Transcript Highlights:

• costs in the Health Care Authority.
• Because of that, there's less funding available to cover health care costs in the Health Care Authority
• The Working Connections Child Care subsidy allows my son to attend a YMCA-based before- and after-care
• It destabilizes care.
• , child care, and education.

Bills: SB5998

Committee: Senate Ways & Means

Keywords: fiscal appropriations, budget, state funding, financial management, operating expenses

Transcript Highlights:

• </c> as the search for better Health Care as the search for better Health Care insurance<00:04:01.079
• Our health care system also has home care and direct care, and the certified direct support professional
• Our health care system also has home care and direct care, and the certified direct support professional
• </c> Care Resources like Youth Care Care Resources like Youth Care transition<01:24:41.960><c> teams<
• acute care in the first place.

Bills: HF2367 , HF2319 , HF2523 , HF1742 , HF671 , HF2331 , HF2722 , HF2406 , HF1674

Committee: House Human Services Finance and Policy

Transcript Highlights:

• Care System Board.
• Care.
• </c> deliver quality care to the patients. deliver quality care to the patients.
• </c> effective care. effective care.
• </c> exceptional care without exception. exceptional care without exception.

Committee: House Taxes

Transcript Highlights:

• PACE is an integrated system of care for older adults who are eligible for nursing home care but who
• PACE is an integrated system of care for older adults who are eligible for nursing home care but who
• PACE is an integrated system of care for older adults who are eligible for nursing home care but who
• and managing long-term care.
• care</c><01:08:26.880><c> these</c> providing them with care these providing them with care these caregivers

Bills: HF1937 , HF2407 , HF1678 , HF1477 , HF2040 , HF1840 , HF257

Committee: House Human Services Finance and Policy

Transcript Highlights:

• You need to take care of your own house.
• higher cost of care.
• Not because they don't care, but because they must work, care for a child, or manage their own health
• It is not substandard care.
• So these days are not in lieu of hospital care.

Summary: The committee first heard Senate Bill 5899, which would create a chiropractic license endorsement allowing qualified chiropractors to perform chiropractic diagnosis and adjustments on non-human animals. The sponsor described it as a complementary tool to veterinary care, especially in rural areas with limited access to veterinarians. Testimony was mixed: supporters said the bill would expand access to animal chiropractic with training, certification, and veterinary referral to non-chiropractic issues, while opponents from the veterinary community warned about animal and public safety, disease detection, and the lack of a required veterinary referral. The hearing on SB 5899 was suspended and later reopened; testimony concluded with strong support from animal chiropractic practitioners and opposition from veterinarians, and the committee noted 57 signed in pro, 4 con, and 1 other. The committee then held a work session on dental workforce shortages. Presenters from the CORA Foundation, the University of Washington Center for Health Workforce Studies, tribal dental programs, and the Washington State Dental Association described major access gaps, especially for Apple Health enrollees, rural communities, and communities of color. They highlighted low preventive-care utilization, high rates of untreated decay, workforce vacancies for hygienists and assistants, and the value of career ladders such as community health aides and proposed oral preventive assistants. Several speakers emphasized that training pathways, retention, and sustained Medicaid reimbursement are key to improving access and keeping providers in the system. Senate Bill 6138, requiring a multi-provider system for dental procedures performed under deep sedation, drew testimony centered on patient safety after recent deaths in dental settings. The sponsor said the bill responds to a pattern of tragic incidents and would ensure one person is dedicated to monitoring sedation. Supporters from anesthesiology and some oral surgery groups backed stronger monitoring requirements, while oral surgeons and dental representatives argued the current rules already require multiple trained personnel and that the bill could reduce access and increase costs, especially in rural and Medicaid-serving practices. The committee then heard Senate Bill 6072, which would update veterinarian-client-patient relationship rules to allow telemedicine-based relationships and limited telehealth services; animal welfare and veterinary telehealth advocates supported it as an access-to-care measure, while the veterinary association sought clearer guardrails and federal-law language. Finally, the committee heard Senate Bill 6094 on pediatric transitional care services, which would create a Medicaid payment pathway and related program changes for residential care for substance-exposed infants; supporters said the model helps infants and parents, improves outcomes, and is financially unsustainable under current funding, and the hearing began with testimony in favor before time expired.

Transcript Highlights:

• It preserves current child care slots and adds 22,770 new child care slots in 2026-27.
• The care that you need changes.
• Child care is education and education is care.
• Child care is education and education is care.
• Care.

Summary: The Senate Budget and Fiscal Review Committee heard AB 109, the Budget Act of 2026, as the main item. Committee leaders described the legislative budget agreement as a balanced two-year plan with about $355.9 billion in total spending, $253 billion from the General Fund, and $36.5 billion in reserves. The Legislative Analyst and Department of Finance said the package assumes about $5.5 billion in higher revenues than the May Revision and uses those resources for a mix of spending changes, including higher Proposition 98 support, additional child care slots, housing and homelessness funding, delayed Medi-Cal reductions, and added support for counties, public hospitals, and distressed hospitals. The administration said the plan resembles the May Revision’s overall structure but includes new spending and revenue assumptions, and members noted that separate revenue trailer bills would be heard later in the week. Much of the committee discussion focused on Medi-Cal, H.R. 1, and the impact on immigrants, low-income workers, counties, and hospitals. Several senators criticized the budget for locking in savings from delayed or reduced Medi-Cal coverage and for not including a mechanism to restore eligibility, while administration and LAO staff said the package delays some reductions but does not automatically reinstate coverage. Finance staff said roughly 1.5 million to 2 million people with unsatisfactory immigration status would move from managed care to fee-for-service, with coverage largely unchanged except for certain services not federally allowed. Members also discussed county administrative funding, indigent care, public hospital support, and the expected rise in uncompensated care. Other topics included In-Home Supportive Services, child care, homelessness funding, Prop. 36, courthouse construction and new judgeships, transit and cap-and-invest/GGRF funding, local journalism, and workforce or reentry programs. Committee members split along party lines in their comments. Democratic members generally supported the agreement as a difficult but responsible compromise that protects core services, preserves reserves, and makes targeted investments in education, housing, health care, and justice system capacity. Republican members argued the budget relies on unrealistic revenue assumptions, does not sufficiently reduce spending, and includes costly policy choices and tax increases. Public testimony largely came from advocates and stakeholders who supported IHSS, Medi-Cal, child care, domestic violence services, hospitals, transit, and other programs, while some business and health plan representatives raised concerns about tax proposals and the shift from managed care to fee-for-service. The chair then moved the committee to public comment and indicated that the revenue bills would return later in the week; no final vote on AB 109 is reflected in the portion provided.

Transcript Highlights:

• care... ...quality child care system, support the building of child care, support the building of the
• The demand for child care has increased due to the universal child care program.
• The demand for child care has increased due to the universal child care program.
• the home for care.
• , evidence-based health care.

Summary: The committee first took up Senate Bill 20, a prior-authorization measure aimed at exempting certain medications and treatments for seriously mentally ill adults from repeat insurance prior authorization, while also extending prior authorization approvals to three years for chronic maintenance drugs. The sponsor described the bill as the latest in a series of bipartisan prior-authorization reforms and accepted an amendment from the Health Care Authority and the Office of the Superintendent of Insurance to apply the bill to adults only and to cover PBMs in the interagency purchasing collaborative. Supporters, including NAMI New Mexico and state health officials, argued the bill would reduce barriers to needed care, especially for mental health treatment. Opponents from health plans, PBMs, and insurers warned the bill was too broad, lacked clear definitions for serious mental illness and chronic conditions, created patient-safety concerns, and should have a shorter reauthorization period and later implementation date. After committee discussion, the sponsor agreed to work on a committee substitute, and the bill was rolled over for a later meeting. The committee then heard Senate Bill 53, the Chispa data privacy bill, which would impose broad limits on the collection, sale, and use of personal data, require opt-in consent for many uses, strengthen rights to access, correct, and delete data, and create enforcement mechanisms including a private right of action. Supporters from advocacy, women’s, behavioral health, reproductive health, and civil rights groups said the bill was needed to protect sensitive health and location data, prevent surveillance and criminalization, and give New Mexicans real control over their information. Business, technology, insurance, and hospital representatives opposed the bill, arguing it was more restrictive than other states’ privacy laws, would burden small businesses and health-related services, create compliance uncertainty, and risk limiting digital services and innovation. After extensive questioning about data breaches, opt-in consent, nonprofit exemptions, and the bill’s impact on businesses and health care access, a motion to table failed 5-4, and the committee then passed SB 53 on a 5-4 vote. The committee next heard Senate Bill 86, which updates the state’s harassment-by-telephone law to cover electronic communications such as social media, messaging apps, and email. The sponsor and a Las Cruces police chief said the change would modernize an outdated 1967 statute and help law enforcement address harassment and domestic violence through current technology. The bill drew support from the governor’s public safety advisor and the Greater Albuquerque Chamber of Commerce, and members asked a few clarifying questions about the wording. The committee approved SB 86 unanimously, 9-0. Finally, the committee began hearing Senate Bill 96, on regulated childcare zoning requirements, using a committee substitute. The sponsor and the Early Childhood Education and Care Department said the bill would reduce confusing zoning and fire-code barriers to opening or expanding child care homes and centers, helping address a statewide shortage of child care slots and supporting working families. The discussion began with the committee substitute and an explanation that the measure is intended to streamline local requirements and expand child care supply.

Transcript Highlights:

• When your kid needs care, you get your kid care.
• When your kid needs care, you get your kid care.
• When your kid needs care, you get your kid care.
• When your kid needs care, you get your kid care.
• kid needs care you get your kid care um kid needs care you get your kid care um and<00:34:40.879><c>

Committee: Senate Health and Human Services

Transcript Highlights:

• Turning to the child care and development programs, the revised budget for child care includes $6.8 billion
• The 2.01% COLA funding for child care programs is still proposed to be repurposed for cost-of-care plus
• The Child Care Infrastructure Grants: the budget includes two child care infrastructure grants.
• On the proposed child care cost-of-living reduction, On the proposed child care cost-of-living reduction
• cost of nurturing child care.

Transcript Highlights:

• </c><00:10:26.880><c> to</c> care, primary care, and to continue to care, primary care, and to continue
• </c> go into a managed care organization. go into a managed care organization.
• </c><01:14:39.760><c> John</c> Care is Dr. John Care is Dr.
• And so, when we talk about charity care and the value of that care, isn't the value of that care kind
• and the value of talk about charity care and the value of that<01:30:28.400><c> care,</c> that care,

Committee: House Health Finance and Policy

Transcript Highlights:

• Technology can support health care when used appropriately, but it cannot replicate the care received
• In many ways, Coordinated Care is the Affordable Care Act success story.
• care services.
• That's the promise of future care when people's long-term care and other health care needs escalate.
• That's the promise of future care when people's long-term care and other health care needs escalate.

Summary: The House Health Care & Wellness Committee held public hearings on HB 2564 and HB 2599, then moved into executive session on several bills. HB 2599, which would restrict the use of AI in therapy and psychotherapy services, drew strong support from the prime sponsor, mental health professional groups, a privacy advocate, and an AI ethics researcher, all of whom warned that chatbots can mislead users, encourage delusions or self-harm, and lack licensure, accountability, and confidentiality protections. Several witnesses from health systems and telehealth organizations supported the bill’s intent but asked for narrower definitions and amendments to avoid unintended impacts on clinician-supervised tools, screening questionnaires, scribes, and other legitimate uses of AI. No vote was taken on HB 2599 during the hearing. HB 2564, which would give the Health Benefit Exchange authority to adopt market-factor certification criteria for exchange plans, was presented as a way to address affordability, bare counties, and plan duplication. Supporters included the Exchange, consumer advocates, rural and tribal representatives, navigators, and some individual consumers, who said the bill could improve access, preserve bronze plan availability, and help stabilize the market in counties with too few carriers. Opponents from health plans, Regence, Premier, and insurance producer groups argued the bill would expand exchange authority without clear standards, could reduce competition and carrier participation, and might conflict with existing OIC filing and confidentiality processes; the OIC supported the bill but requested an amendment on rate disclosure timing. The committee then moved to executive session and later reported out HB 1784, HB 2242, HB 2384, and HB 2505 with due pass recommendations, while deferring action on HB 1809 and HB 2261. In executive session, the committee adopted a substitute for HB 1784 on certified medical assistants by an 18-0 vote, adopted one amendment and passed a substitute for HB 2242 on preventive services and immunization recommendations by an 11-7 vote, and passed a substitute for HB 2384 on actuarial reviews for continuing care retirement communities by a 16-2 vote. It also adopted an amendment and passed a substitute for HB 2505 on limited adult family home licensure exemptions for certain foster family situations by an 18-0 vote. The meeting adjourned after those actions.

Transcript Highlights:

• and child care workforce programs.
• For foster care, family child care, and other legally nonlicensed child care providers, that is the county
• > and</c><00:47:29.599><c> other</c> Foster care family child care and other Foster care family child
• care programs.
• </c><01:32:47.360><c> still</c> child care and child care is still child care and child care is still

Committee: House Children and Families Finance and Policy

Transcript Highlights:

• The state is investing high dollars to support an increased child care, yet family child care providers
• Family child care is focused on the care of children and families, and we want to ensure the health and
• lead and Care for family child care lead and Care there's<00:02:35.519><c> been</c><00:02:35.680><c>
• </c> child care yet family child care child care yet family child care providers<00:03:31.280><c> continue
• Look at child care provision.

Committee: House Children and Families Finance and Policy

Transcript Highlights:

• than exiting care.
• than exiting care.
• languishing in care.
• They are Medicaid-certified to provide long-term nursing care as well as intermediate care.
• or behavioral health care.

Summary: The committee heard a lengthy update on Washington child welfare from Casey Family Programs and DCYF. Dr. David Sanders said Washington has sharply reduced out-of-home care and increased kinship placements, but he flagged concerns about low screening-in rates, long stays in foster care for many children, and a recent rise in repeat maltreatment and child fatalities, especially among infants. He urged more focus on infants and young children, better coordination among child protection, health care, and law enforcement, and more proactive review and investigation practices. Members asked for disaggregated data on children lingering in care, fatalities, and causes such as fentanyl exposure. DCYF said it has increased relative placements and guardianships, but also reported a concerning rise in 2025 critical incidents, mostly near-fatalities involving children age three and under, many opioid-related. The department described responses including safe child consults for opioid cases, more training, hotspot analysis, and proposed investments in peer support, public health nurses, community referrals, and an updated safety framework. Members also discussed whether a broader commission on child abuse prevention would be useful, and DCYF said it was open to that idea. The committee then received a DSHS reorganization update from Secretary Angela Ramirez, who described the “Reimagined” plan to consolidate four administrations into three new ones, with the stated goals of reducing silos, improving customer experience, and making transitions between services smoother. She said the agency is seeking statutory changes and CMS approval to align the new structure, and members asked about preparing for federal HR1 impacts, especially SNAP. Ramirez said DSHS is monitoring those impacts closely and emphasized the need for accurate data and cross-agency coordination. Finally, DSHS’s Behavioral Health and Habilitation Administration updated the committee on residential habilitation centers and implementation of Substitute Senate Bill 5393, which phases out Rainier School by June 30, 2027 and limits new admissions. Officials reported current census and staffing levels at the state’s RHCs, said Rainier has had some residents transition to supported living or adult family homes, and explained that emergency and permanent rulemaking was needed to implement the law. They also said Rainier was recently cited by federal surveyors for not meeting the active treatment requirement for two residents, and that the facility has 90 days to return to compliance before possible payment penalties or further remedies. Members pressed for details on the citation, the meaning of active treatment, the assessment process for admissions, and whether Rainier could be repurposed for other services; DSHS said it is working on corrective action and will follow up in writing.

Transcript Highlights:

• Supplies for wound care Supplies for wound care and coverage still remain an area of need.
• care for medetomidine-associated harms, like... ...intensive care unit care for medetomidine-associated
• And that also applies to wound care. We do a lot of wound care on site.
• And that also applies to wound care. We do a lot of wound care on site.
• Wound care kits and low-barrier care, and a little more detail for you for your reference.

Summary: The Special Commission on xylazine held its first meeting, with House Chair Mindy Domb and Senate Co-Chair John Keenan outlining the commission’s charge and a proposed work plan. The commission is tasked with studying the public health and safety impacts of xylazine in the illicit drug supply, including whether it should be scheduled as a controlled substance, how to regulate its production and distribution, and how to improve outreach and treatment for people exposed to it. Members were told the report deadline had been extended to March 30, 2026, and staff proposed a series of public hearings and working groups leading to a final report. The meeting also included attendance, packet materials, and procedural planning. The first major testimony came from BSAS Director Deirdre Calvert, who described xylazine’s appearance in Massachusetts drug supply data, the state’s public health alerts, and DPH’s partnership with Brandeis, CDC, and harm reduction organizations. She emphasized four priorities: reducing stigma and discrimination in health care, expanding self-directed wound care support and coverage for supplies, expanding access to drug checking and test strips, and supporting low-barrier services such as mobile vans and drop-in centers. Commission members asked about first responder awareness, medical education, and whether harm reduction services might face federal restrictions; Calvert said misinformation remains a problem and noted ongoing training efforts, including collaboration with public safety agencies. Several other speakers reinforced the need for low-barrier care and drug checking. Dr. Raghini Jala, an infectious disease and addiction medicine physician, said xylazine has become a common component of the unregulated opioid supply and urged support for rapid-response education teams, community-based drug checking, and better hospital and detox protocols for xylazine withdrawal and wounds. Recovery coach Alan Young testified from lived experience, describing severe wounds, fear of inadequate withdrawal treatment in emergency settings, and the value of mobile care vans that can provide methadone, buprenorphine, and wound care in the community. Dr. Sarah Wakeman echoed the need for naloxone, rescue breathing, low-threshold treatment, and non-stigmatizing health care settings, while Sarah Macon of the Boston Public Health Commission described Boston’s harm reduction and drug checking work, including on-site testing, wound care, and a decline in opioid mortality. Tracy Green of the Massachusetts Drug Supply Data Stream explained that xylazine has declined in recent samples while metatomidine is rising, said drug checking is increasingly used but still not enough, and argued for more funding, staffing, and statewide access to real-time drug checking and harm reduction services.

Transcript Highlights:

• I know we have like Cares in the middle, but like, you know, those are the Cares for Kids providers that
• And care coordination program provides, like, the enhanced care coordination for families and children
• And care coordination program provides, like, the enhanced care coordination for families and children
• We are immersed in our DPH care coordination, enhanced care coordination.
• DPH care coordination, enhanced care coordination.

Summary: The Permanent Commission on the Status of Persons with Disabilities equity subcommittee met, approved the prior minutes, and heard a presentation from the Massachusetts Department of Public Health’s Cater Center (Care Coordination Assistance, Training, Education, and Resources for Kids). Presenters Toria Haffey and Patty Loza explained that Cater provides training and technical assistance to MassHealth’s Cares for Kids providers serving children with medical complexity, with a focus on enhanced care coordination, family partnership, racial/cultural/linguistic equity, community resources, education systems, shared plans of care, and transition support. They described five e-learning modules, flexible one-on-one and group technical assistance, case review support, and informal virtual “cafes” for providers. They also noted the program has been operating for about two to three years and currently works with five hospital-based providers, including Boston Children’s, BMC, Tufts, NeighborHealth, and Baystate. Committee members asked about the number of families served, the relationship to MassHealth, and whether the model could be expanded beyond Boston-area providers. The presenters said Cater does not track enrollment numbers because that is handled by providers and MassHealth, and they agreed there is room to broaden reach and improve data collection. Members suggested connecting Cater with regional disability and case management networks, the Health Equity Compact, ACOs, and DDS-related contacts. Questions also focused on funding stability amid federal Medicaid cuts and workforce shortages in family engagement roles; Cater said the work remains a priority for MassHealth, though funding is a concern, and acknowledged staffing gaps, especially for family partners with lived experience. After the presentation, the committee discussed a NIH strategic plan for disability health research that had been circulated for future review. Because members had not yet read it, they agreed to place it on the agenda for the next meeting. The meeting then adjourned with no further business.

Transcript Highlights:

• and direct immediate care.
• and direct immediate care.
• seeking medical care.
• Well, on our side, Department of Managed Health Care. Managed Health Care.
• On our side, the Department of Managed Health Care. Managed Health Care. Yeah, we'll do that, yeah.

Summary: The committee heard SB 1377, which would change California’s medical exemption process for school immunizations. The author and supporters argued the bill would restore physician discretion, reduce fear of audits and discipline, and help families with medically vulnerable children obtain exemptions. Opponents, including pediatric, medical, and public health groups, said the current system created by SB 276 and SB 277 is working, that valid exemptions are still being issued, and that loosening oversight could undermine immunization rates and public health. Members debated the data behind claims of a chilling effect, the number of exemptions reviewed or revoked, and the bill’s amendments, which narrowed the measure to current exemptions and added a small additional threshold. Because there was no quorum at the time, action on SB 1377 was delayed until a quorum could be present. The committee then heard SB 995, the Masuma Khan Justice Act, which would create a statewide inspection and enforcement framework for large voluntary residential facilities, including private immigration detention centers. The author and supporters described alleged neglect and abuse in detention facilities, including denial of medication, unsafe food and water, and inadequate oversight, and argued the state should ensure humane conditions and accountability. The California Hospital Association expressed concern about duplicative oversight and possible overlap with existing regulation, while the author said the bill was being refined to avoid constitutional problems and duplication. The committee voted to do pass and re-refer SB 995 to Judiciary, with the roll call showing five votes and the bill placed on call. SB 1089 was also heard, proposing expanded access to GLP-1 medications for state and local government employees through CalPERS and encouraging broader affordability efforts through CalRx. The author framed the bill as a response to chronic weight disease, diabetes risk, and high costs, and described his own experience obtaining and paying for GLP-1 treatment. Supporters from the American Diabetes Association and medical groups said GLP-1s are effective tools for preventing and managing type 2 diabetes and could reduce long-term health costs. No opposition was heard, and the committee voted do pass and re-refer the bill to Labor, Public Employment, and Retirement, with the vote placed on call. The committee also began SB 1221 on Murphy conservatorships, with supporters and opponents debating whether district attorneys should have a larger role in these proceedings and whether the bill would improve public safety or disrupt the civil mental health process; the transcript cuts off before final action on that bill.

Transcript Highlights:

• While health plans must meet time and distance standards for primary care, specialty care, and hospitals
• They're essential to our care. Also essential to prenatal care is counseling on what to avoid.
• They're essential to our care. Also essential to prenatal care is counseling on what to avoid.
• It's essential to our care. Also essential to prenatal care is counseling on what to avoid.
• Now, enhanced care management are individuals that are contracted with our managed care plans to do this

Committee: House Health

Summary: The committee heard several health-related bills, with extensive testimony on maternal health, prenatal safety, valley fever, Medi-Cal care coordination, anti-discrimination protections in health care, and health data sharing. SB 32 would require time-and-distance standards for labor and delivery units in health plans; supporters said it addresses maternity care deserts and dangerous delays, while one opposition witness raised concerns. SB 646 would require testing and public disclosure of toxic elements in prenatal vitamins; supporters emphasized fetal and maternal safety and transparency, while opponents warned the bill could discourage use of prenatal vitamins or lead to products with fewer nutrients. Both bills were moved out of committee on due-pass motions as amended, with recorded roll-call support. The committee also advanced SB 313, which moves a parent’s birthplace from the public portion of a birth certificate to a confidential section to protect privacy; it passed with little opposition. SB 297 would require CDPH to annually identify high-incidence valley fever regions and publish them to improve screening and awareness; supporters cited the disease’s spread beyond the Central Valley and the need for earlier diagnosis, while county health officials were opposed unless amended. SB 324 would steer Medi-Cal enhanced care management and community supports contracting toward local community-based organizations and clarify related guidance; supporters said local nonprofits and promotoras are more effective, while children’s hospitals and health plans sought amendments. SB 418 would codify ACA nondiscrimination protections in state law and allow up to a 12-month supply of medically necessary hormone therapy; supporters framed it as protecting access and continuity of care, while opponents argued it could conflict with federal law and expand coverage for gender-affirming care. SB 660 would strengthen the California health data exchange framework by creating governance and accountability for data sharing across providers and social services; supporters said it would reduce duplication and improve coordinated care, and the bill passed to the next committee. The consent calendar and the other measures were also approved, with some items held on call for absent members before final passage.

Transcript Highlights:

• I'm all that representative. ...care item, since I work and have worked in the personal care field, I'm
• From the Department of Human Services for personal care agencies, private care agencies, to the Arkansas
• are the ones getting personal care.
• personal care.
• And yes, they have a business treating them in health care, but again, personal care is completely different

Summary: The committee first approved the prior meeting minutes and referred items C1 and C2 to the labor and environment subcommittees. It then took up a Department of Human Services rule package revising the Arkansas State Plan Personal Care Manual and the Arkansas Independent Assessment (ARIA) Manual. DHS said the revisions would repeal and replace the current manuals with streamlined versions, remove overlapping language, align processes across programs, and implement Act 853 by moving licensure and certification for personal care agencies from DHS to the Department of Health. For state plan personal care, DHS proposed replacing the current Optum independent assessment and six-month prior authorization cycle with a PCP referral and a personal care agency nurse assessment, plus a 12-month prior authorization, while keeping the 64-hour monthly cap. For ARIA, DHS said it would remove references to state plan personal care, clarify telehealth and in-person assessments, and update sections for PASS, ARChoices, Living Choices, and PACE. DHS officials argued the current process is expensive and not controlling utilization, citing a high approval rate and annual spending of more than $212 million for about 17,000 people. They said the change would save an estimated $6.173 million, reduce red tape, and better align personal care with other state plan services. Several members questioned whether PCPs should be used as gatekeepers for personal care, noting concerns about physician workload, possible delays in access, and conflict-of-interest issues if provider-employed nurses conduct assessments. Members also asked about the history of the Optum contract, whether DHS had tried to modify it, and whether the fiscal note accounted for training or provider impacts. DHS said training would be handled through an existing AFMC contract and that the proposal was developed after stakeholder engagement since June 2024. Some members expressed support for controlling costs and reducing unnecessary assessments, while others said the proposal could burden PCPs and undermine the independent assessment approach previously recommended by the Healthcare Reform Task Force. Questions also focused on how the change would affect new applicants and whether services would be delayed; DHS said it should not delay services and that the rule would not apply to PASS participants. After extended debate, a member moved to pull the rule down and work further with legislators on a revised approach. The agency agreed, and the meeting adjourned without advancing the rule.

Transcript Highlights:

• </c><00:01:31.840><c> um,</c> improving access to health care um, improving access to health care um,
• </c> care at the facility. care at the facility.
• </c> the care of those patients. the care of those patients.
• for community-based care.
• </c> clinical care and and medical education. clinical care and and medical education.

Committee: House Higher Education Finance and Policy