Joint Performance Review (JPR)

Started first item on the agenda is approval of the minutes from our last july six can I get a motion to accept minutes as presented please get motion second I got a second a discussion and corrections in the minutes ebay sees we need to make note of. Here none then i'm in favor say I posed no k next on the item list is the discussion central arkansas water animal called ted will hand and uh j bars and kevin noten if you all would please come to the table gentlemen thank for being here this morning. Why you come in or two when you get to the table just like show me i'll have been the table before just push at my when you see the into the mike turn read that means it's heart and if you would please name and title for the record please. My name is tad bohini ceo central arkansas water. J barth and the current chair of central concel water board of commissioner kevin commissioner of such a water all right thank you after being here to custom in j p r's where people in whenever it is that we haven't come in protest money and want to have should please seem to take the else if you would please and as you stand just raise your out hand. And do you solving swear that the evidence you will give today in all matters pertaining to the subject force will be the truth hold truth and that's about the treatment of gun. I do thank you may be seated all right center sold a new vast from this meeting and will start off by just recognizing you and if others join in with questions I may hit the pause but nine years to let others have participation in the conversation as well so solving there thank you mister chair gentleman i'm over here at their side appreciate your coming and mister jere appreciate the latter two to that's calling the meeting and we have spoken a few times and communicated in different ways and I feel a strongly achieved what you needed to do to get the issue corrected so it is performance thank you for that I think you've taken action quickly and in a positive manner I for the most part I want to get all this on record so that we don't continue down this path in other ways it's all just and this started with the senate bill seventy one and I had a consumer one of your customers who contacted me with some concerns about an email and members I think you have a copy of that email in front of you exhibit c. And you did out of such comment on that if you'd like to. Sure I could have a little attitude I just want to talk about a couple things central I can sell water is the largest water provider in the state provide breaking water about a half million people that's about one in every six and if I say so myself we do a really good job of it so I just wanted it so that from the effect but you know this email. It was very unfortunate and and and it was inappropriate and i'll tell you where it came from and how we got here to where we are. You know central arguments are water header. DEI committee long before I ever got there is the see how it started mainly back in two thousand and eight and the purpose was just to to educate folks into provide access. In in over the years it's it's moved along better in in what happened in this instances is is after the the events around george floyd are work force was divided are worked force was split our work force was struggling to work together at times. And and I didn't know how to deal with it II did not know how to address the issue I did not know how to dress the pent up anger in it. It's all we actually hired a special advisor to me to say here's what's going on in your community here's what's going on your work force here summised ideas for how you can always the title that person had special advisor to the chief executive officer and in that person came uh and and she is a one that that renamed the the committee to the jet I team and just to give it a name and get out of stands for just a second justice equity diversity of inclusion thank you and and it's it's sponsored events it sponsored lunch of sponsored various things. But unfortunately we like hyber employees those type of employees or high performing innovative values driven informed and passionate. And sometimes when you have passionate people that passion gets the best of them. And so when when set bill seventy one came out that committee. Decided they wanted to say something about it now that it's not their role that is not their purpose it's not with their supposed to do but they wanted to say something about it so they sent out that email. It was sent out I had not seen it and had no idea what's coming had not even heard rumors of it were three hundred and fifty person organization in baltimore different locations. And and so when that email when out and I found out about it we are started looking into it to see what was going on as the first thing we did was we shut down to jet email. Well we had an email where members of that committee could send and I say community and that's that's probably. Two organized for what it was they were now taking over meeting to talk about doing this and anywhere that was interesting could show up and and talk about doing whatever that was if that meeting. But so but we had a we had an email so that they could send an outside outs to say hey come to this meeting we're going to talk about this or we're going to organize a popcorn for all the employees so we they get to know each other better so that they have a a friendship and understanding you know who each other are and so that we can work better together but in this instance they sent out the email that was a inflammatory in in a connection I interrupted for most because i've got copies of the email say sent to various groups all with good internet and all directed towards the purpose that you suggest there to bring people together or so you know again I support what you're efforts for in what you are trying to do and again appreciate what you did as a result I don't want to take too much of the committee's time here they can ask more in death questions but again you responded quickly and appropriately I wouldn't just go on the record some of the things that were out in this email because it was my understanding to say email also went to consumers is that correct. I have no knowledge of it going to consumers I could my understanding was that I heard from a consumer and that this one out to them also so one of my concerns is and I don't know the answer to this and you may not either but it sure appears that they were a lobbying agency and took upon themselves when they did this email to consumers and to employees that they now became a lobbyist and provided lobbying efforts now there's nothing illegal at all about a agency such as yours lobbying that's perfectly legal they have that freedom of speech to a participating there with that sure appears to me what they did do any of you have any comments on whether or not they were engaged in law being activities. I want to address the first part real quick and that it was sent to consumers the only record we have is it being sent to caw everyone on c w everyone is only the employees of. Caw now if one of the employees. Took that email and forwarded it on their own two a consumer an individual consumer that they were friends with our new but I am not aware of any. Bulk email black fair enough to our customer share now I mean there's nothing ever the intent not that that occurred but what about where they engaged in lobbying as they as this goes out and they're addressing if you look at the bottom down there it's telling them to contact other agencies and there are links on that email to contact the first congress arkansas first congress and some other organization that there are references and there in length and that email to other groups far employees at least two to contact in order for those groups to lobby against the bill it's insurer appears to me that they're engaged and again this legally okay but just to clarify are they lobbying I would say in my opinion they are absolutely lobbying. Yep most of you know who've seen me down here no I come down here frequently on water issues and try to try to persuade you on certain matters that impact the delivery of water yep I have not looked into whether that's lobbying I understand what you're asking on a legal definition I have not I do understand what you're asking their members I think on on one of your attachments I think on the I think that's a or maybe the back page you'll see there it talks about be a large talk about what lobbying is what effectively is lobbying and again just to be clear they have your employees have their first memory they're certainly allowed to speak on public matters or against legislation so i'm not contesting whether or not they have the legal right to do it just whether or not they were engaged in that. I will say I told everybody including every employee and employed meetings this is not what we do yeah again I complement you on the actions you've taken you are a totally a government agency is that correct that is correct and you have any revenue sources outside of fees and search you get from your customer we have we have rates with fees we apply for grants from various organizations and you'll have a revenue from an outside stores for all the main that you collect comes from your customers to your customers have any choice about who they get their service is from other than digging their own well under the digital well no sir they do not understand water plan it's it's us okay so it i'm looking also I think if you have a copy of their um if on the back page where you have a breakdown of payments that were that you provided to non profits yes sir in that totals about eighteen thousand dollars and so yes sir are those in some of those groups that you are donating money to actively testify it against seventy one. So is your agency supporting and donating to groups to oppose the bill no sir. Our purpose when we partner with various organizations in the community is to build trust for our product to build knowledge of what we do and how we do it. To develop a future work force no ten year old ever ever woke up and said I want to go to work for the water utility I mean but we need people we are suffering from what we call silver synomy fifty four of our five three hundred and fifty employees are eligible to retire this year. So we work with organizations to to develop a wear and us about opportunities to work in the water industry and we work to take on water issues and i'm i'm looking around the room and I only see a few and so i'm very excited about it but you know one of our issues is bottled water you wait we want people to drink from the tap and so there's kids organizations in there that it's all about education we work with those organizations and educate kids about your drinks on the tap you don't need both water so I guess I could I guess I could look at the board minutes. Cause i'm sure the board had to approve these dominations as that correct no sir they've given me authority to spend up to a certain amount okay so I could look at notes that you have a research that you've done if you could provide that to us that show the rationale for each one of these donations and why you chose one and not the other I can I wrote it down I wrote down little shorthand beside each one thinking you might ask me about that well you know I think we're going to come back to there because i've gotten as i've looked into there since see the amount of money that were expanding on these services rather than necessarily reducing the cost of your product I think it's going to be a larger conversation with utilities across the state in hour donating money to nonprofits and I understand you your board delegated to you the response the opportunity to choose where the money went do you survey your consumers at all and ask them what they would like to done eight to ordered or are they willing you know sometimes we see on on a bill if you want to donate to an organization check this box and we'll put a dollar you don't do that you just in your office to say yes sir. And I will look forward to that conversation. So do I yes it's again I don't want to get to deep into that other than just make that point the arkansas public policy panel was another one of the interest groups that are your jeriferance and yet did it it just seems that some of these. Some of these groups you're donating to further a different cars than educating people I don't know i'd have to go dig deeper into there but personally I don't want to get into that i'm gonna wind up my points at appreciate what the action you took and how quickly you reacted to that and what I think is the right thing you're doing in this case and look forward to coming back and talking more with no you're organization but our funding some of these non profits and why were choosing someone not the others mister chair appreciate thank you share walls. The. Both. All right hey online second center so then would you turn yours off. Represent bentley would you turn yourself in and white back up yet ahead center walls from from you are in now center while she should be good here we are i'm right here thank you. Are you responsible for all the infrastructure for your customers in your your registry yes sir. Okay. And I learned a long time goes a little in it the army that you can delegate. Authority but you cannot delegate responsibility so you responsible you all group and your board your responsible for all the infrastructure. In your area. Yes but it stops here that good i'm just curious to help. The. The hundred eighteen thousand dollars could not have been better use. With if the structure within your group because up in my area my folks were dare to have an extra hundred and eighteen thousand dollars to use on their infrastructure so if if you're infrastructure zero good maybe we need to divert some of that stream of money to folks that need a need more. Yeah I think if you look at the list of the organizations of their there's a lot there for economic development. One of the things that we have there were fortunate to have a rebundant supply of water and there are industries out there looking for areas with upon its supplier of water are from malax like we already have in moment to industries that are looking for location batteries for electronics for other things and so we work very closely with a number of the economic development organizations around to a tracked industries that need high quality water one of the things that we can offer to them and so we we partner with those organizations to do that then as you go down the list and you look at other things it falls into two areas employee engagement or employees being engaged in the community getting them out showing our employees that we are engaged in the community and as I discussed earlier work force to development and community support. As we look at our is we have we have a twenty fifty strategic plan and that twenty fifty strategic plan though what moves us forward including infrastructure replacement. What we need the community support for the resources that we need to be able to do that infrastructure replacement. So we look very hard that we look at that to make sure that we're building community support and we do that through our employees being engaged in various inferiors areas and how they do that. So I appreciate your. You're concerned. There are. The. There are organizations that that we look at in an say how can we help you we get information to communities one of the things that we've challenged with on the work for side and on the trust side of portable water is certain community certain different demographics do not trust what comes out of their tap you can go and you can go and you can look at what's happened in our country with with detroit with jackson mississippi you can go and look at all these areas and you can say not everybody trust that they're going to put that bottle there and drink it and so we reach out to organizations that recharge out into those communities to build that trust the american water works association has conducted survey after survey and and don't think and it says you build trust by communicating by being engaged in out working with those communities and without that trust we have people buying borrowed water when you look at the welfare of people we have fantastic water in palaceki county except for one little area that we're working on senator johnson but the pipe is sitting out there ready to go but we have people buying bottled water county when they drink some of the best water in the country and they five bottle of water with snap benefits they're buying bond water with money that should be buying food because horrible water is high quality and affordable into build that trust we reach into those communities and we say we are here trust us you know my name i've been before your organization you know our education education folks are come out and against in your organization. And that's what it's all about it about building trusts of people start buying bottled water and drink the water that comes out of their tar. At one point thousandth of the cost of barbara and that's fundamentally answer it it's not a it's it's not a support this organization to the political use or whatever it supports this education because it gets us in front of our costumers that need to hear from us that need to hear the speech I just gave you. We have to do that we have to commit seventy one percent of americans do not trust the water that comes through their tap. The highest demographics by far then do not trust the water that comes out of their tap is people's of color. We have to gain trust we have to be engaged in those communities would have to be part of them I think you get a lot of work across let me let me interrupt because one of action while it's my board is filling up okay center wells. The. Another question do your customers. Are they aware that you spent a hundred eighteen thousand dollars or something other than infrastructure. I don't know. I don't know the answer to that question. Well that tells me a lot thank you alright gonna do a representative right thank you mister chairman so since we're on the topic of these donations to the non profits as this where i'll start we just went through this with the audit committee in the mister douglas and that that the tire management district which gave thirty thousand dollars to the clinton foundation for an art exhibit so is it your is that your contention that all of these donations and I know you said that they help with tristan these sorts of things I don't know if you can quantify that but is it your contention that they all comport with the public purpose doctrine. The. Yes sir I would say that I would also say that contrary to waste management and there's a state statute um looking for it right now so I correctly fourteen two thirty four three o seven that provides for water providers water utilities to expend phones. With community chest with organizations nonprofit organizations within their community so this this body this legislature has said that it's appropriate to spend. Funds with community organizations sure why i'm not saying it's illegal I understand you're the statute you reference there but as to whether it's appropriate I mean you gave some remarks about trust issues with drinking water and the reason for these expenditures but you know would you agree that maybe at using this money for an advertising campaign that actually delivered the specific message that you're talking about might be more effective at educating the public rather than just dolling out a bunch of money to organizations in sponsorships I mean because. Most of us in this room from time to time have sponsored some sort of some sort of group or entity and typically that money you get you get your name or your logo want something but in terms of actually delivering a message it doesn't seem like that's a very effective way of doing that would you agree. It think it depends on what you have you define effective well i'll i'll just ask I mean the fifteen hundred dollars that you sponsored rhythm in the rock when what is rhythm in the rock and what is the public benefit of. Spots during that oh rhythm in the rock as a program that reach is out in to kids that are normally not associated with. Um music and. Provide some opportunities with our. With our engagement and rhythm in the rock because kids are powerful units within their families. Where we go in participating those events are employees take water we say no bottle water we were coming we're doing this so it's it's a personal touch it's it's a personal touch in contact of of what we do with those communities it's it's an interesting on our site the most school teachers tell us that the greatest thing we do is pull up and found a school with a proof in a back of and the kids go wow this is cool to better co and they get to go out and claim on it and and have that phone so we reach out to various communities and in various different ways okay so cheer contention that's a public purpose not sure I agree there but I want to go back to the email so the the jet group that sent it email what's the status of that is that no longer a thing that social market so are the emails or the email doesn't exist anymore and the group is it's it's it's we're trying to figure it is non functioning and we're trying to figure out to do because as senator solomon at its real purposes to help with cohesiveness within our own organization yeah II do have a couple questions about the email itself the first line says in an effort to keep all caw employees hiv informed that seems no that seems very awkwardly worded what what is that mean. Hi rep is is what we ask all of our employees to be high performing innovative values driven in formed and passionate okay so that's where that informed and why it's okay so so did central arkansas water have an official possession on sp seventy one no okay you you said that the reason that this was started because you're workployed we are work force was divided over though. George floydenside I assume since you don't have a possession on seventy one that your organization doesn't have a position on other controversial issues like abortion or gun control or death penalty. The. No. No. Employee safety no so if you take those in order. We are very concerned about employee safety okay so wrap up with just a couple of general questions here what where do you or do you derive your authority to operate is it from state statute had this comment of being since I can saw water was precreated pursuing to the consolidated water works authorization act. As it was passed in two thousand and one and then it was created in it before between an inner local agreement between the cities of little rock and north orak called a consolidation agreement and became effective july first of two thousand and one okay and your board how is your board chosen and appointed our board pursue it to the state statute says the organizations that create the board of the create organization will determine how the board of the appointed pursuit of the consolidation agreement four members of we have seven commissioners four members of the commission must be residents of little three members of the commission must be residents of north rock they serve seven year terms when they're terminated when they're going to replace so that there's one seven commissioner seven year old one rolling off each year but when they get to the point they need to appoint a new commissioner the commission looks into interviews talks about who should become the next commissioner they select an individual they choose a sin that name to the city of a little rock in the city of north little rock and then the city city florida ported directors and the north are actually council must approve that selection so it's just north of a rock and little rock that makes the appointments yes but your service area extens well beyond little rock in north little correct yes sir. Okay so i'm a customer I live in marmal as there's a representative to make her whose year you know we have twenty thousand one hundred and fifteen residents does it seem idea that would I would I proceed on the board or any representation on the board that is the agreement we have in those you organization that we as that is the agreement that we as an organization have been found by I would tell you specifically the more mel I understand that's what the statue reads but doesn't my question was doesn't it seem idea. There are water utilities all over the state where. People are served. Do not have a say in the people that are if this is not a situation that is unique to central accounts so. If it's if it's hard it's odd for. All seventy five counties yeah okay I would just I was just point out that the residence of north of the of the county and incorporated areas of the county don't have a seat on the board there approximately twenty thousand of those and then see a sherwood as well has about thirty thousand residents and doesn't have a seat on the board those are I represent a good deal those people and I just want to point that out then thank you mister welcome members just to give an idea where we are right now there are eight members on the board representative bentley europe be next file by senator dismay and then I will advise it who's up and then whose foul and so case you have step by the room you know to be back in it is a ten thirty five magoll hopefully you decide to hear by noon and we still have the pharmacist that are going to speak so just mindful of that representative bentley thank you chairman and I will be briefed him and thank you very much thank you as for being here today I can you tell me are you right periods about to have an increase in the matter spending on their water bill yes ma'am can tell us how much that is and how much revenue you guys will increase over the next ten years or rates will go an average bill will go from seventeen dollars to thirty four dollars over the next ten years. And so how much increase revenue will that get you guys in the total revenue will be around fifty million dollars. Can you tell me how much money your company spent on building a bridge across the mountain well river at the wind rock rest arm how much money your company spent tearing out that bridge after it was a after the huge flood which flooded my constituents out there can you tell me how much money i'll spend on that bridge and how much money spent turn it out. Oh I can give you exact numbers. Ballpark but I don't need exact amount. Yeah. Feel per round a million dollars for both building that beautiful bridge and tearing that beautiful bridge out. Yes a million dollars okay i've loved to talk to you about that privately afterwards when you get event because there's some things going on I think you should be aware of okay thank you germany's that was a appropriate for people to see how much money was spent down that bridge and how much money are has been increased on the right pairs out there in light of the other topics that were brought up thank you for being here today thank you chairman center does mean. Thank you my questions go back to the hundred and eighteen thousand and been really just some of appreciate the impassion pleaded during bottled water I would argue that most people probably drink bottle water out of convenience and that's why it exist most people probably drinking tab at home as you would suspect such as kind of a strange narrative that we went through there but I appreciate your passion about it. The one thing i'd like to circle back to is I don't think if I call a or kids read and ask them if they had a long conversation about how important it was drink by the water and loose the fifteen hundred dollars payment they would tell me that that existed. Inter I don't know that I really buy a a lot of the narrative that you were spending there though I understand it's probably pretty neat as the director to be able to spend eighteen thousand dollars about understood it correctly with almost no oversight or accountability to the outcome the utilisation of those dollars. I mean that would be any immediate thing to be able to do to pick and choose what you thought was a value on your own singerly without having any other imputter communication with individuals are there than those asking. It's a just to be clear your argument is with each one of these organizations with the exceptions and maybe your chamber which then there was a strange argument members of the you know we're gonna contribute strongly to the chamber so that we can demonstrate that we have the water need for businesses to come in and in that sort of thing which they would do for free by the way that's what they're organized to do is to be able to advocate for what you have to be able to offer just as if you were utility company whatever it may be. That it's about bottled water. That the importance of drinking tap over bottled water. And work force development and work force to engage in a. Just kind of wrap it up I do appreciate I guess the awareness that you've brought to several code sections that clearly need to be revised because I do think it's inappropriate that you have been allowed to spend eighteen thousand dollars of rate pairs money. To be able to contribute to the entities of your choosing based on your own personal beliefs of work creates value so I add I do appreciate that and also the maker because they get a very valid point as you all have expanded in together past two thousand and one with answers originally set out there is not representation for a number of right payers across your territory are thinking even including show wooden my mail in a rural black county and on a night so I can appreciate that and i'll look forward to helping offer up solutions to what I think are glaring loopholes in the existing law. Thank you senator dismaying representative flowers. Thank you so much mr chair. And I am not in central arkansas and am hearing concerns about. Uhm sponsorship in contributions to non profit organizations and. And i've worked in the non profit sector and. Um and am aware of how important. Um. Corporate and community support is i'm also aware that often times that sponsorship is an effort to generate exposure. And. Go where people are connect with organizations to establish relationships. Um is is a is this an eighteen dollars in. Contributions and sponsorship sort of tan amount to. That to exposure advertising. And education and you know I noticed. In your twenty twenty three budget summary online that you have a. The. It reflects the seventy eight point three million dollars in the operating expenses and. Fifty fifty seven point eight million dollars in capital costs. Do you have a larger um advertising budget or does a hundred and eighteen thousand dollars reflect all that you spent in a given year for sponsorship the the weather list came from and how it was just generator was request for all sponsorships and so that's how that was responded to our contributions to non profit organizations I think is about it i'd have to I don't respond to the for your request I have to go back and look at it additionally but that's where that list came from that's why chambers on there because that's a contribution and which was specifically authorized by the people when they are modified twelve section five of the constitution that allowed organizations government agencies to support to support economic development efforts. So that's where that is as far as you we we try to keep our advertising budget is low as possible and we try to reach where we think we can get the greatest impact we're not perfect I admit that you we always pick the right place where we're going to get the most perfect we're not perfect. I don't know that anybody in here you have the world has changed we used to be able to go on the good morning showing and talk on channel seven about what we do and reach a large audience like that oh you you'll get that channel seven doesn't give us that opportunity more we can pay on a bunch of money for that opportunity but we don't get that opportunity and more so the world has changed and and how we out to people has changed and it's gonna continue to change and above and are we are we always going to be perfect in getting to the right place I can't tell you that but I can take the heart is in the right place of what we're trying to achieve. It's power one more and then you get a little bit go ahead and do one more and if you could maybe shorten up the answers a little bit please thank you thank you so much in it I also heard concerns about. Uhm these contributions to non profits for some of the ones that were selected over others and i've seen a pretty wide diversity of organizations that have been supported with this hundred and eighteen thousand dollars since the controversy around the email and I guess all of these issues cropping up has there been a will there be a process defined to uh target those to non profits in the future thank you we are actually working on a community sport policy in its i'll have it and but now we're working on that to determine in that policy will be adopted when it spanish but if again focuses on economic development. Education around the quality of our water in the use of our water education around conservation. And development of a future work force. Okay members here's where we are going to come down to reference or center car because you're going to be next i'm up in a take any more as to those that are on the board already because it's been pretty well discussed and at the end there is a motion that's going to be made so i'd like to recognize that so going to move through less than the board and right now can be center clark filed by representative right apart. Thank you mr chair mr bohenian. The. We have worked together. Extensively back when I formed the. Well before a form the. Oh with the legislators help the water test horse which I could chair and you're better bill help and done a lot of good thanks one that reasons that we work so well together I think is it was all about doing the right thing a water and a avenue margin organization quite a bit. But what i'm hearing and then I think you are hearing too. Is we don't want you tilties involved in political activism accidentally even. Is that what you're hearing definitely thank you sir thank you. Thank you representative. I represent baby. Thank you mister chair mr bohen and I appreciate your answering the question is today and and a tree full and in a passionate manner but you do have your chairman of your board there we haven't heard anything from the board's position so my question is to to chairman bar and more in line if the board supports endorses in the stance of the board on on these questions and answers that have been provided today if you could speak to that and then I have a follow up when you finish. So i've earned my stand totally by the answers that have been put forward to the board was informed very quickly about this this air by the judge I committee within probably thirty six hours we were but we got a full explanation of what was going on and and so I felt we felt good that there was an immediate response on this particular issue I think his answers today on the contributions i've been on target terms of what our goals are it is not in either are answer we show up at community events for free a lot to provide water in those settings to to to build trust and so so I think we're we're on the same page in terms of how are our broad goals of course we are going to be looking at this policy to answer to go back to the answer about how we choose contributions to be made there's a policy in the works in and that will of course come to the borders as all policies. And matt that's currently in line with my follow up question is based on the discussions here the questions answered and and the answer is provided what changes would the board be moving forward with to address these concerns and provide the members of this committee a little more confidence in how the administration of the water district would be handled in the future so I think in a very clearly on the the future of the jet I group whatever that form it takes that the border will be involved in those conversations well of course the bug ultimately stops with with tad as the executive director and we're the only person that he we hire or fire he is we he certainly stays in touch with us about those bigger issues and and will be involved in those conversations about the cab have voice in those conversations and then I think when it comes to a policy when it such as our our community engagement policy including the contributions issue we would be involved in in casting boats on on those issues there that put in shrine policies that then guide his work are there after we have appreciate you I just thought it would be remit us if we didn't hear from the board's perspective on this manner. Alright we're gonna go to center johnson then senator irvine and we're a wrapped up with represents springer and I got a question of two so senator johnson your out. Thank you miss chairman mr hernandez you pointed out I want those people that has a well I am looking forward to having central art until water come in our neighborhood where the long people were that now we are the island in west pilaski carry that doesn't have service or grateful for the efforts that you in your staff applied to give us hopefully soon to have the up I would be remissive I didn't ask a question have been warning and now for the last several days what period was this hundred and eighteen thousand dollars because that one year or multiple years. Yeah. I think could like said before your request go to our council which is david johnson but I if I recall correctly I think it's twenty twenty three so that would be it least one or maybe even too a fiscal year or whatever okay thank you the other thing I wanted to had to say to you in this is you remember unit I called you when this issue with this email first came out mainly to give you a heads up and you were you either didn't know are you a just also independently found out of about it and I appreciate the response that you do that time that this was not appropriate but a realising that I think our co chairs would agree the purpose of this committee is to investigate learn about things and state government how we can make things better and I can't help would think about one of my mother's administrations if you'll take care of the pennies the dollars will take care of themselves and and it we're seeing though this is this multiplied toward every but through but the number of every public agency in arkansas you can see how a lot of pennies could be frittered away that could turn into dollars so we sit in this room and think about. Potential legislation too addressed this and I certainly have been and again this is not picking on c a w or any other public entity but the fact is we've got too much of this or what can you give a little bit to our organization in since I chair the here counties and minus palice subcommittee led slavery we see lots of donations and things made to to organizations without a contract in the constitution requires that these cities and counties have a contract we even had one come in with organization that i'm I love the dolly part and imagination library helping kids to read but pilaski county given the money and didn't have a contract so that's an art exception that gets card before so even if there's an ultimate public purpose you know we're gonna have to sharp on our pencils on what qualifies for water and I thought you gave a great example of teaching people they can drink the tap water it's good it's matter of fact I was so shame that one representative gonzales offered me a bottle of water moment ago I turned him down thank you didn't want to be looking at critical or anything on there but but please recognize where not picking out caw per site we're looking at where. Any public entity gets out of their line and comes up here and starts lobbing which each individual employee you have has a right to contact their legislators and let him know their position but collectively that doesn't need to be done in it you know right payer or taxpayer's supported entity so I hope you decide that that difference that we're looking at here because while I have one opinion about senate bill seventy one someone else has a different opinion about it those don't need to be done through using taxpayer or essentially rate payer which is the same thing in the case of the minischool utility they're their dollars so I think you got their instantly when I called you and i'm very grateful for that but I do want you to see the big picture of other entities around the state that may be a freedom frittering away the pennies that can add up to dollars that belong to the people of arkansas thank you for that and thank you mister chairman said her even. Thank you just thank you mister behind and high and i'm just a quick question whenever you was I guess this was for yet or the email was that we have before as this void under number four it says it ignores data and opportunity for bribe prosperity read more here do you have a does this jet I team do they have a website with additional information that included data and opportunity for broadcast what is that link to I am not aware that the jet I team has a website if I had and I would be purely yessing and if you want me to guess i'm guessing it's a link where you're the head person so you should know if this is your jet I team the board should know who these people are. You don't know who these bar that wrote this who wrote it I mean it says jet I team at your asking about the you're asking about the read more here. I'm asking about the whole thing who I mean they work for you right so you aren't dot com but and it says read more here so do you have a website. That that's what I was trying that's what I was trying to ask if if I had to guess that link goes to your guessing with wherever they want it year that you're the head person you're guessing yes sir you're strong okay so you don't know what your employees are doing. You don't know what they're doing you don't know the what they're writing I have to read their accusing the bill of promoting white supremacy do you agree with that. I have already testified that I did not know about this email when it went out and did you do any follow up to see where the link is normal you did not well how are you going to create a policy if you haven't investigated exactly who wrote this email where the link goes to you and why the link was provided in the email for your employees that you are entire how are you going to create any kind of a policy without the knowledge of investigating yourself how this all happened and. How are you gonna do that cos our policy is that are employees as a as it as part of caw organization should not be engaged in lobbying an activities so what do you do board you can speak up you're gonna fire i'm if they do. And is that part of your policy did you investigate where the link was and who it was going to citizens first start or gives when i'm being told that it was the link to citizens first dot org so do you set a central arkansas water works. Do you have a contract with citizens first or you're linking them in your email to all your employees now. We do not have a contract with that organization and you're not aligned with them now. Okay well. I have one more question how many years have you been providing these types of sponsorships without a policy. Literate municipal water works was formed in. Central local water was formed in two thousand and one and I would just. The contributions to organization since it was created in two thousand and one and like in this works in north little rock water before that. So you you don't have any historical knowledge you just this is just the business as usual you just continue to sponsor it do these people contact you for these. Do they ask for this money from you they asked for them our education outrage group works with organizations so you've you've been doing this for many many years. Okay and so they're the ones that contact you and ask for this there are many many the contacts okay. What thank you for the follow up at the questions I think it's important to have all the information that is related to the email to be provided I think it's going to be important for any policy making decisions whether it be your internal policy or the policy the legislature or so I think it would be beneficial to know more information about what was linked to and how and why and in order for you to make the best determination for your policy moving forward with your employees if they're not going to be engaging in political activities thank you representative spread good morning thank you mister terror as I sit here in listen to the compensation is. That has taken please chairman and commissioner was barf and newton as I look at this list of payments that have been made told one hundred eighteen thousand five hundred and twenty five dollars I looked through this list i'm very for me with the number of these entities these non profit organizations that you l listed here and in my past experience in the knowledge of these organizations I know that they do provide scallowships educational opportunities and economic development to the communities the crawls central arkansas so I do appreciate your efforts in doing that because we do need persons such as yourself to provide these kind of opportunities and these great payers who are making the payments for the service that you provide their children in other persons within our community there are been a fitting from these payments that have been made by you so thank you very much make one allowance senator king and then we're done thank you missed chairman so I just appreciate you come and answer the questions about where this money spent I think tax dollars people should be speak that I should run legislators. That we should be looking at a lot of different things one of the things I mean plead plain if an illegal exaction lawsuit against ecosy a college it took three quarters of million dollars our tax dollars and in president went to prison others went to prison for bribery so was just if anybody wants to concern about money being spent they want to sign on with me being a plain if in that illegal exaction lawsuit trying to get the taxpayer money back on that I would appreciate it just let me know. The. No question then okay a couple questions for you first of all too chair mr bars and two commissioner mr. As you said here today listen to the testimony have you heard anything that has caught you off guard or that you are surprised by the in your respective roles you would have rather found out other than sitting in the committee meeting and finding it out. No sir. No sir ok so at that tells me is it for everything the mister will hang in has said that you had full working knowledge of it as well as nothing has caught you off guard today or nothing has caught you by surprise then for the comments that were directed to him they are also directed to you and so do you agree with the response then that mister bohan in has given in the answers to his to the questions to him are you an agreement with everything he said yes. Same here okay very good the who is it you mention a education outreach group a minute go miss rohan and they are the entity within your organization that determines the advertising that should be done is that correct or did I misunderstand that now the our education outreaches jane hurley who is a dynamo and she's are the one that is frequently out with other volunteers from caw reaching out within these organizations and providing those educational opportunities teaching people about the importance of of water that types of things okay. Who did the email originate from that in question. The email was set by the u. The the person who's hit the sin button is. Um. It is an employee of central against a water is my understanding from thanks i've heard and part of my investigation is. Wow one individual hit the button to go send. Though the writing of it was done by a group of people. And the groups of people was. I think we've provided that information that the jet I will use the general group I as I said before that that's a it's always group less group of employees yes okay that answer to you ultimately correct yes okay and then the last question is have you ever been asked to sponsor events and turned them down yes i'd like to get a list of the organizations that have asked you for sponsorship it because what i'm wondering is who made the cut list who didn't make the cut list and and why so you know I would hope there be some sort of record or even just usually memorable just go back from last year best you can remember you know whatever can be written down and if you would direct that to our staff mister little he can push it out to the committee I can't like to know who got told no we know we got told yes but i'd like to know who got told no. And we have no other. I have I have no other questions another thousand board center other than center cell and go ahead and chair we've heard some talk about what the laws are regarding lobbying and I think they're they're maybe some borderlines and i'm just not exactly sure how those apply and the same thing we've had a lot of questions about the donations and the law was cited and I don't I don't know if there's been how true we've held to there so i'd like to move that the jpr committee authorized its chair of to file a complaint with the arkansas commission requesting the commission conduct an investigation a potential violations of the law but can intercentral I can saw waters lobbing in donations activities during sp seventy one during the twenty twenty three regular session and that the jpr chairs provide the results of the investigation to the committee members the motions are second. Your emotion is second floors open for discussion to the motions rate discussion to the motivation. He renewed then all favorite apposed no recognized but the eyes have it by majority votes so this will be carried forward will get with more detail help graph that up and german thank you for being here today we're gonna move on item d is going to be held over till next month two of the three that there is make sure though we do not have lauren christian or curt here in the auditor my right on that. So make sure somebody'd drive in and we missed it okay this is gonna be held over till next month two of the three were legitimately not able to be here they presented the reasoning for why they couldn't be here a consultant with center brand who asked for the sign to be put on the agenda and we are agreement that they're reasoning was rational and understandable and so we have held it over till next month one of the things i'd like to committee to now it's first chairs concern and I try to work with a representative general very is that we want to start taking a look at organizations that are receiving grant money and take a look at similar to what we just experience here what they're doing with the money that they've received also take a look at if they are using any of the money or in any way we are supporting anything that maybe would need to come to the awareness of the legislative branch and so that will be forthcoming next time the item agenda last time we have today is e which is the discussion of closure of independent pharmacies we have like torres whose pharmacist owner of west side pharmacy betsy turboville who is the pharmacist owner of the camden drug and then john vents and executive vice president c of arkansas pharmaceutication which all please come to the table at this time and while they're coming to the table want to acknowledge that we have a new staff member that has taken the helm of JPR as far as our legislative analysis copy little and if you don't have his contact information suggestion combined get it afterwards or healing malitacy priority melts up anyway but want to give him some recognition that has come in on its our new staff and so you all give me a roundabout make the full comfortable all right thank you all for being here today what i'd like to ask first of all is for you to. When you push that button at all little to read like that that means you mike his heart so what if you say it's going to go out we are live streaming and what is our cash you do is first fall give your names who you're so saded with for the record please and then I am going to push all under ours to make sure that to test motor choose to hear today can be used for followed meetings so if you are would please name entitled for the r. The. Blank tourist west and pharmaceutical mental. Betsy tower bill came and drug and camden john vincent pharmacist in ceo of the arkansas pharmacist association here. Your place they are all the channels. The membership may ask why because there may be some bleed over between this amount going activity and I just want to make sure that everything said today is said with accuracy and with honesty not that I don't even their character at all but I think it's good to have that point of reference so do you salmish where firm if you would raise your out here please do you sell me swear and firm that touch many testboard you about the years will be the truth to hold truth and nothing but the truth should have you gone yes I do thank you all right first of all we're going to go from my left to right in the put you at first blake would like to do is ask you just to have contacted you unfortunately in the district that I represent we just had what I believe is the fifth largest independent pharmacy in the state shut down you run a fairly large comparable one as well and what I thought would be good is to have an opportunity to provide you up to to come speakers of pharmacists and we're glad that you hear today elsewhere mr reveal to share with the legislative branch any concerns you may have any thoughts you may have is independent pharmacists that you think it's important for us to hear as we have this our going discussion to that i'll yield to you blake. Thank you and chairman thank you into your offering time to come explain when's happening and selling counter so for those there then not know incentive hammering just reference amount ten days in your smooth forward pharmacy one largest pharmaceutical entire state service thousands of selling callians close unexpectingly patients learnly drove up and on thursday morning and eight o'clock in the side of the north certain basically your prescriptions are no longer here they are now located at watering off the road there is no notification there is no mail out or phone call easier patience from all age types from minorities moms to nine year old old sweet lines that now their health care and provider had literally been taken from them over nights so from the past ten names at western i'm pharmacy. All I can describe it is uncontrolled chaos and if it wasn't for the center hammer in the respect I have from him I would like me sitting here in today I sure nightmares and in here today I hate to use a military analogy my mother extension and you would cooking pay and inventing real light for their choices but my team back at west side then and bad right now when thousands and pensioners transferring and what I like to do today and I know we're short on time and some giving three. Can't just understanding this from a painship point of new from a small business owner for him and from a personal information who have fime so I like to tell you the story that happened just this week about impension that showed up and aren't. And she inventor war greens and and sat there per hours now wouldn't put it on record right now this is not amount this is invalid and community that lost in corner stone on the health care and provider overnight okay and so this painting when it's having typical team receiving a medication because they can not long for this records and their system when this day in a merger occurred okay. So these these records were not found in all she hands was an old smithforward model that she had been filling for literally injecting and the same store and the same location assuming the health care services and so we performed an emergency fail that we have understand you provider within thirty days imply it allow her in some receivers suspension and would help with the mouth source firm post email and i'm learning getting hundreds of the same types of interactions from whether it's a again an elderly patient who is confused whether in some middle east dimension patient who is angry that he was healthcare and promoted and when stolen from him over night or instant single mom who now they don't have delivery instruments and warn some she's having a loan of all five percent and her tahoe in drive in an entertainment senate clinic and they're a hundred and one degree temperature with strap and so now they're being all floated on to west time pharmacy and the other independent foreigners patience are scared patience for angering pensions are upset I am carrying him over then are not located so you're telling their I have nursing homes that were being serviced by selling uh smithforward that are calling me for urgent services for a learning and so the impact of this closer has and I was telling the center hammer. This is going to be in touch from it so hard community not just in the coming days we've been coming weeks and months because they send the access and care in the means pensions have been paying no longer hand yes we're gonna step up and try to fill that void but we lost and keep player or so that's the patient sign of the follow up and i'm answering this question and trying to over a hundred times in the past your news is how do this incur. Why do this occur how to number he meant them smith will it's been around for a hundred and thirty three years maintenance sanction that closer overnight and me honest and frankly I don't have things acting answer and I can't send here in the same and absolute this and main that in the solution but when I cool and I think launching clean we can probably all reach the conclusion as that with hel secondary impacts family issues those things you've sent bills and sign. Then have been business sign when is going really really well. The new wouldn't make that difficult decision for your reputation to sell out to chain form this and put that on jeopardy so what are we seeing in the marketplace and try to move on to learning tearing a standard. This more many years in some in you and then important legislation that we had and put in in place and provided. The safeguards to ensure that we have a fair market place but we continued to see. Tanking or leave it contracts and constant reimbursement the i'm not here and my name is telling you know and well it rains the marine and when I feel like it's pretty good small business owner that we're finers i'm a hustler and two sim five g. I got their school working horn that I work hard by independent practice and then the same say that those market pressures that can continue to incur. They're not singular meaning they're not just one of us okay then continue to incur in the market place and whether that's medicare or more specifically and more recently in advance changes in reimbursements and or state plan which I know is center hammer line and discuss and I know i'm so emails in camden example from a small business owner. June thirty thirtieth thirty days in june june thirtieth only I was being paid wondering. Providing excellent care where a warning when the pharmaceutical brand team on july first literally providing the same exact share and patience. Or reimbursements were slashed significantly then you may ask one settings act percentage well to give you a ballpark and I honestly have job presents act percentage but just know the new instant it was not one percent literally over nine is we moved to a different payer and nab and says I reimbursements inclined significantly and that's one payer in one group but what is happening in the marketplace and it's happening in pharmaceutics and each and every one in your districts and and you say well how do you know that although I don't know where anything but also have sights in forty I am sites and now into a literate I am a sight and time way russell bill danville and kinnock missouri and the marketplace sense a whole weekend to have some tax and cuts and we're dying night by one gigabyte by slash and reimbursements and so I come here in today not asking maybe it is since being on the start asking necessarily for a hand out when i'm pleaning and cross and state for help. If I didn't need help I wouldn't be here my team is literally diagnosing at thousands and prescriptions mean feeling I should be in there in the trenches but instead of here because it matters so much we need assistance in ensuring that the marketplace and the reimbursement practices for all foreigners continues to maintain okay not no insurer responsibility to mean for new sharing taxpayer dollars on the taxpayer okay I want you to have that when here's what I don't want to happen and that leads me to the third part in the same job when I have an and I feel like I am. Nine and consultant that you're with higher but I feel like as being a listen term i'm not expert but i'm filling pretty close and then trenches here's what's going to happen much on the scare you but what were you going to see a smith call will not last nominate there's another one in my counting is in samir jeopardy and i'm consulting on and they may not have six months and there are science in this room and I won't be the night consultant on environment so what we're doing and we do night the burlington marketplace as we are consolidating in the two in single payers we are no longer providing health care. I'm from a hassle or console when providing cattle clear we are running patience through that call shooting when you stick in and with vaccines and the entire and that's what you get and we due not protect the marketplace and as we are creating calendar and stressing that sounds the market will continue to consolidate we will create a single parents system and you will have two options though i'm close with this and no meaning you're passionate but you know my dad's been a teacher thirty five plus years still intention and you more retired I keep telling your time so I understand like there's a cost component I give them and we have to say money in lower costs to your intentions and and staying in points right my wife's intention I get that component but here's what I know I don't want to look up in ten years and i'm not a pharmacy i'm selling insurance or colors and certain right and monday and worn option for missing and he learned your tampered counseling in streamlining canada and again I know that straight when I wouldn't be here today important real issue and with that chairman I appreciate in time. I too have some questions coming up on the board but what i'd like to do is go ahead and give mister ville and up to it to speak at this time and then we'll take the questions and john organs una minute. I just want to echo what blank said am from cambon we also had a not sure what's going on try to turn that one off and pick up where the other mikes are minor the only two answer said this is better i'm just gonna go at blake said i'm from camden recently in this summer the bricks your grocery chain sold all their pharmacies to all greens I had the same customers come into me one day they had a pharmacy inside the grocery store they went to every day. The next day they are like. How can my records just be sold and now moving across town and I have no choice. Mass confusion not on the level he is because we're a smaller rural town. Um but it we'd had patience that were confused that were mad. And we take care of this cause that's what I do I went in a pharmacy because i'll love to help people. Allowed to take care of each individual person and during cobid my pharmacy and my team stepped up and we were the only ones in the county giving the code vaccine. As a result of that my entire staff has turned over. I am the only one left. That live through that that is not left healthcare my pharmacist retired decided to retire early. Both my texts left to get on the health care of field and both clerks within. Probably six months. It's very hard right now to replace the kind of experience I lost. Hiring anyone right now is very hard. On type of making the decisions can I even afford to replace that correct web left. Because of work blakes talking about in the reimbursements that we're receiving. I was in the same boat june thirtieth i'm paying one rate july first i'm trying to decide if I can service that patient or not brand name drugs i'm having to walk out there and look at people live service for your insight i'm sorry i'm gonna have to send you to the store that starts with w because I can't afford to lose money to fill your prescriptions. That is very hard for me. I have taken as minimal officers I can close to one of the stores that blakes talking about that's probably interpreting in rural arkansas. And I will speak to and on m there there are differences and contracts as far as what is considered. I think most of you are nowhere came in is and what our hill status is there if you look at the numbers in these contracts I am not considered rule. I am paid differently. Because i'm not considered rule. Yeah. And i'm to hear also asking per each one of your help and support. I want patience taking care of. That's what I do. And to see as many of my friends and my co workers leave the health care profession and actually have thoughts of it myself. It's it's. I can't even explain how I feel. Mental health in the pharmacy field and health care it is a whole. It's a large issue. And this is one reason we just want to take care of a patience. And be paid for that service. Now thank you. I'm gonna go to questions I want short with just wando based you just made a statement about about reimbursement you're not considered rural are the is there a disparity in the reimbursement rate among pharmacies. As far as any of the contracts that you currently have or based on your location can you speak to that or blake you've got stores scattered across the stake you need to want to be all speak to that yes and there there is a disparity there are a rural contracts. And that are paid at a higher rate that is. Closer to fair. We don't really know maybe a john or blake can speak to this how you qualify for that if came in arguing today that qualify as a rule community. I'm not really sure how you get there. As a mayor spoken to you no II actually called my psa yesterday um and their answer was a you are getting the role conterrect might no not I mean that I can see my reimbursements and I know what they are we don't get an option that's not discussed if we're rule or night it's very. A clearator or pake of. Of how we get paid period but no no one has ever called me and disgusted if came in his rule in what I what does qualifications are. Like he thinked her to that. No sir center boy you're up first followed by representative wouldn't after this now you send her hammer i've got a question for doctor tourism and then doctor topper ville if that's okay sure so i'll start with doctor tourists since he went first so could could you pay a physician legally to refer all his or her patience to you no sir okay is it because there is an inherent conflict of interest in patient choice if that were to happen. Yes sir so does it sound like maybe a good good business practice for the physician but we've already identified that this is a problem in society or potential problem correct yes sir go thank you doctor tubberville how frequently do you set your price for a prescription that is dispensed from your pharmacy. Dismitted to insurance clarification when I come in how many cash prescriptions so how often do you actually set the price versus somebody else tells you what this prescription is going to be paid for a few i'd say less than five percent so you would say you primarily compete on service in your commitment to community is that correct. Yeah. Does a mellor or pharmacy then compete with u by directing patience to themselves based on lower copays and other incentives rather than and. Not competing based on service but i'm incentive as in base on price does that happen frequently thank you. Represent wooden. Thank you mister chairman colleagues. Before I ask question this is a major problem. The scott impact your constituents they were out to state of arkansas. It hadn't happened overnight we've been warning we've been told no more stamps about a situation in the marketplace about a car petition and about term of the evening all activities as it taken place not to tour as my question of you yes. Does while green compound. The. Yes not an eleven that other community pharmaceuties who so the extent of it would be when I can't team on top of compelling which is where you investment yourself a mobile for a malf wash in combined they think pending drill and mainland spent thanks in the external nothing to the level as far as what we do probably what that's he knows that the sport is patient specific compounding no sir so smith garwill was a major compounder. For now the only bin selling county but also pulaski and lonal county correct. Yes sir smith call will actually serve as the entire sting and when it's still in column pounding community pharmacies in the entire state so now we're now just one. In your in your background and and and your. Service to your community what what do you see is the major problem is it is it is it being driven by those who control and this will be a question for a doctor bill later but is it being driven back forces that there are also not only driving the control of the pricing of the medicine but they're also competing against you and some communities. Correct yes sir if I understand they know in saying that. The. The main problem is the mainstream aren't given three companies that control over seventy percent of the marketplace. And when you consolidate the marketplace and when i'm reference and there is premiums when you consult in the marketplace like that and then neuralian premiums whether in a small and nabitus or orange line express rooms are often mail winner and there are also make goal instant snearer result drivers center employed with alluding to. Near your driving and business you're driving and care out away from these communities yes sir. Do use the use how large amount. Would you estimate. This is asking something that you may not be able to answer but cannot receivable is this casting the local forum assistant have to carry not just thirty sixty enough to know any days before they get any payment some more money in my understanding around the state runs to three four hundred thousand dollars that they're out that they were their case flow with slamming is that correct and this is controlled by the pbs are the insurance companies correct yes sir so just give any rough numbers here less than pharmaceutically average around five hundred percent shows per. A snap insist on the upper level as far as total volume for an independent pharmaceutical. Or americans throwing bills around four hundred and seventy five five hundred and twenty five thousand dollars per month if you take out the state payers medicaid your expansion plans your average time for reimbursement important buying an electless dispensing it to you is around anywhere from thirty five and forty one days give or take before that payment action hits my bank account so i'm floating that five hundred dollars just for that one drug for forty days when the pension of payment too much so I get to work so I didn't four hundred and ninety eight dollars more it's my understanding that it may be the matter and that I care and others pay faster than some of the private pdms is that correct and i'm in deferning documents and over here for more accurate answer what we see in this many changes came faster many cane around so many can or solar expansion plans so in your passes and then you're exchanged plans I don't know if they're in the statute of john tonight they pay relatively quick you know in terms of fourteen years on your party plans you're still looking at that third forty days pleasure in the hours that are called back so I confirmed that I want that so you're being asked the local foremost is being asked to carry the dollar cash flow forward to the large accompanies that a control than payment that are made for the drugs. Yes sir not returned reveal if I may most determine that a term reveal would you tell me who says who can have a rural can't track and who has a known rural contrary who who ran who tells you. No one directly tells us that that would be a pbm decision on who gets that contravel and how many pps do you have you service you. I have with not know an exact number server how many of those old retail outlet in your area. At least one. Yeah most of ours and rule arkansas are being pushed in mail order our largest employer in that area you know i'm in the defense area. They are required ease mail order and they are also on their also on their own or they own a pbm. So in other words whether it's one cup one company one large chain our second large joint third large jane just won is which you have none competitive distant managers that correct. The gardens I hope you've got it feel for what what these folks are up against wedges last in maybe a forest is as been in business for a fifteen years. And they had to sell out or they face the same thing i'm assuming I don't know this to be a fact that I think they sold the hand riding on the wall and they got out. The deadline that is a corone shame that independent former so this day or have a stand up and compared people like wall greens and cbs and they at least the image of the cooperate image that through known as all the favor by being in our community and that's a year before you today that they are not doing that they are driving the market plays they are controlling the price and the insurance companies are all time in the gather and one insurance company owns a PBM and then also they all I try you know of drug stores so this this is ridiculous and but here's here's the other side of the corner and i'm on the other street if we force these people to address this issue then they're going to turn around and they're going poor known the independent pharmacist of this day so we're going to be very careful then what we do. But if we if we don't attempt to deal with it we may have to be a later in this area also for the nation thank you mister chairman question to you them ago to represent a lunch from regardless of whatever pharmacy you are fear of while greens or if you're well if you limit qualify. If your pharmacy. Does not owned by a pbm tech you don't have that ability to internal issue scripts back and pay yourself. Different than what you pay a independent but it it could be an and I take where you get while brookshowers you're pretty large organization a member fredge you know they give up their pharmacies. It's not only hitting the independence it's hidden the others because routines you can have a store that has a pharmacy in it and you're going to make a decision am I going to continue to lose money on this one segment of my store while I make money over here and internally subsidize it it's going to hit this this has at perfect storm snowball to hell effect that it is going to impact everybody and to your point like while go it's going to squeeze it down to a single player system and made the best want or made a whoever how are you want to turn on when in my my wrong and then. No sir absolutely incorrect representative thank you chairman here this is infuriating to me that are considered lead the country all the way to the supreme court. The one. And now we find here we're back here again. Either we didn't read the contract that we wrote. Or the pbms are willing to cheat and act like thugs and the marvia. What's going on here john i'm gonna look at you doctor benton cause i'm sure the pbm to public and take it out on these two innocent folks are just trying to do their job so will let him take it out on a lobbyist so helped me out here so which is the pure galleries just to drive every pharmacist out of business sites pretty obvious what's going on. Thanks for the question representing one term john vincent are first want to say I appreciate this legislature legislature nor governor or attorney general that did for those laws that you just described and passed and where the nation in and and i'm thankful that those laser in place cause they have helped with some claims about two percent of the claims were so aggressive from talking to the large psaos and smaller psaos where I can see all the data that they were actually breaking state laws and I we've worked well with rant wireless and his team and the ebd committees that oversee this they also committee to at least fixed those claims but back to representative wouten's question a minute ago on the market basket across all claims generics brand specialties any drug you can think of across the whole market basket this state approved an actual study in two thousand fifteen it looked at what reimbursement should be to operate pharmacy and I know that date is eight years old but i'm using it as a benchmark and the overall market basket reimbursement for most of our members that are providing data to me is thirty percent to three hundred percent below that number from eight years ago prior to inflation the overall reimbursement so the driver is take it or leave it national rates that are implemented by the new pbm with no chance to negotiate no chance to have a conversation set at the table about what's reasonable and even in the ebd advisory committee the advisory board asked was your actually involved in determining these rates and the answer is no there wasn't an actual my understanding is actually what involved in it there are rates that are determined by the pbm based on national rates and national contracts that were in place that these pharmacists didn't have a seat at the table and have a say in top that entries your question why was that. Why one was there not somebody seen at the table if there are negotiating a contract. The. They'll do respect and invents relation into whether of pharmacy psao has. Premiums don't care instinction or leave it no matter where they're telling you we never had a single table. Okay. I would say for the last twenty years in this particular point that the state has set the rates and rejected the national contracts and I do believe from testimony that's beginning and other committees from senator **** and representative members of the committee that oversee this I don't think the intention was to I don't think was the same national take it or leave it rate so i'm hopeful that this can be worked out. Chair clark. Hang up the meeting and read. Thank you mister can help me understand this. I've been with you guys as long as these issues have been brought up and and it's easy for me to be with you. My family has a small business we compete with home depot and lows every day we competed with other chains that no longer exist so it's not just independence that go out of the and I keep hearing on the reimbursement side now get that and from what i'm hearing. Most of your pricing you don't have to do like I do i'm sure you set pricing but it doesn't matter if most those prices are set by insurance but third smart state correct case so so that in this actually fairly simple this is what we sell it for we don't have a choice so then it comes back to the other side because I heard. Oh. You say. That you had told customers and I understand this did you had till customers I can't lose money on this this is actually forget my overhead is what i'm hearing you so forget my overhead and if you're operating for twenty twenty five percent in wall greens is not doing better than you're doing really good so forget for your children what you're actually paying for the drone. Is higher. Then what the reimbursement is. And so you come back and say well it was being set there. I do is home depot lows get a lot better price in your case while greens and are they getting a lot better caused is the mail order company getting a lot better cost then we are in course we had things I was a member of his hardware for years which is a deal on co op and that's one of the ways we competed as we we bought the same way home depot and losed it so if that's happening that's obviously not fair. If if anybody were there's insurance or in especially the governments coming in so you have to sell it for this. Yet your pay and more for heart and what we say you have to sell it for. But the answer may not be on the reimbursement in the answer may be all hua are you getting gouged. As a independent versus what the others are paying. Am I correct. Or am I wrong. Yeah. I would say that's a large corn valid question to be asking now when I want a win clarify and maybe give you. Some inside is for most end of their pharmacies. Or at least satellite here not a slight new model is when I mean the same not all pharmacies are important so in start like we hand just literal west side out here and try and buy five hundred thousand dollars worth of drugs when you're important i'm not only in the state important twenty three other stores some important are in ten and we purchase around ninety million dollars there went there were also important they national networks all purchases and cross multiple states twenty three to be exact so we are adding you that volume for high power now is it possible that it waterings and getting or walmart whoever is getting a slightly better deal on brand name drugs yes better as possible is it through the external and seventy eight hundred dollars cheaper than when i'm bound. Have I ever seen an invoice from them no but I wouldn't find that really hard to leave the question becomes if we're buying right or close to right. Then. How does anyone set a reimbursement level. That is lower than what you're paying I mean is one thing if it's one thing if if those in home depot and are or bailing it out on stoods or or liquid nails and worse selling loss leaders blow calls that's one thing that you're not even you're not even getting to decide that. So how does anybody do that to you or law greens for that matter because we were also hearing that some of these grocery stores with with pharmacies are closing that part of their business so because it that means it's obviously not profitable it looks like you want to answer I have a comment on there that's a great question so one thing that doesn't legislature may not be aware of but the majority of health care today in this country especially in arkansas paid for with either state or federal tax dollars and in two thousand and thirteen the federal government required pharmacies to submit their exact invoice in it created a prossing list it's public and online called the national average drug acquisition costs so everybody in the world can see it what pharmacies are paying for these drugs that date of a four two thousand thirteen did not exist for the PBM so there's not a free market all their cards are on the table and shown by the federal government to everybody set in contracts with them so even if they pay us exactly that cost are slightly above what the drug costs the box because it's all out there for the public to see and published online by the federal government if they own pharmacies and driver reimbursement to the floor it's heads they win because they get the contract because we're going to save money and heads they win because if the pharmacies don't survive they'll just transfer their prescriptions to the mail order pharmacy we own that directly competes and I don't know if you've looked at the forty five page document that the finance board approved that hasn't come to the ALC yet but it's public document but their examples in the pricing tables where the the pbm owned pharmacy is paid at higher rates compared to the arkansas based pharmacy so it's I hope that answered your question but the price of what the drow cost it very very close is publicly available in all the cards are out on the table for everybody to see when pricing a search by insurance companies and pbms let me interrupt because to that point there should be an email if your member of the committee should have received emailed beginning of. The committee that has those documents that he just referenced contained in that email if you're not a member of the committee you may not have got it so if you all see sharing. Go here and see sherry and tell you like to get it and she can send it to you so you can be looking at those documents center card and it's not that I don't want to take any action because like said i'm very supportive. But how much of this do we need to help estate level how much of this needs to be handled at the federal level with our our congressman in some battle in a fine and where area we need help votes federally and state normal and we've written a knowing hand and and amicates or federal representatives well in the incentives and and they are trying to work as you all know on the federal level of things just move the lot slower there is premium legislation that is on the floor whatever you want to call the federal level when it can go back to the point we need help on the state too many cars in time and continuing to know it's there and let me as a finish up here I think dollar general for me as a guy who studies retail shows me that people want to buy a local that and it's not just that they were about is they want something more convenient up and and local I would rather go on the general store that no longer exists than dollar general but I have looked at you know how would I do that successfully I can't because of the buying. That they have were I would much rather deal with local people and and that atmosphere in the whole thing that goes with her and service naturally comes with that so we obviously we can look at that and see what people would prefer and yet as you all have brought out to us were moving away from that and people are really going to miss it I hope that you keep you keep this issue before us thank you. Thank you wanting I want to mention and members will get seven on the board or give everybody in opportunity i'll stay here to all questions get answered i'm just given the update they're seven on the board with questions there is a portion of the perfect storm that's coming january first when medicare part d I believe now becomes payable at the point of sale and if i'm incorrect on that you straight me out but as I understand it become january first you you're not going to have that sixty ninety days whatever it is it'll be paid for it at generally first i've either muddy daughter added to the conversation straight me out in contribute to that if you would. I'd like to go into more specifics but just as a how medicare d is a federal program and the proceeding said and that we don't expect the legislature to to have we don't we're not expecting you to fix that federal issue with medicare today but what I will say is there are two state plans that are paying well below the cost operate then one is the largest employer in arkansas and that is teachers and public school employees and state and boys which that was one of thanks for efforts and the other one is uca and call way the university of central arkansas which would be a public supported university and we've been having private conversations with their leadership about that trying to solve that as well so from a point of which this is better on which is state I would say it the state level those would be the to that we would need help on to address by the federal. Yes sir so january one twenty twenty four and and bagging up a little bit right now in the market place there are fees called our is direct and interact renewation so basically you're in pain a hundred dollars of from. After the forty days and then sixteen and nineteen sometimes six months later then claw mac and portion of the hundred dollars so anywhere from ten and fifteen percent valpart number there that call back in this going away in january one twenty twenty four when set the windshields give the news network we have a more accurate representation of one minute will be at the point of sale however in just giving further the support so the help that we need that is going to create a syrians cash flow approach for a farmer season you're in districts all across the spent because what happens in the first three months and two hundred and twenty four there is all those the hour fees from claims and I october a no member in december aren't going to mean tank and out and those reimbursements then are supposed to be hitting them in january february march then hopefully i'm explaining that the center hammer has an answer question and just required to that also we made that you made their practice he just described illegal at the state level in two thousand and nineteen sender car two thousand nineteen in the federal government paid attention and are do is doing the same thing in terms of eliminating those car backs at the federal level four years later so this state set the example and it swept the nation in terms of popularity and transparency lower process for consumers at the point of sale so long term that's a good thing but short term that first three six months can be paying for cash for was right and if you are pharmacy or sorry struggling with cash flow because i've talked to enough to know they're out there struggling with cash flow if you got a big. Chain that is getting real their pharmacies because it's taking out their cash flow maybe they're selling you know toys or clothing or fishing goods or whatever else talk said it but at the end of the day they're there to make money they're going to load whatever it's not making money. The first of the year if you are radio farmers' in cash flow trouble you just really loaded up the mothership as far as additional cash flow issues which is where we're program to begin to see the effect of the estimated thirty stores begin to close over exaggerating or is it on target I think that's on target and accurate thank you represent bentley. Thank you chairman thank you all for being here today. Mister bensom wanted to answer my question do the first one so are the navigators rates similar to medicaid reimbursements and the state this point are this similar well the medicaid fee for service program I think you're talking about there much different in the methodology and the way they're determined but to look at it as a benchmark you you would look at how much did I pay for the drug how much was my total reimbursement how many claims that I feel in a minute and when you look at a market basket like that and you compare on apples to apples for independent stores that don't that are not in jasper or murphy spiral that don't have one of the rural contracts like she talked about which out of three hundred and fifty independent pharmacies I would estimate that at least three hundred and twenty five of them don't have those contracts and maybe only twenty five I can't give you an exact number because only novetists knows the answer to that because they said it determined and they would be better prepared to answer that but the data i'm seeing from the ones who don't have a rural contract is compared to the actual wear owned determined what it costs to operate a pharmacy back in twenty fifteen the rates across the market basket or between depending on the store the market the which claims were field anywhere from thirty percent to three hundred percent lower than medicaid cost recovery reimbursement determined in two thousand and fifteen and that's prior to information interest rates everything else mandatory minimum wage increases all the things to everybody in the rooms for me with. So just to clarify a quick follow up chairman and it were late on time are you feeling with their door is violating what we put into statute here. Yeah. Are the questionings do I think what they're doing as by waited statue I would say that the rates they have in place and that national network absolutely violated state law so the network itself and my mind is in question is it even real because there were there were rates that very very point or violated state law up to two percent according to talk about earlier insurance commissioners been enforcing the wall but my concern about that is if they promise savings based on contracts and networks they've vowated the state or are there savings even real are they really going to achieve what they promise so that's what I would ask the legislature to investigate. So want one final follow up chairman on this so I haven't had chance to read the contract maybe you have mister vincent so you're. Any idea where the sixty million dollars has come from have you been able to decide that there when you're in your reading of the contract you can't tell for sure I mean there are things that obviously if you pay providers less money and take it or leave it that'll produce savings. There what I heard over the last two years of the primary reason for doing this was that the state wasn't maximizing rebates from manufacturers and there doing a beard out for a proposal and new pbm might be able to save upwards of it fifty million of the savings of the sixty from rebate side they remember that testimony from different committees over the last couple of years but I don't have an exact automatic right now and i'd love to know the answer that's great question. Just to clarify the but the rebate snow supposed to be for the consumer the final end somebody along the way like a pbm of the other rebates that supposed to go to market my constituents. In a perfect world that would be how it would work agree with you this is a self funded point state laws may or may not require that but that philosophically that be good I will say historically the states don't a good job of of watching it really closely and trying to maximize to get to a hundred percent of those rebates come into the state and then to either for the patient or for the overall premiums to be reduced so it's not really necessarily designed to go to each individual patient at the point of the care of the way it's currently designed it's more of a we try to get a hundred percent and lower their overall. Premiums but they're there are things in the contract like in the manufacturer coupon situation which is a different kind of rebate at the point of sale that's available where previously the previous PBM and local pharmacies provided all those savings at zero cost whatever you were paid in rate is what the pharmacy got in the state got all the savings there are some proposed language or is proposed language in the contract where the pp would be paying an admin fee in one place and then on the savings they get twenty percent of the savings and so my question would be is that an admin fee is that spread proceed is that I mean is that a wow and I don't be attorney general or interest department would be better served to answer that question. Thank you representative flowers. Thank you mister jeremy. I want to start by letting many of my colleagues and who work here when I first. Became privy to the dynamics of pbms in the state and in the country which was back in twenty seventeen. And what I learned was pbms most of them their job is to pay claims defined savings. Uhm to help improve health care and I believe that most of them do that the larger pbms who over time have overtaken the industry and gain complete control of pharmaceutical drug reimbursement. As well as setting formularies. It's not that's not the case and arkansas dead become an example by regulating pbms which were completely unregulated. Before we passed a lot in this state and many other states have followed suit. And if you all will forgive me i'm very passionate about this this is probably one of the most important issues that we will come together on prayerfully. These pbms. Who are. Setting drug formularies. Setting fee setting fees defining definitions of what's rural and what's not. Are now. In the farmers the and insurance business. The. Then. As you are keep hearing about this take it or leave it contract pharmacists. Who either work for themselves or work for a larger pharmacy. Who have gone into debt. To be medical professionals in the most regulated profession in the country. And it should be. Our points now. To do their jobs but nap but not be pay or reimbursed. Based upon what they're providing it is that the will of the pbms what they get paid but you just heard is what we get annoyed about. When we set up a contract to buy music or a fitness club. And it charges our credit card. Every month. And when they make a mistake we get to cancel there. Pharmacists have to wait and see what happens when they get reimbursed as to what's going to be taken out. Of their cheques. And they're supposed to run a business on there. The. As it stands right now. This system which we have started to regulate is right with conflicts of interest the void of competition to void of transparency the void of protection for pharmacists and devoid of protection for patience it is not a free market system. And if we don't do something about it now not in the session now as it released to this contract are constituents are going to be gravely affected on our watch they already are pharmacies have been closing ever since i've been reading about in dealing with this issue. The. I have an uncle who is a farmers. So I know a little bit more about this and i'll ask our pharmacists here today what would happen to you if you brought copies of your reimbursement. And copies of your contract. To show us what you're telling us today what would happen to you. They would check and sell a network and we would meal and care so that only are you stuck in these contracts. You can't even legally tell us about it. You can't legally really show us what is happening and how even by following the law you could buy drugs out front to provide for your patience wait for reimbursement and get charged with so many fees and whatever since still essentially clawbacks that you might earn two dollars for a prescription. It's outrageous now for my question. N. My question is about nabitus. We've talked about conflicts of interest nabitus is an out of state company we haven't signed the contract yet. Alc has not approved a contract yet but I think it's important that every legislator in this room and was not in this room understands. The answer so a couple of questions and router ask does not own. Luma sarah in my family right I mispronounced this all the time limits are or costco. The. My understanding represent four hours is that lumis area is owned by the pbm navative and their costco like we have in west litterark you're familiar with costco costco and the mail order pharmacy that they own which are by the way the exclusive only network providers that can provide mail services under this particular draft contract costco owns a significant portion of the pbm navigators. Yes there's a affiliate relationship between both in terms of ownership is nabit is paying below costs. On purpose to eliminate local pharmacies and push a business into their own out of state mail order companies and have so I believe is violate state law can you confirm that. I don't know what navis for sure pays its own pharmacies I know what they're guarantees are suggested in this draft contract but I don't have proof. That they are exact claim that can't bring you today and show you a claim I would encourage you to look at that as as a body could we get that proof and I want to get encourage you to look at it but when whatever method or methodology the ebd can provide or or legislative auditor the instruments commissioner are now can do limited exams of the market conduct on this plan as they have on other plans in the past if you have that concern I would encourage that but I do feel like and I know i'm under oath but my opinion is that pbms that own their own pharmacies absolutely as a whole i'm not talking about narvative specifically but any pbm that owns its own pharmacy is the most aggressive and pushing rates to the four which are publicly published as I talked about earlier and required by the federal government and yes I believe that is part of their business strategy in my opinion thank you thank you mister chairman one question i'm going to senator boyd why was the why was rural used as the definition and not a medically underserved because medically underserved as something that has a you know federal map to it that identifies it has brought her sweep and any of the older why they picked rural enrolled print sake I think that was part of your testimony and not something more you know definitive like the federally underserved area I think there were decider could do that I think the point could do that the finance board could do that is ratified by ALC in the way the governance allows that to happen but currently as it stands all those definitions and decisions are in the control of the pbm you could decide as a body to say we're going to take that away and and make that decision as a state not allow the pbm to decide that or maybe they'll get thrown in the mix but I mean it's just a little bit. Discouraging that there is despair see in reimbursement based on a term if I understand it right then the pbm has determined what constitutes rule vs what doesn't and i'm not sure i'm not i'm not sure that out to be in their control to define it because that that creates a great a great disparity unfair advantage if you want to target you know who you want to put out a business said her boy thank you senator hammer darter vincent the table you're you're answering questions now I don't probably ask you this this earlier so I want to start with i'm on the office of inspector general hs website and it talks about kickback schemes now those specifically again relate to physicians but I just want to say what what i've understood is we believe costco owns the pbm and then the pbm owns the mail order plummer sarah and so basically it at some point. Costco has israeling a contract for itself if it owns the pbm that correct that's the way I see it too that's so the office of inspector general hs says that kickbacks in health care in health care lead to overutilization increased program costs corruption of medical decision making patient steering and unfair competition so if you were the the company who has receiving rebates if you were the one the company who had the pharmacy and therapeutics committee that was driving the formula decisions. Could there's list be applied to a situation where a pbm owns its own pharmacy or costco owns its own pbm agree with that and that's why there's federal law in the physician space and other health care provider space that does know how it. And I would also say that this legislature just a few years ago legislative did an audit of pbn practice in the things you're describing were listed as concerns of things that the state article sitter passing state last to address in the space and course we've done some of it but there's quite a bit of conflicts of interest that still exists that haven't been addressed by the body yet as recommended by the slave okay so again doctor vince this question is to you and it's my last one. Turn it back over to somebody else. Act nine hundred of two thousand fifteen. One of the key components from my opinion was it unparaphrasing but it said something along the lines of if you own your own pharmacy and you're the PBM you can't pay yourself more than you pay another pharmacy or pharmacist for the same services so when you referred to that forty five page document. Is there anywhere in there that may be on the surface it looks like the pbm is going to pay its own pharmacy more than what it might pay a local pharmacy who could otherwise provide the same service. Yeah so on page then I know not everybody has this printed out but just for testimony there are a couple of points. On page thirty five and thirty seven were blumassairs proceeding and the guarantees are described between us there and retail and other competing pharmacies and it appears on the surface like the contract would allow that thank you and membership so you know there is an attorney generous opinion has been drafted requesting a review of the contract to see if it violated state laws at the time it was issued and presented timelines for that getting turned around it back is out of our control but there is one that has been drafted representative gas way that you miss the chairman and uh senator boy just asked one of the questions that I had but you know I want to focus specifically on this navigators contract. John maybe you can tell us when was this contract or has this contract been signed on behalf of the state so I would ebd could answer that question better than me but my understanding of it is the state did enter into kind of a number of contract and then there's a more specific details around the. The implementation beyond this transition phase of first six months and that's the forty five page draft document that I keep talking about and that's been presented to be the advisory board who passed it although there were concerns from members of the committee voiced and in in a voice one person abstained from boating and then it also went to you on august ninth the finance board which governs and and cooperation with alc and it has not yet been presented to ALC d subcommittee or to the full alc body and and test them only even last week there were questions asked about it and they're still concerned things that the staff is still working on and legislators are still working on so it has not been approved a little details of implementation beyond this transition phase to the new PBM but just to be clear I mean there has been it sounds like some preliminary approval given and it's being implemented we're operating and and pharmacists are being being reimbursed under the terms of this agreement this received at least some preliminary approval even if it hasn't been approved by legislative council yet is that correct yes and there were times in meetings I mean you would have heard from us before if if I knew they were going to be dramatic rate cuts but in my conversations with legislators and ebd directors and I know there's been some change over and one lay after new one came in but in all my conversations most of the savings are coming from rebates the first six months don't expect any major changes formula is going to be the same rates are going to be the same etc but that's not what we experienced on you offers yeah and so one of the key things that you just said was if you knew so it so what I have to wonder is you didn't know obviously good raised these issues earlier had you known. Which makes me wonder who was looking out on behalf of the state who was reviewing this to make sure that these the representations that were being made were accurate exactly what those representations were and and reviewing the truly reviewing the contents of this contract to ensure that what's happening now wouldn't actually happen who was responsible for doing th. I'm asking you. Procurement was involved ebd was involved alce has been involved. I don't know how to answer where the back of ours but I mean they're various players within the state involved in that process represent gas way came I heard earlier. And you mentioned something about the insurance department I guess has some oversight and and how this operates have they've been engaged on this at all so I have shared my concerns whenever we saw the rates and yes they've been engaged in terms of at least enforcing the two percent claims that I talked about earlier directified that clear violation of state law commissioner alan mcclain also is a voting member of the finance board so he is also involved personally as asked by the state to to count it overseas this contract but I can't call me on what level of detail his team where they've done to verify what they will gality is of the of the current draft okay and so. It's it's also my understanding of course the seagle group has been involved in. A lot of these discussions and that may be a bringing us to the table as that right that is true that there is a consultant true okay did they pick up. Not as expressed to me I mean we I haven't had conversations with them directly about concerns they would have about this okay so. That that leads me to this point you said earlier if you knew or if you would have known. Which makes me wonder if the seagle group didn't know and other people did no because. There may be were false representations made. By nabitus to the seagle group two. Everyone has been involved in betting this that you mentioned that as far. Can we have them here at some point that because i'd like to know what representations were made on the friend that made them think this was a good idea because obviously this is not a good idea. That sounds good good point now I have one one more followed thank you. I heard you mentioned earlier and and senator boy here on this olympia. But there's a specific provision in the contract. Use it sounds as earth that allows. Nabites to pay its own pharmacy that it owns more money than it pays local pharmacies. Which sounds to me that that is a direct violation of act nine hundred of twenty fifteen which. That's why we enacted that law is to specifically prohibit companies like nabitus from doing that very thing. If that's an illegal provision in the contract. You know i'd also like to hear from the attorney general's office about whether we have the option to potentially declare this contract void. If that certainly if they made false representations in. You know their presentation of this contract to the seagle group or to. You know if other officials with the state on how much money this could save the state if there were false representations made that induced the state to enter into this contract. I'd be interested to know that because and and also the attorney general's opinion about that because there may be a way for us to try to get out of this. Agreement that i'd be very interested in looking at so. The. I guess my question would be have you thought about that have you talked with the new at the attorney general's office about. Any of those issues. I have not spoken with the attorney journal's office yet about those issues but. And generalities I have spoken with the insurance commissioner's team about concerns I haven't long item by line ad i'm gone through the forty five page document yet because that's relatively new in terms of being public information but in generalities conversations with interest department but not with the turn general's office yet okay thank you. And just for clarification in is that in the room or at least a sea grant is that in the room that I see him earlier. Great you have to come but am I say something you know you're here to from right on the saying if they're not this contract has not been thoroughly very nor has it made it up to us as a legislature through the proper channels it's still being better over it added armed strong's office so it's part of it's been a signed deal it's not at that point yet it has been made public it is now out there that as part of it has parked to conversation but as far as it having gone all the way up to approval it should not be talked about in terms of its a contract the story is signed deal inches dry on it and it's gone in my in my right on there can you just give me not their grant okay all right so just please keep that money represented to win. Thank you mister chair II guess I was a little bit concerned by something I heard from this topper bill about how. You were not you you're not being designated as a rural pharmacy and you have no control over that not only that you don't even know what the parameters are to be determined rural did I characterize that correctly yes that's great so I guess with maybe for you mr chair do we have anybody that it represents any of the p b m's here today no sure they will be actually in the other committee on september thirteenth I think it's the date the ebd committee my understanding is that they are on the agenda to be in that committee that day this meeting was too exposed that are pharmacies pharmacies in a in a I know a lot of chalk is round the independence and that is true I think they're on the front line of the chop in block but the reality is there others they were going out that are part of change short you give an example already of brookshowers this morning so I don't think this is limited to just independent pharmacies they're the ones that the table talking about they will be in the committee on thirteenth I would highly encourage members of this committee to be in that committee taking the information you're learning today in the perspective from the pharmacies represented so that we can put that in the equation of whatever the final outcome of all this was going to be okay well that'll be one of my questions for them then in september of one for for any of you at the table or perhaps for the chair as well do we have any data on what the end result is for the consumer are the consumers paying more paying less equal trending one where the other do we have any indication as to what this is doing for our end user. I do not do you have anything like. So the initial data now since now ran comparing june data versus july and finish it paid amount in june for those claims when it's nine dollars and fourteen cent company in july it was eight dollars in eighty seven representative i'm not the other information as far as the premiums and all that aspect but from a company at the pharmaceutical there was a slight decrease in total company amount average now I will say though if I may the automated result from these patients as we will have to end up turning them like trying to want to speak for mentioned but they will not get service and anymore than twenty three locations and process and I hate as bency learns you earlier we got in the news because we care for patients like remember some of the flowers that we hate having to do that and make that decision but we have to so when you keep our worse open to be able to care other hundreds and people so the ultimate from a pharmaceutical perspective there access will discipline in shocking i'll get well thank you for that thank you very much I know just simple basic economics were dictate if we are bringing less providers to the marketplace prices have a tendency to go up for the end consumer and that would be something that we'd be very concerned about thank you very much mister chairman. Representative last year just so you have update where we are get two more in the queue and after that we'll cut it off as we've we've pushed pretty far today a under so I got two in the representative lunch from go ahead. Headed again. Okay go ahead thank you my question was first of all I would like to make a motion that we hold the silver and then how can a pharmacist close the door and then send our private medical information to an unknown entity. That'd be a better question for the state board of pharmacy but my understanding is that we do allow that to allow the sale of the business and it is allowed under state board of farm seeing and federal. Currently and motion at the proper time chairman let me ask you this question. The. What can you tell us about the processes in a major so store closes and understand they can't maybe make that public because of my jeopardized sale of their business and so there is a little bit of common sense business one or one there but as in the case of what you referenced you've got a pharmacy that just nobody knew shut it down. The quote the quick explanation of the process of what happens in all those went in this case to wall greens but that doesn't mean they have to stay there educate people on the process in a couple minutes or less if you would so when I am in this instance when their records are all that wall greens they automatically should have that data in their store so when the patient walks in they should be able to pull their records that were purchased. Um in this case from smith carl will the patient at that point when they realize where their prescriptions have gone to they do have a choice under state love work you know they fill the prescriptions so they can either go to that pharmacy to while greens and decided to stay there my choice or what we saw happening and I know blakes are happening as they're string me in our door what do I do how do I get my prescriptions here don't need to bring my bottles into I need to call my doctor you know honestly work. We can call wall greens and get with called prescription transfer we can request the whole profile we can get one prescription and time whatever the patient performers but we have to make a phone call to walk greens as for that information they're under extreme stress cause they despot all these records and here we are calling to get those transferred out also we offer to call the position directly and we could get new prescriptions on pal at my pharmacy for that patient so that we can service them you know in all that one thing. Parcels me is all we're doing is shifting. The loss to the next door and if that store goes out of business it goes to the next door as just a trickle down effect because to your test money while go blake you can't you know would I should be in filthy rich but we don't you go and broke because of take you out out of the community that you serve but there is a you know there there's that concern that all we're doing is kick in the can down the road to the next pharmacy till they go out and that goes down to the next one down the road eurosay so and then i'm a go to the next legeller. Real quick I want to say for those of year relationships with malmark talk to them kroger talk to them kroger lost the pharmacy recently while more is out of network crowders out of network with track here with those national taken to leave it rates and I think somebody mentioned tracking earlier we went from almost every pharmacy and arkansas was in network to sixty percent of the pharmacies with for our military or no longer network so what may work in new jersey isn't working in arkansas and st percent of our independence are not able to fill prescriptions for track you're beneficiaries because of take it or leave it below costs to operate and i've seen evidence from military families where they've been forced to switch to melder and the process back to mister **** representatives question where their process now through mailed or higher than what they were paying at the local pharmacy north of rock in brill examples this year from tracker and I don't want to see uca and ebd go down that same path i'd like to have help and a partnership to fix that to avoid that. All right here's where we are i'm going to go to representative ladyman sender urban represent flowers you very had one shop to my comma let you get a question in at the end and then i'll call out and then represent launched from a coming to you for your motion so representative ladyman thank you mister chair and. I may get weeds here all this are trying to be quick mister chairman but i'm gonna get down in the weeds a little bit because I think it's important I have in front of me a PBM complaint the reason I think this is important these are real numbers this is a real life situation so a farmer see made a complaint a pbm complaint. And basically what they said was hey i'm paying fifty five dollars in two cents for this prescription and the patient is paying me thirty three dollars and twenty six cents so I lost forty percent on this one sale twenty one dollars. Speaking a small business man I couldn't stay in business very long losing forty percent on the sale so this pharmacy is complaining. And navities there response was will go to another wholesaler. You're using the cassette go to cardinal well the pharmacist responded II can't go to another wholesaler and won't go into the details why they can't do that but but they're in the business they have a provider you have contracts that that all gets in the player so this pharmacy can't really do that so they're stuck with losing forty percent and i'm sure this is multiply many many many times across the state. In this pharmacy is one that's II think there they have in a rough time i'll just put it that way so my question is what another thing people talk about violation of state law this is a glaring violation of state law this pharmacy is being required by state law to lose forty percent. That's illegal. Now what do you do about that what can this farmers do. That he filed the complaint got the answer once he do. The. Representative way and agree with you and i'm probably familiar with the case you're talking about because i've been i've gotten a similar phone call in the resolution would be to work with the insurance commissioner to have the law enforced and the insurance commissioner's team does a good job at that but it does take time I mean it takes money in time and staff time away from seeing patience in order to do what they shouldn't have to do they shouldn't hear order to contract if they can't follow the laws in my opinion but nonetheless here we are and in that particular example i've got i've had coles grant wallace's help facilitate nov to this year's job instant cell phone number meet within farm association I get a call from their act we are absolutely committed to fix in this and following the law and we're going to respond to mac appeals like that one within three business days and get it we're going to get resourced super quick and that's what they tell me and then a hang up the phone and I get calls from our members and that's what's really happening now if they told me he's going to happen bullet what is really happening well and in three business days I have a small pharmacy my despite that has like four people feel and prescriptions how many of those are they losing money on in three days they could lose their business so anyway that was my question thank you mister miss and represent layman I think that's where. Pharmacies. Have. Dug into a hole. As far as your cash flowers because that is not overall contributing factor but that is a contributing factor that that their money is being been held just sidebar senator. Arianna. On eighty six center irving thank you thank you mr chair for let me ask this question so it just just a quick thing like i'm just trying to to also say that there is also another side of this correct so you're I mean a business didn't just close their doors they sold to another they sold a lot and that was a private business decision that happens all the time like mean in every industry if me is a business owner decides that i'm ready to leave i'm ready to close my independent practice in which we actually did it and sell through a larger outfit than now that's a decision that that business owner makes periods and in there and so I mean is this speculation or did you talk directly with I just want to make sure that we're clear as to are we speculating as to why this independent pharmacy closed or do you know for a fact you know why they closed and sold to while greens I have thank you for that question that's a really good question and on the sorry how it couldn't be here today to send her hammer talk about a minute ago for contractual reasons she won't able to be here but I talk to her directly I went to her pharmacy the day it quotes a met with her a spoke with her for an over an hour about it and i've also received many many many texts and calls from her over the last two years where not trying to speak but wish she could be here to speak for herself but i'm on answer the best I can she is my age we're the same age and she had many many more years ahead of her in terms of being business owner and successful to blake's description earlier one of the top five most successful on paper independent pharmacies in the entire state multiple only two stereo compounding pharmacies in the reality is the take it or leave it pbm contracts her words directly to me. From track care medicare and now state employee medicare are federal legislature has nothing right and I was trying to finish joint me I mean the ebd the state piano too didn't give her hope that she'd be able to survive for another five years in that way there are decision making as she part of i'm at a hermes to tourists says that he's part of what ten twenty three other farmers translate your partners with that's a huge large business that you're you know that's that's of that's bigger than just one marm and pop shop that's a pretty big she was part of the same buying group that representative just and army senator just the boy was part of the has thousands of stores in its god epic so she's part of that and are you then tied to one wholesaler as a contractor your time you can't break that contract with and go to a different wholesaler but I mean is that part of your for how long are you talking like if you can't shop your prices with wholesalers in her situation she actually her buying group and she as part of the issue of declining reimbursement take it to they did change health sales they went from a small regional wholesaler to one of the largest fortune twenty five companies in the in america a different whole say where that she believed in that buying group believe would get better process in order to be more likely to succeed and her words to me where's a lack myself raps and there's some differences about the service but in terms of being able to buy and purchase is very similar to where I was before it's so but they do have that flexibility within their own business practice to move from one whole saler to another you're most wholesale and contracts are on an annual since review and then they require that you purchase nineteen percent or more than all of your medications from them important here agreement is an again access to your data that's going to bring your software system to the people. And then track that versus what you're spending so you're selling I mean you're selling the data on your customers to them and exchange for a better price of wholesale I don't I don't get any return on that data it's a contractual requirement so they can track the number of purchases basically as an oversight to make sure that i'm not moving around to me and cornell in a mirror source and smile and the insuring that can control basically how much that purchase in years and then can you go back to manufacturers and say we had this welcome business once your investment needs it's also federally required for controlled substances so it's not something he has a choice and it's required by the debate i'm assuming that that's probably not down to the individual person no inside into the fine just into an awareness monthly purchase and it's on the unit perspective and finally I just would say you know for the legislature I think it's important that we also look at all the work that the that the legislator has had to do on ebd and all of the hundreds of millions of dollars we've had to put into that paragraph and plan to add to it to save it to bail at all I mean there have been there were absolute reasons why we hired siegel as consultants there are absolute reasons why we have taken all the stats necessary to do what we've done to save their state plans for both public public employees and teachers and so I would encourage my colleagues to make sure that you do your research and you understand all the work that's been done by the eb oversight committee for all these years starting with senator hindran years and years and years ago so there have been a lot of work for us to have to bail out these plans and there's everybody's in this space mean that's not just yall it's doctors it's hospitals it's for its pharmacist it's therapist it's all of these saying. And you know we have to be for dissure responsible for those plans to make sure that our public employees and our teachers public school employees and state employees have a health benefit plan that a they can afford and be weakened afford so I mean that is the nature of our job as well so I mean I just I just incourage as to understand fully all the implications of you know of the decisions that we have to make and looking at it from all perspectives I mean I just want to say that so that we can all be very educated on the process. And inside her heart running in for me and chairman I appreciate the understand the one graciously speak that decision now and there is a provider as well not me on the back so providers then ultimately in jeopardizers patient care and that's all I would ask is that we women are considering implementation in responsibility then we also like it what the old game result couldn't potentially be sort of imperative that we have across the board fairness and every aspect of all the health care providers that are in the space and those dollars are important so it's important that we look at that number one and also that we look at where we are in the market place across the country and where were out of line and we've had to adjust that over the years so I appreciate it thank you. Let me let me ask you on that point and then send flowers recognize you for a question the when all the discussion was gone on you know feds and what happens with my care d understand with that's a different bucket okay I hope that are federal delegation I feel they are but I hope that as a result of meetings like this and others that have been going on would recognize the seriousness and I know they do. The. But. Would you own a pretty big block of business smith call well was a pretty big business i'm i'm not sure about your sausage business I fear it must be significant or you would be here. Did anybody talk to you as pharmacies when it came down to the development of the ebd contract or any of the other contracts what dialogue occurs which you as a business owner to get your input before the decisions that come before us as legislators are made. Anybody talk to you and they call you say hey what's your thoughts where your input. Mean directly no sir nor any of my business partners are in in my pharmacist cross about you. Nobody get so john we used to have AC n n for its and a seat at the table as association and we don't anymore the legislation that was passed a couple years ago cut us out of that just for perspective and I do have a good working relationship with. Uhm leadership in the legislature and as well as staff at the terms of being able to talk but. No I mean just as that testified earlier we were we were not expecting a drastic rate curt. And you are to happen for our members okay so we're gonna go to for final earn representative flowers thank you so much mister chairman in this in this environment where. The. Your community pharmacies as well as your chain pharmacies are closing most of which are closing they're not selling out their clothing you've got the issue of closure you've got the issue of consolidation just in this year we've had super one close and then another super one just recently announced consolidation with wall greens. Um probably two or three years ago wall greens closed one of its stores and that's just in jefferson county. Um. If most of these savings back here with if most of the savings are supposed to come from rebates sixty million dollars. What happens that's completely out of the control of the pbm that's completely out of control of pharmacies what happens if the drug companies say hey we're not offering we're not offering these rebates anymore we're not offering these coupons and we're locked into a contract. What happens to our pharmacies more importantly what happens to our patience and what happens to arkansas. Mister vincent doctor fence I would just say to the rebate numbers there and the pbm's do you have some control over that and they negotiate it either directly or through rebate aggregators with the manufacturers and then also the the savings programs the coupon programs that also it's not really called rebate there's the same thing it's a discount offer the list price at the point of sale by using a coupon ultimately you're right that that is decided by the manufacturer on whether they want to participate are for those or not but I would encourage you in this committee and subcommittee and others to definitely take a hard look at the forty five page draft agreement and ask questions of. Siegel or the pbm brand walls and ebd or whoever you want at the table about are those savings legitimate are they real how many workplaces in the contract if this happens we don't get the rebate or we don't get the savings or the guarantee doesn't have to be met there definitely lots of loopholes or lots of areas where those guarantees are those savings don't have to be real and I would just encourage the legislature to take a really good hard look at that and get get answers from the consultant you hired in your staff and team thank you and thank you as senator hammer thank mister chair I want to make comment and will recognize a representative launch this this meeting is was set up to give pharmacies and it is personal to make us of the large pharmacy that went out my district and I think maybe at some time when opportunity of forget we would be able to get more insight from some of those that have had their stores closed the question years did the store closed because they were forced out was at a good business opportunity etc etc II can only tell you theirs that having talked to several other pharmacies I don't know very many. That want to sell because they don't have any choice it's when pharmacies are put in a position or doctors office or whatever else somebody is putting a position that they have to close because they can't afford to operate because the way the laws in the contracts are structured and it forces them out I think the warning signal was this and it was hit on a while ago this is this is a snowball effect that when it starts with one and one of decent size watched to make a sank that is not going to go down especially when you consider the CVS that have been closed you look at the the brookshowers that have just continued you'd look at the you look at the freds that have discontinued and you look at the independence of discontinued I do think that in our decisions we have to weigh everything that's been discussed day in that look forward to the meeting and i'm glad that the PBM will be an attendance on the thirteenth again I would encourage you to be present in that meeting take which have learned today and strolled in a mix of that because at the end of the day we all have constituents that we've got to answer to whether you're on the committee or not we've all got to stitch when some stores that we've got to answer to with that representative lunch from you got the final. I'm sorry. Thank you mister chairman is it possible and if I could just ask your question is it possible to get a breakdown of that sixty million where it came from worst going from from earn. Nah what's how do you say that nor never task. Is that something we could get before the next meeting. I will learn the chairs will put in the fisher request I will say that that has been requested by individual legislators it has not been produced to them as yet will throw the full force of the chairs and the committee behind that request and would as should that be provided to the committee as a whole but also put a time table that it would be provided by the september thirteenth meeting that ebd subcommittee is going to have an and hopefully that'll get some attention to get her done okay with that I would like to hold this issue over until the next september the thirteenth meeting okay where I don't have the control of the thirteenth meeting because that's not my committee that I chair but what I would do is if you'd like to put emotion in to hold this over to the next joint performance review committee will at least keep the door open to have it on on as an agenda item maybe we can have other pharmacies in there will be september nineteenth think that's right okay let's hold an overtill september nineteenth through a joint JPR motions or second a discussion to the motion. I'll favor say I posed with that we thank you for being here we know you have scripts to fill and we appreciate you being here with that no other business for the committee we are adjourned.