Transcript Highlights:

• Things like test and treat for our citizens, so they don't have to go long distances for care or wait
• is federal legislation that is working through that would enable pharmacists to bill for test and treat
• Things like test and treat treat treat uh<00:52:48.160><c> for</c><00:52:48.640><c> our</c><00:52:48.920
• I, as you heard me state in my last comments, that I work with a hospital, with physicians.
• I work with health care physicians.

Summary: The committee opened by explaining it would work through a long list of interim topics one at a time and asked members to complete a selection form at the end. The first topic, long-term care, drew testimony from AARP Wyoming and the Wyoming Long-Term Care Association. AARP emphasized Wyoming’s aging population, the state’s roughly $200 million annual Medicaid spending on long-term care, and the need to examine whether more support for home-based care could reduce nursing home use and costs. The association agreed with supporting people at home as long as possible, but asked that any study also consider increased support for nursing homes and assisted living when home care is no longer feasible. Committee discussion also touched on adult day care and PACE-like services, with Mr. Laycock noting prior Department of Health discussion and limited adult day availability due to reimbursement concerns. The committee then heard proposals for neonatal intensive care unit family leave, expanded midwifery scope, and a modification to workers’ compensation law. The NICU leave idea, presented by the Wyoming Women’s Foundation, would explore leave options for families with premature infants in intensive care, potentially paid or unpaid, while considering business size and the burden on families who may need out-of-state care. The midwifery topic was framed as a way to address rural maternity and women’s health gaps by allowing midwives to practice to the full extent of their training. On workers’ compensation, the Wyoming Association of Municipalities sought to classify dispatch personnel as first responders so they could receive mental health coverage under workers’ compensation; the Department of Workforce Services explained that current law covers dispatchers under workers’ compensation generally, but the first responder mental health provision added in 2018 applies to law enforcement and firefighters and does not currently include dispatchers. Other topics included problematic gaming and program funding, breast cancer diagnostic and supplemental exams, prescription drug coverage for advanced metastatic cancer, SNAP education, behavioral health workforce clinical training site shortages, CPR in schools, and broader midwifery oversight. The behavioral health workforce proposal, brought by a WICHE commissioner, focused on increasing psychology internship slots in Wyoming, noting that the state currently has only three and that expanding placements could improve recruitment and retention. The CPR in schools topic drew strong support from the American Heart Association, which argued that CPR training in high school could improve bystander response in a rural state with long EMS response times; committee members asked about cost and curriculum fit, and the witnesses said hands-only CPR could be taught by school staff rather than requiring expensive certification. The midwifery discussion later broadened into concerns about oversight and standards after a representative described a constituent’s pregnancy loss and said complaints involving midwifery practice and staffing delays in investigations warranted a deeper review. No votes were taken during the portion provided, and most topics were simply introduced, discussed, and left open for further testimony or later committee selection.

Transcript Highlights:

• neighborhood gathering place built on simple values, homemade recipes, quality ingredients, and treating
• appreciate the sponsor on this and all that have been engaged on all sides, from the midwives to the physicians
• Yeah, just to remind members of the importance of the EMS Compact, along with the Physician Assistant
• I'm a registered nurse in a compact state, and I see the benefit of less time and money if I want to treat
• SB 1178, Non-appropriated physician. SB 1291, Ways and Means. SB 1330, Family court right to jury.

Transcript Highlights:

• with numerous awards, including the 2015 Robert Ramirez Award of Excellence and the 2020 Carl Meyer Physician
• want to caution with grave concern and share some of the feedback I've received from providers and physicians
• A pharmacist is not trained to treat or diagnose, and in other states where this has been enacted, they
• have physician oversight to monitor.
• There's no space and privacy in a lot of our retail providers where will these treating and testing be

Summary: The House convened, opened with prayer and the Pledge of Allegiance, welcomed Judges Day guests and other visitors, and read a proclamation recognizing March 2026 as Social Work Month. Members also made brief introductions of guests and the doctor of the day, Dr. Philip Williams. The chamber then moved through a long Committee of the Whole agenda, taking up numerous bills with committee and floor amendments, most of them receiving do-pass or due-pass recommendations after brief explanations and some debate. Notable discussion included HB 2444, where several members raised concerns about pharmacist-led care, patient safety, and rural health impacts, while the sponsor argued it would expand affordable access to care; HB 2726, which drew comments about a new sleep apnea device and whether it was a vendor-driven proposal; HB 2991, a bipartisan effort to address social media harms to children; and HB 4070, a bill framed as a “corporate death penalty” approach to combat sex trafficking. Other measures addressed kinship placement in child welfare, midwifery oversight, vulnerable adult protections, tuition waivers for children of disabled veterans, license plate omnibus language, and county and education-related issues. After the Committee of the Whole reported, the House adopted the report and assigned measures for engrossing. The chamber then proceeded to third reading votes on several bills. HB 2123, dealing with financial institutions and gold/silver legal tender, failed on a 24-28 vote after an excusal request was granted to one member with a financial conflict. HB 2270, concerning county authority and sheriff’s posse dissolution procedures, passed 50-3. HB 2324, creating a state fire marshal-related provision, passed 53-0, as did HB 2404 on mental health services. HB 2495 on sentencing failed 26-27. HB 2557 on patient records passed 37-16, HB 2574 on traffic violation appeals passed 52-0, HB 2594 on domestic relations and address confidentiality passed 44-9, HB 2611 on child welfare passed 51-0, HB 2681 on the county employee merit system passed 53-0, and HB 2697 also passed 51-0. The session continued into additional votes beyond the excerpt.

Transcript Highlights:

• So the country is short of physicians, not just New Mexico. is short of physicians, not just New Mexico
• happening because it is too frequent that we are getting this notification and information from our physicians
• One great thing about CCBHCs is that they are required to treat the whole lifespan, so we have to have
• program that we have for folks with schizophrenia and bipolar is assertive community treatment, where we treat

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• Under current law, manufactured homes are treated the same as stick-built homes in placement.
• Under current law, manufactured homes are treated the same as stick-built homes in placement.
• I just want to note that according to an Association of American Medical Colleges, State Physician.
• Third, it allows medical professionals to treat serious bodily harm as needed.
• And finally, it allows a hospital professional to treat a baby that's addicted to drugs the minute they're

Transcript Highlights:

• On behalf of NextGen California, California Physicians Alliance, Improve Your Tomorrow, Western Center
• In practice, this effectively requires districts to treat these positions as classified even when they
• Michelle Gomez, a family physician with over 20 years' experience providing primary and abortion care
• Michelle Gomez, a family physician with over 20 years' experience providing primary and abortion care
• Vanessa Hina, on behalf of the California Academy of Family Physicians, here in support. Thank you.

Committee: House Higher Education

Transcript Highlights:

• And whereas it is reported in the United States, more than 5 million people are treated for one or more
• total direct annual cost of melanoma treatment exceeds $290 million, and whereas the annual cost of treating
• skin cancer in the United States is $8,100 million, with $3,300 million allocated to treating melanoma
• . $100 million with $300 million allocated to treating melanoma specifically, and whereas the objectives
• Dermatology Training Advocacy Group is the organization consisting of dermatology trainees and practicing physicians

Transcript Highlights:

• The physician settlement... ...to over $600,000.
• The physician settlement counts, again, have been more stable, but we do see a bit of a jump in 2024,
• that are here in the presentation that you all are challenging us by a complicated issue and not treating
• This bill asks us to treat the most serious sexual crimes the way we treat murder: as offenses so grave
• So, Charlie, what would you, would you treat this as a favored or an unfavored amendment?

Bills: HB99 , HJR5 , HM39 , HB206 , HB213 , SB41 , SB153 , SB165 , SB261 , SB264

Committee: Senate House Judiciary

Summary: The committee first took up a lengthy informational presentation on the Patient Compensation Fund (PCF) and New Mexico medical malpractice insurance. Teresa Hassey, a plaintiffs’ attorney, described the PCF’s origin in the 1976 Medical Malpractice Act, its role as a state-backed excess coverage system, and her view that it was mismanaged when hospital participation expanded without individualized risk assessments. She argued that hospitals underpaid surcharges, that the fund was depleted by claims, and that the 2021 amendments and later legislative infusions were meant to shore up deficits and phase hospitals out. Superintendent of Insurance Alice Kane and LFC analyst Julia Rodriguez presented a different perspective, emphasizing recent general fund infusions, current surcharge collections, the use of actuarial reviews, and the PCF’s budget and settlement activity. Kane said the market is highly concentrated, New Mexico’s malpractice costs and defense expenses are high, and the fund still provides lower-cost coverage than the open market, while also noting ongoing issues with future medical claims, TPA transition, and investment management. Committee members questioned the presenters at length about why New Mexico malpractice premiums are so high, whether defense costs were being conflated with claim payouts, how the PCF works with primary coverage and excess coverage, and whether hospitals were properly assessed when they entered the fund. Several senators raised concerns about punitive damages, corporate practice of medicine, and whether the state’s legal environment is driving doctors away. Others challenged the data comparisons, noting differences between one-year figures and multi-year averages, and asked why New Mexico’s costs remain far above neighboring states. Kane and Hassey disagreed on the causes, with Kane pointing to high claims and defense costs over time and Hassey arguing that hospital participation and punitive-damage exposure distorted the market. The chair concluded the discussion by saying the committee had not exhausted the topic and that he still wanted a clear path to reducing doctors’ insurance costs. After a break, the committee moved on to Senate Bill 41. Senator Charlie introduced the bill, which would eliminate the statute of limitations for the most serious sexual crimes in New Mexico. He argued that trauma, coercion, fear, and delayed disclosure often prevent survivors from reporting promptly, and said the law should reflect that reality. The bill was presented as a response to survivor testimony heard in a prior hearing, and the sponsor framed it as part of a broader effort to modernize the justice system for sexual violence cases.

Transcript Highlights:

• What would you think if I told you that treating 40 disabled people could potentially save the state
• 40 disabled people could treating 40 disabled people could potentially<00:19:14.080><c> save</c><00:
• Let's go back to the question of how treating 40 disabled individuals could potentially save the state
• Treating just 40 disabled individuals doesn't cost the state $2.8 million.
• </c><01:11:52.880><c> them</c> you know, can you uh can you treat them you know, can you uh can you treat

Committee: Joint Medicaid

Transcript Highlights:

• As far as your physician, the bill also makes it clear that this bill cannot be used against a health
• So for the purposes of a traditional surrogacy, the mother would be treated like the mother throughout
• That doctor is going to be afraid to treat her.
• I believe we have some of the best physicians in the United States and quite possibly the world.
• In other words, how do we make sure everyone's treated the same? You're recognized.

Transcript Highlights:

• Today we have Heidi Teval, who is an MD and a FASA board-certified physician anesthesiologist who practices
• Known for his humility, kindness, and authenticity, Representative Grijalva treated all people with dignity
• Known for his humility, kindness, and authenticity, Representative Grijalva treated all people with dignity
• Treat them as such, respect them as such.

Summary: The House convened, opened with prayer and the Pledge of Allegiance, approved the Journal, and recognized Dr. Heidi Teval as Doctor of the Day. Members then offered several points of personal privilege, including tributes to former Representative Noel Campbell, introductions of guests, and observances tied to Muslim Day at the Capitol, Food Bank Day, and Holocaust Remembrance Day. The chamber also heard remarks from Holocaust survivors and community members, and the House later adopted a proclamation recognizing International Holocaust Remembrance Day. The main legislative action was House Concurrent Resolution 2045, honoring the life and public service of former Congressman Raul Grijalva. The resolution detailed his career in education, county government, and Congress, and highlighted his work on public lands, tribal sovereignty, environmental protection, public education, and social justice. The House unanimously adopted the resolution and stood for a moment of respectful silence, then received the Grijalva family in the chamber. Additional floor business included referral changes for HB 2351 and HB 2573, the first reading of several bills, and the second reading of a larger slate of measures covering water, land, energy, agriculture, public safety, immigration, and other topics. No substantive debate or votes on those bills occurred during this session. The House also announced upcoming committee meetings and adjourned until 1:15 p.m. on Wednesday, January 28, 2026.

Transcript Highlights:

• Today we have Heidi Teval, who is an MD and a FASA board-certified physician anesthesiologist who practices
• Known for his humility, kindness, and authenticity, Representative Grijalva treated all people with dignity
• Known for his humility, kindness, and authenticity, Representative Grijalva treated all people with dignity
• Treat them as such, respect them as such.

Transcript Highlights:

• He's an emergency room physician whose career has spanned the local, state, federal, and international
• He's an emergency room physician whose career has spanned the local, state, federal, and international
• You must go to the VA hospital because we find that doctors who treat veterans, for whatever reason,
• This bill builds on AB 1636, which removed the Medical Board's discretion to reinstate a physician or
• SB 849 clarifies that a physician or surgeon who has committed specified sexual offenses against a patient

Summary: The Senate convened with a quorum, observed a moment of silence, offered prayer and the Pledge of Allegiance, and recognized several guest delegations, including UCLA Latino Policy and Politics Institute fellows and community college representatives. The body approved the Senate journals and then moved through gubernatorial appointments, confirming Dr. Hernando Garsohn as Chief Medical Officer at the Emergency Medical Services Authority and Stephanie Weldon as Deputy Director of the Office of Health Equity at the Department of Public Health, both by 39-0 votes. The chamber then took up a series of third-reading bills. Measures approved included SB 799 on the South Bay Regional Housing Trust, SB 33 on prompt payment for public works contractors, SB 222 to streamline permitting for heat pump installations, SB 300 strengthening protections for minors in AI chatbot interactions, SB 457 expanding support for community land trusts, SB 479 authorizing city-based homeless response multidisciplinary teams, SB 719 extending a reporting sunset on automated decision systems, SB 722 protecting mobile home park residents from demolition-related displacement, SB 832 updating the Upper Los Angeles River working group, SB 342 limiting forfeiture when a contractor’s license lapses, SB 490 allowing local inspections of unlicensed treatment facilities with state approval, SB 828 requiring permit-data verification for fireworks and explosives facilities, SB 849 barring physicians who committed sexual misconduct from license renewal, SB 742 addressing decommissioned electric lines in response to the Altadena fire, SB 96 regulating amplified advertising on streaming and related platforms, and SB 58 updating hydrogen sulfide monitoring and response standards. Most passed unanimously; SB 222 and SB 677 drew some opposition, and SB 222 passed 38-3. A major floor debate centered on SB 694, which would restrict unaccredited private firms from charging fees to assist veterans with VA benefits claims and align state law with federal accreditation rules. Supporters argued the bill would protect veterans from predatory “claim shark” practices and preserve access through accredited providers, while opponents said it would limit veterans’ choice and could reduce access to needed help. After a motion to pull the bill from Rules and take it up immediately passed 29-9, the Senate approved SB 694 by a 39-0 vote. The session ended with unanimous approval of the consent calendar items and adjournment until January 27, 2026.

Transcript Highlights:

• Care is delayed or discontinued, and prescribers lose the flexibility needed to treat individual patients
• I'm a board-certified internal medicine physician here in the state of Arizona. Dr.
• DeRosa, I'm a board-certified internal medicine physician here in the state of Arizona, and I've been
• Over the years, I have been unable to specifically treat and best treat my female patients in particular
• using over the last 30 years that provide the care that I personally need and the patients that I treat

Committee: House House International Trade Committee of Reference

Summary: The committee began with a presentation from Berthold Barak Karlich of Benor Capital on investment and innovation from a European perspective. He argued that legacy in trade and innovation is about enabling future generations, not isolation, and highlighted Austria and Europe’s strengths in education, applied research, hidden-champion SMEs, and deep-tech. He also warned against economic nationalism and emphasized that entrepreneurship and cross-border trade create shared interests, peace, and long-term collaboration. In response to questions, he said Arizona had impressed him as a strong, international deep-tech hub, and he expressed interest in learning more about opportunities there. The committee then considered HB 2746, which creates a study committee on trade offices under the Arizona Commerce Authority to review existing trade offices, gather stakeholder input, and report recommendations by December 31, 2028. Members discussed oversight of Arizona’s trade offices in countries including Mexico, Korea, Taiwan, Japan, Romania, and Germany, and the sponsor said the bill would help evaluate effectiveness while identifying new opportunities. The bill received a due pass recommendation on a 7-0 vote. HB 2750, which establishes the Arizona-Sonora Trade Commission with legislative appointees, also received a due pass recommendation after members discussed its role as a complement to executive-branch efforts; it passed 5-1 with one present. The committee next heard HB 4036, a bill restricting the sale and distribution of compounded GLP-1 weight-loss drugs made with certain bulk drug substances and authorizing inspections by the State Board of Pharmacy. Supporters, including Novo Nordisk and the Partnership for Safe Medicines, argued the bill would address unsafe imported ingredients, impurities, misleading advertising, and a surge in mass compounding that they said exceeds the intent of compounding law. Opponents from the Arizona Pharmacy Association, compounding pharmacists, and a physician argued the bill would burden lawful compounders, raise costs, reduce access, and could harm patients who rely on compounded medications. After extensive debate, the committee failed to pass HB 4036 on a 5-5 vote. Finally, the committee took up HB 2765, as amended by a strike-everything amendment creating a vapor product manufacturer licensing framework, fees, penalties, and Department of Revenue oversight. The sponsor said the measure was intended to address illegal smuggling of vape products and protect children, while opponents argued it would burden lawful businesses and that the real problem was illicit actors outside the regulated market. The transcript ends during the discussion of this bill, before a final vote is recorded.

Transcript Highlights:

• Care is delayed or discontinued, and prescribers lose the flexibility needed to treat individual patients
• I'm a board-certified internal medicine physician here in the state of Arizona. Dr.
• DeRosa, I'm a board-certified internal medicine physician here in the state of Arizona, and I've been
• Over the years, I have been unable to specifically treat and best treat my female patients in particular
• using over the last 30 years that provide the care that I personally need and the patients that I treat

Bills: HB2746 , HB2750 , HB2765 , HB4036

Committees: House International Trade , House House International Trade Committee of Reference

Keywords: trade offices, committee, Arizona commerce authority, stakeholder input, efficiency, Arizona-Sonora, Sonora, Mexico, trade commission, cross-border trade, bilateral trade, international trade, economic development, foreign relations, border economy, investment, infrastructure, business exchange, academic exchange, legislative commission

Transcript Highlights:

• It's not always the need to have physician or orthopedic and ultimately surgical intervention.
• It's not always the need to have physician or orthopedic and ultimately surgical intervention.
• </c> an appropriate treatment to treat an appropriate treatment to treat whatever<00:57:12.720><c> the
• </c><01:55:03.920><c> disease</c> preventing disease and treating disease preventing disease and treating
• </c> but they are legally treated but they are legally treated much<02:26:41.600><c> the</c><02:26:41.920

Committee: Senate Health and Human Services

Transcript Highlights:

• We insure 62 not-for-profit hospitals around the state of Missouri and over 2,000 physicians and thousands
• We insure 62 not-for-profit hospitals around the state of Missouri and over 2,000 physicians and thousands
• of nurses, people that the state of Missouri, and over 2,000 physicians and thousands of nurses, people
• And I'm very proud of the manner in which they conduct themselves and treat people fairly.

Committee: House Commerce, Consumer Protection, Energy and the Environment

Summary: The Commerce Committee met in executive session and voted do pass on House Bill 2717 by a 7-0 vote. It then adopted a House Committee substitute for House Bill 2465, described as changing a number from two to one, and passed the substitute bill 8-0. The committee also adopted an amendment and House Committee substitute for House Bill 1791, which adds an emergency permit provision allowing a 30-day extension to obtain a full permit, and passed that substitute 8-0. Representative Manser raised a question about whether the bill would align with federal disaster recovery grant requirements, and the chair said he would look into it further. The committee then heard House Bill 2927, which would revise Missouri’s bad faith/time-limited settlement demand statute. Sponsor Representative Parker said the bill is intended to clarify that settlement demands used to support extra-contractual or bad faith claims must be in writing, remain open for at least 90 days, and reference the statute. Supporters, including representatives of the Missouri Insurance Coalition, Shelter Insurance, and health care and business groups, said the bill closes a loophole created when plaintiffs avoid the current “time-limited demand” language and instead use untimed or vaguely timed demands, which they argued increases litigation and insurance costs. Opponents, including attorney Blake Marcus, argued the bill would make it harder for injured people and policyholders to hold insurers accountable, would encourage delay, and would increase the need to hire lawyers earlier. No vote was taken on HB 2927 in the transcript. The committee also heard House Bill 2057, a technical fix for an entertainment district in Osage Beach. Representative Vernetti said the bill corrects language from last year’s legislation after the Senate used the wrong population figure, and supporters said it would allow patrons to move between venues within the district under controlled alcohol rules similar to other Missouri entertainment zones. The committee then heard House Bill 1707, which would exempt credit card surcharge amounts from sales tax. Sponsor Representative Coleman and supporters from the business community said the Department of Revenue has been taxing these surcharges in audits, creating a burden for small businesses, and that the bill would clarify that fees tied to the extension of credit are not taxable. The committee adjourned after the hearings, and no further votes were taken on those bills in the transcript.

Transcript Highlights:

• six years ago we... passed collaborative pharmacy practice, which allows pharmacists to work with physicians
• conditions to this collaborative practice, and these are... specific diseases that are difficult to treat
• They frequently need examination by a physician and, in some cases, further surgery or other interventions
• Patients need to be seen by their physician.

Bills: SCR5 , SCR13 , SB3 , SB6 , SB10 , SB12 , SB13 , SB15 , SB17 , SB18 , SB19 , SB24 , SB35 , SB57 , SB65 , SB112 , SB284 , SB290 , SB388 , SB400 , SB402 , SB412 , SB495 , SB499 , SB502 , SB509 , SB621 , SB706 , SB740 , SB815 , SB842 , SB854 , SB875 , SB893 , SB917 , SB974 , SB1025 , SB1061 , SB1073 , SB1106 , SB1268 , SB1281 , SB1300 , SB1362 , SB1379 , SB1447 , SB1451 , SB1555 , SB1902 , SJR36 , SJR12 , SCR13 , SCR25 , SCR5 , SCR22 , SCR12 , SCR24 , SB495 , SB412 , SB10 , SB18 , SB565 , SB372 , SB842 , SB765 , SB62 , SB19 , SB666 , SB707 , SB888 , SB687 , SB706 , SB847 , SB290 , SB13 , SB1248 , SB740 , SB14 , SB1006 , SB504 , SB917 , SB925 , SB388 , SB1902 , SB1121 , SB995 , SB857 , SB305 , SB296 , SB284 , SB35 , SB6 , SB815 , SB3 , SB1281 , SB1379 , SB1300 , SB1497 , SB1499 , SB1498 , SB1451 , SB1061 , SB15 , SB65 , SB241 , SB304 , SB402 , SB499 , SB621 , SB974 , SB1023 , SB1024 , SB1025 , SB1106 , SB686 , SB112 , SB371 , SB204 , SB400 , SB609 , SB1447 , SB670 , SB502 , SB427 , SB850 , SB854 , SB413 , SB1555 , SB1362 , SB1346 , SB1033 , SB1220 , SB1073 , SB810 , SB987 , SB1539 , SB893 , SB447 , SB875 , SB406 , SB509 , SB985 , SB965 , SB17 , SB1119 , SB1505 , SB12 , SB24 , SB57 , SB1194 , SB1253 , SB1215 , SB1532 , SB1268 , SB1302 , SB856 , SB650 , SB583 , SB673 , SB840 , SJR57 , SCR8 , SB213 , SB681 , SB1172 , SB1252 , SB378 , SB610 , SB918 , SB1343 , SB608 , SB487 , SB955 , SB957 , SB988 , SB990 , SB1019 , SB1021 , SB1120 , SB251 , SB958 , SB535 , SB761 , SB1 , SB541 , SB315 , SB379 , SB1018 , SB1737 , SB266 , SB1415 , SB3 , SB6 , SB15 , SB35 , SB290 , SB706 , SB842 , SB917 , SB1281 , SB1451 , SB1902 , SB12 , SB13 , SB17 , SB19 , SB388 , SR261 , SR265 , SR276 , SR277 , SR281 , SR286 , SR293 , SCR5 , SCR13 , SB2425 , SB2880 , SB10 , SB12 , SB13 , SB17 , SB18 , SB19 , SB388 , SB412 , SB495 , SB2425 , SB2880

Transcript Highlights:

• He comes back with a lollipop or, you know, a treat.
• He comes back with a lollipop or, you know, a treat.
• If they do, they should be treated with full human rights. That's follow-up.
• If they do, they should be treated with full human rights. That's follow-up.
• I am a medical physician, as well as being a transgender female.

Committee: Senate Education

Transcript Highlights:

• </c><01:58:44.080><c> are</c> newer means that less physicians are newer means that less physicians are
• to treat patients properly and in a timely fashion.
• </c><02:04:56.960><c> in</c> um well I should say physicians in um well I should say physicians in general
• </c> general ability to treat patients general ability to treat patients properly<02:04:59.760><c> and
• The other factor that we have to consider is that stimulants are now being used to treat dementia.

Summary: The committee met with DHS Chief Financial Officer Nathan White to receive an update on the department’s budget lapse and vacancy rates. White explained the difference between the “back-of-the-budget” reduction and lapse assumptions, saying DHS is facing a current biennium reduction of about $23 million and estimating roughly a $60 million general fund lapse in state fiscal year 2025, compared with about $13.5 million the prior year. He said DHS’s lapse is driven largely by program utilization, labor market conditions, contract spending, and statutory carry-forwards in areas such as Medicaid and developmental disabilities, which tend to produce a smaller lapse in the first year of the biennium and a larger one in the second year. He also noted that the House and Senate budgets differ on some operating items, including Medicaid rates, with the Senate having struck a House proposal to reduce rates by 3%. Members questioned White about whether DHS ever spends down lapse money on last-minute purchases. He said the department does not engage in that practice, though it does retain some flexibility in its facilities budget for emergencies. He also described the process for transferring funds within and between class lines, including the need for fiscal committee approval above statutory thresholds, and gave examples such as moving funds to cover overtime in the SYSC budget and to ensure Medicaid payments for nursing facilities. White said such transfers are public and transparent and are reviewed by the governor and Executive Council. The committee then discussed DHS staffing. White said the department has a little over 3,200 authorized positions, with a vacancy rate around 14.5%, and that a hiring freeze had been imposed a few months earlier while exempting direct care positions. He said DHS is planning for about a $30 million general fund reduction to personnel, equivalent to just under 400 positions, and is managing postings centrally to stay within budget by July 1. In response to questions about the loss of about $80 million in federal funds, White and Associate Commissioner Patricia Tilly said DHS avoided layoffs by shifting staff into vacant positions, but that the cuts affected community contracts, public health workers, laboratory work, and some IT/data projects. Tilly said roughly 20 positions were affected, most were reassigned, a few staff left voluntarily, and the department has less flexibility going forward if more federal funding ends.