All right.

Good afternoon.

I'd like to call this meeting to order.

Today is Wednesday, May twentieth, twenty twenty-six.

The time is three or four PM.

We are in room five hundred of the John A.

Wilson building.

This is also being broadcast live on the Zoom Internet platform, as well as Cable Channel 13, and my YouTube page at CMC Henderson.

I have been joined by all of the members of the Committee on Health.

Councilmember Zachary Parker from Ward Five, Councilmember Brianna Joe from Ward 1, Councilmember Wendell Felder from Ward 7, and Councilmember Charles Allen from Ward 6.

We have a strong quorum of the committee.

Today we will consider and vote on two measures.

The first will be a nominee to the Board of Nursing, and then the second will be the FY27 Committee on Health Budget Recommendations report.

First, PR26 Death 600 nominates Brianna Jones to the Board of Nursing as a licensed nursing home administrator for a term to end July 21st, 2027.

Ms.

Jones currently serves as an administrator at Inspire Rehabilitation and Health Center.

Previously, she held administrator and assistant administrator roles at Stardard Baptist Global Care and Capital City Health and Rehabilitation Center.

She holds her Masters of Science in Aging and Health from Georgetown University and a Master's of Health Administration from the University of Maryland.

She is a Ward 5 resident.

The committee did hold a round table on this nomination on April 15th, 2026, and we discussed her experience working in long-term care and what she hopes to add to the Board of Nursing.

Members will recall that we folded in the former Board of Long-Term Care Administrators into the Board of Nursing, and so Ms.

Jones' nomination would add an addition and needed perspective to that body.

I will open the floor for any discussion.

Hearing none, I move the draft report in print for PR 26-600 in block with leave for staff to make any technical changes.

All in favor, please say aye.

Aye.

Great.

Let the record reflect that the ayes have it and the measure passes unanimously.

We'll now discuss the fiscal year 27 budget report and recommendations for the committee on health.

I will first provide an overview of overview of the committee's recommendations before opening up the floor for discussion.

The committee's budget report was developed after several months of hearings, testimony, and meetings and other forms of public engagement.

I want to thank each resident, advocate, organization, government official who testified before the committee.

Many of your voices were reflected in this budget report and the work that we did.

This fiscal year, the mayor's budget proposed included significant cuts to the health cluster for critical health programs, including for behavioral health services, maternal and child health, healthy food access, and more.

The committee worked diligently to identify funds to restore some of the most harmful cuts and make strategic investments to increase access to health care for our most vulnerable residents and improve health outcomes.

I'm going to summarize the changes we're proposing for each agency under the committee's purview, as well as health-related transfers to other committees.

I do encourage that the public review our full committee report available on DC Council's hearing management system at DC Council.gov backslash hearings.

First, the Department of Health Care Finance.

As the mayor highlighted in her budget presentation, the big news in the fiscal year 27 budget for the Department of Health Care Finance was that the budget proposed to maintain the alliance adult eligibility for existing beneficiaries at 138% of the federal poverty level.

It also included a $3.9 million enhancement to restore dental and vision coverage, which the committee heavily advocated for over the past year.

In addition to these restorations, the committee was able to allocate $907,300 to restore specialty services for adults on the Alliance program.

This includes hospice care, home health care, and skilled nursing services, including physical therapy, occupational therapy, speech therapy, and podiatry for up to 30 days.

Department of Health Care Finance did not submit a budget support act subtitle to reflect their FY27 alliance changes in time for the budget transmission, but they later sent the committee a draft of that subtitle, which we amended, and it is included within our committee report.

It is the DC Healthcare Alliance Amendment Act of 2026.

Unfortunately, the committee was not able to further restore eligibility for alliance, and we will recommend for the committee of the whole for further considerations and restorations.

To support residents no longer eligible for alliance coverage, the committee accepted a transfer from the committee on Public Health, excuse me, public works and operations of 800,000 to establish a one-time grant for our federally qualified health centers to serve uninsured patients.

The committee will be collaborating with Councilmember Nadeau's office on a subtitle to establish this grant in the Final Budget support act.

Thank you, Councilmember Nadeau.

To further expand health coverage, the committee provides 526,000 in recurring funds to partially fund Bill 26-463, the Judith Human Memorial Workers with Disabilities Amendment Act of 2026, which establishes a Medicaid buy-in program for district residents with disabilities.

Notably, the district and the great state of Alabama are the only two states in the United States that do not currently provide a Medicaid buy-in program.

This funding covers all non-health care costs for the legislation, including staff and software upgrades.

And I do plan to advocate for the council to fund the remaining health care cost of $782,000 in FY28 and $12.8 million over the financial plan in the committee of the whole.

This could be a game changer for a lot of residents living with disabilities here in the district.

To improve maternal health, the committee does fully fund Bill 26-356, the prenatal and postpartum remote patient monitoring clarification amendment act of 2025, which provides remote blood pressure and glucose monitoring during pregnancy and up to 12 months postpartum.

Implementing this legislation costs 1.3 million in FY27 and 4.1 million over the financial plan.

The health care finance budget eliminates, excuse me, the proposed budget from the mayor's office, eliminated $14.9 million of local dollars for direct medical education, which reimburses teaching hospitals for resident salaries and faculty supervision.

Combined with the federal match funding, this would be a $50.9 million hit to our district's teaching hospitals.

The committee believes this cut will harm district residents, but unfortunately, we were not able to restore it in committee, and we will recommend that it be restored in the committee of the whole.

Health Benefit Exchange Authority.

So in FY26, Health Benefit Exchange Authority successfully rolled out the new Healthy DC plan and enrolled $14,826 residents who were formerly Medicaid beneficiaries, between $138% to 200% of the federal poverty level.

Similar to the alliance, the Health D DC plan did not include certain benefits such as dental envision in plan year 2026.

The committee sounded the alarm throughout 2026, and we are thrilled that the executive was able to add 5.7 million to cover dental envision services for the Healthy DC plan beginning in calendar year 2027.

Federal policy changes last year rolled back access to health insurance nationwide, including limiting eligibility for premium tax credits to exclude lawfully present residents under 100% of the federal poverty level.

The Committee on Health coverage, hold on.

The Committee on Health was able to restore some coverage for residents by providing 1.2 million in FY27 and 2.5 million over the financial plan.

The committee's investment, which includes a 450,000 transfer in recurring funds from the Committee on Public Works will partially covered the estimated 250 people under 100% of the federal poverty line that is at risk of losing their health insurance coverage in January.

HBX will likely need to institute a wait list, but we're glad we're able to make these investments and hopefully the full council will fund the remaining portion needed to cover the remainder of the population who we anticipate will lose coverage.

Finally, the committee does approve the $12 million in funding within HBX to maintain the health care for child care program, which is part of the pay equity fund and provides affordable health care options for early childhood educators.

The committee is deeply concerned about the overall $72 million reduction in the pay equity fund and will urge the council to restore it in the committee of the whole.

DC Health.

DC Health's proposed budget included federal and local funding cuts to critical public health programs across the agency.

As Dr.

Bennett testified, the agency's proposed budget included no increases for any of their programs, and instead, the agency had to make some very difficult choices to cut some public health programs in order to maintain others at FLAT funding.

The committee worked diligently to restore some of these cuts and to make some critical investments within the agency.

First, the FY27 budget proposed over $3 million in cuts to maternal health and early childhood services programs within DC Health, including zeroing out the $1.35 million for the Healthy Steps program, which embeds mental health specialists within pediatric primary care clinics to provide support during well child visits for 3,500 children across the district each year from birth to three.

DC's health rationale for the cut was that healthy steps could be billed through Medicaid, but it became clear through the government and public testimony that transitioning the program to Medicaid would have a significant challenge and not be ready to roll out by the beginning of the fiscal year.

To prevent significant disruption in services while DC Health and Healthcare Finance work with grantees to pilot Medicaid billing, the committee does restore the 1.35 million in one-time funds for healthy steps for fiscal year 2027.

DC Health's local funding for tobacco cessation activities decreased in FY27's proposed budget by $62,400, which will limit the reach of our mass marketing campaigns.

The committee addresses this by funding.

Well, addresses this funding shorthole through amendments to the mayor's proposed BSA subtitle on tobacco permit fees, which requires tobacco retailers and wholesalers to obtain an operational permit from DC Health.

The committee increased the proposed fee for these permits to better reflect surrounding jurisdictions and increasing the tobacco retailer permit from $15 to $75, and the tobacco wholesaler fee from $50 to $125.

DC Health's proposed budget also reduced the chronic illness initiatives by $168,000.

These grants were used and are used to support uninsured individuals who would otherwise not be able to afford sickle cell treatment at Howard University Hospital, cervical cancer screenings, and mammograms.

The committee is therefore pleased to restore the funds for FY27.

DC Health plays a critical role in addressing the food security insecurity and increasing healthy food access for district residents, including through its healthy food access grants.

During a year when an estimated 17,000 district residents may lose their SNAP benefits due to federal work requirements.

Restoring and bolstering these programs was particularly critical for our committee.

Therefore, we're pleased that we're able to make the following investments in food healthy food access.

$400,000 in recurring funds to reduce the wait list for the produce plus program, $50,000 in recurring funds to restore the cut to the joyful food markets, $98,500 in recurring funds to restore the local cut to home delivered meals.

$500,000 annually for fiscal years 27 to 29 for the renovation of the Food and Friends Ward 5 headquarters to expand access to medically tailored meals.

$200,000 in one-time funds to restore lost funding for dreaming out loud to provide grocery delivery to low-income seniors out of its Mary and Barrie Avenue Market and Cafe in Ward 8.

$200,000 in one-time funds to extend and expand the grocery access grant pilot program, and we are increasing the farmers market support grants to a baseline of $250,000.

These investments, these critical, critical investments were made possible by the generous transfers from other committees.

Thank you to the Committee on Public Works and Operations, as well as the Committee on Youth Affairs.

Thank you, Council Members Parker and Nadeau.

The BSA subtitle on food policy functions proposed repealing the Food Policy Council and the Office of Food Policy within the Office of Planning.

The Committee on Health and the Committee of the Whole heard from many public witnesses about the impact of the work of the OFP, as well as the Food Policy Council, which has made over the past decade.

I repeat, a decade.

They have been in work.

The committee therefore restores 413,000 in FY27 and 1.7 million over the financial plan for the Office of Food Policy and the Food Policy Council.

We also propose transferring them to DC Health.

This funding came with transfers from the Committee of the Whole as well as the Committee of Public Works and Operations.

Thank you, Councilmember Nadeau and Chairman Mendelssohn.

In addition, the committee is currently considering Bill 26-444, the Food Policy Council Procurement Amendment Act of 2025, which was introduced by Councilmember Zachary Parker, which would expand the Office of Food Policy's authority to coordinate with districts' food procuring agencies with the goal of increasing nutrition performance and compliance with the district nutrition and sustainability standards for food contracts.

As a reminder to the public, the district spends $62 million annually on food.

It should be the core function of one agency that we're not only spending to ensure that we're not only spending those dollars thoughtfully, but that there is equitable access to healthy food access across the district.

In anticipation of moving that legislation forward, the committee is pleased to accept a transfer of $125,000 in recurring funds for one FTE from the Committee on Youth Affairs to fund that anticipated cost of implementing that legislation.

The committee also restored several critical positions that were cut in the DC health budget.

This includes the Bureau Chief, yes, the whole Bureau chief within HIV AIDS, hepatitis, STD, and TB administration to lead the programs and strategy work for HIV and STI prevention.

We also were able to restore a supervisory sanitarian position within the environmental health administration to oversee and ensure healthy and safety inspections of food establishments, and a public health analyst in the indoor environment program within the environmental health administration to ensure timely response to residents' calls regarding pest, mold, and other indoor health hazards.

Finally, the committee provides 307,000 in FY27 and 882,000 over the financial plan to fully fund Bill 26-438, the Medical Debt Mitigation Amendment Act of 2026, which will prevent medical debt and will place guardrails on medical debt reporting and collection in order to lessen the harm of long-term compounding debt on patients.

DC Health proposed several other BSA subtitles, which the committee reviewed and makes the following recommendations.

The committee approves the AIDS Drug Assistance Fund Amendment Act of 2026, which updates the name, revenue structure, and allowable uses for a current communicable and chronic disease prevention treatment fund to align with the federal requirements associated with the Ryan White HIV AIDS program and the district's AIDS drug assistance program.

The committee does not recommend the School Health Services Amendment Act of 2026.

This subtitle would further water down the current school health suite cluster model with less supervision and oversight over school health technicians.

The committee does recommend the commercial pet facilities subtitle to be adopted, along with some proposed revisions, including removing the pet food manufacturer registration requirement and the provision that would make spay and neuter services optional.

The committee amended the subtitle maintaining the provision that authorizes DC Health to inspect commercial pet facilities and that change in the percentage with dog license fee that will go to the Animal Health and Education Fund.

The committee also provides 154,000 in FY27 and 481,000 over the financial plan to fund BSA subtitle improving prescription drug access amendment act of 2026.

The subtitle is very similar to Bill 26-593, the lowering the cost of prescription drugs amendment act of 2026, which authorizes the district to operate a new prescription drug discount program.

This is especially critical now that federal and local policy changes will lead to more district residents being uninsured or underinsured and therefore are more vulnerable to high drug prices.

The committee believes that this is a strong budget nexus of this program will increase will decrease prescription drug costs for consumers and will impact drug prices for government and privately operated pharmacies, likely resulting in cost savings.

The committee also makes several investments to rodent abatement efforts in the district because rodent problems are public health problems.

With an interagency effort between DC Health, the Department of Public Works, as well as the Department of General Services and others.

The committee does transfer $100,000 to the Committee on Public Works and Operations for the Department of Public Works to invest in rodent-proof trash receptacles in public spaces with high rodent populations.

We also send 100,000 to the committee on facilities for the Department of General Services to invest in rodent-proof trash receptacles in high traffic Department of Parks and Recreation properties with high rodent populations as well.

Now to the Department of Behavioral Health.

The committee remains deeply concerned about the persistent operational workforce and service and delivery challenges within all of DBH, particularly as the agency proposed significant reduction to core behavioral health services in FY27, including St.

Elizabeth's Hospital, the school-based Behavioral health Service Program, as well as crisis services.

The committee continues to have serious concerns regarding the safety and security condition work at St.

Elizabeth's Hospital, particularly raised by the front last staff regarding workplace violence, inadequate security staffing, and unsafe conditions for both patients and employees.

To address these, the committee recommends an additional $500,000 in FY27 to strengthen the security services at the hospital by hiring five additional SPOs.

Excuse me, those are special police officers to improve safety and support for frontline staff.

The committee will request that the committee whole committee of the whole match this amount to provide a total of 10 additional security for the hospital.

The committee strongly opposes DBH's proposed comprehensive redesign of the school-based behavioral health program and the decision to transition away from the current service delivery model, which has a component for community-based organizations.

Further, the budget reduced the school-based behavioral health program by approximately 6.1 million.

Many public witnesses testify that the existing model, while needing improvements, has produced measurable progress in clinician placement, vacancy reduction, and student access to services.

The committee does recommend reallocating $6.1 million to restore funding for CBO grants for a net increase of $700,000 and a total budget of $19.2 million.

The committee also recommends a BSA subtitle called School-Based Behavioral Health Program Stabilization and Oversight Act of 2026, which pauses the implementation of DBH's comprehensive redesign program for school year 26-27, maintains the current CBO inclusive service delivery model during that period.

The committee also recommends 988 lifetime and crisis support fund and sustainability establishment act of 2026, which dedicates funding for the district's 988 suicide and crisis line as well as other related behavioral health services.

For colleagues, this originally was a permanent bill that was introduced by the committee.

We did hold a hearing on this, and we're including it as part of the budget support act to ensure that the anticipated revenue is directed towards critical behavioral health response services for fiscal year 27.

Therefore, the committee directs 2.4 million from the 988 fund as follows: $600,000 to restore the community-based crisis stabilization bed contracts, $1.3 million to restore the CHAMPS contract, and $500,000 for operational enhancements to the 988 suicide and crisis line, as well as the access helpline, including staffing, training, technology infrastructure, and coordination with crisis response services.

The committee recognizes that the district has made progress in reducing opioid overdose fatalities, however, non-fatal overdoses continues in high numbers across the district.

To support the targeted opioid response investments, the committee allocates $796,000 from the opioid abatement fund through the Budget Support Act for $400,000 to support the Office of the Chief Medical Examiners Forensic Toxicology Text Testing and Data Analysis related to opioids and emergent substances and 396,000 to expand evidence-based adolescent substance use disorder treatment services and community-based treatment options for children, adolescents, and young adults across the district.

The committee continues to support the district's targeted place-based substance use disorder outreach, and we accept 115,000 in recurring funds from the Committee on Public Works and Operations to fully fund Bill 26-226, the Place-Based Substance Use Disorder Outreach Amendment Act of 2026 to make this successful pilot program permanent.

We currently have this operational in uh ward 5, ward 1, ward 7, ward 6, and ward 8.

And despite our ongoing disagreement about the need to provide an FTE for a program that has been operational for two years, we thank Councilman Bernadeau for her partnership on this effort.

All right, the Office of the Deputy Mayor for Health and Human Services.

The proposed DMHHS budget reduces the number of staff for the interagency council on homelessness by seven FTEs.

That left literally just the director by herself with no support.

The committee is concerned that the director, by herself on her own, will struggle to comply with the federal requirements for the interagency council on homelessness, as well as to inform district operations related to homeless services.

The committee therefore accepts a transfer from the Committee on Human Services to restore one FTE for the deputy director positions for ICH, and we thank Councilmember Fruman for that as well.

I will just mention as a note for colleagues, there is an additional vacancy that we didn't take from DMHHS.

But for the last, oh, I don't know, five years or so, maybe eight years.

For the last eight years, we haven't actually been funding a deputy mayor for health and human services because one guy's been doing uh multiple jobs.

So we're hopeful that that office will use that position.

So when there's a new administration and they decide that they might want a deputy mayor, they can actually hire one.

Clever.

Okay, um, our new agency friends, the Department of Insurance, Securities, and Banking.

Uh, the committee approves the mayor's proposed FY27 budget for Disby.

We do have one recommended change.

The committee reallocates 295,000, which was a proposed increase for the opportunity accounts.

We reallocate that to the DC Business Capital Access Program within the Securities and Banking Special Purpose Revenue Fund.

At the Disby Performance Oversight and Budget Hearings, the agency testified that it is restructuring the opportunity accounts program and there has paused it until the agency onboards a new program administrator.

The committee therefore questioned the budget increase for this program, and we reallocated to DC BizCap to better support small business owners across the district.

Okay.

The committee does make several other health-related transfers out of the committee beyond the ones that I spoke about.

So to support youth outcomes and health career pathways, the committee does transfer 150,000 to the committee of the whole to fund BSA subtitles Certified Nurse Aid Workforce Support Amendment Act of 2026 within the Office of the State Superintendent of Education to continue its partnership with a local university to train at least 25 district high school students to become certified nurse aides.

That first cohort will go this summer.

We're really excited.

To protect families, the committee also transfers 250,000 to the Committee on Human Services to restore the domestic violence service grants.

And finally, the committee transfers 170,000 in recurring funds to the Committee on Public Works and Operations for a Board Licensing Operations Manager at the Department of Licensing and Consumer Protection to oversee professional licensing boards, including the Board of Funeral Directors, which was a new addition for the Committee on Health as well.

In closing, I'm incredibly proud of what we were able to accomplish within the committee's budget to restore some of the critical public health and health care programs and invest in strategic initiatives to improve health outcomes for district residents.

And I look forward to working with my colleagues to continue to work on this as we go forth with the committee of the whole.

And with that, I will open the floor to any questions and or discussions on this report.

Councilmember Nidau.

Well, thank you, Madam Chair, for all the work that you and your staff have done on the FY27 budget and your partnership on many of our shared priorities.

The proposed budget that we received made devastating cuts to many of our critical programs in the district.

The budget that you and your team have prepared show that even when we are faced with these financial pressures, we can still find ways to support some of our most vulnerable communities.

I'm excited to see funding for so many critical programs and supports, including the millions for the crisis response programs, school-based behavioral health, remote patient monitoring during pregnancy, chronic illness screenings for uninsured residents, and medical debt mitigation.

The reversal of cuts to the health care alliance and expansion of the DC Health Benefit Exchange will support life-saving care for so many residents.

However, I remain concerned that we continue to be unable to reverse some of the most devastating cuts to the Healthcare Alliance, leaving thousands without medical coverage for the second year.

We've seen the impacts of the cuts in our community and our clinics, and these will only get worse as these families are forced to continue without health care.

I was pleased to be able to transfer $800,000 to fund a grant program for clinics who are continuing to provide care to these families despite their coverage, and $450,000 to help restore coverage for residents impacted by federal Medicaid eligibility changes.

These transfers will not plug all of the gaps that remain.

And I urge the committee of the whole to prioritize restoring this coverage this year.

Thank you, Chairperson, for accepting my transfers in support of food access programs across the district.

I am delighted that I was able to send $800,000 of recurring funds to support several grants at DC Health to expand food access across the district, as well as funding to support the continuation of grocery access pilot program in FY27 and to restore funding to the Food Policy Council starting in FY28.

No one should have to worry about where their next meal is coming from.

And these programs are critical for ensuring that residents across our city have access to enough food and food that is healthy for them and their families.

Finally, I am pleased that I was able to send funds to support the implementation of my place-based substance use disorder outreach amendment act, which permanently establishes successful council-funded pilot that has resulted in community improvements and life-saving reductions in overdoses in target areas around the district.

Thank you, Chairperson Henderson, for your partnership on that work and for all of the improvements in this version of the budget before us today.

Thank you, Councilmember Nadel.

Councilmember Parker.

Thank you, Chairperson Henderson.

In the midst of an exceptionally difficult budget year, I appreciate the work of you and your team in navigating this year's budget and putting together what I think are pretty solid recommendations.

We understand the difficulties that our residents face in light of the proposed cuts to alliance, and I commend the committee on health on restoring medical services for alliance beneficiaries and maintaining eligibility levels at a 138% FPL, which was the fiscal year 26 level.

I'm also pleased to see the committee's support for the dental envision benefits for alliance and healthy DC plan enrollees.

I know we've had a lot of discussion about that, so it's great to finally see it happening.

As a council member, I have a championed access to behavioral health for our young people, and I support the committee on health's decision to pause changes to the DBH school-based behavioral health program.

Students deserve to be supported in a stable manner, and the CBOs have established strong relationships with both schools and students over the years.

Not to mention there's uh a lack of evidence that DBH would be able to pull off facilitating such a program.

The restoration of funding for community-based crisis stabilization bids, which includes sums, Jordan House and Ward 5, and the Champs program will provide further access to behavioral behavioral health services.

Behavioral health and substance use can be intertwined, and will we support individuals in one area?

We must also be prepared to offer support in others.

I applaud the committee on health's plan to implement the place-based substance use disorder outreach amendment act of 2025 and expand adolescent substance use disorder treatment services.

Uh also special shout out to Councilmember Nadeau for her work in making that happen.

My committee was proud to fund the implementation of a bill I introduced with the support of you, Councilmember Henderson, the Food Policy Council Procurement Amendment Act of 2025, which would expand the authority of the Food Policy Council to evaluate food procurement practices across the district.

This bill necessitates the restoration of the Food Policy Council, which I'm glad to see we were able to do as well.

My committee was also uh supported the renovation and the expansion of food in France in Ward 5, which provides medically tailored meals to neighbors living with serious illness.

Finally, I'm proud to see the Care for Animals bill that I introduced last year move forward in part as the revised subtitle commercial facilities and the budget support act.

I do have a few questions, three broad questions.

One on nurses, the second on school-based behavioral health, third on champs, and then the last, just clarification on that animal bill.

It will be uh rapid fire if you don't mind.

Um the nursing, um, I noted in your statement as well as in the committee print that you didn't move forward with the mayor's school health Services amendment act of 2026 uh subtitle, which I think the justification is clear.

This uh subtitle kind of mirrors a bill that we worked on, I want to say back in 2024, which essentially acknowledges that all of our schools doesn't they don't have nursing coverage.

And so with the uh rejection of this, is there any sense that you have that we are any closer to ensuring that our schools have full coverage for nurses?

Um the short answer uh to that is no.

Um this bill was not, or excuse me, the proposed subtitle that the mayor was proposing wasn't addressing the ongoing workforce uh challenges that we've had in nursing, not just for school health, but um hospitals, doctors' offices, et cetera.

We need more nurses.

The country needs more nurses, period.

Um, and so uh this wouldn't necessarily resolve that, but one of our concerns was that by essentially allowing this broader flexibility to say, nope, you don't need a nurse, no, you don't need an LPN, but a school tech would be just fine.

We thought that DC Health might um get complacent in just having school texts across the city as opposed to truly trying to continue to actively recruit um RNs as well as LPNs uh for our school health suites.

And uh I think that's defensible.

Um I just and I know this doesn't fully fall under health, as we would also need to look to the committee of the whole.

I think it's an area that we need to continue to focus on as a council on to ensure that our kids and our schools have coverage.

Um I did want to just quickly touch on school-based behavioral health.

Uh I fully support your rejection of uh DBH trying to bring that program in-house, and I just want to make clear when DBH says they were bringing the plan uh the program in-house, I think that was code for something else, and I'm not sure what else, uh, but I just have very little faith that they could actually pull that off.

Um, I guess my question is now what it we revert back to the status quo with our CBO partners, but again, similar to nurses, we also know all of our schools don't have coverage.

Like what is the vision or path forward to expand coverage?

Um, I'll be honest with you, Councilmember Parker.

I think that school year 26-27 is going to be a challenging year because before prior to this marker, prior to our ability to even circulate, um, the Department of Behavioral Health last week uh canceled the contracts for several CBO partners for next school year.

And I think by our count, the number of schools impacted, I think it was above 50.

So we're already behind because DBH wanted to press ahead, even though they didn't have the backfill of people hired to be able to do that work.

Um so it's gonna be a challenge, and and not for and I can't even blame some of the CBOs who have lost faith in the ability to partner with DC government on this, given how that has sort of happened.

Um I am hopeful that school year 26-27 comes in the middle of a larger transition, and I'm hopeful for a new vision and a new uh renewed interest in making this program truly work.

Um I think we heard a lot of testimony for folks who were very concerned by the idea that our entire strategy for high school was going to be virtual, it was going to be a telehealth-based model, which is not what students have been asking for, nor for schools.

So I think the continued oversight is gonna need to work there, but um there are going to be some gaps as a result of um DBH um plowing ahead, even knowing that the council had significant reservations about their plan.

Wow.

Uh I just would add it's not only what students were not asking for, it's also not supported by the research.

So I digress.

Just very quickly, two last things.

Chance, can you just let us know where we stand now?

I know you two are rejecting efforts of DBH to say we'll bring that in-house too, again, with no evidence of what that actually means.

Uh so now what happens there?

Um, so um the 988 subtitle that we're proposing would generate um additional funding, and we're directing funding for a pediatric crisis response.

Now, we have vocally, we've written it down.

We are wanting and desiring for this money to go to chance.

But there are also limitations in terms of the council being able to direct contracts and grants.

And so that will be an implementation for the Department of Behavioral Health.

But the money is there, and it can only be used for that purpose.

Okay.

And then lastly, I know you uh moved in part portions of the care for animal bill.

Uh there was a component of it, uh, a pet food registration fee, which uh which for some might be controversial.

If you could just for the record say what the intention moving forward is there, which I think you're planning to do something later in the year.

Yes, so um the the pet food registration uh piece.

So we like the components around uh somebody needs to inspect some of these commercial pet facilities.

So for those who are listening in the public, uh a doggy spa, a doggy daycare right now.

Um, there's no responsibility across the government for anyone to inspect it beyond it just being a regular business, which we know is a little bit different.

Um so we wanted to move forward with that.

We also wanted to move forward with some of the changes around uh pet registration fees.

One of our app um, one of our pauses around the pet food registration was that in further conversation with DC Health.

The cost to administer this program would have exceeded perhaps the amount of money that would have been received from the subtitle.

Pet food uh inspection uh is not something that's already within the wheelhouse and expertise of DC Health.

Um, as my two FTE curses sits with us in this committee, they said it would have required two new FTEs to be able to implement this program, which would have been about the amount of money, maybe just a little bit more that they would have even collected from it.

So, like the juice really wasn't worth all the squeeze at this time, but we're happy to um review it at a later date.

Understood.

I just would say on that uh the underlying goal there is to provide a fund to support residents uh that are grappling with very high vet bills and fees, and animals that are not receiving care because it's uh prohibitive for a lot of residents.

Yes, and let me sorry, uh, speak more on that.

Um the committee does have a hope, well, an interest slash desire slash we are going to sort of move forward on this in conversation with DC Health.

There are some um things that we believe that DC Health can make adjustments on in terms of um licensing fees that could be used to fund some of the low-cost spay neuter services that are already there.

Um we feel like some of our licensing fees are a bit out of whack.

So for instance, um the licensing fee for a veterinarian in the district is $100.

Meanwhile, a level one dental assistant, which is an entry-level position, is paying over, well, more than a veterinarian to be licensed in the district.

Um so they acknowledge that there needs to be some modifications and changes there, um, but we'd like to do it in a bit more of a comprehensive way.

So um, yes, thank you for sort of speaking on that.

I we think it is important for funding the um low-cost spay and neuter services, but we feel like there might be a more sustainable funding source for those services.

I will leave it there.

Uh, but I think there's a lot of good work here and for district residents.

Again, this was a difficult budget year.

I think the work that the council is trying to do is to preserve as many lifelines and supports for residents as possible.

So thank you again, Chair Prison Anders.

Thank you.

Councilmember Allen.

Thank you very much, Madam Chair.

Um, I think this is my 12th budget uh as a member of this council, and the last couple of years, I feel like I've been saying this is one of the toughest budgets we've ever seen.

Um, I think this budget takes the cake, though.

Uh, I think what we've seen in the proposed budget that came to us was a drastic, cynical, and sometimes curious decisions around cutting programs and services that help our most vulnerable residents and communities in DC.

Um, a lot has been made about how our economy is shifting and we need to adapt to recent decisions by the federal government to reduce its workforce size, real estate footprint.

Unfortunately, I think the executive has chosen to go down a path where the budget may be balanced uh, but it's on the backs of those who are most vulnerable and ask nothing of someone like me or my family at a time like this.

And in this committee, we've seen that play out in terms of people's access to health care.

Um I think that we are confronting drastic cuts to health care, behavioral and mental health services, and programs that provide support to district residents so they can be successful and thrive and lead healthy and productive lives.

There's a lot in this committee's recommendation and the work that you and your staff have done that I want to specifically thank you for helping reverse and then make substantial investments.

The work is clearly not done when this uh when we move, like all of our committees up to the full council, we still have a lot more to do, but I think um you have done a great job with what you were able to do and made substantial and impactful decisions that are for the betterment of the city here.

Specifically, I want to thank you for leading the charge to find dedicated funding source for the district's behavioral health programs and services, the BSA subtitle and accompanying revenue on the 988 fee on phone lines that are eligible for 988.

Um, I think it's the right move.

Um I understand nobody likes to see a fee, but I think it's something that also is clear because it's important for district residents to know what the fee is, what it's doing, and what it's supporting.

And in this instance, the revenue generated from the fee is going to restore champs, uh, the child and adolescent mobile psychiatric service program, which is deeply important and impactful, and community-based crisis stabilization beds.

Uh, these are critical investments that were cut in the mayor's proposed budget.

I want to thank you for your leadership in restoring them and putting this forward.

Sticking with behavioral health.

I also want to thank you for your efforts to stop whatever the Department of Behavioral Health was thinking of doing with the school-based behavioral health program.

Um, I understand there's still a funding gap, and we will continue to work on that.

Um, but I have met recently with a lot of providers that are deeply concerned with DBH's plan or their capacity to even execute it and bring that program in house.

So I think that the lack of any detailed planning or vision was extremely concerning, especially as those providers and their clients have everything to lose the program being restructured.

Uh I don't think now is the time to fundamentally restructure an important program like this, especially when there's been a leadership shakeup and things may look different in a few weeks.

I also want to highlight your investment in the St.

Elizabeth Hospital.

Um I know you have made a particular focus of your oversight on conditions there.

I was able to join you for one of those round tables that you held earlier this year, and it was concerning.

Um I know when I asked the hospital leadership, one of the employees of the hospital about what's going on with security.

I remember that the hospital leadership tell told us they don't even have an internal process to investigate security incidents.

I appreciate that you are putting additional resources and special police officers for the hospital so that it can be a safe place for patients and for staff.

So I think that's a really important investment.

I also want to commend you on your efforts to support and expand our food access programs.

Access to healthy food, unfortunately still remains an equity issue in our city.

Where you live should not determine whether you're able to access healthy food.

There's a lot of investments in this space and it's a meaningful impact.

I want to specifically highlight the restoration of the Office of Food Policy and Food Policy Council.

Uh perhaps those two entities shouldn't have been housed in the Office of Planning, but I'm glad we're able to continue the good work at DC Health.

And lastly, I want to highlight your efforts on patient care and outcomes.

I appreciate your approval of the mayor's restoration of both dental and vision benefits for the alliance and the healthy DC plan.

Um it was also something that uh you and I think this entire council highlighted a year ago or nine months ago as significant.

I hope we can work as the council to make those restorations permanent in the out years.

And I also want to thank you for your investments in making sure that individuals that are slated to lose health care coverage because of HR1 FY27 are able to maintain coverage through the DC Health Benefit Exchange.

Before I conclude, I do want to speak on one capital project in the DBH budget, and that is with CPEP, moving it from its current location in Hill East in Ward 7 to NOMA.

The committee report goes into much greater detail.

Suffice to say, I'm concerned with the lack of planning around this project.

I think you have correctly identified the programmatic impacts, and we're trying to find a way to address those through the 988 fee you're proposing.

But I have more practical concerns, and it's the current site is also occupied by the stabilization center.

I'm wondering if there's even space available to move CPEP over that space.

I'm wondering how it's going to connect residents to the care of the need.

I'm wondering a lot of things.

So are the neighbors there.

Much of that wonder could have been avoided.

DBH would have picked up the phone, fired off an email, come to maybe talk to the Ward 6 council member or the neighbors about what their proposal has to do.

Maybe even a single conversation.

That has not happened.

So I continue to want to work with you and making sure the project is going to be successful, no matter what it is, because CPEP is an important part of our functioning government.

But it is a bit jaw dropping that such a substantial change has had no conversation or uh and has such a lack of planning to it.

Um so again, I want to thank you and your staff for the work and the effort to put this set of recommendations together.

Uh it's not easy, but you've got a great team, and I think you've put forward something that we can be proud to support today.

Uh so I look forward to supporting the report and recommendations and the work that we have in the weeks ahead.

Thank you.

Um thank you, Councilmember Parker.

Not Parker, Alan.

Y'all are on the edge of each other.

Councilmember Allen.

Um Councilmember Felder.

Uh yes.

Uh Madam Chairperson, uh, first and for first and foremost, kudos on uh this committee report.

Um, as other colleagues alluded to, uh you had to make magic happen with the significant budget cuts that we're seeing across the district.

Uh, but I do appreciate your investments and addressing rowing issues, uh, strengthening food access, school based behavior health, the work in the alliance uh greatly appreciate that.

Um great minds think alike.

So I will not ask uh all of my questions pertaining to the CPEP, but I did have a question, just one question.

I know DGS has yet to begin the design, but almost 11 million dollars uh was allocated uh to the relocation.

My question is how did you come up with that amount?

Um the thank you for that question, Councilmember Felder.

The 11 million dollars was what was included in the mayor's proposed budget.

We didn't make any um changes there.

Uh the fact is, from my understanding of uh the schedule for the RFK site, CPEP has to move regardless.

Um right, Councilmember Allen.

There's a road uh that is essentially uh being planned to be built um through that space, and so we didn't um we didn't remove the capital funding because we do believe that it is necessary.

Um, although my understanding from conversations with DGS as well is that um they haven't gotten to the design stage yet.

But we we didn't move remove the funding so that that can move forward.

Thank you.

Um, you know, as I was reading the report, things that stood out to me that I supported what I just mentioned.

I was like, check, check, check, then I stumbled across.

Um reevaluated the plan for ward seven freestand and emergency department, in which you're recommending that we shift to our urgent care model.

And a couple things.

As you know, my predecessor uh Vince Gray, he talked about a healthcare network.

Um I think when we look at Ward 7, we always are put in a position in which we have to compete for priorities, whether uh supporting a men's shelter or investing in our downtown corridor.

Um I say all that to say when where we are with the freestand and emergency room, I think we can always improve health care outcomes, and we want additional supports to establish a network.

Uh, but given that the planning is already done, the council will get the disposition package from Dempeh shortly.

Uh and uh from my conversations with folks about the difference between the urgency and the emergency room compared to the urgent care uh center, uh the urgency um the urgent care rather, it provides minimum standard versus the emergency room, kind of you know, supports uh a number of needs.

And then I think about unfortunately the three minors that were recently killed.

If we have an emergency room in the ward, uh accessible, then that will at least be able to stabilize those trauma one needed incidents.

I say all that to say, uh, why now?

And have you had any conversations with neighbors in the community about this?

Um yes, thank you for that, uh, Councilmember Felder.

Um, so some of this came out of the oversight that we've been doing around Cedar Hill uh Regional Medical Center, which is in Ward 8, which would be operated by the same operators in that regard.

Um, if you recall the original original agreement uh with Universal Health Services called for an urgent care to be open in ward eight, and it also called for an urgent care center to be opened in ward seven.

Um there was a change that happened where it was like, nope, we're gonna do a freestanding ED that didn't have uh a lot of discussion with the Committee on Health before that announcement was made.

Um, some of it is economics, some of it is what we desire long term.

Uh you know, a um emergency room is not a place where we want everyone to get their preventative health care, nor does everyone who are going to the emergency room need that acute level of care.

Um, we saw that from Cedar Hill.

The first quarter of Cedar Hill's operations, um, nearly 80% of the people who went to the ED did not need to go to the ED.

It could have been met at an urgent care or a different type of health care setting, which would have been the more um least expensive option for both our Medicaid services and other insurance types.

Um, and so when we look at the landscape of Ward 7, there aren't any urgent cares, uh whether it be for adults or for pediatric, and it is a serious need.

A lot of Ward 7 residents uh have communicated with us about they they always have to go to Maryland if you are in need of an urgent care.

So it is not to say that a freestanding ED can't happen, but I it was um we are asking for the executive as well as UHS to truly evaluate the current need of the area to determine whether a freestanding ED makes the most sense or if an urgent care can truly meet some of the more immediate needs.

Um, and this even came up in a conversation with the um the head of children's national hospital, they have an interest in doing pediatric urgent care, um, and this could be a a good partnership in site development.

So it is not to say don't invest.

Nope, we already agreed.

We want their money and we want it to be built.

We want we believe that the Fletcher Johnson site is an appropriate site for that.

But long term, if we want to get away from people using emergency departments as their primary care, then we need to provide an alternative option, and urgent care is our good model.

No, I appreciate that.

I would just say um, given where we are, you know, really just want to be mindful of us going back to the drawing board.

I think is which you make you make a good point in terms of evaluating uh the opportunities in the war.

I would love to continue to work with you and the committee uh to figure out how we can get everything we need.

Thank you, uh, madam chair.

Great, thank you, Councilmember Felder.

Um, and thank you to all of my committee members.

This was truly uh a team effort on a variety of different fronts.

Um and I would certainly encourage the public and those who are interested to read the committee report.

Um my team worked uh diligently on this to incorporate everything that we have learned from our oversight endeavors as well as the performance oversight hearings.

If you have a question about a decision that we are making or recommending, we likely cover it in detail in that committee report.

Um so uh with that, I want to move the dice print of the report and recommendations of the committee of on health for the fiscal year 2027 budget for the agencies under its purview.

Uh the diasprint was circulated at 12:37 p.m.

Um we'll leave for staff to make some uh technical changes and cons in consultation with the general counsel or the council's budget office as appropriate.

All in favor, please say aye.

Aye.

Aye.

Great.

Let the record reflect that the motion passes unanimously.

Before we begin, I have so many thank yous.

I yeah, we have a lot of thank yous because it takes a lot of work to put something like this together.

So I want to thank those who helped my staff and I with this process.

Errol Spence Sutherland, Ann Phelps, Jen Boudoff, and Joe Wolf and their teams in the council budget office, Nicole Streeter and David Guo in the Office of the General Counsel, who makes sure that every dot is dotted and T is crossed from a legal perspective.

I want to thank Kevin Lang and Deborah Fries and the Office of Revenue Analysis.

Thank you guys.

But know that it is out of love and a desire to ensure that the taxpayer dollars are being spent in the utmost ways.

I know that sometimes it might feel like a cavity search, but again, it is out of love.

And a desire to ensure that taxpayer dollars are being spent appropriately.

Beyond the hearings, the agencies did work with the committee staff to answer pre- and post-hearing questions and to provide additional context.

I want to give a special thank you to the Department of Healthcare Finance staff who essentially sat through a mini hearing before the hearing to make sure that we were able to meet our timeline when their hearing had to be postponed.

I want to especially, especially thank my staff, Michael Schaefer, Heather Edelman, Ona Bacchus, Marcia Huff, Rebecca Cooper, Lako Casimo, Taylor Coleman, Ashley Strange, Gabrielle Rogoff, Sierra Wallace, Anna Vierros Vasquez, and NACA, oh Yawula Jay.

I think I got it right that time.

There being no further business before us, we are adjourned.

The time is 401 p.m.

Thank you so much.