5 Providence Medford Medical Center jobs in Foots Creek

Description

Patient Care Technician – Medical Surgical Unit at Providence Seaside Hospital. This posting represents a .9 FTE, day shift opening with rotating weekends.

Want to know more about living on Oregon's Coast click here

Providence offers a fantastic benefits package which include but is not limited to:

• Free, convenient, and ample parking
• TriMet annual pass (Hop Fastpass) for benefit eligible staff who work within the Portland Service Area (does NOT include Wilsonville, Newberg, Seaside, Hood River, Washington State, or Medford)
• Medical Plan Assistance Program- provides free or reduced-cost coverage to caregivers and their eligible dependents who qualify based on household size and income
• Tuition reimbursement/education– includes 100% tuition paid program options; up to $5,250 per year for select undergraduate and masters degrees within Guild catalog. Required books and fees are 100% covered or reimbursable for select schools in the Guild catalog up to program funding cap
• Paid Time Off – Benefit eligible caregivers receive up to 25 days per year
• Retirement - The Providence retirement program consists of employer match and discretionary contributions that work together with your pre-tax (and/orRoth aftertax) contributions to help you save for retirement.
• Lyra Caregiver Assistance program- Up to 25 counseling or coaching sessions per eligible member per year

In this position you will:

• Contribute to a high functioning team
• Assist RN with admissions, discharges, and transfers
• Measure and record vital signs, output, and weights
• Collect specimens and perform fingerstick capillary blood tests
• Assist with client mobility and transfers, using lifts and safe patient handling devices
• Opportunities for continuing education and professional development, including annual CNA conference
• Other duties as assigned

Under direct supervision this position is accountable to the bedside RN and charge nurse to facilitate a safe and secure environment for the patient, family and providers in the department in completion of the duties assigned to them for the shift and maintaining clear communication between the needs of the patient through the RN and Charge Nurse. These activities focus on maintaining a safe, hazard free, clean environment which facilitates patient focused care.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Seaside Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

• Upon hire: National Provider BLS - American Heart Association.

Preferred Qualifications:

• Coursework/Training Medical Terminology Course. Or equivalent educ/experience.
• Successful completion of hospital Medical terminology test within 90 days of hire.
• 6 months Health care experience.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."

About the Team

Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID:

Company: Providence Jobs

Job Category: Nursing-Patient Facing

Job Function: Nursing

Job Schedule: Full time

Job Shift: Day

Career Track: Nursing

Department: 5000 PSH MED SURG

Address: OR Seaside 725 S Wahanna Rd

Work Location: Providence Seaside Hospital-Seaside

Workplace Type: On-site

Pay Range: $8.00 - 26.00

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Description

Patient Care Technician – Medical Surgical Unit at Providence Seaside Hospital. This posting represents a .9 FTE, day shift opening with rotating weekends.

Want to know more about living on Oregon's Coast click here

Providence offers a fantastic benefits package which include but is not limited to:

• Free, convenient, and ample parking
• TriMet annual pass (Hop Fastpass) for benefit eligible staff who work within the Portland Service Area (does NOT include Wilsonville, Newberg, Seaside, Hood River, Washington State, or Medford)
• Medical Plan Assistance Program- provides free or reduced-cost coverage to caregivers and their eligible dependents who qualify based on household size and income
• Tuition reimbursement/education– includes 100% tuition paid program options; up to $5,250 per year for select undergraduate and masters degrees within Guild catalog. Required books and fees are 100% covered or reimbursable for select schools in the Guild catalog up to program funding cap
• Paid Time Off – Benefit eligible caregivers receive up to 25 days per year
• Retirement - The Providence retirement program consists of employer match and discretionary contributions that work together with your pre-tax (and/orRoth aftertax) contributions to help you save for retirement.
• Lyra Caregiver Assistance program- Up to 25 counseling or coaching sessions per eligible member per year

In this position you will:

• Contribute to a high functioning team
• Assist RN with admissions, discharges, and transfers
• Measure and record vital signs, output, and weights
• Collect specimens and perform fingerstick capillary blood tests
• Assist with client mobility and transfers, using lifts and safe patient handling devices
• Opportunities for continuing education and professional development, including annual CNA conference
• Other duties as assigned

Under direct supervision this position is accountable to the bedside RN and charge nurse to facilitate a safe and secure environment for the patient, family and providers in the department in completion of the duties assigned to them for the shift and maintaining clear communication between the needs of the patient through the RN and Charge Nurse. These activities focus on maintaining a safe, hazard free, clean environment which facilitates patient focused care.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Seaside Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

• Upon hire: National Provider BLS - American Heart Association.

Preferred Qualifications:

• Coursework/Training Medical Terminology Course. Or equivalent educ/experience.
• Successful completion of hospital Medical terminology test within 90 days of hire.
• 6 months Health care experience.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."

About the Team

Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID:

Company: Providence Jobs

Job Category: Nursing-Patient Facing

Job Function: Nursing

Job Schedule: Full time

Job Shift: Day

Career Track: Nursing

Department: 5000 PSH MED SURG

Address: OR Seaside 725 S Wahanna Rd

Work Location: Providence Seaside Hospital-Seaside

Workplace Type: On-site

Pay Range: $8.00 - 26.00

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Description

Patient Care Technician – Medical Surgical Unit at Providence Seaside Hospital. This posting represents a .9 FTE, day shift opening with rotating weekends.

Want to know more about living on Oregon's Coast click here

Providence offers a fantastic benefits package which include but is not limited to:

• Free, convenient, and ample parking
• TriMet annual pass (Hop Fastpass) for benefit eligible staff who work within the Portland Service Area (does NOT include Wilsonville, Newberg, Seaside, Hood River, Washington State, or Medford)
• Medical Plan Assistance Program- provides free or reduced-cost coverage to caregivers and their eligible dependents who qualify based on household size and income
• Tuition reimbursement/education– includes 100% tuition paid program options; up to $5,250 per year for select undergraduate and masters degrees within Guild catalog. Required books and fees are 100% covered or reimbursable for select schools in the Guild catalog up to program funding cap
• Paid Time Off – Benefit eligible caregivers receive up to 25 days per year
• Retirement - The Providence retirement program consists of employer match and discretionary contributions that work together with your pre-tax (and/orRoth aftertax) contributions to help you save for retirement.
• Lyra Caregiver Assistance program- Up to 25 counseling or coaching sessions per eligible member per year

In this position you will:

• Contribute to a high functioning team
• Assist RN with admissions, discharges, and transfers
• Measure and record vital signs, output, and weights
• Collect specimens and perform fingerstick capillary blood tests
• Assist with client mobility and transfers, using lifts and safe patient handling devices
• Opportunities for continuing education and professional development, including annual CNA conference
• Other duties as assigned

Under direct supervision this position is accountable to the bedside RN and charge nurse to facilitate a safe and secure environment for the patient, family and providers in the department in completion of the duties assigned to them for the shift and maintaining clear communication between the needs of the patient through the RN and Charge Nurse. These activities focus on maintaining a safe, hazard free, clean environment which facilitates patient focused care.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Seaside Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

• Upon hire: National Provider BLS - American Heart Association.

Preferred Qualifications:

• Coursework/Training Medical Terminology Course. Or equivalent educ/experience.
• Successful completion of hospital Medical terminology test within 90 days of hire.
• 6 months Health care experience.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."

About the Team

Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID:

Company: Providence Jobs

Job Category: Nursing-Patient Facing

Job Function: Nursing

Job Schedule: Full time

Job Shift: Day

Career Track: Nursing

Department: 5000 PSH MED SURG

Address: OR Seaside 725 S Wahanna Rd

Work Location: Providence Seaside Hospital-Seaside

Workplace Type: On-site

Pay Range: $8.00 - 26.00

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

PURPOSE AND SCOPE:

Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Patient Related

Education:

• Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access.

Treatment:

• Welcome assigned patients and inquire as to their wellbeing since their last treatment.

• Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law.

• Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment

• Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).   

• Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.   

• Monitor patients’ response to dialysis therapy. 

• Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.   

• Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure

• Obtain Hemostasis and apply appropriate dressings.   

• Evaluate the patient prior to discharge.

• Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification   

• Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed.   

• Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160.   

• Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification   

• Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes.   

• Report any significant information and/or change in patient condition directly to the registered nurse or supervisor.

• Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor.

• Perform and document any intervention for unusual patient status and document patients' response to intervention.

• Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor.

• Obtain all prescribed laboratory testing and prepare specimens for collection.   

• Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.   

• Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.   

• Monitors patients performing self-care under the supervision of RN.

Staff Related

• Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse.

Education/Communication:

• Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices

• Maintain environmental integrity and aesthetics - ensure all areas are safe and clean.

• Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy.

• Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT).

• Initiate Solution Delivery System (SDS) system.

RECORD KEEPING:

• Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities.  

• Enters all treatment data into the designated clinical application in an accurate and timely manner.   

• Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure

omitted entries are completed or corrected by appropriate staff.

• Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart.

• Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination.   

• Collect, label, appropriately prepare and store lab samples according required laboratory specifications.   

• Ensure collection of lab specimens by appropriate lab courier.

INFECTION CONTROL:

• Assists in collecting  information for infection control audits.   

• Supports staff and patient Adherence to infection control practices.   

• Follows infection control Policies and Procedures   

• Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law.

TRANSITIONAL CARE UNIT:

• Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care 

• Reinforces all education and care related matters as it relates to the new patient     as allowed by state law

• Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan.   

• Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them.

• Sets and preforms a treatment on all machines used in the transitional care unit.

• Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up.

• Assists with coordination of transition to patient’s modality choice.   

• Assists with supply ordering and inventory for TCU   

PHYSICAL DEMANDS AND WORKING CONDITIONS:

encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable

individuals with disabilities to perform the essential functions.

• Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the

Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable

accommodations can be made.

• Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required.   

• The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials   

• The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist” devices for the heavier items.

EDUCATION AND LICENSES:

• High School diploma or G.E.D. required.

• Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline.

• All appropriate state licensure, education, and training (if any) required.

• Demonstrated commitment to organization culture, values, and customer service standards

EXPERIENCE AND REQUIRED SKILLS :

• Previous patient care experience in a hospital setting or a related facility preferred.

• Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification.

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.