Transcript Highlights:

• So we say, you know, I know you're a nurse.
• I know that also, Madam Chair, the nursing agencies reach out all the time.
• I'm a nurse practitioner, and I'm here on behalf of the New Mexico Nurse Practitioner Council.
• There are close to 700 nurse practitioner openings and more than 6,400 nursing openings, according to
• Do we currently track graduates and licenses for nurses and doctors?

Committee: House House Health & Human Services

Transcript Highlights:

• Nurse practitioners, certified nurse midwives, and physician assistants, also known as advanced practice
• Nurse practitioners, certified nurse midwives, and physician assistants, also known as advanced practiced
• Marie Lopez, California Nurses Association, in support.
• Marie Lopez, California Nurses Association, in support.
• Marie Lopez, California Nurses Association, in support.

Committee: House Health

Transcript Highlights:

• Julie Miller from the Board of Nursing.
• basically the equivalent of an advanced practice registered nurse.
• That list includes a dental hygienist, licensed practical nurses, registered nurses, medical interns,
• She added that she has been a nurse for 35 years and a nurse practitioner for 13 years.
• She said she is a prescriber and is on the State Board of Nursing.

Committee: House Joint Committee on Administrative Rules

Transcript Highlights:

• HB 237 is Advanced Practice Registered Nurses, a nursing title bill.
• Many APRNs hold a Doctor of Nursing Practice or a Ph.D., the terminal degree in nursing.
• A Doctor of Nursing Practice or a Ph.D., the terminal degree in nursing.
• We are told this is comparable to nurse historical histories.
• We are told this is comparable to nurse.

Transcript Highlights:

• The way that we have it— The way that we have it in our regulations, it's not just cancer, it's cancer
• And I think we're going to have to continue to come back and do new regulations after new regulations
• My name is Laura LaRose, and, as the Senator said, I'm an oncology nurse practitioner.
• Maybe the doctor or nurse practitioner? Sorry, nurse. So the follow-up tests might...
• Nurse practitioner, but. Sorry, nurse. So the follow-up tests might. Sorry, nurse.

Committee: Senate Health

Summary: The committee heard several health-related bills, beginning with SB 1124 on lung cancer screening awareness. The author and supporters said the bill would require CDPH signage about lung cancer screening eligibility at tobacco point-of-sale locations to address low awareness and low screening rates. Support came from medical students, physicians, and the California Academy of Family Physicians, while retailers raised concerns about sign size, retailer notification, and implementation. Committee members generally supported the bill and noted the need to work through those concerns. SB 1150 sought to require clearer patient notice when cancer cases are reported to the California Cancer Registry. The author described the bill as a response to inconsistent notification practices and privacy concerns, and the chair and other members shared personal stories about learning they or family members were in the registry without knowing it. Cancer registry and university stakeholders expressed appreciation for amendments but continued to have concerns or wanted more time to review the language. The bill was discussed as a patient-awareness measure rather than a change to reporting requirements. The committee also heard SB 1400 on Alameda Health System governance, SB 1094 on biosimilar substitution and health plan policies, SB 1314 on smoke shop regulation and nitrous oxide restrictions, and SB 1309 on eliminating cost-sharing for medically necessary follow-up after lung cancer screening. SB 1400 and SB 1314 drew support from local officials, labor, and public health advocates, with members emphasizing youth protection and local oversight. SB 1094 passed after extensive debate over pharmacist substitution authority and notification requirements, with a 6-0 vote and opposition from biotechnology and physician groups. SB 1309 also passed after members discussed the cost of follow-up care and the value of early detection, despite opposition from health plans over premium impacts; it received a 7-0 vote and was placed on call.

Transcript Highlights:

• It exempts above-ground public and semi-public cold plunges from regulation as spas under the existing
• Madam Chair and members, House Bill 2195, Nursing Facilities Record Survey Timelines, modifies the state
• process for nursing facilities.
• Madam Chair and members, House Bill 2189 mandates that the State Board of Nursing revise the rules or
• It also defines a licensed medical provider as one of the following: a physician, a nurse practitioner

Summary: The caucus reviewed a long list of House bills with Senate amendments, with members generally indicating the sponsors intended to concur on most measures. Topics included public health and medical regulation (HB 2086 on face coverings/vaccinations, HB 2140 on gold and silver bullion investments, HB 2195 on nursing facility complaint timelines, HB 2189 on licensed health aides, HB 2932 on Access reimbursement and prior authorization, HB 2557 on medical records timing, and HB 2641 on PFAS firefighting foam), criminal justice and courts (HB 2673 creating an inmate mental health study committee, HB 2028 on community restitution for indigent homeless defendants, HB 2662 on expert testimony in parenting-time cases, HB 2440 on prisoner transition services, and HB 2594 on address confidentiality in family court), and education-related bills (HB 2830 on prenatal development instruction, HB 2249 on parents’ rights and social transitioning, HB 2481 on school district financial record compliance, HB 2482 on school construction job-order caps, HB 2895 on Native American language proficiency, HB 2423 on automatic advanced math enrollment, HB 2621 on special education and certificates of educational convenience, HB 2592 on AI rules, HB 2379 on school board training, and HB 2380 on out-of-state travel and public meeting materials). Other bills addressed transportation, development, housing, and local government issues, including HB 2909 on distracted driving, HB 2369 on photo enforcement citations, HB 2745 on legislative subpoenas, HB 2946 on development fees, HB 2999 on infrastructure finance districts, HB 2244 on eviction record sealing, HB 2342 on HOA shade structures, and HB 2752 on Commerce Authority trade offices. Several members raised concerns or asked questions on bills such as HB 2932, HB 2249, HB 2830, and HB 2028, but no formal votes were taken in the transcript; the meeting ended with adjournment after brief discussion of the final bills on Caucus Calendar 19, including HB 2248 on medical intervention requirements for businesses and schools.

Transcript Highlights:

• ><c> home</c> municipalities cannot regulate home municipalities cannot regulate home education<01:59
• </c> probably wouldn't have been regulated. probably wouldn't have been regulated. but<02:04:56.320><
• . regulations. regulations.
• And I think that should and nurses.
• has</c><05:55:17.360><c> to</c><05:55:17.520><c> meet</c> regulated segment that has to meet regulated

Committee: House Housing

Transcript Highlights:

• I continue to teach them as a nurse. I found this unacceptable.
• I work for the DPH as a sane nurse, and I'm a school nurse. I teach everyone.
• I have nursing students that I precept.
• It is a nursing specialty now as of October 2023.
• You had a nurse here who gave you all kinds of information about how they've added programs to nursing

Committee: Joint Joint Committee on Cannabis Policy

Summary: The Joint Committee on Cannabis Policy held its first hearing of the 194th session to take public testimony on 21 cannabis-related bills. Chairs Donahue and Gómez outlined hearing procedures and noted that written testimony would also be accepted. Much of the hearing focused on the Cannabis Control Commission (CCC), with Senator Mike Moore urging support for S. 90 to create an inspector general unit within the CCC. He argued the commission has suffered from dysfunction, workplace harassment allegations, delayed governance reforms, missed fee collections, and high legal costs, and said stronger legislative oversight is needed. Committee members largely agreed the CCC needs reform, though some expressed hope that new leadership would improve operations. A major theme was market structure and business viability. Representative Tyler testified for H. 183 to raise adult-use purchase limits from one ounce to two ounces, saying the change would reduce confusion and help retailers compete with neighboring states. Senator Payano supported S. 100, which would require a study of cannabis supply and demand to guide cultivation licensing, warning that oversupply is driving down prices and threatening cultivators. The Massachusetts Cannabis Coalition, represented by Ryan Dominguez, backed a package of bills aimed at increasing revenue, reducing regulatory burdens, attracting investment, and stabilizing the market, including higher purchase limits, simpler badge and testing rules, and a phased increase in the retail license cap. Attorneys Kevin Conroy and Mike Ross also supported raising the cap, arguing that the industry lacks capital and that more investment and exit opportunities are needed for provisional and distressed licensees. The most contentious issue was whether to raise the retail license cap from three to six. Supporters, including several business owners and industry advocates such as Peyton Shubrick, Tito Jackson, Armani White, Sean Burt, and others, said the current cap traps owners in declining businesses, prevents exits, and limits access to capital. They argued that many social equity and economic empowerment operators are struggling, that oversupply has pushed prices down, and that allowing more ownership could help businesses scale or sell. Opponents, including Senator Liz Miranda and several social equity operators, warned that lifting the cap now would let larger operators and multi-state companies dominate the market and harm equity-owned businesses. Miranda’s S. 88 would instead strengthen enforcement of ownership limits through audits, whistleblower protections, an anonymous tip line, and greater transparency. Another major topic was worker and consumer safety: Laura Bruno, Danny Carson, Al Vega, and others supported H. 194 after the death of Lorna McMurray, arguing for a CCC workplace and consumer safety department, better ventilation and PPE standards, stronger testing oversight, and retaliation protections for workers. The hearing ended without votes, with members thanking testifiers and indicating the committee would continue reviewing the bills.

Transcript Highlights:

• And what that means is, in addition to all the statutes and regulations that apply to all hospitals,
• So if you're looking for nurses and you want to find out what an area nurse is making and you want to
• One of the things that the lady who was the compliance officer for the nursing home, responding back
• So that's kind of hard to track, kind of hard to regulate.
• And, you know, like I said, they operate under strict compliance regulations.

Committee: House Health and Mental Health

Transcript Highlights:

• And what that means is, in addition to all the statutes and regulations that apply to all hospitals,
• So if you're looking for nurses and you want to find out what an area nurse is making and you want to
• One of the things that the lady who was the compliance officer for the nursing home, responding back
• So that's kind of hard to track, kind of hard to regulate.
• And, you know, like I said, they operate under strict compliance regulations.

Committee: House Health and Mental Health

Summary: The Committee on Health and Mental Health first met in executive session and voted House Bill 2370, House Bill 3278, and House Bill 1638 do pass. HB 2370 passed 13-9, while HB 3278 passed 15-0 and HB 1638 passed 17-0. The committee then moved into public testimony. Senate Bill 1015, sponsored by Senator Nuremberg, was presented as a measure creating a legal process for assisted outpatient treatment for adults with serious mental illness who are at risk of deterioration, hospitalization, or harm. Supporters, including the Missouri Behavioral Health Council and the Missouri Association of Public Administrators, said it would reduce hospitalization and incarceration and improve access to care. The senator and witnesses emphasized collaboration with hospitals and the Department of Mental Health, and no opposition was offered. The committee also heard a detailed presentation on the STARS program from SSM Health representatives, explaining it as a Missouri-based EMS and pediatric emergency planning system that uses physician-approved, electronic care plans for children with complex needs. Members asked about costs, access, and how the program differs from the bill discussed previously; witnesses said the program is free for EMS and emergency access, but hospitals that write plans pay implementation and subscription fees. House Bill 2903, by Representative Mayhew, would give county and district hospitals relief from certain public-entity requirements, including some Sunshine Law-related burdens, board qualifications, and financial reporting timelines, to help them compete with private hospitals. Supporters from Phelps Health said the bill would reduce administrative burden and protect proprietary information; there was no opposition. Finally, House Bill 3379, by Representative Dolan, would expand and strengthen Missouri’s employee disqualification and mandated reporting rules for abuse, neglect, and financial exploitation of vulnerable adults. The bill adds more mandated reporters, including bank personnel and first responders, creates penalties for knowingly failing to report, and requires quicker DSS follow-up to reporters. DHSS supported the bill, citing recent financial exploitation complaints, while the Missouri Bankers Association said it supports the goal but wants to work on the mandatory reporting language so banks are not exposed to liability for situations they cannot readily detect. No formal opposition was presented, and the committee adjourned after the hearing.

Transcript Highlights:

• We also license and regulate about 50,000 providers.
• everything except for a doctor's office, which is regulated by the Department of Health.
• We also license and regulate about 50,000 providers.
• But I want to get them before they have to go into nursing home.
• He said usage has increased, and that nursing home beds are full.

Summary: The Health Care Budget Subcommittee met to organize the new term, take roll, and hear introductory presentations from the six agencies under its jurisdiction: the Agency for Health Care Administration, Agency for Persons with Disabilities, Department of Children and Families, Department of Elder Affairs, Department of Health, and Department of Veterans’ Affairs. The chair outlined the committee process, including assigning members to review agencies and make budget recommendations. Each agency head gave a high-level overview of their budget, staffing, major programs, and priorities, with recurring themes including Medicaid, long-term care, disability services, child welfare, mental health, aging services, public health, and veterans’ health care. Several agency leaders highlighted recent initiatives and funding priorities. AHCA emphasized Medicaid managed care, provider regulation, Hope Florida, hospital-at-home, and cancer-related efforts; APD discussed iBudget services, Hope Florida, a managed-care pilot, online applications, and forensic care costs; DCF focused on child protection, foster care, adult protective services, food/cash/medical assistance, mental health, and opioid treatment; Elder Affairs highlighted Alzheimer’s services, community-based senior care, guardianship, ombudsman services, and disaster outreach; DOH covered cancer innovation, maternal telehealth, cybersecurity, HIV/hepatitis/syphilis screening, and school nursing; and Veterans Affairs described benefits and health care access for veterans, long-term care, and federal reimbursement. Several speakers also raised concerns about rising costs, provider rates, disaster response, and access to services. The committee heard two public comments from disability advocates about Medicaid redeterminations affecting iBudget waiver recipients and provider payment delays. In response, AHCA and APD said they were coordinating on data sharing, early outreach, escalation processes, and efforts to reduce disenrollments and make recertification smoother. Members then asked questions about provider rates, opioid settlement spending, managed care quality measures, pediatric rare disease grants, group home transparency, senior outreach, ABA services moving into managed care, annual Medicaid recertification, veterans’ service utilization, waiting lists for elder services, and prevention spending. No formal votes were taken during the meeting.

Transcript Highlights:

• </c><00:36:35.920><c> By</c> the cost of nursing home care. By the cost of nursing home care.
• care coming once a day or nurse-assisted nursing assistant or anything like that that come and maybe
• care coming once a day or nurse-assisted nursing assistant or anything like that that come and maybe
• once a day or nurse assisted a nursing<00:40:11.040><c> assistant</c><00:40:11.440><c> or</c><00:40:
• </c> services in a skilled nursing facility. services in a skilled nursing facility.

Summary: The Medicaid Oversight Advisory Board’s fourth meeting focused primarily on a presentation from University of Kentucky and University of Louisville health leaders about the state university directed payment program. Mark Birdwhistle and Ken Marshall described the program as a long-running, value-based Medicaid arrangement that began in 2019, uses university-provided matching funds rather than provider taxes, and ties a portion of payments to quality outcomes. They said the program has improved measures such as tobacco cessation, diabetes control, depression screening, and cancer screening, while supporting access to specialty care, medical education, and workforce training. They also emphasized that Kentucky’s model is nationally notable and has helped improve health rankings and generate cost savings. A major topic was the federal reconciliation bill signed July 4, which the presenters said will reduce directed payments by 10% annually for 10 years beginning in 2028. UL Health estimated a first-year loss of about $75 million and a cumulative loss of about $600 million over the decade; UK estimated about $100 million in the first year, for a combined first-year impact of roughly $175 million. Both speakers warned the cuts could affect access to care, training capacity, and the sustainability of Kentucky’s value-based model, though they expressed hope that congressional action could alter or delay the changes. They also noted that 340B drug pricing changes could further strain already thin operating margins, but did not provide exact figures during the meeting. Committee members responded positively to the program’s reported outcomes and the institutions’ role in Kentucky health care. Senator Berg praised the quality of care and shared a personal example of being advised to stay at UofL for breast cancer treatment. Representative Moer highlighted Kentucky’s strong cancer-control score and asked for more explanation of the value-based payment structure; the presenters said the system is built around ongoing measurement, accountability, and collaboration with the Cabinet for Health and Family Services. No votes or formal actions were taken beyond approving the amended August 27 minutes by voice vote.

Transcript Highlights:

• Senator Hines, you're recognized to introduce the Nurse of the Day. Thank you, Mr.
• Members, today is my honor to recognize our Nurse of the Day, Marla Linscombe, MSN, RN, with Integris
• Marla brings more than 27 years of nursing experience with a strong clinical background in critical care
• Members, we are grateful for Marla Linscombe's dedication to the nursing profession and for her service
• Double regulations. With that, I urge adoption. I yield for questions.

Bills: HB1937 , HB2153 , HB3674 , HB2978 , HB3885 , HB3671 , HB3261 , HB3021 , HB3029 , HB4274 , HB3701 , HB3076 , HB2299 , HB3852 , HB3244 , HB3345 , HB3114 , HB3764 , HB4144 , HB3304 , HB2939 , HB4227 , HB3262 , HB2941 , HB3498 , HB4343 , HB4425 , HB3386 , HB3087 , HB3062 , HB3431 , HB4141 , HB3581 , HB4237 , HB2960 , HB3645 , HB3648 , HB3974 , HB3045 , SCR18 , HCR1024 , SJR39 , SJR49 , HB4486 , SB1130 , SB1131 , SB1132 , SB1133 , SB1134 , SB1142 , HB1823 , HB4476 , HB3378 , HB3880 , HB3031 , HB3369 , HB3429 , HB3657 , HB4215 , HB3624 , HB1170

Summary: The Senate convened with a quorum, offered the daily prayer, and recognized a series of guests and special introductions, including Langston University Day, Moore Public Schools cheer and pom squads, a student shadow, former Senator Connie Johnson, Brazilian missionaries, and a long-serving mental health employee. The chamber also heard introductions from the day’s pages. The Senate adopted Senate Concurrent Resolution 18, recognizing April 21, 2026, as National Lineman Appreciation Day, and House Concurrent Resolution 1024, designating Route 66 Day at the Capitol and honoring the highway’s centennial. Senators then advanced Senate Joint Resolution 49, which revokes a Wildlife Department rule requiring oil and gas companies to post a surety bond, after discussion clarified the measure was intended to eliminate duplicative regulation; the resolution advanced on a 42-3 vote. The Senate also passed House Bill 4486, authorizing the State Capitol Preservation Commission to arrange a privately funded Gold Star Family Monument near the Capitol Square Arch, and approved several appropriations measures tied to ARPA interest or excess funds. These included Senate Bill 1130 for the University of Oklahoma Hospital Trust Authority’s Child Behavioral Health Project, Senate Bill 1131 for the Office of Juvenile Affairs’ Youth Services Program, Senate Bill 1132 for the Rural Hospital Rebuild Program, Senate Bill 1133 for Griffin Memorial Hospital replacement capacity, Senate Bill 1134 for the Human Performance Project and Pharmaceutical Expansion Project, and Senate Bill 1142 for grants to the Boys & Girls Club and YWCA. Most of these bills were adopted with emergency clauses after roll-call votes, with some members changing votes before final emergency passage. The Senate then announced committee meetings and adjourned until the next scheduled session.

Transcript Highlights:

• It has been producing engineers, architects, nurses, and educators for more than 150 years.
• Engineers, architects, nurses, and educators for more than 150 years, members.
• It remains one of the top producers of nurses in the state of Texas. Mr.
• Senate Bill 2727 by Cook, relating to the regulation of abortion, to State Affairs.
• Senate Bill 2752 by Blanco, relating to the regulation of fantasy contests, to State Affairs.

Bills: SJR12 , SCR39 , SB27 , SB29 , SB241 , SB406 , SB414 , SB464 , SB568 , SB578 , SB609 , SB660 , SB689 , SB693 , SB785 , SB857 , SB879 , SB921 , SB922 , SB955 , SB985 , SB993 , SB996 , SB1008 , SB1035 , SB1036 , SB1059 , SB1098 , SB1120 , SB1122 , SB1147 , SB1188 , SB1197 , SB1209 , SB1227 , SB1245 , SB1267 , SB1307 , SB1321 , SB1332 , SB1386 , SB1396 , SB1453 , SB1484 , SB1494 , SB1536 , SB1537 , SB1596 , SB1610 , SB1664 , SB1741 , SB1814 , SB1822 , SB1841 , SB1948 , SB2065 , SB2155 , SB2188 , SB2230 , SB2406 , SB2407

Summary: The Senate convened with a quorum present, heard an invocation, and approved the previous day’s journal. The chamber then adopted Senate Resolution 358 honoring the University of Texas Rio Grande Valley on its 10th anniversary, with senators highlighting the university’s growth, medical school, research expansion, and role in serving South Texas. The Senate also adopted Senate Resolution 368 honoring outgoing Texas A&M University System Chancellor John Sharp, with numerous senators praising his long public career, leadership in higher education, and statewide impact. Senate Resolution 361 recognizing Texas HBCU Day and Senate Resolution 362 recognizing Denton County Days at the Capitol were also adopted, along with other routine recognitions and gubernatorial appointments being read into the record. The Senate then took up several bills. Committee Substitute Senate Bill 27, relating to rights and support for public school educators, was debated and amended to shorten vacancy posting requirements, allow bilingual certification candidates to retake only failed test sections, give teachers more flexibility with paid leave, clarify classroom removal procedures, and ensure parents are informed of appeal rights. The bill passed to engrossment, the three-day rule was suspended, and it was finally passed unanimously. Senate Joint Resolution 12, proposing a constitutional amendment to establish a parent’s right to direct a child’s education, was also brought up and passed to engrossment after a contested suspension vote. The Senate next passed Committee Substitute Senate Bill 1741, which would require reporting of foreign funding at public universities, bar gifts from adversarial governments, and require training and reporting systems to prevent foreign influence and intellectual property theft in higher education. Committee Substitute Senate Bill 29, the so-called “Dexit” bill, was debated at length for its corporate governance changes, including codifying the business judgment rule and altering internal corporate litigation and records rules; it passed to engrossment, the three-day rule was suspended, and it was finally passed by a 30-1 vote. Senate Bill 857, allowing law enforcement discretion to tow vehicles driven by unlicensed or uninsured drivers, passed after discussion of towing abuses during flooding and disaster conditions. Committee Substitute Senate Bill 1536, requiring dementia and Alzheimer’s training for certain guardians, passed with broad support, and Senate Bill 922, addressing delayed electronic disclosure of sensitive medical test results so physicians can discuss them first, was taken up and passed to engrossment as the chamber continued through its calendar.

Transcript Highlights:

• Nurses Association and Sarah Flachs with the California Labor Federation.
• I’m a registered nurse, a proud union member of the California Nurses Association, which is co-sponsoring
• Nurses must be able to evaluate a sepsis alert against the patient in front of us.
• Nurses aren’t anti-tech.
• Hanna, on behalf of the California Nurses Association, co-sponsor of the bill. Thank you.

Summary: The committee heard several bills focused on public safety, labor enforcement, pensions, and workplace safety. AB 1054 would create a voluntary DROP-style retirement option for CHP officers and Cal Fire firefighters to help retain experienced personnel; supporters said it would be cost-neutral and help staffing, while an opponent warned it could affect bond ratings and create pension risk. The bill passed the committee 4-0 and was sent to Appropriations. AB 2129, which would improve Cal Fire compensation to aid recruitment and retention, also passed 4-0 to Appropriations with support from firefighters and no opposition. AB 1383, a broader PEPRA-related measure lowering retirement age and adjusting compensation caps for public safety workers, drew extensive support from firefighters and peace officers and strong opposition from cities, counties, and other local government groups over long-term pension costs; after debate over fiscal impacts, it passed 4-0 to Appropriations. The committee also considered AB 605 on refinery safe staffing during shutdowns, prompted by layoffs and reduced staffing at refineries such as Phillips 66 Wilmington. Supporters argued the bill would protect workers and nearby communities during refinery wind-downs, while petroleum and business groups said closures are not inevitable and opposed the bill’s premise. The bill passed 3-0 to Environmental Quality. AB 1859 would let joint labor-management committees access public works sites to help detect wage theft and safety violations; construction labor supporters backed it as an enforcement tool, while laborers, local governments, and builders raised concerns about duplication, property access, and project disruption. It passed 2-0 to Judiciary, on call. The committee then heard AB 2321, a pilot program allowing county district attorneys in Alameda and Santa Clara to investigate workplace deaths, which supporters said would address Cal/OSHA’s backlog and weak enforcement; employers and safety practitioners opposed it, citing expertise, due process, and overlapping investigations. It passed 2-0 to Appropriations, on call. Finally, AB 2575 began testimony on healthcare AI guardrails, with the author and nurses arguing that AI should support, not replace, clinical judgment and that patient safety requires human oversight.

Transcript Highlights:

• Senate Bill 1927 by Hinojosa of Nueces relating to municipal regulation of the removal of an ash juniper
• Senate Bill 1954 by Campbell relating to the authority of the county to regulate land use in certain
• Senate Bill 1964 by Parker relating to the regulation and use of artificial intelligence systems and
• Senate Bill 1973 by Kolkhorst relating to the regulation of human body acquisition services to Health
• Senate Bill 2011 by Johnson relating to the adoption of noise regulations by certain counties to Local

Bills: SJR4 , SCR36 , SCR37 , SCR38 , SCR39 , SCR40 , SCR41 , SCR42 , SB7 , SB30 , SB31 , SB32 , SB33 , SB34 , SB36 , SB37 , SB38 , SB39 , SB1851 , SB1852 , SB1853 , SB1854 , SB1855 , SB1856 , SB1857 , SB1858 , SB1860 , SB1861 , SB1862 , SB1863 , SB1864 , SB1865 , SB1866 , SB1867 , SB1868 , SB1869 , SB1870 , SB1871 , SB1872 , SB1873 , SB1874 , SB1875 , SB1876 , SB1877 , SB1878 , SB1879 , SB1880 , SB1881 , SB1882 , SB1883 , SB1884 , SB1885 , SB1886 , SB1887 , SB1888 , SB1889 , SB1890 , SB1891 , SB1892 , SB1893 , SB1894 , SB1895 , SB1896 , SB1897 , SB1898 , SB1899 , SB1900 , SB1901 , SB1903 , SB1904 , SB1905 , SB1906 , SB1907 , SB1908 , SB1909 , SB1910 , SB1911 , SB1912 , SB1913 , SB1914 , SB1915 , SB1916 , SB1917 , SB1918 , SB1919 , SB1920 , SB1921 , SB1922 , SB1923 , SB1924 , SB1925 , SB1926 , SB1927 , SB1928 , SB1929 , SB1930 , SB1931 , SB1932 , SB1933 , SB1934 , SB1935 , SB1936 , SB1937 , SB1938 , SB1939 , SB1940 , SB1941 , SB1942 , SB1943 , SB1944 , SB1945 , SB1946 , SB1947 , SB1948 , SB1949 , SB1950 , SB1951 , SB1952 , SB1953 , SB1954 , SB1955 , SB1956 , SB1957 , SB1958 , SB1959 , SB1960 , SB1961 , SB1962 , SB1963 , SB1964 , SB1965 , SB1966 , SB1967 , SB1968 , SB1969 , SB1970 , SB1971 , SB1972 , SB1973 , SB1974 , SB1975 , SB1976 , SB1977 , SB1978 , SB1979 , SB1980 , SB1981 , SB1982 , SB1983 , SB1984 , SB1985 , SB1986 , SB1987 , SB1988 , SB1989 , SB1990 , SB1991 , SB1992 , SB1993 , SB1994 , SB1995 , SB1996 , SB1997 , SB1998 , SB1999 , SB2000 , SB2001 , SB2002 , SB2003 , SB2004 , SB2005 , SB2006 , SB2007 , SB2008 , SB2009 , SB2010 , SB2011 , SB2012 , SB2013 , SB2014 , SB2015 , SB2016 , SB2017 , SB2018 , SB2019 , SB2020 , SB2021 , SB2022 , SB2023 , SB2024 , SB2025 , SB2026 , SB2027 , SB2028 , SB2029 , SB2030 , SB2031 , SB2032 , SB2033 , SB2034 , SB2035 , SB2036 , SB2037 , SB2038 , SB2039 , SB2040 , SB2041 , SB2042 , SB2043 , SB2044 , SB2045 , SB2046 , SB2047 , SB2048 , SB2049 , SB2050 , SB2051 , SB2052 , SB2053 , SB2054 , SB2055 , SB2056 , SB2057 , SB2058 , SB2059 , SB2060

Transcript Highlights:

• practitioners and registered nurse practitioners.
• midwives, nurse anesthetists, nurse practitioners, psychiatric nurses, professional counselors, psychologists
• Do those regulations create higher costs? Probably.
• You need people, nurses, people to clean the building.
• It's Code of Federal Regulations.

Summary: The committee met to review the history and current treatment of North Dakota health insurance mandates, with presentations from Blue Cross Blue Shield of North Dakota, Sanford Health Plan, the Public Employees Retirement System (PERS), and the Insurance Department. The discussion focused on how mandates apply differently to fully insured, self-funded, ACA, Medicaid, and PERS plans; how the state’s benchmark plan and federal essential health benefits affect coverage; and how the existing process requires cost-benefit analysis and, for certain measures, a PERS pilot period before broader application. Presenters also reviewed the long list of existing state mandates, including provider, beneficiary, and coverage requirements, and noted that many were enacted decades ago and have not been revisited despite changes in medical evidence and treatment options. Witnesses from the carriers argued that mandates should be reviewed periodically because some are outdated, can create unintended costs, and may not align with current medical guidance. Examples cited included PSA screening, off-label drug coverage, prior authorization rules, step therapy, and cost-sharing provisions for mental health and substance use treatment. They emphasized that carriers often cover services without a mandate when supported by clinical evidence, and that mandates can shift costs to employers and employees, especially in the fully insured small-group market. They also suggested possible policy improvements such as clearer mandate definitions, better transparency around cost-benefit analyses, a regular 10-year review of mandates, and more timely submission of proposals through the interim process. PERS and the Insurance Department highlighted a recurring tension over what counts as a mandate and when a measure triggers the state’s defrayal obligation under federal law. PERS described its interim committee process, the April 1 deadline for fiscal-impact proposals, and the limited pilot program used for certain measures, noting that only a few bills have gone through the full pilot process. The Insurance Department explained that it views new benefit mandates through the lens of the ACA benchmark plan and essential health benefits, distinguishing true new benefits, such as infertility coverage, from changes to existing benefits, such as telehealth or insulin cost-sharing caps. No votes were taken on policy changes; the meeting was informational, with members asking questions about costs, applicability, transparency, and whether a periodic mandate review should be established.

Transcript Highlights:

• Nurses set nursing standards through professional boards.
• </c> grounded care because the regulations grounded care because the regulations and<00:35:48.079><c>
• home, you have to be a in a nursing home, you have to be a nursing<01:08:21.199><c> assistant.
• </c> nursing assistant. 75 hours of training. nursing assistant. 75 hours of training.
• </c> They're all about regulating emotion. They're all about regulating emotion.

Transcript Highlights:

• And as you all know, we do have our HSOA work that we really license and regulate the health care arena
• And as you all know, we do have our HSQA work that we really license and regulate the health care arena
• The department regulates the transportation components of organ donation, but we don't regulate the care
• So that is the department's portion of this and how we regulate the organ transport services.
• It works alongside federal hospital regulations requiring OPOs to honor all donor decisions.

Committee: Joint Joint Select Committee on Health Care and Behavioral Health Oversight

Summary: The committee met to hear introductory briefings from the Department of Health and the Health Care Authority on agency priorities, federal changes, and implementation challenges. Secretary of Health Dennis Worsham said his department’s listening tour is focused on strengthening governmental public health, improving health care quality and access, and responding to federal funding disruptions and the shutdown’s effects on programs such as WIC. HCA Director Ryan Moran said the agency is prioritizing coverage preservation, oversight of major contracts, affordability, behavioral health integration, rural health transformation, and internal agency operations. Members asked about licensure delays; Worsham said the backlog had been reduced from about four months to six weeks and should be caught up by January 1, with possible further process changes if needed. A major portion of the meeting focused on H.R. 1 and its Medicaid-related implementation. Governor’s health policy advisor Caitlin Stafford, HCA staff, and interim Medicaid Director Trinity Wilson said the state is working with DSHS, the Health Benefit Exchange, tribes, and other partners to prepare for eligibility changes, work requirements, and six-month redeterminations. They said the state expects up to 30,000 Apple Health enrollees could lose coverage under the law’s non-citizen eligibility changes, and that the work requirement/redetermination provisions could affect about 620,000 adults, with roughly 80,000 also enrolled in SNAP. HCA said it hopes to automate most verification, but about 15% to 20% of cases may require manual review, with technology costs estimated at up to $30 million. Staff also said they are trying to keep H.R. 1 implementation mostly in budget language rather than statute, and that communication and navigator support will be important to minimize confusion and coverage loss. The committee also received an update on the Rural Health Transformation Program created in H.R. 1. HCA said Washington submitted its application to CMS on November 5 after extensive stakeholder engagement, including more than 310 written comments, webinars, and tribal consultation. The application centers on six initiatives: rural hospital innovation, community care and prevention, tribal investments, technology and data, workforce development, and rural behavioral health. HCA said the state is likely to receive less than the full $200 million annual amount assumed in the federal program, and that an advisory committee may be created to help guide spending over the five-year program. Members asked about palliative care, small business impacts, and communication with enrollees; HCA said it expects to share outreach toolkits and that no 2026 statutory changes are currently anticipated, though that could change. The final panels covered organ donation and transplant services. Department of Health staff explained the 2023 “Lights and Sirens” law for organ transport vehicles, including licensing, driver qualifications, insurance requirements, and use of emergency lanes and traffic preemption; the department said one company is currently licensed and there have been no complaints. LifeCenter Northwest described the organ procurement process, the legal framework under the Uniform Anatomical Gift Act, and the rarity and complexity of deceased donation, noting Washington has seen strong growth in donation and transplants over the past decade. University of Washington Medical Center staff then outlined its transplant programs for kidney, liver, heart, lung, pancreas, and multi-organ transplants, describing the multidisciplinary evaluation and waitlist process and the coordination required with donor organizations and hospitals.

Transcript Highlights:

• So, in looking into this, there was no regulation on these kiosks.
• At least 19 other states have enacted legislation to regulate these.
• <00:36:36.280><c> on</c> regulation on regulation on these<00:36:37.480><c> kiosks.
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• </c> Kentucky Sheriff's Association, Nurses Kentucky Sheriff's Association, Nurses Association, Association