Transcript Highlights:

• Texan over the age of 21 needs a copy of their birth certificate, they must pay $22.
• Now, currently, that can pay for the cost of the birth certificates.
• So they know that I really don't have enough money for the birth certificate.
• You're gonna come back here to pick your birth certificate up.
• . going to send their birth certificate when their birth certificate come in.

Bills: HB713 , HB827 , HB932 , HB499 , HB510 , HB163 , HB296 , HB879 , HB913 , HB163 , HB296

Committee: House Public Health

Transcript Highlights:

• from a healthy birth, healthy mother, pre-planned C-section.
• We're taking those systems with these birth-derived tissues, and...
• We're taking those systems with these birth-derived tissues.
• I think a lot of women need to save their birth tissues.
• It does not set denial limits, and it does not regulate rates.

Committee: Senate Senate Health and Human Services COR

Summary: The committee approved the minutes and then took up a large agenda of health-related bills. SB 1214, the Arizona Stem Cell Therapy Act, drew extensive testimony from supporters who said it would create guardrails for regenerative medicine, protect patients, and encourage biotech investment, while opponents argued it was tied to abortion politics and imposed harsh penalties. The bill passed on a 4-3 vote. SB 1194, which would prohibit health professionals and institutions from denying care based on vaccination status, also passed 4-3 after testimony from supporters framing it as an access-to-care and religious-freedom measure and opponents warning it would interfere with private practice policies and parental choice. SB 1814, creating a study committee on substance use disorder treatment standards and oversight, passed unanimously 7-0. SB 1602, increasing stipends for kinship foster parents, passed as amended 7-0, and SB 1603, expanding child-only cash assistance eligibility, also passed as amended 7-0. The committee then considered several bills focused on gender-related care and public funding. SB 1177, which bars public monies from funding gender transition procedures and makes intentional violations a felony, passed 4-3 amid testimony that it protects taxpayers and counterarguments that it is discriminatory and unsupported by evidence. SB 1014, requiring insurance coverage for detransition procedures when transition care is covered and directing data reporting on transition and detransition, passed 4-3 after supporters said it would help detransitioners and collect needed data, while opponents argued it would chill providers and target transgender patients. SB 1094, creating civil liability for physicians who perform irreversible gender reassignment surgery on minors, was heard with testimony from supporters citing malpractice concerns and detransitioner harms and from opponents saying it would create a hostile environment for providers and treat trans patients differently; the transcript cuts off before the vote is shown. SB 1752, which classifies commercial harvesting or sale of mescaline as a felony while preserving bona fide religious use defenses, passed unanimously 7-0. Later, SB 1628, requiring insurers to report claims-denial and prior-authorization data and DIFI to publish standardized reports, passed unanimously 7-0 after supporters emphasized transparency and opponents called it redundant to federal reporting. SB 1629, requiring AHCCCS managed care organizations to give advance notice and network-adequacy documentation before terminating high-volume providers without cause, also passed 7-0; supporters said it would prevent patients from losing access to behavioral health care, while health plans and Access said existing oversight already covers much of this and warned the bill could slow necessary network changes. Throughout the meeting, the committee repeatedly adopted motions for due-pass recommendations and, where applicable, amendments, with several bills passing on party-line or near-party-line votes.

Transcript Highlights:

• A lot of those have. higher rate of return for healthy food choices.
• , the five-star rating, so it deals with things like pressure ulcers.
• And birth mothers are not, they're not wanting to wait that amount of time.
• Representation of birth parents. I understand what you're saying.
• But I know that the birth mother picked them long before or long before the birth, and so I know often

Bills: HB2510 , HB3589 , HB4611 , HB4655 , HB4665 , HB4666 , HB4670 , HB4700 , HB4730 , HB4798 , HB4838 , HB5136 , HB5243 , HB5302 , HB5539

Committee: House Human Services

Transcript Highlights:

• From 2019 to 2022, the rate of mortality cases...
• The rate that it has nationally. Correct.
• This excludes the 10% of women who are not able to give birth. give birth? Are they men?
• You know, so it looks like they could give birth, but they can't. ...can't give birth.
• Who is more than just a vessel for birth.

Bills: HB229 , HB229 , HB3990 , HB5082 , HB5510

Committee: House State Affairs

Transcript Highlights:

• And it was found that there was 11% that resulted in live births.
• rate among babies.
• We already have a mortality rate issue in the state of Missouri.
• The birthing centers wouldn't have doctors in them.
• We already have a mortality rate issue in the state of Missouri. Yes.

Committee: House Children and Families

Transcript Highlights:

• from a healthy birth, healthy mother, pre-planned C-section.
• We're taking those systems with these birth-derived tissues, and...
• We're taking those systems with these birth-derived tissues.
• I think a lot of women need to save their birth tissues.
• It does not set denial limits, and it does not regulate rates.

Bills: SB1014 , SB1094 , SB1146 , SB1177 , SB1192 , SB1194 , SB1214 , SB1372 , SB1390 , SB1398 , SB1399 , SB1494 , SB1557 , SB1561 , SB1564 , SB1602 , SB1603 , SB1621 , SB1628 , SB1629 , SB1713 , SB1752 , SB1776 , SB1813 , SB1814 , SB1821

Committee: Senate Health and Human Services

Transcript Highlights:

• Thank you. what would be listed as the date of birth for the fetus?
• So first of all, what is it going to do to their rates?
• And we have men, men, who cannot give birth to a child.
• And that was passed to lower the rates. And guess what? The rates weren't lowered. Thank you.
• Representative Soroy continued: “Rates. And guess what? The rates weren’t lowered.

Transcript Highlights:

• and insurance rates that are affordable for all of us.
• and insurance rates that are affordable for all of us.
• At birth, August had subtle signs of CMV, but they were missed.
• We received his newborn screening results just four days after his birth.
• As you heard, screening rates are 70, 75 percent.

Committee: Joint Joint Committee on Public Health

Summary: The Joint Committee on Public Health heard testimony on a wide range of bills focused on children’s health, tobacco control, newborn screening, pediatric cancer, palliative care, and professional licensure. Early testimony highlighted Senate bills to expand newborn screening for pyruvate dehydrogenase complex deficiency, lysosomal storage disorders, and congenital CMV, with families and clinicians describing severe diagnostic delays, missed treatment windows, and the benefits of early detection. Speakers also supported a bill to improve pediatric cancer research through a dedicated trust fund, and a bill to extend pediatric palliative care services to age 22, with parents and providers emphasizing continuity of care for seriously ill young people. Several witnesses gave personal accounts in support of the newborn screening measures. Families described children who endured years of misdiagnosis before receiving diagnoses such as Gaucher disease, Fabry disease, Pompe disease, Niemann-Pick disease, and CMV, often after irreversible damage had already occurred. Medical and advocacy witnesses said Massachusetts already collects some of the relevant screening data and argued that results should be reported to families, while others urged the committee to add conditions to the state panel because effective treatments already exist. The committee also heard support for a bill to establish a fetal alcohol spectrum disorder program and training for providers. On tobacco and youth health, testimony supported bills to ban internet tobacco sales, strengthen youth protections, and reduce lung cancer deaths through point-of-sale information and quit-line access. A student testified about easily purchasing flavored nicotine products online without meaningful age verification, and public health advocates backed measures to keep tobacco out of children’s environments. The committee also heard testimony on a bill to ensure parents have access to their children’s medical records through age 16, with exceptions for sensitive services already protected by law. The committee additionally took testimony on an optometry licensure bill, where ophthalmologists opposed language they said could broaden scope of practice and allow optometrists to use the title “optometric physician,” while optometry educators and students supported the bill as a modernization measure with no scope expansion. No votes were taken during the hearing; the chair repeatedly reminded speakers of time limits and noted that written testimony could be submitted for additional comments.

Transcript Highlights:

• their rates get better either.
• </c> improved rates. improved rates.
• This year we saw lower rates of teen births, children under 19 with health insurance, and smoking during
• Additionally, we saw that teen birth rate drop from 28.2 per 10,000 to 21 per 10,000.
• </c> Um, additionally, we saw that teen birth Um, additionally, we saw that teen birth rate<01:13:48.560

Committee: Joint Families & Children

Transcript Highlights:

• His birth certificate says female.
• Who carries their birth certificate with them?
• And even then, my birth certificate My birth certificate does not have my correct assigned gender because
• marker for a birth certificate.
• or birth certificate because we've established that intersex folks don't have that option on a birth

Committee: House Emerging Issues

Transcript Highlights:

• The CSU programs have single digits acceptance rates as well.
• Her next option was to purchase over-the-counter birth control, but she could not afford it.
• requires a prescription to cover over-the-counter birth control.
• The prescription is not required if you have a birth control condition.
• Obtain over-the-counter birth control at no cost.

Committee: House Business and Professions

Transcript Highlights:

• What is the fundamental purpose of a birth certificate?
• on the certificate of birth shall not be amended.
• on the certificate of birth shall not be amended.
• Birth certificates are not identity documents..." "...Birth certificates are not identity documents that
• The five-year retention rate is an important number.

Bills: HB4319 , HB4317 , HB1225 , HB3076 , HB3081 , HB4226 , SCR17 , HB4432 , HB3304 , HB3411 , HB3435 , HB4339 , HB4331 , HB4341 , HB4342 , HB1770 , HB1016 , HB4113 , HB2950 , HB4141 , HB3277 , HB2988 , HB3029 , HB3338 , HB1889 , HB3834 , HB3831 , HB2939 , HB3045 , HB3657 , HB1739 , HB3759 , HB3755 , HB4484 , HB4486 , HB4108 , HB1250 , HB2961 , HB1219 , HB3025 , HB1782 , HB1907 , HB3718 , HB4459 , HB2976 , HB3548 , HB3545 , HB2952 , HB2929 , HB2956 , HB2973 , HB3055 , HB3086 , HB3040 , HB3794 , HB4336 , HB3151 , HB1590 , HB3581 , HB3313 , HB3429 , HB3448 , HB1752 , HB2650 , HB3584 , HB4202 , HB3586 , HB4321 , HB4280 , HB3650 , HCR1020 , HB2116 , HB2206 , HB4301 , HB3625 , HB3147 , HB3403 , HB3498 , HB3970 , HB3975 , HB3976 , HB3980 , HB4265 , HB4266 , HB3638 , HB3880 , HB3930 , HB3942 , HB3944 , HB4191 , HB3242 , HB3678

Summary: The House convened, took the roll, offered the invocation and Pledge of Allegiance, and introduced Dr. Zachary Fowler as Doctor of the Day. The chamber also received several visitor introductions, including CPA representatives, Ms. Oklahoma 2025 Tessa Dorrell, Osage County elected officials, and retired firefighters. The floor leader noted a lengthy agenda and moved through second- and third-reading business. Members debated and passed House Bill 437, which updates Oklahoma CPA licensure pathways to align with the 2025 Uniform Accountancy Act and create three structured routes to licensure; it passed 73-0. House Bill 1225, dealing with vital records and birth certificate sex designation language, drew extended debate over self-determination, accuracy of records, and constitutional concerns; it passed 73-18. House Bill 3076 created a new alternative teacher certification pathway and passed 76-17, with debate centered on whether alternative routes help fill shortages or weaken traditional preparation programs. House Bill 381 lowered the age to become a licensed fire extinguisher technician from 21 to 18 and passed 90-0. During debate on the education bill, supporters argued alternative certification can improve recruitment and retention and cited out-of-state programs and retention data, while opponents said it could disincentivize traditional teacher preparation and worsen long-term retention. On the vital records bill, supporters described it as a transparency and accuracy measure, while opponents argued it would impose government judgments on identity and conflict with prior court rulings. After completing the listed business, the House recessed until 1:30 p.m.

Transcript Highlights:

• Should we look at poverty rate requirements and expanding it and open up... ...reimbursement rates.
• So we actually have more providers now with the new rates than we did under the old rates.
• That has impacted our reimbursement rates in this grant and will also reimpact reimbursement rates in
• The rate change was their reason for closing.
• The rate change was their reason for closing.

Committee: All EDUCATION- HOUSE EARLY CHILDHOOD SUBCOMMITTEE

Summary: The committee met to review early childhood education funding, access, and program sustainability, with Secretary Aleva and Director Ashland Abney providing updates on Arkansas’s ABC state-funded preschool program and the federal CCDF/SRA program. Members discussed the long-standing flat funding for ABC, which rose from $11 million to $14 million in 2018, compared with roughly $137 million in federal CCDF/SRA funding. Officials said ABC serves about 23,000 children, while SRA serves about 14,871 children and has a wait list of about 2,971 children. Members also asked for more data on rural versus urban access, provider types, and the number of slots and providers by region. A major topic was how to improve quality and access while aligning early childhood with K-12. Officials said the department is moving from the Better Beginnings environmental rating system toward CLASS observations, using local leads and a kindergarten-readiness strategy tied to quality improvement. Members raised concerns about deserts and islands in service availability, the cost of school-based versus community-based providers, and the need to support infant-toddler care as well as preschool. The commissioner said early learning should be part of long-term state education investment, but that simply adding money would not solve access gaps without broader structural changes. The committee also discussed recent funding changes and their effects on providers and families. Officials said a $14.741 million PDG-BFV competitive grant will support systems-building work, including local leads, workforce, data systems, and third-party CLASS observations, but it is a one-year grant and not direct service funding. Members questioned the impact of new co-pays, provider closures, and slot reallocations; officials said eight closures were tied specifically to funding changes, and that paying only for enrolled children rather than allocated slots saved about $576,000. They also discussed dual enrollment in home visiting and ABC, with officials estimating that limiting double enrollment could save about $2.4 million and potentially serve about 470 more children. The meeting ended with agreement to continue regular updates and further discussion, and the committee adjourned without a vote on legislation.

Transcript Highlights:

• What is the fundamental purpose of a birth certificate?
• And so, if somebody has a birth certificate that they're using for identification purposes that does
• But when it comes to a birth certificate that's a vital statistic that needs to be accurate.
• on their certificate of birth shall not be amended.
• Birth certificates are not identity documents that change over time.

Bills: HB4319 , HB4317 , HB1225 , HB3076 , HB3081 , HB4226 , SCR17 , HB4432 , HB3304 , HB3411 , HB3435 , HB4339 , HB4331 , HB4341 , HB4342 , HB1770 , HB1016 , HB4113 , HB2950 , HB4141 , HB3277 , HB2988 , HB3029 , HB3338 , HB1889 , HB3834 , HB3831 , HB2939 , HB3045 , HB3657 , HB1739 , HB3759 , HB3755 , HB4484 , HB4486 , HB4108 , HB1250 , HB2961 , HB1219 , HB3025 , HB1782 , HB1907 , HB3718 , HB4459 , HB2976 , HB3548 , HB3545 , HB2952 , HB2929 , HB2956 , HB2973 , HB3055 , HB3086 , HB3040 , HB3794 , HB4336 , HB3151 , HB1590 , HB3581 , HB3313 , HB3429 , HB3448 , HB1752 , HB2650 , HB3584 , HB4202 , HB3586 , HB4321 , HB4280 , HB3650 , HCR1020 , HB2116 , HB2206 , HB4301 , HB3625 , HB3147 , HB3403 , HB3498 , HB3970 , HB3975 , HB3976 , HB3980 , HB4265 , HB4266 , HB3638 , HB3880 , HB3930 , HB3942 , HB3944 , HB4191 , HB3242 , HB3678

Transcript Highlights:

• It's also the safety net for birthing centers and home births if complications are...
• It's also the safety net for birthing centers and home births.
• Baines noted, declining birth rates, workforce shortages, and financial instability have left some hospitals
• I had planned to have a midwife birth, and I was very very very. dramatic situation.
• Monitoring of birth defects and related health...

Summary: The Assembly Health Committee heard a long agenda of health bills focused on access to preventive care, behavioral health, hospital services, and patient safety. Early items included AB 554, which would expand and protect access to HIV prevention drugs like PrEP, including injectable forms and coverage protections; supporters said it would shore up access amid federal threats, while insurers opposed it as a costly benefit mandate. AB 577 would limit insurer and PBM practices that steer medications away from physician offices and require more transparency and patient consent; doctors and patient advocates supported it, while health plans and insurers warned it could raise drug costs and disrupt specialty pharmacy networks. AB 546 would require coverage for portable HEPA purifiers for vulnerable enrollees during declared emergencies, especially wildfire smoke events, with support from air quality and public health groups and opposition from insurers concerned about benefit expansion and cost. The committee also heard AB 224, which would codify California’s updated essential health benefits benchmark plan after a public review process, adding infertility treatment, hearing aids, and durable medical equipment if approved by CMS for the 2027 plan year. DMHC said the state had completed the review and needed legislation to meet federal timing, and the measure drew broad support. AB 1032 would require plans and insurers to reimburse up to 12 additional behavioral health visits for enrollees in wildfire-affected counties for a limited period after an emergency; supporters argued it would fill gaps in trauma care after disasters, while insurers said existing parity and continuity-of-care rules already address the issue and that the bill could create inequities. AB 849 would require trained chaperones for sensitive ultrasound exams and training on how to observe and intervene; it was backed by a survivor and patient advocates, with hospitals and health districts raising staffing concerns. Later, AB 1196 would direct the Department of Public Health to update outdated rules requiring three surgeons for certain heart surgeries using cardiopulmonary bypass; supporters said the rule no longer reflects modern practice and strains staffing, while cardiology representatives had no formal opposition but wanted to review amendments. AB 1113 would codify a right to wear a mask for health reasons in public spaces, with support from disability and public health groups. AB 1386 sought to add perinatal care to the list of basic hospital services, prompting testimony about maternity ward closures, workforce shortages, and rural access; the author said the bill would be amended further and that the committee would need to revisit timelines and implementation details. The committee also heard AB 1429, which would address Kaiser’s repeated mental health parity violations and improve access to behavioral health care, though the transcript cuts off before any action on that bill is shown. Several bills were moved with motions and seconds, but many were held for quorum; AB 1196, AB 1113, and AB 1386 were among the measures advanced to a roll call or held on call, and the committee repeatedly noted that final votes would occur when quorum was available.

Transcript Highlights:

• Our unemployment rate is low, but our chronic unemployment rate is over 8%.
• H.J.R. 1053 would require county clerks to calculate this revenue-neutral rate.
• And the other is about the rate of growth. And I look at this as a rate of growth idea.
• on a birth certificate shall not be amended.
• Birth certificate, which is kind of a private document.

Summary: The committee heard and advanced a series of bills and resolutions, many involving taxes, education funding, health policy, and election rules. Representative Newton’s HB 1823, on the Oklahoma Housing Finance Agency’s home-building activities, passed 10-0. Speaker Hilbert’s HB 2425, which would align Oklahoma election dates more closely with Texas and move some elections to March, passed 9-2 after debate about turnout and accountability. HB 4440, requiring Medicaid work requirements to track federal law, passed 10-2 amid discussion of chronic unemployment and the limits of changing Medicaid expansion because it is in the Constitution. HJR 1087, a major proposal to restructure the T-SET tobacco settlement trust and redirect funds toward higher education and related uses, passed 12-0 after extensive debate over venture capital investing, public health spending, and whether the trust should be modernized. The committee also took up several property-tax measures. HJR 1053 would create a revenue-neutral ad valorem framework, requiring local approval for increases beyond prior-year levels; it passed 9-2. HJR 1054 would exempt business inventory from ad valorem taxation, and after questions about scope and possible abuse it passed 9-2. HJR 1044 would lower the annual cap on growth in assessed value for homestead and agricultural property from 3% to 2%; it passed 9-2. HB 4145 would raise the homestead exemption from $1,000 to $7,000 and passed 9-1. HJR 1081 would freeze ad valorem taxes for qualifying seniors and passed 8-1. The committee also advanced HB 3891, a county commissioner pay bill, after title was struck and members discussed its impact on small counties; it passed 9-2. Other measures included HB 1770, directing an elk population study by Oklahoma State University, which passed 11-0; HB 1675, requiring youth camps to complete site-specific hazardous assessments, which passed 11-0; HB 3627, allowing the State Committee of Blind Vendors to meet by video conference due to quorum issues, which passed 11-0; HB 3472, expanding tire-recycling fund eligibility, which passed 10-1; and HB 1225, barring changes to the biological sex designation on birth certificates, which passed 8-2 after debate over medical, legal, and equal-protection concerns. The committee also advanced HJR 1019, a heavily amended proposal concerning party nominations for general elections, after striking title and narrowing the scope to federal, state, and county races; it passed 8-1 with two not voting. HB 3462, updating plumbing licensing law and aligning exam standards with other trades, passed 9-0 after title was struck to accommodate further negotiations.

Transcript Highlights:

• What's the formula for determining reimbursement rates?
• Should we look at poverty rate requirements and expanding it and open up Reimbursement rates.
• So we actually have more providers now with the new rates than we did under the old rates.
• That has impacted our reimbursement rates in this grant and will also impact reimbursement rates in a
• The rate change was their reason for closing.

Summary: The committee met to review the minutes and then held a workshop-style discussion with Arkansas Department of Education early childhood officials about the state’s early learning programs, funding, and access. Officials explained that the state-funded ABC program has been largely flat for years, rising from $11 million to about $14 million in 2018, while the federally funded SRA/CCDF side is much larger. They described differences between the programs, including ABC’s 10-month school-year structure, current enrollment of about 23,000 children in ABC and about 14,871 in SRA, and a SRA wait list that has grown to roughly 2,971 children. Members raised concerns about rural access, school-based versus community-based providers, reimbursement rates, and the need to align early childhood funding with K-12 and kindergarten readiness goals. A major topic was the recent $14.741 million PDG B-5 competitive grant. Officials said it is a one-year systems-building grant, not a direct services grant, and will support local leads, CLASS observations, workforce efforts, and data systems while helping offset some costs that otherwise would have been paid through CCDF. Members also discussed the end of a federal pre-K funding stream in June, with children either moving into ABC slots or requalifying for SRA, and the state’s new enrollment-based payment approach, which officials said saved about $576,000. The committee also heard that the current cost-of-care study is about three years old and that a new market-rate survey is being planned. Several members questioned dual enrollment in home visiting/HIPPY and ABC, with officials saying about 1,200 children are enrolled in both and that limiting double enrollment could save about $2.4 million and affect roughly 470 children. Members also asked about provider closures after rate changes; officials said eight providers cited funding as a reason for closing, while 26 new providers have been added under the new rates. The discussion ended with broad agreement that the committee should continue regular updates, keep providers and families informed, and explore policy changes, waivers, and possible state investments to improve stability, access, and quality in early childhood education.

Transcript Highlights:

• ><c> overall</c><00:37:16.079><c> is</c> recognize that the rate overall is recognize that the rate overall
• </c> The time of birth?
• If an adult changes<01:07:34.319><c> birth</c><01:07:34.559><c> certificate,</c> changes birth certificate
• </c> &gt;&gt; if if the request to amend a birth &gt;&gt; if if the request to amend a birth certificate
• My 1452 relating to birth certificates.

Bills: SB2211 , SB2025 , SB2038 , SB2050 , SB2051 , SB2090

Committee: House Health

Summary: The House Committee on Health held its first hearing of the session and opened with housekeeping notes, introductions of members, and an explanation that the agenda would be taken out of order to accommodate a sign language interpreter. The committee first heard HB 469, relating to parking for disabled persons. Testimony from the Disability and Communications Access Board and the State Council on Developmental Disabilities supported the bill, explaining that a travel placard would help people with disabilities who must travel interisland or to the mainland for medical care. Members asked about emergency travel, misuse prevention, and how to distinguish the travel placard from existing disabled parking placards; witnesses said the bill would need to be tied to administrative rules, and agreed the placard should clearly show an expiration date and likely be a different color. No vote was taken. The committee then heard HB 218, relating to hospital surgical smoke. The Department of Health supported the measure, and the Healthcare Association of Hawaii supported it with amendments, saying hospitals already follow existing standards but that any new policy should account for different procedures and provider safety. A committee member questioned the proposed amendment language and whether it was too flexible; the witness explained the intent was to allow case-by-case application because some procedures generate only brief exposure. Members also asked what surgical smoke is, and the witness explained it is produced when electrical or cauterizing tools are used on tissue and creates vapor or fumes. The bill remained under discussion with no final action reported. The committee next took up HB 814, which would fund a public information campaign and related services on cannabis use among youth. The Department of the Attorney General said the bill should be amended to clarify whether the funding would be used for contracts or grants and to include proper grant standards if grants are intended. The Department of Health supported the bill and said the funds would expand prevention, treatment, recovery, and public education efforts, including social media outreach, PSAs, and school-based youth services. Multiple organizations and individuals testified in support, emphasizing the harms of youth cannabis use and the need for prevention and treatment resources. Members asked what the department currently does, whether it is fulfilling existing law on science-based cannabis information, and what kinds of treatment would be provided; the department said services would mainly be intensive outpatient, outpatient, counseling, and related youth-focused supports. No vote was taken during the hearing.

Transcript Highlights:

• Tenare has increased their reimbursement rates some above commercial rates.
• rates</c><01:10:48.719><c> of</c> pre-term birth rates and higher rates of pre-term birth rates and
• In 2024, Kentucky Medicaid paid for about 22,375 births, which is roughly about 43% of all the births
• And one of the most live births.
• </c><01:14:57.520><c> And</c> all the births in the state. And all the births in the state.

Summary: The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well. Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk. Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.

Transcript Highlights:

• Decades of research show that doula care is associated with lower rates of preterm birth and cesarean
• and infant mortality rate in the state of Florida.
• We have among the highest rates in the country, and we need to address it.
• Because we're now at an error rate of 15%.
• So I'll skip on the error rate stuff.

Committee: Senate Health Policy

Summary: The committee first considered SB 268, a public records bill for emergency physicians. A strike-all amendment narrowed and clarified the exemption, and the sponsor said it was intended to protect current emergency department physicians and eligible family members who submit a written request. Emergency physician Dr. Sean Patterson and several health care organizations supported the bill, citing threats, harassment, and safety concerns tied to mandatory reporting and patient encounters. The committee adopted the amendment and reported SB 268 favorably as a committee substitute. The committee then heard SB 514, creating the Doula Support for Healthy Births Pilot Program in Broward, Miami-Dade, and Palm Beach counties for pregnant and postpartum women, with priority for those affected by substance use disorder. Members discussed how the Department of Health would implement the pilot, collect data, and work with existing maternal health partners. An amendment changed the funding source to specific appropriations in the General Appropriations Act. Supporters said doula care can improve maternal and infant outcomes and help address Florida’s maternal health crisis. The bill was reported favorably as a committee substitute. SB 36, on use of professional nursing titles, drew extensive debate over whether nurses with doctoral degrees should be able to use the title “doctor” in clinical and advertising settings while clearly identifying themselves as nurses. The sponsor said the bill was about transparency and patient clarity, while several senators raised concerns that patients could confuse DNPs with physicians. Supporters from nursing groups said the bill protects earned credentials and does not expand scope of practice. The committee adopted an amendment aligning the bill with the House version and reported SB 36 favorably as a committee substitute. The committee also reported favorably SB 864, creating a public records exemption for uterine fibroid research data; SB 844, requiring continuing education on sickle cell disease care management for certain health professionals; SB 1404, revising memory care licensing for assisted living facilities; and SB 914, clarifying dry needling authority for occupational therapists. Finally, the committee took up SB 1758, a broad public assistance bill affecting Medicaid and SNAP. The sponsor described reforms including stronger fraud enforcement, a Medicaid work requirement for certain able-bodied adults, expanded behavioral health services through a waiver, pharmacy program changes, and SNAP fraud reduction measures. Members questioned the work requirement, implementation costs, eligibility verification, and due process concerns, while the sponsor said the bill would require federal approval and legislative review before implementation. Three amendments were adopted to adjust drug list update timing, expand public testimony on the high-cost drug list, and require faster prior authorization responses with a temporary supply in emergencies. The transcript cuts off before the final disposition of SB 1758.