House Public Health, Welfare And Labor Committee
Video
Transcript
Bills discussed (11)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
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HB1874
· 3 mentions in chapter, transcript
Matched: “HB1874”
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Pre-2017 bill | ||
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HB1930
· 2 mentions in chapter, transcript
Matched: “HB1930”
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Pre-2017 bill | ||
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HB1959
· 2 mentions in chapter, transcript
Matched: “HB1959”
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Pre-2017 bill | ||
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HB1011
· 1 mention in transcript
Matched: “…t, I'm kind of winging it here, but I will tell you that on House Bill 1011, there are potentially some conflicts on the rules I need t…”
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Pre-2017 bill | ||
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HB1038
· 1 mention in transcript
Matched: “…is bill set for special order on this Thursday, March 14th, House Bill 1038. Also, House Bill 1568 is set for special order on March 19…”
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Pre-2017 bill | ||
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HB1568
· 1 mention in transcript
Matched: “…order on this Thursday, March 14th, House Bill 1038. Also, House Bill 1568 is set for special order on March 19th.”
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Pre-2017 bill | ||
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HB1791
· 1 mention in chapter
Matched: “HB1791”
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Pre-2017 bill | ||
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HB2033
· 1 mention in chapter
Matched: “HB2033”
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Pre-2017 bill | ||
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HB2049
· 1 mention in chapter
Matched: “HB2049”
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Pre-2017 bill | ||
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SB482
· 1 mention in chapter
Matched: “SB482”
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Pre-2017 bill | ||
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SB790
· 1 mention in chapter
Matched: “SB790”
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Pre-2017 bill |
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Okay, we're going to go and get started. I'm going to do the housekeeping items first. If everybody go ahead and grab your seat and turn
your phones on silent and stop talking, we'll get started. A
couple special orders to note, Representative Althus has his bill set for special order on this Thursday, March 14th, House Bill 1038. Also, House Bill 1568 is set for special order on March 19th.
And then we have several special orders on March 21st. Is Representative Altus in the room? OK. I will tell you just, I'm kind of winging it here, but I will tell you that on House Bill 1011, there are potentially some conflicts on the rules I need to visit with Representative Altus about today, but if there's a challenge to that bill not being filed in a proper fashion, it will go to the Rules Committee.
So that special order may end up not occurring, but just a note for the committee, I'm probably a little bit ahead of myself, but I think it probably is in violation of some of our filing rules. So just a note, I'm ahead of myself, but I'm going to visit with Representative Altus about that today. Also, a reminder that now that the bill filing deadline has passed, we're going to get pretty serious about dropping bills off the active calendar and down to the deferred, so we'll probably start that process on Thursday.
So if you have a bill that's been on that calendar for more than a week and you wish to run it in the next two meetings, we'll leave it on there. Otherwise, just consider it going. Consider it gone. It's going to deferred. We've got a few members here to run bills. No special orders today, but a couple other notes before we get into the bill presentations. The UAMS and Harding Colleges of Pharmacy are here today, and they're doing a health
screening in the Rotunda. Let's see. Is it 9 a.m. to noon? 9 a.m. to noon today. You can get all your stuff checked. We did this back in the most of your stuff check. We did this earlier in the year. My blood pressure was only about 10 points up on both ends. I'm going to go get it checked here in a little bit and see. After the meeting may be a bad idea. But nonetheless, they'll do all the normal screenings. It's going to be 9 a.m. to noon. We do have a few pharmacy students here in the committee today. So welcome very much, or welcome to the committee.
Hope you enjoy it and your day at the Capitol. And thank you to the Pharmacy Association for having them. Also, actually, I think that's it. So we're going to start running bills. Representative Baltz, you in the room? Yes, sir. Members, I've kind of got an assessment of who's here to run bills, and without objection, I'm just going to recognize them to run their bills, the ones
that are here, since they are here. Representative Baltz, you're recognized to present HB 1930, please.
Thank you, Mr. Chair and Committee. I'd like to ask Cora Gentry with the Arkansas State Police to join me, please. This bill was brought to me by the Arkansas State Police concerning fireworks, and I'll turn it over to Ms. Gentry to explain the
Speaker 7
3:39
bill. Thank you. I'm Lieutenant Cora Gentry. I'm with the Arkansas State Police. If many of
Speaker 8
3:43
you remember last summer when we had the problem with July the 4th whether we're going to have firework shows or not, how dry it was.
One of the main things this bill does, there is a product out there where you are creating a lit candle that has a small element of fuel in it, and you're letting it go in the air. It's called a sky lantern. We are outlawing those. So the rest of the things are changes in the definitions to clarify
any questions thank you for the presentation Miss
Gentry I was could you I was kind of I was reading through the agenda so one year I was at a New Year's Eve celebration and they had those balloons that they lit up and sent off the balcony I think it was actually a well It was at a hotel here in Little Rock. Is that what
Speaker 8
4:48
this is meant to address? Yes. That specifically? That specifically. It is an unmanned hot air balloon with fuel that can come down anywhere and either burn the little nice thing that's on the top of it
or if there's fuel left, burn whatever it hits the top of a tree, a corn
field. What normally happens in that? Has there been an incident where it actually, the fuel fell and caused a fire
Speaker 8
5:13
or damage? that not not to have been reported to state police but this is an
issue period so representative vaults in my previous life i was a fire
Representative Andy Mayberry
Unverified
5:26
chief and we have had issues with those yes we have okay uh what yeah um representative
mayberry you're recognized for a question thank you
Representative Andy Mayberry
Unverified
5:36
Is this a ban ongoing, a permanent, or is it just during burn ban times or specific?
It's ongoing. So this is permanently done away with. That's correct. How long have these particular fireworks been in use, or do you have an idea? I mean, is this something that's just come about in the last couple of years? It is just something that's come about
in the last couple years, and, you know, when you have a lit object like that and you turn it loose, it lands on top of somebody's house or something, you have issues with it, you know.
Representative Andy Mayberry
Unverified
6:16
Are these particular types of fireworks, some that are traditionally used in large
fireworks displays that are put on by communities or? No, those fireworks, you have
to have permits for them, and they're a different class. You have to have permits through the state police. These are just individuals can buy these. I have visited with the sellers up in Randolph County, and they don't have a problem with banning these. They don't sell that many of them.
Representative Ward
Unverified
6:48
Okay. You finished, Representative Mayberry? Okay, Representative Malone. thank you
Representative Stephanie Malone
Unverified
7:02
Mr. Chairman along the same lines of Representative Burris' question is this like paper lanterns as well so isn't there a big festival I saw a billboard in Little Rock for the paper lantern festival is that
Speaker 14
7:15
the same unmanned free floating devices
okay if it's on the ground, no, this isn't covered Okay,
okay. Thank you. Did you say it was a floating
Representative Stephanie Malone
Unverified
7:30
lantern though? Releasing paper lanterns. I mean, some places do that. Like, for instance, if I were to ever get married, I would want to do that at my wedding, but that's
Speaker 14
7:41
a long shot there, period. Just questioning. Just checking. Well, I think if you had maybe a destination wedding
and. So just to be clear, though, it would be covered under this bill, right? That would be prohibited.
Speaker 8
7:52
free-floating unmanned lanterns so yes not yes okay yes yeah and and most of the time they are used in celebrations that I guess balloons weren't good enough anymore that used to they just released balloons or birds or whatever that now it's sky lanterns well sky lanterns pose a little bit more of a fire hazard than balloons
any other questions from the committee okay is
everybody in the audience that would like to speak for or against what's the pleasure of the committee representative Hank Wilkins makes a motion do pass any discussion on the motion not all in favor say aye any opposed now I just have it congratulations you
passed your bill thank you mr. chair and committee next representative Gillum you
in the right all right you're recognized to present house bill 1874 thank you mr. chair thank you committee
Representative Jeremy Gillam
Unverified
9:03
we thought this was going to a different committee so I apologize that I've not I had a chance to talk to many of you about this bill, so I'm going to try to be as brief as I can, but also clarify the bill as much as possible as well. What you have before you is House Bill 1874, and basically it's to create the offense of insurance fraud by a procurer or a runner, as they're commonly referred to in the medical and legal industries.
And it does not, let me clarify this, It does not outlaw the use of the procurers. You can still, if you are a lawyer or a doctor, you can still hire somebody to go out and solicit business. That part is not being outlawed. What we are trying to address here is the fraud that is occurring from the procurer. When they are, after an accident, many times what will happen is if Representative Meeks is in an accident, he'll get a phone call within 24 hours from somebody who says,
hey, we've got a doctor's appointment set up for you with a chiropractor or somebody, and, you know, don't worry about it. The insurance company is aware of it. They're all good. Everything is good. So you go to the doctor's appointment thinking that it's an official appointment and everything. Meanwhile, the insurance company gets billed for this, and they assume that you actually set the appointment up and everything. So what we're trying to address is the fraud that's actually taking place by this bill. and the chiropractors are also in this bill with some extra authority from
their board to internally regulate and police this among their membership as well so they they're very much in favor of this this bill so basically that's the bill in a nutshell I'll take any questions if you
have any members any questions excellent presentation representative Gillum thank see no questions anybody in the audience like to speak for against not what's the pleasure of the committee motion
do pass all in favor say aye any opposed
Representative Andy Mayberry
Unverified
11:11
congratulations you've passed your bill thank you mr. chair thank you committee
y'all have a good day representative Scott are you here okay Representative House House bill 1959 you're recognized
Representative Douglas House
Unverified
11:35
to present Thank You mr. Chairman ladies and gentlemen of the committee a Constituent contacted me and asked me to run this bill. It's been passed by several other states in a little varied form I
Looked at the the bill that she presented to me 1959 and toned it down a little bit because the one in other states has some criminal penalties that I felt like were a bit inappropriate. What this bill addresses is a very discomforting and sometimes horrible physical condition called inflammatory bowel disease. Dwight D. Eisenhower suffered from a disease called Crohn's, C-R-H-O-N-S,
And there are other inflammatory bowel diseases such as iliitis, colitis, diverticulitis, ulcerative colitis, granulomas colitis, iliitis. These diseases require a person to find a bathroom very, very quickly or otherwise very unpleasant consequences result. It is especially devastating for a child who must find a bathroom very quickly because of their lack of control.
A lot of retail businesses don't offer public restrooms. And what doctors and the doctors are doing now are issuing identification cards and says, please allow this person to use your restroom. Now, I have a daughter in the jewelry business, and they keep jewelry in the back of their store. They don't have a public restroom. It's a store in a strip mall. My son's in the gun business, has an indoor shooting range. He does have a public restroom.
But in both instances, they can't allow people to come back in the back of their store for security, safety, insurance, other concerns. so I told this bill down quite a bit and ask it asks the cities and the counties if they issue business permits to put something in their code to put this language into their code asking their businesses to give fair warning to people either they don't have a public restroom available which will allow
someone to see a sign at the front door no public restrooms available or make their public make their employee restrooms available to someone that has one of these identification cards there's no penalty if they don't do it except such as maybe the cities might decide to impose but it it begins to bring awareness to these folks that there are a lot of people out there that have this particular problem a lot of city codes do require public restrooms
may be made available for members of the public but in some instances that's just not practical or possible so I present this filed this bill on behalf of my constituent who has a who has a child and oh by the way I have Crohn's disease and suffered from it since the 70s but as an adult you learn to live with it I'll take any questions thank you
for the presentation members any questions okay anybody in the audience would like to speak for or against
Representative Andy Mayberry
Unverified
15:05
representative Mayberry you're recognized for question thank you mr. chair with the eligible medical conditions on here and forgive me it may say this in the bill I may have just not seen it how would
Representative Douglas House
Unverified
15:24
a person identify themselves with one of conditions there are a couple of there are a couple of organizations and National Foundation for Elias and Colitis National Crohn's Disease Association and internal medicine doctors and I'm the name of the doctors
that work on your intestines gastroenterologists thank you gastroenterologists are familiar with this program and they they can get cards or they have cards or they can issue a letter and says, please allow this person to use your restroom. They have an inflammatory bowel disease that requires immediate relief. Something along those lines. So that's how they would do it. And these cards are readily available? Yes, sir. They are.
Representative Andy Mayberry
Unverified
16:07
I was just picturing a rather awkward conversation taking place in the middle of... It is awkward.
Representative Douglas House
Unverified
16:14
It is awkward. And the idea is that if the cities put this in their code and let their retail establishments know, it becomes less and less
Representative Andy Mayberry
Unverified
16:23
awkward over time. Is there any sort of fiscal
Representative Douglas House
Unverified
16:26
impact involved with this? I don't think so. I couldn't foresee any. It's a matter of cutting and pasting from the statute. You're talking about a dollar sign that says no public restrooms. And I left enough flexibility for a business just to say we're not going to do it for their own good reasons. If they'll just put a sign near the door down at the bottom, no restroom available.
Representative Andy Mayberry
Unverified
16:48
But there are some areas, some municipalities, where these retail establishments are required to have public restrooms. Is that correct? I think so. I've
Representative Douglas House
Unverified
16:58
seen a couple of codes over time, and if they are a large enough store, places like Kohl's or J.C. Penney's or Lowe's or Home Depot, yes, they do have public restrooms available. But little mom-and-pop shops out in a strip mall, they don't have those facilities as part of the building. They don't have to make any accommodations for the handicap other than what may be required by federal or state law now.
So I can't foresee any physical impact. Okay. Thank
Speaker 65
17:27
you. Yes, sir. Representative Meeks. Thank you, Mr. Chair. My question goes to, I guess, page 2, line 8. It says
Chair
Unverified
17:33
three or more employees of the retail establishment are working at the time the customer requests to use the employee restroom facility, is there a reason? I mean, I kind of have an idea about why that is, but can you explain why it mentions three or more employees?
Representative Douglas House
Unverified
17:48
The ability to escort that person to the back of the room, back of the building,
and still leave two people up front to watch the store is the way that this was originally drafted. If they don't have three, they don't have to comply. If they have 10 and
just don't want to comply, they don't have to comply. And then they would need to put the no
Speaker 69
18:09
public rest room or whatever on the sign? And many stores do that now. Okay. All right.
Thank you, Mr. Chair. Members, any other questions? If not, anybody in the audience?
Well, okay. Representative Mayberry, you will be recognized for a
Representative Andy Mayberry
Unverified
18:36
question. Thank you, Mr. Chair. A few
months back I was dealing with some different issues regarding restrooms and with handicap access, family restrooms as well, and some different things. And that's part of why I was asking you with regards to certain cities having requirements
for each retail location. But if I recall correctly, and I think this is the case, that the state
plumbing code does require all public businesses, I think perhaps all public businesses, to have a public restroom available for use, including, you know, what you were talking about with the mom and pop. Well, maybe not everyone follows that, perhaps, but are you familiar with – in which
case, I don't think that this bill would necessarily be necessary.
Representative House, if it's okay with you, I might ask Mr. Breck with the Health Department to join us, because I think he can answer that question, unless you have an answer you're dying to give. My
Robert Breck
Unverified
19:54
answer is, I don't know. Okay. Thank you, Mr. Chair. My name is Robert Breck with the Arkansas Department of Health. There is a provision in the state plumbing code that's been somewhat controversial at times. It does require all businesses to make restrooms available to patrons or anybody who comes in.
It's been somewhat controversial because you do have some older businesses, some mom and pops, that aren't set up for that. And so we don't enforce that 100% of the time. For instance, if there's a security
issue where the only bathroom is through the office where they count the money or where they keep valuables, we don't require, we don't enforce that 100 percent. But that rule went
into effect in the early 90s, and since then, all new commercial buildings have to have a plumbing plan review.
Those plans are reviewed to ensure that there are public restrooms that will be available in that business. And so for all of those businesses, we do enforce it because occasionally we'll have a convenience store that wants to close their restrooms because they're tired of maintaining them or cleaning them. It's just it becomes troublesome for them. We do require them to open those back up. And so there is a statewide requirement now in the plumbing code that
would require the use of the restrooms. And when you see signs in public places that say employee bathrooms only, that's really
not appropriate in my mind in my opinion thank
Representative Ward
Unverified
21:25
you mr. Breck represented may bear do you have any
Representative Andy Mayberry
Unverified
21:31
follow-up questions I don't I don't really have any follow-up questions I get well I guess I do representative house given what mr. Breck just testified to with regards to the Arkansas plumbing code do you feel like there is a continued need
Representative Douglas House
Unverified
21:47
for this particular bill well my constituent does And my daughter's jewelry business, of course, they have employees' valuables in the back part of their shop.
Their building was built in the 1970s, and, of course, it wasn't subject to this particular requirement. New construction, that's true. My son's gun shop and shooting range, of course, has an indoor facility for handicapped male and female. again I think over time I believe it would by pushing this down to the city level let them just make it part of their code I think over time that it would perhaps relieve some problems in my daughter's case in her business next
door is the Department of Finance Administration driver's license and car tags and that sort of thing they do have a public restroom so they direct folks over there when it does
does occur okay thank you okay sir if you'd like to sign up you can sign up to speak for against the bill members any other questions okay so you can just go ahead and join us at the end of the table and if you'd
Jimmy Daly
Unverified
22:59
like to speak for against the bill my name is Jimmy Daly I'm with the Arkansas on-site wastewater Association and I'm really don't necessarily for or against I just want to inform you that this is correct and that there is some mostly regulations but I have friends that suffer from these type of problems and even though we have regulations believe it or not they're not really always enforced or people deal with them correctly I have seen numerous times
where the intent is to have facilities available and you walk in and it says bathrooms are non-functioning the public can't get in and the people are walking into the bathroom so I think maybe of an identification for the people that have this problem and that they get some kind of availability because I have friends that I have seen them walk out of places crying because of the problem grown men crying I think that maybe we ought to do something because quite honestly not
everybody out there in business is going to take care of their clients in the way that they should okay
thank you representative Wilkins you recognize for question I believe it's for you mr. Daly sorry
Representative Butch Wilkins
Unverified
24:21
if you mr. Daly a few of you say that we have the regulations
are true but they're not being enforced at this time how is this bill going to
Jimmy Daly
Unverified
24:33
change that I'm not sure that it will but maybe it's just something that will make the thank you owners cognizance of
Representative Douglas House
Unverified
24:40
the problem okay thank you thank you for your testimony mr. Wilkins if I could answer his last question this asks the cities to make this part of their municipal code and to inform their business licensees of this requirement whenever their licenses are issued or renewed. Okay.
Any other, anybody else in the audience speak for or against? Okay. If not, what's the pleasure of the committee?
Okay. Not hearing a motion? Your bill will stay on
Representative Douglas House
Unverified
25:21
the calendar. Thank you, Mr. Chairman. I thank you. My constituent thanks you for your consideration, and may I be excused? Yes,
sir. Thank you. Thank you. Next on the list, Representative Ward-Law, House Bill 2049, we recognize to
Representative Jeff Wardlaw
Unverified
25:55
present. Thank You mr. chair and committee house bill 2049 is a to remove a regulation for
TB test on students for massage therapy and I have with me today mr. Robert Breck from Health Department I'll let him explain a little further yes Robert Breck
Robert Breck
Unverified
26:15
with Health Department the department's been looking at different requirements for TB testing the state of Arkansas does much more testing than the surrounding states and probably any other any other state in the country we we've had a very good TB program however we we did take efforts to remove the
requirement for school teachers that that requirement is only for new school teachers when they start this is a similar type requirement they're only tested one time when they enter massage therapy school and we don't think that the science really dictates that they should be continued to be tested should it become a problem we
could still do it by rule okay thank you for the presentation members any questions representative Ward you're recognized
Speaker 100
27:03
for question how many cases of tuberculosis have you had in the last 12 months reported in the state of Arkansas I wish I
Robert Breck
Unverified
27:15
could answer that question definitively but I cannot I can tell you that what they look at typically are people who convert and that's when that's when they test people one year and they they test negative they test people the next year they test positive Those are the people that they really focus on because they, in that 12-month period, they have been subjected to tuberculosis.
For these people that are tested one time only when they enter school, it really doesn't help, and so we'd like to remove that requirement. But I can't tell you how many cases we've had in Arkansas, but Arkansas
has one of the lowest case rates in the nation. Thirty years ago, we
Speaker 103
27:56
were one of the highest. I do know that. The home health industry, the home health aides, I know that they are still required or will they be exempt from having to have this particular test?
Robert Breck
Unverified
28:11
Right now that is a requirement under
our rules, and I guess it's an interesting time to bring that up because Representative Branscombe has a bill that would eliminate that requirement. And I'd hope to talk to him privately about this, but I guess I'll
answer the question. There is a requirement under rule, and there is
a bill to remove that requirement. I can tell you that we would like to see the bill not run with a commitment that we would do it by rule.
Our main concern is with teachers and with these massage therapists, if there becomes a problem in those industries, we could reinstate that by rule. When you pass a law that would prohibit the testing of a certain group, we couldn't do that by rule should it become necessary. So the question, the answer is right now they are currently required under the Board of Health rules. We don't think that, we think that many of those groups can be excluded by rule.
Chair
Unverified
29:14
Thanks, Mr. Speaker. Thank you. Representative Meeks. Thank you, Mr. Chair. And when you're talking about reinstating it by rule, the legislature would still have to go back over that rule and would actually have to
Robert Breck
Unverified
29:28
pass it or allow it to happen? Absolutely. We'd have to follow the Administrative Procedure Act. We'd have to have public comment, period. It'd have to be all the Board of Health rules have to be reviewed by this committee and the Rules Committee, the Rules Subcommittee of Legislative Counsel. Okay. So we would
Chair
Unverified
29:42
still basically, I mean, I guess my point is that we would still, the legislature
would still have oversight on that. Absolutely. Absolutely. Thank you, Mr. Chair.
Representative Ward
Unverified
29:57
thank you any other questions okay anybody in the audience like to speak for or against okay representative wardlaw you want to close or say anything else uh i
guess i'll make a motion do pass okay um any discussion on the motion all in favor say i'm any opposed okay
congratulations you passed your bill i'm gonna well let me i thought
Is there any other member here to run a bill? Representative Ferguson? Okay. What bill number? Well, if you'll join us at the end of the table, tell us the bill number. Three bills. All right. And Representative Scott is on her way to run a bill is why I was – Okay. I can let her do it. Well, no, I'm glad you're here to take up some time until she gets here. So if you'll tell us the bill numbers,
Representative Deborah Ferguson
Unverified
30:47
you'll be recognized to present. Okay. Thank you, Mr. Chairman. This bill is Senate Bill 482, and
it's an act to reinstate the minimum qualifications of the director of the Department of Health.
And this bill is necessary to reinstate the minimum qualifications for any future director of the Department of Health. From the creation of the Board of Health in 1913 until 2005, when the department was merged with DHS, so in 05, DHS and the Department of Health merged for DHHS, and the director up until that time was the licensed MD.
Then they merged and became DHHS, and then in 07, they split back apart. so now we need to create the minimum requirements for the director since the Department of Health is no longer part of DHS the current board request by the Board of Health would have the minimum qualification set as a licensed medical doctor with public health experience or a person with a doctorate in public health regardless of the minimum qualifications the director would serve it the pleasure of the governor and you know I'm open for questions okay we're
Representative Andy Mayberry
Unverified
32:08
gonna pause just for a moment because there's a couple members
had a little trouble finding it on the agenda representative
Chair
Unverified
32:18
meets you're recognized for a question thank you mr. chair is our current director of the
Representative Stephen Meeks
Unverified
32:27
Department Health meets these qualifications? Thank you.
Robert Breck
Unverified
32:34
Robert Brooke with the Health Department again.
Yes, actually he does have a doctorate in public health. And this actually, this went into motion last summer, but by coincidence, no conspiracy here, Dr. Halverson is leaving the department effective I believe May the 5th. And so it does have some more importance now. But, yes, he did have a doctorate in public health, and that's why that qualification was put into the bill. Okay. Thank you.
Members, any other questions? Okay. Anybody in the audience would like to speak for or against the bill? I thought
about a joke. I'm not going to do
Speaker 120
33:28
it. Representative Branscombe, you're recognized for a question. Looking over the qualifications that we want to implement, what were the qualifications before this would be a peg effect? From
Robert Breck
Unverified
33:37
1913 to 2005, they had to be a licensed medical doctor.
That was the extent of the qualifications. Okay. That's correct. Thank you. Okay. Anybody in the audience like to speak for or against the bill? All right, motion do pass any discussion on the motion all in favor say
aye any opposed Congratulations, you passed your bill.
Representative Deborah Ferguson
Unverified
34:07
Thank you. Mr. Chairman Yes, maybe you can keep going I'll give you time this time Senate bill 790
Okay, is everybody there? An act
to improve the quality of health care to ensure that peer review committees for medical professional associations are afforded confidentiality and for other purposes. There is already in hospitals, they're a great are y'all ready in
hospitals just one second does
everybody have the bill pulled up
tell us the bill number again representative ferguson seven senate bill 790 sb 790 members who's the sponsor uh
Representative Deborah Ferguson
Unverified
35:06
senator bledsoe senator bledsoe okay um okay members everybody got it up Okay. You
can continue. Okay. In hospitals now, there are groups of doctors that get together to review charts and talk about patient care and possibly things that could have been done better and, you know,
maybe it would have been better to give this medicine or that. And those peer review committees now are protected from confidentiality from discovery and lawsuits. medical records, not everything else is certainly discoverable for malpractice, but it was felt that these peer review committees needed to be protected so that doctors would feel comfortable getting together and being helpful to each other in treatment of patients to improve the quality of the care of the patients.
As the medical profession has changed, you know, we no longer have many Dr. Welbys that are out in practice by themselves. We have big corporate medical groups, you know, with 40 or 50 doctors. So all this bill does, it affords that same peer review process to medical corporations and LLCs so that they're, when they get together as a group to do peer review of the patient chart that that's also protected from confidentiality. Vice Chair Murdoch, you're recognized for a question.
Speaker 128
36:23
Thank you, Chairman. Thank you, Representative Ferguson. How does this peer review waiver, how would that possibly affect investigation and discovery if there was something that so many times I guess in malpractice type suits, the inception, the original thinking, the consultation, those type of meetings, if you will, are very critical to the outcome of what happens with the patient.
And certainly peer review seems to me that that should still be available for that. So when you say confidentiality, you don't mean that it's not subject to law enforcement or lawyers having access to those conversations or meeting notes. I do mean that. That's what happens in hospitals today
Representative Deborah Ferguson
Unverified
37:16
because what they found was happening that when doctors gathered to talk about patient care they didn't feel comfortable in fact they didn't meet at all because they they knew if they said anything you know not critical but if they gave advice to
another doctor and it might be later part of the lawsuit then they were reluctant to be frank but the medical records are still part of the malpractice discovery process it's just these peer review meetings where they where doctors gather after rounds usually and talk about a patient and how care could be better. Like I
said, it's already done in hospitals, and the trial lawyers
Speaker 131
37:57
are okay with this, Phil. Right. Well, I'm speaking from another side
Speaker 128
38:05
of it probably because doctors practice medicine.
Right. And I'm sitting here today. I mean, I had no idea that you were going to bring this today, obviously, but today is an anniversary. It's my son's birthday. He would have been 21 today. as a result of some misfortune. It's very similar. You remind me of what happened to him when he was 16. And part of the discussion that went on was the early discussion, the consultation as the doctors practiced medicine. I would think that some of these conversations probably,
if, you know, if things happen in a different way, then it may be a different day today even. So I guess where I'm going with this is that this doesn't happen again. I would hate to, as you all practice, and I don't mean nobody mean to do anything wrong, but I think as long as we keep all of this under review and possibly a part of the process, then that holds us all accountable in your practice of medicine. Not intention, but practice. So why would we take this out?
Because it may be very critical that as you all get together as doctors in the early stages of consultation as you look at a patient and you discuss what's going on, that this just continues to be a part of the process to just make it all better. I understand protection of, I guess, doctors, but I'm also just looking at the other side of it and trying to make for better outcomes for the patient and families as
Representative Deborah Ferguson
Unverified
39:41
well. I'll let David Roden for the Medical Society address because he was involved with the process when it was approved for hospital
If you'll say your name and
Speaker 138
39:50
title for the record, you'll be recognized David Roden, I represent the Arkansas Medical Society I think that's a really good, valid question and I think Representative Ferguson addressed it early on but let me repeat what she said the information that is available today in a medical malpractice case or in any kind of investigation remains discoverable. None of that information is being protected or hidden or subject to non-disclosure. This only occurs, the peer review
protections that are in law now only occur when there is an organized committee that is set up specifically to review the quality of care for patients. It goes on in hospitals. It's both state and federally protected. It can go on in medical societies. The Arkansas Medical Society could set up a process with a committee to do this. With all of the changes in health care that we've seen, a lot of large clinics, particularly radiology groups,
are being required by federal accreditation standards to conduct peer review. But right now, you know, they're leery of doing that because, quite frankly, if they get together in an organized fashion to discuss cases, multiple cases, to measure the quality of care that they're providing to make sure they are doing the right thing, then, you know, none of that is protected. They can be sued by a physician that maybe is a physician in their clinic that they want to take action against.
They could be sued by that physician, all of that material. In other words, it's not being done because of this limit. So what we want to do is encourage these practices to form organized committees to do peer review to improve the quality of care. But all of the information from the very first time they see the patient, all of that information is in the medical record
Speaker 140
41:49
or supposed to be. And all of that continues to be subject to discovery. Whenever
Speaker 128
41:54
I do something that's subject to inspection or any kind of review, I tend to take what I say and do much more seriously.
Even if it's a matter of talking to colleagues about a bill or talking to one of my customers in my business, whenever something is under review or inspection, I think you would agree that we tend to take it seriously. So I just think the peer review, and especially in these particular cases where doctors are depending upon their peers, possibly to take that advice because of the experiences that they've had and using it in the care for people.
I just understand the protection that you're explaining that very well, how you're protecting the doctors. But because there's accountability for what they say in developing and the evolution of this care, I don't understand why you want to relax that. I don't understand why the doctor would not want to be a part of it. Maybe a doctor may choose not to be a part of peer review because of this. I can understand that. But I certainly cannot understand this being taken out in terms of accountability standards.
Representative Deborah Ferguson
Unverified
43:17
It should go with it, in my opinion. Well, I think I can address that. It's really about improving patient care and protecting patients because it's not being done now because it's not protected by confidentiality. So you have these doctor's groups not forming committees and getting together and discussing quality, but, you know, among themselves about patients because it's not protected. So when you allow that and you allow them to be very frank and open with their peers about, I think, you know, you should try this or do this with patient care, then you're actually improving patient care.
I mean, it's – it's just – it's not going to be – they're not going to do the peer review if they're
Speaker 142
44:02
not protected is the bottom line. Okay. Well, I'll yield the floor, but I
Representative Deborah Ferguson
Unverified
44:10
not having standards, but I understand. Well, like I
said, it's already – hospitals, it's routinely done. We're just asking that this be extended to, you know,
Representative Ward
Unverified
44:20
large corporate doctor groups. Okay. Representative Meeks, you have a question? No.
okay members any other questions representative okay anybody in the
audience like to speak for or against the bill okay if not representative Ward Law you recognize for motion okay any discussion on the motion if not all in favor say aye all opposed chair rules the ayes have it Thank you
Representative Ward
Unverified
44:45
Mr. Chairman and committee. Thank you. The next bill is House Bill
Unknown speaker
44:57
2033. Tuesday Okay, is everybody there?
An act to authorize. I'm sorry, give us one second. Mine's not pulling up, but I want to make sure that's isolated. Anybody else get in the blank grace there? Okay. From the tablet, not from the committee. Okay, go ahead. I think it's only a couple, so Representative Ferguson, you're
Representative Deborah Ferguson
Unverified
45:51
recognized. Go ahead and present. I'll get a copy. Okay. This is an act to authorize the Arkansas State Medical Board to issue unrestricted licenses to practice medicine to certain University of Arkansas for medical science faculty and
for other purposes. This is a bill that I worked on with the Medical Board and with UAMS. and a foreign medical graduate now, if they haven't done three years of post, they can go to a foreign medical school and then if they come to the United States and do a residency for three years, they can be licensed. But what they've run into, they have several doctors at UAMS
who have done all of their training in a foreign country. They graduated from, and there's an approved list of foreign medical schools. I might say that, you know, this isn't like you can just graduate from any foreign medical school. The state board has a list of approved foreign medical schools. So they've graduated from an approved foreign medical school. They've done their three years of, say, radiology in a foreign country. Then they've done a year of fellowship here, and they're hired by the,
They can teach at the university, like maybe teach in the radiology department, for instance. They've passed all of the boards, but there's no path for them to ever get their doctor's license to practice in the United States. So what this bill says that if they haven't done their three years of internship in the U.S., But if they have served three years as an intern or resident in a postgraduate medical
education program, in other words, if they've taught three years at the university, if they have passed their ECFMG, which is foreign medical exam, and they have gotten their board certification in their specialty, which is very important, it's very difficult to pass the medical board. So if they've received their board certification, then the board of medical examiners has agreed that that this would be another path to licensure any questions representative
Representative Justin T. Harris
Unverified
48:09
Harris you're recognized for a question thank you mr. chair and represented Ferguson you may have said it but just to
clarify do they have to practice
Representative Deborah Ferguson
Unverified
48:21
for three years before receiving unrestricted well they can't practice because they don't have a license but they have to teach at UAMS Yes. Okay. As, you know, as part
Representative Justin T. Harris
Unverified
48:31
of, that's part of their, instead of residency. Okay.
Well, I guess, let me rephrase the question then. When an intern practices, what I mean, under a licensed doctor, can, is that required?
Representative Deborah Ferguson
Unverified
48:43
Can they intern under, even though they... Well, they have to do a year of fellowship. That's what I'm... Right. Okay, that's because I'm not a doctor. They have to
do, but the old law said they also had to do three years of residency in the United States. We're substituting the three years of residency for teaching three years at the university. Okay, so instead of? Instead of doing three years of residency. They've already done a residency in a foreign country. But instead of requiring them to do three years of residency in the United States, then we're substituting that they can use those three years they taught at UAMS as that requirement.
Representative Justin T. Harris
Unverified
49:16
Okay, so you answered my question. They don't have to do residency in the United States. Right. Okay. But they have to
Representative Deborah Ferguson
Unverified
49:22
teach at UAMS for those three years. Okay. Right.
Representative Justin T. Harris
Unverified
49:24
but not residency okay thank you thank you representative malone
Representative Stephanie Malone
Unverified
49:30
thank you mr chair uh representative ferguson real quickly on um when when the license is issued did they say how quick the turnaround time would be uh i'm not sure
Representative Deborah Ferguson
Unverified
49:43
what you're asking i guess my question is um
Representative Stephanie Malone
Unverified
49:48
the the turnaround time and this comes from doctors back home is that it takes so long to to get your license in the state of arkansas usually up to a year so i'm
Representative Deborah Ferguson
Unverified
49:59
just curious if if they gave a time frame on this one they didn't but i'm sure it'd be at the discretion of the medical board they would have passed all the like i said all of the not only undergraduate board exams but also their specialty board certification but yeah i'm not sure that i would have to ask the
Speaker 103
50:19
the medical board okay okay thank you representative word Ferguson earlier you mentioned that there was a list of foreign countries that you will accept these medical students from how is that list compiled who actually compiled that list these students from whatever you may select and all. How do they
actually go about selecting that list that those particular persons can participate in
Representative Deborah Ferguson
Unverified
50:56
the program? He's asking the list of foreign medical schools that are approved by the state
medical board. Where does that? Several states use the same list but I'm
Speaker 138
51:08
not sure where it comes from. I'm not sure. The key to this bill my understanding and we've been involved just kind of on the periphery of this These physicians are granted educational license today.
So the medical board has certain requirements that they have to meet in order to get the educational license. And what this bill would do would be provide a pathway for those people who, once they obtain the educational license, which already means they've met certain qualifications, they come here and meet more qualifications that are provided for either in the bill or through the board. And then at that point, they could apply for a regular license to practice. And I know someone told me one time, you know, we trust these.
These are very good to high-qualified physicians. We trust them to train our medical students and residents. They're already well-qualified enough. And it's just that they didn't meet. You know, we've got the United States has certain requirements that you have to meet when you come from another country. And they don't meet every single one of them. but many of them are already board-certified in this state or in this country. So that's really the gist here is just to provide a pathway. We'd have to get someone from the medical board over here to answer very detailed questions.
Speaker 103
52:25
That's over my pay grade. Well, what I was more or less getting at, like if you had a physician that wanted to come to this country, let's just say he was from Ghana or somewhere like that, and he has finished the criteria to be a medical doctor there, and all, and what kind of work or what kind of application would he have to do whether or not that he's on that list to be approved to
Speaker 165
52:50
actually to come? That really, if he is a medical doctor in another country,
Speaker 138
52:56
that's a question for the medical board. I don't know what, I don't think either one of us know what those criteria are, but they do have some very strenuous criteria. you yeah
Representative Deborah Ferguson
Unverified
53:09
I mean any you know if you feel more comfortable I can get Bill Trice as the attorney for the Medical Board to come but they do I know there is a approved list they don't accept graduate they
Speaker 168
53:21
don't they won't license people from just any foreign medical school thank you representative hammer
Representative Kim Hammer
Unverified
53:27
thank you mr. chair I was just curious I may have missed a while ago when they come in and they are going to enroll our school do you give any kind of a a test to determine that what they're bringing with them from a foreign country is at least an equal starting point comparable to somebody else who maybe has gone through the U.S. system to that point, so there's an equal comparison. Right. Like I said, they
Representative Deborah Ferguson
Unverified
53:52
have to come from an approved foreign school with the same curriculum that the U.S. would have, and they have to pass
the ECFMG, which is the same as our Step 1, 2, and 3 of the medical boards. So
Representative Kim Hammer
Unverified
54:02
no matter where they come from in the U.S., outside the U.S., there is a point of reference at which they all have to equal up or come up to the bar and then moving forward, which is what you're trying to do with the bill, is allow them to move forward, but it's after there's been a filtering process. Right. Okay. Thank you. Thank you, Mr.
Chair. Thank you. Any other questions from the committee? Anybody in the audience would like to speak for or against the bill?
If not, Representative Wardlaw, you're recognized for motion. Motion do pass. any discussion on the motion all in favor say aye any opposed congratulations you passed your bill thank you mr. chairman representative Scott you're recognized to present HB 1791 and members I believe
this is going to be our last bill for the day unless somebody else comes in
Representative Sue Scott
Unverified
55:09
desiring to run thank you mr. chairman thank you committee you all are in luck today I'm also presenting in judiciary so I'm gonna hurry right through this this little old bill here of mine is such a simple one the purpose of this bill is to require revocation of the license of a health care provider who has been convicted of a sex crime and to ensure the safety of patients of health care
providers by requiring criminal background checks at least once every five years I'll take any questions members it's
HB 1791 pull it up on your tablet representative Malone you're recognized
for a question I didn't
Representative Stephanie Malone
Unverified
55:52
have one but does it I do I will ask one since I've been recognized and does this
Speaker 157
56:02
not do the Medical Board do they not already have that this
Representative Stephanie Malone
Unverified
56:08
is done I know by the Medical Board they take people's
Representative Sue Scott
Unverified
56:15
license away correct that's correct so this is you this encompasses all health care workers
workers yes okay vice chair Murdoch you're
Speaker 127
56:28
recognized for a question okay that representative Malone got
Speaker 128
56:31
my first question about the duplicating of this and you say all
all health care workers. Now, that's a broad stroke. Yes, it is. And so let's talk about that a little bit then because it's not defined clearly as what health care workers, when you say all, who that defines and who that excludes. And let's go through a scenario. Someone commits a crime of this nature, serve their sentence, whatever it is, so they're done and they're starting their life over. They want to be, they're
rehabilitated, which is what this system's supposed to do. And they need a job and they have some certification in this area. You're saying they're never to
Representative Sue Scott
Unverified
57:20
work again? It is my opinion that if someone commits a sex crime, they should never be working in the health care profession ever. Representative Hammer.
Representative Kim Hammer
Unverified
57:40
Just for a point of reference, health care workers could be like a dental hygienist, it could be a school nurse, it could be a CNA at the nursing home, it is a top to bottom across-the-board application. Is that your intent of the bill? That's correct. Okay. And if somebody already had a conviction and then they got in the health care,
were they already, was it already going to be difficult the way the laws are currently written to prohibit them from getting involved in the health care industry, or will this be the bill that will help preclude them from being able to get into the health care? I hope this
Representative Sue Scott
Unverified
58:29
would be the bill that would preclude them because I don't know about you, Representative Hammer, but I sure want to go into any health care facility I go into or that any of my family go into, and I know for sure that I am not being examined
or they are not being examined by someone who has committed the crime of sexual abuse against anyone. And to my point, as
Representative Kim Hammer
Unverified
58:54
it is right now, if somebody is convicted of a crime, there is nothing that's stopping them if they decide that they want to enter the health care field. There's no law that would stop them or prevent them from doing that if they went out and got certified or qualified in that particular area. That's what this bill would help achieve. Exactly.
Okay. Thank you. Thank you. Just to be clear, you're requiring background checks for every health care worker? Yes, every five years. Okay. Who, I assume, the worker pays for the background check themselves? Yes. Or does
Representative Sue Scott
Unverified
59:34
the board? That background check is going to be a very nominal fee, something like $15. And then they
present it to the medical board? That's what
I've understood. I've just got a few questions on the process because I mean that the simplest
way to do it if you're to accomplish it I would I would think is maybe to require the Medical Board to do background checks and everybody they license but
Representative Sue Scott
Unverified
1:00:02
I don't think they're gonna be willing to do that mr. speaker I would have
Representative Ward
Unverified
1:00:08
thought they already did you know this surprised me okay we're gonna to get to questions.
Ferguson, okay. Yeah, I might come back to the process because I think there's probably some pretty legitimate questions on how this would operate. The Medical Society is still
here. Is that right? Okay. We'll get around to that in a little bit. Representative Scott, I'm going to make a little bit of an executive decision. I think you've got a bill to run in judiciary, I think. Is that right that's correct I'm gonna go out on a limb and say I don't think there's any way we're gonna pass this out of here today okay there's probably a lot of questions okay are you comfortable with me asking you to pull that down and let's get some questions answered in private and with other
groups and if you choose to
Representative Sue Scott
Unverified
1:00:58
run it again we can may I make a comment yes ma'am you all passed it when it was the chiropractor bill number 1356 this is the same basic bill just with more wording on it to encompass everyone and you know if we cannot take care of just making sure all chiropractors do isn't this a greater bill to encompass everyone
i am anti-sex offender um i just i think we've got i think we've got some questions
so i will defer to the sponsor but i i can just tell you the way it's going to go if we keep going Okay. Thank you. Okay. Let's get some questions answered and
then maybe come back and address it again. Thank you, Mr. Chair. Okay.
Speaker 65
1:01:46
Thank you. Representative Meeks. Thank you, Mr. Chair. I just did a quick look at... I'm sorry, did
Speaker 192
1:01:54
she... Were we done with the bill? Oh, I'm sorry.
that that's what i get for looking at my computer screen and getting
Chair
Unverified
1:02:06
yeah well you know representative burris uh no i wasn't quick enough i was gonna ask her
Representative Andy Mayberry
Unverified
1:02:11
okay anyway um okay representative hammer you had a bill that you want to set for special order
Speaker 185
1:02:20
i would like to request special order for the pulse ox bill
Representative Kim Hammer
Unverified
1:02:24
for thursday please We have some witnesses coming in.
Representative Andy Mayberry
Unverified
1:02:28
Oh, yeah, Representative Meeks, your face was clueless. I'll have to look at that on the camera. Yeah. What was the date again, Representative Hammer? Thursday, please, sir. Thursday. Okay. We do have a
special order set for HB 1038 that day, but without objection, we'll go ahead and set another special order. Tell me the bill number again. I'm sorry. I'm sitting next to Mr. Meeks.
Speaker 185
1:02:51
I do not know the House bill number. I'm sorry. I'm going to have to look and see.
Representative Ward
Unverified
1:03:01
Okay. 1468. 1468 out of the bleachers. Thank you. HB 1468 will set for special order
on Thursday. Any other business to come before the committee? Yes, Mr. This is public health. This is public health. Yes, sir. Just kidding. You're recognized. I
Chair
Unverified
1:03:20
would like to put my health care conscience bill in the interim study. It's House Bill
Representative Ward
Unverified
1:03:29
1898. Okay. With that objection, we'll move HB 1898 to –
Okay. He's going to have to put an interim study on the floor. We'll move it off the active calendar. Representative Meeks, you'll have to put that in the interim study on the floor, but we'll remove it from the calendar, and then you can do that from the floor. Thank you, Mr. Chair. Thank you. Any other business to come before the committee? If not, we'll stand adjourned until 10 a.m. on Thursday.
Agenda
HB1930
HB1874
HB1959
HB2049
SB482
SB790
HB2033
HB1791
Documents
No documents posted.
Speakers
Representative John Burris Chair
Unverified
Representative Scott Baltz Chair
Unverified
Speaker 7
Speaker 8
Speaker 9
Representative Andy Mayberry
Unverified
Representative Ward
Unverified
Representative Stephanie Malone
Unverified
Speaker 14
Representative Jeremy Gillam
Unverified
Representative Douglas House
Unverified
Speaker 65
Chair
Unverified
Speaker 69
Robert Breck
Unverified
Jimmy Daly
Unverified
Representative Butch Wilkins
Unverified
Representative Jeff Wardlaw
Unverified
Speaker 100
Speaker 103
Representative Deborah Ferguson
Unverified
Representative Stephen Meeks
Unverified
Speaker 120
Speaker 128
Speaker 131
Speaker 138
Speaker 140
Speaker 142
Representative Justin T. Harris
Unverified
Speaker 165
Speaker 168
Representative Kim Hammer
Unverified
Representative Sue Scott
Unverified
Speaker 157
Speaker 127
Speaker 192
Speaker 17
Speaker 185