Transcript Highlights:

• Falmouth issues a lot of licenses, particularly in relation to its size and population.
• The population of Falmouth is about 32,000 at the latest census.
• For context, here are some examples of other towns with population similar to Falmouth and the number
• about 28 licenses and has a population of about 33,000.
• , with a population of twice the amount of Falmouth, with 72,000, issues fewer licenses.

Keywords: 995, all

Summary: The Joint Committee on Municipalities and Regional Government held a public hearing with testimony limited to three minutes. Committee chairs Jack Lewis and Becker-Rouch opened the hearing, noted members present, and explained that only two people were signed up to testify. Rep. Sylvia testified in support of H. 5388 for the town of Marion. The bill would allow Marion to transfer a 2,900-square-foot parcel from the Open Space Acquisition Commission to the Select Board to help build the Marion shared-use pathway, while permanently protecting about 13.38 acres of town-owned land for passive recreation and conservation under Article 97. She said the measure complies with Article 97 and the Public Lands Preservation Act and noted it had unanimous local approval at a special town meeting. Maura O'Keefe, town counsel for Falmouth, testified in support of H. 5365, which would amend Falmouth’s home rule charter to create a licensing commission. She said the change was recommended by two charter review committees because the Select Board spends significant time handling alcohol, entertainment, and common victualer licenses and related disciplinary hearings, and that a separate commission would better fit the town’s licensing workload. No committee questions were asked, no other testimony was offered, and the hearing adjourned by voice vote.

Transcript Highlights:

• And that's with our adult population and just the longer sentences.
• We have about 50% of the population serving an adult sentence.
• And really, that was just our population was very high.
• I know Jennifer spoke to the population number, I know Jennifer spoke to the population numbers at the
• Obviously, this increases population.

Summary: The Senate Human Services Committee held a work session on child welfare dependency, focusing on implementation of HB 1227 (Keeping Families Together) and SB 6109 (the fentanyl response bill), along with related data and system updates. DCYF first reviewed the dependency process, explaining intake, shelter care, fact-finding, disposition, and review hearings, and emphasized that removal standards are separate from service provision and that children may be in-home or out-of-home at different stages. DCYF said 1227 raised the removal threshold to imminent physical harm and strengthened kin placement, with nearly 60% of children now placed with relatives or suitable others. The department also said 6109 directs courts to give great weight to fentanyl’s lethality and added legal liaisons to support staff in court preparation. DCYF presented data showing that entries into out-of-home care declined after 1227 but rose again after 6109, returning close to pre-1227 levels. The agency also reported a sharp increase in reviewable critical incidents in 2022-2025, especially near-fatalities, which it linked to the opioid and fentanyl crisis, parental stress, and system complexity. DCYF said it has responded with statewide Safe Child Councils, staff consultations, hotspot monitoring, and additional training, and noted that some contracted services authorized under 6109 were not implemented because of fiscal constraints. Senators asked about where children are in the process, who participates in court, the timing of data releases, age breakdowns, and geographic hotspots. Advocates and lived-experience witnesses from LCYC and a family intervention clinic argued that 1227 has not prevented courts from removing children when necessary and said the law appropriately requires the state to show a causal link between home conditions and risk. They said 6109 appropriately highlights fentanyl’s danger, but stressed that the larger issue is lack of prevention and treatment resources, inconsistent county-by-county practice, and insufficient supports such as inpatient beds, family treatment, housing, transportation, and third-party safety plan participants. A parent ally described how early support, peer guidance, and kin placement helped her achieve recovery and stability after losing parental rights in an earlier case. The committee also heard an update on SB 6068 from the Administrative Office of the Courts and K Implementation and Evaluation. The report identified 15 dimensions of relational permanency and child well-being, found that some data already exist while other measures need development, and recommended a phased data collection plan, a restored data-sharing agreement between AOC and DCYF, and a standing cross-agency work group. AOC said its dependency data system lapsed when the prior agreement expired in June 2025 and needs to be rebuilt. The meeting also included a brief update on bridge housing for youth exiting inpatient treatment, with presenters saying two programs are now open, one in King County and one in Spokane, and a short introduction to juvenile rehabilitation capacity updates before the transcript ended.

Transcript Highlights:

• and is being converted to house a general population in a kind of honor dorm environment.
• However, last year's prediction of what the population would be is off by 2,000 inmates already.
• , looking at security factors, looking at the current makeup of the incarcerated population, what the
• And do we know how many COVID-19 cases we've been addressing in prison populations?
• And do we know how many COVID-19 cases we've been addressing in prison populations?

Summary: The subcommittee heard May Revision presentations for the Office of Emergency Services, Judicial Branch, CDCR, and the Department of Justice, with the LAO offering comments and recommendations throughout. For Cal OES, the administration outlined funding for relocating the Red Mountain communications site, increased FEMA reimbursement authority, cybersecurity grants, next-generation 911 support, and a reduction to the Flexible Cash Assistance for Survivors of Crime program. Members raised concerns about VOCA backfill and disaster reimbursement, while the LAO recommended approving the 911 request with reporting, adding contingency planning for cybersecurity grants, clarifying the FEMA reimbursement language, and increasing reporting on emergency spending. For the Judicial Branch, the May Revision included funding for implementation of the Trial Nations Access to Justice Act, reductions tied to court facilities and employee benefits, and General Fund solutions such as a reduction to the pretrial release program, a reversion from the Trial Court Trust Fund, and elimination of the jury duty pilot program. The LAO cautioned that the pretrial reduction could affect detention and release decisions and recommended tighter legislative oversight over the trust fund transfer and reallocation language. Members questioned the impact of the pretrial cut, the lack of Prop. 36 court funding, and the rationale for the jury pilot elimination; the Judicial Branch said it was generally supportive of the budget as proposed. CDCR presented requests for roof repairs, fire alarm replacements, CalAIM-related costs, and trailer bill changes on incarcerated college students, mental health hiring, and tuberculosis testing, along with a planned prison closure by October 2026. The department also proposed reducing or delaying several items, including radio replacement, ADA improvements, COVID mitigation, and some facility upgrades, while adding a $125 million placeholder for consultant-driven operational savings. The LAO recommended rejecting or reducing several San Quentin-related proposals, questioned the staffing and contract medical requests, and urged more transparency on the consultant savings plan; members expressed concern about the realism of the savings targets and the potential legal or operational risks from delaying ADA and radio projects. For DOJ, the May Revision proposed ongoing funding and 44 positions to defend against federal actions, IT and accounting system upgrades, implementation funding for AB 1877, and a special fund loan. The LAO supported the KLETS connection but asked for a contingency plan if the new DMV link is delayed, noted that AB 1877 would not be fully implemented without additional funding, and recommended limiting and reporting on the federal accountability workload. Members questioned the size and permanence of the DOJ request, the use of the earlier $25 million special session appropriation, and the pace of federal litigation; DOJ said the new request would support ongoing litigation, expert assistance, and coordination across multiple cases and states.

Transcript Highlights:

• our working adult population, our population we depend on to be productive, tax-paying... ...population
• Our population is probably over 100,000.
• Overlapping populations.
• ...particular population?
• , i.e., the housed population.

Keywords: 1185, senate, all

Transcript Highlights:

• The director said the numbers have gone down, but the population has also gone down, too.
• 40% of the jail and prison population 40% of the jail and prison population have<02:00:32.920>
• So we are dealing with two different populations here.
• dealing with two different populations dealing with two different populations here<02:08:49.199>
• The language that we typically use is by population. I have comments.

Keywords: 910, house, all

Summary: At the joint hearing on SB 951 SD2, the committees heard testimony on a child protection measure requiring mandatory child abuse and neglect reports to include military status and to improve communication between DHS and the Department of Defense. The U.S. Department of Defense testified in support and described its coordinated community response process for abuse reports, saying the bill would help ensure child safety and better coordination with DHS. DHS was initially absent, later appeared, and said it supported the measure but was still working with DOD on implementation details and staff training. Members asked about how DHS becomes involved and whether there were gaps in the current process. The chair recommended passage with technical amendments, including changing the effective date to 7/1/25 and conforming related language, and both committees adopted the recommendation by vote. The Public Safety committee then heard SB 1377 SD2, which would create a Veterans Cemeteries Board within the Office of Veterans Services in the Department of Defense to provide guidance, education, and technical assistance to state veteran cemeteries. DOD supported the bill and explained that county-run cemeteries must meet National Cemetery Administration standards to remain eligible for federal reimbursements and grants; witnesses described past compliance problems at several cemeteries, including one still not compliant in Hilo, and said the board would help counties prepare for future site visits and improve oversight without taking over operations. Members asked about costs, reimbursement amounts, and whether the state would assume cemetery operations; DOD said the current reimbursement process runs through the state to the counties and that direct takeover would be costly. The committee adopted the chair’s recommendation to pass the bill with amendments. The committee also heard SB 1382, which would make intentionally or knowingly causing bodily injury to a National Guard member performing duty a class C felony. The Hawaii National Guard and HPD supported the bill, citing incidents during the Maui response where Guard members encountered noncompliant and sometimes physically confrontational individuals while assisting police and protecting impacted areas. Testimony emphasized that Guard members are often unarmed and should receive protections similar to first responders. One witness opposed the bill, but the committee moved forward and adopted the chair’s recommendation to pass with amendments. Finally, the committee took up SB 1379 SD2 on emergency preparedness and Community Readiness Centers. Hawaii Emergency Management supported the bill, and supporters said it would create a statewide framework for resilience hubs that can provide supplies, action plans, and refuge during disasters. Testimony highlighted recent hurricanes, wildfires, and other hazards, and argued the measure would complement existing county efforts rather than replace them. County of Hawaii testimony opposed the bill, raising concerns about overlap and cost, while members asked about estimated expenses and implementation. The discussion ended with questions about planning and whether the bill would enhance existing programs; no final vote was captured in the excerpt.

Transcript Highlights:

• So if you don't have the race of the population... ...population, how do you address the concerns of
• The state had grown in population by about two million at minimum.
• And in 2023, we had a large population growth. Is that correct?
• It is a large population, larger than many other states.
• It's a very big issue for our population, is that correct? To everyone, sir?

Bills: SR5, SB5, SB11, SB12, SB25, SB26, SB28, SB35, SB5, SB11, SB12, SB25, SB26, SB28, SB35, SB5, SB11, SB12, SB25, SB26, SB28, SB35, SR5

Keywords: redistricting, Senate procedures, public input, Texas Legislature, amendments, Texas Senate, congressional districts, legislative procedures, legislative transparency, Senate rules, public hearings, committee procedures, hemp regulation, consumable products, cannabinoids, occupational licenses, criminal offenses, SB 11, Texas attorney general, election crimes

Transcript Highlights:

• up to 1,000, small communities with populations up to 10,000, and medium communities with populations
• risk to the population.
• What was the population of our deer in the 2010 time frame?
• Statewide, the population was in the four millions.
• Do we know what that population is and the damage that it is doing? to our fish populations.

Keywords: 1185, senate, all

Transcript Highlights:

• population need through 2049. population need through 2049.
• population is often times shorter stays. population is often times shorter stays.
• you know detailed population you know detailed population projections,<01:29:37.120> facility
• disparities in jail populations, right? disparities in jail populations, right?
• <01:31:04.000> of and to try to limit the population of and to try to limit the population

Bills: HF3700, HF3982, HF3927, HF3933, HF3949, HF4238, HF4275, HF4476, HF4504

Keywords: Duluth, Lake Superior Zoo, capital improvements, funding, bonds, appropriations, capital investment, port development, grant caps, state assistance, navigation facilities, Dakota County, state bonds, park improvements, infrastructure, transportation, safety, congestion, water infrastructure, bond issuance

Transcript Highlights:

• , populations, populations, although I<00:21:25.320> recognize<00:21:26.640> your<00:21
• . populations. populations.
• want to cross their populations. want to cross their populations.
• so many of your populations have both. so many of your populations have both.
• specialty populations. specialty populations.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board met on September 24, 2025, approved the minutes from the September 9 meeting, and then continued its discussion of Medicaid waivers with Leslie Hoffman and Carmen Hancock from the Department for Medicaid Services. Members asked for updates on the 2024 waiver waitlist management assessment recommendations, including aligning waiver policies, standardizing applications and waitlist placement, and modernizing data systems. DMS said that work is being done jointly with Aging and Independent Living and Behavioral Health/Developmental and Intellectual Disabilities through task forces, that ARPA spending delayed action, and that implementation timelines extend through March 2027. The board also reviewed per-member waiver cost averages for fiscal years 2023 through 2025 for ABI, ABI long-term care, HCBS, Model II, Michelle P, and SCL. DMS emphasized these figures were benefit-only averages based on paid claims, not full waiver costs, and explained that true budget neutrality is calculated on an aggregate basis against institutional care comparisons approved by CMS. DMS said all six waivers remain in compliance with budget neutrality and that the most recent 18-month lag review for FY 2022 and FY 2023 found costs at or below institutional care. Members also asked about unused waiver slots; DMS said slots generally cannot be reallocated mid-year if they have been used, except in cases such as death or reserved capacity, because CMS treats participants as unduplicated for the waiver year. A major portion of the meeting focused on the new child waiver created under House Bill 6. Legislators questioned whether the waiver’s design, including the exclusion of participant-directed services and the emphasis on high-acuity children with behavioral health, DCBS, or juvenile justice involvement, matched the bill’s intent to keep children at home. DMS said it used the $14.7 million appropriated for FY 2026 to develop the program, that there is no priority list, and that the waiver is intended to serve the highest-acuity children while also addressing residential needs for those sleeping in offices or placed out of state. Members also raised concerns about the rapid growth of the HCBS waiting list and asked for more detail on age and timing patterns, which DMS said it would provide later. Finally, DMS gave average processing times from application to eligibility determination and from approval to service start, and said the overall average from application to services beginning was about 80 days, while members requested follow-up information on the Carewise assessment contract and related costs.

Transcript Highlights:

• is spread to the greatest needs statewide, which does not necessarily correlate to the greatest population
• Statewide as our our greatest population Statewide as our our neighbor<00:14:39.040> Islands<
• Wildlife by the freeon cat population Wildlife by the freeon cat population thank<00:15:03.160><
• Some states do, from big concerts with big populations, take concert fees for their dedicated funding
• <00:20:04.360> concert concerts with big population concert concerts with big population concert

Keywords: 910, house, all

Summary: The Committee on Culture and the Arts heard testimony on HB 547 HD1, which would create a spay-neuter special fund to reduce pet overpopulation and support spay/neuter services, funded in part through a tax return check-off and other sources. The Department of Taxation said it could implement the check-off; the Attorney General and Budget and Finance raised drafting and placement concerns about which department should house the fund; and the Hawaii Humane Society strongly supported the bill, emphasizing statewide need and the importance of distributing funds to areas of greatest need, including neighbor islands. The Tax Foundation opposed the measure on special-fund grounds, arguing there was no sufficient nexus between the bill’s purpose and the proposed revenue source. The committee later recommended HB 547 HD1 with technical amendments and sent it to Finance, with members voting aye and no objections noted. The committee also heard HB 925 HD1, relating to arts funding, which would impose a 1% fee on ticket sales from concerts at state venues and direct the proceeds to a dedicated arts fund. The State Foundation on Culture and the Arts supported the measure, while the Attorney General suggested defining “concerts” for clarity and Budget and Finance was available with comments. In discussion, the committee chair asked about how other states fund arts programs, and Director Ewald said many states use dedicated funding sources such as concert fees, bond funding, cultural trusts, and hotel lodging taxes. The committee recommended HB 925 HD1 with amendments, including a preamble, a new Performing Arts special fund, a definition of “concerts,” and a defective date, and the recommendation was adopted. Finally, the committee considered HB 1378, also related to the State Foundation on Culture and the Arts. Based on the Attorney General’s testimony, the committee proposed deleting a section of the bill, creating a Performing Arts special fund, specifying revenue sources such as legislative appropriations, foundation charges, grants, gifts, and interest, and using the fund for coordination, planning, promotion, marketing, and execution of performing arts events. The amendments also added a definition of Performing Arts, granting standards, and a defective date, while blanking out the appropriation amount for the committee report. The committee voted to adopt the recommendation on HB 1378 with amendments, and the meeting adjourned.

Transcript Highlights:

• 32:27.200> within there's for certain populations within there's for certain populations within
• , that would be subject to a premium. population we estimated that there could population we estimated
• Um we know that and population needs.
• Um this rates per 100,000 population.
• That's 60% per 100,000 population.

Keywords: 928, house, all

Summary: The committee first approved the draft minutes of its May 16, 2025 meeting, with one correction removing Representative Dry from the attendance list because she was present as a guest rather than an appointed member. The committee then received a Department of Health and Human Services update from Commissioner Lori Weaver, who focused on the rural health transformation grant process. She said the department has been gathering stakeholder input since July, issued a request for information on September 22, and is working toward an end-of-October draft and a November 3 deadline, with a grant writer request expected to go before Governor and Council at no cost to the state. The bulk of the meeting centered on federal changes affecting SNAP and Medicaid. Karen Heert explained that the federal law changes commonly referred to as the “Big Beautiful Bill” or HR1 will affect SNAP eligibility and state costs, including a shift in administrative cost sharing from 50/50 to 75/25 beginning in October 2026 and a possible state share of benefits if New Hampshire’s error rate is too high. She said the program affects about 43,000 households, that New Hampshire’s federal fiscal year 2024 error rate was 7.57% versus a national rate of 10.93%, and that the state must get below 6% to avoid liability. She also said DHS is preparing remediation steps, auditing cases, and seeking technology and staffing support, including a grant for automation and training. Henry Litman then described Medicaid changes under HB2 and the new federal law. He said New Hampshire returned to pre-pandemic eligibility verification rules on July 1, including a 10% income compatibility standard and reduced ex parte renewals, which has increased manual work and contributed to a drop in enrollment from about 185,000 in late June to about 178,000 in early September. He also reviewed new child premiums, pharmacy copays, Granite Advantage premiums, and possible Medicaid work requirements, noting that DHS is working with CMS on implementation details and may use a state plan option rather than an 1115 waiver because it would be less expensive and faster. Members asked several questions about the SNAP error-rate rules, the distinction between administrative and client errors, the effect of unpaid copays, and the timing and legal risk of the Medicaid work requirement; no votes were taken on those policy issues.

Transcript Highlights:

• We could create our entire dental benefit around what we think the special needs population needs.
• Entire dental benefit around what we think the special needs population needs.
• That was applying the increased limit to the entire population with medical necessity criteria.
• So figuring out what that extra population is and can we get them into the PASSes, right?
• Because we need to do whatever we can to get this population taken care of.

Summary: The Administrative Rules Subcommittee of the Arkansas Legislative Council reviewed several agency rules and requests. The Insurance Department’s amendment to its holding company system rule was reviewed and approved, as were two State Board of Election Commissioners rules: one clarifying poll watcher conduct, vote challenges, and provisional voting, and another increasing pay for certified election monitors and defining training, observation, and report-writing compensation. The Arkansas Financial Education Commission also had its rule reviewed and approved after removing membership requirements tied to DEI language to comply with Act 938. The committee held over the Department of Education’s request to be excluded from reporting requirements for one month to allow further discussion about who should write or implement the rules. A major portion of the meeting focused on the Department of Human Services’ request to be excluded from reporting requirements for Acts 567, 568, 967, and 1025. DHS said CMS had raised comparability and other federal approval concerns, especially for the dental and diagnostic lab provisions, and that it might not be able to meet the acts’ effective dates. DHS described several possible paths forward, including broader benefit changes, waivers, or splitting the dental provisions so the pediatric rate increase could move separately from the special-needs adult cap increase. The Arkansas State Dental Association disputed DHS’s conclusion that the acts could not be implemented as written, argued that Act 1025 is workable, and urged DHS to continue pursuing implementation and preserve the September 1 effective date where possible. Public testimony also supported expanded dental access for adults with disabilities and special needs. After discussion, the committee voted not to exclude DHS from reporting requirements for those acts. The committee then reviewed the Division of Higher Education’s Act 781 report. The division said it has 32 rules in effect, asked to repeal three rules—two replaced by new rules and one no longer supported by authority or current law—and to continue the remaining 29 rules. The committee approved that request, with the repeals effective upon adjournment of the Legislative Council meeting on January 16, 2026. The meeting concluded with no questions on the remaining written rulemaking updates from prior and current sessions, which were filed without further action.

Transcript Highlights:

• The next one, I was asked to collect or bring some demographic data around the DYS population, so we
• The next one you'll see, our population almost always runs 80% male and about 20% female.
• The next one you'll see, our population, age, they usually are middle schooling up.
• We brought someone over that Shorter had employed who had worked with the adult population on GED.
• You have to find people who just have a passion for working with this population.

Summary: The Senate and House Joint Committee on Children and Youth met to approve prior minutes, confirm Representative Mary Bentley to the Child Maltreatment Investigations Oversight Committee, and receive several presentations. The Arkansas Infant and Child Death Review team reported on unexpected child deaths in Arkansas, saying its 2023 review covered 148 of 170 non-natural deaths, with the remainder unavailable due to criminal investigations or missing records. Of the reviewed deaths, 69 were accidents, 14 suicides, 18 homicides, and 47 undetermined, and members discussed how the report’s recommendations could be used by agencies and nonprofits for prevention work and grant applications. Committee members also asked about age breakdowns and how the data could be shared without identifying individual cases. The committee then took up HCR 1010 and a broader discussion of juvenile justice reform. Representative Shepard said the resolution was intended to confront data on juvenile incarceration and system outcomes. Senator Missy Irvin, judges Troy Braswell and Kathy Hess, and AOC Juvenile Division Director Burke Steen described the state’s long-running reform efforts, including the SAVRY risk assessment, diversion programs, and efforts to keep more youth in their communities. They said the reforms have reduced delinquency filings, DYS commitments, and revocations, while increasing diversions, but also emphasized ongoing gaps in mental health, substance abuse, and school-based supports. Members raised concerns about school data sharing, behavioral health access, and how to better identify youth with disabilities or trauma earlier. Judge Braswell and others stressed that many youth in the system have significant trauma, family instability, or unmet treatment needs, and that judges need individualized information to make decisions. Several members discussed the role of schools, the school safety dashboard, and the need for stronger community providers, especially in rural areas. The committee then heard from DYS Director Michael Crump, who provided data on commitments, facility use, demographics, offense levels, length of stay, education outcomes, recidivism, dual DCFS/DYS custody, and costs. He said commitments rose after the pandemic and then began to decline, while secure and detention costs increased with the need for more beds; he also noted that most youth in custody have behavioral health needs and that DYS works closely with DCFS, courts, and providers. No final action was taken on HCR 1010 during the discussion.

Transcript Highlights:

• The other is with Population Health and Outcomes.
• Population health dashboards.
• This is an example of the population risk management dashboard.
• Population risk.
• Who is your total at-risk population?

Transcript Highlights:

• But just as a matter of point here. of the population is adjudicated and of the population is adjudicated
• I think population is possibility.
• And yet the population increases.
• And yet the population increases.
• So here we have the provider-to-population rates per 100,000 population across public health regions.

Keywords: 928, house, all

Summary: The committee first handled roll call and approved the prior meeting minutes. Members discussed attendance and substitutions, then moved to the DHS commissioner’s update, which focused on New Hampshire’s Medicaid 1115 waiver and the new community re-entry initiative for people leaving correctional facilities. The presenter explained that the waiver lets the state cover certain services not normally covered under Medicaid, including substance use disorder treatment, serious mental illness services, adult dental benefits, and the new community re-entry component. She also noted that a separate youth re-entry component is federally required, with youth defined up to age 21 and foster-care-related coverage extending to age 26. The update described how the adult re-entry program works for incarcerated individuals with behavioral health needs, providing up to 45 days of pre-release services, care coordination with managed care organizations and DOC staff, telemedicine assessments, discharge prescriptions, insurance cards, and connections to community mental health, primary care, and substance use providers. For youth, the program includes more intensive case management, 30 days of pre-release services, and 30 days of post-release care coordination, with a stronger emphasis on screening, diagnosis, and holistic assessment. The presenter said New Hampshire received the adult waiver in July 2024, has implemented the program in state correctional facilities, and is beginning work at the youth center. Members and the presenter discussed why the program is structured as a waiver rather than a standard Medicaid benefit, with the explanation that CMS is allowing this as a newer policy area and that states generally pursue waivers for certain services. The chair and others emphasized the need for real cost and outcome data, and the presenter said an independent evaluator and evaluation plan are required under the 1115 waiver. Early results cited included 30 adults enrolled so far, 10 released, five youth enrolled with one released, and anecdotal early successes such as housing, employment, and better continuity of medication and treatment. The committee did not take any additional votes or formal actions beyond approving the minutes.

Transcript Highlights:

• IT WOULD EXPAND THE ELIGIBLE POPULATION TO INDIVIDUALS ALREADY IN THE PREENROLLMENT CATEGORIES AND IT
• TO SOME EXTENT THIS REPRESENTS THE DISTRIBUTION OF DISABILITIES AMONG THE GENERAL POPULATION.
• BUT REALLY I JUST -- TO DOUBLE THIS POPULATION IN SIX WEEKS.
• I WAS CURIOUS BECAUSE I KNOW IT IS SUCH A SMALL POPULATION OVERALL IN YOUR MANAGED-CARE SYSTEM.
• ESPECIALLY FOR THE POPULATION THAT WE ARE TALKING. SO IS THERE ANYTHING YOU CAN TELL US ON THAT?

Transcript Highlights:

• underserved populations.
• It just became drastically cheaper to cover the UIS population.
• So that cut—there are certain populations and certain...
• It's a different population, different benefit set, et cetera.
• And we would also like to note our support for population-based prevention.

Keywords: 987, senate, all

Summary: The subcommittee first heard May Revision items for child support, child care, and related human services. The Department of Child Support Services described two technical adjustments, which the LAO said raised no concerns. The Department of Social Services then walked through child care proposals, including a shift in how federal and Proposition 64 funding reductions would be absorbed, a 2.01% COLA, disaster-related child care infrastructure grants, an increase in in-contract administrative support costs for alternative payment agencies, reversion of prospective-pay implementation funding after a federal rule change, a one-time allocation to cover the first quarter of Cost of Care Plus payments in the next fiscal year, reappropriation for existing infrastructure grant closeout work, and estimates of unspent child care funds. The department also outlined trailer bill language on a single rate structure, site safety and emergency procedures, CalWORKs child care data sharing, and child care oversight. The LAO recommended that the Legislature seek more justification for shifting reductions from General Child Care to the Alternative Payment Program, noting that CAP reductions affect more slots and that General Child Care has had significant unspent funds. It supported removing prospective-pay funding, but recommended rejecting the administrative cost shift to a percentage-based rate because it could create future General Fund pressure. It also suggested the Legislature review alignment between the disaster grants and the child care infrastructure program. Senators and members pressed the administration on why the budget would reduce child care slots and COLA percentages while the state still has waitlists and unspent funds, and questioned the need for early funding of Cost of Care Plus payments and the move from a flat administrative amount to a percentage. Public commenters, including providers, advocates, county offices, and infrastructure partners, urged full COLA funding, preservation of child care slots, support for prospective pay, and continued investment in child care access and facilities. After a short recess, the committee moved to Part B on health and heard the Department of State Hospitals. DSH presented a May Revision budget of $3.2 billion and described proposals for a central utility plant replacement at Metropolitan State Hospital, an electronic health record implementation, reduced county bed billing authority due to phased-in LPS bed capacity, limited contract exemption authority for online clinical subscriptions, reversion of prior-year unspent operating funds, and a workforce development proposal shifting some costs to Behavioral Health Services Act funds, including support for an additional psychiatric training cohort at Napa. The department also outlined IST-related savings and a trailer bill to remove the sunset on the independent placement panel program.

Transcript Highlights:

• I represent a very rural, very low-income population with very few providers.
• So currently, the Medicaid expansion population doesn't have the resource test.
• And so that population, we do have a much higher ex parte rate, which is that automatic.
• Throughout the whole population, it's about 50%, but I can get you the exact numbers for the MAGI population
• That's just for the adults, the Medicaid expansion population.

Keywords: House Room C, General Assembly Building, 976, house, all

Transcript Highlights:

• We also see this incline of the Medicaid long-term services and supports population.
• skilled nursing care, and a population which will quadruple by 2050.
• We've identified two successful patient pathways to support the needs of this population.
• Behavioral health funding programs are critical in meeting the needs of this population.
• And then some of the studies focused on more of a Medicare population, which wasn't the population we

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• And then the other population was a part of that expansion population that is now frozen, but is covered
• That other population, as you... ...decision in the 2025 Budget Act.
• They are a state-only population.
• And we eliminated one population, but we maintained the benefits for another population.
• We are serving the population now.

Keywords: 987, senate, all