Transcript Highlights:

• programs.
• So treatment works. effectiveness rate. So treatment works.
• treatment works. treatment works.
• Treatment first and treatment first.
• implementing programs. implementing programs.

Bills: HB1952, HB1951, HB1929, HB2497, HB2208, HB2572, HB1953, HB2551, HB2549, HB1737, HB1628, HB1769, HB2493, HB2264, HB1997, HB2168, HB2427, HB1805, HB2180, HB2184, HB2219, HB2469, HB2233, HB2519, HB2141, HB1904, HB2201, HB2410, HB2007, HB2385, HB2444, HB2349, HB2235, HB1872, HB2416, HB2291, HB2292, HB2263, HB2359, HB2455, HB1509, HB1514, HB1515, HB1648, HB2164, HB2323, HB1825, HB2172, HB1888, HB2005, HB2387, HB2358, HB2119, HB2276, HB2472, HB1714, HB2325, HB1541, HB1960, HB2140, HB2315, HB2367, HB2388, HB1696, HB2333, HB2138, HB2332, HB2283, HB2059, HB2057, HB2589, HB2417, HB2337, HB1588, HB2217, HB2020, HB1915, HB1742, HB2026, HB1965, HB1546, HB2360, HB1563, HB1749, HB2614, HB1511, HB1753, HB1849, HB1641, HB2161, HB2194, HB1721, HB2284, HB2188, HB1897, HB1880, HB1573, HB1876, HB20, HB2137

Keywords: HB1952, Hawaii agriculture, University of Hawaii, CTAHR, College of Tropical Agriculture and Human Resilience, Kauai, agricultural research station, extension station, capital improvements, general obligation bonds, GO bonds, appropriation, ADA compliance, Americans with Disabilities Act, certified kitchen, greenhouse, laboratory, field research, cesspool decommissioning, invasive species

Transcript Highlights:

• c><00:23:36.000> expanding Offender re-entry system by expanding high-quality educational programs
• Research consistently shows that individuals who participate in mentorship and workforce programs are
• Research consistently shows that individuals who participate in mentorship and workforce programs are
• Mentorship and workforce programs are significantly more likely to find employment and significantly

Bills: HB1952, HB1951, HB1929, HB2497, HB2208, HB2572, HB1953, HB2551, HB2549, HB1737, HB1628, HB1769, HB2493, HB2264, HB1997, HB2168, HB2427, HB1805, HB2180, HB2184, HB2219, HB2469, HB2233, HB2519, HB2141, HB1904, HB2201, HB2410, HB2007, HB2385, HB2444, HB2349, HB2235, HB1872, HB2416, HB2291, HB2292, HB2263, HB2359, HB2455, HB1509, HB1514, HB1515, HB1648, HB2164, HB2323, HB1825, HB2172, HB1888, HB2005, HB2387, HB2358, HB2119, HB2276, HB2472, HB1714, HB2325, HB1541, HB1960, HB2140, HB2315, HB2367, HB2388, HB1696, HB2333, HB2138, HB2332, HB2283, HB2059, HB2057, HB2589, HB2417, HB2337, HB1588, HB2217, HB2020, HB1915, HB1742, HB2026, HB1965, HB1546, HB2360, HB1563, HB1749, HB2614, HB1511, HB1753, HB1849, HB1641, HB2161, HB2194, HB1721, HB2284, HB2188, HB1897, HB1880, HB1573, HB1876, HB20, HB2137

Keywords: HB1952, Hawaii agriculture, University of Hawaii, CTAHR, College of Tropical Agriculture and Human Resilience, Kauai, agricultural research station, extension station, capital improvements, general obligation bonds, GO bonds, appropriation, ADA compliance, Americans with Disabilities Act, certified kitchen, greenhouse, laboratory, field research, cesspool decommissioning, invasive species

Transcript Highlights:

• Again, yeah, this was the pharmaceutical program that they've had in place.
• Okay, I heard you mention nursing in particular, a nursing program. Could you elaborate on that?
• State or expanding existing project nursing programs.
• Emergency response and relief grant programs to address gaps. Move to pass. You'll be requested.
• What period of time do they have to implement these programs, or will they have?

Bills: HB4028, HB4029, HB4059, HB4063, HB4073, HB4074, HB4075, HB4076, HB4077, HB4078, SB1130, SB1131, SB1132, SB1133, SB1134, SB1142

Keywords: tax deduction, venture capital, economic development, Oklahoma, investment, ALS, funding, healthcare, State Department of Health, emergency declaration, public finance, state budget, financial regulations, monetary policy, referendum, constitutional amendments, special election, Oklahoma legislature, public voting, recovery fund

Transcript Highlights:

• This is the hospital rural hospital rebuild program that we.
• Representative, we're just trying to look at some of the more current Information about the program.
• What I was just trying to look up some more recent information about the program and I couldn't find
• There are 5 funds that are allowed under this program right across the state.
• the same generic statistics about equity capital investment overall, which is not specific to the program

Bills: HB4028, HB4029, HB4059, HB4063, HB4073, HB4074, HB4075, HB4076, HB4077, HB4078, SB1130, SB1131, SB1132, SB1133, SB1134, SB1142, HB4028, HB4029, HB4059, HB4063, HB4073, HB4074, HB4075, HB4076, HB4077, HB4078, SB1130, SB1131, SB1132, SB1133, SB1134, SB1142

Keywords: tax deduction, venture capital, economic development, Oklahoma, investment, ALS, funding, healthcare, State Department of Health, emergency declaration, public finance, state budget, financial regulations, monetary policy, referendum, constitutional amendments, special election, Oklahoma legislature, public voting, recovery fund

Transcript Highlights:

• programs, including CCAP. programs, including CCAP.
• <00:36:43.920> Ramsey operates in other programs. Ramsey operates in other programs.
• also would help make this program also would help make this program and<01:13:07.480> this
• treatment from some of our counties. treatment from some of our counties.
• a<01:34:40.440> successful program, to have a successful program, to have a successful implementation

Bills: HF3665, HF3002, HF4217, HF4125, HF4174

Keywords: foster care, early childhood education, child care programs, placement plan, social services, extended foster care, kinship care, relative custody, permanent legal and physical custody, Northstar kinship assistance, independent living plan, transition services, youth aging out of care, medical assistance, Medicaid, child welfare, children youth and families, out-of-home placement, case plan, relative placement

Transcript Highlights:

• we know, the Centennial Commission was originally established to plan, coordinate, and implement programs

Bills: HB3443, HB2123, HB3757, HB2445

Keywords: transportation, oversize permit, overweight permit, permit fees, motor carrier, commercial trucking, heavy haul, wide load, special combination vehicle, manufactured home transport, portable building transport, utility poles, rural electric cooperative, farm equipment, agricultural hauling, bridge formula, load limits, weight limits, road funding, highway construction

Transcript Highlights:

• <01:19:11.360> because for kind of a broader program because for kind of a broader program
• <01:19:27.920> just like managing a a marker program just like managing a a marker program
• I believe SHPD do have marker programs.
• <01:19:40.800> until used to manage the marker program until used to manage the marker program
• >> Whatever happened to that program? >> Whatever happened to that program?

Bills: SB2603, SB2083, SB2341, SB2306, SB2782, SB2756, SB2161, SB2477

Keywords: Hawaii Symphony Orchestra, state funding, public performances, educational programs, cultural arts funding, historic properties, preservation, inheritance, working group, public-private partnerships, sustainable funding, historic preservation, Hawaii Revised Statutes, construction, state review, burial sites, cultural artifacts, development review, phased review, administrative fees

Summary: The committee heard testimony on Senate Bill 2603, which would designate the Hawaii Symphony Orchestra as the state orchestra of Hawaii. Testimony was uniformly supportive from the Attorney General’s office, the State Foundation on Culture and the Arts, Retail Merchants of Hawaii, Hawaii Youth Symphony, the Hawaii Symphony Orchestra, the Hawaiian Steel Guitar Association, and others. Supporters emphasized the bill’s value to arts education, cultural vitality, and the visitor economy. The chair noted there were also many written testimonies submitted, and the bill was left without questions or action in the excerpt. The committee then took up Senate Bill 2083, which would create a state-owned historic properties preservation plan working group within DNR. The State Historic Preservation Division supported the bill and said it would help create a statewide database and better planning for state-owned historic properties, while noting its current review work is reactive and project-by-project. The committee asked about duplication and existing consultation processes; SHPD said it already reviews state projects under existing law and has in-house architectural staff. The measure was then set aside after brief discussion, with no vote shown in the excerpt. Next was Senate Bill 2341, which would authorize phased review of certain private-property projects and change SHPD’s review deadlines. SHPD and the Office of Planning and Sustainable Development supported the bill, saying it could encourage more proactive, programmatic review and that the current average review time for simple projects is about 56 days. Several opponents, including Sierra Club of Hawaii, Bianca Isaki, Malama Kane Lua, and Tara Roas, argued phased review would delay projects, create conflict, and weaken historic preservation protections, especially for iwi kūpuna and burial sites. Committee members raised concerns about whether the bill conflicted with prior court decisions and asked SHPD for its view; SHPD said it was not a legal question for them and suggested a programmatic alternative. The bill was not voted on in the excerpt. Finally, the committee began hearing Senate Bill 2306 on administrative fees for the Bureau of Conveyances. HGEA opposed the measure, focusing on a provision allowing the special fund to be used for qualified contractors, while the Bureau of Conveyances supported the bill as a fee correction that would equalize recording fees between systems. The bureau said specialized technical work sometimes requires outside contracting and that it could consider a contract period; the chair and members discussed the HGEA concern and asked whether the issue could be addressed. No final action was shown in the excerpt.

Bills: S0218, S0380, S0936, S0948, S0962, S0984, S1020, S1180, S1434, S1444, S1612

Keywords: land use, disaster recovery, local government, federal assistance, Hurricane relief, legal notices, public accessibility, government transparency, digital publication, government agencies, temporary door locking device, emergency safety, building code, training programs, fire exit security, affordable housing, land development, starter homes, local government regulations, housing shortage

Summary: The committee took up a series of land use, housing, local government, and public notice bills, along with a firefighter cancer bill and a bill on temporary door locking devices. SB 984 on firefighter cancer benefits and prevention was explained as clarifying access to death benefits and a one-time cancer payment for firefighters; it was reported favorably. SB 1612 required local governments to accept electronic payments online; it also passed favorably. SB 1180 created a recall framework for elected community development district board members and, through a strike-all amendment, also addressed synthetic turf enforcement and expanded compact urban mixed-use district definitions; the amendment was adopted and the bill was reported favorably. SB 936 allowed temporary door locking devices above the finished floor and directed the Building Commission to add standards to the Florida Building Code; it passed favorably. The committee also considered SB 380 on legal notices, which would let certain local government entities publish notices on their own websites or other designated sites instead of relying on newspapers in more cases. The Florida Press Association, Common Cause, and newspaper representatives opposed the bill, arguing it would fragment public notice access and make notices harder to find and verify, while supporters said it would modernize and reduce costs. The bill’s amendment clarified which agencies were covered, and the committee reported the bill favorably. SB 962 on affordable housing narrowed prior zoning preemption language so working farms and farm operations would not be unintentionally captured by Live Local-style rules; it passed favorably. SB 1444 on state preemption and religious expression, private clubs, and minor home construction drew support from religious freedom advocates and opposition from cities and counties, which warned of vague terms and overbroad preemption; it was reported favorably. The committee then approved SB 218, which would limit the reach of last session’s hurricane recovery land-use preemption to counties actually damaged by hurricanes and restore normal local land-use authority in unaffected counties. SB 1434 on infill redevelopment would streamline zoning and subdivision approvals for environmentally impacted parcels in certain urban counties to encourage housing on contaminated or underused land; counties and local-government groups opposed it as an overbroad preemption and raised concerns about the environmental threshold and density provisions, but the bill was reported favorably. SB 1020 on chickees prohibited local ordinances from blocking chickee construction if setback requirements are met and made unauthorized attempts to circumvent the building code a misdemeanor; it passed favorably. Finally, SB 948 on local government land development regulations and orders, as amended, proposed a statewide starter-home framework with lot-split and zoning changes to increase housing supply; local-government and planning groups warned it would function as a rigid statewide zoning code and could drive overdevelopment, while housing advocates supported it as necessary state action. The committee reported the bill favorably after extensive debate.

Transcript Highlights:

• I lead the water program for the Environmental Defense Fund here in Texas.
• The need for better access and environmentally supportive programs has become increasingly important
• House Bill 2018 clarifies that the program is intended solely for purchasing conservation easements on
• This program provides landowners a viable option to keep their land in active production, and in HB 2018
• The team will ensure that this program places an emphasis on conserving actual farms and ranches.

Bills: HB2018, HB1633, HB1689, SB612, SB3058

Keywords: agricultural conservation, land preservation, environmental protection, wildlife habitat, Texas Farm and Ranch, groundwater conservation district, Texas Water Code, water permit, permit amendment, groundwater permit, water rights, aquifer, well registration, exempt wells, beneficial use, water conservation, groundwater quality, well plugging, Hill Country Priority Groundwater Management Area, surface water resources

Transcript Highlights:

• This legislation will give heated tobacco products a beneficial tax treatment to reduce the price compared

Bills: SB282, SB300, HB72, HB396, SB282, SB300, HB72, HB396

Keywords: virtual currency, cryptocurrency, tax exemption, state tax law, digital assets, ad valorem tax, tangible personal property, business incentives, economic impact, firefighter, license plate, fees, funds distribution, support programs, memorial, disabled veterans, property tax exemption, debt-to-income ratio, homestead, veterans affairs

Transcript Highlights:

• Today's bills will be covering a wide variety of government programs.
• the interest in the program has increased.
• Fund program.
• What programs exist and what are the gaps?
• What programs exist and what are the gaps?

Bills: SB913, SB1086, SB1087, SB1143, SB1534, SB1553, SB1718, SB1754, SB2004, SB2322, SB2448

Keywords: hotel occupancy tax, municipal revenue, tax code, local government funding, Texas legislation, county taxation, economic development, hotel industry, local government, counties, taxation, tourism, workforce development, youth programs, employment, education, technical training, health physics, higher education, nuclear energy

Summary: The committee heard a series of bills, mostly related to economic development, tax incentives, and workforce programs. Senate Bill 1534 would direct a study by the Texas Higher Education Coordinating Board and the Texas Workforce Commission on health physics education and workforce needs; resource witnesses from the Workforce Commission and Coordinating Board testified, and the bill was left pending. Senate Bill 1553 would authorize Kerr County to impose a hotel occupancy tax for tourism-related uses, and Senate Bills 1086 and 1087 would authorize similar county hotel taxes for Children’s County and Mason County; all three bills received supportive testimony and were left pending. The committee also heard Senate Bill 1754, which would prohibit county and local tax abatements for renewable energy facilities selling power wholesale, with testimony sharply divided between landowners and policy groups opposing renewable subsidies and industry representatives and some senators arguing the bill would harm clean energy investment and local decision-making; the bill was left pending. The committee then heard Senate Bill 2322, which would exempt dispatchable electric generation facilities from the JEDI program’s compelling-factor test so they could qualify for school district tax incentives; testimony was mixed, and the bill was left pending. Later, the committee heard Senate Bill 1718, which would add the NRA annual meeting to the state’s major events reimbursement program. The bill’s sponsor and NRA representatives argued the event brings substantial tourism and economic activity, while opponents said it would use taxpayer funds to subsidize an organization that opposes gun safety measures; the bill was left pending. Senate Bill 2004 would add the Arlington Grand Prix to the major events reimbursement program, with the committee substitute exempting it from the usual competitive site-selection requirement because of timing; testimony from the event organizers and Arlington tourism officials was supportive, and the bill was left pending. Senate Bill 2448 would create a rural workforce development grant program at the Texas Workforce Commission to support college-and-career readiness and technical assistance in rural communities; witnesses from Texas 2036, Collegiate Edgination, and a rural school district supported it, and it was left pending. Finally, Senate Bill 913 would repeal a special requirement that Alpine dedicate at least 50% of its hotel occupancy tax to advertising and promotion, and Senate Bill 1143 would require more coordination and reporting for youth workforce programs serving disconnected young Texans; both bills received supportive testimony and were left pending. At the end of the hearing, Senator Johnson moved that the committee stand in recess, subject to the call of the chair.

Transcript Highlights:

• the interest in the program is growing.
• The program has increased. Slide 10 outlines a little bit how these programs work.
• Taxpayer programs and incentives. Okay.
• role with LSJA, we focus on export programs.
• What programs exist? What are the gaps?

Bills: SB913, SB1086, SB1087, SB1143, SB1534, SB1553, SB1718, SB1754, SB2004, SB2322, SB2448

Keywords: hotel occupancy tax, municipal revenue, tax code, local government funding, Texas legislation, county taxation, economic development, hotel industry, local government, counties, taxation, tourism, workforce development, youth programs, employment, education, technical training, health physics, higher education, nuclear energy

Transcript Highlights:

• Today's bills will be covering a wide variety of government programs.
• the interest in the program has increased.
• Slide 10 outlines a little bit how these programs work.
• The major event reimbursement program that was in Dallas.
• However, when it comes to taxpayer programs, incentives, okay?

Bills: SB913, SB1086, SB1087, SB1143, SB1534, SB1553, SB1718, SB1754, SB2004, SB2322, SB2448

Keywords: hotel occupancy tax, municipal revenue, tax code, local government funding, Texas legislation, county taxation, economic development, hotel industry, local government, counties, taxation, tourism, workforce development, youth programs, employment, education, technical training, health physics, higher education, nuclear energy

Summary: The Senate Economic Development Committee met to hear a series of bills and informational primers, with several resource witnesses from the Governor’s Office, the Texas Workforce Commission, and the Texas Higher Education Coordinating Board. The chair opened by noting the death of Senator King’s son and asking members to keep the family in their prayers. Most bills were laid out and left pending subject to the call of the chair after brief author presentations and public testimony. The committee heard several local hotel occupancy tax bills: SB 1553 for Kerr County, SB 1086 for Childress County, SB 1087 for Mason County, and SB 913 for Alpine. Supporters, including the Texas Hotel and Lodging Association and local officials, said the measures would allow counties or the city to use hotel tax revenue for tourism-related projects and local development. The committee also heard SB 1534, which would direct a study on health physics education and workforce needs in Texas; resource witnesses from TWC and THECB testified on the bill. All of these measures were left pending. A major portion of the hearing focused on SB 1754, which would prohibit local tax abatements for renewable energy facilities selling power at wholesale, with an exception for certain battery storage tied to dispatchable generation. The bill drew strong support from witnesses who argued counties should not subsidize wind and solar projects that can harm neighboring landowners and that renewables already receive substantial federal support. Opponents from the solar and storage industry argued the bill would remove a voluntary local economic development tool, raise power prices, and discourage investment. Senators also debated landowner impacts, grid reliability, and whether the bill was the right policy tool; the bill was left pending. The committee also heard SB 2322, a committee substitute related to the Jobs, Energy, Technology, and Innovation Act, which would exempt electric generation facilities from the program’s compelling-factor test so they can qualify for school tax limitation agreements. Supporters said the change would correct an unintended barrier for dispatchable generation, while Senator Johnson argued it would weaken the program’s purpose by subsidizing projects that would locate in Texas anyway. SB 1718 would add the NRA annual meeting to the major events reimbursement program; the NRA supported it, while gun violence prevention advocates opposed using state incentives for the organization. SB 2004 would add the Arlington Grand Prix to the major events program, and SB 2448 would create a rural workforce development grant program; both drew supportive testimony and were left pending. The committee also heard SB 1143, a substitute bill aimed at improving transparency and coordination in programs serving opportunity youth ages 14 to 24, with witnesses supporting better reporting and workforce alignment. At the end of the meeting, Senator Johnson moved that the committee stand in recess subject to the call of the chair.

Transcript Highlights:

• So the issue here We have a lot of really good programs in Texas.
• So, our goal here is not to create any new programs, but rather simply educate and inform. our veterans
• about the many programs that already exist and that are very successful and that's what this bill would
• , legal assistance, and substance abuse and mental health. treatment.
• , and direct resources. is toward the most impactful investments in treatment, programming, and support

Bills: HB39, HB227, HB930, HB 1078, HB39, HB227

Keywords: highway designation, veteran recognition, commemorative, transportation, Brazoria County, Texas National Guard, combat duty, military activation, state requirements, emergency response, active combat duty, military service, Congressional action, Governor responsibilities, Congressional declaration, state law, conflict, armed forces, congressional approval, war declaration

Transcript Highlights:

• And that program, we had a $100 million program last year.
• could be excluded from the program. could be excluded from the program.
• type programs, residency programs, and teacher recruitment programs all through the budget.
• not damage that program at this point. not damage that program at this point.
• And in those programs include programs.

Bills: HB235, HB236, HB565, HB237, HB238, HB239, HB240, HB241, HB242, HB235, HB236, HB565, HB237, HB238, HB239, HB240, HB241, HB242

Keywords: social media, age verification, minors, under 16, children online safety, online privacy, platform regulation, deceptive trade practice, Attorney General, civil penalties, punitive damages, consumer protection, account creation, algorithmic feeds, internet safety, youth social media, HB236, Baldwin County, Board of Equalization, per diem

Bills: HB199, HB222, HB223, HB224, HB235, HB246, HB405, HB535, HB554, HB907, SCR3, SB43, SB52, SB54, SB113, SB168, SB219, SB222, SB270, SB311, SB359

Keywords: nursing facilities, moratorium, healthcare, patient care, data collection, Medicaid, dental coverage, healthcare access, medical necessity, Louisiana Department of Health, Department of Children and Family Services, sunset law, statutory entities, regulatory authority, re-creation, termination dates, child welfare, foster care, children's rights, legal guardianship

Transcript Highlights:

• the program. we saw with COVID.
• And in that program and are willing to take on those cases.
• There are multiple causes for this lack of treatment access.
• with treatment options.
• programs and the group homes.

Bills: HB 3772, HB 1656, HB 4504, HB 1896, HB 4420, HB 4421, HB 4076, HB 3708, HB 2806, HB 3540, HB 1586, HB 5459, HB 4553, HB 4535, HB 3811, HB 3749, HB 4255, HB 4051, HB 5098, HB 3554, HB 4539, HB 5274

Keywords: e-cigarettes, health and safety, regulations, directory, penalties, regulation, certification, compliance, manufacturers, FDA, nicotine, mental health, emergency detention, paramedic authority, mental illness, healthcare facility, public health, covenants not to compete, health care practitioners, physicians

Transcript Highlights:

• I'm the Administrative Officer for the Red Lake Chemical Health Program and a certified alcohol and drug
• The first letter was from Robert Bob Christie, who works for the Beltrami County DWI Diversion Program
• Behavioral Health and their STD program, and the Red Lake Nation Chemical Health Program.
• These folks have often placed their children on waiting lists for residential treatment, applied for
• We know if we have psychiatric residential treatment, that could be helpful.

Bills: HF2233, HF1999, HF1995, HF1614, HF2781, HF1775, HF1316, HF2127, HF2521, HF689, HF2380, HF1273

Keywords: Uniform Special Deposits Act, special deposit, banking law, financial institutions, escrow, escrow account, trust account, security deposit, beneficiary, depositor, creditor process, garnishment, attachment, levy, setoff, recoupment, financial market infrastructure, retirement benefits, compensation, earnest money

Transcript Highlights:

• from Sanford Behavioral Health and their SUD programs and chemical health programs.
• The second section of this programs.
• <00:26:38.880> they services or residential treatment they services or residential treatment
• upcoming chemo treatment on Tuesday. upcoming chemo treatment on Tuesday.
• , these residential treatment facilities, these residential treatment facilities, the<00:31:59.200

Bills: HF2233, HF1999, HF1995, HF1614, HF2781, HF1775, HF1316, HF2127, HF2521, HF689, HF2380, HF1273

Keywords: Uniform Special Deposits Act, special deposit, banking law, financial institutions, escrow, escrow account, trust account, security deposit, beneficiary, depositor, creditor process, garnishment, attachment, levy, setoff, recoupment, financial market infrastructure, retirement benefits, compensation, earnest money

Transcript Highlights:

• So, if you'll allow some latitude, the general idea of the program is to identify women who are online
• but I just Wonder if there is a better way for us to provide resources within our state utilizing programs
• that we already exist instead of outsourcing those programs.
• We're removing the word 'college' because there are now universities that are developing programs.
• So, we're removing that and just clarifying that they have to be a graduate of a program that's approved

Bills: SB667, SB904, SB1344, SB1380, SB1423, SB1425, SB1484, SB1500, SB1502, SB1503, SB1555, SB1561, SB1562, SB1565, SB1572, SB1644, SB1749, SB1833, SB2007, SB2044, SB2074

Keywords: chiropractic, licensure, animal chiropractic, Board of Chiropractic Examiners, licensing requirements, gender transition, gender-affirming care, transgender, puberty blockers, cross-sex hormones, hormone therapy, sex reassignment, transition surgery, Medicaid, public funds, state facilities, state hospital, Oklahoma, intersex, DSD