House Human Relations & Aging Committee, February 18, 2026

Transcript

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1. 0:28:20

   Thank you everyone for... I apologize for the delay. That is all of my making. And, um, I had to go present a bill at the same time we were to begin, and I learned of that at about 6:30, 7 o'clock last night, and...

2. 0:28:38

   At least they emailed then. I didn't learn about it till much later. Can't read those emails every minute. All right. We, uh-

3. 0:28:47

   That's true.

4. 0:28:47

   So true.

5. 0:28:47

   We're waiting on Dempsey.

6. 0:28:48

   Ms. McCoy, what we got? No, Ms. Katie's here.

7. 0:28:51

   Oh, yeah.

8. 0:28:52

   We have Ms. Dempsey. So is everybody... We have a quorum?

9. 0:28:55

   Mm-hmm.

10. 0:28:55

    All right. Everybody's good. Ms. Katie, we are going to call you up. Representative Dempsey has a very important issue to address, and that is, everybody has it in your folders. Let me get mine out. I apologize.

11. 0:29:18

    House Bill 1238. Representative Dempsey, if you'll just make sure we all have the right LC, and we'll let you begin.

12. 0:29:25

    Yeah. LC 60-227.

13. 0:29:29

    Am I on the right microphone?

14. 0:29:30

    There you go.

15. 0:29:31

    Got me. Got me? Okay.

16. 0:29:34

    60-0227.

17. 0:29:35

    That's right.

18. 0:29:36

    Yes, ma'am.

19. 0:29:37

    That's right. Okay. So this is truly... People talk about simple bills, but this is truly a simple bill to fix a big problem. Um, over the, uh, interim, we did a study committee on children, um, abandoned child placement following hospital discharge. It is a very real problem that we discovered last year. And as we prepared for how to address this for these children, and they're not... It's not that someone just desires to walk away. It's usually some of our most difficult children to place, whether they're foster care, adopted, or a family's own biological child.

20. 0:30:12

    It's usually a parent that has reached the end of the road. That h- child might have been hospitalized multiple times. Um, we hear about it in the teens and 20s, and it's become a risk to bring them back into their household, into their family. It could impact other children. It's a very sad situation. But when that happens and the child is left, whether it's in a hospital or a psychiatric residential treatment facility, there is a gap. There's about a six-month time often to find placement because of the abandonment clause, and we're, we're working on that, trying to clean up that language as well.

21. 0:30:51

    But in the meantime, as we began to discuss this, Commissioner Burke and his team came and spoke to us and had a great offer, and it is to help with the reality that those residential treatment facilities and hospitals also are stuck, not only with a patient that is not getting the exact treatment they have after they've come out of a crisis, but also that the payment was coming out of those facilities. So they were losing money at that point, and wanting to take care of them, and so keeping them for very long experiod of time, uh, extended times.

22. 0:31:29

    So what this bill will actually do is require that by December 31st, 2026, the department will submit a waiver request. Um, and this impacts ch- uh, young people under the age of 21 only at risk for home, out-of-home placement or residential treatment due to complex behavioral health issues. Um, uh, this will be for Medicaid reimbursement for the provision of respite care and related services.

23. 0:32:01

    The department shall take all steps to provide for the payment of such care and services with Medicaid funds. It allows them to proceed with the waiver and move forward, and hopefully help us address this very serious concern.

24. 0:32:21

    We have several questions. I just wanna emphasize. So, um, representative, this is expressly targeting children with severe behavioral issues.

25. 0:32:30

    Absolutely.

26. 0:32:31

    And, uh, respite services, my experience has been, uh, a lot of times families wanna keep their family members at home, but they're overwhelmed.

27. 0:32:43

    Right. Absolutely.

28. 0:32:44

    And what you propose here and what the department proposes is to have a new resource-

29. 0:32:50

    That's right

30. 0:32:50

    ... to, to provide supports to those families so they can hang in there and keep an individual at home rather than institutionalized or in some other setting.

31. 0:32:59

    That is a possibility as well, yes, and that is in our recommendations from the study committee, but also to allow for the facilities that they may be in to not, um, be caught in a, a gap situation actually for payment.

32. 0:33:15

    Right. All right. Representative Hawkins.

33. 0:33:19

    Yeah. Thank you for bringing this. We listened to this all summer, and I think this is a very common sense way to approach this problem. My question is, how long is it gonna be... H- how long is it gonna take to adopt or, or get the waiver adopted? I, I noticed that you had no later than December 13th. K- is this something that we feel like it can be done in maybe a month or two or...?

34. 0:33:44

    Um, the Department of Community Health is behind me.

35. 0:33:47

    Right.

36. 0:33:47

    If we wanna get their input on it as well, um, I will say that that is a date that they shall submit the requaive- waiver request by. So...

37. 0:33:57

    Oh, yeah.

38. 0:33:58

    Some extras.

39. 0:33:58

    Okay.

40. 0:33:59

    Oop.

41. 0:33:59

    Oh, thank you. Uh, so, so yes, uh, I'm Stuart Portmann, the executive director of the Medical Assistance Plans Division.

42. 0:34:05

    Uh-huh.

43. 0:34:05

    Medicaid director. Um, we would submit by that date, but the- There, the, the model that this is built upon, some components of it can be provided under our Medicaid state plan today. We actually have approval already from CMS to do that. But in order to be as successful as it can be, some of those services such as respite and other family supports cannot be covered under a state plan according to the Centers for Medicare Medicaid Services. You can only cover those through a waiver. So in order to make this as successful as it could be, this is to add those additional supports.

44. 0:34:36

    Um, so we are in the middle of implementation work today on those things that we can already cover.

45. 0:34:41

    Good. Good

46. 0:34:41

    But, um, in order to make it as robust for the family, we have to have the waiver, and we'll work expeditiously to submit it and also to implement that as well.

47. 0:34:49

    So you can use funding to move the kids out of the hospitals-

48. 0:34:53

    Mm-hmm

49. 0:34:53

    ... and down the road now? 'Cause that's important. I mean, this is-

50. 0:34:57

    Yes, sir. So the s-

51. 0:34:58

    ... serious problem. Yeah

52. 0:34:59

    ... the waiver submission would just be for those additional services that we are not able to provide through the state plan.

53. 0:35:06

    Services like?

54. 0:35:07

    So it's prima- it would be respite care, um, sort of family training and supports-

55. 0:35:12

    Okay

56. 0:35:12

    ... to help make sure the family has the, the skills they need in order to support those children in a home setting.

57. 0:35:20

    How about the ones that, that the families drop off and never come back?

58. 0:35:23

    Well, and that's, that's certainly what this addresses as well-

59. 0:35:27

    Okay

60. 0:35:27

    ... for the, for the need for services.

61. 0:35:29

    Right.

62. 0:35:30

    Um, they are, they are the ones that will be in the facility waiting, and we're, we're working on some procedures for DFCS.

63. 0:35:37

    Right.

64. 0:35:37

    That may be another measure you hear about-

65. 0:35:39

    Right

66. 0:35:39

    ... to help expedite, to change the definition actually of abandonment is probably the goal-

67. 0:35:45

    Okay

68. 0:35:45

    ... in the code.

69. 0:35:46

    All right. But-

70. 0:35:46

    And to Chair Dempsey's point, during the study committee, we did hear from families that y- you know, they, that this is not a situation they want to be in-

71. 0:35:55

    Right

72. 0:35:55

    ... but they don't feel like they're capable of managing-

73. 0:35:59

    Right

74. 0:35:59

    ... things at home.

75. 0:36:00

    Right.

76. 0:36:00

    And so this is really just trying to make sure that, that we're offering all the support we're able to, to help them be successful in that home environment.

77. 0:36:09

    Okay.

78. 0:36:11

    Thank you. And, and, uh, Director Portman, uh, to Chairman Hawkins' question, uh, it might be helpful for some of the newer members, Medi- a Medicaid waiver of course w- so you're waiting on federal approval for that. To his question about the timeline, could you maybe just do a real brief overview of the process of seeking a, a, a Medicaid waiver? 'Cause this is not something we do every day. This is, uh, this will be the first one in a long time, and so maybe speak to that real briefly.

79. 0:36:39

    So there are, um, a variety of different types of waivers in the Medicaid program. This is specifically, um, the, the approach is to submit a waiver envisioned to be, uh, what is referred to as Social Security Act Section 1915i, um, to be specific. Um, and it is what allows us to provide, um, a variety of those services that you cannot do. The, the requirements in the Social Security Act within the Medicaid program of what you can and cannot cover are pretty s- specific, um, and that is why, uh, states have a variety of waivers, because there are built-in protocols in order to address the unexpected, if you will.

80. 0:37:16

    Um, and so, um, when we submit that waiver for approval, it usually, um... The team that would review this will, it'll take them a few months to review. They will then come to the state with questions. We will engage in a back and forth to make sure that they have a full understanding of both what it is we are proposing and the enforcement of it, and that it can be equally applied to any of the children and families that are eligible for it to receive it. Um, and usually it, it depends on the nature of the waiver how many rounds of questions there are.

81. 0:37:46

    Um, and at that point, it's a few more weeks typically before we would receive approval. So it's hard to give a firm timeline. Um, but for something like this, there are at least eight if not closer to 10 states that have similar waivers, um, for this type of service that, uh, so CMS in their, in their approval to us of the, what we could cover under the Medicaid state plan under federal law explicitly said, "Even though we can't cover these other things that you envision in your model, there is a path." So they're already willing to work with us to get to that point, which does speed things up.

82. 0:38:25

    That, that was very helpful. Uh, Chairman Bonner.

83. 0:38:29

    Hey, thank you. Thank you. Um, so the, the, the waiver makes the funds available essentially. E- e- once we, once those funds are available, d- is there the capacity in the system to actually provide this care?

84. 0:38:48

    I'm happy to.

85. 0:38:49

    Do you guys?

86. 0:38:50

    Yeah.

87. 0:38:53

    These are experts. I wanna make sure that they, you know, have the first chance at that. So, um, these are children that are gonna have to be cared for. It's not usually a situation where it is, is there capacity? It is that it must happen. They are in either a hospital in your community, in my community. We often hear about adults that are left in a hospital for a long time after following a mental health crisis without a bed and a placement, but these are children that are in that same situation, and they will be cared for with our without the money.

88. 0:39:30

    This is going to help us help the facilities. There's no doubt there are other needs that the study committee found, whether it's increased number of beds, all-

89. 0:39:38

    Mm-hmm

90. 0:39:38

    ... all kinds of things to deal with it, because the number of children going through traumatic mental health crisis is not decreasing right now.

91. 0:39:47

    Yeah. No, I, I get it, and I, I, I certainly support the, the ability to provide those ser- I guess, uh, my specific question is, I mean, this is great if we provide the money, but is there, again, is there the capacity to actually utilize those funds for the pr- the care that's needed?

92. 0:40:09

    I mean, in general, that's something that across the board we're always looking at in Medicaid is that provider network and ensuring that our members have access to the providers that they need. Um, so it's certainly something that would not be unique to this space. Uh, but we absolutely have providers that are capable of delivering these services, um, and that's just kind of a continual conversation-

93. 0:40:33

    Yeah

94. 0:40:33

    ... we're having to make sure that-

95. 0:40:34

    And I'm, and I'm sorry, just one, if I could, just a w- quick follow-up, and thank you for that. And, um, is this, how often do we have to reapply for this waiver?

96. 0:40:44

    Um, sorry. So, so, so this, uh, specific waiver, w- we will, we will f- it's usually an initial five-year authorization, um, and then the follow-up, it depends on the administration, if they want it to be three or five years, every, every three or five years thereafter, um, as part of the renewal process. But this is-

97. 0:41:03

    I think she's referen- referencing the members of the public.

98. 0:41:05

    Oh, I'm sorry.

99. 0:41:06

    Or w-

100. 0:41:07

     No, I'm s-

101. 0:41:07

     Oh, I'm-

102. 0:41:07

     Uh, no, I'm sorry. That, that, but that is a good question. But, uh, from the state-

103. 0:41:12

     Yeah

104. 0:41:12

     ... we, um, how often do we have to apply for this waiver, and, and for the families that apply, how often do they have to apply for that? So.

105. 0:41:19

     So, uh, for, for the services under the waiver, the family has to do nothing additional. We'll handle all of that on the back end. It is all something that we can flag based on the claims data to know about eligibility and the nature of their placement, um, and so we can handle all that on the back end. Um, so there's no additional burden on the individual or family. Um, and the only thing I would say to your in- init- initial question is that there is a, um, uh, I think I mentioned there's some, some implementation work underway. The lead c- the major component of that is stakeholder engagement, including the provider community, to provide education and to bring in the necessary providers to make sure that there is support.

106. 0:41:56

     Is it ... Yeah, and I guess the assumption is if it is a five-year, say it's a five-year window that this waiver is available, that that would help build capacity because their providers would, would have, uh, certainty that this waiver would be available, and they could invest in that capacity.

107. 0:42:11

     That's right.

108. 0:42:11

     Yeah. Okay. Thank you.

109. 0:42:14

     Thank you, Chairman Bonner. Lots of, uh, lots, lots of interest in this bill, Chairman Dempsey. Uh, Representative, uh, Campbell.

110. 0:42:25

     Thank you. Thank you, Chairman.

111. 0:42:28

     And thank you, Representative Dempsey, for bringing this bill. I'm a huge supporter of this bill, and I think it fills a really, um, growing and, um, urgent need, and I have similar legislation, um, around expanding, um, services for caregivers in our state. Um, I have a couple questions, um, very briefly. Um, to that end, is there a possibility, or would you be open to, um, a friendly amendment that would include other things in the waiver request, such as expanding the definition of caregiving to these parents so that they also would be eligible for Medicaid, since currently the work that they're doing is not qualifying as work for Medicaid eligibility?

112. 0:43:13

     My second question is, is there a state cost associated with, uh, admin- going through the waiver process? And then the third question is, how will the families know, once this is enacted, hopefully, that these cert- new services are available?

113. 0:43:30

     Let's, let's start with the cost. How about that?

114. 0:43:33

     Yeah.

115. 0:43:33

     That might be the easiest one to address first.

116. 0:43:35

     Yeah. So the, the cost b- uh, to develop a waiver and go through the normal cost neutrality components related to it that the federal government requires, um, has a estimated cost, uh, of $500,000. So that is consistent across all waivers.

117. 0:43:49

     Um, yeah, and to kind of clarify that point about the cost neutrality, by definition, waivers must be cost neutral. Uh, so it can't have an increased cost to the state and the federal government.

118. 0:44:03

     Mm-hmm.

119. 0:44:03

     So there's no ongoing expense.

120. 0:44:05

     Okay.

121. 0:44:05

     It's just that one-time $500,000 for us to develop the waiver application.

122. 0:44:15

     To the amendment, this is a department bill, and usually, historically, we don't add onto department bills unless the department asks for that to be done. So I understand your desire to want to go farther. I think at this moment in time, to address this urgent issue, we probably need to keep this one clean and go forward with that. And I can't remember the third one.

123. 0:44:40

     How will families know?

124. 0:44:41

     How will families know? Well, um, specifically, it's not something that would be advertised. This is usually a crisis situation. It's much like if you or I walked into care for a crisis right now. There's not a lot of questions asked. I mean, there are EMTALA laws. There are all sorts of things that go into effect at that moment. You will be cared for. And then if a family, and usually we heard in the, um, conversations around the study committee that often as the family arrives, you realize they've hit the end.

125. 0:45:19

     They've hit the end, and they're not gonna be coming back. They're not gonna engage. We're gonna be working also to develop more wraparound services at the beginning to help our families. That's a, a huge DFCS effort going on right now that we're gonna be working on to make sure that they are, um, more likely to want to take care of that child, to understand what the child is that is coming into their home. Now, there are surprises along the way, especially in some of our infant adoptions, when you don't always know what might develop later.

126. 0:45:54

     But we're, we're work- It's a, it's a giant problem, I would say. And if not addressed quickly, it will be a bigger problem. And we will have not children only, but adults with lifelong challenges.

127. 0:46:13

     Question from Representative Byrd. Thank you, Mr. Chairman, and thank you, Madam Chair. Um, I have several questions because I'm quite involved with foster care. What happens to children that are in group homes? So if they are put in a facility, they're brought back to the group home, how is that gonna work for a respite worker to, or a care person to come into that group home? And then, um, I'll do a follow-up after, please. Well, theoretically, um, going back to a group home would mean that that group home had decided they were able to accept that child back, that, that the situation had not become more, um, aggressive in a way that they did not have the capacity to take care of.

128. 0:46:59

     Um, personally, that did not come up in any of our conversations as we did the study committee. I think our group homes may be a little more well-equipped to handle this. It is that parent usually that is having a real problem. Are you aware... I, I will say, you know, if you're aware of them, we need to certainly wrap that into some of the considerations and work we'll be doing. Certainly, it's a major concern for myself. I'm working with this group, group home for sure. I mean, girls are placed in facilities.

129. 0:47:30

     They are returned to the group home. Right. And so the question is, is how is that respite person going to take care of that individual that is among other 19 and 20, 21 girls? Thank you. Follow-up, please. Yes, ma'am. So contrary to popular belief, lots of people believe that, um, we throw children out at 18 years old and leave the foster system. They check themselves out.

130. 0:48:01

     So when they check themselves out, they have six months to return. Is that correct? That's my understanding. So for someone who has taken themselves out of the system at 18 years old, how is that gonna work? This is specifically focused, this measure, and this, as I understand it, this waiver will be focused on the work to, to care at that time following crisis, following, um, when they have been released from care, um, but no place to go.

131. 0:48:33

     So I'm not sure that where they would be going is as important as that they are cared for at that moment in time. It is a part of the process. No doubt, someone cannot leave a psychiatric residential treatment center or a hospital w- without a destination, and that is true to all ages. Hospital cannot just drop you off. Um, they are not supposed to, for sure. You must be, have a, um, good space to go to, especially when dealing with mental health issues.

132. 0:49:03

     So I, um, you know, I'm, I'm, I'm gonna tell you that this is probably not intended to fix every component that we may, we may see as a society, and we'll continue to need work to take care of each and every unique individual, but this addresses a real concern that we're having right now. Thank you. Mm-hmm. Thank you.

133. 0:49:27

     Representative Bazemore. Thank you, Mr. Chair. Over here. And thank you, Madam Chairwoman. I so appreciate you bringing this bill. Um, a little bit of my history, family member that had mental illness for over 30 years. And you can break a family and other members associated. And as you just pointed out, um, the children are now dealing with their issues. And so it's, it's very difficult when you don't have all the resources.

134. 0:50:01

     So I so appreciate you bringing this bill so that these families are not broken forever and they can sustain themselves to a certain degree. And so I appreciate it. Thank you. Oh, thank you. Chairman LaHood. Hey, thank you. Um, apologies if this has already been answered. Um, but I, I do want some clarity if, if we can get some. Is there an example of, uh, placement options that you can share with us, like for these difficult behaviors?

135. 0:50:33

     Um, and, and part of the reason I'm asking is because I had a constituent, and Ms. Silvan and I actually worked on together, but he had to be placed in Texas, uh, at least temporarily because there were either no options or no availability in, in the state. He was just an extreme case. His father was a law enforcement officer, and this, I think he was 12 or 13 years old, was just overpowering his own father, um, you know, due to the behavior. So where do you place people like this?

136. 0:51:04

     The shortage of beds and capacity in our state is very real. Um, I would say through every appropriation cycle, we deal with that. Those are the... Expanding that are in some of the recommendations from the study committee. There's a true need, and we know there's a need. As I said, there are different, different portions of this. It's not to fix everything, but the Medicaid waiver would help with a portion of the concern that we're addressing.

137. 0:51:37

     I will tell you, too, I, I wanna brag on DCH just a little bit because we had a, a sort of around the table discussion with behavioral health and with the Department of Human Services and with DCH, and they quickly went to work on a space that they felt they could do. So this was not a, a push. They knew it was a need, but they came up with this plan pretty quickly and announced it in our very first study commiting, committee meeting, I believe. And so they've been working on it ever since then.

138. 0:52:08

     We share the concern and the desire to help the, um, I would say, the serious need as quickly as we can with the resources that we have at hand while trying to build out on the others. Yeah. So thank you, and I, I support the department in this, and you, um, just

139. 0:52:27

     Still curious on where, where, what is the placement, what are the placement options?

140. 0:52:33

     And I-

141. 0:52:34

     Yeah, you go ahead.

142. 0:52:35

     I, I do wanna kinda clarify that the goal of this waiver is to provide services in that home or community setting.

143. 0:52:44

     Mm-hmm.

144. 0:52:45

     Um, it's not so much focused on the, that residential placement. Um, and but the, the goal is hopefully to avoid or reduce those res- those facility placements-

145. 0:52:57

     Right

146. 0:52:57

     ... by offering the families the support they need to have their child at home. Um, you know, because as you are familiar with your constituent, uh, you know, that it's a very challenging situation, and a lot of times they feel like, "I just don't, you know, I don't know what to do." And, uh, it, the goal is just to get them that additional help at home.

147. 0:53:17

     Okay. S- Re- Representative Scott.

148. 0:53:22

     Um, good morning, and thank you, um, Katie, for bringing this bill. I would just like to know, um, under this waiver, uh, will it require any type of s- standardized training for the families, or oversight? What type of oversight are we going to have with this to ensure the quality and prevent misuse of the funds that will be provided?

149. 0:53:47

     Sir, thank you for the question. We would, um, as i- as with any of the, the Medicaid dollars that we would spend, we would make sure that there's, uh, and built into the model there is training both for the care, the, the family. There's also training related to the providers, because there's a variety of different services that can be provided relevant to this model of care, and so there's a variety of different providers that would be, um, meeting that standard. So there's, um, those that are Medicaid licensed providers, because the nature of the work would all go through the normal Medicaid licensure and, um, accreditation process, uh, or credentialing process, excuse me.

150. 0:54:21

     And for those- ... that are, um, more ad hoc trainings for the family, we would, we're working to make sure as part of this implementation effort that those are robust enough that everyone can have confidence in the services that are provided.

151. 0:54:33

     Okay, a follow-up. Okay. Is there a fiscal note, uh, for this, and will the state have to match the funds?

152. 0:54:41

     So again, it's just that one-time $500,000 cost. Um-

153. 0:54:45

     Oh, okay

154. 0:54:45

     ... and it, because when we talk about cost neutrality, we're comparing what the state and the federal government would be spending on a residential placement compared to what we would be spending by providing these supports in-home. And we have to demonstrate that that is a lower cost to offer these services than what we would be paying if they were in a, a placement.

155. 0:55:08

     Okay. All right. Thank you.

156. 0:55:10

     Uh, yes, ma'am, and last question, Representative Okoye.

157. 0:55:14

     Thank you, Mr. Chairman, and thank you Chairman Dempsey. This is a great bill. I know we have so many questions for you today, and many of the answers may not be in this bill, but you eat an elephant one bite at a time.

158. 0:55:31

     Thank you.

159. 0:55:32

     All right?

160. 0:55:32

     Thank you.

161. 0:55:33

     And, um, for me, on, on line 14, the cutoff for this waiver is 21 years.

162. 0:55:41

     Right.

163. 0:55:42

     Um, children that may have mental issues may not leave home, uh, at the same time when the other ones will leave home. They may stay at home longer.

164. 0:55:56

     Mm-hmm.

165. 0:55:57

     Do we have a program for those who are just above 21?

166. 0:56:02

     That's a good one.

167. 0:56:04

     Uh, so the... Yes, so what, we have, um, a waiver program, the, um, I- ICWP, the Intermediate Care, uh, Waiver program, um, that is w- many of these children may, uh, as they age, may receive care there, or specifically in the NOW and COMP waivers as they age into adult populations.

168. 0:56:25

     Mm-hmm.

169. 0:56:25

     Depending on the nature of their, um, their conditions, whether it is solely, um, a mental health condition, a behavioral health condition-

170. 0:56:32

     Mm-hmm

171. 0:56:32

     ... or there's some other component. Uh, there are a variety of different waivers that, that we do have, um, and that we are always working to, um, uh, make sure that they can address the, the needs of the population here in the state. So they are not, um... There is, there, there is effort always to be made for warm handoffs between systems-

172. 0:56:53

     Mm-hmm

173. 0:56:53

     ... especially when children, um, age out of the Medi- Medicaid definition of a child. Um, and there are, those efforts are, um, only, only growing.

174. 0:57:01

     Thank you.

175. 0:57:02

     And I would say, just to reiterate, this is to try to prevent out-of-home placement if possible. If at all possible, if it's, um, uh, a person under 21 who is already placed in a home, or is a, like as I said, an adoptive or biological child, the goal is to help keep the family together so they can give the care that is necessary, and this is only one component in that.

176. 0:57:31

     Thank you, sir. We are gonna move on. We have rules in about nine minutes, and so here's what we're gonna do. We have, um, uh, Ms. Sarah Phillips. I think you want to... We have one individual that wants to speak to the measure. We wanna hear you first. And, uh, thank you, Ms. Dempsey. There is no greater advocate for any disabled subset population in our c- in, in our state that, uh, no greater advocate than you, and I appreciate you bringing this measure.

177. 0:58:01

     Thank you.

178. 0:58:02

     Thank you. Ms. Phillips, and, uh, uh, in the interest of time, if you would be as brief as possible, please.

179. 0:58:09

     Yes, sir, absolutely. Good morning, Mr. Chairman, members of the committee. Uh, my name is Sarah Phillips, and I serve as the associate director for the Carter Center's Rosalynn Carter Mental Health and Caregiver Program, um, where we work at the intersection of mental health and caregiving, advancing policies that support caregivers while improving outcomes for children and families with complex behavioral health needs. So, um, I will keep my remarks brief, but I am here today in support of this measure, which would provide critical support to family caregivers who are caring for children and adolescents with, um, serious mental health conditions.

180. 0:58:44

     Um, caregivers are the backbone of Georgia's behavioral health system, particularly for children with these complex needs like we've been talking about this morning. When caregivers burn out, children are more likely to experience crises, uh, emergency department visits, and of course, residential placement, as we've been discussing. Um, respite care is a preventative stabilizing support that helps families stay intact and helps children, um, have better outcomes long term. Um, research shows that caregivers who receive respite support, um, uh, report lower distress, better self-reported health, and improved wellbeing compared to those who do not.

181. 0:59:22

     Um, a recent study, uh, c- in 2025 found that caregivers using respite-oriented strategies experienced significant improvements in positive caregiving outcomes, particularly among women, lower income households, and those providing the majority of care for their, um, care recipients. Um, additionally, nearly 40% of caregivers say respite services would be helpful, but only about 13% are able to access them, even though evidence shows that respite reduces caregiver strain and improves health outcomes for both the caregiver and the care recipient.

182. 0:59:55

     So this bill, um, and this waiver would help close this gap, um, by making respite financially feasible for those families who need it most. Um, should it be approved, it would help delay or avoid institutional or residential placement. Even these modest delays can generate substantial cost savings, uh, while keeping children connected to their families and communities, which, um, is an outcome that aligns with Georgia's behavioral health and, uh, Medicaid goals. I also want to, um, touch on what Representative Campbell asked earlier, which is how will, uh, how families will know.

183. 1:00:28

     Um, this is something that the Carter Center, should, um, the Department of Community Health be, um, be willing, we would love to partner with them on getting the word out. This is something that we've done with the, um, Department of Insurance on raising awareness around mental health parity. So, um, we would stand ready to assist in making sure that families know that this is a resource to them, um, should they need it. Thank you very much.

184. 1:00:52

     Thank you, Ms. Phillips. That was most helpful. Um, we have a measure here that is all about, uh, yet again, as we have done time and again here, focusing Medicaid resources on the people Medicaid was created for, the most vulnerable and the most frail. And so, uh, I have a, uh, I have Chairman Hawkins with a-

185. 1:01:15

     Make a motion do pass.

186. 1:01:17

     Second.

187. 1:01:18

     We have a motion do pass and a second. Any conversation? Any discussion? Hearing none, all in favor?

188. 1:01:29

     Aye.

189. 1:01:31

     Any opposed? Okay. Chairman Dempsey, this bill is passed unanimously. Thank you for your good work.

190. 1:01:45

     Thank you, buddy. Thanks for reminding me we were getting close to 9:00.

191. 1:01:48

     Yeah.

192. 1:01:48

     So thank you. Hey, Bonner. Thank you for coming through for me there, buddy. I'm sorry. They had me nervous with that.