ALC - Hospital, Medicaid, & Developmental Disabilities Study Subcommittee
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Representative Mary Bentley
Unverified
6:00
okay thank you everyone for your patience we're going to get this committee meeting started this morning and I apologize I missed the update on the time so all my fault that we're going to start a little bit late but if everybody don't take their seats we're ahead and get started
Representative Mary Bentley
Unverified
6:25
you all for this exciting morning I'm really excited for everyone to see um the final and our look at what we're looking at not quite
our final with what we've come up with for our plans and our opportunities for us to really make a difference in arkansas i'm really excited for you guys to hear what we have going so if we want to get um secretary
man here and get that out of the way for our reimbursement rates we'll get that part behind us if you recognize yourself and proceed
Senator Breanne Davis
Unverified
6:57
with your report when you get there thank you. Thank you. Good morning, Janet Mann, Secretary, DHS. And just very quickly, I'll summarize in your
packet is our monthly letter updating on where we are on the ALF cost report reporting. We have finished that cost report. It has been put out for public comment. The date of this letter is September the 10th, but it's for the month of August. So public comment was 30 days. It ended on september the 6th we are compiling those staff is reviewing and sending a recommendation up to the secretary's office i have not seen the recommendation of staff yet after that then it will be going through the normal process so that i really don't have anything else besides that
Representative Mary Bentley
Unverified
7:39
so um we should be able to hear something next month you think on where we are
with our rates yes ma'am i hope so yes okay all right any questions from committee members all right thank you so much for your report appreciate it okay well with that we'll go down to our next session we have mason bishop and cameron christie here from our work ed and hear their recommendations that we proceed with thank you all for flying here to be with us today and again appreciate your patience with me today you guys can recognize
yourselves when you get seated and get ready to proceed
Speaker 18
8:21
with your presentation. Good morning, Representative Bentley and Senator English. Good to see you all again.
Speaker 19
8:27
So we're here this morning to give you a set of preliminary recommendations as a result of the work that we've been doing this spring and summer regarding workforce development, social services, modernization and reform we're excited that we've been able to try to balance
the realities of certain situations regarding agency alignment the situation in arkansas with the work that's been done around arkansas launch and other initiatives while at the same time really trying to help figure out ways that can improve service delivery and in particular again as you've heard from me in the past, create a common customer experience for both businesses and job seekers and workers across the state of Arkansas. And we think we have a set of recommendations here that present a very strong balance
and ability to serve people better. We actually have affectionately called this Learns for All to build upon the momentum that Arkansas has gained around the Learns Act where you've reformed the K-12 school system and have initiatives there and now what we're suggesting is that we expand that to all available talent in the state of arkansas including non-traditional adult workers and others who need assistance so with that i'll go ahead and get started with the powerpoint
hopefully hit the right button so we have had an advisory group working on this made up of a number of stakeholders from around the state including agency personnel legislators and others so we're going to have we have another advisory group meeting this afternoon after this meeting and so you're going to see we're going to be sharing the same thing with them so what is the vision uh real quickly we want to modernize and transform workforce development human services system through an integrated administrative and service delivery model the streamlined state and
local program administration improves both the quality of and access to services and supports and promotes fiscal integrity and resource efficiency for the benefit of Arkansas residents and employers. So this is the vision, and we've really tried to stick to this vision in all the work we've done. What are our goals? We want to promote upward mobility and increased wages for families. We want to provide greater access to services that promote longer-term employment and labor force attachment. We want to maintain a strategic approach to helping employers access sources of talent for well-paying jobs.
We want to create efficiencies that promote effective government services, outcomes, and impact. And we want to innovate to meet rapid changes in employment, labor markets, skills needed for jobs, and deployment of technology. So really, these are the goals that we have focused on as we've done the work and make the recommendations to you today. In terms of the design of what we're doing, we want this to be person-centric, not program-centric. Again, one of the big problems we have in a lot of these programs is often we focus on what's best for the program and not what's best for the person.
This is something I hear Senator English talk about a lot. What are we doing to help people? So we want to be organized around what an individual needs, not which funding stream you happen to be accessing. And again, that's one of the big problems we're trying to address is right now, depending on where you access services, a lot of times you get locked into that pattern and you don't get access to the full array of things that might help you become self-sufficient we believe in a work first approach where employment
training proceed and inform eligibility determination this is particularly important on the social services side the first message you want to send to people is we are here to help you we are here to help you become upwardly mobile to help you get out of the situation you find yourself in and to help you rise above poverty and the way you do that is through employment education and training we want statewide consistency with regional flexibility again somebody shouldn't be dependent on what happens to them depending on what community they live in or what door they walk
through so we want to ensure that services are delivered the same way in every part of Arkansas with room to tailor to local economic conditions you all have heard me talk about a franchise model and the way private franchises operate and we want to do the same thing here we want to be results-based and publicly accountable so that outcomes such as employment wages credential attainment sustained labor force attachment are measured consistently and reported to you as legislators and we do believe that bold action requires difficult decisions which must be made with the best information and data
available and so we think a number of the recommendations we have for you are are bold and do require some level of difficulty and challenge, but we think are realistic. So what is our foundation here? We do believe that there needs to be a fundamental organizational shift. There's sort of three components to this shift. And what's informed us in making these recommendations are a couple things. One, obviously what's happening here in Arkansas and the data we've been able to pull thus far
and the discussions we've been able to have with a number of stakeholders and individuals. But also we're closely monitoring what's happening in Louisiana, who is about a year ahead of Arkansas right now in terms of looking at redesigning and what did they do and what challenges are they facing and what has become sort of their path forward. And we think Arkansas and Louisiana have a lot of similarities around the way they should approach this. And so what we're recommending is this. the office of workforce solutions which is currently in the department of commerce
we believe becomes the front door for all individuals who are seeking assistance that includes your traditional workforce development services and obviously office of workforce solutions also currently has vocational rehabilitation so individuals with disabilities use that as the front door but we also believe this should be the front door for individuals who are initially seeking public assistance as well. That they see somebody at the workforce agency and they are quote-unquote case-managed first
based on employment and the situation the individual's in and not have their first experience be an eligibility determination. We believe that there's an opportunity here to redefine what it means to be an Arkansas workforce center, that it can be a lot more comprehensive and connected in all communities, And that would be the place where people would go for assistance, both virtually and physically. Also, the Office of Workforce Connections would be the coordination entity for employer relationships
and trying to create sort of a customer relationship management amongst a lot of different entities around how do we work with employers. Then we are -- centralized eligibility is something we've been a proponent of as part of our principles, and we do believe centralized eligibility is important to still do. We do believe, though, you can still accomplish the same thing by keeping centralized eligibility in the current Department of Human Services. They have ARIES, which is a lot of investment
has been made in that system. It's probably the leading eligibility system, and so eligibility determination would be done from the Department of Human Services. They would have the system of record, And that eligibility would be sequenced behind the employment planning that would be happening by the Office of Workforce Solutions. So again, employment planning, education training, what is your situation happens first, that case management, first initial piece, followed by the eligibility determination.
Then you also have what's called the Department of Shared Administrative Services here in Arkansas. This is really the integration layer. What they are currently doing and would, under our proposal, continue to do is really they create the tools and the services that Office of Workforce Solutions would essentially be helping implement. So civi form, which is common intake, so people would have a central point of intake that they could come to. They're not doing intake five or four different ways. The Hope Hub platform, which is the case management and also Hope Hub
and the 1033 initiative are where we try to take case management and expand access points to community and faith-based organizations. That Hope Hub platform would continue to be managed by shared services but used by Office of Workforce Solutions in coordination with those community and faith-based organizations. Arkansas Data Hub, Master Person Index, and statewide IT governance would continue to be managed by the Shared Services Center. Essentially, that is, again, providing the support mechanisms for the Office of Workforce Solutions,
in particular, who then is doing the centralized case management and connection of trying to get people employed. Specifically, we've talked to you about three pillars, integrating administration, integrating service delivery, integrating financial management so we wanted to give you some quick bullet points under each one of those areas again under integrated administrative structure we are recommending that OWS be the single state workforce agency and that we consolidate all federal state employment training and re-employment
programs under that that agency right now not to get too in the weeds but Arkansas has been approved by the US Department of Labor for what's called WIOA waiver packages is very important we've been very involved up front we created a waiver set of waiver options back in February my company did that a number of states have been utilizing including Arkansas essentially what this means is that Arkansas has been approved to move toward more of a single
planning region model which means that right now some of the splintering that occurs by sending WIOA money only down to the local boards no longer needs to happen essentially OWS can be the administrative authority over the state of Arkansas the state workforce board would oversee the operations across the state of Arkansas and but also the for those of you who are legislators in different parts of state including rural Arkansas still has to provide the
funding to those local areas or dedicate the funding to those local areas so nobody's going to lose out on money because Arkansas still even though they're going to OWS will manage and the state board will manage oversight dollars still have to flow equitably to those local areas and so those services would still continue. This this waiver package is very important approval and it only goes through June 30th of 2028 so one of our big recommendations is is that you codify
what OWS has asked for and been given permission of by the federal government and that this be something that Arkansas says this is the vision for how we want to move forward regardless of whether we have a waiver or not this is the right thing to do. 1.3 we believe in confirming that Department of Human Services is the integrated eligibility authority looking at ARIES as the eligibility system for workforce and social services programs and that have a
statutory Component that an employment plan precedes or accompanies eligibility determination for every work capable customer We do believe that the development of a common intake system the platform job matching integrated data and physical facility consolidation be assisted by the shared services center and that they have a statutory mandate to serve both Office of Workforce Solutions and Department of Human Services that we establish a transition structure
effective July 1 of 2027 and then we align appropriations to the way we recommend this administrative structure under integrated service delivery we do believe that through this we can operationalize service delivery consistently across the entire state of Arkansas while allowing for regional innovation and tailoring. We do believe that there are some things you can codify to ensure that physical and virtual infrastructure is integrated and
that physical locations, whether they be state-owned, state-leased, state-run, have some type of access point around integrated delivery instead of having it be a program off it program offices that we work toward again having a much broader access footprint for workforce development that we establish a single workforce intake process so that every work capable customer regardless of where they come into the system receive an employment plan that's part of the case
record managed by the Office of Workforce Solutions and that that precedes eligibility determination again we talk about consolidating eligibility functions into DHS implementing integrated case management on a shared platform and separate case management from eligibility determination and I think this is really important one of the things we do unfortunately is we throw a lot of terms around that may mean different things to different people so part of what we need to really do is define what does case management
mean, define what does eligibility determination mean, and really talk about case management, which could be things like employment counseling, education counseling as part of quote-unquote "case management", but really define that in law and talk about who's responsible and how that's going to occur. Establish a single regional point of contact for employers, and particularly important is adopting a common performance and accountability framework built on outcomes rather than inputs with a defined reporting relationship to the legislature.
One of the things we'd really like to do working with you is ensure that the right reporting is done, that you guys really sort of have an accountability dashboard for this so that whether it's interim meetings next year, whether it's during the general sessions, those type of things that you have a dashboard and you have what are the milestones and metrics that show that they're moving in the right direction, that you know the right questions to ask and the right information to try to get back from the executive branch.
Finally, under integrated financial management, we do recommend the state of Arkansas look to establish and submit a statewide cost allocation model. That's, again, a little bit in the weeds, but we think there's an opportunity to do that. That would be really a huge benefit. What that means is that the costs are shared across all these programs consistently across the entire state. Right now, cost allocation's done in multiple different ways, through the local boards, through DHS and their programs.
Everybody's doing cost allocation separately and differently. And this is an opportunity to integrate through spreading costs across the entire set of programs. This is how you move to more of a service delivery model and not a program delivery model. In the absence of approved statewide cost allocation, We worked to braid federal funds to the extent permitted and seek federal waivers where available. Again, because of the waivers that the Office of Workforce Solution has now gained, there's an opportunity now to have a statewide memorandum of understanding
and infrastructure funding agreement and not 14 separate ones. And that we begin the process of requesting inclusion in the federal benefits cliff pilot and approval of an alternative cost allocation model. We have an opportunity to pilot some things on the human services side and try to address the benefit cliff issue. And then identified administrative savings toward direct participant services, particularly training and support services that address child care transportation and benefit cliff barriers.
We do believe that there are cost savings. Right now, one of the things for next steps that we wanted to report to you that we're still in the process of identifying that and gathering all the data but I can tell you that the Office of Workforce Solutions in their waiver package to the Department of Labor identified just in their world six million dollars in savings that they believe they can achieve through through the waiver model which now we're suggesting you codify so there's at
least six million dollars on the table that could be redirected to more training more education more supportive services for individuals and we believe it's going to be even more than that so real quickly I'm going to turn over to Cameron to just kind of cover the next steps that we're recommending and
Speaker 23
25:44
then we're available for questions good morning thank you for hearing us today and so yes as Mason mentioned we have some proposed next steps one includes
continuing to gather feedback we plan to do that through the end of September so that way we can continue to move forward with an October report for you all so we know that we don't have all the information available we are continuing to gather data and we know that those of you in Arkansas and working in these offices have a better understanding than we do so we are soliciting feedback so that way that can be included in a final report Additionally, this subcommittee and the governor's office may want to begin identifying legislative
and executive actions necessary to enact this reform. And we're here to support you all with that this month and going forward. Thank
Speaker 19
26:39
you. So we are recommending at some point it might be an option to open a bill file and start to begin. And I've already committed to represent Bentley Center English. Cameron and I are here to work with legislative council, to work with the executive branch, whatever we can do to provide technical assistance and support around bill drafting and moving forward,
Representative Mary Bentley
Unverified
27:03
if that's the choice of the legislature. Thank you very much. And
Representative Stephen Meeks
Unverified
27:13
we'll start with questions. We'll start with Representative Stephen Meeks. Thank you, Madam Chair. so all this sounds great um back in 2015 i set up a the data and transparency panel with one of the express goals of trying to create a master citizens file to create a one-stop portal for citizens so that we weren't having to have citizens go to 20 30 different places and it
sounds like you're recommending a good step along that along that path but i think one of the challenges that we face is these are all wonderful recommendations but you know state employees they have their regular jobs they they kind of get into the rhythm of of what their you know their normal workflow and trying to implement change can be something on top of what they're already trying to do we're adding another burden for them even though in the long run it'll be great
Like, you know, like technology, AI, I've been pushing that for our state. We need to let the computers handle the computer stuff so that the people can interact with people, right? But, again, the challenge is, and I think you see where I'm going, is we kind of get into this everyday routine, and trying to implement change is never easy. And so I'm wondering, should one of the recommendations here be that we need to have a project manager or hire an employee whose sole responsibility is to push this forward, is to make this happen?
Because if you don't have that point person who's really pushing it, who's really engaged in this, and this is their sole responsibility, chances are trying to get it implemented is going to be near impossible because it's just one more thing we're trying to fit in, even though the ultimate outcome may be wonderful. So just your thoughts on how do we make this happen from a practical standpoint, right? who's who's that person who's going to push this forward
Speaker 19
29:22
yes great question um and i will point to
the two probably most relevant examples which is utah back in the 1990s in louisiana in the last year um in utah they in their legislation because they were creating actually a new agency they were doing it slightly different than what we're recommending here um they actually codified the legislature, the ability of the governor to hire a new executive director, who was Robert Gross, who came out of the private sector. And again, that change agent, so to speak, to kind of head things up. Louisiana has basically, the governor, again, has empowered Susie Schoen, who's over
what's now the Louisiana Works, which we're suggesting is the Office of Workforce Solutions sort of counterpart that's going on in Louisiana, to do that as well. And not only that, but then And Louisiana also has hired an individual who is half paid for by Human Services and half paid for by Louisiana Works because of the split between eligibility and the case management workforce stuff there. So similar to what you're talking about. So I 100% would agree with you that at some level this probably comes to the governor's
office and through either someone who's an existing employee or bringing in a new individual that sort of empowering somebody to-- and really it needs to come from the governor, in my opinion-- to say, this is the direction we're moving in. We don't really have a choice. And the reason I say we don't have a choice-- because I really don't think we have a choice to do this, because I do think with AI and other things that are coming, if we do not figure out ways to be more efficient
and consolidate these programs, we're not going to have an effective approach to helping people with the AI and technology situation, and we're just going to throw lots of money around and have the chaos we saw during the COVID era, in my opinion. So that's why, yeah, so I agree
Representative Stephen Meeks
Unverified
31:16
with you, Representative. And that's one of my greatest fears, is we have a generational opportunity here, and if we don't get the people who are going to push that generational opportunity, so, and of course, you all know I'm term limited, so I won't be here, so to my colleagues,
find, we need to find those people who are going to push this for our state or else we're going to be last again and it's going to be because the opportunities are here and we don't take advantage of those opportunities and so thank you for for your response and hopefully this is an opportunity we will take advantage of thank you representative mason
Representative Mary Bentley
Unverified
31:54
mason real quick before we go to the next question if my memory serves me correctly when
you guys are on the ground actually doing interviews and visiting with folks across the board in the DHS offices, those employees were willing and
wanting to help more. They just didn't have the opportunity to do so. So would you say there really is, not by all, but by some there really is an opportunity they want to make a difference in people's lives and would love to be able to tell them about jobs that are available and go a different
Speaker 19
32:21
route than what we're currently doing? Yeah, 100%. I mean, the interesting thing about it, while change is very difficult for people, at the same time, I've noticed when you're on the ground not only in Arkansas but in other states I've been in and you talk through the issue with people on the ground and said if you could be on the same team that's usually how it's referenced
if you could be on the same team would you take that opportunity and 100% they always say yes again people fear for their jobs clearly and worry about change does it gonna mean I lose my job and nobody wants any of that but if you say to them let's take that off the table yes that we need the people to do the services and we can do them differently every 100% of the time they said yes we would we would be it'd be worth going through that change if that was the end
Representative Rick Beck
Unverified
33:11
result thank you representative Beck thank you madam chair my question is we talked about the the centralizing
of the data and the input and also about eligibility. But then you may reference to that eligibility might stay within an agency that handles that, is currently handling that eligibility. So just to get a little bit more granular on that and saying, okay, so I have this block where I have the data and really the eligibility for the individuals.
But that eligibility might have came from a different agency that's sort of a sub-agency of, I shouldn't say that, not a sub-agency, that is an agency that would be receiving data from the blocks. In other words, they're doing the eligibility in one aspect, whatever that would be. And then that eligibility is up in the larger block of data for this individual. So how is that working? Because you've kind of got people working across agencies, it seems like.
Like DHS has got this block, right, as I understand it. But the eligibility would come from a different agency. Yeah, so that's a great
Speaker 19
34:34
question. So one of the unique developments that's occurred, again, going back to what happened in Utah, Eligibility was centralized, and that centralization of eligibility is in the same agency, the Department of Workforce Services, that the case management and everything is in. So everything is in the same agency.
Louisiana found that that was a challenge to bring that eligibility function, and we feel the same kind of component is here in Arkansas because the ARI system, that public assistance eligibility side, because don't forget, I mean, OWS is still doing eligibility, but it's for unemployment insurance and other parts. So you've got eligibility going on in OWS and you have eligibility going on in Department of Human Services. So the goal is, on the public assistance side, how do you have that centralized eligibility,
but how do you intervene before the individual? What's happening right now is somebody comes in and they either virtually or physically show up somewhere, And what's happening is, is they essentially aren't really case managed or talked about employment or their situation. It's mainly, okay, I'm applying for these benefits, I get on these benefits, and then once I'm on the benefits, something is supposed to happen. And what we've seen from our prior work is that there isn't a lot of work and education training activity going on with those individuals.
so what we're essentially recommending is that and again this is some of the work that has to occur both legislatively and on the executive branch side is how do we develop the business processes and pathways for when somebody comes in either physically or accesses a virtual system and they're interested in getting on public assistance how do how do we have the um strategy of they actually talk to somebody from OWS first and are assigned I won't call it a case manager let's say
an employment counselor they're assigned an employment counselor first who finds out what is their situation what's happening to that individual what are their long-term goals short term and long-term goals and then based upon that they then apply for public assistance if that's the appropriate avenue for them to do or they maybe are dislocated worker and there's a different service, so they may be an unemployment insurance person who, you know, does apply for unemployment insurance. But again, that sort of triaging occurs by the Office of Workforce Solutions before they
apply or are deemed eligible for any particular public assistance type program. How that happens, A, B, C, D, I can't answer for you exactly today because that's part of the next steps that we're talking about, that that has to be worked through realistically based upon the people who work in the agencies and others have to kind of
Speaker 24
37:27
design those -- we need to design those processes, that's some of what needs to happen over the next couple
Representative Rick Beck
Unverified
37:35
of months. Another question. So the other question I have is -- and maybe you've seen it in other states or -- is like
We're talking about some of these, the private sector opportunities, Hope, Help, Hub, and all that stuff. And they do, some of them are doing great jobs. So they're going to kind of plug into this new system. My concern would be, like, we have this system that they need to plug into where they've been kind of operating independently. How do we ensure that we help them, or is there a system that's going to help them be able to plug in and be part of this larger system?
Speaker 19
38:24
term the 1033 initiative, which is utilizing community faith-based organizations as access points, I think is extremely important. And I think we absolutely 100% of what we want to do here is how do we create more access points for people? And how do we ensure that those access points are trained up and are consistent and are working together? And one of the things I have talked to folks about here in Arkansas is that unless you get the public sector side integrated,
And I think the 1033 is always going to be somewhat limited or hamstrung because where are most of the dollars and most of the, you know, case management things happening is going to be on the public sector side. So I think the way you expand the 1033 and have it ultimately be successful is to get our act together and have the integration on the case management of individuals who are accessing the public sector side. And then they have a consistent and coordinated approach around those access points that are happening in faith and community-based organizations.
And it's not sitting over here, in your terms, as an independent initiative. Because you can be doing good work over here, but then the bulk of the dollars and everything are over here, and you don't have that sort of comprehensive approach to helping people. Again, the way I think about this is like I think about it as operationally as we need to create a franchise model of this. So regardless, what does a franchisee look like? It may be a community of faith-based organization.
It may be a public sector office in a community somewhere. And how do we ensure that that franchise operates consistently? And the reality of the 1033 initiative, too, is often a lot of the work they're doing is a lot more intensive and helping people through crisis situations and those sorts of things. And so part of what you want to do strategically, it seems to me, in all of this is figure out at what point are people case managed and what does that look like on the public sector side?
And at what point are they needing more intensive help and are better adapted to what's happening in the community and faith-based organization side, if that makes sense? But it's having that consistent approach and access throughout this entire state of Arkansas, no matter which door somebody is coming through, so to
Representative Rick Beck
Unverified
40:58
speak. Well, I certainly appreciate all the work that you guys have done, and I'm looking very forward. It is a
large task, but I think we're up for it. So I do appreciate your help.
Representative Mary Bentley
Unverified
41:13
Thank you, Representative Beck. And I just want to say, you know, at the very beginning, my hope was that no matter where
in Arkansan lived, no matter where they were in the state, that they were going to have the same opportunities and that there are so many great things going on. But unfortunately, people have no idea about what's going on, even at the community college 30 miles down the road. I love that opportunity. I love the franchise approach. And I love what's going on with Restore Hope and Hope Hub. And if we can help it to make it successful in every county, is it's going to
Representative Denise Garner
Unverified
41:44
on that uh representative garner thank you madam chair over here um i have a question about um consul or switching out services
to ows does that mean and this may be part of the processes that we're looking at but does that mean that um ows is the one that's determining who is work capable and if so what happens to those folks who are not work capable where do they go after workforce services yeah I think
Speaker 19
42:08
that's a good question I think that might some of that may yet to be determined we that's where some of the detail work has to occur I think especially involving the agent different agency personnel I would say in general
again the ODA best would do the first screen upfront kind of triage as I mentioned and then depending upon that it's probably going to require other individuals which may be a combination of DHS and/or OWS that have to make that work-capable determination. If somebody is not work-capable then they obviously would be accessing other types of programs and services and maybe there they don't have an employment plan per se but maybe there's some kind of
independence plan or you know something else that happens but I think some of those details still need it would still need to be worked out between the
Representative Denise Garner
Unverified
43:01
agency folks okay and follow up madam chair the second question um i've heard a lot of questions about the local rural especially in rural areas the local control in rural areas yeah um how how will the state measure whether we're successful in consolidation yeah great question other other than just yeah that's a great question that's a really good
Speaker 19
43:24
question because that's the one question even i get going back to you one of the kind of neat things that's happening right now is um there's a particular organization that is uh funding um a potential well we're calling it a planning evaluation in louisiana because of this very question and um my hope would be that we could do a similar thing here and actually try to fund uh and we're looking at the efficacy of can they fund a random control trial or quasi-experimental evaluation in louisiana to see what happens what what's the result of consolidation and what are
the what are the kind of factors i do believe there are certain outputs we should measure like there's sort of integration outputs like did we get to integrated case management do we have locations that people can access that are you know where programs are co-located or whatever those outputs are and then you have your out shorter term and longer term outcomes um i would suggest it would be my hope that we could try to arrange a similar kind of thing here in Arkansas, that if you move forward with legislation, it passes, you're moving toward this integration model,
that perhaps we could have a similar type of evaluation here. Because I think that's one of sort of the open questions is, what does the success of consolidation actually look like? And I think, again, there's output short-term measures and longer-term measures. And those longer-term measures would be things like poverty, I think, in some of those labor force attachments, some of those bigger picture items. And so I think that's a great question, and I think that's something you could consider putting in legislation. Again, we would love to work with you on that, is what would that look like?
And again, maybe as part of the legislation, you want to fund an evaluation that would occur as part of the integration consolidation. In national legislation, this happened in the 1990s with welfare reform. One of the reasons welfare reform happened, as I've mentioned in the past, is that states had these waivers, Waiver and Demonstration Authority, that started in the early 1990s where they were showing, and each of those waivers had a random control trial attached to it.
So like in Utah, we had out in our Kearns office in the west part of Salt Lake County, people were randomly assigned to the current AFDC program versus the the program that the waiver program that Utah had done and so we were states like Utah and other in Wisconsin everybody was tracking the differences that were happening to people as a result of the current program and the new intervention and the new interventions were having so we're showing so much more success that that's what drove the states to basically get
the federal government Congress and President Clinton at the time to come agreement. Well, in federal legislation two years ago, the Stronger Workforce for America Act, which I've mentioned to this group in the past, that was WIOA reauthorization reform that almost passed. It was on the floor of the House, but it was bundled under the appropriations bill that Elon Musk blew up in December of 2024, not because of WIOA, but because of the spending part of it. But what we we had that pilot and demonstration authority in there that Arkansas would have been a part of
Louisiana was a part of that Arkansas There were eight states that qualified where you could have done what we're kind of suggesting here I also had suggested and Congress had written into that pilot and demonstration authority that states would do evaluation similar to what we did in the 1990s So I think your question is fantastic and I think that would be my recommendation is that we look to maybe fund the legislature look to fund some type of quasi-experimental random control trial evaluation see what is the result of consolidation what what happened thank
Representative Glenn Barnes
Unverified
47:12
you yeah okay representative Barnes thank you chair this first of all thank you so much for you I understand how you're approaching this because most time we approach things with a dollar mentality and we forget about who's was affected by it. State Representative Denise, I want to say thank you for your question because I'm along those same lines. Rural area people having good access, but also one of the common
calls we're getting is when people lose their benefits for various reasons. Sometimes it's a small reason and they lose it and it take them a month, a month and a half to get back on so that period of time between the time they lose and then get reconnected they suffer quite a bit so I'm wondering with this one hub place would they lose the ability would it be faster for them to get back on or would it be a lot of red tape yeah I know I actually think it would
Speaker 19
48:17
be better because the idea is by integrating these programs in and having in this case the Office of Workforce Solutions be that sort of case management hub for people, then their case, so to speak, is owned by somebody whose job it is to help them become self-sufficient and employed and/or education skills, upgrades, whatever it is they need. Maybe it's they need to go to the community college and there's a training program they can access. So the idea here would be, yes, you would have a person
who sort of owns that case and it's not owned by all these different program people across the board. So if I lose something here, I don't know what it means to me over here and that sort of thing. The other thing your question spurs I want to mention too is, I think one of the major improvements this can make, when you look at the issue of outcomes, I was at a conference a few weeks ago and I mentioned this to the group. When you look at public assistance programs and you look at things like work requirements,
that is not an outcome. That is an output. The challenge we have, in my opinion, with public assistance programs, Medicaid now has work requirements. TANF has work requirements. Work requirements only tell any of us what is that person doing while they are receiving the public assistance benefit. It doesn't tell me what happened to them after that public assistance benefit ended, or did they become self-sufficient or employed. And so I think one of the things this really helps you
as a legislature do is set up an outcomes matrix of we don't want to know just that somebody's doing the work requirement, what is the result of that? And I think that's what an integrated case management system helps you do. It helps you connect what are people doing while they're accessing public assistance or a public benefit and what happens to them after they're done accessing that public benefit. Did we, and this is where evaluation other things help with too did we get more people higher wages longer term labor force
attachment etc which is really what we want to do for anybody that's work capable and so that that's that would be my response representative is that yes I actually I think there would be more transparency around what happens to that individual I think there would be more assistance in a more integrated way and not that they have to go to five different people and figure out what happened. And I think that there's a better opportunity to connect while they're accessing a benefit, what happens to them post-benefit.
Did we actually help lift them off the need for that benefit or did they get kicked off for some other reason? What was the result? Thank you so much. Thank you, Mr. Bishops. I would say that
Representative Mary Bentley
Unverified
51:16
we're trying to get away from just being case managers of programs and actually case managing people and helping
people and have people be the center of what we're doing, which is I really love what we're trying to do here, just actually make it people-centered and not program-centered so actually people will get more help. And again, one person can help them and not have to go to 10 different people to see what in the world is going on. Awesome.
Can I add to that, Representative, too,
Speaker 19
51:38
because you remind me of another thought. One of the challenges you have right now around, I'll call them the work requirements and public assistance side, is that become, right now, it's a compliance mentality. It's, did we meet a number? We don't want to lose money in Arkansas, so we want to make sure X amount of people are working while they're on Medicaid, or we want to make sure our error rates are a certain number, that sort of thing. It becomes a compliance exercise. It doesn't become a help the people exercise. And I think one of the things we're really trying to do here is say, yeah, work requirements are a good thing because it means that people are trying to get work experience and exposure.
But let's not have it be a compliance activity. Let's have it be a we're helping people meet a work. We're meeting a work requirement because we're helping people get work experience. We're helping them get skills upgrades. We're helping them get education and training access because ultimately we don't want them meeting a work requirement. We want them not needing the public assistance in the first place because they're self-sufficient and they're earning enough money to support them and their families. That's the bigger picture of all of this, I think.
Senator Jane English
Unverified
52:48
Okay, Senator English, do you have any comments for me? So I love that, and I think one of the things that we always kind of have to remember is it's so easy to talk about compliance, and it's not so easy to talk about how do we help people move to a better place. And I think that's kind of what we're all about. We just have to figure out how we do that and make all these things available because we do have a lot of wonderful things going on in the state right now that so many people have no idea that it's out there,
and they don't have access to some of these things. So we really want to help people move forward. We just got to get past compliance because that seems to be our biggest thing. We appreciate very much all of the recommendations and the work that you've done with us and the thoughts that people have in the committee. I think there's a lot of really good thoughts in here that hopefully we'll be able to pull together for some more recommendations.
Representative Mary Bentley
Unverified
53:52
Okay, thank you all so much for this amazing work that you've done. going to give us the groundwork for us to move forward
as a committee to see what our final recommendations will be in october thank you so much for your time and again i'm just very very excited about this opportunity to really move a good for a program forward so thank
you very much and um i guess we'll let you guys go for now thank you so uh committee our next
discussion is going to be on the recommendations i hope everybody received the packet that's on your table so remember the job of this committee is to send some recommendations to alc next month so we'll
need to look at those we're going to hopefully uh look at these and make a initial vote on thursday to move these forward again there's going to be some changes as this as we get feedback from agencies and uh from all of you okay so if you have if other members of the subcommittee want to make recommendations if you're a member of the committee you can write a proposal and bring that to the committee as well and you have to email kate steel but has to be a member of the committee of our subcommittee to bring the recommendation to kate so but
i would love any questions Our concerns, as far as our recommendations go, from the committee.
Senator Fredrick J. Love
Unverified
54:58
Senator Love. Thank you, Madam Chair, and thank you for outlining the process because I did want to, and there's a conversation that's online in regards to the CS waiver wait list, and I wanted to make that proposal because I think that's something that the committee needs to look at, so I will be submitting a proposal in regards to that. Okay. Thank you, ma'am. Representative
Representative Denise Garner
Unverified
55:25
Garner. I just have a quick question. Is this going to be added to the meeting documents?
Okay, great. Thank you very much. I'd just like a PDF.
Representative Mary Bentley
Unverified
55:36
Sure. Thank you. I'm with you. Nothing like having something on the computer you can share. And, again, you know, I'm excited about this because of the returning investments that we can see in this and the money that we can take to actually help folks, whether it be child care, those are things that we're all very interested in. I think there's some things that we can really look forward as a committee and those things that are recommendations we can put forward as look forward to legislation in 27. So Senator English and I are both here for recommendations of all of you, concerns or questions at all.
So without seeing any other business, we'll call this meeting adjourned. Thank you.
Agenda
A. Call to Order
B. Update on Reimbursement Rates Under the Living Choices Assisted Living Waiver Pursuant to Act 213 of 2022, Section 15 [Exhibits B1-B2]
C. Presentation on WorkEd Consulting and Advisory Group Recommendations [Exhibits C1-C2]
D. Discussion of Recommendations by Subcommittee
E. Other Business
F. Adjournment
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — ALC - HOSPITAL, MEDICAID, & DEVELOPMENTAL DISABILITIES STUDY SUBCOMMITTEE, Sep 14, 2026 | Agenda | 1 | Official source ↗ |
| Exhibit B1- ALF CHOW Report-August 2026 | Exhibit | 1 | Official source ↗ |
| Exhibit B2- August CHOW RCF | Exhibit | 2 | Official source ↗ |
| Exhibit C1- Arkansas Workforce Modernization | Exhibit | 14 | Official source ↗ |
| Exhibit C2- LEARNS 4 ALL | Exhibit | 12 | Official source ↗ |
Speakers
Representative Mary Bentley
Unverified
Speaker 4
Senator Breanne Davis
Unverified
Speaker 18
Speaker 19
Speaker 23
Representative Stephen Meeks
Unverified
Representative Rick Beck
Unverified
Speaker 24
Speaker 25
Speaker 40
Representative Denise Garner
Unverified
Representative Glenn Barnes
Unverified
Senator Jane English
Unverified
Senator Fredrick J. Love
Unverified