Transcript Highlights:

• and $5 million to the Department of Commerce to pay for the establishment of international office rural

Bills: SB311, SB322, SB304, SB313, SB315, SB316, HB489, SB90

Keywords: electric transmission, public highways, permit processing, economic growth, infrastructure, rural development, condemnation actions, state regulations, community development district, CDD, annexation, municipal annexation, wet municipality, dry county, wet county, Sunday alcohol sales, ABC Board, alcohol licensing, on-premises consumption, golf course

Transcript Highlights:

• </c> have a fiscal impact. have a fiscal impact.
• </c> significance of the economic impact. significance of the economic impact.
• </c><00:45:34.040><c> are</c><00:45:34.200><c> job</c> The impact of the events are job The impact of
• And so, the larger impact to ISO was the communities that joined our district, the more rural communities
• And so, the larger impact to ISO was the communities that joined our district, the more rural communities

Bills: HF1016, HF2800, HF156, HF3051, HF526, HF2658, HF2062, HF2801

Keywords: local government aid, Baldwin, taxation, base year formula, municipal funding, population aid, aid penalty forgiveness, Minnesota, city funding, appropriations, HF156, lawful gambling, veterans organizations, licensed veterans organization, Minnesota gambling law, gross profits, lawful purpose, real property repair, facility maintenance, capital assets

Transcript Highlights:

• state, especially in high-risk specialties and rural areas, are stretched thin.
• I just want to move on from that and say there, I do have another rural concern.
• And say there, I do have another rural concern.
• Do we have any idea how many rural optometrists have that equipment?
• How many rural optometrists have that equipment? Mr.

Bills: HB145, HB164, HR1, HB20, HB65, HB66, HB80, HB306, SB29, SB37, HB99, HB206, HB213, HB270, SB104, SB193, HB38, HB254, HB256, SB58, SB64, HJM1, HM7, HM17, HM4, HM22, HM23, HM24, HM26, HM2, HM16, HM32, HM13, HM47, HM20, HM51, HM1, HM31, HM35, HM36, HM46, HM53, HM54, HM39, HM29, HM43, HM59, HM11, HM14, HM21, HM34, HM50, HB253

Keywords: high-wage jobs, tax credit, job creation, New Mexico, economic development, lobbying, transparency, public records, government oversight, accountability, House Resolution 1, HR1, House investigatory subcommittee, special committee, legislative investigation, subpoena power, public corruption, criminal activity, Zorro ranch, Santa Fe County

Transcript Highlights:

• state, especially in high-risk specialties and rural areas, are stretched thin.
• And if it actually will, will this really reach rural New Mexico, I guess?
• So when I think of this, I think of my parents or my grandparents in very rural New Mexico, rural country
• In very rural New Mexico, rural country, they're not going to know the difference.
• I do have another rural concern.

Bills: HB145, HB164, HR1, HB20, HB65, HB66, HB80, HB306, SB29, SB37, HB99, HB206, HB213, HB270, SB104, SB193, HB38, HB254, HB256, SB58, SB64, HJM1, HM7, HM17, HM4, HM22, HM23, HM24, HM26, HM2, HM16, HM32, HM13, HM47, HM20, HM51, HM1, HM31, HM35, HM36, HM46, HM53, HM54, HM39, HM29, HM43, HM59, HM11, HM14, HM21, HM34, HM50, HB253

Keywords: high-wage jobs, tax credit, job creation, New Mexico, economic development, lobbying, transparency, public records, government oversight, accountability, House Resolution 1, HR1, House investigatory subcommittee, special committee, legislative investigation, subpoena power, public corruption, criminal activity, Zorro ranch, Santa Fe County

Summary: The House opened with quorum, invocation, pledge, and several announcements recognizing guests and Early Childhood Day at the Roundhouse, including remarks supporting New Mexico’s universal child care efforts. The chamber then received and adopted a long series of committee reports, moving multiple bills forward, including HB 303, SB 96, HB 195, HB 279, HB 292 (with a Judiciary substitute), SB 30, HB 234, SB 35, SB 40, SB 43, HB 153 (with an Appropriations substitute), HB 253, HB 255, HB 287, HB 371 (with an Appropriations substitute), SB 143, HB 248 (with a Taxation and Revenue substitute), HB 309, SB 48, and enrollment/signing reports for memorials. The House also received Senate Judiciary Committee substitute for SB 41, which would eliminate the statute of limitations for certain sexual crimes and was referred to Judiciary. The main floor debate centered on House Judiciary Committee substitute for HB 99, a medical malpractice reform bill. Supporters said it would balance patient compensation with provider stability by capping punitive damages, raising the burden of proof for punitive damages, and limiting when such claims can be pleaded. Several members described the bill as the product of months of bipartisan work and argued it would help retain doctors, especially in rural areas. The House passed HB 99 on final passage by a vote of 16-3. The House also passed HB 66, expanding the health care provider loan repayment program, by 69-0; HB 306, addressing unexpected patient-facing facility fees, by 69-0; HB 38, adding wheelchairs to insurance coverage for certain prostheses-related benefits, by 69-0; HB 20, allowing Native American applicants to request a distinguishing designation on driver’s licenses and ID cards, by 66-3; and HB 253, preserving and regulating virtual education with an emergency clause, by 69-0. The chamber then took up HB 213, which expands optometrists’ scope of practice to include certain laser eye procedures. A proposed amendment requiring patients to sign a disclosure acknowledging that optometrists are not MDs or DOs and did not attend medical school was debated at length, with supporters framing it as informed consent and opponents calling it demeaning and unnecessary. The House tabled that amendment 35-19, and the underlying bill continued in debate at the end of the transcript.

Bills: SCR74, SR68, SCR108, SCR76, SCR150, SR141, SCR69, SR64, SCR25, SR22

Keywords: no-bid contracts, emergency procurement, audit, state agencies, public funds, accountability, auditor, state and county agencies, government accountability, emergency declarations, easement, submerged lands, drainage, Kahala Hotel, Oahu, state land regulations, biomarker testing, health insurance, precision medicine, H.B. No. 1971

Transcript Highlights:

• the bank more that is that could impact the bank more significantly.<00:38:00.400><c> Now,</c><00:38
• They directly impact whether organizations like ours can afford to continue operating.
• So the impact in central and south Maui.
• So the impact is<01:57:06.480><c> very</c><01:57:06.719><c> different</c><01:57:07.599><c> um</c><01:
• Uh, joining several liability is the main aspect that I think is going to have the most impact on the

Bills: HB1946, HB1515, HB1514, HB1648, HB1644, HB1619, HB1571, HB1810, HB2475, HB1645, HB2301, HB1889, HB1840

Keywords: time shares, registration, renewal, real estate, Hawaii, Director of Commerce and Consumer Affairs, workers' compensation, functional capacity examination, occupational therapy, physical therapy, employer responsibilities, injured workers, medical stabilization, vocational rehabilitation, injury recovery, employment services, return to work, nonprescription drugs, over-the-counter medications, healthcare providers

Summary: The committee on Consumer Protection and Commerce met on February 26, 2026, and heard several bills, mostly in the areas of workers’ compensation and consumer protection. HB 1946 HD1 on timeshare registration renewal drew support from DCCA’s timeshare program and major industry groups including Hilton Grand Vacations, the American Resort Development Association, and Marriott Vacations Worldwide, with no opposition noted. HB 1515 HD1, which would allow an attending physician to request a functional capacity examination without employer permission, was supported by DLIR and the Department of Human Resources Development and had no other in-person testimony; the bill was then moved on without questions. The committee spent substantial time on HB 1514 HD1, which would streamline workers’ compensation vocational rehabilitation by clarifying provider selection and requiring vocational plans within 90 days. DLIR supported the intent but asked for amendments, saying the 90-day deadline was too rigid given case-by-case complexity, limited staffing, and the need for coordination among injured workers, employers, and counselors; members discussed possible extensions and whether a 120-day timeline or other flexibility would be better. Testimony on the bill included one individual in support and seven in opposition. HB 1648 HD1, concerning workers’ compensation and physician dispensing of non-prescription drugs, drew support from DHRD and comments from DLIR and industry witnesses. DLIR said the bill should be narrowed so it does not restrict medically necessary over-the-counter medications or oral guidance from providers, while Aloha Billing Company and Solera Integrated Medical Solutions urged tighter limits on physician dispensing and raised concerns about pricing abuse through average wholesale price. Members discussed clarifying the bill’s language so it targets written prescriptions rather than oral advice. HB 1644 HD1, requiring a standardized disclosure form for residential solar contracts, received support from the Hawaii Solar Energy Association and Kauaʻi Island Utility Cooperative, while DCCA’s Office of Consumer Protection supported the consumer-protection goal but proposed stronger remedies, including a three-day cancellation right, voidability for missing disclosures, and possible lender liability; members questioned how those remedies should apply to lenders, and no vote was taken on the measures in the portion provided.

Transcript Highlights:

• for recovery services to allow qualified plans examiners or building code inspectors to work in impacted
• grant program definitions of communities eligible to reduce cost share, expanding access for small, rural
• grant program definitions of communities eligible to reduce cost share, expanding access for small, rural
• You know, they would have to pay for their share of the impact to the resource.
• And then, ...they would have to pay for their share of the impact to the resource.

Bills: S0598, S0934, S1260, S1300, S1452, S1510, S1566, S1580, S1668, S7034

Keywords: funeral homes, cemetery law, cremation, embalmer, funeral director, preneed contract, preneed funeral, human remains, unclaimed cremated remains, disposition of remains, hospice, palliative care, end-of-life care, direct disposal, mortuary science, funeral service arts, licensure by endorsement, cemetery license, contiguous acres, consumer services

Summary: The committee first took up appointments, recommending confirmation of James Patrick Grambling and Brian J. Aungst on a single favorable vote. It then heard and approved several committee bills, including CS/CS/SB 1260 on building code inspections, which directs the Department of Management Services to contract with private providers for plan review and inspections; CS/SB 1668 on NICA, which updates benefits, oversight, funding, and immunity language; SB 1300 on a workforce/CDL training program for selected nonviolent inmates; CS/CS/SB 598 on funeral and cemetery services; CS/SB 1580 on illegal gaming enforcement; CS/SB 934 on Florida Keys affordable housing tax exemptions; and CS/CS/SB 1452, an agency bill updating DFS programs and licensing rules. Each of those bills was reported favorably after committee debate and, in several cases, amendments were adopted. The committee spent substantial time on CS/CS/SB 1510, the DEP package, which reorganizes environmental rulemaking and land acquisition authority, expands septic-to-sewer and nutrient-reduction requirements in sensitive areas, updates stormwater and resilience provisions, and revises related permitting and grant programs. Two amendments were adopted, including one adding solar-energy and stormwater-related provisions and another removing septic disclosure reporting language. Testimony included support from DEP and concerns from environmental advocates about septic timelines and implementation. The bill was ultimately reported favorably. The committee also considered CS/CS/SB 1566 on local government budget transparency, requiring counties and municipalities to post budgets and related materials online for extended periods in a standardized format. The League of Cities opposed the bill as an unfunded mandate, while the sponsor argued it would improve taxpayer access and accountability; the bill was reported favorably. Finally, the committee heard SB 7034, a rule ratification for minimum flows and levels for the lower Santa Fe and Ichetucknee rivers and priority springs, with testimony focused on the proposed Water First restoration strategy, conservation measures, and concerns about water quality, funding, and local opposition. The transcript ends during closing remarks on that ratification bill, before a final vote is shown.

Transcript Highlights:

• with other states with recovery services for plans examiners, business code and inspectors to work impacted
• revises Resilient Florida Grant Program definitions to reduce cost share, expanding access for small rural
• participating if this is the project that is used, that they would have to pay for their share of the impact
• They had plans that they were working on for how they would take care of their individual impacts and
• Without some type of project like this, to speak plainly, the utilities can take care of their impacts

Bills: S0598, S0934, S1260, S1300, S1452, S1510, S1566, S1580, S1668, S7034

Keywords: funeral homes, cemetery law, cremation, embalmer, funeral director, preneed contract, preneed funeral, human remains, unclaimed cremated remains, disposition of remains, hospice, palliative care, end-of-life care, direct disposal, mortuary science, funeral service arts, licensure by endorsement, cemetery license, contiguous acres, consumer services

Bills: HB1601, HB1616, HB1603, HB1604, HB1605, HB1606, HB1802, HB1569, HB1619, HB1730, HB1749, HB644, HB1620

Keywords: biosecurity, invasive species, Hawaii Invasive Species Council, Department of Land and Natural Resources, appropriation, agriculture, aquaculture, commercial activity, swine production, Korean natural farming, land leases, Hawaii, extension, Department of Agriculture, housing, workforce, land use, zoning, public-private partnerships, tax credit

Transcript Highlights:

• If we're not quite sure that the use of organized retail thefts impact on state and local tax receipts
• and the business owner being impacted.
• And oftentimes in the rural areas, we have a lot of volunteers that respond.
• And, you know, I live in rural Oklahoma. It's our news travels by Pony Express.
• And, you know, I live in rural Oklahoma. It's our news travels by Pony Express.

Bills: SB1226, SB1456, SB1462, SB1463, SB1980, SB1479, SB1608, SB1923

Keywords: motor vehicle, accident, notification, liability, civil action, gender neutral, SB1456, Board of Tests for Alcohol and Drug Influence, sunset extension, sunset law, breath alcohol testing, DUI, DWI, drunk driving, drug testing, chemical testing, field sobriety, roadside screening, blood test, saliva test

Summary: The committee first heard Senate Bill 1226 by Senator Rader, which would add property damage to the state’s leaving-the-scene statute so a driver who damages property and leaves would be treated similarly to a vehicle accident. After brief questions about whether the driver would need to wait for law enforcement or the property owner, the bill advanced unanimously, 6-0. Several sunset-extension bills from Senator Burstrom were then considered. Senate Bill 1456 would extend the Board of Tests for Alcohol and Drug Influence to 2036 and passed 6-1. Senate Bill 1462 would extend the Oklahoma Organized Retail Crime Task Force to 2036; members questioned whether a task force created in 2023 needed such a long extension, but it still passed 6-2. Senate Bill 1463 would extend the Polygraph Examiners Board to 2036 and passed 8-1, with some members again objecting to the 10-year sunset length. The committee also advanced Senate Bill 1980 by Senator Logan, which updates larceny and forgery language to cover gift cards, gift certificates, and redemption information when possessed or used with intent to defraud. Members pressed the author on whether the offense would be a misdemeanor or felony and on the bill’s scope, but the measure passed 7-2. Senate Bill 1479 by Senator Stewart, dealing with release of crime- and collision-scene information by first responders, was amended to strike the title after concerns about scope and private entities; it then passed 6-2. Senate Bill 1608 by Senator Frick, as amended, would make school location and employer information searchable in sex offender and violent offender registries, and it passed 6-2. Finally, Senate Bill 1923 by Senator Murdoch would prohibit inmates from accessing social media, prompted by a constituent’s concerns about inmates contacting victims’ families through contraband cell phones. Members questioned whether the bill was necessary given existing DOC policies and whether it should address tablets as well; an amendment was withdrawn, and the bill passed 7-1. The committee also laid over Senate Bill 1612 and concluded its Public Safety agenda for the week.

Bills: HSB314, SF304, HF708, HSB500, HSB501, HSB502, HSB503, HSB504, HSB505, HSB506

Keywords: medical release, incapacitated, terminal illness, serious medical condition, parole, risk assessment, victim impact statement, supervision, care facility, Iowa, minors, medical consent, healthcare services, sexually transmitted infections, privacy, youth healthcare, healthcare decisions, palliative care, hospice care, life-sustaining procedures

Bills: SB3074, HB49, HB2440, HB3556, HB3619, HB3866, HB4042, HB4112, HB4271, HB4413, HB4426, HB5033, HB49

Keywords: SB 3074, TCEQ, Texas Commission on Environmental Quality, Water Code, permit applications, environmental permitting, administrative record, ex parte communications, legislative communications, governor, lieutenant governor, state legislators, district projects, public records, recusal, conflict of interest, substantial interest, agency transparency, environmental regulation, permit renewal

Transcript Highlights:

• Because there are, in a lot of cases, no way to avoid impacts in those scenarios.
• The rural landowner cares about his animals, his land, and his water resources.
• While it does impact each individual, it doesn't impact everyone equally. ...So income and frontline
• How would this bill, if it were to pass, impact non-attainment areas?
• No, it impacts applications going forward.

Bills: SB3074, HB49, HB2440, HB3556, HB3619, HB3866, HB4042, HB4112, HB4271, HB4413, HB4426, HB5033, HB49

Keywords: SB 3074, TCEQ, Texas Commission on Environmental Quality, Water Code, permit applications, environmental permitting, administrative record, ex parte communications, legislative communications, governor, lieutenant governor, state legislators, district projects, public records, recusal, conflict of interest, substantial interest, agency transparency, environmental regulation, permit renewal

Bills: SB 2041, SB 1777, SB 1681, SB 2311

Keywords: child welfare, foster care, Department of Family and Protective Services, DFPS, Family Code, conservatorship, placement selection, contract residential care, kinship care, relative placement, designated caregiver, best interest of the child, least restrictive setting, placement stability, child protective services, residential treatment, group home, family reunification, Texas foster system, residential care

Bills: SB2041, SB1777, SB1681, SB2311

Keywords: child welfare, foster care, Department of Family and Protective Services, DFPS, Family Code, conservatorship, placement selection, contract residential care, kinship care, relative placement, designated caregiver, best interest of the child, least restrictive setting, placement stability, child protective services, residential treatment, group home, family reunification, Texas foster system, residential care

Transcript Highlights:

• observed at March 2025 to focus attention on hemophilia and other hereditary bleeding disorders that impact
• Hispanic attorneys and left an immeasurable impact on our judiciary and on the Texas Supreme legal system
• But I'm so thankful for your impact in my life.
• vital role in our office, contributing to policy work on natural resources, water, agriculture. and Rural
• There's very few families that aren't impacted by disability and it is It's so great to have organizations

Bills: SB 26, SJR 36, SB 26, SB 616, SB 565, SB 384, SB 28, SR 109, SR 122, SR 126, SR 130, SR 136, SR 137, SR 141, SR 142, SCR 20

Keywords: teacher compensation, education funding, public school educators, teacher retention, teacher designation, aquifer, water management, Edwards Aquifer, sustainability, regulatory framework, SB 565, Texas Water Code, TCEQ, Texas Commission on Environmental Quality, compliance agreement, enforcement suspension, utility consolidation, regionalization, water supply, sewer

Summary: The meeting was marked by significant resolutions recognizing various contributions to Texas and celebrating community initiatives. Key discussions included the adoption of resolutions commemorating Texas Hispanic Judges Day and highlighting the 100th anniversary of Memorial Park. Senators expressed appreciation for the judges' dedication and legacy, with notable mentions of individual judges and their impact on the community and legal landscape in Texas. The Senate also honored students and organizations contributing positively to their communities, showcasing the interconnectedness of public service and the legislative process.

Transcript Highlights:

• We have an economic impact of more than 135 million dollars each year, creating thousands of jobs just
• to avoid us getting to a point where it has... ... avoiding us getting to a point where it has an impact

Bills: SB 26, SJR 36, SB 26, SB 616, SB 565, SB 384, SB 28, SR 109, SR 122, SR 126, SR 130, SR 136, SR 137, SR 141, SR 142, SCR 20

Keywords: teacher compensation, education funding, public school educators, teacher retention, teacher designation, aquifer, water management, Edwards Aquifer, sustainability, regulatory framework, SB 565, Texas Water Code, TCEQ, Texas Commission on Environmental Quality, compliance agreement, enforcement suspension, utility consolidation, regionalization, water supply, sewer

Transcript Highlights:

• As you know, the tax policy has been impacting them.
• That's the impact of this amendment. Zero dollars.
• It's only a $26,000 impact to an $80 billion budget.
• And it's not a huge impact to an $80 billion budget.
• Everyone is affected and impacted by a state budget.

Bills: SB6061, SB6234, SB6170, SB6176, SB6182, SB6335, SB5647, SB6047, HB2367, HB2606, SB5998, SB6005, SB6003, SB6129, SB6225, SB6228, SB6231

Keywords: tourism, self-supported assessment, funding, statewide promotion, economic development, sewage, grinder pumps, residential buildings, regulation, construction, contracting rules, state highway construction, procurement limits, state regulations, infrastructure funding, vehicle registration, enforcement, renewal, transportation, state law

Summary: The Senate met on February 23, 2026, opened with the usual roll call, pledge, prayer, and approval of the previous journal. Members then adopted Senate Resolution 8698 recognizing piano teachers, with several senators sharing personal remarks about their own teachers and the role of music education in families and communities. Guests from the Washington State Music Teachers Association and the National Guild of Piano Teachers were recognized in the gallery. The chamber then moved into budget debate, considering a series of amendments to the operating budget. Several proposals focused on housing costs, local planning, utility rates, and state spending restraint. Amendment 0772, which would have created a housing-related task force and increased funding, was rejected after debate over housing affordability and regulatory costs. Amendment 0785, restoring growth management planning funding for local governments, was also rejected. Amendment 0791, directing the Department of Commerce to study the effects of climate and clean energy laws on utility costs, and Amendment 0769, related to grid capacity and clean energy investments, were both adopted. Other amendments drew sharper partisan debate. Amendment 0798, which would have reduced the Supreme Court from nine justices to five and redirected savings to public defense, failed. Amendments 0794 and 0795, seeking funding for ballot measure costs tied to initiatives, also failed. Amendment 0799, intended to redirect Pacific Tower lease savings to developmental disability services, was rejected after discussion of the building’s current public uses. Amendment 0773, capping state spending growth and tying it to median wage growth, failed on a roll call vote, while Amendment 0777, addressing concurrent use of paid family and medical leave and sick leave by state employees, also failed after extended debate. Later, Amendment 0776 on tort liability reporting was adopted, as were Amendment 0758 creating a DSHS work group on community-based services for people with intellectual and developmental disabilities, and Amendment 0786 was introduced to reduce cash and food assistance work-related funding, with debate beginning before the transcript ends.

Transcript Highlights:

• As you know, the tax policy has been impacting them.
• That's the impact of this amendment: zero dollars.
• It's only a $26,000 impact to an $80 billion budget.
• And it's not a huge impact to an $80 billion budget.
• Everyone is affected and impacted by a state budget.

Bills: SB6061, SB6234, SB6170, SB6176, SB6182, SB6335, SB5647, SB6047, HB2367, HB2606, SB5998, SB6005, SB6003, SB6129, SB6225, SB6228, SB6231

Keywords: tourism, self-supported assessment, funding, statewide promotion, economic development, sewage, grinder pumps, residential buildings, regulation, construction, contracting rules, state highway construction, procurement limits, state regulations, infrastructure funding, vehicle registration, enforcement, renewal, transportation, state law

Summary: The Senate convened with roll call, prayer, and approval of the previous day’s journal, then moved to a resolution honoring piano teachers. Senate Resolution 8698 was adopted after remarks from Senator Conway and others describing the role of piano teachers in music education, family life, and community service. Members of the Washington State Music Teachers Association and the National Guild of Piano Teachers were recognized in the gallery. The chamber then took up the operating budget and considered a long series of amendments. Several amendments focused on housing costs and local planning, utility and energy policy, ballot measure costs, state spending growth, tort liability, and paid family and medical leave. Some amendments were adopted, including a study of utility cost impacts from climate laws, a grid-related funding amendment, a tort liability oversight/reporting amendment, and a workgroup on services for people with intellectual and developmental disabilities. Others were rejected, including proposals to create a housing task force, cap state spending growth, fund ballot initiative costs, restore local planning grants, and change paid family and medical leave usage rules. Debate on the budget amendments was often partisan and detailed, with supporters arguing for fiscal restraint, cost transparency, and relief for taxpayers and local governments, while opponents emphasized existing work, program solvency, and the need to preserve services. The Senate also heard amendments on zero-based budgeting, federal education tax credit opt-in language, reproductive health funding, food assistance work requirements, and support for the Pediatric Interim Care Center; some were defeated and some were adopted. Roll-call votes were taken on certain amendments, and the transcript ends during consideration of Amendment 0787, which would restore funding for the Pediatric Interim Care Center.

Transcript Highlights:

• And then, There is no state revenue impact.
• Some, you know, might not be impacted by the change, whereas others could be impacted significantly.
• . 5826 also carries a significant physical impact.
• There's a fiscal impact of $1.2 million to the general fund in the 2025-27 biennium and a four-year impact
• The bill has no fiscal impact.

Bills: SB6194, SB5963, SB5909, SB5826, SB5988, SB5872, SB5879, SB5834, SB5835, SB5905, SB5832, SB6177, SB5970, SB5994, SB6047, SB5647

Keywords: SB 6194, Washington Medicaid, medical assistance, fee-for-service, managed care, rural hospital, Indian reservation, tribal hospital, federally recognized Indian reservation, Indian Health, hospital reimbursement, Medicaid payments, inpatient services, outpatient services, psychiatric unit, health care access, rural health, tribal health, safety-net hospital, RCW 74.09