Transcript Highlights:

• I rise to request a waiver of the public notice requirement pursuant to Senate Rule 21 to hold a hearing

Bills: SB3225, HCR53, HCR57, HCR101, HB1878, HB1481, SCR40, SCR59, SCR114, SCR197, SCR198, SR30, SR107, SR185, SR186

Keywords: statutory revision, Hawaii Revised Statutes, clarification, obsolete provisions, legal accuracy, University of Hawaii, Board of Regents, associate degree, degree audit, reverse transfer, credit audit, student completion, credential attainment, community college transfer, four-year campus, higher education, postsecondary attainment, workforce development, student retention, graduation pathways

Transcript Highlights:

• And the increase in budget was the cost for insurance had gone up.
• Senate Bill 1477 is a request from the state regents.
• This is just cleanup at the request of the regents. We want to ensure.
• I will be asking for funding through the normal budget process with this.
• Requesting the enemy's consent to strike title.

Bills: SB1726, SB1236, SB1633, SB1413, SB1317, SB1360, SB1342, SB1477, SB1189, SB1546, SB1524, SB1338, SB1193, SB1812, SB1617

Keywords: higher education, graduate instructors, training program, academic integrity, First Amendment rights, administrative reporting, education, consolidation, board, public schools, resident tuition, Oklahoma State Regents for Higher Education, state scholarships, financial aid, immigration status, undocumented students, noncitizen students, lawfully present, postsecondary education benefits, college tuition

Transcript Highlights:

• I would respectfully request that Senator Martin consider extending the effective date of Section 2 of
• The goal of this legislation is to increase transparency within local government budgets to mimic the
• The legislation is to increase transparency within local government budgets and mimic the availability
• The bill requires counties and municipalities to publish their budgets online and to keep them online
• And when you look at their budget, it’s not much greater than $2.6 million.

Bills: S0018, S0028, S0260, S0848, S0934, S1014, S1102, S1264, S1566, S1622, S1724

Keywords: negligence, compensation, child welfare, law enforcement accountability, personal injury, police negligence, law enforcement, monetary compensation, civil rights, city liability, electric vehicle, EV, battery fire, lithium-ion battery, towing, wrecker service, vehicle storage, submerged vehicle, saltwater damage, fire marshal

Summary: The committee heard and advanced a wide range of bills focused on water safety, utilities, housing, transparency, and claims relief. CS/SB 848 on stormwater treatment was presented as a follow-up to prior water-quality legislation and reported favorably with one support waiver. SB 28, a claims bill for Reginald Jackson against the City of Lakeland, was also reported favorably. CS/SB 658, a bipartisan child-drowning prevention bill for rental properties, drew extensive testimony from child advocacy and drowning-prevention groups in strong support; amendments required rental license applicants to certify compliance and removed local-government add-on authority, and the bill was reported favorably. CS/SB 18, a claims bill involving the estate of a deceased minor and the Broward County Sheriff’s Office, prompted questions about settlement and responsibility but was ultimately reported favorably despite opposition from a waiver form. Several utility and infrastructure measures were considered. CS/SB 1724 would regulate municipal utility service outside city limits, limit revenue transfers, require public meetings, and cap rate differences; an amendment added gas utilities, and the bill was reported favorably after testimony from municipal utility representatives and small-county advocates. CS/SB 1014 would require municipal utilities to extend water and wastewater service to certain nearby residential properties without conditioning service on annexation; an amendment narrowed the bill to residential uses and clarified capacity and grandfathering provisions, and it passed favorably. CS/SB 1102 would allow local infrastructure surtax revenue to fund body camera programs, with an amendment making the surtax authorization prospective and requiring a new referendum; it was reported favorably. CS/SB 260 on electric-vehicle storage in towing yards was amended to focus on storage only and to tie the higher fee to the period before fire-risk inspection, then reported favorably after testimony from insurers, fire officials, and EV industry representatives. The committee also advanced education, housing, and ethics-related bills. SB 1264 would ease zoning and code barriers for small private schools and micro-schools, with supporters arguing it would expand school choice and opponents raising implementation concerns; it was reported favorably. SB 934 on Florida Keys areas of critical state concern was amended to remove a tax-exemption section that conflicted with the Live Local Act, then reported favorably. SB 1622 would provide a one-time waiver of late financial-disclosure fines under specified conditions and was reported favorably. Finally, CS/SB 1566 on local government spending and transparency required online posting of budgets and related materials, and an amendment added utility revenue reinvestment and other changes while removing DEI spending restrictions; the bill drew support for transparency but concern from small cities and counties about cost and workload, and it was reported favorably. The meeting ended with adjournment after senators recorded votes on selected bills.

Transcript Highlights:

• Senate Bill 1477 is a request from the State Regents.
• Again, this is just cleanup at the request of the regents.
• Senator Pugh requests unanimous consent to strike the title.
• Madam Chair, requesting unanimous consent to strike title.
• Senator Pugh requesting unanimous consent to strike title.

Bills: SB1726, SB1236, SB1633, SB1413, SB1317, SB1360, SB1342, SB1477, SB1189, SB1546, SB1524, SB1338, SB1193, SB1812, SB1617

Keywords: higher education, graduate instructors, training program, academic integrity, First Amendment rights, administrative reporting, education, consolidation, board, public schools, resident tuition, Oklahoma State Regents for Higher Education, state scholarships, financial aid, immigration status, undocumented students, noncitizen students, lawfully present, postsecondary education benefits, college tuition

Summary: The Senate Education Committee heard and advanced a large slate of education bills. Early measures included SB 1726, requiring formal training for university teaching assistants before they teach classes and evaluate students, with emphasis on First Amendment rights; SB 1236, creating an Administrative Report Consolidation Act to reduce duplicative reporting by schools and agencies; SB 1633, codifying existing higher education residency tuition practices; SB 1413, requiring notice to parents when a teacher is emergency certified and limiting adjunct teachers to 270 clock hours per semester; SB 1317, allowing career teacher status to be portable across districts with local board approval; and SB 1360, expanding the state’s math initiative by restoring instructional coaches and creating a math office at the State Department of Education. Most of these bills passed on favorable votes, with SB 1413 drawing some concern over teacher shortages and the adjunct-hour cap, but still passing.

Transcript Highlights:

• I request favorable consideration on this bill, and I will close. Thank you.
• With such tight budgets, it can only take one setback, such as an emergency room visit, a car repair,
• that we will come back with an additional substitute after visiting with stakeholders, and at the request

Bills: HB158, HB714, HB 1198, HB1630, HB1998, HB3509, HB3788, HB3875, HB3948, HB3977, HB4097, HB4313, HB4314, HB4317, HB158

Keywords: housing, veterans, surplus government property, affordable housing, funding sources, housing assistance, homeless prevention, landlord incentives, rural housing, domestic violence, community development, tenant readiness, program participants, financial assistance, homelessness, rental support, Texas Tenant Readiness Program, tenant assistance, housing stability, Texas Department of Housing

Transcript Highlights:

• We request the right to close and reserve the right to close.
• I respectfully request the right to close or reserve the right to close.
• So I respectfully close and request favorable consideration.
• If there are any other questions, all right, a closing request for favorable consideration.
• I respectfully request the privilege to close, and I'll take any questions you have.

Bills: HB158, HB714, HB 1198, HB1630, HB1998, HB3509, HB3788, HB3875, HB3948, HB3977, HB4097, HB4313, HB4314, HB4317, HB158

Keywords: housing, veterans, surplus government property, affordable housing, funding sources, housing assistance, homeless prevention, landlord incentives, rural housing, domestic violence, community development, tenant readiness, program participants, financial assistance, homelessness, rental support, Texas Tenant Readiness Program, tenant assistance, housing stability, Texas Department of Housing

Transcript Highlights:

• These are clarifying changes also requested by the department.
• And then finally, the rest of page four of the A6 includes changes requested by Minnesota Management
• and Budget to their personnel management statute changes.
• We just need a one-year extension; we are not requesting additional funding.
• I respectfully request your yes vote. Thank you for your consideration.

Bills: HF1837, HF361, HF2725, HF2566, HF2744, HF1685, HF501, HF1889, HF1389

Keywords: state policy, employment, health insurance, fossil designation, public funds, community resources, Capitol Mall, grantmaking, community vitality, livability, funding, healthy aging, aging policy, older adults, seniors, elderly, gerontology, long-term care, assisted living, nursing homes

Transcript Highlights:

• These are clarifying changes also requested by the department.
• Finally, the rest of page four of the A6: these are changes requested by Minnesota Management and Budget
• Finally, the rest of page four of the A6: these are changes requested by Minnesota Management and Budget
• by Minnesota management and requested by Minnesota management and budget<00:15:44.680><c> to</c><00:
• We are not requesting additional funding.

Bills: HF1837, HF361, HF2725, HF2566, HF2744, HF1685, HF501, HF1889, HF1389

Keywords: state policy, employment, health insurance, fossil designation, public funds, community resources, Capitol Mall, grantmaking, community vitality, livability, funding, healthy aging, aging policy, older adults, seniors, elderly, gerontology, long-term care, assisted living, nursing homes

Transcript Highlights:

• </c> so the city of Burnsville is requesting so the city of Burnsville is requesting 8.55<00:09:23.320
• senary tower and getting back to the senary Sewer request<00:46:09.960><c> our</c> request our request
• </c><00:54:11.720><c> 4.5</c> tech Innovation uh we are requesting 4.5 tech Innovation uh we are requesting
• are 55 to 60% of our budget.
• </c><01:00:41.200><c> that</c> this is a followup to that request that this is a followup to that request

Bills: HF201, HF217, HF314, HF315, HF406, HF408, HF425, HF426, HF730, HF731, HF652, HF761, HF1079, HF928, HF1017, HF1056, HF1081

Keywords: HF201, Minnesota income tax, tax subtraction, tax deduction, volunteer firefighter, volunteer fire and rescue, emergency responder, ambulance service personnel, EMR, EMS, search and rescue, canine search and rescue, underwater search and rescue, paid-on-call, part-time volunteer, tax relief, state tax law, section 290.0132, drivers license, identification card

Keywords: HI Senate YouTube, https://www.youtube.com/watch?v=iS0VbQIk5fQ, 2026-07-02T01:22:43+00:00, 2.2.24, Data collected via generic collector engine, Scheduled for February 4, 2020: Ke Kōmike ‘Enehana COMMITTEE ON TECHNOLOGY Kenekoa/Senator Jarrett Keohokalole, Luna Ho‘omalu/Chair Kenekoa/Senator J. Kalani English, Hope Luna Ho‘omalu/Vice Chair Ke Kōmike Hana Aupuni COMMITTEE ON GOVERNMENT OPERATIONS Kenekoa/Senator Laura H. Thielen, Luna Ho‘omalu/Chair Kenekoa/Senator Lorraine R. Inouye, Hope Luna Ho‘omalu/Vice Chair ‘Ōlelo Ho‘olaha No Ka ‘Aha Ho‘olohe NOTICE OF HEARING Lā / DATE: Pō‘alua,Pepeluali 4, 2020 / Tuesday, February 4, 2020 Hola / TIME: 3:45 p.m. Wahi / PLACE: Lumi ‘Aha Kūkā 225 / Conference Room 225 Ke Kapikala Moku‘āina / State Capitol 415 South Beretania Street Papa Kumuhana A G E N D A SB 3031 RELATING TO INFORMATION TECHNOLOGY. Requires the department of accounting and general services and the department of budget and finance, in consultation with the office of enterprise technology services, to develop and implement a uniform financial database, with parameters, benefits, and features that are compatible to the software system currently being implemented by the office of enterprise technology services at other agencies for use by all state agencies. Appropriates funds. TEC/GVO, WAM No Ka ‘Ike ‘Ē A‘e, E Kelepona Aku I Ke Kākau ‘Ōlelo Kōmike Ma (808) 587-7217. FOR FURTHER INFORMATION, PLEASE CALL THE COMMITTEE CLERK AT (808) 587-7217., 912, senate, all, 2.2.42, 2.1.47

Transcript Highlights:

• Representative, which entities would be responsible for patrolling our lakes, and have any of them requested
• Moved to adopt Representative Ranson, request unanimous consent that the resolution should be adopted
• Members, hospitals 3466 is a bill request from the Corporation Commission that eliminates their petty
• This is The request from Oklahoma County Sheriff Tommy Johnson.
• This is a request bill from the Oklahoma City Police Department bomb squad.

Bills: HB3419, HB4153, HB3430, HB3791, HB3277, HB4119, HB4408, HB3905, HB3968, HB3835, HB3386, HB2650, HB3742, HB3588, HB3748, HB4303, HB4311, HB3028, HB4428, HB4429, HB4132, HB1889, HB3265, HB1739, HB4434, HB3313, HB3852, HB4263, HB3413, HB3414, HB3415, HB3416, HB3417, HB3418, HB3420, HB2116, HB2206, HB3625, HB2939, HB3721, HB1823, HB2425, HB4440, HJR1087, HB4003, HJR1077, HB1770, HB1675, HB3627, HB3891, HJR1067, HB3462, HJR1053, HJR1054, HJR1044, HB3472, HB1225, HJR1019, HB4145, HJR1081, HB1746, HJR1069, HJR1050, HB1638, HB3327, HJR1055, HB3127, HB4488, HB2955, HB3781, HB3783, HB3802, HB2471, HB2937, SCR16, HB2960, HB3466, HB3262, HB3269, HB3152, HB4140, HB4142, HB3148, HB3378

Keywords: corruption, nonpublic information, government accountability, criminal law, public office, driver license, reading proficiency, minors, education requirements, alternative testing, attendance, remedial reading, public school, oath of enrollment, court financial obligations, cost hearing, payment plan, community service, court compliance program, debt relief

Transcript Highlights:

• Representative, which entities would be responsible for patrolling our lakes, and have any of them requested
• Representative Ransom requested unanimous consent that the resolution be adopted.
• Members, House Bill 3466 is a bill request from the Corporation Commission that eliminates their petty
• This is the request from Oklahoma County Sheriff Tommy Johnson.
• This is a request bill from the Oklahoma City Police Department Bomb Squad.

Bills: HB3419, HB4153, HB3430, HB3791, HB3277, HB4119, HB4408, HB3905, HB3968, HB3835, HB3386, HB2650, HB3742, HB3588, HB3748, HB4303, HB4311, HB3028, HB4428, HB4429, HB4132, HB1889, HB3265, HB1739, HB4434, HB3313, HB3852, HB4263, HB3413, HB3414, HB3415, HB3416, HB3417, HB3418, HB3420, HB2116, HB2206, HB3625, HB2939, HB3721, HB1823, HB2425, HB4440, HJR1087, HB4003, HJR1077, HB1770, HB1675, HB3627, HB3891, HJR1067, HB3462, HJR1053, HJR1054, HJR1044, HB3472, HB1225, HJR1019, HB4145, HJR1081, HB1746, HJR1069, HJR1050, HB1638, HB3327, HJR1055, HB3127, HB4488, HB2955, HB3781, HB3783, HB3802, HB2471, HB2937, SCR16, HB2960, HB3466, HB3262, HB3269, HB3152, HB4140, HB4142, HB3148, HB3378

Keywords: corruption, nonpublic information, government accountability, criminal law, public office, driver license, reading proficiency, minors, education requirements, alternative testing, attendance, remedial reading, public school, oath of enrollment, court financial obligations, cost hearing, payment plan, community service, court compliance program, debt relief

Summary: The House convened, heard an invocation and the Pledge of Allegiance, and then moved through a long floor calendar with several introductions and recognitions, including guests from Broken Arrow, Oklahoma Trucking Day participants, Mid America Christian University, and the day’s doctor and nurse honorees. The chamber also adopted Senate Concurrent Resolution 16, recognizing March as National Women’s History Month. Members debated and passed House Bill 2937, which extends constitutional carry to allow qualified individuals to carry firearms on boats. Questions focused on alcohol use on lakes, public safety, and whether law enforcement agencies had requested or opposed the bill. The House also passed House Bill 2960, limiting lawsuits against firearm manufacturers when a purchaser modifies a firearm; House Bill 3466, removing the Corporation Commission’s unused petty cash fund from statute; House Bill 3262, increasing the warrant-service fee from $50 to $150 at the request of the Oklahoma County Sheriff; and House Bill 3269, allowing electronic arrest warrants to mirror existing electronic search-warrant procedures. Additional bills passed included House Bill 3152, authorizing Corporation Commission officers to transport certain detained truckers to jail and book them; House Bill 414, making theft of a firearm a Class 2 felony regardless of value; House Bill 4142, expanding criminal statutes at the request of the Oklahoma City Police Bomb Squad; House Bill 3148, modernizing VIN inspection procedures and fee handling; and House Bill 3378, creating a revolving board for OCAST’s grant-awarding body after all members rolled off at once and delayed grants. House Bill 3378 also had its emergency clause adopted. Most measures passed with strong bipartisan margins, and the House adjourned after announcements and committee notices.

Transcript Highlights:

• Members, you have heard the unanimous consent request without objection. That shall be the order.
• Members, you have heard the unanimous consent request without objection. That shall be the order.
• Members, you have heard the unanimous consent request without objection. That shall be the order.
• Remember, as you've heard, the unanimous consent request for Senator Peterson to bring an entourage onto
• The unanimous consent request is without objection. That'll be the order.

Bills: HB3834, HB3940, HB4346, HB2947, HB3257, HB3264, HB4326, HB4421, HB3944, HB3979, HB4118, SCR22, SB169, HB1047, HB2123, HB2650, HB3260, HB3403, SR41, HB3649, HB3742, HB3831, HB3996, HB4321, HB4339

Keywords: HB3834, Oklahoma Breakthrough Therapy Act, ibogaine, ibogaine-based therapeutics, ibogaine analogs, clinical trials, FDA approval, breakthrough therapy designation, opioid use disorder, substance use disorder, traumatic brain injury, mental health, neurological disorders, drug development, public-private partnership, State Department of Health, intellectual property, revolving fund, research funding, medical licensing

Transcript Highlights:

• Members, you have heard the unanimous consent request without objection. Microphone.
• Members, you have heard the unanimous consent request. Without objection, that shall be the order.
• Members, you have heard the unanimous consent request without objection. That shall be the order.
• Members, you have heard the unanimous consent request. Without objection, that shall be the order.
• Colleagues, you've heard the unanimous consent request. Without objection, that'll be the order.

Bills: HB3834, HB3940, HB4346, HB2947, HB3257, HB3264, HB4326, HB4421, HB3944, HB3979, HB4118, SCR22, SB169, HB1047, HB2123, HB2650, HB3260, HB3403, SR41, HB3649, HB3742, HB3831, HB3996, HB4321, HB4339

Keywords: HB3834, Oklahoma Breakthrough Therapy Act, ibogaine, ibogaine-based therapeutics, ibogaine analogs, clinical trials, FDA approval, breakthrough therapy designation, opioid use disorder, substance use disorder, traumatic brain injury, mental health, neurological disorders, drug development, public-private partnership, State Department of Health, intellectual property, revolving fund, research funding, medical licensing

Summary: The Senate convened with a quorum, heard an invocation, and recognized several guests and groups in the gallery, including the Ponca City High School Poe High Steppers, the Edmond Democratic Women, family members of senators, a Grace Reform Baptist Church co-op group, and Oklahoma 4-H participants. The chamber also honored the Red Oak Lady Eagles state championship basketball team with a citation and remarks celebrating their first school basketball title and strong season. The Senate adopted Senate Concurrent Resolution 22, supporting the Lights Out Oklahoma campaign to reduce bird mortality during migration by encouraging reduced exterior lighting in peak migration months. The chamber also adopted Senate Resolution 41, proclaiming April 22, 2026, as the 27th annual 4-H Day at the Capitol, with testimony from 4-H representatives emphasizing youth leadership, civic engagement, and workforce readiness. Several bills passed, including House Bill 169 (house amendments adopted and the bill passed as an emergency measure), House Bill 2123 on the Arkansas River bridge, House Bill 2650 on summary administration estate thresholds, House Bill 3260 on funeral director continuing education approvals, House Bill 3403 on a DEQ/OSU sewage sludge pilot study, House Bill 3649 on the Mental Health Department real property trust, House Bill 3742 on criminal discovery, House Bill 3831 on a Task Force One revolving fund, House Bill 3996 on indigent defense experts in capital cases, House Bill 4321 on limits on retroactive building rule application, and House Bill 4339 on summary administration notice timing. House Bill 1047, which would have authorized a tribal sports betting framework and related revenue distributions, drew extensive debate over gambling addiction, revenue, tribal compacts, geofencing, and NIL funding, but failed 21-27; Senator Coleman gave notice of intent to reconsider. The Senate then announced an Appropriations Committee meeting and adjourned until the next scheduled session.

Transcript Highlights:

• It was included in the governor's budget.
• You hope not to use all of your budget.
• But this money is already in the budget, isn't it? It's already been budgeted? Thank you so much.
• I've read the budget several times.
• But would you put it in your request for your budget? Oh, absolutely.

Bills: HB12, HB42, HB205, HB222, HB324, HB325, HB350, HB416, HB482, HB610, HB749, HB797, HB807, HB821, HB979, HB992, HB1193

Keywords: survivor benefits, law enforcement, reserve officer, auxiliary officer, public safety, phased retirement, Teachers Retirement System, faculty retention, administrative fees, public postsecondary education, Medicaid, dental coverage, healthcare access, medical necessity, Louisiana Department of Health, judicial salaries, judges, judiciary compensation, cost of living adjustment, COLA

Transcript Highlights:

• The necessary funding is in the governor's proposed budget.
• There needs to be a request for a transcript, and the request goes directly to the court reporter who
• The fees are paid at the time of the request. All right.
• multiple requests.
• , but yet if I request the court, it costs me $2.

Bills: HB29, HB39, HB77, HB153, HB183, HB211, HB263, HB299, HB324, HB519, HB520, HB533, HB538, HB559, HB562, HB805, HB823, HB1004, HB1011, HB1018

Keywords: insurance fund, retired employees, Ascension Parish, court clerks, premium costs, investment advisory board, HB 39, Act 283, peace officer, law enforcement officer, police certification, citizenship requirement, U.S. citizen, United States citizen, naturalization, lawful permanent resident, green card holder, immigration, public safety, law enforcement hiring

Transcript Highlights:

• Texas' conservative policies and robust economy have fostered a strong fiscal outlook for the state budget
• I understand you're requesting we leave this pending as you continue to work on it until the next meeting
• To ensure proper implementation and prevent misuse, the comptroller is authorized to request documentation
• These were all requests from the Comptroller's Office. All right. Thank you.
• If I may, the bill itself provides for the Comptroller's Office to provide... ...request to have the

Bills: HB104, HB2434, HB2529, HB2688, HB3161, HB3486, HB3487, HB3745, HB4044, HB4226, HB4945, HB104

Keywords: Texas Future Fund, investment review board, economic stabilization, innovative technology, national defense, retirement, service credit, Employees Retirement System of Texas, employee benefits, pension reform, salary supplement, county judges, judicial functions, state law, government compensation, public retirement systems, municipality pensions, firefighters, police officers, retirement age

Bills: SB2024, SB227, SB268, SB1467, SB1580, HB5537, SB1313, SB1677, SB918, SB331, SB2207, SB2721

Keywords: e-cigarettes, marketing prohibition, youth protection, criminal penalties, public health, school funding, education reform, state budget, property taxes, equity in education, health care, licensing, complaint procedure, disciplinary action, law enforcement, death records, vital statistics, healthcare, trauma facility, Medicaid

Transcript Highlights:

• We don't have that budget.
• And they can't really run their programs and budgets without MOC.
• The board that sustains their budget. That's what... okay, because that's what I was...
• Their organization has their budget; our organization has our budget.
• Senate Bill 918 is a cleanup bill requested by the Texas Department of Licensing.

Bills: SB2024, SB227, SB268, SB1467, SB1580, HB5537, SB1313, SB1677, SB918, SB331, SB2207, SB2721

Keywords: e-cigarettes, marketing prohibition, youth protection, criminal penalties, public health, school funding, education reform, state budget, property taxes, equity in education, health care, licensing, complaint procedure, disciplinary action, law enforcement, death records, vital statistics, healthcare, trauma facility, Medicaid

Transcript Highlights:

• Employees' exemption requests can be denied without explanation or justification.
• Then we would be able to give the physicians their information upon request.
• So they would have to request it. And that's good and reassuring. The public, you know, access.
• We haven't actually voted a budget out until May. Probably.
• If hospitals are forced to grant every exemption request, Without discretion, we will see a decline in

Bills: SB227, SB269, SB407, SB463, SB527, SB547, SB1283, SB1380, SB1383, SB1511, SB1640, SB1784, SB2069

Keywords: school funding, education reform, state budget, property taxes, equity in education, healthcare policy, vaccines, exemptions, religious beliefs, public health, workplace violence, healthcare facilities, definition expansion, safety regulations, health and safety code, health insurance, anesthesia, pediatric dental services, coverage, medical necessity