House Public Health Committee
Video
Transcript
Bills discussed (6)
| Bill | Title | Sponsor | Status |
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HB1301
· 2 mentions in chapter, transcript
Matched: “HB1301”
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Pre-2017 bill | ||
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HB1279
· 1 mention in chapter
Matched: “HB1279”
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Pre-2017 bill | ||
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HB1315
· 1 mention in transcript
Matched: “…ndsey that we would consider a special order of business on House Bill 1315 on February the 15th.”
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Pre-2017 bill | ||
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HB1316
· 1 mention in chapter
Matched: “HB1316”
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Pre-2017 bill | ||
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HB1317
· 1 mention in chapter
Matched: “HB1317”
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Pre-2017 bill | ||
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SB77
· 1 mention in chapter
Matched: “SB77”
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Pre-2017 bill |
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Representative Linda S. Tyler
Unverified
0:00
Today, we have the free prostate cancer screening that is taking place outside the Capitol Steps for all of you gentlemen who have not had your prostate screening. We love our men and our families, and we love our men in the legislature, and we want to take care of them. So if you haven't had your screening, please go ahead and do that, and it's free, something we want to pay attention to. I have been requested by Representative Uvalde Lindsey that we would consider a special order of business on House Bill 1315 on February the 15th.
That is the autism bill, and without objection, we'll set that special order of business on February the 15th. we have a fairly full agenda today on our agenda we have Mr. Jay Bradford I think he's known to all of us with the insurance commissioner's office and he's insurance department's office and he's going to spend a few minutes talking to us about
the insurance exchanges we've given him a few minutes We'll take a few minutes for questions, but we also have some bills to get to. So if we find that we have more questions and we have time, then we'll find a way to get back to that over the session. So we'll make sure that we get to some bills today because I know we have some guests who have come long distances to make sure that those bills have been considered. So, Mr. Bradford, if you would introduce yourself and go ahead and proceed. Thank you, Madam Chair.
Speaker 6
1:44
I'm Jay Bradford. I'm the Insurance Commissioner for the state of Arkansas. I thought maybe I should just take maybe about five minutes to give you a briefing. Your request was for me to come and talk to the committee about the exchange and what effect it will have on Arkansas citizens. And first, I'd like to start with the mission of your Department of Insurance, and it starts with the consumers on the front.
That's our primary mission, to take care of the insurance consumers of the state of Arkansas. And this is my second year there, and it has been at the forefront of my service, and it comes from the same way that you all do in your districts. You're here taking care of your constituents. That's how you got here, and I'm sure that's why you're here representing them. And so with my background, which is similar to yours, by the way, that's the way I approach
it. And so my concern about affordable health care, which has gotten to be a major, major national issue and a very emotional issue, is that we put ourselves in a position where we're not able to take care of your constituents. Somebody at this table that has called over there and had a problem with the constituents, you know that we make that a priority. And you have a great standing as members of the legislature with our agency.
And what I would say is I'm not going to editorialize or even become a part of the federal legislation because I don't have a vote up there. I ran in 94, but I didn't get there. But the facts are is I am concerned that if we don't put in place the insurance exchange, if it happens, you know, every day I'm acting like it's going to stay in place,
it's going to be there, and we're going to take care of our constituents. It may change, certainly. and probably ought to change in certain ways. I'm not getting in that because that's not my role now. But my fear is and what I worry about, and I've talked to a lot of individual members here, and I feel better every time I do. I don't care what side of the aisle you're on. Everybody here in their heart wants to be sure we can take care of our people. So if the Federal Affordable Care Act becomes a reality,
I want it to be whether your constituent has a problem with their health insurance, They know where to go. They go right to their department of insurance. Probably come to you first. You come to us or you hook us up. We try to take care of it. We're not magic, of course,
Speaker 7
4:43
but we do focus on those issues. So what I've got to convince
Speaker 6
4:49
the legislature this time is to give us the authority to continue. We've got two grants. One is a grant to formulate a health insurance exchange for the citizens of Arkansas.
That's a work in progress. I can't give you the answer right now. I will report on an orderly basis to this committee about where we are in the interim and during the session, of course, anytime. But that is a million-dollar federal grant, and we have people, Cindy Krohn, who's here in this room, who is working diligently to plan this grant and to make it where it will perform for our Kansans. You all have to okay that. You all have to okay that we would operate that.
And I'll have legislation out here. I'm going to be asking for some help and for some sponsors, especially people that are on this committee. And so what we have to have is the authority to govern that like we do now. you know, regulate the issues for insurance. And so what if we don't do it? Bottom line is that's kind of the bottom line. So what if we say we don't want to operate the exchange,
we don't want to operate the medical loss ratio, that's to review the rights. We've got another grant. We're working on that too to be sure that the companies do not overcharge your constituents, which means if they have a certain amount of profit over above that they've got to give it back to the policy owner and so that's another function of state government if you all want it to be if you all want it to be that's like the operating the exchange that will be a function of state government if we want to do that and I sure hope I hope that that's the answer to you all okay we don't do it so if we don't
do it it's in place on a federal basis and some states have said fine they're turning their people over to the federal system I'm I'm not I'm I'm
Speaker 6
6:57
of that to do that because I know we can do it better so so that's going to but those are the decisions we're going to be asking you as members to to make we don't know the bottom line it's a planning grant it doesn't come into effect of 2014 you're going to have another whole session you know a regular
session, not counting your budget session. And we'll probably be back out here with some more legislation at that point in time trying to make it work for Arkansas. So you know, we've got to integrate this with Medicaid, which is a daunting task that we're not there yet. It's a marriage between private industry and the public system, which is a weird combination. But that's all in the federal legislation, and that is a work in progress up there.
But what we do have a vote in here is whether or not whatever comes out of this, or doesn't, are we going to be the regulatory body? When I say we, I'm not talking about your insurance department, I'm talking about everybody sitting around this table here to have input. So, you know, bottom line, that's where we are on the exchange. I know that I really feel like that our legislature will see, you know, the merits of keeping the management of that on our turf here.
No matter whether you're for or against, that would be, you know, that's what
Speaker 18
8:27
I'm selling, folks. Let's just take care of our people. That's what I'm
Speaker 6
8:32
selling. I'm an old insurance guy, okay? So, anyway, I'll yield for questions on this, and like I said, Ms. Crone's here who's working on it on a daily basis. I welcome the chance to get you all in one
Speaker 15
8:47
place to be able to explain it, how it fits
Speaker 6
8:54
with your service to your constituents, and so I'll yield, Madam Chair, for questions if anybody has any. Thank you, Mr. Bradford. we
Representative Linda S. Tyler
Unverified
9:01
do have a few questions. Representative Lee.
Speaker 25
9:06
Thank you, Madam Chair. Thank you for being here today. Mr. Bradford, you said something that I really appreciate. You said we, Arkansans, can do it better than the federal government can for our own people. And I really appreciate that you said that. Part of the reason you're here today, I'm sure you know, is because of the
discussion that took place last Thursday, having to do with abortion opt-out bill that I helped Senator Bledsoe run in this committee. I'd like to ask you, the only advantage and disadvantage you mentioned in setting up our own insurance exchanges instead of letting the federal government was simply that you thought we could do it better. Can you
Speaker 29
9:44
elaborate on that? Are there any other advantages or disadvantages? Probably are on both
Speaker 31
9:51
sides, Representative Lee. You know, that's something I would miss.
Speaker 6
9:56
But I guess on a scale of 10, I mean, I'm thoroughly
Speaker 19
10:01
convinced that we're 9 if we administer the, you know, the program
Speaker 6
10:07
here. Just because we can respond better and respond to your needs better. We, on the federal congressional offices, they get constituent work on insurance issues. They don't regulate insurance federally now. They give them to us, and we welcome those. And we try to staff those issues for your United States senators and congresspeople.
And it's really just a more practical approach for our Kansas. We don't have all the answers over there for sure. And we don't win every battle, but we come from that direction.
Speaker 19
10:43
You know, we come from the direction of the consumer. Exactly. The companies have got
Speaker 6
10:49
to have a healthy business atmosphere, so we have to balance that. But, you know, that's just kind of – that's our approach over there. I may not have answered your question very well.
Speaker 25
11:05
better. I think Arkansans take care of Arkansans better, and so I think we agree on that. Of the
Speaker 6
11:13
million-dollar grant, when do you expect to receive that? We have – Representative, we have gotten two grants. We've got a million-dollar grant to plan the exchange, which we're in the midst of that now, And then we have a second grand to plan the medical loss ratio function. That's the review to hopefully hold the cost down to the consumer.
Those are all – I mean, those are just in their first stages of the study. MS.
Speaker 19
11:46
you spent at this point? MR. I would guess probably very little,
Speaker 6
11:51
probably 5 percent of it. MS. some RFPs out that will cost, you know, money, but that is 100 percent federal money. We have hired some people that the – your personnel committee in the interim authorized. These are people who are 100 percent paid for by the grant and who are 100 percent attached
Speaker 25
12:17
jobs go away. Correct. On health insurance exchanges, what decisions in your studying of this, what decisions can states make about abortion funding, either in the context of a federal exchange or a state exchange? Ma'am, I... As you've studied that and read that as our insurance director, what can you answer on that? Well, you know,
Speaker 19
12:39
I've certainly seen the issue come to the fore
Speaker 6
12:42
here, and really I I don't know that, you know, that we have any play there because of the constitutional
issue here in Arkansas and because of the strong position that the federal bill made that there would not be any funding allocated to those procedures. And so it's really, to me, with our constitutional position and the federal position, I think it's pretty well off the table from the insurance point of view. Define off the table. I mean, I don't think I have any latitude, I don't think, as your commissioner on that subject, I don't think I have any latitude except to follow the Constitution and follow
Speaker 25
13:23
the federal legislation. And can you define that – I'm asking for a definition of what your understanding is then
Speaker 7
13:32
of what can be spent on abortion funding. No public money can be spent on
Speaker 6
13:38
– in my viewpoint, I'm not a lawyer by the way, but No public money can be spent. It's in the federal legislation and then, of course, in our state constitutional change that says there's no public money that can be spent.
Speaker 48
13:54
It can be privately funded by an individual, I suppose.
Speaker 29
13:58
And your understanding in the health care exchanges is that private and public money will never commingle? That's my understanding. Let
Speaker 7
14:05
me say this. I'm not a I'm not a I'm not an expert in the in the constitutional law there I'm sorry to you know
Speaker 6
14:12
I don't but that's my understanding and I'm getting most of that just the way we all are you know thank you thank you
Representative Linda S. Tyler
Unverified
14:24
Representative Penards you're recognized good morning Mr.
Representative Tracy Pennartz
Unverified
14:29
Bradford welcome to our committee thank you I'm going to focus on really the duties of the exchange because I think that it's helpful if we especially on public health all
understand what the duties of the exchange are on behalf of the citizens of Arkansas so my questions will be toward that as
I understand it and please correct me if I'm wrong one of the things that the insurance department will do in setting up the
the health exchange is what y'all call certify health plans to offer coverage in the exchange. Is that correct? Yes,
Speaker 31
15:11
Representative Pennares. We will. The participants in
Speaker 6
15:14
the health insurance exchange will be the commercial insurance companies, and they have to meet certain standards to be authorized to write insurance in our state. And it's a protection for the client to be sure that they have the ability to fulfill their contractual obligation to pay the claims.
And so just everybody won't be able to walk in and sell policies through the exchange, nor will the individuals. They all have to be licensed individually, in my viewpoint, and we're in a study of that right now, Because we've got to have authority to take care of the bad actors, whether it's an insurance company that's not paying their claims on time or paying them properly, or an agent that's misrepresenting the coverages to the consumer.
And so we have to be able to police those areas. That's what we do now, and we'll do that within
Representative Tracy Pennartz
Unverified
16:18
the exchange. Does that, and I know this may be a hard question for your answer yet, since maybe the EHB's, I'm sorry, essential health benefits have not been finalized by the federal advisory group that is actually going to make a recommendation with regard to that. Will all of these certifications of these health plans, will one of your function be
to actually make sure that all of them cover these, what is being called now, EHVs? Yeah, you're correct. What they
Speaker 6
16:56
will have to, the coverages that are in the exchange, whether you're with X, Y, or Z company, the policy will say the same, have the same provisions. And those essential benefits, which is a work in progress, on the federal level.
Those are the benefits that will be covered. Anything
Speaker 9
17:21
over and above the essential benefits that might be covered, let's just say plastic surgery, which is generally elective, the state's got to pay it. So that's not going to float in this room. I know that
Speaker 6
17:33
y'all would not let that happen. So it's going to call on us to change benefits that are mandated under state statute. We don't have to do it this time, but we will have a menu
from the federal government of essential benefits, and we'll match those with what we have mandated throughout the years here. And the ones that have been mandated by people like me, I've done it myself as a legislator, those will either have to go away, will rely on the federal menu, are what they pay for by the state which is not a practical situation now I do believe that it will
Speaker 19
18:16
be a very generous federal menu well certainly wouldn't it
Representative Tracy Pennartz
Unverified
18:22
very least it would cover inpatient care and oh yes patient care and you think it will cover prescriptions oh yes like that I
Speaker 6
18:31
think all of those essential things are the things that you're going to be some question about what these procedures that
Representative Tracy Pennartz
Unverified
18:39
might be elective okay let me ask you another question one last question really is I've talked
to a lot of small businesses and I know all the thing that always comes up is that they say it's not that they don't want to
provide health insurance options for their employees it's just that they can't afford it, will there be some providement for small business where they'll have options that they can cover, say, like their employees through the exchange?
Speaker 6
19:19
business, and they will be like this. Depending on the income level of the employee, there will be some federal subsidy.
There will also be federal tax credits for the small business to induce them to enter into the program. And so those parts of the federal law which may – could change as we all know, you know, those are designed to make it better for small business to participate for – with their employees at the health care plan. They're an inducement to do that. Now, there again, I'm going to try to stay out of that part of this whole scenario.
Representative Tracy Pennartz
Unverified
20:00
I'm just your mailman. Well, I'm just asking you questions with regard to what are the duties of the exchange. And I appreciate you being here today, and I appreciate the chair requesting that you come. And I hope that this won't be as Mr. Bradford's last visit with us about the progress of the setting up the structure of the exchange for
the benefit of Arkansas citizens. I appreciate your being here. Madam Chair, thank you very much. Madam Chair,
Speaker 6
20:32
I will come any time. Just give me just any small warning, and we'll be here from out of town. I've got very competent people, and we want to work with you. And I hope that I've gotten my point across is that we want to take care of our Kansas. And thank you very much for the opportunity. Mr. Brapper, we do have a
couple more people raise their hand for questions. I didn't want to overstay. No, that's all right. we'll we'll make sure you don't um
we do have we i didn't mean that the way it sounded i've sat in your chair before
Speaker 91
21:01
it's a lot better than this one i can tell you before before we
get to the next questions uh we have had two people who have signed up to
Representative Linda S. Tyler
Unverified
21:12
speak against house bill 1301 and i just wanted to let you all know that this bill was withdrawn from consideration this morning so i didn't want you to have if you're standing in the audience i don't know who you are for sure, but if you're standing in the audience, I just wanted to give you that as a courtesy to let you know that we will not be considering that
bill this morning. Next on our list is Representative Hyde.
Representative Linda S. Tyler
Unverified
21:40
I'm sorry. I did say 1301, but it is 1293. I'm sorry, Representative Hyde. I'm sorry to give you apoplexy this morning.
Speaker 94
21:50
Thank you, Madam Chair. You were just seeing if I was paying attention, and I was, and I was. As one
Representative Barry Hyde
Unverified
21:56
of the senior members here with a whopping, I guess, just over four years of experience now in the legislature, my friends down here on this end of the table will grin with me. We acknowledge the years of experience that you spent in this committee and specifically on issues such as this, as well as sitting in the chair of this committee.
And I just want to thank you for your good work both in the legislature and now as the commissioner of the insurance department and to remind everyone here that your office and you personally and your staff are very accessible and have been helpful to me in numerous matters. And the resources over there are really impressive. A lot of sharp folks over there with a lot of experience, a lot of knowledge,
of not just this particular issue on the exchange, but insurance issues in general, and that if you don't take advantage and use those resources, it really is your own fault. And so thank you for being here this morning, and thank you for
Speaker 19
23:01
all your work, Commissioner. Certainly thank you, Representative Hyde. I hope I can get out
of here on that note. Mr. Bradford, I'm sorry that we do have a couple more questions. Representative King, you're recognized.
Representative Bryan B. King
Unverified
23:18
Thank you, Madam Chair. Commissioner Bradford, thanks for coming. There was a meeting, I believe it was maybe in the fall or summer, at some point in time I came down here and you were talking about that you didn't know at that time how many positions you were going to have to add to be able to comply with this. Do you have an idea now, or do you know, we keep hearing figures about what this is going to cost the state, that it's going to be $100 million, $200 million, $600 million. And do you have a handle on those things right now?
Speaker 6
23:49
Representative, if I can answer part of that question, we have added – we will have added four people to this grant, these grants. And we possibly will add more if we get second phases of the grants. It's just – a lot of it depends on things that are out of our control. So you all in the committee where you addressed this, I think it was the council, very concerned about getting any of our general revenue involved in this project, and the governor has certainly
been very plain to me about that. And so until 2014, we'll be operating on federal grant money, all right? When that exchange kicks in, it's going to have to be self-sufficient, and that will entail some type of a fee for the participants in the exchange. I'm talking about the company side. Now we have a 2.5% tax on all insurance premiums.
Maybe some of that would be diverted to operate the exchange, which should not be a high overhead operation. It shouldn't be. We're not talking about hundreds
Speaker 19
25:10
later about how much because we're just at the early stages
Speaker 6
25:14
of that. But the ongoing cost was when the federal government starts backing out of the subsidies or if they do or when they do, that will be a bridge that will be crossed at a later date.
But my theory is I'm not going to be down here asking for your general revenue at this stage, and it'll just kind of have to
Speaker 19
25:39
develop as the federal picture unfolds about where we're going to go
Speaker 6
25:44
from there. So right now, I'm very comfortable in saying that there's not any state money involved in this, and probably won't be any until they start pulling that Medicaid money out in 2015 So, you know, that's an issue I know that weighs heavily on your minds, and I know it does the governors, too.
It's kind of a work in progress. But I'm not going to put you in a bad position.
Representative Bryan B. King
Unverified
26:14
You're not going to let me do it anyway. Chair, can I ask one more or maybe a couple more short questions? Certainly. On the exemptions, you know, we keep hearing the news media that a lot of the unions are getting exemptions exemptions and organizations and companies do you know how many people
Speaker 108
26:28
here in Arkansas are are going to get these exemptions and I mean what's your opinion on that or what's going to
Speaker 6
26:34
happen just from just reading the media on this I could tell you who's out now and that's McDonald's that's Arkansas
and they got a waiver they have a bare bones plan I understand it's not regulated by your insurance department it's an arrest a plan it's regulated by department of labor but i understand they got a waiver uh... from the and then there will be uh... i guess other maybe large employers that will apply for and get a get a waiver that's a federal waiver by the way it's you know it's not through us but the
Speaker 6
27:10
you know uh... get there again they are under the uh... labor department
U.S. Department of Labor, and there's certainly a possibility, yes, sir, that they might
Speaker 19
27:18
get one. Now, they have those, like I said, we don't regulate them. I'm just kind of talking off the top of my head. You know, they have those super, some of those are super rich plans. You
Speaker 44
27:33
know, remember during the early days of this thing, they were talking about taxing those plans because they were, you know,
Representative Bryan B. King
Unverified
27:41
Cadillac plans. So. Okay. In other states where they're doing the lawsuit, as far as your part,
when you talk to other people in those states that are involved in the lawsuit, are they doing anything compared to what you are? Are they doing zero? What's the comparison? And if we're going to be changing, I know you have to comply with the things right now. I mean, I guess what are other states doing that's involved in the lawsuit different from what you're doing? And the second part of that question is what are we going to do? I mean you're just making the changes and we know Congress is going to already start breaking
Speaker 115
28:14
this down again I mean what do you think about that
Speaker 6
28:23
the federal changes out of my mind I just kind of have to deal with the hand that we've been dealt now and plan based on this and then react to the to the changes and so that's you know I'm trying to do what I have some control over you see and for our people and that's what I'm asking y'all to you know endorse that basically
and what was the other part of your question about the other states that are involved in the lawsuit I can give you an informal response to that and I just came back from a commissioner's meeting and it's all over the map there are some states I talked to my colleague in Louisiana who's a close friend He's an elected commissioner, a member of the Republican Party, Jim Donnellan. And he said, send everything back. They're not going to do anything.
That's Governor Jindal's call on that. I just had a conversation with him yesterday. And, you know, that's scary to me because that means the feds are going to take care of theirs. And so that's an extreme case there. And I think there's others that would fall in that category. I don't have a survey, but a lot of my colleagues say even though my governor is against the federal reform, they're telling me to get ready to be sure that we're going to be the
gatekeepers of it. You know, whether they like it or not, they won't, you know, that to me is the general consensus. Now, I haven't talked to all commissioners, but the ones that I've talked to saying that Even though my governor may be, you know, certainly on the other side, he said be sure you're ready to take care, no matter how this thing falls, that you're ready to take care of people. And so I think that's the best advice, really. If you're against it, that's the American way. Be against it, but just don't make a fatal mistake for people we're here to take care
Speaker 120
30:28
of. Okay. Thank you. Yes, sir. I think we have time
Representative Billy W. Gaskill
Unverified
30:35
for one more question. Representative Gaskell. Commissioner, I'm going to assure that you were completely sober when
Speaker 109
30:41
they gave you this job. Well, I came from behavioral health. It's director of behavioral
Representative Billy W. Gaskill
Unverified
30:46
health, so, you know. If in its infinite lack of wisdom the Supreme Court is going to decide this thing is constitutional, then a lot of the things that we're doing are kind of moot, aren't they? Correct.
Yeah, you know, and you can bet that they're going to declare it constitutional. I'm not going to bet either way on that. Well, I'm going to bet on it for this one reason. Anytime that crazy bunch up there can't decide on anything, they bring in the damn Commerce Clause and watch them bring
Speaker 19
31:15
it in. I think that is certainly what I've read in the media, that Commerce Clause is a... Anytime they can't make an intelligent decision, they bring
Representative Billy W. Gaskill
Unverified
31:22
in the Commerce Clause. Thank you, Madam Chair. Mr. Bradford, thank you very much.
And as this continues to move forward, we'll certainly take advantage of your willingness to come before this committee and answer our questions. We thank you for being here. Thank you so much.
Speaker 6
31:40
And any individual that needs to come talk to me or me to come talk to you
all over here, I'll be glad to thank you. Certainly.
Representative Linda S. Tyler
Unverified
31:50
Thank you. Now we'll move to our regular agenda. We have – I don't see Representative Lovell here. We have House Bill 1299. Is there anybody planning to present Representative Lovell's bill?
Looks like we're not. So then we'll move to
Speaker 127
32:03
Representative Hyde, House Bill 1301. Next. That's what this report. Yes. Representative Hyde has
a handout that he has provided to the staff ahead of time and
Representative Linda S. Tyler
Unverified
32:31
they are handing that out. I think that's information for you to take with you and to peruse as you have time to do so. Representative Hyde, if you will, go ahead
Representative Barry Hyde
Unverified
32:45
and present your bill and introduce your guest. Thank you, Madam Chair. Members, House Bill 1301 is really very simple and has long been serving the young school-age children in Arkansas envision screening in the schools. This bill will simply continue the existence of the commission that oversees this work
be done, and this may be the most perfect or the best partnership between private industry and our schools and our children that exist out there. This commission solicits private funds to pay for any cost that they have and to date or actually let me just quote for you that in fiscal 07-08 they actually spent $987 that was donated by themselves.
They spent $30 in 2008-09 and in 2009-10, 2009-10 they spent nothing. So they're absolutely using no public funds in getting a great job done and, you know, something we could only hope might be achieved in other areas of our private sector. I have with me today one of my constituents, Dr. Haas, representing the vision industry and eye care industry, and he's going to briefly describe to you what that work involves for the commission.
Dr. Haas, if you will, introduce yourself. Let us know who you're representing, and then
George Haas
Unverified
34:17
go ahead and proceed. My name is Dr. George Haas. I am a practicing optometrist in Sherwood, Arkansas, and I represent the Arkansas Optometric Association. Let me
Speaker 138
34:26
give you a little history so you can put this into perspective. Prior to 2003, there was no definite program in terms of screening of kids who were, let's say, in elementary school and also in the junior high level.
It became very apparent because every year we saw countless numbers of individuals that literally could not see what was going on down at the end of the room. The vision levels a lot of times were 2,400, and a lot of times these kids didn't even know they even had a problem with that. So it became so apparent because of the problems associated with kids and learning and vision to be able to do the things that they have to do, we asked the legislature to put together a commission, the vision and eye vision commission in 2003. That commission functioned, and in 2007, the legislature came back and enacted the parameters
in order to do the screening from each school district within the state of Arkansas. Prior to that time, there was no mandate that the school would have to do the screening. We fine-tuned this in 2007, and each time that we introduced improvements to the bill, we had a sunset clause that sunsetted. It has become apparent to us that we need to make this a permanent, let's say, part of state government so we can continue to improve things. And let me tell you the primary reason, and this will alarm you.
Last year, the data that is in the handout, in 2009 and 2010, there were 226,000 kids that were screened. that 8.6% of those individuals were referred to an optometrist or an ophthalmologist for eye evaluation, 48% of those actually received an eye examination and 74% had visual problems. The problem is going from when the number that were referred at 19,000 individuals to
those that received the exam, all of them did not come in and get their eyes examined. And the problem is that some parents are just not necessarily doing the things that they should do, which puts these kids in a jeopardy situation in terms of learning. The state of Arkansas, as you know better than I, spends lots of money to make people competent within society, and this is just an intricate part of it. We respectfully ask that you extend the life of the Commission on a permanent basis so we can continue to be able to provide this level of coverage so the kids will have a
a better chance within the classroom. The president of the commission is standing behind me, Dr. Wyatt, and he has been on the commission from the very start. If you have any questions about what we're doing and why we want to do it, we'd be happy to answer those questions. Thank you,
Representative Linda S. Tyler
Unverified
37:14
sir. We do have a couple of questions. We have, first of all, on our list Representative Gary Smith. Thank you,
Speaker 141
37:22
Madam Chair. Thank you, committee. at the proper time.
Representative Linda S. Tyler
Unverified
37:25
MS. Thank you, Representative Smith. We'll get to that at
Speaker 145
37:42
the proper time. Representative Lee. Representative Penartz. Thank you,
Representative Tracy Pennartz
Unverified
37:47
Madam Chair. Representative Hyde, as a child who didn't know that such a wonderful world existed until she got glasses when mother could afford to buy them.
I think that the purpose of this commission is absolutely necessary. But let me ask you, I would not be a good member of Joint Budget Committee if I did not ask this question. We're creating a commission here. Do you anticipate that we're going in the future then to have an appropriation for this commission and there'll be
Speaker 80
38:23
an employment of staff for this commission and where would that money
Representative Barry Hyde
Unverified
38:29
come from? Representative Pernartz, thank you and
really I mean this is the easiest piece of legislation I probably have ever carried because these folks do such great work and at literally no expense to the public. And we're not creating the commission, we're continuing the commission. Well,
Representative Tracy Pennartz
Unverified
38:45
but I mean you make it a
Representative Barry Hyde
Unverified
38:47
permanent commission. And we are in In fact, the commission carries a $1 million appropriation, and they have carried that $1 million appropriation for a number of years. And as you and I both know as members of budget, all that means is you have a mechanism to spend money if you have any.
You know, there's not any request for staff. There's not any staff anticipated. and that appropriation, as you know, is required so that they can spend the money that they donated to take care of needs, such as some of these schools can't even afford the instruments needed to conduct a quick screening. So your answer is no new money, no money in the future, no current staff, no plans for any staff.
It's fully intended to continue to be an industry-funded and an industry-run commission for the betterment of our schoolchildren. Well, I'm fully supportive of it. You know, we don't like to create
Speaker 147
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commissions unless we have to, and we certainly don't want to make them permanent unless
Representative Tracy Pennartz
Unverified
39:52
there's a need. And in this case, the need is worthy. Thank you, Representative Hyde. I appreciate that. Madam Chair, I think
Speaker 134
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we record that as one positive vote so far. So far, we'll see. MR.
Speaker 151
40:06
Well, I think all my votes are positive, Representative. Hi. MS. Representative
Mayberry, you're recognized. MR. Thank you, sir. I appreciate you being here
Representative Andy Mayberry
Unverified
40:17
today. I just had a quick question. I think you mentioned that along the way that there have been some tweaks made and some improvements made. Can you just briefly describe what some of those may have been? MS. Sir, if
you will, identify yourself for the record and the organization you represent. Okay. I'm Dr. Kenny White.
Chair
Unverified
40:37
I'm an optometrist for Mountain View. I've been chairman of Eye and Vision since its inception. When we first took over the mandate to change the Eye and Vision screening for the state of Arkansas, So most of the school nurses around the state that were doing screening then, all of them had different kinds of instruments, different kinds of methodology, different kinds of forms. So it was very, very difficult for us to look at statewide and see, you know,
who was doing the best job, what the test results were. We wanted to standardize across the state, try to get everybody on the same page, make everybody run the exact same test the exact same way with hopefully eventually with the exact same instrument. We just didn't have the money to go in and buy everybody a brand new $2,500 vision screening instrument. But that is changing. As schools go in and buy new equipment,
we kind of recommend what they would buy so everybody would kind of be on the same page. Our association is also in the process of buying instruments now, and our goal is to have there are 16 health co-ops around the state, have an instrument in each health co-op so a school could come, check it out, use it, and everybody would be the same instrument. But that was the biggest challenge to begin with, getting everybody on the same page.
Once we did that, we immediately saw a drastic improvement in the way things were done as far as the school nurses. And the school nurses have done a fantastic job. And you can see by the number of students that they screen out, the ones that actually make it to the doctor's office, you know, 80 percent of those do have a problem. Where before, the way we were doing it, probably I'd say 50% had a problem.
So there was a lot of over-referrals. Now there's not much referral problem. Again, like Dr. Haas said, the problem we're running into now, and we don't have a mechanism to force the parent to take the child or anything like that. And if anybody's got a solution for that, short of not letting the child move on up, I don't know, but I'd love to hear some answers for that. But that is our number one goal right now is to try to reduce the number of children that are referred,
try to get most of those in the offices because, you know, if they can't see, they can't perform in the classroom. The State Department of Education has been wonderful for the Vision Commission. And D. Cox was our go-to lady at Department of Ed, and Paula Smith, she's the head of the school nurses, and she works with us, gives us all kinds of statistics, helps us
in any way we can. You know, I think it's been a win-win situation for the state of Arkansas in that you have private people coming together, working with state government, you know, at no expense. to you and that just doesn't happen very often and I really think that the vision commission still has some work to do it's not a perfect system right now but we're slowly moving in that direction and hopefully
at some point in time we'll be able to report that 90% of the children are getting their eyes
Representative Mark Perry
Unverified
44:34
checked when they're referred out We
have Representative Perry you're recognized Thank you, Madam Chair. And Representative Hyde and Dr. Haas, kind of piggyback on what Representative Mayberry was talking about. Looking at this chart on the number of screened and referred, you were touching on there's about 10,000 kids there that didn't receive an exam.
I'd like to even see a way that the commission could work to, you know, If they were recommended to see an optometrist and they didn't, was there a way to do a follow-up visit or a plan in place to maybe reach those kids? If you're talking 60%, 70% of the ones that actually received an exam had difficulty, out of that 10,000 that didn't receive an exam, that tells me there's about 6,000 to 7,000 kids out there that are struggling through school by not being able to see.
Chair
Unverified
45:34
So, Representative, if I might answer your question on that, the school nurses actually are in charge of notifying the parents when they have a problem, and it's not a one-time send the letter home, and if they get it, fine, and if they don't, fine. They contact them over and over and over again, either by phone, by letter, whatever, and And those parents are still not responding to that.
And again, short of some kind of penalty for not letting their child or getting their child's exam done, you know, I don't know how to solve that problem. It's not an easy problem to solve. Let me add to that, a lot
Speaker 138
46:23
of these kids that should have gotten their eyes examined and parents haven't done this, a lot of them are funded under Medicaid, our kids. They've got a free eye exam and a free pair of glasses if they just simply, you know, bring that
child into the office. And that's the biggest stumbling block, which is also the main reason why you want to continue the commission on a permanent basis so that hopefully we'll be able to find solutions so that these kids are seen and
Representative Linda S. Tyler
Unverified
46:54
their problems are corrected. We have no further question – oh,
Representative Tracy Pennartz
Unverified
47:00
I'm sorry, Representative Penartz. Madam Chair, if you will allow just for information for the committee members, a point of information,
I think in some respects it may be helpful here to remember that there are coordinated school health clinics. I know, for example, in Lavaca Elementary School they have an on-site clinic there. Maybe some of that, y'all could hook into coordinated health, the clinics that are located in schools, for example, like Lavaca, that might be helpful to catch those that maybe are eligible and we're not now getting them glasses. Just a point of information, Madam Chair.
Thank you, Representative Penartz. We have no further questions. Do we have anyone in the audience who wishes to speak against the bill? I believe you've already heard from the two doctors. Thank you very much. You wanted to speak for the bill. Representative Smith, you're recognized for your motion.
Thank you, Madam Chair. I have a
motion do pass. We have a motion do pass. Any discussion on the motion? All in favor indicate by saying aye.
Any opposed? Motion passes. Mr. Hyde, you have passed your bill. Thank you, Madam Chair. Thank you, Committee. Thank you, doctors, for coming. We appreciate you. We're going to go out of agenda just a little bit, if you will, Representative Letting. We're going to hear Senate Bill 77, I believe Representative Bradford is going to be presenting that bill, and she has a couple of guests who are going to help her present that bill.
Representative Bradford also has a handout. She's going to make sure that the committee gets to explain exactly what we're trying to do so that you'll have this for further information. Representative Bradford, if you will, go ahead and present your bill and allow your guests to introduce themselves and the organizations they represent. Thank you, Madam
Representative Toni Bradford
Unverified
48:59
Chair. I'm Tony Bradford, State Representative, District 18, and I will let my guests introduce themselves. I'm Bob Abbott from Pine Bluff.
Speaker 169
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I'm a member of the Arkansas Kidney Disease Commission for 40 years.
Speaker 172
49:16
Jim Moreland, Arkansas Rehab Services, and also Administrator of the Kidney Disease Commission. Mr. Moreland,
you're going to have to get really close to that mic to make sure you can be heard. Yes, ma'am. Okay. Representative
Representative Toni Bradford
Unverified
49:29
Bradford, go ahead and proceed. Thank you, Madam Chairman. Senate Bill 77 is sponsored by Senator Jerry Taylor, and it would authorize the State Kidney Disease Commission to honor persons who have provided living kidney donations to Arkansans
in need of kidney transplantation. In 2009, the governor appointed board of the Arkansas Kidney Disease Commission voted to institute an award recognizing individuals who provide living kidney donations to Arkansans in need of kidney transplantation. The award is designated as a chain of life award, and I think the copies that we've passed out will explain that to you. This award would honor those living donors who are willing to give a gift of life to
individuals in need of a kidney transplant. We will be glad to answer any questions that you might have on this particular
Representative Linda S. Tyler
Unverified
50:23
bill. We do have a couple of questions, but I'd like to say
first, and this is a point of personal privilege, if you will, the gentleman at
Representative Linda S. Tyler
Unverified
50:33
the end of the table, Mr. Bob Abbott, is a dear friend of mine and he's been on the Kidney Disease Commission for 40 years. What he doesn't tell you is he is the number one advocate for kidney disease in kidney patients
in Arkansas. His father was diagnosed with kidney disease many years ago when Mr. Abbott was a young man and he saw firsthand what it was like to try to get dialysis and what it was like to get a transplant. There's no one who advocates on behalf of kidney patients anymore than Mr. Bob Abbott does, and I just want to say thank you, sir. My daughter is a kidney transplant patient. She had her transplant 14 and a half years ago. There are 80,000 Americans
today on a waiting list for kidney transplant, and living donation, particularly the way that they're doing these unmatched donors is one of the best solutions we've got to serve that need. And I will tell you that every day on dialysis is a life saving. I'm not diminishing the importance of dialysis, but every day off of dialysis is a gift of life. And this is something I would ask you to consider. So with that point of privilege, I will go
Representative Clark Hall
Unverified
51:52
to Representative Hall, who has a question. Thank you, Madam Chairman. The intent of the bill here is absolutely commendable. I don't think anybody would object to what you're trying to do here. My question has to deal mainly with the line 25 on page 2, which deals with the municipal county governments being able to to give grants out is that what the intent of this is to
allow cities and counties to to provide grants if they so desire or am i reading this without limitations to accept gifts grants donations from private sources municipal county governments and the federal government to be used to honor persons who have provided living kidney donations to Arkansas in need of kidney transplants. So we're allowing municipal and county governments to participate in the grant program.
Speaker 174
52:56
Is that an accurate statement? Representative, what we're doing is allowing them to provide donations that will help fund the Chain of Life Award. The award itself is just a certificate it to where we recognize individuals who have made this living donation of a kidney. We're not, we're just giving that avenue or opportunity if a
Speaker 172
53:26
county government wanted to provide a donation toward the cost to offset the certificate award.
Representative Clark Hall
Unverified
53:33
Well, I appreciate that. And what I'm really trying to get at is for my own clarification, municipal county governments right now under the municipal codes are prohibited from from doing this type of uh uh even though it's commendable they're kind of being limited because of the uh it opens up a large uh potential for other organizations to ask for grants uh do you not do you do not feel that this would be in
this would not be in conflict with the municipal and county codes as they exist today in government and in the code and statutes? I was
Speaker 172
54:16
not aware of that. We asked the... Well, the reason I asked is
Representative Clark Hall
Unverified
54:21
because I, quite frankly, I was the mayor and we gave a donation to a very worthy cause that was beneficial to the community, you, but I already slapped my hands fairly hard for doing it, and I just want to make
sure that it's understood or clear that if this goes through, which, and not against the object, the objections here, but the object of what you're trying to do, but you could potentially put city and county governments in an awkward position if we're not in compliance with the municipal codes, and I just want to make you aware of
Representative Toni Bradford
Unverified
55:03
that. if I may say something representative this is just a certificate it's just an award so you know it's not a grant with money as I understand it it's just a
Speaker 183
55:15
certificate well that that and that I would agree with I
Representative Clark Hall
Unverified
55:21
understand but then you read it when I read it when he's talking about gifts and grants right in donations, it presumes about funds and expanding funds from counties and cities, you get in conflict with audit and municipal codes, but as I read this, it doesn't say certificates, it says grants and donations, and I'm just bringing that out as an issue, not that I'm
opposed to what you're doing, I'm just letting you know that some cities could wind up getting into potential problems
Speaker 188
56:01
with audit municipal code and things. Thank
Speaker 95
56:05
you. Thank you. Representative Wagner, you have
Representative Charolette Wagner
Unverified
56:12
a question? Thank you, Madam Chair. I, too, think this is very commendable. I'm just curious about one thing. On page 2, line 19, number 6, talks about to accept gifts, grants, donations from private sources, etc.,
to be used for the purposes of defraying costs. Then on line 24, it says to accept gifts, grants, donations to be used to honor. Would these be kept in separate accounts? Are we talking about this is all the same money, it appears it should be separate? Yes,
Speaker 174
56:52
ma'am. They'll be kept in separate accounts. Our goal is to fund this purely by private donation.
Representative Charolette Wagner
Unverified
57:01
And since you're talking about the new language, it's just for a certificate, I assume this would be very little that you would be soliciting. Yes, ma'am. Thank you. Thank you,
Chair
Unverified
57:13
Madam Chair. Representative Mayberry. I have a question.
Representative Andy Mayberry
Unverified
57:21
This is just for my own personal information. I
don't know the answer to that. How difficult would it be to amend this last portion just where we didn't specifically
mention grants or money coming from the government for that, just related to private sources? That would be no problem. Of course, this
Representative Toni Bradford
Unverified
57:44
was Senator Taylor's bill. He simply asked me to run it, but I see no reason that, you know, this would be a problem to just amend, maybe change the wording slightly. Representative Bradford, do
Representative Linda S. Tyler
Unverified
57:59
you want to do that? Do you want to pull it
Representative Toni Bradford
Unverified
58:02
down for now? Let's pull it down, Madam Chair, and we will take care of that.
Thank you. Very good. Thank you very much, and thank you very much, Mr. Abbott. We appreciate you being here. We'll
Speaker 201
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reconsider that once we have an amendment. We'll
Representative Linda S. Tyler
Unverified
58:24
now consider House Bill 1279, Representative Letting, if you'll take your place at the end of
Speaker 203
58:31
the table. Would you take over? Sure. Can I sit here? Sure.
Speaker 205
58:43
Representative Letting, you can introduce your bill when you're ready, and I'm pleased to have your guest to state his name for the record
Representative Stephanie Malone
Unverified
58:51
and who he's with. Thank you. Thank you, Mr. Vice Chair. Ladies and gentlemen on the committee, good morning. With me this morning is Mr. Robert Depper. He's an attorney with the Department of Human Services, serving in the office of Chief Counsel up in Benton County. Coincidentally, he's also an old college roommate of mine. He is here today to answer any questions, should my own answers provide insufficient and if pressed to share embarrassing stories about my undergraduate years at the University of Arkansas.
If you'll take a look at House Bill 1279 before you, it is a simple bill that makes modest but important changes to the laws governing the way officials can come to the aid of maltreated adults in our state. I'm going to touch on just a few of the changes that could potentially impact our state budget. The first one we're going to look at, if you'll flip to page 4, line 12, these changes create a less-than-custody status. This gives officials one extra option in coming to the aid of an individual in need.
As an example, if you have, say, an elderly individual who is largely capable of taking care of themselves, but they have nonetheless been assigned a guardian, and this guardian is in some way exploiting that individual, perhaps spending through their assets or causing some other kind of harm. than custody allows officials to come to their aid without taking full custody of the individual. It is a less disruptive method and a less costly method. So any potential impact to our state budget would be positive. And I think we can all support that kind of thing. The second change, if you'll flip to page 6, line 30.
This just makes a minor change to a timeline. It gives courts a little extra discretion in deciding when to close certain cases. If an individual passes while in state care, and this individual has no assets, no family, no outstanding debt, the courts can close these cases sooner rather than later. Obviously, this would save time, money, and free up the docket. So any
Speaker 209
1:00:43
potential impact on state budget would also be positive. If you'll flip to page 8, line 33.
Representative Stephanie Malone
Unverified
1:00:56
we're adding Arkansas State Hospital to the language here
the way the law stands now an individual could meet every criteria to be considered a maltreated adult except if they're a patient of the Arkansas State Hospital I want to note that there are to my knowledge no examples or certainly no recent examples of abuse at the Arkansas State Hospital so this is kind of a preemptive move but certainly I think it makes sense that if somebody is a maltreated is being abused we don't want their status as a patient in the hospital to prevent us from being able to come to their aid with that I'm willing to take any questions about anything except junior year or we could
Chair
Unverified
1:01:37
just pass this and get on out of here representative
Representative Charolette Wagner
Unverified
1:01:44
Wagner we have quest has a question. Thank you, Madam Chair. Going back to page 4, line 12, where you talk about the less than custody. Yes, ma'am. And it says that the endangered adult, you're talking about that, but does not give the department custody over an endangered adult. Correct. So it's less than custody, and the department does not have custody. Who has custody?
Representative Stephanie Malone
Unverified
1:02:10
MR. That's a good question. Less than custody isn't probably the best term for what they're trying to create
Robert Depper
Unverified
1:02:20
here. I'll let Mr. Depper address that. MR. Yes, again, my name is Robert Depper. I'm an
Speaker 223
1:02:27
attorney with the Office of Chief Counsel for DHS. Representative Wagner, Representative Letting articulated this is a horrible name for this. It's been a horrible name forever. We have a similar provision in the child maltreatment and child custody codes.
Less than custody is just that. Typically if someone, if an endangered adult is in someone else's custody and they're being abused in that custody or guardianship over the person, then we would go the extra step to protect them if we needed to to take them into custody. This is an interim sort of measure. Right now it's pretty binary and we have as you can imagine the galaxy of possible things that could be going on in an endangered adult's life that may not immediately impact their
health and safety. They may not be in imminent danger. So they may have say a guardianship of the person or a power of attorney over their financial matters and they're being exploited. the current code we have as adult protective services has a very limited ability to do something that doesn't disrupt their home life provide services short of bringing them into care and then making a placement obviously again that's very disruptive to people people want to stay in their homes and
understandably so so we're trying just through this to have more options available to us to keep people in their homes thank you
Chair
Unverified
1:03:57
representative Lee you have a question thank you
Speaker 225
1:04:10
the concept of what you're doing here and I can see how it fits in as always the devil's in the details. Page seven, running a background check. Who would pay for the background check?
Speaker 214
1:04:30
question? Who would pay for the background
Speaker 227
1:04:37
would pay, correct? So there would be a fiscal impact to the agency? Well, okay. I'm
Speaker 223
1:04:46
being told actually that as we currently have it now, the person who is being studied pay okay but also many checks central registry checks obviously don't cost the department anything because they're internal state state police checks for
the government as a whole or budget neutral because it's one agency paying another part of government so there's actually no money leaving the government federal checks are really we have to have state authorizing language even to be able to request a federal background check and I anticipate that will not be used very often and would be used more for people that are out of state that are seeking guardianship over their relatives and it would be paid by the
Speaker 225
1:05:35
person seeking the guardianship that makes sense page 9 if an investigation under the subchapter is determined to be true the Department of Human Services may open a protective services case if the department opens the case they shall provide services to the endangered person or impaired person in an effort to prevent talk to me about that they shall provide services meaning what can you point to the line you're on Representative Lee pardon me page 927
27 well 26 27 28 Well representative Lee what
Speaker 232
1:06:15
that would do that the mandatory language is
Speaker 223
1:06:18
We have the option to open a protective service case But once that case is opened we are obligated to provide services that we think in consultation with the adult evaluating their situation, will prevent their removal, prevent our need to take them into custody and disrupt their life. Got it.
Chair
Unverified
1:06:42
you, Madam Chair. Representative Smith, you're recognized. Thank
you, Madam Chair. Let me go back, if we could, to this less than custody. Who determines if there is exploitation and, therefore, kicking in this less than custody? What kicks that, what
Robert Depper
Unverified
1:07:02
triggers that? Well, exploitation, as a general
Speaker 223
1:07:05
proposition, falls under the code in the 12.12.17 section.
That's the investigative section. So typically what will happen is we will get a hotline call, and a worker will go out to investigate and see what's going on. The short answer to your question is the court would. we would apply to the court for some provision the destruction of a power of attorney or the destruction of guardianship based on an affidavit outlining facts to the court and we'll say you know your honors this is what we think is going on this is the allegation this is what we found
based on this we would like you to enter an order on an emergency basis for this and then the court would have the option of looking at that and then typically we would have another hearing very shortly thereafter to have a more,
Speaker 237
1:07:54
what we call an adjudication, a more fact-based hearing. But does a caseworker give you that preemptive note
that there might be some exploitation? Or is it a family member, or would it be a combination, or could it be of those? Well, I
Robert Depper
Unverified
1:08:09
would say generally it would be a combination because typically we'll get a hotline call first
that initiates the investigation. Then the investigator,
Speaker 223
1:08:15
once they have made their findings or during the course of their investigation, they may come to me and say, this is what's going on, here are our concerns, do we meet the definition of this maltreatment or that maltreatment? And so we'll have that conversation, and then we
Speaker 237
1:08:30
would go to the court for authorization. Okay, and one last question, if you will, Madam Chair. Will
there be a large number of this type category that you'll have to determine in a given period of time?
Speaker 223
1:08:45
Well, truthfully, Representative, any number I could give you would be absolutely speculative. How many have you
Speaker 241
1:08:50
dealt with in the past or noted that they might fit this criteria then? Well,
Speaker 223
1:08:54
just off the top of my head, in the past month, I have seen two or three situations that have been what I would call borderline to where there's a real question, well, do we need to take them into care, or can they stay home, and what can we do to keep them in their home? So this type of thing, I would say, again, just based on my experience in the past month,
two, three times a month, maybe. But it would certainly give us a broader menu of options to protect adults. Then it wouldn't probably require additional staff to
be added to your facility then? No, sir. Okay. Thank you, Madam Chair. Thank you. Representative Penartz, you
Representative Tracy Pennartz
Unverified
1:09:44
have a question? Thank you, Madam Chair. let me see if I understand
on page four lines 12 through 15 you're creating the
less than custody language would that then become a legal term before the court
Speaker 223
1:10:01
yes ma'am it would it would not necessarily be less than custody would not be a legal standard per se but it would be
Representative Tracy Pennartz
Unverified
1:10:11
a term that we would use before the court yes ma'am so I'm confused now oftentimes by legalese so it's not but it is well is that your response
Speaker 223
1:10:23
I'm sorry I was not clear representative
again I'm not a lawyer so I'm just trying to ask it in plain language sure I understand and this is a term that we would use before the court anything less than custody when we're asking
Speaker 227
1:10:38
for court action we would call it less than custody but just as a
Representative Tracy Pennartz
Unverified
1:10:44
term that's all it would be all right and I see that applies to all of these learn long-term care facilities and there's a list of those is that correct on
page four just below that line 16 through 25 yes ma'am okay
Let's go to page 9, line 36, where you say, start at line 35, if at any time during protective services case the department determines that the endangered person or impaired person cannot safely remain, and
let's turn to page 10, at home. I guess the problem I have with that language is you define it only as at home. shouldn't that refer to if it's at
home or in a long-term care facility or any
other place where that person currently resides so are we only restricting this to at home which would then therefore exclude all persons in long-term care facilities I think that's a good
Robert Depper
Unverified
1:11:55
point representative Bernard but when we use the terms endangered and impaired
Speaker 223
1:11:59
adult, certainly those are defined higher up in the code, in the definition section, which would include people that are in an assisted living facility or
Speaker 248
1:12:10
a nursing home. Well, but you're in this language,
Representative Tracy Pennartz
Unverified
1:12:14
you're specifically referring to remain at home.
And what I'm saying is you need to amend that language and make it broader than just what you indicated there, either through reference to a subsection of the code or remove the language at home and refer to the subsection that talks in those terms. So I mean, it may be an arcane point, but I think it's relevant. Well, certainly, Representative Penards, it
Robert Depper
Unverified
1:12:40
would be relevant. Of course, P.S. cases are only going to be those cases where the adult is in the home.
I'm sorry, you mean a protective service case? The protective service case, I apologize, are only going to be those cases where an adult is in a home, in their own home. Typically, we
Speaker 223
1:12:58
wouldn't open a protective service case on someone who's already in an assisted living facility or nursing home because they are already being provided services.
Representative Tracy Pennartz
Unverified
1:13:06
Well, I beg your pardon. Are you saying that anybody that resides in a nursing home couldn't be maltreated? No, ma'am, not at
Robert Depper
Unverified
1:13:14
all. They would be, under the definition of endangered or repaired adult, could be a maltreated adult.
Speaker 223
1:13:20
But simply for the purposes of the authority of the department to open only a protective service case, a non-court-involved protective service case, that would only be the case if someone was actually living at home and not getting services already.
Representative Tracy Pennartz
Unverified
1:13:37
Well, now you've thoroughly confused me, so you've
almost made me where I can't hardly vote for this bill because your clarification is not actually a clarification.
Speaker 178
1:13:52
Madam Chair, I'd like to bring somebody else to the table. Yes, I was going to
ask you to do that anyway because the lady who's been supplying some information really should come and introduce herself rather than approaching the table. So if you'll do that, let us know who you are and who you represent,
Speaker 256
1:14:10
and maybe you can help clarify this. Okay, I'm Lisa McGee. I'm an attorney with the Office of Chief Counsel with the Department of Human Services, Representative Penartz. The way that we've drafted the bill, if you'll look on page 9, it's on the protective services section.
So we have the option to open the protective services case. Once we do it. What line are you referring to? Line 25. Okay. Once we open the protective services case, we provide services in order to keep the person from having additional maltreatment occur. And then the next line is, or to prevent the removal from the home. So you can see when we open a protective services case, that's normally for the clients who are in the home setting, and we want to provide services to keep them in
Speaker 258
1:14:51
their home setting and to prevent additional maltreatment to them.
Representative Tracy Pennartz
Unverified
1:14:54
Well, let me go back to my original question, ma'am, which is, are you telling me that you never open a protective services case for someone who's in a facility or in a
place, a physical place, other than their home? We have two statutes that deal with maltreated adults. One
Speaker 256
1:15:11
deals with investigations. That's over in the 12 section in law
Speaker 258
1:15:14
enforcement. Then we have another statute that deals with adults. That's over in the 9 section. That's in the family law section. So those are two different code sections. This happens to be the one that's over in the family law section.
Speaker 151
1:15:28
Title 12 is the law enforcement section. Title 12 is the family section. Title
Speaker 258
1:15:33
12 is law enforcement. 9 is family law. So what you'll see for
Speaker 256
1:15:37
an adult who's in a long-term care setting or a nursing home, we're going to take that under the investigation section and the 12th section. So we'll get the hotline report. They'll say there's a person in a nursing home we think is being neglected or abused. We'll initiate an investigation. During the course of that investigation, services will be provided.
Representative Tracy Pennartz
Unverified
1:15:59
But you wouldn't open a protective services case
Speaker 258
1:16:01
on them? Not necessarily, because the service provision will be during
Representative Tracy Pennartz
Unverified
1:16:05
the course of that investigation. Well, my concern here is that regardless, and you have not assured me through this further testimony, my concern is that regardless of where that adult is, that older person or whoever it is that's being maltreated, you have not assured me through your testimony that I guess that y'all are going to look into it in the sense that somehow that person
Speaker 256
1:16:31
is going to be protected. in the in the investigative statute and this has got both parts of that in here so if you look at the bill we start with like the 920 section at the beginning and that's the custody section then we get over to the 1218 that's the maltreatment section so you've got we've commingled all our stuff on maltreated adults and pulled in both sections since they deal with both of them so for the maltreated adults who are in already a residential setting those will happen
during the course of that investigation. Once the investigation's closed, if we have a person in a home environment, we want to be able to have the additional capacity to do more services for that adult who's still at home. So if there is early onset of dementia, but we think they can remain in the home, we want to be able to provide meals on wheels, home health care,
Speaker 263
1:17:20
and that kind of a thing. That's not something that we would do to someone who's already in a nursing home environment.
Speaker 164
1:17:29
Thank you for your testimony. Thank you, Madam Chair.
Representative Linda S. Tyler
Unverified
1:17:34
Let me follow up to that. Are you saying that we have other code, separate code, that takes care of the maltreatment of adults in nursing home or other living facilities besides the home? In
Speaker 263
1:17:49
the 1200 section on law enforcement,
Speaker 256
1:17:52
the one that starts at the 12-12-1700, that deals with all maltreated adults. In the home, in nursing homes, long-term care facilities, it's Arkansas State Hospital. We get reports on all those people.
If you're endangered or impaired, we take those reports under that section. Then we have another section of the Code and Family Law that talks about when we want to actually take an adult and put them
Speaker 267
1:18:17
in the custody of the state of Arkansas. They should have separated those out. I see. All right. I think that
Speaker 269
1:18:24
has helped me understand it. Representative Ward, do you have a question? Thank you, Madam Chair. Currently, the Division of Agent and
Adult Services operate under Act 166. Representative Ward, would you either turn on your
Speaker 268
1:18:34
mic or get closer, please? Thank you, Madam Chairman.
Speaker 269
1:18:37
Can you hear me now? Okay. Can you hear me now? Currently, the Division of Agent and Adult Services operate under Act 166, which normally investigates cases of abuse, neglect, and exportations. So I can understand it a little bit clearer, but would this law have any impact or change on Act 166
Speaker 271
1:18:55
that are currently on the books? And I guess
Speaker 258
1:19:02
I'm not familiar with Act 166. Was that the act that was then codified at 12, 12, 1700?
Yes, uh-huh. Okay. We are making some amendments to that, and you'll see that. So when you look at each section number, for example, on page 8, on line 24, it says Arkansas Code 12-12-1703, little 5, is being amended. And so that lets you know where we've made particular amendments to that section. And so that's the one that Representative Letting said we're wanting to make clear that Arkansas State Hospital residents are now going to be covered when we get
Speaker 276
1:19:37
those hotline reports. Okay, and going back to Representative Bernard's question earlier about those, I guess the
Speaker 269
1:19:43
problem with investigation, I think that when we talk about protective services, those persons that are deinstitutionalized versus those persons that are institutionalized, I think that the Division of Aid and Adult Services have a protective services unit for those persons that are deinstitutionalized and they work with protective services, but those persons that are institutionalized, I think, normally work with an Ombudsman that actually work with the Department of Long Term Care. Is that not true? We have the Office of
Speaker 256
1:20:11
Long Term Care by statute who does do
some of the investigations in the nursing home, that's
Speaker 279
1:20:16
correct. That statute itself delineates who does which type of investigation. That's correct. Okay. So
Speaker 280
1:20:21
it will remain that protective services normally will investigate those complaints, those three areas of complaint
Speaker 269
1:20:27
that deal with deinstitutionalized persons versus those persons that are institutionalized. That's correct. both under the big umbrella of the
Speaker 258
1:20:34
department but two different units that's correct thank you
Representative Linda S. Tyler
Unverified
1:20:40
thank you madam chair representative wilkins you're recognized
Speaker 282
1:20:45
thank you madam chair i i'm curious about section d on page seven
Representative Butch Wilkins
Unverified
1:20:51
i'm i'm wondering where you would get your probable calls if a person was in their home would that just take a hotline call I mean, that's not much probable cause. So where would your probable cause come from? And I'm concerned because I have two adults that are under my care.
And I just had a recent case where there's no basis to it. But, you know, I would certainly object to anyone coming to my house, and they'd had a hard time getting through the door, I thought.
Speaker 227
1:21:34
if i may representative wilkins certainly this is dealing you'll turn on your mic
please and get closer to the mic
Speaker 245
1:21:42
this provision of the code is dealing with custodial duties uh and again if
you're on line 26 page 7
Representative Butch Wilkins
Unverified
1:21:50
is that correct no i'll go on d on section d of page 7 line 5 line 5 Where do you get your probable cause to take in people to court? What do you have to have as a basis
Speaker 223
1:22:07
for probable cause? For probable cause, we have to submit, practically we have to submit an affidavit to the court based on the investigator's knowledge and information and investigation.
The court then decides whether or not we have that probable cause on an emergency basis based on that affidavit. But you
Representative Butch Wilkins
Unverified
1:22:27
keep talking about hotline calls. You wouldn't base probable calls on a hotline call, surely. Not on
a hotline call itself. If you got a hotline call and wanted to come to my house and check on my wife or my mother-in-law, and I refuse to let you in there on a hotline call, I'm not going to do that. Who are you going to do then?
Speaker 223
1:22:50
Well, it would be your prerogative to refuse the investigator entry. At that point, typically what would happen would the investigator would come to me and ask for an order of investigation that is authorized in the 12-12-17 section. Sir, I don't think
Representative Butch Wilkins
Unverified
1:23:10
a call is probable cause. I mean, I spent
36 years in law enforcement, and I never got a call that I considered probable calls without evidence to go with it.
Robert Depper
Unverified
1:23:26
And, yes, sir, in terms of the family law section, as Ms. McGee was talking about earlier, again, these would be probable
Speaker 223
1:23:32
cause to get an emergency order. In terms of just the investigation, we would also have to submit an affidavit to get an order of investigation. Again, in most situations. And what would be affidavit? So what kind of
Representative Butch Wilkins
Unverified
1:23:45
information would you have to have on the affidavit? The affidavit
Speaker 223
1:23:48
would say, this is the information we're trying to get. This is the person we need it from. They're
Speaker 237
1:23:54
denying access to DHS, and we need it for these reasons.
Representative Butch Wilkins
Unverified
1:23:58
And don't get me wrong, because I'm all for you if we can do this legally, but I don't understand how you would get into the house on a phone call
Speaker 223
1:24:10
without other evidence to go with it. Right. We wouldn't get into the house on a phone call. We would submit a formal motion to the court for an order of an ex parte
Representative Butch Wilkins
Unverified
1:24:19
emergency order of investigation. But what would you base your formal motion on?
Speaker 223
1:24:23
One phone call? No. It would be based on the actions of the investigator when they got out there, what they found.
I'm not going to let them in. And that coupled with why the investigator needs to get in, what information they're trying to obtain, and why you were the only person they could obtain it from would all be information that would be required to go before the court
Representative Butch Wilkins
Unverified
1:24:50
before the court's going to issue an order. Well, like I say, I've got a mother-in-law who's done in my care
with dementia. I've got a wife who's really far along in Alzheimer's.
And so I'm okay with what you're doing. I just want to know how you're going to do it. And I'm still not sure I'm satisfied, you know, with the answer I've got.
Speaker 256
1:25:12
Representative Wilkins, if I could help. When we talk about doing the investigation, it's going to be very fact-specific, and facts are what we're going to put in the affidavit. So if the doctor says the person has bruising all over, they're malnourished. So that's going to be the kind of facts that we're going to submit before the judge. You're not telling
Representative Butch Wilkins
Unverified
1:25:29
me how we're getting there to the doctor in the first place.
Speaker 256
1:25:32
Because we get the hotline report, and once we get the report, no, then once we get it, I agree with you, that's not enough for government to tear somebody's door down. Once we get that call, then we have an obligation as government to go out and then conduct this investigation. We're going to know who made that hotline report. We're going to follow back up with them and say, do you have pictures? Do you have medical records? Have you seen this person? When was the last time you saw them? Then we're going to go talk with the neighbors and say, have you seen her? Has she been out in the yard? Did she really have black eyes? So we're going to get all this information.
Representative Butch Wilkins
Unverified
1:26:02
Let me give you an example because I had a woman that was staying with my mother-in-law just a couple weeks ago that my mother-in-law has a severe shaking of her head at times when she gets nervous. Now, she was only shaking her head around this particular person, but we have been everywhere we could think of to go to find a solution for that. And, you know, she's 94-year-old.
It takes a brain operation, and she's not going to be able to do that. You know, that's what we've been told. So this woman called her boss, who's a service provider, and said that we were not treating her right because we should do something about that shaking of her head. Well, I took that woman with me when I went home last Thursday, as a matter of fact, and took her to the doctor with her and had the doctor tell her. That's the first thing I've done. But the next thing I've done is fire that woman.
But if you're just taking a phone call and you get a phone call from this woman and she says we're mistreating this woman, my mother-in-law, which, you know, would never happen, but I don't see how you get from there in
the house to prove that this person is. And that's just an old cop talking. That's okay. And, you know,
Speaker 256
1:27:22
we don't take all phone calls. If they called and said this man is battering his wife, If the woman is not an endangered or impaired person, the state of Arkansas is not going to get involved.
That's a domestic battery issue. That's a law enforcement. That's a different ballgame. So we have criteria on the phone calls we'll even accept. So I don't know if that makes you feel any better, but they've got to allege something that's an endangered or impaired person, someone who either lacks capacity or has a mental or physical impairment. And they've got to allege that, and then they've got to tell us something happened to them, that they're being beaten, that they're being exploited. And they're going to have to give us some facts that show it. Just calling and saying, I think you should be taking her to the doctor, and he's not.
Representative Butch Wilkins
Unverified
1:28:05
It isn't going to be enough. We're going to have to make sure. If you got that call, and this
person said he's beating his wife or strangling his wife every night to the
point of death or whatever they do, if you get that call and you come to my house, and I say, well,
no, it's not happening, but I don't want you
Speaker 310
1:28:26
coming in my house. If it's an endangered or repaired adult and it's a credible report on someone. Well, I
Representative Butch Wilkins
Unverified
1:28:32
mean, we're not getting any work, but I don't know what their incredible report would be.
Let's say the next-door neighbor. Because sometimes we get the next-door neighbor who makes, I hear stuff. What makes the next-door neighbors a
Speaker 256
1:28:49
statement any more valid than mine? And to your point, that's true. People lie. So what will happen is if you deny us access, and we think we have a legitimate report, and that's an endangered or repaired adult, and when the allegation is going to be physical abuse, and you deny us access, we'll go to the judge. And he's either going to say, I'm going to let you in the state of Arkansas, or I'm not. You gave me enough or you didn't. And they're the gatekeepers on us getting to somebody's door.
Speaker 314
1:29:10
Thank you, ma'am. Thank you, Madam Chair. Sorry to
take so long. That's quite all right. Representative Malone,
Representative Stephanie Malone
Unverified
1:29:20
you're recognized. thank you madam chair i guess following up
Chair
Unverified
1:29:23
on representative wilkins questions there let's say you did get a call on him and i'm my questions are simply referring to section nine um let me see here i'm sorry page nine section nine it says and he's asking about a call that's
received and this section refers to unfounded report she'll be expunged after one year However, an unfounded report or screened-out report may be retained for risk assessment purposes. Can you explain to me, after keeping one for a year, do you just take from those and keep certain ones and keep that information on file for however long? If a
Representative Stephanie Malone
Unverified
1:30:02
report isn't strong enough to maybe put things into action, but you keep getting a string of reports that may be enough to warrant moving, that's just why they're kept
for a certain amount of time. I'm sorry, say that again, I'm sorry. Maybe the report you get isn't quite strong enough to move into action, but you keep getting a constant stream of just reports that can't be – that have been screened out. You keep getting a trail that might be, you know,
Speaker 321
1:30:32
where there's smoke, there's fire, that kind of situation. That's just why they hold on to
Chair
Unverified
1:30:37
it for a while. How long do they hold on to it for? If it's after a year, it's not expunged, how long?
Speaker 256
1:30:45
The report itself after the year is destroyed, but we keep a very high level amount of information so we would be able to look backwards and say we've had three reports. They've all been physical abuse. So it's just for our risk assessment purposes that we're able to do this. We have the exact same language in the Child Maltreatment Act, that we're able to keep stuff for risk assessment purposes. So the report itself is going to be destroyed, but we'll have that high level, what it was. Thank you, Madam Chair.
Speaker 269
1:31:19
Representative Ward, you're recognized. Thank you, Madam Chair. I know as a licensed social worker, we are bound by law to report suspected cases of abuse, election, and exploitation. Representative Liddy, I think that with this particular bill here, since this includes both institutionalization and non-institutionalization persons. Do you feel that this bill should be separated maybe to just simply have an institutionalized bill and a deinstitutionalized bill that works a little bit different relative to actually
combining this with institutionalization and deinstitutionalization abuse? I'm certainly fine with the bill
Representative Stephanie Malone
Unverified
1:31:57
being structured the way it is. I do understand your concerns, but I'm fine with the way it
Speaker 269
1:32:03
is. problem i got it like with uh... when a person are in intimate danger and all and uh... uh... we you have you actually bag that person and when i say bagging it's more or less you know take that person to custody uh... how long are you how long can you actually keep a person without
going before the judge if you bag that particular person did not mention it in this
Speaker 227
1:32:28
particular bill here uh... that's part of our previous uh... family law in the nine twenty section we can
Speaker 237
1:32:33
only hold someone for 72 hours prior to going
Chair
Unverified
1:32:44
before the court. Representative Mayberry, you're recognized.
Representative Andy Mayberry
Unverified
1:32:50
This is just a follow-up to Representative Malone's question a couple of moments ago in Section 9.
And line 14 says, an unfounded report shall be expunged one year after completion of the investigation. And then following that, it says, an unfounded report may be retained. And those two lines seem to be in direct conflict to me. I see that the original language said that demographic information may be retained. And then it was changed to say an unfounded report.
But, you know, you've got one line that says that it shall be expunged. So no question about that one year later, and then that it may be retained. Can you explain? That just
Speaker 256
1:33:37
gives us the discretion to do it, and I can tell you what the practice has been, according to our APS policy manual.
Representative Andy Mayberry
Unverified
1:33:43
I guess what I'm saying is if it shall be expunged, then that means it's definitely gone. It's out of there. And so what happens is
Speaker 256
1:33:50
they have files. Those files are destroyed. And then we have a computer system that has some information in it.
Speaker 330
1:33:56
And so that's what we've been keeping is the statistical stuff because that
Representative Andy Mayberry
Unverified
1:33:59
was in the current law. But that's not what it says. It doesn't say the statistics. It doesn't say the demographic. It used to say the demographic information. And this is current law. And now, but now it's being changed to say unfounded report, which is the exact same language that is found above it. That unfounded report shall be expunged. It's gone. But now it's back again. Well, we have the
Speaker 259
1:34:19
discretion at the department to decide, are we going to destroy
Speaker 256
1:34:23
all of them, or are we going to retain some of them? I can tell you our practice has been destroying all the hard copy records, and then we keep a very high level.
What we've been keeping, of course, is the statistical information. What we want to do at this point now is keep it
just a little bit more in our discretion.
Representative Stephanie Malone
Unverified
1:34:45
Okay. Thank you. Representative Malone, you're recognized. Representative Mayberry asked my question. Although I will say, if I may ask
Chair
Unverified
1:34:51
another question, can you explain to me how you, how do you decide which information you keep from these unfounded reports? It's just, or which ones you get rid of. Is it just, you said it was at your discretion, the agency's discretion?
Speaker 256
1:35:04
Yes. I mean, right now what we've been keeping is just the demographic information. Right. And you've taken that. And just keeping the demographic, yes. As he said,
Representative Stephanie Malone
Unverified
1:35:11
you've taken that out and now you're going to keep reports?
Speaker 256
1:35:14
Now we want to have the discretion to keep some more information on some unfounded and screened out report
Representative Stephanie Malone
Unverified
1:35:19
Why do you need that if it's been expunged? If these records are expunged, why do you need to
Speaker 256
1:35:25
keep that? We have the same language over in the child arena and has proved helpful in that arena because what we have sometimes is multiple Reports on a particular person and after you get third or fourth report
We do a higher level of investigation It just it alerts us that there might be something going on here Are we not asking the questions the right way? Do we need to get them to a forensic interview? If it's an adult with dementia, do we need them to take them to a gerry psych facility as opposed to bringing a home health nurse into
the home to do any evaluation? Okay.
Representative Tracy Pennartz
Unverified
1:36:02
Thank you. Representative Penarts, you're recognized. Representative Letting, there seems to be some real concern about this particular issue.
And I was wondering, Madam Chair, if Mr. Letting might consider withdrawing this from today's consideration and try to clarify
with representation alone and the rest of us who have some problems with keeping demographic or information for an extended period of time without a real valid purpose. Happily. we'll pull the bill down
thank you Representative Letting thank you guests and members that was good debate and we'll I'm certain have an opportunity to talk about it again
Representative Linda S. Tyler
Unverified
1:36:57
I don't see Senator Johnson in the room for Senate Bill 165 we have I know Representative Catlett is here he's been waiting here quite patiently
Representative Catlett if you'd like to take your place at the end of the
Representative John Catlett
Unverified
1:37:45
we'll do you next thank you madam chair members appreciate
being here and my all 30 days of experience have taught
me to bring plenty of knowledge to the table and I have it and I'd like my
guests to introduce If you all at the end of the table would introduce yourself and the organization
Robert Breck
Unverified
1:38:05
you represent, we'll proceed. Thank you, Madam Chair. My name is Robert Breck, Deputy General Counsel for the
Arkansas Department of Health. Okay. I'm Dr. Bill Mason. I'm Branch Chief, Preparedness and Emergency Response for the Arkansas Department of Health. And if
Representative Linda S. Tyler
Unverified
1:38:28
you'll turn your mic on for sure and get close to the mic, it will be helpful.
Speaker 346
1:38:32
I'm Penny Rubo. I'm the director for the Arkansas Wireless
Representative Linda S. Tyler
Unverified
1:38:36
Information Network. Thank you, Ms. Rubo. Mr.
Representative John Catlett
Unverified
1:38:40
Catlett, go ahead. Thank you, Madam Chair. I have House Bill 1316, an act to allow the Arkansas Department of Health to utilize radio encryption to protect confidential patient data. Now for those of you that don't know, our communication system here in Arkansas is called AWIN. The taxpayers gave it to public safety in the mid-90s. It's a great system.
We came from talking on a can and a string to actually being able to communicate, and it's just worked wonderful. Now over the years, it was started, the state police were solely the users of it, but over the years other public safety agencies came on board and the health department also. Now this system and I brought the technical person with me if you want to ask any questions but all I know is you pick the mic up and talk and you can actually talk on it so that's
about the extent of what I know about it but one of the capabilities of our system is the ability to scramble voice data. And what that does is it allows law enforcement agencies to transmit sensitive data from point A to point B without everybody being able to hear it. That's a simplistic way to explain that. Now, by statute, and that statute is 554-130, only firemen and policemen can use that.
But now what we'd like to do is allow the health department the capability of using that. And the reason why is they transmit patient data, sensitive data, and according to our HIPAA laws, not everybody can hear that. And me being a user, if they transmit that data normally, I can switch over to their frequency and I can hear what they have to say. So what we're asking, Members and Madam Chair, we're asking to add the Health Department
to utilize the encryption capability of our AWIN system. Thank you. Any questions? We do have a question.
Representative Smith, you're recognized. Thank you, Madam Chair,
and thank you, Representative Catlett, for bringing this bill. I'm an old JP
from way back, and I want to know, are you going to cause my counties to have to add new frequencies to that radio capability or will he be able to utilize what's already
there? I don't like unfunded mandates.
Representative John Catlett
Unverified
1:41:14
Can I say that? Thank you for that question and sorry I didn't bring it up, but there won't be any other cost to the state. The health department, they already have the radios and the encryption capabilities already there. It's just a matter of writing the language where the health department can use the system. so there are in place frequencies
that can handle these transmissions no extra equipment will be required on a user level is that right that that is correct representative thank you thank you madam chair
representative Penartz motion at the proper time seeing seeing that we have
Representative Linda S. Tyler
Unverified
1:41:59
oh I'm sorry we do have one other question I will
Representative Andy Mayberry
Unverified
1:42:04
listen to that motion in a moment. Representative Mayberry. Thank you, Madam Chair. A couple of questions regarding this. Right now, if I understand correctly, law enforcement and fire departments are the only users of this. Is that correct? Yes, sir. With law enforcement, this talks
about police and fire department communications capable of receiving and decoding police and fire department communications. Does the law enforcement only have access to the police communications do they have access to the to the fire
Representative John Catlett
Unverified
1:42:34
communications well this it's all one system they just have different frequencies and this is a digital system they only and you can jump right in here ma'am if you if I'm not explaining this correctly they have their own frequency and go ahead but you can expound
Speaker 347
1:42:51
on that generally what happens is that different agencies will
have frequencies that are assigned for their use and then the system has 30 or so interoperability channels that if it's a widespread disaster and the law enforcement and fire have to talk to each other at the same time then they go to one of those interoperability channels okay so
Representative Andy Mayberry
Unverified
1:43:12
is there some police communications then that the that is so sensitive in such a way that that the fire departments would not have access to that that is that correct when I
I'm looking through here, and I see that the purpose of it is to be able to have patient data communications, but I don't actually see that. I see that in the title, but I don't see it anywhere, unless I'm overlooking it, in, like if we're looking in Section 1, Line 28, you know, it says that the device capable of receiving and decoding police and fire department communications that have been transmitted through a voice privacy adapter.
So we've added the Department of Health, but the actual patient information
doesn't appear to have been added in. Can I refer that
Representative John Catlett
Unverified
1:44:04
to counsel here? Go ahead. Well,
Robert Breck
Unverified
1:44:09
actually, you may have a point on that. What this is is a criminal statute, and these are exceptions from the criminal statute that would allow that. You may have a point about having somebody with the capability of receiving and decoding police and fire, we didn't include that in there,
and that may have been an oversight and maybe something we need to ensure that
Representative Andy Mayberry
Unverified
1:44:31
that does take place. It's just a thank you. The way I read it is it looks like we've added in where the Department of Health can listen in on the police and the fire department communications, but they haven't actually accessed their own
patient data that is the purpose of them being added in
Robert Breck
Unverified
1:44:48
on. The way I understand the system, we would have encryption codes for our radios. Now, whether or not those would be the same encryption codes for fire and police, I don't know.
Speaker 347
1:45:01
Those, the encryption happens at the radio level, so not every radio that the Department of Health would have would be encrypted. It would just be the ones that they select to be encrypted, and they would have their own frequency that they would do that work on. They would not necessarily have the frequencies that the law enforcement and fire have. Would you
Representative Andy Mayberry
Unverified
1:45:22
agree, though, that there need to be some changes to
Robert Breck
Unverified
1:45:25
what we're seeing right here? I think what the concern is is if somebody had a decoding device or the capability of intercepting that and decoding it,
there would be a criminal offense for fire and police and not necessarily for health department data. And so I think that probably is a legitimate concern. But the intent was to allow the health department to use its frequencies. I understand the intent, and I'm good with the intent. And
Speaker 155
1:45:47
I just, thank you. Representative Wilkins. Mr. Breck, you already
Representative Butch Wilkins
Unverified
1:45:57
have, you currently have this radio system. Yes, sir, that's correct.
We just can't use encryption. You can't scramble it. That's correct. You can't scramble it. So really it would have nothing to do with whether you can pick up because you currently have your system in place. That's correct. Each scrambling device goes on each individual radio, and, you know, wouldn't you agree with
Robert Breck
Unverified
1:46:23
that? I would agree with that. I think what Representative Mayberry's question was, and it's a good point, if somebody were to intercept our communications, that wouldn't necessarily be a criminal offense under this statute,
and I think that is something that we, you know, probably should consider amending.
Representative Butch Wilkins
Unverified
1:46:41
But they wouldn't necessarily, they'd have to have the ability to, you're already on there so they can intercept your transmissions without being scrambled. That's correct. It's going to make it more difficult. This is going to make it more difficult
Speaker 314
1:46:54
to scramble it. Absolutely. Now that's our hope. Thank you, sir. Thank you,
Representative Linda S. Tyler
Unverified
1:46:58
Madam Chair. Representative Catlett, there's been some discussion about maybe some amendment need to be put on this bill.
Is this something that you're willing to do at this time to pull the bill down and amend it and bring
Representative John Catlett
Unverified
1:47:11
it back to this committee? Yes, ma'am. We are willing to do that. And thank you, Representative Mayberry, for discovering that. Thank you. And
the system works. Thank you, ma'am. Yes, it does. Thank you all very much for
Representative Linda S. Tyler
Unverified
1:47:25
being here. We appreciate it. And committee, when we started the meeting, Representative Lovell was detained. and his House Bill 1299, if Representative Lovell will take his place at the end of the table,
we'll hear that bill. Representative Lovell, I apologize. You are recognized, sir, and introduce your guest.
Teresa Marks
Unverified
1:48:07
Thank you, Madam Chair, and my guest is Teresa Marks with ADEQ, Arkansas Department of Environmental Quality. Okay. You know, I've been here four years, and when the first time I came down here, somebody told me that the wise thing to do was that if you were going to pass a bill, then find one that you could take out off the books. So this is one that's coming off the books, and there's not a word being added to the
law. And actually, it repeals the law concerning hazardous duty compensation. And I'll let Ms. Marks tell you the reason that we can take it off. Thank you. My name
Theresa Marks
Unverified
1:48:50
is Teresa Marks. I'm the director of the Arkansas Department of Environmental Quality, and basically this bill is just no longer necessary. This was passed about 15 years ago, and it dealt with increased payment for our hazardous waste inspectors and our hazardous waste division to those that would encounter those types of hazardous substances that could be harmful.
We now realize that basically all of our inspectors go into these facilities, whether they're air inspectors, water inspectors, sometimes storage tank inspectors, salt waste inspectors. They all basically go into the same facilities because all of those permits are at certain hazardous waste facilities. So it's really not necessary to have this type of legislation anymore, especially since the class and comp study came in. And the class and comp study has given us enough of a range in our compensation, and we have got all of our inspectors on the same level.
Plus, we do medical monitoring of our hazardous waste inspectors to make sure that there's not any problem with them. That's done on a regular basis. And there's also a provision in class and comp that if we feel like somebody does need extra pay for a particularly hazardous waste duty situation, we can go ahead and petition OPM to do that. We've not found that necessary at this point.
Thank you. Any questions from the committee? Seeing no questions, what's the pleasure of the committee?
Representative Penartz? Motion do pass. We have a motion do pass. Anyone want to speak forward against the motion? If not, all in favor indicate by saying aye. All opposed, no. Representative Lovell, your bill has passed. Thank you, Madam Chair and Committee. Committee, we're going to hear one more bill, House Bill 1317. I'm going to step to the end of the table and present that one, and Vice Chairman Woods is going to take over. So watch out, he's honoree.
Representative Jon Woods
Unverified
1:50:50
Okay, Madam Chair Tyler, you're welcome to present your bill when you're ready and your guests can state their name for the record. Thank you.
Representative Linda S. Tyler
Unverified
1:51:09
Yes, thank you, Mr. Vice Chair. I'll go ahead and let my guests introduce
Robert Breck
Unverified
1:51:15
themselves. Thank you, thank you, Mr. Chairman. My name is Robert Breck, Deputy General Counsel for the Arkansas Department of Health.
Speaker 375
1:51:23
And I'm Dr. James Phillips, Branch Chief of Infectious Disease at the Arkansas Department
Representative Linda S. Tyler
Unverified
1:51:31
of Health. Thank you. Members, what this bill is, it allows us to expand the immunization registry so that
we can allow adults to also participate in the registry of immunization. I don't know about you all, but when this bill, the health department brought me this bill, one of the things I did was to think about my own immunization records and started
thinking about, okay, if I needed to present those, where are they? And I have records on my children, even though they're quite old, I still have records on my children, but I don't have
Representative Linda S. Tyler
Unverified
1:52:07
my own records. So that's what this bill is about, and I'll let Mr. Breck explain it a
Robert Breck
Unverified
1:52:15
little further. That is essentially what it is about The immunization registry presently is just for children It records all immunizations that are provided to children under 22 years of age
So anyone over 22, that information can't go in the registry And it is really something that will be a useful tool for people People go back to school, they need to prove that they have MMR shots And they don't have those records and they don't know when they got it people don't realize the last time they had a tetanus shot all that information would be available on the registry for providers to determine if you needed a another immunization or if you needed to get into school okay at this time we
Representative Jon Woods
Unverified
1:52:58
have questions from the committee and madam chair you prepared to take a few questions from the members certainly sir okay first on
Representative Tracy Pennartz
Unverified
1:53:14
the list we have a Representative Penartz with a question. My main concern with this bill or any bill that requires or where we're talking about keeping a record or registry of something, And I know, Dr. Breck, we talked, and can you assure me that you are going to make through
your actions at the Department of Health in your adoption of rules that persons who are going to try to get into this medical
information are going to be stopped from getting into it? My main concern is access to the information and what type of procedures you all are going to take to ensure that only those persons with a reasonable need to have that information
have access to it. So that's my concern. And
Robert Breck
Unverified
1:54:11
it's a legitimate concern with any electronic registry. A person to gain access to the registry has to fill out an agreement with the Department of Health. have their own user IDs and passwords everything that they do can be audited and so if someone were to search for someone's records and they didn't have a need to know that they weren't a provider they were trying to find their neighbors or friends records there is an audit trail that could be used if and
this is protected health information so if anybody were to access that information illegally or without authorization it would be a violation of HIPAA now that HIPAA is not a state law it's a federal law that's administered by the Office of Civil Rights of the Health and Human Services the maximum penalties for accessing or releasing protected health information is fifty thousand dollars a maximum with one year in jail or both if you do it maliciously it can
go up to two hundred and fifty thousand dollars in ten years in prison so those are very severe penalties in addition if someone were to do that without authorization they'd also be in violation of state law they'd be in violation of an Arkansas Board of Health rule that could the penalties for that or $1,000 per violation per day also there are criminal penalties could be $500 fine and or 30 days in
Representative Tracy Pennartz
Unverified
1:55:39
jail well you've answered part of my concern the other
Another issue I would have is one of enforcement. The agreement, in my opinion, whatever agreement you use needs to make mighty sure that these people understand the penalty for misuse of this information. Can you assure me that that agreement that you all will have will be sufficiently detailed to ensure that these persons understand the what
happens to them if they break the law?
Robert Breck
Unverified
1:56:14
We will strengthen that. Currently, the agreement only says that they would be blocked from having access to the registry, but we will strengthen that agreement. I will also make a commitment to you when we open up the rules and regulations to administer this that we'll put those penalties in the rules
Representative Tracy Pennartz
Unverified
1:56:34
and regulations so everybody is very aware of the possible penalties. And the third
question to this, last question, Mr. Chair, is will you be using state-of-the-art encryption so that that will further assure me of confidentiality?
Robert Breck
Unverified
1:56:47
The registry, everything is encrypted. Everything, when it moves from point A to point B, everything is encrypted. From what I understand with the system, Dr. Phillips may be more aware of that. But everything is encrypted. you would have to have the proper hardware and password and keys to get
Representative Tracy Pennartz
Unverified
1:57:05
into that system. Okay. Thank you. Motion at the proper
Representative Jon Woods
Unverified
1:57:09
time. Thank you, Representative Penards. Next we have a question from Representative Smith.
Thank you, Mr. Chair. On the second page down there, line 13 through 16,
you talk about failure to make the required report. The department shall be fined $25. How are we going to enforce
Robert Breck
Unverified
1:57:28
that? That's really a provision that's already in place. And any provider who provides childhood immunizations, that is the penalty that is levied under the statute. But that only applies to a provider who does not report childhood immunizations to the registry. It would not apply to any doctor that may or may not submit adult information.
How would you know that they did not submit that information? I guess that's really my question. So perhaps Dr. Phillips has better insight on that. Well, there would
Speaker 375
1:58:01
have to be a complaint or evidence. The parent brings the child and it shows that they're deficient, but they know they had an immunization. Then we could have to go back into the doctor's office and see if it was on a copy of theirs, but they didn't put it on the registry. But it wouldn't be my word against their word.
At that point, you'd have a record in the medical facility that the immunization actually
Representative Jon Woods
Unverified
1:58:32
have some record at that point, right. Okay, thank you. Thank you, Mr.
Representative Charolette Wagner
Unverified
1:58:40
Chair. Thank you, Representative Smith. Next, we have a question from Representative Wagner. Thank you, Mr. Chairman. Following up on part of my question has been answered, but following up on that same section, page 2, 13 through 16, it indicates that if they fail to make the required reports, they'll be charged $25.
So no matter how many reports they fail to make, it's just
Robert Breck
Unverified
1:59:05
$25. Well, unfortunately, it's probably correct. When this was passed, it wasn't the intent to make criminals out of doctors who may or may not participate in the program. And so the penalty is relatively light, but that is what
Speaker 366
1:59:19
the penalty is in the current statute, and it's been in place since it began.
Representative Charolette Wagner
Unverified
1:59:25
Okay. One other question, please. Just to be sure I understand on what you're doing with keeping records, so how long do they keep the records now?
Robert Breck
Unverified
1:59:38
Right now, I think the records are kept
Representative Charolette Wagner
Unverified
1:59:44
indefinitely. so we could have we could get that information
Robert Breck
Unverified
1:59:47
on some individuals if you had a if a child had a shot prior to becoming the age of 22 then that information what does stay in the registry after that but there are a number of individuals after the registries form they weren't eligible for the registry because of the age restriction and so if you're a certain age and you try to go back to school it's not going to be in the registry because it was never there but
this would allow it to be there that's
Representative Jon Woods
Unverified
2:00:18
correct thank you thank you thank you representative Wagner next we have a question
Representative Andy Mayberry
Unverified
2:00:25
from representative Mayberry this quick question is there any additional cost to the
Speaker 366
2:00:30
state for this no there won't be any additional the system has
Speaker 386
2:00:40
plenty of capability to handle it I'm sorry, could you, well, I'm
Representative Jon Woods
Unverified
2:00:45
sorry, Representative Mayberry, I was discussing with, okay, okay.
Well, we do have a motion at the proper time. Are there any other questions from the audience or anyone here to speak for or against the bill? Okay, I recognize Representative Penards with a motion. Motion do pass. Okay, we have a motion. All in favor say aye. Aye. Anyone that opposes? If the ayes have it, congratulations, Representative Tyler, Madam Chair. Thank you very much. All right.
Just one moment. Committee members, if you can just hang
tight. Thank you. Thank you, Mr. Chair. I'm going to pass over House Bill 1321. If we have any further business to come before the committee, remember we have a special order of business on February the 15th for Representative Lindsey's bill. Otherwise, we stand adjourned. Thank you very much.
Agenda
Call to Order
HB1301
SB77
HB1279
HB1316
HB1317
Adjournment
Documents
No documents posted.
Speakers
Representative Linda S. Tyler
Unverified
Speaker 6
Speaker 7
Speaker 18
Speaker 15
Speaker 25
Speaker 29
Speaker 31
Speaker 19
Speaker 38
Speaker 48
Representative Tracy Pennartz
Unverified
Speaker 9
Speaker 5
Representative Garry L. Smith Chair
Unverified
Speaker 91
Speaker 94
Representative Barry Hyde
Unverified
Representative Bryan B. King
Unverified
Speaker 108
Speaker 112
Speaker 44
Speaker 115
Speaker 120
Representative Billy W. Gaskill
Unverified
Speaker 109
Speaker 127
George Haas
Unverified
Speaker 138
Speaker 141
Speaker 145
Speaker 80
Speaker 147
Speaker 134
Speaker 151
Representative Andy Mayberry
Unverified
Chair
Unverified
Representative Mark Perry
Unverified
Representative Toni Bradford
Unverified
Speaker 169
Speaker 172
Representative Clark Hall
Unverified
Speaker 174
Speaker 183
Speaker 188
Speaker 95
Representative Charolette Wagner
Unverified
Speaker 201
Speaker 203
Speaker 205
Representative Stephanie Malone
Unverified
Speaker 209
Robert Depper
Unverified
Speaker 223
Speaker 225
Speaker 226
Speaker 214
Speaker 227
Speaker 232
Speaker 43
Speaker 237
Speaker 241
Speaker 248
Speaker 178
Speaker 256
Speaker 258
Speaker 263
Speaker 164
Speaker 267
Speaker 269
Speaker 268
Speaker 271
Speaker 276
Speaker 279
Speaker 280
Speaker 282
Representative Butch Wilkins
Unverified
Speaker 245
Speaker 310
Speaker 314
Speaker 321
Speaker 330
Speaker 259
Speaker 202
Representative John Catlett
Unverified
Robert Breck
Unverified
Speaker 346
Speaker 347
Speaker 155
Teresa Marks
Unverified
Theresa Marks
Unverified
Representative Jon Woods
Unverified
Speaker 375
Speaker 366
Speaker 386