Transcript Highlights:

• Governor's Message 585 is submitting for consideration and confirmation to the Game Management Advisory
• Ruas to the Game Management Advisory Commission for a term to expire June 30, 2028.
• ><c> for</c><00:02:29.680><c> a</c> Management Advisory Commission for a Management Advisory Commission
• </c> resources to convene a Kyua Bay advisory resources to convene a Kyua Bay advisory working<00:15:
• This is submitting the confirmation to the Game Management Advisory Commission.

Summary: The Committee on Water and Land heard two gubernatorial nominations and one resolution. Governor’s Message 585 nominated Stanley Ruidas to the Game Management Advisory Commission for a term ending June 30, 2028. DLNR supported the nomination, citing his prior service as GMAC chair from 2020 to 2022 and his work on hunting and wildlife management issues. Ruidas said he hoped to continue as chair and focus on bringing meetings to hunters across the islands and advancing island-specific wildlife management plans. The committee later recommended advice and consent on GM585, and the motion passed unanimously. Governor’s Message 550 nominated Alexandra Kelly Polo to the Legacy Land Conservation Commission for a term ending June 30, 2028. DLNR and several supporters, including the County of Hawaii and community advocates, praised her experience with land acquisition, conservation easements, and county open-space efforts. Kelly Polo said her work has helped protect thousands of acres on Hawaii Island and emphasized the importance of preserving natural resources and working with community groups. The committee recommended advice and consent on GM550, and the motion passed unanimously. The committee also considered SCR 19/SR 100, which requested DLNR to convene a Kīua Bay advisory working group. DLNR and the Hawaii Tourism Authority offered written support, and members said the working group could help address long-standing issues in the area. The committee recommended passage with technical and nonsubstantive amendments, and the motion was adopted unanimously. In a separate joint portion of the meeting, the committees also advanced SCR 75/SR 58, supporting historic preservation staffing for Lahaina rebuild efforts, with both technical and substantive amendments, and later advanced STR 24 with an amendment to include the 100th Infantry Battalion alongside the 442nd Regimental Combat Team.

Transcript Highlights:

• </c><00:55:17.040><c> Um,</c><00:55:18.319><c> Representative</c> missing something?
• Um, Representative missing something? Um, Representative Wade. Wade. Wade.
• And you say you give advisory opinions on matters? >> In interpretive rulings. >> Okay.
• </c><00:56:35.599><c> um</c><00:56:35.839><c> advisory</c> potential conflict. um advisory potential
• :33.680><c> opinions</c><00:58:34.319><c> on</c> say you give advisory opinions on say you give advisory

Committee: House Legislative Administration

Transcript Highlights:

• Advisory boards going back to 2007. My advocacy in here started in 2005.
• But they're, I'm missing their body inside, you know.
• missing a medical opinion or anything like that.
• All right, see, we miss in here. We have one more person. Do we have a... Miss Simmonson? Mr.
• Heights is missing. Okay. All right, we'll move forward in ways then.

Summary: The Senate Select Committee on Veteran Affairs met on August 26, 2026, adopted its committee rules, and heard opening remarks honoring veterans, military families, and service members who died in a recent Fort Hood helicopter crash. The committee then took up interim charge number two on military-to-civilian transition, with invited testimony from university and community leaders from Wichita Falls and Texas A&M. Witnesses described programs such as Midwestern State University’s Military Education Center, the Sheppard Military Affairs Committee’s community connections, Texas A&M–Central Texas’s military talent pipeline, and campus veteran services that help service members and veterans move into higher education, employment, and community life. Members emphasized that transition should begin well before separation, with better data-sharing, stronger local “warm handoffs,” and more coordination among bases, schools, workforce systems, and community organizations. Testimony focused on practical ways to keep transitioning service members in Texas and match their skills to workforce needs. Witnesses urged earlier outreach before the TAP window, better tracking of service member skills and destination plans, and stronger use of peer mentors and community partners. Several witnesses highlighted the need to recognize military training for civilian credentials, including proposals for a Texas medic/corpsman-to-nursing pathway modeled on Wisconsin’s WISMAC program, and broader reciprocity or competency-based credit in fields such as nursing, aircraft maintenance, trucking, teaching, and other trades. Members asked about AI and future job skills, and witnesses said Texas should better prepare service members for emerging technology jobs and use existing programs more effectively. The committee then heard from Texas Veterans Commission and transition experts on the role of the Military Veteran Peer Network, the Governor’s Challenge on suicide prevention, and the need for more resources and better access to bases. Witnesses said the transition period, especially the first 12 to 18 months after separation, is a high-risk time for suicide, unemployment, housing instability, and loss of purpose. They recommended installation-specific transition plans, stronger coordination between TAP, Texas Workforce Commission, Texas Veterans Commission, and local partners, more trained counselors, expanded College Credit for Heroes use, and better employer apprenticeship pipelines. One witness from Onward Ops said its program has shown an 80% reduction in suicidality among participants and asked for more Texas community partners and certified mentors. No formal votes were taken beyond adopting the committee rules.

Transcript Highlights:

• Miss But, if you'd like to answer Mr. Miss Doctori. Doctori. Doctori.
• You are missing maybe pages.
• You are missing maybe pages.
• You are missing perfect copy. Right? You are missing maybe<01:08:31.960><c> pages.
• </c><01:35:21.480><c> council</c> It also creates an advisory council It also creates an advisory council

Bills: HF4456 , HF4544 , HF3698

Committee: House Commerce Finance and Policy

Transcript Highlights:

• SHIPA has advisory committees scattered across the state geographically and around topic areas.
• SHIPA has advisory committees scattered across the state geographically and around topic areas.
• committees</c> Um SHIPA has advisory committees Um SHIPA has advisory committees scattered<00:28:38.320
• Did I miss anyone else who wishes to testify?
• </c><01:22:03.600><c> or</c> up one day and to find their child or up one day and to find their child

Bills: SB2936 , SB2850 , SB2851 , SB2521

Committee: House Health

Summary: The joint hearing covered House Bill 251, which would require hospitals to report costs associated with Medicare and uninsured patients, and House Bill 1875, which would expand protections for gender-affirming health care services. On HB 251, the Department of Health said it supported the intent but described the bill as complicated and potentially impractical as drafted because the department lacks the expertise to produce the required analyses without outside help. Hawaii Health Systems Corporation echoed those concerns, while the Queen’s Health System said it was willing to work with the department to provide the information. In committee discussion, officials explained that hospital support in Hawaii includes public hospital appropriations and the provider tax program, which uses hospital and nursing home contributions to draw federal matching funds; a department witness estimated the net benefit at about $150 million for hospitals and $20 million for nursing facilities, though exact figures would be provided later. On HB 1875, the Insurance Division testified with concerns that the bill’s language on prohibited actions by malpractice insurers was broad and vague, and that a rate-increase prohibition could conflict with actuarially based insurance pricing. The division also noted it was not the primary enforcement agency for the statute. In contrast, many testifiers strongly supported the bill, including the Hawaii State Commission on the Status of Women, the Hawaii State LGBTQ+ Commission, the Hawaii Public Health Institute, PFLAG Oahu, the ACLU of Hawaii, the Drug Policy Forum of Hawaii, the Hawaii County Democratic Party, and others. Supporters argued that gender-affirming care is medically necessary, evidence-based, and protected by privacy and bodily autonomy principles, and that the bill would protect patients and providers from outside political interference. No votes or final committee actions were taken during the portion of the hearing provided.

Transcript Highlights:

• And maybe I missed it, but I'm trying to...
• I just wanted you to know what we're doing, and if there are other questions that I missed that were
• We had a serious mental illness advisory group, and now, in January, we'll be paying a daily rate and
• Family-centered treatment started out with child welfare and with the Division of Youth Services.
• And so family-centered treatment started out with child welfare and with D.S with the Division of Youth

Committee: All PUBLIC HEALTH- HOUSE HEALTH SERVICES SUBCOMMITTEE

Transcript Highlights:

• you was that if I walk into a workforce office and I may need supports to help me get to work, like child
• So what is the missing link?
• There's the regional centers and kind of looking at regionalism, but in my opinion, what's missing in
• One is through work, and the second is through increased child support collections.
• They've become more of a true advisory board. And that's another issue.

Committee: All ALC-HOSPITAL, MEDICAID, & DEVELOPMENTAL DISABILITIES STUDY SUBCOMMITTEE

Summary: The committee met to hear consultants Mason Bishop and Cameron Christie discuss Arkansas’s “one door/no wrong door” workforce and social services modernization effort. Bishop argued that the current system is fragmented across multiple agencies, offices, and portals, making it hard for job seekers and employers to access services efficiently. He said the goal is to create a more integrated system that promotes upward mobility, longer labor force attachment, better employer access to talent, greater efficiency, and faster adaptation to changes such as AI and other economic disruptions. Bishop repeatedly pointed to Utah as a model, describing how that state combined workforce and public assistance functions into a single agency, used statewide cost allocation to blend funding streams, and improved customer service and outcomes after reform. He said Arkansas should consider integrating governance, service delivery, and financing, including possible waivers, a statewide cost allocation plan, and a benefits-cliff pilot. He also said Arkansas’s current local workforce board structure creates duplication and weak coordination, and that Launch is a useful tool but not a full service-delivery system. Committee members asked how the proposal would work in practice, including whether TANF could be used to cross-train DHS workers, how federal waivers might be obtained, how local boards would be affected, and how disabled clients would be handled. Bishop said TANF should be treated as part of a workforce strategy, that federal pilot authority for workforce reform nearly passed but did not, and that waivers are now the practical path. He also said Arkansas could either merge functions more fully or at minimum co-locate workforce staff in DHS offices statewide. No votes were taken; the meeting ended with plans to continue the discussion in August, including a focus on case management and whether the state is managing programs or people.

Transcript Highlights:

• Waiting is not an option when a child is declining and sometimes declining rapidly.
• beyond 30 days, even when those claims are considered clean, meaning that there are no errors or missing
• Seattle Children's was founded on a promise to care for every child in our region regardless of their
• The bipartisan Medicare Payment Advisory Commission, which I'm going to call MedPAC for the rest of this
• It eliminates the 20% co-pay requirement and adds benefits, all currently missing from original Medicare

Summary: The Health Care and Wellness Committee held a public hearing on several bills and a joint memorial. SB 5915 would update the health technology assessment program by adding technologies recommended for Medicare populations or in national guidelines to the review priority list, requiring broader evidence review for life-threatening or rare diseases, and setting timelines for posting and deciding review requests. Supporters, including rare disease advocates and providers, said the current process is outdated and too rigid; the bill was then held for later action. SJM 8002 urged Congress to strengthen original Medicare, oppose privatization, add benefits like dental, vision, and hearing, and reduce Medicare Advantage overpayments and fraud. Supporters from labor and senior groups argued it would protect beneficiaries and send a message to federal officials; the memorial was also held after testimony. The committee also heard SB 5395 on prior authorization. Staff explained it would tighten notice requirements, require a licensed clinician—not AI alone—to deny requests based on medical necessity, add transparency around policy changes, and change how retrospective denials are treated. The prime sponsor and provider groups said the bill was a negotiated compromise meant to reduce delays and inappropriate denials, while insurers were generally neutral but sought a narrow amendment. Testifiers described prior authorization as a major source of delay and administrative burden, and the bill was held after public testimony. SB 5845 would require carriers to pay or deny clean claims within 30 days, set timelines for non-clean claims and information requests, and allow penalties for repeated noncompliance. Hospitals, physicians, and health systems supported it as a way to improve predictable payment, while insurers were neutral and asked for a narrow amendment; the bill was also held. The committee heard SB 6025, which would change the definition of fetal death so gestational age is calculated using the best clinically accurate age rather than the last menstrual period. Obstetric and nursing witnesses said the current law can force inaccurate records and unnecessary burdens on grieving families, while opponents objected to the bill’s abortion-related definitions. The bill was held after testimony. Finally, SB 5988 would authorize the Department of Health to continue accrediting opioid treatment programs and charge fees to support that work. The department and the sponsor said the measure would preserve a patient-centered accreditation option amid budget pressure, and the committee closed testimony and held the bill.

Transcript Highlights:

• </c><00:22:10.960><c> one</c><00:22:11.200><c> phone</c> missed uh the father missed one phone missed
• &gt;&gt; Miss<00:44:45.839><c> Westman.</c> &gt;&gt; Miss Westman. &gt;&gt; Miss Westman.
• Miss Olsson, do Did you say question?
• </c> &gt;&gt; Senator or Miss Olson. &gt;&gt; Senator or Miss Olson.
• And now we will go to testifiers, and Miss N. Lima Sitati Monet... Miss N. Lima Sitati Monet.

Committee: Senate Health and Human Services

Transcript Highlights:

• </c> trust fund community grants advisory trust fund community grants advisory council<00:19:45.440><
• </c> little bit further but the advisory little bit further but the advisory council<00:19:52.000><c>
• </c> &gt;&gt; Miss Robson. &gt;&gt; Miss Robson. &gt;&gt; Mr.<00:37:52.320><c> Mr.
• &gt;&gt; Miss<01:08:49.600><c> Sherman</c><01:08:49.920><c> Hone.</c> &gt;&gt; Miss Sherman Hone.
• &gt;&gt; Miss Sherman Hone.

Committee: House Environment and Natural Resources Finance and Policy

Transcript Highlights:

• Madam Chair, Representative Martinez, we do sit on their resource planning advisory council, specifically
• I'm just wondering, is there another category that I'm missing, or I mean these things by their nature
• would tend to be commercial, is that right, or am I missing something?
• Love to work on that on the housing front, on the child care front, and on the health care front, as
• Not to minimize that, but we're also looking at housing costs, child care costs, and health care costs

Bills: HB2014 , HB2113 , HB2145 , HB2331 , HB2340 , HB2389 , HB2400 , HB2401 , HB2428 , HB2494 , HB2696 , HB2756 , HB2795 , HB2955 , HCM2008

Committees: House Natural Resources, Energy & Water , House House Natural Resources, Energy & Water Committee of Reference

Keywords: air emissions, fuel blends, environmental quality, feasibility study, Arizona Department of Agriculture, utility consumer, rate intervention, public service corporation, Arizona Revised Statutes, residential rates, consumer protection, fuel reformulation, gasoline standards, environmental regulations, ethanol supply, Air Quality, energy reliability, electric service providers, reliable resources, public power entity

Transcript Highlights:

• But we, as a state, immediately came together and put together an advisory council for the advancement
• Now, if you read the missing... And we disaggregate that data.
• My father was a child. the Trio program. I'm one of eight siblings.
• Going into the fall 2025 semester, half of our TRIO staff was missing.
• Half of our TRIO staff was missing. Many left in panic over the uncertainty of continued funding.

Committee: Joint Joint Committee on Racial Equity, Civil Rights, and Inclusion

Summary: The Joint Committee on Racial Equity, Civil Rights, and Inclusion held an informational hearing on “Protecting Equity in Higher Education” and emphasized that no bills were being heard. Members and witnesses focused on the effects of recent federal actions on DEI, admissions, financial aid, student loans, international students, and campus equity efforts in Massachusetts. Opening remarks from the co-chairs and the chair of Higher Education highlighted Massachusetts’ investments in free community college, expanded financial aid, and early college programs, while warning that federal policy changes could undermine those gains. Testimony from BU law professor Jonathan Feingold argued that many DEI practices remain legally defensible after Students for Fair Admissions v. Harvard, and that the decision did not end all race-conscious or equity-oriented efforts. He said the Trump administration’s anti-DEI actions and funding threats were legally suspect and had created confusion and a chilling effect. Bahar Akman-in-Boden of the Hildreth Institute testified that proposed federal cuts to TRIO, Gear Up, Pell Grants, SEOG, work-study, and student loan programs would disproportionately harm low-income, first-generation, Black, Latino, and other underserved students, and urged the state to prepare hold-harmless and advising supports using Fair Share revenue. Commissioner Noe Ortega described Massachusetts’ long history of equity in higher education and said the state has expanded aid, success programs, and early college, but still has work to do on attainment and completion. He said the state responded to SFFA by creating ACARE and continuing to defend equity practices, while also warning that federal disruptions and “dear colleague” letters have created uncertainty. In the second panel, state university leaders and campus officials said federal threats to Pell, DEI grants, Medicaid, and international student policies could affect access, campus operations, and the economy; they stressed that most state university graduates stay in Massachusetts and that institutions are continuing their equity practices despite federal pressure. Roxbury Community College’s president said RCC remains committed to open access and inclusion, noted enrollment growth, and said executive orders do not change existing law or the college’s obligations.

Transcript Highlights:

• Through its Judicial Management Council, which is its senior advisory body, the Supreme Court created
• of child support.
• But when the child support has changed, that doesn't reclose the case.
• I mean, you used to be able to get a contempt motion heard in a divorce case for child support.
• And I'm wondering, is that something new that I missed?

Summary: The committee first heard an update from the Florida Department of Corrections on the proposed Lake Correctional Institution mental health project in Clermont. Tim Fitzgerald explained the project’s history, including the 2016 Disability Rights Florida litigation, the 2018 consent decree, and the original plan for a 550-bed inpatient mental health facility. He said inflation and design changes pushed the project above the bond amount, leading the department to shift to a “continuum of care” alternative with 572 beds total: 92 inpatient beds and 480 residential treatment beds in three special housing units. Fitzgerald said the project is currently paused pending House concurrence, while the Senate has already agreed to the alternate plan, and noted the bond balance, prior expenditures, and the need to spend down the tax-exempt bond by August 2026. Members questioned how the new plan differs from the original facility, whether it satisfies the consent decree, and what caused the cost increases. Fitzgerald said the department believes it has already met the consent decree through systemwide improvements to housing, staffing, programming, and out-of-cell time, though he said he would confirm the court documentation. He also said the original scope grew from 275,000 to 350,000 square feet as treatment, nursing, security, and programming needs were refined, and that inflation, fees, permitting, and contingencies contributed to the higher cost. Several members asked for follow-up information on Senate approval, consent decree documentation, and the project’s impact on crisis-stabilization capacity. The committee then received a joint court-system presentation from State Courts Administrator Eric McClure and Clerks Corporation Executive Director Jason Welty on caseload trends, case tracking, and staffing. McClure described statewide filing trends, the use of weighted caseload studies to certify judicial need, and recent Supreme Court rule changes aimed at active civil case management, including differentiated case tracks, stricter deadlines, and proportional discovery. He said the latest workload study led the Supreme Court to certify a need for 23 circuit judges and 25 county judges. Welty reviewed clerk workload trends, the statewide case maintenance and CCIS systems, and declining clerk FTE despite rising case volumes, and said clerks are seeking additional funding for injunctions, Baker Act/Marchman Act/sexually violent predator work, and juror management. In questions, members pressed both presenters on data quality, case-weight calculations, filing fees, and whether current resources are enough to reduce delays. McClure clarified that the workload weights are based on judge time studies and that a capital murder case averaged 3,177 minutes, while other examples such as auto negligence and dissolution cases were much lower. Welty said the Legislature could help by increasing funding or potentially revisiting filing fees, and noted that many clerk services are unfunded or underfunded, especially indigent and protective filings. The chair and members also raised concerns about backlog, inconsistent case reporting across circuits, and enforcement of judicial time standards; McClure said there is no direct sanction in the rules, and compliance is largely managed through chief judges and the Supreme Court. The meeting ended with no votes taken and adjournment by motion.

Transcript Highlights:

• Anderson, and Miss Patton.
• The Advisory Board is crucial.
• </c> for uh Miss Jensen please sir uh Miss for uh Miss Jensen please sir uh Miss Jensen<01:37:03.119>
• A fellow board member had to miss a meeting when her child became ill at the last minute, while she was
• </c> had to miss a meeting when her child had to miss a meeting when her child became<01:45:51.800><c

Committee: Senate State and Local Government

Transcript Highlights:

• It makes changes from fetus to unborn child.
• It makes changes from fetus to unborn child.
• and Department of Child Safety.
• and department of child safety.
• It shows up in rent, groceries, utilities, and child care.

Summary: The committee worked through a long Minority Caucus calendar covering a wide range of bills, with many items on consent and several pulled for discussion. Early items included resolutions on Judea and Samaria, bullion depository bills, a produce incentive appropriation, a biennial budget proposal, and a veterans services appropriation. Members also heard transportation-related bills on driver permits, citations, boat insurance, English proficiency for commercial drivers and motor carriers, photo enforcement, and a measure restricting incarceration for unpaid fines and fees. Several members raised concerns about constitutional issues, public safety, or whether bills were duplicative or targeted at specific groups. A large portion of the meeting focused on education and school governance bills. These included proposals on school district bond advisors, restrictions on school property leases and purchases, public meeting requirements, term limits and training for school board members, patriotic youth group access to students, computer science proficiency, and a bill requiring fingerprint clearance cards for traffic school instructors. Members repeatedly criticized what they described as inconsistent treatment of public schools versus ESA/private school programs, and several education bills were pulled from consent for further discussion. Other bills addressed child safety and family law, including DCS credit freezes, recorded child interviews, parents’ rights notices, mandatory reporting of threats by minors, sex offender residency and GPS monitoring, and a bill on guardianship rights during DCS investigations. The committee also considered a number of social services, health, and labor/consumer bills. These included SNAP work requirement and verification measures, a SNAP error-rate audit, dementia care telemonitoring funding, a Braille transcription appropriation, court fee limits, a physician assistant compact, pediatric licensure compact, and a kratom regulation bill. Members debated an earned wage access licensing bill at length, with opponents calling it predatory and akin to payday lending, while supporters argued it provided a regulated consumer option. Other measures covered cash acceptance by businesses, 529-to-Roth IRA rollovers, AI rules for state agencies, and a bill on public nuisance actions by the Attorney General. Several of these drew warnings about constitutional problems, preemption, or burdens on vulnerable populations. Energy, water, and tax policy also featured prominently. The committee heard bills on fuel formulations, gas tax relief, data centers and small modular nuclear reactors, utility reporting, and a Commerce Authority mandate to reduce fuel prices. Members criticized some proposals as favoring industry, preempting local control, or lacking a clear funding plan. The meeting ended after additional items on veterans, sample ballot mailing dates, and other miscellaneous measures, with multiple bills noted as pulled from consent or subject to later votes; no final roll-call results were detailed in the transcript excerpt.

Transcript Highlights:

• Often I hear from parents, "I had no idea my child was struggling.
• My child gets good grades, it's passing, but I had no knowledge."
• The child might just, I mean, it gets a little tough.
• So now, anybody accessing this free universal child care is going to be able to drop their child off
• I apologize for missing your presentation.

Transcript Highlights:

• Miss James, to the policy, Madam Chair and members.
• Thank you Miss guests back to the table. Thank you Miss James,<02:01:24.960><c> Mr.
• Miss James.
• </c><02:23:12.720><c> Miss</c><02:23:12.960><c> James.
• Miss James. Uh, info if you would like. Miss James.

Committee: Senate State and Local Government

Transcript Highlights:

• reflect those of Johns Hopkins University, the American Enterprise Institute, the Medicare Payment Advisory
• What is missing? We know what the problem is, and recommendations are made.
• The important part, though, that I want to make sure we don't miss is that the analysts play a critical
• one has told me that if you want to look at efficiency in the federal government, AHRQ is the poster child
• This has, though, led to lots of reports of delayed and missing checks, difficulty for seniors, including

Committee: Joint Joint Economic Committee

Keywords: artificial intelligence, waste reduction, fraud prevention, government efficiency, improper payments, data reliability, oversight

Summary: The meeting was chaired by Chairman Schweikert and involved a comprehensive discussion on how to utilize artificial intelligence (AI) for reducing waste, fraud, and improper payments within federal programs. Key witnesses, including Mr. Andrew Canarsa from the Council of the Inspectors General, provided insights on the potential of AI in enhancing government efficiency. The committee emphasized the importance of reliable data and thorough examination of AI application to avoid unintended consequences while addressing the estimated $162 billion in improper payments reported by the federal government. Concerns were raised regarding the recent firing of inspectors general and the impacts that could have on oversight and accountability processes.

Transcript Highlights:

• Um, we added some folks to the Youth Advisory Council.
• Miss Hall, you want to speak on the sub or the bill?
• I'm trying to find you the line number. >> Okay, Miss Hall.
• </c> of emergency to get their child. of emergency to get their child.
• We added somebody to the advisory council.

Transcript Highlights:

• , fostering a child, or adoption of a child.
• That would be child-on-child sexual abuse that they could respond to.
• On child-on-child sexual abuse? Sure.
• on child.
• On child on child sexual abuse? Sure.

Bills: SB25 , SB132 , SB155 , SB157 , SB202 , SB237 , SB250 , SB433

Committee: House Appropriations

Keywords: dental care, cancer treatment, health insurance, medically necessary, health coverage, paid parental leave, educators, teachers, school employees, public schools, local education agency, LEA, school board, charter schools, maternity leave, paternity leave, adoption leave, foster care leave, pregnancy loss, stillbirth