James Woodward — Called during roll and responded 'Here.'
Brooke Green — Continued asking about how long estate recovery cases remain open and whether families are waiting for final distributions.
Brooke Green — Praised the witness's work and compared the proposal to a Tax Commission software contract that promised increased recoveries; asked whether the current contract includes performance guarantees.
Brooke Green — Returned to the backlog issue and asked how long families may be waiting for estate decisions.
Brooke Green — Asked for specifics about external employment services and whether there are goals for participants receiving job coaching.
Brooke Green — Representative Green asked where Meals on Wheels appears in the budget and whether it is included in the current line items.
Brooke Green — Representative Greene questioned the director about estate recovery funding, contractor costs, and whether the services could be administered more cheaply in-house. The director responded that they were seeking contractor support and clarified that the $2.4 million expansion and estate recovery program costs involved both contractor and related expenses.
Brooke Green — Representative Green asks whether the cuts concern the crisis response teams or another program, citing concerns from law enforcement and the Sheriff's Association.
Mr. Williamson — Mr. Williamson clarifies that the expansion figure reflects combined funding and explains that the expansion plan table breaks the amount down into general and federal funds.
— Senator Craig explains that MMIS funding was tied to milestones and deliverables, not simply annual requests for more money.
— Referenced as having previously pointed out that the standard federal match is lower than 70%.
— Referenced as having discussed the Medicaid program integrity unit earlier.
— Addressed at the end of the response, likely a mis-transcription of a member's name.
— Addressed as the official responding to questions about Medicaid expansion costs.
— Ms. Williamson is repeatedly referenced as helping explain the UPL and related budget differences, with comments noting that she may have a slide deck, can help clarify the issue, and has already provided or emailed answers to prior questions.
Ilana Rubel — Explained that Gainwell remains the current vendor for the existing MMIS system and that the department will transition to new modules as they come online.
Ilana Rubel — Confirmed that the department still has an existing MMIS system.
Ilana Rubel — Confirmed that both vendors are currently being paid and was asked to explain contract inflation.
Ilana Rubel — Explained that contract inflation refers to preset year-over-year increases built into multi-year contracts to account for inflation and market changes.
Ilana Rubel — Clarified that contract inflation is usually built into the contract at the outset or through later negotiation, and that it reflects planned payment increases over the life of the contract.
Ilana Rubel — Was asked to explain the discrepancy between the agency request and the governor's recommendation for the population forecast line item.
Ilana Rubel — Explained that the agency request included the ongoing impact of the 4% provider rate cut and that the governor split the figures to show the underlying request and the cuts separately.
Ilana Rubel — Explained that the governor's recommendation separates the cuts into a second line, resulting in a net amount close to the agency request.
Ilana Rubel — Clarified that the net ask is about $235.3 million, which is close to the agency request of $234.9 million.
Ilana Rubel — Responded to a clarification request about the $235 million request and the 4% rate cut.
Ilana Rubel — Returned to the ongoing enhancements and introduced the hospital assessment fund alignment item on page 2-54.
Ilana Rubel — Was asked to explain estate recovery and the software pricing basis.
Ilana Rubel — Deferred to the department on the source of the software cost estimate.
Ilana Rubel — Said she did not want to speak for the department and guessed the request was conservative.
Jeff Cornilles — Representative Harris is referenced in the lead-up to a follow-up exchange and then asks whether, if the state invests in a new program and additional contractors to expand case processing to 350 cases per month, what the total monthly return on investment would be.
Deputy Director O'Connell — Was invited to respond and state her name for the record.
Jim Guthrie — Senator Cook asked whether the $2.5 million request could include something in writing, specifically seeking contractual assurance and regular reporting on return on investment. The request was acknowledged, with a response indicating appreciation and a willingness to share the information with everyone.
Jim Guthrie — Senator Cook participates in a sustained discussion about Medicaid and hospital financing, first asking about the offset and how the state would make up any difference from changes in payment practices. The conversation then continues with concerns about whether the state loses money by not moving to the average commercial rate, followed by a question about whether age demographics—especially the baby boomer generation—are driving rising costs. Senator Cook also seeks clarification on the ACT program and asks whether restoring it in 2027 would cost the general fund $2 million.
Deputy Director — The Deputy Director explained that contractors are paid based on what they recover, and that the related funding request is expected to more than cover costs. He added that the receipt authority would allow recovered funds to be sent back to other services.
Chairman / Representative — Responded that the program anticipates more than covering costs.
Director — Confirmed the general understanding of state recovery and explained the federal requirement and exceptions for family members living in the home.
Director — Said she could not provide a time frame for the backlog but would circle back with the information.
Director — Explained that Medicaid supports independence by helping people remain in their homes and communities and by providing services for long-term disabilities.
Carrie Semmelroth — Asked whether participants in extended employment services graduate from the program and requested metrics on outcomes.
Carrie Semmelroth — Was addressed by the speaker as the senator asking the question.
Carrie Semmelroth — Requested data showing what percentage of participants remain in the program versus graduate and move on.
Carrie Semmelroth — Was addressed as 'Senator' in the response.
Carrie Semmelroth — The chair asked whether she had more questions before returning to Ms. Williamson.
Carrie Semmelroth — The chair indicated questions would be held until after Ms. Williamson finished.
Carrie Semmelroth — Commented that dental services were restored after significant work and warned against shifting costs elsewhere.
Carrie Semmelroth — Senator Winterall comments on the impact of revenue cuts, expressing concern about how to determine who deserves services, and urges restoring revenue to reduce harm to families.
Ms. O'Connell — Ms. O'Connell was referenced as briefly mentioning the Medicaid program integrity contract.
Ms. O'Connell — Ms. O'Connell is addressed as the director and then asked whether the department or nonprofits have mechanisms to help Medicaid recipients improve their economic circumstances.
Carl Bjerke — Senator Bjerke raised concerns about the size of the budget, the volume of constituent emails about cuts, and the need to prioritize limited resources in Medicaid and related programs. He argued that funding should focus on helping the most vulnerable, even if that means choosing between services such as adult dental and care for a severely autistic child. He questioned whether the program is sustainable, asked what the main cost drivers and policy levers are, suggested overprescribing may be contributing to costs, and sought clarification on how much of the increase is from the general fund versus federal funds. He emphasized that the state should control general-fund spending as much as possible.
Carl Bjerke — Referenced as having asked about the 133% to 138% Medicaid expansion buffer.