Transcript Highlights:

• Here's how Medicare and state Medicaid programs currently reimburse for the procedures.
• :26:40.000> reimburse Medicaid programs currently reimburse Medicaid programs currently reimburse
• program.
• When the tax program was set program.
• reimbursement for that hospital stay. reimbursement for that hospital stay.

Keywords: Medicaid - Room 216, 4 February, 2026; 2:00 PM, 925, all

Summary: The committee heard presentations on several Medicaid-related topics. First, a pharmacy representative discussed nonopioid pain medications as a way to reduce opioid dependence and overdose risk, emphasizing that options such as acetaminophen, NSAIDs, and topical diclofenac can be useful for pain management. She cautioned that nonopioids can still have risks and said any policy should avoid requiring patients to step through opioids before accessing safer alternatives, while still allowing reasonable step therapy among nonopioid options. The presenter said the goal is to keep patients from being pushed toward opioids by cost or insurance design. The committee also heard emotional testimony from parents of a child with Prader-Willi syndrome, who described the condition as a rare genetic disorder that causes severe, lifelong hyperphagia and requires rigid supervision and ongoing treatment. They argued that alternative funding programs can disrupt access to medically necessary drugs such as human growth hormone, forcing families into costly and uncertain coverage gaps. They asked lawmakers to ensure insurance coverage remains stable for rare disease patients and thanked Senator Blackwell for prior support of rare disease legislation. Next, a Livanova representative urged the committee to support higher Medicaid reimbursement for vagus nerve stimulator surgery for drug-resistant epilepsy. He said inadequate hospital reimbursement has reduced access in Mississippi, causing patients to travel long distances or go without treatment, and argued that better reimbursement would improve outcomes and save money over time. He cited studies showing seizure reductions, lower ER use, and a projected $2.8 million in five-year savings for Medicaid based on 40 patients, and asked that hospitals be reimbursed at 100% of Medicare rates for the procedure codes. Finally, a Medicaid official gave a broad overview of hospital payment structure, including fee-for-service, managed care, MHAP, DSH, UPL, provider taxes, and related funding mechanisms. She explained that hospital payments are interrelated and have shifted over time, with major changes tied to managed care, MHAP/UPL increases, and provider taxes. At the end of the discussion, the committee was running short on time and asked her to skip ahead to the provider tax component; no votes or formal actions were taken in the portion provided.

Transcript Highlights:

• Those programs are funded beyond the 3.5 billion except for the local. The PLHA program.
• Center Enhancement Program.
• Sorry, there's been no changes to that program. And how much is that program funded for?
• Thank you Assemblymember Ward for your question, you are correct it is a reimbursement program and it
• . program also.

Keywords: 988, house, all

Transcript Highlights:

• The expense reimbursement policy is quite extensive.
• On line six is the high school page program.
• how much U High School page program how much U High School page program during<00:15:39.920>
• the undergraduate internship program the undergraduate internship program again<00:15:50.160>
• <00:20:22.159> maybe that all members get reimbursement maybe that all members get reimbursement

Keywords: 1183, house

Summary: The Committee on Rules and Legislative Administration met with a quorum present and began with member introductions, during which members identified their districts and, informally, their favorite restaurants. The committee then turned to a housekeeping resolution, 2025-P100, covering House policies and administrative procedures. The chair explained that the resolution consolidated routine rules updates prepared by House Research. The committee adopted two amendments to the resolution. The A1 amendment gave members more flexibility in how they receive their postage and digital constituent communications allotment. The A2 amendment corrected titles in the resolution. Staff then reviewed the resolution’s contents, including service awards, donated leave, comp time and time cards, remote work, member business services payments, leadership compensation, expense reimbursement, stationery, postage and digital communications, member communication expenses, alcohol and drug policies, legal fee provisions, photographs and digital images, chaplain pay, the high school page program, and the undergraduate internship program. Members asked several questions during discussion. Representative Long confirmed there were no changes to the legal-fee policy. Representative Hollins asked about the high school page stipend, and staff said it was proposed to increase from $10 to $15 per day. Representative Pursell asked about the 50-mile reimbursement threshold for members’ expenses; the chair said it is derived from IRS tax regulations. She also suggested reviewing how other states handle reimbursement. No members of the public testified. After discussion, the committee renewed the motion and adopted the 2025 resolution as amended. The meeting then adjourned.

Transcript Highlights:

• WICHE offers three major student access programs. WICHE offers three major student access programs.
• Our graduate program is the Western Regional Graduate Program, or WRGP.
• access programs they were called student exchange program but we are excuse me, student access programs
• Legislation also added new requirements for the program, such as schools participating in the program
• , especially a program as important as the school safety program.

Keywords: 1182, all

Summary: The Senate Education Committee of Reference met for sunset reviews and first heard a presentation on the Credit Enhancement Eligibility Board from the Governor’s Office. The presenter explained that the board, created in 2016, has no dedicated staff or administrative budget and is supported by existing budget and policy staff and the Treasurer’s Office. The board’s purpose is to lower borrowing costs for qualifying schools by using a guarantee fund to enhance credit ratings, and it has largely been used by charter schools. Because the board has reached its statutory leverage cap and has not met since 2022, it is currently in a monitoring role, but it must remain in place to honor guarantees if any approved financing defaults. The committee asked about financing maturities, demand from schools, and whether a shorter continuation period would make sense. No public testimony was offered, and the committee voted to recommend continuing the board for 10 years, until July 1, 2036. The committee then reviewed the Western Interstate Commission for Higher Education (WICHE). WICHE’s president described the interstate compact, its regional role in higher education access, workforce development, and data services, and its major student programs: the Western Undergraduate Exchange, the Western Regional Graduate Program, and the Professional Student Exchange Program. She highlighted tuition savings for Arizona students and the state, the return of many PSEP graduates to practice in Arizona, and additional cost savings through cooperative purchasing and technology contracts. The committee asked no substantive questions, and it voted to recommend continuing WICHE for 10 years, until July 1, 2036. The final major item was the Arizona Department of Education School Safety Program performance audit, followed by testimony from the department. The Auditor General reported that the program has grown substantially, especially after expansion to counselors and social workers and increased appropriations, but that ADE did not consistently ensure schools complied with program requirements. In a sample of 16 schools, most had issues such as missing or incomplete operational plans, inadequate safety team activity, incomplete required training, missing activity logs, or reimbursement requests lacking expenditure reports. The audit said these problems reduced the program’s effectiveness and increased the risk of improper spending, and it recommended stronger monitoring, written procedures, and better documentation review. ADE accepted the findings and said it is implementing the recommendations through more direct staff oversight, training requirements tied to funding, encrypted submission of emergency plans, site visits, and representative desk reviews. The discussion then shifted to whether emergency plans should address federal law enforcement actions; the director said the plans are designed for campus safety threats generally and do not specifically contemplate ICE enforcement. The committee took no vote on the audit presentation and adjourned after discussion.

Transcript Highlights:

• And we did add reimbursement for transportation costs.
• And we did add reimbursement for transportation costs. and we did add reimbursement for transportation
• million, an effective reimbursement rate of 40%.
• An increase in the reimbursement rate to 90% would provide North Middlesex with an additional reimbursement
• There are many pilot programs out there.

Keywords: 995, all

Summary: The Joint Committee on Education held a hearing focused primarily on special education-related bills, with testimony centered on two major themes: transition planning for students aging out of school-based services at age 22, and the fiscal strain special education costs place on districts. Committee members explained hearing procedures, noted the House was in formal session, and periodically stepped out for votes while staff recorded testimony. A separate bill on special education due process was also taken up briefly, along with a bill on special education finance and another on equitable access/data reporting. On House Bill 752 and Senate Bill 313, witnesses from the Arc of Massachusetts, the Massachusetts Down Syndrome Congress, the Developmental Disabilities Council, families, self-advocates, and Senator Comerford described the “Turning 22” transition as a crisis point that often leaves families without adult placements, services, or clear communication. Testimony emphasized earlier planning, more accountability, better data collection, and a commission to improve coordination and residential placement. Several parents and advocates shared personal accounts of traumatic transitions, delayed placements, and the need for plans to begin at least a year before age 22. The committee later closed testimony on these bills after hearing from all signed-up speakers. House Bill 4217, on special education due process, drew support from Representative Sullivan-Almeida, parents, and advocates who argued that the burden of proof should shift from families to school districts. Testimony described costly legal battles, delays, and parents having to become experts in reading instruction or hire advocates and attorneys to secure services. Brody Dwyer, a 10-year-old student with dyslexia, and his mother described how evidence-based instruction helped him after years of struggle. The committee also heard testimony on House Bill 546/Senate Bill 317, which would require DESE to publish cross-tabulated data on race, disability, gender, income, and other factors; advocates said this would better expose disparities and help address the school-to-prison pipeline. Finally, on House Bill 691/Senate Bill 430, school leaders, educators, and union representatives testified that special education costs are outpacing district budgets and that increasing circuit breaker reimbursement and creating a commission to study long-term sustainability would help prevent staffing cuts and service reductions. No votes were taken during the hearing; the committee repeatedly closed testimony on individual bills as speakers finished and moved through the agenda.

Transcript Highlights:

• assistance program.
• Um, so it's basic needs programs.
• our Medicaid program.
• our Medicaid program.
• our Medicaid program.

Keywords: 918, senate, all

Summary: The program focused on two major Senate efforts: emergency support for Hennepin County Medical Center (HCMC) and modernization of the state’s human services software systems. On HCMC, Senator Rich Draheim said the hospital is a critical level-one trauma center and a key part of Minnesota’s safety net, warning that its closure would overwhelm the rest of the system. He argued the state should prioritize stabilizing HCMC and other hospitals rather than expanding programs that he считает are not adequately fixed, and he opposed raising taxes such as Hennepin County’s sales tax to fund the hospital, saying property-tax and cost-of-living pressures are already too high. The Senate’s Health and Human Services Supplemental Budget Bill includes a one-time $150 million appropriation to stabilize HCMC, with accountability and reporting requirements. The segment also noted DFL Senator Ann Rest’s bipartisan Senate File 4986, which would direct Hennepin County sales tax revenues to HCMC after certain county obligations are met. Draheim and others emphasized that HCMC’s finances are strained by uncompensated care and low reimbursement rates, and that rural and metro hospitals alike are under pressure. The second half of the program highlighted Senate File 4719, sponsored by Senator Melissa Wicklund, to create a Human Services Systems Steering Committee. Wicklund said outdated, siloed Department of Human Services systems slow access to SNAP, medical assistance, and other basic-needs programs, create errors and inefficiencies, and make fraud harder to detect. She said the committee would bring counties, state agencies, and IT officials together to prioritize modernization. She also said the upgrades would be expensive, citing a child welfare system replacement estimated at nearly $80 million, but noted federal matching funds are available and that failing to modernize could lead to penalties. Wicklund also discussed a longer-term bill, Senate File 5020, to create an IT funding account and planning process for future system upgrades.

Transcript Highlights:

• And if you comply with the requirements of the program, you can also have some of your co-payments reimbursed
• program that is designed for high-risk individuals, which is a prevention program.
• in this program.
• Again, a unique 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 approve prior minutes, hear presentations on state employee health insurance, compensation, leave, and related policy issues, and then recess for lunch. PERS reviewed the history and structure of the state health plan, noting the long-standing state-paid family coverage, cost-control measures, wellness incentives, the current grandfathered PPO and high-deductible options, and the effects of recent benefit mandates such as insulin caps, prosthetic coverage, medication management, prescription copay changes, and ambulance balance-billing limits. Committee members questioned the fiscal impact of adding benefits and the possible cost of moving to a non-grandfathered plan, while PERS and HRMS emphasized that health insurance remains the top-ranked employee benefit and that any major plan changes should be considered carefully. HRMS also presented compensation comparisons showing state pay generally below private-market benchmarks, discussed targeted market equity adjustments, identified ongoing recruitment and retention concerns in fields like nursing, IT, engineering, and attorneys, and reviewed leave policies, tuition reimbursement, and family leave comparisons with neighboring states. Job Service provided labor market data showing low unemployment, high labor force participation, and wage growth that still trails some neighboring markets, and OMB explained that prevailing wage requirements apply to federally funded projects under Davis-Bacon, not to ordinary state contracts. After lunch, the committee took up the required process for health insurance mandate bills and adopted an amendment to Joint Rule 211. The amendment clarified that the deadline for submitting mandate measures is intended to allow time for all required reports, including both the cost-benefit analysis and any Employee Benefits Committee actuarial report, while leaving the existing deadline unchanged. The amendment was adopted on a roll call vote, with several members voting yes and a few no votes recorded. The committee then moved into its jurisdiction review of bill drafts, beginning with a bill that would automatically renew pre-tax dental and vision elections; members debated whether it had any actuarial or administrative impact on PERS or the state, and the chair explained that the committee’s role was only to decide whether further analysis was needed before later testimony and recommendations.

Transcript Highlights:

• Um, I can tell you that we administer the county program on behalf of the DFS and are able to reimburse
• My first couple of years administering that program, the counties, we were able to reimburse every county
• My first couple of years administering that program, the counties, we were able to reimburse every county
• My first couple of years administering that program, the counties, we were able to reimburse every county
• My first couple of years administering that program, the counties, we were able to reimburse every county

Bills: HB0032

Keywords: English proficiency, commercial drivers, vehicle operation, traffic safety, penalties, 916, all

Transcript Highlights:

• It is a pilot program. present. It is a pilot program.
• not getting reimbursed.
• <00:44:01.359> If reimbursement. Did it get reimbursed? If reimbursement.
• Did it get reimbursed?
• Reimbursed. Reimbursed. Why? >> Again, that's the discretion.

Bills: SB222, HB560, HB475, HB484, HB583, HB542, HB566

Keywords: medical clinic board, clinic board, hospital bankruptcy, Chapter 11, bankruptcy, debt restructuring, municipal indebtedness, municipal bankruptcy, health care provider, acute care hospital, lease property, board immunity, director liability, civil liability, healthcare finance, insolvency, debt readjustment, federal bankruptcy law, Alabama Code 11-58-5.2, library materials

Transcript Highlights:

• Can you expand a little bit on the Amigos program?
• So when those are encumbered and there's a federal reimbursement, are the reimbursements sent with the
• What's the timeline to get the federal reimbursement?
• I know, but you're in charge of the reimbursements, and if you're not pushing the reimbursements timeline
• The entire expended project to FEMA for reimbursement.

Transcript Highlights:

• Now that we have delays in the federal KWF program and reductions in other programs at the federal level
• This program is designed as a grant program.
• So, as you noted, the Distressed Hospital Loan Program, that 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%.

Summary: The committee heard AB 108, a budget bill junior that would amend the 2025 Budget Act to create a one-time $25 million General Fund grant program at HCAI for hospitals in immediate and significant financial distress. The bill also included a technical change related to property tax deferments for eligible low-income seniors. Finance explained that eligible hospitals would have to be not-for-profit, have less than 10 days cash on hand, show best efforts to exhaust other financing, and have a payer mix of more than 50% government payers and uninsured patients; the bill also gives HCAI expedited contracting and rulemaking authority. Members and the LAO noted the proposal is intended as a short-term bridge until July 1, while broader hospital support is expected in the May Revision and next year’s budget. Much of the discussion focused on whether $25 million is enough, how many hospitals would qualify, and whether the 10-day cash threshold is too narrow. Several senators argued the administration had not provided enough data or a clear methodology, and raised concerns about fairness compared with the earlier Distressed Hospital Loan Program, which used broader criteria and provided loans rather than grants. Members also raised broader policy issues affecting hospital finances, including Medi-Cal reimbursement rates, seismic retrofit costs, federal funding changes, and the need for better data and more immediate assessment of hospital distress. The LAO said the current proposal is narrower than the prior loan program and emphasized the need for better reporting and analysis going forward. Public commenters, including the California Hospital Association, district hospital representatives, Children’s Hospital Los Angeles, and county officials, supported the bill and urged additional longer-term funding for distressed hospitals. The chair and several members said the bill is a short-term emergency measure for a small number of hospitals at risk of imminent closure, while broader solutions will be addressed later in the budget process. AB 108 was then moved and passed out of committee on an 18-0 vote, with the roll held open briefly to secure remaining votes.

Transcript Highlights:

• And for their program support based on the current fiscal year's needs of their program, regardless of
• And the final The final program that I was asked about is the teacher apprenticeship program and mentor
• So that's one similarity, but the types of programming—the baccalaureate programs for us are just under
• reimbursed.
• reimbursed.

Summary: The Higher Education Budget Subcommittee met to review funding models for the Florida College System and district workforce education programs, with an emphasis on how new dollars are allocated in the program fund and how performance and targeted funding are incorporated. Chancellor Hebda explained the Florida College System model, including base program funding, student success and pipeline funds, performance incentives for industry certifications, and the 2022 president-developed formula that weights enrollment, workforce enrollment, completions, small-college factors, and regional cost differences, plus a targeted funding floor for colleges below a minimum per-FTE level. Vice Chancellor Goodman then outlined the district workforce model, which uses lagged enrollment, program cost weights, local revenue offsets, small-district adjustments, and unmet-need calculations to distribute lump-sum appropriations to school districts offering workforce education. The department also provided updates on several grant programs and funding delays. Goodman said the Workforce Development Incentive Grant, Pathways to Career Opportunities Grant, Graduation Alternative to Traditional Education Startup Grant, and teacher apprenticeship/mentor bonus programs all involve multi-year awards and often require reversions and reappropriations because projects are delayed, extended, or not fully obligated by year-end. She said the department is moving toward an electronic grants system and had already adjusted internal deadlines to speed awards, while acknowledging some reimbursement delays and explaining that mentor bonuses for teacher apprentices will not be paid until the first cohort reaches the statutory timing requirement. Members asked about tracking whether CTE students work in their trained fields, how Xello is used to inform students about career pathways, how FTE is calculated, whether the funding formulas could encourage growth over quality, and how students with disabilities are counted in workforce funding. Questions also focused on tuition, enrollment trends, and the gap between college and university funding. The committee heard that tuition has remained flat for more than a decade, enrollment has rebounded from COVID and is projected to exceed pre-pandemic levels, and the college system’s funding per FTE varies widely. Valencia College President Kathleen Plinsky testified in support of the proposed formula and an additional $200 million for the Florida College System, saying Valencia is the second-largest college in the state but ranks last in per-FTE funding, which has made it difficult to recruit and retain faculty and admit qualified students in high-demand programs like nursing. The committee took no vote and adjourned after the presentations and questions.

Transcript Highlights:

• The Medicaid-to-schools program, including who uses service reimbursement funds.
• program including who uses service<00:16:30.240> re<00:16:30.639> reimbursement<00:16:
• Reimbursement from this program for an individual child can be sought only after eligible costs equal
• Reimbursement<00:48:22.720> from<00:48:22.960> this<00:48:23.200> program<00:48:
• 23.520> for<00:48:23.760> an Reimbursement from this program for an Reimbursement from

Keywords: 928, house, all

Summary: The commission held an organizational meeting under SB 57 to study the cost of special education, with the meeting streamed publicly at the chair’s request. Members introduced themselves, and the chair explained that the bill creates two separate pieces, one dealing with SAU structure and the other with a commission on special education costing. He outlined his background in education and special education and said the commission’s work would focus on understanding and controlling special education costs. The commission reviewed its membership requirements and noted several vacancies or unfilled appointments, including the special education advocate, two governor-appointed parent advocates, and a Department of Health and Human Services representative. The members then elected Representative Rick Ladd as chair, Representative Dick Ames as vice chair, and Representative Megan Murray as clerk. Representative Ames briefly described his legal and policy background in disability and special education work in Massachusetts and New Hampshire. The chair then walked through the commission’s study topics, including referral rates by IDEA category, reasons for increases in categories such as autism and other health impairment, post-COVID referral trends, pre-referral interventions, Medicaid and 504-related costs, out-of-district placements, dispute resolution, billing practices, privacy, reimbursement, legal services, graduation rates, attendance, and adult learning. Members discussed how special education costs are distributed, noting that the state spends about $977 million annually on special education, with only part covered by state aid and the remainder largely borne by local districts. Testimony also noted that out-of-district placement costs have risen sharply since rate-setting changes around 2018, and that some categories may reflect changes in identification practices, medical factors, or broader population shifts. The commission agreed to continue reviewing the data and formulas in future meetings.

Transcript Highlights:

• So an alternative program would be a regular education placement because alternative programs are not
• students within that program.
• alternative program.
• education program within it so special education program within it so they<00:51:16.319> have<
• that special education program within that alternative<00:51:49.000> program<00:51:49.480>

Keywords: 928, house, all

Summary: The work session focused on special education, especially the differentiated aid component and special education aid, which members noted is still often called “catastrophic aid.” The chair said the committee was trying to better understand how special education costs are growing, how districts are delivering services through SAUs or internally, and how reimbursement formulas affect local costs. Members also discussed the need for better data before making decisions on several education funding bills, and Representative Brown was tasked with capturing questions for follow-up information from the department or elsewhere. Testimony from the state special education director, Becky Fad, centered on why student counts in various disability categories have shifted over time. She said the categories themselves have not changed much, but autism has increased because of greater understanding and identification, developmental delay has grown because it applies to children under age 10 who may not yet have a clear diagnosis, and some students previously classified under speech/language or other health impairment are now identified in more specific categories such as autism. She emphasized that the IEP is based on a child’s individual needs, so a change in category would not necessarily change services, though it may help educators support the student differently. Members asked about whether the shifts reflect better diagnostic capability, whether the department should gather more data on the reasons for the changes, and whether autism-spectrum data could be broken down further. Fad said the department does not currently have data on the causes of the shifts or on where students fall within the autism spectrum, but that collecting and analyzing such data is on its list of priorities and a new data manager had recently been hired. She also explained that each child is counted only once on the chart by primary disability, that the IEP or eligibility team determines the primary category based on evaluations, and that any child can be referred for special education by a parent, teacher, or doctor, after which the district must meet within 15 days to decide whether to evaluate. No votes or formal actions were taken in the portion provided.

Transcript Highlights:

• They do not reimburse for the health insurance.
• They do not reimburse for the health insurance.
• They do not reimburse for the health insurance.
• They do not reimburse for the health insurance.
• They do not reimburse for the health insurance.

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:54 Pension System Update 00:03:38, 958, all

Summary: The committee held its first official interim meeting after merging the General Government and Finance, Personnel, and Public Retirement committees, establishing a quorum and opening with the pledge and prayer. Members then received a briefing from KPPA representatives Ryan Barrow and Aaron Sarock on the state retirement systems, including KERS, CERS, and SPRS, and on the importance of fully funding the actuarially determined employer contribution, supplemental appropriations, and investment earnings in reducing unfunded liabilities. They said the systems have made progress toward a statutory closed amortization target of 2049 and emphasized that supplemental funding lowers current employer contribution rates but does not change that end date. A major topic was federal and state reemployment-after-retirement rules for retirees who return to work with participating employers. KPPA explained that retirees must have a bona fide separation from service, no prearranged agreement to return, and generally a one-calendar-month break in service for retirees on or after January 1, 2024. If a member fails to comply, retirement benefits can be voided, payments stopped, health coverage ended, and benefits repaid. The presenters also noted that rehired retirees do not earn a second retirement account, and employers rehiring them must pay employer contributions and, in non-exempt cases, reimburse health insurance costs. Members asked about the scale of rehired retirees and the difference between employer contribution and health insurance reimbursement amounts. KPPA said that in fiscal year 2025 there were over 3,500 rehired retirees in CERS and over 5,000 in SPRS, with substantial employer contributions and health reimbursement payments collected. They also explained that some positions are exempt from these chargebacks, including school resource officers and certain law enforcement positions that meet statutory criteria. The committee discussed House Bill 213, which allows cities, sheriffs’ departments, and post-secondary institutions to offer health insurance to rehired officers if authorized by the governing body, effective August 1, 2026, and clarifies the fiscal-year basis for certain exemption limits. No votes were taken.

Transcript Highlights:

• That program is completely distinct from the LCCMR.
• So that um you reimbursement uh process.
• , those funds will not be reimbursed.
• <00:29:50.559> is community grants program is community grants program is appropriately appropriately
• And in the case of this new program<00:29:57.360> rolled<00:29:57.679> out, program rolled

Bills: HF3426, HF3428

Keywords: natural resources, environment, sustainability, conservation, outdoor recreation, land acquisition, real property, trust fund, commissioner approval, Department of Natural Resources, DNR, conservation easement, land purchase, state land, public lands, property acquisition, value assessment, tax assessed value, Metropolitan Council, Board of Water and Soil Resources

Transcript Highlights:

• Program.
• that program has gone in a second.
• There's an opportunity to invest more funding to help stabilize the program, and increasing reimbursement
• program, and the link to the program is included in my slides.
• the DANB exam reimbursement.

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.

Transcript Highlights:

• our managed care program.
• And quite frankly, we do have to subsidize Medicaid reimbursement rates.
• We can definitely share with you the programs that we've been examining.
• We can definitely share with you the programs that we've been examining.
• We create programs.

Summary: The Health Care Budget Subcommittee held a panel discussion on Florida’s mental health and substance abuse system, with representatives from DCF, AHCA, two managing entities, and two providers describing how the state’s behavioral health network is funded and operated. Members focused on the implementation of prior legislative investments, especially the $50 million in recurring funding from Representative Maney’s bill and the earlier $126 million community behavioral health appropriation. Witnesses said the newer funds were used mainly for crisis beds, discharge planning, outpatient services, regional collaboratives, and a USF Marchman Act report, while the larger behavioral health appropriation supported CAT, FACT, FIT, forensic teams, residential and outpatient services, and crisis care, with most dollars going directly to services and only a small share to administration. A major theme was access to crisis care and the role of mobile response teams, 988, and central receiving facilities in diverting people from Baker Act admissions and reducing readmissions. DCF and providers said mobile response teams have expanded, are being used to de-escalate crises and connect people to care, and have shown strong diversion results and reductions in Baker Acts in some regions. Members also asked about waitlists, children in crisis, and how to handle people without housing or support; providers said discharge planning is individualized but often constrained by homelessness, transportation, and a lack of safe placements, and several witnesses identified housing as one of the biggest barriers to recovery and stability. The committee also examined provider sustainability, reimbursement, and funding gaps. Witnesses described delays caused by contract timing, cost allocation rules, and Medicaid reimbursement rates that do not always keep pace with labor and operating costs, especially for smaller providers and rural networks. DCF and AHCA said managing entities can provide advances, retroactive rate adjustments, and technical assistance, and that Medicaid managed care plans have network standards and complaint/dispute processes. Members raised concerns about a reported $7 million loss in federal non-sustainable funds, provider closures, and whether there is a formal ombudsman process for disputes; DCF said the federal reductions were known and tied to one-time funds, and that the department generally handles provider issues informally while working with managing entities to preserve continuity of care.

Transcript Highlights:

• I did slam the desk a little bit, but then I found out somebody else was cut off the program.
• One of the areas that we did do is increased reimbursements for the opioid treatment providers.
• One of the areas that we did do is increased reimbursements for the opioid treatment providers.
• increase in um Medicaid reimbursement increase in um Medicaid reimbursement rates<00:36:02.240><
• in our state because of low reimbursement rates.

Keywords: 1191, senate, all

Transcript Highlights:

• programs.
• Programs.
• programs have ended.
• Programs.
• programs have ended.

Summary: The Committee on Community Affairs met with a quorum present and heard two hurricane-recovery presentations focused on Florida’s response and long-term recovery efforts. Kevin Guthrie, Executive Director of the Florida Division of Emergency Management, reviewed response and recovery operations for Hurricanes Debby, Helene, and Milton, including meals, water, sheltering, search and rescue deployments, power restoration, debris removal, flood-control efforts, and generator distribution. He also described ongoing public assistance and mitigation funding, the state’s FROC system for standardizing and speeding reimbursement documentation, and the Elevate Florida residential mitigation program, which will use about $400 million to elevate or reconstruct eligible flood-insurance properties and may expand to county-run programs. Senators asked about manufactured homes, school shelter hardening, mobile home tie-downs, reimbursement for USAR teams, debris hauling, regional sheltering, and FEMA review delays; Guthrie said the state is trying to move recovery faster and more proactively, while acknowledging some limits and federal bottlenecks. The committee then heard from Justin Domer, Deputy Secretary of Community Development at Florida Commerce, on HUD Community Development Block Grant Disaster Recovery programs. He explained that Commerce administers long-term recovery funds through its Office of Long-Term Resiliency for housing, infrastructure, and economic development, with funds used as a last resort after FEMA and insurance. Domer outlined the process for the most recent $925 million allocation covering multiple disasters, including Idalia, Debby, Helene, Milton, Broward flooding, and North Florida tornadoes, and said the state currently manages about $3.4 billion in DR funds, rising to over $4 billion with the new allocation. He highlighted completed and ongoing housing programs for Hurricane Irma, Michael, and Ian, plus workforce recovery programs and subrecipient infrastructure grants. Senators asked about Broward and Fort Lauderdale funding, homeowner turnaround times, and mobile home eligibility; Domer said Broward and Fort Lauderdale will have separate HUD-directed programs, and the committee adjourned after the presentations and questions.