Transcript Highlights:

• It also has some areas that are semi-rural.
• Rural stackability is awesome in the bill.
• So, one, I didn't want to compete with our rural incentives.
• With the rural health care practitioner tax credit, as a senator who represents rural New Mexico, I was
• So the $5,000 for my rural physicians with the $4,000 is enticing to keep them in rural New Mexico and

Bills: SB12, SB13

Keywords: tax credit, physician, healthcare, income tax, rural health, tax deduction, gross receipts, coinsurance, managed care, 996, all

Transcript Highlights:

• These are identical bills dealing with the rural health initiative monies come in.
• dealing with the rural health initiative monies<00:13:33.120> come<00:13:33.279> in.
• This includes 11 initiatives to improve healthcare in rural areas, and legislation that he just passed
• But on page two, rural healthcare facilities are closing and losing important specialty services due
• <00:18:14.240> hospitals awareness is closed in rural hospitals awareness is closed in rural

Bills: SB367, SB368, SB350, SB351

Keywords: rural health, healthcare access, state funding, health transformation, appropriations, fiscal policy, healthcare funding, economic development, mental health, maternal health, antitrust, competition, market regulation, business practices, consumer protection, anaphylaxis, epinephrine, auto-injector, public health, school safety

Transcript Highlights:

• The Rural Health Transformation Program.
• doing, is covering our rural, so...
• The... ...most rural residents.
• The only thing that my amendment is doing is putting the rural hospitals, the rural clinics, the rural
• , you know, in furthering rural health care.

Bills: HB1623

Keywords: HB 1623, North Dakota, rural health, rural health transformation program, medical facility infrastructure loan fund, medical facility infrastructure loan program, rural health loan program, Bank of North Dakota, Department of Health and Human Services, HHS, federal grant, health care infrastructure, rural hospitals, critical access hospitals, nonprofit health care providers, gap financing, loan fund, public health funding, healthcare financing, Medicaid

Summary: The committee first heard House Bill 1624, the “Universal Lunch Bill,” from Rep. Mike Nathie. He argued the proposal should be placed in Century Code rather than the Constitution so future legislatures can adjust it if state finances tighten, and said the bill would start the program a year earlier with a $65 million appropriation for one school year. DPI testified that the estimate did not include nonpublic schools that do not participate, and members questioned the impact on Title I, free-and-reduced applications, private-school accountability, breakfast mandates for schools that do not currently serve breakfast, and whether the funding could come from the DPI budget or other sources. Supporters, including North Dakota United, the North Dakota Catholic Conference, a pediatrician, and the American Heart Association, said universal meals improve student health and learning, reduce family costs, and are better handled in statute than by constitutional amendment. No opposition testimony was offered, and the chair closed the hearing for later work-session action. The committee then took up House Bill 1627, introduced by Rep. Tye Dressler, which would raise the income threshold for the state-funded school lunch program from 225% to 300% of poverty, with an estimated cost of about $7 million for 2026-27. Dressler said the bill is intended as a targeted, budget-friendly alternative to the ballot measure and emphasized that the state should maximize federal meal dollars while improving participation in the current program. Members questioned whether raising the threshold would actually increase utilization, whether a dollar amount would be clearer than a percentage, and how the change would affect federal reimbursements and application rates. DPI said it could quickly calculate additional percentage levels, and the chair closed the hearing, directing DPI to prepare more numbers for the work session. Finally, the committee opened Senate Bill 2403, presented by Sen. Schiable, to create a short-term bridge-loan program for financially distressed hospitals, centered on Jacobson Memorial Hospital in Elgin. The bill would authorize up to $5 million per loan, with a $10 million appropriation available on a first-come, first-served basis, and would run only through June 30, 2027. Schiable said the hospital’s debt and operating problems threaten local health care, ambulance service, and the community’s economy, and that the proposal was designed narrowly with Bank of North Dakota review to avoid creating a broad precedent. Committee members asked whether the appropriation could be reduced and whether the bank would still apply commercial feasibility and repayment standards; Schiable said yes, the bank would still evaluate the loan and could reject it if it was not sound.

Transcript Highlights:

• To states for rural health care transformation.
• Wyoming was up quite a bit, very rural, very rural. So they scored very high, and $64 in Iowa.
• It's really for these rural areas associated with these rural hospitals and then health clinics.
• patient or the rural We have to ask the question, is the rural patient or the rural citizen being the
• The gyms do qualify in the rural area.

Bills: HB1623

Keywords: HB 1623, North Dakota, rural health, rural health transformation program, medical facility infrastructure loan fund, medical facility infrastructure loan program, rural health loan program, Bank of North Dakota, Department of Health and Human Services, HHS, federal grant, health care infrastructure, rural hospitals, critical access hospitals, nonprofit health care providers, gap financing, loan fund, public health funding, healthcare financing, Medicaid

Summary: The committee heard House Bill 1623, the appropriations bill tied to North Dakota’s Rural Health Transformation Program, which is funded through a new federal rural health care grant. Senator Bekkedahl explained the bill’s background, the interim committee process that developed it, and the federal conditions attached to the award, including spending deadlines, administrative cost limits, and restrictions on uses such as new construction, supplanting existing funding, and certain other costs. Legislative staff then walked through the seven sections of the bill, including appropriation authority, transfer authority, contingent appropriations for pass-through grants, procurement and public improvement exemptions, recipient reporting, legislative reporting, and immediate effective date. Commissioner Traynor and HHS staff described how the department plans to implement the program, emphasizing that the funding is intended to improve rural access, workforce recruitment and retention, technology and data connectivity, and community health initiatives. They said the department will rely on local applications, technical assistance, templates, listening sessions, and partnerships with providers, schools, public health units, tribal entities, and other community groups. Members asked about reimbursement timing, upfront costs, administrative expenses, sustainability after the five-year grant period, and whether CTE centers, public health units, gyms, grocery stores, and other community partners could participate; the department said yes, within program rules and with a focus on measurable outcomes and sustainability. Several supporters testified in favor. Mental Health America of North Dakota and the Mental Health Advocacy Network supported the bill and urged investment in community-based mental health, crisis response, children’s services, peer support, and mobile crisis teams. HIA Health described the grant as a chance to expand home-based and hospice care, noting that rural providers already have workable models but need funding to scale them. A cybersecurity representative also supported the bill, warning that the large amount of health data and AI-related tools will require strong data protection and professional support. The hearing was closed with no opposition testimony, and the committee announced it would return later in the day for further work on the bill and other measures.

Transcript Highlights:

• That is really rural. I think Albuquerque deserves rural.
• Urban rural and thank you Dr.
• And so just say, well, it's rural. Rural me, no paved roads, population.
• our rural areas, and perhaps stay in our rural areas because they want to be there.
• It is rural New Mexico's culture. It is rural New Mexico's food.

Bills: SB5, SB6, SB8

Keywords: physician residency, healthcare, rural communities, medical education, appropriation, education, medical school, New Mexico, construction, behavioral health, funding, mental health services, general fund transfer, 996, all

Transcript Highlights:

• health clinic or comparable rural health access point to serve the Volcano community.
• Kathleen, please proceed. or comparable rural health access point or comparable rural health access point
• <00:11:41.320> access step towards improving healthcare access step towards improving healthcare
• <00:14:12.560> Act, Prepaid Healthcare Act, Prepaid Healthcare Act, Medicare<00:14:13.760>
• <00:15:44.560> future we really fix our healthcare future we really fix our healthcare future

Bills: HCR18, HCR32, HCR35, HCR105, HCR173

Keywords: hospice, health care, aging population, regulations, Medicare, working group, fraud prevention, quality of care, mental health, recidivism, civil commitment, Hawaii State Hospital, justice system, shelter, treatment pathways, biomarker testing, health insurance, precision medicine, healthcare access, medical necessity

Summary: The committee heard testimony on SCR 21 SD1, which asks Hawaii Health Systems Corporation’s East Hawaii Regional Health Care System to study the feasibility of a rural health clinic or similar access point for the Volcano community. Testimony in strong support came from HHSC representatives, Volcano residents, the Volcano Health Collaborative, the Rotary Club of Volcano, and others, who said the area has a clear need and that local primary and urgent care would align with regional plans. HHSC said it had already looked at the area, found no suitable temporary buildings, and would need a longer-term, capital-intensive solution, but that the study could help accelerate next steps. The committee then took up SCR 50 SD1, proposing a Hawaii Health Plan Working Group to design a basic affordable health plan for residents. Dr. Jack Lewin of SHIPTA said the state faces a growing uninsured population and argued for a short-term, lower-cost plan focused on preventive and primary care, drawing on the old State Health Insurance Plan as a possible model. Members asked about whether that prior program still exists and whether the working group should include the Hawaii Medical Association and Hawaii Primary Care Association; Dr. Lewin said the statute still exists but is unfunded, and that the group should be inclusive. The Department of Labor and other organizations also provided comments. For SCR 75 SD1, which urges a coordinated interdepartmental effort to reduce fetal alcohol spectrum disorder, Dr. Lewin and others said prevention, prenatal screening, and early intervention are needed because FASD is often hidden until later problems appear. Amanda from Hawaii FASD Action Group said current implementation under Act 192 is still largely a landscape analysis and that Hawaii lacks the infrastructure and specialists for a full system. Darlene Chance Govor urged adding the judiciary as a partner so juvenile justice and probation staff can be trained and referral pathways improved, while the Department of Health said it supports prevention but prefers a broader, systems-based approach focused on child needs and upstream care. The Disability Rights Center supported the resolution and asked for an earlier reporting date. The committee also heard SCR 149 SD1, which seeks an informal working group to address complex patients with multiple diagnoses involving substance use, mental health, or chronic physical illness. The Hawaii Substance Abuse Coalition and Ke Nui Malo strongly supported the measure, saying current siloed systems leave people bouncing between medical, mental health, and substance use providers without coordinated care, often ending up in crisis, emergency rooms, or the justice system. They said integrated residential care and a coordinated working group could improve outcomes and align with federal funding opportunities. The transcript ended before any final vote or action on the measures was announced, and SCR 109 was noted as withdrawn from the agenda.

Bills: HB611, HB897, HB902, HB931, HB1030, HB1092, HB1100, HB1118, HB1138, HB1143, HB1160, HB1185, HB1216

Keywords: pregnancy help centers, healthcare services, licensure, Department of Health, medical services, counseling, regulatory compliance, public health, healthcare data, privacy, pregnancy services, confidentiality, client rights, Louisiana Pregnancy and Baby Care Initiative, trauma-informed, child education, mental health, training program, adverse childhood events, religious instruction

Transcript Highlights:

• This is the rural health care transformation grant program.
• committee, who represents a rural district?
• Why do we have a rural health transformation fund?
• Why do we have a rural health transformation fund?
• Rural Arizona needs hospitals. They die preventable deaths.

Bills: HB2190, HB2202, HB2233, HB2251, HB2252, HB2396, HB2437, HB2689, HB2796

Keywords: physician assistants, licensure compact, medical services, multistate practice, patient care access, healthcare workforce, military families, adverse actions, dementia care, telementoring, healthcare education, rural communities, grant funding, HB 2233, rural health transformation, rural health transformation program, AHCCCS, Arizona Health Care Cost Containment System, Joint Legislative Budget Committee, JLBC

Summary: The committee began with a presentation from the Alzheimer’s Association Desert Southwest Chapter and Dr. Anna Burke of Barrow Neurological Institute on the scope of Alzheimer’s disease, the shortage of specialists, low rates of timely diagnosis, and the need for caregiver support and early intervention. Speakers emphasized that Arizona is a leader in Alzheimer’s research and that lifestyle changes, new therapies, and research funding offer hope, but only if patients are diagnosed earlier and providers are better trained. The committee then heard House Bill 2202, which would appropriate $300,000 over three years for a dementia care telemonitoring/telementoring grant program through the Department of Health Services to help providers statewide learn best practices in dementia care. Supporters, including the Alzheimer’s Association, Dr. Danny Cabral, and a patient advocate, said the bill would address major gaps in provider training and improve early diagnosis and treatment. There was no opposition, and the committee voted 11-0 to give HB 2202 a do pass recommendation. The committee next took up House Bill 2251, the “Jordan and MacTerry Act,” which would expand licensed midwives’ authority to administer certain medications, require liability insurance disclosure and reporting, and create an Arizona Midwifery Advisory Committee. Supporters said the bill would improve safety, oversight, and access to emergency medications in home births, while opponents from ACOG and the Arizona Osteopathic Medical Association raised concerns about the adequacy of oversight, the medication list, and whether eight hours of pharmacology training is sufficient. After testimony from midwives, physicians, and stakeholders, the bill was held for further stakeholder work and anticipated floor amendments. House Bill 2252, which would allow certified nurse midwives, certified professional midwives, or licensed midwives to accompany a patient in a ground ambulance during transport if approved by medical direction, also drew support and opposition. Supporters argued it would preserve continuity of care in emergencies, while firefighters and EMS representatives objected to ambiguity and scene control concerns. That bill was likewise held for further stakeholder meetings. The committee then recessed and reconvened for later presentations on federal budget and health-related topics.

Transcript Highlights:

• You can look at each of the different types of areas that increase our taxes with healthcare, public
• <00:10:31.519> our<00:10:31.760> taxes<00:10:32.160> with<00:10:32.399> healthcare
• , increase our taxes with healthcare, increase our taxes with healthcare, public<00:10:33.200>
• What type of system might work best for what we have here based upon our population, the rural environment
• What type of system might work best for what we have here based upon our population, the rural environment

Bills: HB0111, HB0112, HB0122

Keywords: capital construction, state funding, Wyoming, major maintenance, community colleges, task force, legislative services, budget appropriation, unexpended funds, sunset clause, healthcare, rural health, transformation program, funding, incentives, training, access, perpetuity fund, 916, all

Bills: HB0111, HB0112, HB0122

Keywords: capital construction, state funding, Wyoming, major maintenance, community colleges, task force, legislative services, budget appropriation, unexpended funds, sunset clause, healthcare, rural health, transformation program, funding, incentives, training, access, perpetuity fund, 916, all

Transcript Highlights:

• Haroldson, I think probably what you're referring to is that today in Teton County, they do not permit rural
• 02:15:19.440> permit in Teton County, they do not permit in Teton County, they do not permit rural
• 15:21.679> And<02:15:21.920> so<02:15:22.239> that<02:15:22.560> leaves rural
• And so that leaves rural subdivisions.

Bills: HB0111, HB0112, HB0122

Keywords: capital construction, state funding, Wyoming, major maintenance, community colleges, task force, legislative services, budget appropriation, unexpended funds, sunset clause, healthcare, rural health, transformation program, funding, incentives, training, access, perpetuity fund, 916, all

Transcript Highlights:

• Final bill this morning, House Bill 122, Wyoming Rural Health Transformation Program.
• House Bill 122, Wyoming Rural Health Transformation Program.
• Number two, the bill authorizes what we call the rural health transformation perpetuity.
• Number two, the bill authorizes what we call the rural health transformation perpetuity.
• Do we have a roll call on House Bill 122, Wyoming Rural Health Transformation Program?

Bills: HB0111, HB0112, HB0122

Keywords: capital construction, state funding, Wyoming, major maintenance, community colleges, task force, legislative services, budget appropriation, unexpended funds, sunset clause, healthcare, rural health, transformation program, funding, incentives, training, access, perpetuity fund, 916, all

Bills: HB288, HB403, HB420, HB783, HB815, HB915, HB927, HB933, HB944, HB962, HB971, HR74, SCR3, SCR20, SB5, SB34, SB37, SB190, SB255, SB270, SB273, SB314, SB415

Keywords: medical terminology, documentation, miscarriage, spontaneous abortion, healthcare, medical records, billing, homemade food, food safety, small business, exemption, regulation, Department of Children and Family Services, background checks, child welfare, employee screening, safety regulations, criminal history, non-lactational dairy, labeling requirements

Bills: HB689, HB742, HB926, HB946, HB948, HB1028, HB1095, HB1114, HB1121, HB1155, HB1185, HB1217, HB1220, HB1227, HCR76

Keywords: public assistance, child welfare, benefit adjustment, DCFS, LDH, fraud detection, household reporting, Medicaid, immunization, healthcare eligibility, Family Independence Temporary Assistance Program, health policy, vaccination requirements, vaccination status, vaccine mandate, medical freedom, medical autonomy, public buildings, public access, government services

Bills: HB0122, SF0004, SF0012, SF0013, SF0067, SF0070, SF0124

Keywords: healthcare, rural health, transformation program, funding, incentives, training, access, perpetuity fund, Medicaid, emergency medical services, ground ambulance, healthcare funding, reimbursement rates, military, national guard, reenlistment, extension bonus, Wyoming, Wyoming National Guard, recruitment

Transcript Highlights:

• <00:02:44.080> health don't want to get the rural health don't want to get the rural health
• Rural health this request.
• > funds<00:02:58.319> to rural health transformation funds to rural health transformation
• It does urban rates, does a 2% add-on for rural areas, and then does a 26% add-on for super rural areas
• It does urban rates, does a 2% add-on for rural areas, and then does a 26% add-on for super rural areas

Bills: HB0122, SF0004, SF0012, SF0013, SF0067, SF0070, SF0124

Keywords: healthcare, rural health, transformation program, funding, incentives, training, access, perpetuity fund, Medicaid, emergency medical services, ground ambulance, healthcare funding, reimbursement rates, military, national guard, reenlistment, extension bonus, Wyoming, Wyoming National Guard, recruitment

Bills: HB0122, SF0004, SF0012, SF0013, SF0067, SF0070, SF0124

Keywords: healthcare, rural health, transformation program, funding, incentives, training, access, perpetuity fund, Medicaid, emergency medical services, ground ambulance, healthcare funding, reimbursement rates, military, national guard, reenlistment, extension bonus, Wyoming, Wyoming National Guard, recruitment

Transcript Highlights:

• Rachel Wolleman, and we've got you listed as Rachel Wolleman, Texas Women's Healthcare Coalition for
• My name is Rachel Wolleman, and I am the Policy Coordinator for the Texas Women's Healthcare Coalition
• This change would extend vital care to those caught in the healthcare coverage gap—earning too much for
• done that's good here, last session we funded the mobile health units that have gone out into the rural
• It's a cost-effective diagnostic tool that can empower families and healthcare providers to transform

Bills: HB321, HB 1027, HB 1295, HB1782, HB2295, HCR29, HCR56

Keywords: Medicaid, child health, express lane option, income verification, supplemental nutrition assistance, telepharmacy, healthcare access, remote dispensing, rural clinics, pharmacy regulations, health literacy, state health plan, health care, patient outcomes, public health, economic impact, healthcare, breast cancer, cervical cancer, insurance eligibility

Bills: SCR96, SCR109, SCR164, SCR172, SCR166

Keywords: electric reliability, renewable energy, interconnection, Hawaii Electric Reliability Administrator, Public Utilities Commission, capacity shortfalls, energy policies, mail-order pharmacy, insurance, healthcare access, chronic disease management, cost savings, rural access, emergency healthcare, patient adherence, critical infrastructure, foreign influence, local control, energy dependence, economic resilience

Summary: The Committee on Consumer Protection and Commerce heard several Senate concurrent resolutions related to utilities, pharmacy access, critical infrastructure, and energy policy. STR 96 SD1 asked the Public Utilities Commission (PUC) to report on the progress of the Hawaii Electric Reliability Administrator; the PUC offered written comments and the measure later advanced as is. STR 109 SD1 urged the insurance commissioner to study expanding mail-order pharmacy use. Testimony was split: DCCA’s insurance division, HMSA, and the Hawaii Association of Health Plans supported the study, while Shipa and the Hawaii Pharmacist Association opposed it, arguing mail-order pharmacy is already available and that in-person pharmacist counseling should be preserved. The measure was ultimately deferred. The committee also heard STR 164 SD1 on protecting Hawaii’s critical infrastructure from foreign influence. Greenpeace Hawaii and 350 Hawaii strongly supported the resolution, framing it as a consumer protection and resilience measure tied to reducing dependence on imports and strengthening local food and energy systems. No opposition was presented, and the resolution was moved out as is. STR 172 SD1 HD1 directed the PUC to conduct a comprehensive analysis of ways to maximize cost reduction and minimize financial risk while meeting state goals. DCCA, the Hawaii State Energy Office, and the PUC offered comments, and Earthjustice supported the measure; it was also advanced as is. For STR 166 SD1, which concerns how the PUC should evaluate generational energy commitments, DCCA, the Hawaii State Energy Office, and the PUC provided comments, while 350 Hawaii, Greenpeace Hawaii, and others opposed any move toward LNG, arguing it would harm ratepayers and conflict with Hawaii’s renewable goals. After discussion, the committee amended the resolution to add language directing the PUC to evaluate any LNG or other imported-fuel proposal for its potential effects on or delays to the state’s renewable portfolio standards, including the 2045 deadline. The amended resolution then passed, and the committee adjourned.

Transcript Highlights:

• He is the founder of the Rural Cancer Institute and a current practicing rural oncologist.
• exposure leads to rural practice.
• He is the founder of the Rural Cancer Institute and a current practicing rural oncologist.
• practice in rural Minnesota. practice in rural Minnesota.
• healthcare workforce. healthcare workforce.

Bills: HF3843, HF3597, HF4003, HF3167, HF4193

Keywords: workforce development, appropriations, nonprofit organizations, employment services, state funding, paid leave, S corporations, employment law, exemptions, Minnesota Statutes, cancer, healthcare, appropriation, Rural Cancer Institute, Minnesota clinicians, pilot program, nursing, education, University of Minnesota, equity