Transcript Highlights:

• Elimination of food security services, including meal and grocery services.
• These are public service employees.
• It means immediate cuts to real people, real jobs, real services, real people who rely on those services
• If not, the cities that provide critical services will face service reductions at no fault of their own
• And so it's right-sizing all of our business services and all the services and programs that we oversee

Transcript Highlights:

• I'm the director of Home and Community Services.
• did a study on the need for PAC services in Washington State.
• So kind of having that help to find the services that they need.
• I am the CEO of Alpha Support Living Services.
• I am the CEO of Alpha Support Living Services.

Committee: Joint Joint Legislative Executive Committee on Planning for Aging and Disability Issues

Summary: The committee held what was described as its final meeting and began with introductions, then received updates on several long-term care and aging initiatives that originated from earlier J-LEC work. A presentation on the WA Cares Fund reviewed its development from a 2014 research project to implementation, including premium collection, expanded eligibility for near-retirees, portability, recent technical fixes, and the creation of a supplemental private insurance market. The presenter said the program is now largely in place and ready for future use, with benefits expected to go fully live next summer. The Dementia Action Collaborative also reported on its state plan, including Project ECHO dementia training, dementia-capable community pilots through area agencies on aging, and ongoing work on early detection, brain health, and caregiver support. Another DSHS presentation covered the Medicaid Transformation Project, including Medicaid Alternative Care, Tailored Supports for Older Adults, presumptive eligibility, and health-related social needs benefits such as rental assistance and nutrition support, with officials saying the waiver is likely secure until its 2028 renewal. The meeting then shifted to emerging issues from advocates and ombuds. The long-term care ombuds described persistent staffing shortages, concerns about low wages, the growing use of technology and surveillance in care settings, private equity ownership of facilities, and illegal or pressured discharges and evictions. The developmental disabilities ombuds focused on people with developmental disabilities who remain hospitalized without medical need, the need for better mental health and behavioral health access, and workforce training gaps for people serving this population. Disability Rights Washington urged more community-based supports to reduce repeated institutionalization, pointing to gaps in programs such as PACT, GOSH, and peer bridgers, and recommending those services be expanded and bundled at scale. Provider and workforce panels emphasized similar themes. Washington Health Care Association and LeadingAge Washington said assisted living and skilled nursing facilities face workforce shortages, Medicaid rates that lag behind costs, increasing client acuity, behavioral health needs, and discharge bottlenecks. They highlighted the need for more flexible care models, improved case management, and better reimbursement, including for complex behavioral health cases. Supported living providers reported high turnover, underfunding, and a successful pilot that used enhanced rates and added training to place 30 hard-to-serve individuals. SEIU 775 argued that the central problem across settings is the direct care workforce crisis, driven by low wages and inadequate benefits, and said rate increases must be tied more directly to worker compensation. DSHS closed by noting heavy reliance on federal Medicaid funding, ongoing pilots in training, transportation, remote caregiving, smart-home technology, and rental subsidies, and said future planning should shift toward a multi-sector state strategy after the committee sunsets.

Transcript Highlights:

• services necessarily fit within the covered service definition.
• services necessarily fit within the covered service definition.
• OT can order OT services and services.
• So services like if the child services.
• ,</c><02:18:10.080><c> student</c><02:18:10.479><c> services</c> educational services, student services

Summary: The subcommittee opened its second meeting on House Bill 742, which would require catastrophic special education aid to be drawn from the education trust fund, and discussed whether to also examine differentiated aid within the adequacy formula. The chair said the committee had previously heard from HHS/Medicaid officials and now wanted to hear from local special education directors about how the aid system works in practice, including billing, training, data collection, and whether districts handle claims consistently. Members also referenced Arkansas as a possible comparison state and said they hoped to develop ideas by November to address the current funding process. Committee members focused on the current special education aid thresholds and the impact of proration. The chair described the existing formula as requiring districts to absorb costs up to 3.5 times the state average per student, with the state paying 80% from 3.5 times through 10 times and paying above that, and said FY25 appropriated about $34 million while actual claims were about $50.1 million, leaving roughly a $16 million shortfall that caused proration. Members also raised the possibility of lowering the threshold to 2.5 times and asked how that would affect the number of eligible students and costs. Another member asked about how districts decide whether services are education-related or medical-related and how Medicaid or private insurance reimbursement affects later state aid claims. District representatives from Boothby Therapy Services, Bedford, and Guilford introduced themselves and described their roles. Guilford’s director said the district tracks students with paraprofessional support, nurses, transportation, or specialized programming, uses a data system to log every service touchpoint, and tries to maximize both Medicaid and special education aid; she said a lower threshold would likely capture all students with paras or nurses and that rising staffing and service costs would increase the number of students over the cap. Bedford’s assistant director said the district uses a different system, tracks roughly 60 to 80 students a year, and pursues Medicaid and special education aid simultaneously but does not pursue private insurance if it would affect FAPE; she said reducing the threshold to 2.5 times would likely double the number of qualifying students. Members asked follow-up questions about software, data entry, and how districts decide whether to bill Medicaid or seek state catastrophic aid, and the directors explained that their systems log services by staff type and student, with some districts using the same data for both Medicaid and state reimbursement claims.

Transcript Highlights:

• And $13.4 billion, about 9.4%, is for developmental services.
• placement decisions, services, and transition.
• Would all YCR be engaged in how services are going to be, how effective services are going to be given
• So that is... ...despite this demand and services.
• The services are entirely unnecessary.

Summary: The hearing began with an overview of the California Health and Human Services Agency, which described its 2026-27 budget, major departments, and strategic priorities, including behavioral health, housing and human services integration, children and youth, and aging/disability services. The agency also explained a technical CalHHS/CalHires budget adjustment tied to HR1 compliance and eligibility system work. No LAO concerns were raised on that item. The committee then heard from the Office of Youth and Community Restoration on its budget, its SB 823 realignment report, and related issues. OYCR said county-based realignment has generally succeeded but outcomes and readiness vary widely, and it recommended more climate surveys, youth advisory councils, stronger behavioral management, better programming, improved transition planning, and integrated longitudinal data systems. Members pressed OYCR on “net widening,” county-by-county trends, and the gap between the detailed recommendations discussed in hearing and the more general recommendations in the public report. OYCR also described problems with federal Title II grant timing and a pending $14 million administrative funding adjustment, and discussed implementation of the juvenile justice realignment block grant formula. The Ombudsperson division separately requested two new positions due to rising complaints, site visits, and records-access disputes with counties; LAO noted the proposal would create ongoing General Fund costs. Several other departments presented budget change proposals. The State Council on Developmental Disabilities requested $730,000 General Fund ongoing to cover an interagency administrative support gap with DSS; LAO had no concerns. EMSA presented its department overview, said its AB 716 ambulance-rate report has been delayed after resources were reduced, and requested funding for disaster-response vehicle replacement, IT security assessment work, and additional HR/legal staff; members questioned delays, compliance, and the ongoing General Fund impact. The Department of Community Services and Development sought reappropriation of LIWIP funds and explained a new Proposition 4 process for continuing the farmworker housing component. The Department of Rehabilitation requested authority for $60 million in additional federal funds and 54 positions to meet growing vocational rehabilitation demand, with no General Fund impact. The Department of Child Support Services presented its budget and a supplemental report on full pass-through of child support collections. Members questioned why local agency funding was being restored despite declining caseloads, and staff explained that staffing costs have risen faster than caseload declines and that additional funding is needed to maintain service levels. The supplemental report estimated full pass-through would cost about $150 million General Fund annually, or about $80 million for a state-and-county portion, with $3 million to $5 million in automation costs. Finally, the Department of Public Health gave a broad overview of its $5.1 billion budget and its State of Public Health report, highlighting improved mortality and life expectancy, declining overdose deaths and STI rates, persistent racial and regional disparities, and increasing public health emergency demands. CDPH also warned that federal funding threats and policy changes are creating major uncertainty for state and local public health systems.

Transcript Highlights:

• work, and our veteran services.
• Services.
• It's an incredible service.
• Legal Services for Children.
• What is "other services" and what are these contractual services?

Transcript Highlights:

• I received an honorable discharge from active-duty service. I am still in the IRR right now.
• Honestly, in the military service, you know, we have men, women.
• If it's different, can we get them to have these other services, these other pieces?
• I think it's important for us to, of course, recognize the service, but also the impact.
• It's important for us to, of course, recognize the service, but also the impact.

Committee: House Military and Veterans Affairs

Transcript Highlights:

• We ensure that no veteran ever chooses to use our services without understanding the free services that
• First of all, let me say thank you all for your service.
• So not all the services are being provided.
• Association of County Veterans Service Officers.
• providing services, a choice.

Summary: The Assembly Committee on Military and Veterans Affairs met with a quorum and first approved its consent calendar, which included AJR 15, SB 56, SB 296, and SB 855, with the roll left open for absent members. The committee then heard SB 694 by Senator Archuleta, a bill aimed at protecting veterans from unaccredited claims representatives and other for-profit entities that charge fees to assist with VA disability claims. The author and supporters, including county veterans service officers and veterans organizations, argued the measure would curb predatory practices, restore accountability, and steer veterans toward free, accredited assistance through CVSOs and other authorized representatives. Testimony in support emphasized that veterans are often targeted online and may pay large fees for services that are available for free, while supporters said unaccredited firms lack transparency and can exploit vulnerable veterans. Opposition witnesses, including representatives of claims-assistance companies and individual veterans, argued the bill would eliminate choice and that some contingency-based firms provide useful services, better outcomes, and faster claims processing. Committee members debated whether the bill would unlawfully bar legitimate assistance or whether it was needed to stop illegal business practices, with several members noting the issue is also being litigated in federal court and that an accreditation process already exists through the VA. After discussion, the committee voted to pass SB 694 and refer it to the Committee on Judiciary. The final vote was 6 ayes, with some members not voting. The committee then completed the consent calendar vote, which passed with eight votes, and adjourned.

Transcript Highlights:

• to support those services.
• , and social services.
• that they provide valuable services, education, and on and on to the local ambulance services.
• fee-for-service.
• services, other reductions would have resulted in a direct reduction in service to individuals that

Committee: Joint Joint Committee on Ways and Means

Summary: The Joint Committee on Ways and Means held a Health and Human Services budget hearing in Clinton, with opening remarks from Chairs Meg Kilcoyne and Robin Kennedy, local officials, and many House and Senate members introducing themselves. The hearing focused on Governor Healey’s FY27 EOHHS and MassHealth budgets, with repeated themes of rising health care costs, federal funding uncertainty, workforce shortages, and access to care in underserved regions. Members also raised concerns about primary care shortages, rural and regional disparities, behavioral health access, maternal health, food insecurity, and the impact of federal policy changes on Massachusetts programs. EOHHS Secretary Kiame Mahaniah said the FY27 EOHHS budget totals $33.7 billion, reflecting mostly non-discretionary growth from health care costs, labor costs, caseload increases, and provider rate pressures. He highlighted targeted investments in foster care, family resource centers, maternal health, youth services, nutrition programs, immigrant legal services, and human service workforce rates, while warning that federal actions could strip roughly $3.5 billion annually from the state’s health care funding. In response to questions, he defended the administration’s cooperation with federal audits and program integrity efforts, discussed the primary care crisis, and said the state is trying to preserve core services while preparing for a more difficult FY28 budget cycle. MassHealth Undersecretary Mike Levine then described two major FY27 challenges: double-digit cost growth and the expected effects of the federal One Big Beautiful Bill Act. He said MassHealth’s proposed $22.7 billion gross budget includes a 7.5% increase and relies on a moratorium on new expansions plus targeted reductions, including a $1,000 annual adult dental cap, ending GLP-1 coverage for weight loss only, reducing care management to peer-state levels, and work groups to slow growth in PCA, adult foster care, and adult day health spending. Members questioned the impact on Boston Health Care for the Homeless, preventive care, and regional access; Levine said the changes are meant to preserve sustainability, that children and certain disabled populations remain protected, and that the administration will continue working with providers, advocates, and the Legislature on implementation and longer-term reforms.

Transcript Highlights:

• be able to access under fee-for-service?
• The only two services that will not be covered in fee-for-service because they're not currently federally
• But everything else is the same in fee-for-service as it is in managed care in terms of services and
• Indigent care services are still needed in our counties.
• Thank you very much. for service.

Summary: The Senate Budget and Fiscal Review Committee heard AB 109, the Budget Act of 2026, as the main item. Committee leaders described the legislative budget agreement as a balanced two-year plan with about $355.9 billion in total spending, $253 billion from the General Fund, and $36.5 billion in reserves. The Legislative Analyst and Department of Finance said the package assumes about $5.5 billion in higher revenues than the May Revision and uses those resources for a mix of spending changes, including higher Proposition 98 support, additional child care slots, housing and homelessness funding, delayed Medi-Cal reductions, and added support for counties, public hospitals, and distressed hospitals. The administration said the plan resembles the May Revision’s overall structure but includes new spending and revenue assumptions, and members noted that separate revenue trailer bills would be heard later in the week. Much of the committee discussion focused on Medi-Cal, H.R. 1, and the impact on immigrants, low-income workers, counties, and hospitals. Several senators criticized the budget for locking in savings from delayed or reduced Medi-Cal coverage and for not including a mechanism to restore eligibility, while administration and LAO staff said the package delays some reductions but does not automatically reinstate coverage. Finance staff said roughly 1.5 million to 2 million people with unsatisfactory immigration status would move from managed care to fee-for-service, with coverage largely unchanged except for certain services not federally allowed. Members also discussed county administrative funding, indigent care, public hospital support, and the expected rise in uncompensated care. Other topics included In-Home Supportive Services, child care, homelessness funding, Prop. 36, courthouse construction and new judgeships, transit and cap-and-invest/GGRF funding, local journalism, and workforce or reentry programs. Committee members split along party lines in their comments. Democratic members generally supported the agreement as a difficult but responsible compromise that protects core services, preserves reserves, and makes targeted investments in education, housing, health care, and justice system capacity. Republican members argued the budget relies on unrealistic revenue assumptions, does not sufficiently reduce spending, and includes costly policy choices and tax increases. Public testimony largely came from advocates and stakeholders who supported IHSS, Medi-Cal, child care, domestic violence services, hospitals, transit, and other programs, while some business and health plan representatives raised concerns about tax proposals and the shift from managed care to fee-for-service. The chair then moved the committee to public comment and indicated that the revenue bills would return later in the week; no final vote on AB 109 is reflected in the portion provided.

Transcript Highlights:

• Thank you for your service.
• All of our veteran service dogs also retrieve.
• all the way to service.
• We're servicing the Midwest out here in the middle.
• Now they have a service dog from, from Richard.

Committee: House Veterans and Armed Forces

Summary: The committee first heard House Bills 1993 and 2771, both sponsored by Reps. Irwin and Boykin, which would extend Servicemembers Civil Relief Act-style protections to Missouri National Guard members when they are called to state emergency duty. The sponsors and supporting witnesses said the bills would help Guard members with issues like eviction, lease termination, debt collection, and civil court proceedings while they are serving, and would align state law with federal protections already available to active-duty service members. Committee members generally expressed support, noting the financial strain on Guard members and their civilian employers, and witnesses from the Missouri National Guard Association and the Guard itself said the bills would provide clarity and stability. No opposition was presented, and the hearing ended without a vote in the transcript. The committee then heard House Bill 1869, which would create a grant program administered by the Missouri Veterans Commission to help repair and reset damaged veteran grave markers in private and public cemeteries when the damage is caused by natural events. Rep. Roberts explained the bill was prompted by a constituent’s experience with a deteriorated headstone, and members asked about eligibility, whether the money would go to families or cemeteries, and whether vandalism or non-cemetery graves would be covered. The sponsor said the bill was aimed at natural causes and family-member applications, though he was open to suggestions for expansion. The Veterans Commission director supported the concept but warned the agency lacked funding and staffing to take on another program without additional appropriations; members also raised broader concerns about underfunding the commission. No formal action or vote was taken in the transcript. After the bill hearings, the committee received informational testimony from Retrieving Freedom, a Missouri-based service dog organization, and from Compass Health on firearm suicide prevention. Retrieving Freedom described its training of service dogs for veterans and children with autism, including demonstrations of tasks such as grounding, retrieving items, and helping with mobility, and said it had a waiting list but was expanding its work in Missouri. Compass Health discussed its firearm suicide prevention grant work, emphasizing community-based education and conversations about safe access to lethal means rather than confiscation. These presentations were informational only and did not involve committee action.

Transcript Highlights:

• And these are selected services.
• The speaker continues explaining the selection of services. They are selected services.
• banking services.
• same services are not taxed.
• payment services and Loan Servicing payment services and stuff<01:26:44.840><c> like</c><01:26:45.000

Summary: The committee took up House File 2437, the governor’s proposed tax bill, and first adopted the A25-Z42 amendment to put the bill in the desired shape. Commissioner Paul Marquardt of the Department of Revenue then presented the bill as part of Governor Walz and Lieutenant Governor Flanagan’s budget, describing it as a response to budget pressures that would make the tax system more fair and stable while supporting economic development and jobs. Marquardt walked through the bill’s major provisions. These included sustainable aviation fuel policy, repeal of K-12 education credit assignment, elimination of the political contribution refund, expansion of the research and development credit, short-line railroad infrastructure modernization, changes to the state airport fund levy, replacement of attachments and appearances with distribution systems, a narrow personal property tax exception for low-income housing tenants, reduced aquatic invasive species aid, and a 34% reduction in PILT payments. He then focused on the sales tax article, saying it would lower the statewide rate by 0.75% while expanding the base to selected professional services such as accounting, banking, brokerage, and legal services, with business-to-business transactions exempt. He said the proposal would be effective for sales and purchases after September 30, 2025, and estimated a first-year rate-cut impact of about $99 million versus $215 million from the service expansion, while arguing that most households would see a net tax cut. He also noted other changes such as landlord penalty adjustments, a 30% reduction in sustainable aviation fuel incentive payments, repeal of local government cannabis aid, and repeal of the tax filing modernization account. Public testimony began with Kyle Playford of the Financial Planning Association of Minnesota, who strongly opposed the proposed sales tax on professional services, especially financial planning. He argued that financial planning is an essential service for retirement, investment, and long-term financial security, and said the tax would raise costs for consumers, reduce access for middle-class families, small business owners, and retirees, and put Minnesota firms at a competitive disadvantage. The chair then indicated that additional public testimony would continue before member questions.

Transcript Highlights:

• services manager.
• services manager.
• , and employment services.
• , and employment services.
• , and employment services.

Committee: House Children and Families Finance and Policy

Transcript Highlights:

• General obligation bond debt service.
• FAA to estimate debt service on commercial paper and bonds.
• , and support. and direct services.
• Services.
• . changing life-saving support services to these survivors.

Committee: House Appropriations - S/C on Articles I, IV, & V

Transcript Highlights:

• Those three services together, those three baskets of services, account for about 80% of the growth we've
• , and social services.
• I realized that they provide valuable services, education, and on and on to the local ambulance services
• Other services and other reductions would have resulted in a direct reduction in service to individuals
• that are currently receiving those services from the department, and those are services that are not

Committee: Joint Joint Committee on Ways and Means

Transcript Highlights:

• And then we have the social services Social services fund, which, again, is funded with a stream of oil
• services costs.
• service fund.
• , our service fee timeline.
• It's actual costs of services.

Committee: Joint Government Finance Committee

Summary: The Government Finance Committee met with new leadership and approved the December 11 minutes. The committee first received an update from the Office of Management and Budget on the state general fund and major special funds. OMB reported revenues were tracking very close to forecast, with an estimated ending general fund balance of about $397 million, higher than previously expected. Staff also reviewed balances in the budget stabilization fund, legacy fund, foundation aid stabilization fund, social services fund, and strategic investment and improvements fund, along with oil tax collections and the current revenue picture. Legislative Council staff then summarized the special session budget changes and noted the updated beginning balance increased the projected ending balance for the next biennium. The Tax Department presented taxable sales and purchases data by county and industry, showing overall sales tax activity remained strong, with retail trade the largest sector and several counties posting notable gains. Commissioner Kraschis then reviewed federal tax changes under the One Big Beautiful Bill Act and estimated their impact on North Dakota income tax collections, explaining that the figures were compared to the 2025 baseline and would be incorporated into future forecasts. Members asked about the overtime and tip exclusions, the senior standard deduction, and the primary residence property tax credit application count, which was running ahead of last year at more than 154,000 applications. The committee also heard from the Department of Transportation on fee schedules, with members focusing on driver’s license fees and the fact that current fees cover only about half of program costs, meaning the highway fund subsidizes the remainder. DOT also reported on specialty plate activity, including nearly 3,900 blackout plates issued, and noted increased state fleet usage. The Information Technology Department explained its internal service fund rate-setting process and discussed possible billing simplification, including annual billing and improved invoice detail. OMB also provided data on leased office space in the Bismarck-Mandan area and state workforce counts, and Legislative Council updated the committee on legislative branch space planning. Finally, subcommittee reports noted continued work on fixed-route transit funding and regional jail capacity, including Burleigh-Morton’s new DOCR housing wing and ongoing overcrowding in state correctional facilities. No formal votes beyond the minutes approval were taken, and the meeting adjourned with the next meeting set for June 25.

Transcript Highlights:

• </c> service is never forgotten. service is never forgotten.
• Your service, your us today.
• </c> stress that comes with military service. stress that comes with military service.
• </c> rooted in service, not status. rooted in service, not status.
• </c> through service. through service.

Transcript Highlights:

• , and 23% receive residential services.
• The available services for seniors in Arkansas are really the same as the services I mentioned earlier
• Well, not children's services, but these services are available to everybody, including individuals with
• We represent 80 service providers in Arkansas.
• So I've always understood that to be a function of the services, the diagnostic services that kind of

Committee: All TASK FORCE ON AUTISM

Transcript Highlights:

• The providers of services make strategic decisions and invest resources and staffing and services.
• services to people with disabilities.
• at six, just reducing service hours for some individuals and jeopardizing services for some going forward
• We're a nonprofit service provider of residential and unit-based services, and we're based in Minnetonka
• When legitimate providers close or cut back on their service offerings, people lose services to support

Committee: House Human Services Finance and Policy

Transcript Highlights:

• Thank you for the opportunity to speak to you today about procurement it. of management services.
• They often have broad scopes and are generally related to complex types of services.
• Roughly 21% of all purchase order spend is spent on IT services.
• Chapter 282 of Florida statute requires coordination between agencies and Florida Digital Service.
• to improve these processes as we seek to find value for IT commodities and services.

Committee: Senate Governmental Oversight and Accountability

Summary: The Committee on Governmental Oversight and Accountability met with a quorum present and first took up SB 268, a public records exemption bill for public officers. Senator Brodeur explained the bill on behalf of Senator Jones, saying it would protect partial home addresses, phone numbers, and certain family information for the governor, cabinet members, and other elected officials because of threats and harassment against public servants. An amendment narrowing and clarifying the definition of public officer and the process for claiming the exemption was adopted without objection. Chair Fine and Senator Brodeur both spoke in support of the bill, citing personal experiences with threats and the need to protect officials and their families. CS for SB 268 was then reported favorably by roll call vote. The committee then heard a presentation from Brandon Spencer, Director of State Purchasing and Chief Procurement Officer at the Department of Management Services, on state agency procurement and contracting practices, including IT procurements. He described the state’s procurement structure, including state term contracts, alternate contract sources, and agency procurements, and said the division now manages more than 960 enterprise-wide agreements, with that number continuing to grow. He also highlighted that roughly 21% of purchase order spend is on IT services, discussed statutory requirements for IT procurements, and said the division is working with Florida Digital Service to improve oversight, training, vendor accountability, and procurement options. No committee action followed the presentation, and the meeting adjourned after no further business was raised.

Transcript Highlights:

• </c><00:25:06.320><c> because</c> service or billing for services because service or billing for services
• assisted living services.
• </c> uh services program. uh services program. &gt;&gt; Good<01:14:51.760><c> afternoon.
• </c> can bill Medicaid for those services. can bill Medicaid for those services.
• </c> are services that are currently covered. are services that are currently covered.

Summary: The Medicaid Oversight Board met on March 9 with a quorum present and no minutes to approve. The chair reordered the agenda to hear House Bill 689 first. Representative Amy Neighbors presented HB 689, which would authorize Kentucky to seek CMS approval for a Medicaid state-directed payment program for physician and non-physician professional services delivered through qualifying hospital-affiliated groups, beginning January 1, 2026, with retroactive payments for that year. She said the bill is intended to improve access to care in rural and underserved areas, support workforce retention, and generate about $29 million annually in federal Medicaid funds without using general fund dollars. Representatives from Owensboro Health and St. Elizabeth Healthcare testified in support, describing staffing and subsidy pressures, lower Medicaid and Medicare reimbursement, and the importance of the program for maintaining access and quality in rural and safety-net settings. Committee members noted the bill had already passed the House Health Services Committee unanimously and discussed broader concerns about Kentucky’s low reimbursement rates and the need to consider other systems not covered by the proposal. The board then heard Senate Bill 2011 from Senator Donald Douglas and Cody Hunt of the Kentucky Medical Association. The bill would address a Medicaid coding issue by ensuring that coverage limits do not reduce payment to fewer than two evaluation and management service units per provider, per patient, per day. Douglas argued the current one-visit, one-issue limitation forces multiple visits, increases no-shows, and prevents providers from treating the whole patient. Hunt explained that the bill is meant to correct a longstanding regulation that limited E&M services to one per physician per recipient per date of service, which can prevent providers from coding additional medically necessary work during the same visit. He said DMS has already filed a regulatory amendment to fix the problem, but a statutory change is still needed to prevent the issue from returning. He also said the bill is not intended to change reimbursement policy, only coding rules, and that MCO payment practices vary. Members generally supported the concept. Senator Berg asked about fiscal impact and private-payer billing; Hunt said there should be no fiscal impact because the bill does not change payment policy, only coding. Representative Moore said the proposal could reduce costs and improve convenience by avoiding extra visits. Chairman Meredith said the bill illustrated problems with fee-for-service care and supported moving toward a more holistic delivery model. Dr. Schuster raised a drafting concern about the bill summary language, and Hunt responded that the regulatory amendment should address the issue generally for providers. No votes were taken on either bill during this portion of the meeting.