Public Health Welfare and Labor Committee - Senate and House
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- October 1, 2026
Representative Jeff Wardlaw
Unverified
0:10
a motion need a second all those in favor say aye all opposed ayes have it with that we'll start moving on through this agenda we have Misstanya Phillips from Arkansas Wellness Network So if you guys would
turn your mics on and introduce yourselves and then I'll recognize
Tanya Phillips
Unverified
0:46
you to open your presentation good morning my name is Tanya Phillips with the
Tyler Phillips
Unverified
0:51
Arkansas Wellness Network, founder and president. my name is Tyler Phillips and I'm the
Speaker 9
0:55
vice president of the Arkansas Wellness Network. my name isanniia Sanders. I am a registered nurse in a verified wellness provider with the
Kathy Lenahan
Unverified
1:02
Arkansas Wellness Network. hi my name is doctor Kathy Lenahan I'm an occupational therapist, founder of Alta integrated Wellness with the Arkansas Wellness Network.
Representative Jeff Wardlaw
Unverified
1:12
subcommittee a couple of weeks ago these guys had
a convention across town over in North LittleRock with our mayors and county judges and Missan you can fill in where I lead the gaps and I ran over and ran into these guys and sat down and talked to them and thought it was important that you guys hear what they were telling the judges and the mayors you won't get to hear the whole thing because this would be a a small presentation but you'll get an idea of what these guys are doing around the state in your communities and with that I'll turn it over to Miss Tanya
Speaker 13
1:44
thank you thank you so much it was great to meet
Tanya Phillips
Unverified
1:47
you the other day and I believe Representative coming. several others came as well and we appreciate that. so senators, representatives of the house and Senate public health and wellness welfare and labor committee thank you for having us
Speaker 17
2:00
we appreciate the invitation and the opportunity to tell you about what we are doing to try and
Tanya Phillips
Unverified
2:07
help with health and wellness in the state of Arkansas. My name istanya Phillips and I'm the founder of
the Arkansas Wellness Network an initiative of our501c3 nonprofit reinventing ourselves. before we begin talking about the actual Arkansas wellness Network what it is and what it does. I do want to take a moment to explain why creating it was so important to me december of 2008, 5 days before Christmas, I returned home from Iraqq. I was a national Guard member with the irinth Infantry Brigade who
Speaker 17
2:44
I came home. I was physically broken and I was on every kind of pain medicine that
Tanya Phillips
Unverified
2:50
you could imagine. my husband had wiped out the bank account and asked for a divorce a month before I returned. My twins were a year and a half years old and when I left and they were3 when I was returning home. they didn't really know who I was. The day I got home again5 days before Christmas, I learned that my teaching job had been cut while I was deployed. I was national guard so that was my full time job.
my life as I knew it was completely destroyed. I was broken mentally physically and financially. I didn't know how to put 1 ft in front of the other and I definitely didn't know where the resources were to help me. within the next few months we lost 15 veterans to suicide here in arkansas and I completely understood their pain and honestly had contemplated that myself. Ironically I was offered a job as the state's first suicide prevention programme manager.
that job saved my life and it forced me to figure out how to heal myself so that I could help others I quickly encountered the same exact problem even though I was working with the statewide agencies and entities and a professional role. It was extraordinarily difficult to determine what resources existed and where people could turn for help and the help was often very fragmented. if I didn't know that something existed I didn't know where to find the information
about it and I was unable to refer people that were in crisis or professionals to the right resources Too often people in crisis receive a medication or a short term hospital stay and then they're sent back to the very same factors that contributed to that crisis with no other support. I've learned that Arkansas has a lot of caring people, organizations and programs but if people don't know where those resources are and that they exist, they don't know to ask
for them and if we do not know what exists we cannot accurately identify where the gaps are in our state either. because of that I returned to school got two more degrees and created the Arkansas Wellness Network to help people to help connect people, creating the policy the organization's delivering the care, the providers supporting wellness and the kansas the Arkansans needing those resources or experiencing those barriers firsthand. our long term vision is to help
move Arkansas from fortyninth towards 1st. our immediate vision and mission is to make it easier for every arkansan to find credible resources participate in preventative whole health and wellness opportunities and have their communities's needs heard by the people in a position to help. I'd like to introduce you to Kathy, one of our members today my name is You hit that mic for
Representative Jeff Wardlaw
Unverified
5:48
us one more time please thank you very much
Kathy Lenahan
Unverified
5:56
so hi thank you for having us my name is doctor Kathy Lenahan. I'm an occupational therapist. I'm the founder of Alta integrated Wellness and I have connected with Arkansas Wellness Network and what I do is I own a private practice which offers communitybased services so we go directly into the environments the homes the grocery stores, the workplaces and we ensure that people are able to utilize tools that they have in order to be successful in those environment and we do that through offering occupational therapy services This is done under the
wholehealth model of care and I'm also a certified veteranowned service disabled veteran owned and womanowned small business and I'm going to speak today about how Arkansas Wellness Network is breaking down silos and creating connections in a fragmented system. so I have personally experienced this through the Arkansas Wellness Network. I was providing services to an adolescent who needed resources for an injury and through the Arkansas Wellness Network I got connected immediately with an expert in our community who
not only provided me with resources in hand that I personally delivered to that family, but they provided us with future resources they could use as that adolescent transitioned into adulthood so they are s helping me set this adolescent up for future success. I've also previously worked in a hospital system and I helped a patient who suffered a stroke. It affected their left side of their body, the function of their left side of their body was significantly impaired and they were receiving rehabilitation services this
person wanted to work very much was very motivated to go back to work and nobody in that system knew what resources were available in our communities to help support them in the workplace as they would need modifications and ad ap t ations to be successful at work and that was within a big hospital system I've been practicing as an occupational therapist for almost 15 years in Arkansas and this year I learned about resources that were available that could have helped that patient. and as a practitioner that hits you pretty hard that something has been available that you
didn't know about that could have impacted the life and wellbeing of one of your patients So I am so thrilled to be part of Arkansas Wellness Network where I can get directly connected with other providers and other experts and other resources so Arkansas Wellness Network is changing the fragmentation and silo experience we're having in Arkansas by creating a searchable database that database has certified and vetted healthcare and wellness
providers also small businesses local experts community resources government services hotlines websites and other services you can search by using a map, a category, a name, a name could be a discipline so you could look for an individual practitioner's name but you could also look for occupational therapy, nursing, chiropractor. you can look by category or discipline you can also research by agency name
you can search by keywords such as TBI, maternal healthalth, domestic violence this makes statewide resources easy to find and searches efficient this is a very powerful tool because it serves not only the community but also the patience the providers, experts, agencies and systems. anyone can access and use the Arkansas Wellness Network searchable database.
Speaker 9
9:38
Good afternoon and thank you for the opportunity to be here my name isannisa Sanders I am a registered nurse with the background in critical care and currently serve as a neonatal intensive care unit nurse um'm also a national board certified nurse coach and the founder of the rerus a nurse led health and wellness business here in Arkansas Through the rerise I help individuals workplaces and communities approach well being from a whole person per
s pect ive not simply responding when someone becomes sick but helping people better support their health and wellbe before they reached that point. I want to speak specifically about why the Arkansas Wellness Network matters from the perspective of a small wellness business owner one of the greatest challenges of starting a small business is not necessarily having something valuable to offer sometimes the challenge is access how do you get connected to the right people how do you build credibility? how do you
find opportunities to serve and how do the people who could benefit from what you offer even know that you exist for an independent wellness professional or small business building that network alone can take years that is where the Arkansas wellness Network has been incredibly valuable to me through the Arkansas Wellness Network I have connected with professionals across health and wellness disciplines learned about resources outside of my own expertise collaborated with others and become part of a much
larger wellness ecosystem across our state but it has gone beyond networking Arkansas Wellness Network has created opportunities for me to actually use my expertise to serve others through Arkansas Wellness Network involvement in the healthy moms healthy babies initiative I was selected as a subject matter expert and given the opportunity to speak and educate from my perspective as both a registered nurse and a national board certified nurse coach I served on a panel
alongside several s physicians including Arkansas surgeon general doctoratey Chandler creating connections and professional relationships that as a new small business owner I may not have otherwise had access to. Arkansas Wellness Network has also connected me with opportunities such as the central Arkansasomen's expo and the Arkansas wellness summit along with educational initiatives retreats book clubs pod podcast opportunities and opportunities to contribute
professional knowledge through peer reviewed articles in the free digital Arkansas wellness magazine for a larger organization those opportunities may simply be another avenue for visibility for a small business they can be transformational they allow us to establish credibility, build relationships collaborate instead of operating in isolation and connect our expertise with Arkansans who may actually need it when you support the Arkansas
Wellness Network you are not simply supporting an organization you are helping build infrastructure that allows Arkansas wellness professionals small businesses health care providers community organizations and resources to find one another and work together. as a critical care nurse I have spent years caring for people during some of the most difficult and vulnerable moments of their lives as a nurse coach and business owner I now also
have the opportunity to work further upstream to help people develop the knowledge the resources the behaviors and supports that contribute to better health and wellbe in everyday life. but professionals like me cannot create statewide impact working independently in our own corners of Arkansas we need connection we need collaboration we need opportunities to share credible information and we need a way for ourkansans to find the right
people and resources that are already here that is what the Arkansas Wellness Network is building I have personally experienced what can happen when a small wellness business is given access to that kind of network and the reriise is still a young business so when I think about the potential impact of Arkansas Wellness Network with additional resources and support I think about the other small w wellness businesses and professionals across Arkansas that could gain those same connections and
Speaker 8
14:24
opportunities and ultimately how many more are
Tanya Phillips
Unverified
14:29
kansans we could collectively reach and serve thank you so much thank you both for joining us. as I learned and as I'm sure you guys know much better than I do. Arkansas has significant room for improvement in the health and wellness of our citizens. According to the 2025 America's Health ranking annual report that's referenced in exhibit C that we provided
today. Arkansas ranks fortyninth in overall health. I will not take your time by reading every statistic and metri c but we have provided some of that information from that report and other recent sources to help illustrate the challenges facing our state. as you heard from our two members the Arkansas Wellness Network was created to connect every part of our health and wellness ecosystem. we want to help the individuals the families, the communities,
the businesses the providers the nonprofit organizations the state agencies and the policymakers bringing us all together letting us all know where each other is and what we need. we're not trying to duplicate anyone's good work that's already being done. We want to help find it, connect the dots and strengthen it. Our podcast that we have recently created gives health and wellness providers an opportunity to explain who they are what they specialize in, why
they chose this work and how they can help. it allows the public to see them not simply as providers but as people who care deeply about the communities that they serve. Our Arkansas wellness magazine we brought with us our Arkansas wellness magazine features educational articles written by our own providers and peer reviewed by other providers here in the state of Arkansas.
c ro s s all eight dimensions are where the articles come from. so we have articles on physical wellness, nutritional wellness, emotional relational, spiritual, environmental, financial and contributional. We want ourkansans to understand that wellness is not limited to exercise and nutrition and a doctor's visit. it includes the relationships your finances, mental health, your environment your sense of purpose and connection to others.
all of these areas influence our health and overall wellbeing. one of our most meaningful programs is our virtual ebook clubb for survivors of traumatic brain injury. with our nonprofit we have provided that in collaboration with UaMS brain injurygrame for the last two years This month suicide prevention month we are also launching an ebook club for veterans and first responders in collaboration with mems we are the 2wo tactical wellness and the kitchen table Foundation.
These organizations are all led by veterans and first responders and so participants will be among people who understand their lived experiences and the situations that they are dealing with. we're also seeking to collaborate with partners to develop an ebook club for expectant and new moms. This program will complement Arkansas's healthy moms healthaly baby efforts by offering education connected connection and trusted resources to families as we work
collectively to improve maternal and infant health. so a book club might not seem like a big deal to you and might seem pretty petty or it's like a small program but to someone living in a very rural community without the specialized resources or a strong support system, it can be both an educational resource but also a lifeline. one of our members, Kim gave us permission to share a bit about her story today. Kim was a very successful businesswoman whose
car exploded after being struck by an 18 wheeler. she sustained a very severe brain injury that was not diagnosed correctly for over a year and a half because of that injury and not being diagnosed properly, Kim lost her career, her home, the support of her entire family and most painfully she lost all hope. she lived in a rural area where neither her or her treatment team fully understood traumatic brain injury. she had to learn
to walk, to talk, to do everything all over from scratch. One day her speech therapist began searching for additional resources and found out about our book club. Through that one simple connection Kim gained access to brain injury specialist with UAMS she gained information about resources that were specific to her injury and more importantly she gained a community of people who understood what she was experiencing.
Kim was inspired by the books that we were reading and she went on to write her own book, her own memoir. her experience of what happened she dedicated that book to our book club. and her book has since been accepted by a major publisher and she is now preparing for a national book tour and a TE talk in New York. the most powerful part about her story is what happened next. when the book publisher told Kim that she had to have professional photographs. she
insisted that she would not work with any of their photographers because they wouldn't understand her. she insisted that one of the photographers that was part of the book club be her photographer because he understood her and her disability and what her limitations were. then the executives of the TE Talk gave her music options to introduce her on stage. She tried to explain to them that that music would trigger her brain injury symptoms and that she could not work with that but she told them that she would
go out to a song created by one of the people in the book club a musician, a former musician that she has gained trust in and they worked together to create a song that she could go out to that would work for her. the people in that book club did more than read together they became a community. Kim found hope, meaningful work and a renewed sense of purpose, and she began creating opportunities for other brain injury survivors as well.
Tyler Phillips
Unverified
21:10
that is what connection can accomplish. In addition to those programs that you just heard about we are also praying to launch two statewide initiatives beginning in January of 2027. the first one is a student focused challenge that is called the Arkansas Healthyuture challenge this studentcented initiative will introduced middle school and high school students to the resources that are available in communities and
also the careers so we're wanting to help educate these students on principles like what is your health savings account what resources are available in your community because that is how we create a healthier future is helping them understand how they can best utilize as what resources do exist in this state and the providers that are out there the other part of it is to help expose them to potential careers in health and wellness
because that is another way that we help create a future a healthier future Arkansas is by helping expand the variety of services that are available and making sure that we have passionate and qualified people to provide those services the other challenge is a city versus city challenge and it's almost like a scavenger hunt and we are trying to get people in our community to go out and find those resources and service
providers that exist in their community so that they can begin to take advantage of them and become healthier Arkansans and also to help spur economic development so that the resources that these people have in their you know through their various types of insurance aren't just sitting in those accounts and it's actually being deployed in the community to make people healthier so those are two of the programs and while they are different they share one purpose which is creating connection
and improving wellness in our state and a healthier future we also will be looking to connect survivors with peers who understand them we connect families with trusted resources we connect we connect providers with the public and we connect students with future careers we recognize that no single organization, agency, provider, community or piece of legislation can move Arkansas from the fortyninth healthiest
state to the first the the healthiest state on its own it will take all of us working within our respective roles and finding thoughtful ways to connect our efforts. we are grateful for the opportunity to introduce the Arkansas Wellness Network, share the work that is already underway and make you more aware of the programs that we're developing for our communities in this great state thank you for your service to Arkansas for the work that you do to improve public health and
for allowing us to be part of
answer any questions y'all have. will have an app that very good sorry
Tanya Phillips
Unverified
24:34
I do also want to point out that our city versus city challenge we'll have an app
where the participants will be able to track steps they'll be
able to track meals they'll have access to ondeman fitness classes and programming they'll have access to meal plans, shopping lists, all the things that they need to be successful and they'll also be able to log habits that they're doing which will give us great metrics around the state to help develop programs as well and as well as learn about
Speaker 17
25:12
where they're going to to participate in the different activities that they're going to
be doing in their cities. Thank you. appreciate y'all coming and your presentation.uick question, couple of them. One is how
do you vet people as far as providers what is that process look like? thank you
Speaker 13
25:38
we have a thirdparty company that we are working with and that is the only fee to join
Speaker 17
25:43
the network is they do pay for their own background check and there is a
thirdparty company that does a background check and verifies their license and certification and we have a list of certification that we believe is appropriate. We have a committee that checks out different certifications the wellness industry is not as regulated and so we have a committee that looks and it's full of professionals doctors, nurses, providers they look at the different professions they look
Tanya Phillips
Unverified
26:22
at the certifications they check the education that kind of thing and decide what
certifications are appropriate and which ones are not. ok so like how would a you're looking
for licensing correct information to make sure that they're a licensed occupational therapists for example there's something else beyond that licensing that you're looking for or beyond like an an MD or an occupational therapist or physical therapist or nurse is there anything above and
Speaker 13
26:52
beyond like a different level of certification yes ma'am so we have
Tanya Phillips
Unverified
26:58
your traditional healthcare providers that are licensed but a lot of the wellness industry is not for example your naturopaths, your
Speaker 17
27:06
health and wellness coaches, your they are licensed in other states but they are not yet licensed in Arkansas but they are practicing. You also have personal trainers, nutritionists there are a lot of different professions that are out there
Tanya Phillips
Unverified
27:24
existing and working, not all of them are trained not all of them are certified and they are out there giving advice and training people in areas that they don't have
Speaker 17
27:34
the proper credentialing and so what I'll I'll give a perfect example or I'll give two examples um, I know of a naturopath who has no training, no experience, calls herself a naturopath and is providing services to individual people. I knew of a personal trainer who was doing one on one
services in people's homes and he was a registered sex offender in another state. I also have seen a lot of people who are and no offense to anyone who may drink it or purchase it or sell it but there are a lot of
Tanya Phillips
Unverified
28:10
supplement products that are being sold in little drinks. and those people are calling themselves certified healthalth and wellness coaches they are not they do
Speaker 17
28:18
not have the proper training they don't have the proper certification so
we have taken that step to create a committee that has determined in our professional opinion what is a credible health and wellness coach. there is an actual national board certification for that and it is recognized in other states and licensed in other states but it's not yet being done in Arkansas so this was our way of trying to have a safeguard and if you are part of that network it gives you a little bit more credibility because you have been checked out and verified.
OK. I got you. OK that thank you. I appreciate that explanation and then I'm interested more also in the kids connecting
kids to activities that you discussed. could you give me a little bit more about that. I'm hoping you know, I just feel like kids are way too much on screen time and not getting out and playing little league football and soccer and baseball and all those, you know, things and I see from your background, thank you for playing for the razorbackx my
brother was also a former razorback player and so I just kind of wanted to hear a little bit more about that because so many oftentimes you know my brother has participated. he lives in North LittleRock but you have you have a lot of single moms you know that don't have dads in the family and so you know they struggle with making sure that their kids are getting connected with those little league football programs and
things like that so I'm just I just
want to hear a little bit more if you don ' t mind
Tyler Phillips
Unverified
30:03
about that kind of outreach particularly for our younger kids. yes ma'am and you're you're you're striking a chord that I vibe with because I I just started volunteer coaching for North ofRockoo and so yes I'm all about getting these kids involved in our our sports I stat that's not in our packet Arkansas is also near the bottom in a student sport
participation nationwide and you know what you're talking about and what we're doing in this challenge one of the things is we're sending people around to providers or people who are doing things in the community and educating families about what is there you talked about North LittleRock I grew up playing Lakewood property Owners association you know baseball and so many of my friends for life I developed in that and we would go on to play high school sports together so it does you know it starts on that level and we part
of the challenge will be trying to expose them to the people who are providing those opportunities for kids to get involved but also my mom was a teacher and she loves to teach teach teach and teach them all about you know what's healthy about going outside and what is healthy about being part of a team and getting that community of participating on your high school team or in the band right it doesn't necessarily have to be purely physical but there
is that community wellness that contributional wellness of volunteering and how that can not only help you but help us create health healthier communities so it will be educating them on holistic wellness in ways that they can tap into the things
that are going on in our communities so I think this this that partners very well with through our learns legislation where we require some volunteerism now for graduation I young graduate from Mount Saint Mary Academy
and we had to have 100 hours I think of volunteer time before you graduated So I'm a big believer in that. and then the second thing I would just encourage you to do is also work with our county extension offices they have a lot of programming already available through the department of a through the University of Arkansas cooperative extension Services and there's a cooperative extension office in every single county. and my husband is a a family practice physician often connects his patients with that county
extension office to take those nutrition classes or to sign up for those extra sauce classes or what have you but what I'm hearing is you're kind of a connector of existing resources and that's definitely one of the existing resources we have that's located in every county. So I would just encourage you to really look at that and try to incorporate that also into what you're doing thank you for being here ma'am Representative Bentley
you recognize thank you chairman thank you all for being here today and I hate
Representative Mary Bentley
Unverified
33:04
to miss your event unfortunately some physical therapy and a knee surgery didn't allow me to to be there but thank you for being here today to hear what the great things you're doing and thank you as well for what you're doing to help our constituents to understand who is actually certified as a naturopath and those that are wellness because to me it's very concerning that folks can do an online course or six week thing and call themselves a physician when they are not it's very very concerning to me so thank you for that to help them to understand who really is certified and who is
not and that's great great customer service. My one question was how were you guys funded how are you doing this financially?
Speaker 13
33:37
well at this time it all comes out of my
Speaker 17
33:40
pocket we are looking to work with others to sponsor some of our activities we are also looking at future grants to help us with what we're doing but right now this is has been my passion project for the last 18 years. oh uhuAMs we do have a small grant through UAMS to help with the book club. We are working
with the VA hospital on looking at partnering with some opportunities there as well so we're slowly developing those resources but right now we're self funded and everything is volunteer. every single person, every bit of what we do from the magazine to the podcast to everything the network providers pay for their background check and so right now we are just selffunded thank you thank
Representative Mary Bentley
Unverified
34:35
you for what you're doing one more quick
thing you might want to check on a group called every child a swimmer as a mom from Florida whose young child died at 18 months old was drowned and she's very passionate about helping to do sponsorships of of swimming lessons to Arkansas does a kids that are 1 to 4 this is the number one reason for dying is drowning excuse me 1 to8. So every child a swimmer, I will connect you guys with her. I think she would love to help you guys get some swimming lessons and those things added to your wellness so
Speaker 13
35:03
thank you for being here today thank you and ironically I met with them at the Arkansas Women's
Speaker 17
35:09
expo. they were there and they asked about joining the network and I said 100% that is a part of wellness. it's a huge part of wellness not only is it an activity, a physical activity they could be doing but it could save their life so yeah 100% we would love to work with them and promote what they're doing. and that's the biggest part of what we're doing is promoting the people that are doing the work that are out there. there are lots of great programs in Arkansas. people just don't know where to find them.
Representative Jeff Wardlaw
Unverified
35:40
thank you so much with that we have no further questions we thank you guys for your presentation so with that committee we'll move on to item D Miss Mary Franklin
if you would I think you know the protocol but tell
Representative Aaron Pilkington
Unverified
36:17
us your name and you're recognized to present. good afternoon I'm Mary Franklin director of the division of county
operations for DHS. Today I have a presentation for you about the snap quality control process and payment error rate improvement strategy.
right what is snapuality controll this is an audit process that follows the food and
Representative Aaron Pilkington
Unverified
37:01
nutritiondministration's Handbook310 it's a process where that involves sampling of and reviewing two types
of cases active snap cases and inactive snap denials lo enclosures the snap payment error rate is based on the outcome of the reviews of the active cases that
are sampled and reviewed during the federal fiscal year October 1 Sure, I'm sorry is that better OK so the snap payment error rate is based on the outcome of the reviews of the active cases during the federal fiscal year which is October 1 through September30th. the inactive case reviews are they're reviewed to determine if the adverse action that resulted in the denial or closure or termination of the case was
Representative Aaron Pilkington
Unverified
37:51
correct as of the review date. the payment error rate is calculated by comparing the total benefits issued in
that sample universe to the dollar amount that was determined to be issued incorrectly. bothth underpayments and overpayments count in toward the payment error rate and both agency cause and client caused the errors count toward the payment error rate and for federal fiscal year 2026
errors that are under58 dollars errors that are58 dollars or more countunt in the state's payment error rate but errors that are under that amount do not count in the state's payment error rate unless that case was totally ineligible in which case it doesn't matter the dollar amount it still counts toward the payment error rate. so here's an example just to help make it more clear about the payment error rate calculation
so assume that a case issued benefits inoctober is selected for review. the total benefits issued in that case were $900. The QC review determined that income the household received was undercounted and that the benefits that were issued were75 dollars too much. the correct amount of benefits should have been 825 instead of 900 which resulted for that case in a payment error rate of 8.34% so again75 dollars incorrect
benefits issued out of a total $900 in benefits for that case resulted in that payment error rate. Another example would look at a whole month assume 95 cases were selected for review for the month of October the total benefits issued in those 95 cases was34,485 dollars assume that 2070 of those dollars were determined to be issued in error that resulted in a payment error
rate for that month of6.01% so 2070 out of334,48 $5 resulted in a6.01 payment error rate. how do we select cases for QC review? The food and utrition Administration requires us to sample 1020 active cases per federal fiscal year. We opt to over sample a little bit to make sure that we review the minimum number of cases
caseses are selected for review after the end of each month of the federal year and it's based on a sampling plan that we submit in that food and nutritiondministration approves states have 115 days for to complete a review once a case is selected in that sample to be reviewed. So this also means there's a lag time between the time the case has worked the time the case is selected for review and when the outcome of that review is known
so for example afteroctober ends a sample of active snap cases is randomly identified in November. The QC staff have 115 days to complete those reviews of those sampled cases so the reviews for October are due in February depending on the day the case was assigned to the QC staff. consequences of this snap payment error rate, there is a new benefit cost share that was implemented with the Hr
one beginning federal fiscal year 2028, which startsoctober 1st of 27 states are required to share in the cost ofsnap benefits based on the state's payment error rate right now they're one the benefits themselves are 100% federally funded for federal fiscal year 28, the cost share will be based on either the federal year 25 or the federal year 26 payment error rate
the state can select the year based on which year is most advantation but advantageous based on the error rate for those years after federal fiscal year 28 that cost share will be determined based on the payment error rate three years prior and we'll continue on the chart there shows you just the breakout of the error rate in the different percentage of costhare. so if the payment error rate is under6 there is no costshare if the payment error
rate is between6 and7.99%. there's a5% cost share and just based on our benefits issued over the last 12 months that cost share for5% would be 2 about $24 million if the payment error rate is between 8 and 9.99 that costsha increases to 10% which would be an estimated amount of48 million and if the error rate is 10% up to 14.99 that error rate is 15%
or could be around72 million based on our history of benefits issued. there is another consequence to the snap payment error rate that is not new that has been part of federal law as long as I I've known about Snap so but just to help inform about that there is a penalty process in addition to cost share and the Hr one law did not change this penalty process it is still in effect and what the penalty process is
is that in addition to the cost share that begins in 28, states are also subject to penalties based on the payment error rate if a state exceeds 105% of the national performance measure for two years in a row, two or more years in a row consecutive. the liability amount is based on a calculation and it is eu it's based it is based on benefits issued by the agency during the year multiplied by the difference between the state's payment
error rate and the6% threshold and then that's multiplied by 10%. so we did an example of that if you assume the national performance rate is 10.62%. that was the national error rate average for the second year in a row the state exceeds 105% of that at say an error rate of 12% and that state issued472 million in benefits for the year so that calculation would result in about a651,000 dollars
penalty if a state is assessed a penalty up to50% of that in discussion and negotiation with food and nutritiondministration can be deferred or50% of that instead of being paid to food and nutritiondministration can be reinvested by the state into activities that would specifically help improve payment accuracy in the remaining atris amount would become payable as a penalty if the state
did not meet the error rate or was again at that penalty threshold the next fiscal year So this walks through when the QC results are available. so we're about5 months into the federal review year before we start to see the outcome of the reviews from the first month the lag time does make it difficult to make adjustments to impact that federal fiscal year because we're5 months in at that point
the results of the state QC reviews are reported to the food and nutrition Administration and they in turn review a sub sample of these cases to the review behind us to determine the results if there's any differences between the results we reported and what F andA determines those are arbitrated on a case by case basis and then F andA determines the final ranklin
Representative Jeff Wardlaw
Unverified
46:13
may interrupt you for a second. my co-chair
has a question no and I appreciate this and this is what I wanted and this is what I requested. but what I what I wanna do instead of reading the sos to us which I appreciate this is exactly what I need. I need to know specifically the reason why I asked for this to be on the agenda is we have to get our error rate down below6% because of our budget. OK? We are a balanced budget state. We cannot be hit arbitrarily with a
fi8 or48 million dollar you know penalty out of the blue.
What I need to know is specifically what is it that we need to request from the federal government to provide to us or to provide for all states so that we can become more compliant. The lag time is what I'm hearing is to be incredibly problematic and so I I need specifically what do we because I wanna take legislative
action on this issue and I want them to hear from us as a legislature. I get what they're trying to do. I'm for what they're trying to do but what I'm not for is a is playing gotcha with the state of Arkansas and what what what do they need to give to us so that we can become compliant and know what how we're doing and what is happening because to me the way that this is being implemented or whatever is not well thought out
so that states don't have the opportunity to really meet what they need to meet. below to get below that that6%. So so be because we are in charge of the state budget. that's the legislative our responsibility and so this is a big deal in my opinion and I feel like we as the public health committee in the house and the senate along with our legislature, we need to say to the federal government, hey, we want to work with you but we
got to have you working with us as well and collaboration so can you boil this down to what it is exactly that we need from them in order to ensure compliance as quickly as possible so we're not just blindsided with a50 million dollars hit to the state budget.
So I can give I I have some ideas I can give you some thoughts on what it would be helpful if the federal government would do and I can also tell you the things that we are working on in you know ourselves
to help improve that rate and and just you know to have it on the record to let you know this is very important to us too it's important to DHS it's important to county operations and every person on my team wants to get that error rate below6% and are working to get there as best we can but there are some things more time would be helpful before this cost share goes into effect if we could have a little bit more time to
Representative Aaron Pilkington
Unverified
49:26
adjust our processes to adjust our training just to make progress, it would
Speaker 87
49:34
be helpful more time may meaning delay it don't make it don't put it into effect in 28. OK. ive us more
time wait until you know a later federal fiscal year you know even one more year would be helpful for us what about real time data
from from them are we being compared to other states that have a different threshold
of benefit amount so every state has you either review 1020 or like 2500 cases so we're the same in that respect that every state has and I think maybe all but one state reviews the minimum. there's not much advantage to reviewing more because the outcome is the outcome based on that sample so
but Arkansas we have about 116117 1000 snap households that are active right now Texas probably has 1.5 million a lot bigger but they can review the same number of cases either 1020 or 2500 so it's not proportional it's not proportional
sample size is not proportional to
Speaker 87
50:51
recipients I mean it it's statistically I guess I think statistically
valid because the same criteria applies to all the states whether you select 1020 or 2500 but you're not reviewing the same percentage of every caseload across the state's right the there is no way at this point to get realtime data because the work has to be done the universe has to be established before those cases are sampled they're sampled randomly to you know and the process needs to have integrity in it definitelyfinitely we don't interfere with it the cases are the cases and we
review them and report the outcomes, both agency and client caused errors count both so we it counts just as much against us if we incorrectly count the income and issue incorrect benefits because we didn't put the right income in the case as if someone fails to tell us about a source of income and we don't have a data source that could tell us that even if they you know to find it out to verify it right
underpayments and overpayments count in the error rate and if we've underpaid a family that's bad. we we want to pay the right amounts to what everyone is entitled to but we've underpaid the federal benefit in that case not overpaid it but they both count. so there are different things that could help from the federal level with this whole QC process I mean the the process itself has been in federal regs for many many years
and the cost share was added but there was no really other overhaul or just look at the entire process when that new cost share was put into effect and
then last question and there may be some others just because I I think this is good information for us to really have and I appreciate all the effort you did it to the slide and I want you to continue with your slides but I just we what is our asset limitation just remind me one more time in order to qualify
Speaker 68
53:00
the asset limit for snap we well we use the
the federally established asset rates which is different for regular households and aged and disabled households but the state did pass legislation in the last session to implement broadbased categorical eligibility which essentially raises the asset limit up to5,000 and then we incrementally change it as the federal rate, you know increases just to keep it
to keep it you know to where there is room but individuals can go over the asset limit up to5,000 for 12
months that's what we have in place now ok and other states that have nothing in
place are we counted against them or how do they if they have no asset limitation, how are they determining their error rate? Is it just
based on federal then you when you implement broadbased categorical eligibility you have the option to define how you do that and broadbased categorical
eligibility means that we are using a non cash tanniff service not a cash benefit but a noncat eligibility for that non cash ta of service to confer that eligibility onto the SNA recipient and some states that do broadbas categorical eligibility use it to remove the asset limit, which means the the staff are not spending time verifying assets and that also means though in the QC process if a case is sampled
you're not gonna get an asset error because there is if the case was eligible for broadbased categorical eligibility there won't be an asset error and I can tell you that if there is an asset error there is no a little bit over or it's just a totally ineligible case if the if a case is over the asset threshold it's a totally ineligible case unlike say a household composition error or an income error which may be the entire case didn't close just the benefit amounts
were wrong so so because of the way that we have it structured it's harder on I mean we are kind of subjecting ourselves to more error rates. Is that a fair statement to say I mean just because I feel like it's not a one size fits all across the country and I need to be able to how to articulate that to the federal government because I feel like we've tried to be specific about this benefit so that it's not taken advantage of so that it can be there for the people that need it the most, but other states
are not and so I I want to make sure I can articulate to the federal government hey and and maybe this this legislature doesn't want to do that. I do just because it's on us. I mean, you know it's going to cause an issue with the budget that we're supposed to be in charge of here. So I guess my as other people are asking questions, I want you to think about how we can articulate that to where they can make sure that we are being held to the same standard as California, Texas, Vermont, Maine, whatever because I feel
like right now with the way this is structured we're not being held to the same standard of of policy so because of the way that we've implemented our benefit versus the way other states have so as you're you don't have to give me an answer right now but that for me is why I wanted this on the agenda so that we could fully understand this and also push back if we needed to at the federal level to say hey you need to consider this. we we
are with you we want to work with
you, we want to collaborate with you but we can't you know, I'm I'm kind of tired of Arkansas always, you know we have the lowest medicare reimbursement in the entire country. I'm really kind of tired of that. I'm ready, you know I'm here to represent Arkansas. so if you can, I'll I'll go to other questions or if you want to but that's why I really wanted to kind of drill down on this. thank you ma'am how many more slides
few more but I do have a good stopping point in just a
minute we're and the rest of it is just
Representative Jeff Wardlaw
Unverified
57:15
really more information that you all can look at the queues pretty full I'm gonna let you
get to your stopping point and then I'm gonna come back to questions Oh going the wrong way this line just gives you acclimates you to where we've been our federal fiscal year 24 final payment error rate was
9.56 that was made up of $19,546 of agency cause errors and $9,653 of client caused errors in 25 our final error rate was 8.81% which was made of 10,714 dollars in agency caused errors in 13,0107 in client caused errors in the last bullet there is for this federal fiscal year that we are in as of August
21st the rate we are reporting to food and nutritiondministration as of that date was7.27 withoctober through January reviews 100% complete the February and March reviews were 90% complete in april was about75% complete as of that date in the current results that we have reported uh6,010 dollars in agency caused errors in4,284
client dollars in error and so about55 or so percent of
Representative Aaron Pilkington
Unverified
58:50
the way through the review year. these are things that we are
doing to improve we monitor these QC results even though they lag they're still important we monitor them we look at root causes of those we look to see are there system changes we can make? Are there policy considerations we need to look at are there different reviews we need to do we we are looking at that we do
secondparty reviews on cases. These are reviews that we do that are outside of that QC sampling process we do case investigations we have a special investigations team that takes referrals from our caseworkers, from the public they review from transactional information they review from reports that we create they investigate case which is beyond a case review you know in an investigation they are going to try and talk to the client and possibly even visit the client in an
investigation we do refresher training regularly some topic that's related to the QC and payment error rate we do something called prevention in a snap which basically gives caseworkers pointers on hey we had some errors that were caused by this it's plain language, it's drilled down to hey if we just did this this could help prevent errors of that type and then we also have done some technology enhancements to help us with that and we do have a monthly
team meeting where we look at and review all of this data and talk about ways we can collaborate together as a team or ways we can support each other or any new strategies that we can implement
Speaker 76
1:00:28
and that is a good stopping point the rest of these slides just go into more detail about these things
Representative Jeff Wardlaw
Unverified
1:00:35
we're doing to make improvements p re s ent ative
Representative Aaron Pilkington
Unverified
1:00:41
Pilton your you're recognized for a question Thank you Mr Chairman. thank you Director Franklin for being here. I've got more of
a a budget question you know as you know October firstt the administrative funding is dropping from50 to25% which shifts are a portioned from50 to75%. we're gonna have to pay for it. Do we have funding pool or pot of money to to be allocated for this and if not I mean how is that how are we're going to make up that difference that's coming down the line.
So we that factored into the budget that we submitted for this federal I mean for this state
fiscal year we knew that this was coming and I can tell you we have balanced our budget. it's tight we are also looking at efficiency some of the technology enhancements that we've implemented will help with accuracy but part of that help is helping with efficiency like we we have invested in AI to some bots to help us automate some things so that our caseworkers can spend time on other things just to help reduce the workload and we can spend time on other things so we are
going to continue to monitor our budget very closely. we're going to be frugal and we're gonna look at ways we can invest in things that will help us be more efficient
Representative Aaron Pilkington
Unverified
1:02:01
and help us be more accurate that I'm glad to hear that I guess but that money that increase that we are using to fill the gap where did that come from? just is that you're overgen you know general fund that you guys had or was there something we cut somewhere else down the line where where did that 25% that we're going to make up for where
did that come from? well you know some of that has been in not feeling as many positions as we had in the past some of it was made up by cutting back some of our expenses and some of it is is as you mentioned funds that DHS was able to make available to us
Representative Aaron Pilkington
Unverified
1:02:41
OK great thank you appreciate the thoroughness. Representative Bentley thank you chairman thank
Representative Mary Bentley
Unverified
1:02:50
you Mary for being here today. I just want to quickly I know some
other states have done like we've talked about landlord certification to make sure that when you guys are doing the household composition we're getting it accurate is it something we have looked at possibly doing or
Speaker 111
1:03:05
not so we we typically verify everything we we ask for verification. I understand that but are you getting
Representative Mary Bentley
Unverified
1:03:10
the verification back from the landlord to their saying yes what they're saying is correct and what you're seeing is correct. I'm just trying to help you guys out when you're doing your report and all the states have found that very helpful to cut down on their error rates so
sometimes that verification is a rent receipt sometimes it might be a lease there are different things that we can take for verification to verify household expenses like rent and utilities we look for mail coming to the person in their name uhze stubs you know I get all that but I'm just saying other states are using that that the
Representative Mary Bentley
Unverified
1:03:43
landlord has to get back with you information to verify yes these people live at this address and this is the number of people that are living there just to help you decrease your er r or rate and that's what they're using so anyway again I
would suggest that another thing is how long are we had a marriage penalty in Arkansas where folks that are living together, their income doesnt not combine with people that are married their income is combined do you know that or can you get back with me on that because I think we should look at when it comes to benefit cliffs that's a very hard for folks to think we
should look at not having a marriage penalty in our state. so so in snap if you're not married and you do not purchase and prepare your meals together. you
can live under the same roof and not be in the same snap case. but if they're married then they then that is then you have to be in the same snap
Representative Mary Bentley
Unverified
1:04:38
case in both of your income will count so other states don't allow that so I think it's something that we need to consider other states do not have a marriage penalty if they're in the same household then they're considered joint income so I think we should look when we're looking at benefit clips in the massive amount of benefit clips we have, I think we should consider what other states are doing so thank you chair
Representative Jack Ladyman
Unverified
1:05:00
Representativeladyman you recognize thank you Mr Chairman. well, Representative Bentley asked one of my questions about verification I'm over here and I think that's been that horse has been beat up. but you know we talked about what can we what can we get the federal government to do for us and it's been my experience we can't get them to do too much but we ought to be looking at
that like the vice chair said but what can we do ourselves to to help improve that number to get from48 million to 24 million to zero get our numbers down to to below5 or6% what can you
identify how many officers do we have around the state? We got75 some counties
are shared right? we have at least one office in all75 counties here in Pulaski we have
three local county offices andeline County we have a main office in Benton in annex in Bryant which just overflow staff mostly children and family services staff in that bryant andex and we in Washington County have a
Speaker 87
1:06:17
small annex in addition to the main office but
Representative Jack Ladyman
Unverified
1:06:22
so if we have a problem county or a problem office can you zero in on you know 90% of your problems
may be coming from three counties. I mean, can you tell where your problem offices
are do you have that ability. So we do track the outcome of these results based on county where they where the staff works not necessarily where the client lives but where the staff works we do we do track results to the county to
Speaker 90
1:06:56
the area. We also look at agency versus client yes we look at all
Representative Jack Ladyman
Unverified
1:07:04
of that so in these county these offices
it's not county these agency officers is that office responsible for everything that that they're graded on or do they share customers from other counties? I mean you've got a zero you gotta identify the problems in zero in on the problem can you do that?
Representative Aaron Pilkington
Unverified
1:07:25
So yet we are trying to do that yes we have we also have performance I
Representative Jack Ladyman
Unverified
1:07:30
mean can you change your policy to improve
that that's what I'm asking we so we do have performance measures in place for our individual staff and and for managers and so part of that performance is accuracy accuracy for things they control you know client cause errors we would not necessarily hold an individual staff person accountable for that or a county but yes we do look at errors what are causing them we have performance measures in place we do performance improvement plans
Representative Jack Ladyman
Unverified
1:08:05
when they're needed we do training we do coaching I understand you're doing a lot but tell me what your what are your three
Speaker 87
1:08:14
offices that have the highest error rate. don't
Speaker 124
1:08:18
don't have that today but I can get you that
do you look at that on a regular basis at the causes more than like I can tell you some of these slides are at the point in time we were at in the QC reviews what are the top three causes of errors which number one is wages and
salary errors and at the time that this was pulled there
Speaker 68
1:08:39
were more client errors then agency errors and we're looking at what can we do to prevent those errors what can we
Representative Jack Ladyman
Unverified
1:08:46
do to make that better what'm asking is accountability at the office level. So I would like to know what are the three highest and then you I don't know whether you understood my question but so one office, say the office in my county
so are they just responsible for the cases that they work or are the calls transferred to other cases worked by other people outside of that office
that is in their numbers they're responsible for the cases they work not necessarily responsible for the outcome of all the reviews for clients who
Representative Jack Ladyman
Unverified
1:09:23
live in if you identify your three worst counties it would be the people in that office that are
working all those cases that's how we track and attribute the errors yes based on where the case was worked not
Representative Jack Ladyman
Unverified
1:09:37
where the client lives well I know y'all are doing a lot but I hope you understand what I'm asking your worst case is where you ought to be putting your resources to try to fix that and yeah, I'd like to
Representative Jeff Wardlaw
Unverified
1:09:52
know what the top three are Thank you but Miss Franklin if I remember correctly we've had this discussion before. If I call Bradley County right now I may end up getting a different county on the phone, correct so when you're what he's asking you
you're contributing that error rate to those counties but it may be somebody else in another county that made the error correct? right well the if talked to him in Drew County and I called Bradley County, Drew County does my case. Bradley County got a contributed my era when
Representative Aaron Pilkington
Unverified
1:10:26
Drew County caused the air if it was an agency caused error so when a case is selected for review, wherever that worker reports to, that's where we
attribute the error to so if it's if it's a
client who lives in Bradley County but a worker in Drew County is the one who worked the case then that error goes to Drew County even though
Speaker 129
1:10:49
the client lives in Bradley County yeah senator
Ivin you recognize and is there any penalty for somebody who for an individual that incorrectly reports information
so there are penalties some you know if it rises to the level of fraud like intentional
withholding and not reporting then we do refer those to our fraud team for further workup prosecution they also can have intentional program violations where they are ineligible for snap for a period of time because of that violation and they can have an overpayment even if it was an unintentional you know, mistake. it it can result in an overpayment. So there are incentives for clients to not
you know, repeatedly make mistakes in reporting
and providing information so how many of those cases have been can you have been reported for fraud of the client base, not the agencyba. ones but the clientbased ones. how many of those clientbased cases where it was their fault for not reporting the correct information to us. I'll get you that. Yeah, I'd like to know that because
and is there any federal rules that prohibit us from increasing those penalties the
intentional program violation is progressive like first defense is is that state or federal law it's the intentional program violation is allowed in the federal law I need to take that back and find out how much room we have as a state to establish this time'd like to see
how I mean if we're trying to pull as many levers as possible to get our error rate down. we've got to look at this from every angle agency
rate of incorrection and clientbased thank you
Representative Jack Ladyman
Unverified
1:12:50
p re s ent ative ladyman thank you Mr Chairman. I had another question after that discussion. I ask you for the three offices what are the three most often mistakes made do you do you know what that is? I mean is it income is it family members is it debt is it assets? I mean can you zero in on one thing and then try to figure out how to fix that question
on the client side it's usually unreported information on the on the agency side it can be several different things income calculated incorrectly information that we knew that we had that we didn't apply to the case so careless error but do you
Representative Jack Ladyman
Unverified
1:13:38
have the ability to to find which question is most often answered incorrectly do you have that ability through data
so for each error type, I can tell you the not today but in the data I can tell you the most common cause like for example if it's client reported clientca income error. I know that we still have a
Representative Jeff Wardlaw
Unverified
1:14:02
lot of rules on the agenda so I'm must I'm gonna halt this for a second. Can you put together a report that would answer most of the questions we're getting from the members today and send that to the staff and I think that would help and then we can have a follow up meeting to go over
Senator Bryan King
Unverified
1:14:22
that report if need be. Sure I can put some of this together and send it to you thank you thank you so much you're welcome Senator King you're recognized for
a question just one quick question what's Deloitte's role in all this with this snap program Deloitte is our system integrator that helped us build the eligibility system the Arkansas integrated eligibilityystem. so with that thank you for your presentation we look forward to seeing your report
Representative Jeff Wardlaw
Unverified
1:14:54
we'll move on to item E Miss Elizabeth Putton Pitman. if you would introduce
Speaker 148
1:15:17
yourself for the record and you're recognized to present good afternoon Elizabeth pitman division for director for the division of medicalervices I have a simple rule today I hope
it is a rule that we passed pursuant to Act431 of2025. it was a law that required that medicaid pay for diabetic shoes and inserts? and also that anyone who could prescribe within their scope of practice prescribe that be able to prescribe them. We already covered the s issues and inserts themselves so we just expanded the the language of the rule to make it clear that anyone who has prescribing authority within their pc scope of practice can prescribe those diabetic shoes and inserts and'm happy to take any questions so
Representative Jeff Wardlaw
Unverified
1:15:56
Gus used to be in the DmE business full disclosure not anymore. but I got quite a few calls this week from audits
from it medicare where they're dis al low ing a nurse practitioner's signature so if
Speaker 149
1:16:12
we pass this is that putting us in direct violation with medicare? so we
Representative Jeff Wardlaw
Unverified
1:16:16
can have different rules than medicare what we again very familiar with the process. We can have different rules but our rules can't be less than their rules. We can
always be more but we can't be less and by allowing a nurse practitioner or a physician's assistant that would
be less so have we got approval
Speaker 148
1:16:36
for Medicare to do this? so we didn't have to submit a state plan. We have approval from medi or
Speaker 149
1:16:42
CmS the Medicaidederalartner to allow for nurse practitioners and physicians while we're going through the process of allowing for physician's assistants to beer going through the process and we have the approval we have approval for ARns andcNS's and
the physician's assistants is pending with them right now. OK. any other questions from the committee Go ahead so if the DmE providers that have contacted you are being audited under Medicare are they, I mean I I guess does the DME people that that for me it would cause
a lot of confusion. I wouldn't want to subject myself to audits. I mean, I know we passed a law and I know you're doing your job as like is trying to implement the rule. I'm just saying I think DME providers need to figure out if this is something they want to do or not because if you're subjecting yourself to you know, accidentally not following the Medicare rule but following this rule for Medicaid and get confused then you're potentially recreating a an
audit for yourself that's not really for you
to answer but you're just doing your job and implementing the rule based on the legislation that was
Representative Jeff Wardlaw
Unverified
1:18:08
passed but I would just read a reports yesterday and Cms does not allow a APRN RPpa to sign for diabetic shoes they can do the initial face to face and send the order in but a physician has to cosign on the rules RdO for it to be valid, payable claim.
that's what the audit said I read one yesterday because they saw this on the agenda and they said this is they said exactly what you just said this is will be very confusing for them because they'll be doing it one way for medicaid and a second way for Medicare and that's the reason I asked
Miss Bittman, did she have that approval because why would they approve for one hand to do it and they're not letting themselves do
Speaker 148
1:18:53
it it's kind of my point. I ask that often so it will it will mean they have to bill medicare according
Speaker 149
1:19:00
to the medicare rules so they would not be able to use a nur se practitioner or a physician's assistant if it's not allowed and then that would limit who they could if they want to cross over to us that would limit who they could use for us if it's a sole medicaid patient they could then use a PA or or a nurse practitioner. that's how that would work for them and so yes I agree it's something they'll have to look at Happy to take a look at those audits and and see but commonly Cms has applied different rules to Medicare and
Medicaid for whatever reason and I understand that it's really not for you I I mean I
don't have any issue with the the rule as it's written because it does follow the legislation. I would just encourage the DME folks to get these audits and get with you guys and decide if this is something that they really
Speaker 35
1:19:42
want or not because they may want to repeal this law. OK, thank you. Any other questions? seeing no other questions
Representative Jeff Wardlaw
Unverified
1:19:49
thank you for the role it stands reviewed without objection. Thank
you y'all have a great day we'll move on to number to adamf Department of Health
r t ie ri a se if you guys would introduce yourselves for the record and
Speaker 161
1:20:21
you're recognized to proceed. good afternoon. my name isrtie Cressy and I'm the EMS section chief for 8Dh. Good
Speaker 163
1:20:29
afternoon Chuck Thompson attorney Arkansas department of healthalth.
Speaker 164
1:20:35
good afternoon Craigsmith attorney for the Arkansas Department of Health and community members we thank you for your time this afternoon. our first rule is the rules for emergency medical services this includes changes to both the rules and the appendices the proposed amendments are to comply with Act384 regarding the interstate compact as well as 863 regarding the removing the advisory council and establishing the emergency medical services advisory committee as well as changes
recommended byblr and incorporation of the accreditation manual for training facilities into the roles the department opened for public comment we had two periods one for the wolves, one for the appendices last days were March31st as well as June 16th for each. only one comment was
Speaker 165
1:21:24
received on the rules and just a clerical error and with that open to any
questions Senator Irvin so the committee is we're
establishing just per the law if you'll just remind me real quick we are we abolished the emergency medical services advisory council and then established the em emergency medical services advisory
Speaker 164
1:21:52
committee which is under what yes ma'am that is under the board of health as was the advisory council this was an act that was sponsored by Representative Johnson and it adjusted how how involved the advisory
council was before the advisory council was very limited it advised on certain standards this advisory committee is more involved with rules and more involved with disciplinary actions for licensees and other areas and they've been doing some wonderful work over the past year once they were established thank you.
I just wanted to make sure we were they were still under the board of healthalth not standalone. OK, thank you. seeing
Representative Jeff Wardlaw
Unverified
1:22:33
no further questions rule stands reviewed without objection with that we'll move on to item G. I think the only
change is Miss Paula Day. if you guys want to take upg and we'll just move all the way down toca I think y'all are the same presenters
Speaker 169
1:22:55
all the way through. Yes sir thank you thank you Paula Day section chief Health faccilityervices
Speaker 164
1:23:02
with Arkansas Department of Health. you're recognized the next rules are the rules for critical access hospitals in Arkansas these proposed amendments are pursuant to
Act52s52138141772819,861 and 862 of2025clu changes that allow admitting privileges for certified midwives permoting certain hospitals to operate retail pharmacies adding provisions for emergent blood transfusion process allowing APRns to pronounce and document patient death and adding requirements regarding the in organ and genomic harvesting Act for this role as well as the next the last day for comments was august4th no comments
Representative Jeff Wardlaw
Unverified
1:23:45
were received. seeing no questions we'll move on to itemh
Speaker 164
1:23:56
without objection stands reviewed. insert these rules are for home health agencies in Arkansas the proposed amendments are to add a provider exemption forpace providers at entities that solely provide therapy services to not reimbursed under Medicare Part A as an exemption and allow home caregivers that have
previously received the required training to not have to repeat that training I said earlier the department opened for a public comment last day was August4th and
Representative Jeff Wardlaw
Unverified
1:24:28
no comments were received Do no questions item stands reviewed without objections.
Speaker 164
1:24:35
move on to item the next rules are the rules for hospice agencies in Arkansas the proposed amendments are to allow add allowances for electronic medical records allow private
professional providers to complete building project review and approval as well as change name for additional hospice locations for a primary location from satellite office to alternate delivery side multiple location utilizing the same terminology as Cms ga in department open for public comment ended on august4th and no comments were
Representative Jeff Wardlaw
Unverified
1:25:08
received. See no questions without objection the item stands reviewed without objection. move on to adam J
Speaker 164
1:25:19
These rules are for hospital and related institutions in Arkansas the proposed amendments are pursuant to actcts52138141772819,861 and 862 of2025s include allowing admitting privileges for certified nurse midwives permitting hospital certain hospitals to operate retail pharmacies adding provisions for emergent blood transfusion process allowing APRns to pronounce and document patient death and adding requirements regarding the in organ and genomic
harvesting Act the department opened for public comment and the last day was August4th and no
Representative Jeff Wardlaw
Unverified
1:25:58
comments see no questions or objections as item stands reviewed we'll move
Speaker 164
1:26:04
on to item K our last rule is the rules for private care agencies in Arkansas the proposed amendments are to allow home caregivers that have previously received the required training to not have to repeat that the revised definitions for
contractor to state does not receive a form W2 removeependent from the scripture for contractor and add contracted individuals to have the same requirements as employees as well as remove certification by DhS's uhdpS QA as well as adding additional requirements for reimbursement through the Medicaid program. The department opened for public comment and last day was August4th and no comments were received.
Representative Jeff Wardlaw
Unverified
1:26:52
seeing no questions without objection the stands reviewed as
well. thank you committee members thank you you guys did that like champions. With that committee
senator Irvin has some remarks on the healthal for rural transformation grants that were given out this
week. so we're going to recognize her for those. Thank you Mr Chair. members as you know the rural healthal transformationgrame last Thursday the first grants were awarded that was nearly $150 million for Thrivempact all75 counties will
receive benefits from the selected projects another55 million approximately and grants will be announced later this month for the rise in the heart buckets we there was nearly700 applications with almost $1.5 billion in requests year one budget is 209 million. year two funding opportunities will be available this fall. so if projects were not funded they
are encouraged to reapply emphasizing multiyear projects collabor ation and partnerships across healthcare systems and providers year this is a year one out of year five year plan with Cms under the one big beautiful bill, for rural health transformation program and we are also competing with other states so Cms is rewarding states who are meeting federal metrics with potentially
more money. So just I just wanted to give us a report so that you should be looking for the rest of those grants at the end of this month for rice and for hearts and we will have the link sent out to all the members of public health from the governor's press release last Thursday but tremendous amount of support for rural Arkansas and rural healthcare and the projects were really great and they'll we will send the link out that
provides the list of all of those once all of the grants have been given out for all of the buckets of money then we will invite them to come and have a complete report to the committees at that time yes yeah you're
Representative Jack Ladyman
Unverified
1:29:10
recognized is there any will this report have the pending requests that have
come in that have not been approved or is that can you see that somewhere no
I don't have access to all of the projects that were
submitted. I I don't have that and I think at the end the report because I think what they're doing is they're working with a lot of folks to try to tweak those or collaborate with them to make those stronger applications for year two right now all we
Representative Jack Ladyman
Unverified
1:29:42
can see is the approved ones that come out thank
you and so be on the lookout for the end of the month for those other other projects that will hopefully get funded so any other questions from members of
the committee? I really want torec thank Jim Hudson, Secretary Hudson and Brad and I andpresentative I mean Secretary Mawy and uhjanet mann and and our the doctor with the the crime lab and our surgeon general those were kind of the team that reviewed all these projects so anyway, if you have any questions but we'll send that link out to everybody all right and if there's no other business to come before the committee we are adjourned. thank you members for being here.
Agenda
A. Call to Order
B. Consideration to Approve the August 5, 2026, Meeting Minutes [Exhibit B]
C. Presentation on Arkansas Wellness Network [Exhibit C]
D. Discussion of SNAP Error Rates [Exhibit D]
E. DHS, Review of Rule, Signature Authority for Diabetic Shoes and Shoe Inserts [Exhibit E]
F. Arkansas Department of Health (ADH), Office of Preparedness and Emergency Response Systems, Review of Rule, Rules for Emergency Medical Services [Exhibits F1-F2]
G. ADH, Division for Health Protection, Health Facility Services Section, Review of Rule, Rules for Critical Access Hospitals in Arkansas [Exhibit G]
H. ADH, Division for Health Protection, Health Facility Services Section, Review of Rule, Rules for Home Health Agencies in Arkansas [Exhibit H]
I. ADH, Division for Health Protection, Health Facility Services Section, Review of Rule, Rules for Hospice Agencies in Arkansas [Exhibit I]
J. ADH, Division for Health Protection, Health Facility Services Section, Review of Rule, Rules for Hospitals and Related Institutions in Arkansas [Exhibit J]
K. ADH, Division for Health Protection, Health Facility Services Branch, Review of Rule, Rules for Private Care Agencies in Arkansas [Exhibit K]
L. Other Business
M. Adjournment
Documents
Speakers
Representative Jeff Wardlaw
Unverified
Tanya Phillips
Unverified
Tyler Phillips
Unverified
Speaker 9
Kathy Lenahan
Unverified
Speaker 13
Speaker 17
Speaker 8
Speaker 24
Senator Missy Irvin Chair
Unverified
Representative Mary Bentley
Unverified
Representative Aaron Pilkington
Unverified
Speaker 87
Speaker 68
Speaker 102
Speaker 76
Speaker 111
Representative Jack Ladyman
Unverified
Speaker 90
Speaker 124
Speaker 129
Senator Bryan King
Unverified
Speaker 148
Speaker 149
Speaker 35
Speaker 161
Speaker 163
Speaker 164
Speaker 165
Speaker 169