House Public Health, Welfare And Labor Committee
Video
Transcript
Bills discussed (3)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1018
· 3 mentions in transcript, chapter
Matched: “…special orders today. First one is Representative Nichols, House Bill 1018. Representative Nichols, if you'll join us at the end of th…”
|
Pre-2017 bill | ||
|
HB1185
· 2 mentions in chapter, transcript
Matched: “HB1185”
|
Pre-2017 bill | ||
|
SB134
· 1 mention in chapter
Matched: “SB134”
|
Pre-2017 bill |
Machine transcript
May contain errors. Verify important quotations against the official video.
About transcript accuracy
- Source
- Whisper
- Model
- ggml-large-v3-turbo.bin RTX5060
- Processing date
- October 3, 2026
It's your particular interest, that's your FYI, but we do have two special orders today. First one is Representative Nichols, House Bill 1018. Representative Nichols, if you'll join us at the end of the table, you'll be recognized to present your bill. Thank you, Mr. Chairman.
Representative Jim Nickels
Unverified
0:30
This is a simple bill. It goes from eligibility from 25 weeks to 26 weeks. We're adding a week of unemployment benefits back, and this week was effectively deleted last session with a comprehensive bill dealing with unemployment compensation insurance. insurance is a program that is designed to help not only the unemployed worker
who has lost his or her job through no fault of the worker that's one main purpose of unemployment compensation the second main purpose of it is to help the economy because when a person receives a check for unemployment insurance benefits it goes straight into the economy people buy groceries gas rent
whatever they need unemployment comes with crushing force only unemployed for about 20 years I traveled this state explaining unemployment compensation law to those workers who had experienced a a plant closing I've probably been in every district that is represented in this committee explaining to the recently unemployed what their rights are under the unemployment insurance
system and remember these people have lost their jobs through no fault of their own the the best information I have and and maybe people from the agency will be here, but I think this does not come from general revenues, but we're talking about six million dollars that does not go into the local economy because of this taking away of a week of benefits. Most of our surrounding states
pay 26 weeks of benefits. We are at 25. I would think that this bill is to take care of the least of these and we have an obligation to help our unemployed and remember they have to stay eligible for unemployment compensation benefits they have to be looking for a job they just can't sit home and draw benefits and so I thought it was somewhat cruel for us to penalize
the unemployed with that legislation and historically unemployment insurance has been an agreement between the the business community and a labor community if and there are certain accommodations made workers or the The unemployed may give some things up. They may freeze the weekly benefit amount, and I think that was accomplished last time.
But there would also be some accommodations coming from the business community. They may have to raise the taxable wage base or do some things where it is a shared sacrifice. It's just not all coming from the unemployed side. And we kind of set a precedent last time of just taking it from the unemployed, and that also just it takes it out of our local economies. There's just no question about that, that these people spend who are unemployed do spend
the checks that they receive. So I would be willing to accept any questions on this. I think it puts us back to where just about all of our surrounding states are, and it puts some more fairness into our system. It does not target the unemployed like I'm afraid that we've done. It puts them back at 26 weeks. So Mr. Chairman, if anyone has any questions, I'd be happy to respond.
Thank you for the presentation, Representative Nichols. You hit on something that I think was key. You talked about how one of the – it's required for anybody receiving unemployment to be currently active and searching for a job. Is that correct? That's correct. I heard yesterday in committee testimony about how the state has a compelling interest to ensure that recipients are performing up to the standards by which they're required to perform to receive the unemployment. Did you hear that testimony over in Senate Public Health yesterday?
No. No, Mr. Chairman. Generally speaking, as an attorney, do you think that's accurate? Well, what's your specific question now? That the state, you hit on one of the requirements for unemployment being actively searching for employment. Correct. And the question was just, I guess, just generally that the state has a compelling interest to ensure that we're living up to our standard and recipients are living up
Representative Jim Nickels
Unverified
6:03
to theirs. I agree with that okay I believe and maybe it's been a while since I have
made presentations on unemployment but my history is depending upon knowledge depending upon what part of the state you're in you may have to make at least two contacts a week or sometimes three contacts a week I assume that's still the standard but the agency may be able to correct me on that and if the agency does not have enough folks to monitor that then I think that's something that this committee and others need to need to address there are some who always
abuse the system there's also employers that abuse the system you know paying people in cash instead of putting them on a payroll that's an abuse of the system so but I do agree that there is a a state requirement that's our public policy of this state that if you are unemployed you're out there looking for a job then you're making applications for jobs you're just not sitting on the porch and the rocking chair waiting for your check I think and I'm straining a
little bit a little bit I think they told you we're waiting on language for an amendment on another bill so I thought usually I'm told talk less I I know, but I'm kind of enjoying it, and I'm not going to outlawyer you because I know I'll lose, but the point is, and Mr. Price shared the exact language with me as far as being ready and available to work, and the testimony that I was referring to was specifically in regards to drug testing because the statistics that were shared were that 80 percent of jobs require some level of compliance on drug testing before you're employed.
that seemed like a reasonable burden to place on our system because to be living up to the standard of ready and available and currently searching,
that seems to be not out of line with the
Representative Jim Nickels
Unverified
8:04
state protecting its compelling interest in the unemployment program. And I think also that maybe Mr. Price can show you the part of the law that talks about how unemployment comes with a crushing force and the public policy based upon the unemployment law is to pay those benefits if at all possible
and make sure that that unemployed is taken care of and that the economy does not dip deeper, a deeper recession or even a depression. You know, I think the law, the national law was passed in 1935. the and you know I might get a little bit too lawyer like right now but it's a it's a federal state partnership Congress cannot does not have the power to tell a state you have to have an unemployment insurance system that is a
state function we can do that but what the feds do they say we're going to tax you we're going to tax your payrolls and if you want it back if you want these tax dollars back you have to have an unemployment insurance system that meets certain guidelines and so there's always I would say vigorous debate between the states and the federal government on what the states can do to be in
compliance with the federal federal law federal department I like the way you they
basically take our money and then tell us what we have
Representative Jim Nickels
Unverified
9:38
to do to get it back. Yes, it's similar to we have a 21-year-old drinking age. Louisiana had to move to 21. Why? Because the federal government said if you want these highway tax dollars back, you have to have a drinking age of 21. Same principle. Representative
Meeks, you're recognized for a question. Thank you, Mr. Chair. Representative Nichols, my
Representative Stephen Meeks
Unverified
10:01
understanding of the reason why we moved it from 26 weeks to 25 weeks is because Arkansas right now is in debt, I think at one point of over $300 million to the federal government as far as unemployment is concerned. Was that
Representative Jim Nickels
Unverified
10:17
correct? I believe it was, and I think that indebtedness has shrunk more than people thought, more than the policy of the agency thought. But my main concern is, yes, we have to deal with that, but why put all of it on the backs
of the unemployed? You know, there should have been some other shared sacrifice with it. That's my main concern.
Representative Stephen Meeks
Unverified
10:41
Well, there is. You know, there was other things in the bill that helped to address those things. Also, too, I've had several business owners who have written me concerned because in January of this year they got hit from the federal government because we're in debt with extra unemployment.
I had one business owner that got hit with $3,000 in the month of January when his cash flow wasn't that great, and he was trying to figure out how in the world he was going to be able to pay that $3,000 because we are in debt so much to the federal government. You know, he was afraid that because we were in debt And the federal government now is taking and will continue to take every money every January until we get that paid off that it will actually end up putting some of the smaller business out of business because they can't afford the extra money that's being charged.
So while you say it helps the workers and we honestly want to help those as much as we can, we also have to take a look at the business owners in the business side as well and how it's actually affecting them. You know, the more money that they're being charged for unemployment, you know, they're either having to charge more to the consumers to make up for it, hire less, pay people less. So on the flip side, I would say that because we're so far in debt, you know, we're so far in debt to the federal government, that some of these changes were necessary in order to help our actual businesses out.
And I guess if you want to respond to that, you can. But then my other question is, on top of the 25 weeks, does not the federal government also pay for some unemployment weeks? It's my understanding that in certain circumstances, the federal government will actually pay for up to 99 weeks. So, again, it's my understanding that dropping the 26 to 25 didn't actually shorten the amount of benefits as far as weeks. It just basically took that one extra week and put it over on the federal government. I mean, you might correct me or kind of explain that whole.
Representative Jim Nickels
Unverified
12:57
Well, I think for the increases that some of your small employers are having, maybe Mr. Williams or his staff can respond to that. But I think the total hit on the unemployed from last session was $68 million. dollars and my point is it all of it should not have come off the backs of the unemployed other there needs to be a shared sacrifice there and we are we
are doing better on reducing that debt and maybe mr. mr. Williams can can give you the numbers on that. As far as the federal extensions, if that goes away, the federal extension, which I expect it will, then we're at 25 weeks. You know, the law wasn't passed to say we will lower this to 25 weeks as long as we have federal extensions. And there must
be a cost to it to the local economies and I would say that's that six million dollar figure that I've been given so I expect the federal extensions to to go away they almost didn't make it this time it was just part of that last minute deal they cut or compromise it to cut in Washington well I appreciate that And I think the way that Washington
Representative Stephen Meeks
Unverified
14:34
works right now, I don't know that they're going to have the heart anytime soon to cut those benefits off at the federal level.
I mean, I guess I could be wrong, and we may have to deal with it when that point ends. But I guess my point now is that regardless of whether Arkansas does 25 or 26 weeks, there's no difference now because of the federal extension. And you're not really hurting the economy at least until the federal government decides they want to do it. And I think, you know, at that point, the Arkansas legislature, you know, might deal with it. But right now, you know, we're actually helping to lower our debt, thereby helping our businesses a lot quicker to get out from underneath that debt and not having to pay so much in unemployment.
But I appreciate your time in answering my
Representative Jim Nickels
Unverified
15:20
questions. So I would assume then that you would support legislation that would restore 26 weeks if the federal extensions are not available? I would have to
Representative Stephen Meeks
Unverified
15:28
cross that bridge when we get there, and that would be something that I would have to do at the behest of the businesses that are in my area and constituents and everything else when we cross that bridge. But right now, I would have to say no. Thank you. Okay. Thank
you, Representative Meeks. One more question from Representative Mayberry.
Representative Andy Mayberry
Unverified
15:49
Thank you, Mr. Chair. Representative Nichols, you had mentioned about that you felt that there needed to be a shared burden with this, with regards to I think the debt was about $360 million, and now we've paid it down to $200 and some odd million with projection, I think, to be paid off sometime in 2014. It would appear as though we're at least fixing that problem. Would
Representative Jim Nickels
Unverified
16:14
you agree with that? I would agree. I think they're reducing it quicker than they thought because our employment numbers have gone up some,
and the unemployment has stayed relatively stable. If you want to call, 7% stable. Okay, thank you.
Representative Andy Mayberry
Unverified
16:30
With regards to your bill, I see this takes it from 25 back to 26 weeks, but I don't see anything else in there that would share a burden. And so essentially I guess I'm failing to see how we're not putting ourselves right back into the same boat that we were
Representative Jim Nickels
Unverified
16:51
in. Well, it doesn't. the it takes a since I think the previous last legislation put
all the burden on the unemployed I'm trying to lift some of that burden from the unemployed now if you know but doesn't this I mean if
Representative Andy Mayberry
Unverified
17:09
this bill were to pass by itself then wouldn't that just put us right back into the same predicament that we were faced
Representative Jim Nickels
Unverified
17:17
with not too long ago I don't don't think so I think the economy is improving and that we are paying our debt down quicker and the and mr. Williams or somebody from the agency there is I think serious talk
about the feds just the wiping out a lot of that debt that is out there see the the way it in a perfect perfect economy dealing with unemployment compensations benefits we would collect enough during the good years I think it was Joseph that did that and then we would pay use that to pay the benefits in the bad years and what happened we did not collect enough during the good years to
take care of our unemployed during the bad years I don't understand
Representative Andy Mayberry
Unverified
18:12
and agree with all of that. I just, to me, it looks like your bill puts us
back into the same situation where we were without providing some type of alternative to right the ship.
Representative Jim Nickels
Unverified
18:26
Well, Mr. Mayberry, I would welcome an amendment that would take $6 million from the other side to balance this out,
Representative Andy Mayberry
Unverified
18:37
Right now, I'm just looking at your bill as is. Thank you, Representative Nichols. Thank you,
Representative Mayberry. No other people signed or no questions from the committee, so thank you for the presentation, Representative Nichols. We have a couple people signed up to speak for and against. We'll start with the against. Mike Moore, if you'll join us at the end of the table and state your name and affiliation for the record, you'll be recognized to speak against House Bill 1018. Hit your mic, please.
Speaker 57
19:07
Thank you, Mr. Chairman. Mike Moore here to speak on behalf of the State Chamber and AIA. against this bill this bill is seeks to reverse the legislation from last session which took weekly benefits from 26 back to 25 weeks I listened to what representative Nichols said and I had some some comments to that that you know he said it costs the economy when these people go off the unemployment rolls but as we saw in the discussion they're not going off the unemployment rolls at the
end of 25 weeks they're going on to the federal benefits for at least an extra 37 weeks and maybe more in some circumstances and and one of the comments he made is that these are all workers who are unemployed through no fault of their own and that's not entirely true there are circumstances when an unemployed worker can be disqualified for misconduct but an employee who does not do their job and gets fired still gets unemployment
benefits in this state almost always so it's not completely with no fault of their own what what what it my understanding of the bill though in the last session which which took us back to 25 weeks is to try to to jumpstart the payment of the payment down on the debt that we had in the trust fund and and my My understanding is that has been happening pretty well. But what has happened because of the deficit in the trust fund is that the federal tax
on employers, as Representative Meeks I believe was talking about, has gone up. There's a tax credit to employers, but each year that we're in the deficit standpoint, The FUDA tax charged to an employer goes up by .3 percent each year. It did in 2012. It will in 2013, and it will, in my understanding, until we get that trust fund back to solvency.
That's scheduled to be in the middle of next year. Obviously we don't know, we're not sure what the economy is going to do, but this tacking on six million dollars of debt of money we don't have is just going to further lengthen the time before that FUDA tax rate goes back down. So Representative Nichols' statement that this falls squarely on the backs of the unemployed is not correct.
Each employer in this state pays more money per employee every week in their unemployment Taxes because we're still in a deficit situation and they're going to continue and those That extra bit per employee is going to continue to go up Until we get some reserves built up then that rate will start dropping back down Right now the average number of weeks that somebody is on unemployment is 15.1
So most of the people who are on unemployment will not even be affected by this bill. But it will be a cost of $6 million in a trust fund that's already insolvent. And I'd be happy to answer any questions. Thank
you for your presentation. Any questions for Mr. Moore? Okay. If not, thank you for your testimony. Next, to sign up to speak for the bill, Stephen Copley, if you'll join us at the end of the table,
state your name and affiliation for the record. You'll be recognized to speak for
Representative Harold Copenhaver
Unverified
23:00
the bill. Thank you, Mr. Chair. Stephen Copley, I'm a United Methodist pastor. Currently I don't serve in a local church, but after 25 years, I want to come and encourage and offer a reminder. There are a lot of interests, and by that a lot of balancing interests in this whole issue of unemployment, But let's remember to put a face on the person who's unemployed, the one that has to look every day at how do I pay for my prescriptions, how do I put food on the table, how do I pay
rent, how do I pay my mortgage, how do I even put gasoline in my car to go look for a job and the pressures that one faces. We certainly went through the worst recession since the 1930s, and we know that many, many Many people were laid off, and they are continuing to struggle each and every day just to try not even to try to make ends meet, just to keep from going under water. And I'd like to encourage the committee just to see those faces.
And as a pastor, I've walked with people who have been unemployed and watched the struggle that they've experienced and their families experience, the community experiences. So I just would like for us to remember them and to see their faces as we make this decision. Thank you.
Thank you for your testimony. Any questions, members? If not, thank you, Mr. Copley. Next, we have Susan Meadors, signed up to speak for. You're going to pass? I'm sorry, against.
Buddy, you're going to pass? Okay. All right. Thank you. Mr. Alan Hughes, this is the last person signed
Speaker 64
24:48
up to speak for the bill. Thank you, Mr. Chairman, committee members. Last session, Representative Nichols touched on this. He was talking about $68 million was saved by cutting this, which affects $6.5 million.
The rest came from the index. In the past, the governor's had an advisory committee made up of labor, business, and general public. We've always tried to come out of it with some agreed upon language. We've been fortunate to do that a lot of years, but last time was impossible. But go back and think about this. When he's talking about $6.5 million taken out of there, there also was a bond issue being floated around about to help everybody have skin in the game, as we call it, to put
their part into it. And the bond issue quit once the 68 million this other bill passed on unemployment taking the 26 weeks away. The ones that having time to struggle and make ends meet is the one that was affected. There was no other part of skin in the game that happened. We talk about the fund right now, it was 360 million dollars that we borrowed from the federal level. It's down to 214 or 34 now. It's getting paid off sooner.
Now, if we talk about skin in the game, why can't we give some of that skin back to the ones that really suffered? Yes, there is a debt still out there, but you think we've got to get it built up. We've tried for years to get it and get the business side to understand we ought to have a fund built up with a surplus in it for these occasions, but every time it got to where the economy was good, things were rolling, what did they want? They wanted breaks on their unemployment instead of building that fund up. We're here. a lot of times we feel like it was set up to fail
I know a lot of it can't be controlled but you talk about somebody making seven dollars in a quarter an hour and they only get eight hours a week be able to make two hundred seventy five dollars fifty cents then when they go on employment they drop down to one thirty seven a week no fault of their own but set down and try to figure out how you would make your ends meet a hundred and thirty seven dollars a week i don't know where you can rent a place for a hundred thirty seven dollars a week
i don't know where you can turn around and get car insurance afford groceries electric bill the gas bill on something like this they're the ones suffering and i agree i'm always agreeing about everybody should have skin in the game we're asking for this to come back to them right now what happens in the future about the federal level i don't know but those out there suffering right now they suffered last time and if you want to see more suffering there's no index on this it's not gonna go up now to keep up with the cost of living I hadn't seen my vehicle fuel gas bill go down I seen
341 the other day on a pump everything's going up so it's not going to keep up with the cost of living so not only did they lose that one week they lost the index to help them keep up with the cost of living I'm asking use the others days take those that's really suffered and hardship and take them in consideration this it does go back in the economy immediately because a lot of these people they're already on their last check a lot of them don't have pensions we don't want to go into pensions having a bailout on it they're
penalized they need help I'm asking you if you everybody's gonna have skin in that game think about this 6.5 million we know we're gonna get this thing paid off in 2014 I hope give a little bit of back of it because it's gonna get paid off sooner than they said and it's liable keep getting paid off a bit quicker
so with that I'll be willing to answer any ask answer any questions thank you mr. Hughes and I don't want to unnecessarily drag it out but you talked a lot about the the weekly rate and the brain home pay and then how that
factors into the weekly unemployment benefit but just to be clear this bill doesn't do anything to change that pardon this bill doesn't do anything to change that this bill just just adds one more week on to to what they can draw albeit a low unemployment
Speaker 64
29:04
benefit well I was just I was want to make everybody aware that if there's several pieces that passed that's where the numbers came from and this 26 meet weeks means a lot to go out there and talk to someone and hear the problems it is I
understand okay thank you any other questions for
mr. Hughes all right thank you for your testimony members there's nobody else signed up to speak for against representative Nichols would you like to close for your bill mr. chairman how much
Representative Jim Nickels
Unverified
29:38
time do you want me to take you you
you did your job and I thank you for it okay take whatever time you feel
Speaker 36
29:48
is appropriate all right well I think you've heard the both sides of this
Representative Jim Nickels
Unverified
29:53
issue dealing with with unemployment compensation benefits and I think the we got to this stage because we did not save enough during the good years to pay the benefits in the bad years and I would hope that labor and management would get together this session and come up with a compromise bill that we can all agree with that
shares the sacrifice. So I would appreciate a good vote from the committee. Thank you, Mr. Chairman. Thank you, committee. Thank you for the presentation. Members, you've heard the testimony
of the presentation. What's the pleasure of the committee? We've got a motion to do pass. Any discussion on the motion? If not, all in favor of the do pass motion, say aye. Aye. All opposed? No. Chair rules the no's haven't.
Roll call. Two hands. We'll call the roll. Thank you. Go
Speaker 72
31:12
ahead, Mr. Price. Okay. Representative Word. Representative Word. Representative Butch Wilkins. Representative Perry.
Representative Malone. Representative Hank Wilkins. Representative Lading. Representative Love. Representative Link. No. Representative Harris, Representative Wardlaw, Representative Hammer, Representative Hammer,
Representative Branscombe, Representative Meeks, Representative Mayberry, Representative Overby? Yes. Representative Ritchie? Yes. Representative Womack? No. Representative Ferguson? No.
Vice Chair Murdoch? Yes. Chair Burris? No. Rep. Nichols, you failed to pass your bill. Thank you. Next, special order, we have House Bill 1185. Rep. Wright, if you'll join us at the end of the table,
well, you're recognized to present the bill. I think Senator Dismang will be presenting with you. So you two are both recognized to present 1185.
Representative Marshall Wright
Unverified
33:13
Thank you, Mr. Chairman. Thank you, committee, for the special order. Hopefully
we won't take too long. Before we get to the bill, I do have an amendment, Mr. Chairman, committee. All the amendment does was just modify a little language on the bill to make some different representative groups out there happy. So all I did was just modify the language.
I appreciate a good vote on the amendment. Good news, members. The
pull it up. It's MGF-212. Okay.
Representative Wright, I mean, would you just like to go ahead and adopt the amendment and then explain the bill? I think this kind of changes the substantive nature of the bill. So this is a member's own amendment. If it's okay with the committee, I think we could probably discuss it in the context of the whole bill. But I'll leave that up to the committee once you pull it up. I'll entertain a motion or questions on the amendment. Okay. You've got to move to adopt by Representative Wardlaw. Any questions on the motion? Okay. If not, all in favor of adopting the amendment say aye.
Aye. Any opposed? Okay. You've adopted the amendment. Representative Ryan, if you'll give us just a second. I think we're
okay we only got a couple members who aren't able to pull up the amendment we're going to go ahead and move forward and if we have to we'll print some out but y'all are
Representative Marshall Wright
Unverified
35:34
recognized to present your bill as amended thank you mr. chairman committee thank you for your time I'm going to be brief and just give you an overview of what this bill does and then I've got some representatives from the pharmacists association and the medical society here to answer any more detailed questions. What this bill does is it allows for a doctor to write a prescription,
and if that doctor specifically says it's okay for the pharmacist to substitute a therapeutically equivalent drug, this allows the pharmacist to do that. It does not put any requirement on the doctor that they have to do that. It simply allows the doctor to do that if they so choose. If this is done and somebody goes into their pharmacist after a doctor has specifically allowed this and a certain drug is not on somebody's prescription plan and it's a very expensive drug and there is a therapeutically equivalent drug, same class of drugs, the pharmacist can say the drug prescribed to you is not included in your plan so you'd have to pay full price for it,
But your doctor has allowed me to therapeutically substitute that drug. Are you okay with it after a detailed explanation by the pharmacist to the patient and notifying them of that? I'd like to turn it over now to any questions and specifically to the Pharmacists Association and the Medical Society. Go ahead and state
your name and affiliation for the record.
Speaker 92
37:10
I'm Mark Raleigh with the Arkansas Pharmacists Association.
Speaker 93
37:15
David Roten with the Arkansas Medical Society. So
Speaker 96
37:21
we're open to questions if anybody needs any clarification. Okay. Thank you.
Yeah, we'll just go ahead and open it up for questions from the committee. So Representative Love, you're recognized for question. Thank you, Mr. Chairman. Can you talk
Representative Fredrick J. Love
Unverified
37:34
me through or walk me through the process? what's the current process as of right now? As would
Speaker 96
37:42
happen now, Representative Love, if a doctor wrote a prescription for a specific drug that we tried to run through and the plan wouldn't pay for it, we would go out and talk to the patient, say your plan doesn't cover this drug, this is how much it is, generally more expensive than their copay they're expecting to pay, $30 or whatever their copay is, at that point almost universally the patient says would you talk to my doctor and see if there's something on my formulary that could
be used in the same class. If the doctor has already told that patient, you know, you have to take this. And at that point, they'll say, yeah, I know that, and that's over. So if they ask us to, then we call the physician's office, and then there's a series of, maybe a series of phone calls and a time element where maybe the patient goes home, it might be the next day, it might be that afternoon. We go through a process where we figure out what is on their formulary, and then the physician okays that drug if he chooses to do it. And this so that's how we do it now
So this this process really doesn't change anything other than it shortens that process when the physician says here's a class of drugs This is the one I generally write, but I know there's others that are fine and there's formularies out there I'm going to let the pharmacist know by writing may therapeutically substitute on
Speaker 92
38:54
the prescription to take care of that 24-hour process or whatever it is to get it done Satisfied thank you representative love if
Representative Marshall Wright
Unverified
39:04
I may I may have skipped a little step two The pharmacists and doctors are all down here in support of
this, so that the doctors are for it
Speaker 104
39:13
and the pharmacists are for it. Thank you, Representative Wright. Okay, now
Representative Deborah Ferguson
Unverified
39:19
we have a question for Representative Fergus. Thank you, Mr. Chairman. I just wanted you to clarify something, because this is things that I'm hearing from my colleagues, and I have tremendous respect for pharmacists. They're very well educated, and I think they're completely capable of understanding what's their, even though it's not generic, what's therapeutically appropriate. But kind of the concern I've heard is the 24-hour period for notifying doctors.
But if you could sort of explain with the new electronic prescriptions how that time frame is really shortened. Representative Ferguson,
Speaker 93
39:55
let me answer part of that question. We asked for the 24-hour notice. Part of what the Medical Society asked for in this bill, There were three things that were really important to us when Dr. Riley first brought this to us. We wanted the physician to be in charge and that therapeutic substitution could only take place if the physician specifically authorized it.
They agreed to that. We wanted it to be in a case where it would save the patient money. That was our second condition. That's in the bill. And the third one was that if a therapeutic equivalent drug is substituted, we believe the doctor needed to know as soon as possible so they put it in their records so that they would have that now as far as the electronic stuff I'll let Dr. Riley address that because he probably understands it better than I do and
Speaker 96
40:46
again we we agree with all three of the points the medical society made we
intended that in our bill and that process as far as the 24-hour piece that we just picked a time frame because if someone's really busy maybe at the end the day before they can call it in or whatever however in practice what's going to happen is we will go to work on this as soon as the bill passes the software vendors will automate this system in a way if all their pharmacists are going to be doing this at some time where the pharmacist will indicate it's a therapeutically substituted prescription I believe this is what will happen and when the prescription finishes when the last remittance comes
back from that it's paid and all that it will automatically send to that doctor of record the drug that was used I think it'll all be electronically an automatic so it's instantaneous thank
you representative Ferguson representative Ward-Long thank you Mr. Chair
Representative Jeff Wardlaw
Unverified
41:42
Mark thank you for coming today can you tell me does this put any unnecessary burden upon the patients at all not at
Speaker 113
41:52
all it's a process we already do it actually
takes burden off because now they don't have to
Speaker 96
41:58
wait they can leave the pharmacy in 10 or 15 minutes with a prescription that we would have gotten
Representative Greg Leding
Unverified
42:10
to some hours later. Thank you. Representative Letting. Thank you, Mr. Chair. Just one quick question. The last paragraph of the bill in Section 3, where it says therapeutically equivalent means drug products from the same therapeutic class that if administered in appropriate amounts, can you give us any kind of clarification?
Speaker 96
42:28
application or guidance on what appropriate means? Well, appropriate means that if you change from one drug to another, the milligram strength of those may be changed. And our word appropriate would mean to make sure there's therapeutic equivalent. For instance, a simple one, if you go to the class of proton pump inhibitors for stomach acid, Nexium 40 milligram is essentially in therapeutic class equivalent to Prilosec 20 milligram. And so we know those equivalences, and that's one of the we specifically agree with the medical society that it's best for the doctor to write exactly
what they want, so then we can make those equivalences off of that. If they didn't give us a drug and a strength and just said therapeutically substitute it, then we don't have enough information, and they may not get what they want. So we like to start with a specific drug that they want. If that drug will go through, that's what they're going to get. It's only when they're, you know, it doesn't, and they've said that we can therapeutically substitute it, and the patient agrees to it, from that intent from the physician,
Speaker 92
43:25
we can go to the one that's therapeutically and has the appropriate dose to be therapeutically equivalent.
Speaker 118
43:30
Thank you. Thank you, Mr. Chair. Thank you, Representative Link.
Representative Kelley Linck
Unverified
43:39
I imagine a lot of people do this. Sometimes I will pick up my wife's drugs or vice versa. If you're not feeling too well, you don't necessarily want to go into the pharmacy sometimes. What's going to happen if the person is not prescribed for? What will be the process there? Will it be different than it is now, or what will happen? Excuse me, you're saying when
Speaker 99
43:56
that person can't come in? Yeah, let's say that I
Representative Kelley Linck
Unverified
43:58
come in for my wife to pick up a drug,
and the pharmacy recommends therapeutically changing it for the reasons that you've given. Will she have to come in, or, I mean, the person that it's actually prescribed for, how will that work? As a pharmacist, I would ask that person how I could communicate with the
Speaker 96
44:13
patient, and if I had to call them or whatever. As a pharmacist, you would, but what does the bill say about it? What will
Speaker 118
44:19
be the law? The bill says you have to communicate that with the patient. Okay. Thank you. Thank you, Representative
Link. Don't see any other questions from the committee, so we'll move on to anybody sign up to speak for or against the bill. We've got five. I don't know if that's going to stand, but we'll work our way through it. We'll start with the against Marjorie Powell with Pharma. Yeah, if y'all would step aside and let Ms. Powell have a seat. If you'll state your name and affiliation for the record, you will be recognized to speak against the
Speaker 121
45:02
bill. This is, I'm Marjorie Powell. I'm the Senior Assistant General Counsel at Pharma, the Pharmaceutical Research and Manufacturers of America. I represent the women and the men who are making the research and development decisions to bring new medicines to market for patients who don't have fully effective treatments for their diseases and conditions. I would like to say first that while we were opposed to the bill, and I signed up against the bill,
with the amendments that the committee has accepted, we are no longer opposed to the bill. But I do want to take just two minutes, if I could, and tell you why it was that we think there are some concerns. As you heard from the sponsor of the bill and from the representative from the Pharmacy Association, this is driven because of the cost-based provisions that insurance companies are proposing.
It's pharma's position on this bill and on other bills that it is vitally important that the patient have access to the medicine that their physician or their nurse practitioner or whomever is prescribing is prescribing and thinks would be best for that patient. The physician is in the best position to know what all of the patient's medical conditions are and all of the reasons for selecting a particular drug rather than another drug.
It may be because of a concern for side effects or it may be because of a particular desire for a particular side effect. Particularly when patients are taking multiple medications, it's important that the prescriber know all of the medications that the patient's taking and make the choice among those. We think it's also particularly important that the patient understand that there will be a change and what that change may mean for the patient.
It may mean that there is a different prescribing or different administering schedule. Maybe rather than taking a medication twice a day, I now need to take it four times a day. Or perhaps the pills will look different. My husband codes what he has to take at which times by what color and size the pills are, not by the pill's name or what they do. He takes the little red ones at night, and he takes the blue and the white ones in the morning.
And if those colors change, we have to go through approximately a week of, okay, did you take the right medicine, and which one am I supposed to take today? Now, my husband is fairly well-educated until he retired. He was a college professor, and he also lives with me, and I focus on what it is he's supposed to be taking. So we have the advantage that we know something about the system, but it is vitally important that the pharmacist actually talk with the patient about what the dosage is, when they are to take it, why it may look like a different color.
It's also frankly one of our concerns that this could result in changes for the patient each month when they go back in if there is a different drug available or if the insurer has changed what's on the formulary. This is a change from what will be happening now because the prescriber will get the information afterward but particularly with the amendment it is very clear that the prescriber has to
explicitly say in this instance pharmacist you can have the I am turning over to you a portion of my prescribing authority to let you select the particular medicine that and in that situation it's quite different from the collaborative care arrangements that are I understand legal in Arkansas where the physician and the pharmacist work out an agreement for
the range of drugs within a particular class and the physician knows which pharmacy the patient is going to. Now with electronic prescribing it's more likely that the physicians now do know which pharmacy because at least in all the physicians I see they say to me which pharmacy do you get your drugs filled at so that they can do the right electronic prescription but that is going to involve the pharmacies in greater interaction with patients and we
think this may in fact increase the workload of some of the pharmacies but it will eliminate the calling of the physicians. We also just want to put on the record that I would anticipate that this would increase the liability concerns of the pharmacies and both the pharmacists and the pharmacy owners because I would assume that any personal injury lawyer that is suing a pharmaceutical company
and a doctor would also include the pharmacy in the litigation. Thank you. As I said at the beginning, with the amendments, we do not oppose this bill any longer. But I did want to note some concerns. Thank you, Ms. Powell. Any questions? Okay.
Thank you for your testimony. Next, Kim Arnold, would you still like to testify against the bill? Okay. If you'll state your name and affiliation for the record, you'll be recognized to speak
Kim Arnold
Unverified
51:05
against the bill. Thank you, Mr. Chair and committee members. My name is
Speaker 126
51:16
Kim Arnold and I'm the Executive Director of NAMI Arkansas, the National Alliance on Mental Illness. I speak against this bill today for three reasons. This bill has tragic, unintended consequences for people with mental illness and their family members. It's expensive, unintended consequences for Arkansas taxpayers.
it has more questions raised than answered. Therapeutic substitution replaces the prescribed medication with an entirely different one. It's not the same as generic substitution. Medications for persons with mental illness, an antipsychotic for example, have different side effects. Some are known to be more sedating. Some are known not to cause significant weight gain. Some are more stimulating. Some have side effects that are concerning if you have
heart problems or if you are at risk for other common conditions. Imagine the person prescribed an antipsychotic that was sedating because one of his or her symptoms was that he or she was highly agitated. And the pharmacist substituted an antipsychotic that aggravated that symptom and it caused the individual to stop taking the medication or perhaps the individual stopped due to other side effects. Either of these situations is concerning for
the individual and their family. The unintended consequences could be tragic and it's the taxpayer who will foot the bill if people end up in emergency rooms or in jails because of the substitution unanswered questions are what are the consequences if any if the individual who received the substitution if the pharmacist fails to follow procedure and does not notify the physician of the substitution if the substituted medication causes side effects or other intolerable conditions
will the individual or the individual changes his or her mind because the medication isn't working will he or she be able to obtain another prescription if so when will the individual have to be seen again by the prescribing physician if so given the waiting period for some individuals to see psychiatrists or prescribing providers can they be seen in a timely manner will this additional prescription or change of prescription be covered by insurances and other payers
or will the individual be responsible for this cost fully how will the pharmacist know that he or she is speaking to the individual who makes the medical decisions for the individual will the pharmacist ask if the person has a legal guardian first before suggesting the substitution many individuals with serious mental illness have a legal guardian who makes those decisions for them will the pharmacist know the individual's diagnosis the unique symptoms of the individual the unique symptom each medication targets
the patient's medical history health history and how a different medication may affect the patient's other health conditions if any and finally should we expect any person but especially a person with a mental illness where there's so much shame and stigma associated with the condition to have this discussion at the local pharmacy counter I know the answer to the last question it should be no that's a decision left in privacy thank you for
your time thank you for your testimony and I have a question
there's a couple others and you're because of your organization naturally what you do you focused on mental illness but I guess my question is everything you addressed in terms of you know the tragic consequences of you know of a delicate balance being interrupted at a pharmacy counter in public I guess the my point would be isn't that why all of this is simply at the discretion of the prescriber the doctor and then the pharmacist at the pharmacist can't act
or do anything without the the doctor who is the prescriber giving the permission and the people that are prescribing and diagnosing the situations that you laid out know
everything that you just said and I don't think would start
Speaker 129
55:37
that chain of events that you laid out is that fair that's possible not all persons who prescribe medications for persons with mental illness or psychiatrists there could be physicians and my concern is that we don't know currently how that substitution will look is it if it's
written is it how that would look so I'm a little concerned about how the form would look or how that would look in terms of an electronic notification to the pharmacy whether an error could occur and I
understand concerns and I guess for me somebody that's outside the system yeah all I know is that if somebody that deals with the types of situations that you're talking about they're not required or mandated to do anything differently than what they're doing now all it's saying is a doctor can delegate a little bit of discretion
to a pharmacist and I would just think the professionals that deal in the situations you're dealing with do understand the balance better than anybody won't exercise the discretion if they don't think it's it's it's needed and I guess that's my point so representative Mayberry thank you mr. chairman and
Speaker 44
56:41
my question is along similar lines to yours and
Representative Andy Mayberry
Unverified
56:46
so I don't want to just repeat what you just asked but with regards to the side effects that you talked about that one drug may have a different side effect than than
another wouldn't the physician who had I guess pre-approved the use of certain therapeutic drugs wouldn't he already know what those side effects were and and would not pre-approved something that that might not be appropriate for that patient it would be my hope okay I I guess just the way that I've understood this and correct me if I'm wrong that they're already approving the use of some
therapeutic drugs that this is just kind of expediting the process and and making a little more efficient delivery of it my concern
Speaker 129
57:43
again is that we don't know based on what I've seen here what the procedure will be or how that will look So I think there's a lot of places where we don't know what that procedure will look like for the substitution and how that would look. So my concerns are there. Thank you. Okay, thank you.
Speaker 118
58:03
Representative Link, that's the last question. From what I'm hearing right now, the
Representative Kelley Linck
Unverified
58:09
last person came up to oppose mentioned that, you know, the amendments, she was more comfortable with the bill at this point. Are you more comfortable with the bill with the
Speaker 129
58:21
amendments or are you still very opposed to this? It sounds like you are. I'm concerned for individuals with mental illness because they're a very vulnerable population. I'm concerned because they make the decisions with their psychiatrist or their prescribing
physician and they may have sometimes they're very shamed and once they've made that decision to have someone else suggest something to them, they could feel shame to even go and get that prescription filled, or they just might say, I don't want to have this discussion at a pharmacist, just never mind, I won't pick up the prescription at all. And I think that's,
Representative Kelley Linck
Unverified
58:58
I do think that's a legitimate concern, but as I, well, I'm not going to argue with you at the table here, I just want to know if you are more comfortable
Speaker 129
59:09
now with. The amendments are helpful. I still have concerns. Very good. Thank
you. Thank you. Okay. Thank you for your testimony. Next, signed up to speak against Mr. Jason Brady. If you'll state your name and affiliation at the end of the table, you'll be recognized to speak
Speaker 139
59:37
against the bill. Good morning, Mr. Chairman. Can you hear me? Great. Jason Brady, American Cancer Society Cancer Action Network.
the C4 sister affiliate, nonpartisan advocacy arm of the American Cancer Society. With the amendment, we have fewer concerns. I won't say that we're outright opposed to the bill. We were going to suggest a couple of items which I think may be addressed. I do want to take just a moment to note for the record, though, that we did have some concerns because for cancer patients, it's the chemotherapy. It's a cocktail mixture of drugs, therapeutic drugs. These are not really drugs that can be substituted, in our opinion very freely and so that was our main concern bringing to this if the law if the
legislation is now where the doctor gives a pre-described list of drugs that can be substituted then we may have less concern we still have some problems with the 24-hour notice just because of the chemotherapy and the side reactions that can occur very quickly for cancer patients we'll look at this legislation again I really just want to take a moment and note our still concerns with this law as it is and I will with the interpretation try to answer any questions if there's any okay thank you for
your testimony uh any questions members okay not thank you sir
thank you mr. chairman uh next signed up to speak against we have two more lasha avance are you in the still with us okay if you'll join us at the end of the table and state your name affiliation you'll be recognized to speak against the bill
Lachey Vance
Unverified
1:01:21
good morning my name is Lachey Vance I'm a facilitator with a pilot chapter under the Lupus Foundation of America, Arkansas. I consider it a privilege to speak before you this morning about a topic that will affect me and other Arkansans depended upon your legislative voting. Knowing that your time is important, I have written a prepared statement to speed up this process alone. I was diagnosed with a chronic condition known as systemic lupus arithmetosis, which is an
autoimmune disease where the antibodies that are created to fight off infections or ward off invaders that can make one ill continue to attack the body in a negative way. My initial diagnosis was discovered in September 2000, which is about 12 and a half years ago, and it has been an uphill journey with many struggles along the way that has included continually rediscovering who I am now with this condition, who I define myself with this conditions, battles with health crises, acquiring comparable medical services and treatments
which include medicine adequate under state and federal guidelines provided due to my socioeconomic status. Which brings me to why I am here today on such short notice. As a Medicaid recipient, I am afforded the opportunity to receive commonly practiced generic substitutions because I currently cannot afford neighboring drugs. For these generics, after a decade of tweaking, appears to be working under the due diligence of my doctors and specialists,
working hard together to discover which medicine combinations and dosages fare well with me to help me to get along with my day-to-day. Interchanging my generic substitutions for questionable therapeutic replacements may prove more harm than good. Generic drugs use the same active factors, ingredients as you will, as those brand-name medications with a far less potential for a risk of negative sound effects. Now with a therapeutic substitute, it is to my recent understanding that it will not have
the same active ingredients regulated by the FDA with a broader range of variability in its chemical formulation, increasing the possible risk of negative outcomes detrimental to my body enduring this condition. It is also to my recent understanding that therapeutic substitution is cost-driven and not patient-driven. This may jeopardize patient safety. As a patient, I risk the chance of being given an entirely different refill prescription each time dependent upon the pharmacy's cost of those said medications at the refill date.
Since each therapeutic medication has its own unique clinical and chemical characteristics, in the end will be subjected to accept frequent switches between these medications that will trigger negative drug interactions, side effects, and treatment failures, eventually harming patients such as myself and further burdening the already stretched medical system with more cost. Medicaid recipients stand the possibility of being impacted more by therapeutic substitution than other populations within the state.
For example, those receiving state medical assistance to aid in their care may suffer from multiple chronic conditions, secondary conditions including mental and behavioral health issues. This would be a gambling practice, consequent in dramatic setbacks to an individual's treatment stability plan devised by both physician and patient. Therapeutic substitution may, in the end, place an unnecessary burden on the patient health-wise. is supposedly prescribed to the unique individuality of each patient regarding factors such as
age, weight, height, sex, and even the severity of condition. Therapeutic substitution will quote the efforts of the patient's physician who oversees the entire treatment regimen for that said patient, that he as a medical expert provides and knows what will work best for his patient. Under this point, the patient obtaining a possibly different therapeutic substitution each time, her prescription needs refilling run the risk of taking a different medication further challenging the already established stability of that patient regressing
her health. Not neglecting to mention the patients for personal reasons may use multiple pharmacies to fill medications based on proximity and immediate refill availability further putting the patient's health at risk because the pharmacist will not have a complete picture of the patient's medication and or medical history. Thereby dispensing different therapeutic substitutions will definitely pose a greater problem regarding health. Understanding that doctors and pharmacists alike, I believe, have taken a Hippocratic
oath to first do no harm with this proposal to support therapeutic substitution may rob them of their ability to perform at their best in providing care for patients. are specialists in the medical expertise and knowledge is invaluable. Furthermore, taking the power of being confident with the medications currently provided by Arkansas patients by adopting a premature policy in prescribing therapeutic substitution
would pose a grave mistake and a possible overburden that our state may not be able to handle. In conclusion, a better Arkansas is a healthier Arkansas, maintaining the current system of prescriptions with generic prescriptions included to our state's patients and not haphazardly switching therapeutic substitutions without weighing the grave risk I have presented can negatively impact the residents here so before even considering the support for therapeutic substitutions I suggest as
not only a person sojourning with a chronic condition daily but also as a resident and a regularly voting constituent of Arkansas, I urge you to favor opposition to therapeutic substitution. It will strengthen condition-affected constituent residents and state legislator relationships for securing our belief, knowing that the state's majority voted the right policy makers in office, ensuring our confidence that not only are you concerned about what is best for Arkansas, but you are also truly concerned about what is best for the health of your
residents what's it then thank you
for your opportunity thank you for your testimony members any
questions okay if not thank you for your testimony ma'am thank you we have one more signed up to speak against Bob Coffey mr. Coffey if you'll state your name and affiliation you'll
Bob Coffey
Unverified
1:08:21
be recognized to speak against the bill thank you sir my name is Bob Coffey I'm a private citizen and I do volunteer advocacy and so I'm not really affiliated with anyone other
than the United States of America I'm a retired military officer which puts me at a peculiar point on this pharmacy kind of thing because I have TRICARE which I mail back and forth so they don't really get to talk to me I have the airbase that if my doctor gives me a prescription I can go to the airbase and get it for free and then there are some that since the air base wouldn't have them on their formulary or the TRICARE folks are so far away to try and get it and it's not
on their formulary that I would go to my local pharmacist and say I need this prescription by my doctor here filled. So as I read the bill and I did get the amendment that says the 24 hours the change I don't know whether there's any other amendment but there were Some things that I thought of that I said, wait a minute, I'm also HIV positive and have hepatitis B, and I was fat two years ago. I weighed 292 pounds, and so I was on blood pressure medication.
The reason that that's important is they put me on a medication, lisinopril, that I coughed, and one day I passed out five times from the cough. one of them was in a hot tub not a good place to pass out my doctor knew about that my doctor changed the prescription we went back to an old prescription that I had when I was in the military vendor all they gave me and draw which is a the name brand but they change it to propaninol I was on propaninol
everything's going great blood pressures going down I lost weight that helped and then suddenly even on the propanol I was getting that familiar cough back again my doctor knew about it I contacted my doctor once we get that we start looking and said okay what's what's causing this what we found out was it was simply the manufacturing compounds in the different
manufacturer of the propaninol so my pharmacist ultimately had to go back to only the Watson brand of propaninol which I went out to the air base and said can you do this for me and fill it that way they said we will never know what brand we get of that generic drug so there are some issues on that because I want my doctor informed I don't have the pharmacist I also have some notes that I talked to a doctor, one of the gentlemen before me indicated
that all the doctors are behind this and I called my physician and I said, hey this is going on, what do you think? And my doctor was, my doctor, my physician was not for this. So some are. Generalities don't always work. Cost savings. I'm all for cost savings. If you look at my wardrobe, I'm cheap. So I'm all for cost savings. And I do recognize that
pharmacists know compounds better than my doctor. So I want pharmacists to talk to my doctor. I told you I did advocacy. And a lot of that advocacy is with HIV. We talked about stigma with mental health we talked about cancer you know their diabetes there's every kind of drug that everybody in this room is affected by that you and your doctor know about that I want that doctor involved first line because that's who I pay when I had my problems with Inderol I didn't call my
pharmacist and say this is what's going on I call my doctor I don't see I I I heard you talking about the doctor could pre-approve on a script that they could do a therapeutic substitution. I didn't see that in the bill, I'm old,
Speaker 144
1:12:41
60 years old, you know, sometimes you skip over
Bob Coffey
Unverified
1:12:46
some stuff. Maybe it's in one of the other amendments.
Not all of the systems that I work with are automated yet. I was talking to somebody in Mountain Home, Arkansas, and they don't even have broadband. It was their problem there. So we sometimes make assumptions on electronics will get through. You know, sometimes telephones don't even get through. And someone also made the comment that this would only happen, this default would only happen if the insurance company rejected
if that didn't go through with the insurance company when they plugged that in I want to hit on that I take a tripla which is $1,500 a month I want cost savings I definitely want cost savings sadly for my particular mutation as opposed to somebody else's mutation the same therapeutic class doesn't always work That's why they have to do expensive genotype and phenotype tests to find out, you know, all the specifics.
Again, my doctor has all that information. My pharmacist doesn't. I have a friend who was on this medication that I'm on that contains a drug called systeva in it. And that person wound up going into epileptic seizures. They associated it back to the systeva. so I'd love it to be as simple as what we're talking about about I just go into the pharmacy and say here's my prescription and I would love for my
pharmacist to say Captain coffee we've got something cheaper and I'm all for that okay I'm all for cheaper but I want that that pharmacist if we have that conversation I want that pharmacist contact my doctor and say look we've got this big old guy here who wants us to talk to you first before we change this med what say you that's what I would ask y'all thank you thank you for your
testimony any questions members thank you for your testimony thank you and I for the record I think you look very nice okay nobody else
signed up to speak for against the bill um representative bryant you're recognized to close for your bill thank you mr
Representative Marshall Wright
Unverified
1:15:17
chair committee uh i wanted to bring up mr roden again and uh mr riley
to address uh any questions that may have arisen before i turn it over to questions for them i just remind
you there's no requirement whatsoever placed on the doctor at all it's totally at the doctor's discretion and i would let committee ask any questions i believe they'll be able to
Speaker 93
1:15:43
address mr. chairman I'd like to make just a brief comment after listening to some of the testimony in opposition of this bill it it re reinforces my decision to be here at the end of the table today a couple of weeks ago our position on this bill was the pharmacy association had made all the changes that we'd asked for
and we were satisfied that the bill would work as intended and that physicians were still in charge of their prescription writing authority so that was our position we weren't going to fight for the bill we weren't going to support the bill we weren't going to be out here talking about the bill as things changed over the last week or so we changed our mind and what really changed my mind was earlier this week when I got a phone call from one of my members and I've heard shades of that conversation in some of the testimony
today I received a call earlier this week from a local Little Rock physician who happens to be a good friend of mine we play tennis together periodically and he said David what do y'all know about this bill at the capital to let pharmacists substitute anything they want for the drugs that are that we write and I went you know doc who who told you that well one of the pharmaceutical reps and I said okay thank you now let me tell you what the bill does and when told him what the bill does he said well that that makes more sense that's
reasonable nobody knows more about the patient than their doctor nothing in this bill changes that nothing in this bill says that a pharmacist can change a prescription it's a therapeutic substitution within the same class it's not like a totally different drug that it's not intended to treat the same condition but if that physician doesn't proactively authorize it it won't happen and the only reason the physician would proactively authorize it is
because they felt comfortable with it one of the pharmaceutical reps asked a friend of mine a couple of days ago so what's in this bill for the doctors and when he said well there's nothing in this bill for the doctors other than maybe saving a couple of phone calls well there's got to be something in it for the doctors so you know it really bothers me when that kind of information and misinformation is put out to the physicians that I represent and to you all and I just felt like you ought to hear that from me rather than
from mark dr. Riley you know or the sponsor of the bill because it's really you've been given a disservice and some of the people that are here I think have been given misinformation this is a tightly regulated business that we're in writing prescriptions doctors not going to authorize a therapeutic substitution If he's got a patient, he or she has a patient, that's on a drug that's working well for them. And it's not necessarily a cheaper drug. It's a drug that costs the patient less. Maybe it's a lower cost on their tiered system.
Instead of a $100 copay, it's a $50 copay. If it's less expensive for the patient and it does the same thing and it treats the same conditions, you know, and the patient can say no. I don't want that. the patient can say, sounds like a good idea, Dr. Riley, but would you call and talk to my doctor first? He's got to do that. So all of those things are taken care of. You know, I just I would encourage you all to
help this bill move forward. Thank you. Did you want to add anything, Representative
Representative Marshall Wright
Unverified
1:19:13
Brian? Mr. Chairman, I don't think I can add anything to that. I'm closed for my bill. Thank you, committee.
I appreciate a good vote. Okay, what's the pleasure of the committee? I had Representative Wilkins. I'm sorry. Did you have a question? Representative Wilkins. Motion do pass. There's a motion do pass. Any discussion on the motion? Do pass as amended. So any discussion on the motion? If not, all in favor say aye. All opposed? The ayes have it. Congratulations. You've passed your bill as amended. Thank you, Mr. Chairman.
Thank you, committee. Thank you. I know there's going to be several folks exiting. We kind of go through this every time. If you could do it, please do it quickly and quietly. We still have a little bit of work to do, so get on out. On the next on the bill, we have SB 134, Senator Raper. I believe Representative Klemmer has an amendment to present to the committee, and that should be on your tablet. And we'll wait for some of the folks in the audience to follow my admonition.
do what and the members the amendment is engrossed in the bill so we don't have to adopt the amendment but the bill as amended should be on your tablet okay folks if you could get a seat or go outside I'd appreciate it we're going to go ahead and conduct some business representative
Clemmer you're recognized to present SB 134 as amended Thank You
Representative Ann V. Clemmer
Unverified
1:20:57
mr. chairman members of the committee I'll
wait for the door to shut old teachers are not usually tolerant of noise when they're talking I'm kind of an old teacher All right, I'll also have a loud enough voice to talk over some of this.
Last week you were very gracious to approve SB 134 in this body, but I heard some of your concerns and when we found that there were a couple of technical corrections that were not of any concern except that they had to be corrected, we decided that we would address your concerns and include them in this bill so the primary things that i think you would be interested in knowing is that
this bill was has been amended to address the possibility
of a lethal fetal disorder or a fetal anomaly but we did we have we chose the words lethal fetal
disorder, just because it's a little bit easier to say than fatal fetal anomaly. And they mean the same thing. We didn't just make up those words. We did get those from physicians. So we have addressed your concern that a woman who might be pregnant with a child that would not likely live
long after birth would be able to receive an abortion. we also addressed the class D felony for the doctor and again we wanted to discourage obviously in a strong way doctors from performing abortions in violation of this bill if it becomes law but we decided that perhaps a finding would be better established by a state medical board
So the finding would have to be established The finding of a violation of these rules Would be by the state medical board And then it would result in revocation of license And that's the essence of it There was another place in the bill That said a life-threatening medical emergency And we took out life-threatening and says medical emergency.
So in cases of medical emergencies, there would also be an exception. Okay, so essentially taking out the life-threatening and just leaving it to say medical emergency to add an exception for when these procedures might be performed for the presence of a lethal fetal disorder as determined by the state medical board and then to take out the Class D felony and result in just a finding by the State Medical Board and loss of licensure.
And that really is the essence of the amendment, and
I'd be happy to take any questions. Thank you, Representative Klemmer. Representative
Representative Justin T. Harris
Unverified
1:24:18
Harris, you have a question? You're recognized for a question. Thank you, Mr. Chair. Representative Klemmer, can you explain to me what a highly lethal fetal
Representative Ann V. Clemmer
Unverified
1:24:29
disorder would be? There are a number of them, but we chose not to list
them for fear that our list might not be comprehensive.
Even the list that I found had an exception that this was an extensive list, but it was not comprehensive. So it would include anencephaly, enencephaly, hydroanencephaly, infantile polycystic kidney disease with anhydromonas. Okay. Anyway, but a number of the circumstances that we address, and I would be happy to circulate this, but all of these, again, are determined to cause an infant not to live very long,
Representative Justin T. Harris
Unverified
1:25:17
if at all, after birth. Okay, but nothing like spion bifida or anything? No,
Speaker 120
1:25:22
no, no. These are all deadly, fatal, or lethal, whichever word you would like to use. Okay. All right. Thank you. Thank you, Representative Harris. Any other questions from
the committee? Representative Letting? My question doesn't have to do with the amendment. Should we wait
Representative Greg Leding
Unverified
1:25:37
until we adopt the amendment? No, it was engrossed. Okay. The
amendment was engrossed, yeah, from the floor. My apologies. I do have just
Representative Greg Leding
Unverified
1:25:44
one question for clarification, and it has to do with a section of the bill where it talks about the tolling of effective
date if a state or federal court of competent jurisdiction voids a provision of this subchapter as unconstitutional, the effective date of that provision shall be tolled, T-O-L-L-E-D, until that provision has been upheld as valid by an appellate tribunal. Not having a legal background, I
don't quite understand what that means. So if you could just clarify for us, please. I
Representative Ann V. Clemmer
Unverified
1:26:11
would probably have to consult with an attorney myself, and I believe two of our resident attorneys just left the room
okay and I'm sorry representing that's
okay representative Clemmer just to be clear that language was in the bill that was passed out by this committee before yes that was not a change the amendment that you have offered and was adopted on there will be adopted on the floor hopefully simply address some of the concerns from opponents of the bill and
Representative Ann V. Clemmer
Unverified
1:26:40
made it a little bit more accommodating correct and and and again everyone has been sincere in there I spoke with representative Ferguson at length and she's been very sincere sincere and forthright and just some of her
concerns and again when we went back to make some technical corrections I said let's just let's just put these in there I mean let's make this the best possible bill that may go to court but let's make
it the best possible bill to be a test okay thank you for the presentation anybody's we do have one person signed up to speak for miss Nancy Emmons would you pass that's not the bill okay okay there's nobody signed up to speak for again so we've heard the presentation what's the pleasure of the committee motion do pass as amended from
representative Meeks any discussion on the motion if not all in favor of the motion say I'm all opposed chair rules the ayes have it well I don't see
Speaker 175
1:27:43
two hands I'm gonna stand him call the roll Representative Word.
Speaker 72
1:28:00
Representative Word. Representative Butch Wilkins. Aye. Representative Perry. Representative Malone. Yes. Representative Hank Wilkins. Representative Hank Wilkins, Representative Letting, Representative Love, Representative Link, Representative Harris, Representative Wardlaw, Representative Wardlaw.
Representative Hammer, Representative Branscombe, Representative Meeks, Representative Mayberry, Representative Overby, Representative
Speaker 180
1:29:06
Ritchie, yes. Yes, Representative Womack, Representative Ferguson,
Vice Chair Murdoch, Chair Burroughs. representative Clemmer 10-6 you failed to pass your bill and to go back on the active calendar we'll make everybody come and we'll do it again thank you thank you no other business come before the committee will stand adjourned
Agenda
Documents
No documents posted.
Speakers
Representative John Burris Chair
Unverified
Representative Jim Nickels
Unverified
Representative Stephen Meeks
Unverified
Representative Andy Mayberry
Unverified
Speaker 8
Speaker 57
Representative Harold Copenhaver
Unverified
Speaker 64
Speaker 36
Speaker 72
Representative Marshall Wright
Unverified
Speaker 83
Speaker 84
Speaker 92
Speaker 93
Speaker 96
Representative Fredrick J. Love
Unverified
Speaker 104
Representative Deborah Ferguson
Unverified
Representative Jeff Wardlaw
Unverified
Speaker 113
Representative Greg Leding
Unverified
Speaker 118
Representative Kelley Linck
Unverified
Speaker 99
Speaker 121
Kim Arnold
Unverified
Speaker 126
Speaker 129
Speaker 44
Speaker 139
Lachey Vance
Unverified
Bob Coffey
Unverified
Speaker 144
Representative Ann V. Clemmer
Unverified
Representative Justin T. Harris
Unverified
Speaker 120
Speaker 175
Speaker 180