Arkansas Legislative Council (ALC)

Members. By my time it is not a clock forget to clock at the back of the room it's not ever right. Thank you for being here I'm going to recognize Senator Chesterfield soon as she gets to her seat for a point of personal privilege before we start. Senator Chesterfield. you are recognized. Thank you Mr chair ladies and gentleman of the council I would ask for a moment of silence with the family of Mr Frank Witherspoon who is a tan coat. In the Arkansas state Senate his wife has died at her funeral is today and so I would just ask for a moment of silence please thank you. Thank you Mister chair Mister with this phone is a veteran of the Vietnam War in most of you in the Senate know him for his work and so I would ask for traveling grace as I attended funerals thank you so much. Thank you have if we stand on as center Grove's we will lead us into or for. Do you have in the father thank you for safe travels here lord watch over us if we as we do the people's work guide our hearts do the right things and do things that are the best for the state of Arkansas in your name amen. Thank you members appreciate. First up we have our minutes that you've got in your packet I hope the dead time look at those take a motion to approve the minutes I have a motion I have a second second all in favor proving the minutes say aye. The post minutes are approved members next up we have three brief presentations that from Iraq for thirteen to twenty twenty one first of the department of health Mr Rene Mallory if you come up. If you please turn your back on call it up pull it toward you where we can hear whale and Identify yourself when you're recognized Percy. Thank you Mr chair members of the committee I'm Rene Mallory interim secretary of health and we provided you all a handout and I'm just going to briefly go through that handout so I'm starting with our public health lab and I know some of you have experience with our with our lab you've toured our lab and I hope you appreciate our lab as much as we do we taken in advantage of additional funding this year to enhance lab capacity one area that we focused on is the ability to perform genome genome sequencing FOR test sample such as T. B. norovirus salmonella and E. coli G. not what genome sequencing does is allow us to know whether the strain that we tested positive as antibiotic resistance which of course is important to healthcare providers that are treating the illness or we can tell if the strains are related which would be important like in a food outbreak so with that we can see if someone in Greene County is positive for the same same strain is somebody found in Pike County and I'm throwing Pike County out there because always give a shout out to my home county where I grew up so and that's important because and we're looking for a common thread if somebody has salmonella that is that is from Craighead county and also from Pike County we know they have something in common so it whether that's what they ate at any via at or what something that I'm not a purchased in a grocery store somewhere so we hope to be able to add cystic fibrosis fibrosis HIV and Hansen's disease at some point this year staying with our lab our BSA L. three lab is close to being back up and running as you can see from your hand out we had some water damage. It's and so we we had to stop testing in that lab and so right now we're going through a second round of equipment certifications and once that's complete we should have a BSL three were up and ready to go and with that lab does is test toxins that can be transmitted through the air and it's vital so they're strict requirements about conducting a test in what's called a biosafety cabinet and there's air regulations air flow regulations that we have to mate and we get what we can test their as possible agents such as anthrax ricin and other terroristic agents that law enforcement want not want to bring to us switch into our local health units of course eighty H. has ninety four locations throughout the state where we do clinical and other services every Tuesday each of those locations offers a late day where they're open to for a nine thirty to six in September of last year would being we begin offering extended hours other days of the week and that staying open later to better allow working adults to access our services and this is also allowed parents to not take their kids out of school they can save them they can come to see us after school is out and it's also benefited our staff in we've been able to allow flex scheduling for our staff such as you know in our locations where we have it you know staff that allows it to happen we can they can now work for tens or nine nine for a two week period and and our staff that are able to do that love that In January of last year where we're able to allow online access to our patients for their clinical record we've not been able to do that before I know you know at those of us who go to private providers are able to do that we can now do that with our patients we give them information on how to register when I came into our local health units and as you can see from your hand out eight over eighteen thousand of our patients have taken advantage of that in registered in March of this year we begin piloting the ability to take A credit and debit cards for our services you know for our birth certificates death certificates things they have to pay for we started with our local health unit in North Little Rock simply because we didn't want anything to happen so starting small and we're we're and Faulkner County join the pilot this month and then we hope to roll out that out to the rest of our counties in the coming months and we have six counties that will out hopefully have remodeled and updated their buildings I made that may have twenty four two more counties have applied for funding for our local grant trust fund and you know as you may recall the way we operate our local health units is the buildings are owned by the counties we have a partnership with the counties so the counties on the buildings they provide the maintenance and upkeep and we provide the staffing for those local health units. I move into maternal health I know you all heard a lot about maternal mortality these days so I'm maternal mortality review committee has completed their reviews for the years two thousand eighteen and nineteen what they found with the where the top causes of pregnancy related deaths there were cardiovascular conditions hemorrhage and in a large heart in December of twenty to the committee put out a complete report on their findings and identified key recommendations so we're working on putting some of those recommended recommendations in place the committee has also now completed the twenty twenty review of death and it's going to three The review and completion process right now so we'll have another report out in December of this year. eighty H. is also continue our maternal and perinatal outcomes review committee we now have thirty seven hospitals that participate in our maternal and perinatal classification system this committee put out a report in twenty two that identified the leading causes of knee and neonatal death which is defined as the first twenty eight days of life in two thousand and nineteen the the causes of death were congenital malformations deformations and chromosomal malformations which totaled forty six disorder disorders related to short distaste just station and low birth weight which were thirty nine and maternal complications which were eleven would they also put out the numbers for post neonatal dance which is defined as more than twenty seven days and less than a year after birth and that was caught they were caused by mail for by the mail for that formation class which I just talked about that numbered seventeen and then forty seven deaths were considered to be seated. Moving on to the to to arts tobacco cessation program of course you know be well as our in house quit line we now have a total of over thirteen thousand it's an role since we brought it in house in two thousand eighteen and as you can see from your hand out weeds Arkansas still remains above the national average in quit rates we also started to be well baby program in April of twenty one which is our program targeting pregnant women who smoke and we've been rolled over thirteen thousand pregnant women since since we put that in place. in response to hearing concerns from our teachers our nurses that go out to our schools and others regarding that the young age of kids beginning to date and now what vaping is we begin looking for programs and educational materials that we could consectetur and distribute there's nothing out there there's nothing out there nationally so our staff come up with our own program. It's call coral to reap its cartoon based for the younger kids and we're you know the the everybody we have demand for the the materials that were distributing teachers our nurses our health program specialist to go out to the schools are R. Levin is for the kids we're trying to do the things that we have to do to make sure it's evidence based and that it is making a difference so we're in the process of of doing that now suicide prevention as most of you know how we operate and the health department operate the state suicide prevention line and is part of the national suicide prevention call line we we also went to the nine eight eight And prefix in July are the number of July of last year we operate the call twenty four set call line twenty four seven and we've answered over ten thousand calls in in twenty twenty two Hey healthcare required infections. Our health care required inspection team educates and offers technical expertise to hospitals and long term care facilities on how to cut down on rates of infections that are required in those facilities facilities are required to report on a national basis on certain healthcare required infections so we monitor that data and so we will reach out to hospitals and offer our assistance on if we see rates that are of concern or that or increasing and often are facilities reach out to us I know our team members day know that we're there to help and they'll reach out to us asking us can we come in and look and see if we can find what what may be going on as far as efficiencies in two thousand nineteen we gain twenty three boards and commissions as part of the eighty H. family we've re Loke from nineteen two thousand nineteen to two thousand twenty one re re located eight of those into eighty eight space in twenty two we moved three Moran and we have plans to move even more this year we now provide HR finance and I. T. services for all of our boards and commissions we're implementing systems to allow for electronic reporting from hospital labs and other health care facilities for the reporting of disease data for years are disease data came in by facts and then sent one of our staff had to into it all of that information into our system so it helps for that information to come into us electronically so that we skip that step So along that line we also now have a portal to allow for electronic submission of on site wastewater in food permits and as you can see from the handout we're making we're definitely making progress in increasing our number of electronic submit submissions. improvements in progress we have on the horizon plans for improving with it with the new electronic records system R. eighty eight slab with a newborn screening reporting system and our systems for reporting disease data on our website we get so many requests for data and that we have to answer on an individual basis so we're hoping putting that on the website will help people get that themselves and not have to ask us for you know every time they want some of our data and then as you can see we have our legislative initiatives listed and I'm I'm not going to go over those because I'm sure you're very familiar with that so with that Mister chair on incomplete. Thank you for your port sector put the bill of one question represent relating you're recognized. Thank you Mr chairman. A man Secretary I I am a very will please that you're looking that maternal health. In infant mortality the covered you've got here as you know the our home program that was one of the three areas of emphasis because infant mortality and maternal health we're still fiftieth in the nation and that pulls our number down I think we're forty seventh overall but those two areas in particular pull us waiting on because we're we're so bad in that and this this is a really good what you're doing here with these committees my question is are they do they have a way to measure outcomes or progress is there anyway you can do that to see that that we are improving that these things are working yes Sir and. Representational amen we are we look at that data every year that's why I was saying the twenty twenty to data is complete so we can look to to measure our progress and along the our home front we are working with this is Department of Human Services and you know others to see what we can do together and if I could and thank you all going to cover that in the July public health meeting yes Sir okay. Thank you thank you for your report today we appreciate you being here thank you next up we have the inspector general secretary Alison right if you come forward. They give me here today if you'll turn your microphone volume toward you and give us your name and title for the record and you're recognized president. Thank you Mr chair I'm Alison Bragg I'm the secretary of the department of inspector general and I'm Linda Mathis chief of staff. This is a brief presentation on your screen and it's identical to what is in that right now that's in front of you. It members of the committee I want to thank you all for your time this morning and for listening to an update about our department I want to tell you that we are currently made up of four different divisions in each of those divisions has in common these two purposes the purposes of all the components of our department are those integrity and independence I think you are probably familiar with the fact that most of the entities in our department were previously within other departments Medicaid inspector general for example came from DHS and was pulled out in order to create a level of independence to provide for independent audit and responsibility and program integrity that's what really our entire department is there to accomplish. And as I mentioned these are those four divisions under. Here we go. And we'll talk a little bit about more what each of these divisions is doing as we go through our presentation. First we have the office of internal audit and you're probably familiar with the components of that we have a staff within our office but they're also internal auditors in several different departments throughout state government and those departments are listed there there are for departments that have internal auditors on site with themselves and then there are other entities as well such as the Arkansas lottery and the Division of work for services all of those people Dadabhai report to our director required upon and so he helps to maintain a level of independence with those reviews as well. There is an act from twenty nineteen that also requires the office of internal audit to conduct an annual review of our diet of the Department transportation our upcoming audit is due in October twenty twenty three and that comprises the majority of what the office of internal audit spends its resources on you can see there that it requires about sixty four percent of the total resources of internal audit so that are not audit is a very significant to our department and takes up a lot of time in is certainly a worthy effort for that entity. In addition office of internal audit is working on a hundred and forty seven controlled self assessment tools for state entities to use in conducting their own internal compliance reviews as well. Another agency within our department is the office of Medicaid inspector general and some of the dollar amounts that you see there are some of the recoveries that were made within the last fiscal year fiscal year twenty twenty two. That number at the bottom eight million eight hundred sixty four thousand and someone dollars is largely the result of one very big return that was made there was that you probably are familiar with the case surrounding and power that was about a seven million dollar result and so this number we're very proud of it is not a typical number of recovery for our office based on that large and power case that we dealt with last year. We also have the tax appeals commission and you all might remember the fun that surrounded that getting started and getting established this is the first year for the tax bills to commission to be up and running they started taking cases in January they've done a really good job they're maintaining their work flow there and they are dealing with a lot of incoming cases so we're staying on top of that as best we can we are trying to facilitate and continue a positive relationship with DFA who have been very gracious in helping us get up and running with this commission despite having only started hearing cases in December they have closed over six hundred and fifty cases already this year so we're hopeful to maintain that pace with the tax appeals commission. We also have the fair housing commission which as you probably know is largely federally controlled we are there to facilitate and to oversee but most of those decisions are controlled by hud by housing and urban development and it's almost almost entirely federally funded but they are lovely people were happy to have the money our department and we do the best that we can to help help that entity wherever we can in addition that agency has an MO you with the attorney general's office who when cases reach a point that litigation is necessary the attorney general's office will get involved and will be very helpful in taking on those cases as well. That is really a summary of what we have going on at the department of inspector general I appreciate y'all's time and Mister chair that concludes my information. we thank you for being here today you got a question represented the you're recognized. Thank you Mr and just this may not be a time you can answer would you mention the tax appeals commission if there was a vacancy on that do not that's been filled that has been built representatives very recently and and I don't want to overstep I think there's a press release probably coming from the governor's office but we're very excited about him joining us and after the governor makes that announcmenet I'll be happy to talk a little more about that thanks I appreciate it yes Sir. Senator Hester you're recognized Hey I'm over here how many I mean how many cases have gone to the tax bill's commission so far like to were twenty they have a heard and issued opinions on six hundred and fifty already and some of those a case might be submitted and it doesn't really it's not really a case maybe a taxpayer submit something in the tax bills commission can say you don't really that's not really what we need to be doing that's included in that number but all together they have been six hundred fifty that have gone from start to finish petition being filed case being heard and case being decided by the commission and the commission with the make a decision is final. A taxpayer can appeal that decision if they want to it goes out of the Commission at that point and I think it goes to circuit court and whatever jurisdiction as appropriate. Have have there been any. Any cases cited for the taxpayer. Some of them are at the percentage is mostly in favor of DFA just basically because of the procedures that are already in place DFA does a good job of getting it right as often as they can but there are certainly a significant number of cases that are found in favor of the taxpayer thank you thank you thank you we appreciate your being here today for your support and your work thank you very much next up members we have department of veteran affairs secretary opinion if you. Go up. Thank you for being here today if you get it. Name and rank. In it we will get started good morning Mr chairman my name is candle pattern the Secretary for the Arkansas department of Veterans Affairs Scott Sanger chief of staff for a thank you for being here you're recognized the report. Sir thank you for the opportunity to come in and speak as many of you probably know are advisable to the small department we have a hundred sixty two and you will pull your back a little closer to you please Abbas a relatively small department we have a hundred sixty two employees the majority of which a work out in our veteran homes we provide three we perform three a statutory missions we provide veteran services for the state of Arkansas. The party will provide we run to veteran cemeteries one here in North Little Rock and then one up in the small. Kind of bird island northeast Arkansas in that we run two veteran homes here again here in Little Rock over by for roots and then and the second one is up and up yet though so I'll I'll begin speaking first about the the veteran home division that's where our our biggest challenge comes and the the probably the greatest risk that we manage for both veterans and for the state so the we have two bedroom homes the one in North Little Rock was opened in two thousand sixteen after new construction if you've ever had an opportunity to go out there and look where did not I would welcome you to come out there and take a visit it's a it is what I think is probably a showpiece for better homes across the nation if you go out there and look the homes from created on a modular designs each one is a small cottage that houses fifteen to twenty veterans and the colleges are run by the veteran themselves with the assistance from our employees at they set their own menus they set their own activity schedule and quite frankly you know when it's my time to go into a home at some point in the future that is the kind of place I would like to be if the the kids that profession choose not to keep me at their house the veteran home up and they have the however is a different matter so the home was established in two thousand six it was established based on an old wing of the old Washington regional Medical Center there close to the department of Veterans Affairs hospital of the facility itself there is no way you can walk in there and look around and see anything other than institutional care and it's not I mean the the carriage to standard it meets all the requirements for the senator the Senator center for Medicaid services but in fact it is not a place where you are I would look at and recognize those. Facilities as being a home so We have in the queue for the at the US department of Veterans Affairs currently a grant request that would give us the ability to come in and build a new facility we just found out this morning that that grant request has been moved we're now currently number nine in the nation for a new home we think probably sometime in calendar year twenty four we will have of the grant request in hand to begin construction we already have a fifteen million dollars from the state is there as the match portion sitting in restricted reserve and we have the the acreage up on promenade road between Bentonville and Rogers so we expect that when it's on all completed will be the model facility for the center for the nation but that's the facility is not the only issue up and fans also over these both of these homes are designed to be a self sustaining based off of reimbursement from the federal government with the care of the veterans and just kind of give you a quick. Insight as to how run so it cost us about four hundred dollars a today and provide care for veterans and both of the homes a medic if the veteran is a seventy percent disabled veteran as defined by the US department of Veterans Affairs they will reimburse the home at the rate of four hundred and seventy seven or four hundred and fifty five dollars a day creating a certain surplus there to operate the whole by. However if the veteran is paid for by Medicaid or paid for out of their own pocket at the rate of reimbursements to read three hundred ninety two dollars a day so we don't break even on those cases so what we've done over time as we've let the the census the the number of veterans we have in each pair category get upside down and fat bill of the result of that over the last three years we've had to come back and ask for additional funds to make that facility solid. Over the life of the last five months since we've been here in the office we spent a significant period of time digging through our programs and books we have reviewed every contract and shut off a bunch of contracts that were not that providing the service that our veterans just deserves we've also gone through every personnel position at the better homes for all of the the medical providers up there for which right now are the state pay scale simply does not entice people to join would turn those positions all we're currently using a contract of the medical providers so we turned off the of the the state positions about moving them into the unfunded category that save us about that will begin saving us about six hundred thousand dollars a year beginning here on a July the first all told between those efforts we have to a. now we will turn that facility soften here of the text of the school year we've also now if you look at our line and block chart there is a Division headquarters for the federal home division in fact there was no such organization since we've come in we've hired a division director to provide technical expertise necessary to manage a long term care for care facilities we've also implemented a compliance program at both of our home so that that would and the center for Medicaid Services showed Medicare services shows up we're compliance or audit ready as opposed to of finally having findings and having to catch up after the fact. Moving on to the. The. Veteran services division we don't provide necessarily so much in the a veteran services directly to veterans what we do that with that role is provided primarily by the veteran service officers that belong to each of the county judges. In our southern regional veteran service officers provide training for those county veteran service officers they also provide a backstop should there be a vacancy out in the county or we have a a county veterans service officer on board who is simply not experienced enough yet to the. Provide the services to veterans we also have in under the that division the veteran child welfare service that provides a small grant program to veterans with children who are facing some some level of financial need and then the the veteran cemetery a division of for provides burial services for of veterans their spouses and certain family members at the veterans it's at no cost to the spouses that the US department of Veterans Affairs a set schedule and the the facilities are just beautiful out and budget amount hello Sir subject your questions. Thank you we've got a couple questions centre Chesterfield you're recognized thank you and welcome. Thank you very much for your service as well thank you I've been a little spoiled. Because I've been able to call the secretary and ask the stuff. That I don't know where to go to at the local level absolutely are you gonna spoil me to yes ma'am and I'll and I would I would school everybody else here I mean you have to have a question thank falls in the US for or the the Arkansas department will be able to get the phone and call you and say I got a problem with that yes ma'am my phone number is five zero one wait hold that. You might you might wanna okay I'm ready five oh one seven three two six zero five five six zero five at seven three two six zero five yes ma'am I'm feeling spoiled. And again thank you so very much for your service one of the things that I. I have prided myself on is being able to reach out to you all. when our veterans any health and sometimes they don't know where to turn except us and then we reach out to you so thank you very much I appreciate this okay thank you Matt thank you Mr thank you represent relating you're recognized. Thank you Mr chairman. Of the sector ten I don't know what you can answer this question but it's one I've got but you mentioned the veteran service officers by county I don't know where this is yours or someone else's but do you know are these positions filled I know up in northeast Arkansas we had a problem where there was those were vacant for a long time they had trouble getting people in those positions the you the dress that or is that another department yes Sir will address. Yes Sir it's those positions appointed by the county now we have seventy district better service officers that are scattered around the state one in northeast Arkansas however the county is responsible for appointing or hiring however each county does it different you know across seventy five counties now what we do is we have the ability to provide a stipend for them to help them with that and we also do the training to certify them by the federal VA standards to be able handle VA claims benefits and that kind of stuff but it's ultimately they work for the county so am I correct in the funding is shared between you in the county is that the way it works is yes Sir in some counties that's the case some counties don't and then they take care of themselves and then once the BSO is certified through us we have the ability then to give them a sample and but currently with some counties have high turnover and there be a so may not be certified so we set the training up on their schedule to be able to do that and once they receive the certification they can do that without a truck with that certification allows is that when a veteran comes in the BSO they they sign a power of attorney or release for the VSO to represent them through us to handle their claim with the federal VA. Thank you. Representative berry you're recognized for a question thank you Mr chairman and thank you general pan and current state your for for your many years of service and to outstanding combat soldiers sitting right there I just have one quick question and general pain when you start picking roommates at that home would you consider sure room with airforce guy Sir I would consider a. An Air Force guy however your way to need for me. German thank you for your report we thank you for your service to our veterans thank you Sir. Members next up we're at the revenue report I believe Kevin Anderson is going to get or or today. Transgender recognized give our revenue report. Yes Sir thank you. Kevin Anderson pure of Legislative Research I'm filling in for Carlos today So when I to me this is the monthly revenue report for may. With one month left in the fiscal year general revenue collections year today. Of seven point nine million I'm sorry billion increased over twenty eight point nine million above last fiscal year year to date. For net general revenues available for distribution there was a decrease of two hundred eighty two point nine million. From the available for distribution last fiscal year today this is due to increase in income tax refunds compared to last year. On page two. This looks at the collections compared to forecasts not not compared to the previous year the forecast was revised last month and basically what that did was. Give us a projected surplus of one billion thirty five million from six hundred million. because our state was fully funded so when the forecasters revised upward are projected surplus was more. And that was last month when that was revised so you can see in may we're still eighteen point five million over the revised surplus. And Mister chairman on the next pages pages three. On you'll see there's detail. Of this significant take away for the detail for this month is sales tax collections were up about ten point four percent in income tax collections were a. We have one month remaining in the fiscal year Mr chairman. I'm happy take any questions facing none thank you for reporting this transition yes Sir members next up we have our executive subcommittee record culture Wardlaw thank you Mr chair the executive subcommittee met on Thursday June fifteenth and heard a presentation from secretary of state's office regarding a capital maintenance room project subcommittee also made the determination to move forward with a study regarding property insurance coverage for school districts and authorize bill are to begin an RFP process for consultant to assist in the study in addition to subcommittee was notified of the procedure to allow public comment for emergency rules that will be submitted related to learn that some committee also met again this morning eight thirty an authorized dealer to contract with outside legal counsel for representation related to a subpoena for documents for LC consultant the Siegel group moved for adoption of this report. I have a motion to Senator injured I have a question for this item. No I actually was so it was on the revenue not in get the but it didn't hit but I mean I was going to ask of Mr Walters okay if you question the revenue and I in the but when it and if you can give them offline we have moved down don't have any questions for executive subcommittee report I have a motion I have a second. Second all in favor aye. Does. The executive report it is passed. Pardon. Senator Hammer you have a question yeah I'm up for the next reporter thank you Mr chairman pardon I think I'm up for the next report or just get in the queue if you hold for me without objection I am moving here to the top of the the. Reporter standing committees we will have a report for peer from a Senator Dismang. J. DISMANG you're recognized thank you Mr chairman peer subcommittee met twice this week on Monday subcommittee was present presented with information by consultant hired by the F. A. that value waited hospitals who have applied for the state American rescue plan funds for emergency relief on Tuesday the subcommittee receive reports reviewed request approved the following various temporary preparation request American rescue plan ACT preparation request infrastructure investment jobs preparation quest appropriation transfer request and restricted reserve transfer request two items on the report will help by the committee B. two K. and K. one a members have received information requested and both items can be released I move adoption report including additional are including approval of item B. two K. and review of that item K. one a. Okay members we have a motion approved we have couple questions Senator Teague you're recognized. Yeah Mister chairman after this hospital money going out and now we're or got an allocation out of it and some hospitals don't know what's happened some of those just got the reports on this so at the proper time I'd like to make a substitute motion to approve everything else and cool B. one B. the arc of requests funds out and send it to public health for discussion and bring it back next month. If you put yourself back in the queue if you have a question and I'll come up to you okay but I'll give. Recognized for motion at the proper time you will get recognized for substitute motion property if you bit it back in the queue. Senator just for the record yes thank you Mr chair and allow me to apologize to my chair Senator Dismang for not being able to attend the pure meeting. Is this the contract is going to cost ten million dollars is that what we're talking about. The. You. Senator Dismang do you need to restate our question yes ma'am I'm sorry we're trying to track down the question backfire and I'll for the upon my apologies to the chair for not being able to attend the meeting but I'm wondering is this the contract with ten million dollars that DF and a once. No ma'am okay thank you. Where is that contract. For consultant we have someone that's willing to come up BFA to help answer that thank you Sir and again my sincere I know you miss by bubbling personality in the meeting. They could not be here. You're recognized if you use your name okay Andy Babbitt DFA so in this month's peer review we did have a ten million dollar contract but that's for the consultants for or the infrastructure and to speak up and ensure the socially. Of it we do have a ten million dollar contract for consultants for the infrastructure improvement and job that to help us with competitive grants okay the consultants that came on Monday for the hospitals are not part of this request and I guess someone record cost ten million dollars what what does a consultant do that cost ten million dollars that would include both a dashboard that monitors all the grants along with helping agencies write grant proposals there's a number of things that they can do over the next couple years for that ten million dollars. So you would you share with us the specifics of that because I've never heard of a ten million dollar contract before we we put out some big contracts but this one takes the cake for me I think we can you don't mind just kind of delineating what constitutes that ten million it would help me okay all right thank you thank you Mr clear and thank you senator dish nine. Thank you I have a. Senator Hammer you're recognized. Could I get a question back at the table please. You have a question. Yes yes or Senator Dismang can answer do you want maybe. The morning the the ten million is that federal funds or how much that state funds all ten million this is federal funds. All federal funds and is it was a part of a requirement that we have this in place for any other moneys that we would receive and that's that's why we received it. Can you restate the audit we got to we got ten million dollars in federal funding. To set this program up to do this grant oversee and everything but did was was at ten million awarded. Because of other moneys that are coming down that they require us to audit or or which is just money to set up a new program. It's a it was money that we are expanding to hopefully get more I just money so I'm not saying it would be a direct award just for this program okay so ten million out of federal funds should help us get more grants is what we're after right yes okay thank you. You see thirty one. Thank you Mr Miss Bennet. With the hospital consultant so what what was the crux of what was the recommendation as far as. You know the position the hospitals are in and and what we need to do. Okay the hospital consultants is reviewed approximately eighteen hospitals in it varied some hospitals were in in the better shape financially some of them had They had monitored their revenue cycle really well and had really low days of a are on hand and had good cash on hand however coming out of because it in the pandemic they were struggling with a higher than normal expenses some hospitals were more state so the recommendations kind of Very depending upon the hospital some hospitals Woodring memorial B. in the the one on the agenda today The recommendation was really to merge with a larger system okay. So that they can provide the needed a building in a in a medical records system that was functional for that hospital and maintain that hospital that community other other recommendations that you may see coming down maybe a conversion to a rule emergency hospital status which is a newer designation for Medicaid or conversion from a non critical access hospital to critical access hospital effects allowable by Medicaid Medicare rather so the recommendations I can give you a specific one that overall blankets all eighteen hospitals but there are specific recommendations for each hospital where there any hospitals in in in and risk of closing the next I'm assuming next three six months. I think drew was the one we've been monitoring to re memorial for approximately six months now having weekly bi weekly meetings with them and they were probably the one that was the closest and so that's why we have moved them to the list today plus they have also have a letter of intent to merge with Baptist so that they begin to fulfill the requirements to make. To maintain sustainability. Okay is it so. Let me ask you this with this infusion of funding. Is there any hospitals that that we see. That will possibly face a closure I guess within the next six months I mean are they well here here's what I'm I'm trying to get it if we infuses cash or we just. Tron good money after bad in in and I don't mean in the sense of I know that. All areas need great health care and I know that all you know I know that but. Senator low if you can let my co chair a good been much discussion on that I realized all members can't be an old customer recognized Written Wardlaw and maybe give you some background okay thank you Mister senator love it's hard for me to say by the way is always been represented love That that's been a big concern of members throughout this whole push it was a concern last year it was also a concern this year I can tell you what the Baptists of situation where drew they gave a performer in the Tuesday meeting Baptist did and it showed how they would create more services in the delta region and how that would generate revenue going forward it was going to take about a an eight million dollar investment to get that off the ground state's gonna put in about four point nine of that through this operate quest and Baptist is put in the rest of that cash themselves in a county is off all also putting forth the hospital facility as their investment so it's almost like an economic development project instead of saving a hospital is going down because you're putting in a new operator they can offer new and better services to a region that did not have that before and it will also generate Medicare dollars that will pay for it going forward so yes it will sustain itself going forward and that is what we're hoping with every one of these hospitals as we go forward and that is something we're looking at very deeply to make sure they either need to merge change classification are a sustainability plan that changes their practices going forward that they consisting of long term. President help to enter into a. A no no I'm I'm proficiency shared I appreciate the explanation thank you. Senator Hammer you're recognized thank you Mr can I direct this to the co chair please go ahead thank you long and short of it is this report just systematically evaluated all the hospitals this is the first probably not the last that will be coming to try to assist once there is a plan put in place for each one that would show sustainability moving forward is that a fair assessment of what this is all about and there are other hospitals that potentially could be helped in the future this somebody's gonna be first and these guys are referred. That it that is exactly right but they're they're meetings going on right now between governor's office DHS and DF and a with the members and their hospitals that are included in that report to see which one of those eighteen would need to be next because of where they're at in their finances of and those meetings are ongoing I know of three or four that are already taking place I know of two or three that are scheduled for the next week's of to come and they are looking at different options with those hospitals to be able to come to the committee and one thing that was required from drew is they had to have that binding paperwork signed from Baptist and they're not getting all their money this week when we when we process this request today are prove it they'll get half of their money today because management plans in place July first and once that merger takes complete control December first I'll get the other half of that at dollar figures so we're making sure these hospitals are following through with the plans that they're providing to the legislature and to the agencies before we actually expand all of the dollars so there's a lot of safety nets here a lot of insurance that these hospitals actually go forward and we're not just throwing good money at bad as senator Love said earlier thank you. Senator Chesterfield back to you yes thank you so much miss it you're just one last question for Mr Babbitt was the delight to the age or whatever however you pronounce their name was that a competitive bid on wasn't the sole source contract. it went through a cooperative agreement that had been competitively bid in another direction. And for staff I would like to know. Over the last several years the contract that we have let. I'd like to know the prices of those contracts in the scope and over the last two years let's just say two years because I don't staff to do much but this is and this is one of the biggest contracts. I have ever seen. In my tenure here we've had million dollar contracts two million dollar contract I've never heard of a ten million dollar contract but then I'm just looking through the removal of Arkansas who knows but I would like to know what other contracts in the scope of work that they did that would require ten million dollars even though it's federal money to steal money that you and I spend every day so I'd just like to know where we are with this and again I want to know what constitutes ten million dollars thank you so much thank you Mr thank you Mr making note of representative later in your life for a. Thank you Mr chairman I don't know that this is a question but I don't know when to make the statement but. I tend to agree with the senator that made a motion to withdraw B. one B. and vote on that because in here the other day I ask DHS and the FNA of for the reports on the other seventeen hospitals we're voting to give a hospital almost half a million dollars and not you know I didn't see what the other seventeen hospitals required I believe the legislature should look at these reports I believe it takes a little more study by the entire legislature. And not individual legislators I believe this should go to public health before it's passed here in this body. So that the legislature as a whole sees the comparison with these hospitals I was told that this was put on the agenda because it was an emergency. the first day that we had here and I was told I get information the second day I didn't get any more information that really tell me why it was an emergency. So anyway this may be the wrong time to say that but I'll discuss when the motion is made thank you Mr chairman. Senator king of members were rat we've got a motion from center displaying for the report Senator king as requested a so to motion Senator Teague you're recognized. Thank you Mr chairman and not let me just comment on this emergency thing I've been down here long enough to know that we always have these emergencies come up the reality is that every member as represent late and said should have been this this consultants been out there this thing's been out there for a long time we shouldn't be rushed into this thing and be put in this situation it's a mercy thing or what do it that's just not the way things should have been done members should have been known about this I just got an email this week about the report I mean my hospitals know anything so as curve represent Ladyman dealing this money out we just need to have a discussion doesn't mean it's not gonna happen but so right now Mister chairman I'd just like to make a substitute motion sir all items are finalized but then asked that B. one B. the R. per request by DHS to provide mercy relief fund hospitals the poll for the Rick report and held until the July A. L. C. meeting and referred to public health just for discussion and before we decide this money get this big lump sum in this big deal with me to just be able to have an informed decision and no these people emergency part they had plenty of time to be able let people know and where we can have an informed decision today and that's all I'm asking is to support this motion and ask for a second the second member generator jacked a little bit of. Personal opinion in this and I've been on both sides. We all are collected in we all committees are put on committees. What we pay for every legislator that will come to committees you can either be involved. In very important discussions critical discussions. Or you can just come when you want to. That's my personal statement. Representative Beatty you are recognized if you have questions only substitute motion. Do you have a question September you're recognized I have a question to the senator that offered the motion in relation to public health and serving on that committee would this be a meeting that you would actually voting on the question you're you're recognized you can ask questions. Thank you Mr chair my question is to the senator the proposed the motion with that motion being a member of public health with this actually be a committee meeting that you would attend and participate in the discussion all I mean depending on the meeting if there's a mercy thing then yes and as far as attended the meeting thank you that's all I need. Okay got the two movers. Senator Hammer you're a question on the substitute motion questions on substitution ocean with moment of the roof comment I'd like I'd like to chair the co chair when was this up. Consultant originally hired to start this work. Stefano. Last year's what I'm being told but I we we we don't have the chart that shows so it's been over a year late late last year maybe right so it's been over a year that it was originally a initiated for the work to start am I correct in that statement Allen the co chair. When your county came to of definite myself back in January they had already started looking at Drew County and one of things we found out at that point that the time it would take for the consultant to go through the books and the time of days on cash on hand at that time of the process was too long and we work through all that and there was some Medicaid dollars that could be pushed to the hospital and that's how that crutch was put in to get there those were advance payments they were not anything that that they would have got before June thirtieth anyway but yes that report was public then and there was a lot of talk between legislators at that point that we would have full appear of Budget Committee meeting together to move money to keep your county open we were able to avert that and get to this point and some of that's because Bob this is already stepped in You know I got this management agreement going so this this is not new news this this went on we we put together between myself and Senator Dismang and representative of Cavenaugh and Senator Rice a meeting Monday so that all members and had a chance to listen to the consultants and how they analyze the hospitals the metrics in which they look at that was an incorrect informational meeting there was no discussion of any specific hospital Monday it was basically just so all members knew how their hospital or any hospital next of them would be looked at if they signed up to be looked at also like I said this is not new everybody knows the hospitals no choose date Drew County was the hospital on the pier agenda that's where substance did take place so I I mean I don't understand when folks say they don't know if you come to the meetings and you pay attention you should know and the other hospitals that are referenced they were also included in the discussion with the consultant is that correct it was adjuster hospital which hospitals after so they they would have known it would have been involved in the discussion over the last year is that a correct statement I think a lot of these actually applied to critical access hospitals that are in that list what allowed to apply to December but they've been in the discussion since December the hospitals in the mid grade area have been involved since September of last year and I see he shaking his head so that the that's correct it is this is Blake said none of these are new we've had no new additions I think there's one hospital that will qualify in the next few days that one will be a new one added to the list or thank you and thank you Mister that says five hours before thank you AOC best your senate Gilmore your question on the subject of a motion well I think I have a question related to thank you and Mister I have a question really to the cochairs but I. I think I sort of make a little bit a statement first members I think we understand the dire need with health care in our state we understand that we have hospitals they're in great need in rule areas many areas that I see represented in this room here today. This has been vetted. Well over a year. Is that not correct Mister culture Wardlaw. Yes Sir. And this is gone through the appropriate channels through a LC this is had due diligence done on this is that correct Mr Kircher that's correct. So members with that I would ask that we defeat the substitute motion that we get back and focus on addressing hospitals in need some of which will be coming through very shortly that have had the the due diligence that this hospitals had and we need to make sure that the X. constituents that we represent have healthcare and and I'm I just want to point out that with this study that's been done. We have looked extensively. And what it'll take to make it sustainable. True moral has has gone through all the steps they've gotten very creative and how they've been out there doing that working with Baptist health to make sure that this is sustainable going forward so with that I ask that we defeat the substitute motion and thank you Mr chair for recognizing. Mr I'd like to respond a couple things Get you back in the queue Senator Irvin you're recognized if you or but substitute motion. Thank you I I think I'm speaking against the substitute motion for the the reasons why at center Gilmore laid out but I would just also say these are our assigned seats are from the American rescue plan act you know we have these are appropriate expenditures for those federal funds as it relates to COVID many of our hospitals are still reeling because of what happened during covid you know we all went back to life as normal your doctors or nurses your therapist they never got a break ever they had to they had to step up and answer the call and save people and go into really the line of fire at an unknown time there's a lot of people that died and and it was hard and they have not had a break and they are struggling in these hospitals are all over the state of Arkansas I don't care whether they're in my district or your district they're important to the Senate to the economics to success and stability of our entire state health care hospital any type of a healthcare infrastructure is a cornerstone to any local economy and so we should all be equally and you know it just passionate about making sure that we have economic stability in all areas of the state of Arkansas and healthcare is where that starts so I'm speaking against a substitute motion but I'd also remind members you can go back and watch committee meetings we live stream committee meetings now go back and watch them inform yourself if you miss the meeting also you can go online and you can see the report that's listed that's where you'll find where the eighteen out of twenty six hospitals are listed that's where you can find the report for the consultants and read it for yourself before you come today so I would just remind people that that service is available to them and their constituents as well with that I would appreciate a vote against the substitute motion. Senator king the two more were in the queue do you want to. The dress something for everyone just wanna make a comment a hospital's didn't know anything peer was on Tuesday I did not get an email from the governor's office into Wednesday. Okay I just want to clear that up. Cavenaugh you're recognized. On the subject. Thank you Mr I just wanna emphasize also as someone who came to the meeting and listened I'm myself as senator rice there was very. In minor participation in this meeting there were very few senators or representatives that came to hear this very important information and then we come to peer and we want to say we don't have the information is because we didn't do our work and I too low speaking against this motion thank you. Represent relating you're recognized speak on substitute motion thank you Mr chair. And if we're talking about people not attending meetings we've talked about this for a long time in public health I think that all those meetings I chaired some level in this this is been going on for a long time and in this may be a very good thing to give this hospital the money I was in that meeting Monday I was in the meeting Tuesday and I did have discussed in that meeting on Monday all I ask for was do we have any comparison this was the final report and at three all that one there the meeting on Monday was to tell us the members appear how the evaluations were done what parameters they used and I ask a number of questions about that and it did not talk about specific hospitals they told us there was twenty four hospitals that were asked to be involved eighteen responded. And that they were gonna give funds to one hospital and I ask can I see the final report that shows a comparison of these eighteen hospitals and I was told by DHS that that report is not available. That that's not been done yet. I just want to see. Comparisons how how these hospitals compared after all the work has been done for a long period of time. I haven't missed any public meetings I may have missed some private meetings. But I've been to every meeting where we discussed this all I want to see is how are these hospitals compared do we have enough money to cover all the needs of these eighteen hospitals if not how are we going to rank them there's two hospitals up in my area of the state that need money I haven't seen the reports now up maybe they're out there online but I haven't seen the comparison with those. And I believe you know something like this should have went through public health we have a public health meeting scheduled for Tuesday of next week. Why did this not go through public health at this point when we have file reports now if I'm wrong tell me but I don't I just don't believe we've seen the data that's my opinion. So I'll be voting for a substitute most. Okay members with a substitute motion center king on the floor of all in favor of the substitute motion by Senator king. Pardon. You are meant for you okay I thought you made coming as represent lady said we did not have all the decision by hospitals did not know of we need we need to have the whole report and know all the information to be able to ask questions before this money is given out that's just very simple let's and every hospital out there rural hospitals having the same issues the same problems and they should just be have an informed decision and just allow a little bit of time that is it it's that simple I understand people in the district that want to get this deal done but you know what we need to respect all the citizens of the State and all these hospitals need to make a decision like I said I'm not a voting member appear. But I'm a voting member of this committee I am here today where I can make a vote and make a decision and I'm just wanting to wait in making them more informed decision and give fairness to everybody involved in this that gave a process that's it. It's just a simple request. So this thing of like not showing up I'm not a voting member appear I could have voted no and it wouldn't have mattered that I am a voting member today and I think the best though today is to be respectful all the hospitals in the people Clyde and just allows a little bit more time to make an informed decision and get the information out as representative Ladyman said he did it in the meetings your historic. I appreciate a good vote. Members as of two motion on the floor and center King own favor I. Those have it Senator Dismang has a motion on the floor to accept the report I have a second all in favor say the report of peer is Senator Dismang stated say aye. Opposed. Report carries thank you next we are going on to administrative rules Senator Hammer you're recognized give the scent of rules report thank you Mr forget the report I have a request of the chair please. Go ahead I'd like to request a chair direct staff to gather information as to when the hospital's mentioned in the previous report that was discussed were notified and made aware that there was report going on whether that would come from any source being the consultant that was hired or staff or members that notified the hospitals that this report was under discussion I'd like that information be pushed out to full A. L. C. body please given the nature of the conversation today and I'll be glad to answer any questions from those M. lo co chair Wardlaw. It wasn't mentioned in the peer report but it was also a motion made in peer that quarterly definite DHS will give reports on the status of payments that have been made to these hospitals so members will be welcome to come to peer to hear those quarterly reports and what's the agenda for when they take place but as we expend this money through these eighteen hospitals and obviously as I mentioned there's in addition to an extra one. On the pier so you can hear those reports in here the status going forward hospitals as we move down this road. Thank you but my request was that. The hospitals when where the hospitals notified of made aware that this report was going on and were they notified of the consultant would be talking to them to gather information for that report you know what is far superior listen stuck in traffic shows listen on the way here and I just wanna have established that the hospitals in reference were contacted and made aware that this report was going on and that they were invited to participate in the discussion thank you Mr mayor has that down before you start report I have a question from center or yes. So I just wanna make a comment about what public health committee role is here this is This consultant was a function of A. L. C. and appear subcommittee because that's where this money is being reviewed and approved and voted on so I just wanted to make some response yes of course you know our hospitals and health of our hospitals is a topic in a subject for public health committees however this is really in the purview of the peer subcommittee and I felt like it was important to respect that process because that's ultimately where the vote is going to be taken on the approval of those funds so thank you Mr chair for just responding to that we always in public health will have discussions about the health of the hospitals and what is happening in DHS but as it relates this consultant and the contract that is a function of peer subcommittee because that's where the vote is going to be taken ultimately just FYI and appreciate the courtesy thank you senator Senator hammer your question been noted and will be fulfilled. So with that Senator hammer will recognize you for the report for rule subcommittee thank you Mr the measure rule subcommittee met on Thursday June fifteenth twenty twenty three the subcommittee adopt a report from the executive subcommittee concerning its review and approval of an emergency rule percent ACT five ninety five of twenty twenty one the subcommittee receipt agency updates on outstanding rulemaking and filed with the June written update of the department of corrections all rules were reviewed and approved as noted in the report and Mr chairman I'd moved for adoption of this report. Proper motion drive second of second orders favour say aye aye. NA's Is haven't report has to as been adopted claims in review litigation report center Dotson you're recognized. Thank you Mr chair the claims review litigation reports oversight subcommittee met on Thursday June fourth on sorry on Wednesday June fourteenth twenty twenty three following adoption the rules the subcommittee reviewed thirteen litigation cases the subcommittee also reviewed one proposed settlement submitted by the department of agriculture and to proposed settlement submitted by the department of finance administration I move adoption of the report as proper motion the second. All those in favor say aye. All opposed Is have it not report is adopted will move on to the employee benefits division Senator Hickey. This division oversight committee met Wednesday June fourteenth at ten AM. Of the subcommittee approved approved the following we approve the state board of finance changes to the B. D. drug formulary we reviewed and approved the B. D. E. B. R. X.'s contract for consulting services through June thirtieth of twenty twenty four we reviewed and approved a BT contract with mainstream technologies we also heard a discussion on connect your care services contract report region to region a tree I can already say that therapies Act two thousand seventeen. Prior authorization for position emission tomography scans of bariatric service coverage the subcommittee requested he be deeper bring monthly updates regarding network issues affecting retirees. S. the report Mr. Thank report you have a motion that report as I move the passage of a motion passed the AB day report I have a second second all in favor aye. Opposed thank you for that report next up we have higher education Senator Solomon you're recognized. Okay. You have. Are we recognized the higher education subcommittee met on Thursday June the fifteenth twenty twenty three. The subcommittee heard testimony regarding the following items overview of agency priorities for the Division of higher ed an update on teacher preparation from the division of fire red and the Division of elementary and secondary education Mister chair that I move for the adoption of this report I have a motion up to higher ed report on us I have a second. Second on favor I. Opposed just one minute I've got to the representative McNair is yours own this report. It is okay you're just up next I'm more members on break just a minute or recognized Riker Shepherd for first privilege thank you Mr chairman I didn't want to let today go by without one final recognition of our house parliamentarian Buddy Johnson who is most of you know is retiring at the end of this month after a long career with the house of representatives and since we have so many former house members that have moved over to the Senate we have many that are out in the audience just wanted to take this opportunity to thank buddy for his long tenure and good advice and good counsel and service to the state of Arkansas. Thank you for a job well done we're gonna let you have the might just a minute. Thank you Mr chairman I've always joked that up I would have the opportunity to saying one Elvis Presley song from the well of the house Before I ended my career and I think doing something like that would have ended my career and I end up but all jokes aside I'll I'll spare you that performance today thank you Mr chairman thank you Mr Speaker for the and all the all the you members the House and Senate for giving me the opportunity to work up here for thirty eight years this been a privilege and honor and I hold. My time here has the benefit Arkansas and that the our state is a better place for what I've contributed and I know it's a better place for what you contribute every day so thank you. Congratulations. members up next we have the Highway Commission review an advisory. Representive McNair you're recognized. Thank you Mr chairman Highway Commission reviewed advisory subcommittee met Wednesday June fourteenth twenty twenty three subcommittee heard testimony and reviewed the following items quarterly land conveyances report the second and third quarter progress report of each highway construction project of ten million dollars or more in a January to August twenty twenty three monthly updates of the AOC of physicians the study recommendation rules for implementation I move adoption of the report. Okay I have a motion and a second second of the three questions on favor I. Posed board is adopted the thank you for the agenda McNair etcetera lottery scholarship center call will if you hit your button you're recognized. Thank you share the lottery oversight subcommittee met Thursday June fifteenth twenty twenty three subcommittee heard testimony and reviewed the following items one was the Arkansas lottery directors report to was Arkansas lottery proposed fiscal year twenty twenty four annual budget in three was the A. L. tier two LLC in Cranford Johnson road would contract Mr chairman I move with for adoption this report. Thank you senator Colwell have a motion and a second second own favor I. Loads thank you we have occupational lasting review Senator English if you eat your button. And you're recognized group of thank you yeah conditional licensing review subcommittee met on Thursday June fifteenth twenty twenty three to approve the subcommittee rules discussed occupational entities up for review and approve a time line of the review I move that we accept this report. You have a motion and second on favor I. Posed the report is adopt. And next up we have Review Senator Flippo. You are recognized thank you Mr chairman the review subcommittee met on Tuesday and reviewed agenda items including MOS a construction contract grants and contracts two items were held for additional information to hold have been released on both of them and I move adoption report. have a motion and a second. Thank god on paper I. Posed in of dozens of films Senator English R. A. is operationalized exit that passed members we have one mower that is Senator Breanne Davis if you hit your button for a personnel. Davis you are recognized the report thank you Mr chair that personal committee met on Wednesday June fourteenth and reviewed their requests and reports listed as items one through thirty two on the report the Committee also suspended the rules and approved a request from the office of personnel management listed as item thirty three to provide merit increases to the base salary of employees at or over the maximum salary of their current pay grade based on their highly effective or roll role model designation through their performance evaluation as requested during the personal committee meeting at PM as provided an updated list of those employees for a Elsie's review I'm happy to take any questions and moved to adopt the report the proper time including the approval of the merit increases for those employees over the Max. Okay not seeing any questions and accepting your motion to approve that second of all in favor aye aye opposed thank you six days for that report members going on to section II review of communications there are four items that require the motions in and to be reviewed Arkansas teacher retirement system are there any questions on that if not I would take a motion to review that I have a motion to have second. Thank you all in favor aye. Closed that is I ask members going down to number four if you have any of these other ones that you want to request anything else feel free to do that number four we have Department of Human Services I believe secretary Putnam is here if you will come forward. Thank you Secretary button for being here and and the other staff members. Have you today. Good morning thank you for having us here Kristi Putnam secretary department Human Services. Are quite chief of staff DHS J. hill and you don't have your health of the H. S. thank you. We are just we are appearing as required by section fifteen about two thirteen of twenty twenty two with a report on the The choices assisted living waiver reimbursement rates just want to report per our letter to you of may thirty first that we are continuing our broad based review of the entire Medicaid system we will bring forth some recommendations later this year to ensure some long term long term sustainability of the Medicaid program in whole we also are preparing to implement ACT one ninety eight of twenty twenty three which authorizes us to establish cost reporting for Medicaid funded assisted living facilities. In the meantime the assisted living providers continue to receive a temporarily higher payment rate that was increased and they have been receiving a during the covered nineteen pandemic these higher rates will continue at least through November eleventh of twenty twenty three father and I will ask chief of staff Clark Wade and jae Health to add any additional comments on this but we are in partners we've had several meetings with providers and legislators regarding the assisted living rates and we are committed to bringing back a written a report and a plan in July for an additional two million dollars in the interim until we get the cost reporting implemented to address some of the concerns that providers and legislators have about these facilities. Okay I'll just add that we expect there will be a request for a restricted reserve funding for that two million dollars I know we've had some conversations leadership for the legislators but what we will bring back to you is a detailed plan for how we intend to distribute that those funds. Okay in the the cost reporting that you're talking about because there's gonna be decision by the latter part of the year and and we had the that in legislation there was massive that will be done soon have you done before you can make decisions. It's I would say that that'll be a piece of looking at this two million dollars but also it is available or long term project of implementing that act where we do those cost reports it will take some time to get that and get that data back and providers because they're going to pull their numbers and get that back to us with or see before that we're in the process now of identifying what information we need them to submit what that format will look like and how will be receiving that so we work to get those details of this two million dollars to be a good stock after the mean time until that process is thank you got a question from a culture Wardlaw. Yeah I don't allowances have so many on a top thank you so. I'm kinda wanna timeline I kinda like to know when things come in so that members can participate if they want to participate would you bring those rules for that distribution of the two million dollars next month and I ask for pure requested the same time or we ask for the rules next month in the peer request in August. I'm. Both in July so that is we we plan every detail for in a report on a detailed plan for how those that two million could be expanded to assist these facilities and then request make the peer request as well so that that will come through or not like an emergency rule. And to set up the rules I don't legal or promulgated rules which do that as a a plan will bring to you in connection with an appropriation that's that's perfectly fine thank you. Thank you have a couple questions represented the you're recognized for a question thank you Mr chairman mark this kind of goes back to both chairman's questions just to get some clarification out thank think I heard you say that the current rate which is higher than the normal rate will. Will that continue until you get the cost analysis done I heard somebody mention November time frame so you is there going to be a gap ever where they're not receiving this right before we decide on what the rate should be or how we doing that based on what we know now we do not expect the gap and it's I don't get to do that deep in the weeds because this is some some convoluted CMS rules that were covered in here we know that at a bare minimum it will continue through November as we look at it we think under the relevant COS rules it would continue past that as well but we want to we'll hold off committing saying that it to actually get there because we think we can get things done the tonsils in the comment was made that the the analysis or whatever you're doing will be later in the year I mean is that December or September. We estimate to be August or September to be able to have the cost reporting plan in place and bring it before you that will determine what the rate's going to be going forward the cost reporting process will will determine that the actual submission by the facilities of their cost reporting their financial information will help us determine additional rate changes as needed okay I thank you. Thank you of the representative Mayberry C. thirty you're recognized. Thank you Mr chair can you give us an idea of there was already a cost analysis done on this last year just take a step back and explain why that's being rejected and why we have to go through this process again. I was a consistent with any mistrust came in there was a detailed look at that I think there's some concern about some of the elements that were in that cost analysis about so the decisions that were made in there and terms like for example the inflation adjustment that perhaps that may have been higher than it should have been but also keep in mind that that cost analysis there. That was only tied to a limited amount of data and it was based on quite a bit of I'm trying make some estimates based on older cost data with this cost report mechanism that is now in place and legislation you all passed we can have very up to date data and have a rate that's much closer to what is truly one off on out there right now rather than something that may have been impacted by the the LR's OR emplaced during a pandemic. Thank you US senator Hammer good question. Thank you Mister you receive notification that any you're going to be shutting down are they required to give thirty day notification. They are required to notify us if there is any shut down and that is that is for in any assisted living facility because we do whether not they take Medicaid patients they're still obligations they have to us for office long term care and so yes they are supposed to use that notice and do you have any that it give you thirty day notification. I'm. Not aware of any. We will double check our staff to make sure there's not ones come in the last couple of days but I'm not aware of any in the last six months. Are there any that have given you notification of going through the closure process there were two private facilities that did close some some months back but need to those facilities to Medicaid patients so they're no Medicaid patients involved in once it shut down last six months and you don't have thirty day notification of any right now is that where we are right now that's my understanding our thank you. Okay and just if it was mentioned model if I missed the reason for the call study it was legislation it said you you got to do because the that's because representative maybe you got a question I'm yes Sir thank you eight. When this study was done last year was it a DHS picked vendor to to look at it and did DHS have a say into what was factored into that analysis or was in other words did you did you have a role in deciding what those factors are that you're now saying should have been the factors it is a DHS vendor that was used for that and it was a collaborative effort between DHS and the providers in working through that process. So DHS had an opportunity if there was concerns back then to say this probably is not correct data okay this was an opportunity but when we've had a change of ministrations and stand and with the new administration you have a new new view things and wanted to look at things we'll differently. Thank you. Thank you we appreciate your being here today. I'd like to. Hammer you have another one. So. If you receive notification while this process is going on from a provider that does have Medicaid patients involved in it. Is there any remedy to intervene within that thirty daytime frame so that facility does not have to shut down or just because to get it back through peer get back through to A. L. C. I don't see a pathway forward that we could step in and rescue one that would give you thirty day notice is there any other pathway Forder. I. I'm out of a law that would depend on the specific circumstances but just off the top of my head I think it would be difficult for staff that would that is farmer's we're gonna bring that back this two million dollar request in July so there is some finding out there and that would prostitution support shall be the bandaid for any facilities that will get in trouble that's the whole purpose of this that if any and you said you but just because they send you thirty day notice you still have to look at it justified just make sure they're not coming to you you know asking for the money I mean they're they're you've got a process to evaluate to make sure that it's a legitimate request in order for them to get access to that is that correct that is correct okay thank you. Thank you and and the back time to say mark you're changing jobs some of us don't know if they will say that is because you're changing jobs but we appreciate that you have always been good to answer our questions may not always got the answer won't it but you could get back to me and and answer that and I know you've been a wealth of knowledge but others or sector but The challenges ahead I know you've got good people March on we are going to replace the thank you Mr chairman Mr permission yes I would you beat me to it I want to publicly thank mark for his service and legacy that he's leaving with DHS we know he's not going far I reserve the right to phone a friend any time I need to I tried to reject his resignation and he informed me probably that I don't have that authority. So but I do want to the first few months yes since January coming in New not just to DHS but to the state of Arkansas mark has been an incredible asset and friend and he has tons just served incredibly well in his heart is definitely with DHS and we appreciate him to thank you I appreciate the committee's still got recognized. Again thank you all for being here thank you. Okay members if you look at the seven B. division of information services does require a motion to ninety questions on that I have a motion that second second I have a all in favor aye. Okay seven these past number eight is a secretary of state any questions on that I have a motion and second second all in favor aye. And the opposed none appreciate to that passage now members own K. we have four interim studies without objection will batch those together Senator Hickey you're recognized. Yes I would request that we pull out K. four I want to have some discussions deal with that one separate. Okay I have that request members or the any questions on batching one two three. We have a motion the batch one two and three and second all in favor aye. Okay On item number for any discussion Senator Hickey fuel the you want to address that yes of course I just noticed this and I guess the thing is made we need to have a little discussion here but it it appears to me I'm not for sure that this would be appropriate course as we all know ALC is a made up of both bodies of the house and Senate and I don't know that we should be doing to interim study proposal you know for the rules of the house the General Assembly so if somebody wants to try to persuade me differently I'll be happy to listen but at this point. I think that should be included as interim study through this committee. Okay represent Crawford recognized you this year instead thank you Mr chairman this is an interim study at With buddy helping me put it in here it will not come before the ALC Committee but it need he said it needed to go into interim study and then that the house rules committee would then come together and go over it after we've had people to come in and discuss it. Recognize Senator Hickey football. Maybe all fine and dandy but I don't I don't the no disrespect representative but I don't even see with the Senate should be voting on the. On referring this if all due respect of course for for buddy but I don't know if we should to at least put this off for a month to get with our staff because I think we all know that the bureau can work directly with the the House for the bureau can work directly with the Senate. But as far as it involving US voting on anything to do with your all's rules I just do not think that's appropriate so request that I'm course I'm not going to make a motion at this time but if it if there is a motion on this I would request that we voted down. I will recognize representative these for questions thank you Mr chairman I have to agree with the Senator Hickey I don't know that the Senate members should be voting on something that's primarily that we take care of in the house I think the. In the House Committee could have their own meeting and bring up this on their own so I just I'm not entirely sure this is something that they'll see these begin with I could be wrong I'll defer that to staff of they have any recommendations. President Crawford do you want like a motion what you wanna do you wanna yes Is delay it for a month and get more information okay and see which direction we need to go I was just following what but he said he said in terms of time to do this work so we'll follow proper procedure whatever that it reject reject that will look to July on that. The any other business unit in the. Members saying no later than this home we are journey thank you for your attendance.