Public Health, Welfare and Labor Committee- Senate and House
Video
Transcript
7 documents
Machine transcript
May contain errors. Verify important quotations against the official video.
About transcript accuracy
- Source
- Whisper
- Model
- ggml-large-v3-turbo.bin RTX5060
- Processing date
- October 6, 2026
I just thanks, everybody, for coming. I know summer is hard sometimes. We've got a lot of members traveling, but it was imperative for us to have a meeting this week because next week is going to be incredibly busy with ALC meetings and special sessions. So we really needed to get this meeting in before the rules subcommittee meets next week. So we'll just move right ahead and go forward. Do you have any comments? All right, well, we will get started and we'll need to consider a motion to approve the minutes.
Motion made. Second. All those in favor say aye. Opposed? I have it. The minutes are approved. Moving to item C, Ms. Hsu. If you'll just state your name for the record and then you are able to proceed.
Speaker 4
0:56
Thank you, Madam Chair, members of the committee, I'm Laura Hsu, I'm General Counsel for the Department of Health, and we have one rule to present to you today for review, dealing
with the standards pertaining to breast milk banks. You all may recall back in 2019, there was the initial legislation to set up the breast milk banks in Arkansas. Act 216 of 2019 authorized the Department of Health to establish these standards, and we did so, and we had the initial rules. Since that time, there's been another act in 2021, Act 225, that provided for the breast milk bank at UAMS, and these standards
are being revised to comply with both of those acts, and the Laboratory Accreditation Association has made some suggested changes that are found in the summary the purpose of these standards is to comply with the requirements of the acts regarding appropriate safety standards in the transporting processing and distribution of the human breast milk to protect the citizens of arkansas we worked with uams and dr vermonti in 2022 we've complied with all the executive orders that have been issued in 2023 and 2024 to improve maternal health these rules were approved by the
Board of Health in September of 2023. The governor's office approved them in January of 2024. The public comment report was submitted to the Bureau in April of 2024. I believe there were some typos that were discovered by the Bureau of Legislative Research and we appreciate their due diligence in finding those. The corrections have been made and we have made the recommended amendments pursuant to the public comments, and there is no other public comments that
we received since that time, and we're happy to submit this rule for review and happy to take
any questions. All right. Are there any questions regarding this rule? Seeing none, the rule stands reviewed. Thank you, Ms. Hsu. Thank you.
Without objection. Okay. Next. Item D.
Speaker 9
3:29
DHS. Amy Webb, Deputy Director of the Office of Substance Abuse and Mental Health. You may proceed. All right. So this, thank you, Madam Chair. This is a rule change. We talked with the crisis stabilization units, and we're brainstorming ways for them to have some additional revenue. So the rule does a few things. First, previously, there was no way for the CSUs
to get paid by Medicaid for doing less than 24 hours of observation on an individual. And so we changed that in the manual to now allow less than midnight observation, meaning someone leaves before midnight after a short-term observation. And then they also can do an after midnight, which allows for a longer-term observation. In addition to the observation, though the CSUs could always do this, it wasn't clear to them that they could bill for mental health stabilization assessments.
for people who were not being observed for that longer-term period. So we made that clear that Medicaid would pay for that, both telehealth and in-person. And then finally, there's some cleanup language to make it clear that the acute crisis units that were referred to in the manual were the crisis stabilization units. I'll take questions.
Okay, are there, yes, Representative Bladyman, you're recognized for question.
Representative Jack Ladyman
Unverified
5:10
Thank you, Madam Chair. I had a question on the comments. You had two comments, and both comments had to do with physician assistants. And I think what they asked for was, I mean, the way I read this, physician assistants are not able to work and get paid in these CSUs, right with this rule is that correct that's the way i understand it yes sir okay so and then in the response to this they requested that they would be able to work there and get paid that
was what the comments were for but it says that um you know we this applies to hundreds of uh bh assess agencies and the law is not clear can you expand on that a little bit why PAs could work in other areas and get paid and
Speaker 14
5:59
not in a CSU? Well, I don't know the details of that answer, but I can get back
Speaker 15
6:05
to you on it. The way I understood it broadly is we didn't know how this would impact this particular rule, and so we didn't want to make that change, and then it impact the whole behavioral health spectrum,
and we've got some unintended consequences there. So when these comments were made, We told them, and I believe our response was basically, we're going to look into this and we'll come back with changes to this rule later once we have a better idea of
Speaker 14
6:33
what the deeper dive and impact of that is. Well, yeah, if you could give a
Representative Jack Ladyman
Unverified
6:38
summary of why that is, maybe to the chair and get it out to people, because it may take legislation to do this. Definitely. Yeah,
and I will say this rule is really as a result of kind of an emergency meeting that
several of us had regarding CSUs and their inability to really be able to kind of stand on their own financially. So this rule opens up additional pathways for them to code and bill for services. And so I think this is one step. I mean, I think the comments, you know, none of us would discuss that section of the rule. But we are fully committed to making sure that the crisis stabilization units are able to bill for services,
opening up additional pathways for them to gain reimbursement and provide the different services. But we're also committed to looking at this issue as well, making sure, because we want to make sure that they have full capabilities of providing staffing, you know, for the CSUs to be successful. So, yes, Representative Leidemann, I concur with Mr. Rouse. We will definitely follow up on that with these comments. And if something needs to be changed legislatively, then we may not have to look at that, as it
Representative Jack Ladyman
Unverified
7:57
affects the whole spectrum of VH. Well, I think that would improve the funding, or could
improve the funding, if we use PAs in those units. Yeah, let's see. Representative
Representative Bart Schulz
Unverified
8:10
Schultz and then Representative Pilkington. Good morning. Thank you all for being here. I just wanted to ask, have any of the CSU providers or the county judges who have CSUs had time to review this? They're
Speaker 15
8:23
more than likely good with it. Yes, and this change came about from those conversations.
So we've been working with those providers. So, something we did back last fall, last summer, was we put some controls in place and we said, hey, we want to analyze this over the coming months. We upped the funding, we were originally going to cut it, and then we provided some additional funding. And when we provided that additional funding to those CSUs, part of the requirements of that was to look at better ways they can operate, ways that we could help them either by changing
rules or doing something different, and this came about from those conversations where they said, hey, if you could find a way for Medicaid to pay for some of this under 24 hours, that would help us in our utilization rates. And so this rule is really a result of working with providers. And it was something that
Speaker 9
9:20
we could do fairly quickly that didn't require legislation. Okay. Glad to hear that. I just wanted
Speaker 22
9:26
to make sure we were working with our partners. Thank you.
And I'll remind members that attended the meetings in Fort Smith that we heard from
the crisis stabilization unit there in Sebastian County, and they specifically talked about how important this change is and how supportive they were of it. They referred to the less than 24 hour as recliner care. I don't know if you'll remember that conversation, but not that they're sitting in recliners, But basically, you know, that it's under 24 hours instead of a bed, overnight bed service. So, great question.
Representative Pilkington, you're recognized. Thank you. Thank
Representative Aaron Pilkington
Unverified
10:07
you, Chair. This is a little bit off topic, but it is still the same. Can you give me an update on the CSU in Washington County? I know UAMS pulled out as the partner, and I just haven't got an update, and I wasn't there
Speaker 9
10:21
on Friday. I was hoping you could kind of give us an update. So we, I think maybe about two months ago, we met with an interested party, a provider that was interested in partnering with the Washington County. They had a lot of great ideas.
They were talking with the county, but to our knowledge, they have not entered into a contract or have any sort of agreement to run it, but they were actively discussing it. and we'll continue to get those
updates and I'll share with the members of the committee representative Pilkington I know that that was part of the conversation that we were having at that time as well particularly with the delegation that represents Washington County it's a big concern any other questions all right thank you so much for your due diligence on this and hard
work on it and moving so quickly I know it's going to be a really good positive thing so without objection, this rule will stand reviewed. Okay, next. Item E. Good morning.
Speaker 29
11:35
Martina Smith, Director for the Division of Provider Services and Quality Assurance. Good morning.
Thank you, Madam Chair. I am here today to present changes to two different manuals, the Nurse Aid Training Program Manual, NATP, and the Nursing Home Administrator Manual, our NHA Manual. These rules are as a result of changes made during the regular session in 2023, specifically to Act 137, which removed the one-year limitation for veterans to apply for certification. It also extended the requirements to spouses of veterans and active service members.
And then it also stated that we should consider national certifications for the licensure of nursing home administrators. Also Act 457 required that automatic licensure of out-of-state individuals be considered if they have a similar certification in the state from which they are coming from. We also made some technical corrections and updates to the manual, updated our table of contents, corrected some typographical errors. We had no comments, and I don't believe we have any known opposition, and I'll be happy
to take any questions. Thank you. Are there any questions from members of the committee? All right. Seeing none, without objection, this rule will stand reviewed. Thank you so much.
Speaker 34
13:26
Thank you. Good morning, my name is Jay Hill, I'm the Division Director for Aging and Adult Behavior
Health, and this morning we are here to present to you an amendment to the Living Choices Assisted Living Medicaid Provider Manual in order to be in compliance with Act 198 of the 2023 General Session, which now requires the agency to complete annual cost reports as a condition for participating in the Arkansas Medicaid program as an assisted living provider.
Okay, are there any questions? From members of the committee.
All right. Seeing none, without objection, this rule will stand reviewed. Thank you. Thank you. Okay. And then the last item we have, item G, is an interim study proposal that I am filing actually kind of on behalf of Senator Payton. He'll be the one to, I think, take the charge on this, but, you know, our committees did, I think due diligence and a lot of work on the Waste Tire Program, we know this needs to be studied in preparation for next session.
So if anybody wants to participate with Senator Payton, I would just direct you to contact him if you want to participate in this ISP. Are there any objections for the consideration and adoption of this ISP? No objections? Okay, then we will adopt this interim study proposal. Is there any other business to come before the committee?
Do you have an update from what I've talked to you about? No, Arkansas Healthcare Association, I'm asking them a question because I had an issue that popped up this weekend, but no update. Oh, you will tomorrow, okay, perfect. So just members, I had a constituent issue that popped up this weekend on nursing home long-term care that I visited with the Healthcare Association about just ensuring that residents
are able to get their medications in a timely fashion and not having to wait on certain test results to come back, which could be pretty detrimental if you're an elderly person and you have a UTI and you are not able to prescribe medication until the results of that come back, the patient could end up dying. So I'm real concerned about that. The physicians in my area have contacted me about that. So I've contacted the Healthcare Association,
but I'm just putting that on y'all's radar as well. You know, you don't have the luxury of time in elderly patients. You really need to act fast to get any type of an infection under control. So this would affect our long-term care facilities, our physicians, but especially the residents in our long-term care facilities. So I'm concerned about it, and I've asked for the Arkansas Health Care Association
to follow up on that for me, and we'll get that information and maybe get a report back at one of the next committees. The only other thing I would say is I'm glad that Senator Murdoch is here. I've asked Senator Murdoch if he would assist us. I'd love to have a meeting in West Memphis area and then also visit some of the schools that participate with Arkansas students that are in Memphis. So we're going to work on that meeting for public health.
Representative Johnson and I have talked about this, but you have the dental school there, you have an optometry school there, and so I just think we also have St. Jude's and Le Bonheur hospitals there that treat a lot of Arkansas patients, and as far as dental school, that's the only, the majority of Arkansas students attend that dental school, and we haven't done a lot in that area of dental and of us being informed and educated about you know what is happening there
so I just think it would be a great opportunity for us to visit they've just done a huge renovation there at the dental school and have invited us to come for a tour so I'll I will be tasking Senator Murdoch to assist our committee with that and some meetings perhaps maybe at Mid-South community college as well all right and if you have any suggestions if you're in that area and you represent any of that area please let me know because we would like to um we would like to visit
that area of the state um i don't think we have yet um but i'm real interested in the delta area and what's going on there health wise um and so if you want to reach out to me or senator murdoch If there's a topic that you're interested in, we may look at exploring some other areas instead of just West Memphis, maybe Helena, West Helena, or someplace like that. So let me know. Okay? All right. Any other business or comments? All right.
That's it. Thank you all so much for coming this morning, and glad we got our business out of the way, so we'll be ready to work next week. With that, we're adjourned. Thank you.
Agenda
A. Call to Order
B. Consideration to Approve the May 21, 2024, Meeting Minutes [Exhibit B]
C. Arkansas Department of Health (ADH), Center for Health Advancement, Review of Rule, Human Breast Milk Bank Standards [Exhibit C] Laura Shue, General Counsel, ADH
D. Department of Human Services (DHS), Division of Developmental Disabilities Services, Review of Rule, Crisis Stabilization Units [Exhibit D] 1. Amy Webb, Interim Deputy Director, Office of Substance Abuse and Mental Health, DHS 2. Mitch Rouse, Chief of Staff, DHS
E. DHS, Division of Provider Services and Quality Assurance, Review of Rule, Licensure for Veterans, Spouses, and Active Military [Exhibit E] 1. Martina Smith, Director, Division of Provider Services and Quality Assurance, DHS 2. Mitch Rouse, Chief of Staff, DHS
F. DHS, Division of Aging, Adult and Behavioral Health Services, Review of Rule, Assisted Living Facility Cost Reporting Pursuant to Act 198 [Exhibit F] 1. Jay Hill, Director, Division of Aging, Adult, and Behavioral Health Services, DHS 2. Mitch Rouse, Chief of Staff, DHS
G. Consideration for Adoption of Interim Study Proposal (ISP) [Exhibit G] 1. ISP 2023-110 by Senator Missy Irvin – Requesting the Senate Committee on Public Health, Welfare, and Labor to Study the Operations of the Arkansas Waste Tire Program and the Potential for Improving the Strength of the Arkansas Waste Tire Program
H. Other Business
I. Adjournment
Documents
Speakers
Senator Missy Irvin Chair
Unverified
Speaker 4
Speaker 7
Speaker 9
Representative Jack Ladyman
Unverified
Speaker 14
Speaker 15
Representative Bart Schulz
Unverified
Speaker 22
Representative Aaron Pilkington
Unverified
Speaker 29
Speaker 34