Public Health, Welfare and Labor Senate and House

Everybody could take their seats. And come on in from the back hi. Receipt everybody coming here today calling this meeting this week the purpose of us calling this this meeting is really to respond to what's happening with that kind of a pandemic we are the public health welfare and labor committee I know there's been a lot of discussions about this topic and lots of the subcommittee meetings this week however you know this this public health committee meeting and this you are on public health committee for a reason you have spent and dedicated much of your time and energy and efforts as a member and a legislator of public health committee in understanding policies and understanding how public health is working in the state of Arkansas so it is really critical and important for us to hold these meetings because this needs to be a collaborative efforts we are. We are elected to represent the citizens of the state of Arkansas in each of our pockets of the state look differently they all are dealing with this in a different way but no one is more important than the other and you as things change and as things things unfold when there is inconsistencies people become frustrated. And and that doesn't help us in our understanding what our goals are and how we achieve those goals and how we sent those goals and so it is very important to me as an elected official that represents about eighty six thousand people in north central Arkansas that their voices are heard. And that every single person in here that represent their people that their voices are heard and that their questions are asked but it's also critical to me that this become a collaborative efforts with the executive branch and the agencies and the legislature if you do not have collaboration you don't have good policy. And people get frustrated. And people feel like they're not being listened to and we are policy makers that's our role that's what we do people like does to vote but they liked us to solve problems we are problem solvers and we are connected to the grass roots of the state they bring their problems to us and we try to help solve their problems in partnership with the agencies that's how all that works and that's how it works well when that happens. It's been difficult during this pandemic because we haven't had that level of collaboration and partnership and I'm not blaming I'm just saying it is important that we can we do that and continue to do that because of the emergency nature of this because of the separation in the distance seeing a lot of that has not been able to happen and we understand that because we've been reacting to the realities of this pandemic and it's been tough we've been meeting on zoom and we've been doing all these things but at the end of the day I think policy has to be consistent we have to have consistency we have to have a consistent policy we have to have comprehensive policy comprehensive for all again there's not one person in the state of Arkansas that's more important than the other I believe that one hundred percent and the other thing is this virus is not pick and choose and it's affecting every single person so every citizen is vulnerable and I I want to make sure that whatever we do we do it in a comprehensive approach in that we understand that reality we need to be reasons. We need to be reasoned and are spending so that makes sense so that whatever is communicated to us needs to have a reasoning behind it and it needs to be details in and why we need that it needs to be justified needs to be itemized because we're used to seeing that as budgets come before us and appropriations come before us and we make those types of decisions we want to see a reason and spending and an itemization and a justification of that targeted our actions need to be targeted an intentional so that we have targeted action plans that are written down that are widely communicated so that people understand what our actions are and that they're targeted to meet a specific goal and then what those goals are those goals we need to be intentional about the goal and what that goal is and that could be changing and it has been changing because of the realities of what we're dealing with sometimes our goals have to change and we have to re calibrate I think is but I represent Ladyman was an hour talking about but that's a constant thing and so we need to be intentional with how we set those goals and how then we meet those goals I'm and so that's my purpose for calling this meeting in the future meetings that we are going to be having is because we have to have all those things and then that's how I think we achieved you know what we're all trying to achieve which was keeping people safe and healthy and alive not our standard is to keep people alive. And so you know with that that's why we have this meeting Representative Ladyman. Thank you senator Irvin and some stuff I want to say relates what you just said now trying to go too long and repeat what you said I agree with your statement there but thank you for putting this together quickly the last two days hello Sir been done before it was difficult but thank you for your work and I one thing Mister price for what he's done I mean the absolute the speed that he did this with amaze me in thank you Phil for your work to do this and also the health department for you know changing their schedules and being here and I read to change their meeting time so there's been a lot of effort going into this but I think it's really important what the senator said that the people of Arkansas see the legislature getting involved in this and working on this and and putting forth what our constituents are telling us because it's really important because we're their voice and we should at least put this out there in the public arena what they're thinking up I also want to talk a little bit about what senator Irvin talked about it's really easy to get tied up in the statistics we see daily statistics a lot of different numbers and and you can individuals can go out there and focus on a number and forget what the goal is we need to be very clear as a government entity on what the goal is our goal is to save lives. And to keep people from getting ill and being in hospital and and you'll not being able to be with their family people in nursing homes not being able to see their family but we want to save lives and make people healthy that needs to be a singular goal of ours a lot of these other things in these other statistics are just tools to get us there and as senator Irvin said those tools change and that we may be focusing on the wrong thing I think in some cases that we are. and if we're spending money in the wrong place and we're collecting data or doing things that are not helping us do that specific central goal that we're here to do and we don't need to be doing that and we don't need to be spending money for that and I'll as many people in this room that feel like we maybe need to reallocate some of funds and reallocate what we're doing so we we need to stay focused on that the other thing I want to mention is and I'll probably about in this room has gotten the same feedback that I've gotten through emails and calls. There there's people out in our state that feel like they're losing their freedoms and they're being forced to do things they don't want to do and and the the. But once a rebel but they they push back against that and I understand their feeling on that there's also another group of people that think we're not doing enough that we should be doing more things and we should have done things sooner to protect them and their families and those are strong feelings that they have and I understand that but what we need to think about as individuals pause and think about what we do and how that affects our small businesses are people out there that are trying to get their business is open and trying to make a living and they're trying to give a job to those folks that work for them so that they can buy food and they can make a living so that our kids can go back to school and be with their friends and have a normal life so you may have to give up a little bit of that strong feeling that you have for that bigger goal. To save lives together kids back in school to have a normal life so I would just ask folks out there to pause and think about that in maybe got to give them a little bit because we can hit this go we need to end this pandemic as soon as possible and that takes all of us working together thank you senator. Thank you for someone that I'll have the folks from the department of health component and we're going to start talking about testing and as they come to the table there's an article that I came across yesterday and doctor Burke stepper Burke's of the White House corona virus task force told fox news the turnaround times for testing particularly across the south or too long and test results that comeback after two or three days or nearly worthless many health experts say because by then the window for tracing the person's contacts to prevent additional infections has essentially closed and I think no testing is a big issue right now and that's why I wanted to have this meeting specifically focused on testing and contact tracing and this article outlines exactly you know I think what people in our state my my area of the world but also as we've heard all throughout this week that the testing is is such a big issue because the turnaround times are sometimes twelve and thirteen days and I know we have a lot of folks here with questions And said this article really to me highlighted exactly what was happening am here but we've got to get our hands around this and figure it out and and I'll save the rest of my comments for after your presentation that but this to me is critical and it's timely so if you will introduce yourselves for the record you all may proceed thank you. Good afternoon thank you I'm Stephanie Williams I'm chief of staff the department of health. Good afternoon I'm doctor Jennifer Delahaye state epidemiologist with the Arkansas department of health. And I'm sharing quanta sorry on the nursing director for the department of health. Senate senator Irvin and Representative Ladyman I just want to start by extending apologies for Dr America or New in interim secretary of health and fortunately he was not able to adjust his schedule he had prior commitments that can be changed to be here but he will be here with the committee on Monday for that called meeting so and he looks forward to working with both of you in this body it is my pleasure today to start with our presentation and I did mention to senator Irvin yesterday I've got lots of questions about just in general the process that we use in public health and how this all fits together so I'm gonna take just a few minutes to give you a little overview and touch on some things that we haven't had the opportunity to present to the committee before we do the deeper dive and let the experts talk about testing and contact tracing so my presentation is going to be brief it won't be data it's really going to focus on operations but I know you all get lots of questions about a variety of things and so I just want you to know these things are happening in case you have constituents that are interested the other thing I want to mention is I was a little bit frustrated when I couldn't answer all of the questions I got during peer and they were really good questions and you know we've tried to basically keep our experts at the department work in because we are in is still in the middle of an emergency they have a lot of important work to do but today I brought with me a Representative sample of the entire team that is working on this issue because I really want us to take a positive step toward that collaborative relationship that we want to have with you to make sure you know who are experts are or what their opinions are how to reach out to us so I brought everybody and I just want to give you an idea of who I have in addition to doctor deal Hey and. and miss Quanah saw doctor to occur Thorius here he's one of our infectious disease experts has expertise in lab doctor Joel time Wilson is here he's another one of our physicians and has been working with our schools Dr Mike cinema is one of our lead epidemiologist miss Connie melt and he's leading our work on contact tracing Greg brown who is our incident commander for code response don Adams are deputy director of administration he's been working a lot with higher ed K. twelve and on guidance documents Joe Thompson who is our CFO and then also miss make Marable who's our communications director so hopefully I've covered the whole ram of of issues that may come up today and our discussion so you do have a power point presentation in front of you that has some of the details because some of the numbers you get a little bit I don't want you to have to take notes if anything is of interest to be to you the first thing I'd just like to mention is. We prepare for pandemics and emergencies all the time as with the department we participate in the states emergency response system the SF system and typically we're we're ASF eight which is health services support response mortuary services those type things and we play a supporting role to Adam and others when we're dealing with natural disasters and other events the times when public health steps up and leaves the response or when we have a radiologic abandoned nuclear wonder when we find ourselves in a pandemic situation such as we are now so although our roles are reversed with Adam we work very closely with Adam and we also worked very closely with our regional health care coalitions these are the hospital based coalitions that are in the seven regions of the state. So that system. Goes into action whenever we have one of these events so on March eleventh when we had our first case we activated our EOC we didn't go to full activation but we activated and started pulling in all the resources when we implement activation we basically is same an incident command structure so what that means for us is we're fortunate that we have an emergency operations center at Adam we collaborate and share information with the emergency operations center at Adam. In our EOC we were able to have a liaison officer with Adam we were able to have a liaison officer from the Army National Guard and then at the Adam EOC I have a liaison officers with FEMA and with health and Human Services this is really helpful and was really unimportant part of the information flow when we began our response when we activated we went to a seven day a week operation we had people in the EOC from eight to eight we do have a smaller crew that stays twenty four hours a day all the time and then eventually our lab ramped up to twenty four hour so day seven days a week so just want to know that's kind of the framework that we've Danny and since this started and the linkage that we have with Adam the other agencies that or so play per supporting roles by linking and they those AO cities and I also have weekly calls director Gary does a weekly call where we are also joined by all of the county judges and all the County emergency managers this is really helpful it's really good for us to get feedback from that group an important piece of the communication flow and then all the other agencies everybody does a situation rip every day during kind of it response we started out to into a day we did one at six AM six PM every every single day to brief an update and that continues we've now gone to want today sit rep for kind of it but it goes out every day at three o'clock so everybody can read and kind of see the highlights of what's going on in the in that report we share information about about availability resources in just various different things that might need to be shared across that group and saw kind of talked about this when I want to skip this one but it basically gives us that structure one of the things we did really fast what was we set up the data dashboard this dashboard has evolved and has grown now then at the bottom of the slide you could see. Has multiple tabs so we have lots of different tabs down there too so you can do a deeper dive into the data this is been really important to help people understand what's going on because it it has moved so incredibly quickly this is been a really good tool and we had really strong support from the department of the geographic geographic information system shall be Johnson it GIS he came in was embedded in the EOC with us and helps our folks put together this dashboard and this is been a really helpful tool I think to keep everybody on the same page and just want to mention that PP has been a challenge it shall will now I won't spend too much time on that just to say that we do continue play a role in PP distribution and identifying areas of need we certainly are where we want to be but we're better than we have better in a better position than we were in March that we continue to get request for PP from nontraditional users we've done a lot of work with the nursing home with the with the home care association and others to try to resource the improperly are homeless shelters and others so that continues to be significant also one thing to mention here we were able to secure a federal asset it to a Bataille PP sterilizer it has been cited here in central Arkansas it is a a high throughput sterilizing machine it can sterilize up to a thousand in ninety five may I mask in a twenty four hour time frame in those mass can be re used if they're not not to soiled up to twenty times so that really expands our capacity there and we're lucky that we were able to secure that and staff it we also have what we call the pandemic physician group these are the experts from across the department that we pull together they have been meeting daily since this started but now I'm going to three days a week. But they mate they may often and I'm they were met tirelessly and they provided a lot of support to many many different groups and I know doctor deal hazel speak to that more but proud that we've had that expertise. Also call lines we've set up a number of call on that the department have gotten tremendous volume of calls that general Colin member we activated within the first week we had assistance in staffing that call line from the Army National Guard and also the department Human Services I think then the guard gave us fifteen called operators and I think the I just gave us twenty to help staff that one when we stood up in the calls that come in there they're just random they're people that just want basic information there people trying to find resources there people with complaints I'm a it just runs the gamut but thirty nine thousand calls so far have come in over that line said quite substantial and we're still continuing to get lots of calls it yes over five hundred calls yesterday so still an important part of our communication system I'm the physician line was stood up probably when we were several weeks into the response this was also initially staffed by with some assistance from the National Guard we had a physician a PA I think a nurse practitioner thank you well maybe maybe several nurse practitioners and physicians from the guard have helped us with that call on there still receiving quite a few calls and then we also have a K. twelve education line since this began probably in week well it was either the end of week one or the beginning of week two we had staff from the department of education that were embedded with us in the EOC and I've been with this the entire time so we have this special call on for K. twelve we've been added one for daycare switches has been staffed with DHS staff and they're still fielding quite a few calls that's been very helpful as we move into the fall we have received notice from department of ed that a Representative from higher it will be also embedded. With us to assist with answering questions and providing information. The quarantine facility I know this is been mentioned in at least one meeting but just want you to know that this isn't available service in your communities and occasionally we will have someone that doesn't have a way to quarantine in their home we have this happen sometimes because of family circumstance we will have somebody that may have immune compromised people in their home or some circumstance where it's not appropriate for them to stay we've had individuals that were homeless that needed to be quarantine we've had people that were incarcerated that were released and had nowhere to go that we've quarantine currently we have assist a census of eight in the facility and it's gone up and down as we move through the pandemic but this facility is at DHS building and I leased it to us for free we were able to stand it up it was it originally was a dormitory style building that had been converted to offices we converted it back in so now we can house up to twenty eight individuals in that facility if we need to and it is staffed we do have to medical directors that serve that facility. A median messaging I want so much about this other band we just we do have a statewide media campaign it does have components that address specific populations like the Marshallese in one of the ads that you see there's actually in Marshallese. And then god sent response we've had lots of guns documents I know you all got many got many many questions any and you know we've done lots and lots of reviews of plans and continue to try to be of assistance of the department of agriculture has been very helpful in reviewing plans that relate to lock stock advance in the department of ed in things that relate to to the education sector in those special events also we have continued to receive complaints and I have been doing compliance inspections in collaboration with ABC. The healthcare associated infections team is led by doctor Levine Patillo and unfortunately he could not be with us today I think he's spoken with this group several times on several of the of the phone conferences he is the leader of of this team and has done the heavy lifting work with our congregate facilities the prisons are nursing homes and his really his team is done tremendous work to be responsive pretty pretty much twenty four hours a day to these facilities to meet their needs. And I'm not gonna read all that and skip them probably talking too much and then also the healthcare association site visits as they have time when they haven't been dealing with these outbreaks I have proactively gone in and then collaborative visits and provided consultation to these facilities so the visits that they have listed there are visits where they've gone in and provided technical assistance to try to assist these facilities with prevention and doctor Patel is also working closely with the higher ed community and doctor Maria Markham and her team. See and doctor del Hey I'm in the. I'm a pass it to you now to talk about contact tracing and if we need to switch seats that that makes it easier or sharing you're gonna click. Yeah I I mean I I think you know for the purpose of today and I appreciate the overview I think that's important but I really want to drill down on testing and contact tracing okay because I am super concerned by the fact that you have some areas of the state of Arkansas where people are waiting twelve and thirteen days to get a test results and I realize that this is exasperated because of the commercial lab situation there is in it and we're competing globally for re agents and globally for supplies I understand that however we have to accept that that's the reality and we have to recalibrate we got to figure out how to do this because in my opinion and you're gonna have to show me or tell me that the home wrong but in my opinion I don't understand spending forty million dollars or sixty million dollars or seventy million dollars on contact tracing if you can't get a test result back within twenty four hours and so you know I want to really focus on testing and are you monitoring so I have if you have questions that are listed on here and I think it's I want to know how all testing is being prioritized how it's being monitored by the department of health what are you doing to address it when you are are you finding out that people are getting are waiting so what and and then how is that gonna alternate contact tracing because again. I I don't want to spend money if it's not gonna work I would rather spend money on what's going to work and so. That that's really what the purpose of this meeting is about so I want to toss it to you and then I know we have several with questions but that that's what I really want us to focus on is how are we prioritizing testing through the department of health how are you work with you a mess on that how are you getting information about what's happening on the ground when it relates to testing how are you utilizing that information to inform you on how to do contact tracing. What's the turn around time how are you connecting with people what's the terms so. If all up doctor delay out a pitcher to you but that's really what I want to be focused on so would you like us to advance to the lab section or would you. Because we have contact tracing first. Yes A let me go ahead and do two slides on outbreak response and cut and contact tracing so that we have that frame of reference and then I'll move to testing okay so those first two slides. All right so just for a frame of reference before cove ID we had eighteen nurses at the health department that responded to reportable diseases when there was an outbreak three and central office in eighteen around the state those were expanded with covert nineteen to over a hundred nurses plus some assistance from the National Guard. And when we received a report of a covert nineteen case the nurse calls the patient they discuss that positive lab result with them what is needed to them in terms of isolation and those that they live with and who may have been exposed and then we did enter them in a monitoring program and we do the data entry and we follow up with written communication the. after the person has been interviewed by the nurse then we would do contact tracing before covered nineteen we had three nurses they were three of the same nurses who did the outbreak response in terms the case investigation now we have over eighty and that some point we had over a hundred doing the contact tracing plus some National Guard. And we now have expanded that so that we have provided training to partner organizations that also have staff that do the follow up contact tracing and the idea of a contact tracing is to see who is a close contact who has been exposed provide them with information about how to quarantine. And then track them to see if they develop symptoms and get them tested if they haven't been tested already they are also monitored on a daily basis so that in case they do develop symptoms and this is the function that the contracts that you have heard about will take over so that the health department staff who we're doing con tract tracing can be reassigned some of them have already been trained in resigned to help with case investigation and contacting new cases to inform them of their test results all right now go to lab keep going. All right all right so at the beginning of this pandemic would go back the CDC head the only was the only place to get testing. And they could do about three hundred day so they were very limited and had to approve the tests as that develop tests were developed in the national goal was to increase the testing many commercial labs came on board and the health department acquired the ability and more equipment to also do the testing at this time we have two Perkin Elmer machines and the third one is on order of we are moved from a daily staff to twenty four seven staff we've hired ten extra microbiologists and additional lab techs that have been hired or reassigned so that they can enter the data needed one the specimens are received and there many of the other public health lab employees have come from other areas of the lab to assist in this and we've really had a a focus on some of the critical populations health care workers persons living in congregate living situations such as nursing homes or prisons as well as other high risk people. So I'm want to stop there and go ahead and take your questions I know there were some that were already posed so let me just start with a little bit of answering those questions and then is that a good day to okay right so one of the questions what is the state's percent positive rate so yesterday the the and the positive rate is the number of Positive test that we would receive the results. The calculated against all of the test receives results that we received so yesterday the positive rate was five point eight percent overall it's seven point nine percent it has been higher over ten percent can you pull the Mike close to you so that we can hear you loudly is that better yeah make it okay guy almost like we're touching it with her thank you. there was a question about the cost of the test so I know that there's ways of looking at this so for a person to get the test if they come to the health department for testing we do not charge them we may build their insurance if they have it and the amount that we building insurance is either seventy or hundred dollars depending on the test now all recently quick tests have been come available there called an engine tests and they're now available through many pharmacies and there is a range of tests of costs for those under one pharmacy charges ninety five percent of heard of another one that charges ninety five dollars another one that charges a hundred ninety dollars and I even heard of one place that charges three hundred dollars so there's a wide range of costs to the public. How long does it take to get the results so that's a complex question when I'm sorry when you say they can be tested at the department of health is I in little rock or is that at their department of health units in every county that people can go to their local health units to get tested okay. There's a few places where they contested because people can go to their clinic if they offer it they can go to the local health units and now with the pharmacies have quick test and so that's another option. How long does it take to get results the antigen test that many of the pharmacies are using nowadays and some other clinics you can get the result the same day it just takes fifteen minutes for some tests a little bit longer for others but you can get the result the same day as you know the commercial labs are taking longer we're getting reports that it's between seven and ten days and in some cases longer the health department can give results in approximately forty eight hours it depends on the transit from the local health unit up one of the issues that has been raised not only getting the test result but the person being notified of their test result and there have been delays and that also and that compounds the problem. is that delay because of data entry issue or not getting it to it's a multi faceted some labs when they report dated to us do not report the demographic data so we don't have contact information so we have to take steps to find it in other cases it's up so many cases the report coming at the same time that we don't have sufficient staff which is why I was so happy that the contact tracing contracts came into place coat so we could take re assign the staff at the health department who were doing contact tracing and train them so they can also assist the case investigators to make more timely contact in inform people of the results so it's all of that happening at the same time okay. there was a question of who should get tested of people who need to get tested especially or people who have symptoms of covert nineteen so the symptoms would be fever a cough shortness of breath people may have gastrointestinal disturbances like nausea vomiting or diarrhea and we especially want people who are known contacts to get tested and the people who are non contacts they don't have to have symptoms because we know that this proportion of people who A do have that virus do not have of really clear symptoms people may not have symptoms at all. I'm the percent population that has been tested this is not the easiest thing to calculate because we're receive reports of negative test but we don't have a way of knowing how many of them have been tested before but you can get an approximation by the number of tests that have been done so as yesterday it was four hundred and forty four thousand two hundred twenty five tests done in up Arkansas and we have a population of about three hundred and millet three million. Twenty thousand so that's a little over fourteen percent of the population now we know it's probably not quite that much because some people would have received more than one test but that gives you an approximate idea. And just by a. For interest's sake we have had thirty five thousand two hundred and forty six cases and so that would be a about one point two percent of the population has had a confirmed positive test up of covert nineteen. So that's the part that I have up to answer for the testing do we want to stop now and answer or have questions about testing yes Representative gray th thank you madam chair I am I guess this kind of came up this week in my district in that you know you mentioned the department of health is doing testing so let's take Izard county for example world north central Arkansas the closest rapid testing is that Baxter regional which is us roughly an hour drive away or the health department there in the county so they started sending people to the health department well there's that the health department will bring out a tray set by the vehicle patients not allowed to roll the window down that's the question if they do they're yell that and told we don't answer questions they go stand on the other side of the parking lot and then the patient has to get the self information sheet sometimes they blow across into the park and they don't get it but they get there she may get their testy and their swallow up and there to swap themselves I have talked to multiple healthcare professionals this week physicians nurse practitioners PA's who all say that that testing method is not very accurate and so I guess I wanted you to. Maybe reassure me that this self testing method is accurate. And how how do we know it's accurate are we doing some pre sampling of the samples to make sure that we're getting enough sample material that it could could contain the virus shed that. Make me feel better about my health department. Right there isn't it's not possible to do the pre sampling like that the tech it wouldn't work there's no way to test that but I'm glad that you did bring the issue up because that's something that we can address and I have sure inclined the site and she's been in charge of the training that are nurses have been given so I would like you to. Respond to that. So what we're doing at the health department is we're doing nasal swab I'm sorry you have to bring that Michael right just pull it up put all the way up okay there you go. Thank you I can hear okay now wonderful yeah what we're doing at the department of health is we're doing nasal swabs instead of the nasal pharyngeal swabs which is the most common that I think most people have heard with the nasal swabs we chose that method because it is a site for math it not only for the patients but for our staff as well because it's a self collection and so when we do those drive through clinics and people come up what the process is is that they are asked to hold up there's there state ID so we can verify their information they do that with the windows up they hold that to the window so the nurse can can see that after they do that then day are given an information sheet that is placed on the table so they can can get that and then they they can roll the window down the nurse steps back and we'll explain that information sheet to them at that that's what's supposed to happen then at that point of the collection two been swab is placed on a tray they roll their wonder back down and and get that up that is the point that direction is also that the nurse provides with is how to collect that sample in so the individual will do a self nasal swab and put that sample back into the collection to in place that to back into the basket of so that's the process of how of how that goes they're given an information sheet also as for is a win A with that letting people know that it's recommended that day a self quarantine until those results come back in that somebody will be notifying them. Thank you just to follow up how far into the nasal passage or how for into the nose does that nails what nasal swab need to go it has to go all the way until the cotton tip swab is that you cannot it's not visible so it's not all the way back into the nasal pharynx but it has to go in as far far enough for the client to swap not to be visible and they have to rotate and hold it there for about fifteen seconds okay would you say a certain amended that a large majority of the population understands that is capable of doing that properly I do believe a judgment I'm a majority of the population is capable of doing that that's why we went with that method and also if there is doubt that of someone does not understand those directions then our nurses will collect that sample K. I guess it's it is it's frustrating for me I was to be honest it's embarrassing for me as a legislator that the department of health is supposed to be leading this across the state and I've got hospitals clinics all across the state that have been doing testing for their patience in full PP drive through clinic since the beginning of the S. and my own health department won't even come out and do this wall of themselves. It's it is embarrassing that we can't do that is a state at least set an example that we you know our frontline workers we want it's okay for you to go and get that potential exposure but department a health I know we're leading the state but we're not going to do it it isn't a very bad message and I don't you did never actually enter my question are we talking one inch an inch and a half three quarters of an inch to get past that salt not sure how big that cotton's. Probably will is listening and. One to two inches one to two inches I can tell you I've had the nasal pharyngeal and I've also had the regular I couldn't do either myself. Seven yet no the nasal pharyngeal is not expected to be a self collection. Thank you am represent Johnson. Thank you madam chair I just have a couple questions regarding testing out traveling my questions to that since that's the topic that we're discussing right now what we question regarding the tracking of turnaround times there's a lot of discussion about how quickly getting test results back there's a lot of variability across the state and a lot of that depends on whether we talk about in state testing or out of state testing most the urban hospitals at the same ability as a part of health you a mass to do with the in state local testing but the problem is the same as all we don't the re agents to do that so when you're looking at turn around time as an average are you looking all this together or you separating out the are you able to separate out the commercial labs and test those averages separate. So the health department when the commercial lines report to us we do not receive information always about when the specimens was collected we received when it was resulted so it's very difficult for us to know the turnaround times we depend on a reports from health care providers to understand that so the average turnaround time it's been reported that we've seen reported we did that come from the apartment I thought there was that from a different data one I have it heard reports of what the range is I have not seen the calculation of the average okay I thought at one point it was said there was two point five days recently so just trying to see if that was. I don't may I may be misunderstanding where I heard that says okay on on the testing for may have another question that one of the things is still requirements of five day test for pre op so they're still part of the requirement for the guidelines for elective surgery to do a test within five day time frame as of any thought about waving that requirement because five days seems like such a long stretch of time a lot of things can happen in five days you start losing the value of the test when you're testing five days out a lot you know people can be exposed they could catch with the so is initially forty eight seventy two five days at what point is that loses value to the point that we would we don't want to prioritize our local testing for this purpose because you when you have that set in place in the testing such a finite resource with that requirement your your your encouraging people to prioritize they're testing on a sin to many people that may be there for a colonoscopy and so I I didn't know if there was any thought to maybe waving that at this point and what you know what point is it loses value as you keep pushing this out it's it seems like at some point it becomes something we want to look at maybe just not requiring a your point is well taken actually tomorrow morning at the pandemic physicians group that will be a topic of discussion. To potentially removed that requirement good I think that would be helpful to all the hospitals the other one I would encourage you look at is the labor during the live requirement I think that's also one that we're still doing and that also loses some value in the sense that people are coming in with the turn around time being as late as it is a lot of those are going out to commercial in so you're not getting the test results back to the ladies come in delivering gone home and so again it the spirit of that is great right if we have fast turnaround time if we can get quick turnaround time it loses value and again we're prioritizing scarce resource for something that were you know not get a lot about you for so it I would encourage all if you could to look at that as well yes we are and actually that's a a recommendation it's not a requirement for the labor and delivery it's it's difficult because as recommendations you know that's harder for the facilities I have one more question on yes the simple I'm just I'm gonna jump in for your next question but I recommendation from the health department is what we go by for liability issues so whatever you're doing has an effects on what everybody else is gonna do you may say it's not a requirement but when it's a recommendation you better damn follow it because if not you're gonna get your **** suit off that that's where we're at and that's the level of frustration when it comes to testing and there's no consistency so we're wasting valuable scarce resources on testing a symptomatic people we have physicians and surgeons he can't get a turn around test quick enough that because they're so scared of the liability they're going to pay and a hundred and twenty dollars or a hundred seventy dollars or three hundred dollars or ninety five dollars for a rapid response test just so that they know that they're safe with their patients so we have to have whatever's coming out of the department of health is affecting. Bill and a lot of different areas particularly in health care and it's this is what's becoming problematic. Can we get the turn around time collection can we get that from the lapse because I don't know if you're not collecting that data of turnaround times for testing and we don't have a state wide strategy for testing the it's not then contact tracing is just going to go right out the window. So I'm I guess I'm not understanding why we're not collect teen what the turn around time is for testing all across the state of Arkansas monitoring what that is and then if it is twelve to thirteen days in this area we got to know that we get a turn that around fast because our contact tracing money that we're spending which is multiple millions of dollars is literally just going to be a waste of money it's going to go right down the drain and it's not going to slow it's not going to flatten the curve it's not going to prevent people from getting exposed because it's just not going to work because the test so the testing data collection is incredibly important and we have to note turnaround times we have to know that from every hospital every clinic that is testing we really have to know that and my opinion and yard golf you've got doctors in the audience yeah prove me wrong I guess but. I mean that that's where I am really frustrated and then people aren't getting contacted well I'm not gonna tell somebody what we don't know if you're positive or not but you guys at your house for fourteen days you may be or you may not be that that's not making sense with the average citizen average person. I just wanted to follow up on that I'm sorry Representative Johnson no I have your last question sure so the other thing I wanted to ask is about pool testing so one of the strategies is how there's pool testing for when test ridge you for when testing resources are scarce and so I did not the department health is employing that strategy if they thought about employment if they have how it and if you're coming to get your opinion on where that strategy might be best employed in the current you know situation sure so just so everyone knows pull testing is when you takes a several samples together and you test them at the same time and then if one of them is positive you go back and see which one that was but if they're all the negative and you know they're on negative and you don't have to run several different negative tests that works best in situations where you don't have a lot of positive tests so it would work in a and a kind of screening situation and that is an option that we could use in Arkansas we have not had discussions yet that I'm aware of at the health department about doing it I know that we have had discussions about increasing our capacity for testing as I mentioned we have a third high throughput machine that's coming on line I understand that Baptist health also has a high throughput machine coming online we have other additional equipment at the health department that will assist with testing and increasing our capability the the slow down in the commercial testing has to do with the lack of re agents for us some of those tests and that is not a permanent situation re agent will be available and those companies will be able to come back online and do the high level of testing that they have been and if a in the. Past so it is that the situation will improve and that it will improve in the near future he's do you get reports from the major labs about daily are they giving you you say it's going to improve in the future do you have any idea of time frame on how long that's going to time frame at this time we know that there is a lot of work being done at the federal level to address that situation but I don't have it okay frame. Okay that's that's all the question after an hour okay thank you represent Bentley. I have a multitude of questions but alone in to testing so thank you very much Kenny couple first I want to say that we had a drive thru clinic in a very hot spot in my district on the twelve the chief of July they still drug other to inspect it. Then when the hot spots in the state we still not good artist backs yet so until we get that done I think we're wasting time so which the availability this engine test is it limited this point or it is but. More and more pharmacies are coming on line to be able to do that is the reason we couldn't do it at the health department in indigent is where the where the contradictions to that well I think at the health department our turnaround is going to be fast enough as we increase our state staffing capacity to do contact tracing because then those staff can be reassigned to assist with notification because some of the delay at the health department is not the turnaround of the test is the delay in notification and that has to do with the inadequate number of staff who have been deployed to do that but with contact tracing those staff that were doing contact tracing kit are being trained and reassigned now to assist with the notification. Okay I just think it would be do you know Jenson USA seventy the represented wait we are trying to secure a point of care testing and got a pull the Mike up so far I I you have to just pretend like you're I know Britney spears or something that might. So we are attempting to secure additional test right now we are building capacity and adding additional platforms within the public health laboratory itself to do the PCR hot throughput because that's the one thing we can control we can't control the commercial situation and we do expect it to get better but we are attempting to secure additional entity machines and other point of care methods. It would be ideal to have point of care testing in many many local community locations in addition to pharmacies local health units hospital clinics private provider clinics. And if I get one more follow up chairman yes instep anymore you're here I'm sorry the data that we show up on our you know when we're showing that dented map and recent line of the cities and counties it asked for that to be specifically by cities that they can show the data unfortunately when we did that we've done it by zip code so when a rule county when you do is zip code the zip code for for parent the city a parable covers half of Perry County so if we can get which shall be and and have that more fine tune because when we're we're getting data out they were getting bad press for the city of of Dardanelle because their show that zip code covers half of the county so you can't take the positive numbers for for the held zip code and then check try to connect that to the population of the city could you get a very high number which is not accurate so if we can maybe I just that it nine it was a fine tune it but maybe she'll get help us with that so Representative Bentley I act I'm sorry now to close I just can't get that right I'm sorry am I actually had a conversation with Joe Thompson at a cop earlier this week I will because actually partnering with us and with the municipal league to develop those data reports that are broken down for the municipalities and he brought up the issue of the zip code in it being problematic and he didn't use your example but he used a similar example so they're aware of the problem and they're trying to tease to tease that out so it is much no no no we're near support is testing with us what we had to hear on to bring that up yes I I know that you know I'm still very concerned about the turn around time and it will I think we've got to purchase people are symptomatic at this point two in get turned around I just don't see that we're we're helping our constituents have specially in Mars part of the state you know in our rural areas one is taken we had a very hot area we had a drive thru clinic in its twelve days and we're still not get results back so. And maybe the test results back but no one knows about so the contact is amended to those people and no other positive or negative and one thing I would say is we we do have challenges we have a a text notification for negatives but we don't have a text notification for positives so it you know we are working on that we're looking at ways we're exploring that may be doing a text notification for positives if we can get confirmation from the person that there that that's an acceptable method of contact so we are trying to explore methods to expedite rapid return of test results and not just the reallocation of staff today those notifications but also electronic methods that might be available let me ask you to this morning and the department the higher ed subcommittee meeting a doctor Bobbitt was under the understanding that the new machine that you're acquiring is going to be dedicated to hire at. Is that true or I mean are are we I'm not I mean is that a kind of goes back to my a how are you prioritizing who gets tested with your twenty four hour noticed testing through the department of health so I actually met with doctor Markham and representatives of higher ed yesterday and doctor Bob it was not I don't think you have a was represented on that call and doctor Welch was in a number of others the the. Point of have in multiple platforms is that if we run into issues with re agents we can switch somewhat I shared with them is yes we will be purchasing and other platform and yes that will increase our capacity to serve higher ed but if something was to happen with that Perkin Elmer instrument and we didn't have re agent we would switch and run this test on a form of Fisher instrument or you know one of my other platforms so it gives us increase band with and it it gives them more protection than just focusing on all our samples are going to be run on this this certain machine and so I think they felt comfortable with that and I can certainly follow up with doctor Bob it and and clarify okay and argue are you all run and the numbers on point of contact antigen testing and what that would look like and how many need and how much they are just because the reason I ask that is because. It's you know if you're a single clinic out here it's really difficult to get in the supply chain so we need just like with PP when the state can bulk purchase the PP we got first online because we're fighting against North Carolina and Florida and Kansas and you know everybody's online the same is true you know with I think this testing and so to me. Point of contact testing that you can get a result quickly is going to help all of us and so I'd really like to see what those numbers are how much those are and how instead of peace milling this together you know how we can get that going for the state so are you all running those numbers yet how much that costs yes doctor sealing the lab is looking at that daily and we actually some of those instruments are are not really expensive some of them are very you know you can get a good price three hundred dollars for an instrument now the materials might be a little bit more expensive but she is looking at that yes ma'am okay thank you for that if you can get that I think I'm very interested in that because again it's Bob purchase power and money make sure you know what does that look like you know instead of sending three million here and two million here and four million here or whatever. Looking at it comprehensively back to my for statement Senator hammer you're recognized for a question thank you ma'am chair been trying to do as much research to get a perspective on this and I'm a quote a line in the lancet this is access to testing should therefore be optimized and a mobile app technology might reduce delays in the contact racing process an optimized contact tracing coverage just from my perspective I want to give a chance respond it seems like we got it backwards because we're focusing on contact Racine the mobile app was discussed this morning which was very educational I'd be curious to get your yells opinion about that apt process and they said it's like four to six weeks out from implementation and then testing seems to be at the end of the line it would seem like we would want to throw all of our resources and testing and get a handle on that first maybe at the app and then develop contact tracing but it seems like it's backwards so based on the statement that reporter in this medical journal would you respond to that please why. center hammer madam chair with your permission I'd like to bring doctor cinema apiece familiar with the mobile app if that's okay yes but yes to let my question answered though about it seems like we're back we're going at this backwards based on what I just read out of this journal and and I'd really like to hear your explanation as to why we're going the direction we're going instead of doing what they're saying. Well I I don't think we're for I don't think the process that we're following is contradictory to it to the recommendations I mean we're we're doing testing where follow in the the guidance for trying to implement contact tracing your correct everything has to happen in the proper sequence to get the optimal result and the lab testing delays significantly impact our ability to to today timely notification and make the most of those notifications and and the men and the the utilization of contact period to do the appropriate spacing made we've got to improve the time frames that's you know it is not going to work really well until we get ahead of it but that doesn't mean we need to stop what we're do and it means we need to continue and that we need to work to improve it so I don't know if that if that specifically answer your question I started thinking about doctor setma answer the mobile app but from our position I think we're doing all the right things are we doing them as well as we like to be doing them at this point no we now we got time delays we're trying to control what we can from the department of health perspective we have limited control over the over the private labs and some of these other issues but we're trying to increase our capacity or trying to improve the turn around time on notification of the test results in the and doctor Johnson your comment about the two point five day report am I did trigger my memory that is actually a turnaround time a median turn around time that was from the department of health lab that included the transport of the specimen in and then the turnaround time report the lab is done our public health latest in a really good job of rampant at their capacity and do and turn around but it is challenging when we or ordered machines were having to wait a month or more to get the machine in and then ramp up I mean it's just it's just difficult when we have this volume of a positive cases but we are making every. For to try to refine this time line so it can be just as effective as possible. Senate and house would still like to have doctor then go ahead come on up. Senator hammer yes well do I let him answer that and then I got one other. Thank you. Good afternoon thank you for your question I do serve with a month to another college within state government on the governor's advisory board and I was one of the things we were charged with doing was investigating mobile technologies to really help our contact tracing efforts and we have sat through a number of presentations really at the crux of this technology is using Bluetooth and you know people having Bluetooth technology on their phones turned on when you come in contact with another person has a Bluetooth on that is recorded okay and this method this mobile app takes advantage of that technology to see if you were in contact with somebody for longer than fifteen minutes at a very close range now other states have taken to a download this are. Employee this mobile technology we did have a several questions that it is very interesting however this requires people to a have cellphones B. have cell phones that are capable of Bluetooth and see download an app of their own free will and then also have to report that they are positive to this app so there's multiple levels of opting in here questions whether or not the the you know enough for the public would actually often at this multiple levels for this technology be useful we've reached out to ours our counterparts in different states to get an idea what their experience has been unfortunately I don't have an update on that on that front a new no some states have some issues South Dakota comes to mind they rode out one of their apps and had some some issues related to a free up in some information related to patient information so. Senator questions are it did I don't know if miss what you want to come back up because the follow up is here and everything you just said between the the potential problems with the app for we're so far out and getting it developed and when you weigh a testing and the problems you're having with testing against the contact tracing and the problems we have with that and the money that were thrown at it it just and and I'll I'll stop with this just to say it seems to me like we need to be focused more on the testing because when you get a test result you got some in your hand and then we can deal with the tracing as a secondary one but if we because this report says if you don't get the if you don't get the results back within one to two days but contact tracing is pretty much minimized and so I'd just struggling with why were going the direction we're going in I will beat the horse anymore and that manager. I do have a question local barbecue thank I thank you. So I I mean I again I think you know it goes back to I think what Senator hammer was saying if we can't get our handle if you're we. We've got to. We've got to figure out a way that we can monitor this this testing throughout the state and I'm not sure we we've got to figure out how we do that can we do it through the trauma com system the trauma dashboard can we can can our. People that are that are testing. And the reporting those results to you but is there a way that we can monitor what the turn around is in throughout the state and then how we can go and figure that out because. Because because to me that might be why you're having these huge outbreaks in certain areas that the testing is so delayed we're not able to contact these people to say Hey you're positive you need to stay home and so they're not knowing and they're going out and they're spreading it right so to me we've got to really focus on that data collection to inform us on how we're we're moving through this path I'm not sure if you want to try to answer his question before I don't represent of love I think so too to senator hammer I would say again we are focused on testing we're focused on both we do think it's important to continue the efforts and build capacity for contact tracing eventually we're going to get a more rapid turnaround on the lab testing result notification we want to be in a position to be ready to maximize efforts for contact tracing I I think you have to continue doing both and eventually will reconcile those time lines I don't think you can do one and not do the other at this point time we need to continue ramping up capacity in the fall when we have potentially students on campuses kids in school man we don't want to have inadequate system for contact tracing wind we potentially are going to have outbreaks in in some parts of the state but we can effectively contact trace right now I mean it's more challenging in areas that are more densely populated but in some counties that small rural I mean you can effectively do that now. And so I don't know if that come answered that look at your complete question I think it that was two parts but I think we got vote I mean it is so we do have a point person on contact tracing so we do we have miss Connie Milton but I actually am is center if you hit on something I think is really important that I would like to ask doctor could for you to speak to you because you know we put a lot of emphasis on the test and the test result but that is really that's only a part of it you know we have lots of information out there for us to make good decisions about our behaviors and when we should quarantine when we should not and sometimes we have people that may walk into you know at any type of venue where they're able to readily access to test and I really don't need to be tested right and then there tested their test is negative and I think they can do whatever they want and it really it doesn't mean that at all and doctor to flori if you would come forward Hey actually brought this up in the challenge with how we educate our patients and how we help people understand this and you know I think to your point you know. Your trusted leaders people listen to you you have a large followings I mean I think I'd like for you to have the opportunity to hear what he has to say yes thank you come forward. Thank you. If you're just identifier to suffer the record and then the Mike right there thank you a doctor at the local tidy hi thank you thank you for your question and thank you for this opportunity of one of the points which I would like to make is we probably haven't gotten some messaging out correctly in terms of ventilation to S. V. probably need to be talking about patients self quarantining themselves if they're gonna protest so one of the issues that this disease is being thank you either test when you a symptomatic on you test when you are contact and if somebody's coming out to get a test in the testing done on time has unfortunately going to seven to ten days then rather than V. eight for the contact research to get in touch it might be better for the patient to self quarantine bill they get present and vine of my hopes is that this committee would have to get that message out to the public. No and I appreciate that I think I will I think a lot of your physicians and your hospitals and doctors that they're telling and and nurses they're telling their their patients to do that and so with we're already doing that I can I can assure you that is the first thing that if you think you even have had it you need to self quarantine that message I think is getting out maybe not across the board but definitely with people that have a relationship with that whoever their healthcare provider is now I'm not sure if that's come and you know if they go to get tested the department of health that that's the message it's been part of your training and your technique I'm not sure but I think that the the problem is we're in consistence because you you say okay self quarantine but now we've got contact tracers or spend a lot of money on that so you know some people say I will I I can go out because I'm going to get contacted by somebody from the health department so I don't have to self quarantine until I get contacted by somebody so that's we're doing this to see once I I mean there that's the messaging you can say this message but we're kind of we're we're if it's inconsistent so so that's why it's so important to me to understand how you're going to do this throughout the state with contact tracing and how we're going to use all this money and if you don't have a quick turnaround and a test it's just not going to make sense or go together I hear you and I understand you and I agree with you and I think that message is getting out. To some people but. Yes I think people get frustrated as well and so that that's kinda where we're here I'm gonna go to represent of love. Thank you madam chair Senator hammer said that that testing horses D. it but I'm what come up a little bit. As a I tell you I'm I'm. Confused about some of the things that we're doing I'm going to go to Representative Grays Issue about self testing. Well before I go to that let me ask this because we eat I thank you miss the frustration with focus in all contexts racing and I I guess we haven't got the testing. Right but let me try to make I guess a breach to this so in this context tracing. Are you saying that you have to have the contact tracing piece because you need to report the testing results is that is that it. Okay so then I can understand that I mean I can understand this frustration because. If we don't have the testing together. I don't think we should even it's not going to to to square see when you don't have a right so let's focus on this test all right so this this one this one point so testing why are we why do we choose the self testing. Because I've been tested for Covin and I'll tell you there is a horrible experience and I don't think I could test myself I don't I mean I I don't understand why we went to self testing. So can somebody is can somebody tell me what we do and. So when you got tested you likely got a nasal pharyngeal swab which goes all the way through the nose to the back into the throat area. That's a difficult test and. To tolerate it's not a pleasant test. In the beginning that's all we had. But then we can now do and nasal swab which is the front part of the nose. Be that quite that far it's the front part of the nose. It's yeah the nostril. So So you insert it far enough so you don't see the little cotton part of it and twirl it and then that's it you do both sides and I have done that to myself and it might make you tear up a little bit but that's about it. So it's much easier for people to do and they can do it on their own okay all right within it within us house stand down on that one because I thought you talking about ex that experience and I went through and I was like no one is No Way that one has to have a health a trained healthcare provider to collect okay so now let's talk about this test and speed or are of the results reporting results so doctor della hang with this hello this this P. E. machine this tell park in our machine. I I guess I have to I have a couple of thoughts about that but. Is this going to is this going to improve the speed that we're gonna be reporting the results in. So that machine is called a high throughput machine and it can run if everything goes well I'm up to a thousand samples that we have to already so this would be a third one and that would give us increase capacity and other health care organizations also getting high throughput machines so we'll have more capacity for doing that in Arkansas and will be less reliant on the commercial labs and I'm the commercial labs will not be in the same situation they are now for ever they're going to solve their problem also so the testing problem is temporary and we have got to have the contact tracing a mechanisms and the staff and the training in place so that we don't want to wait till the trust testing problem this off and then try to set that up because that will result in the ladies and we really need to have the contact tracing and ready to go when school starts out we need people to be trained to know what they're doing under the new contracts and when they outbreaks occur in school or in communities then they're ready to go as soon as we get a positive result. Okay I guess I can understand I can somewhat understand what you're saying but again with why are we so. Why we suffer in this I mean we are several months into this. This testing so what is it is it that that we can't get the equipment to test is the. I mean because like I think about this we we have to call the rainy day fund. We put seventy five million dollars or whatever we gave it to you and this. And we got the machine we got the PP for everybody and it was all will why do we not take this approach with the testing is that the mission of the machines available in that I guess well and getting they weren't there was such a high demand for them people ordered them and waited for them and it's take we've ordered one ounce taking us a month to get that in a month in the time of this pandemic is a. Long time so and how longer the the is the wait for the point of contact antigen tests yeah do you know how long those are and through that right in the entity that. Sorry I just wanna jump in here yeah well I'm just trying to I'm trying to string this together to nationally there such a surge in high demand for these the Arkansas has to compete with other states that are also wanting these of machines and reagents and equipment and so forth so is it the cost is it but I mean I will it's that they can't make them fast enough action okay that's what that's what I'm trying to understand all right so so then these things are not available. So the the park in Elmer that we have added it was the cares funding we were able to secure an instrument we got it in and have have have it now operational we have order to additional machines and we've been told these are hot the high throughput ones another Perkin Elmer and another is that they are proficient we've been told that the thermos this your may take as a couple of months and that the Perkin Elmer you know maybe another month so now we're we ordered that two week probably two weeks ago so two more weeks where we think will have the the park and Elmer available the thermo Fisher they did tell us that they might bump us up we've submitted a letter of request the governor actually signed a special little river crest also to see if that might speed them along and we haven't heard back from them but we're trying everything we can to get back up to the top of the queue with the point of care test we have been trying to secure additional abit machines there are some issues with the abit machines but they're still usable machines and we we were expecting at least ten to come in this week and then we just found out yesterday that for some reason that we weren't going to receive those set those type of things continue to happen when we're trying to secure the testing platforms now there are some new point of care testing machines the integer machines that we've been told we might be able to get you know and you know three weeks to a month so doctor Salih is looking at those right now to try to get us in the queue to place an order yeah and I'm out of it I think that's really important because I mean you have the ability for you know individuals maybe and and we could allocate money to clinics or whatever for them to choose to do that but again it's about purchasing power because if it's just a single clinic they just don't have the purchasing power they're gonna be at the bottom of the totem pole. In the supply chain and they're just they're not gonna ever mean we've we've had things on order for our clinic since March we're still haven't received it which are PP so if you know it you that's the problem and so I think testing in this point of contact tasked I mean I know that one pharmacy waited eight weeks to get their machine but again that's one person trying to purchase it I think as a statewide approach we've got to figure out that better for the love to have another question or I'm gonna go I've got kind of questions here in about a I'll go here yield okay thank you thank you. All right represent Fortner. Thank you first of all I want you know this is indeed a sincere question. And if I appear ignored on this subject is probably because I am. What I want to know. Why are we doing this testing if in fact we don't have the ability to test everyone in the state on a regular basis. Is this not something that loses its validity after a week or so say I got a test today. And if I go to a situation where I might affect somebody in a week do I not need to be attested again because I could have contacted it between now and then. So partly it's a a use of resources so given the fact that we don't have unlimited testing then it's going to be important to focus the testing on the people who are most likely to be positive those who are have symptoms and those who have been in contact with the non case in some situations serial testing which you are describing could be important and we haven't use that in our some kind of get living situations particularly in our correctional facilities when we have limited ability to segregate people who are positive from those who are negative so in those situations when there are negative people that we know may be a symptomatic the and not or we know they've been exposed but maybe they have not had enough viral replication of the virus in their nose to have a positive test then we test them again at a certain period of time say five to seven days but given the situation that we are in the US right now and in Arkansas there's not a testing availability to test up people who would not be at high risk on at the A regular basis does that answer your question this sort of clever follow up please yes. Up. I understand that. But. If we have finite resources. And if we tell the public there's going to be a drive thru tested. There are people that will go for a social outing there are hypochondriac's there are people that are going to go because there's thank it's just the thing to do I am may have it is that a good use of our resources why do we not just confined it to people that are susceptible or or places where it's very likely. To spread or to be in contact or or deadly to the people there why it why are we not focus in that way I know there's I I I'm not totally occurred I know there's publish the there's a public relations there is the media I understand all that. But if this truly is effective this testing as a way to stop this virus or slow it down. Why are we not. Being real about it and putting our resources just say Hey listen. We're going to test the old folks homes. We're gonna test in four people are really confined we're gonna test where we know what's liable to break out. What we do that. Well as a matter of fact we are doing that. During the month of June we went through and tested all of the nursing homes in Arkansas and whenever there is a case in a correctional facility we go ahead and test everyone it is important because we know that there is community spread to identify where it is spreading and communities so we need to do a certain amount of testing in order to find those cases if that is occurring and then in communities where we know there is spread especially if that spread is escalating then it's appropriate to work to get those people in that community should be focused to get tested so that if they are positive they can isolate and we can be the contact tracing to break the chain of transmission. So I'm I'm gonna jump in here I'm sorry I turned you off I'm an. I'm sorry accurate. The PCR tests that we usually use is very accurate when the viruses present. In some cases a person may be exposed and they have not headed it's been too soon there's not enough virus in their nasal pharynx to having the first present for the case to pick up and that can be a false negative and it varies with the length of time from when they were exposed to when you test them. So let me also just add and you can talk about this but I had to call yesterday but you know you I think the department of health is really been focused on kept I mean just given their capacity what they're trying to do and so there capacity in what you've had capacity to do it's been half has to focus on high priority high priority has been health care situations nursing homes vulnerable populations people that are congregate living but but there's also the issue when it goes into a jail or a correctional facility there's a nineteen eighty three constitutional standard called deliberate indifference and so. If you get that requires our state to have to go in and test everybody and so get tell me if I'm incorrect but that's been another I mean that has taken a lot of your capacity at because we have to meet these legal standards because if we don't test everybody in that facility then we could potentially be violating this deliberate indifference constitutional standard because of the inmates and everybody that that comes in contact with those inmates so I know that that a lot of our your department of health testing has been focused on that the problem I see is now we have gone too fast community spread. Right the vast community spread well we're depending on the outside labs and commercial labs and whomever else is testing. For this vast community spread we're staying on this testing component that's not really within your control but then you're trying to fit the contact tracing lay that on top of something that you don't have a lot of control over with the testing in the community so that's where I see the issues and the problems are as it exists right now. With the department of health because because you're you're you're moving from what you can have within your control and what you're trying to tasked what we have to test to now community spread and you're depending on something that's a variable that you can't control which is the testing. That does that I mean you can respond to that but I think that's. That's important to know and you all did a great job with happen to meet those standards that we have to to to meet when it comes to testing our correctional facilities and our jails and everybody associated with that break out ms because of a legal standard that we have to write so I but but the ads were move into this vast community spread that's where I see this huge problem moving Fort. Also we have ramped up capacity tremendously and I think one of the slides that doctor deal Hey have in this project actually gives a reference to the volume of testing that's been done in the public health lab so when you look at the break down between I lab you a mess and the commercials I mean you say just a steady increase in our capacity and volume so we recognized that what we needed to do had to increase to meet the burden of the spread out the community said we ramped up to increase that demand me we're not when you compare our numbers to the commercial yes all the commercial lab volume is higher but it's a substantial piece of the testing that we're able to do so to the extent we can we are trying to make sure that we have the capacity to adequately address the state needs okay Senator garner you're recognized for a question thank you madam chair. I'm trying to think the best way to put this special when the German earlier said that if somebody is exposed or feel like to have symptoms they need to self isolate FOR certain on time. It seems like that is it. You all talk to people who actually live in the real world about this because what I see is. There are people out there and I'm tell you specifics to worry this girl I know her son was teething but ran a fever from the T. than she knew that's what it was knew exactly what it was but the day care to their credit would not let her takers on the day care Senate he has to pass a covert test she went on a Friday she had a missed a week a work self isolating with her and her son she went to the department of health clinic and it took over a week to get a results back she actually didn't get a results back from you guys she had to go to Louisiana and pay a private lab a hundred fifty dollars so that she could go back to work to make money. To feed her family and I hear that from countless people in my district countless small businesses who are exposed to people because of the how they do their business every day and you're sitting here telling them they need to self isolate if they have symptoms when I come in contact there's no way in the real world that can happen the only recourse they have the quick turnaround from you guys and honestly day are not seeing that in my area I've heard from dozens of people who waited weeks or ten days or twelve days ago test back an example I was tested on June six and one those mass ones just to get people out to do I did feel symptomatic or anything I've never gotten results back. No idea. Get email call takes or anything I'm assuming I'm good I feel fine but if that's happened to me how many more people are feeling that in in the real world they can't sell isolate for fourteen days when they've been hurting for four months and haven't gotten a paycheck so how do you address the real world consequences of this in and when are you going to get this thing fixed so people who need to go back to work who need to have that happen can get the results back in a timely manner I've heard everything you say it but is way too far down the line to keep making excuses you got to get it fixed thank you madam chair. Thank you Representative gray. Of thank you madam chair just a couple things here so I'm going back in this is the last time I will say this is but back to the county health offices. Based on the responses we're not going to change anything I can tell we're not going to change anything we're gonna make the patients continue to self test it's pretty evident but can we at least go back and re educate the nurses to make sure that they all are A answering questions at the window and not going they need to actually educate the patient they also need to observe and make sure that that patient is doing the test properly that's my biggest concern the concern of my health care providers is that the patient actually doing it properly and we'll get a valid results and said one I had a physician text me and say what can you ask what the false negative rate is and then I had another one that's watching text and say what's the accuracy of the nasal verses the narrow the naso faring G. ill So could you answer that do you know that. Let's see if a tool can. Qatari do you know the answer to the difference between this one's. Yeah I'm not aware of any difference myself. Right. And the rapid testy if we could also throw that in there with the accuracy is or the false negative so as far as the needs are just as concerned planted a couple of questions taxes validated by the CDC initially they asked for Dan's afoot in jail in order for engine so forth logs and then they did some validation and said that we don't need the oral syringes fault just the needs of putting that is good enough and I'd like to point out that since we started on March that currently about a hundred and twenty different tests so that and they have validated a lot more needs those logs and as part of the night I know that equally accurate to until question about antigen test I think that about ninety eight percent accurate but the ninety nine percent accurate but the calculator to but some of the. Of the reviews that you've done at the eighty H. that of our committee eight percent accurate. Okay is that more accurate than the naso the. I have your I haven't seen any. Specific literature talking both knees those is needs of for India whether there is any difference. and part of the reason via initially accused of A thank you and Mrs so we know that people doing needs of the you know self collection because of PP shortages and that's one of the reason by self collection was advocated often. Okay that but not with the PP we kinda kinda going past that which that leads me into my my other question in that we talked about Stephanie had talked about someone trying to you know looking daily to look at a indigent testing and we know it whether we could purchase analyzers and that kind of thing are you do are they looking at that just for the the department of health lab we look in that state wide so we can start sending these out regionally okay she's not in and because that's part of part of the thing I know senator Irvin I've talked about is we need an overall state wide approach because I like I was told that the department of health gave a clinic in hot springs and indigent testing analyzer and I was wanting to ask those were my things is did we and if we did why did we pick that location and not any other locations across the state eight and then I have one more after that number okay I do not think we have any on to generalize as the acting does just came out AT simply the dead give out the advocating all the tree cart initially from the federal government that is a push by the federal government to send out antigen tests to nursing homes that to what we've heard about but I don't know more information about that. So we did not give any kind of test hot springs okay. We haven't that we had Abbott ID now we had fifteen of those that we receive from the federal government early on and we did place those throughout the state the physician groups surveyed hospitals clinics try to identify areas where there wasn't adequate access to testing and at that point in time there were still great concern about pregnant women so some of those machines went to areas where they would be utilized for women who were pregnant so I can I can get you the list please list of all those locations I'm sorry I didn't think to pick that up and bring it but we did place probably about fifteen of the abbot ID now but it's been quite awhile since we were able to distribute those okay yeah if you could provide that list thank you and then yes the other thing is for a call made a comment but you know. On the stem on the steering committee has we always we see each other on that quite a bit and we keep approving money for contact tracing And I guess I'm frustrated maybe I'm past frustrated because I've got to that I've got to possess positions in my district that both tested positive neither one has ever been contacted by the department of health and if I can get a physician contacted I even had one physician call the department of health hotline twice both times were told will call you back. Never call backs of I've not got position to have multiple contacts within this forty eight to seventy two hours prior what's happening to the rest of my district and then I have another position that I know it's not in my district he was contacted five days out in his contacts were contacted twelve days out so we're so far behind the curve. I guess eight and so by frustration comes from being on the steering committee and then we're approving all this money but to no avail because I don't feel like it's helping. We're not doing it properly. I had have you to admit how do you explain all the people that are positive that are not getting contacted so a couple of a couple things I would like to say in response to that and ended to response to a to represented garner in your question Previously about the testing process you know part of our role here today that it's important for us is to listen so we are listening to the comments we hear the frustration we're listening to the recommendations and concerns your share and so I just want you to know we are actively listening it's part of the process and I appreciate that part of the process you know senator Irvin brought she bought two items to my attention earlier this week one of them was something I was completely unaware of it was an issue of of people I think it was faxing either was batch uploading well that's an issue we bart we fixed it we've given well I'm not gonna say we fixed it but we've come up with a better solution so just want you to know sincerely for me that we recognize the value of listening to you we're listening to this body and the concerns of your constituents that I know you all here all the time so we will be looking to act on recommendations and things that we can do differently and that are in response to the issues you raised so that the cares committee I'd like to comment on that you know you all have been asked to make a lots of really significant decisions in allocating those dollars you've been very supportive of the department you have responded each time we've ask you to set aside resources or give us resources that's one of the reasons we have been able to be aggressive in trying to add testing platforms because of that bonding the contact tracing has not happened as quickly as we would like honestly I feel what we were almost a month behind we made the presentation to the cares committee I think it was may the eighteenth and we got the appropriation approved to to spend those dollars I think on the twenty seventh we intended to go through and I remember senator Hickey I think he stepped out of the room but you know he asked me when when we got that approval you know what our intention was to go through a process. To secure the contact tracing providers and I said our intention is to go through a competitive at the traditional competitive process for request FOR proposals and and bedding and that was fully our intention we started down that time line with you know the you know submission of that the you know questions or responses to questions and all those types of things it was going to take this until July the twentieth to get that first contract in place that is obviously you know that was not workable so we did go to an expedited process to get a contractor in place we were able to get General Dynamics we awarded the contract to them July the first now this is you know three weeks in and you know they part three hundred five staff they've had to train staff we've had to stay in the met but we are getting there it's starting to make a difference it's not as quickly as we would have liked but it is starting to make a difference and you know I just I appreciate the role that that you'll have in this body and then also the cares committee the other thing and I think represented gray you were the one that did this when we were saved our funding you said this is a lot of money and you know this is really going to be difficult for all the agencies that receive funding that cares to spend the money because it all has to be spent by December and you know what we promised is that we would come back in September and we would report to the cares committee so that if we haven't spent that money then you all will have an opportunity to re examine that with us a potentially re allocated for another purpose in time for it to be spent so just want you to know that I remember that that is our promising commitment we will be there in September or or whatever the committee wants us to report on those things because we understand you're having to make the best choices and best recommendations for everybody and all army's. Thank you thank you one thing to you know how much to date we have at through the I know we had a proposal with higher and you a mass is doing contact tracing for all of higher at correct five million is so hard on text racing currently am we have been allocated. Twenty two million of Kerr's funding we additionally ask here the cares committee for the sixteen million that was presented in peer the sixteen million is a supplemental request and that would allow us to have the contact tracing contactor contractors potentially scale up beyond the original three hundred and fifty tracers that we ask them to hire it would also allow them to hire people to do case investigation that was not something we ask them to do we thought we would have the internal capacity to do the case and the instigation pace and that's been a challenge so to make sure that we're not under resource because we're trying to get this right we ask for that also if they're able to hire those case investigators so that was the supplemental proposal and then there is the higher ed piece. The higher a piece is five million dollars that was to you I miss college of public health to serve educational institutions in the fall it's part of the plan for the return to campus so the college of public health I actually have been doing contact tracing I'm not sure exactly when they started probably probably and end of April may they set up contact tracing they got trained and we're doing that work they sort of phased out when you know camp when when the semester ended and I didn't have as many staff but they know how to do it but I've been trying to they have the capacity to to do that for higher ed and it made sense for Hari and I think they felt like it was important to have someone that was within their system that understood campuses understood how to interact you know with the institutions in that way so that was the plan for higher ed so okay so twenty two million sixteen million and five million so far yes as it for contact tracing K. through twelve are they contact tracing are we doing anything general General Dynamics and I at them say they'll be handled by the two main contractors and there's there's been a lot of confusion about higher ed any and also K. twelve some confusion with schools thinking that that we expected them to do contact tracing we don't that will be handled by the state contractors what we're asking them do and actually I saw a presentation yesterday that Gino Wendell it department of it put together in the Senate now that I think will go take care of some of the confusion but it basically explains their role is is to sort of be a liaison with us I mean we're gonna need information on. And you know who was the teacher in the classroom what other children were in the classroom did those kids you know were they in the cafeteria at the same time you know maybe we're going to need some of that information from the school to to do rapid case investigation in tracing and so that's all we're asking of them it's not any different than what we do with them when we have outbreaks of you know months or any other communicable disease so that they're familiar with the school nurses I think they know how to do that I think everybody's nervous because because it is different and it is true we haven't done this before you know is this going to be an added burden on school nurses I'm sure it will and and for our schools to but we're not asking them to do contact tracing are you all developing the protocols for the contact tracing so it's consistent yes amongst all these different entities okay and then secondly I would suggest that as they are being contacted that they find out the date of the wind that person got tested that will help you gather that turn around information data that will help us on the front end it'll help is on the back and so that's something that those people are being contracted in pain a lot of money to they could ask questions you are you are positive you are negative when did you get tested docket questions are in that in the questionnaire their collection and they can you give us a copy of the questionnaire yes and actually we have that that came up I think represented Dotson ask for that so it should be in the queue getting to it'd okay here and then we'll also get it for your committee as well yes by Representative Ladyman. Thank you you answered most of my question but because about K. through twelve and contractors going to be doing that tracing for them yes Sir but the other question that I received this All of the people in the schools going to be required to do extra things for this particular pandemic because it's much bigger than what they've handled in the past are they going to be asked to do certain things and are they going to be trained and maybe in this document you're talking about but but I appreciate the answer here either going to be trained if necessary and are they going to be need additional funding for the things that they're going to be required to do in addition to contractors if any. So I'm not sure I can speak to the funding pace for a head because I'm not sure what resources they have I'm sure they probably will have added expenses like everyone else we are and assisting part of the cares funding that car it requested and received was for PP purchase for their for schools and and so we have been assisting them in order to involve bulk of not built bulk orders for the PP for higher ed I'm not quite sure about K. twelve and don Adams is here. He might be able to answer that question. Person that. Dr peppers here from department of ed. Yes come forty one. Good afternoon IV Pfeffer department of education state so I want to go back and make sure I answer the correct questions in in the correct order and you are asking about the role and responsibilities with people have to do more the plan is that every school district will identify a point of contact and this will be somebody in it may look different in different districts in some districts the point of contact might be a school nurse it might be a school administrator it might be someone that the district contracts with to come in as a as an employee that will help with gathering the information any time someone is a positive case to help gather that information about who might have been in proximity with them and be of probable close contact and they'll serve in that liaison role. Now as far as well that require additional funding that's going to depend on that the person who's who's asked to do that in some cases if it is it not be an additional stipend that the district would pay for additional duties it may just be that duties get reassigned and that person can just been their regular time and acting in the role point of contact so so that will depend on on the district in the decisions that are made locally districts to have flexibility in the funds they use to address any of their copay needs and all districts in the state did read look and did receive some emergency fines from the cares act and so those kinds of things are an allowable use of funds that point of contact might also be able to be paid from other federal or state funding sources. Thank you I also note want to note that and in addition to the twenty two million sixteen million five million that you also we also the minutes pending before L. C. tomorrow which is an additional three million for the population in northwest Arkansas and miss Williams one of the things on that funding so that's an additional three out of that seven Mike my concern with that proposal was and and I'll say it again is now we're going to have everybody come before us wanting to do their own and so can the people that we've contracted with step up and help out if we need help with additional help at higher and or K. through twelve because. I I. Our cares money is dwindling and I to me I'd I'd I don't want to spend. I would rather spend more money on testing and so can can those two companies that we've contracted with step in and help with those situations if it comes to that so the expectation of the two contractors is by serve the entire state of Arkansas okay that was the expectation and that has not changed for either one of those contractors and I understand that expectation the additional proposal that was put forward to the cares committee was from the northwest Arkansas council that was not a request that was it was it was not a request that was made at the request of the department of health that was a request that was submitted by that community because they have resources that I think will help serve their community we have been supportive of that request because honestly we're in the middle of a pandemic we don't want to turn away any agency or entity that that seems to have a resource that could potentially be valuable I understand your I understand your point completely but I just want to clarify that was not a request that we we ask for help we feel like we have sufficient coverage but were not going to oppose and then providing service if that yeah seems to be beneficial in a doctor deal Hey review that proposal and you will make a comment about that in there it's specific for the Marshallese and and some of the Hispanic populations but they are included in the populations that will be served by the contractors and continue to be served by the department but that it is your opinion that the two contractors that we've hired for contact tracing can effectively serve the entire state yes ma'am that's what I were selected okay. Doctor delighted to one of my call I just wanted to add that the Latino and the Marshallese population was a focus and they would also assist with those populations and other counties so I think those are unique hard to reach populations that may take some a special strategies and so a group that could focus on those would likely be beneficial okay and on the testing component of that was four million for testing. My fear is everybody's going to if they're organized they're gonna reach and say well we want money for testing I really would prefer. I that was the part of the the proposal I had an issue with to be Frank is because. Because I would rather take that four million and added to the sixteen million and two twenty million more mind dollars for testing and point of contact testing the whole state instead of this piecemeal approach and so I I would just I I will state those are my concerns because mine area and everybody else's areas important to them and so if you have like a ten cent think Representative gray talked about this where you know if you want to have it a rapid test you have to drive an hour sometimes an hour and a half or two hours to get that in some areas of the state of Arkansas also. We need to be in my opinion if if testing is an issue and we more money let's let's not pick and choose let's be comprehensive statewide that that's just my my two cents on that I'm gonna go to and senator Ingram. Thank you madam chair and I appreciate you and the co chair putting this meeting together and I know that a note of a so many of us or or or or frustrated I think it's very. Important that we separate the things that we're responsible for the things we your out of our control of. You know the fed response to this is been disastrous there are things that of the re agents and things that we just don't have the ability to generate within our state. And I think that it's important to control what we can and things like of Representative gray talking about what's going on at the health department those are things that we've got control over on our local area so I mean nobody could be more frustrated than I am with the health department I've asked for information from the health department pretty easy statistical stuff for twelve days now in of gotten every excuse in the book and not received it and I thought about another way to do it got it within fifteen minutes of I I had asked doctor Smith. What bench marks we used of when we began to re open the state and compare give me a a graph an overlay of the CDC guidelines and where we worry at that place and time and I got a letter back did I will use from doctor amero that forever morale use is a model for how not to answer a question that's asked up so nobody could be more frustrated than I am with some of the things that that that that I received but I think it's very important that we concentrate on the things that the this is the hand that we burned out and the things that we can control within the state such as testing of and there's things that are at our control their more at the federal level that we have to wait to to to get just the test results of Enron and ten twelve fourteen days you thought that this would have been figured out by now but I guess where I'm going back the abbot care machines the rapid testing ACT of senator Irvin said something that sparked a question and of. It is a heart or not all the abit care machines acquired by the department of health and then they are distributed throughout the state to the health departments as well as to doctors or to tell me how that distribution works. So we're not the only Avenue to access an abit ID machine I believe that that you can access those we happen to receive fifteen from the federal government allotment of those machines that we were able to place around the state and we've attempted to order more but I don't think that's not exclusive their private providers that have purchased abit or lease abit equipment and utilize that platform and how is that decision made on those fourteen that. where they're placed. Those it was a decision that the position group met doctor deal Hey do you remember can you describe that process so at that time we were looking at areas of the state we tried to determine where they already worked through private providers. And look at strategic locations at that time of certain groups would need quick access and we were looking also at birthing hospitals those areas so we place than that counties around the state in clinics mostly and could been in the hospital and that's how we allocated and and that I might have missed this in the question when do we expect the possibility of more machines being made available. So we thought that we were going to get a shipment of seven this week and we're told yesterday that we're not going to get that shipment and we're not quite sure why. Okay. Already have we have at least two clinics that are on a waiting list right now for those machines and if I'm not mistaken I believe one of them is in your area I think one got rerouted from our area to another part of the state if what what is is is sort of what happened of. Okay thank you very much appreciate you madam chair. Thank you senator representing Gonzalez. The manager so are we still requiring confirmatory test like we were in the beginning of this are people getting multiple test and how are those counted. If that does happen or they thank test positive twice is not counted as two positives or they. Individual chart. So confirmatory tests are not required. And when we're counting the case it's an individual person no matter how many positive test they may have when we're discounting tests this just all the tests some people may have had more than one test in that total. Senate help so when they're counted positive this counted just once yes so each case is counted just once even if they've had multiple positive test okay. Okay it on the accuracy of the test was go back to that because I I keep hearing all say it's ninety eight ninety nine percent accurate but also hear a lot of stories about people going out thank you they get a positive test they'll turn around and and maybe do the blood test by the do the AG G. AG AGM. Hi G. I. G. G. I. yes okay I'm sorry I'm not a medical expert monies But they'll get get one of the other one specific case heard about a girl who got tested twice here in Arkansas they center home says is university student center home she got tested at home had two positives here so positive than a confirmatory with the health department and then went home got too negative test in a row never was symptomatic and I just hear stories over and over about cases like that so how do you justify that was saying that there's a ninety eight to ninety nine percent accuracy rate on these test. Well it depends on what kind of tests this person got and we know that the test when people are ill with covert nineteen the swab that we use tests for the genetic material of the virus and. People have more virus in that area of the nose in the throat and so forth right before they develop symptoms that's when it's most likely to find that virus if it's there and then as they get symptoms that's the immune system kicking in so as they as days go on in the new system has fought that virus then they're more likely to have a negative test. So in looking for the presence of that virus and but this later in the case of the one who is a symptomatic yes they would not have had. Well sometimes people are a symptomatic and they do have an immune response but it makes it difficult to know when the illness really started so of in that case we just count the day they got that tests taken and count that in terms of when they need to isolate in order to prevent transmission now you did bring up on a point about an antibody test and an antibody test is a measure of the immune response it's a bit like. Right and it doesn't turn positive until someone's getting well right so it's possible to have the infection and have a negative antibody test so it's not a useful test for making clinical decisions it will be useful later on when we want to look at what percentage of what proportion of the population of got infected it will be useful later on when we want to look at response to vaccines but it's not useful for making a clinical decision to another question of I've heard that there are several nursing homes out there who are showing at and I know one personally that showing that on the website that they have a positive case and that they have never they never had a positive case in their facility from what I understand there's maybe seven to thirteen of those total out there but us specifically no one personally that they're they're listed on there as having a positive and never have well house we need to correct that that if you could give me the name of that there's no doubt I will look into it and I know we have had one instance in incidents of that happening that we did correct so it's possible it's happened again so if you could get us that we will okay art thank you thank you members if you have other questions you can type them or a mom to me I'm trying to get people that haven't asked a question yet Senator Clark. Thank you madam chair. The. When it comes to. Testing. What is your plan the because I heard two different answers Waldo I heard it thus the testing tracing. I heard we would part two contractors and they're going to cover the whole state and then I heard but we have specific populations. And we could use help with them. That's our point. Of what's the plan. So the plan FOR the department is to utilize the take contractors higher ed has suggested that they would like to have particular expertise focused on how to trace within a campus population that was presented to the cares committee it was approved and so we are working with the college of public health to implement that plan so those are the three major components the additional offer of assistance is from northwest Arkansas because we have the Marshall islanders in that area I mean we think that would be helpful so it could be part of the plan But it. We have a plan to utilize the two contractors and to work to support our institutions of higher ed in doing their tracing work and that was part of the plan that they came to us with the proposal we discussed it and felt like it was it was valuable to utilize that expertise. So we we are making these decisions independently we are listening and trying to make the best plan available I don't know that I answered your question it's not different plans it is one plan doesn't Selleck one planet sounds piecemeal it sounds like you've. If some other group. This but here's about this in the size that they can come help to that even though we think we've already handled it. That. The death it'll probably sound like it's a good idea to there are only certain groups that are going to have the capacity to truly do this work it's not easy it sounds easy and we've had this discussion with some of the some schools and colleges they said will you know we could really trace our own well when you really look at the requirements to do tracing the reporting this needed to try to link it all together there's really not the capacity to do that they can provide information that will be helpful to the process but there's a specific way in a specific method that's utilized to do case investigations and contact tracing to make sure that it's all linked together in the right way okay but also you know if I was presenting a plan. To my bosses or when my step comes to me with a plan if they said okay forty million going to do it. And then we come back and say but. The let's here's another four million over here. Forty million in forty four millions not the same thing. So when we initially put our proposal for thank you put are perfect house bill four to the cares committee back in may our case numbers were low they're not anywhere near what they are now if we had been dealing with the number of positive cases that we have now we would have asked for much more money typically and the there are lots of different models on contact tracers and how many contact tracers you need to be effective what we've tried to go with the one that you know is it's not how it's not low it's the average and it's basically for every thousand posted cases you have you need roughly three hundred fifty tracers so we were we thought we were asking for planning when we went to the cares committee and said potentially you know we would need seven hundred you know additional tracers but you know ark ark number of cases is much higher than that now so there is an additional need for more capacity to do tracing beyond what we initially asked for. Are we learning from the tracing. So doctor deal Hey you might be better able to answer that the non. miss Milton this is Milton here too she delay okay if she could come up by the I would appreciate if she's the contact person for the entire state I would like to hear from coming out as well thank you bill Hey go ahead in minutes mean to interrupt you. All miss Milton is the one that is the best knowledge but I did want to point out that the contract to have just be gone so we're still have a lot to learn from them okay. Milton. And thank you for the opportunity to share information. Close enough to loud yes. My class we have a lot of people are watching and so we may be able to hear you but they're texting me saying that we can't hear them so just let me know that okay thank you and. the contact tracing. Is the last step. This whole process so somebody gets tested the agency nurses call when we get the positive result the agency nurses. Call the case the patient given the medical information that they needed to know let them know that they're positive given the instructions about quarantining an isolation how to take care of things in their household. Perhaps works with their employer. Then. Jack gets handed off to the contact tracers the contact tracing aspect. Contact the patient. And talks with them about the other individuals that date may have been in close contact with the contact tracer helps them remember. The prior days where they've been what they've been doing and bills the. Possible contacts list and then the contact tracers contact those individuals and inform them that they have possibly been exposed discuss what that means with them gives them the isolation and quarantining information tells them what they need to do about that about their household how to monitor for symptoms and rolls them in the. Serra alert programs there alert is an electronic system which will send them a text message or an email so they can enter their symptoms so that the agency can identify if somebody's having symptoms. So we get a lot of information and we share a lot of information through the contact tracing process these are the people it's reaching out to the people who may not know that they've been exposed lets them know that they possibly been exposed help them determine whether or not they need to get it passed and where to find the test answers their questions reminds them just quarantine and isolate helps them understand what it all means and Ultimately if they become a positive patient it links them back to the. Source. And we had and. We can close that loop. Right so but it again the if somebody you know done if they if it's ten twelve even seven days for me really difficult sometimes for people to remember. What happened seven days ago or a week you know ten days ago or two weeks ago and who all they came in contact with during that whole time period. Right absolutely I have a hard time remembering two days ago myself the contact tracers part of the training is to you know is to kind of prompt and helping top. As as we can speed things up this will happen faster so the cases that have been assigned to the contact tracing contractors today we're cases that that agency nurses contacted yesterday so this is. This is already speeding up. Okay. Senator Clark actually and then I'll come to you represent Ladyman so. We want people who have come in contact but were we're also trying to assimilate information correct yes so what are we have we learned if anything about where. Of this is being contracted for people are getting of ours. So our epidemiologist work on the. The cases that are related the contact the contacts to see where they're outbreaks and we've had a number of different types about breaks in Arkansas I understand that we've had seventy six episodes of outbreaks or cases and At a school related sports over the summer. and that's what the contact tracers help us with those cases that say it's a football player they help us identify who else that person would have been around we work with the department of ed to address those outbreaks in order to prevent them okay and then We also Work with employers up and so cases that our names cases we find out where their contacts were and if there are employed in a certain situation we work with the employer to protect their Of employees and so we learned about the numbers of those and those types of places and does that answer your question no I'm trying to be more specific amend it we got down to school. athletic activity so were so some of this is coming from school athletic activities that partly answers okay the question of I know part of it without shall insurance it's coming from prisons because I've got a present in my district and so I know there's a lot of cases in the prison I know there's a lot of a lot of the cases in two counties are from employees of the present I know a lot of the other cases are from people who they came in contact with I'm assuming that's what you all are learning yes yes okay and so that's what I'm trying to I'm trying to you know we work with the eighty twenty rule let's let's let's find out the most important things are we are we get a lot of of we finally a lot of transfer in restaurants and no we are not because I saw that we were gonna have a cracked a heard on the radio we're gonna crack down a restaurant well we do have certain restaurants where there has been transmission overall it's not been a problem but that has been transmission certain restaurants especially those that have not followed the guidelines of the requirements so that is the case so the so there's been a few restaurants and we know who they are yes but not restaurants overall so we're probably wasting resources if we're going out after everybody out although it looks good but that but that's one of it is so that's what we're trying to find out with computers one to warn people that they've been in contact but second is where the case is coming from so and another example of where cases are coming from our work sites so we see cases and Poultry plants thank you of glad you'll finally said that okay so we know that's a problem. And poultry in school and school activities we've seen it in some manufacturing facilities but some manufacturing facilities is there any with the manufacture facilities is there any common denominator with them at the the moment the common denominator seems to be the close contact of the workers close contact to the workers that's helpful of the you know for for all of us run around here with a mask on it's helpful to know where the cases really are and what's really happening and and that's what's on the whole go with the plan and that's one trying to find out what you're finding out now and what we're doing with that my next question would then be what we're doing with that information yes. So Doctor sum up for you here would you like to talk about other works because. I want to go and answer that question Senator Clark I'm gonna move on to a few others that I've got in the queue absolutely thank you. Thank you for the time they're welcome. Go ahead thank you for the question yeah and with the to add on to doctor don't his points we do ask every single case through our case investigation in the past fourteen days leading up to their diagnosis what types of facilities generally are they attending restaurants bars barber shop all the like and they were cut expounding on that through the investigation to identify the specific place they want the time in which they went there and they went there with to try to nail down within of these clusters that the total the tight knit social clusters with the dynamic is within between these cases so that is specifically we also collect information about who this person who the new case may have been exposed to I we do ask question have you been exposed to a laboratory confirmed case and a large portion people I item start on the exact number for you but like portion people will say yes and they will provide us with the name of a person who I was diagnosed with cover nineteen they were in contact with that person. quickly manager yes it how many. How may confirm cases do we have from people having contact in a retail store. Not on but employees but customers in a retail store I'm sorry I don't of information. The call with the up contact first you'll have any on. Contact in a retail store I don't know. I have to be referred. What that would be helpful research are one retail store and if there's none that's helpful if there's a bunch that's helpful of I have a feeling it's very very small and yet we're working really hard on that and we need to figure out what it is we really need to be working thank you thank you madam chair yes go ahead A just to explain I don't have information from me however we do have you know ways that we collect that there is an other category in which we collect specific types of retail store so we can definitely you know that down for you Sir represent of Ladyman then represent a Bentley yes I have a question on the track contract racing ma'am if you'd answer I appreciate you going through the process of in detail on how I'm appearing. Thank you. Of I appreciate you going through that process step by step tells how you do that but you mentioned you ask they've been in contact over the last day. The is it you just go back one day or do you buy more than one day how many days back do you go with these contacts I'm. You're referencing the the positive patient yes and. Karen do you remember. So may add to that so when we interview a new case we learned either when they started their symptoms and we go back to days in that would define their infectious period or if they didn't have symptoms the date of the testing we go back to days and that's the infectious period and that's one more interested in who they were around that they go to work they go to a social event and so forth and then we try to the contact tracer will work with them to make a list try to remember where all they went up we learn about who's in their household or who may have visited them in their home those types of things and then they make a list and they follow up with those people okay so that answers my first question sent question you we've talked about delays again the results may delay it be delayed for day six days a days up to fourteen days so the you put that in your formula when you talking about the two days I mean it took four days to get the test then you go back six days or how I mean is that what twenty years from the date that their symptoms started or the test was collected. So the At case investigator will fight define when they're infectious period and sometimes some of you said that the results are so delayed they're out of their infectious period right so then we would go out through ten days after their onset of symptoms or that test and that's the end of their infectious period so if it's close enough when we get the information there still may be people who are exposed during that period of time that would benefit from quarantine that would still help this of break the chain of transmission if it's a very lengthy period of time then it may not be in the best interest to follow up with that person and their contacts and so forth so we have to make that determination since things have been delayed about what is the best of course the strategy now as things improved with tests and we can begin the contact the case investigation the contact tracing more timely we'll be in much better shape the particularly this fall when school starts I think that's going to be when it's really going to be important to shorten these time lines and get the turn around on that case investigations and the contact tracing. one more question and on what senator Clark just talked about we have a retailer or different types segments of the business or the community and you all can get that kind of data down to that level is that right yes so the interview that of the case investigation about who they may have been around that they would have gotten the infection from is important sometimes they don't know but it's important to know where they have been because sometimes we know there's an outbreak at such and such a place they may not know the people there it could be a restaurant it could be some other location it could be it could have been a funeral or some event that we're aware of but they wouldn't be aware. So I think that information would be helpful to this group this committee if it if you all I mean if you had the number of cases in a retail related manufacturing whatever if you could get that present to us either send it to us or have it for Monday's meeting. So that we know that the you know like Senator Clark said if one percent of the cases are in retail then resources should be put their they should be put somewhere else so I mean is there anyway you could provide data like that the the type of industry or business or whatever yeah we look at that will if you can get that forced even if you can present Monday in our meeting that be great. The other thing the other thing mandate for Monday at so if if. I'd like to come to see the protocols to it like if it's a restaurant and an employee is an employee contacts is is tested and it's positive and how what's the time frame your shot if you shot that restaurant down I understand the Comiskey because I've had a few restaurants shut down at or were told to close but the problem was the employee got tested and then the test wasn't until seven days later thank you the results I'm not sure what good it is to shut the restaurant down seven days later when they were symptomatic a week ago. So I'm not quite understanding. Yeah what's the point or what is the protocol and and why and how long you're shutting these places down or. How that's happening and then everybody's getting tested to go right back even if they're not symptomatic or not. Well it doesn't sound like all of that's under the health department guidance because we really try to keep the restaurant's open but some restaurants do closed voluntarily the one I have was told that they had to close. I will if. Sears one might be able to speak to. Okay thank you. Afternoon hi don Adams with the health department so we had one facility food service licensed facility that we have closed down now there have been other establishments that have chosen to close down maybe because they had several. Probable or confirmed cases but only in one instances we shot a facility down. And that facility has re opened. Okay okay well that's different information I have then okay yes ma'am if you have other information you get us we can definitely look into that okay already I will thank you did you have other questions represent Bentley. Thank you on this for Stephanie Williams issue coming. Yes ma'am thank you step in a couple quick questions General Dynamics where they her in employees from other from across the country they are Kansans where we get in these they have hired at least hundred eighty our Kansans and I don't at the I think it's around a hundred eighty of the three hundred and five I can get you that exact number I was just curious thank mother question is you know at the small business owner may just quickly looks under numbers I'm sorry represented Bentley it at its Two hundred one two hundred one yes ma'am okay so if we've given this company twenty two million dollars for three hundred fifty contract tracers at six hundred twenty eight thousand five hundred seventy one dollars per contact tracer it just seems like an awful automat money to me so explain what we're we're my missing it so I'm sorry I didn't hear the first part of what you say you use it we we gave you twenty two million dollars for this first contract in it in that you wanted three hundred fifty contract tracers for the twenty two million dollars so did I miss something yes there so that the it was twenty two million for both contractors not just one and the amount the twenty two comes from that both are about the same in price there Randall think eleven million there's a little bit up in addition that we've asked for to hired nurses to do case investigation and that bumps them up to roughly about twelve million H. for that six month period of time for both so we get three hundred fifty million three hundred to contract traces of both groups three hundred fifty contact tracers out of both groups plus an additional number of nurses which I think was. Twenty twenty forty nurses. It's three hundred fifty each contract yes seven hundred yes seven hundred total. Yes man forty nurses and fourty nurses still still a lot you know when we're looking at some more even tomorrow just remits even if you cut that in half it's three hundred eleven thousand per contract tracer. So they also are managing the staff and providing the supervision the equipment all of that so we're not doing that their pay and their pay and everything for those employees were not paying any any of those cost I just think I need to quit making cups and two tractors I'm sorry either in and I'm going to just be indulgences amiss in here for a few hours are are really appreciate a lot what you guys have been here today and doctor delays and you're sitting here as for like to ask you a question this is tell has nothing to attesting that has to do with mass because I'm still very concerned have employees employers call me that their employees because they have a convenience store there are having to wear mascara day employees are now have chronic cough chronic sort not cop current sort through their eyes are hurting them they're tired in the war out because we put a mask on her face as you know will put a cloth mask on her face were trapping CO two when there and I'm really concerned that we are decreasing people's abilities specialties employees that are day and for eight hours a day having to wear these cough mass on their face that we're creating sickness and then that they're they're less likely to be able to fight off this and this fires and you know I saw a bird reports have reports and trying to get a grasp on I'm just just not convinced that we're doing anybody a favor when required him to wear a mask all the time and I seek loose mass everywhere the nurse to me just pops out you know I'm looking everywhere I go I see people loose Massa coming down the fix them and the minute we touch amount we're getting germs on there and I'm just really concerned that we're focusing on the wrong things I guess that wants to get I want to let river remarks from you because for decades we've said you can't separate fires for mask I've read report after report don't think I can find is made little camps to report about that that testing is an hour my will convince cloth master stopping stuff I just I'm just not seeing it and I'm concerned I'm real concern for the long term health effects that we're creating and my constituents that are working have no work everyday and not forget environments with a cloth mask on all day. And they're just that that the long term health effects I'm really concerned about and that we're seeing people wore out and tired. They're not gonna be able to find out this virus I'm I don't really like your response doctor delay in that. Well I do agree that wearing a cloth facemask for long periods of time is an inconvenience and it's not necessarily of the most comfortable thing we've ever done. I do. Wish to say though that It is a important in terms of its source control when we're out in public because we know that many people can be at pre symptomatic or a symptomatic with this virus and it can be easily spread so I think if we were all able to do it for a period of time we can reduce transmission and then we can get to a point where we can get a vaccine and then not have to do this any more I'm not aware of any medical evidence that shows that it leads to chronic health conditions but I do realize that it's uncomfortable and it's a hard thing to ask people to do. The so we know that in. Controlled settings like in a hospital's so there was a recent study that came out from The one of the largest hospital systems and Massachusetts that when they went to universal masking of all the a staff as well as all of the patients than they greatly decreased the rate of spread of covert nineteen in their facilities so those were very good data that were helpful the course these for surgical masks that they were wearing but there are studies that demonstrate if the. Off mask this properly made and properly warned then it can decrease the spread of droplets as well as aerosols that would carry the virus so at the end there's modeling studies because all of this is new we don't have any random randomized control trials and so forth that would be very difficult to do in this setting. But we know that Where There is good masking than that spread is decreased and now we're getting more studies there was that excellent review of a case in Missouri where to hair stylist wore cloth face coverings and all of their clients were cloth face coverings one of A worked for about a week or so with symptoms and exposed everyone they were and a co worker also became ill and exposed people while she was working I believe together they served about a hundred and thirty nine clients none of them got up covert nineteen but the stylist the original one everyone in her home got it so she was definitely able to spread it but because people were wearing cloth face coverings it did not spread in that particular setting so we're getting more evidence that this works on a practical level. And I think that as time goes on we'll see that there is great benefits. Yeah and I I just wanna also follow because we did have a conversation about the software that's being utilized to Missouri and where people can look and kind of make their own determinations and as to why where there maybe breakouts and offense so I know that that that's part of it I know that you all have been here at the table for very long time and I appreciate that I'm gonna go to cover has not asked a question yet and then that nobody else time in I'm going to cut this off and I want you to do rapid fire questions I represent adoption and then Representative Evans. Thank you madam chair over here you're right So. The. Contract racer contracts that you've got I'm. If you would leave me through because I'm kind of still concerned about personal private data they would be collecting I know the other day you testified that that data goes into a database and the they can't query that information on the public health department can do that. And then what happens how long is that data stored what happens to it afterwards and more specifically these third party vendors that were hiring Is that data stored by them I mean I understand they're putting the information into the into the system but Is there anything in the contract that prohibits them from storing or keeping that information Erin requires them to destroy that data so that they cannot use it for other purposes If you could yes I represent Dotson I've asked the doctor similar come to the type one speak to that issue assistance specifically from our system of what we used to do active monitoring there is a purge mechanism so after so many days I'm sorry I'm blanking on the number of days after they have been released from their quarantine release from their isolation they're identifying information is purged from that system for that specific related to the contracts in the Clinton crunch Contracts for contact tracers I'll have to ask Mouth one. Could you repeat your question Representative Dotson yes on contracts the contracts for the contact tracers Is there any sort of requirements prohibiting them from using the data from storing the data or from retaining it a requirement to destroy the data once they have collected that data. So I. Don't have all those details in my memory on what's in the contract I do know that there's a Some specific Security standards I'm not an I. T. person that are stated that they have to meet their system has to be operational. A specific percentage of time. And. We do expect them to. Have a secure systems of the state. So they they can't so that it so it's not accessible by other you know by hacking or whatever the destruction component I don't have that in mind the I don't remember that and I will look that up. Can you get us a copy of those contracts absolutely and. How are these contracts procured and I I understand these were statewide contracts for at least for a couple of them but now we're adding additional entities to this that we didn't go out and from my understanding it didn't solicit a bid didn't ask for parameters being out there this is basically a sole source contract that's going to another third party entity just because they gave us proposal and we said yeah we like it and to my knowledge and familiar with organization northwest Arkansas. I'm not sure what their expertise in this area is they're more of a. A group of business people on a political organization then I medical organization so represented dots and the The two primary contractors General Dynamics and I have him say they were procure the emergency procurement process that was overseen by the office of state procurement and the proposal that you're referencing the taper other proposals that have been received the one that was from higher read that actually the university of Arkansas put together that proposal the department of higher ed doctor Maria Markham's office endorse that proposal and it went to the cares committee and then we were asked to to review and consult with them and in helping to revise that plan before the cares it was presented to the full cares committee for consideration and approval so doctor Bobbitt his team others presented as part of that process the information about how that would work and the capabilities of the college of public health at the time that that conversation happened we had been actively working with the college of public health they had stood up their system back on the training they'd actually perform some of the work so we did have more insight into the capabilities of of the year organization the northwest Arkansas council proposal they have partner organizations that that are listed as the entities that will help facilitate any work that they are approved to do and that includes eight hospitals in that northwest Arkansas area and I'm sorry I'm a litte bit fatigued from from a print from talking quite so long and I'm probably I would be able to name all of the eight but I do believe it includes I think seven hospitals and then their community health center as well as part of the resource capacity and also you a miss northwest and children's northwest. So can you can you get to that I'm not gonna ask you name off top your head but it can you get a list of that and specifically the contract you're putting together yes Sir and whatever the proposal is because to my understanding of it we're going to be dealing with this tomorrow morning and I checked the agenda and the only thing it says is you want seven million dollars. The the request is available online right now on the carrier's website I believe they posted a proposal that was updated following input from the cares committee because they were asked to expand the county is that they would potentially Sir beyond just Washington and been to also severe yell thank Randolph and independence but yes Sir we can get you that information thank you that. He actually makes the point that I had not considered yet in its hawks it's the contract and the contract that we went through emergency procurement with to do this work but that does not exist with this entity. So we want to make sure there's some consistency there and that. Private and that that does need to sync up so that's something that you had just brought up and you're exactly right there's if there's not a contract in place for something like that went that we're doing over here we we need to make sure that whatever they're doing is consistent with whatever those contracts that we have employed but those vendors is the same thing that makes sense yes yes ma'am it does now that I have been provided with the expectations and that the other vendors are meeting and they're aware that it wouldn't be the same expectations for how they report the time frame for in writing with everybody that to them we haven't entered into any sort of agreement with them but they do have that information that we may need to yes ma'am yes we we need to enter into an agreement that's based on the same parameters so at that the thank you all right I represent of Evans. Thank you madam chair and I appreciate you giving me the opportunity and ladies appreciate you being here is. Been down there that hot seat for quite some time today. I want to parlay off of what senator garner talked about and that was what's going on the real world. And I wanna keep this under the topic of testing but I want to get away from the science. And I want us to just look at this from some common sense. If you go back several weeks ago there was a whole lot of controversy across the state because of. Unprecedented and unsubstantiated mandates and restrictions that were put on the dental industry from the department of health. It was all wrapped around what was known as the hand tool which has two purposes either to drill for a cavity or to remove a bracket for braces if you're an orthodontist in the department of health said that that that that had to be stopped because the aerosol created from the mouth was so potent that it could just be a hold epidemic within the pandemic in that community if that aerosol spread through that dental office. It seems to me if twenty three in me can tell me from my saliva seven generations back from my family is that that same saliva could tell you whether I had cold or not but yet we've gone through four to five different types of testing now that you're trying to offer from the one that goes way back up here to now just to a swap around the nose but yet what was in my mouth was what was so potent that we shot the dental practices down for months and so we're spending millions and millions of dollars on testing it just seems like something from common sense. Could be handled that in that manner. I have a district for people that have a lot of common sense but I don't have any scientist in my district so I've got a I've got to get my questions answered from common sense and in in miss Williams is actually set this question yesterday based upon a on a real life situations going on in my district. I wasn't able to tune peer yesterday but had the question asked. And so I kind of felt like you really danced around the topic. Any defects the department of ed it affects the department of health it affects everyone in this room in our districts so I'll I want to kind of turn the music down let's turn the lights up let's get away from dancing let's just let me walk you through this please give me very clear answers because I've got a lot of people back home that are terrified of this. One of the largest employers in the state. Has a. Daycare preschool facility within their organization. They offer that as a free benefit to their employees if if you're an employee of a forty five year old. You your child can attend this pre K. program and have a curriculum and they have food service and they have activities it it it's a great program in a great benefit to the employees. At seventeen students in the summer program last week child number twelve as they came to the line that morning in a nurse took thirteen up. Child had a low grade fever red flags go up protocol kicks in the call the department health department helps is quarantine covert test twenty four hours later. Not ten days later twenty four hours later was a positive result back that that five year old child had coping. Based upon letter signed by doctor Delahaye I have copies of those letters here was what happened. Seventeen students were quarantined. Three teachers to nurses and thirty for parents do the math sixty something people were quarantine for fourteen days because one five year old child had a low grade fever and a twenty four hours tested positive for code seventeen of those in parents were employees of that organization. Severely put a cramp up on that that company. I got to thinking about how that would affect me in my business. Here's the real problem here's what I like to dance with me because the question went up and I would like to commend one of your employees Matt Gilmore who help walk me through the process of understanding and trying to help the situation. But he put us in touch with one of your doctors and this was your doctor's explanation as to why that happened. Brian it's really a two fold problem one the child must have someone home to tend to them I don't believe that's the department of health decision to stay home with that child it could be an aunt and uncle brother sister grandparent not making parents quarantine home for fourteen days with that child. The other part is that this is because of constant contact not second hand. Someone of passport from last week August twenty four. I have ten thousand five hundred students in my school district. And I want to know from you miss Williams. The second week of school when my son is sitting in a classroom with twenty four other classmates in one of those children test positive for coated I want to know what's going to happen to the other twenty four students. The rotating teachers if they have that they have constant contact with every day. With their coaches with their parents what's going to happen from the department of health. Remember the question it wasn't as specifically like this but very similar and it wasn't my intention to dance around it and I'm sorry it was perceived that way I think the difficulty with this is that each situation is a little bit different and you know I don't have a good answer to an upper deck I wish I could predict exactly what was going to happen I think we've we've seen that when we have close contact and when we're not practicing good infection control the virus spreads very easily so I mean these things they are going to happen I mean your exact you're exactly right and and it's a balance you still didn't give me the answer because here's what the department of it says we have two hundred seventy five public school districts across the state and every superintendent everyone is district is begging the department of education to say what am I supposed to do. The department of ed says we will follow up on the recommendations of the death of the department of health senator Irvin. Was very clear crystal clear about what your recommendations do. To businesses and school districts across our state. And so I understand that you can say there's all these different scenarios but what I do know is this. I had sixty three people last week that because one child in close contact. Tested positive for coated that those fourteen parents or are not working for two weeks I have children not going to school I have employees that can't go to work. And if that's going to be the protocol because my scenario with my son in it in a room with twenty five students for eight hours a day wearing mask and all it's no different. There's no different in that in that scenario. Are we going to get a directive from the department of health when one child in a public school classroom of twenty five test positive come with that that classroom and those teachers and the parents of those twenty five students are gonna be quarantine for fourteen days because that's a very and that could be a very in the cycle because if date ten into the quarantine one of the parents then come symptomatic the cycle starts over so we're talking about kids that we're saying you're going to go back to school August the twenty fourth and potentially in the very first week of school we're going to take a classroom and send them home and one of those parents do. So if so if you don't have a clear answer between now and August twenty four we need to get a very clear answer how our schools are supposed to handle this problem manager thank you for the leniency in the time and asking the question that to to Representative Evans question so that's exactly what would happen if a foot if a child in the classroom of twenty five test positive then you would quarantine the twenty four other students the twenty five plus that student. All of their parents the teachers and anybody that came in contact with them based on what happened to his district and the daycare facility. I don't want to speak percent are for Representative Wardlaw but I know that's exactly what happened to him right Representative Wardlaw son tested positive. Football practice. And seven or eight people were quarantined in a home. For twenty four days. Because one student tested positive for coated. Twenty four or nine people were quarantined in the home for twenty four days and I believe that the young lady there setting to your ride was actually assigned to that in contacted him malt couple times a day to make sure how that process was going so that seems to me that that's what the protocol is going to be. No one is willing to step forward and let the school districts know that that's the way it's going to be so they can prepare for that and how their parents can prepare for that go ahead doctor delay. It's on okay all right so we have had cases in state football teams and their. So some of the practices have gone very well and they did good social distancing someone became positive and no one had to be quarantine because they had followed the guidance is about social distancing and none of the other players had qualified for close contact it would be the close contacts that would be quarantine not just everyone on the team okay but it but how to care facility so I don't know about that specific incidents personally but it could be that at that childcare facility that there was not good distancing and many people works but was so that has to be taken into consideration in terms of a classroom if there's good social distancing it may be just just the student centered around the case would be the ones that would need to be quarantine so it depends on the individual situation and that's why the point of contacts at the school are going to be important to help gather the information so that we can make a determination about whether just a few people need to be quarantine or whether more people need to be quarantined. Is that help yes it does help I think it makes sense and I understand that but it also creates an inconsistency which is difficult for us to answer the question well it is and I each and for and for you to answer the questions yeah because it it's it it is at its each case on its own I do understand that. That releasing. At some point people's lives can't and they can't miss work for twenty four days I can't pay bills I can't I mean I'm a little puzzled why it would be twenty four days usually quarantine is no more than fourteen days because it was. I don't. well I was about to say I think and I'm at the there's it's happening quite frankly as it's happening to a lot of people I happen to Representative Wardlaw. Representative Johnson. Yes I think where they get to twenty four days they're saying your your quarantine if you're positive if you're living house of contact with the no positive it correctly from wrong but it's ten days from the date of the test and then if you're the household for the positive the isolation produce ten days from the date of the test the quarantine period for the close contact would be fourteen days from the last contact within that ten day time frame so you're you're living with by this positive for ten days your last day of contact is day to you and then you get another fourteen tag on for twenty four I think that's where they're getting that it makes sense so so mad from may have a question was in yes quick quickly I'm so sorry and then represent Senator hammer and then the person of great so it seems to me the crux of the problem that represent Bevins is discussing has to do with the definition of close contact and how we how we set that up to the school so I guess my question is it seems like I did that I've seen a version of close contact which which was you know best practice by CDC policy certainly at the safest approach but what we seems like we have to balance is what's the safest approach with with what's the most practical approach right I think we can all say the safest approach is we don't have school everybody stays home that's the safest approach it is that the right of practical compose approach shot so we're talking about risk management and in a green to take on a certain amount of recess. For the advantage of having the benefit of everybody being a school and so it seems to me where you have to draw that line is by looking at those those definitions they're within that policy that the school has right now with alertness levels in trying to make sure the terminology is defined in a way that the provides an acceptable amount of risk right that still allows for functional school so I know my understanding is those things are still being negotiated with regard to how those terminologies are being to find my hope would be that you continue to look at that so that we can to find a way that mitigates risk but still allows for functional schools or does still in negotiation or the set in concrete. I would say there still in negotiation we have a standard definition for close contact which is within six feet for fifteen minutes or more but there's always special situation and that's I think what part of the frustration because we can take special things into consideration and each situation can be different and we can make decisions based on differences in those situations so it can't be it won't work for it to be a one size fits all. Okay thank you Senator hammer. Thank you major I've got a copy my hand of the response levels for on site learning and it refers to you all as being contributors to this guideline that was understood handed out to the schools yesterday or sent out yesterday can you all does that look familiar to you all or do you all remember that. Okay so it's got like limited response which is low risk and then it's got moderate response than high and it pretty well outlines the details for what a schools post do in the event that they come in contact with the student so is this going to be the official guidelines that schools are going to go by. That's the intention. But this is gone out as official I think I may be wrong but I think this is gone out is official now superintendents from what I understand initially there some conversation but in the last two weeks they haven't been contacted about this and this going out and so on I just wonder is that contributing to some of the confusion about how are things going to be handled for can you speak to that. So I think that has gone out I think there are is concerned from the school districts that they're gonna need more specific technical direction on how to implement best practices and how to deal with potential scenarios so I know that doctor Romero along with camp had arson and other representatives of the medical community have it been ask if they would be willing to put together a resource group that would be available to work with schools and I don't have all the details of how that's going to work but we've supported that endeavor and I know that something that's looked at being looked at to develop additional support mechanism of experts that they could be a link to for guidance and advice okay well. But you know just a commentary that based on the information I got from some of the speaks on behalf of the superintendents that they've not been very much involved in this last two weeks and then this thing was handed out to almost as a mandate if they're gonna be experts involved in the conversation we need to make sure the people they're going to have to in force what you all are passing out is are actually in it because it goes back to the representatives comments while ago this is there have to read there have to live with what's being handed out to them but they need to be involved in the process of give you a case in point on this document page three we're talking about initial actions after notification and the it's been referred to in this meeting today about the point of contact for the schools what the schools are worried about is when you get down to point number three assists district notifies probable close contacts to self quarantine immediately for past for fourteen days from the last date of contact with the positive case they're interpreting that as while they may not be filling out the contact tracing form they're gonna be responsible to call everybody down the line and that is creating a financial hardship on them I'm reminded of a contract that we issued to DHS or DHS issued with very little legislative input if I remember right about the often contract when that once I got the contract Centerville appreciate this all of a sudden now the providers head start doing the work on behalf of the ones that had the contract what what I'm afraid of is that we're issuing these contracts to all these contact tracers and they're gonna turn around and they're going to force it down on the school is gonna be a financial hardship on them so I'm voicing a little bit of frustration that if they haven't been involved at the table with the discussion and they're about to be given a mandate with financial ramifications to it it's an unfunded mandate on the schools who yet have been remember. For all the food expenses from I'm just sounding the alarm that from this point forward if they should be a point of reference I'm only in close contact with my superintendents because they've got to deal with this now any any comment because I got one or two other quick things may appear any any comments so I'll to all take your concerns back to interim secretary Romero and secretary key I'm not sure of the process that and went through to engage with the superintendents but I will take those comments back thank you the other thing is and I've got I've got some convenience stores that I represent and distantly represent they are starting to be issued warnings from the department of health because our employees are not making the customers that come in there where the mask and they're getting sided Fortin of got a got the form. I've asked the department or bureau to look at what what is your authority to make the private business owner the enforcers of what the department health has handed out to where they are receiving punitive punishment in the way of being written up. Because they're expected to enforce the mandate that the department of health is issued. What's the legal authority for you all to expect the stores to do that well this is a public health requirement it's been issued as a directive and so we do expect for the public's health that those be followed. Okay. What will credit your hammer I'm in a. Just stay there senator Ingram has a request and he I want to get his request and it's not a question thank you of madam chair sits Schaller gonna be meeting next week get up in this will probably in this follows up with Representative Evans and and and others with the schools and it's probably going to involve a D. E. I would like to know how they feel that we can justify it with with school going back. On April the fifteenth we closed or April sixteenth we close schools on April the fifteenth our account was seventy one infections that were reported on April the fifteenth at that time we had a cumulative total of fifteen hundred little over fifteen hundred we have over a thousand today and we're it thirty five thousand total I would like the department of health and eighty E. to report back to the health committee. What's different why are we going to me we shot schools down over seventy one what's going to be different about this and try to anticipate what we're facing and I don't think anybody's of any all these questions it senator hammer's got you know these are all back to that what's different and why should we go back to school when we close schools at seventy one. Yes No thank you for that and we do have another meeting set for Monday we're going to talk about those kinds of things but we also discussed having a joint and education and public health joint committee meets specifically about back to school and what that's going to look like and all of that so we'll try to fast track that as much as we can thank you for the request thank you thank you senator hammer as did you have another question I forgot to represent of gray yes ma'am thank you for leads to been waiting thank you up to Senator Clark choice while ago you don't have a list by don't you all have a list like by of location of who what stores have had maybe employees that have had the been been identified as positive is that correct on our website we do identify businesses and facilities where there been five or more cases a significant number of cases okay and that's publicly available tiebreakers just one hit appoint the church's got singled out and I know I think that was by FY request yes media if I remember right so they could if I don't anything else Sir could they have seen that on the website so the church listing was not on the website it was and FOR request and the businesses that are associated with five or more cases those are listed and have been they well are you at liberty to say who if allied to churches honestly Senator hammer I'm sorry I don't remember okay if you can do that legally if it does violating laws I'd like to know who have full I the church is if you don't mind please hang I think we could tell you that I'm just I'm sorry I'm not I don't let's for that's fine you can you can get it to me and Last question. What's gonna be the definition of when the pandemic's over because there's a lot of spill over you take represent Evans comments over there while ago and I'm not minimizing death okay but there's been a lot of people that died a lot of other diseases we've been fighting for a long time to that are on the front page there buried back in the obituary and I just wonder at what point are we going to be able to say okay let's resume normal C.. From the department of health perspective not if you will thank you madam chair. So this is a new disease so I don't know what our baseline is going to be. and whether we can establish herd immunity three vaccination I think that's going to be key so it's going to be one we get to a level study state where there's either vaccine is preventable or there's a good treatment and it will be it's likely that this disease will be ongoing I do not know when we will declare a pandemic over and when we will just. Consider it to be a on going in on this like flu or a their respective respiratory illnesses that circulate. Go ahead thank you require thank you based on the comment you just made when you look at the number hospitalizations the people that are on the ventilators and the deaths bill no three things right there when when you take those in comparison to the number of people that have been tested the number of people that have recovered and the number of ongoing cases which are some date debate about that there's even some debate about the number of deaths and how they're classified as co would level the the covered being the actual calls or the underlying cause and that's a debate that's going on how do we justify it being classified as a pandemic when you throw all that into the mix as far as the the number cases the active the recovered in the hospitalizations how do we justified as being a pandemic when you put those numbers in the mix. So the definition of a pandemic is basically a work work global epidemic so it won't be the Arkansas department of health declaring the pandemic over. We do see seasonal epidemics and such as influenza so At some point we will have a baseline and the CDC and will work to determine what the baseline is when you get a certain amount over the baseline like we do with flu then that's when you call it an epidemic and so it. I anticipate that in the future we will have surges of this illness just like we have flu and it will be S. when we reach a certain threshold over and the amount of cases is not necessarily a At in its in flew its the A death and more from it so so it's the amount of. Deaths from flu and pneumonia it's there's a bass line and it goes over that that's when it's declared an epidemic and I mentioned that will be some baseline like that that the CDC will establish and will then have periodic epidemics of it. So can this Arkansas state department help determined as it is relevant to Arkansas only take to worldwide definition out do you have the latitude defined pandemic on the basis of what's happening here in Arkansas separated from the rest of the world number cause a pandemic is defined as a global the Entity. So the health department could define an epidemic we may have a epidemic or an out break but the pandemic as a global thing and usually it's declared by the World Health Organization the health department would not declare a pandemic in our state because it doesn't fit the definition has to be global for it to be in pandemic thanks for Yeltsin Durrance today too by the way thank you thank you Representative gray okay thank you madam chair real quick two things I wasn't under this but the senator hammer's question like to the businesses that are getting cited I mean that would be like starting a business because the person walking in head marijuana on and they weren't legal so you're going to start the business but they didn't have any authority to say yes or no to what that person was bringing in I just like to know what the authority is authority to find the person but not the business. So there's the the public health directive is for businesses and involves businesses they're expected to comply so when we visit a restaurant that we license we do a note any observation of of governmental guidelines that they have not complied with so it is noted now you know we have as Mr Adams pointed out would not shut anybody down we haven't fund any of these restaurants I think there is there are some misconceptions that you know we're trying to be heavy handed were not but we are going to know if they're not in compliance with gotten lots and lots of calls in complaints about entities that just haven't wanted to comply and have basically said whether it's you know director from the public health department or any other governmental directive that they're not going to follow okay that's I haven't re read the executive order but I haven't read the directive and so in the directive you may be telling businesses all businesses even those you don't regulate that they have to follow it is that the case the the Ansari I'm tired I wish I had a copy here so I could A read it remember exactly right out of the tractor supply the let the tractor supply stores in my nature to tractor supply store two people in there don't have a mask on you guys committed are you going to cite them because to the people in the store don't have a mask on so we understand that you know a business can't for somebody to put a mask on but they should at least ask them to comply and if they're not going to comply they need to ask them to leave until they're prepared to that say comply to hear that Senator hammer that's a huge overstep. And we had anyways that's another for another day and we a I that's actually on the agenda for Monday but you do have a question about testing health Jett represented Jamie Scott was here and she had to leave what about is there any any of Arkansas I'm getting tired J. but any preparations been made I guess for those patients or those people who are like home by owned their own home health they can't get to a testing site if they become sick without having to use an ambulance so is there anything like has a county health officers are county health local offices made their tests available to home health so that they can go do it at the home do you know if there's anything been done for that that population so I actually I'm not sure about home health and Sherri and. I don't know specifically what we've done for home health but I do know individual cases where we have had request to go in and test someone that's home bail then on our agency has actually sit nurses into that home to do that test okay. Thank you. I thank you on your data dashboard testing here on this map on that side is there a way you could ask when the date when the test was performed. To those that are reporting testing. So. We're able to. So we're able to determine for a positive case when they got their tests it's the negative cases that we cannot determine the when the test was collected all lace because that's not reported to us the labs don't report those to us but because we interview the cases we can determine that information but the negative cases we don't interview. That makes sense yes that thank you you're not be in it so you're not getting the report from when they're doing the test only practice okay thank you I'm okay I've got three more and then we're done. Sorry Senator Clark one quick question. Could you come back to me regarding the directive here okay and and the directive on masks and those kinds of things is going to be on Monday's agenda. represent of Evans thank you madam chair I just I just want to clarify on and something that Senator hammer brought up because I think it's important for everybody to know is you'll probably get question from your superintendents inter district and and apologize I don't know if this came from from the department health from the department of it the P. O. C. that they are talking about or that they mentioned in the Senator hammer mentioned in the document that he was reading from the point of contact that's that person in that school district that is the main point of contact is going to be the liaison between the district and the department of health districts are being advised number one that that should not be a current school employee to your disturbs going to go out have to hire a P. O. C. depending upon the size of the district they may have to hire more than one I know our district was advised to hire at least two eight is that is that correct. I have no idea honestly that would be a department of bad process that they've set up and I'm sorry I can't I don't. Learn this and I ask that question earlier and you gave a different answer somebody did it could be a nurse. No Sir at the the. Point I was speaking to is a point of contact and sometimes that is a school nurse in you know typically when we have outbreaks in schools of other things too can parks and whatever you know we work with the school nurse this is a little bit different because we. Evans just said that it had to be an outside person that they we were advised that they did not need to be a current employee of the district. Because they wanted to one eliminate any bias of the reporting that district and that that person was going to be very busy and needed to be available twenty four seven. And we were advised in my district that we needed to hire no less than two PO cities which are to new employees for the district that's unfunded mandates in our districts are going to push back really hard on that so I just want to be very clear what that P. O. C. was okay well I appreciate you point that out that's actually not I knew how they were defining the role of the the point of contact not how they directed that that be implemented so we can also express that that's a point of concern. Yes Sir okay we did that's going to be a feature what will have to do this and that and that the next meeting but the yes there's got to be again consistency between the us department of that and what department of health is he's got a some consistency thank you will address that thank you for me just a minute but Sufjan master the two different ways you are someone the audience that can clarify that one and yeah can you. Explain it better than I. Yes don Adams of the health department I work closely with the department AT and and and this point of contact process and so to my knowledge it can be and in most cases will be a district employee that example being a nurse I think there was a concern about it being the superintendent because they're so just busy doing other things that this person needed to be available to contact the health department and the department of ed when there were cases in that sort of thing but there was uh of course there's the funding that the districts get and it they could use that funding to hire someone to do that but that was not a requirement to my knowledge so we can confirm that with the department of ed but in all the discussions I've hated the point of contact can be an existing staff member within that district or school campus so you may need to re issue that document that's been sent out that and we just were handed that. Yeah yeah I'm telling you I mean I yes they are getting funding I understand that but hiring somebody new. and and this is requiring the district to basically do contact tracing what we are content we are spending millions of dollars to hire companies to do contact tracing but this specifically says that the school district needs to compile a list of probable close contacts. and then they needed notify probable close contacts to self quarantine yeah yeah you got it so. We we can look at that wording of the to my knowledge the intent is to quickly identify those that in contact with the case and exclude them from the school setting and that's different than contact tracing okay so that that is the intent not to go down the full list of contacts or give them all the information that the health department does is the initial identification of close contacts within that school setting so they can immediately be excluded from school to hopefully break that transmission that is the intent okay I I understand that I just think we need to probably clarify that because I don't want to pay somebody to do something and then expect these people to also do it that'll get with the permitted on that word and see if we can clarify that at that's a great thing all right thank you absent Johnson did you have. Sure just briefly at you know the comment was made what's different between March when we cancel school and now my question would be is the testing situation now better than it was in March I know we talk about this issue situation be poor but I remember what it was like in March I have the machine to the department felt that in March compared to now. That's not necessarily a rhetorical question do you have more machines now then you had a March yes yes you have a better testing capability now then you have a March would you say the state of Arkansas is markedly better equipped to test kids people now than they were in March yes we did you have contracts with two companies to do contact tracing in the in the month of March okay do you have more employees and how to handle the situation at hand the date March. If I could go on this is not a fair comparison okay to just to do it over simplifies the process to say we only had a handful case in March we cancel school why can we have school now school is important in person school is important and we need to try to figure out a way to practically have in person school as safe as we can I don't think we can just set up school in to over simplify the argument the situation is markedly different we can say it's this not ideal it's not perfect all disagree would like a quicker turnaround time we'd like to have better you know timely contact tracing that doesn't change the fact that we're much better quit the other thing is would you say we know more about the virus now than we did yes did we have a mass mandated March no were we even asking people to wear masks in March no so there's a lot of things that have changed I think make its in a better position we can thank about have an in person school sat just want to ask this question to get the Representative Johnson you you you you have your answer earlier when you said as risk management it's a matter of how we manage the risk. Everything that we do every single. House the street is risk risk management is the key and is a very. Elements that we know now that we did not know in March that helps us manage this risk better. Thank you and Senator Clark did you get your question do I wait till next week. Of a note that the superintendents have sent me. Some stuff here the total I have one question I'm not going to address I'm going to address the mass Monday because I was very unhappy with the answer that I heard but what I would like to address today I've been very content of been very patient. And I know that you were all limited. The vast majority of the cases in my Senate district. Or the state. I have no problem per se with the mask or a little problem with the mask what I have a problem with is over region incompetence in the same. Top. I asked earlier what our plan. This isn't a plan. The we've got the cases in the prison I asked the I asked the guard the Precourt I ask the head of the prison earlier this week in a committee meeting what do the experts tell you because I know you were you were doing everything you could try to stop it no way to tell us anything. So now that cases in garland county I got cases in hot spring county outside the prison besides all the cases in the prison. From the employees are in the present and they spread it to other people but one because the refer a restaurant it wasn't because of a barber shop it wasn't because of a dentist. And they tell me although I've been told otherwise unofficially that they can't tell me how it got into the press. So what is our plan what how are we really dealing with it and how are we really going to deal with that I'm becoming very frustrated that on one hand the executive branch tools to him with all their own and on the other hand don't seem to be able to so tell me what plan is. So we do have a plan for correctional facilities. Of when a case is identified we test all of the inmates and the staff and we segregate the positive from the negative and we seven seven segregate the negative who've been exposed in the ones who were an exposed and then those who were exposed the negative then we go back in the future and we re test them in the event that they may have become positive. So that's the plan that is the piece of the plan that we have for the facilities for the communities it's going to be testing and. The. Contact in this case investigation and contact tracing to minimize the spread break the spread and the plan is to increase our capacity in Arkansas to do the testing to get ready for the fall and then continue doing the contact tracing get that ramped up so that we can do it well and then in the future when it's time we will We are planning for the event when we have a vaccine and how we will distribute it and make that available to people Arkansas so there's different components and we have different aspects of plans to them. Sorry. Okay. Hi thank you and so thank you and I think the sides and and I do appreciate all the work that you all have done and ana and staying here for all this time to answer these questions we have a lot my main concern again is just making sure that we react to the new normal and then a reality as the testing situation and then be and so exasperated out there because I want these two things to work and they have to work together I want them to work I know you all want them to work so how can we make that happen and and and I appreciate them and making sure that those protocols are clear in their outlined and and putting them on paper so everybody knows what what the plan is for this what the plan is for this with the plan is for this and how we react to that appreciate all the time that you could in today and all the people that came from the department of health today and thank you very much and we will March fort thank you this meeting is adjourned.