Transcript Highlights:

• What they found out is that they have an extreme debt load and vendors are asking for money.
• that they are a viable product going forward, that they can continue and that they can make their debt

Bills: SB2401, SB2402, SB2403, SB2404

Keywords: SB 2401, North Dakota, Century Code, occupational therapy, occupational therapy board, criminal history record check, background check, licensee investigation, physician continuing education, medical license renewal, nutrition education, metabolic health, chronic disease prevention, health occupation boards, medical board, licensure fee, audit response, disciplinary action, Title 43, board of medicine

Summary: The Senate convened with prayer, the Pledge of Allegiance, and a quorum present. It adopted the procedural employment committee report naming Senate staff for the special session. The chamber then took up several health-care and appropriations measures, first adopting amendments to Senate Bills 2401, 2402, and 2403 before moving them to final passage. Senate Bill 2401 passed 44-2 and requires physicians to complete at least one hour of continuing education in nutrition and metabolic health, part of a broader rural health care package. Senate Bill 2402 passed 46-0 after major amendments negotiated between the medical and pharmacy boards; as amended, it expands pharmacists’ prescriptive authority and therapeutic substitution in limited areas while excluding categories such as antidepressants, antipsychotics, chemotherapy agents, Schedule II drugs, biological products, and narrow therapeutic index drugs. Supporters said it would improve rural access and help secure rural health transformation funding, while questions focused on how pharmacist competence would be measured and enforced. Senate Bill 2403, also passed 46-0, creates a short-term medical facility emergency operating loan program through the Bank of North Dakota, reduced by amendment from $10 million to $5 million, to help a financially distressed rural hospital. Senators discussed the hospital’s mismanagement, the need for a bridge loan, and safeguards including a limited application window and expiration in 2027. Senate Bill 2404 passed 46-0 and provides supplemental appropriations to the Information Technology Department for ADA-related website accessibility compliance and to the Public Service Commission for additional legal costs in federal energy-rate litigation. The Senate then made announcements about a Highway Patrol safety presentation and filing deadlines, excused an absent member, and adjourned until the next morning.

Transcript Highlights:

• The bill provides that any revenue in the 21st Century Fund not needed to pay debt service on the authorities
• does have any outstanding obligations, it must maintain funding no less than 1.3 times the annual debt

Bills: SB311, SB322, SB304, SB313, SB315, SB316, HB489, SB90

Keywords: electric transmission, public highways, permit processing, economic growth, infrastructure, rural development, condemnation actions, state regulations, community development district, CDD, annexation, municipal annexation, wet municipality, dry county, wet county, Sunday alcohol sales, ABC Board, alcohol licensing, on-premises consumption, golf course

Transcript Highlights:

• of Senator Johnson Stewart's, a mowing program initiative of Senator Jasinski's, and we do carry a debt
• We do carry a debt service for trunk highway bonds that is an ongoing conversation.
• Then line 122 is an increase to trunk highway debt service.
• <01:50:02.239> This<01:50:02.400> is trunk highway debt service.
• This is trunk highway debt service.

Keywords: 1187, senate, all

Transcript Highlights:

• It could be debt service on a building.
• It could be debt service on a building.
• It could be debt service on a building.
• It could be debt service on a building.
• It could be debt service on a building.

Keywords: 1183, house

Transcript Highlights:

• So we can't work on those debt payment in advance. That's kind of how bonds work.
• service earlier to try to pay our debt service earlier to try to end<01:31:53.119> the<01:31:
• You know, if our $50 million cap per year, once we work on the debt service and we're looking at a 17
• You know, if our $50 million cap per year, once we work on the debt service and we're looking at a 17
• You know, if our $50 million cap per year, once we work on the debt service and we're looking at a 17

Keywords: 928, house, all

Summary: The Finance Committee Division II met with the New Hampshire Department of Education to review school nutrition programs and related funding. Department staff Melissa White and Kelly Rambo walked through a packet covering the National School Lunch Program, Fresh Fruit and Vegetable Program, Community Eligibility (CEP), After School Snack Program, Child and Adult Care Food Program, and Summer Food Service Program, explaining that these are federally funded USDA programs, with some state supplemental funding in certain areas. They also reviewed reimbursement rates for lunch, breakfast, child/adult care, and summer meals, noting that summer rates follow calendar-year timing while most others follow the state fiscal year. Members asked several questions about how the funding works, especially the difference between federal reimbursements and the state match. Staff explained that the state lunch line in the budget is a fixed match amount tied to federal participation, while breakfast funding is broken out by meal type and reimbursement category. They also discussed why FY 2022 federal spending was much higher during COVID, when USDA covered meals at the free rate for all students, and why FY 2023 and FY 2024 dropped as normal income-eligibility rules returned. A committee member also asked about the “severe need lunch” two-cent rate, and staff said they did not know USDA’s formula. A substantial portion of the meeting focused on summer meals and the distinction between the Summer Food Service Program and Summer EBT. Staff explained that SFSP provides meals at approved sites, which can be open or closed sites, while Summer EBT is a separate DHHS-operated benefit program that provides funds to families. They said some schools or sites may not qualify under USDA rules, but eligible children can often use another nearby open site, and the department posts an interactive map and phone line to help families find locations. The committee also discussed the Community Eligibility Provision. Staff said New Hampshire currently has three CEP schools, that the eligibility threshold had recently been lowered from 40% to 25% identified students, and that the program allows participating schools to offer free meals to all students while the local district covers the non-federal share. Members asked whether any districts in the 25% to 40% range had joined; staff said no. The department offered to provide the eligibility report in Excel and noted that the CEP intent is to reduce application burden, though the lower threshold can make the local cost share harder for some districts to absorb.

Transcript Highlights:

• financing strategies that may lower borrowing costs and improve flexibility in managing the state's debt
• Steenhausen said, I'm also the executive director of the California Debt Allocation Committee.
• That's Protect Our Students, Student Debt Crisis Center, and Young Invincibles. Rights Coalition.
• Also speaking on behalf of other co-leads, that's Protect Our Students, Student Debt Crisis Center, and
• and has secured over $14,000 in monthly savings to Californians, totaling $4.6 million in student debt

Summary: The committee opened with the State Controller’s Office May Revision requests, including funding for Fiscal book-of-record stabilization, a Broadcom IDMS licensing adjustment, the California State Payroll System, ACFR reporting automation, and $3 million for unclaimed property outreach. Testimony emphasized progress on Fiscal becoming the state’s accounting book of record in July, faster ACFR publication, and the move to electronic unclaimed property claims. Members asked about the size of the unclaimed property fund and how quickly money is transferred to the General Fund; the Controller’s office said about $15 billion is held, with most excess transferred regularly, and the LAO noted the fund is the General Fund’s fourth-largest revenue source. No concerns were raised by Finance or the LAO, and the item was closed after no public comment. The committee then heard the administration’s proposal to tax prewritten digital software and software-as-a-service, with Finance saying it would modernize sales tax treatment and raise an estimated $450 million General Fund and $560 million local revenue in 2026-27. The LAO supported modernizing the tax but suggested broader digital goods coverage and a business-use exemption; industry and taxpayer groups opposed the proposal, warning of higher costs for consumers and businesses. Members also heard CDTFA’s administrative request tied to the proposal, plus a separate CDTFA budget reduction reflecting lower operational needs; that reduction was presented as a savings item and drew positive reactions. Next, the committee considered federal conformity for “Trump accounts,” which would align California tax treatment with federal rules for tax-deferred children’s accounts and avoid tracking burdens for families. The LAO recommended approval, and the item drew no opposition. The committee also heard a proposal to cut the first-year $800 annual business tax to $400 for LLCs, LPs, and LLPs; Finance argued it would lower startup costs and encourage new business formation, while the LAO said the benefit was not well targeted and could subsidize entities that would form anyway. Members discussed the policy tradeoff, and public commenters split between support for small business relief and concern about revenue loss. The final major revenue item was a permanent business tax credit limitation, capping credits at the greater of $5 million per corporation or 50% of pre-credit liability, while excluding the low-income housing tax credit and personal income tax credits. Finance said it would raise significant revenue from large profitable corporations, and the LAO said it was a reasonable option but noted it would mainly affect the R&D credit and could have future implications for programs like California Competes. Public testimony was sharply divided, with business groups opposing the cap and anti-poverty advocates supporting it as a way to recapture revenue. The committee also heard FTB’s CalFile realignment request, which would return most of the direct-file-related resources to the General Fund while retaining a smaller staff to improve CalFile, and the California Arts Council’s request to reauthorize the Keep Arts in Schools voluntary contribution fund, which members and advocates supported despite relatively modest annual donations. The hearing continued with GoBiz proposals on civic media funding, CA RISE reappropriation, and a semiconductor facility reversion, with the LAO supporting the latter two and members raising questions about the civic media program’s scope, outreach, and inclusion of broadcast and ethnic media.

Transcript Highlights:

• and the state treasurer made it clear that this proposal does not appropriate funds, does not issue debt
• And even under a modeled worst-case scenario that assumes all guaranteed debt is triggered, the debt
• the existing loan guarantees already in place, the state is currently at about 65% of the affordable debt
• is currently at about 65% of the is currently at about 65% of the affordable<01:05:26.480> debt
• c> set<01:05:27.280> in<01:05:27.440> statute<01:05:27.839> in affordable debt

Keywords: 1189, house, all

Transcript Highlights:

• My concern, however, goes back to 2023 when the bill's debt was paid off.
• My concern, however, goes back to 2023 when the bill's debt was paid off.
• when then the bill's debt was paid off. when then the bill's debt was paid off.
• The first is for state bond debt service.
• As things stand now, with the debt service relieved, the bonds have been paid off.

Keywords: 1187, senate, all

Transcript Highlights:

• In fiscal year 2024, local debt service outstanding rose to $499.7 million, which equates to a per capita
• debt burden of about $16,000 owed for every man, woman, and child in Texas.
• Of this amount, debt is held by ISDs. represented the largest share at $202.6 billion, or about 41% of
• to decide on a total of 313 propositions valued at about $41 million. $1.3 billion in new principal debt
• , and of those, these proposed 153 items are worth about $13 billion in new principal debt.

Bills: SB 13, SB 27, SB 57, HB1325, HB1655, HB3312, HB5526, SB13, SB57, SB207, HB441, HB591, HB5019, SB27, SB843

Keywords: lobbying, public funds, political subdivision, local government, county association, municipal lobbying, registered lobbyist, Texas Legislature, taxpayer lawsuit, injunctive relief, attorney's fees, government finance, county dues, state association of counties, sheriffs association, law enforcement officers, legislative advocacy, bill tracking, legislative alerts, Government Code Chapter 556

Transcript Highlights:

• We do not countenance unfairness and trying to steal from our kids, loading them up with massive debt
• We do not countenance unfairness and trying to steal from our kids, loading them up with massive debt
• We do not countenance unfairness and trying to steal from our kids, loading them up with massive debt
• We do not countenance unfairness and trying to steal from our kids, loading them up with massive debt
• We do not countenance unfairness and trying to steal from our kids, loading them up with massive debt

Keywords: U.S. House of Representatives Floor Proceedings on Thursday, February 27, 2025, 1012, house, all

Transcript Highlights:

• obligation debt backed by taxing power. obligation debt backed by taxing power.
• If you're going to future debt service.
• You'll see some budgeted debt service. You'll also see operating cost.
• It's not counted against your debt, your overall debt limit, because you're pledging your user fees and
• debt that they're requesting, and they have funds left over to save and to pay for emergencies.

Keywords: 916, all

Transcript Highlights:

• Our debt crisis is out of control.
• When I was first sworn into office in 2010, our federal government had $9 trillion of debt.
• And now, today, in 2025, we're staring down the barrel of $36 trillion of debt.
• <08:54:58.958> It add 7 trillion to our national debt.
• It add 7 trillion to our national debt.

Keywords: U.S. House of Representatives Floor Proceedings on Wednesday, May 7, 2025, 1012, house, all

Transcript Highlights:

• What these reports excess debt and rent.
• This is on top of the typical statewide rent debt of $45 million expected during any two-month period
• This is on top of the typical statewide rent debt of $45 million expected during any two-month period
• This is on top of the typical statewide rent debt of $45 million expected during any two-month period
• But these urgent issues of rent debt and eviction risk will continue to impact families for months.

Keywords: 1187, senate, all

Transcript Highlights:

• It eliminates school meals debt and significantly reduces the administrative work required to operate
• This would also create costs for unpaid meal debt collection for the LEA participants.
• This would also create costs for unpaid meal debt collection for the LEA participants.
• This would also create costs for unpaid meal debt collection for the LEA participants.
• This would also create costs for unpaid meal debt collection for the LEA participants.

Bills: HF51, HF1161, HF2201, HF2786, HF1053

Keywords: HF51, Sibley County, State-Aid Highway 21, capital investment, bonding bill, general obligation bonds, transportation infrastructure, road improvements, sanitary sewer, water main, storm sewer, local infrastructure, county grant, Minnesota Department of Transportation, bond proceeds fund, public works, utility infrastructure, education finance, school district funding, tax base adjustment

Transcript Highlights:

• Just as with coerced debt, we are proposing not to count those payments as taxable income.
• a victim from this special revenue account in the same way as we are proposing to do with coerced debt
• um we do not uh we're proposing not debt um we do not uh we're proposing not to<00:53:48.799> count
• a victim from this special revenue account in the same way as we are proposing to do with coerced debt
• debt debt um<00:54:43.760> and<00:54:44.119> I<00:54:44.359> I<00:54:44.440>

Keywords: 1187, senate, all

Transcript Highlights:

• producers have the option, once they secure a contract through the PUC and HEO, to refinance their debt
• some motivation to get a premium interest rate and then, 18 months down the line, refi into a lower debt
• reasonable from a... ...the question is whether independent power producers could refinance their debt
• /c> through the Pu and heo to refinance through the Pu and heo to refinance their<00:25:14.039> debt
• <00:25:27.039> load<00:25:27.840> and lower debt load and lower debt load and avoid

Keywords: 910, house, all

Summary: The committee heard several energy and environmental bills. On HB 974, which would authorize state step-in agreements for certain power purchase agreements and create a trust fund/reserve mechanism, the Attorney General’s office raised concern that the state should not incur liability beyond the trust fund. The Division of Consumer Advocacy said it had comments but did not take a position, while the Public Utilities Commission, Ameresco, Hawaiian Electric, and other industry groups supported the measure, saying it would help developers secure financing for renewable projects and improve reliability. Hawaiian Electric said the bill would not use state funds and that its proposed reserve account would be held in trust and returned to customers if unused. Committee members questioned whether the reserve would raise customer costs; Hawaiian Electric said the amount would be small and would be offset by avoiding higher financing costs, while Consumer Advocacy suggested the language should be strengthened to ensure unused funds are fully returned. The committee then heard HB 338, which would clarify that premium interest-rate adjustments for non-fossil fuel generation are just and reasonable and allow the PUC to include them in rates. DCCA and the State Energy Office supported the bill, and the PUC also supported it. Hawaiian Electric opposed unless amended, arguing the PUC already has discretion and warning the bill could weaken competitive procurement by encouraging higher bids tied to the utility’s credit rating. DCCA said the concern was that developers might not seek the best financing if premium rates are recoverable, but said Hawaiian Electric’s suggested amendment requiring clear and convincing evidence of unavoidable financing-cost increases would help. Members also asked about refinancing and whether developers could later lower debt costs after locking in a premium rate; DCCA said that ability exists and suggested a time limit or review mechanism. For HB 337, which would direct the PUC to establish standards requiring utilities to remove certain fossil-fuel costs from the rate base when adding renewable resources, the Department of Hawaiian Home Lands, Hawaii Clean Power Alliance, and the State Energy Office supported the measure. Hawaiian Electric opposed it, saying it misunderstood utility cost recovery and could threaten grid reliability because fossil plants provide ancillary services such as voltage regulation and balancing, not just energy. Hawaiian Electric pointed to its integrated grid plan and recent fossil-unit retirements as evidence of ongoing transition, and asked the committee to defer the bill and leave oversight to the PUC. The committee also heard HB 879 on cesspool conversions, which would raise the maximum grant from $20,000 to $30,000 and add DOH positions; DHHL, DOH, environmental groups, Hawaii Realtors, and others supported it, while DOH discussed staffing needs and the practical effect of the higher grant cap. The committee also began HB 379 on requiring denitrification capacity for certain wastewater systems near shorelines or groundwater, with DLNR testifying in support.

Transcript Highlights:

• and it just tells us what we are earning from our operations that allows us to cover the amount of debt
• And so our bond covenant that we made was that we would generate at least 1.25 times the amount of debt
• each year, and in these past years we have been right about at zero, which means we can cover our debt
• and it just tells us what we are earning from our operations that allows us to cover the amount of debt
• And so our bond covenant that we made was that we would generate at least 1.25 times the amount of debt

Keywords: 1183, house

Summary: The Health Finance and Policy Committee heard testimony from the Minnesota Hospital Association and several hospital leaders about the financial strain facing hospitals across Minnesota. The association’s CEO said hospitals are essential 24/7 safety-net providers, but rising labor, supply, technology, and drug costs are outpacing reimbursement from Medicaid, Medicare, and commercial payers. He warned that many not-for-profit hospitals are struggling, that workforce shortages remain significant, and that the committee should consider help on Medicaid rates, discharge/boarding problems, mental health services, workforce development, protecting the 340B drug discount program, and avoiding new mandates that add costs. Relle Schultz of Winona Health described a community hospital with a 49-bed facility and long-term care services that has faced years of losses, including a $17 million loss in 2023 and $12 million in losses the following year. She said government payers now make up about 65% of the hospital’s mix, and each 1% increase in that mix costs about $1 million. She highlighted the difficulty of sustaining services such as dialysis, which was nearly closed until a local donor provided $3 million to keep it open for three years, and she emphasized the importance of 340B savings and the need for higher Medicaid payments. Carrie Mulski of Riverview Health in Crookston said critical access hospitals are also under pressure despite their federal designation. She explained that federal support has eroded, that Medicaid and other public programs do not cover full costs, and that her hospital’s 340B savings help keep the doors open. She said Riverview opened a new hospital in 2020 but was hit by the pandemic and inflation, leading to annual losses of $5 million to $6 million and a negative operating margin of 9% to 10%. She also described bond covenant problems, low cash on hand, the prior closure of the nursing home, and the need for rapid state action to stabilize rural hospitals and preserve access to care.

Transcript Highlights:

• The legislature put a stop to that, and so now we're in the process of paying off that debt.
• So, the $100 million I was just talking about is not related to the debt.
• <01:38:01.360> that to pay down existing empower debt that to pay down existing empower debt
• c><01:38:42.360> but<01:38:42.480> the that debt payoff component, but the that debt payoff
• I also want to make clear the debt is being paid down. It's being paid down in a process.

Keywords: House streaming session for Tuesday, March 17, 2026, 957, house, all

Summary: The House opened with prayer, a quorum call showing 116 members present, and approval of the previous day’s journal. It then took up three ceremonial resolutions. One honored Robert Buchanan for his philanthropy, community leadership, and service in the greater Washington region; another welcomed a visiting delegation from County Tipperary, Ireland, and recognized efforts to strengthen Maryland-Ireland ties; and a third congratulated Dr. Miriam Rogers on her retirement as superintendent of Baltimore County Public Schools and her 2026 Woman in School Leadership Award. The chamber then moved through a series of committee reports, largely adopting favorable reports on bills without objection and ordering them to third reading. Measures included House Bills 435, 954, 1087, 1470, 936, 1110, 1554, 187, 324, 688, 776, 1152, 1320, and 1348, covering topics such as movie captioning in public accommodations, procurement and finance, health care facilities, school food procurement, tax foreclosure notice requirements, agricultural electricity tax study, expungement, child support rights, intercepted communications penalties, juvenile supervision, police orders studies, victim notification, and human trafficking reporting. Several bills were amended before being advanced, including House Bill 768 on benefits for children in custody, which added a foster youth savings program; House Bill 877 on institutional debt reporting, which changed reporting dates and required a data dictionary; House Bill 1092 on child advocacy centers, which clarified continuity-of-care standards and technical assistance grants; House Bill 310 on restrictive housing for people with developmental or intellectual disabilities, which required assessment at admission; House Bill 634 on police training, which added training on intellectual and developmental disabilities; House Bill 750 on access to religious facilities; House Bill 752 on gift card valuation and forgery; House Bill 1005 on child abuse and neglect reporting; and House Bill 1105 on consumer protection limitations, which was amended to apply only to civil suits. House Bill 1105 drew additional discussion, with the minority leader asking for a special order to review the changes, and the House agreed to postpone it until the appropriate time the next day. Later, House Bill 953, which would authorize transfers from the Revenue Stabilization Account to the State Disaster Recovery Fund, prompted extended questioning about Western Maryland flooding, FEMA denials, and the state’s response; the bill was presented as a way to provide relief after federal aid was denied. The transcript ends with the House still in session and continuing through the appropriations report.

Transcript Highlights:

• not seem like a lot to some people, but for me, it helped me pay my car insurance, registration, and debt
• The foster youth tax credit has helped me personally make rent, keep my housing, get out of debt, afford

Summary: The Assembly Committee on Human Services met to hear several measures focused on children, foster youth, farmworker families, and disaster assistance. AJR 12, recognizing May 2025 as Head Start Month and urging Congress and the President to protect and increase Head Start funding, was presented by Assemblymember Hadwick on behalf of Assemblymember Arambula. Testimony emphasized Head Start’s role in early education, health, and family support, especially in rural and low-income communities. The resolution passed 6-0. The committee also heard SB 624, which would expand access to the California Foster Youth Tax Credit by requiring counties to mail notices and provide guidance to non-minor foster youth about filing taxes and claiming the credit. Supporters from John Burton Advocates for Youth and former foster youth described the credit as a meaningful poverty-reduction tool that helps with rent, transportation, and other basic needs. Members praised the bill, and it passed 7-0 as amended to the Assembly Appropriations Committee. SB 778 would broaden eligibility for the Migrant Child Care and Development Program by redefining migrant agricultural worker family and allowing self-certification of income eligibility. Support came from the Mexican American Opportunity Foundation, California Citrus Mutual, and First 5 California, with witnesses saying the changes would ease enrollment for farmworker families facing seasonal and verification challenges. The bill passed 7-0 to Appropriations. The committee also approved a consent calendar containing SB 444, SB 471, and SB 792, all on a 7-0 vote. Finally, SB 739 would authorize the Department of Social Services to check whether counties in disaster areas can provide timely CalFresh and Disaster CalFresh services, aimed at improving coordination when local systems are damaged or overwhelmed. Supporters said the bill would help protect access to food benefits after disasters, and members noted its importance in light of recent Los Angeles County emergencies. The bill passed 7-0 to Appropriations, and the meeting adjourned after all items were acted upon.

Transcript Highlights:

• In Kentucky, our in-state students are averaging $310,000 in debt.
• their own practice to take on debt to do that.
• So they end up working for other practices, which can increase the debt cycle as they go forward.
• To take on debt to do that.
• So they end up working for other practices, which can increase the debt cycle as they go forward.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board meeting began with a roll call and approval of the October 7 meeting minutes. The chair then reordered the agenda to hear the item on Medicaid reimbursement rates and network adequacy first because of scheduling issues. Dr. Steve Robertson of the Kentucky Dental Association was sworn in and testified at length about Kentucky’s dental Medicaid program, arguing that reimbursement rates are unsustainably low, have been largely flat for decades, and are often below the cost of providing care. He said Kentucky ranks near the bottom nationally in oral health, dental Medicaid rates are often 60% or less of commercial rates, and the program’s share of the Medicaid budget has effectively remained around 2% despite growth in enrollment and services. Dr. Robertson said the low rates are contributing to provider losses, rural access gaps, longer wait times, dental deserts, and greater use of emergency rooms for preventable dental problems. He cited examples of office costs exceeding reimbursement for basic procedures, noted that many dentists are small private businesses, and said the state is struggling to recruit and retain dentists because of low payment levels and high student debt. He also pointed to disparities with neighboring states and said recent increases in some oral surgery and cleaning codes were not enough to address the broader problem. His recommendations included completing the rebasing study, increasing dental reimbursement in the upcoming budget, tying future reviews to inflation and cost data, aligning benchmarks, and prioritizing preventive and restorative care to improve workforce stability and access. Board members asked about the size of the needed increase, the effect of private insurance on dental practice finances, and what a new dentist might expect to earn. Dr. Robertson said the association is working on an appropriations request and that private insurance pressures are part of the problem as well, since many plans are HMOs or PPOs with limited provider control over rates. He also said the association can no longer conduct reimbursement surveys because of FTC restrictions, but would try to obtain current ADA data. In response to questions about the future of the program, he warned that without significant changes it could become unsustainable and cited Ohio and Missouri as examples where higher reimbursement improved provider participation and access. The board then heard from Mr. Bowman of Baldwin Consulting, who discussed outpatient behavioral health providers, including ABA therapy and mental health/substance use disorder services. He said these providers face similar issues of rising costs, flat reimbursement, and access problems. He reviewed Kentucky’s network adequacy standards, including travel-time standards, 30-day appointment limits, and newer federal requirements that will require services within 10 business days by 2029. He said wait times for outpatient behavioral health, especially children’s services and ABA, have grown substantially, sometimes to more than a year, and emphasized that the Medicaid department must enforce these standards.