Transcript Highlights:

• He said the bill establishes a nonopioid directive form. It is simple and easy to fill in.
• <01:08:58.679> directive<01:08:59.359> form establishes a nonopioid directive form
• establishes a nonopioid directive form again<01:09:00.679> it's<01:09:01.120> simple<01
• issues with this language a nonopioid issues with this language a nonopioid directive<01:09:34.040
• This bill will allow patients the ability to create a nonopioid directive, ensuring that they are not

Bills: HF696, HF1429, HF1379

Keywords: HF696, rural EMS, ambulance, emergency medical services, uncompensated care, payment pool, rural health, Office of Emergency Medical Services, public safety answering point, PSAP, nontransport, unpaid ambulance calls, EMS reimbursement, rural ambulance provider, general fund appropriation, Minnesota health finance, specialized life support, metropolitan counties, emergency response funding, HF1429

Transcript Highlights:

• This directive and its immunities match what we have in other current statute for other health directives
• <00:08:04.080> that agreements Andor the U directives that agreements Andor the U directives
• you have one of these um nonopioid you have one of these um nonopioid directives<00:09:46.040>
• have<00:10:29.120> to that nonopioid directive so you have to that nonopioid directive so
• <00:10:43.760> from nonopioid directive they are immune from nonopioid directive they are

Bills: HF1379, HF1596, HF2260, HF1429

Keywords: nonopioid directive, opioid refusal, opioid-free care, pain management, health care directive, advance directive, patient autonomy, informed consent, substance use disorder, opioid epidemic, prescriber immunity, provider liability, emergency medical services, EMS, health record, Minnesota Department of Health, health care agent, medical power of attorney, Metropolitan Council, Minnesota government data practices

Transcript Highlights:

• So, God of wisdom, direct the councils of this honorable assembly, enable us to settle the things to
• Members, do me the privilege of directing your attention to the back of chamber.
• Logan, the Oklahoma State Senate extends to the Morris High School Eagles sincere congratulations and directs

Bills: HB3976, HB3000, HB3001, HB3003, HB3004, HB3066, HB3904, HB3644, HB1687, HB3920, SR40

Keywords: rural hospitals, small hospitals, grant program, healthcare funding, Oklahoma health department, cosmetology, barbering, massage therapy, State Board of Cosmetology and Barbering, Service Oklahoma, license renewal, license reinstatement, licensing fees, sunset extension, board membership, human trafficking, victim services, beauty school, barber school, esthetics

Transcript Highlights:

• On page four, where it talks about the detailed report, I I see that it is directing that report to the
• speak for themselves, replacing two older inconsistent state laws, which were the Oklahoma Advance Directive

Bills: HB3976, HB3000, HB3001, HB3003, HB3004, HB3066, HB3904, HB3644, HB1687, HB3920

Keywords: rural hospitals, small hospitals, grant program, healthcare funding, Oklahoma health department, cosmetology, barbering, massage therapy, State Board of Cosmetology and Barbering, Service Oklahoma, license renewal, license reinstatement, licensing fees, sunset extension, board membership, human trafficking, victim services, beauty school, barber school, esthetics

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:

• No patient should face delays when accessing nonopioid treatments.
• So, with us today is Chris Fox of Voices for Nonopioid Choices.
• I'd love Voices for Nonopioid Choices.
• working on this new um nonopioid working on this new um nonopioid options. options. options.
• And we see over 24 states have legislation right now moving in the same direction.

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:

• If this is an advance health care directive that I am directing my care, and it's a voluntary admission
• So I can't give a directive in advance.
• So I can't give a directive in advance.
• Respectfully, Representative, this is an advance directive, and so I’m filling it out in advance to direct
• This resolution builds on those efforts by directing This resolution builds on those efforts by directing

Bills: SB274, SB301, SB249

Keywords: healthcare, life-sustaining treatment, patient preferences, POLST, advance directive, medical orders, hospital discharge, pregnancy, patient care, discharge planning, healthcare policy, substance use, harm reduction, syringe services, needle exchange, overdose prevention, naloxone, opioid antagonist, drug paraphernalia, syringe

Summary: The committee heard and advanced several measures related to health care, public health, and patient protections. House Concurrent Resolution 148, urging a statewide educational strategy on menopause, was presented as a workplace awareness measure and received supportive comments from members before being released. Senate Bill 274, updating Delaware’s MOST program to POLST and clarifying capacity determinations and documentation for end-of-life orders, also drew supportive testimony from medical and nursing groups and was released. House Bill 458, limiting local backflow preventer requirements for certain low-hazard buildings, was presented as a cost-relief measure for homeowners and small businesses; DHSS expressed concerns but said it was willing to work on amendments and a sunset provision, and the bill was released. Senate Joint Resolution 18, designating August 31, 2026 as International Overdose Awareness Day and ordering flags at half-staff, was released after brief supportive remarks. The committee then considered Senate Bill 339, a technical correction to the advance health care directive form clarifying that an agent’s authority for voluntary mental health admission cannot exceed 72 hours, consistent with existing law. Members asked detailed questions about how the 72-hour limit works and whether it applies to voluntary directives; the sponsor and a Disability Rights Delaware witness explained that the bill only aligns the form with current statute and does not expand authority. The bill was released. House Bill 301, requiring hospitals to create discharge plans for pregnant patients discharged while showing signs of labor, prompted extensive discussion. The sponsor and supporters said it would improve safety, transportation planning, and aftercare, while some members noted Delaware hospitals already do much of this work and questioned whether codifying it was necessary; supporters emphasized maternal mortality disparities and the need for guardrails. The bill was released. Senate Bill 196, creating ownership disclosure requirements for long-term care facilities and resident notice rules after ownership transfers, was presented as a transparency measure for seniors and families and was released after supportive testimony from the Delaware Nurses Association and elder-care advocates. Senate Bill 320, expanding pharmacists’ independent prescriptive authority for certain non-controlled medications and allowing opioid use disorder medications under standing order, with added malpractice reporting requirements in Senate Amendment 2, was supported by pharmacists and nurse practitioners as an access-to-care measure and was released. Senate Substitute 1 for Senate Bill 161, establishing a unified licensing and oversight framework for adult behavioral health providers under DSAM, was presented as a patient-protection measure; providers supported the goal but cautioned that regulations must be workable, and the substitute was released. Senate Joint Resolution 19, directing DHSS to study strategies to reduce health care costs, was released with a note reflecting concerns about broadening the analysis to include additional cost drivers and alternatives. Finally, Senate Bill 249 with Senate Amendment 2, modernizing harm-reduction programs and paraphernalia laws, generated the most extended debate: supporters framed it as life-saving public health policy, while opponents raised concerns about needle litter, community impacts, and whether the approach facilitates addiction. Despite the objections, the bill was released.

Transcript Highlights:

• They operate under direct supervision, and this bill reinforces that structure.
• They operate under direct supervision, and this bill reinforces that structure.
• This bill moves us in the wrong direction by concentrating authority without really enough checks.
• identification license for individuals to indicate that the licensee has an advanced health care directive
• Requires licensees to affirm that the directive is in effect at each renewal and prohibits ADOT from

Bills: HB2170, HB2417, HB2418, HB2771, HB2772, HB4018, HCR2059

Keywords: procurement, foreign adversary, China, state contracts, information technology, security, speeding, speed limit, traffic enforcement, driver safety, speed inhibiting device, appropriation, law enforcement, task forces, funding, criminal justice, community supervision, rehabilitation, supervision fee, victim compensation

Summary: The Committee on Public Safety approved the minutes from March 18, 2026, then heard and voted on several bills. HB 4018, which clarifies that a county sheriff has exclusive authority to regulate posse and reserve organizations acting under the sheriff’s authority, passed on a 5-1 vote after supporters said it simply codifies existing authority and improves accountability; one member opposed it as giving too much unchecked power. HB 2417, allowing certain drivers to use a court-ordered speed-inhibiting device instead of a license suspension for specified offenses, passed 6-1, with supporters calling it an optional safety measure and opponents raising cost, privacy, and enforcement concerns. HB 2771, allowing ADCRR to require prisoners to pay reasonable rehabilitation-program costs as a condition of community supervision, passed 5-2, and HB 2772, creating a driver’s-license medical indicator for advance directives such as a DNR, passed unanimously after discussion about implementation, renewal, and cost to applicants. The committee also approved HCR 259, a resolution reaffirming support for county sheriffs and recognizing their constitutional role, on a 4-3 vote. HB 2418, which appropriates $600,000 to be distributed evenly among the five original major incident regional law enforcement task forces in Cochise, Coconino, Navajo, Pinal, and Yuma counties, passed unanimously; testimony said the bill codifies a distribution practice that has already been followed administratively. Finally, HB 2170, the Protection Procurement Act, which bars state contracts for certain Chinese government-controlled companies unless no reasonable alternative exists and imposes penalties for false certification, passed 4-3 after proponents argued it protects Arizona from security and supply-chain risks. The meeting ended with thanks to staff and pages and adjournment.

Transcript Highlights:

• Page 208, line 14, after directive, delete the rest of the line.
• House Joint Resolution 50, a joint resolution directing the auditor of public accounts to study the applicable

Bills: SB141, SB124, SB56, SJR116, SB94, SB37, SB127, SB197, SB66, SB70, SB133, SB160, SB214, SB312, SB52, SJR62, SJR75

Keywords: legal advertisements, tax rates, public hearings, transparency, local government, sick leave, education, teacher retirement, benefits, employee compensation, Medicaid, nonopioid analgesics, pain management, health care regulation, utilization controls, physician shortage, health care access, medically underserved areas, medical education, workforce development

Transcript Highlights:

• > subject Nonopioid treatments are often subject Nonopioid treatments are often subject to<00:
• <01:14:48.000> That's<01:14:48.320> nonopioid. "For pain. That's nonopioid.
• four companies that offer a nonopioid four companies that offer a nonopioid drug<01:17:30.239>
• nonopioid drugs. nonopioid drugs.
• appropriate nonopioid prescription drug. appropriate nonopioid prescription drug.

Keywords: 981, all

Summary: The Senate convened with a quorum, approved the previous day’s journal, and received a long list of bill status reports and enrollments. It also introduced Senate Bill 168, concerning reporting of money handled by legislative caucuses, and Senate Bill 169, a non-substantive revision bill for the Colorado Revised Statutes. The chamber then agreed to proceed out of order for moments of personal privilege and recognized the Denver and Colorado Springs chapters of The Links, Incorporated for Lynx Day at the Capitol. The Senate next took up a special-order consent calendar containing House Bill 1110, Senate Bill 78, and Senate Bill 151. All three committee reports and the bills themselves were adopted without objection, and the Committee of the Whole report was later adopted by a 35-0 vote. As reported, Senate Bill 78 was amended, Senate Bill 151 passed second reading and was ordered engrossed, and House Bill 1110 was amended, passed second reading, and ordered revised for third reading and final passage. The chamber then moved to special orders on Senate Bill 6 and Senate Bill 15, and the transcript focuses mainly on Senate Bill 6, which would require health insurers to offer at least one non-opioid pain medication option. Supporters argued the bill would expand access to safer pain-management alternatives, reduce opioid addiction, and encourage innovation; several members shared personal or professional experiences with opioid harms. Opponents argued the bill would mandate newer, more expensive drugs when less costly alternatives already exist and could raise health care costs. The debate continued in the excerpt, but no final vote on Senate Bill 6 is shown here.

Transcript Highlights:

• It has to be going in the same direction, and that's codified in statute.
• It has to be traveling in at least two lanes in the same direction.
• Additionally, the bill outlines requirements for private towing carriers, including directing carriers
• The bill... ...provides proof to ADOT of the directive that fulfills prescribed requirements.
• So I think there's a direct nexus to the work that we do, why we support 2772. Mr. Chair, please.

Bills: HB2127, HB2257, HB2305, HB2573, HB2772, HB2941, HB2957

Keywords: special license plates, transportation, funding, nonprofits, charitable contributions, boating, watercraft licensing, law enforcement, safety fund, state funding, Arizona Revised Statutes, towing regulation, private towing carriers, vehicle impound, towing rates, preemption, DUI, ignition interlock, substance abuse treatment, driving privileges

Summary: The House Committee on Transportation & Infrastructure heard several bills, beginning with HB 2957, which would require physical driver licenses to be accepted for identification purposes and prohibit cities, towns, counties, and districts from requiring digital mobile IDs for government services. The sponsor framed the bill as a privacy and choice measure tied to concerns about Real ID, biometric data, and federal overreach. Supporters said it preserves a non-Real ID option and protects privacy, while opponents raised concerns about travel requirements and whether the bill could affect proof of legal status. The committee approved HB 2957 on a 4-3 vote. The committee then considered HB 2941, which would make certain motorcycle lane-splitting or passing behavior subject to reckless driving penalties. The sponsor and a motorcycle rights representative explained the difference between lawful lane filtering and unlawful lane splitting, saying the bill would add enforcement teeth for unsafe conduct and improve safety. Members discussed the distinction between filtering and splitting, and several related personal safety concerns. The committee passed HB 2941 unanimously, 7-0. HB 2305, dealing with private towing carriers, would establish statewide rules for private-property towing, including rate standards tied to DPS agreements, documentation and photo requirements, notice to law enforcement, and penalties for unlawful towing. Supporters said the bill would create uniformity and curb predatory towing, while the Arizona Trucking Association raised concerns about the DPS rate structure and the need for further stakeholder work. The committee adopted an amendment clarifying the bill applies only to motor vehicles towed from private property and then passed the bill 7-0. HB 2257, a strike-everything amendment changing the distribution of watercraft fee revenues and requiring an annual expenditure report, also passed after Game and Fish warned of a significant fiscal impact and committee members discussed Mohave County’s water patrol needs; the vote was 4-3. Finally, the committee heard HB 2573, which as amended was narrowed to address a 45-day gap before repeat DUI offenders can install ignition interlock devices. Supporters said the change would improve public safety by allowing earlier use of the technology, while members discussed whether it would weaken DUI laws and how the interlock system works. The transcript cuts off before the final vote on HB 2573, so no committee action is shown for that bill in the provided text.

Transcript Highlights:

• The first we're going to hear about nonopioid pain medications.
• The first we're going to hear about nonopioid pain medications.
• instead of nonopioids. instead of nonopioids.
• in direct healthc care spending<00:21:50.000> annually.
• add-on payments or state directed add-on payments or state directed payments<01:09:22.080> are

Keywords: Medicaid - Room 216, 4 February, 2026; 2:00 PM, 925, all

Summary: The committee heard presentations on several Medicaid-related topics. First, a pharmacy representative discussed nonopioid pain medications as a way to reduce opioid dependence and overdose risk, emphasizing that options such as acetaminophen, NSAIDs, and topical diclofenac can be useful for pain management. She cautioned that nonopioids can still have risks and said any policy should avoid requiring patients to step through opioids before accessing safer alternatives, while still allowing reasonable step therapy among nonopioid options. The presenter said the goal is to keep patients from being pushed toward opioids by cost or insurance design. The committee also heard emotional testimony from parents of a child with Prader-Willi syndrome, who described the condition as a rare genetic disorder that causes severe, lifelong hyperphagia and requires rigid supervision and ongoing treatment. They argued that alternative funding programs can disrupt access to medically necessary drugs such as human growth hormone, forcing families into costly and uncertain coverage gaps. They asked lawmakers to ensure insurance coverage remains stable for rare disease patients and thanked Senator Blackwell for prior support of rare disease legislation. Next, a Livanova representative urged the committee to support higher Medicaid reimbursement for vagus nerve stimulator surgery for drug-resistant epilepsy. He said inadequate hospital reimbursement has reduced access in Mississippi, causing patients to travel long distances or go without treatment, and argued that better reimbursement would improve outcomes and save money over time. He cited studies showing seizure reductions, lower ER use, and a projected $2.8 million in five-year savings for Medicaid based on 40 patients, and asked that hospitals be reimbursed at 100% of Medicare rates for the procedure codes. Finally, a Medicaid official gave a broad overview of hospital payment structure, including fee-for-service, managed care, MHAP, DSH, UPL, provider taxes, and related funding mechanisms. She explained that hospital payments are interrelated and have shifted over time, with major changes tied to managed care, MHAP/UPL increases, and provider taxes. At the end of the discussion, the committee was running short on time and asked her to skip ahead to the provider tax component; no votes or formal actions were taken in the portion provided.

Transcript Highlights:

• That, um, prescribes specific, not so much nonopioid, but opioid.
• but opioid I just feel like nonopioid but opioid I just feel like that<00:15:09.120> um<00:15
• And nonopioid both allowed if you really wanted to go after eliminating the opioid prescribing through
• telehealth without that follow-up in-person visit, you could strike that opioid and or nonopioid and
• just leave it as nonopioid controlled medication in the language, at least providing, not my opinion

Keywords: 1191, senate, all

Transcript Highlights:

• The bill stipulates... ...that the ADOT is not required to accept or interpret directives that do not
• Chair, for a pre-hospital medical care directive, like an organ donor or heart patient... ...or heart
• care staff. ...direct care staff.
• So they would still have to have an advanced directive, is that correct?
• and not an advanced care directive.

Bills: HB2163, HB2256, HB2305, HB2367, HB2369, HB2669, HB2772, HB2916, HCM2007, HCR2004, HR2003

Keywords: lighting laws, construction equipment, farm equipment, vehicle safety, Arizona Revised Statutes, salvage vehicles, insurance claims, abandoned vehicles, salvage auction dealers, vehicle title, towing regulation, private towing carriers, vehicle impound, towing rates, preemption, law enforcement, neighborhood electric vehicles, alternative fuel, vehicle license tax, tax exemption

Summary: The committee first took up HB 2669, which would limit railroad train length to 8,500 feet on main and branch lines in Arizona. The sponsor and several supporters, including a Santa Cruz County fire captain and a BNSF engineer, argued that very long trains create public safety risks by blocking crossings, delaying EMS and fire response, and increasing the consequences of derailments involving hazardous materials. Union Pacific’s witness opposed the bill, saying train length does not cause derailments, that railroads already track crossings and train movement, and that shorter trains would increase congestion and delays. Members debated safety concerns versus interstate commerce and constitutional issues, then advanced the bill on a do-pass recommendation by roll call vote. The committee then considered HB 2369, as amended, which requires certain photo-enforcement citations to be signed by the presiding judge and allows electronic signatures. The sponsor said the bill was prompted by a Mesa issue involving about 40,000 citations that bore the wrong judge’s signature after a judge left the bench. A Mesa representative and a Paradise Valley court director testified that their photo-radar citations already include a judge’s signature, though the practice varies by court. Members discussed whether the requirement should apply only to photo enforcement, whether a designee should be allowed if a judge is unavailable, and whether the bill should be clarified further. The Martinez amendment was adopted, and the bill was returned with a do-pass recommendation. HB 2256, a technical cleanup measure for salvage auction dealers, was then approved. The bill allows a salvage auction dealer to obtain title to a vehicle abandoned after an insurance claim is denied or unpaid, and sets notice and title-release procedures; the amendment refined how an insurance company may request actions regarding a salvage vehicle and payment of storage fees. A CoPart representative said the change would streamline handling of total-loss vehicles when coverage is denied or the owner cannot be located. The committee adopted the amendment and gave the bill a do-pass recommendation. The committee also approved HCM 2007, which urges renaming sections of State Route 69 to honor veterans from five wars, after members discussed adding World War I to the memorial. HB 2772, which would place a pre-hospital medical care directive indicator on driver licenses or ID cards, generated extensive discussion about DNR/advance directive language, first-responder liability, good Samaritan protections, and whether the designation should be handled through a hospital-style advance directive instead. The sponsor said he was willing to work on amendments and broader stakeholder input, and the committee recessed and then held the bill for later consideration. Separately, HCR 2004, which would prohibit photo enforcement systems such as speed and red-light cameras if approved by voters, was heard with strong opposition from Scottsdale Police, who said photo enforcement reduces collisions and serious injuries and should remain a local decision; supporters argued the systems raise due process concerns and do not stop dangerous driving. The transcript ends during that debate, before a final committee action on the resolution.

Transcript Highlights:

• The [laughter] money is every spending in the right direction.
• The [laughter] money is every spending in the right direction.
• The [laughter] money is every spending in the right direction.
• The [laughter] money is every spending in the right direction.
• <00:53:05.520> pain utilization controls for nonopioid pain utilization controls for nonopioid

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well. Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk. Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.

Transcript Highlights:

• <00:18:10.400> Pain accessing nonopioid treatment. Pain accessing nonopioid treatment.
• for a patient, prescribes a nonopioid for a patient, they<00:18:15.760> aren't<00:18:16.000><
• health plans are offering nonopioids health plans are offering nonopioids without<00:18:26.320><
• And it has been estimated by the Minnesota Department of Commerce that the direct savings attributed
• savings attributed to early the direct savings attributed to early diagnosis<01:08:41.839> can

Keywords: 1187, senate, all

Transcript Highlights:

• Um, the direct answer to your question is, you know, we approve the business’s financing.
• Um the<00:30:06.720> direct<00:30:07.039> answer<00:30:07.279> to<00:30:07.520><
• c> your<00:30:07.760> question<00:30:08.000> is, the direct answer to your question
• is, the direct answer to your question is, you<00:30:08.799> know,<00:30:09.279> we<00
• Um, just to make sure that there are no restrictions that are more stringent for nonopioid treatments

Keywords: 1189, house, all

Summary: The committee first heard testimony from State Treasurer Monica Misipelli on House Bill 1042, which would increase the contingent credit limit for the BFA. She explained that under RSA 66 the state’s debt capacity is capped at 10% of unrestricted revenue, and that guaranteed debt counts in the calculation even though it is not direct debt. She said the state currently has about 65% of its capacity used, roughly $120 million of remaining room, and that raising the BFA contingent credit limit from $200 million to $450 million would reduce that capacity. She noted the state’s debt-to-revenue ratio is about 4.2%, that the state’s credit rating is not immediately affected by the guarantee program unless the state actually has to assume the liability, and suggested unused guarantee authorizations, such as one for the Peace Development Authority, could be reviewed in the future. Members asked whether a credit guarantee affects bonding ability like actual debt, what the usual debt level is relative to the statutory cap, and whether the increase would crowd out future capital borrowing. Misipelli answered that guarantees are included in the formula and do affect available capacity, though the current ratio remains manageable. She also said she had been using a $120 million benchmark for capital budget planning and was now modeling $130 million in future state debt. When asked whether the full $250 million increase was necessary, she deferred to the BFA, saying the question should be answered by the agency. James Key Wallace, executive director of the New Hampshire BFA and interim commissioner of Business and Economic Affairs, then testified in support of the bill. He said the request was driven by larger project costs over the last several decades, with construction inflation causing guarantees to be used up in bigger chunks, and by the fact that the BFA has been close to its current cap. He said the agency does not use taxpayer funds, has never had a payout on a guarantee in nearly 35 years, and requires collateral, reserves, and an 80% loan-to-value buffer. He told members the Senate had a similar bill to raise the limit to $400 million and that the BFA considered that range acceptable. In response to questions, he said a smaller increase such as $150 million would cover known transactions but might not provide enough runway for future opportunities, and he confirmed the bill was brought at the BFA’s request. He also said businesses consider housing availability when deciding whether to locate in New Hampshire, since housing and workforce are key location factors. At the end of the work session, the chair closed House Bill 1042 and opened House Bill 241, a bill on health insurance coverage of pain management services for chronic pain. Representative Nagel began introducing the bill and asked for copies of the treasurer’s debt-capacity report, but the transcript cuts off before any further action on HB 241.

Transcript Highlights:

• And then we're also going to have a brief briefing on nonopioid medications and some, um, a stimulator

Keywords: Medicaid - Room 210; 2 February, 2026: 2:30 PM, 925, all

Summary: The committee first took up a placeholder bill related to the Medicaid “L tax” for long-term acute care hospitals. The sponsor explained that these hospitals pay into Medicaid but do not receive Medicaid reimbursement, and said members had reached a general consensus that a solution is needed. The bill was described as a dummy bill with no firm language yet, and the committee adopted a motion for title sufficient do pass; the bill was reported despite one opposing vote. Members then heard a detailed explanation of the committee’s Medicaid technical bill. The sponsor said it was much lighter than in prior years because of uncertainty around federal Medicaid conditions and the lack of a signed bill in recent years. Most changes were described as federal-language updates, cleanup, or department-requested revisions, including changes from “shall” to “may” to give the department more flexibility, shortened notification and care-period timelines, and removal of outdated provisions. Substantive items mentioned included allowing the department to review value-based payment models, adding pediatricians to a covered list, increasing ambulatory surgery center reimbursement from 80% to 85%, approving “treat in place” for ambulances, allowing supplemental payments to hospitals, and reestablishing the Medical Advisory Council. After brief questions, the committee adopted a motion for title sufficient do pass on the tech bill and reported it, again with one opposing vote. The chair then announced a follow-up hearing for the next day at 1:30 p.m. in Room 216 on the L tax, the hospital bed tax, a Medicaid 101 overview on hospital financing, and a briefing on nonopioid medications and a device intended to prevent or reduce epilepsy seizures.

Transcript Highlights:

• Line 443 contains directed MA payments for hospitals and modifications to the hospital surcharge at a
• Line 882 is a House position relating to nonopioid directives.
• I'm also pleased that the hospital direct payment program bill is included.
• <00:56:23.359> payment application for a directed payment application for a directed payment
• direct payment program bill is included. direct payment program bill is included.

Keywords: 1187, senate, all

Transcript Highlights:

• Um, the direct answer to your question is, you know, we approve the business’s financing.
• Um the<00:30:06.720> direct<00:30:07.039> answer<00:30:07.279> to<00:30:07.520><
• c> your<00:30:07.760> question<00:30:08.000> is, the direct answer to your question
• is, the direct answer to your question is, you<00:30:08.799> know,<00:30:09.279> we<00
• So, obviously reading the fiscal note and hearing your testimony, are we confident that nonopioid pain

Keywords: 928, house, all

Summary: The committee first heard testimony on House Bill 1042, which would increase the BFA contingent credit limit. State Treasurer Monica Misipelli explained that under RSA 66, state debt capacity is tied to unrestricted revenue and that guaranteed debt counts in the calculation even though it is contingent rather than direct debt. She said the state currently has about 4.2% to 4.3% debt-to-revenue ratio, about $120 million in additional capacity, and that approving the bill’s proposed increase would reduce available capacity for future state borrowing, including capital budgets. She noted the BFA has a long history of using guarantees without a state payout, but said the legislature should consider whether the full additional $250 million is needed and whether unused guarantee authorizations, such as one for the Pease Development Authority, should be reviewed in the future. Committee members asked whether guarantees have the same effect as actual debt for bonding capacity, and the treasurer confirmed that they do for purposes of the formula. Members also asked about the usual level of debt relative to the statutory 10% cap, and she said the state generally stays well below that limit. BFA Executive Director James Key Wallace then testified that the request was driven by rising project costs, inflation, and the need for more runway so the agency does not have to return to the legislature in an emergency. He said the BFA is self-supported, has never had a guarantee paid out by the state, requires collateral and reserves, and believes the appropriate range is closer to $400 million to $450 million; he also said a Senate bill would raise the limit to $400 million. He added that the BFA’s pipeline includes projects from about $15 million to $100 million and that housing availability is an important factor in business location decisions. After closing the work session on House Bill 1042, the committee opened House Bill 241, a bill on health insurance coverage for pain management services for chronic pain. Representative Dave Nagel, the prime sponsor, gave extensive background on his long career in pain medicine and said the bill is intended to improve access to non-opioid therapies and evidence-based pain management. He described the broad population affected by chronic pain and opioid use disorder, and said the proposal has long had bipartisan and stakeholder support. No vote or final action was taken on House Bill 241 in the portion of the meeting provided.