Public Health, Welfare and Labor Committee- House & Senate

If you would get your C. within the starting few minutes. Call this Committee meeting of of public health welfare and labor to order Committee there's been a number of changes to the agenda fast moving in this environment that we're in and I apologize for those late changes but there will be more probably with the way things are going with availability rooms and changes in people schedule of but we did give you a heads up and and this is on the web page I believe already but next Thursday we will have a public health meeting with the Education Committee so we moved that from today to next week so they'll be a joint meeting with education. And maybe. Of well on the web that's a good question Representative Bentley and and timely on the web pages says nine o'clock is that right. Ten o'clock ten o'clock but we're going to change that. Two one thirty. So that'll that change will be made as soon as we can get that in the process but it will be one thirty next Thursday public health and education joint meeting to talk about the re opening of schools. also this afternoon thank you all seen this on the web page but we have a subcommittee meeting the medical subcommittee to talk about I. S. P.'s I think we have six on that list there may be others that may come and want to present if we have time Based on the discrepancy the chairman's Decision Representative Ferguson you'll be chairing that so that your call not mind that but maybe they'll be people here that might wanna talk in this year discretion as to where they had them or not so just a heads up that we have this afternoon so we will get started senator Irvin could not be here today she's out of state. so I've asked Senator Wallace to sit in and help me with the meeting Senator Wallace did you have any comments. Thank you thank you for agreeing to help out today all right so we'll move on to item see consideration to adopt the minutes of July seventh July twenty third in July twenty seventh you have a motion. I have a motion. Second I have a second. All in favor signify by saying aye. All opposed nay motion carries. All right we're gonna move on to item II item deems that has been struck Representative McCollum could not be here today he had some good numbers about how we're doing compared to the states around us and want him to present that but he could not be here today so we'll look at adding that to future meeting I think it's a good yardstick to see how our actions are working compared to our neighbors so we're trying to add that at a later date. So moon Titan II. Art of education if you all would come forward and they have a rule A to present. So if you would please notify yourself for the record. Good morning Taylor do again with the Arkansas department of education division of elementary and secondary education and I'm a company with Mister David Dawson who general counsel of the Arkansas state board of nursing. Alright you may proceed lasing gentlemen what I have in front of the. Panel today is the rules governing insulin and glucagon administration to students with diabetes there is only one little change to these rules and it was from ACT seven fifty seven section thirty seven that allowed a public school employee to be trained to minister of insulin glucagon to students that have diabetes and so that was the only subsections to these rules the rest emerges technical adding in the division of elementary secondary education things like that so this is just to comply with act seven fifty seven yeah these were released for public comment we receive public comment they went through the state board of education and also the state board of nursing as far as these rules and the statute requires that they come to this body before we can present them to a LC so that's why the of the departed cations here today and so there's any questions we love to a technical. The Representative Payton you're recognized for a question. Is. By Representative Payton. Senator Chesterfield you're recognized. Jan A school staff to help to make sure that this rule is carried out. I don't have the answer to that I I did have someone from the division that was supposed to company but at of miss miss miss Clark can answer that question. Please identify yourself for the record good morning Jerry Clark division of elementary and secondary education. What was the question is there sufficient school staff to make sure that as we promulgate this rule we have the persons in place to make it happen. So it would be involuntary basis if there's a parent typically what you're going to see a situation like this if a parent identifies a school staff that they would trust to be trying to administer glucagon or insulin that that's the appearance discretion and the school employee whose agreeing to that so it's a very personal decision I don't know if it's a matter of the availability of staff I think it's at the discretion of those involved how many school nurses per school do we have rather than because a lot of times it's shutting down to the secretary who feels compelled to say yes and I'm concerned about people who are really not sufficiently trained. Doing this of especially in the middle of this pandemic because that would indicate that a child would have an underlying condition so I'm trying to find out from you what is the number of nurses does every school have a nurses certainly didn't when I was there so every school has a nurse that serves every campus we have a ballot and the last time I checked around eight hundred and fifteen nurses serving public school campuses across the state but that was probably twelve months ago when I looked at those numbers we don't have any at I haven't looked at the most up to date numbers there so we have the recommendation is for one school nurse higher seven hundred and fifty students and I think for the most part when we the last time we looked at those numbers most school districts are not only meeting that recommendation but going above that recommendation so is the is the proposal then to really have certified staff a certified nurse administer this rather than shutting it off to the secretary of somebody else. With rules us senator it just they would still have to be trained those volunteers that have to be trained by a medical health professional like a doctor or nurse and so this just would allow them to be able to do that they want to volunteer will they be paid extra. I would think not since it's just a volunteer in unfortunately that's what I thought thank you. You're recognized for a question. Thank you Mr chair for as long as I've been down here it's been ongoing issue right here ma'am or to me thank you. Okay The need for more school nurses has been championed around here and working toward that tell me what happens if we don't pass this rule. Will it prohibit what we're gonna be the limitations of we don't pass this rule I would say so this was just copied verbatim from the act and so I would say then that the law would govern there because the law says that the. The the school may allow volunteer to administer insulin glucagon if they're trained in so We were just trying to make our rules near the law copy law so I would think then that they would still be allowed to because it is in the law. Okay and with regards to what our members about to debate when this went to public health back when the law was being passed These this is. The parents have A lot of input as to who gets volunteered to do this in my correct on rats. So were what we're doing is clear and a barrier to give parents more involvement in their children's welfare and care by opening a pathway to let those who want to volunteer to do this have access to the children to administer this because if they got to administer this the child already in trouble if this has to be administered correct that's correct represent of yes okay and that's what I want to point out is we don't want putting barriers between what parents want with regards to what's best for their kids if somebody's willing to volunteer to do it otherwise we're going to subject a child to a higher risk of health dangers by them not being able to get access to the fair fair statement yes Sir that's correct thank you Mr. All right. Further questions this rule stands review thank you thank you. Be safe everyone. To the item itself review of the Arkansas tobacco settlement commission with Jochem Ford. Please introduce yourself for the record. Matt Gilmour department of health. That you may proceed thank you Sir. So thank you Mr chair this is the bi annual report for the tobacco settlement commission for twenty eighteen and twenty nineteen this is similar reports to which all seen before over two year time period the report is lengthy but is broken down by section you can flip through and see a specific section if you turn to page believe it seven and eight there's an infographic. And like this I'll hit some of the highlights from that if that's okay and keep this as brief as possible you have a long agenda today. So if you look at I think it's page seven on the left hand side there you will see some of the different Topics of the program's all have a part in. And education is very important as you all know and we have the programs have done a good job of trying to reach out to reach out to more individuals there some numbers there on the education encounters about three hundred seventy five men scheme to second circles are numbered is that the one this is collective impact is top of the page it looks like this okay. On the left hand side of the folder thank you. The three hundred seventy five thousand individuals encounters there that's an increase of about a hundred thousand of the last the two year time period. The of youth education encounters as well as an increase of about. Is the sixty thousand so the good increases they're they're trying to reach out to more of populations more sectors working with schools things like that you can also see just below their other working with young adults and high school and then also college graduates the the call's public health and some of the numbers that they provided they're working with them and research and in their graduates as well. And then down below you'll see some of the services that are provided the number of individual servers through the Medicaid expansion program it at DHS that's an increase there of about about nine thousand individuals that were served also the screenings you can see those numbers and then the clinic encounters those are increases as well and the other services that you can see they're working with chronic disease working with opioids things like that. You're the next page you can see some of the research opportunities that were provided here in the state the publications presentations some of the patents that were awarded that's an increase there is also the the research projects that were involved increases. And then down at the bottom of the economic impact of the programs this is money that they bring in through contracts or grants also county in private donations volunteer hours the programs or see in a little bit of a decline in outside funding they're getting right now but they do strive to find any Avenue they can to bring in more outside funding to support their search their services and efforts. Also some of the returns they're they're offering and then the number of volunteer hours report about when the programs are as well. There's also infographics and highlights for each program at those tabs if you flip through there so I'll take any questions you might have a with that kind of quickly but I don't want to take too much your time the things in the I can provide we have to do that. Of yeah I have a question or maybe a comment on the first page there you you talked about the opioid epidemic yes Sir and course that's a big problem but it's kind of taking a backseat with the virus and reading there looks like there's quite a bit of activity going on the express the U. A. M. S. eastern region up and where I live but can you cannot talk a little more about that on what they're doing sure I can speak to it ruefully I might ask miss Becky hall who's the director there's they have several campuses of master to come up with she has formed a task force over there working with that and provided the none of the locks on other things come up with all to us some of the emergency services providers over there but she can address that better than I can. Other programs are involved as well but the jury has for the record. Good morning and doctor Becky Holland center director over your A Maciste in Helena two years ago when we realized the magnitude of the LP opioid epidemic in eastern Arkansas your menses was instrumental in putting together a task force to try to address this problem we are have been meeting monthly until the co that academic with about sixty different people coming in for about an hour an hour and a half meeting us that everything from governor officials to clergy to education to service providers the whole gamut people just even just interested in this disease and some of the outcomes of this we had no money we had no coordinator no director this is been completely volunteer but some of the outcomes is working with the state department of state director of a current line of we have been able to secure an Arcanum for all the first responders in Phillips county. Of we have been very instrumental in doing don't drug take back days with that three of that is in the community within a secure drug take back boxes for all the police stations in the county of we have been very instrumental in the schools going to do in Prague opera up doing programs during. Are read wait ribbon week and then just whenever they ask us we showed the the film chasing the dragon to all the schools you there's just some of the activities with Bennett put together no of course and scope viewed we haven't been able to meet publicly are as a group that we are still keeping this taskforce growing. Thank you for that I I know and I think you all related Kirk was involved in a presentation there in Jonesborough Craighead county had a real good turn out I attended that but I didn't have much previous information but but it was really well attended and I thought it was a real good meeting do you know I know we all have our outreach through the entire state UAMS does are you aware of other sections of the state are they doing something similar to what is being done in northeast Arkansas are you aware that I don't know the answer that now Sir you know some of the other programs I know the Arkansas biosciences to house bill of health to do research on appeal would Senate minority health commission does some education as well miss hall's primarily in the delta as far as other you know local you a mess programs I know the centers on aging is one of our programs they also do some education there as well so it's kind of a. Our programs are involved but it's it's more targeted I guess well I think what they're doing in northeast Arkansas has been really good I think other parts of the state I really look at what your own maybe try to do something similar I want to recognize Senator Wallace. Mister Moore I I just wanna say thank you you're done a an absolutely outstanding job of being a liaison and by call your in the morning call you late night and you're going to good job of getting information back to me I'm sure the other legislators will I just want knowledge that thanks ma'am senator thank you it's a pleasure to work with the yes Sir all right we do have a couple questions. Senator hammer you're recognized thank you Mr chair and I would echo what center wall said you you're great in a position to do so appreciate your willingness to work with us with regard to the patents that you mentioned while ago is there revenue received off what is patented once it's cleared. That is a good question I think there probably is I think it goes back to the institutions that do that I'm not a hundred percent sure let me ask of. I'm gonna get the of Arkansas biosciences institute the. associate director come up an address that thank you. Ms Leslie Humphries. Please introduce yourself for the record please. Percent of that yes you're on okay you may proceed. patent revenue. There can be Patton revenue there's not a lot of patent revenue I can certainly see if I can pull some numbers and get that for you generally Patton's go back to the institutions are shared with institutions where the researcher works. Follow Mr yes okay and I'm over here to your left ma'am thank you thank you if you don't mind I'd like to get that list I'd like to know what the patents are and if the funding is originating from the tobacco settlement money. And the institution that develops a patent and gets the Patton I'd like to know the moneys that are socially with those patents and are they generally internalized back into the institution for further development or what happens to those dollars okay generally they do go back to the institution a researcher would have many funding sources so professor Smith would have funding from tobacco settlement from department of agriculture from university of Arkansas division of agriculture so generally it goes back to the institutions but yes I can get you more detailed information okay happy to do so if you would Senate Mister price he can send it out to everyone who might be interested in that all right thank you Mr chair can get one more quick one yes quick thanks so let me ask you meant where in this booklet you know we see numbers of people reached and all the things that are done the numbers associated where in the booklet does it actually show that for the money that's being invested there's measureable results FOR where that money is dedicated toward is there anything in here that specifically says. This is what we're getting or bang for the Buck so each each section there is there are metrics in that show you know their number of encounters their number of as she said patents and so I I think it's the. There are measures each program is required to report on and there's a funny break down in there as well that shows the dollars each program gets but that is part of what the evaluation tracks and looks at so it is it is part of the report so each each section reports on you know. The metrics are set forth in the in the original act and there are measures that were that are shown to report that and we're meeting those metrics I think so yes Sir our clinicians the commission believes as well yes Sir our thank you Mr. Bentley you're recognized for a question. Thank you chairman Mr Gilmour can you tell us where men here looking trying to see what we're doing specifically whether student population in vaping. So if you there the tobacco prevention program has a section in there I know so this report the vaping epidemic. Yes after this report this is for twenty eighteen twenty nineteen that they can epidemic was kind of brought to attention a little bit later than we knew was an issue before but the There is a quarterly report coming out soon that will focus more on that but basically they're going to the schools as a school called the show up they'll do a you know an hour too long presentation look at some pretty interactive ways of doing that they are providing the they have chapters across state is will call project prevent coalitions I think there's about seventy of those around the state right now and it's a school school based school led a student led program educating their fellow students on you know the dangers of AP and things like that we have they have ramped up their efforts recently though in the last you know I think. Six months to a year focusing on that We do routinely work with young people across the state besides this but they have really ramped up those efforts certainly get a copy that report when it comes in yes ma'am it would it'll be presented here yes ma'am okay thank you. All right seeing no further questions of thank you Matt for presenting this some discreet information thank you to bring thank you. Okay moving on to item G. department Human Services has a rule to present feel would come up. And please entities yourself for the record. Thank you Mr chairman mark white with department him services you may proceed mark thank you Mr chairman of members this rule relates to medication assisted treatment or in eighteen what this is this is the use of prescription drugs in conjunction with the other behavioral health services to treat opioid addiction back in the session and your passed an act that removed prior authorization requirements FOR MATC we went in implement that in our system so we're compliance with that we are not requiring PH for that treatment now with this rule does this to some clean up in our manuals to reflect those changes and make clear that product providers need to be following the guidelines that are set up by the federal government for use of those prescription medications we have some back and forth with CMS on the precise wording of it nothing substantive more just on the structure of it and some of the house worded we got that resolved CMS is now approved this and now Representative for your review I'll be happy to answer any questions. All right committee of any questions. Seeing none this rule stands review thank you thank members. Okay item H. department of health has a rule to present a number rules be overcome board. Please introduce yourself for the record. Thank you Mr chair members Chuck Thompson attorney with the Arkansas department of health. You may proceed members what you have before you are number of rules and they go through the consistent theme this is all all this is in compliance with acts by the twenty ninety General Assembly the vast majority of which are the red paste red tape occupational reduction axe those are specifically acts regarding reciprocity temporary licensure and ACT eight twenty which is military automatic licensure so the language is consistent throughout them so just so you're aware the lay midwives which is the first one on the agenda does have one other substantive change change represent burgers and ran a bill requiring hospitals to report lay midwife transfers to them accordingly and compliance with that act we have done promulgated a former trying to promulgate a form that the hospitals will use to To report this transfers so I'd be happy to take on any questions on the lay midwifery rules we did have one public comment it was not in regard to anything that we were changing and compliance with twenty nineteen acts it was regarding CP are acceptable CPR programs for instance it was a public comment from a individual in Oregon who represents a a company that that does CPR and safety programs across the country that are accepted by the national association for met lay midwifery and so we our doctors looked at it agreed that it is comparable to American red cross and other similar ones so we went ahead and and then accordance added language to assure that they could in fact blame mid wives could use this program for their certifications otherwise it is again those acts and also acts regarding the removal regulation we don't use word regulation anymore in Arkansas and Arkansas rules per per active twenty nineteen I'll be happy to take any questions on the lay midwifery rules. The questions from the committee. Seeing none this review you may proceed to Adam I thank you Mr chairman the the the next set of rules are all rules that are come from our environmental section and they are all in accordance with the requirements of this red tape occupational licensure acts ACT eight twenty ACT three fifty removing the word regulation there is one and the plumbing rules where we do add the definition of apprentice plumber but that is already contained in the acts that the clean up in compliance with Arkansas statute that that I definition already been in there and been in there for a while we just why we were doing why we were compliance with a twenty nineteen acts wanna make sure we're compliance with prior acts we added that in there the first one on your first one on your list is actually I believe on site wastewater again acts three fifty four twenty eight eight twenty ten eleven which are all at occupational red tape licensure reduction acts and be happy to take any questions on that set rules so this rule. Reduces the mayor the time of the requirements for obtaining a license is that. Check it out I mean I have one those licenses women rest your chairman all these the the language consistent through all for these rules in this the the language is a model language that was developed in consultation with the attorney general's office and also discussion with other executive branch attorney such as the department of labor so this language that you see is going to be consistent that you that that's already going through this body on some other rules and also from other agencies so these rules are all to make sure we're in compliance with those red tape production acts to ensure reciprocity to ensure those with substantially similar licenses good comments start working in Arkansas all right away for example somewhere in southwest Arkansas had a project and they needed to get qualified individuals there there was nobody local that person could at that substantially similar license from Texas could very quickly start working to get that project going so that's the whole idea behind most of those acts and that's what that's reflected in language in these rules thank you a. The questions that rule stands reviewed so move on to item J.. Thank you Mr chair item J. is plumbers the rules regarding plumbers it's it's title problem or license fees there's no license fee changes that has nothing to do with fees there's no fee change it is to do with again the licensure itself the Red tech red tape reduction rules reciprocity ACT eight twenty on medical licensure for military and their spouses who who are in Arkansas I'd be happy to take any questions. So you did have a public hearing on this did you get any comments I'm sorry I would know no comments and we back on these rules we kinda batch the public hearing because they're all the same the same Subject matter again that red tape reduction occupational licensure so we've got receive no public comments on any of these rules. Well it looks like on this when you have a public comment about. back flow testing repair technicians. I believe that was a question from BLR I am. Yeah I was. All right. Seeing no further questions this rule stands review. Move on the item K. K. again is rules regarding septic tank leaders again you have the red tape occupational like Senator reduction group acts acts three fifteen axe eight twenty for automatic licensure be happy to take any questions one noticed on this you had a public meeting. And there were a number of comments in one of these came from my district We're talks about grease traps. it and and then the second one there Talk about septic tank the the markings on. vehicles I believe For those those were outside of the rule is the way I read your answers to this I believe yes that was outside of what we were doing they were comments on our substantive rules that are already in effect and not the amendments I have Terry Paul here with our environmental section I can have him come up and talk more yes we all went on like to know with these comments were dressed by other sent to the appropriate agency. Please identify yourself for the record. Hi Terry Paul the environment health branch she for the part of health yeah I do remember getting a question or two along that line grease traps and grease trap waste is actually under eighty Hughes regulation sometimes septic tank cleaners or pumpers also point grease traps and so it makes it a little bit weird for all of us but those grease traps a have a different disposal site or different treatment site then we do it's all terrain E. Q. septic tank clippers typically either take to a wastewater treatment plant somewhere or there might be occasions of for land application sites but for the most part when you talked about your district I can't remember what the come the of comment while us but I do know that I directed the commenters to either AT queue or I think there was a comment about Where you can dispose of grease trap way yes that's the other question was Ninety degree straps within cricket county I guess within that district and there's no disposal within the district they have taken outside of the district that was the question correct and and that's you know some wastewater treatment plants will treat grease laden waste about most do not because it's a it's detrimental to their treatments game so they then sometimes have to go to larger cities to dispose of that now I believe AT few does have sites that are some grease trap pumpers to have made application sites but Greece is a little harder to break down so you have to have a lot of property and a lot of things that you have to meet through eighty Q. to do that okay of the second comment I was interested in because it had to do with record keeping and it talked about the requirements of the record keeping and how that was burdensome I'm not sure what areas came from but yeah it did that A had requirements sword did just not change that in the current book in the current rule it says that septic tank poppers are to recall are required to have a bound book obviously that's a fairly old old regulation and we have worked with some entities or they want to do it by computer and by other means so we don't. Hold on to that is quickly this is and we I believe I did reply to that gentleman as well that we have other methods that we could help them with and and it's a rule that does need updating there's no doubt so that would require legislation to do that above it would yes it would well back addition it would require some changes I'm I'm not sure of it require legislation but yes. Thank you. do you have a question here. Senator hammer you're recognized thank you Mr chair one of things that with one of the hollers at that I deal with this the bill to to find a location that will take it because of the content and mix in like with city municipality systems and then eighty two goes out and things on there trying to lay it back on the septic tank callers is that still an ongoing problem or do you know has it started resolving itself through the rules a regular in place. I thank I do believe it's probably an ongoing issue I haven't heard anything about it lately a lot of times they will either the health find in and take it to the proper entity and in the in the Pulaski County areas that's at I've got some engineers here but the since we don't deal with that aspect of it that much is really up to the treatment scheme of the treatment facility where they can handle that waste and and like I said I'm not a hundred percent sure on that I had asked AT Q. them. As per my concern is that if it keeps going the direction it's going where the septic tank callers can be able to take it because they get charged if they can find place did not but they're getting charged pretty good place peace to dump it and I wonder view are you guys talking about any long term plans to help. You know address that issue so that five ten years out we're not having people don't put on side road or not be able to find it at all sure that's a concern for all of us and we have had some I have had a few talks with people AT Q. about some of these issues and it's it's confusing because you can do some land application you can do you can't do that some things land application wise and most land applique mention permits are two eighty Q. as I think which discussions today so uh there's a lot of things that could be improved with this sure are will follow up on that thank you Mr. I see no further questions is rules review thank you. let's see moving on to. We had an email. Thank you Mr chair item L. is the rules pertaining to walk up or water operator licensing it's in compliance act acts three fifty four twenty six eight twenty nine ninety and ten eleven those are right red tape reduction licensing act and also acts three fifteen is to remove the word regulation we don't use that word anymore I'll be happy to take any questions. Any questions from the committee. Seeing none this rule stands review. Thank you thank you. Alright moving on item AM we have to interim study proposals to be presented for acceptance by the committee. The first one is interim study Bozell twenty nineteen one fifty nine by Representative Pilkington. Is Representative Pilkington here. Senator Davis did you want to present this nine. Please identify yourself for the record we know who you are but we need to be on record thank you I'm and state senator Brianne Davis you may proceed thank you Mr chair members of the committee and FOR let me present today this is the interim study and that and would allow pharmacists to at prescribe birth control. And it would only apply to those eighteen years and older. And that they would have to see a and primary care physician and or a gynecologist within six months of the pharmacist would not allowed would not be allowed to prescribe birth control for longer than a six month period of time before the patient had to see a doctor and some things I just want to point out is that there are several states hue and have allowed pharmacist prescriber control and they've all seen a decline in their teen pregnancy rates includes California Colorado Maryland Oregon and Washington and in Arkansas based on twenty fourteen data which is the most recent data I can find a couple months ago and we had almost eighteen thousand unwanted pregnancies in our state that's approximately thirty six percent of all teen a teen pregnancies in Arkansas. And based on the number of abortions that were performed that year you can conservatively say that twenty five percent of unwanted pregnancies were terminated a human life was ended. It's studies project that seven to twenty five percent and if studies project that this policy and would result in seven to twenty five percent fewer unwanted pregnancies because of this then that would be a reduction of somewhere between three hundred and thirteen and one thousand one hundred and eighteen abortions a year in Arkansas. We are one of the top two states in the nation in regards to pro life being a pro life state and based on the legislation that we passed but the truth is we have the highest birth rate for eighteen and nineteen year olds in the nation. In twenty fifteen Arkansas had seventy two point four births among eighteen and nineteen year olds per one thousand people. The US average was forty point seven. At some point we have to ask ourselves if our policies are working. If one of our goals is to reduce abortions in the state of Arkansas then we have to look at the data to see if the policies we have in place are making a difference. And if not we need to study new policies see what their effectiveness is in other states and see what we can do different. So I ask all of you today to please consider voting for passing this interim study proposal so that we can look at other ways to help make Arkansas not just be a pro life state in terms of bills that we've passed but in our actions in our policies and things that we can do to help women and eighteen and nineteen year olds hue and are getting pregnant and and not knowing what to do in a scary place such after you guys please consider this proposal and and look for ways new ways to help us reduce abortions in the state of Arkansas answer any questions. I have a question Senator hammer you're recognized. Thank you Mr chair and I think it's addressed on the last page regarding those that are this this would only be. Allowable to those that are eighteen years old and older is that correct yes Sir. Okay and then with regards to who holds the liability in the event that the pharmacist prescribes something medically happens to the individual associated. With the contraceptive that is prescribed is it going to fall on the pharmacist or is it going to fall on the PC P. who last saw all the individual and I don't have the answer that and fortunately present evidence not here but I do see that that pharmacists would have to go through training and and that would all be and fall under that state board of pharmacy and so that would be my best guess but I'm not in the we're not the guessing business right now set at a let him answer that question when he's here okay that's fine and and when I'm just concerned about the liability to make sure that the consumer is not caught in a argument between two provider groups if something goes south that affection medically and I wonder what that can do to the pharmacies liability cost if that's gonna be assigned to them so maybe for we get for and we could find that out yeah and certainly we can make note of that and and mix that in with the study and make sure we have answers to those questions are thank you thank you Mr. Any other questions from the committee. Seeing none to have motion. I have a motion to adopt in a second. In discussion. Seeing. Of Mr Representative did you have a discussion or just the second okay. Second is seeing no further discussion all in favor of the motion signify by saying aye. All opposed nay. Motion carries thank you senator thank you thank you committee. All right we have one other I. S. P. M. study proposal by Representative on. And I think this is an ACT to create less the city mental behavioral health. Of Representative gray was going to present this I don't see her here. So I guess we'll we'll move this to the next agenda later later meeting then. Carried over next meeting all right seeing no further business this meeting is adjourned.