Transcript Highlights:

• I've been personally impacted by these kinds of situations.
• In our area, we're in a rural area. We run probably more medicals than we do.
• So we're a very rural county. We were included, we have been. So we're a very rural county.
• There are no career departments, for the most part, in rural Missouri.
• In rural Missouri. So you have to have a volunteer firefighter.

Keywords: 959, house, all

Transcript Highlights:

• They reported in 2024 that, quote, the Renaissance Zone program has made significant impacts on our rural
• They reported in 2024 that quote, the Renaissance Zone program has made significant impacts on our rural
• Your department and USDA Rural Development.
• So they are impacted most greatly.
• Again, all of them, however, raised long-term concerns about how the impact of the cap would even impact

Keywords: 908, all

Summary: The committee met to continue its tax reform and relief study agenda, approved the December 3, 2025 minutes, and announced a new subcommittee to examine property tax statement issues with counties, auditors, and the tax office. Representative Headland was named chair, Senator Rummel vice chair, and Representatives Dressler and Dr. Dr. and Senator Patton were also assigned. The chair noted the group may need an additional meeting and thanked staff and attendees. A major portion of the meeting focused on economic development incentives. The Department of Commerce presented on the Renaissance Zone program and TIF districts, describing Renaissance Zones as locally tailored tools that combine local property tax relief with state income tax incentives. Commerce said the program has supported thousands of projects since 1999 and cited examples from Beach and Mandan showing increases in property and taxable value, business retention, housing, and downtown revitalization. Committee members raised concerns that smaller rural communities often lack the staff and expertise to apply, and Commerce said it provides outreach through conferences, office hours, and one-on-one assistance. League of Cities and local officials from Bismarck and Ellendale echoed the capacity issue, discussed how the programs have worked in their communities, and suggested possible reforms or more targeted support for small towns. Ellendale’s mayor also described two TIF districts, one for industrial infrastructure in Oaks and one for housing infrastructure tied to a data center project in Ellendale. The committee then turned to stripper oil taxation. The Tax Department gave a comparison of oil and gas tax structures in selected states, noting that most have some form of stripper or marginal well provision, while Alaska does not appear to have a specific stripper-well exemption. Members asked for more detail on definitions and North Dakota’s annual adjusted rate. The Department of Mineral Resources followed with a detailed presentation on North Dakota stripper wells, explaining the statutory thresholds, the 12-consecutive-month production test, and the fact that once a well qualifies it remains on stripper status even if production later rises. DMR said about 11,332 stripper wells are active, representing roughly 54% of wells and about 16% of state production, and emphasized that stripper status can extend well life, preserve tax revenue, and reduce orphaned wells. Committee members and industry witnesses discussed refracs, the economics of keeping marginal wells active, and the competitive disadvantage created by North Dakota’s oil price discount. No votes were taken on these informational items.

Transcript Highlights:

• And in doing so, we've tried to make suggestions that would minimize the impact on our... ...rural schools
• , but with a 40% reduction, it is hard to prevent that from impacting schools.
• And so there will be impacts to large and rural schools.
• reduce our services by almost half and protect all of our rural schools at the same level.
• Is really awesome for kids, and that works in urban schools and rural schools. Thank you.

Summary: The Senate Education Committee first approved the January 26 and January 27, 2026 minutes by voice vote. The committee then heard a presentation from Idaho Digital Learning Alliance (IDLA) Superintendent Jeff Simmons, joined by Cambridge Superintendent Anthony Butler, on IDLA’s role as Idaho’s statewide supplemental online learning program. Simmons described IDLA’s funding model, course offerings, growth in enrollment, quality controls, teacher certification and oversight, use of Idaho teachers and curriculum, free open-content resources, and efforts to support families through lower course fees and waived dual-credit fees. He also said IDLA is preparing for a proposed $10 million budget cut, which he said would significantly reduce enrollments and course offerings. Butler testified that IDLA is especially valuable for small rural districts like Cambridge for credit recovery, dual credit, scheduling flexibility, and keeping students on track to graduate. Senators asked about teacher certification, costs, evaluation in a virtual setting, AI use, statutory naming, and how IDLA would be affected by budget reductions. The committee then took up Senate Bill 1234, sponsored by Senator Carlson, which would change Lewis-Clark State College’s name to Lewis-Clark State University. President Cynthia Pemberton testified that the change would not alter the institution’s mission, programs, or focus, but would reduce confusion about the school’s offerings, better reflect its four-year and graduate programs, and help recruitment and partnerships. She said the proposal has broad support from the State Board of Education, K-12 partners, local chambers, and campus stakeholders, and estimated a one-time rebranding cost of about $50,000. Senators asked about the cost and intent language, and the committee voted to send the bill to the Senate floor with a do-pass recommendation. The meeting adjourned afterward, with notice that there would be no Education Committee meeting the following day.

Transcript Highlights:

• Mary Selecky, who is also from a rural community, I am very committed to our rural communities and, in
• Impacts of select federal changes to the health care.
• So patient impacts now.
• workers impacted.
• But the impact of federal policy changes really varies broadly this coming year.

Summary: The committee heard a JLARC presentation on the Department of Health’s oversight of hospital inspections, complaints, and reporting. JLARC said DOH was late on 72% of acute care hospital inspections as of December 2024, had not verified that third-party accrediting standards were substantially equivalent to state standards, did not consistently require proof of those inspections, did not review adverse health event corrective plans, and could make hospital data more accessible. JLARC also raised a possible language-access barrier in the complaint system. Members asked about complaint filing by staff, the meaning of adverse health events, inspection outcomes, and whether the audit compared DOH to other agencies. JLARC said it had not reviewed inspection results or cross-agency comparisons, but noted inspectors were dedicated and working long hours. DOH later said it concurred with the recommendations and outlined a strategic plan with target dates for improving timeliness, verifying accreditation standards, expanding language access, reviewing adverse event laws, and improving public data access, with annual reporting to the Legislature expected. The committee then heard a Department of Health presentation on certificate of need modernization. DOH described the current certificate of need process, which reviews need, financial feasibility, quality, and cost containment for certain facility changes and new services, and said the program has not been modernized since the 1980s. DOH proposed 10 statutory modernization recommendations, including clarifying the program’s purpose, creating a planning entity, adding flexibility, reducing legal costs, updating access-to-care standards, expanding oversight to freestanding emergency departments and urgent care, addressing equity, improving cost control coordination, strengthening long-term funding, and using better data systems. Members asked about oversight of freestanding urgent care and EDs, funding sources, and whether the process could be streamlined or made more responsive to complaints or other triggers. A third panel discussed artificial intelligence in health care. Lucy O’Rourke of the Coalition for Health AI described CHAI’s work on responsible AI principles, technical standards, model cards or “nutrition labels,” testing and governance tools, and educational resources for providers. She said the group is focused on trust, transparency, fairness, safety, security, and privacy, and noted Washington’s AI-related policy work as among the more progressive in the country. No questions were asked. The final portion focused on the financial impact of federal and state health care policy changes. The Washington State Hospital Association said hospitals are facing low or negative operating margins, service reductions, layoffs, and closures, and that state cuts and taxes enacted in 2025, combined with federal HR1 changes, will significantly worsen finances. Providence Swedish leaders described staffing reductions, service cuts, delayed capital investments, and pressure from denials, tariffs, and reimbursement changes, while emphasizing that frontline staffing cuts are tied to service reductions rather than nurse-to-patient ratio changes. The Washington Health Benefit Exchange then began a presentation on expiring federal ACA premium tax credits, state Cascade Care Savings assistance, and eligibility changes affecting lawfully present non-citizens, with examples showing large premium increases for customers if federal subsidies expire.

Transcript Highlights:

• Impact those things.
• How does this impact **Plano**? How does this impact **Anna**?
• Did you look into the impact in your study on The impact in your study on school takeover and the impact
• Is coastal under rural? No. Is coastal under rural? That is a good question.
• our rural schools.

Keywords: 1184, house, all

Transcript Highlights:

• One, mandate impact mitigation.
• So what are the impacts of this?
• the impact.
• rural?
• and roadway impact fees.

Summary: The committee held a hearing on high-capacity groundwater wells proposed in Anderson, Henderson, and Houston counties, with members framing the issue as one of local water supply, fairness, and the need to modernize groundwater law while protecting private property rights. Opening remarks focused on the scale of the proposed Redtown Ranch and Pine Bliss projects, the potential export of tens of thousands of acre-feet of groundwater annually, and concerns that the applications lacked sufficient technical detail and could harm nearby landowners, cities, agriculture, and manufacturing. Members also noted the broader context of the recent flooding tragedy in central Texas and the Legislature’s intent to address water-related loss of life in the upcoming special session. Witnesses from the Texas Alliance of Groundwater Districts and the Texas Water Development Board explained the current groundwater management framework. They described groundwater conservation districts as the state’s preferred management method, the role of groundwater management areas and desired future conditions, and how the Water Development Board uses those conditions to calculate modeled available groundwater. They emphasized that districts rely on local data, monitoring wells, and planning processes, but that information is often more limited in areas without a district, where the rule of capture applies. Members pressed witnesses on recharge rates, export permits, subsidence, the effect of pumping on nearby wells, the age and real-time availability of model data, and whether the proposed project would exceed modeled available groundwater in some counties. TCEQ explained its limited oversight role over groundwater conservation districts, including inquiries, compliance actions, and, in extreme cases, dissolution authority. Water Development Board staff also outlined funding programs, saying the New Water Supply for Texas Fund is limited to projects such as brackish desalination, reuse, ASR, and other new-supply projects, and does not fund fresh groundwater exports alone. They said the project at issue had not applied for board funding. A water lawyer then testified on the rule of capture, ownership in place, and district regulation, arguing that districts must use permitting and other tools to manage production within modeled available groundwater and that the Legislature could consider additional authority over groundwater exports under current law.

Transcript Highlights:

• rural fire districts and fire protection districts which are uherry Hill there's some.
• And so we just felt that the impact for allowing those small rural districts, the fire protection districts
• And so, the rural fire departments, and a lot of them don't do this. They won't do this.
• Do you have a fiscal impact on this bill? Thank you for that question.
• under the Municipal Fiscal Impact Act found in Title I, Section 11-17-301.

Bills: HB3045

Keywords: accident response, motor vehicle, law enforcement, fire department, fee prohibition, 914, all

Transcript Highlights:

• That is directly to challenge the rural communities, what the rural communities face in attracting private
• And for non-rural regions, it is a 40 percent tax credit.
• Our mission is to drive economic impact.
• Every city, every one of your districts could be impacted by this.
• Louis, but for those rural areas as well.

Keywords: 959, house, all

Transcript Highlights:

• Is there more information about the cost impacts to the patient?
• The 340B program is the backbone of rural health care.
• This jeopardizes the ability of rural hospitals to maintain services for rural communities.
• The fiscal impact is really significant.
• The fiscal impact is really significant.

Bills: HB2145, HB1828, HB2155, HB2437

Keywords: 340B drug pricing, healthcare access, patient rights, discounted medications, manufacturer limitations, health professions, plasma donation, physician substitutes, medical regulation, nursing titles, healthcare, regulation, professional standards, licensure, accreditation, opioid treatment, health services, fee authority, public health, 904

Transcript Highlights:

• When something breaks down in rural New Mexico, that matters.
• And we know dealerships do have a significant impact, especially in the rural areas; they have a significant
• impact on the community.
• Market share, though, for rural communities might not change very much.
• I am the president of the Rural Communities Assistance Partnership.

Bills: SB22, SB310

Keywords: motor vehicle manufacturers, licensing, dealers, franchise agreements, consumer protection, water supply, sewage improvements, environment, funding, Mora County

Summary: The committee first heard Senate Bill 22, which would allow certain motor vehicle manufacturers, including electric vehicle companies, to be licensed as dealers in New Mexico and sell/service directly to consumers. Supporters, including the sponsor’s office, Taxation and Revenue, Rivian, and clean-energy advocates, argued the bill would expand consumer choice, lower prices, improve EV access and service in-state, and bring new investment and jobs without eliminating existing franchise dealers. Opponents, including auto dealer associations, chambers of commerce, and franchise owners, argued the measure would weaken the franchise system, harm local businesses and jobs, reduce community reinvestment, and could disadvantage rural and tribal communities. After questions about trade-ins, tribal land sales, tax effects, and economic impacts, the committee voted to table SB 22 by a vote of 7-2. The committee then took up Senate Bill 310, which appropriates $1.1 million to the New Mexico Environment Department for planning, design, and construction improvements to the Mora mutual domestic water system. Supporters described aging water and wastewater infrastructure, an AOC related to discharge into the Mora River, flood and fire impacts, and heavy-metal contamination concerns in private wells. They said the project is part of a larger effort to address inflow and infiltration, improve treatment capacity, and protect public health, with additional funding already sought through the Clean Water State Revolving Loan Fund and the Water Trust Board. Some senators questioned whether the request should instead go through existing water funding programs and raised concerns about piecemeal financing and the Environment Department’s role, but others supported the need for the project. The committee approved SB 310 on a 5-3 due-pass vote.

Transcript Highlights:

• Bright, is now the vice dean of our rural campus. Dr.
• Bright is now the vice dean of our rural campus.
• are applying for rural training in Arizona.
• They could go back to another rural location.
• processes, and it may result in a fiscal impact.

Bills: HB2035, HB2086, HB2434, HB2611, HB2732, HB2733, HB2830, HB2923, HB2932, HB4004

Keywords: kinship care, child welfare, foster care, relative placement, child protection, vaccination mandates, mask requirements, public health, government entities, COVID-19, controlled substances, prescription monitoring, opioid crisis, healthcare regulations, patient safety, group homes, children's rights, safety protocols, employee training, mental health

Transcript Highlights:

• This would likely have minimal fiscal impact.
• This would also have minimal fiscal impact.
• This would likely have minimal fiscal impact.
• However, as the number of facilities and counties that would be impacted is unknown, the fiscal impact
• Weather-impacted shutdowns of our system, unfortunately.

Keywords: 904, all

Transcript Highlights:

• Maximize our impact by adding administrative and paralegal support.
• Inflation continues to impact our staff.
• rural criminal defense bar.
• They, you know, we talked about that rural justice issue.
• Like many rural counties across the state, we are a legal desert.

Transcript Highlights:

• And then what is the anticipated impact of these actions once they are made?
• And then the rural classifications, which are a lot of our hospitals in our state, and the rural, less
• This slide shows the rural composite measure of the 10 rural acute stroke measures.
• I think about what is the impact on the patient and also what's the impact on the family and community
• Senator Lee said the rural emergency hospital designation is intended to serve rural areas, and he does

Summary: The committee first approved the previous meeting minutes and then heard a detailed annual report from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and policy issues. He explained the committee’s review process, confidentiality protections, and national and North Dakota data showing that most maternal deaths are preventable and that mental health conditions, substance use, cardiovascular issues, infection, hemorrhage, and embolism are the leading causes. Members asked about suicide, domestic violence, midwife training, home births, and whether pregnancy testing at death scenes should be expanded; Dr. Arnold said better coroner education, more investigation of unexplained deaths, and possible post-mortem pregnancy testing could improve case identification, especially in rural areas. He also noted that deaths often occur well after 42 days postpartum and that mental health-related deaths remain a major concern. The committee then heard from State Fire Marshal Dr. Matthew Clark on cigarette reduced-ignition-propensity standards and related fire prevention issues. He recommended updating the state’s cigarette propensity law to current national standards and also raised a separate recommendation to require fast-breakaway oxygen tubing for home oxygen users, citing fatal fires linked to smoking around oxygen. Members asked about implementation, cost, insurance coverage, and whether the standards apply in tribal communities; Dr. Clark said he would provide follow-up information and was willing to help with any legislation, but no agency bill had yet been planned. Next, Christine Greff of the Department of Health and Human Services reported on the North Dakota Stroke System of Care. She described the statewide network of stroke-ready hospitals, registry-based quality improvement, and performance data showing continued improvement in stroke recognition, imaging, thrombolytic treatment, transfers, and EMS pre-notification. She highlighted new quality measures for inter-facility transfers and intracerebral hemorrhage care, and said the system remains strong but depends on continued legislative and hospital support. Committee members asked about participation by the VA hospital and were encouraged to consider outreach to include it more fully in the stroke system. Finally, the committee began a presentation on prior authorization and non-opioid pain treatment from Taha Khan of Vertex Pharmaceuticals. He argued that prior authorization can delay access to non-opioid acute pain medications, especially in the 24- to 72-hour post-discharge window when pain is most severe, and said delays can push patients toward opioids. He emphasized that prior authorization has a role in utilization management but should not create barriers in acute pain care, and he noted that current use of the company’s non-opioid product remains very low. The discussion was still underway when the transcript ended.

Transcript Highlights:

• If my mom and I would have had a little bit more support services in our rural county, we may have been
• If my mom and I would have had a little bit more support services in our rural county, we may be able
• And so it had a significant impact on their cognition scores.
• Of course, non-members attending, learning more because it's impacting most of you.
• I think some of the rural states are having the same kind of issues.

Summary: The Arkansas Alzheimer’s Disease and Dementia Advisory Council met to introduce members, adopt its rules and procedures, approve prior minutes, and authorize the co-chairs to approve special expenses. The main discussion focused on updating the Arkansas State Plan for Alzheimer’s disease and dementia, with David Cook of the Alzheimer’s Association outlining major changes in prevalence, caregiving burden, diagnostics, and treatment since the prior plan. He noted rising disease and caregiver numbers in Arkansas, the expansion of amyloid PET access, the growing use of blood-based biomarkers, and the availability of FDA-approved treatments such as Leqembi and Kisunla, while emphasizing that access, insurance coverage, and provider education remain major barriers. Members and presenters also discussed the need to better reach rural primary care providers, who may not be aware of new diagnostics and therapies, and the bottlenecks caused by limited specialists and infusion capacity. There was concern about overreliance on blood tests without confirmatory evaluation, and several members stressed the importance of collaboration, public education, and promoting brain health through exercise and diet. The council also heard about existing programs such as the dementia services coordinator, the BOLD grant, caregiver respite grants, workforce training, and a pilot dementia resource center with UAMS Centers on Aging. The council approved a new four-part outline for the next state plan: advancing risk reduction and brain health/early detection, strengthening family caregiver support, improving access to diagnostics and treatment, and supporting access and quality of care, including workforce and crisis response. Members also agreed to consider future agenda items on new treatments, brain health and lifestyle prevention, workforce training, and possible legislative changes to the enabling statute. The meeting ended with discussion of scheduling the next meeting, tentatively set for August 12 in Hot Springs, and adjournment.

Transcript Highlights:

• So, what health care in rural settings.
• </c><00:04:10.560><c> Part</c> services for folks in rural areas.
• Part services for folks in rural areas.
• It allows for a super rural add-on for the EMS transport rate.
• So and we can weigh the fiscal impact.

Bills: SB9, HB400, SB9, HB400

Keywords: Alabama Athletic Commission, Attorney General, criminal penalties, unarmed combat, regulation, boxing, mixed martial arts, civil fines, dental insurance, benefit rollover, healthcare, insurance policy, annual maximum, smoking ban, vaping, public health, indoor air quality, clean air, ambulance services, health insurance

Transcript Highlights:

• areas that are going to be impacted the most.
• Our rural communities need... And this will especially help those in the rural communities.
• I grew up in a rural community in Los Chavez, New Mexico.
• President, about rural New Mexico.
• As a rural New Mexican and as a rural legislator, I want to put some of this into perspective.

Transcript Highlights:

• they're impacting on the general fund.
• Idaho Children's Trust Fund and the Rural Physician Fund.
• The purpose of these funds is to strengthen rural health care and access.
• Regarding the Rural Health Transformation Program, they're asking for 12 FTP.
• , how rural they were.

Keywords: 989, all

Summary: JFAC began with a presentation from Legislative Services on the general fund and the “green sheet,” explaining how the committee tracks starting cash, revenue forecasts, transfers, appropriations, and ending balances. The analyst walked through general fund revenue sources, the difference between transfers and expenditures, structural balance, and how the green sheet is used to compare current-year collections against forecasts. Members asked about continuously appropriated funds, federal dollars, sales tax exemptions, and cash reconciliation issues tied to the state’s new Luma finance system and interest allocations. The discussion also covered the revenue monitor and how the committee can use it to track collections against forecasted amounts. The committee then moved into the Department of Health and Welfare’s overall budget overview. Legislative Services reviewed the department’s size, organizational structure, vacancy rate, five-year spending trends, and the role of continuously appropriated funds such as the Idaho Children’s Trust Fund and Rural Physician Fund. Members asked about personnel vacancy rates, reverted funds, and whether the department could provide a list of subgrants and trustee-and-benefit payments. Department officials explained that some vacancies reflected a department-wide review, hiring freeze, and FTP realignment, including moving positions to State Hospital South and reverting some federal spending authority. They also said the department was actively filling funded positions and would provide additional information on grants and other payments. The committee then heard the first division-level budget presentation for Indirect Support Services. The analyst described the division’s role in centralized administration, IT, legal, communications, and management support, along with its staffing, historical expenditures, and base budget changes. The division’s budget request included a one-time irrigation system project at State Hospital West, a fund adjustment for the background check unit, the transfer of 58 FTP and related costs to the Office of Information Technology as part of modernization, and a request to remove restrictive budget language on personnel and trustee-and-benefit transfers. The governor’s recommendation also included support for some replacement items and a major new item tied to Idaho’s Rural Health Transformation Program, including 12 limited-service FTP in 2026, ongoing FTP in 2027, and $294 million in one-time operating funds. Members questioned the need for the new FTP, the use of AI, the definition of “rural,” and the mechanics of the IT transfer; department and ITS officials explained the transfer was a budget shift of personnel and operating costs, not a net increase in staffing. The committee adjourned after members also raised broader concerns about public input on Health and Welfare budgets and suggested a joint public meeting with the Health and Welfare committees.

Transcript Highlights:

• The intent is to serve rural areas.
• And I know that this is for the rural population, but I hope that somehow it works for the very rural
• a rural part of the state and my county is very rural, not just my district.
• a rural part of the state and my county is very rural, not just my district.
• , families that have been impacted.

Keywords: 996, all

Transcript Highlights:

• Uh, neighborhood and is meant to protect no impact home-based businesses.
• So the non-impact part of the non-impact definition means you cannot see any of the business' activities
• I mean, we are predominantly rural, affordable and subsidized housing, right?
• direct impact on some of these homes that you traditionally see.
• The rural rental housing represents 652 properties.

Bills: HB303

Keywords: jail standards, living conditions, Harris County jail, safety, inmate welfare