Transcript Highlights:

• Because that funding would otherwise come straight from the state road fund.
• But it takes funding.
• You'll see that the Fire Protection Fund, the Local Government Road Fund, and the DWI Grant Fund are
• Major and non-major funds, just like the general funds, have both increased.
• The quick ratio was $53, and the current ratio was $55.

Transcript Highlights:

• The ratio in Livingston County for residential was 86. The commercial ratio study was at 58.
• Yeah, I just have a quick question on those ratio studies.
• Yeah, I just have a quick question on those ratio studies.
• I do not think their ratios are typical.
• You mentioned one of the ratios was Worth County, and it was the commercial ratio that you mentioned?

Committee: House Special Committee on Property Tax Reform

Transcript Highlights:

• our operations through general fund and funding our reconstruction through capital funds. heard about
• and funding our through general fund and funding our reconstruction<01:07:35.359><c> through</c><01:
• to do that, but this funding would probably help offset some of our general fund expenses. general fund
• </c> funds to do that, but this this funding funds to do that, but this this funding would<01:11:01.920
• </c><01:16:18.480><c> is</c> maintenance fund now is that fund is maintenance fund now is that fund is

Summary: The committee first heard testimony from State Treasurer Monica Misipelli on House Bill 1042, which would increase the contingent credit limit for the BFA. She explained that under RSA 66 the state’s debt capacity is capped at 10% of unrestricted revenue, and that guaranteed debt counts in the calculation even though it is not direct debt. She said the state currently has about 65% of its capacity used, roughly $120 million of remaining room, and that raising the BFA contingent credit limit from $200 million to $450 million would reduce that capacity. She noted the state’s debt-to-revenue ratio is about 4.2%, that the state’s credit rating is not immediately affected by the guarantee program unless the state actually has to assume the liability, and suggested unused guarantee authorizations, such as one for the Peace Development Authority, could be reviewed in the future. Members asked whether a credit guarantee affects bonding ability like actual debt, what the usual debt level is relative to the statutory cap, and whether the increase would crowd out future capital borrowing. Misipelli answered that guarantees are included in the formula and do affect available capacity, though the current ratio remains manageable. She also said she had been using a $120 million benchmark for capital budget planning and was now modeling $130 million in future state debt. When asked whether the full $250 million increase was necessary, she deferred to the BFA, saying the question should be answered by the agency. James Key Wallace, executive director of the New Hampshire BFA and interim commissioner of Business and Economic Affairs, then testified in support of the bill. He said the request was driven by larger project costs over the last several decades, with construction inflation causing guarantees to be used up in bigger chunks, and by the fact that the BFA has been close to its current cap. He said the agency does not use taxpayer funds, has never had a payout on a guarantee in nearly 35 years, and requires collateral, reserves, and an 80% loan-to-value buffer. He told members the Senate had a similar bill to raise the limit to $400 million and that the BFA considered that range acceptable. In response to questions, he said a smaller increase such as $150 million would cover known transactions but might not provide enough runway for future opportunities, and he confirmed the bill was brought at the BFA’s request. He also said businesses consider housing availability when deciding whether to locate in New Hampshire, since housing and workforce are key location factors. At the end of the work session, the chair closed House Bill 1042 and opened House Bill 241, a bill on health insurance coverage of pain management services for chronic pain. Representative Nagel began introducing the bill and asked for copies of the treasurer’s debt-capacity report, but the transcript cuts off before any further action on HB 241.

Transcript Highlights:

• So we have a strong funded ratio.
• 8% projected to be funded ratio is 82.8% 8% projected to be fully<00:24:59.600><c> funded</c><00:24:
• The funding ratio tells you where you're at.
• </c><01:01:59.599><c> ratio</c> million today and our funding ratio million today and our funding ratio
• </c> our funding ratios and our contributions our funding ratios and our contributions um<01:04:27.440

Transcript Highlights:

• look at as taxable funds, you know, funds?
• funds would be public funds which have the whole other set of rules.
• </c> you know, funds. you know, funds.
• funds which &gt;&gt; Taxed funds would be public funds which have<00:36:09.119><c> the</c><00:36:09.440
• So, you're saying it's a 1:1 ratio? >> I can't speak to the 1:1 ratio.

Committee: House County and Municipal Government

Transcript Highlights:

• This brings total LCFF funding to $83.4 billion in 2025-26, including costs for TK expansion and TK ratio
• the 24 and the ratios.
• We have enough funding to cover existing commitments and then funding for additional funding beyond that
• Currently, Tier 2 funding varies each year. Funding varies each year.
• Years to get that funding.

Transcript Highlights:

• General fund impact of 1.6 million and 2.1 million, a total impact of other state funds and federal funds
• Of patient-provider nurse-patient ratios.
• Overworked and unsafe staffing ratios.
• The ratios became an option.
• If they can't get them because of the funding...

Transcript Highlights:

• our operations through general fund and funding our reconstruction through capital funds. heard about
• and funding our through general fund and funding our reconstruction<01:07:35.359><c> through</c><01:
• to do that, but this funding would probably help offset some of our general fund expenses. general fund
• </c> funds to do that, but this this funding funds to do that, but this this funding would<01:11:01.920
• </c><01:16:18.480><c> is</c> maintenance fund now is that fund is maintenance fund now is that fund is

Summary: The committee first heard testimony on House Bill 1042, which would increase the BFA contingent credit limit. State Treasurer Monica Misipelli explained that under RSA 66, state debt capacity is tied to unrestricted revenue and that guaranteed debt counts in the calculation even though it is contingent rather than direct debt. She said the state currently has about 4.2% to 4.3% debt-to-revenue ratio, about $120 million in additional capacity, and that approving the bill’s proposed increase would reduce available capacity for future state borrowing, including capital budgets. She noted the BFA has a long history of using guarantees without a state payout, but said the legislature should consider whether the full additional $250 million is needed and whether unused guarantee authorizations, such as one for the Pease Development Authority, should be reviewed in the future. Committee members asked whether guarantees have the same effect as actual debt for bonding capacity, and the treasurer confirmed that they do for purposes of the formula. Members also asked about the usual level of debt relative to the statutory 10% cap, and she said the state generally stays well below that limit. BFA Executive Director James Key Wallace then testified that the request was driven by rising project costs, inflation, and the need for more runway so the agency does not have to return to the legislature in an emergency. He said the BFA is self-supported, has never had a guarantee paid out by the state, requires collateral and reserves, and believes the appropriate range is closer to $400 million to $450 million; he also said a Senate bill would raise the limit to $400 million. He added that the BFA’s pipeline includes projects from about $15 million to $100 million and that housing availability is an important factor in business location decisions. After closing the work session on House Bill 1042, the committee opened House Bill 241, a bill on health insurance coverage for pain management services for chronic pain. Representative Dave Nagel, the prime sponsor, gave extensive background on his long career in pain medicine and said the bill is intended to improve access to non-opioid therapies and evidence-based pain management. He described the broad population affected by chronic pain and opioid use disorder, and said the proposal has long had bipartisan and stakeholder support. No vote or final action was taken on House Bill 241 in the portion of the meeting provided.

Transcript Highlights:

• My other question deals with ratios in your assertion that cost of living doesn't affect a ratio.
• and the ratio would decline?
• Chairman, is simply creating a revolving fund? Yes. There's no funding in the bill.
• So going forward, would you be willing to consider if we are going to fund this revolving fund and we
• Chairman, is simply creating a revolving fund. Yes. There's no funding in the bill.

Bills: HB3622 , HB3621 , HB3151 , HB3882 , HB3661 , HB4273 , HB3644 , HB3706 , HB3708 , HB2021 , HB3986 , HB3972

Committee: House Appropriations and Budget

Keywords: HB3622, 2030 Census, Decennial Census, U.S. Decennial Census Revolving Fund, Oklahoma Department of Commerce, Commerce Department, census preparation, federal census, state treasury fund, revolving fund, continuing fund, deemed appropriated, technology upgrades, census outreach, redistricting, population count, Title 74, OMES, State Treasurer, budgeting

Transcript Highlights:

• But sometimes, just a question: are these homes often government funded, maybe funded by some grant?
• Hospitals have to meet those ratios right now.
• The ratio laws are very specific.
• The ratio laws are very specific.
• Day after day where they were out of ratio.

Committee: House Health

Summary: The Assembly Health Committee heard several bills focused on health care access, staffing, and coverage. A major special order was SB 306 by Senator Becker, which would reduce prior authorization requirements for services and drugs that are routinely approved. Becker and supporters, including the California Medical Association, California Hospital Association, Health Access, Planned Parenthood, and others, argued prior authorization delays care, adds administrative burden, and can lead to serious patient harm. Opponents from health plans, insurers, the Chamber of Commerce, and physician groups raised concerns about preserving utilization management, the bill’s 90% approval threshold, drug coverage, and how “modifications” are counted. After late amendments and discussion with the Department of Managed Health Care, Local Health Plans of California withdrew opposition, while the bill remained opposed by some groups. Committee members discussed patient stories, cost concerns, and the bill’s amended structure, and the author asked for an aye vote. The committee also heard SB 35 by Senator Umberg, which would let cities and counties inspect unlicensed sober living homes if the Department of Health Care Services does not act on complaints within set timelines. Supporters, including the League of California Cities and several local governments, said the bill responds to inadequate state enforcement and growing problems with unlicensed facilities. One county behavioral health group opposed unless amended. Members largely supported the bill, citing community impacts and the need for stronger oversight. SB 62, also by Senator Becker, would codify California’s proposed essential health benefits update if approved federally, adding hearing aids, durable medical equipment, and infertility/IVF coverage. Health Access California and several advocacy groups supported the measure, while the California Family Council opposed. The committee then heard SB 596 by Senator Menjivar, which would tighten the definition and use of hospital on-call lists in the nurse staffing ratio enforcement process. Nurses and labor groups supported the bill as closing a loophole, while the California Hospital Association and other hospital groups opposed, arguing it would reduce staffing flexibility and increase costs. Finally, SB 40 by Senator Wiener would cap insulin copays at $35 per month and limit step therapy for insulin; it drew broad support from medical, patient, labor, and student witnesses, with no opposition testimony heard. The committee ended with discussion of SB 363, which would address health care coverage and independent medical reviews, but the transcript cuts off before that item was fully taken up.

Transcript Highlights:

• There are also tech ratios.
• Actually has ratios in law?
• I believe they do have ratios.
• So yes, they did have ratios.
• They do a one-to-three ratio up there.

Committee: House House Health & Human Services

Transcript Highlights:

• The funding policies in place will trend these funded ratios toward 100%.
• funding to get that funded ratio to 100%.
• Funded ratios are still produced...
• Funding ratios are still projected to improve through fiscal year 2025.
• or slowing of those funded ratios.

Committee: Joint Select Committee on Pension Policy

Summary: The Select Committee on Pension Policy met on June 17, 2025, with Vice Chair Fitzgibbon presiding initially in Chair Benke’s absence. The committee approved the May minutes and then held its annual election of officers. Representative Travis Couture was elected chair, Senator Steve Conway was elected vice chair, and the executive committee seats were filled by Member Yistramski for actives, Bev Hermanson for retirees, and Anthony Murrietta for employers. The committee also recognized Pat Thompson for her long service and upcoming departure from the committee. Staff then briefed the committee on Engrossed Substitute Senate Bill 5357, which changed pension funding by increasing the assumed long-term investment return from 7% to 7.25%, lowering normal cost contribution rates, suspending Plan 1 UAAL contributions for four years, and extending the amortization period for Plan 1 benefit improvements from 10 to 15 years. The Office of the State Actuary explained that the bill produces significant short-term budget savings but increases the risk of higher contribution rates later if investment experience underperforms. Members asked about the suspension of Plan 1 UAAL rates and the implications for future rates and funding risk. The committee also received an introduction to the required study of proposed LEOFF 1 merger and termination legislation under the 2025-27 operating budget proviso, covering Substitute Senate Bill 5085 and Substitute House Bill 2034. Staff outlined the study plan, including legal, tax, actuarial, administrative, and pension policy analysis, with input expected from the Attorney General’s Office, Ice Miller LLP, the Office of the State Actuary, DRS, the State Investment Board, and the State Treasurer. Members discussed the unusual issue of an overfunded plan and possible IRS implications. Public testimony was split, with some speakers supporting a merger as a way to create room for a Plan 1 COLA and others opposing any diversion of LEOFF 1 assets, citing legal, tax, and member-rights concerns. The meeting adjourned before the scheduled executive session.

Transcript Highlights:

• Our funded ratio in this plan grew significantly up to 93.17%.
• Our funded ratio in this plan grew significantly up to 93.17%.
• You'll note here our funded ratio. Again, a pretty material increase. Now we're at 86.75% funded.
• And our ratio, our funded ratio, now 99.43%. And our ratio, our funded ratio, now 99.43%.
• And at the bottom of that page, you'll see that everything lined up. ...And our ratio, our funded ratio

Summary: The Public Retirement System Actuarial Committee met on February 23, 2026, approved the December 18, 2025 minutes, and heard no public comment. The committee then reviewed actuarial valuation reports and, for most systems, accompanying experience studies. The actuaries reported generally favorable investment and demographic experience across the systems, with funded ratios improving and employer contribution rates declining in several plans. They also explained the role of funding deposit accounts, frozen unfunded liabilities in some plans, and how recent legislative changes, especially the move to five-year DROP periods in some systems, affected assumptions and costs. For the Louisiana Clerk of Court Retirement Relief Fund, the committee adopted the valuation and experience study, recognizing a fiscal 2027 minimum recommended employer rate of 14.75%. For the District Attorney’s Retirement System, it adopted the valuation and experience study and recognized a fiscal 2027 minimum rate of 3.00%. For the Firefighters’ Retirement System, the committee adopted the valuation and experience study, recognized a fiscal 2027 minimum rate of 25.5%, and noted that DROP balances left on deposit will earn the market rate of return of 11.7%. The committee also adopted the Municipal Employees’ Retirement System valuation for both Plan A and Plan B, recognizing fiscal 2027 minimum rates of 20.75% and 8.75%, respectively. It adopted the Municipal Police Employees’ Retirement System valuation and experience study, recognizing a fiscal 2027 minimum rate of 26.5%, a DROP crediting rate of 7.4%, and a policy range up to 29.35% for future contributions. For the Registrars of Voters Employees’ Retirement System, the committee adopted the valuation and experience study, recognized a fiscal 2027 minimum rate of 0%, and noted a $207,683 allocation to the Member Supplemental Savings Fund for fiscal 2026. Finally, it adopted the Sheriff’s Pension and Relief Fund valuation and experience study, recognizing a fiscal 2027 minimum rate of 7.75%. All motions passed without objection, and the meeting adjourned.

Transcript Highlights:

• My other question deals with... ...ratios, and your assertion that cost of living doesn't affect a ratio
• Wouldn't you agree that would affect the ratio and the ratio would decline?
• an increase in the amount of money that the ratio, both the absolute amount and the relative ratio of
• Chairman, is simply creating a revolving fund? Yes. There's no funding in the bill.
• So going forward, would you be willing to consider, if we are going to fund this revolving fund and we

Bills: HB3622 , HB3621 , HB3151 , HB3882 , HB3661 , HB4273 , HB3644 , HB3706 , HB3708 , HB2021 , HB3986 , HB3972

Committee: House Appropriations and Budget

Summary: The committee heard and advanced several bills, beginning with HB 3622 and HB 3621, both related to census and state data functions. HB 3622, as amended, removed direct appropriation language and would let Department of Commerce staff carry out census-related duties such as updating local census addresses and upgrading technology. HB 3621 would recreate the State Data Center at the Legislative Service Bureau to coordinate census-related programs across agencies such as Commerce, Tax, and others; both bills received unanimous or near-unanimous support and were reported out due pass. A lengthy portion of the meeting focused on HB 3151, which would redefine instructional days so that only time students are actually in the classroom counts toward the instructional minimum, excluding professional development and parent-teacher conference time. The author argued the bill would close Oklahoma’s instructional-time gap and improve outcomes, while members raised concerns about funding, teacher pay, contract negotiations, and how districts would absorb the change. After debate, the bill passed 19-7. The committee also advanced HB 3706, which sets minimum elementary math instruction standards and expands math screening requirements, and HB 3708, which would allow private schools to use scholarship-granting organization funds for capital improvements to increase instructional capacity; both drew questions about funding, scheduling, and the scope of the programs but were reported out due pass. Other measures approved included HB 3661, extending a sunset on a timber equipment tax provision; HB 3882, creating a revolving fund for ODOT’s lake access and industrial access grants; HB 4273, extending a tax credit to certain aerospace engineers at an ARM 1 higher education institution; HB 3644, tied to medical training and best practices after a fatal misdiagnosis; HB 2021, creating a DHS grant program for out-of-school programming, with discussion centered on whether it would effectively favor Boys and Girls Clubs and exclude other providers; HB 3986, extending a sunset; and HB 3972, cleanup language related to the Comanche County prison purchase. Most bills passed with strong support, and the meeting adjourned after the final votes.

Transcript Highlights:

• House Bill 2283 relates to the medical loss ratio.
• The minimum medical... ...referred to as the minimum medical loss ratio standard.
• The medical loss ratio is a basic accountability measure.
• First, a higher medical loss ratio does not automatically mean better care for patients.
• We know a tighter medical loss ratio can lower health insurance premiums.

Summary: The committee held public hearings on House Bill 2261, which would require health care providers to wear badges showing name, credential, and relevant degrees, require similar disclosure in advertising, and restrict use of the title “physician surgeon” to certain physicians and osteopathic physicians. Supporters, including the Washington State Medical Association and patient advocates, said the bill would improve transparency and informed consent. Opponents from nurse, naturopathic, and adult family home groups argued it was overly broad, burdensome, confusing, and could harm access to care or residential home settings; several also said existing disciplinary laws already address misrepresentation. No vote was taken on HB 2261 during the hearing. The committee also heard House Bill 2283, which would raise the medical loss ratio for fully insured individual, small group, and large group health plans to 90 percent. Supporters, including small business, patient, and physician groups, said the bill would push more premium dollars toward patient care and lower costs or increase rebates. Insurers and the Office of the Insurance Commissioner warned it could destabilize the market, reduce flexibility for administrative services, and lead to carrier exits, though OIC said it was working on amendments. The bill was not voted on in the hearing. House Bill 2425, an agency-request bill on nurse delegation, would broaden what tasks registered nurses may delegate, remove some setting and training restrictions, expand emergency medication authority, and adjust liability and retaliation protections. The Board of Nursing, long-term care providers, and skilled nursing/assisted living representatives supported the bill as a modernization that could ease workforce shortages and improve care access, while the Washington State Association for Justice opposed the immunity provisions and raised patient safety concerns. The hearing ended without a vote on HB 2425. In executive session, the committee advanced several bills. HB 2110, with an amendment clarifying ambulance staffing and RN scope, passed 18-0 with one excused. HB 2113 passed 18-0 with one excused. HB 2122, as amended to require hospitals to offer flu vaccines with several flexibility and critical-access-hospital exemptions, passed 15-3 with one excused. HB 2152, as amended to require certain facilities to allow medical cannabis use for qualifying terminal patients and to add related exemptions and protections, passed 17-1 with one excused. The meeting then adjourned.

Transcript Highlights:

• DHS does fully fund...
• </c> assessing is this the best way to fund assessing is this the best way to fund something<00:21:21.360
• To families so that they can pay providers more funds.
• ><c> these</c><00:56:44.440><c> ratios</c> potential income ability these ratios potential income ability
• </c><01:04:44.920><c> for</c> so in um for preschoolers the ratio for so in um for preschoolers the ratio

Bills: HF656 , HF655 , HF633

Committee: House Children and Families Finance and Policy

Transcript Highlights:

• These bars show the program-funded ratios on a combined basis, and this metric tracks funding progress
• You'll note that on a combined basis, the program... ...has a funded ratio of 100%.
• We're seeing increases in the funded ratio.
• One thing to keep in mind on these metrics: funded ratio is tracking funding on earned benefits, benefits
• One thing to keep in mind on these metrics: funded ratio is tracking funding on earned benefits, benefits

Committee: Joint Select Committee on Pension Policy

Summary: The committee approved the July minutes and then received an informational presentation from the Office of the State Actuary on the financial condition of the state retirement systems. The actuary reported that employer contribution rates are generally declining, helped by strong investment returns and reduced funding for PERS 1 and TERS 1, while funded ratios have continued to improve; on a combined basis the plans were reported at 100% funded in 2024, with open plans above 95% and legacy plans varying by system. The presentation also reviewed projected rates and funded ratios under current assumptions, noted that pension costs are taking a smaller share of the state general fund, and discussed risks from investment volatility, policy changes, and demographic experience. Committee members asked about savings from lower rates, deferred asset smoothing, and how Washington compares with other states. The committee then considered the state actuary’s recommendation on long-term economic assumptions and adopted all four recommendations by roll call votes: inflation at 3.0%, general salary growth at 3.5%, membership growth for Plan 1 funding at 1.0%, and investment rate of return at 7.25%. The actuaries explained that the inflation and salary growth increases were driven largely by higher long-term inflation expectations, while the investment return recommendation matched the current statutory assumption. Members discussed the timing of the Pension Funding Council’s decision, the effect of tariffs and inflation uncertainty, and how assumption changes would affect future contribution rates and budgets, particularly for open plans. Staff then gave an update on the LEOFF 1 study, explaining the difference between being “ahead of schedule” and truly overfunded, and summarizing responses received from DRS, the State Treasurer, and the State Investment Board on the merger and restatement proposals. DRS said both bills could be administered, though the merger bill’s COLA banking provision would be challenging until its new system is ready; the Treasurer urged caution, especially about the restatement bill and the use of one-time funds; and the Investment Board said removing assets from the trust would have some transaction costs but likely small impacts. The committee discussed whether to invite additional agencies and local government groups to testify, and staff said more responses, including from Ice Miller and the State Actuary, were expected for the October meeting. Finally, the committee heard a briefing on PERS 1/TERS 1 COLA policy and related bills from the last session. Staff reviewed the committee’s prior ongoing COLA recommendation, the SCPP-endorsed bills that would have created a one-time 3% COLA followed by an ongoing COLA, the Senate merger bill, and a separate ad hoc COLA bill. Public testimony largely supported Plan 1 COLAs and stable contribution rates, while several speakers urged caution about transferring LEOFF 1 surplus assets or merging legacy plans, and others raised concerns about climate risk and the pension fund’s investments. No further committee action was taken on the COLA item during this portion of the meeting.

Transcript Highlights:

• . funded. funded.
• </c> Medicare Medicaid fund. Medicare Medicaid fund.
• </c> see if that could fund it. see if that could fund it.
• </c> worker pay ratios. worker pay ratios.
• </c> ratio has grown to 281 times. ratio has grown to 281 times.

Committee: House Taxes

Transcript Highlights:

• the physician-to-PA ratio.
• And if you look at other states, 22 states have no physician-to-PA ratio.
• And the states that do enforce a physician-to-PA ratio, 45% of those states have adjusted their ratio
• Barriers such as a ratio limitation in our practice settings have essentially Barriers such as a ratio
• CMTC receives no funding from the state or any local jurisdiction.

Summary: The joint sunset oversight hearing reviewed five regulatory entities: the Board of Behavioral Sciences, the Board of Psychology, the Physician Assistant Board, the Podiatric Medical Board, and the California Massage Therapy Council. Across the hearing, each entity described recent accomplishments, licensing and enforcement workload, workforce shortages, and efforts to modernize processes. Common themes included streamlining licensure, expanding access to care, addressing telehealth or emerging technology, and balancing consumer protection with workforce needs. For the Board of Behavioral Sciences, members discussed workforce shortages in mental health, supervision barriers, telehealth confidentiality, AI in therapy, interstate compacts, school-based services, and military spouse licensure. The board said it has expanded outreach, improved licensing processes, and created temporary practice authority tracking, while also expressing concern about counseling compacts and emphasizing California-specific law, ethics, and cultural competency. Public commenters supported the board’s work and the possible move to a national MFT exam, while also urging more resources. The Board of Psychology highlighted fee adjustments, streamlined licensure pathways, enforcement process improvements, new CPD requirements, and proposed changes including a psychotherapist-client privilege exception for investigations. Committee members and public witnesses focused heavily on that privilege proposal, with some members opposing it as too broad and privacy-invasive, while the board argued it is needed to obtain records in bias and sexual misconduct cases. The board also discussed workforce shortages, processing improvements, and the use of inactive status for psychological associates. The Physician Assistant Board reported growth in the PA workforce and education programs, SB 697 implementation, and financial pressure from rising enforcement costs. The main policy debate centered on physician-to-PA ratios and practice agreements, with board representatives and many public commenters arguing that current restrictions limit access to care, especially in rural areas, while the California Medical Association defended the need for explicit ratios and agreements. The board also discussed AI, fee increases, and tracking temporary practice authority. The Podiatric Medical Board described licensing and renewal reforms, residency expansion, enforcement support, and budget constraints, while public testimony raised concerns about a proposed fee increase and about reimbursement parity and practice recognition for podiatrists. Finally, the California Massage Therapy Council defended the certification model over licensure, citing lower costs, local government collaboration, anti-trafficking work, and its role in vetting applications and disciplining bad actors; no formal votes or final actions were taken during this portion of the hearing.

Transcript Highlights:

• If I'm mis-speaking, correct me, but let's say that you were perfectly funded, ideally funded, for what
• Could you clarify how much of that funding would be federal matching funds and how much would be the
• state share funding?
• Could you clarify how much would that, how much of that funding, money would be federal matching funds
• would be federal matching funds and how much would be the state chair funding. Okay, thank you.

Summary: The Health Care Budget Subcommittee took up two bills and then continued oversight discussions with APD and AHCA. CS/HB 27, the Social Work Licensure Interstate Compact, was presented as a way to let Florida social workers practice in other compact states and vice versa; AARP, the Florida Chamber, and NASW Florida supported it, and the bill passed favorably. HB 1127, a child welfare bill, would create a treatment foster care pilot for children with high behavioral needs, improve DCF data collection on commercially sexually exploited children, and expand recruitment for protective investigators and case managers; the bill also passed favorably after brief supportive testimony. The committee then questioned APD at length about the iBudget waiver waitlist, enrollment pace, spending projections, and provider capacity. APD said it had sent more than 1,100 interest letters in categories 3, 4, and 5, enrolled 1,124 people so far this year, and expects to spend about 96.4% of its waiver appropriation, leaving roughly $82 million unspent. Members pressed APD on why prior discussions suggested more reserve was needed, how long the SANS process takes, whether category 6 could be expanded, and whether the agency has enough waiver support coordinators and direct support providers. APD said it has about 1,061 waiver support coordinators statewide, adequate capacity for current enrollees, but would need further analysis if the legislature directed a much larger enrollment increase. Members also asked about outreach, annual maintenance of the waitlist, portability for military families, and whether communication efforts should be privatized. Finally, AHCA walked the committee through the 2023 Achieved Savings Rebate (ASR) report for Aetna and explained how the report is used for financial monitoring, rebate calculations, and transparency. AHCA said the ASR is separate from the medical loss ratio (MLR) calculation, though both are reviewed, and that Florida uses the ASR mechanism rather than an MLR remittance requirement to recover funds from plans. Members asked about related-party disclosures, CVS/Caremark relationships, expanded benefits, encounter data, network adequacy penalties, denials and appeals reporting, interest earned on capitation payments, and whether rate increases were reaching providers. AHCA and the outside auditors said they review the plans’ reported data, reconcile it to underlying records, and can assess liquidated damages for network adequacy violations; several members requested follow-up data on rebates, interest, provider capacity, and related-party reporting.