Good afternoon.

I'd like to call this meeting to order.

Today is Tuesday, April 7th, 2026.

The time is 1213 p.m.

I'm calling this meeting of the Committee on Health to order.

I'm at large Councilmember Christina Henderson, chair of the committee.

Today we have been joined by Councilmember Brienne Nadeau from Ward 1, Councilmember Charles Allen from Ward 6, and Councilmember Zachary Parker from Board 5, and we have a quorum of the committee.

Today we will consider and vote on three bills, one nomination to the Board of Funeral Directors, and six nominations to the Board of Nursing.

I will start with the bills.

This bill amends the Postpartum Coverage Expansion Amendment Act of 2020 to require that the Department of Health Care Finance specifically cover remote patient monitoring, or RPM of blood pressure and blood glucose levels during pregnancy in up to 12 months postpartum.

The original version included a broad and vague requirement that the Department of Healthcare Finance provide coverage for provider delivered digital health interventions that are used to directly manage a patient's pregnancy.

Research shows that RPM improves maternal health by enabling early detection of complications, supports better management of chronic conditions, and reduces preventable morbidity.

RPM is particularly effective in managing hypertension and improving postpartum blood pressure control, with some studies showing improvement in blood pressure control by as much as 43%.

This is especially critical in the district where mothers with gestational hypertension and diabetes experience a significantly higher rate of preterm births compared with those without the conditions, and black mothers facing the highest preterm birth rate compared to white and Hispanic and Latino mothers.

The council had previously funded this postpartum coverage expansion amendment act of 2020 in the FY22 budget at 1.1 million in recurring funds over the four-year financial plan.

However, despite being funded, Department of Healthcare Finance never fully implemented the bill.

During our FY26 budget oversight hearing, um DHCF explained that RPM was in the FY25 budget, but not continued in their FY26 budget.

The agency also noted that MCOs were covering RPM as a value add service through post through as a value add service, though in post-hearing responses, it showed that only two of the district's MCOs uh were actually doing this, which is uh terribly insufficient.

Uh healthcare finance explained that the original FIS was insufficient to cover the cost of RPM for all Medicaid and Alliance patients and did not include equipment cost.

The agency admitted that they, quote, dropped the ball on implementing this law, end quote, and that once they realized that funds were insufficient, they submitted an enhancement to the city administrator and the mayor's budget director.

However, those enhancements were not approved.

Uh DHCF is exploring bundling RPM as a wraparound service under the transforming maternal health model, a federal model that they will implement in 2030.

This bill would enable uh us to do this much earlier.

The committee print did not make any substantive changes to the bill as introduced except for it to update the bill title to reflect the current year.

The updated fiscal impact statement says that the local cost for this will be 1.3 million for the first year of implementation and 4 million over the financial plan, with most of the cost coming from the equipment and monthly monitoring.

Um I want to just add that uh the committee is a little disappointed that the council's uh Office of Racial Equity has said that this bill would likely have a negative impact.

Um the committee believes that there is a flaw in the RIA assumptions, which are based solely on the text of the law and ignores the 2020 law that was never implemented and will not be implemented in the foreseeable future as currently written.

Um as a result, by providing RPM has been left up to the discretion of MCOs.

Only two are providing it voluntarily by improving upon the original bill and clearly defining the scope.

It does significantly uh raise the likelihood that healthcare finance will be able to actually implement the law.

With that, I want to open up the floor to see if there's any discussion.

Okay.

Hearing none, I move the draft report in print for bill 26-356 in block with leave for staff to make any technical or conforming changes.

All in favor, please say aye.

Aye.

Aye.

Any opposed.

Great.

Let the record reflare reflect that the I habit in the measure passes unanimously.

Now, Bill 26-463, the Judith Human Memorial Workers with Disabilities Act was introduced on November 3rd with Council Members Matt Freeman, Brianna Doe, Anita Bonds, Brooke Pento, Robert White, Charles Allen, and Janice Lewis George.

Named after the disabilities rights activist Judith Human, this bill amends the district's Public Assistance Act of 1982 to establish a Medicaid buy-in program, which would be titled the District Workers with Disabilities Program.

This program would enable employed individuals with disabilities who meet specific eligibility criteria to enroll in Medicaid and pay a monthly premium.

Although 48 states have enacted Medicaid buy-in programs, the district lags behind in providing comprehensive coverage options for residents with disabilities.

Currently, aged blind and disabled individuals who earn more than $1,330 per month, or two in person household earning more than $1,800 per month, are ineligible for Medicaid in the district.

This leads to disabled residents experiencing a benefits clift, a phenomenon in which modest increases in their income could result in a loss of critical public benefits, including their health care under, as well as long-term services and supports.

As a result, individuals may decline promotions or higher paying employment opportunities in order to remain eligible for Medicaid services.

And we heard this in our hearing of several witnesses who testified.

This legislation would create a centralized pathway for residents with disabilities to access comprehensive array of services, including prescription drugs, personal care services, non-emergency medical transport, and assistive technology.

The committee print does make several changes to the bill that's introduced.

It removes the introduced virgins age limit of 64 years old.

It allows older adults to participate in the program given that Medicare does not cover long-term support services.

Medicare doesn't even cover dental vision or hearing aids, interestingly enough.

Additionally, the committee removed language restricting home and community-based services waivers, recipients from enrolling in the program, modified the definition of employment to provide greater flexibility for self-employed individuals.

We clarified that temporary behavioral health admissions will not automatically disqualify someone, and clarified that assets and spousal income of enrollees will not be considered in determining eligibility or premium amounts and removed language requiring Department of Healthcare Finance to administer savings accounts for enrollees.

The Office of the Chief Financial Officer estimates that the bill will cost $4.4 million in FY27 and $545.6 million across the financial plan.

That includes both local and federal costs.

The Department of Healthcare Finance requires resources to update the District of Columbia access system, also known as DCAS, build a premium uh plat payment platform.

Uh of course, they need to hire an FTE, and then also pay for services.

The OCFO estimates that the enrollees premiums will generate about $45,000 in fiscal year 27 and $1.4 million over the financial plan.

I do look forward to advancing this legislation and providing comprehensive health care services for those who are employed individuals with disabilities with my colleagues.