Transcript Highlights:

• care setting or maybe in urgent care as well.
• Those were things that you may want to go to your primary care physician for are seek an urgent care
• For those patients, hospitals will communicate and collaborate with that managed care plan to ensure
• With that managed care plan to ensure that that applicable plan assigns them an in-network primary care
• I know you said you're working with Medicaid managed care on making sure that non-emergent care needs

Summary: The committee opened with roll call, welcomed members back for the first committee weeks, and heard brief personal updates from several senators before moving into agency implementation updates on recently enacted health care laws. The Agency for Health Care Administration reported on Senate Bill 64 creating rural emergency hospitals, explaining that AHCA adopted the required rules effective June 1, 2025, but that no hospitals have yet been designated. Members asked about possible hospital conversions, accreditation and survey responsibilities, and whether Florida would apply for federal rural health transformation funding; AHCA said it intends to apply and has already been working on the issue with federal officials. AHCA also reviewed the non-emergent care access plan requirement under Senate Bill 7016. The agency said hospitals with emergency departments must submit plans that help redirect non-emergent patients to appropriate care settings while complying with EMTALA, and that 83 plans had been received and 63 approved as of September 30. Members asked about data collection, managed care coordination, and the state’s health information exchange; AHCA said it has moved to a new HIE vendor and will continue monitoring implementation and possible care gaps. AHCA then updated the committee on the TEACH program, saying $6.8 million was spent in 2024-25 across 59 parent organizations and 229 facilities, with more than 1,800 students and nearly 380,000 clinical hours reimbursed. The agency said rulemaking is nearly complete, a new nursing student category and expanded facility eligibility were added, and a federal 1115 workforce waiver remains stalled after CMS signaled it will not approve new workforce demonstrations. AHCA also reviewed House Bill 121 on KidCare eligibility, explaining that implementation of the 300% poverty-level expansion remains blocked by federal litigation and waiver issues tied to premium nonpayment rules; members and public speakers urged action to close the coverage gap. Public testimony on AHCA’s presentation came from representatives of health centers and advocacy groups, who said the non-emergent care access plan has improved hospital-health center coordination and reduced repeat emergency use, and who urged implementation of KidCare expansion for children in the coverage gap. The Department of Health then presented updates on FRAM, the Sanadi screening grant program, the Health Care Innovation Revolving Loan Program, telehealth maternity care, swimming lesson vouchers, and House Bill 159 on pharmacist dispensing of HIV post-exposure prophylaxis. DOH reported strong participation in FRAM and the telehealth maternity program, 24 Sanadi grant awards in 42 counties, 4,945 swimming lesson vouchers issued last year and 2,371 so far this year, and three approved certification courses with five pharmacist certifications issued under HB 159. Committee members asked about recruitment of dentists and other providers, telehealth maternity outcomes, and why participation in the maternity program remains below expected levels; DOH said outreach and regional referral networks are expanding and more detailed outcome data will be included in the upcoming legislative report.

Transcript Highlights:

• who improve access to care and enhanced care delivery.
• The PA profession continues to improve access to care, improve continuity of care, and health care delivery
• This also optimizes patient care and collaboration between the care team.
• Giving people care that need care, right?
• They're a great part of the team, as you know, and health care is a collaborative team effort.

Summary: The joint sunset oversight hearing reviewed five regulatory entities: the Board of Behavioral Sciences, the Board of Psychology, the Physician Assistant Board, the Podiatric Medical Board, and the California Massage Therapy Council. Across the hearing, each entity described recent accomplishments, licensing and enforcement workload, workforce shortages, and efforts to modernize processes. Common themes included streamlining licensure, expanding access to care, addressing telehealth or emerging technology, and balancing consumer protection with workforce needs. For the Board of Behavioral Sciences, members discussed workforce shortages in mental health, supervision barriers, telehealth confidentiality, AI in therapy, interstate compacts, school-based services, and military spouse licensure. The board said it has expanded outreach, improved licensing processes, and created temporary practice authority tracking, while also expressing concern about counseling compacts and emphasizing California-specific law, ethics, and cultural competency. Public commenters supported the board’s work and the possible move to a national MFT exam, while also urging more resources. The Board of Psychology highlighted fee adjustments, streamlined licensure pathways, enforcement process improvements, new CPD requirements, and proposed changes including a psychotherapist-client privilege exception for investigations. Committee members and public witnesses focused heavily on that privilege proposal, with some members opposing it as too broad and privacy-invasive, while the board argued it is needed to obtain records in bias and sexual misconduct cases. The board also discussed workforce shortages, processing improvements, and the use of inactive status for psychological associates. The Physician Assistant Board reported growth in the PA workforce and education programs, SB 697 implementation, and financial pressure from rising enforcement costs. The main policy debate centered on physician-to-PA ratios and practice agreements, with board representatives and many public commenters arguing that current restrictions limit access to care, especially in rural areas, while the California Medical Association defended the need for explicit ratios and agreements. The board also discussed AI, fee increases, and tracking temporary practice authority. The Podiatric Medical Board described licensing and renewal reforms, residency expansion, enforcement support, and budget constraints, while public testimony raised concerns about a proposed fee increase and about reimbursement parity and practice recognition for podiatrists. Finally, the California Massage Therapy Council defended the certification model over licensure, citing lower costs, local government collaboration, anti-trafficking work, and its role in vetting applications and disciplining bad actors; no formal votes or final actions were taken during this portion of the hearing.

Transcript Highlights:

• care businesses to increase the child care slots in California by 12,013.
• Trust is the foundation of patient care.
• system and provide excellent patient care.
• As California faces widespread OB-GYN and primary care physician shortages, care provided by APCs is
• Those disparities are often due to substandard care. Well, that can Health care.

Keywords: 987, senate, all

Summary: The committee began with announcements about consent items and then heard AB 72, which would create an electric vehicle economic opportunity zone in Riverside County. Supporters said the bill would help bring EV manufacturing jobs and training to the Inland Empire, while some senators questioned whether the state should favor one region over others and whether local economic development groups should handle the effort. The bill was passed on a roll call vote and sent to Senate Labor, Public Employment and Retirement. Members then took up AB 685, which would establish the Small Business Resiliency and Innovation Fund to support technical assistance and capital infusion programs for small businesses. The author and supporters emphasized the importance of TAP and related programs for women-owned, minority-owned, immigrant-owned, veteran-owned, and rural businesses, while some chambers of commerce raised concerns about amended eligibility language and whether the funding would be truly supplemental. After discussion, the bill was passed and sent to Senate Appropriations. The committee also approved ACR 173 on a 7-0 vote, and consent items AB 375 and AB 1587 were adopted 10-0. Later, AB 1760, a Dental Practice Act cleanup bill, and AB 1637, which would limit who may alter physician-authored medical records, both passed unanimously. AB 1785, allowing online sales of pseudoephedrine products with existing safeguards, also passed 10-0. AB 1973, expanding abortion-care authority for advanced practice clinicians, drew strong support and opposition and passed 7-3 after senators raised safety and training questions. AB 2025, requiring disclosures for digitally altered rental listings, passed 8-1, and AB 2697, allowing locally approved drive-through cannabis sales with security requirements, passed 7-3. The committee then heard AB 2249, which would tighten cannabis packaging rules to reduce child appeal, and the author described it as a response to poison-control calls and an audit finding that current law is too vague.

Transcript Highlights:

• And by the time they do get care, they're going to need critical care.
• And so there were metrics developed that look at access to care and timeliness to access to care.
• Collaborate with each other.
• Again, from four decades working with managed care organizations, I can tell you most managed care Organizations
• , outpatient care, remote care, and pharmaceuticals in combination.

Transcript Highlights:

• , risk assessments for recuperative care, risk assessments for recuperative care, um,<00:19:36.640
• This was with that collaboration.
• care from that provider.
• care from that provider.
• go, that they have continuity of care. go, that they have continuity of care.

Keywords: 1183, house

Transcript Highlights:

• This was a crucial step toward achieving my dream of becoming a primary care physician in Minnesota.
• This bill would provide necessary clinical exposure to the U.S. health care system, which is a major
• where health care is mostly needed.
• where health care is mostly needed.
• participated in the collaborative participated in the collaborative agreement<00:08:58.600> am

Keywords: 1187, senate, all

Transcript Highlights:

• It strengthens access to health care.
• Uh accessing the care that they need.
• <00:30:28.720> as um and those folks need that care as um and those folks need that care as
• kind of care and that makes me nervous. kind of care and that makes me nervous.
• but I think for me that access to care but I think for me that access to care is<00:31:07.360>

Keywords: 1187, senate, all

Transcript Highlights:

• We are collaborating on marketing and working on degree pathways in health care and other high-need majors
• Our academic alignment has progressed with care and intention.
• Our academic alignment has progressed with care and intention.
• Program mapping is now complete, revealing with care and intention.
• I do want to thank the collaboration and the staff.

Summary: The joint Assembly Higher Education and Budget Subcommittee hearing focused on the future of the California State University system, with opening remarks emphasizing CSU’s major role in California’s economy, workforce, and degree production. Chairs and members said the hearing was intended to inform 2026 budget decisions and to examine three main issues: declining enrollment at some campuses, cost controls and possible consolidation, and oversight of recent state investments at campuses such as Humboldt and Sonoma. The meeting was briefly delayed by microphone and sound problems before reconvening. The first panel featured CSU Academic Senate Chair Dr. Elizabeth Boyd and Cal State Student Association Vice President Katie Karam. Boyd urged the Legislature to protect academic freedom, strengthen faculty governance, provide stable ongoing funding, end unfunded mandates, support student food and housing security, fund flexible course schedules, improve transfer systems such as ASSIST, avoid over-centralizing academic programs, protect immigrant students, and expand intersegmental collaboration. Karam said students are feeling the effects of budget shortfalls through fewer course sections, reduced advising and services, longer time to degree, and tuition pressure, and she called for transparency, meaningful student involvement in budget decisions, and sustained state investment rather than cuts that harm the student experience. The second panel covered enrollment management and included CSU Chancellor’s Office and campus administrators from Chico State, Cal State L.A., and San Diego State. Dr. Delcy Perez said CSU Forward and the new systemwide enrollment plan are aimed at expanding access, aligning programs with workforce needs, and increasing resident enrollment; she reported systemwide enrollment gains and strong application numbers, including a direct-admissions pilot that expanded from Riverside to more campuses. Campus representatives described local recruitment and retention strategies, including early outreach to high school students, community college partnerships, guaranteed admission programs, and expanded advising and student support. San Diego State highlighted record enrollment and high demand, while Cal State L.A. described efforts to recover from impaction and rebuild enrollment. Members pressed CSU officials on the accuracy of enrollment data, the gap between funded targets and actual enrollment, and the system’s reallocation formula. CSU staff explained that campuses below target will see a 5% ongoing reallocation beginning in 2026-27, with one-time reserve funding also being directed to campuses that can grow, and that fiscal health reviews have been completed for 21 of 22 campuses. Legislators also asked about turnaround plans required by the budget act; CSU said those plans are being developed and will be shared in the spring after campus consultation. No formal votes were taken.

Transcript Highlights:

• care.
• care.
• <00:32:37.679> with collaborate or the doe collaborates with collaborate or the doe collaborates
• In a collaborative sense, okay.
• In a collaborative sense, okay.

Keywords: 912, senate, all

Transcript Highlights:

• and the kind of care and the various interagency collaboration the level of care and the kind of care
• Her therapies and medical care are fragmented across multiple providers who cannot easily collaborate
• Her therapies and medical care are fragmented across multiple providers who cannot easily collaborate
• for hospital care.
• Do they need a lower level of care or a higher level of care?

Keywords: 995, all

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

Transcript Highlights:

• Yet many do need long-term care, home care, adult day health care, and assisted living at some point
• It is working collaboratively with a team of care professionals at the centers, both medical and social
• care facilities.
• care facilities.
• With respect to direct services, in close collaboration with the Department of Health Care Services,

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• Supplies for wound care Supplies for wound care and coverage still remain an area of need.
• care for medetomidine-associated harms, like... ...intensive care unit care for medetomidine-associated
• And that also applies to wound care. We do a lot of wound care on site.
• And that also applies to wound care. We do a lot of wound care on site.
• Wound care kits and low-barrier care, and a little more detail for you for your reference.

Keywords: 995, all

Summary: The Special Commission on xylazine held its first meeting, with House Chair Mindy Domb and Senate Co-Chair John Keenan outlining the commission’s charge and a proposed work plan. The commission is tasked with studying the public health and safety impacts of xylazine in the illicit drug supply, including whether it should be scheduled as a controlled substance, how to regulate its production and distribution, and how to improve outreach and treatment for people exposed to it. Members were told the report deadline had been extended to March 30, 2026, and staff proposed a series of public hearings and working groups leading to a final report. The meeting also included attendance, packet materials, and procedural planning. The first major testimony came from BSAS Director Deirdre Calvert, who described xylazine’s appearance in Massachusetts drug supply data, the state’s public health alerts, and DPH’s partnership with Brandeis, CDC, and harm reduction organizations. She emphasized four priorities: reducing stigma and discrimination in health care, expanding self-directed wound care support and coverage for supplies, expanding access to drug checking and test strips, and supporting low-barrier services such as mobile vans and drop-in centers. Commission members asked about first responder awareness, medical education, and whether harm reduction services might face federal restrictions; Calvert said misinformation remains a problem and noted ongoing training efforts, including collaboration with public safety agencies. Several other speakers reinforced the need for low-barrier care and drug checking. Dr. Raghini Jala, an infectious disease and addiction medicine physician, said xylazine has become a common component of the unregulated opioid supply and urged support for rapid-response education teams, community-based drug checking, and better hospital and detox protocols for xylazine withdrawal and wounds. Recovery coach Alan Young testified from lived experience, describing severe wounds, fear of inadequate withdrawal treatment in emergency settings, and the value of mobile care vans that can provide methadone, buprenorphine, and wound care in the community. Dr. Sarah Wakeman echoed the need for naloxone, rescue breathing, low-threshold treatment, and non-stigmatizing health care settings, while Sarah Macon of the Boston Public Health Commission described Boston’s harm reduction and drug checking work, including on-site testing, wound care, and a decline in opioid mortality. Tracy Green of the Massachusetts Drug Supply Data Stream explained that xylazine has declined in recent samples while metatomidine is rising, said drug checking is increasingly used but still not enough, and argued for more funding, staffing, and statewide access to real-time drug checking and harm reduction services.

Transcript Highlights:

• Sufficient child care capacity is crucial for economic success.
• And the North Dakota Development Fund has active loans with 43 child care businesses that care for 3,754
• available for child care?
• Internally, we're refining By collaborating with partners and adopting new technologies.
• We also need to do a better job of sharing program success and encourage collaboration...

Keywords: 908, all

Summary: The Budget Section’s Commerce and Legal Services Division met to review the Department of Commerce base budget for the 2027-29 biennium and to receive an update on Commerce programs. Legislative Council staff first walked the committee through the “blue sheet” base budget summary, explaining the major line items, the large share of federal grant authority in Commerce’s budget, and the continuing appropriations that support several Commerce funds. Members asked how grant funding is coordinated across agencies, and staff said collaboration varies by program but is strong in areas like UAS and LIHEAP. Commerce Commissioner Chris Schilken then presented on current activities, focusing heavily on grant administration, transparency, and economic development programs. Members questioned how grant applicants are selected, whether Commerce tracks applications and return on investment, and how long grant awards take to reach recipients. The commissioner said Commerce uses scoring criteria, outside reviewers, a minimum 30-day application window, and typically completes awards within two to three months. A lengthy exchange followed over whether Commerce should open some grants only to intended recipients versus running competitive application processes; Commerce said it follows best-practice grantmaking and that its attorney in the Attorney General’s office approved that approach. Commerce also highlighted the North Dakota Development Fund, citing long-term investment and job creation results, examples such as Red Trail Energy, Packet Digital, Valiance, Corvent Medical, child care loans, and the Automate ND program. Members asked about acceptable failures, lessons learned, regional economic development coordination, and the expansion of the fund into non-primary sectors. Workforce Director Katie Ralston Howell then outlined a statewide workforce ecosystem review, a new governor’s workforce sub-cabinet, and three task forces focused on simplifying entry, warm handoffs, and data integration. She discussed the in-demand occupations list, Workforce Pell, apprenticeships, and efforts to better connect students with employers and higher education. Commerce also briefly reviewed housing programs and a new housing sub-cabinet. No votes were taken; the committee simply received testimony, asked questions, and adjourned after setting up the next meeting to hear the Attorney General budget in June.

Transcript Highlights:

• It was just the two of us taking care of her, and we needed respite care.
• I don't care where it's from. I don't care what jurisdiction it is.
• I don't care if it's sovereign land; State Police does not care.
• I don't care what jurisdiction it is; I don't care if it's sovereign land.
• State Police does not care.

Transcript Highlights:

• That's what studies call them when they study how first responders get care.
• in that chain of care in that chain of care before<00:11:07.880> the<00:11:08.040> ambulance
• Matt Perleberg, on behalf of Holomua Collaborative.
• , Hawaii Workforce Funders Collaborative, Hawaii Workforce Funders Collaborative, in<00:27:05.520
• corporation creating a collaborative corporation creating a collaborative working<00:34:00.520><

Bills: HCR112

Keywords: HCR112, House Concurrent Resolution, DHRD, Department of Human Resources Development, civil service, classification system, compensation system, salary study, pay scale, job classification, position classification, state workforce, vacancy rate, hard-to-fill positions, labor shortage, recruitment, retention, public employees, state agencies, labor organizations

Transcript Highlights:

• managed care, and HCBS. managed care, and HCBS.
• care home care nursing workforce care home care nursing workforce shortage<01:25:21.520> in
• care.
• would collaborate. would collaborate.
• collaborate. No. collaborate. No.

Keywords: 1187, senate, all

Transcript Highlights:

• Tarleton State is uniquely positioned to respond to the primary care and rural health care shortages
• Access to health care, particularly access to a primary care physician, should not be aspirational.
• Well, in rural health care, we are master collaborators.
• We don't just talk about ecosystems... health care. We are master collaborators.
• It's the need for perpetual care. And so having the physicians in place to provide... ...care.

Bills: HB42, HB125

Keywords: special prosecutor, state law, criminal justice, accountability, law enforcement, stormwater management, counties, regulation, environment, water quality

Summary: The Committee on Higher Education met to hear several bills and first corrected the minutes from its April 1, 2025 meeting to reflect that a committee substitute for HB 271 had been adopted before the bill was reported favorably. The committee then heard HB 3326, which would help Texas higher education employees, especially adjunct faculty, qualify for federal Public Service Loan Forgiveness by counting classroom hours toward full-time status, requiring institutions to verify employment within 60 days, and requiring annual notice to eligible employees. No witnesses testified against the bill, and it was left pending. Members then heard HB 2853, authorizing UTEP to phase in a student union fee increase to fund demolition and reconstruction of its aging student union. Representative Perez and UTEP student and university witnesses said the current facility is outdated and insufficient for a campus of more than 25,000 students, while some members raised concerns about the size of the fee increase and its impact on low-income students. UTEP representatives said most students receive aid, the fee would be phased in over time, and the project was student-approved; the bill was left pending. The committee also heard HB 4066, a one-line bill to abolish the Texas Research Incentive Program after the state cleared its backlog of matching obligations, with the author saying the program was no longer needed in light of newer research funding approaches. The bill was left pending. The committee spent substantial time on HB 125, which would create the Tarleton State University College of Osteopathic Medicine. Supporters, including Tarleton leadership, the founding dean, a rural hospital CEO, and a feasibility consultant, argued the school would address severe rural physician shortages by recruiting Texas and rural students, training them in rural settings, and developing new residency slots rather than competing for existing ones. Members asked about affordability, residency placement, and whether the school would draw students from rural Texas; Tarleton said it would seek to keep tuition and debt low, had already raised private donations, and would request $25 million in state support over the biennium. The bill was left pending. Finally, the committee heard HB 42, which would increase the annual Higher Education Fund appropriation and adjust its allocation methodology. The chair and university witnesses described rising deferred maintenance, inflation, cybersecurity needs, and enrollment growth at HEAF-eligible institutions, with witnesses from Texas Tech, Sam Houston State, and UNT saying the additional funding would help address aging facilities and technology needs. After testimony, the committee left HB 42 pending and recessed.

Transcript Highlights:

• High food, housing, child care, and health care costs, combined with wages that are too low, are pushing
• Some community colleges have very robust health care clinics.
• But I definitely invite that kind of collaboration.
• But I definitely invite that kind of collaboration.
• entire health care system.

Summary: The joint informational hearing focused on CalFresh enrollment, food insecurity in California, the recent federal shutdown’s disruption of SNAP benefits, and the long-term effects of H.R. 1 on eligibility, benefits, and state and county costs. Opening remarks emphasized that millions of Californians rely on CalFresh, that the shutdown briefly delayed benefits for the first time in the program’s history, and that state and local governments, including Alameda County, stepped in with emergency food aid and funding. Members also framed the issue as both a hunger and affordability problem, with several noting that California’s agricultural abundance contrasts sharply with persistent food insecurity. The first panel presented research and advocacy perspectives on food hardship. PPIC’s Tess Thorman described food insecurity rates, disparities affecting households with children and Black and Latino households, and the role of nutrition programs in reducing poverty. Nourish California’s Betzabel Estudio argued that hunger is a policy choice and highlighted campaigns to expand state-funded food assistance for immigrants, support reentry populations, and continue the CalFresh fruit-and-vegetable incentive program. The California Association of Food Banks’ Josh Wright said food banks are seeing sustained high demand, lower federal food supplies, and cannot replace CalFresh, while urging more state support for food purchasing, school meals, and SunBucks. The second panel reviewed CalFresh operations and participation. The California Department of Social Services reported that CalFresh participation has risen over the past decade, with the state closing much of the participation gap through outreach, simplified applications, and demonstration projects such as the Elderly Simplified Application Project and a minimum nutrition benefit pilot. Alameda County Social Services described local caseloads, application trends, and emergency food distributions during the shutdown, while also warning that H.R. 1’s work requirements, immigrant eligibility restrictions, and possible cost-sharing could reduce enrollment. A student CalFresh ambassador testified about the burdensome application and recertification process and urged more funding for campus basic-needs centers and outreach to reduce stigma and administrative friction. In the final panel, county, food bank, and policy witnesses described the shutdown response and the expected impact of H.R. 1. Alameda County Community Food Bank and the County Welfare Directors Association said counties, food banks, and community partners mobilized emergency funds, pop-up pantries, and food purchasing to bridge the shutdown gap, but warned that hundreds of thousands of Californians could lose benefits under the new federal rules. The California Budget and Policy Center began outlining the scale of federal cuts, noting that H.R. 1 will significantly reduce SNAP funding and shift costs to states. No votes or formal committee actions were taken; the hearing was informational and concluded with discussion of possible state responses, including backfilling benefits, preserving outreach funding, and improving administrative systems to protect enrollment.

Transcript Highlights:

• And we look forward to working in collaboration with you.
• critical moment where we find ourselves in health care.
• And we look forward to work in a collaboration with you.
• Primary care, rural health care transformation—tremendous amount.
• I mentioned the multidisciplinary care team earlier.

Summary: The committee met to hear introductory briefings from the Department of Health and the Health Care Authority on agency priorities, federal changes, and implementation challenges. Secretary of Health Dennis Worsham said his department’s listening tour is focused on strengthening governmental public health, improving health care quality and access, and responding to federal funding disruptions and the shutdown’s effects on programs such as WIC. HCA Director Ryan Moran said the agency is prioritizing coverage preservation, oversight of major contracts, affordability, behavioral health integration, rural health transformation, and internal agency operations. Members asked about licensure delays; Worsham said the backlog had been reduced from about four months to six weeks and should be caught up by January 1, with possible further process changes if needed. A major portion of the meeting focused on H.R. 1 and its Medicaid-related implementation. Governor’s health policy advisor Caitlin Stafford, HCA staff, and interim Medicaid Director Trinity Wilson said the state is working with DSHS, the Health Benefit Exchange, tribes, and other partners to prepare for eligibility changes, work requirements, and six-month redeterminations. They said the state expects up to 30,000 Apple Health enrollees could lose coverage under the law’s non-citizen eligibility changes, and that the work requirement/redetermination provisions could affect about 620,000 adults, with roughly 80,000 also enrolled in SNAP. HCA said it hopes to automate most verification, but about 15% to 20% of cases may require manual review, with technology costs estimated at up to $30 million. Staff also said they are trying to keep H.R. 1 implementation mostly in budget language rather than statute, and that communication and navigator support will be important to minimize confusion and coverage loss. The committee also received an update on the Rural Health Transformation Program created in H.R. 1. HCA said Washington submitted its application to CMS on November 5 after extensive stakeholder engagement, including more than 310 written comments, webinars, and tribal consultation. The application centers on six initiatives: rural hospital innovation, community care and prevention, tribal investments, technology and data, workforce development, and rural behavioral health. HCA said the state is likely to receive less than the full $200 million annual amount assumed in the federal program, and that an advisory committee may be created to help guide spending over the five-year program. Members asked about palliative care, small business impacts, and communication with enrollees; HCA said it expects to share outreach toolkits and that no 2026 statutory changes are currently anticipated, though that could change. The final panels covered organ donation and transplant services. Department of Health staff explained the 2023 “Lights and Sirens” law for organ transport vehicles, including licensing, driver qualifications, insurance requirements, and use of emergency lanes and traffic preemption; the department said one company is currently licensed and there have been no complaints. LifeCenter Northwest described the organ procurement process, the legal framework under the Uniform Anatomical Gift Act, and the rarity and complexity of deceased donation, noting Washington has seen strong growth in donation and transplants over the past decade. University of Washington Medical Center staff then outlined its transplant programs for kidney, liver, heart, lung, pancreas, and multi-organ transplants, describing the multidisciplinary evaluation and waitlist process and the coordination required with donor organizations and hospitals.

Transcript Highlights:

• Line 364 for MA and Minnesota Care.
• coverage for traditional healthc care coverage for traditional healthc care practices. practices
• public private permanency collaborative public private permanency collaborative services<00:15:44.399
• <00:32:19.679> agreements<00:32:20.240> between collaborative agreements between collaborative
• Um, and increases and delays in care.

Keywords: 1187, senate, all