Joint Budget Committee - Pre-Fiscal Session Budget Hearings

Good morning. We're still punish demon appear. Members we're going to start with like item seven and eight rooster or flag Adams seven. Thank. The Dotson do you have an amendment you want to offer. But hang on that Reverend Dr we're looking Mr Anderson remind us what seven does. Thank you Mr chairman one item B. one in your packet item B. one is flag list language number seven the this is to allow cabinet level departments with several departments to move administrative positions at a separate divisions into one shared service division and paid out of a paying account as chairman. Okay I don't have. I am meant. I we passed out the amendment yet. Represent Dotson you're recognized for a substitute amendment on flag seven. Amber's do give the are they are desk. Being passed out now just a moment while we get it. A dot your hat not to amendment yet will let him do it. The driver still pass amount its hang on a minute. The new document we're going discussed this flag list number seven substitute at the top. Black list number seven substitute. They're by got one now. Alright members. Representantes in you're recognized explain your amendment thank you Mr chair so the amendment that you've got before you're hopefully you've you've been passed out should say supplied number seven substitute at the time. And D. the change in this from. Item be one that you have on your desk is a. Item be. In the amendment. Would add upon prior approval of ale see or J. B. C. depending on the legislatures in session. And then it also includes in section D. the bold language that is is basically if this is challenged in court the entire section is struck The the reason for this. Would be I I agree with the need for the executive to be able to to. have the ability to try to realize savings through transformation and through the shared services. I just believe that it needs to come before a LC or JBC if they're just going to make changes to the preparation and we need to approve it before they they go forward and do it talking with D. with Mr bleed the accounting of doing this basically they would. They would come before us probably in a L. C. in June. And give us the plan in the Senate having zeros in these columns they'd actually have. Some some numbers of what their plan is and then we would be able to prove that are or disapprove that in June And then at the very last at the very end rise we're gambling in the meeting There's some. This language would need to be done upon passage and approval And I think Mr Andersen scribbled how that would work on my sheet but I can't completely read what he wrote a if he might be able to to explain that. Well I used to explain it will take some questions yes. I will turn you off for a minute. Senator Johnson mark Johnson from southern informed today Mister chairman. I'm as alternate today's gone. I would recognize you add Senator Senate ever you're recognized thank you Mr chair maybe this question be directed to the sponsor or who in the room wants to answer the chair direct question to set aside the fact that it might potentially go to court can someone explain to me how this does or does not violate the constitution that we would be yielding our authority to the executive branch based on the wording of the proposed change. So the question is are we giving up our authority. Question is are we violating the constitution by giving up authority as represented in the terminology in B. all right Mister does anyone to try that are you all we have staff to it. Mr so you want to try. The standard answer we give is anytime there's approval required by the General Assembly during the interim that it could be subject to challenge is being separation of powers issue that's short sweet answer Mister chairman of health phone you may thank you when was the last time that that was challenge that you remember. Our members ever being challenged okay. Long yeah a was game and fish and I I don't know it was a long time ago then they won thank you. You're done. Yes Sir thank. Mr Speaker. A quick question. If it's challenged and the challenge were successful what happens per the language is drop dead language on the end of it and that's what I thought. I'd also like to hear from Mr bleed at the appropriate time had now be as good as any Mr bleed. Both of a. So the good morning check please DFA office of budget at I understand you had an opportunity review this proposed amendment to item seven. And is it my understanding that that the of may the governor's office is an agreement to this amendment I've had a chance review quickly here and I think that the executive branch agencies and if they can accommodate that. I'll take that as a yes. Well as close as you can get a thank you Mr Speaker. Of John is there you are you fifteen. Well I didn't recognize you Red label for brief question. Thank you Mr chairman Representative Dotson not. I'm in agreement with the amendment but the only thing that I see in here is we are completely bypassing the personnel compensation committee we we and I realize this is a new a and a new arrangement set up but are we just gonna represent will not believe the approval part makes it go before personnel there but the approval part would make you go in front of the committee okay that's but that's all right the in okay thank you Sir. Jim Dotson center you just dial in line we got more to go. Senator Ballinger you. But not yet. Okay. Senator Elliot you have a. Mr Mr chair I had a question kind of along the line of the personnel as well so your statement just now that you will leave the language or would require if it's a personality issue to go be before personnel is is that something to IT is there something more come concrete or practices more concrete such as rather than it just saying coming before a LC that it would naturally A. L. C. would naturally refer something to the personnel caught I think that I misspoke it would go to a LC and then they would refer it personnel is the assumption that that's the assumption because that's the practice is that yes nothing that out if a L. C. chose not to send it to personnel in a R. C. would also have that authority would say would deal with it in and just in the council meeting yeah that's what I'm saying a LC what about choose to deal with it rather than send it to a subcommittee that could happen right yes This so be stepping on chairman Stokes several tank but yeah I think it happened. Yeah what I my question I guess to to Mr bleed in cases in in a in a case where we have some of our some of the agencies or commissions that have been merged had language previously that was quite autonomous about personnel like who they would hire and that commission has the authority to hire them. It will just with that still be the case under this kind on this kind of language that we have the transformation acted not to my knowledge affect any of that particular language that specific to those individual agencies in the individual agency still have a great amount of leeway to make sure that they have the right people the people they want this language is only really dealing with administrative positions so if you think about what an agency does with their front line employees the people who are actually out delivering to services for the agency in carrying out the mission of that agency those employees are not going to be affected by this this is really just aimed at the shared services like accounting H. R. I. T. that sort of thing. So if if for example a commission has all of the folks that you mentioned and the. that secretary chose to merge those those positions. So how does how is it determined that who pays for that is is that when the secretary has the authority to take funds from each one of those who pay for what happens the funding for would be determined using an objective cost allocation process so they would have to sit down and look at that shared service and determine some means of to of measuring out how much of that commission cost as opposed to the other pieces within the division and then allocate those costs out effectively the intent being that at the end of the day the service that is being provided to the commission will ultimately be less expensive ultimately save the money than they had been previously paying by doing it on their own. So just one last question of when when I voted for this I voted with the assumption and with the reassurance that. this was about. Efficiency and and so forth I understand efficiency. A. But I didn't get any notion of the thing we're talking about right now that this is what efficiency was going to need at I voted with the notion that on the other side of what we were told that these directors these commissions although they'd be a part of a cabinet they would maintain their autonomy so when it comes to the positions that you mentioned or the secretary wants to merge these functions they would not I would cease to have autonomy at that point even though that's kind of what I thought they would have would have voted for this. Autonomy in terms of the mission of the agency no about that I'm talking about what happens to their funds. Well there funds would remain where they're at and in fact they would have more to work with that this is effective well no I'm saying I'm saying it they will remain where they are but I don't know how they're going this is they're going to have more to work with I don't know if that's going to be the in game or not because if the if we want to the for example marriage the human resources. How do I know at this point that that's not going to have a deleterious effect on one commission or or the other I know you said it would be proportionate but this is a kind of. Thank quagmire I'm kind of into trying to square thinking when I voted for it none of this kind of stuff is going to happen and now it is I'm not saying good bad ugly necessary right now I frankly don't see I'm worried about the ugly that could come out of this But. This is a process that we're going to go through all fifteen agencies are to be working together every secretary has challenges ahead of them to avoid some of the very problems you're talking about it's something that we've been talking about internally for for sometime now I'm state something that hi I am sure will have some bumps along the road but at the end of the day were very confident that this will result in not only lower cost savings but more focus on carrying out the ultimate mission of some of these individual agencies which would have more money to do that but also the focus in the time of those those division directors will be up on that mission not so much on carrying out some of the administrative functions just one last question this on the on the human resources side if I'm a commission and I have for all these years have the autonomy this is a human resource question to hire the person I want to be safe my whatever. Do I still have that autonomy or not it would depend on that relationship that they have with their secretary with their department but also you know the class and contact and some of the laws that are set up for hiring people we're limited to a great extent and who we we can't just go out and hire the person we want to hire all the time a lot of times it's required that we comply with qualifications and other things. How is that different from what they would have to do if they have when they have wouldn't they have to do the same thing house at any better it with the intent to this is not so much to change how we we hire people or the people we hire necessarily but it's really too intent the intent is to set up that structure that that administrative back office structure so we can provide more efficiencies agencies. I wish we could I'm I'm talkin affecting your talking intent so I'm trying to clarify if I am a person who is the director of the commission was say. And my commission has always hire the person who is going to be the director. If that is the case am I subject now still as I have been to the will of that commission am are now subject to the will of some of the larger body the world transformation acted not change any the laws that are out there that require a commission or agency or some entity to determine individual position I know that that's one of the reasons I voted for it but this appears that it could so I want you to tell me that it won't this only deals with administrative positions okay I'll thank you. Thank you senator other senator Chesterfield are you waiting to make your point ours is you have a question. Okay but I thought you and I had an agreement as to when I would make my for October will make point after we finished with this well that is absolutely correct and that is my understanding okay now may I proceed you may thank you so very much I would like to hear from Representative Dotson as to his legislative can't if this is indeed his bill Representative Dotson. You're recognized. Thank you met Mr chair it can you repeat the question was what is the legislative intent of this are you the author this your legislation well the amendment offering I mean is like number seven was not so what is the legislative intent that's what I'm trying to find the legislative intent that I'm trying to add the amendment is requiring approval bail C. or J. B. C. before action is taken and not as it was drafted before it is already taken away. Before action is taken on what or any of the shared services transfer transfers are made that there's a plan presented to us on on what those transfers are in we we are able to sign off on it prior to them taking those actions and as it as flag seven was originally drafted it would be a report at the end of the year on what what they done okay and in hindsight I see thank you that that's that clarify some of it for me and to you Sir. If I have if I am for instance a towing board and have always hired whom I choose. Right now be subject to shared services or what I continue to our to operated in a time expansion the towing recovery board would still operate within the letter of the law as it's written and if the time recovery board had the authority under the law to hire a director for example the transformation ACT didn't change that what the towing and recovery board would get as a result of this though is the opportunity to operate with a full departmental level staff of not just maybe a part time bookkeeper but full time maybe legal staff H. our resources and some of the other resources that you would expect from a larger division or larger department but which are now not currently available for a small agency like towing and recovery thank you thank you Mr chair. Thank you senator. Senator Malick you're recognized. Thank you Mr chairman our to follow up on the. When this is course what we have. An item for joint budget we routinely if it's personnel referred to personnel. But when we're on council of you mentioned with the council could referred to personnel or if it's a change of appropriation then peers subcommittee would be the proper committee. But to keep from slowing the process now does this language allow it to a mediate Lee go to a subcommittee before it comes to counsel rather than going to counseling and being referred back to the subcommittee you know typically all council whatever the appropriate subcommittee considers it first and then it then there's a report to council for the council's full consideration Mr Garrity said yes it can go straight to committee but that's what I also did I just want to make that clarification with this language and and that because subcommittees are a part of counsel okay thank you thank you. Represent Cavanaugh. Thank you Mr chair just report for we have a long day just remember we're gonna be here all dark anyway so take all the time in the. Is that directed toward me now Just want to clarify that there's some concern that with the the with the commerce department that some of their money if we did this could be improperly moved in used for things that should not be done can you address that is that is that going to allow that to happen so that was the initial concern when we set up and we begin to look at well how do we create shared services and the immediate concern is that constitutional issue of miss using state dollars if we've got special revenue or federal funds are cash money we don't want to put ourselves in a position where an auditor whether from division of legislative audit or the federal government could come down and say we gave you money for one purpose but you used it for another and so this whole section was really build and and designed and has been in use in other agencies before now to avoid that issue where if an auditor comes down we can show to a penny that all funds were used appropriately within the letter of the law and this is not in contrary to the transformation bill at all no ma'am okay thank you and. Well the first twelve to fifteen pages the transformation act really addresses the need to create these sorts of shared services. Thank you Representative enough. Hendren. Thank you Mr chairman so I know we're not talking about eight now but with this amendment. We will have because I know there's a lot of talk about we're given up or authority in our oversight and all that stuff. But with this amendment both of the say nothing can be done nothing without approval not not review approval of the legislature in one form or another is that right that's right and and all of this our original plan even without the special language would have required three quarters majority in both chambers when it was presented in appropriation at so if you guys want to take a secretary. And share that secretaries costs because there's not a full time job as a result of combining some of these agencies. You can't do that now without coming and asking a LC year or the legislature. How we would have to present that and planning details the approval as I read this well I say give us a lot of stuff that I don't really want thank you. Thank you senator Hendren. All right we're down to three more questions whose thirteen. Johnny in your company do not turn yours off this morning. You're recognized. senator J. thank you Mr chairman of basically what we are doing and this is once you have forty two or forty four different agencies that go together and just say fifteen or sixteen and you have a need for secretary instead of going and and hiring one for each particular H. particular agency you're trying to put one office one secretary to take care of two or three. Of those. The intent here is to really streamline some of these operations so you know you're right we took of forty odd agencies and brought them down to fifteen in some cases some of those agencies labor and licensing is a good example health department as ordered a lot of small boards and commissions previous to transformation all of those entities were in effect independent and and so they're all responsible for their own administration their own human resources their own IT their own legal that created some issues that when we sat down to look to transformation we felt like we could address we could do it in a manner that would not only save us money but would also create more efficiencies allow those agencies have resources they didn't previously have or really sharp and some of the the mission focus of those agencies pull people away from warring about making payroll and instead have them focus on what really date there being hired to do in the mission there really intended to carry out so yes you're right in the sense that what we're really doing is pulling together those administrative functions but I want to be clear we're not collapsing or not wanting to combine the program functions to people who are actually out there doing that the job of the mission the agency those will not be affected by this. so overall in this. It's going to save money but at the same time. You're still gonna have to come before this body to make that type of adjustment is that not right. My understanding of the process is that we would present a plan a report to the LC in June on how we anticipated the cupping the coming fiscal year would operate through the appropriation section that would be created to this language if they'll see approves that report then starting July one we would be able to set up the shared service operations and operate through this special language is laid out here to create the sort of efficiencies that we think we can create. Thank you. Senator Irvin you're recognized. Thank you quick question I'm right here in front of a headache and Mister Billy I know that some of those as shared at or the attorney general's office has to work with a lot of those boards and commissions on providing them legal advice and and and deal out with that well this and anyway of facts that arrangement that we have to have with attorney general's office or for attorney services or anything like that it you know it very well mine because there are some agencies that previously didn't have lawyers on staff that might be pulled into departments that now have legal staff and that's just something I think we're going to have to work out on a case by case basis okay thank you know similar situation we have over it DFA we have something called the service bureau where we have folks in accounting in HR and procurement who provide those services to those little boards and commissions and agencies we're now working out how that's going to work because those folks will have their own in house staff now to help them okay so so attorneys that could be considered the admin as well some of the departments have identified that as a shared service okay gotcha thank you. Thank you senator Irvin. Senator Hickey. Thank you Mr Teague house will try to keep my mouth shut but did not get their. Members that represent Dotson he's made a great stab at trying to make this palatable but and this is a large but I want everybody here to remember. That we talked about this because since the that is supposed to be specific this state and we cannot delegate that that's is about as simple as you can get with that one other thing that I want to remind the committee is that those appropriations within those parameters that I just say it. Are supposed to be bile wall so in other words whenever we would do that they were supposed to be specific and distinct and by wal A. L. C. doesn't do statute you all know that that's the reason that will over all these years that we've done it through the legislature. I had a little bit to do with the transformation and I wanna tell everybody here that whenever we did the transformation. And that was down at the Senate we worked on that for days weeks basically more. One thing that we did do is that we we ran an amendment at that time that would make the independence of the banking insurance securities and the plant board so that they would be totally independent. This is a legislation and so basically what we're doing is. That amendment that we put our own worst circumventing it with this so I want everybody to understand that AS IT relates to. To those for entities. I personally would want to vote no on the thing because I have an issue with the constitutional part. But at the very least if there's enough people in here that want to vote yes on this I think that we should. back up into the desire of what we just passed in the session with the amendment and exempt totally exempt those Those agencies right there. One last thing is I want to make sure everybody fully understands Senator hammer brought it up and Mister Anderson we talked about when was the last time that it was challenged and there was the issue with the game and fish I want everybody to understand that the legislature will lost when we did this last time I don't know if everybody here was clear is as to what that ruling was or not but we actually lost. Of whenever that was challenged has been quite a few years ago nineteen thirty four nineteen thirty six I can't remember and I don't have that in my pocket but it's pretty close to that date so anyway. No question but I'd to I want to bring it up before we voted thank you thank you senator Hickey alright members we have no more questions Dotson are you ready to make your motion. Thank you thank you Mr chair And before I make a motion good I have Kevin explained the how the motion needs to make upon passage and approval of. Transient. Thank you Mr chairman it's been brought to our attention that to you Meet the fiscal year twenty one demands that this language should be drafted in the emergency clause adjusted to make this passage and approval in other words this language would be effective as soon as the act was as soon as it was enacted. So. That would be my motion to that your motion is to adopt the amendment up the men on passage and approval and and have staff insert this language into each of the preparations to draft for the session driver body good on that. All rights Senator sample. Thank you Mr chair I would like for the vote the. A roll call and divide it. Massey three hands. Hi three. Cant two three. All right I see three hence. So members we're gonna vote now on Senator dot sings amendment thanks Senator sample. Representative Dotson whatever. To our first. Senator flowers. First alternate senator rice. Senator Clark. Senator Malick hi. Senator Stubblefield. Okay Senate up I'll I'll I'll call that again senator MALOCH. No vote. Thank you Mr Senator Stubblefield. Senator Cheatham. Senator Irvin. FOR Salter senator Caldwell. The first alternate Senator Wallace. Senator Ingram. Senator Cooper. Senator Flippo. Senator Blake Johnson. By senator Elliott. Senator Chesterfield. Senator DISMANG. Senator English. First alternate Senator hammer. Senator bond. Senator mark Johnson. Senator Hendren. Senator Hester. Senator eight. Senator Breanne Davis. First alternate senator page. Senator Ballenger. Senator leading. Senator Bledsoe. Senator sample. Senator Rapert. Senator Hickey. So that's thirteen it's still fails. Yeah. Membership fail with thirteen about. All right that takes care of that Dotson. Jett center Ballenger do you have a. Motion. Amend nope thank you Mr chairman hi yeah right at this point with the without that one passing I'm not sure that that mine is going to pass out of my making the motion giving it a try but you know I I yes so essentially what what No actually I'm I'm not gonna make a motion thank you I appreciate it. Alright members that we're gonna vote on amendment seven I mean the seven without the amendment is that right. A Tatham B. one in your agenda be one in your package. And it is. Seven without any amendment. All right. Senator sample. Mister Mister would you like to divide the body in. Roll call. We can do that hi I need to see three hands hands thank you very much. All their side this time. A Mister chairman just to clarify what we're talking about the language be one in there and I. Is that also to make this upon passage and approval. Say that again is that also to make this language upon passage and approval that's. Being be fine upon passage and approval members. But what but. Not. No it. It it's just to make the language effective immediately it's just like it is though. Alright members this is the amendment but with passages approval selection you start using it now. To the house yes. Representative shepherd. Representative Holcomb. First alternate represent Burch. hope. Okay we didn't hear represent Holcomb. Yes. Eubanks. Representative person. Representative Richmond. Represent money Hodges. See. Okay. Ladyman. Representative Tosh. Is he here. Okay. A first alternate Representative Tosh represented Gazaway. Okay we can't I didn't hear that sorry I'll speak up. Representative Jett. Representative gray. Representative Cavenaugh. Representative makes. Representative back. Not saying represented back first alternate represent Wooten. Representative house. I sing Representative house. Second alternate. What is that I can't. Absent in it. Representative Mickey. Represent any Davis. Representative eaves. Representative McCollum. Not saying rep semicolon represent first alternate represented Penzo. Represent one stram. Represent della Rosa. Not saying represent della Rosa second alternate Representative Crawford. Representative grant Hodges. Representative Boyd. Absent Coleman. Representative Wardlaw. Represent Dotson. Represent Womack. By Representative capp. Okay. You get sixty two all right thank you. All Senate senator flowers. I think Senator flowers senator rice. Senator Clark. Senator Malick. Senator Stubblefield. Senator Cheatham. Senate urban. Senator Caldwell. See you. Not seeing center call well Senator Wallace. Senator Ingram. Senator Cooper. Senator Flippo. Senator Blake Johnson. Okay I didn't hear vote us out that's a yes. Senator Elliot. Senator Chesterfield. Senator DISMANG. Senator English. I think Senator English first alternate Senator hammer. Senate senator bond. Senator mark Johnson. Senator Hendren. Senator Hester. Senator eads. Senator Breanne Davis. First off it Senator Pitsch. Senator Ballenger. Senator leading. Senator Bledsoe. Senator sample. Senator Rapert. Senator Hickey. You get nine votes it did not can vote to do not pass center Hendren you've. Thank you Mr chairman out. I mean that they're it since we're gonna be here all day anyway I just wanna make one more motion if we can one of the things that at least on our side that had been discussed and I think what is a laid the concerns of some has had would be that. Rather than a report at the end of the year about any changes that are made as a result of at number seven there would be a monthly reporting to a LC about these changes about IT year shared services or whatever it would be and I my understanding is that the the governor's office and D. F. and A was was fine with that because again it gives them the ability to do it and report back so there be even more transparency to what we have center in that what we just voted on Dotson no his was approval yeah a tract of is Ballenger's it so do you have that amendment drawn up. All right so even though this is Senator Ballenger's amendment can I offered is amendment to for for adoption. You may have sent about true is that alright with you. All right so again he may want explain it but we had some discussions about this yesterday and again to in an attempt to try to satisfy some members this basically required there would be a monthly report given to a LC or or whatever or personnel about any of these changes that are made so again I I think it hopefully is something that we can get get past this in and move on to the fight on number eight so I move that we adopt this amendment. Alright members if you don't have it it's flag list number seven alternate flag list number seven alternate. No limit will get in handed out they will take questions. Senator Chesterfield you're recognized for a question yes Mister I am I wait for the information to be passed out. But it does not a lay my concern about the lack of legislative review. Of what we're talking about now is late just giving us a report and we either take it. Are we don't take it. Any even was review as the executive have has done in the past has chosen to continue with doing it anyway. But at least we would have legislative review not just legislative look at it and that's it because the act will have already been done and I'm wondering if within this. Is there something I'm missing about the legislative review because I remember holder refused to review something in the past the governor said what I want to do it anyway and that's his prerogative. But within this I don't see the legislative review part and so could the maker US senator Hendren do the chair to senator Hendren could you explain to me the and what the legislative review process would look like rather than just giving me another report to read. Senator Hendren you a lot up answer that question. You're recognized well again the the I think the amendments been circulated now if you look in be one this isn't a review requirement this is a reporting requirement again which and I'm not trying to say that it's anything other than each department utilizing salaries assured service section and again we're talking about shared service for administrative things as defined in the rest of it shall submit a monthly report a LC or in if the sessions if we're in session joint budget under D. F. and A so again this is an effort to make sure that the legislature is aware of any of these administrative changes are that are made. Which makes it easier for us since we're gonna be having budget hearings in November anyway if we're not happy with it we have the information to make adjustments to do the normal process. Yes ma'am. Law. In making everybody. Let it back up. You're recognized I understand there is to me a difference between a report and a review. And maybe I'm the only one this this this wrestling with the difference between a report and a review the review gives us the right to say up front we really don't appreciate this however the executive still has the right to proceed with whatever him or her wishes to DO and concerned we don't have the review and I would I would prefer having the ability to review it. Rather than just saying here it is so that's my concern with with with the amendment. You still own. Well again this is a this is something personally I don't even think was necessary to begin with because I again personally I don't think that it's really a of of of appropriate function for us to get into the weeds of administrative sharing of services I think that's what our directors and our and our people that we pay salaries are joint to do but in an effort to try to get past this and and again since the the governor's office agreed to the previous amendment which failed which required approval I'm certain they would agree to an amendment which required to review process on the front and instead of the back again and again of that would allay enough concerns to get this behind this I'm fine with that as well which is taking that represented Dotson's amendment and changing it from approval to review it if that gets us to where we need to be house second. So can I make a substitute amendment to my amendment already got somebody online for a substitute you've substitute to substitute a second. The mind is so good. I miss that Sir right. Representative by Senator Ballinger your. Okay. Senate has withdrawn his amendment centre Ballinger members that I. I think we ought to consider dealing with this during the session but we will we'll move on Senator boundary do you want to try to get something. Mr and and I'm interested in hearing the substitute so I won't be offended if the subset motion comes up but I'm gonna make a motion that we try again adopting represent of Dotson's amendment the requires the approval process we've been working we think that we have some people who were deported I think that it can I speak to my motion the I think we got that expunged to in order to do that okay so so if you want to make a motion that we had make a motion that we expunge the vote by which his name it filled it is everybody. We need a second. I have a second everybody aligned with what we're talking about. Okay so. I have a motion the second we read about. I guess we'll call Senate again. Not a we don't have a motion to a yeah. Because of this all those in all right we're voting Allen Dotson amendment the expanding of the arts and the vote by which we explode voting links plunging the amendment yeah you got me confused all those in favor I. A. All right we expulsion vote Senate we waving at me. A little late but tell me what you want to. Who. All those opposed. Hi eyes seven. Right so it's been expunged. So Mister chairman is motion now. I'm I'm just making the same motion that represent Dotson have that it requires the approval process and and to me I think that this is probably a pretty good compromise from them not having it and and I think we're we're actually providing them the tools to to try to move people around but it's still provide us the complete oversight and approval process in order to to get it done and so I think that I can understand you know if I were in the minority party I'd be really concerned about just yielding the the parents of the executive branch but this I think it's a mechanism where will be able to have that oversight and I think it actually is still maintains the authority of the legislatures so that would be my motions without that amendment. Not hang on a minute alright members you know we're on for we're back to flag list number seven substitute blacklist number seven substitute. I need to be able to push the. You're on. Right now. All right so We have the motion any discussion senator Hendren. Is it not I'll. Issue green but. No all right as I said earlier we've already voted on that once I think it what I do is make a substitute motion that the only word we change there is upon prior approval we change that to review like we do with almost everything else then we passed that so I would be the substitute motion that we take like lex evidence a substitute amendment except change the word approval to review. I have a motion and a second. Our voting on the. Amendment adopting the amendment we're voting L.. Yes ma'am. Go right ahead. I miss the chair I this is a question of a Mr leader whoever can help me out with this before any vote. Out what is the process for determining. who gets merged into what and who has what position who gets let go or anything of the kind what who who actually does that. And. Is there any kind of appeal process within or does it just happen to folks that will be turned into departments by the agency they'll the secretary is in their staff are going to have to sit down and look at the workload to make those to certain decisions. What the secretary and the agents is within I got to make that decision is there is something on paper that guides that process or they just make it that by discussion or whatever so there's audit standards and there's different rules they're in place largely with our federal funds that lay out how cost allocation principles work and those principles organ and then guide how we can allocate the costs that which is of course the the main target of what we're trying to do here I think I'm asking poorly because I'm talking about personnel if when we it is like part right now if each one of the commissions boards or whatever if if they have somebody who is doing the work that is about to be merged for example if there's going to be one big human resources are part of this. Does that mean that everybody who was doing something whether the human resource is going to be moved into that that that bunch of folks. It seems to me that I don't know my to my not be efficient yeah but if that is not the case what is the process who decides that to the agencies will be asked and have been asked to identify the positions that will be operating through the shared services appropriation which is before you today and so all those positions which the agency identifies as working in these different areas human resources are right here whatever we'll move into their now their actual day to day work what their responsibilities are the answer to that will be determined at the department level. If if there is a board or commission right now for example who does not have a director at this very moment Is there going to be a star director hired of to take the place of the director who is no longer there. if so. For good but if not how did those people get treated if they don't have a director because I know that lease one board that does not have a director the directors and would all depend on the position but by and large I don't think directors would be affected by this because of course the director would be running that agency that border that commission they wouldn't necessarily be involved in the human resources the I. T. or some of the back office stuff we're talking about now how they get hired that really depends on the individual circumstances within each agency in this case where this at the board does not have a director then we still leaving it to that board to hire that director as they have been in the past or is this decision going to be made for this board by this new configuration that we were put into place what happens this would have no effect on the hiring and to my knowledge this would have no effect on the hiring of an individual board director that would be done as it's always been done in the past. Okay. I will. Take that as a. Something I can go with and will see down the road and talk later if it doesn't work out that way that's a real problem thank you I appreciate your answers. Senator you Sir yes I'm through thank you Mr chair you're welcome. I've got senator DISMANG we got shall hold listy also Thank you Mr in where it discussion right now yes we are okay so I I you know I'm trying to chase through make sure I understand some of the concerns that are you know out there's we have constitutionality I think is one that we're hearing we've got lack of legislative oversight that we're hearing and and I'm gonna be honest when I look at this I don't quite see it the same amend. Most of us don't like that we have annual sessions but we do mean the longest time period that this can stay in effect is roughly what six seven months before could be altered the longest time period that it could be quote unquote on constitutional would be the eight that same time period and also even if it were contested my understanding is that this ability to have the shared services goes away soon and in a way that if you don't want to have shared services concern about the constitutionality than those items are addressed you know we've talked a lot about savings and I guess worst case scenarios which again I'm still trying to follow through what those are but when the we haven't talked about that I see just a little bit from my background is the ability to have some additional oversight which is something that we push for over and over again legislatively and I'm not just saying legislative oversight because it's going to come to us for review but also let's just say you do have a board commission that has an account that operates in the silo that doesn't really you know expose their numbers anyone else but what you know the board that there under whatever it may be. If they are part of the shared services and have let's just say it's CFO that it in is ultimately over them beating watching and seeing that there is some reassurance that we should have from that kind of function also logically if you just think about again I would just go back to accounting I mean lots of times in the counting world you have busy months let's just say you have a board commission that collects dues and you know for the realistic purposes that eighty percent of what that accountant does in that time period only last three months. Well you know this would create an opportunity for that person to not just collect those dues for three months but also be part of another position that is suggested a different agency at again I'm just having a hard time following through some of the concerns mostly because this is on a very compact timeline of of how this can happen in Kerr anyway with with that that's that's my contribution to the discussion. Thank you senator DISMANG senator bond you're recognized. Thank you Mr chairman well I'm not admits and I'm inclined to give the administration some leeway but I'm also wondering why we're sort of rushing to put this in the bills now is it something we could do a half day on to address the constitutionality and all this and then. Maybe understand exactly how the administration is going to work through this process if you look at the amendment that item to at the bottom the transfer authority. Includes the says including without limitation to administration human resource procurement communications field operations and information services and I just I'd like to hear more about it and and have a couple hours to do that as opposed to rushing around with the amendments and it may be because I'm a short timer that I haven't heard everything from everybody here but that would be my suggestion what's the rush. I don't know that the budget is going we're gonna have a more hearings but if we don't do it we can always do it in the session and spend more time on. So. Are you done center bond. fifteen who is at. Representative wouldn't. So. What what are we voting on this time substitute. This senator Henry I thank you I think it's a valid question Reggie wouldn't. Well are we voting to explain it to review. Review go ahead as chairman we are voting on the language in the upper left hand corner it says flak list number seven substitute. And where it says an item be upon prior approval and bold that will be changed to upon prior review for the motion as as that's okay. You got it I got it thank you Mr thank you. Senator sample do you have a motion. We can we right we're not ready yet all right I'll come back to you. Under the divide to have. Senator Chesterfield of just a. Point of personal privilege as we discuss this this is not about being in a minority party. The minority party presented none of this for discussion. Representative Dotson is a member of the majority party. In the last I'd look nobody in the minority party even had a dog in this fight. Except that we are concerned as citizens about what we do the separation of powers and also making sure that our people are treated properly in this. Transformative age and so I would ask that we stop dealing with that kind of stuff and start dealing with the issues. I'm not engage in the hyper partisanship that we see so much at the federal level because. Minority party has not brought any of the is to this body thank you Mr chair point taken thank you. Absent Dotson you. Your back up. Thank you Mr chair Still processing last comments there What I was going to bring up. Was just try to further clarify and and make sure I understand with staff might be able to clarify this force as well. The motion that's on the table the substitute motion that would change my original amendment or motion. To review and as far as a yeah a substantive thing it would be the same exact process any of the services would come before ale see if it's personal related it would automatically go to personnel subcommittee if it's other related it would go to peer something else that does go to the subcommittees as far as process concerned review the difference between review and approval like I originally had had suggested was that once we review it if we did not positively review it the executive can still move forward with it after they've given us their their report approval they can't move forward with it and tell we give their their report I just wanna make sure that everybody's clear on that that's the substitute motion is for review and then should that not pass the underlying motion is for approval and just want to put that out there and this this for me is as stated before about legislative oversight and has nothing to do with partisanship. Thank you Representative. Senator Rapert. Thank you Mr chairman I've just been listening of course we've had it for two days and it's been mentioned here I just want to from my perspective. When I first came down here in eleven we had just had our first fiscal session. And before then we only have one time ever sixty days to even deal with the budget even talk about making changes in and that was the process the the whole idea of the fiscal session was to bring more calendar ability and have an opportunity for us to take a look at things the one point I do want to make it very important is this idea of not of non delegation or illegal delegation of legislative authority. Anybody can go out T. NCSL and read the history of that that's that's a very clear subject in it basically states the legislatures we all know makes the loss did executive administers the laws. I don't see that this subject is delegating authority in terms of authorizing a department to make changes within their department according to the statutes. We're not delegating authority for them to make any law because this body today as a matter of fact is making a decision on what authority we want them to have or not have. So I don't I don't agree with the the stretch to say that is some sort of illegal delegation of authority I'll close my remarks there's a lot that can be said on the issue but we've been dealing with this for many many years Mister chairman as you know with the national association of insurance commissioners has a guideline that accredits all of those insurance departments which was of subject in here the other day they make changes in an A. I. see which affects our law and we haven't even looked at it so we've had hearings in the insurance a committee on illegal delegation of authority meeting that we need to at least approve that and we do that in Arkansas as a result of the commissioner making sure we we do it and here's the illegal delegation thirty can't delegate legislative authority to a non governmental entity and that's where you get into the insurance compact's in the other compact's that we've agreed to in the states so I just want to say that is long as we is this body or making decisions that are authorizing certain powers that's not delegating authority way what we're arguing over here's where the we want to come and get approval every month for something they do raver every session for what they do and so as long as there are binding what with they've been authorized to do I don't have a problem but we absolutely have a problem with people begin to get outside the lines it and do things they shouldn't my concern is always been about the special revenue my concerns been about the special revenue not being either up inside of a department used for other purposes the assurances I thinker they're already in the statute so I just wanna make sure for my and ask a state that because it's up to us if we want to come down approve every single thing that's fine we already meet every month anyway but I just wanna make sure it's not it's not illegal delegation of authority in my opinion thank you thank you senator Senator Hickey you have some four Senator sample makes this a. Motion I do Mr chair for the members. We would look stupid if we passed review. When we could have approval. There's at least two to three of us over here that have been voting no. That if we will kill the review and go to the Pro Bowl we're going to go with that because here's the thing you do have enough votes probably to do the review I don't think that would be smart with this body so that being said at this point you know that you'll have the votes on the Senate side and the some people change to do to do the approval thank you. Go back to that anyway. Senator Hendren you're recognized. Just look at the same. Senator Hendren you don't have anything. Good your good. All rights Senator sample you have a motion I day Senate divide. And roll call and roll call vote roll call three hands. I see three hands. You can. Ms chairman a by my understanding is now we are voting on flag list number seven substitute at the upper left hand corner we are changing prior approval to prior review that is the but we are currently under. Seconds okay Mister. Senator flowers. I think Senator flowers senator rice. Senator Clark. Senator Malick. Senator Stubblefield. Senator Cheatham. Senator Irvin. Senator Caldwell. I think Senator call well first off Senator Wallace. Senator Ingram. Senator Cooper. Senator Flippo. Senator Blake Johnson. Senator Elliot. Senator Chesterfield. Senator DISMANG. Senator English. That's saying center and is Senator hammer. Senator bond. Senator mark Johnson. Senator Hendren. By senator Hester. By eads. Senator Breanne Davis. Senator Ballenger. Senator leading. Senator Bledsoe. Senator sample. Senator Rapert. Senator Hickey. Members that fail with ten we we did the one motion and they were going to move on to We're going back to the motion already in the motion is. To pass number blacklist member seven seven two. We're gonna we're gonna vote on flag list number seven substitute as idiots. All right. With approval as it is now about to make a run at a boat she trip here By god go find a copier. all those in we're gonna voice vote all those in favor I. The pose the eyes have it. You members. Members I hate to admit it my co chair was Barker and me when we first started this session last week he said I'll go first and actually he planned this all out so that the I would be the chairman when we got to this so with that done of we want audit up. eight are we gonna do eight. I don't see reason debate are we going to write. we're not gonna do right. All right you can go to yeah all right. Alright members that leg audit. Committee of the report DHS. Into the table recognize yourself. Thank you Mr chair my name is Tammy Shaw with legislative audit. I'm I will be summarizing the federal compliance findings and Mr Morgan will cover the findings from the financial audit. The federal compliance findings FOR the department of Human Services. Are located on pages eight through fifty six of the audit findings document. There were twenty one findings for five programs administered by DHS. These findings were reported in the twenty eighteen single audit and were presented to the legislative joint auditing committee on Friday may the tenth of twenty nineteen. The child nutrition cluster had one finding. Two findings were reported for the child and don't care food program. Foster care had one finding. There were five findings that affected both the children's health insurance program commonly referred to as chip and Medicaid. Chip had two additional findings and Medicaid had an additional ten findings. The deficiencies found included inadequate or missing documentation to support expenditures are claims paid. Failure to follow established procedures for lack of documented internal control procedures over compliance areas. Conflicting data between systems. And inaccurate or incomplete federal reports. Question costs totaled a little over fifty eight million. And affected Medicaid chip and the child and adult care food program there were no question costs associated with the findings for the child nutrition cluster or foster care. That concludes the summary presentation for the federal compliance findings. Members will get any question for audit. Yeah one more report this don Morgan legislative audit I'll be presenting the departmental audit findings from two thousand eighteen they're located on pay they start on page fifty seven of your handout. The first funding deals with equipment well performing an observation of cap less this we noted the following out of a sample of sixty equipment items to equipment arms could not be located for observation five equipment items at a different serial numbers and the serial number of record in aces in three equipment items do not have a serial number recorded in asus. Funding number two during a review of checks written from the gifts and the quest account we know to one check written for the purchase of a green house totaling three thousand three hundred ninety five dollars and is the capital asset guidelines definition of equipment low value and is not accounted for and asus. Funding number three during a review of the Arkansas Medicaid program re re fund account we noted to businesses were check it been posted twice in aces all those checks that cleared the bank during the fiscal year due to the difficult recordings agency continue to list them as outstanding checks on the bank reconciliation at your in resulting in an understatement of the agencies book balance of sixty one thousand and thirty five dollars. Funding number four. During our review of the Medicaid drug rebate is bank account we found that the agency did not adequately monitor the accuracy of Medicaid drug rebate monies being transferred from the account to the treasury fun we know the one instance in which the agency failed to transfer a hundred twenty seven thousand dollars a rebate moneys received and three instances totaling three thousand one hundred three dollars in which the agency transferred more rebate moneys than had been received in addition the agency incorrectly recorded twelve point seven million and Medicaid drug. Medicaid drug rebate funds help for transfer fiscal year in a sister only to report this is revenue to cash fund when it should have been reported as revenue in the treasury fun. Funding number five during a review of purchasing card transactions we know that the agency purchased ten mused that part season passes totalling one thousand two hundred forty five dollars for ten foster children under title for the foster chair foster care program. The cost of the music park season passes would be considered already covered of the child's title for maintenance costs per diem rate provided to the care giver and is therefore considered allowable additionally the agency did not maintain outside source documentation of the children for whom the passes were actually purchased were documentation of the applicable care givers receipt of the passes. Funding number six during our review of a hundred and five Wickes fuel card transactions totaling seven thousand five hundred seventy eight dollars. We noticed seven question will charges totaling seven earned seventy three dollars agency personnel so they were unaware of these charges into we inquired about them subsequently the agency disputed the charges with wicks and seeking reimbursement. In addition the agency was unable to provide supporting documents to documentation and applicable vehicle logs for thirty seven fuel card purchases totaling two thousand five hundred and eleven dollars. Funding number seven during a review of the Arkansas state hospital patients money fund we know the patient leisure contain seventeen accounts with negative balances totaling two thousand one hundred five dollars the majority of this total was due to one patients negative account balance according to the patient leisure to patient had a balance of seventy dollars and discounts however when the patient was discharged eight inches agency issue the check an amount of one thousand four hundred twenty one dollars resulting in an over payment of one thousand three hundred and fifty one dollars we also noted an account label miscellaneous with a negative balance of four hundred forty four dollars. And finding number a during a review of the general account cash fund we know that the agency maintain an account balance in excess of two million dollars for fiscal years two thousand twelve three two thousand eighteen agency personnel indicated the purpose of the General countess provide a temporary holding place for deposit transactions that need to be research prior to transferring the moneys into their appropriate fun. We your crest requested documentation from the agency as to what constitutes the balance in the account however however the agency was and unable to provide supporting documentation of the two point three two million. Balance Mister chairman that concludes the findings okay we have I think a question for leg audit Representative Lundstrum got a question. Yes Sir you said could you start at the top when you said a hundred and twenty seven thousand right over here over here and. Of funds that were misdirected or not given to me but I think it was the drug reimbursement driver in the drug rebates they were just not moved from that county that they received into the treasury fund Hey and was there is reason for that I'm so the other reason for that oversight wages. It just the money just and get transferred I'm not sure what the reason for that was that they just lack of oversight and getting what money came into that count transferred over did it ever get transferred over the yes ma'am I believe you can ask the agency but I will I'm pretty sure I got transfer over okay and then any twelve point seven million dollars that you mentioned. Again again that was made to get did they got recorded wrong it got recorded in the cash fund as cash fund revenue but it was actually treasury fund revenue. Right sounds like there's a lot of things going on that we can check into. Thank you. The Representative yes Sir. Representante you're recognized. Over here thank you Mr chair under what you referred to is finding number six hello concern we had thirty seven fuel card purchases that the there was no documentation to is have put that fuel was used for which totaled up two thousand five hundred and eleven dollars which is unaccounted for in and exactly the purchases that were made in without the documentation. One of my concerns is under the recommendation only recommend recommendation made for the A. unaccountable twenty five hundred dollars is is that you the suggestion was made that the agency establish an adequate internal controls. Is it is or any of. Best to gate shins ours as been turned over and tried to establish exactly where the twenty five hundred dollars and who used it now we used. I'm not aware of any investigations on that we brought this to the agency's attention and left it with them to To investigate that. I just saves money that's pretty line at the you know procedure to move forward wages to suggest to you know A. establish more adequate internal controls I think we probably some point you look a little harder and to try to discover. For the twenty five hundred dollars you know who use it how they used it and so forth would you agree I agree I agree we we follow up on our findings each year. We start the audit again But I don't I'm not aware of what any additional investigation but I agree with you. You know further Mr. Kevin off you're recognized for a question Mr chair mine will be directed toward DHS in is about audit findings okay we'll have them up after they get through. All right the. Revenue moved that you fifteen that would be you're recognized chair thank you. The did I understand you correctly the check should have been issued for seventy dollars and it was issued four thousand Yes Sir that was correct would you review them one more time briefly. have others that happen. The Was it the Arkansas state house bill in their patients we looked at your general ledger Shiz so it should have a balance for each patient. And when and this one patient only had a balance of seventy Bucks but when he was dismissed they run check for one thousand four twenty one dollars I'm not sure. One. It in interviews of the the people that wrote it or. I knew then that in may I know that this yes Sir. Hello in. And this is an opinion. From you. Is is this pretty fragrant fried throughout the throughout that agents. Relative to all of your you're all its in your working they lacks over there completely on the financial matters. No Sir that's not my opinion a at gently think they do a good job the this is just one of the items it fell through the cracks. How many. How many fell through the cracks. Well the just the items that I have mentioned to you these eight findings is is what was involved two point two million dollars two point two million dollars. All this there a. It was last one it was the is. Their general fund they deposit money into this account or money gets deposit in this account that they they're not sure where it goes supposed to go to. And so they try to do research on and figure out where it goes to before they send the money out and over the years we went back to two thousand twelve through two thousand eighteen this amount is accumulated up to two point two million dollars that they weren't sure. Where went to Izzie just laying there in that account. Yes Sir. So we have two million dollars there we can account for or where it came from. It's account of force there we just don't know where it came from yes yes. How often do you run into that. The app it out emitted other agencies well other agencies within that agency is this agency this is one back to two thousand and twelve. So this is still going house and well we've had two million dollars that they have collected or come in is revenue and then you know where to put it was it came to ask somebody DFA you so room I'm a bring up the DHS may bring and from the question thank you and I got Reverend Kevin also. A senior I'm let you make your opening statement after we entries audit questions but somebody of your department and I think reviewed cabin off also has a question if you over yeah could help. Mister wood with his article questions whoever the personnel we need to have a peer. And if we need to roll more seats would have line that that whole row was C.. Yep but some out. All your excuse liberty to call you back yeah could you. Here. That's good what's is. And where we're going to begin with Mr with this question. They will get relative Cavenaugh the question on the audit part of thank you Mr chairman. Ms Gillespie. Can you share with me have two million dollars of taxpayers' money or revenue has ended up an account nobody knows where it came from which raises a question. A million two million dollars when we don't know where they went for sure okay Sir will be happy to explain I'm gonna start and then let misty Eubanks take over and provide the detail about what's been done and where we set. The account as he was describing. Is We will get from individuals in the mail Companies except or a check sometimes. And it to large organization there's a lot that goes on and so people think they're paying us something they're sending us a check to pay for back it could it could be almost anything that they feel they owe us money for and they send us a check and it ends up in this place they're not sending it with all the invoice or the paper work attached it's checks that show up and so is the Boca this in those show up they go in this account and then someone has to try to research across DHS to figure out. Where could this check for eighteen dollars and seventy one cents from this person come from what could be connected to which is a very large. Exercise to undertake and what had happened is over the years those had built up there without that research being done to figure out where they were and get them properly sent over to be in another account so that the it's it's an internal not moving it over into the other account. But trying to figure out where does it belong so it's across a lot of programs so with that I'm going to turn it over if if it's okay to misty to chief Eubanks to a walk us through what they found and what they've done. Sure so as secretary Gillespie said this fun collects many and usually paper checks that come into as typically from accounts receivable it could be over payments from beneficiaries providers any of those people take collections Medicaid over payments at pay roll for instance when we wage garnishment one and it could be that when we get day's checks remitted to as it does not have the supporting documentation attached to it at much of this particular lady all the way back to twenty eleven is the main all process so once audit came in and identified that we had days and identified funds sitting in the bank account where they were being held we went back and we did a methodical paper search and research and those we were able tied in a five hundred and ninety seven injuries that we could identify hot and then despairs back to the division or at the unit that was the correct holder for those fans. Then he in a manner she. If you could do that is that point how come you couldn't do it when you got to check the checks none have the names and addresses and phone numbers of somebody on the checks typically not and particularly like when we get a beneficiary checking in or something of that nature that populations pretty transitory when we do call folks on the phone perhaps the phone number doesn't work or that dress is no longer good so how much did you collect with that how much were you able to give to the divisions of the hundred and ninety seven it's about and between two hundred and thirty one thousand about three hundred thousand then we ended up within that there are about two million dollars that we never could get back to us the worst of payment so what we have done is we reconciled the entire king all and three working with the F. and A we have actually moved that many over into our Medicaid tres find and then going forward from September one on we have a whole new internal control in place we're working every check as they come through the door and when we do a wage garnishment for instance that was all our and then with the employee number so that we do not lose track of those funds and we're doing follow up reviews at the general cannot find balance you have made corrections that's correct correction or imply. This question is not I'm trying to make a note on it involves is drug rebate of twelve million dollars yes Sir that was in a county mayor said the twelve million dollars was in place however when we did closing book reports we incorrectly stated that it was in a cash fund when in actuality it was in a treasury funds so actually state of Arkansas treasury was holding that twelve million dollars for us and that was an account that was just a bit keeping error on our part but the the money was present and it was with state of Arkansas treasury as it should be how long was it in the treasurer I'll. When did you all make the injury to put the twelve million in the treasury it was in the treasury but when we check the box on the form to report where was that Yuri and we check the incorrect box stating it was in past and it was literally a paper work error on our part it was weird the moment the funding was we're supposed of it yes Sir but it was okay Mister chairman that's all and thank you. Thank you represent wooden represent Cavenaugh you're recognized thank you Mr chair all all the way over here to the right I have several of your findings that give me question and so I'm going to hit my hot spot if that's okay two thousand eighteen twenty one finding and it really kind of bothers me because it brings out that we were paying for services after someone was dead and it occurred as far as seven months to twenty seven months after the death. Now. I'm not. I mean I don't understand how that can happen because you are have checks and balances in your system that keeps people from being paid for services when they. On a live. Side like someone to address that concern. For dairy could you please come up and explain and will kind of add to it. Their new issue self and you're recognized. Good morning a merry Franklin the director of the division of county operations and I can. There are several reasons why that may happen and because I know that you you you noted between six months twenty seven months. Some of those reasons are within our control center things we we need to fix and some of those are beyond our control because we are not always notified immediately when someone has passed away. So some of it depends on how quickly we get the information that someone has passed away and some of it has to do with worker air potentially miss carrying the date of death not putting the correct date in. and there may I there have been a couple of system issues as we have been delving into the root cause of this that We will work on correcting and of course re training with workers and we'd we're doing second party reviews and things like that to help prevent the types of errors that we can prevent three. King heirs. Sure and mark why would DHS amendment from my Mr chairman of the Cavenaugh just be clear these are not necessarily claims are made for services provided to an individual like a a doctor from a claim for a visit this maybe things where there's a monthly payment for example make monthly payments for non mercy transportation for all beneficiaries that's paid to a broker and so those things continue until we find out that individual is has passed away but will be clear that doesn't actually mean that someone has filed a fraudulent claim is automatic I don't I'm not saying that they did what I'm saying is we still pay for services when someone had already passed away. As the AGS. We should have the ability to know when someone has passed away I mean that the. That this topic area is what as a Representative when we're trying to find ways that we can find savings when you find areas like this it just makes the hair on the back of my neck stand up because these as you said could have been that in three years where's your checks and balances I mean this is something that we have to fix. Yes ma'am I was in this and I think we're gonna say the same thing as we one hundred percent agree with you we want to be able to get the information as quickly as possible and we are also working to fix system sellout happen do recognize that when we have made out payments like this because sometimes in even in rapid fashion there are a number of payments as As of chief White indicated or we will make a. Payments to it to a broker or payments to another group where we're giving them what we call capitated payment to those payments are made at the beginning of the month and the person might die during the month so even when we are acting rapidly even in those cases we have to go back and reconcile and collect money back so we do it does not address the problem that you're discussing and we are working to get stronger and stronger with that I can now but we do have a mile but twenty seven months is another whole issue. Mr travel ahead. There are some things that we have done since this audit finding came out that have improved our processes first of all we have continued which we have always matched with the department of health we do a monthly match with their debts files so that we can close cases when we're not notified otherwise that someone has to cease and we have a enhance that match with ACT information from CMS is T. B. Q. file NTB Q. stands for territories and states beneficiary query so that should get be giving us information about our residents who may have passed away in another state and that we that the Arkansas department of health would not have known about so we have done that enhancement we have also we are currently working in two different eligibility systems and we have also done an enhancement in our oldest system where everything is manual so that this information when it is a single person household that our system is just going ahead and closing that case we're not having to wait for a worker to get a list to work from and go in and manually close that case so we have taken steps we are also reconciling our information with the imam my S. system and using that information to delve deeper to see if there are any other issues that we can identify where we could make a correction and prevent something like that in the future why I appreciate that because that really gives me pause And if you bear with me Mr chair there is a audit findings two thousand eighteen twenty. And it's got questionable cost of three point five million dollars he says these were claims paid to an eligible prop providers. Page fifty four. With the wrong one this is around provider eligibility so director man would you like to speak to. The improvements we've been making their. Good morning Janet may and director of the division of medical services and yes ma'am. We have made great strides in provider eligibility on our internal controls and we're continuing to improve that by doing checks every month and working on our paperwork that is everything is in the file we Have created new internal controls and we have created some management dashboards in addition to new personnel at the XC and internally at DMS we have put those A new internal controls in the place as a five thirty one of last year after we obtain the finding and we're trying to address it and we we do projects that we could have another funding for next year because of the timing of when we put it into place and the test sample for nineteen but we are having it also monitored by another division. And and they are giving us our quarterly results and I would like to also add that we did close this finding with CMS and we did not have to pay this money back okay I appreciate that you might have closed it was CMS yes and you didn't have to pay it back because they were nice to you but you still didn't do your job and you still paid claims it should in the been paid so just because we didn't have to pay it back doesn't mean we don't have a problem and not at not trying to be rude I'm just stating a fact just because somebody didn't slap your hand over it doesn't mean that it wasn't done improperly. Yes miss ma'am we we concur with that and that's what we did concur with like audits finding in this area provider eligibility operations have been a problem for us for for several years as many of the providers could tell you and under director man who joined us about a year ago she has led a complete overhaul of that program in process and they're still more we are planning to continue to do but we we we agree with you we we take this very very seriously. Mister chair I have some others but I'll get back in the queue so anybody else has questions. You have represent Cavenaugh. Three four. Okay Q. back up thank you. Senator Chesterfield. Thank you Mr chair and director I'm struck by the homogeneity of the individuals before me. But let me move on to my question about on page eleven. Jalen adult care food programs. I continue to read about people who are incarcerated for abusing. The full program. Could you tell me what we're putting into place to preclude these massive amounts of money is being siphoned off in use by people who are not serving in the the population they're supposed to yes ma'am will be happy to I'm gonna ask director Tonya Williams to come please the head of our division of child care and early childhood education she has led the effort the last few years to put in place a significant overhaul of the way those programs run and done in fact has been working under federal guidance as well on how to improve those programs and recently received a final sign off from the federal government good morning senator seal is are you asking about audit finding or so I'm not in that well the audit findings is that under childcare Challen adult care food programs at their findings and Okay I'm sorry go right ahead. So could you explain to me about those changes in personnel contributed to noncompliance yada yada yada. So let me specifically talk about the audit findings that are around and accounting it's FNS reporting so this happened with our office of finance and we were have been working closely with them over this past year and in the two thousand nineteen audit only had one funding related to some reporting so we've and prayed that considerably I think specific to your question about what we've been doing inside of the program senator Chesterfield and we have recently cleared all USDA concerns about our program and actually got quite a few accolades we've done a complete overhaul with the staff in that unit starting in two thousand fifteen sixteen of the legislature was and personnel committee was responsive to getting us some higher grades in that division because I deal with a great deal of funding and have a great deal of complexity in the work so we were able to get some higher grades we transferred some staff or positions out that were lower grades and put those higher grades in and reorganize that unit into some separation of duties that I think can really improve that program well as always is good to see you and thank you so much thank you ma'am. Little gesture you're done. Thank you. John is that you. Representative. Rye you're recognized. Thank you Mr chairman of this list that Representative Cavenaugh was speaking about you guys that a folk center you know passed away that may be on the system. Far as I know every county Clerk has a list wait by the wake of the people who have passed away. Thank you for running away estate turned that over in for the home state if on property tax but you know that that would be a very good source wouldn't cost you anything and They have that okay. Thank you Sir. Thank you Johnny whose twenty. enough think he's gone. Your come back okay. is that you Senator hammer yes Sir. You're recognized thank you in looking over the audit findings let me ask you first of all I didn't see very many if any that shall disagreed with audit findings is that correct. Correct yes yes that's correct okay and when it comes down to the audit finding that involves personnel issues maybe somebody doing something inappropriately fraudulently have all of those that are in the packet of been disciplined appropriately terminated removed for the duties so we have taken a variety of actions including discipline termination and have referred members to prosecution when appropriate yes that's correct on the prosecution wants to know how many have been prosecuted are you getting the local prosecutor to actively pursue those cases we have referred one case the prosecution I do not know if they're gonna except that case or not right now and on the auto findings that involve mechanical issues like software issues Coding issues have you corrected those are you in the process of correcting those or what's the status on those that involve items like deal with software. I can let director man speak more to this but they have in general let me say they've been corrected and where there is a contractor involved in the contractor is the reason for the finding we have done corrective actions with those contractors and assess damages that have you collected on those damages that you've assessed withholding payments yes Sir okay I'd like to get a list of those if you don't mind so finally for all the issues that are listed in the packet are there any that are currently being looked at by legislative audit because you've not taken the proper corrective actions and they are in the process of finding repeat findings. Some of these will it depends on how legislative audit handles it as they said when they come back and they start their next audit one of the things they do is they do look at to look ask us what actions we have taken and then they do look at that and so they will sometimes it takes a long time particularly around things involving software changes except right to actually implement the corrective action and get it done and so in that becomes something that they decide even and repeat findings they will frequently note we found this again but the agency has taken the action since the time we came back in because of the timing and so that's what they were referring to when they said that there is one area we are still working on and That is. This. Complexity around chip retro active and it's something we have made we've taken some steps with the more working with CMS on how to do the right the remainder of it it is where a person is in a particular category and and again it's an accounting person in particular category payment is made in that category later something happens where they're category changes for example receipt we receive information later that says their income change back two months earlier so retroactive actively their category is changed and in the system it's not that there should have been the payment it is that they're category has changed and so we are working on how that goes about because then it's about the gets very into the claiming that you do on the matches and I will we would be very happy to talk to you about it in more detail but it is one that is am I saying this correctly director man it is one that still in the works of all of these some elements done. Some elements still being put together and discussion with CMS to figure out how to do that okay I'll follow up with you on that one individually but but the bottom line is for everything that's in audit finding report you don't disagree with your either taking corrective action by deal with the personnel or the mechanical side of things if it's something mechanical and your continue work with lake audit to address those so that there are no repeat findings is that a accurate statement that is an accurate statement and With just a couple of exceptions all of these have been corrected and closed for you and that was when I just talked about thank you thank you Mr. Thank you Senator hammer at the dollar people said there would be a few repeats but they don't have the report and yet Mister Mister could could. Maybe one sent out the entire committee but I'd like to leased individually get specifically which ones those are please along with that other piece information I ask for so we just kinda do due diligence follow up thank you thank you. Represent Cavenaugh your back. Thank you Mr chair and these are way rather quickly thank you This is two zero one eight fifteen on page forty two and I'm just going to read part of the. I can explain because the agency did not prepare any quarterly comparison to identifying research the variances A. L. A. would be twelve monthly findings in two thousand eighteen and compared to the quarterly reports and data reports determined if the required if we met the required match and because of this it revealed that the agency did fired match for forty seven million three hundred forty three dollars and two hundred and two hundred nine dollars. And I understand that's a match that we're supposed to for federal grants but how do we not know that were. Not meeting our match for those. This is and again I'm the non technical person describing it but this one. Is where we do annual reconciliation and led legislative audit was looking at it from a quarterly reconciliation and if I say anything wrong my folks know to correct me okay because I wanna give misinformation and we so they were doing a quarterly reconciliation you frequently in doing these quarterly filings with CMS. You end up making adjustments from quarter to quarter and you are moving because of changes in what's going on between these quarters bottom line is we have now done as legislative audit suggested and we are now doing quarterly we have implemented that when we put all this together for CMS and ran it they ended up deciding that we would not have to pay back anything because once you looked at across the broader period it had worked itself through as we thought over that larger period but we are doing as legislative audit suggested and are moving to have moved to quarterly reconciliations is that correct. Okay. Okay thank you but there is it but the pay back of zero has been confirmed by CMS also the question I have the last one deals with page twenty seven. And it's a similar finding also on page number. Six and basically it talks about when we did a dump out optimum. And that I guess we lost the documentation that we the detail that we could prove that these claims were paid validly I thank one was four point nine million and the other is just a hundred forty six but it looks to be the same problem that we got when we did the doubt that it does has that been corrected in. The ten ten. At page ten twenty five no sorry sorry if the the to chip twenty seven forty. Recommend I believe it is twenty eighteen ten the chip reporting variance and twenty eighteen five the chip aid category. Both of which relate. If you like come to the microphone. Okay. Part of this first one is connected to that retroactive eligibility discussion that I just had by Senator hammer that is the connection around the hundred forty six thousand. It's twenty ten chip request very thank you yes Janet man director of medical services for DHS on twenty eighteen dash ten where it's talking about the four four point million dollar understatement there a report was generated and create and created and and give in and. Then we could not either re creator funded and I'm looking at Brett for if he has any further details the night and new financing program worked very diligently to re create or pull the dump again that because of timing and claims it was very hard. Because it's a point in time when they run that report and Right would you like to add anything because of none of. Right why don't you come over to the microphone please. You want to give accurate information does who you are you're recognized. This bright Hayes chief of securing compliance with DHS the variants that was noted by like audit in this finding was a result of our change in in in my of systems of from two to the inner changes in that we currently have right now when the report reserve was run in the new system it did not contain these numbers that should have been included and when we provided that information to let god those numbers for the chip were not there it's since been corrected and reports are running correctly now. And if I could just to add On that one it was closed out by CMS and we are paying back zero on the first one that you mentioned that connected back to retroactive eligibility we do think we will be returning the hundred forty six thousand dollars to CMS on that one so. That you understand where we are and are not making payments back. One one quick follow up when we click when we're have overpaid these providers when that we do the are weak recouping the any of that money are we going after them and getting those when we've paid an eligible providers. Because if they're an eligible were not paying them and I also how we get that money. On the. Ineligible provided health writers Dr reconciliations that we have to do. Director man at my at let me make sure I'm saying saying this correctly. In many of these cases the an eligible providers were in not necessarily always technically an eligible it was that the right paperwork had not been filed timely or the site surveys had not been done timely so it is not that they were no we're not Medicaid providers at that time and we're not providing services in good faith. Thank you okay. That correct okay thank you represent Cavanaugh we have one left and remember our my members that were not in the budget yet so you may want to bring your pajamas this afternoon. Senator Chesterfield you're recognized thank you Mr chair I would ask that you direct your attention to page is fifteen thirty four and forty three. on page fifteen it says additional comments from the auditor although the agency stated that it regularly compared budgeted expenditures actual expenditures during the audit period documentation was never provided to a LA during on a period at the preliminary exit conference held on January eighteenth twenty nineteen or at the final exit conference held on February fourth twenty nineteen moving quickly that thirty four additional comments authorize attendant care hours at the PCS B. must be in accordance with the rock school produced by the our path assessment CMS approved assessment tool any deviation from this methodology must be approved by CMS the federal awarding agency the deviations whenever approved by CMS in the hours provided in excess of those allow for the our path assessment are considered question cost and then finding on page forty three it says that is stated in the finding the agency was unable to provide any supporting documentation but the reported match the agency's response states it provided a LA a reconciliation showing of the areas of less than one percent the agency provided a LA the reconciliation on February twenty six twenty nineteen ten weeks after the end of feel work December fourteenth twenty eighteen as a result a LA has not review the accuracy or completeness of the reconciliation as it states as it relates to this finding I need to know from audit are these additional comments your relevant. Audit. Are these additional comments still relevant or have they been corrected. I make a point. They have not been corrected directed the last week could you tell me why they have not been corrected a young man who said they haven't been corrected was that audit. I don't know okay all right it was go ahead. Sure yes ma'am I'll be glad to start two of those what they're referencing there is that in of those two cases and I would expect probably others that was a difficult audit for like audit because we had and ploidy illness on our side and we're not able to always provide them the information they were asking for in the time period that they needed to get so they closed as they should the audit and they were asking and asking and asking but we did not have the right yet we did provide it afterwards and that's why some of these findings wound up when we were we dealing then we see a mass being closed out not saying that what legislative audit came up with was not accurate with the information they had at that time but that's part of what they're stating there is we did not get them all the information timely so yes we we have tried very hard in this latest audit cycle in spite of. Similar issues to be able to get them the information they need so that they can do their jobs. What where you're from audit please someone at a might not yelling at me somebody will come down to. When the dollar moves so they can sit there. In upon hearing this I should be through Mr chair. This man tells you yard you're recognized. Angel with legislative audit this matching finding that you're looking at which is which Beijing referring to Jing forty forty three forty three okay We we did request to the reconciliation and we're told. Date that the agency had not done a reconciliation but was in the process of performing reconciliation procedures. The reconciliation that they provided to us was in February. We reviewed it as part of the twenty nineteen audit we went a step further reviewing the source of funds that the agency uses for state match and we'll have a repeat finding in this area again this year because the agency is unable to provide us any documentation to prove where the source of funds comes from that they use for their state match I say and what about on page thirty four are you satisfied was that. I'm I do not recall if we have a repeat in this area or not but I'd be happy to get that information for you okay and on fifteen. On finding fifteen or pay no page fifteen at the bottom additional comments I found all three of you Comair yes foster care that has been corrected has been corrected thank you so very much in the last year. Thank you senator Chesterfield Senator hammer you live back up. The last question my friends thank you Sir. I'm on page thirty four and it the comment is that the deviations were not approved by CMS Somerset and through public health meetings and we pretty often ask about where did CMS you know shows the documentation of CMS approve or did in fact the committee actually said that if you came into committee you're supposed to bring something from CMS that verified you know your position. I did this kind of. This can goes contrary to what my memory tells me that we have been told in meetings that CMS has approved things in the shower moving forward with CMS is approval so I'm I'm a little confused as fires why would be in the audit funding. Senator I think almost super in trying to address that and let me just say that we don't have the same doctor that you all have in front of you and so I believe you're referring to finding twenty eighteen dash thirteen yes Sir it's how so the issue there was we the finding was that we had not attic we've not followed the service plans for certain beneficiaries on ARChoices the reason we did it was that there was litigation at the time and this is back and twenty seventeen there's a court cases we felt that because the court cases in one case we tend to be found contempt of court for not following the finding that court case in some other related cases and I think essential legislative audit's opinion was we could not do that without permission from CMS seems to not give permission in that case and we don't believe that CMS would give an opinion on that necessarily so it's it wasn't that CMS was saying we could or could not do it it was that at the time the staff felt that because of those court orders they needed to take that particular course of action and legislative audit I think just disagreed with a not that we had afforded to that. Okay and then one other question is is on our page forty three. Of and that's funding two zero one eight dash zero one five. And it's regarding the forty seven million dollars agency believes the finding that it's not did not meet the required match. That that forty seven million. Did where was it paid out of or explain that number little deeper if you would. This is this is the one I was referencing earlier where we were doing annual matches our annual reconciliations and legislative audit was recommending that we do reconciliations on a quarterly basis so this is the one that once we did the reconciliation after after the audit had ended as she said right and we did the reconciliation and provided that information since their audit findings go to see a massively then work with C. amass on resolving them and what we do and don't need to pay back once we did that reconciliation CMS agreed to now pay back on that one. For the forty seven million for the forty seven million because it did reconcile okay once you looked over a broader period of time and not on a quarter okay thank you thank you Mr. Thank you senator hammer. Members that's all the question so we're going to consider the audit discussed and we're gonna move on. Senate Cindy you have a. Was glad for you have a power point you want to show mercy option to stay because you're going to be back up or you can go either way yeah let some have a built come on up to serve but he's here that'll make life faster everyone And I promise we will be very very short with this let's be everybody has a copy of your power point on the desk right so members if you will let her go through her power point and then we can ask questions at the end. Because we may not turn it down. Okay I need a copy that. You have a copy thank you it's great to by go help mark. In. We don't want you yelling out the password so we can get in. Okay. That's that's her power point senator Chesterfield everybody got this blues document. This is going to be very very quick and it's very very high level it's just simply to set the stage so that you see. What we look like for more pulled together as an as an agency said the Representative of needing. Okay thank you just wait until we get you with up okay the great are you working on that. TKS. The information on the okay. Hi I'm gonna may I tease coming. Members we're gonna work till noon and then taken our break. And they will be back at one. Mister Walter. Plot while she's while we're waiting on them to get hurt turned a. It seems to me there's the inordinate amount of audit findings can your people not do something to help with that. Most agencies big agencies don't have that me findings. Yes. What you need to work harder. I'm by I'll buy that of that. Well. There we go. I didn't work so I guess send if you want to start and will catch that we if we can members were all her power point you have a copy of right. Go ahead please Glaspie. Turn your back on please. Okay. Search a as I said this your letter you maybe we're going to get it I'll okay hello Whitey. Okay. Track us and that might help. Why don't we use paper. Committee your start talking I thought this CD and get it up all. All right great so thank you all for your patience with this again as I said this is just simply to kind of roll everything up and give you a high level look it's will up what's going on with us before we dive deep into the budget are the first slide you see on DHS staff type just simply breaks apart our staff so that you get some sense of where they fit and how they fit. We have As you can see because we operate facilities the state psychiatric hospital the state's health care center there's the state's nursing home essentially are five human development centers and all also we do have the DYS facilities are direct patient care for ash the HTC's and A. H. C. as you can see is a little over a quarter of our staff we also then have our DCFS field workers we a you see all of these different groups that are individuals who work for us at our front line working direct care and directly with individuals that's what that grouping looks like you then get down and basically see that to do the operations I E. running the childcare voucher program the people that are doing that kind of work working in Medicaid running those programs and then the folks who are in our shared services which means are legal operations are finance operations H. R. operations security compliance cooperations IT. Retirement a lot of those programs that ends up making up roughly thirty five percent of the agencies with the bulk of that little less than a quarter of it being the people that are running program staff just want folks to have that perspective because large parts of what we do we are dealing with ratios that we have to meet inside these facilities for for patient care And I know down there the one thousand eight hundred seventeen feel direct care positions we are continuing every cycle to work with a PM to be able to relinquish positions obviously we're not relinquishing those in the direct care space that's what we're trying to figure out how to actually be able to have less turnover and to have use less overtime in that space you go to the next page this is just simply to show you how much of our budget is actually federal funds rather than state funds or what we call other funds other funds being funds that come in through fees and costs other. Services that go into the trust fund and other revenue sources like that that we pull from so our state G. R. fund is actually nineteen percent across the entire agency federal is sixty eight percent. This is critical for us because. In many of our areas particularly Medicaid the state percentage changes on us every year they call it F. map the federal matching and the state every year sets the new F. map rate for each state for Medicaid and within the different categories for Medicaid and when they set that each year it affects what we need to make a dollar I mean simplistically said if we are spending a dollar the feds are paying a percentage of it and every year that percentage changes on us so if you go to the next date slide at the bottom of that it does show you what our F. map has look it looks like. You know think about F. map is we all of like it when it's higher because it means in the case of if you look down at traditional I will look at Arkansas works where we are going to be and twenty and twenty one with ninety percent means for every dollar that we spend the state puts in ninety cents of that dollar and we put in ten cents traditional Medicaid runs roughly they're putting in thirty so they're putting and seventy cents for putting in thirty and ship as you can see is now moving to where they'll be putting and roughly eight a little under eighty cents. You see what's been happening I mean chip which is our Medicaid program for kids in this state has gone from a hundred percent federal funds where there was no state money in it two now we are having to put up this coming year twenty cents on every dollar that does have an impact if you look at traditional Medicaid it is a very small. Jeff down that we keep that we saw this year in terms of what they're going to give us but for us that translates into real millions of dollars because the program is so large and again Arkansas works is studying at the ninety ten match rate but that has come down from a hundred percent match over the last several years so this shift in at F. map we show you because it is one of the biggest drivers in terms of the head on our state for those of you that don't spend time around F. map the federal government basically pays at for Medicaid they will at least pay fifty six percent they'll pay fifty cents on the dollar but so we are doing better than other states but it's really tied to a number of factors and bottom line is usually the better your state starts doing economically then the lower your F. map is going to be so that's kind of the trade off and we have been blessed here to have things improving in Arkansas so are F. map is is starting to show that more. This slide were on flight for you yes good thank you is showing you that trend and also talks about the hard thing about the Medicaid budget is unlike some of our other budgets we don't have direct control over our front door we don't have direct control over what we have to spend money on enrollment is one of the largest drivers for what's happening with your Medicaid expenses and the economy's been good and Medicaid has been the Medicaid enrollment over the last few years has come down in the last period we started seeing it just slightly tech up a little bit not a lot but it's no longer going down and it's just like up to percent over the last year this one obviously if there is a large national economic impact that hits Arkansas then all of a sudden this. People are eligible and they are enrolled we do not get to determine yes or no if they are eligible the if their income meets certain levels we have to enroll them so that that can change very rapidly. Utilization meaning simply how many services people are using again as your populations healthier your utilization and can be down but at the same time When you have things go on where you have a lot of people get sick that aren't expected that you're not expecting your utilization goes up we talk every year about one of the factors were having to look at is how bout with the flu season be write a bad flu season higher utilization not just of tests but of medical services caught in subtribe in that up obviously with what's going on now with the corona virus there will be an impact High cost specially drugs or new utilization area that is going to have an impact on what we see. A the new drugs I I think everyone is very excited about what is coming in the way of drugs that can do thank things to help people and can really. Really deal with some very difficult difficult diseases that are out there but these do have an expense that is tied to them of the new cisticola grosses drug just for an example is three hundred thousand dollars a year for a person so eight the there are caught utilization impacts on these prices what we pay for things obviously is something that in some cases we are able to work to set with the with the legislature and others such as rates but many prices we don't get to set they are tied to Medicare rates for example and what Medicare chooses to do and that affects some of our largest areas when Medicaid Medicare sets their rates I access we all want more providers for more services that is something universally I think I hear from almost all of you and we are very much in agreement about building the provider capacity in this state. Recognize that as we improve access that means more people will be getting more services and therefore that will have a budget impact and then as I've been talking about about F. map so all of these things do drive the Medicaid budget as we look each year to develop a projection of what the Medicaid budget would be so if you go to page five. The this just shows you what was in the last this is what came out for us FY two twenty and this is what was for twenty one this is the executive recommendation as well as what was shown to you last year so it's it's not shifted and as you can see. We are planning to use more of our other revenue this time in order to be able to accommodate the growth that's coming it is still a growth well under what's happening nationally that we're projecting here but it's we're gonna use more other revenue and as you see on the next page page six this is basically. Almost that basically the same slide as last time it's I think we one little elements has adjusted around payroll but other than that the sixty five point three eight million is what we came before you within the biennium to be the increase in SG are needed in order to draw the additional federal match for Medicaid for a projection for this coming year and as you can see it's tied to these factors that I was talking to you about the F. map decreases as well as utilization largely and then finally I do want to just take one second. Medicaid becomes really an area where you live in a lot of uncertainty we do have a number of budget risks that are out there as we go into the next year and I realize this is not the point to spend time on these but as we go into session we do have legal action under way around Arkansas works the L. TSS waivers that are out there as well as programs for individuals with developmental disabilities those can impact what we are doing there are new federal rules you'll hear referred to a good bit Medicaid fiscal accountability regulation that is in the works in Washington everyone is waiting to see what comes out on that but I am sure you will hear from providers if you have not Because that new M. four rules when it comes out depending on what it looks like looks like it could have a significant impact on the supplemental payments that the state makes through Medicaid to a lot of our providers clearly what happens with national economic conditions as well as what happens with public health risks we'll have a big impact on our budget so I had to put that in there and could not ignore that and I just wanna make the same point two year old that I made a year ago We are. We we are continuing to work and implementing the what the healthcare task former for tell healthcare task force reform of work group came up with we are making all of those changes were working within these parameters and so far as you can see what we're bringing to you as a budget that is what we brought before what I will point out is we still continue with a trend rate and health care in all areas not just Medicaid Medicare commercial Sentara that means that we will be facing more issues and the next biennium. As we continue this budget so I don't want I am I bring that up again and again so that no one looks at me a year from now and says you never told us that we were heading towards a point when more S. G. R. would actually be needed but we are heading towards that point because the budget is very tight and as the spending elements grow we will not continue to have as much rollover from year to year and therefore not as much of their money and we will have to talk about how do we make changes in what we're doing or have add more state money so that's for a year from now but I just wanted. In for you know being fiscally responsible to keep reminding all of us of the fact that is the largest these numbers are this is a very tight budget so that's a very quick and rapid look at our budget overall I. We look forward to diving into it with you and this afternoon or later this morning I have two questions for you I have senator Chesterfield. Thank you Mr chair and I'm not sure it is in the budget so I just ask you increased funding of funding reimbursement for individuals to twenty four cents when the actual cost increase because of the minimum wage increase was a dollar twenty five have you made any adjustments in that area. Are they disposed that additional cost yes in early referred to the our rates for personal care services we did increase it to eighteen dollars twenty four cents and that rate was based on an average pay rate of ten dollars ninety one cents which is above where minimum wages right now the course as you eluded to come January one the minimum wage increases to eleven dollars now should there is a nonstate gap there in that existing right now what we have proposed is we have asked the a providers and their sensations to give us access the data they say supports an increased amount we're going to look at that will also if Mr will do another cost survey and give providers another opportunity process that data and we're gonna re evaluate that and come back with a recommendation later this year with the intent of having that in place by January one tied to that same day for the minimum wage increase thank you and one other question. When you put together this budget we were not facing a corona virus pandemic. I know that the primary responsibility lies with the department of health but you have so many agencies under your umbrella that an impact people what are you doing to coordinate with them. And what budgetary adjustments are you making because just reading the paper today how this thing grows exponentially in our impacting so many people so what have you done as forced contingency funding is concerned should be nice and I think it will be necessary I'll take the funding question first and then the coordination question second funding question this is what excess appropriation is for okay and so at this stage what we're doing is we're looking are access appropriation is as you saw with what we have for this coming year are excess appropriation for SFI twenty one what is in this budget for an eight billion dollar Medicaid budget the excess appropriation is two hundred seventy nine million okay and that's why you put that they're right but by my point being that one of the things we are looking at is how much excess appropriation we now have around all of these different areas because what happens in a situation like this if it gets much worse is the federal government will in our areas while they primarily will of course work through as they should secretary Smith in our areas around Medicaid around a lot of our other programs they will offer guidance that would allow us the option of relaxing certain things to ensure that patients are able to be seen and get what they need they will and potentially I'm not saying they're going to do this but in the past they've come in with higher F. maps on a temporary basis in other words to allow us to have more federal monies instead of paying thirty percent we might we would pay a smaller percentage or in the case of the corona virus testing of perhaps come in and say you won't pay anything we will pay a hundred percent of that in those cases we have to have the access appropriation to be able to. Except those federal funds all right and that is one of the reasons why we always seek excess appropriations and feel we need. Eight we not going into those except in cases of emergency like this that I have always supported your guy right now may I appreciate it and and it is for these kinds of in these kinds of reasons it is there has to be a balance between ensuring that we are not being irresponsible or money and then at the same time you know and and spending S. G. R. but at the same time being able to draw federal monies and that may apply across the number of my of our agencies and not just in Medicaid but child care and other areas could get the opportunity for additional federal monies should things should it be that there situation gets worse so excess appropriations will be looking at to support that and it's a part of what we'll be looking at for next year as well coordination I will go into a long winded thing on that but I think so I think the government has jumped on this he's been he has had a taken a great leadership role in this particular area and weeks yes and we are in constant coordination and communication secretary Smith and I probably had at least one phone call and twenty tax already this morning so. We are working well together thank you thank you Mr chair. Senator hammer thank you Mr chair before as my question can you tell me what you're what what do you all do as far as paying for the flu shots and just to meet education that real quick please. Director main I want to talk through flu shots less you would prefer to hammer can he do they not answer that later sat on the budget. Okay well I would ask the question and wonder on hearing is with regards to the budget and what Medicaid does to provide flu shots to Medicaid recipients do you track the cost of flu related illnesses that result in hospitalizations and do you measured against the cost to go ahead and give the flu shot work to do something greater to make sure that Medicaid recipients are able to get the flu shot Senator hammer A Dennis Smith senior adviser to US secretary Gillespie yes we have started tracking and going back to prior months to we can look at trend rates for flu shots hospitalizations position visited cetera so again it has not shown up yet in the on the expenditure side but we are preparing to make certain we do track those expenses so we can give an informed opinion on what the future costs might be. How long do you think to you get some supported some defendable data on that. A. Again it and it will show up on a weekly basis so if we are starting to see any trends whatsoever it'll start showing up on a weekly basis Kay and then director Glaspie. Just looking at some numbers of pull going back to two thousand twelve and the air is broken down whether it's traditional Medicaid Arkansas works just the total Medicaid spend it's my perception that it seems like the federal funds do not seem to be keeping pace with the growth of your budget it might incorrect in that interpretation or do you feel that the feds are passing down money equivalent to the growth of your budget. Sell one of the I just got handed this document okay so but one of the things I will say is when you go back to twenty twelve and I'm going to turn it over to you Mister Smith but when you go back to twenty twelve that is before the affordable Care Act and so you do have to remember that a large part of the growth that occurred post affordable Care Act was a hundred percent federal funding so that budget increase there was tied to all federal monies for quite several years Duration. Certainly again there have been at different times that of Congress has intervene and provided special match rates as you saw on the chart chip for example for several years was a hundred percent federal funding never did not start out that way but as part of the stimulus budget and then what was continued over a couple of years later was a hundred percent federal funding that was going to run out eventually because the statute had an expiration date to it and now it has returned to its historical match rate chip is always matched higher is paid to what is in traditional Medicaid so it is a traditional Medicaid is a federal formula that compares per capita income in this each state to the national per capita income that gets adjusted every year it gets the formula does not it gets recalculated every year based on national data and state data so the chip is an enhanced match a percentage above what than regular match rate is for Medicaid and then finally under the ACA as you know those were statutory described again a hundred percent the for several years and then it is declining amount now we have reached the ninety percent match rate and that's where it stays so that will not change unless Congress changes us that statutorily. Okay and regarding those Regarding those that were moved from Arkansas works after you know the ruling came out and based on what you forecasted to be as those are added back on the date your budget account for that ID number as it does center in that we never adjusted the budget based on people leaving because of Arkansas works okay part thank you. Thank you senator hammer center area you're recognized. Thank you Mr chair I I'm trying to do some reconciling on page six of your presentation I and I'm I'm wondering if you have any kind of data that would tell us the number of people who are actually employed a working but are eligible for and receive in any kind of Medicaid funds do we have that kind of information. We a I'm gonna look at Mary to see whether or not there's anything current no we can we can definitely run that for you again because many people on Medicaid are working and so we we don't always know Well let me again merry dollar Mr Mr Speaker. We can usually tell whether not the income they have comes from employment or it could be income from another source so you know that I think you're asking how many of you know what I mean are individuals can we tell whether or not they are they have income from employment because we can pull that for you yes ma'am this one I want to try to understand regarding the budget when people are working we see these decreases you know that are coming from the federal government if How that's really accounted for because I know it has to do with the salaries going up and that you know more people are employed but I don't know if it means more people are employed or we are just paying more people on the what's being paid to people and who were employed is getting higher of but not necessarily people who are eligible for and will be eligible for Medicaid if that does take into account the following me on I am are you saying that you'd like us to see what we could put together for you that would show you from some other point in time what percentage of the Medicaid population. was. Employed and which percentage wasn't first says what percentage now is employed versus not because the income factor. People might be making more. But still working the same hours because the minimum wage increase is that what you're no actually what I'm trying to figure out let's just say let's just say for example the traditional Medicaid Match what what what we get from the federal government uses it changes from time to time it's changes based on. What when it comes to employment. And and what it does is there anyway we could inform people in Washington that maybe there may be some A lack of of coherent continuity and how you're making those decisions because just because more people are employed and we maybe have more money a running through that cycle. Are we still having a lot more people eligible for for Medicaid. And not accounting for the still you're you're cutting what we get is what I'm trying to get to Senator is it if I may in additional Medicaid almost the entire population would not be in the the labor force most almost half for children they are our elderly there are people with developmental disabilities I think of traditional Medicaid which again is our lowest match rate but that that has very little relationship to implying that of the individual it the employment of the family may affect the specially whether a child is in rather regular Medicaid or whether or not family income has gone up and now they're in our kids be which is the higher match rate so so that might but they're trying to save some time I'm really not talking about those people I'm talking about Joyce Elliott to working is Joyce Elliott eligible for any kind of Medicaid you are anytime you are eligible that as an adult you are eligible up to a hundred and thirty eight percent of the federal poverty I want to know how many people I'm asking how many people somebody knows what I'm asking here yes how many people are we talking about because is worrisome to me that we do have people employed and I still eligible for these funds and Hey just something about our policy I'm trying to understand and our budget I know what we do but I'm just trying to understand better one more quick question can hold on that for chip If we if we so we are at a point now that we have to we'll help what's the rate going to be that we have to chip and I see a number here what's the percentage it's a seventy nine. We we now have to pay about twenty percent of the cost of the trip kids hi there about fifty eight thousand a kids who are in chip okay. And if we have if we do not fund what we have to put and then how we we handle that we still will be started backing kids out of chip what would happen. If we don't find but again our but our budget is based on no changes to chip it is simply the change in the match rate which requires us to provide a higher match from non federal share so I should be worried about kids we have not made any a budget assumptions of but changing chip okay alright thank you thank you Mr chair. Thank you senator. Represent Cavanaugh. Thank you Mr chair I just want to have a real quick discussion really quick about the personal care I think we kind of touched on it well I think we've raised it to eighteen twenty four and with that I can eighteen say at increased twenty four standing increase. A bill is a twenty four cent increase we have a lot of providers as legislators who's been getting hold of essay and that that twenty four percent increase doesn't really help them out that much and that they need somewhere close to twenty one twenty two dollars an hour and they say they have studies to back that up have you received any of those studies. We did receive an actuarial study that that believe the of one this associations and paid for we've got that we've asked then provide us the underlying data so we can look at that and review and see where where the differences between the data they have in the data we've collected and follow up is in the budget I know it takes care that eighteen twenty four increase but it's only for six months come January one they're going to have a increase the minimum wage have we addressed a rate increase in the budget that's going to have to happen in January. We were there is no pin it. I believe this theater answer all layout to stay Leding will the Clerk I.. Dawn Staley deputy director Medicaid director Arkansas department Human Services yes just just to add on to that so at the time when the rate studies began last year the budget had already been past and so as such the rate increases with the exception of the personal care rainy day increase that was referenced were not contemplate as part of the budget that was passed as part of the general session. Would we not be wise to address that now when we know we're going to have to do it rather than just putting the and six months worth of what we know it's going to be but we're going to have another one work had to come back for ma'am it's not six months worth this is the the rate increase at eighteen dollars and twenty four cents is now the rate that would start art will and realize so it's not just for six months it goes permanently we are working as we just said you know. We've asked the industry to give us the underlying data so that we can give our actuaries that information and then they can run it and we have committed to work with them over the next few months to look at that look at those results and before too and you worry one we would move to make the adjustments and the rate that are that are supported by the actuarial analysis that we put together so the I I do want you to know it is something that is in the works between us and them and it is also something that we would start that new rate on January one and we have assumed that as part of what the budget that you have today so you assumed that January on twenty twenty one you're going to raise it from eighteen twenty four to a number and that is reflected in this budget not a specific number ma'am no I don't want to this is the budget that was is that was presented a year ago it is also the budget that is now our executive recommendation and what we have seen thus far and the actuarial analysis we believe we will be able to support they have asked to provide us additional data because we did our initial cost survey we got minimum date minimal data from the industry now recognizing on all of us that we need to get more comprehensive data from them they have pulled that together they are providing it and we will be running those that information to the possibility will have to come back and increase and I have to ask for additional funding thank. Number okay thank you. So you represent Cavenaugh I have sixteen you are we're gonna work till noon so you might wanna her your questions a center rosh is that you over there. Thank you Mr chair I mark mention while ago they met the put together another study I believe is what you said and I'm supported studies but Hey in the middle one study that used twenty eighteen data Not specific to Arkansas to calculate rate nor an adjustment for minimum wage which we have all been talking about here. in DHS is responsible for accepting a study like that and let me finish up and and you can answer a in another rate review for the DD population which was published the same day mark Mellman factored in the minimum wage increase why did the department allow. A minimum wage be included one and not the other. As we continue to talk about the the minimum wage if if a company that that. I'm trying to support and pay money for. If we accept that that is clearly not come late I don't I don't let my suppliers do that to me in business who is responsible for saying guys you didn't use the the the common sense step is out here that we've got it could you get to that part I'm here yes I think several may want to chime in but let me Jim covered with a couple of things before the technical experts do. The rate review process that we are doing is for is new for us and you for the providers I think therefore when we in many medical areas we get regular cost reports so that we actually see what's going on and get the the information in other areas such as this we do not receive regular cost reports so therefore in order to get the information needed to be able to give to actuaries for them to run an analysis we go out and we survey the industry it's brand new so I don't know that the industry always realizes it's important to respond to that for the survey for this one we out of three hundred eighty eight for industry members we got responses from twenty five there was dialogue back and forth because our folks were very concerned you cannot do a rate off of twenty five out of three hundred eighty eight however that is what we could get so they'd ran with what they had. Dave did include the first two years of minimum wage trending that in and said let's will all work on coming back to do something else if you will give us more data updated data from nineteen but more data from a broader swath of the industry and so that's what we're trying to do at this stage now who else would like to take and provide more details on the non technical if I can jump in because the last thing I did for close my eyes last night as I watched the public health meeting which I'm not a member but I watch public help me that that Mister white was in there was some discrepancy in there when your claim timing thirty three verses three hundred seven there's some discrepancies in their nurses from time by actors in there some clarity that some of these what what you're asking for for some of these entities to fill out I get amend my business and not like what to use a mac it's not understand what's not time efficient and also there there are some other factors though Mister white need recess sure all dressed the in in the discussion public health that was concerned differ provider top that was assisted living so different numbers of providers but also different cost surveys but I will say in both those cases both with assisted living providers as well as with with personal care providers we develop the cost server that we wanted to use we just threw that out to providers to get their feedback and their questions to see is this clear is our stand will do in the making adjustments and in both cases we made adjustments to the survey based on that feedback from those providers and server that final once those is not a case where they receipts of that out of the blue and just had to respond to it we actually sought out feedback from them so that make sure that we understand will survey and they would provide the correct data and we will get the data we date usually is quickly would you would you say that the route. Porter's battle report whatever else that we're paying for when they're lacking. That we should be requesting. Or or do we need to define the data I'm aware that rear requesting orders to prop that they're. If if I may and again I think Milliman made some references to the short comings and the data as well and that's what we're always trying to improve upon and perfect for example of we know what the minimum wage is we know and and we know right now we're paying greater than the minimum wage were eighteen dollars and twenty four cents as well above the minimum wage so what we need to know is how many workers does the minimum wage apply to and again it's a short coming the a a deficiency in what Milliman had through claims data for example that's why we do surveys that's why other providers do cost reports who does this actually applied to does the minimum wage apply you know it again so that the salary structure who is already on salary versus a direct care worker who's getting paid an hourly wage and finally overhead and in healthcare we always talk about direct costs which a direct care worker clearly is a direct costs but the indirect cost as well how much administrative overhead how much do you pay the the the the the the manager of an office how much goes to profit those are the areas that we lacks specificity on and that we feel that we need more information than what we currently have a descriptor say you know just trying to get to the place that we can keep people to get the job done. I can't keep a lot business if it goes up to boxing and I get twenty four cents more or whatever there's got to be something realistic in there thank you Mr. Thank you. Senator rice members were on break for lunch we'll be back here at one to see all the other. I got for the left on the. Thank you. I hope to get. Alright members. Mr Speaker I'll come back to the front. We got. Call maybe. Absent Tosh you should have a question. We your role now the. Yes he stepped question okay. Follow down there because we we just have one or two questions left and then we'll we'll get started absent Tosh you're recognized. Thank you Mr chair. Here to your ride. Let's go guide to back it thanks chair. I'm like this quake I just want to go back to the something we discussed before lunch today and that was on the hourly rate for the assisted living in the you know in yeah I'll wind hail. And I understand it from testimony this morning that there's going to be a study and you know an actuary and data put together in course you but we all know that sometimes that's long term and it takes awhile to gather that information for you to be able to make a decision in regards to the amount that should be charged so with us understanding that my question is what do you. You know what what if some of these entities that are now going to receive eighteen dollars and twenty four cents an hour what if they just can't make and then you know what we go I mean how do we how do we combat is that's not something we need to address on the part of the and I made I agree with the study I agree with the actuary but also they we would all agree that that's long term I think we need to be looking at a short term because the last thing we need is to have these places close their doors and leave the service is this state without that type of service not is guess what I want to know are we prepared to address that in the event that that happens. Part yes. How the survey and going near douche yourself again yes thank Mister mark white with DHS has yes Sir we we certainly want to identify rate that does match that tree and going forward in that recognizes we do have that one more a minimum wage increase left and top athletes will take a look at it and look at that data and see just where is the gap there between what they're paying those employees and what else do they need in terms of admin cost and for the other things and so I think we'll continue to look at that and we will get a plan place this year It just to What we're and again correct me you are are director man if you if for around so in other words since the the current rate that has been put out there reflects. Including the eighteen and nineteen was to be the nineteen and twenty minimum wage increases but does not reflect twenty one we can use the existing data and train forward using that data and adding the twenty one minimum wage but we're trying to work with the industry to see if we can get more and they have as he said provided now their own study and some underlying data but one way or another by the time we need to put in place this fall something so there's a new rate in place for them in January we can work from what we've got or we can work from additional data from them but either way we will do something this fall so that we have any rate in place in January is that clear. Please under our status one additional point understand that under federal law or obligation for rates is we have to have a rate that sufficient insurers an adequate supply of providers and so if if we start losing providers if that's the result I we will have no choice will have to step in an act because that is our obligations make sure there's a serve there's adequate access to those providers the beneficiaries have a choice and they can get a provider to provide those services for the. Thank you representantes. This is Representative Penzo I was up in the queue so many people have already touched on this and hate to beat a dead horse but the has as far as the personal care The law people touched on it already but there were several things said and I just want to know. If the minimum wage was factored increases were even factored into what you all. Put out your listening quarter increase. Yes Sir it was taken to account and will again take that account as we take this second look over these next couple months to decide of course for January one in in specifically while was wanted the. Developmental disability have a minimum wage factored in and this one didn't because I don't I would real clear on that answer when you give it earlier what minimum wage was accounted for in both studies you may have been treated a little differently but understand that in both cases both with the DD right as well as with personal care rate with actuaries did was they looked at where the labor cost what's the overhead costs where the French connected the with that employees salary and then build from the ground up what does it cost to provide that service so it is so it that same general message was done in both cases for both of those areas. Penzo I'm good thanks thank you I got one more who's in fourteen over there Johnny could you just settle someplace. You're recognized. Sir thank you Mr chairman of miss sandy got one four year let's just say that you had a an average company and they had six hundred employees and the minimum wage went up a dollar an hour. as twenty four thousand dollars on a forty are well a week and altogether over appeared every year it was a one point two million forty eight at the house. Are we going to be able to match set out. Is gonna come along to where they're going to receive that much more and. These additional funding I'll I'll start again he can he can finish with the more technicals in in general when you have a company of six hundred employees they're not all minimum wage employees you've got employees at different levels right and not because minimum wage goes up does not mean every employee gets an increase simple example is you know over here in state government minimum wage went up in certain of our workers are impacted but a lot of others are not impacted by that minimum wage change so part of what we have to look at is actually what is being paid to the line worker how many line workers there are what the impact is then on their benefits and then what the overhead is that's going on inside the organization in order to figure out what what happens when that rate increase goes in. Okay and all that but John let me correct myself please to actually that figure I gave you miss sandy was six hundred that were on minimum wage so is is gonna be one point two million lower that. Well the the low point out is that in the in the rate we calculated which AT and FOR that assumes you're worker making ten ninety one an hour which is ninety one cents above the minimum wage and so that's the so it it's taking the account there and the assumption is that yes that a little more than minimum wage to in order to create the proper work force and get those workers in but that's taken it into account in that in that calculation then follow of mischief senator J. please up with that we'll that figure about another dollar an hour that would they're going to receive one way or another to take care of this it's well the the next increase in the minimum wage is one dollar an hour to get the his January one so but again what we will we will look at in to turn what's appropriate rate come January one is look not just at the minimum wage would also which cost the French would cost the admin in the overhead and making sure that there's that that the gap there between what we're paying and what they're paying that worker is adequate appropriate. Thank you and thank you senator Teague thank you John is Senator I alright members that's all the questions on that we're going to move start missile Allah we're going to do division of aging adult and behavioral health first they got some place they need to go here and that. Fellow just to. Regular department people miss a lot of you'll start absolutely thank you Mr chair their quest for the division of aging adult behavior health services begins on page forty eight of manual to division is comprised of combined central administrative function and operate the Arkansas state hospital the Arkansas health center and the alcohol and drug abuse prevention programs provide services to elderly citizens in Arkansas through network at eight area agencies on aging of one hundred community providers in over two hundred senior citizen centers and awards federal grants and state funds to the private nonprofit community mental health centers. It also serves as an advocate residents of nursing homes and provide protective services FOR individuals eighteen years of age and older who are suffering from abuse neglect and exploitation administers the ARChoices in homecare program provides legal services to the elderly and contracts with providers for substance abuse treatment programs if you'll turn to page forty eight you can look at the it says department appropriation summary to top this is the appropriation summary for this division only. And it shows that they're DIV they're corporations are funded from a mixture of general revenue federal revenue special revenue cash funds administration of justice funds of various programs support the requesting two hundred twenty three point seven million dollars in the coming fiscal year which is a forty five thousand dollar appropriation increase and their continued continuation of currently authorized amounts for they have blended is there a question increase that and the rest of and the requested to be continued at the. The current FY twenty amounts we're going to discuss the continuations briefly at a very high level on the summary page and then we will turn to the pages where we have changes and discuss those in more detail. The first line that we're gonna talk about is the line number three in its community alcohol safety. This appropriation funds programs for those who've been arrested for DWI with funding coming from the state administration of justice funds and special revenue and the Legislative recommendation for FY twenty one is for the continuation of this two point four million dollar appropriation the second item we're gonna discuss is online for it is Ford alcohol and drug abuse prevention this appropriation provides funding for alcohol and drug services including detox residential and outpatient treatment methadone maintenance and special woman services misappropriation is amended by general revenue federal funds administration of justice funds and other friends is available legislative recommendation for FY twenty one is for the continuation of this twenty seven point two million dollar procreation the third line we're gonna discuss is online five of this summary it is the mental health grants appropriation and it provides the core funding for services in support of the private nonprofit community mental health centers during the regular session the state operations which is online one community mental health centers which is online too and a cute mental health services per capita which is on line seven of this summary page were combined with this mental health grants programs that's why they have expenditures in. Fiscal year nineteen and zeros going forward and. This appropriation is funded with general and federal revenues and other revenues as they become available and legislative recommendation for FY twenty one is the continuation of this appropriation. The next item is in six line is on the meals on wheels appropriation this provides nutritious home delivered meals to seniors who are homebound and able to prepare their own meals and who live in an area where meals can be delivered this appropriation is amended their taxes levied on cigarettes and other tobacco products and legislative recommendation for FY twenty one is for the continuation of the current two point four million dollar appropriation the next item is on line nine of the summary it's the grants pay its is DHS grants paying account that's the grants paying appropriation and this appropriation funds many of the services provided by area agencies on aging including projects grants the retired and senior volunteer program the senior citizens pro center programs the older worker program nutrition's programs and the nursing home care alternative programs in the appropriation is amended for general revenues federal funds and other funding is available the Legislative recommendation for FY twenty one is the continuation of this thirty four point three million dollar preparation the next item is on line ten of this summary and it is set for patient benefits Cassian treasury it provides cash funds to meet patient needs it is funded through parking meters interest income and private donations the Legislative recommendation for FY twenty one is for the continuation of this current nearly thirty five thousand dollar preparation the next item that is a continuation for this is for the senior Olympics program and it's on the second to the last line. Is a preparation provides funding to the Arkansas senior Olympics in is paid on a two to one matching basis from general revenues the FY twenty one legislative recommendations for the continuation of the current seventy thousand dollar appropriation the final continuation line item is that the one at the very bottom for community based crisis intervention it provides funding to construct the four crisis stabilization units that provide an alternative to local and county jails for those who've been arrested and are experiencing mental health crisis this appropriations funded through general revenues general revenue carry forward fines and rainy day funds and the FY twenty one legislative recommendations for the continuation of their current five million dollar preparation if you will turn with me to page sixty one we will talk about the operations appropriation for the division that's the only one that has changed. This appropriation provides for the salaries maintenance and operations and other operational expenses of the division including the operation of the Arkansas state hospital and Arkansas health center funding for this appropriation includes a mix of state general revenue federal and other funds and on page sixty two you'll see an appropriation summary for this appropriation and the FY twenty authorized appropriation is for one hundred seventeen point seven five million. And the Legislative recommendation for FY twenty one which is the to right to the right of the authorized one for twenty is for seventeen hundred seventeen point seven nine million which includes a thirty seven thousand dollar increase in salaries and a ten thousand dollar increase in matching for a total of about forty seven thousand dollars and these increases are for her your service payments Mr chair this concludes my presentation for this division and I'll be happy to answer any questions good lord you can talk. I can't. represent Cavenaugh you have a question the. You're recognized thank you Mr chair this will be for it DHS go right ahead let's go to foster care. Page number ninety two. She played to not let's say. We're not on this section so let's get that one let's go back to this one. Are you getting ahead of yourself yes. fifty four which is the alcohol and drug abuse prevention. On the methadone. Out weeks that we do. How much and how much of these grant money goes to those clinics and exactly what is being done in those clinics. Page fifty four. I'm J. him with aging adult behavior health. And our methadone. Represented I'll find that for you. We spend approximately four hundred thousand for the methadone clinic you with you a miss. And what is actually done there and that program is to treat patients that do have an opioid addiction that's it is a methadone treatment clinic to help them to overcome the addictions and to provide FOR continuum of care once daily treatment. Okay there are some methadone clinics throughout the state that actually allow people to come and actually get semester down are those paid through any part of this is that paid through the state you know there's there's several methadone clinics I know throughout the state. They're not paid through my grants or through the funding that I have through concert that is there's allocate contractually to my division. Don't be done silly DHS if I if I may add it and it's going to it's going to very clinic to clone I can kind of patient makes a patient makes but Arkansas Medicaid certainly it is also a pair within this realm but then you also have some of those clinics that accept private pay as well and so it's just gonna depend come on the clinic in on the the individual patient profile. Okay so on the method on I'm to make sure I understand there are some clinics and Medicaid actually pays for those patients to go to those clinics. There there are services that would be billable I just you know I don't want to get into too much detail certainly we're happy to visit about that but yes Medicaid is a pay or they can help with some of those services okay thank you. Senator Cooper. Thank you Mr chair. On page forty eight of. You talked about the crisis intervention. which Jones were is one of those. And the. I thank the my idea of the way this is funded is pretty much in line with what you said there will go but I think I'm receiving some mixed signals about some of this I was told that the. Of. That if a person is owned Arkansas works and the they have a mental health crisis. Episode in their brought to the crisis intervention unit that that does not cover it the the the Kennedy has to cover that and not been told wrong information there. So there there are services that would be eligible we would have to follow up with that specific carrier but but many of the services that are provided within a within a CS you are Medicaid eligible if they've gone ahead and enrolled in Medicaid and are providing those services but not like that we can definitely follow up with that on that specific individual and find out more about the issue I was told that the that this is an insurance issue that the. That the insurance policy of Arkansas works does not cover. Mental health crisis of episodes if it's involved with crisis intervention unit. So the the the qualified health plans in terms of the carry the plans offering services to Arkansas works do have to provide a variety of behavior health services we would just have to look in this instance to just understand more about the particular situations we can follow up with that plan but also all the plans if for some reason there may be some confusion out there okay would you follow up with me on that let me know thank you. Thank you senator Cooper. Senator hammer. Thank you Mr chair on page fifty four the statement says budget budget exceeds authorized procreate grants in aid due to transfer from the miscellaneous federal grant holding account can you explain that what that is to me please. It's under the alcohol and drug abuse prevention appropriation summary yes thank. Senate senator of we had Pages that I'll center fifty four thank you. Senator hammer we had a large carry over the in our grant funding our discretionary grants ticker the opioid grants the state targeted this these state targeted opioid response grant yes so are to the point where the funding that we had in a carry over exceeded what are appropriation was. And what was the reason that there was a carryover was a just lack lack of. Providers access or what was the caller said it wasn't used initially in these grants and these are to your discretionary grants they are substantial grants it was a five million dollar per year ward we as we begin to to roll this out there was a a great lack of infrastructure just be honest in order to apply these monies medical sister treatment providers around the state which have have increased exponentially as we have moved through the grant period but in the first year wards there was no it we just didn't have the ability to get the money out to the providers we just have an adequate number providers to to use all these dollars. Do you have adequate number providers now and are those providers that are listed actually providing services now they are and we have expanded those services tremendously I can tell you from between from FY nineteen to FY twenty we moved from two hundred and thirteen two three hundred and twenty seventy R. D. a waiver Medicaid our medical system treatment providers but just because our D. A. wavered are they actually seeing patients most are yes alright thank you thank you Senator hammer. Object Cavenaugh name we just do this. Yes Sir one more time. You're recognized thank you Sir page sixty two. There's a program that listed under foster grandparent. What is that program and how is it different in foster care. I know we're at spending the money but we do have an appropriation for not just curious what the difference was what were as foster care per actually provides care for a child the first grandparent program allows us to to bring in volunteers to serve as mentors to spend time with with children that are in need to bring in our cans and soup for us as may be retired and looking for a place to expand their services to mentor children whether to educational four four just it enjoyable activities A to be to to fill those gaps in those voids that a grandparent normally would for children that don't have such that or don't have that benefit okay I notice that we didn't spend any money in nineteen on that program is it because it's not funded or we don't have people volunteer in or. And it represents a county not to the foster grandparent program actually moved from the secretary's office or the director's office appropriation to this appropriation during the last regular session it was moved said there are expenses for the foster grandparent program they're just in it for FY nineteen there just in another division. What was that experience. Hang on. Okay. I'm being told one thirty seven six forty three okay thank you. Thank you represent Cavanaugh. Representative Wooten is that you again. Yes Sir that we may name is German. My recognized yes. Page line page forty eight. And you may have covered some of this. The first two. Collins. The first two lines. Thirteen five seventy four and seven point one this twenty twenty million dollars we're that go. So. Representative week combined four four categories into one four F. what will be when we begin FY nineteen the one nine three the one nine six six fifty five of you see all of those lines had or zeroed out if you when you go down that the twenty nineteen twenty twenty historical that a lime they all consolidated and or to ME and on that same line which if you'll notice X. it that expanded from eight million in eighteen thirty one million in nineteen so it was the moneys didn't disappear that it go away they were simply consolidated into one line and prior to for the mill health centers they're they're funding was separated out on individual lines and it was a specific amount of dollars for specific service what we did was we blended that funding and it made it it made it easier for our community health centers are behavior health providers to have access to dollars they needed for a particular service rather than running into a situation where they may exhaust a funding on one line for particular service they now have the ability to pull those dollars to use as needed wherever they may occur within a fiscal year. So that's why you're going from eight to thirty one you can sell it was a consolidation the right wasn't a deletion yes Sir all right Own the. Land the alcohol and drug abuse prevention. We expended actual seventeen million and the the request now as for twenty seven million ten million more than you expended. one. What will you for casting or the U. anticipating here this was due Sir to to the acquisition of discretionary grants particularly opioid grants which to come in at about ten made these these are again these are to your discretionary grants there ten million dollars per grant and we added the additional funding that this appropriation taken to compensate for the monies that were coming in you didn't receive that ten million on the under the actual eighteen nineteen it came in just this for this reflects the S. or grant St opioid response grant that that seventeen that began with in two thousand a little confused and those are all federal monies if you receive seventeen million what makes you anticipate receiving ten million more. Yes represent these are federal grants that come into us that that come to the vision through Sampson that was these are not it's not general revenue dollars it's it's grants to be applied for that we received and the the the jump from one figure from seventy nine to thirty two million you say reflects the influx of these federal dollars. This is don if I if I may if I may add to that as as a director hill said since these are federal grants that come in you know they're one they're on a different cycle than our state fiscal year but to a lot of times we don't always find out about them until midway through a lot of times towards the end of our state fiscal year and so depending upon when they get reported it may look different you know sort of year to year because like for example as we've had to extend forward some of this money that we've gotten a lot of times we make that request to say can we you know carry for that money into the next year we don't get notice of that until late in the year so that's why you are going to see that variation you know kinda year to year depending upon both when the grant award comes from the from the federal government but also at what point in time that actually is an reflected within our state fiscal year budget so. If I'm understanding what you're saying you never achieved twenty seven million in a fiscal year. Is that correct the city comes in different increments what I'm after here is I see a distortion. In the budget budgeting from seventeen million of thirty two million were and when we went when when the budgets are drawn and we go on the thirty two million dollar figure but we're only really receive seventeen million. And you do that a hundred times you're shown budgeting a lot more money than you than you really have or have coming in does that make sense. I'm I can take part of that and then director lane has joined us Kirk lane who is the state drug director that is also part of this team and these grants. Are grants that his department applies for and received and then distributes and we always have a certain number of these in the works with the opioid Epidemic in America the federal government began to provide a lot more opportunities for grants some were actually given to states where you didn't compete form everybody just got a certain amount and then others are competitive and you actually put together a proposal and we do it with partners and we get the money and then we begin to implement and the funds come as she said at all different times so this this budget that you're looking at today as we said reflects correct me if I'm wrong on this line in most cases it's a continuation from what was actually passed last time and so these funds are funds we knew would be coming in and this time now with that said I will also go back to another point I made which is we do try to have with in areas such as this an excess of appropriation not of funding but of appropriation so we can go draw more federal monies to be able to do more in the state around drug and alcohol abuse treatment okay Senator I understand what you're saying but it still goes back to the fact that you only expended seventeen million so and I understand the grant process of you don't know is forecasted you may get it you may not get. And but but in reality we have to it is the sin my budgeting process you have to live we want your actual number is and the only actual number here's seventeen million dollars it was expense represent would not our mind you appropriation isn't money well I realize that what I'm saying about a million we don't have right now in the budget yes they still friend seventeen million and here we are asking for thirty of twenty seven million almost twice will what you actually spent ring is got to be over and I understand the difference between the the the funding and the appropriation and I understand granting you the right to be able to expand that money. But again this again are you anticipating ten million dollars more and what are you basing that on. That if I may just going off so with the with the the actual terms expenditure data verses the appropriation I think it is you know very much as the secretary and said we this is an area where we have received significant funding and we are we are working very closely with the providers and with other partners in the state to spend those funds where appropriate as quickly as we can because we know there are folks that need that treatment and so what you see reflected within within the historical budget but also the the agency request accounts for both the funding we have today that is on that is the additional federal funding that we received but also reflects additional funding that we expect to receive in terms of appropriation so that we have we have this we have the these the flexibility that when those funds come in we can go ahead and utilize those to get those out to a providers and others in need of services. Are you done misrepresent wooden. One more on saw one now that's it okay I I just hours even an appropriation relative to funding and all that I just think we need to be more realistic. In the numbers really what we're looking at twenty seven million versus seventeen with us ten million dollars a lot consent if you have fifty of those in here look at the amount of money that you're budgeting. That you're not gonna have Hugo received in that time has ties that appropriation up when we look at the total number for the total budget does that make sense to what I'm saying. It does we appreciate it yes Sir does it if I could interject Kirk lane state drug director yes Sir You know the grants to allow us to supplant for moneys that are already there they're very restrictive on that and the grants are written in a fashion where you have to pay for what you actually articulated that grant so there's a process and that is like there is a process to get everything reviewed there's a process of billing for usually two or three months behind because of the process of the providers billing that in there getting it through financing getting it going and so a lot of that moves in circles and then getting the program up and running in getting by into the program a lot of times in those grant parameters lately have been one or two year grants which is very difficult for state something that we've been trying to do with federally trying to work past those short term grants because we can't get a program up and running and we end up getting extensions no cost extensions extra money put in there and made for flooded us with money to try to deal with this problem so I respectfully I get what you're saying and I understand that but I understand the process of trying to get money out trying to get programs going having that money available to get that program going trying to get the buy in of getting that program is all part of that process of making this thing work. if that answer some questions that is helpful a person. The German. Members we have six more of you here and We got a long ways to go represent Lundstrum. Thank you my questions on page fifty four you mentioned we had how many treatment programs for drug alcohol services and detoxification residential tree. Yes Sir we know when we would I'm sorry represent what we were talking about providers I was referencing medical assisted treatment providers okay we have we were we commit to we moved from two hundred thirteen two three hundred and twenty seven three hundred twenty seven so you weren't referring to alcohol and drug treatment services in residential I was referred to residential okay have me do we have detoxification residential treatment outpatient methadone maintenance treatment. Do we know how many services we have that were putting folks and are are paying for them trying to have treatment of this fund we have a medical detox contract to serve the entire state with the presently resides with all house and we do provide for residential Bester each of our a treatment providers that cover all seventy five counties so we're outsourcing with private groups yes ma'am. Okay All right thank you are the other the question I had was it said city of little rock funds in this on the third second paragraph bottom line and this is a partnership with the city of little rock. First is something we're helping the city of little rock. Yeah in that. You can you can refer back to me later absent some of all of them get you an answer on that I'm not aware of funding that we get the city of little rock in our and our our funding to the city or funding to the civil rights can or substance abuse services but I'll follow up on this and get you know thank you. Representative Jett you're recognized. Thank you Mr school back to senior citizens centers real quick what was the total amount dollar going to those folks. Appropriation of a million dollars just curious to and thank less as we did a special language five hundred thousand. Out of the eight million dollar preparation there's five million from state general revenue and an additional five hundred thousand of funds that were swept at the end of the fiscal year from DHS and then finally the governor committed one million in rainy day funds so the six point five total yes the issue thank you Mr thank you. Absent a board you're recognized for a question. Thank you Mr chair I'll be quick I just wanna ask date drug director lane real quick you know I'm I'm over here the other side thank you I since we've done a lot on the opioid crisis with the supply side I don't feel like we've done as much as some other states on the demand side which would include some of that the H. C. S. funding I just carriers or are we meeting what you think we need is there anything any opportunity improve just some quick comment this is all on a. It's much more than I hope your problem methamphetamine is the number one drug of choice in our state is the number one drug threat that we have and just because in simple terms of somebody goes to their regular and wants to buy oxy coat on he doesn't have oxy code own they don't say okay I'll come back tomorrow what do you got and so we need to be prepared to deal with all substances across the board we need to realize that drug dealing is a money driven profit driven. program whether it's on the list insider they elicit side so having a balance prevention treatment recovery and enforcement efforts and all those parties working collaboratively together is the solution to our problem and it's been shown time after time and problems before in the state have been based upon A lot of times when people are go to treatment is because they got arrested or they got arrested several different times I got incarcerated and to the point where they realize they need to go to treatment and so that's been that Avenue what we're seeing now is a big program pushed on naloxone to allow somebody to survive that an opioid overdose and a lot of times that that point in their life when they get saved is that time that they want to go and get treatment and we have to be prepared for that but some of the gaps that were saying is that we're not prepared for and so we need to be able to lead people to treatment and treatment needs to be based on that patients problem not on that patients finance and a lot of times are treatment centers are asking. How can you pay for this and still until before asked what the problem is and if they can't pay for it they don't have an insurance provider if they don't have Medicaid Arkansas works or some other program we're not asking those questions and giving those people help and that's turning away and when I turned away they use again and so in that aspect of that how we can develop that mindset to really help our Kansans really comes to caring for those are canceling and finding those monetary solutions of those funding pools and using the effectively because honestly some of our money is left on the table and it's unfortunate that it is because I don't want to turn it back nobody wants to turn back money we get. But because we're not asking those right questions. and caring about that patient we're not getting we're not getting the solutions we made with answers your question Sir yes Sir two one I'm sorry over insured amendment dealer want one very quick follow up and and maybe if enough just very. A could you get me and if anybody else is interested a break down of a like here's a dollar this is where we're spending the resources on the supply side and the demand side and if you were going to reallocate them with that would look like and I don't need that today but just is that a conversation we could have won the future thanks for. Thank you represent board represent garner is that you. It is I've got a quick question to German you're recognized thank you this kind of generalized yesterday we got data saying that we have fifty eight are can't fifty eight thousand Arkansans with Alzheimer's and with baby boomers. Adding older that's only going to increase do we have ways that we are making certain that those board with the aging population are getting the services they need and. Are we appropriating NF Ford for those services. Who is that one. I'll take a stab at it and certainly others can can jump in as they like but we do have a number of of services and programs available for individuals locals Alzheimer's of course one is we do have a great program is operated for our division products services and quality assurance the lifespan respite grant and by piece that is providing some respite assistance to caregivers of an individual that Alzheimer's we also have our ARChoices waiver program and that is for is designed to provide benefits to individuals who are either physically disabled for older adults who are frail and the the systems and that can include individuals who have Alzheimer's restored exhibit those those problematic behaviors that provide that are are a threat to their safety and so they that is one eligible to door and our choices we have a number of individuals who are on the program because of that and in that case we can provide no in home assistance with activities of daily living and provide home delivered meals as well as all the usual spectrum of services that are available in Medicaid. Great thank you thank you Mr represent garner. Miss Glaspie would you say that there is. More mental illness now than ever before or more illnesses recognizes bill mental illness it never before it seems to me that there's more people needing help and we try to. We try to spend less money on than we ever have it appears to me and I'm a member of. Shall put anyway Texarkana community mental health and it seems to me that we're Sidley chipping away at their dollars I know you like to do private stuff instead of of nonprofits but. It looks to me like we ought to be trying to fail has been more money to help those people to get them back in in the real life and back at her home and back at work and it looks to me that we spend less and less. Let me take that from several standpoints first of all I'm not a clinician so I can't say that we do or don't have more all right but I can see I can say that like you we see Much more of an awareness of it now an awareness that which is positive right instead of it being hidden people now are actually willing to talk about it talk about the fact that treatment is available treatment should be available and how do we actually help people right rather than just letting it become more and more problematic. and that is and has been a big part of the approach we have been taking at DHS in terms of trying to look to expand services around mental health and expand the providers that deliver those services around the state. And we can talk about it on Medicaid because that's part of what they were and interestingly referencing which is providers who really want to provide services are used to doing it under contract and now doing it under contract and with the ability to charge Medicaid. Medicaid is an it doesn't have limitations as we talked about a little bit earlier so they that is in there we actually have made available far more money to be able to be used so but if I could so it at the risk of of stopping you well Augusta you are so what okay you want to call when you we call me sometime March out my number and we could finish talking about we need to move on okay fair enough fair enough all right so. We're ready for motion on that. Alright members we're all right before us is DHS division of aging adult and behavioral health services. Any more discussion I have a motion and a second. You discussion on the motion. This is exactly wreck all those in favor I. Oppose the ayes have it thank you. And now Mr owner. What time you have to be gone was down. But she say. Thank you very always which surely the lord it won't take that long Miss Wallace you're right ahead. Thank you Mr chair. Yes developmental disabilities yes Sir this request begins on page one thirty one of manual to this division is responsible for administering state programs for developmentally an intellectually disabled persons services are provided by approximately one hundred community providers into the five human development centers that are located across the state this division also is responsible for administering the children's medical services program for children who are health fragile if you look on page one thirty one will look at the nine appropriations for this divisions that offended for a mixture of general revenue federal revenue special revenues in various programs support the division is requesting approximately one hundred and eighty four million dollars their of their nine appropriations they're it requesting continuations and eight and changes to one AM as previously with the like we did last time I'll talk about the continuations briefly and then we'll turn to the pager changes and discuss it an additional detail. The first continuation itemize on line one as the summary it's for Special Olympics in this appropriation provides a grant to the Arkansas Special Olympics it's funded entirely through general revenues and the FY twenty one legislative recommendations for the continuation of the currently authorized nearly one hundred seventy nine million dollar procreation the second item is children's medical services this is the state portion of it funded through general revenues and it is for children who has provide services children who have special here health care needs and the legislative recommendations for the continuation of this nearly one point seven million dollar preparation the third item on the summary is the federal companion to the state children's medical services appropriation and it is also provides helps provide services to children with special healthcare needs and is funded with federal revenues and the legislative recommendations for the continuation of this over one point four million dollar preparation the next item is line for its the autism treatment and coordination appropriation and this preparation provide specialized services to children and adults with autism this appropriation spend with general revenues it will in the line item it shows that we actually spent zero in nineteen what happens is that that funding is moved into the operations appropriation of the agency to be paired with federal funding so that they can. Expense for that program expenses and legislative recommendation is for the continuation of this currently nearly two hundred seventy four thousand dollar preparation the next item we want to talk about is on line six it's for community programs this appropriation is utilized provide services to eligible individuals through license community providers and is funded with special revenues generated during three additional days of dog racing the FY twenty one legislative recommendations for the continuation of the current fifty thousand dollar preparation the next ones on line seven it's called grants to community providers this appropriation provides the state match portion of Medicaid costs for community private providers provide services to DDS clients it also provides wraparound stabilization services that are not covered by Medicaid was appropriations fund from general revenues and the recommendation is for the continuation of this nearly fifteen point nine million dollar preparation the final continuation line item is the very bottom for inter divisional programs. It provides integrated services and programs for the eighty ex con DDS clients you have complex needs that require the combined efforts of multiple DHS divisions in its fender with general revenues the FY legislative recommendations for the continuation of this nearly one hundred nine thousand dollar preparation and if you will turn to page one hundred forty four with me we'll talk about the operations appropriation which is the one that they have with the changes. This is the operations appropriation for the division of developmental disabilities services it provides administrative support to the division this division administer state programs and services for people with developmental disabilities and in addition to the coronation community programs and services for enveloped vigils with disabilities is responsible for the management and operation of the five state owned and controlled human development centers and these are institutional facilities that provide twenty four hour residential services ability ation medical services therapies and education. funding for this appropriation consisted general revenue federal revenue in other revenue. And if you look on page one hundred and forty six you'll see the appropriation summary for this by line item and in the FY twenty authorized appropriation is for one hundred and sixty four point six million dollars in FY twenty one their recommendation is for an increase of fifty two thousand nine hundred dollars in salaries and about thirteen thousand four hundred and match for a total increase of a little over sixty six thousand dollars and this can increases FOR career service payments and this concludes my presentation I'll be happy to answer any questions. Are there any questions members. I don't see any there's one. Just gone. Thank you. Tell you turn it back off. Too late now represent Lundstrum Lynch from. You're recognized thank you I'm. Just a but not sure where to start and but. I'm really impressed that some areas you've actually managed to keep funding pretty pretty stable we've had some problems with some of the the DD population not getting the increases they've had ten to twelve years they haven't had a price increase on that charge per student our per client but they did have a little bit of an increase in January which I think that helps some what's the the plan for going up on that after they've been I think twelve years without an increase or still trying to recruit from that. Melissa stone division director for development disability services and thanks for the question represent of Lundstrum so as you stated we did a rate increase for day habilitation which is a service that's exclusive to our day treatment facilities and there's two types early intervention day treatment with straight scads birth twenty one and then adult adult developmental day treatment which is really for adults that have graduate high school they're eighteen at five and both of those programs provide understaffed G. they can provide five hours a day of day habilitation which is that the service that just helps clients work on their life skills they were increased an hourly rate by eleven percent that went into effect January one so they went from the adults were and we're getting a state they were. Adding ten dollars and sixty cents per hour and that was raised to eleven dollars and seventy seven cents per hour and then for its the children's program and went from sixteen dollars and forty six an hour to eighteen dollars and twenty seven cents an hour or so and they providers I don't want to speak for them but they were very happy with the outcome of the rate increase they had not received and any increase to that service since two thousand and one so that's why he sees such as substantial increase center that's been discussed here before I got to the table but it had been a very long time since that particular service had received any type of increase yeah I know some in my district were barely holding on and and are still barely holding on even with that they've made tremendous adjustments what's the issue with transportation where are we in that situation the lawsuit that's going on so as you know last Christmas or two Christmases ago and there was a lawsuit filed and and then junction entered when we were trying to select one type of transportation to and from these particular clinics so we put some emergency contracts in place and the General Assembly just approved today's contracts again so there one year contracts we are putting out a formal hopefully a formal procurement we're still working with the providers on which route we want to go Milliman is doing our rate study for **** and will be being bringing that providers and to go through the outcome of that race study into go over kind and next steps but we need and something more permanent in place beginning January one of I would love to see more competition and to the private right carriers can be involved more. I'll tell you about my time. Thank you representation. Senator Cooper. Thank you Mr chair. The. The H. the city's. Of recently there was some information about upgrading employee. classifications. Assume that this is in this new. Budget. For doing that so I'm to thanks thank you for attending that event I heard that you were there and I appreciate you being present and second no it's actually not reflected and as an increase to this budget because we are able due to some efficiencies or able to absorb the cost and if if the legislature agrees and we pass those proposed changes to my staff and we will be able to absorb that cost in our current budget so and if the money's in the budget that's why you're not seeing an increase a request for an increase for me good A guess what flag me about that was it you put on there. Be in effect July first which should be the first day of the end of the fiscal year. So that's what put me on to that that's right so that would be the early as in again and it's going on you have to approve it will be presenting it to you guys to operate but that would be the first act to get the positions record actually may the staff into those higher grades and and so that's why the power point everything have that July one start date on it okay in that being funded of being absorbed but what will it be absorbed from is that the federal funds it's been a joy or from where mix of this seventy thirty and it's a Max so it's direct care position so it will be a seventy thirty split and it's in the fund that lie low went over its out of my operations budget so what will be funded from both of those yes okay thank you. Thank you senator Cooper. Center represent rye yes. Thank you Mr chairman ma'am on page one thirty one. Okay it looks like the the biggest increases on a the line item that the. It says an excess appropriation. And it looks like it's twenty two million fifty five dollars and and our fifty two thousand five hundred what do you have an you may have explained that earlier but. Yes Sir so I'm. So yes I do you have excess of appropriation I have that twenty two million and I'm one of the reasons why you'll see that and that the DD as appropriation is access appropriation is higher than other divisions is for situations and I think Senator elated to earlier kinda like we are today we're talking about this virus so you know we try to keep excess appropriations in case I need to bring an extensive amount of staff and pay them overtime so because the majority of my staff about two thousand and then work in the facilities and and they're doing direct patient care twenty four hours a day so I and I try to maintain at a pretty good amount of excess appropriation said that if I needed to I can come back to you all and ask to have some of that and funded yes if I'm just a I just and service were clear you'll see that in the division of aging all payroll services cemex as preparation as well as in division of youth services again because the importance of one worked at least twenty four seven facilities were out we operate we have to prepare for any contingency and those cases where you can actually wait a week or month if you have an H. back unit go out and you got to replace that to take care of those residents so just a sign of that that's from the recent actions preparation both her budget but also in some of those others will follow ms chairman please I bet you've been running short on this particular fund Page of the funding haven't you. Running swear house well I I just noticed that you know and that nineteen to twenty budget it one put in and told twenty look like twenty twenty and twenty one that twenty two is a million. The previous previous year one mention. Right and those those zero items those are on budget actual that would disturb the appropriation this point actually was there before yes thank you thank you absent rye. Represent Cavenaugh you back. Thank you Mr chair this is gonna be on page one forty six. it's going to be dealing with your professional fees really I have two questions what do you pay out of that for professional faith. And it shows that you had only spent two hundred and thirty three thousand but you're asking for an appropriation of five point three million and that's a really large difference and I'm trying to figure out exactly what that is used for. Right. I'm an ally and if you don't mind represent Cavenaugh I'm a let Tommy Tarpley his my deputy who has at is also was my CFO for many years answer this question so he's so you get the right answer. Tommy Tarpley deputy director for the division of developmental disabilities services so it's it's along the same lines of the. The previous answer where we might have to bring and. Doctors other special medical specialists that have degrees and that's the professional degrees and licenses and that would come out of that. Sees a line item there so you need the extra area for cases just like kind of the the situation going on right now to where we have the flexibility to do that when needed with these facilities. More than five million dollars you only spent two hundred thirty three thousand the most that you have spent in the ten year look back is one point one million but you're asking for five million three hundred eleven thousand are at three hundred eleven thousand seventy nine dollars that is a large if you had to bring in that many doctors were really got a lot of doctors committee and. The cut. Tried again. Some trying to make sure I don't give you bad information so this is just where we have this we have M. sat this excess appropriation in case we needed that necessarily mean that we would ask for it to be used in this particular line item for this type of service. Well if you're not going to use in this particular law madam when you put it there. We you know that because or the yeah because what she's what they're referencing around the facilities is if there were to be an issue where we had to spend a lot of extra money at a facility it would be around professional services associated with the individuals that were there and so that's why the excess appropriation FOR operating these facilities sets in professional fees we ought we have we have over time and we have some contracts but. If we ended up having to go out and bring in a lot of professional resources the assumption was that it would probably have to be through that kind of an area for example right now we we are having to do anything with it but we have medical personnel and on stand by in case they're needed now around our HTC's should we have to move to take any kind of action so it that's why that excess sits there in that line item versus being spread out across several of them. Because you'd only budgeted for five hundred thousand. In terms of funded budget yes ma'am in terms of funded budget and what we would in normal circumstances expect and then excess appropriation is for in case of emergencies. And as we said before in many of those cases it would probably be federal monies that would be made available to flow down to the state and having the ability to receive those and spend those. Okay are you doing. I've lived Cavenaugh thank you. Now I've got for Senator hammer. Thank you Mr chair your reference to Millman report and we're supposed to have them come with force and public health next month to answer some questions are they are the providers involved in the discussion for the for the current reviewed now and what kind of participation are you getting from them if it's an ongoing process. Thank you Senator hammer so yes they were acts of the providers were actually involved when we and worked with Malin men on that rate increase for day habilitation services and then they've also been actively working with me and and DM mass on the transportation right study and trying to come up with the long term plan for that I have really good responses from and and the DD provider community M. as you know we and we meet ally. Okay. And. Is there a foot print plan in place in the event some of the providers should go out of business is was referenced while ago do you have kind of a master plan to prepare for that so that we can maintain full coverage in the state invent a provider goes out. So I think that's comments made were in reference to and some fear about personal care providers yes going out of business so yes many of the clients many of and the TV clients in the behavioral health clients and receive personal care in the community under the pass and that's kind of how I'm connected to personal care and. We like any provider we that pass at the meet network adequacy and that is constantly being reviewed to make sure they have enough at their network is full and and crosses the entire state so we will consistently monitor that just like we always have okay then final question director Glaspie were you in the room this morning to take long but. On for the discussion around flag seven flag gate all that business review in the room this morning in and out yes Sir. Sorry I was dealing with the some issues well in I'm just curious in the in the spirit of. Fairness and what we do for one we do for all if we were to impose a flag seven rule on DHS like we did this morning how would that impact your world. The center out I don't believe will depend because much of an impact if at all simply because DHS we've already moved to a shared services model and so we don't anticipate needing to move any personnel or funding for that purpose in the coming fiscal year that's something that we're other agencies are working to do that now and working through that process that's something that I think we've artwork for an optional believed to be in need I was gonna ask Mister believe if he would also help since. I've never even I will never found him not aware of help okay of what like seven his. Thank you senator yes yet DHS already has a cost allocation plan that's been in place for sometime they have to have that as part of their federal funds and some of the stuff they do so the the thing we debated with flag was number seven this morning would not apply for DHS they would they said they would use their existing cost allocation process okay and that that process is well work well in in DHS as far as you being able to identify some true cost savings to that to that arrangement is that correct. Yes that are for us that's that's a daily effort to make sure we're maximizing the use of all of our federal funds and that's how we do it three is for cost allocation to make sure that any time that we can access the federal matching fund or some other source other than state general revenue we when access that are good but will have an offline conversation like to see those savings and thank you Mr. Thank you senator Senator Cooper your last one. Thank you Mr chair. Several times there's been questions about the authorization versus budget. And Tell me if I'm wrong about this but the. If you had an emergency during the year and you did not have authorized budgeting authority. We would have to have a special session to authorize that. Correct. If you didn't have the authorization to spend it even though you might have the grants available for an unexpected the emergency let me confer with D. F. and A. What check whether to come up here and share one of the points that we were just discussing is. If we had an emergency in one area At and or an opportunity emergency on opportunity give you an example of an opportunity that came out a couple years ago we had and in child care the federal government surprised everyone by coming out with was it. Fifty million I believe yeah all of a sudden coming out that the federal government to Congress passed unexpectedly a huge amount of money to go to the state for childcare vouchers right for working people under it low income working people. And that money all of a sudden was made available immediately. We had at that time enough excess appropriation to be able to say send it and we got it and we got everybody off that waiting list and in two you know vouchers and able to get to work and just got a job school and that kind of thing so that's part of what happens in we also then look within DHS when something like that happens and let's say Melissa doesn't have enough appropriation but she has a need we would look to see whether or not we could read reallocate appropriation between some of the areas there some limitations on us there around that with Medicaid Medicaid kind of sits off by itself but you know within the non Medicaid part of the world and so we but all of that comes before you all for approval so it'd just to do that but if we had an emergency and we did not have enough within all of DHS then. If you do not have the spending authority you could spend it we had the money that's the point that's correct yes thank you. Thank you senator Cooper high winds up for questions any more questions all right. Executive rack were own development disabilities my friends DHS developmental disabilities we have a motion for executor wrecked and a second any discussion on the motion. All those in favor I. Opposed the US Senate committee meeting. To allow a. In the interest. In the interest of time would you stop reading the ones that don't have no change. Thank you all right the next one that we gonna talk about is for the secretary's office it begins on page twenty six of the manual the at this one is specifically for the secretary's position it creates the new cabinet level department FOR the department of Human Services and establishes the secretary of the department of Human Services and is appropriation provides for the secretaries operating expenses in the department of Human Services funding for this appropriation consists of a mix of revenue sources from general revenue federal funds and other friends the federal and other funding is determined by the department's cost allocation plan if you look on page twenty seven this is the appropriation summary for this and this one it is brand new there's not gonna be any and expenditures in nineteen or twenty the agency request is for and the executive recommendation is for a total of three hundred and forty seven little over three and four seven thousand dollars they're only line items in here or for ms glass piece position as secretary and Phil Tosh a filter on page thirty three. Say. There are two appropriations this is for the for the secretary's office which is currently the appropriation bill for it is for the director's office and there there's a there's two appropriations and they're on page thirty six and thirty eight. On page thirty. I'm sorry on page thirty eight is the administrator paying account this is the operations appropriation for the secretary's office and it pays for the personnel in operating expenses of this division. Funding for this appropriation consists of a mix of revenue sources including general revenue federal funds and other funding and as determined by the department's cost allocation plan and the appropriation summary is on page thirty nine and this is where the foster grandparent program was previously located I am in in fiscal year twenty they are total lies total authorized preparation deliver sixty five million dollars and in the agency request executive recommendation are for sixty four point six million dollars this is a decrease of slightly more than three hundred eighty thousand dollars and with the following approximate reductions two hundred eighteen thousand dollars in regular salary seventy five thousand dollars in match eighty four thousand and operating expenses four thousand conference fees and travel a hundred dollars a professional fees and it also shows a decrease of five positions all of this movement is for the americorps program which made to the department of education division of higher education as a result of acting nine ten the americorps program was made data DHS to the department of education and if you look on page forty down at the americorps grant at the bottom and this division formerly administered in americorps grants and it was true that grant was transferred to the department of education division of higher education due to ACT nine ten and if you look on page forty two U. you'll see the appropriation summary that the in the in the appropriation that second line is the americorps grants line in that entire two point five million dollars was is transferred out of DHS to the department of education so it becomes zero I'm in this changes recommended as part of acts nine ten which moves it out of DHS and these are all the changes for this division. Our members any questions. Hard wait a minute. Have you have Cavenaugh the quick one yes. You're recognized thank you Mr chair on page thirty nine. On your data processing services. it showing that in nineteen we spent six point four million dollars on data processing services but we are headed we're budgeting a million eight. Why was there such a large expenditure in nineteen do we know. Yes thank you for the question so we had moved to the shared services model and even prior to that our office of information technology often ran many payments three their own appropriation line and as we have continued to refine our both our cost allocation in our services to divisions we have actually been placing those expenses and to the individual division in offices line items and so many other things that were being paid as consolidated bills perhaps out of high tea are now going through at their division appropriations directly okay so we haven't necessarily cut at those expenses there just allocated to the division that they belong B. and is that correct the same thing with professional phase. Yes yes for the most part those are contracts so that professional fees line on them is largely made up of contracts and so again rather than office of information technology various other shared services holding that contract we may have placed those contract expenses Allen at their divisions are offices okay have we. Because it are allocation our recommend him for appropriation has not decreased in the house have you all increase. What you're asking for those other divisions to cover those costs that you've created there and did reduce this. I'm sorry could you repeat that if you actually if you and nineteen you paid that is consolidated but now you've taken these expenses and you moved on to the visions on your ask for appropriation have you reduced your appropriation ask on these through this service and increased it in the other divisions. Not necessarily and actually if you look at the professional fees it it's actually at that nine point six level. Yes I realize that right at and most of those would be tied to most of what goes on in that professional fees area in this part of the budget is actually tied to I. T. and I. T. projects that we have under way and right now we have under way and number of very large I. T. projects so most of those there tied to that at this stage we are in the process of redoing the state's Medicaid eligibility system we are starting work on the state's child care of not child care child welfare system we are working on the juvenile A statewide juvenile justice system except for us so the the bump up their reflects what we are doing at in terms of IT projects over the next couple of years it'll then when we get past all of that those kind of professional fees should should show those projects moving through an out and kind of keep going like this over the years okay well I'm I misunderstood I thought that you had said that what you were doing as you were taken those perf those professional phase and like in eighteen you had nineteen says that you paid it to a centralized a system but for the budget you have down to four point four million and you said that you're taken those expenses and moving those to the division's inside the department and your allocating those expenses to those divisions correct and I mark my question is when you did that did you also adjust your ask for appropriation and put those in the correct divisions so in the areas where we have done that around certain some projects are run out of shared services and that's where you'll see those professional fees right big projects but run out of shared services other projects are where a division is basically decides they. You want to do one so while it shows up in the shared services budget and the quality is overseen by the I. T. there the division themselves decides that they're going to do they literally get an Eloi on an estimate of the cost of the division of sites are going to do it so it is absorbed by the division than in their budget and we did not you what you've seen with the divisions has been As you seem with all these kind of continuations of gone on our divisions have been able to take that and absorbed into the work that they're into their budgets through that's house some of the things that they might save money on they then might use some of that funding to be able to improve operations by doing that kind of an of an elderly so it's a combination the two depending on what the project is. Okay I'm still confused because of fear you have a change or you have an ask you have a change or ask for appropriation. Am I gonna say that appropriation ask in the division also I guess that's what I'm asking no ma'am the division appropriations that you're seeing are are like they are okay thank you. Cavenaugh no more questions we're ready for motion. I have a motion with executor Acura second. And members were doing. department whose services. Secretary. And would do an administrative services you discussion on that all those in favor I. The close the ayes have it thank you where are you now allow. Child care and early childhood. All right do you want me to continue to just do the one to changes that have standing all right and there're division of child care and early childhood education request begins on page seventy three there are two appropriation to have changes the food program appropriation and the operations appropriation for the division of child care and early childhood education if you'll turn with me to page seventy six will talk about the food program this the fee program is for the child and adult care fee pre program which provides nutritious meals in public and nonprofit licensed childcare centers adult daycare centers daycare homes an outside school hours centers and this program assist with initiating maintaining expanding nonprofit food service programs. this appropriation also includes the emergency food program and the commodity supplemental food program those were both transferred from the division of county operations the emergency food program provides food on an emergency basis for families in need and the homeless and agencies like food banks and community program action agencies have agreements with the department to provide future soup kitchens food pantries in masturbation households and the commodity supplemental food program provides few to seniors in need on a monthly basis and those distributions are also done through community action agencies throughout the state funding for this appropriation is one hundred percent federal revenue which consists of federal reimbursement through the US department of agriculture and the appropriation summaries on page seventy eight and it shows a current appropriated level of about sixty nine point seven million dollars in FY twenty in the recommendation for FY twenty one is slightly over seventy one million dollars which is an increase of one point three million dollars and I was told that the USDA raises the mail rights that are associated with these programs so this accounts for the increase in fiscal year twenty plan and then the next one that we're going to talk about is page seventy nine this is the operations appropriations for this division. And this preparation provides administrative support for the division of child care and early childhood education hit education and whose purpose is to enhance the coordination of tall care and early childhood education programs within the state of Arkansas funding for this appropriation consists general revenue federal revenue special revenue as offense and if you look on page eighty there is the appropriation summary for operations the FY twenty authorized amount is for twenty four point nine million in the agency requesting executive recommendation are for twenty two point eight million which is a reduction of about two point one million and this is as a result of acts nine ten transferring the a portion of the Arkansas better chance program from DHS to the department of education A these reductions include approximately four hundred thousand dollars in regular salaries a hundred forty four thousand dollars a match one point two million dollars in operating expenses four thousand conference and travel and three hundred thousand dollars in professional fees there's also decrease of ten positions as positions also moved to the department of education. and this includes my presentation for this division and I'll be happy to answer any questions urging Kerr. Absolutely. I see no questions I have a motion. And a second and we are owned DHS child care and early childhood executive read a discussion all those in favor I. Oppose the ayes have it good job on a. The. The now we're all no children and family services yes Sir this is for the division of children and family services and it's a department appropriation summaries gonna be on page eighty eight of manual say. And this division only has one appropriation with changes in its to their operations appropriation which is on page ninety three. And this appropriation provides administrative support for the division of children and family services and funding for this appropriation includes general revenue federal revenues and other revenues if you look on page ninety four is that you'll see the preparation summary for this appropriation they're FY twenty authorizes for a hundred and seven million point there is a hundred seven point twenty eight million and they're ready requesting for twenty one hundred seven point three one million which is an increase of about twenty seven thousand dollars the specific increases our twenty one thousand six hundred and regular salaries in about five thousand dollars in matching and these are for career service payments and this concludes my presentation for this division and I'll be happy to answer any questions. Hello Sir any questions. Lives in Cavanaugh you're recognized thank you Mr chair minds on page ninety two foster care. I notice that we had budgeted for points we have budgeted forty seven million it looks like in nineteen we and only really is twenty seven point eight million is that because we didn't have a greater need for that or we didn't have the funding because someone who deals with those children in crisis all the time we're always seem to be looking for more foster families. Right so we we always ask for additional barb when I'm asking but we always need additional appropriation because I when you're dealing with placement of forty three hundred children and you can't predict exactly what where they're gonna be placed or what level of placement there is so we have to be we have to have the additional appropriation in the contracts to be able to move money around to place children where they need so the placement could be as high as six hundred dollars a day or it could be like a foster home which is four hundred and thirty five dollars a day so we need that additional preparation to make sure that we can place kids where they need to be and are contracts that are loaded properly. Did you say a day. Yes ma'am okay. So for foster. So with the foster care program. Is that include what we're paying for foster parents to take care of children that's right but you you're specifically looking at eight eight three and so that's mostly state John revenue so that could be here hi and comprehensive residential treatment that I was referencing at at Hyde high rate of a daily rate does your high in some of your placements in this eight eight three year high and comprehensive residential treatments okay well I just wanna make sure that when we have that we are actually are getting the funds we need for foster care program that's that that's my concern is because I want to make sure that these kids are taking care of yes ma'am we have the funds we need as far as your to address your question related to foster parents were always recruiting and looking for additional foster parents it's not a matter of the ability to pay for the foster parents it's a matter of finding training and recruiting them okay thank you. Roger just just quickly miss Martin if if you can address Is there anything of in the buddies contact some I got a call at lunch this is the new because the virus the new protocol is no foster children can leave the state of Arkansas is that correct and no Sir in fact I had a I had is in conference with all of my supervisors that need today when we went to lines and and we had a conference call with the department of health and all over in fact it's has happening right now that's why I was out in the lobby and that has not been the message the message is that travel out of the state does need to go at three million three the secretary's office so that we can coordinate with the department of health but as you know we always function on a case by case what is the in the best interest of the child and we're just trying to make sure that if there is travel out of the state that is to have an area one it needs to happen because it's best for the child into that we're looking at where are they going is in an affected area do they if when they come back they need to be self quarantine but again it is a case by case basis and we're starting to final that all the way through the secretary's office and we had one approved last night you know okay to for the bill and I thought it might be helpful committee to hear from you that that no it was that way and that's that's what they thought it might be with the one sure so I'll get you free late thank Mister yes hi. Thank you senator rice. Senate bill you're still here. Fortunately or unfortunately as the case may be trying to find out what we're doing we going to go through the division of youth services which is on about two pages away. By the end of the day are we meant to come back on Monday no ma'am we're Phoenician. Okay okay I don't have anything else to do god forbid if they go home and find out what's happening with their school districts and. There being close today okay Senator mmhm. Fourteen is that you Wooten are Johnny Johnny you're recognized Representative okay thank you so much ms chairman ma'am of latch of let of miss Francis said represent France is going for twenty seven forty seven of of all the years that you have been involved in the as do you know what the hash this ever ran. Have a idea missandei. I think. Right. So the how are you asking me the highest amount appropriation we've had or the highest amount of actual spend with Randy I do not know the high mark. For as far sixteen it was thirty seven point two million twenty now. Thank you very much. Thank you. Alright members I'm ready for motion any more questions I have a motion executor wrecked in the second. He discussion on the motion all those in favor I. Oppose the ayes have it members at Texas county operations. You're recognized law. You Mr chair rate faster. The department preparation summary for the division of county operations is on page one hundred and four and this was all of their preparations out they have one two three that has actually that have changes requested for fiscal year twenty one so we're going to talk about this and the first one that we're gonna talk about is the low income energy assistance program and it is on page one hundred and nine. The preparation for that low income energy since program also known as lye heat this program has been transferred to the department of energy and environment division of environmental quality is part of active nine ten and the agency requests requested executive recommendation is for the movement of this so this appropriation would no longer appear in the division of county operations appropriations bill. And the next one that we're going to talk about is Senate. On page one hundred and seventeen. And this is the appropriation this is the preparation for this divisions operations that are associated with the Medicaid tobacco settlement program and it says DHS Medicaid expansion program as we as a part as part of the flag list from last week we did change the way that this will look in the appropriations bills that's going to be called the Medicaid tobacco settlement program instead and this is funded by federal tobacco settlement funds and these are appropriations are for the positions in operating expenses it medicine operations associated with them and this is for the semi for this appropriation is on page one hundred eighteen the FY twenty authorized amount is for two point two five million and the Legislative requests for an increase of about twenty six thousand dollars in total and salaries matching line items in those FOR career service payments. And the next preparation going to talk about is for the division's operations in its class allocated on page one hundred nineteen. And the division of county operations are the primary responsibility for providing leadership and support in each of the eighty six county offices in seventy five counties and is responsible for administering the snap T. Medicaid our kids programs across the citizens of the state of Arkansas and funding for this appropriation it comes from general revenues federal revenues and other revenues and if you'll turn to page one hundred and twenty one you'll see the appropriation summary for their at the operations appropriation there FY twenty authorized appropriation is for about a little over a hundred thirty five million dollars in the work they're requesting in fiscal year twenty one a decrease to one hundred thirty seven point roughly eight million dollars and it includes the following decreases about a hundred thirty two thousand dollars in salaries about fifty six thousand and match about forty eight thousand and operating expenses ten thousand conference and travel and about twenty three thousand data processing center at. Services and there's also a decrease of five positions and these changes are also as a result of the movement of the low income home energy assistance or lye heat program to the division part and of eventually of our environment division of environmental quality as part of ACT nine ten this concludes my presentation and I'll be happy to answer any questions. Thank you allow. Nobody's lit up to that member ray for motion. I have a motion and a second. The motion is executive wreck on the county operations all those in favor I. Oppose the ayes have it. May you got look your people on the ground help in this. At Texas to medical services. Yes Sir Farmall flower thank you Mr chair and the division the preparation summary for the DIV vision that are hi on a we did it start. Go ahead law this this this one is gonna be on page one hundred fifty they have fourteen appropriations and they're requesting changes and five of them. A so we're gonna talk about the changes that first changes can be on page one hundred and fifty six these are for the programmatic expenses that are associated with the Medicaid tobacco settlement program. And therefore the prescription drugs line item in the hospital medical services line item and these line items provide prescription drugs and hospital medical services for the air folks who were part of the Medicaid expansion that occurred as part of tobacco settlement program in two thousand and one. This as these preparations are funded through tobacco settlement funds and federal revenue and if you'll turn to page one fifty seven and one fifty eight these each line item has its own appropriation of funding sources listed and on page one fifty seven is the summary for the prescription drugs line item and FY twenty authorized preparations for eight point ninety eight million dollars legislative recommendation for twenty one is for nine point five four million which is an increase of about five hundred sixty thousand dollars in this is to support program needs on page one hundred fifty eight we'll see the preparation separate for the hospital medical line item the FY twenty authorized appropriation is for a little over ninety nine million and the recommendation for FY twenty one is for a hundred and. Point four million which is an increase of about one point four million and this is also supposed to be to support program means if you'll turn with the meat you page one hundred and sixty three this is the operations appropriation for the division of medical services whose primary responsibility is the management of the Arkansas Medicaid program. Medicaid the joint federal state program that provides necessary medical services to eligible persons who are not able to pay for such services on their own. M. let's see if you will go to page one hundred and sixty nine in one hundred and seventy agencies funded through general revenue federal funds and other revenues and on page one hundred seventy is the summary for this appropriation the FY twenty authorized amounts for twelve point two million and they're FY twenty one recommendation increases the salaries and match line items to two thousand eight hundred and sat two thousand eight hundred dollars and seven hundred dollars respectively these are for career service payments. If you'll turn with me to page one hundred and seventy nine. We will talk about their requesting three at changes to to the line items within the division of medical services grants paying appropriation which is actually that appropriation big preparation that pays for the Medicaid program at one of them is for the infant infirmary pro appropriation this M. appropriation provide services to infants with special needs and the facilities that are paid through them are licenses private pediatric intermediate care facilities FOR individuals with intellectual disabilities These programs provide a valuable service in that many children are admitted to one of these programs when discharged from hospital they need continuing attention and medical oversight but not necessarily ongoing medical treatment these the preparation is funded through general revenue federal revenue and other revenues the other one that they're asking for changes to use the public nursing home care appropriation which includes title nineteen Medicaid reimbursement for services that are provided at the human development centers the Arkansas health center and the thirty one fifteen better less into intermediate care facilities of programs across the state funding for this program is also from general revenues federal revenues and other finance a field turn to page one hundred and eighty two you'll see the appropriation summary for the infant infirmary portion at that we discussed the FY twenty one twenty authorized appropriation is for thirty one point ninety million FY twenty one legislative recommendation is for thirty three point nine million which is an increase of one point nine million this changes requested for growth and to allow the division the capability to respond to state or federal mandates and if you'll turn to page one hundred and eighty three you'll see the appropriation summary for the public nursing home care line the FY twenty authorized is for two hundred twenty nine point one million in FY twenty one recommendation is for two hundred forty two point two million which is an increase of thirteen point one million and these changes also requested for growth and to allow the division capability to respond state or federal man mandates and this concludes my presentation for this division and I will be happy to answer any questions. Thank you allow Representative Cavenaugh you're recognized thank you Mr chair my question is going to be on page one sixty and one sixty two dealing with the nursing home closure cost and long term care facility receivership. It shows that in nineteen we didn't have any money spent in that but I know that we actually did because we did have to take over some receivership of some homes so I'm kind of curious why it's not showing up in the book and how much it is. It just be clear for to page one sixty two one sixty and one sixty two okay. So a couple things number one there are really three different preparations that we potentially can access when we take over a nursing home and need to provide funds to support that nursing home and so we've been accessing those for the last few months with five nursing homes which we currently have that we're taking into receivership The one one sixty two in particular that one is a unique one that is only applicable in certain situations and so at least so far today we have not tapped in this particular preparation for those nursing homes that may become a possibility but there's a limit is that a fax in which this is on page one six two may be used and we haven't gotten to those facts yet and Mr share miss here's the director of the division of water service quality assurance which includes the office long term care and igniting thing that I may have missed in that answer. Okay Sir Sir order direct yes so I know that we did actually have to take over some homes and can you tell us how much at that actually did cost no matter where the funding came from. At Gerry Sherman director for provider services and quality assurance yes I can it's reference when it's really quick. So for those that first set of nursing homes that were taken to receivership we spent approximately seven hundred thousand after RECOUPMENT from state funds. Okay so it cost us seven hundred thousand if the cost is that what we spent two thousand nineteen yes for the two nursing homes that were taken to receive what about the ones that we have under our care now that into two thousand and twenty one if we spent so far. That's more than two now thank you that's correct so there were five nursing homes that we to conspiracy for ship late last year starting in late September and October and the amount that we have expanded so far is two million ninety one thousand five hundred and twelve. And with additional PO commitments of another eight hundred seventeen thousand. And one thought where is that money coming from. So as at chief White indicated there are several funds that are available the hundred thousand dollar fund that we initially talking about that's more for receivership cost the receivers cost not necessarily running the nursing home itself and I'll get you the the funding just just shortly. And that that fund is the nursing home closure costs and which is on page one fifty. And that that is currently listed as one million but and I was raised to a total of four and a half million in January with the resource we allocation. Okay so you you rights that you took something out of one place and put it up to four and a half million is that going to be enough to cover do we expect any others that we're gonna have to take over. well it's hard to it's hard to tell we didn't expect necessarily the ones that we had in September October I do anticipate the current receivership to and at the end of this month first of the next month and this is these all funds these are not state general revenue fund these are funded from civil money penalties that we get from the federal government as far as whether that's enough we expect that to be enough based on party position even though we've had a a period where we've had several batches in the last couple years we don't know of any current homes now they're in a similar situation okay thank you. Representatives from. Yes Sir can we get a list of those nursing homes and what the cost was. The location and then my questions I'm on page one fifty eight. The tobacco. Medicaid expansion program account the actual was twenty six million the budget was ninety nine and the recommendation was ninety nine we're seventy three million dollars difference. That's kind of hard to budget. It makes it basically I feel like or grab an elephant the dark and I don't know what we're grabbing it looks rather bloated. And then again Have the same thing happening. Just a few pages over. And. And it's another ninety million. I'll find income that and. A is there a way to get a real budget that's actual and budget and I like dreaming and the grant columns is this there's no way we're actually getting a real budget here. And. This is in a real budget under the Medicaid expansion account where it says actual at two thousand and nineteen the real budget the differences seventy three million yet we're asking and the next column for twenty twenty one ninety nine million. It looks like the budgets really huge when actually all. Might be doing an awesome job here. And but nobody know what. This might be the world's worst caps and best kept secret. understand you're turned on Hey it is thank you certainly understand appreciate the question within this category there's actual several different programs that are funded out of it it is an area where with those programs in some in some years past we have had varying levels of spending so some of that money has been carried over year after year and then we are utilizing that you know based on those parties of for example part of what this money can be used for is services for like for example pregnant women that are not eligible otherwise eligible within the existing Medicare program it also is used to help recently was used to help pay down for some slots on the the TV or the committee appointments services waiver so it is an area where we have had some variation in spending the past years and so as a result of that we have asked to be able to then utilize that to support somebody other programs and services that that is why you see a little bit of a difference when you look at previous years versus current and then and then future future requests if I may add to that it I'm into seventy if in a this report person was reduced at one point the past but then was raised again specifically to accommodate taking adding slots to the the waiver and so that is an ongoing use of that and so I think you will see some increase spending from that appropriation as we had lost the waiver. Okay it is. Are you done represent Lundstrum yeah I'm gonna take some aspirin and listen the senator bond. You're recognized thank you very much Mister chairman I may have missed this earlier did we ever get an explanation of wired chip dropped from a hundred percent to eighty did I miss that. I can certainly speak to that and then if a reimbursement for the to serve others want to add to that so we talked a little bit about during during the the are yours in terms of at that point the federal government had increased all states match rates given the the economic situation the time and tied to that was actually an increase in the chip program and so for Arkansas because we have a a fairly high match rate when the cross for us the country with the increase it actually put us up actually just light we actually by a hundred percent but since you can't be about a hundred percent it was at a hundred percent federal funding and that authorization has since ended and so the phone the government has put out a schedule for state to basically say over the next couple years that number will come down as we presented in our brief presentation this morning so it'll always be higher than our traditional Medicaid percentage but it is based on that formula and then and then has a percentage is added on top of that but that's really why there's a difference going from a hundred percent down to where we are today are we going below eighty is that where we're headed or is AT the base all right now it based on what the information we have is right it's like just just under any it's like that seventy nine point eight six I think yes and your point. Yes we does fluctuate your your cause much like you see with our traditional match rate or what we you know offer for you is our our as our F. map since that number is uses the base to calculate the match rate for the chip program as that number changes on your your basis ARE chip number will also increase or decrease on your your basis and then a director glass we mentioned in the lead in about the increase in prescription drug costs and some I guess more exotic drugs for certain things is created some growth in the budget I think that's on the satellite showing up on page one seventy six and is there anything we can do at the state level I was sort of fascinated that when the chip the this that people were here we're encouraged by the federal government to negotiate regionally for wick things formula but are we encourage and negotiated dollar can we negotiate at all on prescription drugs on the Medicaid side and is there anything we can do at the state level to get savings there certainly there there's there's a number of things that we that we rely and to help us be able to to to better manage those needs in those costs one of those is we do have a committee that we work with in terms of pharmacists and clinicians to help us look at utilization and then also come with criteria with regard to how we how we provide access those medications particularly as new ones come on the board a couple other things that we do is then we also have access to federal rebates that we get through the federal government's negotiation with pharmaceutical manufacturers in addition the state can also then negotiate a supplemental rebates on top of that and so we certainly we certainly review on a regular basis to look and see if there are drugs out there that manufactures now may be open to additional supplemental rebates with the state whereas they might not have done that in the past we also look at opportunities where you know we can utilize like our. Formula Aries to look it incentivizing in utilizing you know generic drugs or drug that maybe you know that may be cheaper where appropriate to be able to help many so those costs so there are number of levers that we do try to utilize as part of that process with that said you know we're also and it's it's it's it's a good thing right but is also a challenge of there are a number of new pharmaceutical interventions that are coming out which have you know potential for significant impacts from a you know medical and pharmaceutical perspective but that said also present challenges just in terms of how we and other states you know are able to then operationalize those and and pay for them. If I could add a couple things I mean. As she indicate there are a lot of areas that are folks are looking at with other states and then here to be able to try to to to do more. The other side just to put this on the table the other side of what she said about when the federal government negotiates a rebate we can take advantage of it when the federal government negotiates a rebate we are required to cover that drug. So it is we are not given an option whether or not to allow that drug we are required to do it because they have negotiated a rebate so that's just one point for you to be aware of their areas we don't control our own decisions. Thank you we want to get the most appropriate official medications but we also want to control costs as wasn't there something else that we need to do legislatively to give you more power let us know thank you. Thanks senator bond Senator hammer thank you Mr chair could I get a list of the year carryover accounts in the amounts that you have them. If you just send that to me first of all please and then secondly on the on the subject of the nursing home the nursing home account. It was being talked about a while ago that's only accessible to nursing homes is that not that's not available to assisted living centers who have Medicaid sludge is that correct. Senator that's correct my standing okay could do what's the distinction between the two as to why the assisted living so you can fill out an assisted living that goes out of business and you're able to assist or step in and take receivership of a nursing home well we have a specific statute that covers receivership for nursing home specifically I don't know that there's a corollary for assisted living but also the level of care I think goes into that at at nursing homes verses assisted livings okay and the money that we've been out of what's the pathway is farmers recovering that money if we've had to step in were yelling cover nursing home is gone into receivership so as far as the funds that are you said they are from civil monetary funds which are derived from penalties that facilities pay for deficiencies during the course of their practice and that's built up to approximately thirteen and a half million that's available in that fund that we can draw from some of the appropriation to do so. And just just adding to your question part of what we do when we when we have to come in these situations and then access the funds as director sure said is those funds are available in in those situations but then on the back and what we try to do is if that facilities and transferred or sold two other owner operator we're able to then work through that process to be able to look at costs that may have been incurred and look at how we can make sure that they're up to date on like paying their fees those kinds of things which is just part of the normal operating practice. But you've you've got thirteen million in that fund right now to assist in the event you have to take over nursing home and it's thirteen and a half million before we began incurring costs in October when we took the last round cursing homes okay and what is your what you mission and maybe sit while going to miss we anticipate you're gonna spend down in order to take care of that do you have probably pretty close to the about four million or so at once all the costs are paid out. Okay. Alright thank you thank you senator ever. Represent Wooten is that you again are you fifteen or you that's me. The bill will I am I'm getting ready to beat a dead horse but. Back on page one fifty eight following a represent the looks from the questioning. I I just a longer stay in. Budgeting ninety nine million asking for a hundred million and we're only spent twenty six here again to me this this this starch the budget process. Relative to what we're appropriating. Verse is what we're actually expending or some semblance. Of reality is a relay of a seventy four million dollar difference. Between actual and and what we're asking for and and we don't know how we're going to use it The same conversation we've had for the last. Of three days or six days. It will as if I were not a these would you say your accomplish anything with them well I don't know maybe maybe at some point we'll have a realization that these numbers were looking at or not accurate and are not reflecting exactly what this agency and others are spending are almost all go and lay it out our budget process the to total revamping these to be completely you looked at and we need to go some similar of zero based budgeting because I'm I'm representing the people of of White County. And how can I go back to them and say you know well we put seventy four million dollars in their budget. And and they only spent twenty six million. So I appreciate that hi I appreciate it can we move on this or thank you Sir. Well Jim Holcomb. They answered my question the Senator hammer thank you thank you Sir absent Tosh. Thank you Mr chair. Back to the chip program that senator bond reference while ago it's my understanding correct me if I'm wrong that federal government was Was paid one hundred percent of that program and now it's been reduced eighty percent is that correct that is correct can you give me a price tag what that a what that twenty percent will cost us here in Arkansas. Please. AS conceive that the increase. so if we reference is a little bit earlier and you may have in your packet there but on slide six we talked about some of the basic budget drivers within Medicaid preclude you look at the fiscal year twenty twenty one and on that third line you'll see A number of eleven point five nine million dollars and that's what we're that's what we're projecting as we had projected or continuing to project for state fiscal year twenty twenty one as a result of those chip cost increases due to the F. map change or the match rate so if I understood you correctly the eleven point nine million will be the additional cost to taxpayers of Arkansas for the twenty percent that's for the chip program only is that correct right the eleven point five nine million represents the state share and then will combine that with the federal share to then pay for the cost of the program okay one more time total cost Arkansas them will be eleven point five yes or no state general revenue eleven point five nine million yes okay thank you. Thank you Representative Tosh senator Chesterfield U. let up in I if look throughout your budget and it says contracts over fifty thousand dollars awarded to minority owned businesses and I see absolutely none am I incorrect and my observation. Not. They were very willing to vote in the docket is everyone in a little there's one in the book and getting in the book and we define this is women ethnic minorities military veterans or something what is our definition. Hello is able veterans as well I think ROW lump together as minority owned businesses so it gives me great concern that out of all of those groups we have a we are not really in any parts of this budget looking at the awarding of contracts to minority vendors would you be so kind as to provide me with a list of those minority vendors thank you do have a you don't do it now I promise legal home okay of but if you would send that to me I would appreciate it very much and with that I would move executive wreck we'll take that motion. I have a second any discussion all those in favor I. Oppose the ayes have it that just leaves us with division you services. What you say I can hear. We also have the division of provider services and quality assurance. Well good. Sorry it's on page one hundred eighty five. If you just a quiet we've got this the We're doing. All right so we're all provider services. Yes Sir you're recognized on page one hundred eighty five it is the A appropriation summary division appropriation semi for the device division of provider services and quality assurance and and this is it is responsible for providing services to Medicaid providers including centralizing of licensure certification survey and inspection processes for providers to service multiple Medicaid populations they perform quality assurance provider training and education performance improvement and transparency and how's the office of long term care that three appropriations nav changes in two of them if you'll turn to page one hundred ninety six this is the this divisions appropriation for operations that are associated with the Medicaid tobacco settlement program I am in their path its fetid three federal and tobacco settlement funds and on page one hundred eighty seven is the appropriation summary for that appropriation in FY twenty the authorized preparation was for about one point one million and recommendation for FY twenty one includes is increases in at one thousand three hundred dollars in salary and three hundred dollars in matching FOR career service payments and on page one hundred eighty eight is the larger operations appropriation for the division and it provides for committee services last year and certification quality assurance provider engagement and workforce assessment and FOR the office of long term care the funding for this appropriation is from state general revenue federal revenues and other revenues and if you look on page one hundred eighty nine you'll see their appropriation summary the FY twenty authorized appropriations for eighteen point six million FY twenty one ridge recommendation provides for increases and regular salaries for fifteen on five thousand nine hundred dollars and about one thousand one hundred that's right one thousand four hundred dollars in matching and those are stated to be for career service payments and those are all of the changes that are requested by this division so this concludes my presentation for them. Thank you I don't see any questions no questions I have a motion. I have a motion Zack you're recognized that can. All those in favor I. Oppose the ayes have it. Not for awhile one more time. You services yes Sir this is the the request for the division of youth services begins on page one hundred and ninety seven and they have six appropriations total and they're requesting changes to one of them though operations appropriation which is on page two hundred and nine. And this is the operations preparation it provides for the administrative operations of the division at this appropriation also supports the operations and employee services of the civilian student training program or see step program that was transferred from the department of military to Dave DYS is a part of ACT to nineteen. And this program is located at camp Robinson and it offers rehabilitation for juveniles who referred to the program by juvenile justices throughout the state and with full staff and funding this program can accommodate an annual maximum population of three hundred thirty students funding for this appropriation includes general revenue federal revenues and other revenues and if you'll turn to page two hundred and eleven you'll see the approved appropriation summary M. this one didn't have things taken away it has had a program added to it soon FY twenty authorized appropriations for about nine point three seven million the FY twenty one executive recommendation is for twelve point one million which includes increases of around one point six million salaries six hundred sixty four thousand dollars match seven thousand dollars an extra help seven hundred dollars in overtime five hundred nine thousand dollars in operating expenses one hundred forty four dollars in conference to travel and five thousand dollars a professional fees this also includes the addition of forty three regular positions and three extra help positions these increases are due to the transfer and a deceased at program D. two ACT nine ten and this concludes my presentation and I'll be happy to answer any questions. It arises that you yes reminds for the agency. Your record for that all right of head Okay I was looking for record from the docking. enter in the budget with the Wow wow. Ending at the end of June you have everything covered in the budget. For this or can you give us a brief explanation where we're at are we putting out procurements or what were where we had on that with the with for a regional facilities that we have. Thank you Michael from director do the services we are actually in the process of working with rights of passage to take over those facilities that's already in the budget we're just working on the timing and why why is currently working with our OPD kind of help that transition process get that ready to go when it does take place we have everything do the amount of time we were given the notice we're given we feel very comfortable we will be able to transition over and get this contract amended to be able to add those for facilities to the rights of passage contract. So. please is will already been determined they're going to have the contract. That is that what you're saying that's correct they currently operate our Alexander facility which has a little over half of our of our kids right now and they were the only other bidder only to procurement a year ago there's a I think three years left on their current contract so the decision was made to amend their contract to be able to prevent any kind of. Problems we might have with staffing and disrupting the children's treatment at this point with only three or four months left we Legislature get any kind of update on that from time to time through a LC or whatever else. So you know cases Smith deputy director senator rice we were going to at while well why aligned to give us a significant amount of time to and and notified us that they were going to be leaving the state it wasn't quite sufficient time for us to be going out with a with a R. F. P. before July one and so yes when we modify right of passage is contract that does have to be reviewed because there will be changes made to that contract along with money added to that contract that you've got everything covered in the budget yes Sir thank you thank you Mr. Thank you senator rice. Senator Chesterfield. Thank you Mr I'm not gonna say I told you so about the other contract but okay of. Moving right along what is what is the way did you What I'm concerned about is rites of passage taking over the end of the contract I within not planning on letting it FOR beard when the contract expires. Yes we would amend our peace current contract which will expire in a few years and then we would read procure all five facilities at that time okay so we will lead it off would be we will not act as if this is a sole source contract correct okay and I'm gonna ask you miss Cavenaugh question on page two eleven. Of. Under capital outlay. We actually spent eighty eight thousand budgeted only ninety seven hundred we authorize now four hundred five. Why the fluctuation in. In that particular area of the budget I'm getting a second wind now. Unfortunately for you. So. We initially had budgeted that the ninety seven excuse me the ninety seven hundred amount because that is what we had allocated that's what we had available but we were able to get an infusion of one time funds along with ten of funds and that's where you saw that we did the upgrades to our facilities that we've recently announced so that's why there was that change because initially when we did the budget during the biennium we did not know that we were going to get that funding all right well that makes sense thank you so much thank you Mr chair motion to property. I have a motion anymore discussion I have a second exactly wrecked yes all those in favor I. Oppose the ayes have it ms Gillespie just one question on on on to own your power point where it talks about staff time for those numbers by. Number of employees are they by revenue there by number of employees and it reflects filled positions on that date I could do those vote could you see me well as the revenue certainly certainly thank you any other questions. Senator Hickey says the J. P. R. we'll reschedule their meeting for tomorrow A bill I will reschedule. Anything else thank you Mr espy. Bye bye. Good work man ladies we appreciate you we're done. Yes yes good job. We're.