Transcript Highlights:

• ADCA will be administering these programs, and then some of this will come back through the legislature
• and then some of this will come programs and then some of this will come back<00:19:05.679> through
• And my best guess is that the epipens, instead of being auto, are now single-dose epinephrine delivery
• The epipens, instead of being auto, are now single-dose epinephrine delivery systems.
• So it's still allowing delivery system.

Bills: SB367, SB368, SB350, SB351

Keywords: rural health, healthcare access, state funding, health transformation, appropriations, fiscal policy, healthcare funding, economic development, mental health, maternal health, antitrust, competition, market regulation, business practices, consumer protection, anaphylaxis, epinephrine, auto-injector, public health, school safety

Transcript Highlights:

• As Chair Addis had mentioned in our opening comments, the C-BAS program is certainly a vital program
• Why would we cut this program?
• are providing the cost savings that Programs are providing the cost savings that these programs are
• The IHSS program is the largest home and community-based services program in the United States.
• with additional program data.

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• It eliminates the recycling grants and low-interest loan program and repurposes the Delaware Recycling
• So on line 52, it says a comprehensive recycling program for the commercial sector.
• There's a lot of programs that take time, and there's a lot of things that happen in that space.
• So this cost cap would directly go to the challenge of delivery rates.
• Delmarva Power placed us into a program called capacity and capability.

Bills: SB287

Keywords: solid waste, recycling, universal recycling, single-stream recycling, multifamily housing, apartment recycling, commercial recycling, waste diversion, recycling grants, low-interest loans, Delaware Recycling Fund, Delaware Solid Waste Authority, DNREC, waste hauler, curbside recycling, yard waste, source-separated recycling, pay-as-you-throw, extended producer responsibility, waste bans

Summary: The House Natural Resources and Energy Committee met and considered three Senate bills. SB 287 with Senate Amendment 2, a DNREC cleanup bill on recycling, would tighten recycling collection rules for haulers and commercial generators, require multifamily recycling education, repurpose the Delaware Recycling Fund, and add annual reporting; after brief questions and no public comment, the committee motion to release did not initially receive enough votes, so the bill was circulated for signatures. SB 346, which would speed Environmental Appeals Board hearing and decision timelines so DNREC secretary decisions become final if deadlines are missed, drew support from the Nature Conservancy and also failed to get enough votes at the meeting, so it too was circulated for signatures. The committee then took up SB 326, a major utility-regulation bill sponsored by Senator Hanson and Representative Heffernan that would cap certain non-mandatory utility spending, limit interim rates, increase oversight and transparency, and streamline rate-setting. SB 326 generated extensive testimony and debate. Supporters, including the Public Advocate, Sierra Club, PSC staff, and some legislators, argued that Delmarva Power’s spending on non-mandatory infrastructure has risen far faster than inflation, that the company is a regulated monopoly, and that the bill would help restrain future delivery-rate increases without harming reliability because mandatory reliability, storm response, and vegetation management spending would remain allowed. Opponents, including Delmarva Power, business groups, contractors, labor representatives, and the Delaware Contractors Association, argued the cap would delay needed reliability and capacity projects, hurt economic development, reduce jobs, and interfere with utility planning; they also said supply costs, not distribution spending, are the main driver of recent bill increases. After public comment and additional questioning, the committee voted to release SB 326 on a split roll call, but because several members were absent the bill was also walked for additional signatures. The committee then adjourned.

Transcript Highlights:

• , you've seen one Medicaid program.
• But what's not is your provider taxes, the way that you finance the program and your share of program
• the program and your share of program the program and your share of program expenses<00:10:15.440
• <01:55:35.920> It the program through the grants. It the program through the grants.
• Do you see this as um program.

Keywords: 958, all

Summary: The committee met and approved the minutes from its August 27 meeting. It then received a presentation from Katherine Castanza of the National Conference of State Legislators on the Medicaid provisions in the 2025 budget reconciliation bill, referred to as HR1. She explained that the bill is estimated by CBO to save the federal government $911 billion over 10 years, with more than 20 Medicaid-specific provisions, most of the savings concentrated in five policies and largely backloaded into 2030-2034. She emphasized that the bill’s effects will vary by state, but that expansion states and hospitals are expected to be most affected, in part because of changes to eligibility, provider taxes, and state-directed payments. Castanza highlighted several new funding and flexibility provisions, including a $50 billion Rural Health Transformation Fund for 2026-2030 and a new home- and community-based services waiver option effective July 1, 2028, with $100 million in grants in fiscal year 2027. She also outlined major eligibility changes for Medicaid expansion adults: work or community engagement requirements effective January 1, 2027; twice-yearly redeterminations for the expansion population effective the same date; and new cost sharing for certain expansion adults effective October 1, 2028. She noted that Kentucky, as an expansion state, would be subject to these changes and that state agencies would face significant implementation demands, especially because federal guidance and timelines are tight. A substantial portion of the presentation focused on financing changes. Castanza described new limits on provider taxes, including a 0% safe harbor for new taxes and a phased reduction for existing taxes in expansion states beginning in 2028, while nursing facilities and intermediate care facilities are exempt from the reduction if already taxed. She also explained that state-directed payments will be capped and phased down over time, with existing arrangements grandfathered only briefly; she said Kentucky has 11 approved state-directed payments and could see significant fiscal effects. She added that the bill also bars Medicaid payments to Planned Parenthood or similarly situated providers for one year, changes immigrant eligibility rules effective October 1, 2026, lowers the federal match for certain emergency services, and expands the scope of the federal erroneous payment recoupment provision effective October 1, 2029. Throughout, she stressed that federal savings may translate into state cost shifts and that implementation timing will be critical.

Transcript Highlights:

• the rural health transformation program. the rural health transformation program.
• This being one of those programs.
• That's where that program in the future.
• As we all know, Minnesota is a leader in health care delivery.
• Uh nurses are central to our delivery.

Keywords: 919, house, all

Summary: The committee took up House File 1925, which would have Minnesota join the nurse licensure compact. Rep. Schumacher described the bill as a way to improve workforce flexibility, telehealth, care coordination, and border-community access, while maintaining safeguards such as the same licensure exam and federal background checks. He also said the compact could help retain Minnesota-trained nurses who currently leave for neighboring compact states. Several members questioned whether the compact would weaken Minnesota’s standards or actually solve staffing problems, and some raised concerns about outside states’ differing practice rules and continuing education requirements. Supporters, including a nurse leader, a travel nurse, a business group representative, and a hospital nursing leader, testified that the compact would ease staffing shortages, speed hiring, support telehealth, and reduce administrative burdens. Opponents, including nurses and union representatives, argued it could lower standards, not address root causes like unsafe staffing and turnover, and could create risks for patients seeking reproductive or gender-affirming care. The committee also considered two related amendments tied to rural health transformation recommendations. The A1 amendment would have required two hours of continuing education on nutrition for physicians, physician assistants, and advanced practice registered nurses; members criticized it as government overreach, unrelated to many specialties, and an attempt to chase uncertain federal funding. The amendment failed on a voice vote. The A2 amendment would have reinstated the presidential fitness test in schools and allowed parents to opt out; it also failed. A3, which updated the compact bill’s effective date language from 2025 to 2026, was adopted. Members noted the bill also contained an appropriation and might need referral to other committees if it advanced. The committee then began hearing public testimony on HF 1925, with witnesses split between support and opposition.

Transcript Highlights:

• in this state, including the creation and operation of the Texas Interoperability Council, a grant program
• HB number thirty-six by Garen relates to prohibiting the sale, delivery, or purchase of consumable hemp
• by McLaughlin relates to creating the Texas Flash Flood Ally Interoperability Council and a grant program
• No. 94 by Toth, relating to creating a grant program administered by the Texas Division of Emergency
• of the cultivation, processing, packaging, labeling, distribution, sale, testing, transportation, delivery

Keywords: 997, house, all

Transcript Highlights:

• Block Grant Program and the Bridge Formula Program added by the IIJA has been especially helpful in
• The other programs certainly are the safety program that I mentioned in my testimony.
• The other important part about flexibility of programs is actually in the delivery of projects.
• Another program I'm especially proud of, the Clean School Bus Program, is also in jeopardy.
• program.

Keywords: Surface Transportation Reauthorization Act, IIJA, bipartisan infrastructure, funding flexibility, NEPA, environmental reviews, bureaucratic delays, federal funding, infrastructure investment

Summary: The committee meeting focused on the Surface Transportation Reauthorization Act, discussing the ongoing implementation of the Infrastructure Investment and Jobs Act (IIJA). Chairman Capito highlighted the bipartisan nature of the legislation and the necessity of refining existing provisions to ensure effective delivery of transportation projects. Notable emphasis was placed on the need for flexibility in funding to address inflation impacts and delays caused by bureaucratic hurdles, especially relating to environmental reviews under NEPA. Witnesses from state transportation agencies provided valuable insights into real-world challenges faced in project execution, ultimately underscoring the importance of continuous federal support for infrastructure development. The discussion also touched on the broader implications of federal funding freezes by the previous administration, which have reportedly hindered several ongoing and planned projects. This issue raised significant concern among committee members, who urged the need for reliable funding and the removal of unnecessary bureaucratic obstacles that could cause delays in project implementation. The meeting concluded with a commitment from the members to work collaboratively to overcome these challenges and ensure a smooth path forward for critical infrastructure investments.

Transcript Highlights:

• They've been able to hire people to oversee this program, which I think is a valuable program.
• Justify that program just in the way that they justify all of the other programs they run.
• . other programs established.
• Speaker, while not a perfect program, is a very comprehensive health insurance program.
• program expired.

Transcript Highlights:

• Rules by state agencies in current judicial proceedings refer to the Committee on Delivery and Government
• Assistance Grant Program and the Rural Prosecutor Office Salary Assistance Grant Program for this Club
• Services and supports under the Medicaid program which the individual on the waiting list for services
• Relating to eligibility for bulletproof vests and body armor grant program, refer to the Committee on
• An estimate of the cost of the state of the proposed amendments referred to the committee on delivery

Keywords: 1184, house, all

Transcript Highlights:

• They administer the SNAP program. They administer Medicaid.
• <00:56:01.200> in administering social service programs in administering social service programs
• They administer the SNAP program. They administer the SNAP program.
• , related to administering these programs, related to administering these programs, particularly<
• But the state of Minnesota because of the bill that was passed a delivery fee. a delivery fee.

Keywords: 1183, house

Summary: The House convened with prayer, the Pledge of Allegiance, roll call, and approval of the previous day’s journal. The chamber received Senate messages announcing a joint convention for the governor’s message and transmitting Senate Files 1251, 3769, and 3868. The House also introduced House Files 4868 through 4933 and adopted committee reports and comparison report motions without objection. The Rules Committee placed several bills on the calendar and required pre-filing of amendments for specified measures. On the calendar, the House passed Senate File 3602, which enacts the Uniform Electronic Estate Planning Documents Act and expands electronic signing to estate planning documents beyond wills. Supporters said it would help people who are homebound, hospitalized, or in rural areas and reduce uncertainty for banks and hospitals about electronically signed powers of attorney and health care directives. The bill passed 134-0. The House also passed House File 3516, a Board of Dentistry policy bill that updates licensure language, allows retired dentists to serve low-income uninsured patients, and increases the number of dental hygienists a dentist may collaborate with from four to eight; it passed 134-0. The House then passed House File 3528, a technical barbering bill that reduces training and retesting burdens, gives the board more testing flexibility, repeals duplicative rules, clarifies that waxing is not barbering, and makes other fee and registration changes; it passed 134-0. House File 3718, updating veterinary medicine and veterinary technology statutes, was amended to restore board seal language and then passed 134-0 as amended. Supporters said it modernizes definitions and standards, recognizes licensed veterinary technicians, and may help address veterinary shortages, especially in greater Minnesota. Finally, the House passed Senate File 3402, which broadens who may serve as a medical consultant for Community Health Boards to include additional licensed professionals such as DOs, physician assistants, and advanced practice registered nurses; it passed 134-0. The chamber also considered several motions to move bills between committees, including referrals involving veterans, education, health, and psilocybin-related legislation. A motion to suspend the rules for House File 4487 was presented, and the bill was described as providing a one-time $1 billion property tax rebate or credit, but the transcript cuts off during extended debate on that motion before any final disposition is shown.

Transcript Highlights:

• House Bill directed payment program.
• establish a community engagement program establish a community engagement program and<02:14:22.400
• <03:43:46.720> and state's lowincome subsidy program and state's lowincome subsidy program
• It gives more access and programs.
• program, the 3D State Championship. program, the 3D State Championship.

Bills: HB567, HB776, HB2, HB568, HB619

Keywords: open records, public access, transparency, government accountability, public agency, dental practice, licensing, administrative regulations, dental assistants, supervision, Medicaid, community engagement, healthcare, managed care, eligibility, public assistance, insurance, public adjuster, claim process, contract requirements

Transcript Highlights:

• The changes to the Rural Health Care Delivery Fund statute will do two things.
• There is similar language in other statutes with similar programs.
• Would there be an expectation that you would have an increase in delivery of service? Mr.
• We do have a pretty rigorous contract oversight for our grant programs today.
• Never have I seen health care delivery become the economic development. Issue it is today.

Transcript Highlights:

• you know, order from our delivery you know, order from our delivery company<00:38:01.599> and
• they will sign on with a delivery they will sign on with a delivery company<00:39:20.079> for
• complaint about that delivery company. complaint about that delivery company.
• program any impact. program any impact.
• Next Wednesday. or is delivery the focus? Both. It's or is delivery the focus? Both.

Keywords: 928, house, all

Summary: The committee first discussed a budget-related issue involving liquor commission enforcement staff and tobacco enforcement funding. A member explained that proposed cuts to “group two” enforcement positions at the liquor commission could jeopardize the tobacco enforcement money that flows to Health and Human Services, and expressed confidence that the enforcement division would ultimately be preserved. The main hearing was on Senate Bill 19, which would modernize hotel and motel statutes by repealing outdated requirements. The sponsor and the New Hampshire Lodging and Restaurant Association said the bill would remove obsolete rules such as the old guest book/card system and antiquated posting requirements for room rates and motel signs. Members questioned whether the bill would eliminate the requirement to record guest departure dates or affect inspection rights, and the witnesses said the intent was only to remove the book-and-card reference while leaving the rest of the recordkeeping requirement in place. Supporters argued the rate-posting rules are widely ignored, hard to enforce, and outdated in an era of digital reservations and variable pricing; the committee also discussed whether any consumer-protection purpose remained. The public hearing on SB 19 was then closed. The committee then heard Senate Bill 280FN, which would require food delivery services to have an agreement with a restaurant or food retail store before offering delivery from that business. The sponsor said the bill restores a prior law that had sunset and was intended to prevent third-party platforms from listing restaurants without consent. Restaurant industry testimony strongly supported the bill, describing problems with unauthorized listings, delayed deliveries, and reimbursement disputes, and saying the agreement requirement protects restaurant brands and consumer expectations. Members shared examples of delivery problems and voiced support for reinstating the safeguard.

Transcript Highlights:

• > and foster integration, delivery, and foster integration, delivery, and management<00:04:32.960
• our rural physician associate program. our rural physician associate program.
• We have a number of programs across our academic programs at the university and the medical school to
• <00:31:49.039> We<00:31:49.279> are delivery systems are also facing.
• We are delivery systems are also facing.

Keywords: 1187, senate, all

Transcript Highlights:

• Such programs typically cost more in the short term than a skilled nursing-based program, but if they
• Such programs typically cost more in the short term than a skilled nursing-based program, but if they
• Programs like ours cannot survive long term.
• One example is co-pay accumulator adjustment programs.
• And I'd like to highlight that our midwives lead a program called Curbside Care, a mobile health program

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a lengthy public hearing with testimony on a wide range of health insurance and access-to-care bills. Early testimony focused on prescription drug pricing and pharmacy reimbursement, with supporters of H. 1326 arguing that pharmacy benefit managers and MassHealth managed care arrangements reimburse independent pharmacies too little, contributing to pharmacy closures and “pharmacy deserts.” The committee also heard repeated support for H. 1151/S. 742 on cognitive rehabilitation for acquired brain injury, H. 1288/S. 716 on telehealth parity for nutrition counseling, H. 1309/S. 761 on full-spectrum pregnancy care without cost-sharing, H. 1312 on insurance coverage for doula services, H. 309 on prompt access to health care by removing deductibles for certain services, H. 809/H. 1227 on biomarker testing, H. 1162/S. 810 on reducing inequities in access to medical procedures by limiting insurer cuts tied to Modifier 25, and S. 726 on insurance coverage for mobile integrated health. Testifiers included legislators, physicians, pharmacists, dietitians, emergency and rehabilitation clinicians, and patients and family members. Supporters of the brain injury bill said cognitive rehabilitation is medically necessary, improves long-term outcomes, and can reduce institutional care and public costs; they noted the bill has been heard repeatedly and has support from the Brain Injury Commission and prior favorable committee action. Supporters of the pregnancy care and doula bills described out-of-pocket costs as a barrier to maternal health and shared personal stories of high bills and unmet support needs. Biomarker testing advocates and cancer patients said coverage gaps deny patients access to precision treatment, can lead to avoidable suffering, and should be standardized across insurers; several speakers said insurers often deny claims despite clinical benefit. Dermatology witnesses said insurers’ use of Modifier 25 cuts reimbursement for same-day evaluation and procedure visits, forcing separate appointments and increasing patient burden. Mobile integrated health supporters described home-based care as a way to reduce emergency department use and hospital readmissions, especially for patients with transportation or mobility barriers. No votes or formal committee actions were taken during the hearing itself.

Transcript Highlights:

• As health care delivery continues to evolve and public hospitals face increased...
• Local street repair programs, bus and rail infrastructure, and paratransit programs that serve seniors
• They will receive additional points towards programs. Creating a PIFD.
• That's real accountability built into the program design.
• That's real accountability built into the program design.

Keywords: 988, house, all

Transcript Highlights:

• coming integration of AI capabilities into the tools that the state already uses to power service delivery
• advise MINT and our agency partners on the responsible adoption of AI to improve how we deliver programs
• . uh many if not most if you if delivery. uh many if not most if you if you<00:02:33.920> hear
• and services to how we deliver programs and services to motans.<00:04:14.080> So<00:04:14.239
• um in a might improve service delivery um in a responsible<00:13:52.240> manner<00:13:52.480>

Keywords: 1183, house

Transcript Highlights:

• The delivery address of the individual.
• But here, where it says if there's no delivery address, if the delivery is at that one location, then
• in place, you'd prefer the ESA program?
• in place, you'd prefer the ESA program.
• But one of the benefits could be that people who are using the ESA program do switch to this.

Bills: HB2143, HB2273, HB2290, HB2373, HB2784, HB2794, HB4037

Keywords: public safety, retirement system, investments, trust fund, board of trustees, financial report, income tax rebate, Pinal County, taxpayer eligibility, state revenue, financial assistance, transaction privilege tax, business location, tangible personal property, shared vehicle, sourcing, income tax, veterans, donations, tax refunds

Transcript Highlights:

• I think running a 24-7 crisis line is a unique service delivery model, and it's a service delivery model
• I think running a 24-7 crisis line is a unique service delivery model, and it's a service delivery model
• At Hualapai Indian Village, I am the director of our program, the Acorns to Oaks program, which focuses
• You know, our program is really unique.
• So here, follow this program.

Keywords: 988, house, all

Transcript Highlights:

• And then we also improved our procurement and delivery strategies.
• The other part is now that we're going to one track instead of two tracks in the program.
• However, in terms of impact of the program, it is always about, you took $4 billion away.
• Because this has changed so dramatically since the voters originally passed this program.
• ...passed this program?

Keywords: 987, senate, all