04/29/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES

              SB  45-MEDICAID MENTAL HEALTH PARITY                                                                          
                                                                                                                                
4:05:06 PM                                                                                                                    
CHAIR   DUNBAR  reconvened   the   meeting   and  announced   the                                                               
consideration of SENATE  BILL NO. 45 "An Act  relating to medical                                                               
assistance  services; relating  to  parity in  mental health  and                                                               
substance use  disorder coverage in the  state medical assistance                                                               
program; and providing for an effective date."                                                                                  
                                                                                                                                
4:06:14 PM                                                                                                                    
SENATOR GIESSEL asked why the fiscal note amount had increased.                                                                 
                                                                                                                                
4:06:52 PM                                                                                                                    
CHAIR DUNBAR asked  Ms. Dompeling to explain why  the fiscal note                                                               
for the second  version of SB 45, developed  with assistance from                                                               
the  department,  was  nearly  twice as  large  as  the  original                                                               
version developed by the Behavioral Health Association.                                                                         
                                                                                                                                
4:07:25 PM                                                                                                                    
MS.  DOMPELING replied  that upon  reviewing the  latest version,                                                               
the  team found  clearer  expectations for  reporting and  parity                                                               
analysis, leading them to conclude  that the original fiscal note                                                               
no longer  reflected current  understanding. She  emphasized that                                                               
implementing the  provisions, particularly within Medicaid,  is a                                                               
significant  undertaking   that  will  require   both  additional                                                               
staffing and contractual support.                                                                                               
                                                                                                                                
4:08:18 PM                                                                                                                    
CHAIR DUNBAR asked  whether returning to the  original version of                                                               
SB 45 would reduce the fiscal note to it's original cost.                                                                       
                                                                                                                                
4:08:33 PM                                                                                                                    
MS.  DOMPELING  replied that  the  cost  would  be lower  if  the                                                               
committee   used  the   original   fiscal  note.   She  said   as                                                               
expectations  became clearer,  the team  recognized that  earlier                                                               
assumptions underestimated the scope of the work.                                                                               
                                                                                                                                
4:09:14 PM                                                                                                                    
SENATOR TOBIN asked why the fiscal  note shows higher costs in FY                                                               
2026 and FY  2031 compared to the lower amounts  projected in the                                                               
other years.                                                                                                                    
                                                                                                                                
MS. DOMPELING replied that the  difference reflects workload, not                                                               
an  error: higher  costs  occur in  years  requiring full  parity                                                               
analyses, while lower-cost years  involve only annual reports and                                                               
action  plans with  reduced contractor  needs. She  said staffing                                                               
levels remain consistent throughout.                                                                                            
                                                                                                                                
4:10:35 PM                                                                                                                    
CHAIR  DUNBAR  expressed   dissatisfaction  that  the  Behavioral                                                               
Health  Association worked  with the  Department of  Health on  a                                                               
compromise, after which the fiscal note doubled.                                                                                
                                                                                                                                
4:11:26 PM                                                                                                                    
CHAIR DUNBAR held SB 45 in committee.