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.