Video & Transcript : 'vulnerabilities' :
Page 82 of 372
CA
Transcript Highlights:
- children. counties currently use to help assess risk and safety for vulnerable children.
- And the lack of transparency and accountability has left those same community members completely vulnerable
- And the lack of transparency and accountability has left those same community members completely vulnerable
- Now, in noting low-income or vulnerable populations, tracking potentially dangerous drivers on the road
- is important for safety and quality of life for us all, particularly for the same low-income vulnerable
CA
California 2025-2026 Regular Session
Joint Legislative Audit Committee Jun 18th, 2025
Transcript Highlights:
- It only identifies potential vulnerabilities rather than verifying compliance or the proper use of bond
- AC Transit, in particular, when we're talking about vulnerable populations, prior to the pandemic, they
- So when we're talking about vulnerable communities, we need to make sure that the dollars stay in people's
- But GFOA does find that government or public agencies that are vulnerable to natural disasters, more
- He very vulnerably shared his story with you all today. I'm immensely proud of him.
Summary:
The committee heard several audit requests and related testimony. The first major item was an audit of Coachella Valley Unified School District’s contract and fiscal management. The author and supporters described long-standing fiscal mismanagement, large budget shortfalls, layoffs, contracting concerns, and questions about the district’s foundation and use of public funds. District representatives and the Riverside County Office of Education said the district is already under fiscal oversight, has a stabilization plan, and is working to reduce deficits and improve student outcomes. After extensive debate and public comment, the motion to approve the audit was put on call because the committee did not have the required votes from both houses at that moment.
The committee then approved an audit of East Bay transit agencies in Alameda and Contra Costa counties. Senator Wahab argued the region’s many overlapping transit agencies create fragmentation, duplication, and inefficiency, especially amid a fiscal cliff and possible future tax increases. Transit agencies and labor representatives opposed the audit, saying the agencies already undergo multiple audits, serve distinct local needs, and are implementing regional coordination efforts. After testimony from agency leaders and public commenters, the committee voted to approve the audit.
The next item was an audit of California Community Colleges’ unrestricted reserves. Senator Archuleta and supporting faculty representatives said reserves have grown substantially and may be diverting resources from student services, instruction, and workforce programs. They argued there is little oversight when reserves become too high. The Chancellor’s Office and Calbright College were invited to respond, and the audit objectives focused on reserve growth, reasons for high balances, oversight by the Chancellor’s Office, and effects on students and staff. The transcript cuts off during the Chancellor’s Office response, so the final committee action on this item is not shown.
TX
Texas 89th Regular
Delivery of Government Efficiency Mar 19th, 2025
Delivery of Government Efficiency
Transcript Highlights:
- Urged environments have brought forward a whole new set of challenges, risks, and vulnerabilities. vulnerabilities
- Now that the bridge between cyber and physical assets has been closed, there are more vulnerabilities
- The Texas Cyber Command eliminates these vulnerabilities by consolidating resources, intelligence. response
- Texas, and we hope within some We lose 1.5 million people every month, including many of our most vulnerable
- And it serves over 7.5 million of our most vulnerable Texans.
Keywords:
cybersecurity, state command, information resources, data protection, incident response, information technology, classification officer, job descriptions, state positions, competency-based, information sharing, government efficiency, public sector, private sector, distributed ledger, title registry, real estate, property liens, pilot program, healthcare
TX
Transcript Highlights:
- will almost certainly have a discriminatory impact on our state. most historically underserved and vulnerable
- policy. want to be you know in the business of incentivizing or allowing sort of our youngest most vulnerable
- conversation was redirected toward how we can improve. public school outcomes, particularly for vulnerable
- This is not a partisan an issue, this bill is objectively harmful for our most vulnerable kids, and again
- They funnel taxpayer dollars to private institutions with no legal responsibility for our most vulnerable
Keywords:
education savings account, educational expenses, certified educational assistance organization, school choice, funding, special education, tuition reimbursement, emergency communication, public safety, interoperability, Texas Interoperability Council, grant program, emergency communications, public safety radio, first responders, radio system, dispatch, 911, emergency management, Texas Division of Emergency Management
CA
California 2025-2026 Regular Session
Assembly Floor Session May 26th, 2026
California House Floor Meeting
Transcript Highlights:
- protections for sensitive data and information, leaving immigrant advocates and service providers vulnerable
- It's because this is about protecting vulnerable Californians, plain and simple.
- actually need to do the unthinkable, which is to ensure that those who are protecting our most vulnerable
- These cuts will impact some of the most vulnerable members of our community, such as our veterans, former
- That our minimum wage continues to slip from those who are vulnerable and working hard and who are being
Summary:
The Assembly convened, established a quorum, and proceeded through a large House of Origin floor file, with the Speaker repeatedly urging members to be at their desks and keep support bills brief. Early actions included dispensing with the journal, re-referring AB 2285 to the Banking and Finance Committee, and then taking up dozens of third-reading items, with many bills passed by voice or recorded vote and others passed temporarily or retained on file.
The floor debated and passed a wide range of measures on land use, housing, labor, public safety, health care, utilities, taxation, and consumer protection. Among the bills approved were measures on land surveyor review (AB 1933), nurse midwife access for pregnant and postpartum patients (AB 1696), historic-district transit zoning flexibility (AB 2415), EV charging infrastructure fees and timelines (AB 1820), foreclosure bidding protections (AB 1957), tribal cannabis commerce (AB 2506), outdoor advertising permitting (AB 2024), commercial building permit timelines and third-party plan checkers (AB 2418), DUI penalties (AB 1685 and AB 1687), utility rate transparency (AB 1715), CalWORKs work-penalty changes (AB 1755), dynamic electricity rates (AB 1787), interior designer licensure (AB 1796), compost labeling and contamination rules (AB 1812), modular housing standardization (AB 1815), small claims limits for businesses (AB 1827), Native American Day as a paid state holiday (AB 1841), hospital staffing and maternity access bills (AB 1868 and AB 1882), protective orders tied to release dates (AB 1889), and a series of public health, missing persons, and teacher credentialing measures later in the file.
Several high-profile bills drew extended debate. AB 2624, expanding Safe at Home privacy protections to immigrant service providers, prompted sharp disagreement over free speech and alleged limits on online posting, but supporters said it protected workers facing threats and doxing; it ultimately passed 49-19. AB 2023, creating a framework for regulating AI chatbots used by children, was framed as a child-safety measure after testimony about chatbot-related harms and suicide risks, and passed 58-8. Other notable votes included AB 2208 on Medi-Cal protections against federal cuts, AB 2299 on CalFresh/SNAP losses, AB 2115 apologizing to California Native peoples for historic state harms, and AB 2311 on public hospital physician employment; the transcript ends as the Assembly continues working through the remaining file.
CA
Transcript Highlights:
- Gene synthesis is a critical vulnerability in our defenses against these actors.
- Gene synthesis is a critical vulnerability in our defenses against these actors.
- We do so to protect them during vulnerable stages of their growth.
- They are rigged, exploitative systems that quiet our voices when we are most vulnerable.
- You know, Assembly Member, thank you for your vulnerability on camera. Like Ms.
MN
Minnesota 2025-2026 Regular Session
Committee on State and Local Government - 04/09/26
State and Local Government
Transcript Highlights:
- Second, Minnesota's workforce is particularly vulnerable.
- Second, Minnesota's workforce is particularly vulnerable.
- dollars that should be dedicated to providing critical health care services to Minnesota's most vulnerable
- </c> financial exploitation of vulnerable financial exploitation of vulnerable adults. adults. adults
- adults or elderly residents vulnerable adults or elderly residents in<01:23:05.120><c> nursing</c><01
AZ
Arizona 2026 Regular Session
03/23/2026 - House Health & Human Services
House Health & Human Services Committee of Reference
Transcript Highlights:
- I would love for a single drug to save us a bunch of money on the care for among our most vulnerable
- This bill aims to protect vulnerable members from these predatory schemes and keeps responsible providers
- This bill aims to protect vulnerable members from these predatory schemes and keeps responsible providers
- And these people who should be on Medicaid were now left without coverage in a very vulnerable position
- However, kids under the age of five are even more vulnerable, unable to self-protect, and unable to call
Summary:
The committee heard several bills related to radiation protection in cardiac catheterization labs and later a stem cell/regenerative therapy bill. On SB 1121, which would allow hospitals with radiation protection systems to let clinicians forgo lead aprons if they work in the designated safety area and use real-time dosimetry, testimony was largely supportive or neutral after a late amendment gave radiation safety officers discretion to require protective gear if exposures approach thresholds. The committee adopted the amendment and passed SB 1121 on a 9-1 vote. SB 1120, a more prescriptive bill requiring at least 50% of cath lab rooms in hospitals to be equipped with the radiation protection system, drew divided testimony: sponsors and several physicians argued it would reduce orthopedic injury and radiation exposure and improve recruitment and retention, while hospital and radiology groups objected to the mandate, cost, limited vendor pool, and lack of clarity in the bill’s definitions. After adopting an amendment excluding children’s hospitals, the committee deadlocked 6-6 and SB 1120 failed to pass.
The committee then considered SB 1118, which would appropriate $3 million to help rural hospitals install radiation protection systems in cath lab rooms. The sponsor said the funding would help rural facilities meet the same safety goals, and the committee passed the bill 6-5. The committee also heard SB 1214, a “guardrails” bill regulating non-FDA-approved stem cell and regenerative therapies, requiring informed consent, sourcing and reporting standards, advertising limits, and civil penalties for violations. Supporters said it would protect patients while allowing access to promising therapies; some members raised concerns about evidence and commercialization, but after adopting a technical amendment, the bill passed 9-3. The transcript ended as the committee moved on to SB 1630, which would seek federal approval for a home- and community-based service benefit for adults with serious mental illness; the sponsor described it as a capped, Medicaid-based community care option, and Access testified neutral while estimating a fiscal impact, but no final action on SB 1630 appears in the excerpt.
MD
Transcript Highlights:
- road user protection act of vulnerable road user protection act of 2026. 2026. 2026.
- House Bill 1008, Financial Institutions, Exploitation of Seniors and Vulnerable Adults, Protections and
- Required Referral, Vulnerable Adult Banking Protection Act.
- </c> exploitation of seniors and vulnerable exploitation of seniors and vulnerable adults,<01:31:46.480
- </c><01:31:48.880><c> adult</c> referral vulnerable adult referral vulnerable adult banking<01:31:50.760
MN
Transcript Highlights:
- members in our community who are seniors, who are people with disabilities, vulnerable individuals,
- members in our community who vulnerable members in our community who are<00:12:43.720><c> seniors</c
- </c><00:12:47.600><c> individuals</c><00:12:48.560><c> and</c> disabilities, vulnerable individuals and
- disabilities, vulnerable individuals and we<00:12:49.120><c> have</c><00:12:49.279><c> done</c><00:12
- </c><00:34:38.560><c> citizens</c><00:34:39.119><c> to</c> some of our most vulnerable citizens to some
MN
Minnesota 2025-2026 Regular Session
House Health Finance and Policy Committee 2/12/25
Health Finance and Policy
Transcript Highlights:
- Pregnancy and birth are vulnerable times, especially when housing is uncertain, and they see this impact
- The funds allow us to continue serving vulnerable women and families, ensuring they receive the care
- person in this room who doesn't believe that we should spend more money taking care of our most vulnerable
- person in this room who doesn't believe that we should spend more money taking care of our most vulnerable
- who is more care who is more vulnerable who is more needing<01:09:04.560><c> of</c><01:09:04.839><c>
US
US Federal 2025-2026 Regular Session
US House Floor Proceedings (Tuesday, July 15, 2025)
US Federal House Floor Meeting
Transcript Highlights:
- We made those promises to our most vulnerable.
- ,</c> coverage for the most vulnerable, coverage for the most vulnerable, especially<00:27:48.400><c>
- We are vulnerable to take care of them.
- But we also sent a very most vulnerable.
- Republicans have abandoned vulnerable, Republicans have abandoned vulnerable, hungry<02:16:25.760><c
NH
New Hampshire 2025 Regular Session
House Health, Human Services and Elderly Affairs (03/12/2025)
Health, Human Services & Elderly Affairs
Transcript Highlights:
- </c> and may place especially vulnerable and may place especially vulnerable mothers<01:32:09.560><c>
- with severe and persistent vulnerable with severe and persistent mental<03:07:25.920><c> illness</c>
- um and so for those reasons vulnerable um and so for those reasons we're<03:10:35.840><c> very</c><03
- </c> participants and leave them vulnerable participants and leave them vulnerable to<04:13:58.279><c
- to uh potentially fatal vulnerable to uh potentially fatal infectious<04:25:43.880><c> diseases</c><
MN
Minnesota 2025-2026 Regular Session
House State Government Finance and Policy Committee 3/3/26
State Government Finance and Policy
Transcript Highlights:
- </c><00:41:01.760><c> in</c><00:41:02.000><c> our</c> people who are most vulnerable in our people who
- are most vulnerable in our communities.<00:41:03.040><c> And</c><00:41:03.280><c> anytime</c><00:41:
- ,</c> individuals who are our most vulnerable, individuals who are our most vulnerable, to<00:41:07.839
- ,</c> people who need it, the most vulnerable, people who need it, the most vulnerable, or<01:03:54.400
- Director Ali's report admits that the state has been on notice about these vulnerabilities since 1977
Keywords:
Safe at Home, address confidentiality, domestic violence, sexual assault, stalking, harassment, victim privacy, survivor protection, confidential address, protected address, secret address, identity protection, residential confidentiality, program participant, nondiscrimination, court disclosure, protective order, service of process, driver's license, state ID
HI
Transcript Highlights:
- </c> supply chain vulnerability. supply chain vulnerability.
- Pregnant women are specifically vulnerable.
- </c><01:39:08.960><c> We</c><01:39:09.280><c> also</c> are specifically um vulnerable.
- We also are specifically um vulnerable.
- and they've um particularly vulnerable and they've um now<01:39:23.920><c> a</c><01:39:24.239><c> large
Keywords:
agriculture, aquaculture, livestock, agribusiness, Department of Agriculture, regulatory functions, employee benefits, restorative practices, sustainability, environmental stewardship, local food systems, Native Hawaiian, workforce development, agricultural development, Hawaii Island, property manager, state employment, SB3320, Hawaii, Agribusiness Development Corporation
Summary:
The committee heard testimony on SP 2350, which would transfer oversight of the Department of Agriculture’s Agricultural Development Division and the aquaculture and livestock support services branch to the Agribusiness Development Corporation. The Department of Agriculture and ADC both testified, with ADC opposing the bill as written while supporting the goal of strengthening agriculture. ADC said the transfer could create federal operational and coordination risks, jeopardize federal funding and program continuity, and was unnecessary because ADC is a business development entity, not a regulatory agency. The Hawaii Farmers Union also expressed concern that moving the programs could weaken the department’s ability to access federal resources, while the Hawaii Farm Bureau submitted written testimony and the Hawaii Aquaculture and Aquaponics Association and H-Plan were noted as supporting the measure; the Hawaii Cattlemen’s Council was noted as opposing it.
Much of the discussion focused on aquaculture’s economic potential and the role of regulation, permitting, and funding. Committee members questioned why aquaculture had not grown faster, citing current gross revenues of about $66 million last year, a prior high of $82 million, and a possible long-term target of $500 million. Testimony identified permitting and feed costs as major barriers, along with market conditions and water quality issues affecting producers. ADC described ongoing efforts on feed development, permitting streamlining, coastal-state collaboration on seaweed and restorative aquaculture, and national advocacy for more parity in seafood import standards.
Members also pressed the Department of Agriculture on its leadership and priorities, criticizing the lack of bills and resources dedicated to aquaculture and asking whether the department should have more authority to pursue land purchases and development opportunities. The department said it relies on divisions and industry feedback for bill ideas, noted it funds an annual aquaculture survey, and said it was pursuing congressional earmarks and other funding for aquaculture parks, research, and export/import issues. ADC said it would work with the department if the bill passed, but that its current statute does not give it regulatory authority and any such change would require a statutory amendment.
TX
Transcript Highlights:
- But they're especially vulnerable. And you know what?
- And they're most vulnerable, yes... Definitely. So all of those things are so true.
- And they're most vulnerable, yes, to mental health concerns during that time as well.
- Especially in vulnerable individuals, it can have devastating mental health consequences.
- That means SB 5 is legally vulnerable.
Keywords:
disaster relief, flood preparedness, emergency funding, local government support, meteorological forecasting, human trafficking, trafficking victim, compelling prostitution, affirmative defense, criminal defense, coercion, force fraud or coercion, sexual exploitation, victim protection, Penal Code, Texas criminal law, prosecution, party liability, affirmative defense statute, survivor rights
Summary:
The Senate Committee on State Affairs took up Senate Bill 5, which Senator Perry described as a ban on intoxicating THC consumer products while preserving legal CBD, CBG, hemp seed, hemp seed protein powder, and hemp seed oil products. Perry argued that most retail THC products are already illegal under federal law, that the industry has used loopholes and misleading labeling to sell high-potency products, and that regulation would be ineffective because chemists can quickly alter formulations. He also said the bill would steer people with medical needs toward the Texas Compassionate Use Program (T-Cup), which he and other supporters described as the proper physician-guided alternative. Committee members and witnesses repeatedly discussed the distinction between legal hemp-derived products and intoxicating THC products, and Perry said the bill would not touch non-consumable hemp uses such as fiber and clothing.
Invited testimony came from law enforcement and medical witnesses who supported the bill. Texas Police Chiefs Association representative Steve Dye, Kaufman County District Attorney Early Wiley, and Chambers County Sheriff Brian Hawthorne all said regulation would be too costly, too complex, and ultimately unenforceable, while a ban would be clearer and easier to enforce. They cited overloaded DPS labs, the need for expensive private testing, limited police and prosecutor resources, and the difficulty of keeping up with constantly changing cannabinoids and out-of-state products. Hawthorne and Wiley described raids and investigations involving warehouses, retail stores, cash seizures, and products they said were marketed to young people and often mislabeled or imported from other states. They also said the bill would help law enforcement by creating a clearer legal line and protecting legitimate CBD/CBG businesses.
Dr. Lindy McGee, speaking for the Texas Medical Association and Texas Pediatric Society, testified that retail THC products pose serious risks to children and adolescents, including addiction, impaired brain development, psychosis, suicide attempts, self-harm, accidental toddler ingestions, and possible long-term cognitive effects. She said there is no effective medication treatment for THC addiction comparable to nicotine cessation tools, and she supported restrictions such as child-resistant packaging, no marketing to minors, and age limits, while opposing criminal penalties for possession by minors. Senators asked follow-up questions about brain development, memory, dementia risk, pregnancy, and cardiovascular effects. No vote was taken during the portion provided, and the committee continued with invited testimony and questions.
MN
Minnesota 2025-2026 Regular Session
Debate on bill to bar transgender athletes from girls sports 3/3/25
Minnesota House Floor Meeting
Transcript Highlights:
- children tiny minority of vulnerable children subjecting<00:18:50.440><c> kids</c><00:18:50.640><c>
- We cannot allow our girls to be vulnerable to losing their spot on the team, being on the podium, or
- We cannot allow our girls to be vulnerable to losing their spot on the team, being on the podium, or
- We cannot allow our girls to be vulnerable to losing their spot on the team, being on the podium, or
- We cannot allow our girls to be vulnerable to losing their spot on the team, being on the podium, or
NH
Transcript Highlights:
- Children from birth to six years old are the most vulnerable members of society in terms of risk for
- Children from birth to six years old are the most vulnerable members of society in terms of risk for
- members of society the most vulnerable members of society in<00:18:45.880><c> terms</c><00:18:46.120
- The Family Resource Centers really work as a community hub and keep vulnerable families well connected
- </c> as a community Hub and keep vulnerable as a community Hub and keep vulnerable families<00:30:50.080
FL
Florida 2026 5th Special Session
Appropriations Mar 2nd, 2026
Transcript Highlights:
- We end up scrutinizing the vulnerable while giving a pass to the powerful.
- What vulnerable populations will fall through the cracks?
- What vulnerable populations will fall through the cracks?
- This is fiscally risky, operationally unrealistic, and devastating for medically vulnerable Floridians
- For decades, China has exploited vulnerabilities around the world and here at home, testing the pressure
Summary:
The Appropriations Committee considered a large agenda of bills and reported several measures favorably. Early action included SB 6, a settled claim bill involving the Department of Children and Families and a trust for Leila Estrada and Sapphire Williams, and CS/CS/SB 1266, which creates a cybersecurity experiential learning and clearance-readiness program through the Department of Commerce and Cyber Florida. The committee also approved SB 532 on clerks of court funding, allowing clerks to retain all excess Article V revenue rather than returning half to the state and clarifying foreclosure sale procedures. In addition, the committee passed CS/CS/SB 1602 and CS/CS/SB 1604 to create and fund a pilot housing program for veterans through the Florida Housing Finance Corporation, and CS/SB 1110 to expand Medicaid and private insurance coverage for medically necessary orthotics and prosthetics, including testimony from affected families and advocates. The committee also adopted an amendment and then favorably reported CS/CS/SB 1012 on inmate services, removing the bill’s medical-services compensation provisions while retaining changes to the inmate welfare trust fund and related facility uses. It also adopted a delete-all amendment and then favorably reported CS/CS/CS/SB 1614, which was narrowed to remove a provision allowing local governments to use excess fees to construct new buildings.
The committee spent substantial time on CS/SB 17, a Medicaid oversight and transparency bill. The sponsor said the measure would create a joint legislative Medicaid oversight committee, authorize the Legislature to retain its own actuary, modernize Medicaid statutes, strengthen managed-care performance standards, and increase accountability for pharmacy benefit managers and related entities. After amendment, the committee adopted changes removing several PBM-related provisions while retaining the broader oversight framework. Testimony from supporters emphasized transparency, fraud prevention, and cost control, while a PBM trade association asked to continue working on affiliate-manufacturer, network, and payment issues. The bill was reported favorably.
The most extensive discussion centered on CS/SB 1758, which proposes major changes to Medicaid and SNAP. The sponsor described five reforms: stronger fraud and overpayment recovery authority, a Medicaid work requirement for certain able-bodied adults, expanded behavioral-health services through Medicaid waivers, pharmacy-program changes to obtain rebates and reduce institutional costs, and SNAP/EBT reforms including photo IDs and work requirements. The committee adopted two amendments: one adding a transitional “glide path” for people who gain employment but risk losing Medicaid, and another exempting hospice patients with six months or less to live. Supporters argued the bill would reduce fraud, improve accountability, and encourage work, while opponents warned it would increase administrative burdens, push eligible people off coverage, and conflict with federal law or guidance. The bill remained under debate with extensive public testimony from advocates, providers, and affected families, and the transcript ends before final disposition on the measure.
KY
Kentucky 2025 Regular Session
Budget Review Subcommittee on Health and Family Service (9-17-25)
Transcript Highlights:
- If personal care homes are forced to close, thousands of vulnerable individuals will have nowhere to
- If personal care homes are forced to close, thousands of vulnerable individuals will have nowhere to
- If personal care homes are forced to close, thousands of vulnerable individuals will have nowhere to
- If personal care homes are forced to close, thousands of vulnerable individuals will have nowhere to
- This is crucially important, and we do have an obligation to provide for the most vulnerable among us
Summary:
The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses.
The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness.
Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.