee then questioned APD at length about the iBudget waiver waitlist, enrollment pace, spending projections, and provider capacity. APD said it had sent more than 1,100 interest letters in categories 3, 4, and 5, enrolled 1,124 people so far this year, and expects to spend about 96.4% of its waiver appropriation, leaving roughly $82 million unspent. Members pressed APD on why prior discussions suggested more reserve was needed, how long the SANS process takes, whether category 6 could be expanded, and whether the agency has enough waiver support coordinators and direct support providers. APD said it has about 1,061 waiver support coordinators statewide, adequate capacity for current enrollees, but would need further analysis if the legislature directed a much larger enrollment increase. Members also asked about outreach, annual maintenance of the waitlist, portability for military families, and whether communication efforts should be privatized. Finally, AHCA walked the committee through the 2023 Achieved Savings Rebate (ASR) report for Aetna and explained how the report is used for financial monitoring, rebate calculations, and transparency. AHCA said the ASR is separate from the medical loss ratio (MLR) calculation, though both are reviewed, and that Florida uses the ASR mechanism rather than an MLR remittance requirement to recover funds from plans. Members asked about related-party disclosures, CVS/Caremark relationships, expanded benefits, encounter data, network adequacy penalties, denials and appeals reporting, interest earned on capitation payments, and whether rate increases were reaching providers. AHCA and the outside auditors said they review the plans’ reported data, reconcile it to underlying records, and can assess liquidated damages for network adequacy violations; several members requested follow-up data on rebates, interest, provider capacity, and related-party reporting.

Transcript Highlights:

• I'm going to continue with a little reminder of the historical context about our Medicaid HCBS waiver
• The presentation shows that as of March 26, 198,321 Texans were waiting across the six HCBS interest

Keywords: 1184, house, all

Transcript Highlights:

• a 1915(c) waiver demonstrate it will not increase the average amount of time that people who need HCBS

Summary: The Assembly Budget Subcommittee on Accountability and Oversight held its fifth hearing of the year to examine the newly enacted federal H.R. 1 and its effects on California. Members and the chair described the law as a major threat to state health, food, education, and climate programs, and emphasized that California would not be able to fully backfill the federal cuts. Several members also highlighted the bill’s tax provisions, including temporary deductions for tips, overtime, seniors, and auto loan interest, while warning that the largest benefits flow to higher-income taxpayers and that major cuts to Medi-Cal, CalFresh, and clean-energy incentives are delayed or phased in over time. The Legislative Analyst’s Office and the Department of Finance presented detailed overviews of the bill’s likely impacts and implementation timelines. They identified the main affected areas as health care coverage and financing, food assistance, higher education, personal income taxes, and clean-energy/electric-vehicle credits. They explained that H.R. 1 limits provider taxes used to finance Medi-Cal, adds work and redetermination requirements, restricts CalFresh eligibility and increases state costs, changes student loan and Pell Grant rules, extends and modifies federal tax provisions, and phases out many clean-energy credits. Finance also noted major rescissions of Inflation Reduction Act funds, new border and immigration enforcement spending, and the possibility of PAYGO sequestration if Congress does not act to offset the deficit increase. During member questions, the committee focused on likely enrollment losses, administrative burdens, and fiscal exposure for the state and counties. Witnesses said many details still depend on federal guidance, but they estimated significant impacts on Medi-Cal, CalFresh, and graduate/professional student borrowing, and noted that California’s high CalFresh error rate could increase state costs. UC testified that the elimination of Graduate PLUS loans would affect thousands of professional students, especially in health, law, and other high-cost programs. Members asked for follow-up data on county, health, and tax impacts, and staff agreed to provide additional tables and estimates as implementation guidance becomes clearer. Public commenters from counties, early childhood advocates, health coalitions, disability rights groups, immigrant-rights organizations, and other stakeholders urged the Legislature to mitigate the law’s effects. They warned of higher county costs, reduced access to health care and food assistance, increased administrative burdens, and harm to children, immigrants, people with disabilities, and low-income families. Several urged new state revenue solutions and stronger protections for Medi-Cal, CalFresh, child care, and home- and community-based services. No votes were taken; the hearing was informational and ended with a commitment to continue monitoring federal guidance and to work on state responses in the budget process.

Bills: SB667, SB904, SB1344, SB1380, SB1423, SB1425, SB1484, SB1500, SB1502, SB1503, SB1555, SB1561, SB1562, SB1565, SB1572, SB1644, SB1749, SB1833, SB2007, SB2044, SB2074

Keywords: chiropractic, licensure, animal chiropractic, Board of Chiropractic Examiners, licensing requirements, gender transition, gender-affirming care, transgender, puberty blockers, cross-sex hormones, hormone therapy, sex reassignment, transition surgery, Medicaid, public funds, state facilities, state hospital, Oklahoma, intersex, DSD

Bills: HB1853, HB1591, HB1961, HB1854, HB1965, HB1962, HB1959, HB2505, HB2576, HB1801, HB1804, HB1864, HB2319, HB2314, HB2115

Keywords: HB1853, dementia, Alzheimer's disease, cognitive impairment, memory care, memory clinic, Hanai Memory Network, Executive Office on Aging, aging services, kupuna, caregiver support, long-term care, elder care, geriatrics, public health, dementia screening, care coordination, referral network, neighbor islands, rural health

Summary: The committee heard testimony on SB 2047, relating to pharmacy benefit managers. The Insurance Division said the bill would require new enforcement resources and estimated an appropriation of about $1.5 million and five positions. Kaiser Permanente asked for an amendment to exclude HMOs from the definition of third-party PBMs, saying the bill should not interfere with integrated care models. PCMA and the Hawaii Pharmacist Association supported narrowing amendments, with pharmacists objecting to section 3 and warning the bill as amended could create major operational burdens and a significant general fund cost. No vote was taken in the portion provided, and the chair moved on to the next measure after questions. The committee then took up SB 2080, which would allow Hawaii to join the psychology interjurisdictional compact. Supporters, including DCR, the Hawaii Association of Health Plans, the Hawaii State Association of Counties, the Grassroot Institute, and others, said the compact would expand access to psychology services, especially for people in rural areas or those needing continuity of care while traveling. Opponents, including the Board of Psychology and a Shamanad University psychology professor, raised concerns about client safety, crisis-response procedures, enforcement costs, FBI background checks, and possible loss of state control over training and specialization standards. The board said Hawaii’s current 1,900-hour internship/postdoc requirement is higher than the compact’s standard and that the state is still implementing a separate provisional licensing law that may address some access issues. The discussion focused on whether the compact would meaningfully reduce shortages and whether Hawaii should instead pursue changes within its existing licensing system. Finally, the committee heard SB 2277 on hospital price transparency. The Office of Consumer Protection initially noted the bill could require significant staffing, but later testimony from SHIP suggested the measure could be handled more simply by working with the Healthcare Association of Hawaii and publicly posting violations. The Healthcare Association of Hawaii opposed the bill, arguing hospitals already must comply with federal CMS transparency rules and that adding state requirements would increase costs and legal exposure, especially if violations were treated as unfair or deceptive trade practices. Steve Fenberg testified in support, saying the bill would simply codify existing federal requirements in state law and that he was open to amendments removing state enforcement and the unfair trade practice language. No final action was taken in the excerpt provided.

Bills: HB2118, HB1764, HB1815, HB2117, HB2436, HB2438, HB2532, HB2566, HB2573, HB1736, HB2425, HB1590, HB1913, HB1573, HB1542, HB1804, HB1976, HB1704, HB1996, HB1541, HB1926, HB1703, HB1866, HB1710

Keywords: business development, arts, cultural affairs, Hawaii, commissions, administrative transfer, funding appropriation, music education, public concerts, Hawaii State Library, cultural collaboration, music accessibility, State Foundation on Culture and the Arts, SFCA, Performing Arts Grants Program, arts grants, culture and the arts, history and the humanities, King Kamehameha Celebration Commission, Works of Art Special Fund

Bills: HB2118, HB1764, HB1815, HB2117, HB2436, HB2438, HB2532, HB2566, HB2573, HB1736, HB2425, HB1590, HB1913, HB1573, HB1542, HB1804, HB1976, HB1704, HB1996, HB1541, HB1926, HB1703, HB1866, HB1710

Keywords: business development, arts, cultural affairs, Hawaii, commissions, administrative transfer, funding appropriation, music education, public concerts, Hawaii State Library, cultural collaboration, music accessibility, State Foundation on Culture and the Arts, SFCA, Performing Arts Grants Program, arts grants, culture and the arts, history and the humanities, King Kamehameha Celebration Commission, Works of Art Special Fund

Transcript Highlights:

• for adults who are seriously mentally ill in access to provide, with federal approval, a dedicated HCBS
• Fifteen other states have already created HCBS SMI programs, including 11 Republican-led states and four

Bills: SB1052, SB1115, SB1118, SB1120, SB1121, SB1124, SB1171, SB1172, SB1174, SB1175, SB1214, SB1233, SB1235, SB1316, SB1345, SB1372, SB1399, SB1458, SB1494, SB1496, SB1564, SB1602, SB1621, SB1628, SB1630, SB1631, SB1668, SB1672, SB1814, SB1821

Keywords: assisted living, health care, hyperbaric oxygen therapy, physician orders, informed consent, AHCCCS, remote work, state agency, employment, public health, housing, zoning, middle housing, urban development, duplexes, triplexes, fourplexes, townhomes, historic preservation, radiation protection