Transcript Highlights:

• I would like to propose an amendment that the single pay easy passes are not transferable to different
• I'm not sure I understand how our local people would pay more than they are now.
• Well, I'm not saying they'll pay more than they are now, but if they have multiple vehicles, they'll
• pay more than they should, right?
• And not pay the fee again.

Keywords: 994, senate, all

Transcript Highlights:

• Part was to the pay structures themselves.
• We increased the pay levels associated with these jobs, which was a structural change to our pay plan
• So he approved that portion of this pay package to increase the pay levels associated with those jobs
• Pay levels associated with those jobs.
• Twenty-five percent of the 25% helps to pay firefighters.

Keywords: 965, house, all

Transcript Highlights:

• So a land bank would still have to pay for the tax. I think I...
• So the landlord issues a 30-day pay-or-vacate notice.
• who accept payment after issuing the notice to pay or vacate, then void their notice to pay or vacate
• interest to pay, or is it better for them to use that money to move?
• We don't see residents coming to us and saying, hey, I have some money to pay.

Bills: SB6139, SB6214, SB6237, SB6091, SB6096, SB6200, SGA9278, SGA9279

Keywords: rental payments, landlords, tenants, eviction, legal procedures, housing stability, land banking, property authority, housing development, urban planning, real estate management, SB 6237, Washington landlord-tenant law, Residential Landlord-Tenant Act, rental property disclosure, flood risk, flood hazard area, special flood hazard area, potential flooding, tenant notice

Transcript Highlights:

• So that was part of the pay plan that went into effect last summer, that now we pay them, what did you
• Now, we can say we're paying these people adequately, and we are paying them, based on the rate study
• , what other states pay.
• When the new pay plan was implemented, one of the goals behind it was to, because the pay was increasing
• Everybody is paying.

Summary: The Joint State Agencies committee met to approve prior minutes and then focused on the death of Zachary Moore at the Southeast Arkansas Human Development Center, later clarified in discussion as the Warren facility. DHS officials described Moore’s background, said he died after a prolonged prone restraint followed by a delayed chemical restraint, and reported that 13 staff were terminated, the superintendent was replaced, a consultant was brought in, and the agency entered a settlement with the family for $725,000. Members pressed DHS on the cause of death, restraint policies, staff training, supervision, family notification, and why the family had not been kept informed; DHS said a family-notification procedure exists but that communications during litigation had been handled through counsel. The committee also heard that six staff had been criminally charged with manslaughter and neglect of a vulnerable person, and that the death certificate listed the manner of death as homicide with cause of death tied to physiologic stress associated with struggle and prone restraint. DHS officials gave broader context on the five human development centers, their licensing and accreditation, resident population, mortality review process, and training programs. They said the centers serve highly medically and behaviorally complex residents, that annual restraint training and CPI-based instruction are required, and that the mortality review committee and Office of Long-Term Care review deaths and make recommendations. Members repeatedly criticized the agency for not having complete information at the meeting and for what they saw as gaps in oversight, staffing, and chain-of-command clarity during emergencies. DHS responded that the Warren facility had not been meeting the same standards as the others, that the consultant’s root-cause analysis identified multiple failures, and that new crisis-team and chain-of-command procedures were being drafted. A second major topic was staffing and recruitment. Members discussed low pay, turnover, use of float and on-call staff, rural staffing shortages, and a waiting list of about 2,000 people for home- and community-based services. DHS said CNAs at the centers start at about $39,000 a year, that a broader retention and recruitment plan is being drafted for all five centers, and that a separate rate study for PASS services will be implemented in January 2027 but does not cover CNA pay. The meeting ended with testimony from Moore’s mother, Angela Stevens, who said money could not replace her son and urged stronger training, background checks, and supervision so other residents would be protected. The committee asked DHS to keep members and Stevens updated on consultant reports, recruitment efforts, and follow-up on the family communication issue, and then adjourned.

Transcript Highlights:

• you'd be paying daily storage charges.
• And again, this one drops to $75, so people pay it at that point.
• He's going to be paying the fine and all, chose not to take the class.
• And I'm exaggerating, of course, because it was me who had to pay it.
• He recognizes that he doesn't want to be paying these fines every now and again.

Summary: The Transportation and Infrastructure Committee heard several transportation-related measures, with SB 1010 and SB 1552 held at the outset. SB 1024, dealing with licensing and registration rules for roadable aircraft, was discussed briefly; members raised questions about vehicle license tax revenue and the sponsor was absent, but the bill was still advanced on a do pass recommendation by a 3-2 vote. SB 1205, which creates statewide rules for motor vehicle booting on private property, received testimony from industry and Sen. Kavanagh in support and was approved 5-0. SB 1366, creating a study committee on public property towing and impound practices, also passed 5-0 after supporters described it as a bipartisan, data-gathering measure. The committee then took up SB 1624 on photo enforcement violations. The bill would cap civil penalties at $75 and limit the use of photo enforcement violations for license, insurance, and court-record purposes, while an amendment added a class three misdemeanor for excessive speed and directed $15 of the penalty to the Peace Officer Training Equipment Fund. The measure drew extensive debate, with supporters arguing it would simplify enforcement and keep penalties manageable, and opponents including insurers and local governments warning it would mask risk, reduce revenue for state and local funds, and interfere with school-zone safety. After adopting the amendment, the committee advanced the bill 4-2. SB 1232, a technical bill concerning billboard placement near military airport and facility districts, was amended to clarify local approval and public hearing requirements and then passed unanimously. SCR 1004, the companion measure to a House resolution, would send to voters a proposal limiting photo enforcement unless a local government had a contract in place by December 31, 2026; after testimony describing it as a negotiated compromise that preserves local control, it passed 4-2. The committee also approved two memorials, SCM 1002 renaming a portion of SR 77 as the L.F. Quinn Memorial Highway and SCM 1006 renaming a portion of US 70 as the PFC Michael A. Nolene Memorial Highway, both by unanimous votes, and then adjourned.

Transcript Highlights:

• In other words, we start paying benefits this year, I guess in August.
• That's a 0.2% surcharge, the tax employers pay.
• The second metric there is how long it takes to pay them the first claim.
• We pay benefits daily.
• We pay benefits daily.

Summary: The Senate Labor and Commerce Committee opened its 2026 session with member introductions and a work session on the Employment Security Department’s structure and programs. ESD officials described their roles and reviewed paid family and medical leave, WA Cares, unemployment insurance, workforce services, and agricultural worker outreach. Senators raised concerns about call volume, program solvency, fraud detection, employer access to information, and whether workers can receive leave benefits while working other jobs. ESD said WA Cares is in a limited pilot, PFML has seen rapid growth, UI trust fund solvency is projected to be near the statutory trigger level, and they would follow up with more detailed information on eligibility, fraud referrals, and employer scenarios. The committee then heard Senate Bill 5292, which would replace the current PFML rate-setting formula with a forward-looking actuarial model and require a four-month reserve beginning in 2030. Supporters, including the sponsor, JLARC staff, labor advocates, and employer groups, said the change would improve stability and follow JLARC recommendations; opponents warned it could lead to higher payroll taxes and argued the program is already too costly. The chair said she intended to keep the bill narrow as it moved forward. The committee also heard Senate Bill 6014, a technical bill on pregnancy-related accommodations that would preserve the ability of pregnant workers to request certain accommodations without a doctor’s note and create a public records exemption for sensitive complaint and investigation records; the sponsor and supporters said it corrects a drafting error and protects privacy. Next, the committee heard Senate Bill 5972, which would remove the population threshold limiting interest arbitration for correctional officers in jails, and Senate Bill 5869, which would make permanent and expand from residential to all building construction sites a requirement that L&I notify employers or owners within 10 working days when a hazard is identified. Correctional officers’ representatives and labor groups supported SB 5972 as a fairness and safety measure, while the sponsor said it would create consistency across jurisdictions. Construction industry groups supported SB 5869, and L&I said it had no concerns but wanted the bill kept narrow; the chair noted the bill’s purpose was to speed hazard communication. Finally, the committee heard Senate Bill 5874, which would allow ESD to waive penalties for minor errors in quarterly unemployment reports, especially missing SOC/job-title information. The sponsor said small businesses were being hit with unnecessary fines, and ESD said it had identified a sharp rise in penalties and was working with the sponsor on possible fixes. The committee adjourned after the hearings.

Transcript Highlights:

• They do not provide health benefits, pay payroll taxes.
• There might be a reduction in what passengers are paying because they're paying less of the fee. ...be
• a reduction in what passengers are paying because they're paying less of the fee, but there's no guarantee
• All of us users paying in.
• All of us users paying in.

Summary: The Assembly Communications and Conveyance Committee heard three bills. SB 371 by Senator Cabaldon would reduce uninsured/underinsured motorist coverage requirements for transportation network companies from $1 million to $100,000 per person and $300,000 per accident, with committee amendments adding findings and declarations, higher limits than originally proposed, and a joint study on UM/UIM impacts. Supporters, including Uber, Lyft, business groups, and some consumer advocates, argued the bill would lower fares and increase driver earnings by reducing insurance costs. Opponents, including consumer attorneys, labor groups, and consumer watchdog organizations, warned it would cut protections for riders and drivers and might not guarantee savings would be passed through. The committee approved SB 371 on a due-pass basis and re-referred it to Appropriations by a 9-0 vote. The committee then heard SB 716 by Senator Durazo, which would create a Home Internet Lifeline Program to let eligible low-income households apply Lifeline subsidies to home broadband service. Proponents said the bill addresses broadband affordability after the federal Affordable Connectivity Program expired, and that it would help students, workers, and families access reliable internet. Opponents from the wireless industry objected to the funding mechanism, arguing the surcharge would fall unfairly on wireless consumers, while one broadband group moved to neutral after amendments. The bill was approved on a due-pass basis and sent to Appropriations, but the roll was held open and later completed with the bill passing 7-1. The committee also took up SB 480 by Senator Archuleta relating to autonomous vehicles as a consent item, with no presentation or debate. It was approved on a due-pass basis and re-referred to Appropriations by a 9-0 vote. Throughout the hearing, members repeatedly focused on affordability, consumer protection, and whether savings from the bills would actually reach riders, drivers, or households.

Transcript Highlights:

• So they're, they're participating in our economy, but they, uh, they have to pay, if, if they have to
• Their child would be required to pay this 15%. Um, and they would be taking out loans.
• But it also, right now we're forcing these people to borrow money to pay for the other people.
• oftentimes borrow money to pay for the person next to them.
• So they would still be paying the loan. If they needed it beforehand.

Transcript Highlights:

• It is everyone paying the bill for these.
• When the regulator steps in, they do an audit of us, and we pay for the audit.
• I have to pay one particular PBM.
• I'm voting yes with teachers' pay.
• I'm voting yes because I think 60% of the school district pay, six of the expenses, should go into pay

Summary: The committee first took up a discussion-only strike-everything amendment to HB 2211, which would make it unprofessional conduct for certain health care providers to submit offers in independent dispute resolution above 300% of Medicare or the qualified payment amount. The chair said he was not ready to move the bill because more stakeholder meetings were needed. Testimony split between insurers, who said a small number of providers were abusing the No Surprises Act and driving up costs, and provider representatives, who argued the proposal would improperly cap rates, relied on opaque insurer-set QPAs, and could threaten licensure in a billing dispute. No vote was taken on HB 2211. The committee then considered HB 4028 on accessory dwelling units. The bill would remove the 1,000-square-foot cap, change setback rules, bar municipalities from requiring an administrative use permit and certain elevation criteria, and extend the deadline for cities to adopt ADU regulations. The sponsor argued it would give homeowners more flexibility and help address housing affordability, while cities, neighborhood groups, and residents warned it would allow oversized ADUs, reduce local control, create density and safety concerns, and invite investor-driven development. After extensive debate, the committee voted 8-9 with one present, and HB 4028 failed. Next, the committee heard HB 2620, as amended, which appropriates $300,000 annually for five years from the General Fund to the Department of Veterans’ Services for grants to emergency shelters. An amendment removed age and non-congregate-setting conditions for eligibility. The sponsor and a shelter provider said the funding would help shelters better serve homeless veterans and connect them to services. The committee adopted the amendment and then passed HB 2620 on a 17-0 vote with one member not voting. The committee then considered HB 2960, as amended, which creates a veterans specialty court grant program and a dedicated fund to support local veterans treatment courts. An amendment shifted administration of the fund to the Office of the Courts and allowed support for expansion of existing programs. The sponsor, a Lake Havasu judge, and a veteran graduate testified that veterans courts reduce recidivism and save lives by linking veterans to treatment and support. The bill was still being taken up when the transcript ended, with testimony continuing from supporters including a veterans shelter founder.

Transcript Highlights:

• Who doesn't want to pay six cents a kilowatt?
• They're just going to keep paying that.
• They're just going to keep paying that.
• Where is the General Fund amount that was in there last year that is paying for what we're paying for
• We as taxpayers have to pay for that.

Keywords: 987, senate, all

Transcript Highlights:

• Who's paying them? The county, Mr. Chair.
• All right, so the, so the county is paying for that security.
• And then the question is how do you, how do you use that money to pay claims.
• We've got to be able to pay them.
• I, I want to pay my attorneys. Um, and so those are the three things.

Transcript Highlights:

• As far as an ag retailer to be paying a lot of tax in on our.
• The consumers are still paying the sales tax and wherever they live, right?
• It's really them that's paying it. It's not really a loss to the state.
• I'd have to pay City of Houston sales tax even though I live in Lavaca County.
• If you use Avalara, every business is going to pay $2,500 in a processing fee.

Bills: HB134, HB135, HB 1109, HB 1243, HB1392, HB1399, HJR99, HB134, HB135

Keywords: sales tax, use tax, local tax, municipal tax, county tax, tax sourcing, place of business, principal business location, small business, retailer, marketplace seller, economic development agreement, Chapter 321, Chapter 323, Tax Code, Texas Comptroller, local sales and use tax, tax jurisdiction, order consummation, ship-to location

Transcript Highlights:

• </c> tax on all the insurance that you pay. tax on all the insurance that you pay.
• You pay $40, everybody else pays $6,000.
• You pay $40, everybody else pays $6,000.
• You pay $40, everybody else pays $6,000.
• If the user pays, rather than asking everyone else to pay for what I want, I'll pay a little more for

Keywords: 928, house, all

Summary: The meeting was a House budget briefing focused on the overall state budget and the first of three divisions. The presenter reviewed the size and structure of the budget, noting that the state had eliminated the interest and dividends tax and still balanced the budget. He explained the major spending categories in the general fund and total budget, emphasizing that health and human services and education remain the largest areas, while transportation is largely self-funded. He also walked through the revenue picture, including business taxes, insurance taxes, court fees, communications taxes, and Medicaid recoveries, and said the remaining interest and dividends tax revenue reflected late payments from prior assessments. Members asked about the size of the tax cut from eliminating the interest and dividends tax, federal funding stability, and why Medicaid was being reduced if federal support was expected to remain steady. The response was that the lost revenue would have been about $200 million absent repeal, and that the budget gap was addressed through many small cuts across departments. On federal funds, the presenter said most aid is tied to multi-year grants and that core programs such as Medicare and Medicaid were expected to remain relatively stable, though some federal reductions could occur. He also said some agency reductions came from eliminating long-vacant, funded positions and from expected lapses. The discussion then moved into Division One, which covers smaller and miscellaneous agencies. The division made cuts to the governor’s office, eliminated a temporary position at the Governor’s Commission on Disability, reduced Department of Information Technology spending through a back-of-budget cut, and found savings in Administrative Services. It also delayed maintenance at the Sununu Youth Services Center, stopped advertising for paid family medical leave, changed retiree health insurance funding, and consolidated several personnel-related boards into one. The division eliminated the Commission on Aging and the Office of the Child Advocate, made a temporary special education advocate position permanent, reduced the Secretary of State’s budget, kept municipal rooms-and-meals distributions flat, and made changes to the retirement system, including $55 million to improve Group 2 retirement benefits and a new retirement structure for future state hires. The judicial branch was also asked to find savings and received two additional judges because of expected caseload increases from other eliminations.

Transcript Highlights:

• But maybe if we pay what the others are paying, prevailing wage, we could hire these people.
• But maybe if we pay what the others are paying, prevailing wage, we could hire these people.
• It is way beyond normal pay, way beyond even industry pay. We pay way beyond even industry pay.
• </c><02:50:49.920><c> Uh</c><02:50:50.399><c> we</c> pay way beyond even industry pay.
• Uh we pay way beyond even industry pay.

Keywords: 916, all

Transcript Highlights:

• I pay $2,500 a month for child care.
• </c> I pay $2,500 a month for child care. I pay $2,500 a month for child care.
• </c> going to be forced into paying going to be forced into paying their<02:26:26.480><c> employees</
• :55.760><c> pay</c><02:29:55.960><c> wage</c><02:29:56.600><c> when</c> because it's a different pay
• So, this pitch in and pay for that.

Keywords: 981, all

Transcript Highlights:

• </c> that the general assembly did not pay that the general assembly did not pay what<00:19:06.160><c
• I wish it wasn't, but we have to be responsible and pay this bill because if we don't pay the unfunded
• First thing out of your budget is pay that pension obligation. So, we got to go ahead and pay it.
• pays a percentage of that.
• pays a percentage of that.

Keywords: 958, all

Summary: The Budget Review Subcommittee on Education met without a quorum, so the minutes were not approved. The main presentation was from retired economics professors John Garren and Dr. Kums, who discussed their Bluegrass Institute research on teacher compensation in Kentucky since the Kentucky Education Reform Act era. They said teacher base salaries, adjusted for inflation, have declined over the last decade, while state-paid “on-behalf” benefits such as pension and health insurance contributions have risen sharply; they argued total teacher compensation has increased modestly overall, but less than per-pupil funding. They also presented broader context on staffing growth, declining average daily attendance, Kentucky’s low share of teachers among total school staff, and flat or weak NAEP and ACT performance trends, including widening white-Black score gaps on NAEP. Members questioned the methodology and interpretation of the compensation figures. Representative Bojanowski argued the on-behalf calculations may overstate teacher compensation because they include insurance and pension costs that also benefit classified employees and retirees, and he asked for clarification on the denominator used to derive the per-teacher amount. Representative Truit said the presentation could be misleading if it implies teachers earn $94,000 in salary, and he objected to framing pension stabilization payments as teacher pay. The presenters responded that they were using total compensation, not salary alone, said they had divided total personnel-related on-behalf payments by the relevant staff count, and promised to review and send a technical explanation. Representative Truit and Chairman Typton both emphasized that compensation should be viewed as salary plus benefits, not salary alone, and noted that pension contributions are part of the cost of employing teachers. The presenters said their intent was to show the full compensation package and its relevance to labor supply and teacher shortages, not to claim that individual teachers earn the total compensation figure as salary. No votes or formal actions were taken beyond the decision to revisit the minutes at a later meeting due to the lack of quorum.

Transcript Highlights:

• </c><01:02:44.079><c> a</c> these small arborist are paying a these small arborist are paying a fortune
• Government comes in, pays those people directly when they can't pay their higher utility bills, and then
• Government comes in, pays those people directly when they can't pay their higher utility bills, and then
• </c> income who are already not able to pay income who are already not able to pay their<01:41:04.719
• </c> paycheck because we decided how to pay paycheck because we decided how to pay that<01:41:20.560>

Keywords: 1183, house

Transcript Highlights:

• Who's going to pay for than proven here. Who's going to pay for it?
• this be a luxury for those who can pay this be a luxury for those who can pay out<01:24:06.000><c> of
• </c><01:44:24.400><c> When</c> that pays lifelong dividends. When that pays lifelong dividends.
• And I witness this ability to pay.
• </c><02:02:04.639><c> for</c> Minnesota taxpayers should not pay for Minnesota taxpayers should not pay

Keywords: 1187, senate, all

Transcript Highlights:

• Does Hampstead still continue paying for Does Hampstead still continue paying for the<00:41:11.360><c
• So now that student's not paying, and now the state's essentially paying the tuition agreement.
• It could be transporting staff, etc. pay essentially pay to uh special pay essentially pay to uh special
• </c> districts pay the receiving districts. districts pay the receiving districts.
• </c><00:50:29.400><c> within</c> that they are currently paying within that they are currently paying

Keywords: 1189, house, all

Summary: The committee of conference on HB 751 reviewed amendment 2026-1904H page by page, focusing on open enrollment rules, capacity definitions, statewide enrollment limits, denial criteria, transportation, and funding. Members discussed clarifying that districts may set capacity at zero if they truly have no room, creating a statewide enrollment cap of 500 that can increase by 25% if it reaches 90% utilization, and exempting seats already used by open enrollment students before October 1, 2026. They also discussed how the Department of Education would allocate seats through rulemaking, while local districts would still set capacity, with grandfathered seats preserved where districts already allow open enrollment. A substantial portion of the meeting centered on when districts may deny open enrollment applications. The amendment would allow denials for reasons such as chronic absenteeism or disciplinary history, while requiring districts to consider whether those issues are tied to disability, McKinney-Vento status, foster care, or bullying. Members emphasized that such factors are to be considered, not used as the sole basis for rejection, and noted that the bill separately prohibits receiving schools from accepting or rejecting applicants based on pupil needs, special education needs, disability, aptitude, or athletic achievement. There was also discussion of whether interdistrict transfers should count toward open enrollment capacity, with a suggestion that a carve-out may be needed. The committee also reviewed provisions on program-specific capacity, continuous enrollment, and transportation. It was explained that capacity can apply to a school, grade, program, or class, including CTE programs, and that students may be denied if a specific program is full or if they do not meet prerequisites. The group clarified that open enrollment pupils would maintain continuous enrollment without reapplying, though there was concern about how that would work if district capacity changes over time. Transportation would generally be the parent’s responsibility unless required by an IEP or 504 plan, though students may use an existing bus route if seats are available and the receiving district allows it. On funding, the committee noted that the amendment changes the earlier HB 751 approach and instead ties open enrollment funding to base adequacy, differentiated aid, and an additional grant modeled on charter school funding, with dates removed at the department’s request. Members also raised concerns about how open enrollment would interact with existing tuition agreements and whether districts could use the new pathway to alter or pressure those arrangements. Department staff said districts would still be required to maintain a school of record and provide an adequate education free of charge outside the open enrollment program, and that if open enrollment enrollment became unusually large relative to district adequacy enrollment, the issue could be brought to the state board. No votes were taken in the portion provided.

Transcript Highlights:

• They want to know what they're going to have to pay.
• They want to know what they're going to have to pay.
• And then our Medicaid program outside of ATRIP pays it.
• It's tied to Medicare and actually pays less than what Medicare pays, so that's why we have to have this
• and actually pays less than Medicare and actually pays less than what<00:51:31.119><c> Medicare</c><

Keywords: 00:00 Call to Order/Roll Call 00:16 Consideration of Referred Administrative Regulations 25:49 Discussion of Hospital Rate Improvement Plan 58:50 Adjournment, 958, all

Summary: The committee began by reviewing a large slate of administrative regulations and explaining that it does not approve regulations but can find them deficient and send them back for further work. Members then asked questions on several items, including EMS reciprocity, dental hygienist licensure, and interpreter licensure. The EMS board explained that reciprocity would extend to applicants from any state, not just contiguous states, because the underlying statute had been amended. On the dental regulation, staff said the changes mainly clarified licensure requirements, reinstatement fees, and that dental hygienists administering local anesthetic must do so under direct dentist supervision. The most extended discussion involved the Board of Interpreters for the Deaf and Hard of Hearing. The board chair said the main concern was that the EIPA is an educational specialty assessment, not a nationally recognized certification, yet the regulation would allow it to support full licensure. Members discussed whether that could let educational interpreters work outside their intended scope and whether a separate educational license or statutory change would be more appropriate. The board said it did not think the regulation could be fixed further at this point and suggested a statute could create a narrower educational interpreter license. After discussion, the committee voted to defer both related interpreter regulations, 201 KAR 39:030 and the companion regulation, for further work. The committee then took up two community mental health regulations, 907 KAR 1:044 and 907 KAR 5:005, which had been found deficient in Administrative Regulations. Department for Medicaid Services staff said the rules would expand and rename the mental health associate role as a behavioral health associate, making the role available in many more facilities, but would also require additional coursework or progress toward licensure. Some members and providers raised access-to-care concerns, especially for rural areas and unlicensed staff already working in the field. Staff said the proposal had been revised through work with CMHCs and licensing boards, but the committee ultimately voted to defer both regulations as well. After finishing the regulation review, the committee heard a presentation from the Kentucky Hospital Association on the ATRIP hospital rate improvement program. Hospital representatives said ATRIP is a Medicaid state-directed payment program funded through a provider tax and federal matching dollars, allowing hospitals to receive payments tied to quality measures. They reported improvements including lower Medicaid readmissions, high sepsis screening rates, reduced infections and opioid prescribing, expanded postpartum depression and suicide screening, and training for more than 1,000 people. They said the program has helped hospitals invest in staffing and quality improvement and warned that without it, many hospitals would face severe financial strain.