Transcript Highlights:

• So our Consumer Services Department... So our Consumer Services Department. Good morning.
• covers our transition services.
• We use the integrated service model. We use the integrated service model.
• The same services.
• We provided the same services.

Keywords: 977, all

Summary: The committee met to receive a detailed financial operations presentation from the South Carolina Vocational Rehabilitation (VR) agency, with staff walking members through funding sources, budgeting, accounts receivable, accounts payable, and grants management. Sabrina Walker explained VR’s blended funding structure, including federal grants, state appropriations, program income, and interagency contracts, and emphasized that state funds are essential to meeting the federal match and maintenance-of-effort requirements. Members asked repeatedly about transparency, audit controls, and the risk that state cuts could reduce federal drawdowns; staff responded that all reports reconcile back to the SCEIS accounting system, are subject to state audits and internal reviews, and that even modest state reductions could significantly reduce total available funding. The committee also discussed pre-employment transition services for students with disabilities, with staff confirming services are offered through school districts, charters, and private schools, and that contracts are monitored for performance and compliance. The presentation then shifted to budgeting and internal controls. Walker described a zero-based departmental budgeting process, monthly monitoring reports, contingency reserves for unexpected expenses, and a formal annual cycle that culminates in board approval. Members asked about facilities tracking, culture, and how the agency maintains accountability; staff said facilities staff inspect buildings and equipment, supervisors justify line-item requests, and the process has become smoother over time as departments learned the system. Cynthia Johnson followed with an accounts receivable overview, describing invoicing, receipting, aging, customer verification, year-end reporting, and the use of cross-training, shared email inboxes, and spreadsheets as checks and balances. She also explained work training center billing, interdepartmental transfers, and the revolving fund used to issue consumer checks more quickly than standard vendor payments. Olivia Perez presented accounts payable operations, including invoice processing through SCEIS and OnBase, the three-way match, travel reimbursements, revolving fund checks, State Treasury Office interactions, and handling of reversals, rejections, and levy notices. She reported that AP processed 67,723 SCEIS payments, 13,670 case management system invoices, 3,379 travel reimbursements, and 15,693 revolving fund checks in fiscal year 2025, with only 70 payment rejections. The final portion of the meeting covered Grants and Funds Management, where Walker explained federal reporting, drawdowns, payroll allocation, asset tracking, lease and IT contract reviews, cost allocation, and closing packages. She noted upcoming system changes such as S/4HANA, Workiva, and SC Pro, but said the agency is receiving training and feedback opportunities. No formal votes or legislative actions were taken during the presentation portion beyond approval of the prior minutes and a brief recess.

Transcript Highlights:

• They're very different services. Uh bus. They're very different services.
• Contracted services cost sometimes less than directly operated service.
• > service<00:35:36.240> level<00:35:36.560> increased the service the service level
• . service. service.
• mobility service service requires mobility service associated<00:46:56.319> with<00:46:56.480

Keywords: 919, house, all

Summary: The committee heard a Met Council report from Charles Carlson on high-subsidy transit route analysis required by the transportation bill. Carlson explained that the study uses per-passenger operating subsidy, compares routes by type and service day, and is intended to help providers improve cost-effectiveness while recognizing transit’s importance for access, affordability, safety, and the region’s economy. He noted that routes more than 60% above peer averages are considered the highest-subsidy tier, and that the report also estimates the cost of Metro Mobility associated with those routes. Members asked several questions about why contracted service can cost less than directly operated service, whether contracting affects wages, union membership, or service quality, and why the Met Council targets about 20% of regular route service for contracting. Carlson said contracted service can be cheaper because of lower overhead and other market factors, that the council sets minimum wage and service-quality requirements in contracts, and that customers should not notice a quality difference. He also said the 20% target is meant to balance cost-effective service, geography, and a mix of providers, and that some routes may become more cost-effective with more frequent service depending on local demand. Carlson reported that in 2024, 206 of 264 routes met guidelines, 16 were in the lowest intervention tier, 14 in the middle tier, and 28 were in the highest-subsidy tier. He said the regional share of high-subsidy service was about 4.1%, but the share varied widely by provider, with some at 0% and others much higher. He estimated that discontinuing the highest-subsidy routes would save about $23 million annually and up to $72 million in capital costs. For Metro Mobility, he said the cost associated with trips tied to high-subsidy routes rose from about $368,000 in 2023 to about $6.1 million in 2024, largely because the mix of routes triggering federally mandated paratransit service changed, especially in the Shakopee area.

Transcript Highlights:

• Who are receiving services.
• So they provide a service... ...evaluation and provide some services.
• So we'll be able to provide that service and pay for that service for individuals.
• Crisis services are key here.
• services manual.

Keywords: 1204, all

Summary: The House Health Services Subcommittee met to approve the October 7, 2024 minutes and then shifted to behavioral health as the main topic. Representatives Wooldridge and Vaught described the work of the behavioral health working group, saying Arkansas needs a more proactive system focused on access, workforce, reimbursement, and reducing red tape. Members raised concerns about provider shortages, licensure barriers, rural access, reimbursement rates, jail-based services, non-emergency transport, and the need for step-down options and crisis diversion before people end up in jail or the state hospital. DHS Director Paula Stone outlined the behavioral health system, emphasizing that Medicaid pays for most behavioral health services in Arkansas and that many services cannot be billed once a person is in jail or the state hospital. She described current efforts including family-centered treatment for children, community reintegration group homes, a new adolescent substance use disorder unit, forensic evaluation and restoration changes, and a planned IMD waiver to allow Medicaid payment for certain psychiatric and residential services. She also explained the backlog at the state hospital and in forensic restoration, the role of therapeutic communities, and the challenges of serving rural and difficult-to-serve populations. Members asked about crisis stabilization units, civil commitment, dashboards for bed availability, and whether Arkansas should expand step-down or long-term facilities. Stone said the state has supported crisis stabilization units in several cities, with mixed results, and noted that Fort Smith and Jonesboro have been more successful than Fayetteville and Little Rock. She said DHS does not yet have a statewide bed dashboard but sees it as a useful tool. The meeting ended with agreement that the discussion was a starting point and that the committee would continue the work, tentatively in August, to develop policy ideas for the 2027 session.

Transcript Highlights:

• elderly disabled waiver Services elderly disabled waiver Services Alternative<00:04:58.120> Care
• But those services are tied to people who are using those services to stay on the planet, and as the
• > Services DHS Human Services DHS Human Services programs<00:32:09.080> chapter programs
• <00:33:36.399> and Services related to service planning and Services related to service planning
• uh the regional service centers Services uh the regional service centers and<00:35:31.760> the

Keywords: 1183, house

Transcript Highlights:

• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Legal services. Psychological assessment services. Participant services.
• Services, Independent Living Services.
• Legal services. Administrative law judge services. Payment to risk management services.

Keywords: 981, all

Summary: The House convened with a quorum, approved the prior journal, and heard several brief recognitions before moving to business. Members welcomed foster care advocates for Child Abuse Prevention Month, Girl Scouts visiting the Capitol, and participants in Black Maternal Health Week, with remarks emphasizing foster youth voice, leadership development, and the need for culturally competent maternal health care and doula/midwife support. The chamber then took up House Joint Resolution 1026, honoring former Governor Roy Romer and designating a portion of I-25 as the Governor Roy Romer Memorial Highway. Supporters highlighted Romer’s long public service, his work on education and infrastructure, and his role in major state projects. A proposed amendment to strike the word “memorial” was withdrawn, the House suspended the rules to allow Romer to speak from the well, and Romer offered remarks about legislative collegiality and the importance of democracy and listening to opposing views. House Joint Resolution 1026 was adopted on a 60-0 vote, with four excused and one absent. After a brief recess, the House returned to special orders and resumed reading House Bill 1410 at length, continuing through extensive appropriations language for the Department of Human Services, including child welfare, youth services, Medicaid-related transfers, SNAP and benefits administration, and other funding line items. No final action on House Bill 1410 was taken in the portion provided.

Transcript Highlights:

• services.
• Services and life-sharing services new rate implementation.
• Services.
• services at all.
• The same services.

Bills: HF2434

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

Transcript Highlights:

• . services. services.
• Services, right? Services, right?
• services to people? services to people?
• . services. services.
• episode of services. episode of services.

Keywords: 1187, senate, all

Transcript Highlights:

• Services, deviated Fix Route Services, complimentary Americans with Disabilities Act.
• They cannot be denied service. They must be meet delivered service, all trips.
• for ADA services.
• And a door-to-door service can really slow down the service and that actually time equals money.
• But the demand of services also do that. This is just typical service quality.

Keywords: 999, senate, all

Transcript Highlights:

• Services.
• . services. services.
• service permitted per day in the service service permitted per day in the service uh<00:39:59.440
• Human Services. Human Services.
• . services. services.

Keywords: 1183, house

Transcript Highlights:

• APD will reimburse for the waiver services on a fee-for-service basis.
• APD will reimburse for the waiver services on a fee-for-service basis.
• service network.
• And those services can consist of medical services or long-term care kind of home health services or
• services, residential services, a variety of things.

Summary: The Health and Human Services Committee received an overview of Florida’s intellectual and developmental disabilities (IDD) managed care pilot, created by legislation in 2023 to test whether a managed care model could integrate Medicaid medical services with iBudget waiver home- and community-based services for adults in pre-enrollment categories. AHCA explained the existing system, the pilot’s scope in Regions D and I, and the rollout timeline, including federal approval, contract execution with Florida Community Care, and the October 2024 go-live. Officials reported that, as of early February, 370 individuals had been sent for onboarding and 168 more were in queue, with about $35.8 million of the appropriation remaining. APD also clarified the difference between the pre-enrollment categories and the waiver waitlist, and noted that crisis cases can be enrolled more quickly depending on eligibility and funding. Florida Community Care described the pilot as a comprehensive managed care model offering medical, long-term care, and iBudget services, plus enhanced benefits such as bed-hold days, caregiver transportation, and help with legal guardianship costs. The plan said it uses one care coordinator, a 1:18 coordinator ratio, a face-to-face assessment within five days of enrollment, and 180 days of continuity of care for existing providers. The company emphasized that it is recruiting providers by offering higher rates than some iBudget rates, lower administrative burden, and network adequacy incentives, while APD said it continues to monitor provider supply and demand and recruit across service types and regions. Members repeatedly questioned whether the pilot’s costs, provider rates, and service levels were truly comparable to the iBudget system, and AHCA and APD said it was too early to draw firm conclusions because claims data are still lagging. Committee members also raised concerns about communication, enrollment delays, provider shortages, and whether the pilot could scale statewide. APD said it has used letters, phone calls, texts, emails, and community meetings to reach eligible individuals, and that some delays stem from required assessments, Medicaid eligibility checks, and level-of-care determinations. Several members asked for more detailed comparisons of costs and provider reimbursement between the pilot and iBudget, and APD said it would provide additional data. Public testimony at the end was strongly critical of managed care, with a participant and his mother describing poor service, transportation failures, and loss of control under prior managed care arrangements, and urging the committee not to expand such a model without safeguards. No votes or formal committee action were taken before adjournment.

Transcript Highlights:

• They are service providers, right?
• Service is awesome.
• Service is awesome.
• services.
• It does include congregate meal services, caregiver support services, etc.

Keywords: 912, senate, all

Summary: The Committee on Health and Human Services held an informational briefing on Kupuna Care funding, distribution, utilization, and the status of program rules. The Office of Aging explained that state Kupuna Care funds are distributed using the same federally approved interstate funding formula used for Older Americans Act funds, with eight weighted factors tailored to Hawaii’s conditions: older adults, greatest economic need, low-income minority status, disability, language barriers, geographic isolation, inverse population density, and older adults living alone in poverty. The department said the formula is based on census and American Community Survey data, with current county shares listed as Kauai 7.45%, Honolulu 69.61%, Maui 11.7%, and Hawaii County 17.88%. Officials said the formula is being reviewed with current data and will need federal approval and then public hearing before final adoption. Members questioned how the program works in practice, noting that the statute and eligibility language can sound like direct individual benefits even though services are delivered through area agencies on aging, ADRCs, and contracted providers such as meal and adult day care programs. The Office of Aging said ADRCs determine eligibility and then refer clients to authorized providers, who must meet service standards in their contracts. The chair pressed repeatedly for long-delayed rules, saying the Legislature had expected them years earlier and that clear rules are needed to ensure funds are spent properly and to avoid conflicts of interest. The department acknowledged the delay, said draft rules were written in 2023 after earlier commitments to finish sooner, and said it paused while federal Older Americans Act rules were being updated; it now expects to send the rules to the Deputy Attorney General, then out for public hearing, with a goal of completion in 2025. The department also reported utilization data for the last two fiscal years. In 2023, it expended about 93% of its allocation and served 5,473 older adults at an average annual cost of $1,358; in 2024, it expended about 97% and served 5,520 older adults, with the average cost down by about $200, which officials said may indicate fewer services per person. Eligibility was described as age 60 or older, U.S. citizen or qualified alien, with cognitive impairment or disability and functional deficits, and the statewide profile showed many participants were homebound, living alone, or below poverty. The most-used services were transportation, case management, and home-delivered meals. The chair also asked about the former Kupuna caregiver program; officials said the programs are now combined under Kupuna Care, with most funding going to adult day care to provide respite for working caregivers. County representatives then described local conditions, especially on Hawaii Island. Hawaii County officials said the county covers about 5,000 square miles, has about 208,000 residents, and roughly 24% are age 65 or older. They identified three main challenges: staffing shortages and retention problems among providers, shortages within the county department itself, and the loss of adult day care capacity, with only one center remaining on the island and none on the west side. They said these constraints limit service delivery even as demand grows. At the same time, they highlighted successes such as serving people in the community before they need higher levels of care, providing caregiver counseling and training through adult day care, serving 467 individuals locally, and ensuring the Resource Center answers calls from caregivers seeking help.

Transcript Highlights:

• So this is a state plan service.
• So this is a state plan service.
• So this is a state plan service.
• and other supportive services such as social work services.
• :28.040> we Services such as Social Work Services we Services such as Social Work Services we

Keywords: 1187, senate, all

Summary: The committee heard a presentation from DHS on its early intensive developmental and behavioral intervention (EIDBI) study and related licensing proposal. Christy Grom explained that EIDBI is a Medical Assistance state plan service for children and young adults under 21 with autism or related conditions, and that DHS’s multi-phase evaluation included standards review, community engagement, and a comparison with other states. She said the service is important but that DHS identified gaps in oversight, including stretched clinical supervision, providers affiliated with many centers, out-of-state providers, and rapid growth in enrollment that has outpaced current monitoring capacity. DHS’s main recommendation was to create a provisional license for EIDBI in Chapter 245A as an immediate step, with later work toward full licensing standards. The proposal would let DHS identify controlling individuals, disqualify ineligible people, investigate maltreatment, suspend or revoke licenses, require background studies and qualifications before service delivery, move EIDBI providers into a higher-risk category for revalidation, and make DHS the lead investigative agency for maltreatment. DHS also recommended statutory standards for supervision, caseloads, training, and documentation, while emphasizing the need to balance oversight with continued access to services. Grom said the provisional licensure proposal is part of the governor’s budget and that DHS hopes to begin implementation in 2025, with a possible full license start date in 2028. Testifiers then spoke in support of EIDBI while urging the committee to preserve access and include more community input. Ana Hagi Muhammad, a parent of three autistic children and a Somali community advocate, said EIDBI has been beneficial for her family and that community organizations serving Somali families have not been sufficiently engaged in DHS’s process. Ana Muhammad, a Black mother of a young autistic child, said ABA has helped her son with communication, self-regulation, and independence, and asked that discussions reflect the diversity of family experiences. Committee members asked testifiers to keep remarks brief and to identify which modality they use, and the chair indicated the committee would continue hearing from additional testifiers before further discussion.

Transcript Highlights:

• But yet, we are denying them the services that I provide—the state services that I provide: housing,
• Public Health Service Commissioned Corps is the only uniformed public health service in the world and
• Public Health Service Commissioned Corps is the only uniformed service whose weapon is not a gun.
• We have an all-volunteer service today, regardless of what service you serve in.
• for your service.

Keywords: 995, all

Summary: The Joint Committee on Veterans and Federal Affairs held its fourth public hearing of the 2025-26 session on recognitions, definitions, and designations related to veterans. Chairs John Velis and Joseph McGonagle opened the hybrid hearing with housekeeping rules and noted the committee’s reporting deadlines. The hearing focused on several bills honoring veterans and military-related service, including H. 3825 to include reserve components in flag half-staff recognition for service members killed in action, S. 2499 to place a State House marker honoring three Medal of Honor recipients from the war on terror, S. 2498 to add Merchant Marine recognition at veterans cemeteries and the State House and create a Massachusetts merchant mariner medal, and H. 2500/S. 2500 to have Massachusetts fly the Honor and Remember flag for Gold Star families and fallen service members. A major portion of the hearing centered on H. 3871 and S. 2467, which would update the Commonwealth’s definition of “veteran.” Testimony came from the Office of Veterans Services, veterans organizations, Public Health Service and NOAA representatives, National Guard and Reserve veterans, and Gold Star advocates. Witnesses argued the current state definition is inconsistent with federal law and excludes some service members who should be recognized, especially members of the U.S. Public Health Service Commissioned Corps, NOAA Commissioned Officer Corps, reservists, and some National Guard members. Supporters said the bills would improve fairness, consistency, and access to benefits and services, while several speakers emphasized that service in uniform should be honored regardless of branch. Some testimony also urged a broader moral recognition of all who raised their right hand, while others focused on aligning state law with federal definitions and closing gaps in eligibility. Committee members asked questions about the practical and fiscal effects of broadening the definition, including how the proposed language would interact with existing federal standards and state benefit programs. Witnesses explained that the bills would remove the current 180-day and 90-day active-service calculations and instead recognize certain active service and six-year reserve or Guard commitments, though some members noted that this could create a broader state standard than the federal one. No votes or formal actions were taken during the hearing, and the committee concluded after hearing from the final witness and adjourning.

Transcript Highlights:

• to match what the value of the services to match what the value of the services and<00:05:23.759
• in greater Minnesota through midsize services through urban services.
• in greater Minnesota through midsize services through urban services.
• But unfortunately, the ambulance service But unfortunately, the ambulance service doesn't<00:10:
• <00:42:54.640> services,<00:42:55.119> Madam pay for those services. services, Madam

Keywords: 1187, senate, all

Transcript Highlights:

• Thank you, first, for your service to our country and for your service now to the Commonwealth.
• the service provider.
• of services.
• determination services.
• The second service that we will provide is vocational rehabilitation services.

Keywords: 995, all

Summary: The hearing opened with remarks from Senate Chair Robyn Kennedy and House Chair Chynah Tyler, who emphasized that the fiscal year 2026 hearing was focused on the Health and Human Services budget, asked members to keep questions budget-related, and noted that no public testimony would be taken. They also highlighted the choice of Doherty Memorial High School as the venue to showcase Worcester’s investment in career and technical education. Committee members then introduced themselves before the first panel, the Executive Office of Veterans Services and the state veterans homes, began testimony. Secretary John Santiago said the governor’s FY26 proposal would support implementation of the HERO Act, which he said is now about 95% implemented, including higher disabled veteran annuities, expanded behavioral health benefits, and other service expansions. He described efforts to reduce veteran homelessness, including nearly $20 million in ARPA-funded housing and outreach initiatives, and said the agency has delivered more than 100,000 supportive services to nearly 8,500 veterans. Leaders from the Chelsea and Holyoke veterans homes reported on staffing, quality measures, electronic medical records, and major construction projects at both facilities, including a new Chelsea campus and the new Holyoke home. Members asked about funding transfers, geographic equity in access to the homes, outreach to women veterans and veterans of color, suicide prevention, Gold Star family support, and the impact of federal uncertainty; Santiago said the homes are now licensed and certified, that the current budget is sufficient, and that the agency is expanding engagement and data collection. The second panel, the Office of the Veteran Advocate, testified that its FY26 request is about $3.3 million, up from the current $2 million, to cover staffing, a larger office, and higher technology costs. Veteran Advocate Bob Notch said the office is a new independent oversight agency created in 2022 to examine systems, coordinate with local veteran service officers, and investigate fatalities or serious harm involving veterans in state care. He said the office’s work depends on research, data, and collaboration with other agencies, and that current funding is only enough for minimum operations. In response to questions, Notch and Deputy Commissioner David O’Callaghan discussed the difficulty of tracking veteran suicides, the need for better data across agencies, and the office’s role as an oversight body rather than a direct service provider. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• self-direct all of their services or none of their services, kind of a zero-sum decision.
• have access to some services that appear to be on the service menus.
• Does that really change depending on the service where they're receiving the services?
• <01:31:23.920> services<01:31:24.560> at access their nursing service services at access
• of services.

Keywords: 1183, house

Transcript Highlights:

• service.
• These services include a lot of the independent living services and a lot of the home management services
• And veteran service officers are the front door to services.
• And veteran service officers are the front door to services.
• elder services.

Keywords: 995, all

Summary: The hearing was a FY27 budget session on Health and Human Services held in Mattapan, hosted by the Joint Committee on Ways and Means. Opening remarks from Senator Lydia Edwards, Representative Brandy Fluker-Reed, Representative Russell Holmes, and Boston Public Library President David Leonard emphasized the significance of holding the first Ways and Means hearing in Mattapan, the importance of community access, and the role of libraries as human services institutions. Committee members and attendees introduced themselves before agency testimony began. MassAbility testified first, describing its mission to support people with disabilities through employment, independent living, and disability determination services. The agency highlighted federal funding uncertainty, a modest FY27 budget reduction, and a proposed reworking of its home care program, which it said is outdated and should better target those most in need. Members questioned the home care cut, staffing reductions, and federal coordination. MassAbility also shared a participant story about recovery and community support to illustrate the impact of its services. The Massachusetts Commission for the Deaf and Hard of Hearing then presented its FY27 request, focusing on interpreter and captioning access, workforce development, emergency communication, aging-related hearing loss, and transition services for deaf and hard-of-hearing youth. Members asked about interpreter shortages, after-hours emergency coverage, ASL education, and community training; the commission said it is expanding mentorship and referral systems but still faces staffing and vendor challenges. The Massachusetts Commission for the Blind followed with a $30.8 million request, describing services for nearly 9,000 consumers, peer support groups, vocational rehabilitation, and Turning 22 services, while noting federal funding uncertainty and a 7% budget cut. Members raised concerns about maintaining services with fewer resources, and the commissioner said the agency had trimmed overhead and could manage the proposal. The Office for Refugees and Immigrants closed the segment, outlining expanded legal, housing, workforce, citizenship, and financial literacy supports for immigrants and refugees, including Know Your Rights trainings, legal defense initiatives, and the Massachusetts Access to Counsel Initiative. Members discussed the effects of federal policy changes, the loss of refugee resettlement funding, and the need for state support to fill gaps. No votes were taken in the portion provided; the hearing consisted of agency presentations and committee questioning.

Transcript Highlights:

• , Home Safety Services, Juvenile Services, Residential Treatment Services, and staff training.
• > home Services child protective services home Services child protective services home Safety<
• 00:05:03.240> Services Safety Services Safety Services juvenile<00:05:05.479> Services<
• Juvenile Services.
• c> that these Services these are services that these Services these are services that um<00:16:06.399

Keywords: Meeting Concurrently w/ (H) Families & Children, 958, all

Summary: The committee met to hear the 2025 Social Services Block Grant preliminary plan from the Department for Community Based Services. Commissioner Lisa Dennis and Executive Adviser Mary Carpenter described DCBS’s mission and explained that the federal block grant, about $21 million annually, supports Adult Protective Services, Child Protective Services, Home Safety Services, Juvenile Services, Residential Treatment Services, and staff training. They said most of the funding goes to staff and training, and that the department uses surveys, focus groups, program monitoring, funding availability, and historical data to set annual goals. They also noted that Kentucky uses the grant to fund direct services and that eligibility is generally limited to Kentucky residents or runaway juveniles based on need and available resources. Much of the discussion focused on child welfare data and the distinction between poverty and neglect. DCBS officials said Adult Protective Services investigates abuse, neglect, and exploitation of vulnerable adults, and that self-neglect cases have trended down in recent years, which they attributed in part to access to federal resources. For Child Protective Services, they reviewed intake and investigation numbers, noting that many calls screen out before meeting statutory criteria, while about 48,000 cases were assessed or investigated and about 8,000 were substantiated. Members raised concerns about how poverty can be mistaken for neglect, especially in rural areas, and DCBS said it has been working with the legislature, staff, and community partners to better define the difference and connect families to community supports when cases do not meet abuse or neglect criteria. Members also asked about the risk to federal funding and the impact on juvenile services. DCBS said it had not received notice that the $21 million block grant would be cut, but it is monitoring federal developments closely and would need to return to the General Assembly for a budget request if funding were lost. The department said about 30% of the federal share goes to juvenile services. Questions also covered the transition in staff training from Eastern Kentucky University to a broader statewide model, and the agency said it is expanding training opportunities and modernizing delivery. Officials discussed the MST pilot for youth, saying it is a successful evidence-based practice operating in three regions—Jefferson, Northern Bluegrass, and Central Kentucky—with positive outcomes and possible expansion. No votes were taken; the meeting was informational only.

Transcript Highlights:

• services, as well as early intensive developmental and behavioral health services, or EIDBI services
• <00:03:52.280> for Services or eidbi Services just for Services or eidbi Services just for
• <00:13:09.079> is service so a residential service is service so a residential service is
• crisis services, and behavioral health home services.
• health services.

Bills: HF1005

Keywords: health insurance, medical assistance, behavioral health, reimbursement rates, primary care services, physician fee schedule, managed care, residential services, 1183, house

Transcript Highlights:

• , assessments, lots of different outpatient services to treat behavioral health services and substance
• overview of Behavioral Health Services overview of Behavioral Health Services and<00:04:06.040><
• <00:04:33.759> this<00:04:33.880> is Services some of the services this is Services
• to treat Behavioral outpatient services to treat Behavioral Health<00:04:48.479> Services<00:
• We looked at services based on a paid date of service, and as we go forward we're going to show some

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services held its first meeting and received an overview from the Department for Medicaid Services on Medicaid’s behavioral health and substance use disorder services. Commissioner Lisa Lee and CFO Steve Beal said Kentucky Medicaid serves about 1.4 million members, including over half of Kentucky children, with 485,000 expansion members, more than 69,000 enrolled providers, and total fiscal year 2024 expenditures of $18.5 billion. They said Kentucky covers a broad range of behavioral health services, and behavioral health provider enrollment has grown from a little over 4,500 in 2019 to nearly 8,000 in 2024. They also described how Medicaid spending and utilization are tracked through claims and encounter data, with most members served through managed care organizations. Members focused on sharp increases in certain behavioral health billing codes, especially peer-to-peer services, and asked about reimbursement, utilization review, and whether the growth reflected increased need or expanded coverage. DMS said the rise was partly tied to combining facility and nonfacility behavioral health fee schedules in 2023, choosing the higher reimbursement rate to avoid cuts, and that the department has seen an uptick in peer-to-peer services. In response to concerns about overutilization, DMS said it mailed a letter to behavioral health providers, is considering limits and prior authorizations for some services, and plans to create a standardized monthly behavioral health report to monitor trends consistently and identify when controls may be needed. Lawmakers also asked whether the provider network is sufficient and whether access is adequate, especially for children. DMS said provider enrollment has expanded because behavioral health services were added to Medicaid in 2014 and because demand increased after COVID, but acknowledged studies showing children have less access than adults and said that would be an area of focus. The department said managed care organizations are required to ensure access to needed services and that current trends indicate access is available, though one member disagreed and said workforce shortages remain a major concern. Another member asked about non-emergency medical transportation spending, and DMS explained that it is handled through a capitated arrangement administered by the Transportation Cabinet rather than directly by the managed care organizations.