Transcript Highlights:

• That is a program where if you have diabetes, this is a program that can help you make That is a program
• And if you comply with the requirements of the program, you can also have some of your co-payments reimbursed
• And if you comply with the requirements of the program, you can also have some of your co-payments reimbursed
• We also have a program that is designed for high-risk individuals, which is a prevention program. program
• On the right-hand side, I listed some of the arguments in support of a tuition reimbursement program.

Summary: The Employee Benefits Committee met to hear presentations on state employee health insurance, compensation, leave policies, labor market conditions, and prevailing wage issues, then later took up committee rules and bill-draft jurisdiction. PERS reviewed the history and structure of the state health plan, noting the state has paid the full family premium since 1979, described cost-control and benefit-enhancement changes over time, and explained current plan options, wellness incentives, employer wellness discounts, and the upcoming bid process for the 2027-29 contract. HRMS then presented compensation comparisons showing state classified pay generally trails private and regional markets, with larger gaps at higher-level jobs, and reviewed benefits and leave policies, including the new enhanced annual leave and new-hire leave, the state’s unpaid family leave structure, and varying tuition reimbursement practices. Job Service reported on labor force trends, low unemployment, high labor force participation, job openings, and wage growth, and OMB said there are no state prevailing-wage requirements beyond federal Davis-Bacon rules for federally funded projects. The committee then considered a proposed amendment to Joint Rule 211 to better align the health insurance mandate review process with recent statutory changes. Members discussed how the rule should reference both the committee’s required actuarial reports and the Legislative Council cost-benefit analysis, and the amendment was adopted on a roll call vote. The committee also discussed how its jurisdiction decisions affect whether a bill draft receives actuarial analysis, with staff explaining that a decision not to take jurisdiction means the bill is not treated as impacting the relevant retirement or health plans for purposes of that analysis. After that, the committee began reviewing bill drafts for jurisdiction. The first draft, bill draft 33, would automatically renew pre-tax elections for dental and vision coverage during open enrollment instead of requiring annual re-election. Members debated whether it had any actuarial impact, noting the state does not pay those premiums directly, and the discussion was still underway when the transcript ended.

Transcript Highlights:

• at a higher rate, when we reimburse at 100%, that's allowable.
• , what the Medicare program would have reimbursed for the same service. >> Co-Chairman Larson, it gets
• There are other factors that weigh into what we get reimbursed.
• program and our witchie program, and they're doing a great job.
• Montana, and Idaho's reinsurance program.

Keywords: 916, all

Transcript Highlights:

• HR 1257 by Martinez, Sam Houston State Internship Program.
• program evaluations, recommending changes to the programs where they're needed.
• an associated program list.
• Are you going to oversee this program? No, no, ma'am.
• I do not oversee the program. Are you for the program? I am for the program.

Bills: SB2405, SB2406, SB2407, SB6, SB7, SB36, SB38, SB815, SB1856, SB379, SB1171, SB1121, SB1061, SB1036, SB1019, SB890, SB11, SB868, SB1188, SB1120, SB1254, SB2778, SB2543, SB2443, SB1333, SB1259, SB1401, SB1404, SB2139, SB2165, SB2237, SB2268, SB1202, SB1198, SB1212, SB1451, SB1470, SB1498, SB965, SB1547, SB1667, SB1818, SB1902, SB2129, SB2078, SB2069, SB1737, SB1589, SB1318, SB387, SB1150, SB1574, SB2127, SB3034, SB860, SB1278, SB263, SB370, SB663, SB924, SB1939, SB1937, SB1598, SB2798, SB2801, SB2580, SB2569, SB2514, SB2064, SB1940, SB1621, SB2601, SB1379, SB1376, SB1372, SB1353, SB2216, SB552, SB2405, SB2406, SB2407, SB2166, SB2148, SB535, SB777, SB827, SB1141, SB1330, SB1352, SB1664, SB1612, SB1862, SB1936, SB1453, SB1448, SB1398, SB2137, SB2111, SB53, SB226, SB1677, SB1723, SB1839, SB6, SB7, SB36, SB38, SB815, SB1856, SCR5, SCR32, SCR8, HCR88, HCR91, HCR129, HCR130, HCR131, HCR133, HCR137, HCR138, HCR139, HCR140, HCR143, HCR145, HCR147, HCR150, HCR152, HR6, HR105, HR112, HR124, HR146, HR151, HR158, HR221, HR222, HR237, HR469, HR543, HR571, HR605, HR702, HR703, HR704, HR705, HR706, HR707, HR708, HR709, HR710, HR713, HR714, HR715, HR716, HR717, HR718, HR719, HR720, HR721, HR722, HR723, HR724, HR725, HR726, HR727, HR728, HR729, HR730, HR731, HR732, HR733, HR734, HR735, HR736, HR737, HR738, HR739, HR740, HR741, HR742, HR743, HR744, HR745, HR746, HR747, HR748, HR749, HR750, HR751, HR752, HR782, HR787, HR789, HR796, HR798, HR799, HR800, HR801, HR802, HR804, HR807, HR812, HR813, HR814, HR817, HR819, HR820, HR821, HR822, HR824, HR827, HR828, HR830, HR831, HR832, HR833, HR837, HR839, HR840, HR841, HR842, HR843, HR844, HR847, HR849, HR850, HR851, HR852, HR853, HR854, HR855, HR856, HR858, HR859, HR861, HR865, HR871, HR873, HR874, HR875, HR876, HR880, HR881, HR884, HR886, HR887, HR890, HR892, HR894, HR895, HR898, HR900, HR901, HR903, HR904, HR905, HR908, HR910, HR912, HR913, HR915, HR916, HR917, HR918, HR919, HR920, HR921, HR922, HR923, HR924, HR925, HR926, HR927, HR928, HR930, HR931, HR932, HR936, HR937, HR938, HR939, HR940, HR941, HR942, HR943, HR946, HR947, HR948, HR949, HR952, HR953, HR954, HR955, HR956, HR960, HR964, HR965, HR967, HR968, HR969, HR970, HR972, HR973, HR974, HR975, HR976, HR977, HR978, HR979, HR980, HR981, HR982, HR983, HR984, HR985, HR987, HR988, HR989, HR990, HR991, HR992, HR993, HR994, HR995, HR996, HR997, HR998, HR999, HR1000, HR1002, HR1003, HR1004, HR1005, HR1006, HR1007, HR1008, HR1009, HR1010, HR1011, HR1012, HR1013, HR1014, HR1015, HR1016, HR1017, HR1018, HR1019, HR1020, HR1024, HR1025, HR1026, HR1027, HR1028, HR1029, HR1030, HR1032, HR1034, HR1035, HR1036, HR1038, HR1040, HR1041, HR1042, HR1043, HR1044, HR1046, HR1047, HR1048, HR1049, HR1050, HR1051, HR1052, HR1053, HR1055, HR1056, HR1057, HR1059, HR1064, HR1067, HR1068, HR1069, HR1070, HR1071, HR1073, HR1074, HR1075, HR1077, HR1078, HR1079, HR1080, HR1081, HR1083, HR1086, HR1087, HR1088, HR1089, HR1090, HR1091, HR1092, HR1093, HR1094, HR1095, HR1096, HR1098, HR1099, HR1100, HR1101, HR1103, HR1104, HR1105, HR1106, HR1109, HR1111, HR1112, HR1115, HR1116, HR1117, HR1118, HR1119, HR1121, HR1123, HR1125, HR1128, HR1130, HR1131, HR1132, HR1139, HR1140, HR1143, HR1144, HR1146, HR1147, HR1148, HR1149, HR1151, HR1153, HR1154, HR1155, HR1156, HR1157, HR1158, HR1159, HR1160, HR1161, HR1162, HR1163, HR1164, HR1165, HR1166, HR1167, HR1168, HR1169, HR1170, HR1171, HR1172, HR1173, HR1174, HR1175, HR1176, HR1177, HR1178, HR1179, HR1180, HR1181, HR1182, HR1183, HR1184, HR1185, HR1186, HR1187, HR1188, HR1189, HR1190, HR1191, HR1192, HR1193, HR1194, HR1195, HR1196, HR1197, HR1198, HR1199, HR1200, HR1201, HR1202, HR1203, HR1204, HR1205, HR1206, HR1207, HR1208, HR1209, HR1210, HR1211, HR1212, HR1213, HR1214, HR1215, HR1216, HR1217, HR1218, HR1219, HR1220, HR1221, HR1222, HR1223, HR1224, HR1225, HR1226, HR1227, HR1228, HR1229, HR1230, HR1231, HR1232, HR1233, HR1234, HR1235, HR1236, HR1237, HR1238, HR1241, HR1243, HR1244, HR1245, HR1246, HR1247, HR1248, HR1249, HR1252, HR1253, HR1255, HR1256, HR1257, HR1260, HR1261, HR1262, HR1263, HR1264, HR1266, HR1267, HR1268, HR1269, HR1270, HR1271, HR1272, HR1273, HR1274, HR1275, HR1278, HR1280, HR1281, HR1282, HR1283, HR1284, HR1285, HR1286, HR1287, HR1288, HR1289, HR1290, HR1291, HR1293, HR1294, HR1295, HR1299, HR1300, HR1301, HR1302, SCR49, HCR134, HCR136, HR18, HR247, HR428, HR494, HR538, HR540, HR786, HR791, HR803, HR805, HR808, HR809, HR811, HR816, HR825, HR826, HR836, HR838, HR845, HR846, HR862, HR869, HR870, HR878, HR879, HR896, HR899, HR902, HR911, HR914, HR933, HR934, HR935, HR951, HR958, HR959, HR986, HR1021, HR1022, HR1039, HR1054, HR1058, HR1061, HR1062, HR1065, HR1072, HR1107, HR1108, HR1110, HR1114, HR1120, HR1122, HR1129, HR1142, HR1145, HR1239, HR1242, HR1250, HR1251, HR1254, HR1258, HR1259, SCR21, HB3228, HB2802, HB45, HB1318, HB5560, HB2894, HB4344, HB4238, HB 130, HB2775, HB34, HB33, HB 12, HB148, HB4273, HB4850, HB2733, HB4783, HB4187, HB39, SB2155

Keywords: criminal justice, parole, medical supervision, rehabilitation programs, Texas Board of Pardons and Paroles, Texas Department of Criminal Justice, offenders with medical impairments, Windham School District, Sabine River Authority, board of directors, term limits, removal grounds, government oversight, training requirements, Texas Sunset Advisory Commission, Lower Neches Valley Authority, Sunset Advisory Commission, public participation, complaints resolution, electric power

Transcript Highlights:

• > program<01:00:51.480> and<01:00:51.599> a consist of a reimbursement program and
• a consist of a reimbursement program and a grant<01:00:52.200> program<01:00:52.640> to
• be a neighbor island agriculture reimbursement or not reimbursement transportation grant program, and
• within the bill maybe the two programs within the bill maybe the reimbursement<01:07:54.279> program
• program could be for all reimbursement program could be for all producers<01:07:56.240> Statewide

Keywords: 910, house, all

Transcript Highlights:

• the state directed payment program is meeting the the quality metrics that the program is designed to
• Delta billion enrollment and Medicare Savings Program.
• existing programs with those funds.
• build upon those programs and also for for new initiatives, a new programs to really improve access with
• genome sequencing to be reimbursed outside of of the drg separate reimbursement for this.

Transcript Highlights:

• The name of this program specific to both Medicare and Medicaid is the balance program.
• There are two separate programs. I'll be focusing on the balance program.
• > separate<00:38:16.079> program generous program is a separate program generous program
• balance program.
• Uh the balance program balance program.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board met on February 23, 2026, approved the January 12 minutes, and then focused primarily on Kentucky Medicaid’s coverage and potential expansion of GLP-1 drugs, especially for weight loss. Department for Medicaid Services Commissioner Lisa Lee explained that Medicaid currently does not cover drugs for weight loss, anorexia, or weight gain, but the department had filed a regulation to remove that blanket exclusion so GLP-1s could be covered when used for an underlying health condition. She said the administrative regulation review subcommittee found the regulation deficient, and the co-chairs wanted the board to discuss the policy and financing implications before any change. DMS also said it would be open to adding caveats to ensure coverage would not extend to cosmetic weight loss alone. The department provided several data points on current utilization and spending. In 2025, Kentucky Medicaid paid for appetite-stimulating drugs such as Megestrol, Dronabinol, and Marinol, but did not pay for weight-loss drugs. For GLP-1s, DMS said coverage began in 2025 and is limited to FDA-approved medical conditions, with prior authorization requiring a type 2 diabetes diagnosis code and A1C documentation. DMS reported $234.6 million in GLP-1 spending in 2025 before rebates, about 240,931 prescriptions, and said GLP-1s accounted for 7.3% of pharmacy spend in 2024 and 8.3% in 2025. It also said there were 24,844 expansion members and 13,638 non-expansion members using GLP-1s, with spending of about $156 million and $78.5 million respectively, and that 10 pediatric weight-loss prescriptions were covered under EPSDT. The department said outcome analyses, including whether GLP-1 use reduces insulin or other diabetes treatment, are underway and should be completed in a couple of months. Members asked about cost, rebates, and whether the state should wait for more outcomes data before expanding coverage. DMS said average reimbursement to pharmacies was $975 per prescription and the average dispensing fee was $109; it also said 2025 rebate invoices totaled $90.8 million, with $7.6 million collected so far. Several members expressed concern about the high cost and the need to evaluate whether the drugs improve health outcomes before expanding access, while others noted the potential benefits for obesity and diabetes treatment. Some members also discussed whether GLP-1s are effectively being used for weight loss in diabetic patients and whether broader data collection should be used to assess long-term value. After the Medicaid discussion, Eli Lilly executive Tracy Sims presented on obesity as a chronic disease and the economic burden it creates in Kentucky. She said Kentucky’s adult obesity rate is a little over 37%, that obesity is linked to about 200 diseases, and that untreated obesity costs the state billions in GDP and hundreds of millions in state budget impact. She highlighted recent federal access programs for GLP-1s, including a Medicaid-related program that she said could lower the state share of a Zepbound prescription to about $71 per month after federal matching. No votes were taken on the GLP-1 policy question during the meeting, and the main action was the receipt of testimony and discussion of the department’s proposed regulatory change.

Transcript Highlights:

• Again, these are reimbursement grants.
• We have asked for reimbursement.
• asked for reimbursement.
• We have asked for reimbursement.
• Lucie County almost 10 years to get reimbursed back.

Summary: The committee took up four bills before moving to a broader discussion of the Emergency Preparedness and Response Trust Fund. SB 434, which would prohibit counties from increasing a home’s assessed value because the owner installed wind mitigation measures, was presented as a homeowner protection measure and reported favorably. CS/SB 110, clarifying that certain 98-year-or-longer residential leaseholders remain eligible for the homestead exemption even if the lease ends at death, was also reported favorably without opposition. SB 856, requiring online real estate listing platforms to display estimated ad valorem taxes using prescribed calculation methods and not the current owner’s tax bill, drew supportive testimony from property appraisers, Zillow, and local government groups; members emphasized transparency for buyers, especially first-time homebuyers, and the bill was reported favorably. The committee then spent most of the meeting on SPB 7040, which would recreate and extend the Emergency Preparedness and Response Fund through December 31, 2027. Supporters, including the Division of Emergency Management, argued the fund is needed for hurricanes, flooding, other disasters, and rapid response operations, and said the extension preserves legislative oversight that would otherwise lapse. Opponents from advocacy and policy groups argued the fund has been used too broadly, especially for immigration-related detention and enforcement activities, and criticized the lack of tighter guardrails and transparency. They cited deaths in detention facilities, the use of emergency dollars for non-disaster purposes, and concerns about political favoritism and public accountability. Director Kevin Guthrie testified at length in support of the extension, explaining that the fund is used for natural, man-made, and technological emergencies, that reimbursements from federal and other sources are returned to the fund, and that the state has used it for hurricanes, flooding, civil unrest, international evacuations, and immigration-related operations under Operation Vigilant Sentry. He said the division has sought federal reimbursement for some expenses and that the fund helps the state respond quickly when emergencies arise. Members questioned the size of the fund, the amount spent on immigration-related activities, the status of federal reimbursements, and whether lawmakers should have more oversight or unannounced access to detention facilities. The bill discussion remained ongoing in the portion provided, with no final vote on SPB 7040 shown in the transcript excerpt.

Transcript Highlights:

• Now that we have delays in the federal KWF program and reductions in other programs at the federal level
• Yes, so this program, given the immediacy of the needs, is designed as a grant program.
• As you noted, the Distressed Hospital Loan Program is a loan program.
• So that would be part of any grant program or any kind of program that we would want to put together
• The other one is the Medi-Cal reimbursements. They're reimbursed at 74%.

Keywords: 987, senate, all

Summary: The subcommittee heard Assembly Bill 108, a budget bill junior that would amend the 2025 Budget Act to provide a one-time $25 million General Fund grant program through HCAI for hospitals in immediate and significant financial distress. Finance explained that eligible hospitals would need to show less than 10 days cash on hand, best efforts to exhaust other financing, a payer mix of more than 50% government payers and uninsured patients, and nonprofit status. The bill also included a technical change related to property tax deferments for eligible low-income seniors, plus expedited contracting and rulemaking authority so HCAI could move funds quickly. Most of the discussion focused on whether the amount and eligibility standard were sufficient, how many hospitals might qualify, and whether the state was addressing the underlying causes of hospital distress. Members raised concerns about limited and lagging data, the 10-day threshold, fairness compared with the earlier Distressed Hospital Loan Program, and whether hospitals receiving grants should be required to maintain services. Several members cited broader pressures such as Medi-Cal reimbursement rates, seismic retrofit costs, federal policy changes, and the need for loan forgiveness or a more comprehensive hospital support plan in the next budget cycle. The LAO noted that the bill was intentionally narrow and short-term, while the administration said the grant was meant as a bridge until July 1 and that more extensive discussions would continue with the May Revision and the 2026 budget. Public commenters from the California Hospital Association, district hospital leaders, Children’s Hospital Los Angeles, and county representatives supported the measure and urged additional longer-term funding for distressed hospitals. After discussion, Senator Richardson moved the bill, the committee voted unanimously in favor, and AB 108 passed 18-0, with the roll held open briefly to secure remaining votes.

Transcript Highlights:

• program program for<00:10:00.160> law<00:10:00.360> enforcement<00:10:01.040> agencies
• Are those new programs, or have you more clearly defined those programs that existed before?
• <00:15:54.120> or Corrections are those new programs or Corrections are those new programs
• The free programs are available.
• The free programs are available.

Keywords: 928, house, all

Summary: The Finance Division 2 hearing took testimony from the director of New Hampshire Police Standards and Training on the agency’s budget request and operations. He described the agency’s role in setting hiring, education, certification, and discipline standards for police, corrections, probation and parole, and court security officers, and noted that the agency runs the full-time, part-time, corrections, and court security training programs. He also outlined the agency’s staffing, facility, and budget request for FY 2026-27, including a request to keep funding level with the governor’s recommendation while shifting funds to support an IT manager position by defunding a vacant administrative slot. The agency requested several statutory changes in Chapter 106, including clarifying the definition of police misconduct, allowing a temporary member on the Conduct Review Committee, clarifying reporting requirements for misconduct allegations, and codifying the Law Enforcement Accreditation Commission. The director also reviewed new responsibilities added in recent years, including crisis intervention training, statewide accreditation, the Conduct Review Committee, and increased annual in-service training requirements. He explained that crisis intervention funding is carried in a continuously appropriated, non-lapsing account and that some budget lines were reclassified, including software and janitorial services, to reflect actual spending needs. Members asked about national standards, the different academy tracks, crisis intervention funding, maintenance and contract changes, temporary positions, and the court security training program. The agency said it coordinates with national peers through IADLEST, that the part-time and corrections academies are longstanding programs, and that the new court security academy can be delivered either as a full academy or as in-service training depending on resources. The director also said the agency has been running extra full-time academies because of high vacancy rates, but expects to return to three full-time academies this year, with two corrections academies and one or possibly two part-time academies. He also explained the current approach to misconduct records and public disclosure, saying sustained findings under RSA 106-L are heard by the council and published, replacing the older, less standardized exculpatory list process.

Transcript Highlights:

• THAT HAVE BEEN REIMBURSED UNDER THAT PROGRAM.
• CATASTROPHIC REFUND PROGRAM.
• ALSO, THE LEGISLATURE APPROPRIATED 35 KNOW THE DOLLARS TO REIMBURSE LOCAL GOVERNMENTS.
• THE FOLLOWING TWO SLIDES ARE THE REFUND PROGRAM RESULTS FROM HURRICANE IAN AND NICOLE.
• THERE'S A PRETTY ACTIVE PROGRAM TO MAKE SURE PEOPLE TAKE ADVANTAGE OF THE PROGRAMS.

Keywords: 999, senate, all

Transcript Highlights:

• It is just related to the school lunch reimbursement program. "Yes, Representative Papic, Mr.
• "Moving on to page five, these are the reimbursement rates for the child and adult care food program.
• Um, as you know, the nutrition program is a program about reimbursing for meals and it's about the nutrition
• nutrition program is a program about nutrition program is a program about reimbursing<00:43:52.760
• program or plan education program program or plan program<00:54:04.160> program<00:54:04.839>

Keywords: 928, house, all

Summary: The Finance Committee Division II met with the New Hampshire Department of Education to review school nutrition programs and related funding. Department staff Melissa White and Kelly Rambo walked through a packet covering the National School Lunch Program, Fresh Fruit and Vegetable Program, Community Eligibility (CEP), After School Snack Program, Child and Adult Care Food Program, and Summer Food Service Program, explaining that these are federally funded USDA programs, with some state supplemental funding in certain areas. They also reviewed reimbursement rates for lunch, breakfast, child/adult care, and summer meals, noting that summer rates follow calendar-year timing while most others follow the state fiscal year. Members asked several questions about how the funding works, especially the difference between federal reimbursements and the state match. Staff explained that the state lunch line in the budget is a fixed match amount tied to federal participation, while breakfast funding is broken out by meal type and reimbursement category. They also discussed why FY 2022 federal spending was much higher during COVID, when USDA covered meals at the free rate for all students, and why FY 2023 and FY 2024 dropped as normal income-eligibility rules returned. A committee member also asked about the “severe need lunch” two-cent rate, and staff said they did not know USDA’s formula. A substantial portion of the meeting focused on summer meals and the distinction between the Summer Food Service Program and Summer EBT. Staff explained that SFSP provides meals at approved sites, which can be open or closed sites, while Summer EBT is a separate DHHS-operated benefit program that provides funds to families. They said some schools or sites may not qualify under USDA rules, but eligible children can often use another nearby open site, and the department posts an interactive map and phone line to help families find locations. The committee also discussed the Community Eligibility Provision. Staff said New Hampshire currently has three CEP schools, that the eligibility threshold had recently been lowered from 40% to 25% identified students, and that the program allows participating schools to offer free meals to all students while the local district covers the non-federal share. Members asked whether any districts in the 25% to 40% range had joined; staff said no. The department offered to provide the eligibility report in Excel and noted that the CEP intent is to reduce application burden, though the lower threshold can make the local cost share harder for some districts to absorb.

Transcript Highlights:

• Programming.
• Prior to the State's Universal School Meal Program in 2023, schools relied on a tiered federal reimbursement
• funding and program costs.
• Program. Um, Mr.
• Of the capital outlay program.

Transcript Highlights:

• And I can let the sponsor— but it's just moving the date back to allow for programming and this to be
• And I can let the sponsor— but it's just moving the date back to allow for programming and this to be
• <00:25:27.440> essentially<00:25:27.840> where just creates a program essentially where
• just creates a program essentially where if<00:25:29.919> I<00:25:30.240> am<00:25:30.640
• <00:38:56.560> Does reimbursement insurance policy. Does reimbursement insurance policy.

Bills: HB300, HB40, SB19, HB283, HB179, HB296, HB300, HB40, SB19, HB283, HB179, HB296

Keywords: HB300, Choctaw County, probate court, probate judge, recording fee, filing fee, deed tax, mortgage tax, deeds, mortgages, property records, recordation, county local act, local legislation, technology upgrades, digitalization of records, recordkeeping, county treasury, special fund, court administration

Transcript Highlights:

• This funding-neutral program would ensure hospitals are reimbursed closer to the actual cost of care
• This funding-neutral program would ensure hospitals are reimbursed closer to the actual cost of care
• This funding-neutral program would ensure hospitals are reimbursed closer to the actual cost of care
• This funding-neutral program would ensure hospitals are reimbursed closer to the actual cost of care
• This funding-neutral program would ensure hospitals are reimbursed closer to the actual cost of care

Keywords: 1183, house

Summary: The Health Finance and Policy Committee heard testimony from the Minnesota Hospital Association and several hospital leaders about the financial strain facing hospitals across Minnesota. The association’s CEO said hospitals are essential 24/7 safety-net providers, but rising labor, supply, technology, and drug costs are outpacing reimbursement from Medicaid, Medicare, and commercial payers. He warned that many not-for-profit hospitals are struggling, that workforce shortages remain significant, and that the committee should consider help on Medicaid rates, discharge/boarding problems, mental health services, workforce development, protecting the 340B drug discount program, and avoiding new mandates that add costs. Relle Schultz of Winona Health described a community hospital with a 49-bed facility and long-term care services that has faced years of losses, including a $17 million loss in 2023 and $12 million in losses the following year. She said government payers now make up about 65% of the hospital’s mix, and each 1% increase in that mix costs about $1 million. She highlighted the difficulty of sustaining services such as dialysis, which was nearly closed until a local donor provided $3 million to keep it open for three years, and she emphasized the importance of 340B savings and the need for higher Medicaid payments. Carrie Mulski of Riverview Health in Crookston said critical access hospitals are also under pressure despite their federal designation. She explained that federal support has eroded, that Medicaid and other public programs do not cover full costs, and that her hospital’s 340B savings help keep the doors open. She said Riverview opened a new hospital in 2020 but was hit by the pandemic and inflation, leading to annual losses of $5 million to $6 million and a negative operating margin of 9% to 10%. She also described bond covenant problems, low cash on hand, the prior closure of the nursing home, and the need for rapid state action to stabilize rural hospitals and preserve access to care.

Transcript Highlights:

• There is no reimbursement for any of these programs that we have instituted at AR.
• :24:10.240> these<00:24:10.559> programs reimbursement for any of these programs reimbursement
• programs.
• programs.
• Uh, part of what reimbursement programs.

Keywords: This meeting was pulled from back ups and uploaded in it's entirety due to technical issues., 958, all

Summary: The Make America Healthy Kentucky Task Force met with a quorum, approved the minutes, and then heard a presentation on the state’s “food is medicine” work from Kentucky Hospital Association and Kentucky Department of Agriculture leaders, including Jim Muser, Holly Harris, and Commissioner Jonathan Shell. The chair framed the discussion around personal wellness, injury prevention, and the broader goal of improving health through better sleep, nutrition, and activity, then asked the presenters to describe current initiatives and any policy changes needed. The witnesses described a partnership linking hospitals and Kentucky farmers to improve health outcomes while supporting rural agriculture. They said the effort has moved beyond the pilot stage and now includes more than 40 hospitals statewide, with programs such as healthier hospital cafeterias, grab-and-go options, farmers markets at hospital sites, subsidized CSA boxes for employees, and medically tailored meals or groceries for patients with chronic conditions. ARH was highlighted as a leading model, with local food procurement, employee wellness efforts, and measurable outcome pilots, including a Russell County Hospital project focused on diabetes, heart disease, and obesity. They also emphasized barriers to scaling the model, including fragmented short-term funding, lack of reimbursement for food-as-medicine programs, and burdensome procurement and testing requirements that can make it difficult for small farmers to participate. The presenters said hospitals are using their own funds or temporary grants to sustain programs and argued that policy changes are needed to simplify sourcing, expand reimbursement pathways, and support clinical measurement of outcomes. No votes or formal actions beyond approving the minutes were taken during the portion provided.

Transcript Highlights:

• The school breakfast program served 47 million meals, with almost $124 million reimbursed as Kentucky
• > the program, afterchool snack program, the program, afterchool snack program, the seamless<00
• ><00:20:24.320> funding<00:20:24.640> is The USDA child nutrition program funding is reimbursement
• The school breakfast program meal pattern is three items for a reimbursable meal.
• for program participation. 100% of those meals are reimbursed at the free rate.

Keywords: 958, all

Summary: The task force met with a quorum, approved the minutes from the August 20 meeting, and then heard testimony from Representative Steven Doan on House Bill 439, a school nutrition bill aimed at restricting certain ultra-processed foods in schools. Doan said the bill was inspired by his own health journey and his work in agriculture, and he described the measure as targeting specific chemical additives in foods served during the school day, not concession sales or after-hours activities. He said the bill would phase in later to give schools time to adjust and noted that the list of restricted additives was drawn from efforts in other states and advocacy groups. Members asked about the chemical abstract numbers, fiscal impact, summer meal programs, fundraisers, and whether the bill would affect parent-provided items; Doan said he had not done a fiscal note and explained that the bill was intended to apply only during instructional time on school property. Committee members generally reacted favorably, with some raising practical concerns about cost and implementation. One member asked about high fructose corn syrup, which Doan said was not included because it is too pervasive in the food system. Another member noted that schools already limit some homemade items and asked about the line between school-provided and parent-provided food. Doan also said the list was based in part on Turning Point USA materials and similar laws in other states, and he referenced federal efforts to define ultra-processed foods. The committee then heard from Kentucky Department of Education officials Matt Ross, Lauren Moore, and Katie Embry on school meals and nutrition programs. They outlined Kentucky’s school lunch, breakfast, summer meals, and other USDA child nutrition programs, including participation and reimbursement figures, and explained how community eligibility provision schools, meal patterns, offer-versus-serve, smart snacks, and local wellness policies work. They said USDA and FDA are currently seeking public input on a uniform definition of ultra-processed foods, that there are no current USDA requirements specifically on ultra-processed foods, and that schools already operate under federal and state rules governing competitive foods, including a state time restriction on smart snacks. They also discussed local purchasing, noting its benefits but also the procurement and staffing challenges schools face. No votes or final actions on the bill were taken in the portion provided.

Transcript Highlights:

• reimbursement models have Current reimbursement models have perverse<00:11:28.800> incentives.
• We help oversee a pilot program of reimbursing recovery housing services. Now, yeah.
• <00:35:35.520> for in the pilot is that we reimburse for in the pilot is that we reimburse
• <00:48:18.000> uh hopefully do this pilot program uh hopefully do this pilot program uh within
• <01:07:22.319> in that have been made to our program in that have been made to our program

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well. Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk. Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.

Transcript Highlights:

• visioning what a pilot program would be. visioning what a pilot program would be.
• <00:59:11.359> Yes, program. I highip that we call it. Yes, program.
• adequacy, and reimbursement. adequacy, and reimbursement.
• . reimbursement. reimbursement.
• reimbursed.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board reconvened and heard a presentation from the Attorney General’s Office Medicaid Fraud and Abuse Control unit. AG staff described the unit’s structure and work: it investigates and prosecutes Medicaid provider fraud, and also handles abuse, neglect, and exploitation cases involving vulnerable adults in facility settings when asked to assist. They said the office has prosecutors, detectives, auditors, and support staff, works with federal partners, Commonwealth’s attorneys, CHFS, DMS, OIG, and MCOs, and uses a hotline and referral line for complaints. They also explained the MCO referral process, including monthly meetings, stand-down lists, and review of referrals for a “credible allegation of fraud” before the AG office decides whether to open a criminal or civil investigation. The presentation focused heavily on current fraud trends. Staff said behavioral health is a major concern, along with participant-directed waiver services, medically assisted treatment, cash billing for services, controlled-substance billing, and vision and dental fraud. They gave examples such as duplicate time sheets for family caregivers, questionable Suboxone counseling and urine drug screening practices, and a prior optometry case involving false claims for children’s glasses. They also discussed CMS’s estimate that about 5% of Medicaid payments are improper, noted that most improper payments are at the fee-for-service level, and said there is no reliable overall fraud-rate estimate. They highlighted a sharp shift in behavioral health billing after the cabinet’s November 1, 2024 policy changes, saying individual psychotherapy spending dropped while group billing increased, suggesting providers may have moved billing to different codes. Members asked about the scale and timing of cases, how MCO referrals are screened, and whether the data reflected more people being served or just higher spending. The AG office said investigations can take years, with some federal cases still awaiting sentencing from 2018 and 2019 matters, and that they currently had nine individuals awaiting sentencing in federal court. They also reported 58 hotline reports during the referenced period, six cases opened from MCO referrals, and four additional MCO referrals not accepted for active cases. Several members raised concerns about home-based services and the risk of abuse or fraud when family members are reimbursed, and asked whether the process could be streamlined; the AG office said it had no immediate recommendations but would be willing to return with suggestions after further review.

Transcript Highlights:

• Each LEA will have individualized expenses based on their programs and needs, so reimbursement will also
• Each LEA will have individualized expenses based on their programs and needs, so reimbursement will also
• Each LEA will have individualized expenses based on their programs and needs, so reimbursement will also
• Each LEA will have individualized expenses based on their programs and needs, so reimbursement will also
• <01:09:51.640> will programs and needs so reimbursement will programs and needs so reimbursement

Keywords: 1187, senate, all

Summary: The Senate Education Finance Committee met on January 21 with a quorum present for the first meeting of the 2025 biennium. The co-chairs described the temporary power-sharing arrangement in the tied Senate, introduced committee staff and pages, and had members briefly introduce themselves and share what subject they would teach. After the introductions, the committee moved to a presentation from State Demographer Susan Brower. Brower reviewed Minnesota’s school-age population trends and projections, noting that the state had just under 1 million children ages 5 to 17 in 2023 and that, for the first time, the older adult population exceeded the school-age population. She said the school-age population is concentrated in the Twin Cities metro and other regional centers, and projected an overall decline of about 5% over the next 15 to 20 years, driven mainly by declining birth rates and long-running net outmigration of young adults. She also explained that growth is expected in some areas, especially along the I-94 corridor north of the metro, while northern regions are projected to see the largest declines. She clarified for members that her figures measure resident children, not school enrollment, and that boundary changes are not reflected in the district-level data. The presentation also covered demographic change among students. Brower said about 35% of Minnesota children ages 5 to 17 are children of color, with growing multiracial populations and increasing linguistic diversity. She reported that about 20% of school-age children have at least one foreign-born parent, and about 18% of enrolled students speak a language other than English at home, with Spanish, Somali, and Hmong the largest home languages. She also discussed child poverty, saying Minnesota’s rate is just under 10%, below the national rate of about 15%, and that poverty is concentrated in Minneapolis-St. Paul, some first-ring suburbs, and parts of northern Minnesota, including districts with larger Native populations. Members asked questions about whether the projections accounted for migration and whether open enrollment affected the figures; Brower said the data reflect where children live, not where they attend school, and that the projections are based on recent migration and birth patterns, with future changes more likely to come from international immigration than from domestic migration.

Transcript Highlights:

• The Hazard Mitigation Grant Program, we believe that between the Hazard Mitigation Grant Program and
• The Hazard Mitigation Grant Program, we believe that between the Hazard Mitigation Grant Program and
• The public assistance program...
• How long does it take that reimbursement on average?
• So that loan program helps shorten that.

Keywords: 914, all

Summary: The committee held a budget hearing for the Oklahoma Office of Emergency Management, with Director Annie Verst presenting the agency’s FY26/FY27 request and explaining the agency’s role in disaster response, recovery, preparedness, and mitigation. She said OEM remains a lean agency focused on coordinating resources for local governments, supporting recovery after disasters, and helping communities build resilience. She highlighted recent activity including wildfire response, multiple fire management assistance declarations, $83 million in public assistance payouts, use of the new state disaster revolving fund, and implementation of an Oklahoma resilient recovery strategy and ARPA-funded rural public safety grants. Verst emphasized uncertainty in federal funding and FEMA operations, saying hazard mitigation assistance has been canceled for the first time since 1988, some obligations were delayed under DHS’s “Defend the Spend” review, and the emergency management performance grant period was shortened before later being resolved. She said OEM has restructured by eliminating obsolete administrative work, repurposing positions to regional coordinators, ending warehouse leases, and assigning fleet vehicles more efficiently. Her budget request included $3.7 million to cover a possible loss of federal operating support, $1 million for a required state hazard mitigation plan update, $3.8 million for the state emergency fund to cover anticipated 12.5% state shares and replenish prior expenditures, and $800,000 for anticipated other-needs/temporary sheltering cost share. Members questioned her about Oklahoma Task Force One, the revolving fund, and whether OEM is shifting toward a response-focused agency. Verst said response remains local and OEM’s role is coordination, recovery, and mitigation, not replacing local emergency management. She explained Task Force One is used when local capacity is exceeded, is not currently funded by OEM for routine operations, and the revolving fund helps bridge reimbursement delays. She also said the hazard mitigation plan update would likely be done by an outside contractor or university partner. No votes were taken; the hearing ended after questions and thanks from the chair.