Transcript Highlights:

• involved in the nursing programs at our state college: What is your NCLEX score?
• I know you just mentioned our nursing program.
• the importance of building our nursing programs and our workforce.
• I am familiar with the nursing program, and it's one of our largest programs in our county and in our
• So not only in our nursing program, but similarly in our teaching program, our... Thank you.

Summary: The Appropriations Committee on Higher Education met to consider a slate of trustee confirmations for several Florida state colleges and universities. Chair Harrell outlined the process, including swearing in nominees, allowing brief presentations and questions, taking public comment after each nominee, and voting on the full slate at the end unless a member was pulled for separate consideration. One nominee, Edward Fleming, was not heard and was deferred to a future meeting. The committee also dealt with several technical issues for remote participants before proceeding through the agenda. Nominees and reappointees emphasized their personal ties to their institutions and focused their remarks on workforce development, affordability, and partnerships with local employers. Several highlighted nursing and allied health programs, with committee members repeatedly asking about NCLEX pass rates; reported figures included Polk State at 100%, Lake-Sumter at 97.5%, Northwest Florida State at 100%, Daytona State at 95%, Pasco-Hernando at 97% for associate degree and 100% for practical nursing, Pensacola State at 90% practical nursing and 85% RN, and Hillsborough College at 87.5%. Other priorities mentioned included construction technology, agriculture and ag technology, surveying/geodetic programs, maritime and diesel mechanics, aircraft maintenance, dual enrollment, AI, cybersecurity, and support for military and veteran transitions. After hearing from all nominees, the committee asked whether any names should be voted on separately; none were requested. Senator Bradley moved a block vote to recommend confirmation, the motion was approved by roll call, and all nominees heard that day were recommended for confirmation except Tab 10, Edward Fleming, who was postponed to a later meeting. The committee then adjourned.

Transcript Highlights:

• It also runs our certificate of public need program, our COPN program.
• A set fee schedule to cover the cost of operating the nursing home licensure and inspection program.
• Are the inspectors for the nursing homes currently registered nurses?
• That's cost to the program.
• That's cost to the program.

Keywords: House Room C, General Assembly Building, 976, house, all

Transcript Highlights:

• The examples of this are are nursing program.
• from the Tallahassee State College Nursing program this year.
• One goal is to continue to work with the College out Science program in nursing programs to ensure continued
• Lastly, I want to see expanding the nursing program.
• We have the highest score on and collects for nursing programs in the state.

Keywords: 999, senate, all

Transcript Highlights:

• West Coast University is our largest nursing program in the state of California.
• I am Carmen Comstey with the California Nurses Association representing over 100,000 registered nurses
• We empathize with the students who've enrolled in these non-BRN approved nursing distance nursing programs
• Equally concerning the bill undermines the ability of California approved nursing programs to place their
• The lack of clinical placements is particularly acute for our community college and CSU nursing programs

Keywords: 988, house, all

Transcript Highlights:

• The family health programs include the California Children’s Services Program, or CCS, the Genetically
• So this maintains the skilled nursing facility, or SNF, workforce standards program, which provides enhanced
• So for the level of care nursing staff for programs for all-inclusive care for the elderly, can step
• and out of the nursing home.
• skilled nursing facilities.

Summary: The subcommittee heard an overview of the Department of Health Care Services’ proposed budget, including a $229.1 billion total-funds budget and projected Medi-Cal enrollment decline as redeterminations continue. Members focused heavily on the fiscal and programmatic effects of prior budget solutions and federal changes, especially the elimination of General Fund-supported Prop. 56 dental supplemental payments beginning July 1, 2026, the hospice utilization-management change, and the impact of reduced caseloads alongside rising health care costs. DHCS said it is still completing required access and rate-reduction analyses for the dental cuts and has been engaging stakeholders, but could not yet quantify the real-world effect on utilization or provider participation. The committee also reviewed the November 2025 Medi-Cal local assistance estimate, which shows higher General Fund spending despite lower enrollment, driven by managed care rate growth, Medicare cost growth, state-only claiming, and federal policy changes. The hearing then turned to provider taxes and federal H.R. 1 constraints, with extensive discussion of the MCO tax, the hospital quality assurance fee, and other health care-related taxes. DHCS explained that H.R. 1 phases down allowable tax levels and tightens “generally redistributive” rules, making the current MCO tax structure and the proposed higher hospital fee levels difficult or impossible to renew as originally designed. Staff and the LAO described the tradeoff between preserving Medi-Cal funding and avoiding higher costs on private providers and consumers. Members asked about options for preserving revenue, including possible amendments to Prop. 35 or returning to voters, and were told the department is still evaluating approaches while federal guidance remains in flux. The committee also reviewed hospital payment increases already implemented through state-directed payments, with DHCS noting that H.R. 1 will force those payments down to Medicare levels over time. Several budget change proposals were discussed and left open, including requests tied to the managed care final rule, managed care operations, hospital value strategy, long-term care payment transparency, and interoperability requirements. The committee also heard about a one-year trailer bill extension for skilled nursing facility financing, including continuation of the SNF workforce standards program, the SNF quality assurance fee, and annual rate growth, while the department develops a longer-term financing redesign for 2027-28. Members expressed skepticism about repeated rate reform efforts and questioned whether a one-year extension of the eliminated workforce quality incentive program should be restored during the transition. Finally, Covered California presented its budget and enrollment update, reporting that the expiration of the federal enhanced premium tax credit is expected to reduce affordability significantly, with average premiums roughly doubling for many enrollees and as many as 400,000 Californians potentially losing marketplace coverage over time. The exchange said California’s $190 million subsidy program is helping lower-income enrollees, but not enough to offset the federal loss, and it is also implementing a new gender-affirming care benefit and awaiting federal action on benchmark plan changes.

Transcript Highlights:

• AND PROGRAMS THEY HAVE ELIGIBLE UNDER THE OPEN-DOOR WORKFORCE PROGRAM.
• DEGREE PROGRAMS IN 16 BACHELOR’S DEGREE PROGRAMS.
• FOR US IN PARTICULAR WE HAVE BEEN ABLE TO INCREASE THE NURSING PROGRAM OF OVER $200,000 AWARDED WITH
• NOW OFFERING PRACTICAL NURSING PROGRAMS DIRECTLY ON THE HOSPITAL CAMPUS AND STUDENTS GAIN DAILY HANDS-ON
• THAT YOU HAVE THAT ARE THRIVING AND DOING WELL WITH CORE PROGRAMS LIKE NURSING AND WELDING WHERE YOU

Keywords: 999, senate, all

Transcript Highlights:

• And it's something specific to the nursing program, the way it was explained to her, which alarms me
• And it's something specific to the nursing program, the way it was explained to her, which alarms me
• Senator Lanier, I want to say it is, once you're in the nursing program, it's a little around 85 credit
• hours once you're in the nursing program.
• in the nursing program.

Keywords: 996, all

Transcript Highlights:

• collaboration between our nursing education programs and our health care partners to address Florida's
• The state provides a dollar-for-dollar match that supports nursing scholarships and program expansion
• colleges for a total investment of 60 million dollars to incentivize increased nursing program enrollment
• and healthcare providers and partner with nursing programs to income increased capacity on funds. 24
• Some of the top programs utilizing funding our nursing Health science programs, welding technology, HVAC

Transcript Highlights:

• programs.
• For us in particular, we've been able to increase our nursing program with just over $200,000 awarded
• By now offering a practical nursing program directly on the hospital campus, students gain daily hands-on
• By now offering a practical nursing program directly on the hospital campus, students gain daily hands-on
• that you have that are thriving and doing well with core programs, like nursing and welding, where you

Summary: The Appropriations Committee on Higher Education received an overview of Florida’s career and technical education (CTE) system from Chancellor Kevin O’Farrell, who described the state’s CTE pathways, program types, enrollment and completion growth, quality audit metrics, and the Master Credentials List used to identify credentials of value. He highlighted record postsecondary CTE enrollment and completions, strong statewide performance in talent attraction, and several funding tools supporting expansion, including Open Door, the Florida First Responder Scholarship, Workforce Development Capitalization grants, Perkins funding, CAPE performance incentives, and apprenticeship grants. Senators asked about eligibility for Open Door and first responder aid, top industry certifications, and the teacher apprenticeship initiative. A panel of college and technical school leaders then described how state and federal funding has supported local program growth and facility expansion. Santa Fe College, Palm Beach State College, North Florida Technical College, Lake Technical College, Florida Gateway College, and Manatee Technical College each cited increases in enrollment, high placement or licensure pass rates, and new or expanded programs in nursing, welding, CDL, automotive, manufacturing, public safety, and apprenticeship. Several speakers emphasized partnerships with hospitals, employers, school districts, and local governments, and noted that grants helped fund equipment, renovations, and new training hubs. Palm Beach State also raised a request to broaden line funding beyond nursing to other health science fields, and multiple presenters asked for more flexibility, multi-year support, and continued or increased funding to sustain growth. Members discussed broader challenges, including the difficulty of sustaining grant-funded growth after initial awards, the lag between enrollment growth and funding formulas, and alignment problems for dual enrollment and technical programs with high school schedules. Senators also noted the need to balance support for high-demand core programs like nursing and welding with the ability to respond quickly to emerging industries such as AI and space. The meeting ended with no formal action beyond adjournment after Senator Davis moved to adjourn.

Transcript Highlights:

• Um, fraudulent and substandard nursing licenses out of, uh, nursing programs in Florida.
• We also regulate the 219 and growing number of pre-licensed nursing education programs in Texas.
• They also administer the grant program for preventing workplace violence against nurses.
• The 4th exceptional item is an increase in funding for the Texas Peer Assistance Program for nurses.
• This is a program that our agency contracts with to provide support and case management for nurses who

Transcript Highlights:

• Louis Park is with their school nursing program.
• Nurse Katie and Nurse Suzanne have worked together to enhance our health education programming for our
• Louis Park is with their school nursing program.
• Nurse Katie and Nurse Suzanne have worked together to enhance our health education programming for our
• Nurse Katie and Nurse Suzanne have worked together to enhance our health education programming for our

Keywords: 1187, senate, all

Transcript Highlights:

• A lot of the programs that supported him were Medicaid programs, to your point.
• And if she ends up in a nursing home, will she ever get out of that nursing home?
• And a third reason is the program was designed as a nursing home diversion program.
• they don't want to be in a nursing home, and they really don't need to be in a nursing home?
• Voucher Program.

Keywords: 995, all

Summary: The committee heard testimony on several aging-related bills, with most speakers focusing on housing stability, home-based services, and care transitions. Representative Badger and a commissioner testified in support of H4039, which would create a universal breakfast and lunch program at senior centers funded through a new Senior Breakfast and Lunch Fund, arguing it would reduce food insecurity and social isolation among older adults. Representative Lipper-Garabedian and multiple providers then supported H780/S495, the hospital-to-home partnership program, describing how embedded aging-services liaisons help older patients transition safely from hospitals to home, reduce readmissions, and avoid nursing facility placement; witnesses from Mystic Valley Elder Services and Mass Aging Access cited pilot results, including hundreds of patients served and examples of substantial cost savings and successful discharge planning. The committee also took testimony on S478, which would require continuing care retirement communities to disclose entrance-fee refund policies more clearly at enrollment. Senator Lovely and LeadingAge Massachusetts said the bill would improve transparency for residents and families, while a consumer witness said her family experienced delays and confusion in getting a refund after her mother left a CCRC. Members noted the issue is also being examined by a special commission on CCRCs. A large portion of the hearing focused on S475, a statewide bridge subsidy program for older adults facing housing instability. Advocates from the Massachusetts Coalition for the Homeless, Western Massachusetts, Somerville, Northampton, East Hampton, Old Colony Elder Services, and Somerville’s Office of Housing Stability described rising senior homelessness, long waitlists for subsidized housing, and cases where short-term rental assistance kept older adults housed while they waited for permanent housing. Somerville witnesses said the pilot program helped nine households remain housed and that some participants have since moved into permanent housing. Members asked about wait times, program design, and how to prioritize applicants; witnesses emphasized flexibility, emergency risk, and the need for a statewide expansion. The hearing also included testimony on S465, an ALS bill that would expand home care access regardless of age and bar the use of quality-adjusted life-year metrics in coverage decisions, with the sponsor and ALS Association arguing the measure would reduce discriminatory treatment and better center patient care. No votes were taken during the hearing.

Transcript Highlights:

• to run the nursing home administrator to run the nursing<00:00:51.760><c> home.
• </c> nursing home. nursing home.
• It's a six-month program.
• And a nurse on the board. Um Thank you. And a nurse on the board.
• threes, but we also had public health nurses in the Healthy Moms, Healthy Babies program that we're

Keywords: Appropriations - Room 409, 28 January, 2026; 10:30 A.M., 925, all

Transcript Highlights:

• I arrived at the rest home sector in 2005 as a nursing home for elderly persons nurse manager, right
• from skilled nursing, and I became the administrator in 2018.
• These clearly apply to nursing homes and do not apply to rest homes.
• Opposing the MAP program. So I'm hoping that that answers your question. I think so.
• Fortunately, my family, we haven't had to deal with nursing homes very much.

Summary: The Joint Committee on Aging and Independence heard testimony on Senate 3057/House 5376, a bill to create an Assisted Living Residence Trust Fund and implement recommendations from the Assisted Living Residence Commission. Supporters, including AARP and the state long-term care ombudsman, backed the trust fund for certification staffing, compliance reviews, investigations, ombudsman services, public reporting, and appeals. The assisted living industry, represented by MassALA, supported the affordability task force and certified medication aides, but asked for amendments to expand career paths and to remove or limit fines as a funding source, arguing fines should be capped and tied to health or safety risks. The ombudsman emphasized the need for more staffing and resources, noting the current caseload and travel burden across the state. The committee also took testimony on Senate 3056/House 5243 concerning medication administration in rest homes. Rest home operators, MARCH, and LeadingAge Massachusetts opposed proposed Department of Public Health changes that would replace the long-standing responsible person model with a MAP-based framework or require more licensed nursing staff. They argued the current model has been used for decades, is safe and affordable, and is better suited to rest homes than MAP, which they said was designed for different settings. They urged the committee to preserve responsible person medication administration while improving training and oversight, and several witnesses asked for a task force or substitute language to study best practices rather than impose immediate regulatory changes. Committee members asked questions about the history of the responsible person model, how medication administration works in practice, and whether other states use similar systems. Chair Stanley said the committee was still reviewing building code-related recommendations for assisted living and noted that those issues may require more time. No votes were taken during the hearing, and the committee adjourned after testimony concluded.

Transcript Highlights:

• And any benefit retirement program.
• </c> nursing, the other is assisted living. nursing, the other is assisted living.
• </c> district uh I've lost two nursing homes. district uh I've lost two nursing homes.
• and first Episode psychosis programs and first episode bipolar disorder programs.
• It's like the PACE program.

Keywords: 1187, senate, all

Transcript Highlights:

• improvement of the programs, and publishes educator preparation program review results and other data
• about program quality.
• data for each approved program.
• Additional review includes indicator-based program review, as staff briefed, in which programs annually
• program review, and some of the data collected includes endorsement assessment scores and... ...program

Summary: The House Education Committee heard several bills related to special education records, artificial intelligence in schools, financial aid access, educator preparation, school health, and student mobile device use. Substitute Senate Bill 6268 would require OSPI to keep an online public record of final special education community complaint decisions for 20 years; the sponsor and several parents, attorneys, and open-government advocates said the records help families, schools, and researchers understand past decisions and remedies, while no one testified in opposition. Substitute Senate Bill 5956 would limit school use of automated decision systems, school surveillance technology, biometric data, and facial recognition in student discipline and safety contexts; the sponsor and supporters said it would prevent harmful false positives and discriminatory impacts, while an industry witness warned the bill could unintentionally reduce school safety by limiting emergency facial-recognition uses. Committee discussion focused on the bill’s scope, especially whether it affects classroom grading or only discipline-related decisions, and staff noted the bill does not require teacher training. The committee also heard Substitute Senate Bill 5841, which would add financial-aid application data to the High School and Beyond Plan platform and require students to receive information about the Washington Opportunity Scholarship Program. The sponsor said the bill would make aid status more transparent and easier to track, especially for families facing language or access barriers, and a student advocate testified in support; a committee member raised concerns about privacy for immigrant and DACA students, and the sponsor said the portal would be opt-in and guided by privacy protections. Senate Bill 6278 would codify and update Professional Educator Standards Board review of teacher and principal preparation programs, including program standards, educator role standards, evidence, and input from P-12 partners, while allowing field placement plans to be submitted on a less frequent schedule; PESB staff said the bill largely reflects current practice and adds flexibility. Substitute Senate Bill 5240 would expand who may administer epinephrine in schools and allow use of any available epinephrine when a student with a prescription on file has anaphylaxis; school nurses supported broader access to stock epinephrine but warned against using one student’s medication for another and raised legal and ethical concerns, while the sponsor emphasized faster response in emergencies. Finally, Substitute Senate Bill 5346 would direct OSPI to study and report on school mobile-device restrictions and update digital citizenship resources to include research and best practices on student phone use. Staff said OSPI already has some guidance, but the bill would create formal legislative reports and expand the state’s digital citizenship materials. The committee began taking testimony on that bill as the hearing time ran short, and the chair noted there were ten people signed in to testify.

Transcript Highlights:

• For the post-secondary schools that are offering nursing programs, if there's a school issue, it goes
• As a nation, we have seen the devastating effects of nursing programs fraudulently attesting...
• For the post-secondary schools that are offering nursing programs, if there's a school issue, it goes
• education programs the primary its jurisdiction over the nursing education programs the primary mandate
• programs fraudulently attesting nation we have seen the devastating effects of nursing programs fraudulently

Summary: The committee took up House Bill 2308, which would prohibit a dental insurer or its holding company from owning interests in dental practices regulated by the Arizona Board of Dental Examiners. The sponsor and Arizona Dental Association argued the bill is meant to prevent vertical integration and insurer control over provider care, while Delta Dental opposed it, saying the measure would block nonprofit insurers from investing in clinics for indigent care and create divestment burdens. After discussion of possible exemptions and market-share caps, the committee passed HB 2308 on a 7-0 vote. The committee then considered House Bill 4001, as amended, which creates a licensing and enforcement framework for alternative nicotine products beginning in 2028, increases penalties for sales to minors, restricts youth-oriented marketing, and licenses manufacturers and distributors. Supporters, including the sponsor, Border Security Alliance, Arizona Petroleum Marketers Association, and Vapor Technology Association, said the bill would improve supply-chain transparency and help curb illegal products and youth vaping. Opponents, including the American Cancer Society Cancer Action Network, argued it should instead use a full tobacco retail licensing model and that the bill’s enforcement structure lacks sufficient resources. The committee adopted the amendment and passed the bill 6-1. House Bill 2873, as amended, was also approved unanimously. The strike-everything amendment allows a person or organization that filed a city or town referendum petition to withdraw it before ballot qualification, applies the rule retroactively to withdrawals filed on or after January 1, 2026, and bars tallying or canvassing votes for referenda with a withdrawal notice. The sponsor described it as a common-sense governance fix, and the committee gave it a 7-0 do-pass recommendation. The committee next heard House Bill 2408, which revises Arizona Board of Nursing complaint procedures, confidentiality, investigation timelines, expungement authority, and related disciplinary processes. Nursing board officials opposed parts of the bill, warning that changes to nursing education oversight and tighter deadlines could weaken patient safety and increase costs and liability, while the Arizona Nurses Association and several nurses supported the bill as a way to prioritize serious complaints, improve timeliness, and allow expungement in appropriate cases. After adopting the amendment, the committee passed HB 2408 on a 5-2 vote. The committee also passed House Bill 2342, which limits HOA restrictions on backyard shade structures, and House Bill 2323, which extends Arizona’s motor vehicle lemon law protections to lessees, both by unanimous votes. Finally, the committee began hearing House Bill 4010 on creating a Board of Genetic Counselors, with the sponsor and supporters describing it as a licensure and patient-safety measure; the transcript ends during testimony on that bill.

Transcript Highlights:

• nursing bachelor's program.
• I'm sure you're aware that there are programs for students in ADN programs to advance their nursing education
• nursing programs in California.
• California, selfishly in my district. level programs currently offered by most nursing programs in California
• The programs that we're looking at expand the nursing education into leadership.

Summary: The Assembly Higher Education Committee heard a series of bills focused on expanding access to higher education, addressing workforce shortages, student housing, and labor standards on campus projects. AB 662 would create a South County Higher Education Task Force to explore a mixed-use, intersegmental institution in Chula Vista; supporters said South San Diego County is a “college desert,” while the bill passed on a due pass as amended motion to Appropriations. AB 885 would establish a College Access for All Fund to help make CSU and UC attendance more affordable; supporters cited student debt and affordability concerns, and it also passed to Appropriations. AB 730 would provide $15 million to help establish a medical school in the Central Valley to address physician shortages, and it advanced on a due pass motion. AB 1400 would let up to 15 community college districts pilot bachelor’s degrees in nursing; supporters argued it would expand affordable BSN access and keep students local, while CSU, UC, and other higher education groups opposed it as unnecessary and inconsistent with the master plan. The bill passed to Appropriations, with members raising questions about clinical placements, faculty shortages, and possible effects on associate-degree programs. The committee also considered AB 1235, which would require CSU design-build projects to use a skilled and trained workforce, aligning CSU with other public higher education construction standards. Supporters said it would improve safety, training, and local job opportunities, and the bill passed to Appropriations. AB 1247 would restrict contracting out of classified school and community college jobs unless workers meet training and qualification standards and would address pension and training concerns; supporters said it would protect students and classified employees, while school and college groups warned it would disrupt services and add unfunded mandates. The bill passed to Appropriations with one no vote. AB 1470, presented on behalf of Assemblymember Haney, would allow a portion of student housing revolving loan funds to be used for affordable student, faculty, and staff housing in downtown and commercial districts; it was discussed as a housing and downtown revitalization measure, but the committee held off on a motion pending more members. ACA 3, also on behalf of Haney, would require UC to offer limited down payment loans to eligible long-term support staff first-time homebuyers; it drew extensive support from UC workers and unions, while UC and business groups opposed it as costly and outside UC’s mission, and the measure was still under discussion at the end of the transcript.

Transcript Highlights:

• Our nurse was involved, but it wasn't a nursing error, but maybe it was a physician error.
• Our nurse was involved, but it wasn't a nursing error, but maybe it was a physician error.
• nurse.
• nursing program, you must have implicit bias as part of your graduation requirements.
• If you graduate from an out-of-state nursing program, obviously we don't have authority over what is

Summary: The subcommittee heard a series of budget proposals, beginning with Exposition Park. Park leadership described the 160-acre state property’s historic role, growing visitation, and major upcoming events, including the FIFA World Cup fan fest and the 2028 Olympics. The governor’s proposal sought $96.5 million for utility replacement, site improvements, code compliance, accessibility, and public safety/traffic systems, plus $1.698 million for operational sustainability. The LAO said the proposals had merit but suggested the Legislature could consider downscaling some work given the budget condition. Members generally supported the requests, emphasizing deferred maintenance, public access, and the park’s statewide importance; both Exposition Park items were held open. The California Science Center requested funding to open and operate the new Air and Space Center, a major expansion featuring the Space Shuttle Endeavour. The LAO supported the proposal but suggested the Legislature consider alternative funding sources such as admission fees, higher parking fees, or private funds. Members debated whether the state should continue to fund operations without charging admission, with the Science Center explaining its public-private funding model and warning that fees could sharply reduce attendance, especially for underserved communities. The item was held open. The committee also reviewed continuation funding for the Department of Financial Protection and Innovation’s consumer protection and debt collection programs. DFPI and Finance said the requests would extend existing expenditure authority and were not General Fund asks. The LAO supported limited-term funding but urged cumulative reporting or a sunset-style review before permanent funding. Members pressed DFPI on outcomes, workload, and the high cost of the debt collection licensing program, noting that the number of licensees was far below early estimates and that assessments on the industry were substantial. Public commenters from the debt collection industry echoed those concerns, while others supported DFPI’s consumer protection work. The committee then heard a Board of Registered Nursing request for $1.4 million to fund eight special investigators. The board said complaint volume has risen with licensee growth and more complex cases, and members asked about complaint outcomes, regional caseloads, med spa oversight, viral complaints, and bias-related complaints. The board explained its investigation, probation, and intervention processes and said most cases reaching the Attorney General result in discipline. That item was also held open. After public comment on additional agenda items, the committee voted on several vote-only items. Items 8, 10, 11, 12, 13, 15, 16, and 17 were approved 4-0. Items 7, 9, and 14 were also approved, with the chair correcting the tally to 4-0. The hearing then adjourned.

Transcript Highlights:

• So this maintains the skilled nursing facility, or SNF, workforce standards program, which provides enhanced
• So this maintains the skilled nursing facility or SNF workforce standards program, which provides enhanced
• So for the level of care nursing staff for programs for all-inclusive care for the elderly can step forward
• So for the level of care nursing staff for programs for all-inclusive care for the elderly can step forward
• school nursing facilities. on issue number of and nursing services that are happening in school nursing

Summary: The subcommittee heard a lengthy Department of Health Care Services presentation on the governor’s Medi-Cal budget, including a $229.1 billion total-funds proposal, projected Medi-Cal enrollment declines as redeterminations continue, and several major cost drivers such as managed care growth, Medicare-related costs, pharmacy spending, and changes tied to federal policy. Members focused heavily on the elimination of Prop. 56 dental supplemental payments beginning July 1, 2026, questioning the likely impact on provider participation and utilization. DHCS said it is completing the required rate reduction/access analysis for CMS, has been holding stakeholder meetings and issuing provider bulletins, but could not yet quantify the real-world effect. The committee also discussed a $50 million savings proposal tied to new hospice utilization management authority and asked about possible effects on emergency dental care and provider participation. The hearing then moved through the November 2025 family health estimate and several county and program administration issues, including CCS, GHPP, and Every Woman Counts. DHCS said family health costs are rising despite slight caseload declines because of higher utilization and medical costs, and members raised concerns about CCS website accessibility, county administrative funding, and the transition of youth aging out of CCS. The department said most CCS beneficiaries are also on Medi-Cal, that counties have long raised funding concerns, and that it had clarified use of maintenance-and-operations dollars to address some county workload issues. Members also asked about Every Woman Counts potentially seeing higher demand as Medi-Cal changes take effect; DHCS said that is possible and that the program has multiple funding sources including General Fund. A major portion of the hearing focused on provider taxes and federal changes under H.R. 1, especially the Medi-Cal managed care organization tax and the hospital quality assurance fee. DHCS explained that H.R. 1 restricts new or increased health care-related taxes, phases down allowable tax levels over time, and tightens “generally redistributive” rules, which could sharply reduce the state’s ability to use the MCO tax for Medi-Cal financing. Members asked whether the Legislature could amend Prop. 35 or whether voters would need to act; DHCS said a three-fourths legislative amendment may be possible if it aligns with the measure’s purpose, but the department is still evaluating options. The committee also discussed hospital financing, with DHCS describing recent increases in state-directed payments and the effect of H.R. 1 in capping those payments at Medicare levels, and the LAO noting the tradeoff between preserving provider taxes and maintaining Medi-Cal funding. The subcommittee also reviewed a series of DHCS budget change proposals and trailer bill items, including managed care final-rule implementation, managed care operations, a hospital value strategy, a one-year extension of skilled nursing facility financing, long-term care payment transparency, and interoperability/prior authorization requirements. Members repeatedly questioned the use of limited-term versus permanent positions, the overlap among proposals, and the timing of new financing reforms. DHCS said the SNF extension would preserve current workforce standards, sanctions, growth limits, and the SNF quality assurance fee while the department develops a broader 2027-28 redesign. No votes were taken; items were repeatedly held open for later action. Covered California then presented on the expiration of the federal enhanced premium tax credit and the resulting affordability crisis. The agency said Californians will lose about $2.5 billion in premium assistance for 2026, average premiums could nearly double for many enrollees, and as many as 400,000 people could eventually leave marketplace coverage. Open enrollment ended with 1.9 million sign-ups, down 3% from the prior year, with especially steep declines among middle-income consumers and increased movement into bronze plans. Covered California said the state’s $190 million affordability subsidy is helping lower-income enrollees retain coverage, but cannot fully replace the lost federal assistance. Members also asked about the Health Care Affordability Reserve Fund, repayment of loans from that fund, the status of federal review of California’s essential health benefits benchmark, and implementation of the new gender-affirming care benefit under AB 144.