Transcript Highlights:

• My patients no longer feel safe in health care. Massachusetts is unprecedented.
• My patients no longer feel safe in health care or school settings.
• When fear drives immigrant patients into hiding, the consequences ripple far beyond one family.
• We are seeing our patients no-show. I regularly have half of my patients not show up.
• I don't follow them anymore because they're not pediatric patients, but irreversible harm.

Committee: Joint Joint Committee on Public Safety and Homeland Security

Summary: The hearing focused on the Safe Communities Act, House 2580 and Senate 1681, along with related proposals to limit local and state cooperation with federal immigration enforcement, prohibit 287(g) agreements, and expand legal defense for immigrants. Most testimony came from advocates, attorneys, labor leaders, health care professionals, educators, and community members who argued that fear of ICE discourages immigrants from reporting crimes, seeking medical care, attending school, or cooperating with courts, and that a clear statewide policy would improve public safety, due process, and trust in institutions. Several speakers described personal or client experiences involving domestic violence, trafficking, workplace abuse, or children affected by deportation, and many emphasized economic harms to workers, families, and small businesses. Health care witnesses said immigration enforcement is causing patients to miss appointments, avoid emergency rooms, and delay preventive care, with resulting public health consequences. Labor and education representatives said immigrant workers and students are increasingly fearful, and that the state should not allow local police to act as ICE agents or enter 287(g) agreements. ACLU and coalition witnesses cited examples they said showed existing or recent collaboration between local agencies and ICE, including courthouse alerts, vehicle stops, and use of municipal spaces, while also arguing that the bill would still allow cooperation on criminal matters and public safety emergencies. One witness opposed the bill, arguing that serious criminal offenders should be deported and defending ICE’s role. Committee members asked several questions about whether the harms described were widespread or anecdotal, and about the distinction between assisting ICE in civil immigration arrests versus responding to violent or public safety emergencies. Witnesses said the bill was aimed at civil immigration enforcement, not criminal investigations or emergency situations. At the end of the hearing, a committee member requested a study on immigration enforcement’s effect on emergency room wait times, and the committee then adjourned without taking a vote on the legislation.

Transcript Highlights:

• So as I've said before, we are here because we are standing up for patient safety.
• “I would like to point out that in this case, I have many patients with keratoconus.
• I have patients yearly who will come back and say, you might have saved my life.
• And that’s not unique to me, but there have been patients.
• It can affect patients' travel times, access to care...

Committee: House Professional Registration and Licensing

Summary: The committee first took up House Bill 3111, which concerns bail bonds oversight. Representative Phelps offered a committee substitute that moved bail bondsmen into the existing Board of Private Investigators, Private Fire Investigators, and Professional Surety Bail Bonds to avoid a fiscal note. An amendment was adopted to remove fee caps in the substitute, and the committee then adopted the revised substitute and voted it do pass 21-0. The committee then heard Senate Substitute No. 2 for Senate Bill 1233, the CPA licensure bill, along with related provisions for social work supervisors and speech pathologists. Senator Trent and supporters from the Missouri Society of CPAs, the speech-language association, the social work community, and the State Auditor’s Office said the bill would address CPA shortages by creating a new licensure path based more on experience, while preserving exam standards and adding reciprocity. No opposition was offered, and the hearing concluded without a vote. House Bill 2999 on optometry scope of practice drew extensive testimony and debate. The sponsor and ophthalmology witnesses described the bill as a negotiated compromise that would codify specific procedures optometrists may perform, while opponents from optometry argued it would freeze scope in statute, limit modernization, and require repeated legislative action as standards change. Witnesses disagreed sharply over whether the bill improved patient safety and access, whether the procedures were already within current practice, and whether surgical procedures such as lasers should be included. The bill was heard but no committee action was taken in the transcript. Finally, the committee heard House Bill 2957 on respiratory therapist licensure. Representative Castile and respiratory care witnesses said the bill would phase out the CRT as the entry credential for new applicants in favor of the higher RRT standard, while grandfathering current CRTs and adding renewal audits to confirm active credentials. Supporters said the change reflects current training standards and would raise patient-care quality without reducing workforce numbers. No opposition testimony was presented, and the hearing adjourned without a vote.

Transcript Highlights:

• The current maximum amount is 6% of net patient revenue.
• It just delays them until patients are much sicker and much more expensive.
• There were too few providers and too many patients going without care.
• He said everybody deserves quality care and that his patients deserve the best.
• It's not really an available option in a lot of cases to the SNF patients.

Summary: The subcommittee heard an overview of the Department of Health Care Services’ proposed budget, including a $229.1 billion total-funds budget and projected Medi-Cal enrollment decline as redeterminations continue. Members focused heavily on the fiscal and programmatic effects of prior budget solutions and federal changes, especially the elimination of General Fund-supported Prop. 56 dental supplemental payments beginning July 1, 2026, the hospice utilization-management change, and the impact of reduced caseloads alongside rising health care costs. DHCS said it is still completing required access and rate-reduction analyses for the dental cuts and has been engaging stakeholders, but could not yet quantify the real-world effect on utilization or provider participation. The committee also reviewed the November 2025 Medi-Cal local assistance estimate, which shows higher General Fund spending despite lower enrollment, driven by managed care rate growth, Medicare cost growth, state-only claiming, and federal policy changes. The hearing then turned to provider taxes and federal H.R. 1 constraints, with extensive discussion of the MCO tax, the hospital quality assurance fee, and other health care-related taxes. DHCS explained that H.R. 1 phases down allowable tax levels and tightens “generally redistributive” rules, making the current MCO tax structure and the proposed higher hospital fee levels difficult or impossible to renew as originally designed. Staff and the LAO described the tradeoff between preserving Medi-Cal funding and avoiding higher costs on private providers and consumers. Members asked about options for preserving revenue, including possible amendments to Prop. 35 or returning to voters, and were told the department is still evaluating approaches while federal guidance remains in flux. The committee also reviewed hospital payment increases already implemented through state-directed payments, with DHCS noting that H.R. 1 will force those payments down to Medicare levels over time. Several budget change proposals were discussed and left open, including requests tied to the managed care final rule, managed care operations, hospital value strategy, long-term care payment transparency, and interoperability requirements. The committee also heard about a one-year trailer bill extension for skilled nursing facility financing, including continuation of the SNF workforce standards program, the SNF quality assurance fee, and annual rate growth, while the department develops a longer-term financing redesign for 2027-28. Members expressed skepticism about repeated rate reform efforts and questioned whether a one-year extension of the eliminated workforce quality incentive program should be restored during the transition. Finally, Covered California presented its budget and enrollment update, reporting that the expiration of the federal enhanced premium tax credit is expected to reduce affordability significantly, with average premiums roughly doubling for many enrollees and as many as 400,000 Californians potentially losing marketplace coverage over time. The exchange said California’s $190 million subsidy program is helping lower-income enrollees, but not enough to offset the federal loss, and it is also implementing a new gender-affirming care benefit and awaiting federal action on benchmark plan changes.

Transcript Highlights:

• So it's things like that of how we can reach the patient.
• Yeah, so we already have patient portals, and AI is going to help.
• It's about getting them on the right drug for the right patient.
• It's about getting them on the right drug for the right patient.
• They can interpret it in layman's terms for the patient.

Bills: SB1786

Committees: House Artificial Intelligence & Innovation , House House Artificial Intelligence & Innovation Committee of Reference

Keywords: artificial intelligence, content verification, provenance data, transparency, digital content

Transcript Highlights:

• As a primary care physician, I would still see my patient for those refills.
• How exactly is this going to change for that patient or for those two categories?
• Madam Chair and Representative, so the patient would still need to be making regular contact.
• So this does not change any of the safeguards within the doctor-patient relationship.
• So not getting into that doctor-patient relationship or the doctor's authority.

Summary: The committee first heard Senate Bill 21, as amended, which would create an annual birthday-based open enrollment period for Medicare supplement policyholders age 65 and older, allowing them to switch to equal or lesser coverage without medical underwriting. The Aging and Long-Term Services Department and the Office of Superintendent of Insurance supported the bill as a consumer protection measure for seniors who are locked into rising premiums, while AHIP opposed it, warning it could raise premiums for existing policyholders. The League of Women Voters and AARP supported the measure. After debate over premium impacts and market stability, the committee voted 6-4 to give SB 21 a due pass. The committee then considered Senate Bill 20, dealing with prior authorization for medications used to treat serious mental illness. An amendment to change the bill from limiting prior authorization to once every three years to once every 12 months was debated; insurers supported the annual review, while nursing, disability, and mental health advocates argued that more frequent prior authorization would add burden and delay care. The committee tabled the amendment 5-4, then passed the unamended bill on a do pass vote. Testimony emphasized that the bill would not change how often patients see their doctors, only how often insurers can require prior authorization. Next, Senate Bill 101 was heard, which repeals the delayed sunset of the Health Care Delivery and Access Act so the hospital provider tax can continue. Sponsors and the Health Care Authority said the program has generated substantial federal matching funds and supports hospitals, especially rural facilities. AARP, Health Action New Mexico, the Greater Albuquerque Chamber of Commerce, and the New Mexico Hospital Association supported the bill. Committee members asked about how funds are distributed and reported; the agency said distributions are based on Medicaid discharges and hospitals must report on spending. The bill received a do pass. The committee also approved House Memorial 52, which requests a study group on health insurance premium affordability for working families and small employers. Supporters from Blue Cross and Blue Shield and AHIP said the memorial would help identify cost drivers and improve transparency. The committee then passed House Bill 132, as amended, creating a workers’ compensation presumption for certain occupational conditions affecting police officers. Supporters from labor, state police, OSI, and business groups said it would help recruitment, retention, and recovery, while members discussed the removal of back pain from the presumption and the reinstatement of PTSD. Finally, the committee began hearing Senate Bill 14, which expands the state’s health professional loan repayment program and creates a broader advisory structure to address workforce shortages. The bill would cover physicians and many other health professions, with a large appropriation and special provisions for part-time service and loan repayment terms. The sponsor described it as a competitive recruitment tool, and numerous health care, labor, and consumer groups testified in support. The sponsor also described a proposed amendment to reallocate physician funds to other eligible health professionals if there are not enough qualified physician applicants, but the committee was preparing to move on when the transcript ended.

Transcript Highlights:

• We hold ourselves to high standards with patient safety in mind.
• You should know, and patients should know. I call them patients, sorry.
• So that patient safety is maintained.
• I became a no-option patient at year five.
• He founded a group in 2012 called Patients for Stem Cells, and we educated everyone up here on our patient

Bills: HB 1106 , HB3284 , HB541 , HB713 , HB1403 , HB1586 , HB1942 , HB2070 , HB2844 , HB2851 , HB3151 , HB3749 , HB3940 , HB3963 , HB4454 , HB4466 , HB4795 , HB5154 , HB5394 , SB1357 , HB 1052 , HB4099 , HB4638 , HB5147

Committee: Senate Health & Human Services

Transcript Highlights:

• Next slide shows a lung transplant patient.
• We saw an immediate impact to patient care.
• We had to activate temporary patient care units to accommodate increased patient volume and patient needs
• So we had just unknown patients in our hospital, patients, unknown nursing home patients.
• We really put patients in our auditorium.

Summary: The Assembly Health Committee held an informational hearing on the health impacts of wildfires and the effects on health care systems and access to care. The first panel focused on public health consequences, with testimony from UCLA and UCSF physicians, a community organizer, and an Altadena recovery leader. Witnesses described acute and long-term physical harms from wildfire smoke and ash, including asthma and COPD exacerbations, cardiovascular and stroke risks, pregnancy impacts, infection risk, and possible added hazards from lithium-ion battery fires. They also emphasized mental health effects such as anxiety, depression, PTSD, “firebrain,” and the need for psychological first aid, trauma-informed community networks, and youth-focused resilience programs. Community advocates stressed that Latine, Indigenous, undocumented, and Black communities face disproportionate harm because of language barriers, unsafe work conditions, lack of insurance, and exclusion from disaster aid, and they called for stronger language access, worker protections, permanent disaster relief, and better outreach. Committee members asked about air monitoring, masks, wind events, lithium-ion batteries, and how to reach communities with translation and emergency information. Panelists said AQI is useful but incomplete, that N95s help for smoke but P100 masks are needed for ash/asbestos exposure, and that communities should be warned to stay indoors and avoid windy dust-ups after fires. They also discussed the importance of building relationships during non-emergency periods, using text alerts and trusted community organizations, and providing culturally and linguistically appropriate information. Several members and witnesses highlighted the need for more research on long-term health effects, especially for people with chronic lung disease, workers who cannot stay indoors, and residents exposed to repeated disasters. The second panel addressed health care system response and access to care. DHCS and DMHC described emergency flexibilities used during the Southern California fires, including federal waivers, extended Medi-Cal renewal deadlines, reinstated coverage for some disenrolled members, suspension of prior authorization and prescription refill barriers, out-of-network access at in-network cost-sharing, and communication through websites, toll-free numbers, and social media. Hospital and community health center leaders described major operational strain: emergency room surges, canceled surgeries, dialysis disruptions, staff displacement, temporary housing needs, and financial losses. Huntington Health and AltaMed reported using incident command systems, temporary care spaces, bilingual and culturally tailored services, mobile clinics, infection control measures, and community health workers to keep care going. Members and witnesses also discussed the need for better disaster staffing pools, more flexible facility rules, stronger mental health coverage, child care planning, and statewide coordination for future emergencies; no formal votes were taken.

Transcript Highlights:

• </c><01:31:55.320><c> in</c> telephonic teleah health patients in telephonic teleah health patients in
• </c><01:50:08.080><c> uh</c> medications are dispensed patients uh medications are dispensed patients
• patients and facilities that serve patients and provide<01:53:39.599><c> and</c><01:53:40.239><c> as
• </c> impacts that are going on with patients impacts that are going on with patients across<02:02:50.679
• </c> 15 minutes of my not seeing a patient 15 minutes of my not seeing a patient and<02:03:54.360><c>

Committee: House Consumer Protection & Commerce

Summary: The committees heard testimony on several transportation and consumer-related bills. HB 496, relating to mamaki tea labeling, drew support from the Department of Agriculture, the Department of Weights and Measures, and the Hawaii Farm Bureau, which said the bill would help protect a culturally important crop and the Hawaii brand. Members questioned Agriculture about staffing and whether the bill was being used to reopen a package-labeling inspection branch; the department said it currently has no Oahu inspectors for that function but has a place for an additional inspector. No opposition was registered on the measure. HB 978, relating to electric utilities, and HB 1316, relating to DLNR/park reservations, were also heard. HB 1316 received support from State Parks, and members discussed where reservation fees would go and whether the statewide reservation system for three parks would cover its costs; the committee indicated a change would be made so fees go to the special fund. HB 914, relating to water carriers, drew support or comments from the PUC, Department of Agriculture, Department of Transportation, Young Brothers, and the Hawaii Harbor Users Group. The main discussion focused on the proposed automatic rate-adjustment mechanism tied to the GDP price index, with members asking for alternative index ideas and questioning whether the PUC already had authority to adopt such a mechanism. Young Brothers said the measure would provide clarity and help recover inflationary costs, while the chair raised concerns about repeated rate increases and asked for further testimony on possible alternative indices. HB 1161, relating to transportation and road usage charges, received support from the Insurance Division, DOT, and the State Energy Office, with comments from the Tax Foundation of Hawaii and the Hawaii Food Industry Association. Members asked whether counties need state authorization to adopt mileage-based charges and why the bill included funding for implementation; DOT said it is helping counties build the data collection and billing system and that Honolulu is handling much of the collection work. A question was also raised about whether plug-in hybrids would be covered, and DOT said vehicles under the federal electric-vehicle definition would be included. HB 1301, relating to transportation network companies, drew opposition from the Hawaii Association for Justice, Lyft, and Uber, all arguing that classifying TNCs as common carriers and changing liability rules would raise costs, reduce access, and disrupt the current statewide framework. No votes or final committee actions were taken in the portion of the meeting provided.

Transcript Highlights:

• I believe our patient services lady was fired.
• Patient safety and responsible regulation.
• for higher doses in many patients.
• But for medical patients, cancer patients, high dosing to block the TRPB1 receptor and killing the cancer
• And then for you to say, hey, it's a patient and Each patient has a different dosage amount, and as we

Transcript Highlights:

• But we hear from patients across the state often.
• But clinicians now can give patients hope, which is something they didn't have before.
• But clinicians now can give patients hope, which is something they didn't have before.
• The patient load is so high. And it's not a knock against the docs. They've got so many patients.
• , then they can see the new patients or the new concerns, but... ...follow the patients, then they can

Committee: All ALZHEIMER'S DISEASE AND DEMENTIA ADVISORY COUNCIL

Transcript Highlights:

• Second, the amendment strengthens patient transparency protections.
• It is common for sickle cell patients across the state.
• It is common for sickle cell patients across the state.
• Pass it for the patients whose pain has been questioned instead of treated.
• And today, your vote can change the future for every sickle cell patient in the state.

Bills: S0006 , S0036 , S0560 , S0778 , S0844 , S0864 , S1002 , S1016 , S1022 , S1030 , S1630

Committee: Senate Appropriations Committee on Health and Human Services

Summary: The Appropriations Committee on Health and Human Services heard and advanced a series of health, child welfare, aging, disability, and public records bills. CS/SB 1002, on child welfare and parental substance abuse, was described as clarifying that acute or chronic parental drug abuse can constitute harm or neglect when it creates an ongoing risk to a child; it passed after limited questions and supportive testimony from Florida Smart Justice Alliance. CS/SB 1630, a broad aging and long-term care modernization bill, would streamline eligibility screenings, allow temporary DOEA services during emergencies or lead agency failures, tighten oversight of area agencies on aging, permanently establish the Florida Alzheimer’s Care Center of Excellence, and expand guardianship training and enforcement tools; it drew support from AARP, area agencies, and the Alzheimer’s Association and was reported favorably. The committee also approved SB 1022 to add Bay County and Pompano to the Florida Children’s Initiatives, and CS/SB 1030, via strike-all amendment, to streamline regulation of substance abuse and behavioral health providers and clarify background screening and privacy rules. Several bills focused on health care practice and patient access. CS/SB 36, with an amendment, allows nurses with doctoral degrees to use appropriate titles while requiring clear identification as nurses and making misuse grounds for discipline; nursing organizations supported it and it passed. CS/SB 844 requires physicians and nurses to complete a one-time, board-approved continuing education course on sickle cell disease care management, with multiple patients and advocates testifying about delayed care, bias, and the need for better provider education; the bill was reported favorably after an amendment aligning it with the House version. CS/SB 560 streamlines procedures for psychotropic medication for children in DCF custody by reducing duplicative reports, clarifying evaluator qualifications, limiting repeated background checks, and simplifying consent documentation; an amendment removed postsecondary education language, and the bill passed. The committee also approved a public records exemption bill for a uterine fibroids research database (CS/SB 864). The committee also advanced measures affecting disability services and forensic care. SB 6, a claims bill, would pay $3.8 million to a trust for a child who suffered severe abuse-related injuries after DCF involvement; it passed without opposition. SB 778 updates the definition of forensic clients so certain individuals with intellectual disabilities or autism found incompetent to proceed can be housed in the same secure forensic setting, reducing duplicative staffing and space needs; it was reported favorably. CS/SB 1016 codifies the Working People with Disabilities Program, allowing eligible developmentally disabled adults to work while retaining Medicaid waiver benefits and requiring notice to enrollees; advocates described the bill as essential to employment and independence, and it passed. Throughout the meeting, most bills received supportive public testimony, few questions, and unanimous or near-unanimous favorable votes.

Transcript Highlights:

• I need to set eyes on this patient.
• because they're able to suss out which patients they can treat via telemedicine and which patients they
• I need to set eyes on this patient.
• But there are a lot of cases where you don't need to set eyes on the patient, and where that patient
• Patients' choices are important.

Bills: SB1021 , SB1144 , SB1164 , SB1178 , SB1181 , SB1241 , SB1247 , SB1286 , SB1415 , SCR1011

Committee: Senate Regulatory Affairs and Government Efficiency

Keywords: health profession, regulatory boards, criminal activity, notification, auditor general, investigations, veterinary technicians, certification, education alternative, Arizona Revised Statutes, veterinary education, ALTCS, providers, ownership change, healthcare, Arizona Long Term Care System, naturopathic physician, naturopathic medicine, naturopathic doctor, naturopathic physicians medical board

Transcript Highlights:

• So, I mean, one is the patient. Yes.
• So, again, For some of these patients. So that's built into the care plan.
• I always checked with the nurse before I went in to see a patient, just to check patient status at that
• And that patient had injured a pregnant colleague of mine the day before.
• And that patient had injured a pregnant colleague of mine the day before.

Committee: House Health and Mental Health

Summary: The committee first met in executive session and adopted a substitute for House Bill 1962, then voted House Committee Substitute for HB 1962 do pass by 16-0. The substitute was described as making changes related to an epinephrine-related database and pricing. The committee then adopted a substitute for House Bill 2371 and voted House Committee Substitute for HB 2371 do pass by 16-0; the sponsor said the bill would codify existing Medicaid/state-plan coverage for a blood pressure-related issue and make the private insurance language consistent. House Concurrent Resolution 28 was also voted do pass by 16-0. The committee then heard House Bill 3457, “Maddie’s Law,” which would create an electronic medical-record alert for medically complex children so hospitals can quickly access individualized emergency care plans. Representative Burns presented the bill as a response to the death of a child named Maddie, and multiple family members and advocates testified in support, describing repeated emergency-room delays, the burden of carrying binders of records, and the need for one-click access to care plans. Questions focused on how the alert would work with existing systems, whether QR codes or bracelets might help, whether the bill should also apply to adults, and how the voluntary language fits with the goal of ensuring the information is available. An SSM Health lobbyist testified for information purposes, explaining that the STARS program is a voluntary EMS care-plan system started in 2014 and now includes about 1,800 children in Missouri and Illinois; he said the sponsor was willing to work on the language. Finally, the committee heard House Bill 3401, which would require hospitals to develop workplace violence prevention plans, multidisciplinary committees, risk assessments, training, reporting, and incident review processes, while keeping the bill flexible for different facilities. The sponsor and several health care groups cited high rates of threats and assaults against emergency and hospital staff and argued that violence is a preventable workplace risk that contributes to burnout and staffing shortages. Witnesses from emergency physicians, nurses, the Missouri Hospital Association, and other medical groups supported the bill, with some suggesting the signage language be broadened or simplified. No votes were taken on HB 3457 or HB 3401 before the committee adjourned.

Transcript Highlights:

• When harmed patients pursue litigation, they're looking.
• or reproductive health care, we need to move to safeguard patients.
• Or with the consent of the patient, which is critical.
• are, about the racial demographics of abortion patients.
• The racial demographics of abortion patients.

Bills: HB195 , HB279 , SB30 , HB234 , HB292 , SB100 , SB23 , SB221 , SB261 , SB264

Committee: House House Judiciary

Transcript Highlights:

• I want to thank you for your leadership in this area and... ...our patients.
• Let me tell you about a patient I'll never forget.
• AB 260 protects patients, providers, and facilities while expanding access through telehealth.
• Its safety is supported by over 100 peer-reviewed publications, including 100,000 patients and by 25
• Patients report high levels of satisfaction with telehealth.

Summary: The Assembly Health Committee met on April 8 and heard a long series of bills, beginning with AB 54 on medication abortion access. The author and supporters, including the Attorney General’s office and reproductive justice advocates, said the bill would protect California’s medication abortion supply chain and shield providers and manufacturers from civil, criminal, and professional liability. Opponents from the California Family Council argued the bill removes safeguards and increases risks. The bill was moved forward on a committee motion. The committee then heard several reproductive and public health measures, including AB 551 to create a pilot program supporting emergency departments in providing reproductive health services, AB 260 to protect medication abortion access and telehealth, AB 309 to remove sunset dates on laws allowing pharmacy syringe sales and lawful possession of sterile syringes, AB 536 to preserve colorectal cancer screening coverage if federal guidelines are challenged, AB 804 to make housing support services a Medi-Cal benefit, AB 594 to address student health insurance billing and transparency, AB 836 to study and expand the midwifery workforce, AB 1418 to collect data on health coverage for eligible employees, and AB 1500 to maintain and expand the abortion.ca.gov information site. Supporters emphasized access, preventive care, workforce shortages, and public health benefits, while opponents raised concerns about abortion, syringe distribution, and the focus of state resources. Most measures were advanced by committee vote, with roll calls showing broad support and a few no votes from members on some bills. The final bill discussed in the transcript was AB 1037, which would update substance use disorder laws to reflect evidence-based, harm-reduction approaches and remove barriers to treatment. The author and supporters described it as a compassionate response to overdose and treatment access problems, while law enforcement opposition argued it would encourage drug use and endanger communities. The transcript cuts off during testimony on AB 1037, so no final committee action on that bill is shown in the provided text.

Transcript Highlights:

• They already care for the patients.
• adult patients vary from hospital or state.
• We’re not required to have them for adult patients.
• Senate Bill 320 includes strong patient safety guardrails.
• Many of our patients and residents have multiple treatment episodes.

Bills: SB274 , SB301 , SB249

Committee: House Health & Human Development

Summary: The committee heard and advanced several measures related to health care, public health, and patient protections. House Concurrent Resolution 148, urging a statewide educational strategy on menopause, was presented as a workplace awareness measure and received supportive comments from members before being released. Senate Bill 274, updating Delaware’s MOST program to POLST and clarifying capacity determinations and documentation for end-of-life orders, also drew supportive testimony from medical and nursing groups and was released. House Bill 458, limiting local backflow preventer requirements for certain low-hazard buildings, was presented as a cost-relief measure for homeowners and small businesses; DHSS expressed concerns but said it was willing to work on amendments and a sunset provision, and the bill was released. Senate Joint Resolution 18, designating August 31, 2026 as International Overdose Awareness Day and ordering flags at half-staff, was released after brief supportive remarks. The committee then considered Senate Bill 339, a technical correction to the advance health care directive form clarifying that an agent’s authority for voluntary mental health admission cannot exceed 72 hours, consistent with existing law. Members asked detailed questions about how the 72-hour limit works and whether it applies to voluntary directives; the sponsor and a Disability Rights Delaware witness explained that the bill only aligns the form with current statute and does not expand authority. The bill was released. House Bill 301, requiring hospitals to create discharge plans for pregnant patients discharged while showing signs of labor, prompted extensive discussion. The sponsor and supporters said it would improve safety, transportation planning, and aftercare, while some members noted Delaware hospitals already do much of this work and questioned whether codifying it was necessary; supporters emphasized maternal mortality disparities and the need for guardrails. The bill was released. Senate Bill 196, creating ownership disclosure requirements for long-term care facilities and resident notice rules after ownership transfers, was presented as a transparency measure for seniors and families and was released after supportive testimony from the Delaware Nurses Association and elder-care advocates. Senate Bill 320, expanding pharmacists’ independent prescriptive authority for certain non-controlled medications and allowing opioid use disorder medications under standing order, with added malpractice reporting requirements in Senate Amendment 2, was supported by pharmacists and nurse practitioners as an access-to-care measure and was released. Senate Substitute 1 for Senate Bill 161, establishing a unified licensing and oversight framework for adult behavioral health providers under DSAM, was presented as a patient-protection measure; providers supported the goal but cautioned that regulations must be workable, and the substitute was released. Senate Joint Resolution 19, directing DHSS to study strategies to reduce health care costs, was released with a note reflecting concerns about broadening the analysis to include additional cost drivers and alternatives. Finally, Senate Bill 249 with Senate Amendment 2, modernizing harm-reduction programs and paraphernalia laws, generated the most extended debate: supporters framed it as life-saving public health policy, while opponents raised concerns about needle litter, community impacts, and whether the approach facilitates addiction. Despite the objections, the bill was released.

Transcript Highlights:

• </c> patients with acute pain. patients with acute pain.
• </c> their patients. their patients.
• </c> expense for this patient. expense for this patient.
• ,</c> patient, stabilization of the patient, patient, stabilization of the patient, resuscitation<01:
• Been<01:43:13.360><c> patiently</c><01:43:13.920><c> waiting</c> Been patiently waiting Been patiently

Summary: The committee opened its sixth and final interim meeting with roll call, quorum confirmation, approval of the prior minutes, and a brief change in agenda order to preserve quorum and accommodate presenters’ schedules. Members then moved through several proposed health-related items with limited discussion, and the chair noted the committee would reconvene in January for further conversation. The first substantive item was a proposal relating to utilization controls for non-opioid analgesics in Medicaid. Senator Gerald Neal and Tara Hyde of People Advocating Recovery argued that pain parity is needed so patients can access non-opioid options without prior authorization or step therapy barriers, especially in acute pain situations and for people in recovery. Senator Berg supported the concept and suggested expanding the approach to other prescriptions by allowing physicians to explain why step therapy is inappropriate at the time of prescribing; another member cautioned against unintended cost increases if non-opioid drugs are used as add-ons to opioids. The committee then heard a proposal on physician assistants from Senator Scott and Andrew Rutherford of the Kentucky Academy of Physician Assistants. They described a shift from a supervisory to a collaborative practice model, with practice scope set at the practice level, limited Schedule II prescribing authority under guardrails, and permission for PAs to perform driver’s license vision testing. Supporters said the changes would improve rural access, reduce administrative burden, and align Kentucky with neighboring states; a question from Representative Bratcher focused on experience requirements and how the proposal compares with nurse practitioner rules. No vote was taken. Finally, Representative Nancy Tate, Adia Wuchner, and Representative Jason Nemes introduced a 2026 proposal aimed at “protecting vulnerable people.” They described a broad package focused on abortion pill trafficking, marketing to minors, commercial surrogacy, assisted suicide, and organ procurement safeguards, arguing that current law leaves gaps and that additional criminal and civil penalties are needed. The presentation was informational only, with no action taken before the meeting ended.

Transcript Highlights:

• So that patient, that that person.
• </c> patient account at a nursing facility. patient account at a nursing facility.
• </c><00:42:29.040><c> or</c> has to be at the at the patients or has to be at the at the patients or
• Yes, that person's a patient.
• Yes, that that person's a patient.

Summary: The committee heard testimony on Senate Bill 118, as amended, which contains several unrelated provisions with a modest fiscal note. Nathan White of the Department of Health and Human Services explained that section 1 would change the personal needs allowance for Medicaid-eligible residents of private and county nursing homes from an adjustment every five years to an annual adjustment, increasing the state cost by about $50,000 per year. He also described section 2, a one-time appropriation of about $160,000 to make certain Hampstead employees whole for missed bonuses and lost leave during the state’s transition of the facility to Dartmouth management. White then outlined sections 3 through 5, which would create a dedicated fund for Hampstead lease revenue to cover the state’s contractual obligation to match Dartmouth capital improvements dollar-for-dollar up to $3 million. He said the state receives about $1.141 million in lease revenue in the first year, with a 3% annual escalator, and that the fund would hold lease revenue until needed for reimbursement. Members questioned how the matching arrangement would work, what happens if Dartmouth spends before the fund has enough money, and whether the state could refuse to match certain improvements. White said Dartmouth has final determination under the agreement if disputes arise, and that if the bill does not pass the state could face difficulty meeting the obligation without cutting services or finding other general funds. Several members also raised policy concerns about the personal needs allowance becoming an automatic cost driver. Brian Clark, attorney for the Bureau of Adult and Aging Services, clarified that current law requires the allowance to be updated at least every five years, but the legislature could change it in an off year if it chose. He also explained that the allowance is money residents retain from their own income, such as Social Security, as part of Medicaid cost-of-care calculations, and that the department does not regulate how residents keep those funds. No vote was taken during the discussion, and the committee paused to correct the bill copy before continuing testimony.

Transcript Highlights:

• </c> and Patient Safety Commission. and Patient Safety Commission.
• </c> patients in New Hampshire. patients in New Hampshire.
• You should be reporting a normalized number of events per 100 patients or 1,000 patients or whatever.
• or</c> patients or thousand patients or patients or thousand patients or whatever<01:21:20.159><c> you
• </c> week for established patients. week for established patients.

Summary: The committee first approved the draft minutes of its May 16, 2025 meeting, with one correction removing Representative Dry from the attendance list because she was present as a guest rather than an appointed member. The committee then received a Department of Health and Human Services update from Commissioner Lori Weaver, who focused on the rural health transformation grant process. She said the department has been gathering stakeholder input since July, issued a request for information on September 22, and is working toward an end-of-October draft and a November 3 deadline, with a grant writer request expected to go before Governor and Council at no cost to the state. The bulk of the meeting centered on federal changes affecting SNAP and Medicaid. Karen Heert explained that the federal law changes commonly referred to as the “Big Beautiful Bill” or HR1 will affect SNAP eligibility and state costs, including a shift in administrative cost sharing from 50/50 to 75/25 beginning in October 2026 and a possible state share of benefits if New Hampshire’s error rate is too high. She said the program affects about 43,000 households, that New Hampshire’s federal fiscal year 2024 error rate was 7.57% versus a national rate of 10.93%, and that the state must get below 6% to avoid liability. She also said DHS is preparing remediation steps, auditing cases, and seeking technology and staffing support, including a grant for automation and training. Henry Litman then described Medicaid changes under HB2 and the new federal law. He said New Hampshire returned to pre-pandemic eligibility verification rules on July 1, including a 10% income compatibility standard and reduced ex parte renewals, which has increased manual work and contributed to a drop in enrollment from about 185,000 in late June to about 178,000 in early September. He also reviewed new child premiums, pharmacy copays, Granite Advantage premiums, and possible Medicaid work requirements, noting that DHS is working with CMS on implementation details and may use a state plan option rather than an 1115 waiver because it would be less expensive and faster. Members asked several questions about the SNAP error-rate rules, the distinction between administrative and client errors, the effect of unpaid copays, and the timing and legal risk of the Medicaid work requirement; no votes were taken on those policy issues.

Transcript Highlights:

• Set the both patients and providers.
• </c> patient, they have to have two. Correct. patient, they have to have two. Correct.
• Okay, these are basic patient rights that are included in the existing patient bill of rights.
• Thank you. not include the right of a patient, not include the right of a patient, which<01:59:42.400
• > which explicitly states, "No patient which explicitly states, "No patient shall<01:59:44.239><c> be

Committee: Senate Health and Human Services