Transcript Highlights:

• The Committee on Health and Human Services is called to order.
• Chair Warner and members of the Senate Health and Human Services Committee, I'm Kayla Black.
• SB 1162 establishes the Department of Health Services as the agency responsible...
• and capabilities, non-medical care and support services, and the needs of the patients.
• This is a full-circle moment for me because as we had a Family Service Committee, we had Senator Mary

Bills: SB1017, SB1149, SB1162, SB1192, SB1249, SB1253, SB1331, SB1333, SB1334

Keywords: informed consent, surgical procedures, healthcare professionals, patient rights, regulatory compliance, child welfare, dependency hearings, foster care, court procedures, parental rights, healthcare compliance, behavioral health technicians, licensing, monitoring, administrative burdens, basic first aid, good samaritan, medical licensing exemption, Arizona medical board, A.R.S. 32-1421

Summary: The Senate Health and Human Services Committee opened with approval of the January 28 and 29 minutes and a welcome to Arizona Physical Therapy Day at the Capitol, including remarks from physical therapy advocates and students. The committee then took up several bills related to SNAP, health care oversight, child welfare, dementia planning, and safe haven newborn surrender. On SNAP, SB 1334 would bar DES from seeking or renewing federal waivers of work requirements for able-bodied adults without dependents unless authorized by law; it passed 4-1. SB 1333 would require DES to reduce the SNAP payment error rate to 3% by 2030, with regular reporting, corrective action plans, and possible funding penalties; an amendment changed the reporting to quarterly and required a special audit, and the bill passed 4-1 as amended. SB 1331 would require able-bodied adults under 60 receiving SNAP to participate in mandatory employment and training unless exempt; testimony split between supporters citing work incentives and opponents warning of administrative burden and impacts on families and food banks, and it passed 4-2. The committee also advanced SB 1162, which clarifies DHS as the lead licensing and monitoring agency for health care institutions and, as amended, requires DHS and AHCCCS/Access to coordinate to identify duplicative oversight and report back periodically; it passed unanimously. SB 1017, requiring signatures on emergency informed consent forms for surgical procedures, passed 4-2. SB 1149, dealing with DCS periodic review hearings and notice/reporting requirements, including for tribal parties, passed 5-1. SB 1249, which designates DHS as the lead agency on Alzheimer’s and dementia planning and creates a dementia services program funded through lottery monies under the adopted amendment, passed unanimously after emotional testimony from advocates and family members. Finally, SB 1253, clarifying that a parent may surrender a newborn at the hospital of birth without leaving and returning, passed 5-0. The committee then adjourned.

Transcript Highlights:

• Committee on Human Services will come to order. The clerk will call the roll. Chair hole.
• or a person with disabilities, and I am tasked with their shopping as part of personal attendance services
• School Health and Related Services, better known as SHARRS, is a federally funded program that provides
• For delivering direct medical services to Medicaid eligible special education students in the school
• It mandated that the Texas Health and Human Services Commission worked to ensure compliance with federal

Bills: SB 596, SB 961, SB 1398, SB 1183, SB 1952

Keywords: DFPS, Department of Family and Protective Services, child protective services, foster care, child welfare, Family Code, conservatorship, managing conservator, parental child safety placement, authorization agreement, temporary authorization order, child abuse, child neglect, placement reporting, court-ordered removal, investigation, family preservation, transparency, public reporting, data reporting

Transcript Highlights:

• , family resource centers, navigation services, and we also do foster care adoption and residential services
• In addition to placement and case management services, TFI also provides family preservation services
• Our services for prevention and our reunification services have really made an impact.
• extended foster care services.
• Providers can offer in-home services under the Family First Prevention Services Act, ensuring that children

Bills: SB596, SB961, SB1398, SB1183, SB1952

Keywords: DFPS, Department of Family and Protective Services, child protective services, foster care, child welfare, Family Code, conservatorship, managing conservator, parental child safety placement, authorization agreement, temporary authorization order, child abuse, child neglect, placement reporting, court-ordered removal, investigation, family preservation, transparency, public reporting, data reporting

Transcript Highlights:

• The Committee on Human Services will come to order. The clerk will call the roll. Chair Hull. Here.
• or a person with disabilities, and I am tasked with their shopping as part of personal attendant services
• Members, School Health and Related Services, better known as SHARS, is a federally funded... program
• A 2017 federal audit report revealed that Texas... were improperly billing for services not permitted
• Texas Health and Human Services Commission work to ensure compliance with federal guidelines.

Bills: SB596, SB961, SB1398, SB1183, SB1952

Keywords: DFPS, Department of Family and Protective Services, child protective services, foster care, child welfare, Family Code, conservatorship, managing conservator, parental child safety placement, authorization agreement, temporary authorization order, child abuse, child neglect, placement reporting, court-ordered removal, investigation, family preservation, transparency, public reporting, data reporting

Transcript Highlights:

• Director Collier, 40 years of service to the state. Congratulations to you.
• Director Collier, 40 years of service to the state. Congratulations to you.
• I've been in constable service for 24 years.
• Thank you all for your service. Thank you. Thank you.
• Harris County is the hub for mental health services.

Bills: HB47, HB171, HB285, HB305, HB449, HB908, HB 1024, HB 1306, HB1443, HB1445, HB1741, HB1866, HB1902, HB2001, HB2282, HB2355, HB2492, HB2637, HB2697, HB3464, HB4263, HB4996, HB5667

Keywords: sexual assault, victim rights, forensic examination, medical care, trauma-informed care, crime victims compensation, evidence retention, chemical dependency, court-ordered treatment, mental health, health care, treatment facility, juvenile justice, criminal justice reform, animal cruelty, nonlivestock, prosecution, veterinary defense, animal welfare, pretrial hearings

Summary: The Senate Committee on Criminal Justice met with a quorum and heard a long agenda of bills on criminal justice, public safety, mental health, victims’ rights, and related administrative issues. Early bills included HB 47, the omnibus sexual assault survivors bill, which would expand post-assault care, require courts to consider delays for adult survivors, bar sex offenders from rideshare driving, allow lease termination regardless of where an assault occurred, and require more reporting from sexual assault response teams. Testimony was generally supportive, though one witness raised concern that the bill’s reporting requirements could jeopardize county grant funding. HB 171, the Annel Borrego Act, would set a minimum period for court-ordered chemical dependency treatment; NAMI Texas supported it. HB 908 would require missing children reports to be sent to the National Center for Missing and Exploited Children within two hours, and HB 1443 would criminalize possession and promotion of childlike sex dolls; both drew supportive testimony and were left pending. HB 567, changing juvenile board chair selection in Parker County, and HB 4263, a TJJD workforce retention bill, were also heard and left pending after brief discussion and adoption of committee substitutes where applicable. The committee also heard several bills focused on jail and prison safety, court process, and victim protection. HB 2282 would raise the arrest warrant fee from $50 to $75; constables supported it as a cost-recovery measure, while the Texas Fair Defense Project opposed it as a regressive fee that burdens low-income defendants. HB 3464 would increase penalties for correctional employees who bring drugs or alcohol into prisons, with support from Harris County jail officials and a formerly incarcerated advocate who described the dangers of contraband and retaliation. HB 285, “Poncho’s Law,” would add criminal negligence to non-livestock animal cruelty offenses; animal welfare advocates said it would close a loophole that lets pet service businesses avoid accountability, and the bill was left pending. HB 2355 would keep certain Crime Victims Compensation records confidential when held by the Attorney General, and HB 2637 would standardize jury exemption ages and clean up jury disqualification reporting; both were left pending after limited testimony. Mental health and competency-related bills received significant attention. HB 305 would require a pretrial hearing within 14 days after a defendant is restored to competency, aimed at reducing repeated decompensation and the forensic waitlist; NAMI Texas supported it. HB 1741 would tighten procedures for not-guilty-by-reason-of-insanity outpatient commitments by requiring a stronger nexus to the receiving county and clearer supervision authority; law enforcement and mental health witnesses said it would improve public safety and treatment success. HB 2492 would make the four-hour family-violence post-bond cooling-off period mandatory rather than discretionary, and HB 1445 would allow a managed assigned counsel director to designate someone to approve certain payments for indigent defense attorneys; both were left pending. HB 1024 would require prompt execution of warrants for parole violators on superintensive supervision, and HB 1306 would extend first-responder-style benefits to death investigation professionals; neither drew opposition in the hearing. The committee also heard a series of public integrity and technology bills. HB 449 would expand the deepfake sexual content statute to include sexually explicit images, with Public Citizen supporting the change as necessary to address a rapidly growing problem. HB 1902 would create a new offense for “jugging,” or following bank or ATM customers to rob them; the Texas Bankers Association supported it. HB 2697 would require sureties to notify prosecutors before surrendering a felony defendant’s bond, and HB 2001 would sharply increase penalties for misuse of public information for financial gain and related coercion, with prosecutors and Texas Rangers describing bid-rigging and public corruption investigations as difficult to prove under current law because of short limitations periods and limited penalties. HB 1866 would grant Texas peace officer authority to National Park Service rangers within Texas park boundaries, and HB 4996 would increase penalties for fraudulent liens filed against public servants. Throughout the hearing, most bills were left pending after testimony, and several committee substitutes were adopted without objection.

Transcript Highlights:

• These rebates have funded the HIV support service grants to HIV supportive services organizations, which
• so if you've done um of service so if you've done um successful<00:28:51.799> services<00:28:
• boarding by ensuring the right services boarding by ensuring the right services are<01:21:50.679
• Services, and I'm also here on behalf of the Minnesota Association of Social Services Administrators
• This service is essential.

Bills: HF2367, HF2319, HF2523, HF1742, HF671, HF2331, HF2722, HF2406, HF1674

Keywords: HF2367, Community First Services and Supports, CFSS, personal care assistance, PCA, consumer-directed community supports, CDCS, home and community-based services, HCBS, direct support professionals, direct care workers, caregivers, support workers, SEIU Healthcare Minnesota & Iowa, collective bargaining agreement, retention stipend, health care cost stipend, training stipend, orientation program, retirement trust

Bills: HB 101, HB1819, HB1875, HB1965, HB2193, HB2914, HB3248, HB3354, HB3531, HB101

Keywords: Texas State Guard, task force, professionalization, state missions, critical infrastructure, veterans, veterans' affairs, mental health, community mental health, behavioral health, grant program, matching grant, non-state match, community services, family support, county population, Health and Human Services Commission, HHSC, public safety, homeland security

Transcript Highlights:

• keep providing the service.
• medical services?
• medical services?
• medical services?
• medical services?

Bills: HF729, HF728

Keywords: human services, provider enrollment, medical assistance, healthcare, housing stabilization, substance use disorder, vulnerable adults, fraud prevention, respite care, children, licensed settings, home and community-based services, 1183, house

Transcript Highlights:

• Amendment number seven is providing for what services are not directly billed and provided for; it provides
• Representative Spell: The top of page 15, and it's regarding the forensic medical examinations and that
• In support, not wishing to speak: Sean Hotstream with the Hospital Service District Coalition, Scott
• Representative Walters, this is for service members who are outside of the country.
• Representative Walters, this is for service members who are outside of the country. Yes, correct.

Bills: HR9, HB709, HB1011, HB1057, HB1186, HB1245, HB1247, SB49, SB425, SB479

Keywords: human rights, individual liberties, Magna Carta, constitutionalism, free speech, Uniform Construction Code, building code, construction code, inspector licensing, building inspectors, plans examiners, public inspector, private inspector, private inspector company, building official, code enforcement, Louisiana Uniform Construction Code Commission, state fire marshal, International Building Code, International Residential Code

Transcript Highlights:

• forensic medical examinations by placing them under a protective order.
• We're a nonprofit that provides free legal services to victims of sexual violence and other crimes.
• Much better services still when you have 18 veterans commit suicide a day, you're way too many.
• It establishes a state-directed civil service system for whatever communities have adopted it.
• I am the executive director of the Capitol Area Private Defender Service.

Bills: SB693, SB781, SB836, SB860, SB906, SB993, SB1101, SB1321, SB1370, SB1537, SB1563, SB1610, SB1637

Keywords: notary public, notaries, acknowledgment, jurat, personal appearance, remote notarization, online notarization, e-notary, electronic notarization, fraud prevention, identity verification, real estate fraud, property transfer, state jail felony, Class A misdemeanor, secretary of state, continuing education, record retention, notarial act, Texas Government Code

Summary: The Senate Committee on Criminal Justice heard a series of bills focused on criminal procedure, public safety, victim protections, and law enforcement administration. SB 1537 would require criminal-proceeding interpreters to meet the same appointment standards used in the Government Code, and SB 993 would let the Comptroller’s Criminal Investigative Division seek mobile-tracking warrants directly in motor fuel theft and related tax-fraud investigations. SB 693, as substituted, would create a criminal offense for notaries who notarize documents without the signer personally appearing, with a higher penalty when real property is involved, and would add continuing education for notaries. SB 1610 would tighten rules for civilly committed sexually violent predators at the Texas Civil Commitment Office, including penalties for new crimes and assaults on staff, sex-offender registration requirements, and removal of certain provisions from the filed version; the substitute reduced some of the harsher penalties and preserved parole/community-supervision eligibility. SB 836 would expand privacy protections for sexual assault survivors by limiting livestreaming of certain trials, allowing pseudonyms earlier in the process, and protecting forensic exam evidence and invasive recordings under protective orders. SB 1563 would require county jailers to receive training on interacting with veterans, with testimony emphasizing suicide risk, PTSD, and the need for better identification and support in jails. SB 906 would give the Ysleta del Sur Pueblo authority similar to other Texas tribes to commission peace officers under state law to enforce Texas laws on tribal land. SB 781 would standardize confidentiality rules for peace officers’ personal information and create a confidential departmental file system modeled on Chapter 143 civil-service practices, though members raised concerns about whether the bill could affect disciplinary records and existing disclosure rules. Testimony was largely supportive for the bills, especially from prosecutors, law enforcement representatives, victim advocates, and agency officials. Supporters of SB 693 described widespread deed fraud tied to improper notarizations; supporters of SB 836 stressed survivor privacy and the harms of livestreamed sexual-assault proceedings; supporters of SB 1563 said jailer training could help prevent veteran suicides and improve treatment; and supporters of SB 906 said state commissioning would improve public safety and coordination on tribal lands. SB 781 drew support from police and TCOLE witnesses who said the bill would extend confidentiality protections already used in civil-service departments, while some members questioned whether the bill duplicated existing law or could be read to shield misconduct information. Public testimony included opposition to SB 1610 from a civil-rights advocate who urged waiting for Sunset review, and opposition to SB 781 from a family member of a person killed by police, who objected to expanding confidentiality for officers. Several bills were left pending after testimony because the committee lacked a quorum or chose to hold them for later action.

Bills: SB693, SB781, SB836, SB860, SB906, SB993, SB1101, SB1321, SB1370, SB1537, SB1563, SB1610, SB1637

Keywords: notary public, notaries, acknowledgment, jurat, personal appearance, remote notarization, online notarization, e-notary, electronic notarization, fraud prevention, identity verification, real estate fraud, property transfer, state jail felony, Class A misdemeanor, secretary of state, continuing education, record retention, notarial act, Texas Government Code

Bills: SB693, SB781, SB836, SB860, SB906, SB993, SB1101, SB1321, SB1370, SB1537, SB1563, SB1610, SB1637

Keywords: notary public, notaries, acknowledgment, jurat, personal appearance, remote notarization, online notarization, e-notary, electronic notarization, fraud prevention, identity verification, real estate fraud, property transfer, state jail felony, Class A misdemeanor, secretary of state, continuing education, record retention, notarial act, Texas Government Code

Transcript Highlights:

• forensic medical examinations by placing them under a protective order.
• Much better services still when you have 18 veterans commit suicide a day, you're way too many.
• It establishes a state-directed civil service system for whatever communities have adopted it.
• It establishes a state-directed civil service system for whatever communities have adopted it.
• I am the executive director of the Capitol Area Private Defender Service.

Bills: SB693, SB781, SB836, SB860, SB906, SB993, SB1101, SB1321, SB1370, SB1537, SB1563, SB1610, SB1637

Keywords: notary public, notaries, acknowledgment, jurat, personal appearance, remote notarization, online notarization, e-notary, electronic notarization, fraud prevention, identity verification, real estate fraud, property transfer, state jail felony, Class A misdemeanor, secretary of state, continuing education, record retention, notarial act, Texas Government Code

Summary: The committee heard a series of criminal justice bills focused on victim protections, law enforcement tools, notary/deed fraud, sexually violent predators, veterans in jail, tribal policing authority, and peace officer records. Several bills were laid out, heard, and left pending because the committee lacked a quorum for final action on those items. Testimony was generally supportive on bills addressing interpreter appointments, fuel theft investigations, deed fraud, survivor privacy, veteran jailer training, tribal peace officer authority, and officer-record confidentiality, though some bills drew concerns about due process, scope, or drafting. Senate Bill 1537 would clean up criminal procedure language on appointing interpreters and align it with Government Code standards requiring licensed or certified interpreters; it received no public opposition and was left pending. Senate Bill 993 would let Comptroller Criminal Investigative Division officers directly seek warrants for mobile tracking devices in fuel-theft and tax-fraud investigations; it also drew support and was left pending. Senate Bill 693, as substituted, would create a criminal offense for notarizing documents without the signer personally appearing, with a higher penalty when real property is involved, and would add notary continuing education; a Dallas County prosecutor testified that notary fraud is a major driver of deed theft, and the bill was left pending. Senate Bill 1610, as substituted, would address safety, registration, and criminal penalties at the Texas Civil Commitment Office for sexually violent predators, including assaults on staff and sex-offender registration issues; agency witnesses described increased assaults and operational problems, while a public witness urged waiting for Sunset review and raised due-process concerns. Senate Bill 836 would add privacy protections for sexual assault survivors by limiting livestreaming of trials, expanding pseudonym use, and protecting forensic exam and invasive-recording evidence; survivors and advocates strongly supported it, and defense lawyers said they had no opposition to the substitute. Senate Bill 1563 would require county jailer training on interacting with veterans, with testimony from the Texas Veterans Commission and veterans’ advocates emphasizing suicide risk, PTSD, and the need for better identification and support in jails; the bill was left pending. The committee also heard Senate Bill 906, which would authorize the Ysleta del Sur Pueblo tribal police to be commissioned as Texas peace officers like two other federally recognized tribes in Texas; tribal leaders said the change would improve response times and coordination, and the bill was left pending. Senate Bill 781, as substituted, would standardize confidentiality rules for peace officer personnel and departmental files statewide, mirroring Chapter 143 civil-service practices; law enforcement witnesses supported it as a way to protect personal information and create uniform records practices, but several senators raised concerns that the bill could blur existing disclosure rules or bury misconduct complaints, and public testimony included an opposition witness describing a police shooting involving her brother.

Transcript Highlights:

• And uh we're very Services Coalition.
• award, verification of services award, verification of services delivered,<00:05:01.600> reconciliation
• to track and verify that service to track and verify that service delivery<00:18:19.440> and<
• And so part of based services funding.
• <00:53:26.240> and live can understand the services and live can understand the services and

Bills: HF4210, HF4212, HF4549, HF4464, HF4546, HF4447

Keywords: senior nutrition, older adults, aging services, home-delivered meals, congregate dining, meal delivery, grocery delivery, food insecurity, nutrition support, area agencies on aging, Minnesota Board on Aging, human services, special revenue fund, nonprofit grants, SNAP outreach, medically tailored meals, rural nutrition, food access, transportation services, elderly

Transcript Highlights:

• In her more than two decades of service to public education, state government, behavioral health, and
• disability services.
• Member of Senate Bill 1983 directs the Department of Human Services to provide foster care data to resource
• Health and Human Services will meet 15 minutes after 208.

Bills: SB1323, SB1863, SB1932, SB1950, SB1956, SB1970, SB1599, SB1312, SB1776, SB1858, SB1985, SB1302, SB1809, SB1401, SB2053, SB1503, SB1553, SB1427, SB1642, SB1421, SB1837, SB1566, SB1567, SB1794, SB1484, SB1557, SB1564, SB1591, SB1395, SB1456, SB1562, SB1613, SB1983, SB1550, SB2065, SB2152, SB2159, SB2172, SB2110, SB2111, SB2114

Keywords: memorial designation, highway, Sheriff Marty Grisham, transportation, Oklahoma Statutes, memorial highway, road designation, John Skelley, motor carrier, administrative hearing, legal representation, corporate liability, aviation, aircraft, surveillance, regulations, fees, Oklahoma statutes, memorial, highway designation

Transcript Highlights:

• It was operated by a champion home and community-based services.
• After a meeting that was held in April 17, that A Champion Home group, community-based services, Upon
• Again, he's the owner of a champion community based services at the time.
• Human Services. In 2005, there was 3.8 million.
• , or have their services rendered, or as promotion to get them.

Bills: HB451, HB645, HB 1041, HB 1151, HB 1155, HB1536, HCR12, HCR12

Keywords: commercial sexual exploitation, child sex trafficking, human trafficking, child welfare, foster care, DFPS, Department of Family and Protective Services, juvenile probation, risk assessment, needs assessment, trauma screening, child abuse prevention, exploitation screening, validated screening tool, evidence-informed tool, conservatorship, juvenile justice, at-risk youth, trafficking prevention, Child Sex Trafficking Prevention Unit

Transcript Highlights:

• I worked at San Antonio Independent Living Services, it's called SALES, and I was data entry person.

Bills: HB451, HB645, HB 1041, HB 1151, HB 1155, HB1536, HCR12, HCR12

Keywords: commercial sexual exploitation, child sex trafficking, human trafficking, child welfare, foster care, DFPS, Department of Family and Protective Services, juvenile probation, risk assessment, needs assessment, trauma screening, child abuse prevention, exploitation screening, validated screening tool, evidence-informed tool, conservatorship, juvenile justice, at-risk youth, trafficking prevention, Child Sex Trafficking Prevention Unit

Transcript Highlights:

• , hotel shelter programs, eviction court support services, rental assistance, housing support services
• , hotel shelter programs, eviction court support services, rental assistance, housing support services
• funds pay for community service funds pay for community service navigators.<00:02:08.800> They
• towards, um, services and increasingly digital<00:55:56.280> services.
• sales tax to fund public services. sales tax to fund public services.

Bills: HF4561, HF4343

Keywords: homeless prevention aid, homelessness, housing stability, rental assistance, family homelessness, unaccompanied youth, housing navigation, legal representation, family outreach, county aid, Tribal governments, local government aid, general fund appropriation, unspent funds, aid redistribution, sunset repeal, Minnesota property tax aid, services for persons experiencing homelessness, sales tax, use tax

Transcript Highlights:

• Chairman, members, Senate Bill 1249 requires the Department of Health Services to establish a dementia
• services program and develop an Alzheimer's disease state plan.
• Finally, the bill appropriates $600,000 in fiscal year 2027 from the Health Services Lottery Moneys Fund
• to DHS for the dementia services program and the implementation of the state plan.
• The legislature and governor approved Arizona's first Dementia Services Program and adopted the state

Bills: SB1131, SB1249

Keywords: cardiac arrest, defibrillators, school safety, emergency response, CPR training, Arizona education funding, Alzheimer's, dementia, memory care, cognitive decline, brain health, caregiver support, long-term care, in-home care, public health, health services, state plan, dementia services program, Arizona Department of Health Services, aging

Summary: The Committee on Appropriations heard two bills. Senate Bill 1131 would require school districts and charter schools to report AED counts, CPR/AED training levels, and cardiac emergency response plans to ADE, and would appropriate $1 million for AED purchases and maintenance. The committee adopted an amendment shifting the funding source from the general fund to the industry-recognized certification and licensure reimbursement fund, after staff said the fund had an estimated $2 million balance and continued to receive $1 million annually. The American Heart Association testified in support, emphasizing the need for AEDs, CPR training, and emergency planning in schools. The bill was returned with a due pass recommendation by a 15-1 vote, with two members voting present and several members noting concerns about using the special fund rather than general funds. Senate Bill 1249 would create or continue a dementia services program and Alzheimer’s state plan at the Department of Health Services and appropriate $600,000 from the Health Services Lottery Moneys Fund. The Alzheimer’s Association testified in strong support, saying the prior three-year appropriation helped establish the plan and workgroups and that the new funding would support implementation, caregiver support, data collection, training, and grant applications. Several members raised concerns about taking money from a fund that supports maternal and child health programs such as Health Start and WIC, describing it as “robbing Peter to pay Paul,” while others said they supported the policy but wanted a sustainable funding source. The bill received a due pass recommendation on a 9-3 vote, with three members voting present.

Transcript Highlights:

• that's going to change is the billing process because now they're unable to charge for any of that service
• Are they currently billing insurance companies for these services? Thank you for that question.
• reason they do collect data on someone who's completed a suicide that was being served with the services

Bills: HB3287, HB2947, HB3784, HB3901, HB4275

Keywords: public health, domestic violence, human trafficking, healthcare facilities, hospital protocols, behavioral health, Medicaid expansion, clinical interns, mental health services, licensing requirements, micropigmentation, medical procedure, physician oversight, nursing certification, state regulations, psychological autopsy, mental health, suicide prevention, state health department, investigation