Bills: SB2373, SB2101, SB2905, SB3231, SB2486, SB2376

Keywords: carbon sequestration, marine ecosystem, climate change, renewable energy, biodiversity, nature-based solutions, organic waste, solid waste, waste diversion, composting, bioconversion, recycling, food waste, green waste, food-soiled paper, wood waste, landfill diversion, waste reduction, waste management, county solid waste plan

Summary: The committee heard SB 2006, which would clarify that a farm dwelling permit in an agricultural district may include a single-family farm dwelling with an accessory employee housing structure, subject to restrictions. Testimony was largely supportive, with comments from the Department of Agriculture Biosecurity, DPP, Hawaii Farm Bureau, Hawaii Realtors, Grassroot Institute of Hawaii, Hawaii Farmers Union, Housing Hawaii Future, and several individuals. The chair noted there were nine in support, two opposed, and four offering comments. In decision-making, the chair recommended passing the bill with OPSD-suggested amendments to clarify the definitions of farm employee housing and bona fide agricultural services. The chair also referenced opposing testimony that raised concern the original draft could limit tourism activities that provide supplemental income for bona fide farming operations. The proposed amendments were intended to make clear that farm employee housing is only for workers and not visitor accommodations, while allowing tourism activities on the same parcel if they are secondary and incidental to a bona fide agricultural operation, do not occur in employee housing units, and comply with county ordinances. The committee adopted the recommendation and voted to pass SB 2006 with amendments. The recorded votes showed the chair, vice chair, Senator Rhoads, and Senator Awa in favor, with Senator DeCoite excused. The same pass-with-amendments recommendation was then made to the housing committee and adopted there as well, with Senator Elephante voting aye and Senator Favella excused.

Transcript Highlights:

• Because one of the concerns is starting a grant program, you know, starting a grant program because we

Bills: HB1012

Keywords: health and human services, DHHS, appropriations, biennial budget, behavioral health, substance use disorder, opioid settlement, medical assistance expansion, Medicaid, basic care, long-term care, child care assistance, early childhood care, child care provider payments, guardianship, conservatorship, housing loan fund, disability services, extraordinary medical needs, community health trust fund

Summary: The Senate Appropriations Human Services Division met to consider House Bill 1012, the Department of Human Services budget, and reviewed three previously made amendments: correcting a reference to $30 million underfunding, changing “human service centers” to “behavioral health clinics,” and revising section 31 language so the department would review medical assistance services and report findings and recommendations rather than directly implement adjustments. The committee also discussed whether to include funding related to two other bills with fiscal impacts, House Bill 1485 (personal needs allowance) and House Bill 2399 (PRTF reimbursement), noting those measures may go to conference committee and that appropriations could be added there instead of in HB 1012. The committee agreed to proceed with HB 1012 and members noted provider inflation questions would be raised later in full committee. The division then approved a due pass recommendation on the amendments to HB 1012 and, after a roll call vote, approved HB 1012 as amended on a 4-1 vote, with Senator Mathern voting no. Senator Davison was named as carrier. Members also discussed House Bill 1577, involving wastewater project financing and possible amendments related to a line of credit from the Bank of North Dakota for specific projects, and House Bill 1619, for which additional amendments were expected before full committee action. The meeting ended with general thanks and adjournment.

Transcript Highlights:

• It would affect the same program, so it would be through a contingency revenue rider process.
• It might depend on whether or not the... ...functioning program and the permitting side.
• It would affect the same program, so it would be through a contingency revenue rider process.
• It's just that I don't know that those programs specifically have to generate that under statute.
• In the event that a county or municipality implements a battery recycling program.

Bills: SB2122, SB2050, HB16

Keywords: oil and gas waste, application fees, permit amendments, environmental regulation, Texas natural resources, battery recycling, battery disposal, consumer batteries, energy storage modules, electrochemical devices, lithium-ion battery, household hazardous waste, solid waste, municipal recycling, waste management, battery stewardship, producer responsibility, TCEQ, Texas Commission on Environmental Quality, recycling program

Transcript Highlights:

• It repeals a missed article relating to youth diversion.

Bills: HB16

Keywords: judicial administration, court reform, juvenile diversion, court security, mental health services, drug offenses, constitutional amendments

Summary: The Committee on Judiciary and Civil Jurisprudence met with a quorum present and took up House Bill 16, the omnibus courts bill that had been vetoed by the governor after the regular session. The committee substitute made several changes, including moving certain court creation dates, creating a new county court at law for Maverick County, repealing a missed youth diversion article, removing a civil preference for the 456th District Court in Guadalupe County, clarifying the digital court recording study makeup, correcting a drafting error involving prosecutors in the Special Prosecution Unit, and allowing the Office of the Attorney General to represent SPU prosecutors. Megan LaVoie of the Office of Court Administration testified as a resource witness in support of the bill and thanked the committee for working with the judiciary on the measure. Steve Bresnan of the Texas Court Reporters Association also testified in support of the bill, but used his time to urge action on a separate anti-SLAPP appeal that he said had been pending for 47 months; he distributed materials and proposed an amendment to impose deadlines on the courts, though he said he was not expecting discussion of it that day. After public testimony closed, the committee adopted the substitute without objection. Representative Hayes moved that House Bill 16, as substituted, be reported favorably to the full House with the recommendation that it be passed and printed. The motion prevailed on a 10-0 vote, and the committee then adjourned.

Transcript Highlights:

• several changes, allocating funds from the expedited permit review process to a designated fund for program
• The unit that implements this program.
• It might depend on whether or not the functioning program.
• , uh, or I'm sorry, uh, Mark, did, uh, no, sir, it's, um, I would mention that there are certain programs
• It's just that I don't know that those programs specifically have to generate that under statute.

Bills: HB16

Keywords: judicial administration, court reform, juvenile diversion, court security, mental health services, drug offenses, constitutional amendments

Transcript Highlights:

• It repeals a missed article relating to youth diversion, removes the civil preference for the 456th District

Bills: HB16

Keywords: judicial administration, court reform, juvenile diversion, court security, mental health services, drug offenses, constitutional amendments, 997, house, all

Transcript Highlights:

• I have been conflicted on this because studies generally lead to pilot programs, and pilot programs lead
• Ledge Council can only call it a pilot program or a study.
• And with that, we can ensure that more veterans get access to diversion and treatment programs and access
• program?
• Would the question still apply, since it would not be eligible for a diversion program? Mr.

Bills: HB2226, HB2406, HB2663, HB2695, HB2805, HB2976

Keywords: veteran status, veterans court, treatment court, diversion program, initial appearance, arrestee processing, criminal procedure, DD-214, Department of Veterans' Services, prosecuting agency, court notification, military service, armed forces, veterans benefits, reentry, mental health court, drug court, specialty court, Arizona criminal law, pretrial hearing

Summary: The committee first took up HB 2663, which updates military leave protections for state and non-state employees by aligning statutory language with how service members’ orders are described. Representative Pena said the change was intended to remove confusion without affecting benefits, and members noted it would help protect employees called to training, deployment, or state active duty. The bill passed unanimously with a due pass recommendation. The committee then heard HB 2976, a bill addressing administrative control of justice courts and due process for elected justices of the peace when state or county entities take action affecting their statutory authority. Supporters, including two Pima County justices of the peace, described administrative orders that transferred control of their courts without notice, findings, or a meaningful chance to respond, and argued the bill would require notice, a hearing, written findings, and review before such changes. The Arizona Supreme Court’s government affairs director opposed the bill as unconstitutional, arguing the state constitution gives the Chief Justice administrative supervision over all courts and that the legislature cannot impose those procedures by statute. After a lengthy and at times contentious exchange over constitutional authority and the role of elected JPs, the committee voted 6-1 to give HB 2976 a due pass recommendation. After a recess, the committee considered HB 2406, which requires the Arizona Department of Veterans’ Services to study how aware veterans are of available state, local, and federal benefits and to report recommendations for improving awareness. Testimony in support emphasized that many veterans do not know the full range of benefits available to them and suggested surveys, outreach, and other low-cost methods to gather information. Some members questioned whether a study was necessary or how it would be conducted, but several said they would support it for now; the bill received a due pass recommendation by a 5-1-1 vote. Finally, the committee heard HB 2226, which requires courts at initial appearance hearings to ask whether a defendant is a veteran and, if so, to consider referral to veterans’ treatment or diversion programs. Supporters said the bill would help identify eligible veterans early in the process and connect them to services, while one member raised Fifth Amendment concerns about asking the question before counsel is present. The sponsor and testifier agreed to work on an amendment clarifying that the answer could not be used against the defendant in later proceedings. The committee moved the bill forward with a due pass recommendation, with members indicating support pending that amendment.

Transcript Highlights:

• You do not have the data you need to properly evaluate the program.
• I'd like to acknowledge the Spay and Neuter Action Program, Safe Haven Animal Sanctuary, Action Programs
• So kind of what happens is the program continues forward.
• Because we've got, of course, a diverse group, I mean, we have diversity in terms of cities, counties
• And I would expect that the study would compare urban composting programs with rural composting programs

Bills: SB38, SB46, SB18

Keywords: SB38, pet food, registered pet food, registration fee, fees, sunset repeal, repeal of repeal, revenue, state fee, business regulation, animal feed, pet food registration, New Mexico, SB46, organic waste, solid waste, waste diversion, composting, compost feedstock, waste characterization study

Transcript Highlights:

• So TOPS Tech is restricted to specific programs, and so only those programs would be eligible.
• I'll be quick under the three-minute rule. 823 is your typical diversion program, particularly it is
• a local program to Orleans Parish.
• After discussion with my boss, Secretary Westcott, last night, probation and parole is a diversion program
• After discussion with my boss, Secretary Westcott, last night, probation and parole is a diversion program

Bills: HB198, HB325, HB488, HB719, HB749, HB755, HB797, HB823, HB1028, HB1194, HB1222

Keywords: Medicaid, reimbursement, ambulatory surgical centers, gastroenterology, ophthalmology, otolaryngology, healthcare funding, Louisiana Department of Health, surgical procedures, TOPS-Tech, scholarship, education, eligibility, college credit, dual enrollment, state funding, HB 488, Belle Chasse Bridge, Belle Chasse Bridge Merit-Based Special Fund, Plaquemines Parish

Transcript Highlights:

• last Congress, will continue the critical work of the Environmental Protection Agency's Brownfield Program
• Since first being authorized in 2002, the Brownfield Program has been a resounding success story for
• In Massachusetts, grant money awarded under an EPA brownfields program, of all things, remains frozen
• But we were able to get answers for our Brownfields program. program in Massachusetts so they can now
• They own this land in fee simple; it's a very innovative program.

Bills: SB347, SB351

Keywords: brownfields, brownfield cleanup, site remediation, environmental cleanup, contaminated property, redevelopment, revitalization, CERCLA, Superfund, EPA grants, state response programs, environmental justice, disadvantaged communities, small communities, local government grants, nonprofit eligibility, community engagement, Alaska Native tribes, Regional Corporations, Village Corporations

Transcript Highlights:

• The current Ka Ohana program within DHS does not extend to that group. Is that correct?
• . program. program.
• We understand that there's this program.
• Sure, so this program actually leverages a good federal match, about 60%.
• This is the one for reproducing the DHS Ka Hulu program for other at-risk families.

Bills: SB2479, SB2557, SB2861, SB3204, SB3324, SB3325

Keywords: criminal procedure, family violence, dating violence, child abuse, evidence admissibility, reduced sentencing, homelessness, reporting requirements, statewide office, housing solutions, kauhale projects, public oversight, SB2861, Hawaii, Office of Wellness and Resilience, OWR, Department of Human Services, DHS, Kakou Pilot Program, Kakou

Summary: The committee heard testimony on several measures related to criminal procedure, homelessness, family resilience, Medicaid-funded services, and school Medicaid reimbursement. On SB 2479 SD2, the Judiciary testified in neutral opposition with concerns that the bill could require imprisonment even for probation-eligible defendants, expand sentence reconsideration in ways that could undermine finality for victims, conflict with existing sentencing statutes, and require additional judicial resources. The Office of the Public Defender supported the bill’s intent but asked for language changes so people serving sentences could raise the new evidence in Rule 40 petitions and so probation would remain available in appropriate felony cases. Written testimony also included opposition from several county prosecutors and police, and support from the Office of Hawaiian Affairs. The chair later deferred SB 2479 SD2, citing unintended consequences and problems with the bill. For SB 2557 SD1, which would require annual reporting by the State Office on Homelessness and Housing Solutions, the office said it supported the intent but noted it already produces annual and quarterly reports, that some requested data is already available, and that staffing and cost constraints could make the new reporting burdensome. The State Council on Mental Health supported the measure and suggested narrowing the reporting language to data on individuals with serious mental illness or co-occurring behavioral health conditions, to the extent practicable and in collaboration with relevant agencies. A committee member asked about the availability of point-in-time count data, and the office explained that some figures may not be available every year and may need to be generated through HMIS. Dr. Jack Lewin testified in support, saying the data would be useful for understanding health care costs. The committee passed SB 2557 SD1 with amendments, including a deferral of the effective date. The committee also heard SB 2861 SD2 and SB 3204 SD1, both family resilience pilot program measures. For SB 2861 SD2, the Office of Wellness and Resilience and DHS supported the bill but requested amendments to clarify that the office’s role is planning and advisory, that DHS is a key partner, and that federal compliance safeguards are included. The chair raised concerns about overlap with DHS’s existing Ka Ohana program and asked for language to avoid redundancy while allowing the bill to cover other at-risk children; decision-making was deferred to the next hearing. For SB 3204 SD1, which would create a peer-navigator-based family resilience pilot, the Office of Wellness and Resilience and DHS supported the measure, with the office requesting a two-year pilot period, and both agencies and several advocacy groups submitted support. The committee discussed funding, the proposed five peer navigators, and whether the pilot should be limited to one or two geographic areas; no final action was taken in the portion provided. The committee also heard and supported SB 3324 SD1 on Medicaid home and community-based services, with the Department of Health emphasizing caregiver shortages and the cost-effectiveness of community care, and SB 3325 SD1 HD1 on public school Medicaid reimbursement, where DOE and the Attorney General requested clarifying amendments to reporting language and position titles.

Transcript Highlights:

• Hours depending on the program.
• The program for children in foster care.
• and intensive outpatient program under the bill would be beneficial.
• It also requires reimbursement for diabetes prevention programs.
• Harris County was one of the pilot programs many years ago.

Bills: HB231, HB231, HB475, HB488, HB632, HB821, HB1786, HB1955, HB2036, HB2060, HB2659, HB2677

Keywords: HB 231, Texas Water Code, TCEQ, permit exemption, dam, reservoir, erosion control, flood control, floodwater control, sediment control, watershed protection, Natural Resources Conservation Service, NRCS, Watershed Protection and Flood Prevention Act, local sponsor, water appropriation, small dam, water diversion, maintenance, rehabilitation

Transcript Highlights:

• and launched a new state-funded program.
• Yes, it is a federal waiver program. Okay, well, you would know. Thank you very much.
• Cancer Screening Program.
• Roughly half a million patients were enrolled in these programs in fiscal year 2023.
• While the state-based women's health programs serve a lot more Texans than they did when the WAC was

Bills: HB231, HB475, HB488, HB632, HB821, HB1786, HB1955, HB2036, HB2060, HB2659, HB2677, HB231

Keywords: food access, food deserts, communities of color, health disparities, socioeconomic impact, nutritious food, health effects, socioeconomic disparities, legislative recommendations, nutrition, access to food, Medicaid, multisystemic therapy, healthcare, reimbursement, mental health services, education, funding, local control, school system

Transcript Highlights:

• This unpaid council will be the resource for the agency as it implements the program.
• Is that because those 36%— 86% live in cities that don't have recycling programs.
• This is a beverage container recycling program.
• These are progressive programs, and I have learned in California that progressive programs only make
• None of these programs, if you don't have some financial incentive, are going to help.

Bills: SB410, SB795, SB2510, SB728, SB2689, HB143, HB143

Keywords: Gulf Coast Protection District, navigation safety, special districts, state governance, Texas legislation, Gulf Coast, flood protection, storm risk management, coastal restoration, natural resources, prescribed burns, self-insurance, fire management, liability protection, rural land management, beverage container recycling, deposit return system, container deposit, bottle bill, recycling refund

Transcript Highlights:

• program up, we uh came up with a program program up, we uh came up with a program called<00:07:44.840
• Road Program.
• The Transportation Alternative Program is a federally funded program.
• And it is a good program.
• It It's a great program.<00:48:32.680> It<00:48:32.880> It program. It It program.

Keywords: 00:05 Call to Order and Roll Call 01:55 Bridge Improvement Program 18:56 County Priority Projects Program 38:10 Transportation Alternative Program 51:47 Adjournment, 958, all

Summary: The committee met for the first interim meeting of the 2025 Budget Review Committee on Transportation and heard from Bobby Jo Lewis, commissioner of Rural and Municipal Aid at the Kentucky Transportation Cabinet. She reviewed the new County City Bridge Improvement Program, created in the 2024 regular session, reporting that phases one and two are complete, 45 bridges have been funded so far, and about $18.45 million has been authorized. She said roughly $6.549 million remains for phase three in the current fiscal year, with about $26.445 million in bridge applications still pending. For fiscal year 2026, the program will again have $25 million and will use four application phases. She also described a training resource, Local Bridges 101, and said a new executive advisor, Greg Meredith, has been brought in to help with the bridge program. Members asked how rollover applications would be handled, whether they would be re-evaluated with new applications, how the program would account for bridge longevity and load posting, and how isolated communities would be prioritized. Lewis said applicants not funded in FY25 would be contacted and could choose to roll their applications into FY26, and all applications would be evaluated together at the end of each phase. She said preservation projects are assessed for how much they extend a bridge’s life, and isolated community access bridges or closed bridges with no detour access receive priority. She also said the department aims for equitable distribution across regions and plans to produce a map showing where funds have been awarded. Lewis then turned to the County Priority Projects Program and the Local Assistance Road Program established in House Bill 546 and related resolutions. She said the application cycle opened June 1 and closes October 1, with 106 memoranda of agreement being prepared for awards in House Joint Resolution 46. She described updated application and reporting forms, a scoring matrix, and a County City Pavement Evaluation Manual used to rate projects based on preservation of assets, average daily traffic, recent improvements, safety, cost, and district priority. She said projects must be rehabilitation projects designed to restore the original condition of the road, cannot exceed $500,000, and must use local match percentages tied to the economic development grant program formula. She also reported on funding status for prior road projects, including completed, partially completed, pending, and underrun amounts that may be reauthorized. Committee members asked about photo documentation, online access to project materials, how to measure whether projects truly restore roads to original condition, and what happens when project costs exceed estimates. Lewis said the department is still working on how best to store and share the large volume of photos, and that projects are certified through district offices and local sign-off after completion. She said overages are the responsibility of the applicant because the state does not have additional money beyond the awarded amount. No formal votes were taken during the discussion.

Transcript Highlights:

• In my small county, as I stated before, we struggle to find local resources and programs daily.
• We have a program that's very similar to that, and it's extremely costly.
• I work at LifeWorks as a case manager for transitional living. ...and in diversion services.
• This impacts certain programs.
• They both have two separate diversion programs. ...the Transformative Youth Justice Program and Project

Bills: HB1511, HB1831, HB1988, HB2147, HB2234

Keywords: housing, affordable housing, state regulations, zoning, local government authority, drug court, juvenile justice, diversion programs, rehabilitation, criminal justice reform, remote proceedings, depositions, virtual hearings, court technology, criminal responsibility, age of maturity, expungement, mental health services, juvenile record sealing, 1184

Transcript Highlights:

• This money could better be utilized for rehabilitative measures such as programming and counseling.
• We critically need investments and support programs that make a difference in these facilities and in
• This bill simply allows a program to grow by giving the agency and its partners greater flexibility.
• And I know what a difference a program like this can make.
• I just want to dog pile on and say how much the alternative court programs have been beneficial.

Bills: HB1511, HB1831, HB1988, HB2147, HB2234

Keywords: housing, affordable housing, state regulations, zoning, local government authority, drug court, juvenile justice, diversion programs, rehabilitation, criminal justice reform, remote proceedings, depositions, virtual hearings, court technology, criminal responsibility, age of maturity, expungement, mental health services, juvenile record sealing, 1184

Transcript Highlights:

• This program was.
• For 70 years, the small business administration's flagship lending program, the 7A program, has provided
• Your story is just one example of why SBA programs like the Community Advantage Program is so important
• in the 7A program.
• Community Advantage Program? The Advantage Program gave us $250,000.

Keywords: SBA, 7A loan program, underwriting standards, loan defaults, Community Advantage Program, small business funding, testimony

Summary: The committee meeting focused on discussions regarding the SBA's 7A loan program and its implementation challenges. Members raised significant concerns about recent changes to the underwriting standards, which have been criticized for leading to an increase in loan defaults. Ranking members expressed a desire for a return to stronger guidelines to protect taxpayers and ensure the program remains a viable source for small businesses struggling to secure funding. Testimonies from community lenders highlighted their efforts to support underserved communities and stressed the importance of the Community Advantage Program.

Transcript Highlights:

• This establishes a mattress stewardship program.
• I'm the program manager for the Coalition for Tobacco Free Hawaii, which is a program of the Hawaii Public
• And we urge the committee to program.
• program as outlined in the bill. program as outlined in the bill.
• Um, so we definitely support programs.

Bills: HB1924, HB2121, HB1928, HB1979, HB1650, HB1543, HB1981, HB1982

Keywords: mattress recycling, waste management, producer responsibility, environmental health, steafardship program, electronic cigarettes, disposable devices, environmental protection, plastic pollution, lithium batteries, pollution control, public health, deposit beverage container, bottle bill, container deposit law, container redemption, recycling refund, extended producer responsibility, EPR, deposit return system

Summary: The committee heard testimony on several measures related to waste, recycling, and environmental review. On HB 1924, which would establish a mattress stewardship program, the Department of Health said it stood on written testimony and offered comments, while Hawaii Reef and Ocean Coalition and one individual supported the bill and the International Sleep Products Association opposed it. No questions were raised and the committee moved on. A large portion of the hearing focused on HB 2121, which would prohibit the sale of disposable vapes in Hawaii. The Department of Health supported the measure but suggested the bill may be better placed in a different part of state law because the cited waste-management section regulates products after consumption, while still praising the effort to remove disposable vapes from the market and environment. Testimony in strong support came from the Coalition for Tobacco Free Hawaii Youth Council, Hawaii Public Health Institute, Hawaii COPD Coalition, Hawaii Health and Harm Reduction Center, the City and County of Honolulu, and many individuals; supporters emphasized youth vaping, toxic waste, lithium battery fire risks, and environmental harm. There was at least one opposing individual and the International Sleep Products Association was listed in opposition. The committee noted there were many written testimonies and no immediate vote was taken. The committee also heard HB 1928 on the deposit beverage container recycling program. The Department of Health stood on written testimony. The Solid Waste Task Force of Hawaii Environmental Change Agents and Upstream supported the bill but urged amendments to better integrate reuse and reusables, strengthen enforcement, clarify definitions, and protect existing redemption centers. The Hawaii Food Industry Association supported the concept of a backdrop program but preferred strengthening the existing program and raised concerns about undefined fees, existing infrastructure, and future audit costs. The Chamber of Commerce Hawaii supported the bill, and the chair said the measure needs work and that decision-making would occur in a few days. Finally, the committee took up HB 979 on environmental review and HB 1650 on environmental assessments. For HB 979, OPSD offered amendments, HCDA supported the bill but suggested clarifying the affordable-housing definition, Kauai Island Utility Cooperative supported it, and Earthjustice was asked about the court process for environmental challenges; the chair asked about shortening the challenge period and the relationship between environmental court, the intermediate court of appeals, and the Supreme Court. For HB 1650, OPSD and the State Historic Preservation Division stood on written testimony, OHA asked to retain historic sites, and several groups and individuals testified in support or opposition. Opponents argued that removing Wiki special district and historic sites from Chapter 343 trigger language would weaken environmental review and risk impacts to iwi kūpuna and historic resources.

Transcript Highlights:

• uh for youth intervention program uh for youth intervention program grants,<00:10:40.520> and
• The programs are non-residential, excuse me, community-based programs that provide advocacy, education
• <00:14:27.880> appropriations programs appropriations programs appropriations that<00:14:30.400
• Minnesota, but because our CCAP program Minnesota, but because our CCAP program does<00:27:11.520
• <00:31:07.400> integrity subject of an active program integrity subject of an active program

Bills: HF2136, HF4195, HF4548, HF4432, HF4174, HF3024, HF4389, HF3773

Keywords: youth intervention, grants, community support, early intervention services, nonprofit, Minnesota human services, forecast adjustment, budget forecast, appropriations, Medical Assistance, MinnesotaCare, Health Care Access Fund, general fund, behavioral health, housing support, General Assistance, Minnesota Supplemental Aid, MFIP, DWP, child care assistance