Transcript Highlights:

• than exiting care.
• than exiting care.
• languishing in care.
• We're using a model from 2011, and the developers of this model have updated this model, and it is now
• an evidence-based model.

Summary: The committee heard a lengthy update on Washington child welfare from Casey Family Programs and DCYF. Dr. David Sanders said Washington has sharply reduced out-of-home care and increased kinship placements, but he flagged concerns about low screening-in rates, long stays in foster care for many children, and a recent rise in repeat maltreatment and child fatalities, especially among infants. He urged more focus on infants and young children, better coordination among child protection, health care, and law enforcement, and more proactive review and investigation practices. Members asked for disaggregated data on children lingering in care, fatalities, and causes such as fentanyl exposure. DCYF said it has increased relative placements and guardianships, but also reported a concerning rise in 2025 critical incidents, mostly near-fatalities involving children age three and under, many opioid-related. The department described responses including safe child consults for opioid cases, more training, hotspot analysis, and proposed investments in peer support, public health nurses, community referrals, and an updated safety framework. Members also discussed whether a broader commission on child abuse prevention would be useful, and DCYF said it was open to that idea. The committee then received a DSHS reorganization update from Secretary Angela Ramirez, who described the “Reimagined” plan to consolidate four administrations into three new ones, with the stated goals of reducing silos, improving customer experience, and making transitions between services smoother. She said the agency is seeking statutory changes and CMS approval to align the new structure, and members asked about preparing for federal HR1 impacts, especially SNAP. Ramirez said DSHS is monitoring those impacts closely and emphasized the need for accurate data and cross-agency coordination. Finally, DSHS’s Behavioral Health and Habilitation Administration updated the committee on residential habilitation centers and implementation of Substitute Senate Bill 5393, which phases out Rainier School by June 30, 2027 and limits new admissions. Officials reported current census and staffing levels at the state’s RHCs, said Rainier has had some residents transition to supported living or adult family homes, and explained that emergency and permanent rulemaking was needed to implement the law. They also said Rainier was recently cited by federal surveyors for not meeting the active treatment requirement for two residents, and that the facility has 90 days to return to compliance before possible payment penalties or further remedies. Members pressed for details on the citation, the meaning of active treatment, the assessment process for admissions, and whether Rainier could be repurposed for other services; DSHS said it is working on corrective action and will follow up in writing.

Transcript Highlights:

• You can think of this like a weather model.
• And so we have turned this into now a forecast model.
• So this is just like your weather model, where in a weather model you're going to be looking at what's
• I mean, it's a model. It's never perfect.
• how come California doesn't care about us?

Summary: The joint Senate and Assembly Environmental Quality/Environmental Safety and Toxic Materials informational hearing focused on the Tijuana River Valley sewage crisis, with members from both parties emphasizing that the problem is long-running, cross-border, and severe enough to require federal, state, local, and binational action. Opening remarks described the crisis as an environmental and public health emergency affecting beaches, air and water quality, marine life, tourism, and residents’ quality of life in South Bay communities. Assembly Member Boerner and Senator Jones both stressed the need for continued funding and cooperation, while Senator Padilla said the issue is underappreciated because of where it occurs but has major public health, economic, and educational consequences. Congressman Mike Levin’s office reported more than $650 million in federal funding secured for infrastructure and cleanup, along with federal legislation and requests for CDC and EPA involvement. Supervisor Paloma Aguirre gave a detailed overview of county efforts and the scope of the crisis, citing decades of sewage flows from Tijuana, nearly four years of beach closures, and the county’s expanded water-quality monitoring. She said the county is pursuing warning signs, an air purifier distribution program, an epidemiological study, soil testing, an economic impact study, and a feasibility analysis to remove the “hot spot” near Saturn Boulevard, which she described as a key local source of airborne pollution. She also pointed to binational funding for treatment plant upgrades and said the county is seeking state support, including from Proposition 4 cross-border river funds, to expand relief and mitigation efforts. Scripps researchers Dr. Sarah Giddings and Dr. Kimberly Prather presented scientific findings on water and air transport. Giddings described a high-resolution forecast model that predicts wastewater movement and beach closure risk up to five days ahead, using real-time observations and showing about 72% accuracy against county measurements. Prather said the main exposure route is through air, not just water, and reported that turbulence at the river hot spot aerosolizes pollutants, with hydrogen sulfide and other gases spiking at night and dropping when river flow is diverted. She said the team has identified thousands of gases and linked measurements closely to odor complaints, while also noting that air purifiers can reduce indoor exposure but are not a permanent solution. Dr. Paula Stigler Granados added that community health surveys and CDC assessments show widespread symptoms, sleep disruption, anxiety, and daily life impacts, especially during nighttime odor events. She said her team has found more than 900 contaminants in river water and 106 chemicals uniquely associated with the Saturn Boulevard hot spot, with passive air sampling showing similar chemical fingerprints in nearby homes. The panel discussion ended with questions about standards and accountability, and witnesses and legislators agreed that the crisis requires updated air-quality standards, more health research, and continued coordination to reduce exposure and address the source of pollution.

Transcript Highlights:

• models.
• financial challenges health care facilities face due to antiquated supervision models.
• It's been a... challenges health care facilities face due to antiquated supervision models.
• Anesthesia care is not conducted in a vacuum.
• Physician-led anesthesia care is the safest model, and removing oversight would endanger Florida patients

Summary: The Health Professions and Programs Subcommittee met with a quorum and heard two bills. HB 649 would remove the current written physician protocol requirement for certified registered nurse anesthetists, allowing CRNAs to practice autonomously. The sponsor and supporters argued the change would modernize Florida law, address anesthesia workforce shortages, keep graduates in the state, and improve access especially in rural areas; opponents, including the Florida Medical Association and a cardiologist, warned that physician oversight is important for patient safety and that anesthesia complications can arise quickly. After debate, the committee passed HB 649 favorably by a vote of 12 yeas and 6 nays. The committee then heard HB 723, which requires the Department of Health, working with school districts, to develop informational materials on early detection of type 1 diabetes and have schools notify parents within the first 30 school days about those materials. The sponsor said the goal is to help parents recognize warning signs earlier and avoid emergency diagnoses such as diabetic ketoacidosis, with minimal fiscal impact because the materials would be distributed digitally. Members generally supported the bill and discussed timing and distribution methods, suggesting the notice not get lost in back-to-school paperwork. HB 723 passed unanimously, 18 yeas and 0 nays, and was reported favorably.

Transcript Highlights:

• are enrolled for care at participating child care centers and child care homes.
• Our recommended model is an annual global budget, not an episode-based model or a model based at the
• providers caring for 978 children and 167 non-child care assistance providers caring for 2,297 children
• So the non-child care providers could include child care providers that are serving non-child care assistance
• So it's the non-child care assistance providers could also be caring for child care and non-child care

Summary: The committee first heard an update on North Dakota’s Interagency Council on Homelessness and Continuum of Care funding. Jennifer Henderson of the North Dakota Housing Finance Agency reported that homelessness remains driven by tight housing markets, low incomes, rising rents, and barriers to rental assistance, public benefits, and disability determinations. She said the state’s one-time North Dakota Homeless Grant is serving all regions but reaches far fewer households than the former Rent Help program, and that aging homelessness, shelter staffing shortages, and limited affordable units are growing concerns. Members discussed the need for more housing supply, better coordination with Health and Human Services, landlord engagement, reentry housing, and possible continued one-time funding for the $10 million Homeless Grant and $25 million Housing Incentive Fund. Henderson also warned that federal Continuum of Care funding is uncertain, with HUD expected to issue a new notice June 1 and possible shifts away from permanent supportive housing toward transitional housing and other models. The committee then took testimony on accessibility of government services for people who are blind, visually impaired, deaf, or hard of hearing. Paul Olson of North Dakota Vision Services School for the Blind described the school’s services for infants, children, and adults, including screenings, mobility training, assistive technology, and outreach across the state. He said the agency works closely with Vocational Rehabilitation and is also involved in improving website and document accessibility, especially for PDF materials. Public testimony highlighted barriers such as inaccessible CAPTCHA systems, online forms, driver’s license requirements on job applications, and limited transportation in rural areas. A deaf resident urged broader use of video remote interpreting and video relay services, along with training so people know how to use them effectively. Finally, Kay Larson presented the final report on the child care provider licensing study. The report recommended streamlining North Dakota’s child care licensing structure into three provider types plus a preschool designation, while preserving health and safety standards and maintaining eligibility for child care assistance. The committee discussed simplifying training and qualification rules, revising ratio and group-size requirements, and adjusting age bands for infants and toddlers. The report also noted that some changes would require statutory amendments and later administrative rule changes, with a transition period likely extending through 2029. No formal votes were taken in the transcript, but the committee accepted the updates and scheduled follow-up presentations for a later meeting.

Transcript Highlights:

• and the fee-for-service delivery models.
• In Washington, we provide many of our services through the managed care model, as do many other states
• of care.
• of care, that are relevant to that discussion.
• of care, look at models used in other states, and identify any populations that are currently served

Summary: The committee meeting began with a brief explanation of the renamed Joint Legislative Audit Review Committee subcommittee, now called the Committee to Hear SAO Performance Audits, and a presentation from the State Auditor’s Office on its current biennium performance audit work plan. The auditor described how topics are selected from a large pool of potential audits and highlighted several ongoing or planned audits, including the Liquor and Cannabis Board, oversight of authorized entities serving students with disabilities, the Quality Home Care Initiative, Medicaid managed care versus fee-for-service costs, the Housing Commission tenant ownership follow-up, DSHS vendor payment patterns, implementation of the Since Time Memorial curriculum, and the Washington State ferry system. Members asked about coordination with JLARC to avoid duplication, and the auditor said the offices exchange work plans, monthly updates, and quarterly coordination meetings. The committee then heard the State Auditor’s performance audit on how charter schools identify and support at-risk students. Auditors reviewed four charter schools—Catalyst Public Schools, Innovation High School, Pinnacles Prep, and Rainier Prep—and focused on English language learners, homeless students, and special education students. The audit found the schools met nearly all legal requirements reviewed, with only one area where two schools partially met a language-access requirement. The schools also used several promising practices, including small-group instruction, culturally responsive environments, and multi-tiered systems of support, though the auditors recommended better documentation of procedures to improve consistency. Families interviewed generally reported positive experiences, while noting resource constraints. Committee members asked about how the four schools were selected, whether the audit compared charter populations to home districts, and how MTSS requirements applied to the schools reviewed. The State Auditor’s Office said the sample was chosen for geographic diversity, student population characteristics, and representation from both authorizers, and that K-2 MTSS requirements were not evaluated because they applied to only one school. Representatives from the Charter School Commission and charter school advocates responded positively, emphasizing technical assistance, collaboration, and sharing best practices across schools. Two public testifiers also supported the report and said it highlighted effective practices that could be expanded across charter and traditional public schools.

Transcript Highlights:

• They've been doing this... ...so that they feel like they're creating this new model of collaboration
• and the kind of care and the various interagency collaboration the level of care and the kind of care
• Pappas is not simply a hospital; it's a national model for pediatric rehabilitation care and a lifeline
• Her therapies and medical care are fragmented across multiple providers who cannot easily collaborate
• Her therapies and medical care are fragmented across multiple providers who cannot easily collaborate

Keywords: 995, all

Summary: The special legislative commission on the future of Pappas Rehabilitation Hospital for Children held a hybrid public hearing focused on the hospital’s future, admissions, staffing, infrastructure, and whether the facility should be preserved, expanded, or reimagined. Opening remarks from legislators, commissioners, parents, and union representatives emphasized that Pappas provides a unique combination of medical, rehabilitative, educational, and residential services for children with complex needs, and several speakers argued that the hospital is effectively being depopulated through reduced admissions and ongoing discharges despite public assurances that it remains open. Multiple speakers urged the commission to extend its authorization and continue its work before any closure or major change can occur. Testimony from labor leaders, including AFSCME, SEIU Local 509, and the Massachusetts Nurses Association, described a “silent closure” in practice, with staff reporting confusion about the hospital’s status, declining census numbers, blocked admissions, and uncertainty about the workforce’s future. They called for immediate action to stop admission denials and unnecessary discharges, and some proposed short-term solutions such as temporary modular structures to address infrastructure barriers and allow admissions to resume. Parents and former patients testified that Pappas provided life-changing independence, specialized therapy, and campus-based supports that they said could not be replicated elsewhere, and they criticized alternative placements as inadequate. Commissioner Robert Goldstein of the Department of Public Health said the administration supports keeping Pappas open and funded while the commission works, but he argued that admissions must comply with hospital-level-of-care rules and that the campus’s deteriorating infrastructure limits the kinds of children who can safely be served there. He said the department is continuing admissions for appropriate patients, working to expand outreach and services, and exploring long-term options, including broader statewide models of care. Commissioners pressed him on whether discharge status or lack of a clear discharge plan had been used as a barrier to admission, and requested de-identified data on patients recommended for admission but denied. No formal votes were taken during the hearing.

Transcript Highlights:

• , food. food, health care, transportation, and taxes.
• to support primary care providers in the state using some of the models that I've listed there that
• I've said we don't have health care, but we have sick care.
• We're the folks who take care of the folks who take care of everybody in the state.
• Those are the people that we take care of, and it's an absolute honor to take care of those people.

Keywords: 1184, house, all

Transcript Highlights:

• It’s more of shared services and university, you know, collaborative initiatives like that.
• We're also collaborating with California community colleges and high school counselors to ensure that
• So you heard in the prior panel about some of the multi-campus collaborations that are occurring.
• of collaboration are both effective and scalable.
• And the collaborative approach is really key.

Summary: The Assembly Budget Subcommittee on Education Finance met to review CSU and State Library budget issues, enrollment trends, the Capital Fellows program, and a Title IX update. Chair David Alvarez opened by stressing that CSU faces serious financial pressure, including a systemwide deficit and proposed cuts that he and several members said were too large and likely to harm access, course offerings, and student services. Public comment focused heavily on the Braille Institute Library, with patrons, staff, veterans, and advocates urging restoration of funding and warning that the proposed cut would severely affect blind and visually impaired Californians across Southern California. Several CSU faculty, staff, and union representatives also opposed the proposed reductions and warned of larger class sizes, fewer sections, and layoffs. On the CSU core operations item, the Department of Finance explained the Governor’s proposal to reduce ongoing General Fund support by about $375 million and defer a 5% base increase, while the LAO said CSU core funding would be roughly flat once tuition and targeted augmentations were considered, but warned that rising costs and prior shortfalls would still force campuses to cut spending. CSU’s Chancellor’s Office said the proposed cut would deepen existing problems, citing prior-year budget gaps, job losses, reduced course sections, and student-service reductions. Members pressed Finance and the LAO on whether cuts could be made more surgically, especially at the Chancellor’s Office or in institutional support rather than in instruction, and the LAO said the Legislature has flexibility to target cuts more specifically. CSU also described ongoing consolidation efforts, including shared services among campuses and the planned Cal Maritime/Cal Poly San Luis Obispo integration, while cautioning that savings are not yet fully known. The committee then discussed CSU enrollment. The LAO recommended holding enrollment targets flat because the budget does not add new funding, while CSU reported strong recent growth, including more California residents, record first-year enrollment, and expanded direct admissions and transfer pathways. Members questioned why some campuses with high demand turn away many applicants while others continue to lose enrollment, and CSU said it is shifting resources from campuses with sustained declines to those with demand, using a 10% below-target threshold. The committee also discussed whether enrollment declines mirror local population trends, how to improve marketing and program alignment, and whether lessons from Cal Poly Humboldt’s conversion could inform other campuses such as Sonoma State. The Capital Fellows item drew a Finance proposal for a salary increase and an LAO counterproposal for a smaller raise plus future COLA language; the committee kept the item open. Finally, CSU reported progress on Title IX compliance, saying it has completed most State Auditor recommendations, expanded civil rights staffing, and increased training, prevention, and case-management efforts, though members asked how proposed budget cuts might affect those services.

Transcript Highlights:

• It is not offered by our managed care plans and is an alternative model, an alternative program that
• day health care, home-delivered meals, hospital care, and really a broad package of services.
• It sounds like you're asking about the long-term care program in the statewide Medicaid managed care
• We take care of all those.
• And that's adult day health care.

Summary: The Appropriations Committee on Health and Human Services heard a base budget overview for the 2025-26 fiscal year, which was presented as a $46.8 billion starting point for the silo. Staff explained that HHS accounts for about half of the state base budget and roughly 36% of general revenue, with AHCA and Medicaid making up the largest share. The committee then reviewed the PACE program for the elderly, including its eligibility, service model, growth in applications, slot funding and reversions, and the agency’s plan to move from the federal three-way agreement to a more detailed two-party contract to improve accountability, transparency, and reporting. Members raised concerns about unfilled slots, reversions, rural access, and the need for clearer return-on-investment data; the agency said it would follow up on some of those questions. The committee also heard from the Agency for Persons with Disabilities on its statewide dental program. APD described its history of appropriations, the failed January 2024 solicitation, and a new up-to-$11.5 million solicitation focused on preventive care, community partnerships, teledentistry, and coordination with other services. Members questioned overlap with Medicaid dental coverage, the effect of Medicaid unwinding on APD clients, and whether state dollars were duplicating federally supported services; APD said it tries to act as payer of last resort and that services would continue during procurement. Public testimony from an APD stakeholder and the Florida Dental Association emphasized Medicaid eligibility problems for waiver recipients, low reimbursement rates, limited access to anesthesia and hospital-based dental care, and concerns that proposed Medicaid changes could reduce access for special-needs patients. The Department of Veterans’ Affairs then presented on state veterans service officers and benefits assistance. FDVA highlighted its role in helping veterans access federal benefits, reporting about $27.9 billion in federal dollars flowing into Florida and a high return on state investment. The department said it has increased outreach, claims processing, and services, and has trained staff to identify mental health concerns through its Overwatch program. In response to questions, FDVA discussed plans to expand adult day health care at a new veterans nursing home and possibly at existing locations with additional state funding. At the end of the meeting, the committee completed its presentations and adjourned without objection.

Transcript Highlights:

• That access to care being all in one call center model made sense for us. Thank you.
• care at large.
• care at large.
• I think running a 24-7 crisis line is a unique service delivery model, and it's a service delivery model
• I think running a 24-7 crisis line is a unique service delivery model, and it's a service delivery model

Keywords: 988, house, all

Summary: The joint oversight hearing focused on AB 988 implementation and suicide prevention in California Indian communities. Members and the chairs emphasized that 988 was intended to create a behavioral health crisis system with “someone to call, someone to come, and somewhere to go,” and then turned to the disproportionate suicide burden facing Native youth and the need for culturally responsive outreach and services. Assemblymember Bauer-Kahan, the bill’s author, said the law has already saved lives but argued that key parts of the system—especially interoperability between 911 and 988, mobile crisis dispatch, and adequate funding—are not yet working as intended. The first panel of stakeholders and call center leaders largely said California’s 988 network is underfunded and not fully integrated. Speakers from the Steinberg Institute and 988 California said call, text, and chat demand has grown sharply, but staffing and funding have not kept pace, leaving text/chat answer rates far below the state’s goals and sending many contacts to out-of-state backup centers. They also said mobile crisis teams are not being dispatched through 988 statewide, and that the state’s current governance and funding structure is too fragmented. WellSpace Health and other providers described 988 as the “front door” to crisis care, urged more stable funding, and recommended broader use of the CCBHC model to support mobile crisis and behavioral health infrastructure. San Joaquin County offered a local success story, describing a countywide crisis continuum that links 988, mobile crisis, behavioral health access lines, and follow-up services through warm handoffs and coordinated outreach. County officials said the model has reduced reliance on emergency departments and involuntary holds, and they noted that local partnerships and repeated community meetings were key to implementation. Members asked about staffing, tribal outreach, and how to make the system more measurable and interoperable; panelists said staffing projections should be based on actual call volume and contact length, and that tribal-specific outreach has often depended on temporary grant funding. State officials from CalHHS and DHCS then described the five-year implementation plan, the roles of multiple agencies, and current performance data. They said California’s 988 system has handled more than 74,000 contacts in a recent month, with in-state answer rates of 87% for calls and lower rates for chats and texts, and that unanswered contacts are routed to backup centers. They highlighted training efforts, LGBTQ+ competency work after the end of the federal “Press 3” option, and efforts to improve reimbursement for mobile crisis services. No formal votes or committee actions were taken during the hearing.

Transcript Highlights:

• A few recent examples of agency staff collaborating with the health care industry include working together
• opportunities through that model, as well as ensuring that individuals are getting the care that they
• Most of our recipients are getting care through that model, and it needs to work for each and every person
• They're serving as an adjunct for health care. But... For health care.
• It was complementary and collaborative care.

Summary: The committee first heard Senate Bill 1414 by Sen. Polsky on congenital cytomegalovirus (CMV) education. The bill would require the Department of Health, working with medical experts, to create and distribute CMV educational materials to expectant and new parents or caregivers through hospitals, birth centers, and OB/GYN practices. An amendment removed a section that would have required instruction for medical professionals, and the amended bill was reported favorably as a committee substitute. The committee then took up a block of confirmations. Appointees on tabs 2 through 7 were recommended favorably in one vote, and Chavon Harris was separately confirmed as Secretary of the Agency for Health Care Administration after extensive questioning. Senators praised her leadership and experience, while others raised concerns about Medicaid redeterminations, the state’s CORE modernization project, Hope Florida, and a DCF anti-marijuana ad campaign; Harris said she would follow up on some issues and defended the agency’s work on transparency, managed care oversight, and access to care. Her confirmation was recommended favorably, with Sen. Berman noting opposition. Several health-related bills were then heard and advanced. SB 186 by Sen. Garcia expanded epilepsy training requirements for school personnel, including charter school bus drivers, and was reported favorably. SB 902 by Sen. Garcia, after amendments narrowing dental workforce provisions and allowing certain seizure rescue medication delegation to family home health aides, was reported favorably; testimony focused on medical marijuana regulation, practitioner accountability, and concerns about park and child-care proximity restrictions. SB 196 by Sen. Sharif created a uterine fibroid research database with privacy protections and was reported favorably after emotional testimony from a patient and supporters. SB 688 by Sen. Rodriguez would reestablish licensure of naturopathic doctors; it drew both support and skepticism about diagnosis and treatment boundaries, but was reported favorably. SB 1574, Maddie’s Law, would add biliary atresia screening to newborn screening and was strongly supported by parents describing a delayed diagnosis; it was reported favorably. SB 878 on clinical laboratory personnel, SB 1092 on podiatric medicine and certain cellular/tissue-based products, and SB 1032 on medical marijuana registry timelines and veteran fee waivers were also reported favorably, while SB 1032 drew debate over longer renewal/supply periods. The committee then began SB 1760 on Medicaid oversight and program transparency, with the sponsor describing the bill’s creation of a joint legislative oversight committee and a legislative actuary.

Transcript Highlights:

• <00:26:46.240> um looking for those collaborations um looking for those collaborations um
• Minnesota is looked at as a as a model Minnesota is looked at as a as a model so<00:35:15.680>
• within this is again we're collaborating within this is again we're collaborating with<00:55:12.880
• In terms of care, it used to be just for nursing home care, but they opened that up to allow for payment
• <01:39:57.360> be<01:39:57.520> taken nursing care but allow care to be taken nursing

Keywords: 1183, house

Transcript Highlights:

• NOT IN AGREEMENT BUT IN COLLABORATION WITH THE BOARD OF MEDICINE.
• EMERGENCY ROOM VISITS AND OVERALL HEALTH CARE SPENDING.
• IN CONCLUSION EVIDENCE-BASED COLLABORATIVE CARE MODELS SHOW PHARMACISTS AND PHYSICIANS WORKING TOGETHER
• PATIENT CARE.
• CARE.

Keywords: 999, senate, all

Transcript Highlights:

• It also includes adult care centers, so it's not just child care.
• Our recommended model is an annual global budget, not an episode-based model or a model at the individual
• So the non-child care providers could include child care providers that are serving non-child care assistance
• So the non-child care assistance providers could also be caring for children with and without child care
• Strengthening care coordination across systems and levels of care.

Keywords: 908, all

Transcript Highlights:

• It's a national model the cost of care.
• Assisted living is a cost-effective long-term care model that provides care for patients who do not require
• the level of care. the level of care.
• And there's a two-year model, a four-year model, a six-year model, and an eight-year model.
• What began as a system of care has in many places become a business model built on cheap labor and low-value

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board’s fourth meeting focused primarily on a presentation from University of Kentucky and University of Louisville health leaders about the state university directed payment program. Mark Birdwhistle and Ken Marshall described the program as a long-running, value-based Medicaid arrangement that began in 2019, uses university-provided matching funds rather than provider taxes, and ties a portion of payments to quality outcomes. They said the program has improved measures such as tobacco cessation, diabetes control, depression screening, and cancer screening, while supporting access to specialty care, medical education, and workforce training. They also emphasized that Kentucky’s model is nationally notable and has helped improve health rankings and generate cost savings. A major topic was the federal reconciliation bill signed July 4, which the presenters said will reduce directed payments by 10% annually for 10 years beginning in 2028. UL Health estimated a first-year loss of about $75 million and a cumulative loss of about $600 million over the decade; UK estimated about $100 million in the first year, for a combined first-year impact of roughly $175 million. Both speakers warned the cuts could affect access to care, training capacity, and the sustainability of Kentucky’s value-based model, though they expressed hope that congressional action could alter or delay the changes. They also noted that 340B drug pricing changes could further strain already thin operating margins, but did not provide exact figures during the meeting. Committee members responded positively to the program’s reported outcomes and the institutions’ role in Kentucky health care. Senator Berg praised the quality of care and shared a personal example of being advised to stay at UofL for breast cancer treatment. Representative Moer highlighted Kentucky’s strong cancer-control score and asked for more explanation of the value-based payment structure; the presenters said the system is built around ongoing measurement, accountability, and collaboration with the Cabinet for Health and Family Services. No votes or formal actions were taken beyond approving the amended August 27 minutes by voice vote.

Transcript Highlights:

• this bill and a couple of other bills, but Senator Elliott will be bringing an amendment that takes care
• of another issue and takes care of mine at the same time.

Bills: SJR 2, SB 4, SJR 36, SJR 2, SB 4, SJR 1, SJR 5, SB 9, SB 40, SJR 2, SB 4, SR 98, SJR 40, SJR 41, SJR 42, SJR 43, SJR 44, SJR 45, SJR 46, SJR 47, SCR 13, SB 6, SB 13, SB 21, SB 826, SB 827, SB 828, SB 829, SB 830, SB 831, SB 832, SB 833, SB 834, SB 835, SB 836, SB 837, SB 838, SB 839, SB 840, SB 841, SB 842, SB 843, SB 844, SB 845, SB 846, SB 847, SB 848, SB 849, SB 850, SB 851, SB 853, SB 854, SB 855, SB 856, SB 857, SB 858, SB 859, SB 860, SB 861, SB 862, SB 863, SB 864, SB 865, SB 866, SB 867, SB 868, SB 869, SB 870, SB 871, SB 872, SB 873, SB 874, SB 875, SB 876, SB 877, SB 878, SB 879, SB 880, SB 881, SB 882, SB 883, SB 884, SB 885, SB 886, SB 887, SB 888, SB 889, SB 890, SB 891, SB 892, SB 893, SB 894, SB 895, SB 896, SB 897, SB 898, SB 899, SB 900, SB 901, SB 902, SB 903, SB 904, SB 905, SB 906, SB 907, SB 908, SB 909, SB 910, SB 911, SB 912, SB 913, SB 914, SB 915, SB 916, SB 917, SB 918, SB 919, SB 920, SB 921, SB 922, SB 923, SB 924, SB 925, SB 926, SB 927, SB 928, SB 929, SB 930, SB 931, SB 932, SB 933, SB 934, SB 935, SB 936, SB 937, SB 938, SB 939, SB 940, SB 941, SB 942, SB 943, SB 944, SB 945, SB 946, SB 947, SB 948, SB 949, SB 950, SB 951, SB 952, SB 953, SB 954, SB 955, SB 956, SB 957, SB 958, SB 959, SB 960, SB 961, SB 962, SB 963, SB 964, SB 965, SB 966, SB 967, SB 968, SB 969, SB 970, SB 971, SB 972, SB 973, SB 974, SB 975, SB 976, SB 977, SB 978, SB 979, SB 980, SB 981, SB 982, SB 983, SB 984, SB 985, SB 986, SB 987, SB 988, SB 989, SB 990, SB 991, SB 992, SB 993, SB 994, SB 995, SB 996, SB 997, SB 998, SB 999, SB 1000, SJR 40, SJR 41, SJR 42, SJR 43, SJR 44, SJR 45, SJR 46, SJR 47, SCR 13, SB 6, SB 13, SB 21, SB 826, SB 827, SB 828, SB 829, SB 830, SB 831, SB 832, SB 833, SB 834, SB 835, SB 836, SB 837, SB 838, SB 839, SB 840, SB 841, SB 842, SB 843, SB 844, SB 845, SB 846, SB 847, SB 848, SB 849, SB 850, SB 851, SB 853, SB 854, SB 855, SB 856, SB 857, SB 858, SB 859, SB 860, SB 861, SB 862, SB 863, SB 864, SB 865, SB 866, SB 867, SB 868, SB 869, SB 870, SB 871, SB 872, SB 873, SB 874, SB 875, SB 876, SB 877, SB 878, SB 879, SB 880, SB 881, SB 882, SB 883, SB 884, SB 885, SB 886, SB 887, SB 888, SB 889, SB 890, SB 891, SB 892, SB 893, SB 894, SB 895, SB 896, SB 897, SB 898, SB 899, SB 900, SB 901, SB 902, SB 903, SB 904, SB 905, SB 906, SB 907, SB 908, SB 909, SB 910, SB 911, SB 912, SB 913, SB 914, SB 915, SB 916, SB 917, SB 918, SB 919, SB 920, SB 921, SB 922, SB 923, SB 924, SB 925, SB 926, SB 927, SB 928, SB 929, SB 930, SB 931, SB 932, SB 933, SB 934, SB 935, SB 936, SB 937, SB 938, SB 939, SB 940, SB 941, SB 942, SB 943, SB 944, SB 945, SB 946, SB 947, SB 948, SB 949, SB 950, SB 951, SB 952, SB 953, SB 954, SB 955, SB 956, SB 957, SB 958, SB 959, SB 960, SB 961, SB 962, SB 963, SB 964, SB 965, SB 966, SB 967, SB 968, SB 969, SB 970, SB 971, SB 972, SB 973, SB 974, SB 975, SB 976, SB 977, SB 978, SB 979, SB 980, SB 981, SB 982, SB 983, SB 984, SB 985, SB 986, SB 987, SB 988, SB 989, SB 990, SB 991, SB 992, SB 993, SB 994, SB 995, SB 996, SB 997, SB 998, SB 999, SB 1000

Keywords: SJR 2, Senate Joint Resolution 2, constitutional amendment, homestead exemption, property tax relief, school property tax, ad valorem tax, residence homestead, school district taxes, Texas Constitution Article VIII, public school finance, homeowner exemption, elderly exemption, senior tax relief, disabled exemption, tax year 2025, voter approval, November 2025 ballot, local government, Ways & Means

Transcript Highlights:

• Picardo Zaffarini, she went home to take care of the family.
• And you are a role model. for that.
• Cindy worked with the Harris Health Care System, providing primary care for Houssounians.
• They care about what comes out of their pocketbook.
• provided to children in foster care, to health and human services.

Bills: SJR2, SB4, SJR36, SJR2, SB4, SJR1, SJR5, SB9, SB40, SJR2, SB4, SR98, SJR40, SJR41, SJR42, SJR43, SJR44, SJR45, SJR46, SJR47, SCR13, SB6, SB13, SB21, SB826, SB827, SB828, SB829, SB830, SB831, SB832, SB833, SB834, SB835, SB836, SB837, SB838, SB839, SB840, SB841, SB842, SB843, SB844, SB845, SB846, SB847, SB848, SB849, SB850, SB851, SB853, SB854, SB855, SB856, SB857, SB858, SB859, SB860, SB861, SB862, SB863, SB864, SB865, SB866, SB867, SB868, SB869, SB870, SB871, SB872, SB873, SB874, SB875, SB876, SB877, SB878, SB879, SB880, SB881, SB882, SB883, SB884, SB885, SB886, SB887, SB888, SB889, SB890, SB891, SB892, SB893, SB894, SB895, SB896, SB897, SB898, SB899, SB900, SB901, SB902, SB903, SB904, SB905, SB906, SB907, SB908, SB909, SB910, SB911, SB912, SB913, SB914, SB915, SB916, SB917, SB918, SB919, SB920, SB921, SB922, SB923, SB924, SB925, SB926, SB927, SB928, SB929, SB930, SB931, SB932, SB933, SB934, SB935, SB936, SB937, SB938, SB939, SB940, SB941, SB942, SB943, SB944, SB945, SB946, SB947, SB948, SB949, SB950, SB951, SB952, SB953, SB954, SB955, SB956, SB957, SB958, SB959, SB960, SB961, SB962, SB963, SB964, SB965, SB966, SB967, SB968, SB969, SB970, SB971, SB972, SB973, SB974, SB975, SB976, SB977, SB978, SB979, SB980, SB981, SB982, SB983, SB984, SB985, SB986, SB987, SB988, SB989, SB990, SB991, SB992, SB993, SB994, SB995, SB996, SB997, SB998, SB999, SB1000, SJR40, SJR41, SJR42, SJR43, SJR44, SJR45, SJR46, SJR47, SCR13, SB6, SB13, SB21, SB826, SB827, SB828, SB829, SB830, SB831, SB832, SB833, SB834, SB835, SB836, SB837, SB838, SB839, SB840, SB841, SB842, SB843, SB844, SB845, SB846, SB847, SB848, SB849, SB850, SB851, SB853, SB854, SB855, SB856, SB857, SB858, SB859, SB860, SB861, SB862, SB863, SB864, SB865, SB866, SB867, SB868, SB869, SB870, SB871, SB872, SB873, SB874, SB875, SB876, SB877, SB878, SB879, SB880, SB881, SB882, SB883, SB884, SB885, SB886, SB887, SB888, SB889, SB890, SB891, SB892, SB893, SB894, SB895, SB896, SB897, SB898, SB899, SB900, SB901, SB902, SB903, SB904, SB905, SB906, SB907, SB908, SB909, SB910, SB911, SB912, SB913, SB914, SB915, SB916, SB917, SB918, SB919, SB920, SB921, SB922, SB923, SB924, SB925, SB926, SB927, SB928, SB929, SB930, SB931, SB932, SB933, SB934, SB935, SB936, SB937, SB938, SB939, SB940, SB941, SB942, SB943, SB944, SB945, SB946, SB947, SB948, SB949, SB950, SB951, SB952, SB953, SB954, SB955, SB956, SB957, SB958, SB959, SB960, SB961, SB962, SB963, SB964, SB965, SB966, SB967, SB968, SB969, SB970, SB971, SB972, SB973, SB974, SB975, SB976, SB977, SB978, SB979, SB980, SB981, SB982, SB983, SB984, SB985, SB986, SB987, SB988, SB989, SB990, SB991, SB992, SB993, SB994, SB995, SB996, SB997, SB998, SB999, SB1000

Keywords: SJR 2, Senate Joint Resolution 2, constitutional amendment, homestead exemption, property tax relief, school property tax, ad valorem tax, residence homestead, school district taxes, Texas Constitution Article VIII, public school finance, homeowner exemption, elderly exemption, senior tax relief, disabled exemption, tax year 2025, voter approval, November 2025 ballot, local government, Ways & Means

Transcript Highlights:

• BY SHERIFFS OR A CHIEF CORRECTIONAL OFFICER CAN SELECT THE PROGRAM THAT PROVIDES THE MOST EFFECTIVE MODEL
• The whole purpose of this is the coordination and collaboration with the federal government and ICE to
• It has nothing to do, and you guys took careful pains to include immigration status and all other parts
• This is the person whose dreams I care about. They are dead. They don't get...
• The next president asked for better collaboration, as President Trump is looking for more enforcement

Bills: SJR2, SB4, SJR36, SJR2, SB4, SJR1, SJR5, SB9, SB40, SJR2, SB4, SR98, SJR40, SJR41, SJR42, SJR43, SJR44, SJR45, SJR46, SJR47, SCR13, SB6, SB13, SB21, SB826, SB827, SB828, SB829, SB830, SB831, SB832, SB833, SB834, SB835, SB836, SB837, SB838, SB839, SB840, SB841, SB842, SB843, SB844, SB845, SB846, SB847, SB848, SB849, SB850, SB851, SB853, SB854, SB855, SB856, SB857, SB858, SB859, SB860, SB861, SB862, SB863, SB864, SB865, SB866, SB867, SB868, SB869, SB870, SB871, SB872, SB873, SB874, SB875, SB876, SB877, SB878, SB879, SB880, SB881, SB882, SB883, SB884, SB885, SB886, SB887, SB888, SB889, SB890, SB891, SB892, SB893, SB894, SB895, SB896, SB897, SB898, SB899, SB900, SB901, SB902, SB903, SB904, SB905, SB906, SB907, SB908, SB909, SB910, SB911, SB912, SB913, SB914, SB915, SB916, SB917, SB918, SB919, SB920, SB921, SB922, SB923, SB924, SB925, SB926, SB927, SB928, SB929, SB930, SB931, SB932, SB933, SB934, SB935, SB936, SB937, SB938, SB939, SB940, SB941, SB942, SB943, SB944, SB945, SB946, SB947, SB948, SB949, SB950, SB951, SB952, SB953, SB954, SB955, SB956, SB957, SB958, SB959, SB960, SB961, SB962, SB963, SB964, SB965, SB966, SB967, SB968, SB969, SB970, SB971, SB972, SB973, SB974, SB975, SB976, SB977, SB978, SB979, SB980, SB981, SB982, SB983, SB984, SB985, SB986, SB987, SB988, SB989, SB990, SB991, SB992, SB993, SB994, SB995, SB996, SB997, SB998, SB999, SB1000, SJR40, SJR41, SJR42, SJR43, SJR44, SJR45, SJR46, SJR47, SCR13, SB6, SB13, SB21, SB826, SB827, SB828, SB829, SB830, SB831, SB832, SB833, SB834, SB835, SB836, SB837, SB838, SB839, SB840, SB841, SB842, SB843, SB844, SB845, SB846, SB847, SB848, SB849, SB850, SB851, SB853, SB854, SB855, SB856, SB857, SB858, SB859, SB860, SB861, SB862, SB863, SB864, SB865, SB866, SB867, SB868, SB869, SB870, SB871, SB872, SB873, SB874, SB875, SB876, SB877, SB878, SB879, SB880, SB881, SB882, SB883, SB884, SB885, SB886, SB887, SB888, SB889, SB890, SB891, SB892, SB893, SB894, SB895, SB896, SB897, SB898, SB899, SB900, SB901, SB902, SB903, SB904, SB905, SB906, SB907, SB908, SB909, SB910, SB911, SB912, SB913, SB914, SB915, SB916, SB917, SB918, SB919, SB920, SB921, SB922, SB923, SB924, SB925, SB926, SB927, SB928, SB929, SB930, SB931, SB932, SB933, SB934, SB935, SB936, SB937, SB938, SB939, SB940, SB941, SB942, SB943, SB944, SB945, SB946, SB947, SB948, SB949, SB950, SB951, SB952, SB953, SB954, SB955, SB956, SB957, SB958, SB959, SB960, SB961, SB962, SB963, SB964, SB965, SB966, SB967, SB968, SB969, SB970, SB971, SB972, SB973, SB974, SB975, SB976, SB977, SB978, SB979, SB980, SB981, SB982, SB983, SB984, SB985, SB986, SB987, SB988, SB989, SB990, SB991, SB992, SB993, SB994, SB995, SB996, SB997, SB998, SB999, SB1000

Keywords: SJR 2, Senate Joint Resolution 2, constitutional amendment, homestead exemption, property tax relief, school property tax, ad valorem tax, residence homestead, school district taxes, Texas Constitution Article VIII, public school finance, homeowner exemption, elderly exemption, senior tax relief, disabled exemption, tax year 2025, voter approval, November 2025 ballot, local government, Ways & Means

Transcript Highlights:

• We obviously know child care is a huge component under what the work needs to happen.
• Paid for child care support services in the past for many of our areas.
• Collaborators, and I would like to see those universities included as well because we have to start collaborating
• There are 13 collaboratives, and then with numerous pathways from each one.
• We believe that the ROP model is the exemplary regional model, as it has a decades-proven track record

Keywords: 988, house, all

Transcript Highlights:

• It's more about shared services and collaborative initiatives like that.
• County. and collaboratively seek to address this critical need in the workforce and community.
• So you heard in the prior panel about some of the multi-campus collaborations that are occurring.
• of collaboration are both effective and scalable.
• And the collaborative approach is really key.

Keywords: 988, house, all