The Legislative Finance Committee subcommittee heard updates on implementation of provisions in Senate Bill 42 that move primary responsibility for CARA‑style newborn substance‑exposure care coordination to the Health Care Authority (HCA) while the Department of Health (DOH) will provide direct navigator services under contract to the HCA.

Madam Secretary (identified in the hearing as Secretary Casados, Children, Youth and Families Department) told the subcommittee that HCA “is at the table with us working through all of the changes” but that the authority does not itself provide direct field services, prompting contracts with managed‑care organizations (MCOs) and with DOH navigators for in‑person work. “The care coordinators are employees of the MCOs and they are still the ones that are in the hospital that are working with the patient as they come in,” Secretary Casados said. She added that when concerns arise “they reach out to the Department of Health navigator and together they work with that individual so that they can ensure that we have eyes on that individual.”

Why it matters: SB42 shifted lead responsibility and required HCA to provide an intensive, evidence‑based form of care coordination for infants born substance exposed and to require certain referrals and reporting. The reallocation affects which agency drafts rules, who trains navigators, and which contracts pay for direct services.

Outstanding implementation issues raised at the hearing: several legislators asked whether HCA had drafted rules and whether MOUs were in place to define responsibilities and escalation paths between the MCO care coordinators, DOH navigators and CYFD staff. Secretary Casados said HCA had not yet finalized rules and that the legal review and data‑confidentiality issues (including CAPTA questions) were still being resolved. LFC staff also noted in their brief that SB42 required CYFD to implement multilevel/differential response statewide by 2027 and to develop Family First‑eligible programs.

Committee discussion focused on transparency of roles, escalation procedures when families do not engage, and training and accountability for navigators and care coordinators. Several members asked for public notice of drafts and for the agencies to report proposed rules and MOUs back to the subcommittee before the next session.

Ending: Agency and LFC staff committed to follow‑up reporting on rule development, MCO corrective‑action plans referenced in other testimony, and the transfer of cases and navigators from CYFD to DOH per SB42 timelines.