Bills: HF201, HF217, HF314, HF315, HF406, HF408, HF425, HF426, HF730, HF731, HF652, HF761, HF1079, HF928, HF1017, HF1056, HF1081

Keywords: HF201, Minnesota income tax, tax subtraction, tax deduction, volunteer firefighter, volunteer fire and rescue, emergency responder, ambulance service personnel, EMR, EMS, search and rescue, canine search and rescue, underwater search and rescue, paid-on-call, part-time volunteer, tax relief, state tax law, section 290.0132, drivers license, identification card

Transcript Highlights:

• So, an EMR um what an EMR does.
• one EMR. one EMR. Jason. Jason. Jason.
• EMR. EMR.
• EMR.
• that EMR down. that EMR down.

Keywords: 916, all

Transcript Highlights:

• For example, the requirements of an on-site EMR, which is defined under 144E.27.
• For example, the requirements of an on-site EMR, which is defined under 144E.27.
• It's EMR. So this is like the base level training. Thank you, Mr.
• It's EMR. So this is like the base level training.
• It's EMR. So this is like the clear. It's EMR.

Keywords: 1183, house

Transcript Highlights:

• I'm not against the concept of EMR.
• One was that I have no problem with an EMR. I love our EMR, Acopa.
• That’s an ideal EMR.
• That’s an ideal EMR.
• Next, EMRs are expensive to adopt.

Keywords: 1189, house, all

Transcript Highlights:

• uh, coming up with an EMR is different. uh, coming up with an EMR is different.
• as the representative said, um, the EMR as the representative said, um, the EMR was<01:28:48.840
• Um and if EMR, the more you have to pay.
• We have a national standard EMR and then we got Wyoming's monopoly EMR.
• So, the EMR cal two number calculation?

Keywords: 916, all

Summary: The committee opened by taking roll for the Joint Transportation, Highways, and Military Affairs Committee and noting that 20 topics had been submitted for discussion, including one late addition. Members were asked to number the topics for reference, and the chair explained that each presenter should give a brief overview before the committee returned to the dais for questions and possible ranking or action. No votes were taken during the portion provided. The first topic was a request from the Associated General Contractors of Wyoming to have TRIP, a third-party transportation research organization, present a report on Wyoming’s highway system. The report is intended to identify transportation needs and 25 priority projects, and the committee generally supported hearing the report and methodology directly from TRIP. The next topic combined two similar railroad safety proposals. Representative Chestek described a bill addressing train length, wayside detectors, and track inspections, citing the East Palestine derailment and concerns about reduced inspection frequency. Committee members raised questions about federal preemption and enforcement authority; Chestek said states can be more protective of safety where federal rules leave gaps, and WYDOT said it would need additional expertise and staffing to administer such a program. No public testimony was offered on the railroad topic. The committee then heard two proposals from the Wyoming Military Department. One would study Tricare subsidies for mental health providers by comparing Tricare reimbursement rates with other insurers, gathering de-identified data on eligible members and provider participation, and then returning to the committee with findings before any legislative recommendation. Members discussed whether the issue might fit better in Labor, Health, and Social Services, but the military department said it believed the committee had a strong connection to the topic. The second military topic would study Service Group Life Insurance for state active duty, comparing state and federal death benefits for Guard members to identify any shortfalls. The committee also briefly discussed a VSO program review raised by Representative Neff, focusing on the number of veterans service officers and retention, but no action was taken in the excerpt.

Transcript Highlights:

• One is emergent electronic medical record, EMR, on-shoring.
• SB 1188 has provisions that would require the medical data of Texans in electronic medical records, EMRs
• SB 1188 requires that any EMR data processed by artificial intelligence for diagnostic purposes or to
• It also adds requirements that the use of AI for diagnostic purposes using the contents of an EMR must
• And then finally, members, two other things: metabolic health information, Senate Bill 1188 requires EMRs

Bills: SJR12, SJR81, SCR39, SB22, SB32, SB241, SB393, SB414, SB458, SB464, SB568, SB583, SB609, SB660, SB693, SB731, SB732, SB746, SB783, SB785, SB897, SB993, SB996, SB1008, SB1029, SB1035, SB1036, SB1120, SB1122, SB1147, SB1163, SB1188, SB1197, SB1209, SB1227, SB1245, SB1267, SB1307, SB1321, SB1332, SB1386, SB1394, SB1396, SB1470, SB1494, SB1537, SB1596, SB1598, SB1610, SB1664, SB1814, SB1822, SB1841, SB1948, SB2065, SB2155, SB2406, SB2407

Keywords: parental rights, education, constitutional amendment, school choice, child education, tax exemption, ad valorem, tangible personal property, income production, border security, southern border, federal immigration policy, illegal immigration, cartels, transnational cartels, fentanyl, drug trafficking, human trafficking, Operation Lone Star, Texas border

Summary: The Senate opened with a quorum call, invocation, approval of routine motions, and the reading of gubernatorial nominations and several honorary resolutions. The chamber adopted resolutions recognizing Jack and Jill of America Day and DJ Daniel Day at the Capitol, with multiple senators offering remarks praising youth leadership, perseverance, and public service. The Senate also introduced the Doctor of the Day and then proceeded to a long series of floor actions on bills. A major focus was Committee Substitute for Senate Bill 568, which overhauls special education funding and services in public schools by moving from a placement-based model to an intensity-based system tied to student needs and IEPs. Senators Bettencourt, Creighton, and Menendez emphasized transparency, parent input, evaluation funding, dyslexia services, and better alignment of funding with actual services; Senator Hinojosa shared a personal story about dyslexia and the importance of early intervention. The bill was advanced on second and third reading and finally passed 30-0. The Senate also passed SB 1396 to prohibit national sex education standards in public schools, SB 2065 on the Texas Emergency Services Retirement System, SB 1664 requiring clearer public disclosure of transmission and distribution utility rate changes, SB 1029 on advertising certain used motor vehicles, SB 1120 expanding rights for family violence victims, SB 1036 regulating residential solar retail transactions, SB 464 creating school-proximity restrictions and penalties for tobacco and vaping sales, SB 1035 giving farmers and ranchers equitable relief from certain local agricultural regulations, SB 1610 addressing civil commitment facility safety and prosecution issues, SB 1197 extending drone restrictions to spaceports, and SB 1386 changing legislative witness immunity from transactional to testimonial immunity. Another major bill was Committee Substitute for Senate Bill 1188, which updates electronic health record requirements. Senator Kolkhorst said the bill builds on Texas medical privacy law by requiring U.S.-based storage of EMR data, prohibiting recording of voter registration status and credit score information, requiring provider verification and disclosure for AI-assisted diagnosis or treatment recommendations, preserving parental access to minors’ records until age 18, and ensuring EMRs can capture metabolic health and biological sex information. A floor amendment clarified the bill’s scope and enforcement, and the bill passed 23-7. Several measures drew debate, especially SB 414 on bond ballot transparency, where Senators Eckhardt and Menendez questioned whether requiring estimated interest and total debt cost on ballots could be misleading or difficult to implement because interest rates and financing terms can change before issuance or over time. The transcript ends during that discussion, with no final action shown on SB 414.

Transcript Highlights:

• It includes electronic medical record, EMR, on-shoring, SBCC, SBCC on-shoring, SBCC on-shoring, CD 1188
• has provisions that would require the medical data of Texans in a electronic medical records, EMRs,
• SB 1188 requires that any EMR data processed by artificial intelligence for diagnostic purposes or to
• It also adds requirements that the use of AI for diagnostic purposes using the contents of an EMR must
• And then finally members. other things metabolic health information Senate bill 1188 requires EMRs to

Bills: SJR 12, SJR 81, SCR 39, SB 22, SB 32, SB 241, SB 393, SB 414, SB 458, SB 464, SB 568, SB 583, SB 609, SB 660, SB 693, SB 731, SB 732, SB 746, SB 783, SB 785, SB 897, SB 993, SB 996, SB 1008, SB 1029, SB 1035, SB 1036, SB 1120, SB 1122, SB 1147, SB 1163, SB 1188, SB 1197, SB 1209, SB 1227, SB 1245, SB 1267, SB 1307, SB 1321, SB 1332, SB 1386, SB 1394, SB 1396, SB 1470, SB 1494, SB 1537, SB 1596, SB 1598, SB 1610, SB 1664, SB 1814, SB 1822, SB 1841, SB 1948, SB 2065, SB 2155, SB 2406, SB 2407, SJR 12, SJR 36, SJR 81, SJR 50, SJR 4, SCR 22, SCR 12, SCR 39, SB 765, SB 62, SB 666, SB 888, SB 687, SB 847, SB 1248, SB 504, SB 305, SB 296, SB 284, SB 241, SB 304, SB 1023, SB 204, SB 609, SB 670, SB 850, SB 854, SB 413, SB 1346, SB 1033, SB 1220, SB 1073, SB 810, SB 1539, SB 447, SB 1119, SB 1505, SB 1215, SB 1302, SB 583, SB 673, SB 681, SB 1172, SB 955, SB 957, SB 1120, SB 541, SB 266, SB 1415, SB 53, SB 1352, SB 785, SB 1450, SB 1502, SB 1566, SB 414, SB 1062, SB 711, SB 746, SB 1404, SB 1448, SB 507, SB 1026, SB 1349, SB 1355, SB 1433, SB 1434, SB 1596, SB 1403, SB 667, SB 1059, SB 1567, SB 310, SB 311, SB 505, SB 1209, SB 1210, SB 1470, SB 264, SB 1029, SB 1358, SB 1364, SB 1569, SB 1376, SB 1228, SB 519, SB 1350, SB 462, SB 827, SB 1585, SB 1396, SB 1484, SB 1273, SB 927, SB 1227, SB 1229, SB 1353, SB 1464, SB 1709, SB 1729, SB 1733, SB 1744, SB 1772, SB 1841, SB 1147, SB 1008, SB 2016, SB 1173, SB 1163, SB 996, SB 568, SB 1370, SB 1321, SB 1101, SB 860, SB 993, SB 693, SB 1610, SB 1537, SB 1332, SB 1307, SB 963, SB 493, SB 984, SB 619, SB 1122, SB 455, SB 522, SB 1057, SB 1239, SB 1254, SB 1255, SB 1259, SB 1341, SB 1664, SB 1877, SB 464, SB 1277, SB 32, SB 732, SB 660, SB 731, SB 921, SB 268, SB 1822, SB 1188, SB 1589, SB 397, SB 1058, SB 1036, SB 1267, SB 2112, SB 1930, SB 532, SB 1035, SB 2155, SB 508, SB 292, SB 291, SB 901, SB 1333, SB 1436, SB 1494, SB 964, SB 779, SB 1378, SB 2312, SB 1719, SB 1386, SB 287, SB 2143, SB 1245, SB 261, SB 1247, SB 1948, SB 2406, SB 2407, SB 1882, SB 1197, SB 1814, SB 618, SB 38, SB 393, SB 2065, SB 1371, SB 1394, SB 1365, SB 2243, SB 2226, SB 2039, SB 1919, SB 1895, SB 1598, SB 1493, SB 1810, SB 1791, SB 1706, SB 1644, SB 1238, SB 783, SB 458, SB 22, SB 651, SB 897, SB 1809, SB 1080, SB 745, SB 826, SB 989, SB 1320, SB 1437, SB 2320, SB 2289, SB 1171, SB 664, SB 1637, SB 2064, SB 868, SJR 40, SJR 27, SCR 38, SCR 37, SB 1079, SB 1243, SB 1504, SB 1851, SB 1879, SB 2237, SB 1257, SB 2034, SB 1522, SB 883, SB 249, SB 1318, SB 1151, SB 596, SB 1191, SB 226, SB 570, SB 870, SB 991, SB 60, SB 365, SB 1067, SB 1786, SB 326, SB 1401, SB 1592, SB 1728, SB 1265, SB 586, SB 529, SB 217, SB 209, SB 1923, SB 1559, SB 1839, SB 387, SB 1874, SB 1872, SB 1873, SB 1921, SB 1883, SB 1677, SB 95, SB 1620, SB 1838, SB 2024, SB 2429, SB 1999, SB 511, SB 2309, SB 2166, SB 871, SB 510, SB 33, SB 2420, SB 1860, SB 1541, SB 1316, SB 1314, SB 1313, SB 1426, SB 1398, SB 1869, SB 1750, SB 1871, SB 36, SB 855, SB 1233, SB 760, SB 2425, SB 2037, SB 1758, SB 1759, SB 2365, SB 1924, SB 762, SB 1271, SB 1818, SB 605, SB 1405, SB 1762, SB 1968, SB 1977, SB 2077, SB 2148, SB 2321, SB 1967, SB 1662, SB 1663, SB 2124, SB 2204

Keywords: parental rights, education, constitutional amendment, school choice, child education, tax exemption, ad valorem, tangible personal property, income production, border security, southern border, federal immigration policy, illegal immigration, cartels, transnational cartels, fentanyl, drug trafficking, human trafficking, Operation Lone Star, Texas border

Summary: The meeting primarily focused on educational reforms, particularly in special education funding. Notably, Senator Bettencourt laid out the transformative impacts of Senate Bill 568, which aims to lift a historical cap on special education funding that affected approximately 775,000 students. The discussions included plans for an intensity-based funding model that could ensure fair distribution of resources depending on individual needs, thereby enhancing educational support for diverse learning requirements. Senators acknowledged past failures in the special education framework, emphasizing the necessity of moving towards a system that is transparent and focused on delivering adequate services.

Transcript Highlights:

• Anybody want to guess how much that EMR.
• them to buy their EMR.
• like they were formatting these EMRs like they were formatting these EMRs merely<00:16:04.800>
• I don't know what our EMR use this.
• requiring EMRs. Is that accurate to what requiring EMRs.

Keywords: 1191, senate, all

Transcript Highlights:

• Meaningful use was established to build EMRs.
• The only reason I know that is I owned a software company; we built an EMR, and there were three steps
• Meaningful use two required that these EMRs have a portal built.
• The EMR never had a requirement for printing a medical record where it's legible.
• It would be literally code if we went out and printed most of these EMRs.

Summary: The committee took up a large health and human services agenda and first approved HB 711, the Spectrum Alert bill, which would create a statewide alert system for missing autistic children and require FDLE to coordinate training with state and local agencies. The measure drew a supportive waiver from the Florida Smart Justice Alliance and passed unanimously, 24-0, reported favorably. Members then considered CS for HB 229 on health facilities, which modernizes the Health Facilities Authority Act to allow additional nonprofit health system structures to use tax-exempt financing. Two amendments were adopted: one requiring advance notice, public hearings, and stakeholder notifications before a nonprofit hospital closure, and another removing a property tax exemption for a nonprofit hospital that closes and fails to maintain emergency services for 120 days, applied retroactively to January 1, 2025. The Florida Hospital Association opposed the amendments, citing workforce and nonprofit-status concerns, but the bill as amended passed 24-0. The committee also approved CS for HB 1405 on juvenile justice status offenders, expanding early truancy intervention, parent involvement, and shelter placement review timelines; it passed 24-0. CS for HB 27, joining the Social Work Licensure Interstate Compact, and its linked public records bill CS for HB 29 both passed unanimously after supportive testimony from several advocacy and business groups. The committee then debated HB 111 on out-of-network referrals and HB 1083 on patient access to records. HB 111 would require referring practitioners to inform patients in writing when a referral is out of network and to apply out-of-network payments to deductibles; it drew opposition from medical groups over administrative burden and patient-care concerns, but passed 17-8. HB 1083 would shorten the time for producing medical records to 14 working days and standardize access rules, with amendments clarifying portal access and delaying the effective date to January 1, 2026; despite opposition from some health information and provider groups over HIPAA and access concerns, it passed 19-7 as amended. Later, the committee approved HB 883, allowing autonomous practice for psychiatric nurse practitioners with the required credentials, after strong support from nurse practitioner groups and opposition from psychiatric and medical associations; it passed 23-3. HB 1297, which aligns Florida’s electronic prescribing exceptions with federal law and removes several state exemptions, passed 19-7 despite opposition from hospice, emergency physician, rheumatology, and medical groups concerned about paper prescriptions in emergencies and hard-to-find medications. HB 1353 on home health care services and CS for HB 989 on foster home licensure transfers both passed unanimously after supportive amendments. The committee also heard HB 1505 on parental rights, which would require written parental consent for many health care services, surveys, and biofeedback devices for minors and expand parental access to records; the bill drew extensive support testimony but also questions and concerns about confidentiality, abuse reporting, and existing exceptions, and the transcript ended before a final vote on that bill.

Transcript Highlights:

• open to all high school students to get that training that will put them on the path for an EMS or an EMR
• an<00:08:02.000> EMS<00:08:02.800> or<00:08:03.039> a<00:08:03.240> EMR
• <00:08:04.360> certificate<00:08:05.360> wow<00:08:06.039> all for an EMS or a EMR
• certificate wow all for an EMS or a EMR certificate wow all right<00:08:06.319> now<00:08:06.479

Keywords: 1187, senate, all

Transcript Highlights:

• Prior to this, it was EMTs, just for those EMRs, is what is your first responders then folks like me
• So this also includes EMRs, because what we're seeing is more and more services running an EMT with an
• We're just running EMRs, and then, of course, the person with the EMT or paramedic is in the back of
• :08:37.799> just<01:08:37.960> for<01:08:38.359> those<01:08:38.799> emrs
• and then of course the person with emrs and then of course the person with the<01:09:11.239> EMT<

Keywords: 1183, house

Transcript Highlights:

• This is just when EMRs and EHRs were coming onto the scene.
• Senate Bill 1188 requires that any EMR data processed by artificial intelligence must be verified by
• This is allowing that to be a part of the EMRs biological sex.
• There are a lot of different changes that are coming into EMRs.
• How this got all the way down to 13 must be an EMR issue.

Bills: SB95, SB268, SB493, SB619, SB660, SB922, SB984, SB1098, SB1188, SB1307, SB1332, SB1822

Keywords: immunization, written informed consent, civil liability, health care provider, vaccine compensation, administrative penalty, health care, licensing, complaint procedure, disciplinary action, law enforcement, pharmacy benefit manager, PBM, gag clause, prescription drug pricing, out-of-pocket cost, cash price, pharmacist, pharmacy, prescription drug benefit

Transcript Highlights:

• For example, the requirements of an on-site EMR, which is defined under 144E.27.
• or are you thinking about that one of the staff people would then be required to get EMR training?
• about that one of the staff people would then be required to get EMR training?
• It's EMR. So this is like the base-level training. Thank you, Mr.
• It's EMR. So this is like the clear. It's EMR.

Bills: HF3935, HF2216, HF4354, HF4210, HF4212

Keywords: assisted living, healthcare, training, unlicensed personnel, resident rights, safety regulations, nursing home, long-term care, guardian, conservator, arbitration, mandatory arbitration, consumer protection, fee increase, rate increase, price hike, private pay, public funds, Medicaid, waiver services

Transcript Highlights:

• :45:01.478> an hospitals in America you don't have an hospitals in America you don't have an EMR
• :45:02.478> going<05:45:02.600> to<05:45:02.718> get<05:45:02.958> full EMR
• you're not going to get full EMR you're not going to get full reimbursement<05:45:03.840> from
• Kauai can come on with us, and Castle is actually transitioning, so we'll have one EMR for the state.
• One of the ways that a good EMR, especially Epic, does is that they support the physician to know what

Keywords: 910, house, all

Summary: The Committee on Finance held an informational briefing with the Department of Labor and Industrial Relations on its budget, staffing, and operations. The director reviewed department leadership and reported on recruitment and retention efforts, including a 14% vacancy rate, a 10.5% workforce increase from filling 189 positions, and the Hela Imua internship program, which has placed 516 interns since inception and led to 62 permanent hires. The department also described modernization efforts, including the UI Huakai project and the Disability Compensation Division’s electronic case management system, and said the unemployment compensation trust fund exceeded $71.5 million, triggering Schedule C for calendar year 2025. The department’s main budget requests included $2.9 million for fiscal year 2026 to support maintenance and operations of the electronic case management system, plus restoration of two enforcement specialist positions. Officials said those positions are needed to address a decline in investigators from 11 to six since 2009, improve compliance, and handle Hawaii Compliance Express certificate work. Additional requests included two human resources specialists to address recruitment backlogs, two labor enforcement specialists to reduce a backlog of Chapter 104 prevailing wage and wage cases, and two positions for the Office of Community Services to expand immigrant services and access centers. The department also discussed federal funding for unemployment insurance and workforce programs, including National Dislocated Worker Grants and Workforce Innovation and Opportunity Act funds, and said some funding is received in increments and may require extensions. Members asked about Kauai inspection coverage, federal funding uncertainty, the size of the special unemployment insurance fund, and whether the department could ramp up staffing during a future crisis. Officials said Kauai is currently served by inspectors from Honolulu and there are no plans to open a permanent island position because of staffing constraints. They said the department is meeting federal guidelines and is not in jeopardy, and that the special unemployment insurance fund has about $10 million, with current UI operations funded at a little over $15 million, meaning the fund may need to cover roughly $5 million if federal support declines. The director said the department would use the special fund to supplement shortfalls, but noted that federal funding cuts and the loss of ARPA support have already affected operations.

Transcript Highlights:

• We cannot just replace EMR. So, like, we couldn't go and say we'll buy an EMR for everybody.
• We cannot just replace EMR. So, like, we couldn't go and say we'll buy an EMR for everybody.
• So like we We cannot just replace EMR.
• <00:15:11.760> for couldn't go and say we'll buy an EMR for couldn't go and say we'll buy
• an EMR for everybody.<00:15:12.880> Now<00:15:13.120> there's<00:15:13.440> limited<

Keywords: 958, all

Summary: The Health Services Committee heard a presentation from Dr. Steven Stack, Secretary of the Cabinet for Health and Family Services, on Kentucky’s Rural Health Transformation Program. He said Kentucky received about $213 million in federal funding, among the highest awards nationally, after a fast application and negotiation process. He emphasized that the grant is time-limited, must be used for the specific goals in the state’s application, and cannot be treated as a general bailout or replacement for existing funding. He also noted the state will use a website, ruralhealthplan.ky.gov, to share the full application, award terms, and future opportunities. Dr. Stack outlined five focus areas: maternal health and prenatal/early childhood supports; EMS and trauma response workforce and transfer capacity; behavioral health crisis care through the EMPATH model and mobile crisis services; oral health access through more hygienists, telehealth, and hub-and-spoke models; and rural community hubs for chronic disease prevention and innovation, including food-as-medicine and healthier lifestyle interventions. He stressed that the program is meant to be transformative, not duplicative, and that it cannot pay clinician salaries, fund new construction, replace EMR systems broadly, or duplicate billable services. He said the state will work with community partners, hospitals, universities, and others, including the Foundation for a Healthy Kentucky, to begin implementation. Members responded positively overall. Senator Berg praised the award and the goal of integrating care across the state, but raised concerns about access to prenatal care and about possible future changes to water fluoridation, warning both could harm children and rural families. The chair and other members thanked Dr. Stack for the update and congratulated him on the award. No votes or formal committee actions were taken during this portion of the meeting.

Transcript Highlights:

• open to all high school students to get that training that will put them on the path for an EMS or an EMR
• open to all high school students to get that training that will put them on the path for an EMS or an EMR
• open to all high school students to get that training that will put them on the path for an EMS or an EMR
• open to all high school students to get that training that will put them on the path for an EMS or an EMR
• open to all high school students to get that training that will put them on the path for an EMS or an EMR

Keywords: 1187, senate, all

Transcript Highlights:

• A single health system has multiple health records, including EMRs, paper, microfiche, microfilm, CDs
• Many health care organizations have large volumes of health information not interfaced on the EMR and
• health information not interfaced<00:29:29.200> on<00:29:29.360> the<00:29:29.600> EMR
• <00:29:30.720> may<00:29:30.960> be<00:29:31.120> stored interfaced on the EMR
• and may be stored interfaced on the EMR and may be stored offsite<00:29:32.240> in<00:29:32.640

Bills: HF3521, HF1807, HF1270, HF2070, HF3136

Keywords: hospital moratorium, hospital construction, bed capacity, hospital expansion, health care facilities, hospital licensing, safety-net hospital, level I trauma center, Ramsey County, Minnesota health law, hospital beds, new hospital exception, certificate of need, inpatient capacity, emergency care, trauma services, health system regulation, state moratorium, hospital modernization, health infrastructure

Transcript Highlights:

• Cloud School District and are providing EMR training this spring to Apollo High School students and a
• Students certified in EMR in high school can then seamlessly transfer to St.
• school district and we are providing EMR school district and we are providing EMR training<00:45
• the EM course and get certified in EMR the EM course and get certified in EMR students<00:46:04.119
• > high<00:46:05.960> school students certified in EMR in high school students certified

Keywords: 1187, senate, all

Transcript Highlights:

• We've integrated with almost every major EMR and a lot of minor EMRs too to make that kind of thing happen
• a<00:16:01.120> lot<00:16:01.279> of<00:16:01.360> minor<00:16:01.680> EMRs
• <00:16:02.240> too<00:16:02.560> uh<00:16:02.720> to EMR and a lot of minor
• EMRs too uh to EMR and a lot of minor EMRs too uh to make<00:16:03.040> that<00:16:03.279>
• We can't buy a new EMR, and again, we can't duplicate existing billing things.

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:20 CRISP Shared Services 00:01:39 Rural Health Transformation Plan 00:30:55, 958, all

Summary: The Budget Review Subcommittee on Health and Family Services opened its first meeting of the 2026 interim session, took roll, and moved directly into presentations. The main presentation was from Ryan Bramble of Crisp Shared Services, who described the organization’s health information exchange and health data utility model in Kentucky and other states. He emphasized that Crisp is a nonprofit, that data ownership remains with providers, and that governance is local. He also outlined the technical infrastructure, including a master patient index, cloud-based data lake, support for modern standards like FHIR and USCDI as well as older formats, and data quality tools used to normalize and standardize information. Bramble said the model is intended to reduce duplication, lower costs, and support rural providers and future use cases such as reporting, analytics, and AI-enabled decision support. Members asked how the state can ensure the data is actually used and who should drive priorities for health care improvement. Bramble said Crisp can provide tools, expertise, and examples from other states, but local teams such as KHI and state stakeholders must tailor and lead utilization efforts. In response to questions about ownership and coordination, he stressed that successful HIE governance requires a multistakeholder body that includes hospitals, health plans, government, and other interests, with a unified approach rather than multiple competing directives. He also said the Commonwealth has an opportunity to convene those stakeholders and set clear priorities. A senator raised concerns that responsibility for Medicaid and broader health policy has become fragmented and suggested a stronger central role for the state, possibly through the Department of Public Health, to coordinate health priorities. Bramble agreed that a single convening authority and multistakeholder governance are important, and noted that local governance should determine what data is shared and how it is used. No votes or formal actions were taken during this portion of the meeting. After Bramble’s presentation and questions, the committee was told that Secretary Stack from the cabinet would testify next on the rural health transformation plan.

Transcript Highlights:

• We are planning, have plans to invest in EMR, and that's part of a budget request, which I'll summarize
• implementation of Epic in Hawaii region, and that pretty much is to try to build a backbone of EMR system
• 00:05:33.000> of much is to try to build a backbone of much is to try to build a backbone of EMR
• system that could support other HJC EMR system that could support other HJC regions<00:05:36.160>
• c><00:08:29.520> Capital<00:08:29.800> funds<00:08:30.720> and region for some EMR

Keywords: 912, senate, all

Summary: The joint Ways and Means and Health and Human Services committees heard Hawaii Health Systems Corporation’s biennium budget request, with testimony from HHSC leadership on the Hilo/Big Island region (HTH 212) and the Oahu region (HTH 215), plus discussion of capital improvement projects and systemwide partnerships. HHSC described its role as the rural healthcare safety net, serving a high share of Medicare, Medicaid/Quest, and uninsured patients, and said its costs are elevated by state employee fringe benefits, which it said are about 64% compared with roughly 30% in the private sector. HHSC also said pandemic-era federal aid, including relief funds and PPP loans totaling about $100 million, reduced the need for general fund support in prior years. For HTH 212, HHSC said its general fund request for fiscal years 2026 and 2027 was higher than the governor’s recommendation because of rising insurance, pharmaceutical, and contractor labor costs, and because it includes $13.2 million in FY 2026 and $2.3 million in FY 2027 for Epic electronic medical record implementation in East Hawaii. For HTH 215, HHSC said the requested general funds were aligned with the governor’s recommendation, in part because of increased Medicaid reimbursement rates for long-term care facilities under prior legislation. HHSC also said it was restoring a special fund ceiling so the region could spend its cash collections on operations. Members asked about the 64% fringe rate, and HHSC explained the difference was mainly due to defined-benefit pension and retiree health insurance costs, which private hospitals generally do not bear at the same level. Members also asked about the Daniel K. Akaka State Veterans Home, and HHSC said operations would be funded through the general fund corporation for the home when it opens, with management by Ohana Pacific, but no additional legislative operating funds were being requested at that time. Other questions focused on staffing and vacancies, including an abolished procurement position and an ongoing IT help desk recruitment need. HHSC highlighted several capital and partnership projects, including a $25 million state CIP request matched by $25 million from the Benioff family for the Benioff Health Center, an ER expansion and reconfiguration at Corner Community Hospital, and $7.5 million in each fiscal year for Kauai EMR capital funds to join the Epic platform. Testimony also described collaborations with Queen’s, the University of California San Francisco, Hawaii Pacific Health, the Hawaii Cancer Consortium, the Department of Health, and the state hospital to improve specialty access, clinical trials, behavioral health, and patient placement across the system.