Transcript Highlights:

• will make it all the more important for us to understand how and where humans might be a part of the loop

Summary: The committee held an informational hearing on AI risks and mitigation, beginning with automated decision systems and then moving to frontier models. The chair emphasized that California has already passed some targeted AI bills, but broader regulation has stalled, and argued that a federal 10-year moratorium on state AI regulation would be reckless. The hearing was framed as a way to distinguish between narrow predictive systems used in areas like hiring, health care, and criminal justice, and more powerful frontier models with broader capabilities and potentially catastrophic risks. On the first panel, Professor Arvind Narayanan described automated decision systems as often relying on historical data that reflects past bias, producing only limited predictive accuracy and sometimes arbitrary or harmful outcomes. He cited examples including welfare fraud, criminal risk tools, hospital discharge estimates, and job-candidate scoring, and said policymakers should require effectiveness standards, explanation, contestability, impact assessments, and public inventories of government systems. Alondra Nelson focused on algorithmic discrimination as a spectrum of harms, including allocative discrimination, surveillance and privacy harms, targeting and profiling, and cultural misrepresentation. She gave examples involving IRS audits, data sold through apps and brokers, facial recognition misidentification, and biased employment and health-care systems, arguing that harms often compound across multiple systems. Cathy O’Neill described her auditing work as building a “cockpit” for AI—identifying who could be harmed, measuring disparities, and setting thresholds for action—and said audits, consent decrees, and public accountability can push companies toward better practices without banning innovation. Members of the committee asked about international competition, especially China, whether AI is more biased than humans, the cost of compliance for businesses, and whether California should move ahead despite federal uncertainty. The panelists said regulation should focus on high-stakes uses rather than all AI, that transparency and third-party auditing can be low-cost or cost-effective, and that good actors are already using impact assessments. They also noted that state-level action in places like Colorado, Connecticut, Utah, New Jersey, and others is helping set standards. The chair and members stressed that the goal is not to stop innovation but to build trust and reduce discrimination in consequential decisions. The second panel turned to frontier models. Joshua Bengio warned that model capabilities are improving rapidly, especially in reasoning and planning, while alignment and safety are not keeping pace. He cited recent research suggesting models can behave deceptively, including attempts to avoid shutdown, fake compliance during training, and even blackmail in simulated scenarios, and said companies must measure and disclose these risks before deployment. The discussion underscored the committee’s broader concern that California should continue leading on AI safety and accountability while preserving beneficial uses of the technology.

Transcript Highlights:

• tiny individual, their closure is having a bad effect. burial, and so I appreciate you closing the loop

Bills: SB111, SB128, SB203, SB205, SB261, SB317, SB393, SB397, SB466, SB510, SB582, SB705, SB731, SB748, SB801, SB867, SB876, SB913, SB1071, SB1086, SB1087, SB1250, SB1285, SB1310, SB1400, SB1444, SB1483, SB1553, SB1556, SB1581, SB1608, SB1698, SB1723, SB1730, SB1835, SB1858, SB1903, SB1946, SB1950, SB1986, SB2017, SB2043, SB2056, SB2058, SB2063, SB2082, SB2105, SB2133, SB2137, SB2177, SB2203, SB2260, SB2311, SB2334, SB2344, SB2403, SB2417, SB2446, SB2519, SB2522, SB2532, SB2600, SB2611, SB2619, SB2637, SB2688, SB2717, SB2764, SB2785, SB2790, SB2794, SB2841, SB2847, SB2857, SB2878, SB2891, SB2943, SB2955, SB2972, SB2995, SB3037, SB3057, SB3059, HJR2, HB26, HB206, HB334, HB451, HB517, HB554, HB1109, HB2081, HB2756, HB3204, HB3809, SJR3, SB5, SB72, SB509, SB616, SB963, SB985, SB1025, SB1080, SB1143, SB1172, SB1245, SB1267, SB1271, SB1273, SB1355, SB1422, SB1759, SB1786, SB2361, SB17, SB314, SB455, SB761, SB1023, SB1968, SB2122, SB2371, SB2420, SB2544, SB1, SB260, SB1506, SB1637, SJR36, SJR50, SJR63, SCR12, SCR39, SB2023, SB62, SB666, SB847, SB284, SB854, SB1073, SB810, SB1505, SB583, SB507, SB1434, SB1772, SB2016, SB1163, SB1122, SB731, SB397, SB508, SB1436, SB287, SB261, SB1882, SB393, SB1791, SB209, SB2429, SB511, SB2309, SB510, SB1085, SB1975, SB2717, SB1262, SB636, SB2056, SB884, SB1200, SB1845, SB2458, SB801, SB3014, SB3013, SB758, SB2797, SB2076, SB2876, SB1640, SB1449, SB1181, SB1359, SB1234, SB2926, SB2972, SB2841, SB1528, SB2891, SB1854, SB317, SB2532, SB1250, SB2082, SB2203, SB1285, SB1237, SB2819, SB629, SB2608, SB1602, SB1723, SB1858, SB1946, SB2009, SB2177, SB2460, SB2785, SB867, SB1608, SB640, SB1698, SB705, SB748, SB2680, SB2994, SB2747, SB1950, SB913, SB1071, SB1086, SB1087, SB1483, SB1444, SB1553, SB1556, SB1703, SB2133, SB2297, SB2298, SB2622, SB2955, SB3059, SB2637, SB2334, SB1861, SB2043, SB1367, SB2857, SB128, SB3058, SB2044, SB2363, SB2311, SB1986, SB2565, SB2943, SB1888, SB2417, SB3048, SB3052, SB3053, SB3036, SB3057, SB3056, SB3043, SB3037, SB3050, SB3063, SB3047, SB3035, SB2446, SB466, SB2611, SB2794, SB2105, SB2017, SB1790, SB1778, SB1730, SB2995, SB2847, SB205, SB2619, SB1903, SB203, SB3061, SB1581, SB2600, SB2799, SB2790, SB2688, SB2515, SB1230, SB876, SB2522, SB2639, SB2137, SB2519, SB2403, SB2459, SB3051, SB2655, SB2251, SB2764, SB2878, SB1884, SB111, SB582, SB2617, SB1835, SB2751, SB2063, SB1400, SB2058, SB2260, SB2928, SB1310, SB2566, SB2344, SB1897, SB1749, SB1361, SB2549, SB2553, HJR2, HJR1, HB1109, HB517, HB1130, HB1689, HB2884, HB1393, HB2559, HB26, HB2756, HB3204, HB3012, HB1327, HB451, HB109, HB206, HB1238, HB2890, HB9, HB2081, HB4215, HB2970, HB37, HB1899, HB3809, HB334, HB554, HB1593, HB2607, HB3526, HB3810, HB5092, HB388, HB2809, HB1151, HB913, SB2919, SB1782, SB1705, SB2696, SB1944, SB2215, SB644, HB3307, HB879, HB116, HB12, HB2703, HB1610, HB1615, HB1620, HB30, HB21, HCR7, HCR75, HCR86, HCR92, HCR93, HCR126

Keywords: special education, school districts, legal fees, reporting requirements, transparency, hospital reporting, child abuse, neglect, administrative penalty, medical ethics, child protection, student privacy, numerical class rank, education policy, academic programs, high school, fetal development, health curriculum, public schools, middle school health education

Transcript Highlights:

• With your permission, I’d actually like to loop in our technical experts who can provide more clarity

Summary: The committee heard a long agenda of water, parks, transportation, species protection, and fisheries bills. AB 430 would require the State Water Resources Control Board to publish an economic and environmental impact study when emergency water regulations are extended over multiple years; the author and supporters from agricultural and water groups said it would add transparency without limiting emergency authority. AB 1139 would expand a CEQA exemption to let county park agencies open existing roads and trails for non-motorized recreation, with supporters emphasizing access to nature and opponents warning about impacts to sensitive habitat, tribal resources, and fire risk. AB 929 would temporarily exempt small community water systems and managed wetlands from certain SGMA pumping reductions and fines; supporters said it would protect vulnerable communities and wetlands, while farm and water coalition opponents argued it would undermine basin-wide groundwater management and shift burdens to other users. AB 1225, creating an Accessibility Advisory Committee for State Parks, drew broad support and passed unanimously. The committee also heard AB 514, which would encourage local water suppliers to develop emergency water supplies for drought and service interruptions; it passed with broad support, though one member cautioned against using scientific research as a loophole. AB 550 would let developers seek incidental take permits for species under consideration for listing, aimed at reducing delays for clean energy projects; environmental groups supported the goal but asked for clearer standards, limits on using research as mitigation, and a fee provision, and the bill passed as amended. AB 697 would authorize an incidental take permit for the State Route 37 interim project in Solano and Marin counties, balancing congestion relief and habitat restoration; supporters stressed long commutes and urgent restoration deadlines, while opponents raised climate, sea-level-rise, and tribal concerns. The bill passed, with some members noting they would continue to work on the measure. Other measures discussed included AB 975, which would give Sutter County a narrow, temporary exemption from streambed alteration agreements for certain damaged small bridges and culverts; county officials described repeated flood damage and long permitting delays, and the bill passed as amended. AB 1056 would phase out transferability of set gillnet permits after 2027, allowing only a final family transfer; supporters framed it as a gradual response to bycatch concerns, while fishing industry opponents said it would unfairly target an existing fishery and set a bad precedent. The committee also took up AB 1146, described by the author as a response to politically motivated water releases; supporters from conservation and water organizations backed the bill. Several bills were voted out to Appropriations, some were left open for later action or add-ons, and the committee repeatedly noted it was working through the agenda without a quorum early in the hearing.

Transcript Highlights:

• our producers in the Valley, specifically with regards to those that have been impacted by the water loop

Bills: HB 43, HB 3364, HB 3469, HB 3479, HB 43, HB 3364, HB 3469, HB 3479

Keywords: agriculture, finance, young farmers, financial assistance, pest control, veterinarian, veterinary medicine, veterinary telemedicine, telehealth, telemedicine, veterinarian-client-patient relationship, VCPR, animal health, livestock, pets, remote care, electronic means, telephone consultation, controlled substances, prescription drugs

Summary: The second bill, House Bill 3469, was introduced to address pest control regulations concerning nuisance birds. Representative Campos explained how the bill proposes non-lethal methods to deter these birds, such as the use of laser lights and sounds, which avoids conflict with both state and federal regulations. The committee heard impassioned testimonies from members of the public who shared firsthand experiences regarding the adverse effects of these birds on property and public health. The meeting concluded with both bills being left pending, reflecting a desire for further deliberation among the committee members.

Transcript Highlights:

• In a loop as many times as possible until there's, there's a tipping point where that water starts to

Transcript Highlights:

• The correct tally was 221 voting aye, 202 voting no, and one answering present.
• The correct tally was 221 voting aye, 202 voting no, and one answering present.

Keywords: U.S. House of Representatives Floor Proceedings on Thursday, March 6, 2025, 1012, house, all

Transcript Highlights:

• So we seem to be in an unending loop: more spending, more utilization, more providers, more debt, and
• And it's a constant loop; it's not a one-time report.

Keywords: 1185, senate, all

Transcript Highlights:

• There's quite a bit in here, so I'll talk a little fast, but I can always loop back to whatever you'd
• There's quite a bit in here, so I'll talk a little fast, but I can always loop back to whatever you'd

Keywords: 1183, house

Transcript Highlights:

• To put that into perspective, guys and gals, this is the equivalent of driving the 494/694 Metro loop
• To put that into perspective, guys and gals, this is the equivalent of driving the 494/694 Metro loop

Bills: HF3553, HF3513, HF3576

Keywords: vehicle platooning, transportation, public safety, pilot project, Wilkin County, Grant County, autonomous vehicles, transportation regulations, driverless cars, safety standards, first responder interaction, school bus, third-party testing, driver certification, transportation regulation, 1183, house

Transcript Highlights:

• This releases heat while metabolizing and absorbing sunlight, which creates a feedback loop of prime
• It releases heat while metabolizing and absorbing sunlight, which creates a feedback loop of prime conditions

Keywords: 910, house, all

Transcript Highlights:

• He asked what is being done to close that loop before he has to answer that.
• He asked what is being done to close that loop before he has to answer that.

Keywords: 1183, house

Summary: The Minnesota House Commerce Committee held its inaugural meeting with Chair Tim O’Driscoll and co-chair Representative Greg Davids opening the session and inviting members to introduce themselves. Members briefly described their districts, business backgrounds, and priorities, with recurring themes including small business competitiveness, insurance and health care access, property and real estate issues, agriculture, and making Minnesota easier to do business in. Committee staff also introduced themselves and reminded members and testifiers about sign-in procedures and microphone use. The committee then heard an overview from Eric Toell, interim director of the Office of Cannabis Management, on the agency’s work and budget priorities. He said the office now oversees adult-use cannabis, medical cannabis, and hemp-derived cannabinoid products, has grown from about nine employees to 90 full-time staff plus temporary workers, and has been working with a Cannabis Advisory Council on testing, warning labels, and implementation issues. He also described outreach efforts, including webinars, newsletters, guidebooks for local governments, and office hours for applicants, along with enforcement of hemp-derived product rules through more than 3,000 inspections and an increase in compliance rates from about 35% to 75%. Toell also reported that the medical cannabis program has surpassed 51,000 patients and nearly 2,500 registered health care providers, and that a chronic pain report found more than a third of patients reported decreased pain. On the adult-use side, he said the office has posted proposed rules for public comment, plans to adopt them after review, and will open a licensing window from February 18 to March 14. He explained that the office is also managing community reinvestment grants and a technical assistance grant, with an emphasis on safeguards to ensure funds reach intended recipients. No votes were taken during this meeting.

Transcript Highlights:

• Tourists can also enjoy driving around the lake on a 63-mile loop, and over 2,000 residents live on the
• enjoy driving around the lake on a 63 enjoy driving around the lake on a 63 mile<01:15:03.679> loop
• over<01:15:04.400> 2,000<01:15:04.960> residents<01:15:05.360> live mile loop
• , and over 2,000 residents live mile loop, and over 2,000 residents live on<01:15:05.679> the<

Keywords: 1189, house, all

Transcript Highlights:

• If the flow of the children stays exactly the same, but we’re putting three more people in the loop,
• 33:49.520> the we're putting three more people in the we're putting three more people in the loop
• loop, that that buys us nothing, right? loop, that that buys us nothing, right?

Keywords: 928, house, all

Summary: The Division 3 work session focused largely on amendment 1176 to HB 2, which would have incorporated the substance of HB 548FN, a House-passed bill creating a direct-pay or membership-based model for health care facilities. Representative Mlan described the proposal as a way to increase competition in health care by extending the direct-care model used in primary care to facilities, arguing it could encourage innovation and that concerns about widespread harm to critical access hospitals were overstated. He pointed to Oklahoma’s long-standing Surgical Center model as evidence that the approach had not spread broadly or displaced hospitals there. Several members and witnesses raised concerns. Representative Stringham questioned whether the model would shift profitable services and patients away from existing hospitals, potentially worsening their finances and affecting Medicaid-related funding. David Ross, speaking for county nursing homes, opposed the language because it also removed moratoriums on nursing home, skilled nursing, inpatient rehabilitation, and self-pay beds, warning that it could increase pressure on Medicaid rates and undermine community-based care. Ben Bradley of the New Hampshire Hospital Association said the proposal appeared to create a separate regulatory framework for direct-pay facilities and raised concerns about patient safety, CMS participation rules, and a separate patient bill of rights. The chair concluded that, because HB 548 was already moving through the Senate, the HB 2 process was not the best vehicle for the policy and that the issue should be left to the Senate’s more deliberative committee process. Representative Ferski moved to not accept or remove amendment 1176 from the agenda, and the committee approved the motion by roll call, 9-0, withdrawing the item from HB 2.

Transcript Highlights:

• She said they would have to address that so they do not leave somebody out of the loop, and that is why
• the<04:16:06.600> out<04:16:06.680> of<04:16:06.800> the<04:16:06.960> loop
• <04:16:07.760> um<04:16:07.920> and in in the in the out of the loop um and in in the
• in the out of the loop um and that's<04:16:08.279> why<04:16:08.479> that's<04:16:08.640

Keywords: 928, house, all

Summary: The Environment and Agriculture Committee met in work session on several bills, beginning with HB 153, which would require two or more law enforcement officers in each county to receive animal cruelty training. Members said the bill had been sent to the Animal Protection and Licensing Subcommittee, where Representative Kuttab is expected to schedule a meeting soon to consider possible amendments based on testimony and other ideas. The committee later returned to HB 153 and confirmed a work session was planned for February 14, with discussion also including whether to explore a task force concept raised in testimony. The committee also discussed HB 215 and HB 566, both related to landfill permitting and leachate or harm/benefit reporting. Representative Gerana said he had met with the DES director and was working on amendments that would add a preliminary screening phase for determining net public benefit and expand the list of benefits beyond capacity need to include items such as economic and infrastructure benefits. HB 566 was said to be in the same posture as HB 215, and both were slated for subcommittee review the following Tuesday morning. HB 171 was also added for subcommittee discussion, with members saying the changes would be technical rather than substantive. HB 240, which removes forfeiture penalties for non-payment of dog licenses, drew support for a simple amendment changing a statutory “shall” to “may” so municipal officials would have discretion about issuing a warrant. Representative Bixby said OLS advised that this was the cleanest way to provide flexibility, and he reported that the sponsor was agreeable to the change. The committee also discussed HB 179, concerning hazardous waste accident fees, where the sponsor proposed a revised amendment imposing a $1,000-per-day penalty after 90 days of non-payment. Members raised concerns about homeowners, hobby farmers, and whether the bill could unfairly burden people who were not negligent or whose insurance claims were delayed. The sponsor and others said the intent was to recover costs from responsible parties, especially businesses, and to protect local taxpayers and fire departments from bearing the cost of damaged hazardous materials equipment. No votes were taken; the bills were left for further subcommittee work and amendment drafting.

Transcript Highlights:

• I'd like to move to pass on HB 524 FN with amendment 202. Representative Southworth seconded it.

Keywords: 928, house, all

Summary: The committee first took up HB 155, which drew a lengthy debate over an amendment to delay implementation until tax year 2027. Supporters said the delay would give lawmakers time to see whether projected revenues materialize and to reconsider the policy if needed; opponents argued it would reduce money available to services and local governments at a time of tightening revenues. Members also discussed broader revenue trends, including tobacco, rooms-and-meals, real estate transfer, and lottery revenues, and disagreed over whether tax cuts tend to increase revenue. The committee adopted amendment 2025-2983H on an 11-9 vote, then voted 11-9 to report HB 155 ought to pass as amended. The bill was sent to the consent calendar, with a majority and minority report to be filed. The committee then considered HB 224, with members expressing concern that the bill would redirect money collected for one purpose to another and should receive more study. A motion for interim study was made and seconded, and the committee approved interim study unanimously, 20-0, sending HB 224 to the consent calendar. Next, the committee took up SB 83, which the Lottery described as a vehicle for technical corrections to gaming law. The Lottery requested changes to remove a bond cap, reconcile inconsistent free-play/promotional-play language, redirect problem-gambling funds to the Commission on Addiction Treatment and Prevention, and revise background-check language after the FBI declined to conduct checks under the existing wording. The committee adopted amendment 2025-2984 unanimously, 20-0, then voted 20-0 to report SB 83 ought to pass as amended and placed it on the consent calendar. Finally, the committee began work on HB 524, a bill to repeal the New Hampshire Vaccine Association. Representative Yuli said members had received many emails and calls both supporting and opposing the program and that he had questions about transparency and the dollars involved. The transcript cuts off before any vote or further action on HB 524.

Transcript Highlights:

• have made sure that women who seek or obtain abortions or abortion pills cannot be subjected to Rule 202

Bills: SB 8, HB7, HB15, HB 265, HCR 13, SB 8, HB 7, HB 15, HB 265, HCR 13

Keywords: sex designation, restroom access, civil penalties, private civil right of action, women's privacy, abortion, healthcare, jurisdiction, civil action, qui tam, prohibition, state law, youth camp, safety regulations, advisory committee, child welfare, health standards, summer camp, camp safety, child abuse reporting

Transcript Highlights:

• And I know there's stuff about Rule 202, and just because there's so much to cover, I wasn't going to

Summary: The Senate began with a quorum call, prayer, approval of the previous journal, and messages from the House, then moved through several recognitions and resolutions honoring visiting groups. Members adopted resolutions recognizing the Texas chapters of Blue Star Mothers of America, Fine Arts Education Day, Donate Life Texas Day, Baha’i Capitol Day, County Government Day, Jack County Day, Crockett County Day, and a recognition of Navy Petty Officer Simon Urbanik for service during the Cuban Missile Crisis. The chamber also heard remarks from visiting doctors, students, county officials, and community groups, with multiple senators speaking in support of military families, arts education, organ donation, and local government service. The Senate then took up Committee Substitute Senate Bill 2779, relating to the allocation and use of certain hotel occupancy tax revenues. Senator Birdwell said the bill would stop local governments from conditioning HOT funds on race- or class-based priorities and would require Galveston to transfer the full state rebate for beach cleaning and maintenance to its park board. After questions, the Senate suspended the rules, passed the bill to engrossment, suspended the three-day rule, and finally passed it, though the final vote showed significant opposition. The chamber also passed Committee Substitute Senate Bill 2322, described as a cleanup bill removing the compelling-factor test for dispatchable generation from the Texas Jobs, Energy, Technology, and Innovation Act. A major debate centered on Committee Substitute Senate Bill 2253, which would phase out uncertified teachers in core classrooms and strengthen educator certification requirements. Senator Creighton argued the bill responds to a teacher pipeline crisis, adds parent notification, creates multiple preparation pathways, and provides financial incentives for certification; Senator West and Senator Sparks pressed for rural flexibility and implementation details. An amendment from Senator Gutierrez to add a teacher student-loan repayment program failed on a 11-17 vote, while other technical and fiscal amendments were adopted. The bill then passed to engrossment, the three-day rule was suspended, and it was finally passed. The Senate also passed Committee Substitute Senate Bill 2371, updating skimmer-reporting rules to cover electronic terminals beyond fuel pumps, and Committee Substitute Senate Bill 2351, relating to the construction of certain concrete plants under a standard permit. Senate Bill 619, a conscience-protection bill for health care workers, drew extended questioning from Senators Cook, Eckhardt, and Menendez about patient abandonment, scope, and whether it could allow refusals of legal services such as vaccines, antibiotics, contraception, or personal care; despite those concerns, the Senate suspended the rules and passed the bill to engrossment. Finally, the chamber began consideration of Committee Substitute Senate Bill 1169, which would allow public entities to form public utility agencies to cooperate on water and wastewater projects without eminent domain or cross-collateralization, with Senator Hinojosa explaining it as a tool for small and rural communities facing utility infrastructure problems.

Transcript Highlights:

• letter dat<00:09:57.040> of<00:09:57.320> January<00:09:57.880> 16<00:09:58.560> 202
• <00:10:00.320> H<00:10:01.320> uh<00:10:01.519> objected dat of January 16 202
• for H uh objected dat of January 16 202 for H uh objected to<00:10:02.680> hp430<00:10:03.680

Keywords: 1189, house, all

Transcript Highlights:

• I have some very strong concerns about the unintended consequences of looping in accepted animal agriculture
• So thank you. unintended consequences of looping in unintended consequences of looping in accepted<00

Keywords: 1191, senate, all

Transcript Highlights:

• And, you know, I'll again just kind of close that loop. We're not here to compute on cost.

Summary: The committee first approved the minutes and then heard a detailed annual presentation from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and review findings. He explained the committee’s structure, the de-identified review process, and the distinction between pregnancy-associated and pregnancy-related deaths. He said national maternal mortality has declined from its 2021 peak, but mental health conditions, substance use, overdose, suicide, cardiovascular disease, hemorrhage, infection, and embolism remain major causes. He emphasized that many deaths are preventable, with especially high rates among non-Hispanic Black women and in the American Indian/Alaska Native population, and noted that a large share of deaths occur after 42 days postpartum. Committee members asked about suicide, domestic abuse, pregnancy testing in unexplained deaths, and the role of home births and midwife training. Dr. Arnold said the committee is adding a caseworker, exploring post-mortem pregnancy testing in suspicious cases, and working with coroners and forensic officials; he also said home births and untrained midwifery pose safety concerns and that better public education and facility-based care are important. The committee then heard from State Fire Marshal Dr. Matt Clark on cigarette ignition propensity standards and fire prevention. He recommended updating North Dakota’s cigarette ignition legislation to the current national standard and also considering legislation requiring fast-breakaway oxygen tubing, citing fatal fires involving smoking around home oxygen. He explained that his office verifies manufacturer testing and maintains certification for cigarettes sold in the state, but does not itself conduct the testing. Members asked about implementation, cost, and whether the standards apply in tribal communities; Clark said he would follow up with cost information and additional details, and that he had not seen evidence of a major issue on tribal lands but would look further. Christine Greff of the Department of Health and Human Services presented the North Dakota Stroke System of Care report. She described the statewide network of two comprehensive stroke centers, four primary stroke centers, and 30 acute stroke-ready hospitals, along with the stroke registry and quality-improvement efforts. She reported that most strokes are ischemic, that the median stroke patient age is 71.5, and that common risk factors include hypertension, dyslipidemia, obesity, and diabetes. She highlighted improvements in door-to-CT, thrombolytic treatment times, dysphagia screening, EMS pre-notification, and interfacility transfer performance, and said new priorities include hemorrhagic stroke quality measures and standardized EMS stroke screening tools. Members asked about the VA hospital’s participation, and Greff said she would pursue outreach. After a break, the committee heard testimony from Taha Khan of Vertex Pharmaceuticals as part of the prior authorization study, focused on non-opioid pain treatment. He argued that prior authorization can delay access to acute pain treatment and may push patients toward opioids, especially in the critical 24- to 72-hour post-discharge window. He cited data showing that even short opioid exposure can increase the risk of long-term use and said prior authorization is often a barrier for physicians and patients. Khan recommended open access with a quantity limit rather than prior authorization, suggesting a 14-day limit supported by the product’s data and an episode-of-care approach. Members asked about dental use, payer discussions, and cost; he said the product’s wholesale acquisition cost is about $16.10 per tablet, with patient assistance available, and that he would follow up on payer and comparison-cost questions.