Transcript Highlights:

• And when I came to America to go to college, I was out-of-state tuition in all 50 states.
• And when I came to America to go to college, I was out-of-state tuition in all 50 states.
• So I guess you can call me a U.S. resident without a ...state tuition in all 50 states.

Bills: HB2210 , HB2123 , HB2206 , HB2281 , HB2411

Committee: House State Government & Tribal Relations

Keywords: local representation, fair elections, government accountability, voter rights, transparency, foreign nationals, elections, Washington state, voter participation, government oversight, voting rights, uniform standards, overseas voting, civilian voting, state legislation, tribal relations, government, state policy, sovereignty, federalism

Transcript Highlights:

• And when I came to America to go to college, I was out-of-state tuition in all 50 states.
• And when I came to America to go to college, I was out-of-state tuition in all 50 states.
• So I guess you can call me a U.S. resident without a state tuition in all 50 states.

Summary: The committee opened with member introductions and then heard House Bill 2123, which would change Washington’s foreign-national certification requirements for election contributions and political advertising. Staff explained that the proposed substitute would only require certifications for campaigns or sponsors exceeding a $5,500 threshold, with an amendment raising that threshold to $6,000, which would largely limit the requirement to ballot measure activity. Prime sponsor Rep. Joe Fitzgibbon said the current paperwork burden makes campaigns harder without solving a real problem, and that his proposal would preserve protections where federal law does not already cover ballot measures. Testifiers supporting the bill, including campaign treasurers, said the certification requirement is burdensome and ineffective; one witness raised concern that a related repeal provision might unintentionally allow foreign participation in state elections, and staff/leadership indicated follow-up would occur. The hearing on HB 2123 was then suspended and later reopened with additional supportive testimony from campaign professionals and others before the committee moved on to other bills. The committee then took up House Bill 2210 on ranked-choice voting for local elections. Staff said the bill would replace the current top-two primary structure with a top-five process for jurisdictions using ranked-choice voting, allow counties and other local governments to adopt the system through 2032, and set ballot, tabulation, rulemaking, and public education requirements; Seattle would be exempt because it is already moving toward ranked-choice voting. Rep. Gregerson, the sponsor, framed the bill as a temporary tool to protect free and fair elections amid federal uncertainty and potential Voting Rights Act changes. Supporters from Fair Vote Washington, the Washington Bus, Sightline Institute, and others argued ranked-choice voting can improve representation, reduce vote splitting, and help young, military, overseas, and underrepresented voters. Opponents, including Secretary of State Steve Hobbs, county auditors, and several citizens, said the system is confusing, costly, harder to audit, and may increase ballot rejection or lower participation, especially among communities of color and voters with limited English proficiency. The committee heard extensive debate but took no final action during the transcript. The committee also heard House Bill 2411, which expands the state shared leave program to cover employees who are victims of hate crimes or whose absences stem from immigration enforcement actions affecting themselves or family members. Rep. Osman Salahuddin said the bill responds to real cases where state workers faced detention or family separation and could not use shared leave under current law. OFM, the Office of Equity, and the Washington Federation of State Employees supported the bill, describing it as a humane, low-cost way to help employees remain employed during traumatic disruptions. A Republican member asked whether the change would apply to people not legally present or working under a visa; witnesses said they believed it would not, or would be extremely unlikely, and would follow state hiring documentation requirements. The hearing then closed on HB 2411. Finally, the committee heard House Bill 2281 on government-to-government consultation with tribes regarding state actions affecting tribal traditional cultural places. Staff said the bill would require mutually agreed consultation processes, timely notice, meaningful consultation before action, and a heightened legal standard requiring the state to show a compelling interest and least restrictive means if it would burden tribal cultural practices; tribes could sue in superior court. Rep. Chris Stearns said the bill is intended to protect Native identity, sacred sites, and religious practices from further loss, while tribal leaders and faith advocates strongly supported it as enforceable protection for sacred places and sovereignty. Some business and industry groups said they supported the goal but worried the bill’s broad definitions and cause of action could create permitting uncertainty, project delays, and significant costs, especially for clean energy and industrial projects. The committee also heard testimony on House Bill 2206, which would adopt the Uniform Military and Overseas Voters Act; supporters said it would streamline absentee voting for overseas and military voters, while opponents argued it could allow never-residents or duplicate registrations and raised constitutional concerns. No votes were taken in the transcript.

Transcript Highlights:

• And what this bill does is address that so that we can move forward with a Medicaid waiver in order to
• And what this bill does is address that so that we can move forward with a Medicaid waiver in order to
• of our school readiness program to ensure we're not only providing meaningful access to child care tuition

Summary: The Senate convened with a quorum, opened with prayer and the Pledge of Allegiance, and heard several member introductions before taking up the special order calendar. The chamber first postponed CS/SB 80 on state land management, then moved through a series of bills, often substituting House companions when identical or nearly identical. Early actions included unanimous passage of HB 295 on a comprehensive waste reduction and recycling plan, which directs DEP to develop a recycling and waste-diversion roadmap, and passage of CS/CS/SB 492 on land development and mitigation banking after amendments addressing out-of-service credits and former phosphate mine lands; that bill passed 35-3 after debate over possible constitutional concerns. The Senate also passed HB 255 on aggravated animal cruelty, adding a sentencing multiplier and a searchable FDLE database of convicted animal abusers, and HB 711 establishing the Spectrum Alert for missing children with autism, with $190,000 in nonrecurring implementation funds and a July 1, 2026 implementation date. The chamber then approved HB 1089 to add Duchenne muscular dystrophy to newborn screening, and HB 393 revising the My Safe Florida Condominium Pilot Program to expand eligible mitigation projects, lower the approval threshold, and clarify ownership and reimbursement issues. Members discussed funding levels and whether insurance premium credits would be required, but the bill passed unanimously. The Senate also passed HB 1145 on workforce education, HB 827 on a statewide study of automation and workforce impact, and HB 181 on parole guidelines, all without recorded opposition. CS/CS/SB 976 on court-appointed psychologists also passed unanimously, as did HB 1451 on sexual cyber harassment, which broadened protections against non-consensual and digitally forged intimate images. Later, the Senate approved HB 1156 creating the Home Health Aid for Medically Fragile Children Program, after clarifying training requirements and hearing support that the measure would help families keep medically fragile children at home while compensating trained parents. The chamber also passed HB 1091 on substance abuse and mental health care, with an amendment allowing designated facilities to retain stabilized patients who still meet involuntary examination criteria. Throughout the day, senators used questions and debate to probe charter school governance in CS/CS/SB 822, which was substituted with HB 443 and amended to expand charter autonomy over conduct codes, enrollment, reporting, and facility use while maintaining sponsor oversight; that bill was placed on the calendar for third reading rather than voted on in the excerpt. Several other measures, including SB 716, SB 76, and the final SB 1252 item, were postponed or not reached before the transcript ended.

Transcript Highlights:

• Providers Association is a nonprofit trade association that represents small customized living and waiver
• So while Medicaid waiver dollars that you all talk about in this committee a lot fund the cost of services
• :46.800><c> you</c><00:04:46.919><c> all</c><00:04:47.080><c> talk</c><00:04:47.240><c> about</c> waiver
• dollars that you all talk about waiver dollars that you all talk about in<00:04:47.560><c> this</c><
• waiver funded Disability Services<00:57:38.319><c> reimbursement</c><00:57:39.079><c> system</c><00:

Committee: House Human Services Finance and Policy

Transcript Highlights:

• were discussed, specifically what services fall under the waiver and how the waiver and state plan are
• Highlights of the waiver discussion included information and explanation of the broader service array
• Highlights of the waiver discussion included information and explanation of the broader service array
• of care to qualify for a 1915(c) waiver.
• And then would the waiver allow for greater reimbursement if the needs were greater?

Committee: Joint Human Services

Summary: The Human Services Committee met in interim session and first approved the previous meeting minutes before receiving a series of presentations on homelessness and housing stability. Jennifer Henderson of the North Dakota Housing Finance Agency updated members on the new Interagency Council on Homelessness, describing its executive-order mandate to review resources, gather input from stakeholders, identify gaps, and develop recommendations. She said the council’s first work is building a statewide program matrix of existing homeless services and funding sources, with attention to youth, tribal communities, and other vulnerable populations. Members raised concerns about youth homelessness, homeless veterans, and how the council will stay focused on a practical framework rather than getting lost in details. The committee also discussed possible connections to the rural health transformation grant and agreed to continue the topic later in the spring. Beth Olson of Presentation Partners in Housing described the organization’s housing-first model in Cass County and Clay County, including homeless prevention/diversion, housing navigation, and Cooper House, a 42-unit permanent supportive housing building in Fargo. She said the organization focuses on people with long-term and chronic homelessness, many with mental health, addiction, health, domestic violence, and Indigenous identity-related barriers, and reported strong outcomes: 85 of 86 people housed in 2025, 91% still housed after one year, and major reductions in emergency room use, ambulance rides, jail stays, detox days, and shelter use. She also explained that state funding has grown from a small share of the budget to about $1.1 million in state-connected funding for fiscal 2026, largely through contracts tied to supportive services. Members asked about vouchers, rent contributions at Cooper House, length of stay, and whether similar projects could be expanded elsewhere. Andrea Olson of the Community Action Partnership of North Dakota outlined statewide homeless and housing-related services delivered through six community action agencies in all 53 counties. She explained the Community Services Block Grant structure, said housing was identified as the top need in the most recent statewide needs assessment, and described programs including Supportive Services for Veteran Families, North Dakota Homeless Grant services, and Home ARP supportive services. She emphasized that the end of North Dakota Rent Help has increased pressure on the system, that the current $2 million annual homeless grant is far smaller than prior rent-help assistance, and that community action is using case management and financial assistance to move households toward self-sufficiency. Members asked about funding formulas, rural service delivery, and coordination with Presentation Partners to avoid duplication. YouthWorks then began a presentation on youth homelessness, describing services for ages 12 to 24, the special needs of youth and former foster youth, and the organization’s use of federal and state funds to support transitional housing, emergency shelter, maternity housing, and diversion services.

Transcript Highlights:

• Because a great waiver support coordinator changes everything.
• So we just love waiver support coordinators. We love. We love.
• So we just love waiver support coordinators.
• It requires a deep knowledge of the waiver services, budgets, cost plans, non-waiver services in one's
• It stabilizes the entire waiver system. It stabilizes the entire waiver system.

Bills: S0042 , S0688 , S0762 , S1168 , S1296 , S1298 , S1300 , S1318 , S1332 , S1376 , S1548 , S1570 , S1574 , S1632 , S1634 , S1750

Committee: Senate Fiscal Policy

Summary: The committee first took up CS for SB 42 on specific medical diagnosis and child protective investigations. A late-file strike-all amendment was adopted that made only stylistic changes to align with the House version. Supporters said the bill would help DCF and child protective teams better identify rare medical conditions and give parents a chance to defend against mistaken abuse findings. The bill was then reported favorably. The committee also approved SB 1570, which restores a prior program to help locate missing persons with special needs through voluntary tracking devices and coordination with sheriff’s offices and CARD centers, with nonrecurring funding included. Members then advanced several education, disability, and public services measures. CS for CSSB 182 created a teacher training and mentoring program for high-performing current and retired teachers to mentor teachers in D- and F-rated schools, and CS for CSSB 794 required background screening for employees in residential and day training programs for people with developmental disabilities while directing APD to study support coordination quality, workforce issues, and service gaps. Testimony on SB 794 strongly supported better training, lower caseloads, and more consistent support coordination. The committee also favorably reported CS for CS SB 1168 on background screenings, CS for CS SB 214 to allow rural special districts to pay verified invoices directly, CS for SB 1376 to create grants for genetic counseling education, and SB 1574 (Maddie’s Law) to add newborn screening for biliary atresia; the latter drew emotional support and testimony that early screening could save lives and reduce transplant costs. The committee heard and passed a number of other policy bills, including CS for CS for SB 1510, the DEP agency package, after environmental groups warned that one provision could delay basin management protections and allow more septic systems in impaired watersheds; the bill still passed favorably. Members also approved CS for CS for SB 598 on funeral and cemetery regulation, SB 688 to license naturopathic doctors, SB 1318 on scholarship account reversion rules, CS for CS for SB 682 on domestic violence injunctions and penalties, SB 130 on workforce training for current and former inmates, and SB 1548, the latest Live Local affordable housing update. Several bills were briefly postponed or taken up later in the meeting. In the latter portion of the meeting, the committee approved CS for C.S. for SB 536 on criminal gang membership criteria, CS for C.S. SB 762 on assigning conflict capital cases across regional counsel offices, SB 1332 on career offender registration requirements, CS for CS for SB 1742 creating a new offense for indecent exposure of sexual organs to a child, and CS for SB 1750 increasing penalties for serious sex offenses and child sexual abuse material crimes. The committee also debated CS for SB 1226 on Public Employee Relations Commission procedures and union certification rules, including a late-file amendment setting a 60% threshold and 25% quorum for recertification; the discussion focused heavily on constitutional concerns, union rights, and differences between first responders and other public employees. The transcript ends while that bill’s debate is still underway, with the committee having already taken numerous favorable votes throughout the meeting.

Transcript Highlights:

• And I'll just add these affordable housing fee waivers, these are programs that already exist in a lot
• Affordable housing fee waivers, these are programs that already exist in a lot of jurisdictions.
• There's no such thing as an impact fee waiver.
• In the end, there's no such thing as a waiver because of the nexus requirements. It has to come...
• In the end, there's no such thing as a waiver because of the nexus requirements.

Summary: The subcommittee heard several May Revision proposals related to the state’s housing and homelessness reorganization. On the first item, administration and Finance staff described technical adjustments to move administrative positions and resources between the California Housing and Homelessness Agency, HCD, and Cal ICH, plus authority for a chief deputy director at the new Housing Development Finance Committee. The LAO recommended approval but asked for clarification on funding for the chief deputy position. Several senators questioned whether the staffing shifts would reduce Cal ICH’s capacity and whether adding communications support and a new executive position was appropriate absent new housing funding; the item was held open. The second item proposed a new $100 million CalHFA Disaster Rebuilding Fund, with $56 million General Fund and $44 million in existing National Mortgage Settlement funds, to help disaster-impacted homeowners access construction financing through tools such as a loan loss guarantee and interest rate buy-downs. CalHFA said the fund would help close the gap between insurance proceeds and rebuilding costs and would work through approved lenders. The LAO raised concerns about the lack of alternatives analysis, the broad delegation in the trailer bill, and the General Fund cost. Senators pressed for more detail on the estimated number of homeowners served, lender and homeowner eligibility, equity safeguards, and the role of the Legislature in program design; the item was held open. The third item was trailer bill language for HAP Round 7, including accountability metrics, pro-housing designation requirements for certain large cities and counties, local match requirements, and a mechanism to recapture unspent funds. HCD said the proposal would streamline reporting by using one consistent set of system performance measures and would phase in the new requirements. The LAO questioned the timing, the burden of pro-housing designation, the size and source of the local match, and whether the proposal conflicted with the Legislature’s prior goal of getting funds out quickly. Several senators criticized the added requirements and the lack of new funding, while others said the proposal could improve accountability and reduce administrative burden by reusing existing plans. The item was also held open. The fourth item began a proposal to reduce local development impact fees on state-funded affordable housing projects, framed as a condition on competitive multifamily funding rather than a statewide mandate. The presentation started but the transcript cuts off before questions or action on that item.

Transcript Highlights:

• Department of Agriculture for a waiver, which would allow us to essentially exempt any form of taxed
• </c><00:02:26.840><c> and</c> this bill and ask for this waiver and this bill and ask for this waiver
• So it would be excluded under the waiver. Yeah, thank you, Mr. Chair. That was not hazing.
• So, there are currently 22 states in the union that have that waiver.
• So, there are currently 22 states in the union that have that waiver.

Transcript Highlights:

• If you request that waiver, this is the waiver you're getting, and here's how.
• ,</c> that if you're requesting this waiver, that if you're requesting this waiver, it's<00:25:32.880
• If you request that waiver, the shelf.
• If you request that waiver, this<00:25:36.679><c> is</c><00:25:36.800><c> the</c><00:25:36.880><c> waiver
• </c> process simpler to receive the waiver. process simpler to receive the waiver.

Summary: The Senate convened with prayer, the Pledge of Allegiance, and a roll call establishing a quorum. The chamber approved the prior journal, excused absent senators, and received a House message noting passage of several House bills, including House Bill 1 despite the governor’s veto. The clerk also reported committee recommendations on a number of House bills, which were placed on the calendar, and new resolutions were introduced recognizing Chloe Yates, student wellness and physical activity in schools, and the Kentucky State Long-Term Care Ombudsman program. The main floor action centered on House Bill 1, which implements the Federal Education Opportunity Program in Kentucky. Supporters argued the measure would bring federal tax-credit dollars into Kentucky to expand educational opportunities for students and families at no cost to the state budget, while opponents urged sustaining the governor’s veto and raised concerns about accountability and the bill’s structure. After debate, the Senate voted 31-5 to override the veto, and House Bill 1 was finally passed notwithstanding the governor’s veto. The Senate then took up Senate Bill 183 on proxy advisory services. The House committee substitute exempted certain nonprofits with less than $500,000 in annual gross revenue from proxy advisor services from the bill’s cause-of-action provisions while preserving attorney general enforcement authority. The chamber concurred with the House substitute and then passed the bill as amended. Senators also passed Senate Bill 263, the School of Innovation cleanup bill, which makes technical changes, requires KDE support for waiver applications, and creates a pilot project for three schools of innovation with proposed matching grants. Senate Bill 281 on grandparent visitation was also adopted with committee substitute and passed unanimously after discussion focused on balancing grandparents’ access with parental rights and existing case law. Later, the Senate began consideration of Senate Bill 324 on the film industry credit, with the sponsor describing technical changes and expanded provisions to support film, video, gaming, and related production activity in Kentucky.

Transcript Highlights:

• But... ...in the waiver or the sort of set of innovations that the Department of Labor came out with
• , as well as some ideas of others you can take... ...as a list of existing state waivers, as well as
• Thank you. as a list of existing state waivers, as well as some ideas of others you can take advantage
• Waivers will help in some cases.
• But if you wanted to under this waiver or, you know, under these flexibilities, you and the governor

Committee: All ALC-HOSPITAL, MEDICAID, & DEVELOPMENTAL DISABILITIES STUDY SUBCOMMITTEE

Summary: The committee heard testimony from Nick Moore, Acting Assistant Secretary of the Office of Career and Technical Education, on efforts to better align workforce, education, and human services programs. Moore argued that WIOA, Perkins, and ESSA were designed to function as an integrated talent system, but that federal and state bureaucracy has kept them siloed. He said the Department of Labor and OCTAE are working on more integrated state plan guidance, including a 2026 plan modification timeline, combined Perkins/WIOA plans, and greater use of labor market information to align training with in-demand jobs and Workforce Pell. Moore emphasized reducing overhead, cross-training staff, using common intake and integrated case management, and focusing on the “shadow labor force” of people facing benefit cliffs, child care barriers, or other obstacles to work. He repeatedly urged states to use waivers and flexibility where possible, to consolidate or streamline local workforce structures, and to hold programs accountable through measures such as labor force participation, training-related employment, retention, and cost per successful outcome. Members asked about the balance between flexibility and accountability, the role of employers versus postsecondary institutions, rural “training deserts,” state waivers, and data systems such as Mississippi Spark and Arkansas Launch. Moore said states should use technology and integrated intake to co-enroll eligible participants in multiple programs and better match people to jobs. In response to questions, Moore said some federal rules cannot be waived, but many reporting and administrative requirements can be streamlined, and he encouraged Arkansas to propose ideas for waivers or state-level integration. He also discussed the need for enhanced wage records and state longitudinal data systems to improve workforce planning and economic development. After Moore’s presentation, DHS Secretary Janet Mann and Director Jay Hill gave a brief update on reimbursement rates, saying the department had compiled more than 100 public comments, recommended holding the current rate, and was awaiting executive review; they estimated the process could take 30 to 60 days. The committee then adjourned, noting a later audit presentation scheduled for the afternoon.

Transcript Highlights:

• towards supporting that infrastructure and making sure that our apprentices are supported through tuition
• </c><00:04:04.239><c> um</c><00:04:04.319><c> and</c> supported um through tuition um and supported um
• through tuition um and making<00:04:04.799><c> sure</c><00:04:04.959><c> that</c><00:04:05.120><c> we
• payments to get the programs up and running and be successful so those apprentices can get their tuition
• uh payments and that the their tuition uh payments and that the journey<00:07:45.919><c> workers</c>

Bills: HF4862 , HF4598

Committee: House Workforce, Labor, and Economic Development Finance and Policy

Keywords: apprenticeship, education, teacher training, grant program, labor and industry, workers' compensation, Minnesota workers' compensation, Workers' Compensation Advisory Council, reinsurance association, Workers' Compensation Reinsurance Association, WCRA, occupational disease, presumption, first responders, firefighter cancer, PTSD, post-traumatic stress disorder, police officer, paramedic, emergency medical technician

Transcript Highlights:

• Because a great waiver support coordinator changes everything.
• So we just, we love waiver support coordinators. We love. We love.
• So we just love waiver support coordinators.
• It requires a deep knowledge of the waiver services, of budgets, cost plans, non-waiver services in one's
• It stabilizes the entire waiver system.

Bills: S0042 , S0688 , S0762 , S1168 , S1296 , S1298 , S1300 , S1318 , S1332 , S1376 , S1548 , S1570 , S1574 , S1632 , S1634 , S1750

Committee: Senate Fiscal Policy

Keywords: child protection, medical records, investigation, abuse, neglect, healthcare, Child Protection Team, diagnosis, criminal defense, legal representation, death penalty, indigent defense, regional counsel, conflict of interest, background screening, athletic coaches, youth sports, criminal history, expungement, Florida statutes

Transcript Highlights:

• and the elderly waiver.
• and the elderly waiver.
• and the elderly waiver.
• and the elderly waiver.
• and the elderly waiver.

Committee: Senate Finance

Transcript Highlights:

• I believe the waiver covers the entire district if they're approved. Okay.
• Have there been any waivers issued by the Department of Education?
• Yeah, I don't have exact numbers of how many waivers, but there definitely have been waivers issued,
• They have their waivers approved? 8% of districts.
• I'm actually not sure whether that was approved waivers or submitted requests for waivers. Okay.

Transcript Highlights:

• The waiver, then the entire district is eligible.
• Have there been any waivers issued by the Department of Education?
• Yeah, I don't have exact numbers of how many waivers, but there definitely have been waivers issued,
• They have their waivers approved? 8% of districts.
• I'm actually not sure whether that was approved waivers or submitted requests for waivers. Okay.

Summary: The Assembly Committee on Arts, Entertainment, Sports, and Tourism and the Assembly Education Committee held a joint informational hearing on implementation of Proposition 28, the 2022 voter-approved arts education funding measure. Chairs emphasized the goal of understanding how the roughly $900 million to nearly $1.1 billion annual funding stream is being used, whether it is supplementing rather than supplanting existing arts programs, and what reporting or guidance improvements may be needed. The Legislative Analyst’s Office reviewed the basic structure of Prop 28: funds are distributed 70% by enrollment and 30% by low-income student counts, 80% must generally be spent on staffing, districts may use up to 1% for administration, and annual local reports and audits are required. Members pressed the LAO on waivers, spending timelines, and whether smaller or rural districts face different challenges; the LAO said some waivers have been issued and that districts have three years to spend each allocation, but statewide data remain limited. WestEd, Create California, and the California County Superintendents described early implementation findings and concerns. Their testimony said schools are using funds for arts materials, staffing, expanded instruction, and field trips, and that many respondents saw positive effects on student access and engagement. At the same time, they reported confusion about allowable uses, supplement-versus-supplant rules, and the 80/20 staffing requirement, along with shortages of credentialed arts teachers and uneven access across districts. Create California argued that Prop 28 has generated optimism but also uncertainty, especially for community arts organizations that have seen reduced contracts as districts bring services in-house. County superintendents and researchers called for clearer statutory guidance, stronger technical assistance, better statewide data, and more support for teacher credentialing pathways. District and county officials then described local implementation. Long Beach Unified said it moved quickly to full implementation, using Prop 28 to expand elementary and secondary arts offerings, hire 56 certificated staff and more than 120 classified coaches, and develop a five-year arts strategic plan tied to equity goals. Butte County and other rural representatives said Prop 28 has enabled restored or expanded programs, including arts teachers, theater, and music offerings, but rural districts still struggle to recruit credentialed staff and to make small allocations workable across large distances. The California Music Educators Association echoed those themes, saying members report both new positions and supplies as well as confusion, fear of audit findings, and inconsistent district guidance. Committee members asked about arts definitions, credentialing, rural pooling of funds, and out-of-state teacher credentials; witnesses said media arts are included, multiple credential pathways exist, and recent legislation has eased some out-of-state credential barriers. The hearing ended with public comment beginning after the panel discussions.

Transcript Highlights:

• before new or renewed waivers are approved.
• So effective for new waivers beginning July 1st, 2028 for the home and community-based services, H.R.
• 1 expands the scope of coverage for home. and community-based service 915c waivers be on people who
• Requires that any new requests for a 915c waiver demonstrate it will not increase the average amount
• They yanked one year away from us and now we're down to a one-year waiver and that waiver ends at the

Transcript Highlights:

• CMS no longer has the ability to give any good-cause waivers.
• We do have the ability as a state to apply for a waiver, which we will do.
• The waiver can be applied for for up to two years.
• We've already met the criteria to grant that waiver.
• And so that is the path that right now we're going to take. ...to grant that waiver.

Summary: The committee first received an update on the effects of HR1 and related federal Medicaid and marketplace changes from Governor’s Office and Health Care Authority staff. Presenters said the most immediate coverage losses are expected in the individual market beginning in January, with premium increases and an estimated 80,000 people potentially unable to afford coverage. They warned that larger Medicaid impacts will follow over the next year and beyond, including tighter eligibility checks, work requirements, reduced retroactive coverage, limits on state-directed payments and provider taxes, new cost-sharing, and changes affecting certain non-citizen adults. They also said the state plans to seek a waiver or extension for work requirements and will continue to analyze impacts, including on rural providers and Planned Parenthood-related services. Members asked about the effect on nursing homes, rural hospitals, and how the state can help providers and enrollees navigate the new requirements; staff said timelines and a state-specific implementation chart are being developed. The committee then heard a report on the International Medical Graduate Work Group and Washington’s efforts to create pathways for internationally trained physicians. Testimony described the clinical experience license, the clinical evaluation assessment tool, grant funding for IMG support organizations, and a new hardship waiver process enacted this year. National presenters said many states have adopted similar pathways because of physician shortages, but Washington and Tennessee are among the few states that have actually issued licenses so far. They recommended clear guardrails, an employment offer before application, ECFMG certification, supervised practice, and data collection to avoid exploitation and protect patients. Members asked about state-to-state variation, retention of IMGs, and whether Washington should pursue dedicated residency or preceptorship options; presenters said the key next step is moving successful participants from supervised experience to a durable long-term license. The final topic was implementation of Washington’s Apple Health doula benefit and the statewide doula hub and referral system. Senator T’wina Nobles highlighted the state’s $3,500 per-birth Medicaid reimbursement rate for doulas and the importance of the hub for referrals, training, and billing. Health Care Authority staff said the benefit launched January 1, 2025, and covers prenatal intake, labor and delivery, postpartum visits, and telehealth-supported services. They reported 336 state-certified doulas, 134 enrolled in Apple Health, 287 unique clients served, and 641 claims paid so far. Testimony emphasized doulas’ role in improving birth outcomes, reducing unnecessary interventions, and addressing racial disparities in maternal health, while noting that implementation is still early and ongoing.

Transcript Highlights:

• legislation was that the federal government was going to impose upon us dramatic changes in how the 14c waivers
• So, the Medicaid waiver, you know, home and community Waivers to have an expert on how to build those
• out different ways to Spend to to to a you know allow for waiver spend.
• If you're on a waiver, that changes your income threshold for qualifying for benefits.
• If you're on a waiver, it's a lower income threshold, so we have all of those people to consider.

Transcript Highlights:

• IT EXPANDS THE CURRENT MEDICAID WAIVER PROGRAM FOR MEDICALLY FRAGILE CHILDREN.
• THE MODEL WAIVER SO IT CAN SERVE ALL MEDICAID ELIGIBLE THE MODEL WAIVER SO IT CAN SERVE ALL MEDICAID
• AND IT ALSO REQUIRES ACHA TO DEVELOP A COMPREHENSIVE PLAN TO REDESIGN THE MEDICAID MODEL WAIVER.
• WE REALLY WANT TO LOOK CAREFULLY AT THIS WAIVER AND MAKE SURE IT IS DOING WHAT WE WANT IT TO DO.
• SO WE ARE ALL WELL FORMED OF WHAT THE WAIVER WILL DO.

Transcript Highlights:

• </c> choice to receive Medicaid waivered choice to receive Medicaid waivered services<01:23:52.960><c
• </c> either use utilizing Medicaid waiver either use utilizing Medicaid waiver services<01:24:25.720>
• </c><01:28:37.480><c> wait</c> choice, increased Medicaid waiver wait choice, increased Medicaid waiver
• </c> extended wait list of Medicaid waiver extended wait list of Medicaid waiver providers,<01:30:32.080
• <01:30:38.360><c> waiver</c> Medicaid waiver Medicaid waiver quickly<01:30:40.480><c> rather</c><01:30

Bills: HF3843 , HF3597 , HF4003 , HF3167 , HF4193

Committee: House Workforce, Labor, and Economic Development Finance and Policy