House Public Health, Welfare And Labor Committee
Video
Transcript
Bills discussed (7)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
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HB1197
· 2 mentions in chapter, transcript
Matched: “HB1197”
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Pre-2017 bill | ||
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HB1746
· 2 mentions in chapter, transcript
Matched: “HB1746”
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Pre-2017 bill | ||
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HB1186
· 1 mention in transcript
Matched: “…ithout objection I'm gonna move HB 1190 HB 1215 HB 1256 and HB 1186 to the deferred list they've been on for passed over severa…”
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Pre-2017 bill | ||
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HB1190
· 1 mention in transcript
Matched: “…y all right I'm gonna drop without objection I'm gonna move HB 1190 HB 1215 HB 1256 and HB 1186 to the deferred list they've be…”
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Pre-2017 bill | ||
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HB1215
· 1 mention in transcript
Matched: “…ght I'm gonna drop without objection I'm gonna move HB 1190 HB 1215 HB 1256 and HB 1186 to the deferred list they've been on fo…”
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Pre-2017 bill | ||
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HB1256
· 1 mention in transcript
Matched: “…gonna drop without objection I'm gonna move HB 1190 HB 1215 HB 1256 and HB 1186 to the deferred list they've been on for passed…”
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Pre-2017 bill | ||
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SB387
· 1 mention in transcript
Matched: “…for special order the date planning on being March 21st for SB 387 so if you're here for that I want to hold you up unnecessar…”
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Pre-2017 bill |
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a special order of business. So I'm going to do a couple housekeeping items real quick and then talk a little bit about Medicaid. But I believe Representative Davis just needs to concur on a Senate amendment. So I'm going to do that first because it should be pretty simple. Representative Davis, you're recognized to present your amendment. Thank you, Chairman. Members of the committee, this is
Representative Andy Davis
Unverified
0:28
just to concur with sentiment Senate amendment after this past
unanimously out of the house BLR caught some problems with some technical language in the trust fund that's established in this bill and corrected it before the Senate passed it so we just need to concur with that does not change at all what the bill does just a couple technical terms 1197 House bill 1197 It'll
be on the second page, the amendment will be.
Members, y'all get the amendment. Is everybody pulling it up? Okay, let's give it a second. We've got hard copies. We'll go ahead and distribute. Hard copies are coming around. That's the kicker.
While they're distributing the amendment, I think, Representative Ferguson, if I say anything inaccurate, stop me, but I hope I'm not painting with too part of a brush, but looking out into the audience, I assume there are some people here that are interested in Senator Irvin's bill I don't know the exact number I will tell you that we're
I think we're gonna set that for special order the date planning on being March 21st for SB 387 so if you're here for that I want to hold you up unnecessarily that will be set in fact well I'll have to do it after we're done with this order business but it will be set for special order on March 21st does everybody have the amendment okay representative link
Representative Kelley Linck
Unverified
2:53
you're recognized for a question even if we if I if I had 1197 in front of me 19-5-1249 what does
19-5-1140 do differently you know we're substituting you know referring to one code instead of the code we were referring to so what why are we doing that what's what's it do different represent like I can't tell you specifically all I
Representative Andy Davis
Unverified
3:18
can tell you is it the fiscal section of BLR caught that that they had referenced the wrong code okay it was it was just a correction
to the code they were referencing if the substantive nature of the bill didn't
change that's correct okay members any other questions on the amendment okay there's no other questions entertain a motion to concur on the amendment okay motion by representative Ward law to concur on the amendment any discussion on the motion all in favor say aye any opposed congratulations we have concurred on your amendment thank you thank you a a couple other housekeeping items mr. speaker are you and your son here to
watch okay all right I'm gonna drop without objection I'm gonna move HB 1190 HB 1215 HB 1256 and HB 1186 to the deferred list they've been on for passed over several times bill filing deadline in conjunction with that to know bill filing deadline is March 11th, which is this coming Monday. With that deadline approaching, we're going to try to get a little bit more serious about our agenda and passing over legislation. So if things hang around there for too long,
they're going to drop down to the deferred list pretty quickly. So those bills that I named are going to be ordered to the deferred, and then keep in mind with the bill filing deadline on Monday. Also, we do have an event tonight. If you'd like to see Representative Link about that, be sure to communicate with him. So, also, I believe that's it. Okay. Now, before we run through the agenda, I'm going to turn the chair over to Vice Chair Murdoch, and I'm going to go to the end of the table to lead a little discussion.
So, Vice Chair Murdoch, if you'll lead the
Chair
Unverified
5:42
meeting. You're recognized, Chairman. Thank you, Vice Chair Murdoch. Members, Ms. Juanita distributed out two pieces of paper that I'd like you to pull up.
One is a copy of a newspaper article that appeared in the Democrat Gazette today. The other has the title of Medicaid checkboxes on the title. I'll summarize what's in the documents and then kind of explain why I'm doing what I'm doing. The article that appeared in the Democrat Gazette this morning, I think, gave some very important information as to an update of where we are in the current debate about health care expansion. I have a lot of respect for Mr. Frago. He's done great reporting as this debate constantly emerges and changes.
I've communicated with him my intent to add some context to that article, which is what I would like to do for all of you. The reason I want to do it is because I do feel like there was some context lacking in the article, and I told him, and I'll tell you that's my fault. He did call me yesterday, and I did not call him back. I think if I had the opportunity to do that, I would have been able to provide some context that was missing. Specifically, the portion of the article that I did not, that I thought was unfair, an unfair summary of the situation.
If you look at what would be on page two of the article, specifically one paragraph where it says, emails between BB administration officials and Burris show an evolving, quote, talking point plan in an apparent attempt to collect GOP votes. That is also, I think, the paragraph that led to a headline that says BB advisors, GOP's Burris, develop exchange proposal sales pitch. There's a couple other sentences that kind of imply or state the same. I want to be very clear on where we are, and the reason I'm doing this is because I want to make sure that I'm clear.
I want to say the same thing publicly that I have said to all of you privately, which is based on the decision of HHS about two weeks ago now, we do have flexibility in the debate of expansion that we did not previously have. It was a 180 change. That only leaves several questions, and the opportunity to create what I have consistently said I believe to be a conservative, market-based, consumer-friendly health care system.
Now, that only leaves a lot of questions. And so the e-mails on which this story was based, I printed out for you because I've had a grand total of four e-mail exchanges with Director Selig and the Medicaid Director, Andy Allison. and I printed those out for you too because in the interest of full disclosure I want you to know as your chairman exactly what I'm saying to them and it's no different than exactly what I said to you. It laid out very clearly six what I've termed check boxes of proposals and policies that I
believe could lead to an agreement on health care expansion. You'll see what they are and I said, and in the email addressed to John and Andy, I said, here is a brief list of checkboxes we discussed. Others will more than likely present themselves in time. Flexibility of the current Medicaid system seems to be the main factor in gathering votes. The reason that I'm distributing the email is because, again, the tone of the article I felt implied that there was an agreement, that a lot of this was about talking points and sales pitch, and that is not an
accurate description of where we are the thing that the the ideas laid out in that email that is now in the public are exactly what I've said to all of you all along they lay out some central fundamental principles that I believe if accomplished including maybe most importantly flexibility on the current system I believe we can have a win-win situation where we can offer coverage to all of our Kansans but also make fundamental reforms to our current Medicaid system that at the end of the day make this a revenue-neutral or more
hopefully cost-saving proposal to the state. Again, I'll just conclude, and I'll be happy to take questions because I don't believe we really have anything else on the agenda, but I'll conclude by saying the point of this is not to take away anything, to distract from the report, detract from the reporting. Mr. Frago, only an idiot would criticize the reporter that covers his committee every day, and so it's my fault for not calling him back and I think I could have provided some context that that was lacking and my point in doing this here is to provide the context that I did not
provide to him there is an opportunity but there are many many questions that remain unanswered I think we agree on some and you'll see but from the response of director Selig we agree on some basic principles the details of which are very complicated and that is what we are working on now so I'll be happy to answer any
Representative Kim Hammer
Unverified
10:30
questions. Representative Hammer. Thank you, Mr. Chair. Representative Burris, just a couple quick questions. One, and I haven't had a chance to look, but through the online
feature of the newspaper, was there an expansion of the thoughts or the idea that because of not being limited by print space was expanded further, or do you know? I don't, I didn't
look at the online i read a hard copy that's what you're asking so i'm not quite sure how it appeared online versus in print okay
Representative Kim Hammer
Unverified
11:02
and and based on comment you made i want to ask you this question uh do you feel that the article contained anything that misrepresented the facts then or just was
written on the basis of the information that was given at the time which was it or which would you say it is I certainly
don't think anything was misrepresented and that's not the point at all I think there was just some context that was lacking because and again that would be the fault my fault for not returning a phone call but I think you had a merging of narratives and objectives and I think that the term again that the thing that really bothered me the most was the specific paragraph that said the emails between BB administration officials and
Burroughs shown evolving quote talking point plan and an apparent attempt to collect GOP votes. I've never used that language, quote talking point, quote deal, anything of that nature. My goal has been to develop a conservative, market-based, consumer-friendly health care system based on some principled tenets that were laid out in that email. And if we can do that, I do think we can have a vote that collects broad bipartisan support. But it's never been about talking points
ordeal. It's been about fundamental policy and whether or not it's good for the state of Arkansas. That was my objective in the communication and the email to DHS officials. And I think we're working towards the same goal. But I just don't want the perception to be that there's already an agreement because nothing could be further from the truth. We were given an opportunity based on HHS's complete reversal of their previous decision. And we have an opportunity to craft a policy that's good for Arkansas. And that was an opportunity that did not exist before last week one last question mr. chair yes sir thank you see if you
Representative Kim Hammer
Unverified
12:53
agree with this analogy so I'll ask you on the front end do you agree this issue is like a hundred piece puzzle and all the pieces are floating and anything and anything that is said referred to we should back up and look at as far as the part of the big picture trying to work through the process and being as transparent as possible so that when we get to the completed puzzle everybody knew how we got there and everybody had a chance to participate in the process and this is just one step in the process
articles like this and everything else is that do you agree or
disagree i agree and i can tell you've been in the ministry for a very long time uh as a son of a baptist preacher having to deal with hundreds of people this is a very complex issue and things happen it's an evolving process and I think we're going to look up and I hope we'll be happy with what how we arrived at where we are a lot of
Representative Kim Hammer
Unverified
13:50
business meetings taught me that experience thank you very much
Speaker 31
13:53
thank you mr. chairman okay thank you
chairman I will add that and let me let me applaud you for the effort of of bringing balance to what may have been read. It can be easily interpreted, as you mentioned. And just in the sake and speaking of transparency, let me say that. This is a bipartisan committee, obviously, but there are some key things to both sides. And we want to be balanced in our approach to coming to a good deal, if you will, for all the citizens of Arkansas.
I think that we're trying to do that. I think that as Representative Hammers said, behind the scenes there are lots of meetings, there's lots of things going on and obviously everybody is not in the room at the same time and sometimes the reports or sometimes the reports of those meetings need clarity because it is a lot going on behind the scenes. Everybody's voice needs to be heard and that's why it's important that those that are behind the scenes be as transparent as possible so that all feel a part of the process because
at the end of the day all of us represent about 30,000 people individually and they all need to be accounted for when we come to an agreement. So again I applaud what you're doing and this today it makes sense and everybody do need to understand what Representative Hammer said that this is a big puzzle with a lot of pieces ladies and gentlemen that we have to bring together in a short period of time that we're trying to do. a lot of hard work, and any patience that's shown to the membership would be greatly appreciated
as we all try to get this done. So
Speaker 33
15:34
I do applaud you for what you're doing. Representative Meeks had
Speaker 35
15:39
a question. Thank you, Mr. Chair. My question is, is there a timeline on these checkboxes, because one of them
Speaker 36
15:45
is defined targets for reductions in Medicaid spending. We've got maybe a little over a month left in this session. Do we anticipate getting most or all of these answers back
Speaker 35
15:55
before the end of the session so we can make a decision, or is this going to drag out even
longer? No, that's a good question, and it's also a transition point because my goal wasn't
only to talk about an email and a story because this has been adequately described as a very vast puzzle. So I want to answer any question that the committee has about anything in terms of where we are. So in answer to your question, in my mind, the timeline is the most serious restriction that we are under. I feel like with time and effort and collaboration, we can potentially – we have a high chance of reaching an agreement on what I have laid out as a good proposal.
the fact that we are in a session constitutionally required to be here in the time frame that we're in and that we only got this agreement or the opportunity to work on a proposal last week makes it very, very difficult to do we are working very, very hard I had meetings, conference calls starting at 7 this morning I was a little bit late because I was a little bit angry over the article but I settled down and got on my call and the point is we are spending a lot and a lot of time, and I know all of you are too, on this issue.
Answer your question, the timing is a very real factor. But I will say again, the reason we are under a time constraint is because we were given flexibility that before last week we weren't given. That only leads to more questions. It wasn't a simple answer before the flexibility was granted from Secretary Sebelius, and it's not a simple answer now. I think we've got an opportunity, but it's going to take a lot of time. So,
I mean, there's not a certain date that we – I mean, you know, like
Speaker 36
17:42
on some of these, I mean, do we have, you know, dates that we can set that we would like the information by or –
Yeah, there's – no, I mean, I think we've got – whatever we do has to be defined time frames and everything very explicitly spelled out. So if I can
Speaker 31
18:02
speak to that a little bit, Representative Meeks, we do have some timelines internally that the House has as we're trying to get out of here this session. Those are some timelines that we have, but we're up against some other timelines of reports of data getting back from various entities that are presenting and providing us information
to make an informed decision. Now, the balancing act that we're trying to put together is the time that we exit the session to the time that that information comes back. It's my belief and maybe others share that belief that's working on this that some of that information will not be back before we're ready to terminate our session. And a decision at the end of the day is going to have to be made is do we have enough information Or is that information suffice to those that have questions to say, okay, we got something that we believe is a deal that's good enough that we can go ahead and work for it?
I think it's important to understand at the end of the day, we're never, until this period is over, this next three years of however we deal with it, until we're able to look back at the end of this three-year period and see what has happened to actual costs, actual episodes, the outcomes. Whatever happens, that's going to be our real data. Right now we're dealing with a lot of forecasting and speculation. It certainly is important as you make a decision that you do some forecasting,
that you do some, you know, looking forward to what's going to come. So I think that's what's going on, and I think those questions, I guess where I'm trying to go with you, I don't think all questions are going to be answered before we have to make a decision, and Representative Burrs may or may not agree with that. I do think we have an opportunity to
have a lot of information, to your point, and I hope that that's the case. I know DHS is working very hard. The one thing I can promise you is that we're not going to vote on a bill and find out what's in it. That's not going to happen.
We're not going to give complete control to the administration or to the federal government to implement what we ask for. We're going to be the legislature. We're going to craft a plan, and we're going to make sure it happens. the early bird gets the worm but the second mouse gets the cheese so we're going to make sure we do this right because fools rush in and we're not going to rush into what is fundamental revision of health care policy in the state
Speaker 34
20:25
I appreciate that and I just have one request
Speaker 35
20:28
if it's not already being planned I would like
to have the committee meet to go over some of these reports so that we as a committee can have all that information available if it's not already
agree 100% I mean and the one thing I would ask for that that is absolutely the goal that's why I'm completely comfortable printing off my emails to DHS and showing them to you ain't nothing to hide this was a this was a and a door that opened a week ago and it certainly created a a flurry of questions and we're at the point now where we're at least getting beginning
to get some raw data and answers to set to immediate questions back or the the point where the committee needs to start sorting through all of this
Speaker 31
21:12
in a public way. Thank you. Thank you, Mr. Chair. Thank you. It's certainly not bill debate time, but I will make this point as we talk about reformation of our current system. The door that opened did not necessarily, and again I guess I'm setting up a debate though, give us the opportunity to reform what we have. It gave us an opportunity to have a chance to extend at no cost to the state in
in some estimates what we have to able to take a look at possible reformation and what may need to happen. But again, not to debate that, but I do think that what may bog us down, and I hope it really doesn't, is that we don't try to reform it now in this short period of time. It's too big of a picture. It's too big of a puzzle for us to reform in three weeks, you know, as we try to get out of here. Remember, I'm using that internal timeline that we're in. If that's not the timeline, then some other options do come into the conversation.
Speaker 26
22:06
I've always been a big dreamer. Yes, sir.
Representative Kim Hammer
Unverified
22:12
Representative Hammer. Thank you, Mr. Chair. First of all, I need clarification of that analogy you used with the bird and the cheese. I've never heard that one before. If you want to do that publicly or privately, you'll be fine, but just smart to be second sometimes. Very good. That's right. I'd like to ask the chair and defer to you for your decision on a matter, if you would.
Anybody that's ever heard me sit in a meeting, anytime that somebody's name is brought up and something is stated about that person when they are brought up, I think it's only fair that that person be given equal opportunity or at least an opportunity to respond if they choose to do so, because otherwise we only hear one side. I am totally unknowledgeable of the process, but I would like to at least extend to the member of the press,
of which was referenced in the article a while ago, if they would like to, to come to the end of the table and explain the comment that was made and give them an opportunity to speak if they would like. Otherwise, we'll read about it in the paper. But I think that's always been my standard, that if you say something about somebody else, that you at least extend them the opportunity. And I don't even know if, but I'm deferring to the chair. There's the issue. I'll ask for your ruling on it.
Speaker 31
23:33
Well, what I'll do with that is, first of all, let me say, I think everything that Representative Byrd said about Mr. Frago,
I didn't take it as being anything that he needs to defend, per se. I think it was a clarity point. I don't think nothing here of an indictive nature was said, or I didn't take it that way about Mr. Frago. So I do understand, Representative Hamer, the balance that you're seeking, but I don't know that at this point that's necessary. What I'll do is I'm going to defer back to the chairman and ask Representative Burrs if he would like to make a comment on this. He buys ink by the barrel.
I think we're going to know what his response is. And so I agree completely with Vice Chair Murdoch. The goal here was not at all to take away. I feel like me not returning his phone call did not provide some context that I now want to provide to the committee. And that's the goal. And you weren't
Speaker 51
24:29
blaming him. You took some accountability for whatever the miss was, for lack of a better
Speaker 31
24:35
word. You want to follow up, Representative Hammer? Yes, sir.
Representative Kim Hammer
Unverified
24:38
I just want to clarify my intent.
And I just wanted on the record that an opportunity was extended because what I heard and, you know, prompted my request to the chair, and I just want to make sure everything's out there, everything's transparent, and if there was a time to say anything, now would be the time to say if there's any question directly to what Representative Burr said. And with that, I'll stop and just defer to the chair, and I thank you for the opportunity. Thank you. Representative Love.
Speaker 40
25:04
Representative Love. Well, you jumped on me.
Speaker 51
25:19
All right. Representative Ferguson. Just because Representative Burroughs
Representative Deborah Ferguson
Unverified
25:26
brought it up and the new options that we have and the timeline, I just don't want it to be lost in this discussion that we owe so much to Governor Beebe and DHS for being willing to work across party lines and try to take this compromise to the CMS.
And it does present us with new options, and I think we need to be careful. But a whole part of that timeline is that the 100% payment option from the federal government is tied to a fiscal year. so I mean we do need to start
making some decisions I would agree enrollment no matter what we do enrollment does not begin until October coverage does not begin until January I I agree wholeheartedly that we have a very condensed time frame under which we can make some very significant policy
decisions but time is not the most important factor to me effective and and sustainable long-term policy is the most important goal. Those things do not necessarily contradict, but, again, I don't think we can have the discussion under the understanding with the pressure of being rushed because, to be frank, that was the only argument for expanding Medicaid for six months.
And the only thing that I can tell you with uncertainty today is that that argument was wrong because we clearly were proven to be right by saying that perhaps better options existed. And so the argument that was proven wrong a week ago should not apply to the discussion today. I agree we have to be mindful of the time frame under which we have to operate given ACA's regulations, but we're going to get the policy
Speaker 31
27:32
right. Anyone else have any comments or questions of Representative Burrs or Chair or anybody
on the committee? Okay. Again, thanks, Representative Burrs, and if all heads are clear on that,
Speaker 8
27:58
conference at noon okay I like this seat
a lot better I don't think we have anything else to do oh I'm sorry
Representative Klemmer, glad you arrived. My stalling technique worked. I don't believe we have anybody else to present a bill except Representative Klemmer. Okay, that's fine. I'm going to go ahead and recognize Representative Klemmer to present HB 1746. Thank you, Mr. Chairman. I'm just
Representative Ann V. Clemmer
Unverified
28:36
trying to honor the Speaker's wishes to get these bills running through. So, and I don't have a hard copy of
the bill in front of me.
I can probably pull it up on this, 1746, there it is, just in case I can, so I can reference the same line numbers. Let me just explain the bill, and it's, I think, been, oh, I have a hard copy right here. The bill has been pretty well vetted. Representative Ferguson graciously agreed to be on the bill, as did Representative McGee. and Senator Bledsoe is the sponsor down on the Senate end.
What this bill does, essentially, currently there is no Arkansas statute or any court decisions that really guide a mental health provider when they have a client that presents a credible threat to another person's life. In Arkansas, providers
then have to more or less choose whether they're going to breach a confidentiality or whether they're
going to preserve the confidentiality in the face of a threat and talk to, try to talk their patient, you know, down from the edge, so to speak.
This bill creates a duty for a mental health service provider, and those are listed in the bill, to warn persons targeted by their clients and to notify law enforcement of those threats. In exchange for the warnings and notifications, the provider is then immune from lawsuits for any breach of confidentiality. If the provider does not make the
warnings and notifications, there is no punishment to him, but he is subject then to a potential, as he is now, a potential lawsuit, I mean
You know, you did not – well, it wouldn't be malpractice, but you
did not protect the public safety. You knew and you didn't protect. There is no implementation cost. The bill does not create a new bureaucracy. Provider costs
are limited to the time that it takes to make the phone calls. And there's no regulators, no regulations, no fines, penalties, imprisonment for
any failure to warn. And essentially, the law is more or less self-enforcing providers who warn targeted victims and notify
the appropriate law enforcement agencies to receive immunity from any legal liability. And I'd be happy to take any questions. MR.
Chair
Unverified
31:13
Representative Link, you're recognized for a question. MR. Representative Klemmer,
Representative Kelley Linck
Unverified
31:18
I hear you keep saying, and I may have not read all of it somewhere, but I hear you keep saying that they're supposed to inform the victim and the… MS. I'm reading line 35, page 3, says the mental health service provider may inform an appropriate
law enforcement agency or the victim of the threat, and the victim of the threat. We may have
Representative Ann V. Clemmer
Unverified
31:45
a drafting error then. It is, for all of our proofing, that may have escaped. I would
Speaker 68
31:50
be okay with and, but not or. Okay. Okay.
Representative Ann V. Clemmer
Unverified
31:53
How would you like me to proceed? I could have that amended. I would definitely like
Speaker 70
32:00
to have that amended. Well, yeah, I mean, Mr. Chairman,
Representative Ann V. Clemmer
Unverified
32:03
I don't know what's easiest. I mean, if we could discuss the bill, I could bring the amendment.
If I could take all the other questions, I could bring the amendment.
That will be a very brief amendment, and I could run that very quickly. Or is there an engrossing possibility? Let me
talk to staff. If the committee members are okay, let's go ahead and discuss the bill, and I might just see if we can get an amendment
Representative Ann V. Clemmer
Unverified
32:30
drafted quickly. I mean, it's a change from an or to
an and, apparently. Okay. We'll get on that, but let's just
Representative Ann V. Clemmer
Unverified
32:36
keep discussing if that's okay. Thank you, Representative Link. Again, we've run this, you know, we've run this by a few places, and that was overlooked.
You earned your paycheck today. Okay, Vice Chair
Speaker 31
32:55
Murdoch, you're recognized for a question. I may have missed it. Sorry, Representative Klemmer. Currently that notification that, you know, that the person – let me make sure I asked you the question correctly. You're notifying the police or ambulance service or whomever is coming that the –
Representative Ann V. Clemmer
Unverified
33:19
Essentially, if I'm a doctor and you're my patient and you tell me you want to
kill someone, I am under no duty to warn that person. Actually, this is an instance where medical ethics say you have a duty to warn, but the law doesn't. Okay. So in essence, what we're doing is creating a statute to be in line with medical ethics. And
the source of this is two of my constituents that work in this field that brought this to me.
Speaker 31
33:51
Well, my daughter is a licensed social worker in that. And she's listed here, I
Speaker 33
33:58
think. Yes, I've seen that. So that, okay. But
Speaker 34
34:08
that makes sense. I do understand that. Okay. Representative Meeks. Thank you, Mr. Chair.
Speaker 79
34:13
My question is on, let's see what page it
Speaker 36
34:18
is here, it is on page 3, line 16 and I guess also line 21 as well.
It says if the victim is under 18 years of age, threatens to commit suicide, bodily harm, It says, shall make a reasonable effort to communicate the threat in both cases to the parents, custodial parent, non-custodial parent, oh, the potential victims, custodial parent, non-custodial parent, or legal guardian. Is this going to be a
Speaker 35
34:44
case where by doing that, and again, I don't know if that's mandatory or not because it just says make a reasonable effort, where the professional may say, well, if I tell the victim's mom or dad, you know,
They're liable to get mad and angry and want to protect their son or daughter. And, you know, it might cause a bigger problem with that guardian or whatever maybe taking action against the person who's making the threat. You know what I'm saying? Okay, now I'm speaking certainly not as a professional
Representative Ann V. Clemmer
Unverified
35:14
here, so I don't know if maybe there might
be someone else who'd want to help me out. I'm going on a parent. I'm going to talk like a parent. I would want to know if my child were suicidal.
I would want to know to take precautions. I would want to know to lock any guns in my house away from their use. I would want that
information. And because the child is a minor, I believe I would have a right to know that. Right, and I would
Speaker 36
35:48
it looks like in Section C, it says if the victim is under 18, in addition to taking one or more action, shall make a reasonable effort to communicate the threat to the potential victim's custodial parent. So in a non-suicide...
Representative Ann V. Clemmer
Unverified
36:02
Oh, if the victim is a... I'm sorry. You were speaking of the victim... Well,
Speaker 36
36:06
yeah. I was kind of... You addressed the first one with the suicide. Yeah, definitely. I mean, if my child was wanting to commit suicide, I definitely would want to know that. But it would seem to me that this bill is also saying that if there's a threat and the child is under 18, then I
Speaker 35
36:19
have to also go to the parents of the child to whom the threat is being made too. And as a parent, you're like, you know, you might want to take a shotgun and say, look, you're not going to harm my child type deal. And I don't know if that creates problems by having to go to the other parent and say, your child is being threatened by this other person.
Representative Ann V. Clemmer
Unverified
36:36
I probably need a medical ethicist at my side for this. Okay. But I would still argue that if
someone has a grave threat against them, someone was threatening me, I would want to know to
be extra careful. I would, you know, again, maybe take extra steps to make sure the doors stay locked. I might turn on that alarm system. Oh, I guess I
just told the world my alarm system is not turned on.
Speaker 35
37:06
Yeah, and I can understand, you know, that point as well. But I don't know, like I said, if, and again, it's
Speaker 36
37:12
not a big deal to me, but I don't know, you know, I don't, I guess if a mental health professional feels that notifying the parents of the
Speaker 34
37:22
other child would create a situation where, you know, it could blow up. No, and
Representative Ann V. Clemmer
Unverified
37:26
I don't know, I mean, again, I think we would put some of this in the hands of the medical professionals to decide how much information, you know, it might be more or less instead of identifying the person making the threat, just that your child has been, there has been a threat against your child.
And this bill does not expressly state how that has to be done. That's
Speaker 36
37:47
what I was wanting to make sure that there is
Representative Ann V. Clemmer
Unverified
37:51
that leeway if the mental health professional. I would assume that's present. Let me
say that we did have some of the appropriate, because this was way out of my area of expertise. It was just brought to me by constituents. But we had, I mean, I shared this with Representative Ferguson, and we shared it with some professionals in the field and the Arkansas Medical Society,
and they did not raise objections. I mean, we actually fixed a couple of technical errors in the bill, And other than that, there were no objections
to this. Thank you. Great job. Thank you, Mr. Chair.
Representative Andy Mayberry
Unverified
38:29
Thank you. Representative Mayberry. Thank you, Mr. Chair. Going back to the same lines that Representative Meeks was looking at just a few moments ago on that page three, I think it is, line 16 through 20. if the victim is under 18 years of age the mental health services provider in addition shall make it they're going to make an effort to communicate the threat to the potential victims
custodial parent non-custodial parent or legal guardian I know this would be a rare circumstance but what if the person making the threat is that parent in other words if if you have an adult that they're you know in counseling and such and and they reveal that you know I want to go kill my son or i want to kill my
daughter how how do you address that again that's i know it's a very rare situation but you know the doctor has
Representative Ann V. Clemmer
Unverified
39:22
to determine if it's a credible threat i mean it
can't just be somebody you know i'd like to strangle that kid it had to be a real
Representative Andy Mayberry
Unverified
39:31
say that it is a credible threat what if i'm understanding this
right what it says that you do is that you notify the parent of that person who's being threatened, but in this case, it's the parent who's doing the threatening. Then I
Representative Ann V. Clemmer
Unverified
39:49
think that you would try your best to notify the other parent and that you might. And again, law enforcement, I believe, would be involved here.
Representative Andy Mayberry
Unverified
39:59
I mean, what the bill is... I mean, I very much understand what you're trying to get at. I'm just trying to make sure that we haven't inadvertently – I don't
Speaker 95
40:13
know. Let me – well, I don't want to not answer your question because
Representative Ann V. Clemmer
Unverified
40:18
I think you can find – and I spent a good little while thinking
about all the potential hypothetical situations that could come up. Let me just say, if it reassures you any, not that we will always guide our laws after other states,
but 26 other states have a law like this and when i went to the ncsl website to look at a lot of do some research on this several other states are considering moving their statute from permissive which is what arkansas is law is currently it allows you to tell but it doesn't really clearly say that you have a duty to tell. Now, that was probably not the answer you were looking for,
and I don't know that I have the answer that you're looking for. But if it's against a child, you'd probably try to notify another authority in the
child's life. Yeah, and I mean, I think we could, they're all good questions. I think we could play hypotheticals all day long. I think the bottom line of your bill is if a clinical professional assesses there to be a legitimate threat, against a person, is it better for the person to know? And I think the answer has to be yes, in my opinion.
Representative Ann V. Clemmer
Unverified
41:31
Is that an accurate summary? MS. That's a pretty basic two-sentence summary.
MR. Okay. Representative Hammer. I've got a couple other questions,
Representative Kim Hammer
Unverified
41:41
but picking up on the dialogue that just happens, I think that if the mental health professional – I wonder if there's anybody in the room that's affiliated with any mental health organization that might come to the end of the table if you'd be willing to let them come.
Representative Ann V. Clemmer
Unverified
41:59
I'm actually so used to them being behind me, I
Representative Kim Hammer
Unverified
42:03
sort of assumed they'd be here. I would think, just carrying out a scenario here, that if the licensed social worker notified the parent that, hey,
there's been a threat made against your child, and I'm not sure about HIPAA rules, how much they can reveal about who it is that made the threat to them. But somewhere in that scenario, they ought to be able to go get an order of protection against that person or exercise some other means to where they could build a wall of protection between them and the person that's making
Representative Ann V. Clemmer
Unverified
42:34
the threat once it's established. And I think that's the rationale for
Representative Kim Hammer
Unverified
42:38
the law enforcement being involved, too. Okay. And that leads me to one of the questions I did have, and that is once this information is reported to the law enforcement,
does this law bind them to go out and to establish the credibility of the statement that's been made? And can you kind of summarize what law enforcement is supposed to do once they're given this information? This bill does
Representative Ann V. Clemmer
Unverified
43:02
really not direct law enforcement on how to act. I presume there are law enforcement protocols in place. Okay.
Representative Kim Hammer
Unverified
43:09
Okay. And that was one thing I was wondering is, does it create a liability that if law enforcement is given this information, they have a duty to respond and go out and react to it, and if they don't and something happens,
then it falls on the law enforcement agency to be accountable for their actions having not gone out, or can you enlighten me on that? I'm not
Representative Ann V. Clemmer
Unverified
43:33
sure I can enlighten you much. I did run this past local prosecutor and local law enforcement in Saline County, and they very much were
embracing of the idea. They thought it would help them out a lot. Okay. Well, and that says a lot right
Representative Kim Hammer
Unverified
43:45
there. You know, they've addressed that issue. If there was an issue, they'd be here speaking against it, or somebody would be bringing it up, wouldn't they? I would hope.
Okay. And also in this bill, is there a place maybe on that 18 and under? because to address the issues of 18 and under, doesn't that require a judge getting involved at some point or the potential for a judge to be involved because it is dealing with a minor if there's a commitment that's to be made? You're
Representative Ann V. Clemmer
Unverified
44:16
talking law enforcement protocols again. And I'm not rejecting your question, Representative Hammer, but I would presume that that would be law enforcement would know if a judge needs to be involved.
And I think what we're just trying to do, let me just say clearly, We're just trying
to say, doctor, mental health professional,
do your part in helping keep people safe. If you know somebody is, you know, a cannon fixing a blow up at somebody, you know, or something, then let someone know who can have an intervention in this situation. So it's not really prescribing what law enforcement is to do.
Representative Kim Hammer
Unverified
44:58
It's just saying, you know. It's the vehicle to get the information to the law. This bill is the vehicle to get it to law enforcement so they can pick it up from there now that they've
Representative Fredrick J. Love
Unverified
45:14
got the information. Exactly. Okay. All right. Thank you. Thank you. Representative Love. Thank you, Mr. Chairman. Representative Clemmer, I think Representative Hammer kind of brought to light some of the issues or concerns
that I had regarding this this bill and because we're talking about moving liability from the from the social worker or those from the aspect to other other entities and as in regards to the state police and I'm just thinking about claims now because I serve on claims is that opening up the liability for the state to be opening up the liability for the state and I don't know
it's not that I know the intention of your bill and the intent is good but I just do I would like to have that question answered does it open up since you would be giving the information to the state police or some form of law enforcement does that open up a liability we do have a professional in the room that might could help out
Representative Ann V. Clemmer
Unverified
46:20
a little bit here with the indulgence of the chair Mike Mitchell Mr. Mitchell, if you'll join
us, state your name and affiliation you'll be recognized
Speaker 41
46:32
Thank you, Mr. Chairman, members of the
Speaker 112
46:35
committee I'm Mike Mitchell, I'm general counsel of the Arkansas Medical Society What Representative Klemmer is trying to do is to create a solution to what's called the Terrasoff case, and it was a famous case that we all study out of California where the psychiatrist was in a consult with his patient. The patient advised the psychiatrist that they were going to kill this identified person the next day,
had a loaded gun, the ability to do it, and the psychiatrist, feeling like they had a confidentiality duty to the patient, didn't say anything to anyone. And the patient went out and killed the victim. victim. And so what this does is say, psychiatrist, if you will notify a victim in this circumstance and law enforcement to protect that identified victim, then you won't be sued by your patient
for breach of confidentiality. That is, in essence, what Representative Klemmer is trying to accomplish. Now the detail of it we could get into, but I think the parent, what it says here if there's a minor, well then notify the parent that their daughter or son is in jeopardy. That's what that bill is attempting to accomplish. And it doesn't put the liability on law enforcement or anything, it just says protect this person that's an identified victim by notifying law enforcement and the victim or the victim's
parents. you representative love yes I
Representative Fredrick J. Love
Unverified
48:12
guess that was my concern it doesn't put the liability on someone like the state police because then that would open up the state
Speaker 110
48:19
no okay so it does not okay thank you mr. chairman thank
you mr. climber representative Ferguson you
Representative Deborah Ferguson
Unverified
48:28
were next on the list I was just gonna say I have a good friend who is a psychologist and he said most mental health people now have a disclaimer statement that they have patients sign
when they come in that effectively does this not all of them but this is just to make it uniform across mental health care fields they they have them say sign something saying if they're intended to do bodily harm to themselves or someone else that they forego their
Speaker 99
48:55
confidentiality okay good representative we have a
Representative Ann V. Clemmer
Unverified
48:58
bill drafted that changes excuse me an amendment drafted to the bill that changes the and the or to an and okay well let's keep going with
questions before we have a motion we'll adopt the amendment okay let me just can
Representative Ann V. Clemmer
Unverified
49:13
I just say one other thing kind of in response to this research shows that mental health perfect mental health patients are no more violent than any other person in general population but if a mental health patient presents a threat then they are far more likely I think the data says there I mean there's There's a percentage here. I've got it in my notes. It's not where I can see it. But they are far more likely to carry it out. So if they are under care of a mental health professional and they make a threat, it is
a very, very real chance that they
Speaker 114
49:51
are going to follow through with this threat. Okay. Representative Word. Thank you, Mr. Chair. Going back to Representative Mayberry, a question about the parent and all. I think that Arkansas currently have an act already on the book Act 166 under the Adult Protective Services law that actually protect parents and those persons who either are being threatened feel that themselves are in intimate danger and also I don't think that this will
interfere not with that particular act because of the act that is already there which is Act 166, which is a part of the Adult Protective Services Act and all. So if a parent is actually the perpetrator and all, then Act 166 covers that and which that they are will actually intervene under the Old American Act and Act 166 of the Adult Protective Services Law. So it would not have any bearing at all and it will take care of that.
Speaker 99
50:56
Thank you. Okay. Thank you, Representative
Representative Andy Mayberry
Unverified
51:00
Ward. Representative Mayberry. Thank you, Representative Ward, for that information. And
I was going to say that since I'm the one who asked that hypothetical or that question of dealing with a hypothetical situation, that it's probably incumbent upon me to say that I think in reading closer in the bill, I have come to a satisfactory answer for myself personally. So I'm going to summarize that and ask you if you would agree.
In reading more closely, it would still require in that situation a notification to law enforcement agencies. So someone would know about that who could potentially protect that victim. And then it says that the provider should make a reasonable effort to communicate the threat to the parent. to the parent and and certainly i think that that the word reasonable would give a broad scope on whether or not uh communication there needed to be desired so um in my mind that is that is
Speaker 118
52:00
that situation is satisfactory satisfactorily covered would you agree yes thank you representative Thank
Representative Justin T. Harris
Unverified
52:13
you, Mr. Chair. Representative Klemmer, just a question to clarify that Representative Love brought up. The
state police or whoever, law enforcement would have to act upon the threat. I mean, would that be correct? Again, I mean, this
Representative Ann V. Clemmer
Unverified
52:30
really isn't directing the actions or the
code or the protocols for law enforcement, so I can't really speak to that. Okay, and I
Representative Justin T. Harris
Unverified
52:38
think until you're put in that position, because we have been, this is a good bill, and so I appreciate it. Well, when it
Representative Ann V. Clemmer
Unverified
52:46
was brought to me, and this did not come to me after Sandy Hook. Actually, my
constituents I met with last May, it was just really so far from my area of expertise. I kept fishing around for people to enlighten me, and actually Representative Ferguson helped a lot with that.
All right, thank you. Members, I don't see any other questions. I'll entertain a motion to adopt the amendment first. Okay, motion to adopt the amendment. All in favor say aye. Aye. Any opposed? Okay. You've heard testimony on the bill now as amended. Does anybody in the audience like to speak for or against? Yes, sir. If you'll come to the end of the table and state your name and affiliation, you'll be recognized to speak on the bill. and
you can tell us which one when you start.
Speaker 126
53:47
Name is Mike Rose, and I'm affiliated with myself because I suffer from mental illness, and this is a good bill. It protects both the client and the law enforcement people, In case if they do come and check out the incident that happened, a person that suffers from mental illness who forgets to take their medication and has a withdrawal, they would not understand what's going on.
If there's a law enforcement that comes to their apartment or to their home, but this bill here will protect them and us. And I am in support of this bill. I do believe that people with mental illness needs to be aware of what they have, but they don't have someone to speak on behalf of them. Okay.
Thank you for your testimony.
Any questions? Okay. Thank you, sir. I don't see anybody else signed up to speak for or against. So Representative Branscombe, you're recognized for a motion. Thank you, Mr. Chair. Do pass. Do pass as amended. Any discussion on the motion? All in favor say aye. Aye. Any opposed? Congratulations, Representative Clemmer. You passed your bill. Thank you very much. Representative
Representative David L. Branscum
Unverified
55:14
Hammer, you want to do 1468. Representative Burris, I passed a note up
Representative Kim Hammer
Unverified
55:22
there while ago while you were at the end of the table.
What I'd like to ask is I will be running my bills next week regardless, and I've passed a note up, So can I defer on that for the moment? He's going to run them one
Speaker 42
55:35
way or the other. One way or the other. I don't know who that's directed to, but
all right. Thank you. That's what it says. All right. All right. Any other members here to present a bill? Okay. Keep in mind, we're going to try to keep the agenda clear as possible. So if you have a bill, I'm going to start getting kind of strict about dropping it to deferred or asking you to remove it from the active calendar.
But seeing no other business, look at the calendar. We do have a lot of special orders coming up. But no, the business will stand adjourned until Tuesday.
Agenda
HB1197
HB1746
Documents
No documents posted.
Speakers
Representative John Burris Chair
Unverified
Representative Andy Davis
Unverified
Representative Kelley Linck
Unverified
Chair
Unverified
Representative Kim Hammer
Unverified
Speaker 31
Speaker 33
Speaker 35
Speaker 36
Speaker 34
Speaker 26
Speaker 51
Speaker 40
Speaker 53
Representative Deborah Ferguson
Unverified
Speaker 58
Speaker 8
Representative Ann V. Clemmer
Unverified
Speaker 68
Speaker 70
Speaker 79
Representative Andy Mayberry
Unverified
Speaker 95
Representative Fredrick J. Love
Unverified
Speaker 41
Speaker 112
Speaker 110
Speaker 99
Speaker 114
Speaker 118
Representative Justin T. Harris
Unverified
Speaker 126
Representative David L. Branscum
Unverified
Speaker 42