Public Health, Welfare and Labor Committee - Senate

Come to order I appreciate everybody coming out today I know we've not had the best weather so we're going to get started immediately I want to I welcome the folks with a A. R. RP thank you all so much for being here in the capital with us today we showed a little bit better weather but we're happy to have you here and thank you for your presence all right with that we're going to get started right away Senator Flippo you're recognized to present its members today we're going to try to hear bills that we have not heard yet and then you know we'll we'll go back if there's time to other bills okay which bill are you state your name for the House senator Scott Flippo district twenty three and I'm running house bill seventeen forty four okay house bill seventeen forty four. Okay all right thank you madam chair and thank you members house bill seventeen forty four is very clear very simple on this bill does is it says before before a closed landfill can transfer you know can can can can be bought out that if it's received money from the post holder trust fund that money have to be repaid in full before they could you know before I can be solved. Okay. Are there any questions from the members of the committee. What Senator Solomon. Sir someone that does double that that amount that that landfills are located in cricket council Sir. Okay any other questions for members of the committee is there anyone here to speak for or against the house bill seventeen forty four. Scene nine your clothes from a bill an appreciative I make a motion to pass a motion to pass second all those in favor say aye. And oppose ayes have it congratulations you've passed your bill the manager and the committee. Okay. House bill ten eleven I'm I can run this. I'll run this real quick house bill ten eleven. Senator you would introduce yourself and you may present your bill thank you and this is house bill ten eleven running for representative Pilkington I'm Senator Missy Irvin district twenty four. Members we've we have seen this bill before in the committee however the bill that we had for depression screening was for postpartum women this is depression screening for pregnant women. and so that that's that's what the bill does is it allows for the Arkansas Medicaid program to and reimburse for depression screening of a pregnant woman and that they would apply for waivers to be able to do that since centers that not already done I mean they're school they're reviewing the women and they're not looking for depression. I don't know if I could answer that question to be Frank. I don't someone I don't know the specific I mean I can I can talk about my experience personally I've been through it four times so I'm in this I would wonder if they're doing a. Three. And they're not screening for depression where they screening for. The Medicaid that can come in and for the. Not sure if they're doing screenings per se. when you go in for your monthly appointments you're really not doing a lot of screenings you're really just doing check ups on your pregnancy may or may not do bloodwork and urinalysis all those kinds of things but screenings are not necessarily a typical part of this type of a. Care and. Because of more quiet for Human Services that's my understand will Senator is that it may it may or may not be part of it but I know that my stand intent is to make sure this is something that can will be paid for it we provided for under the Medicaid this is that is something that we cover currently but I think it's the issues really run the health insurers for then you would there's. For the initial screening our appointment they're doing providing certain services and now they're going to add to that a requirement for. Depression screening that will have a reimbursement code. That's my understanding. Okay members any questions it's been a few years the lessons up in three of us so it's just. I find that hard to believe that someone going in that seems to be an issue with. With you know if you're going you're pregnant you're going and it seems to be an issue that the doctors would be looking for already. Well I mean I would just no I have so much appreciate this conversation because I think that you know when you go to an OB gin for your care you're not necessarily going there for these types of issues you're probably going more to your PC paid for these types of issues then to Eurovision but I think it's important for us to really kind of be more comprehensive about this inside the yeah. That anybody else questions. Thing that is anyone here to speak for against the bill. A man senator you're welcome to close and close and I'll make a motion to pass second I have a second all in favor say aye opposed. Congradulations Senator U. pastor bill. Okay representive Collins okay Senator Boyd recognized to represent house bill sixteen twenty two. thank you madam chair senator Justin Boyd did Senate district twenty seven and I have someone here from the American heart association if he'll introduce himself just in case there's a question I can't answer. I am Dave over from American heart association American stroke association okay so currently we have a a stroke task force and what this does is it sets up to do that we have has been very successful in the state of Arkansas and so what this does is it really sets up a similar task force for heart attacks and so basically it would authorize the secretary of the department of health to appoint the fourteen members to the task force and then you know Provides for all of those And explains in there the powers and and duties of the task force. Happy to try to answering questions are there any questions from the members of the committee Senator Solomon you're recognized questions generally not for creating new task force. so that ever before adding a new fourteen people of their cost of the. I know there is no cost and we don't have any other task force. That are. We don't have anything addressing kind of the STEMI heart attack area we're trying to basis on the stroke task force which initially has no cost but is extremely successful in the last ten years since its implementation the stroke mortality rate in Arkansas's one from first the nation to run tenth and we're trying to replicate some of that work that they've done on our tax I get that but if you're how do you create a direct relationship with the task force is down to the numbers going down. with third parties bills and doctors are are the cause of that rate going down I don't know that you can Senate task force does that even with the task force is really did a good job and putting a lot of services that help systems of care the district registry program that helps make sure the hospitals are doing the kind of proper steps for a patient to care working with EMS to make sure that they're taking people to the right hospitals also making sure the hospitals are meeting minimum standards for for stroke care and so they have been able to done a voluntary basis implement a lot of really great things are in the strip Committee to help increase that the mortality rate or decrease session sensor. So we're just trying to see some similar actions taken in the heart attacks I thank you. I any other questions. Members of the committee. All right anyone here to speak for against this bill. No they signed up are if close for your bill I'm closed I appreciate a good vote I make a motion to pass right. Second all those in favor say aye. And oppose ayes have it congratulations you pass house bill sixteen twenty two. Representive enters. Representive Andrews of the sixteen ninety one. Anyone here to pick present sixteen eighty one all right let's pass over that. Seventeen oh five. Thank you madam chair have someone here to testify with me. I feel dispose state your name for the record. My name is bill Taylor. Okay and state your name. Clint Penzo district thirty one. Please proceed okay house bill seventeen oh five is to amend the telemedicine act PT by definition is a physical hands on profession very few patients are appropriate for telehealth physical assessment is critical and not can cannot be done remotely. Physical therapy by definition requires an assessment of physical ability which contest a patient skills this is inherently risky if the therapist is not on site to assure the patient safety. You may proceed. I'm the president of the Arkansas physical therapy association and while this is not our original piece of legislative package for the year we have members that requested this bill summary to speak in support of it and answer any questions you might have to clarify and Anything to resolve any issues might have with the bill. The questions from members of the committee Senator Solomon you're recognized we don't have that threshold for medical doctors would even have anymore far animal doctors so now we need for physical therapist why I believe physical therapy is very unique. Healthcare space I mean it's in our name a physical exam as part of the just the basis of our profession there's not enough data out there that really says that physical therapy is effective without a physical examination and because there's not I think it's best interest of public safety to require at least an in person examination at some point in the course of care just to ensure that we're providing best level care and safety. Thank you. I worked in the this profession for five years before I got into real estate eighteen years ago so it's been awhile but you know it's kinda there's a there's kind of a saying that to see with your hands and you here with your is you know when you're you actually have to have your hands on somebody sometimes to accurately figure out what's going on you know if you can call your doctor of the Blake Hey we have got this hit congestion I need an antibiotic and some things in the you know the the medical profession can be addressed really easily when it's physical therapy I mean a lot of the tests you have to do you have to be in person to do on the you might have to put the person in a to have balance issues might put in a position that would challenger balance if you're not there to make sure they're doing safely they could fall and hurt themselves this is the example but there's a there's a lot of tests that are done in physical therapy that hurt their hands on test you really can't diagnose an issue. On video this just says that the the. That the relationship is established in person so mean follow follow up I'm assuming could be yeah and I'd like to say I'm a huge proponent telemedicine but as a therapist of twenty five plus years I would never think to see a patient without seeing them at least one point one visit in person I just think it affects decision making to actually physically examine them. Yeah I'll just follow up I mean actually agree with you one hundred percent on doctors physical examinations that the policy that this body has adopted has changed but I mean that was my argument from the get go and which was that a physical examination is critically important to have a of at impatient The establishment of that first visit however I kind of got over ruled by the legislature so and I just think consistency in policy is. Something we I think must maybe consider Senator Solomon you're recognized. The test that you mentioned are not really with the Bills about it so as to establish a relationship so I don't know what that stem from relationship and when you say you personally wouldn't well you have that option right. Thank you can you can tell your patients that you won't see them unless they come in first. I do have that option correct yeah and and now you're going to put mandate that on every physician are every PT. Well that's going to expire I mean that was part of the public health emergency and It's it's just it's really an initial valuation for therapy is a little bit different to them like a medical a medical procedure that's where you come establish a baseline of establish a plan of care. And I think subsequent treatments after that telemedicine have to physically put your hands on somebody and you know with their deficits are whether the balance or strength you just have to have an idea that before you I mean you can do it I'll just tell you that it's not best practice therapy and you can pay for it but you're not getting what you pay for. But I would just have to disagree with you because medical doctors on physical examination really absolutely can diagnose and treat a patient by laying hands on that patient it's not just physical therapist and so I I hear you and I don't disagree with you I'm just making the point that physical examination is really really important for medical doctors as well I can share an example of just happened last week with my dad and and so anyway I but but I do hear you and I so much appreciate what you all do physical therapy is wonderful in my world so I appreciate it thank you and I'm not disagreeing I'm just that's really outside of my scope I'm not a medical doctor. Any other questions from members of the committee. C. nine. My clothes for your bill. Okay then if those are closed for the bill and ask for a good vote. It was a pleasure of the Committee. Question do pass second all those in favor say aye opposed. knows have it I apologize I only see three yeses so we'll if we have other people array will try to come back to it thank you thank you thank you Committee. H. B. seventeen forty two. Okay. If you're ready to begin I'm state senator Justin Boyd district twenty seven and I have a couple of people from DHS to join me. Okay. Mark white for review and services Kristi Patton department Human Services. Proceed Farm thank you madam chair so with the bill we have for you is relatively simple what this does is it takes the transitional employment assistance program and moves it from the Department clock commerce division workforce services to DHS when they came into office settings for state secretary panem and centerman Donald quickly I had some realizations in conversations that this program would probably be a better fit at DHS given our mission and our programs currently we do administer eligibility for the program and partners workforce services has the administrative oversight so we shooting that administered oversight in the case management work they're doing now to DHS and that would allow Division workforce services to focus on unemployment insurance analysts Senator Irvin as anything to add would be happy to answer any questions. Okay Senator love you're recognized. Thank you madam chair just as a practical standpoint like is the operation just moving over to DHS I mean people positions have you already worked that out we have thought we have been discussing people in positions of moving over and so it would be an operational administrative transfer over type to transfer okay thank you. Okay are there any other questions from the members of the committee. I see nine is there anyone here to speak against seventeen forty two or four seventeen forty two C. nine you can close for your bill. This is a good opportunity to do some you know important restructuring in our government and in place one plus one program and the the right category have brought place and I appreciate a good vote okay thank you for pleasure of the Committee motion to pass in second all those in favor say aye opposed ayes have it congratulations you've passed your bill we're gonna go back and pick up house bill sixteen eighty one senator Bryant you're recognized. Thank you madam chairwoman. House Bill sixteen eighty one just run state Senate district thirty two. Is a a bill to prohibit universal basic incomes to be given by our local municipalities or county or other districts or political subdivision of the state. As you see across the state across the nation some areas are starting to implements just universal basic income and pay out of the generate any of that of the system this will prohibited in the state of Arkansas. Okay. Are there any questions from members of the committee senator live you're recognized for a question thank you membership cards so what is universal basic income. Program that is not expressly required by federal law in which an individual receives a guaranteed cash payment regularly okay so our ideas give me an example of that because I I've never heard of. this body passes in order to set everybody under the age of access between ages six and why that doesn't make it X. amount of money under retail last year's. federal income statement will be get granted. Two thousand dollars by the city. Okay has this happen in Arkansas not not to my knowledge. We're going to prohibit it from happening in Arkansas okay all right so are and walk me through what has happened in the end but I mean I'm I'm just trying to get a. picture of what what this is because I've never heard of I believe cities in California have five adopted this. I have to I have to Google it. Thank you. The center just the I was running Senate bill seventy one recently I had a well known organization large organization in the state of Arkansas submitted amendments the possible amendments to the bill one of the amendments was that we all quote start in the same place with income. So this bill would prohibit that as I understand that is or if it's just a standard or we're not going to have a guaranteed income. From the state that is correct and so the question is is anybody doing that the answer would be yes they're trying right here in the state of Arkansas. Any other questions. Saying that is anyone here to speak for against the bill. Seven nine what is the will of the committee welcome to close I'm sorry the time is valuable right now I'm closed. Which will of committee motion is second. Second all in favor say aye I'm sorry did you have a discussion. Okay all in favor say aye by any opposed. We say the ayes have it. I'm sorry I would say four one two. One two three four. The ayes have it with five votes your bill is passed thank you thank you. Who is. Please call the roll. Senator Flippo. Senator Flippo votes yes senator Wallace senator Wallace. Senator king. Senator king. Senator Penzo this center Penzo votes yes senator Boyd yes Senator Boyd votes yes Senator love. Senator love votes now. And your your bill fails for lack of a with only four votes thank you I apologize committee I thought we had five. The bill is a house bill seventeen thirty two Gazaway for anyone here to run that bill. Seven ten thirty one representive. Cooper you're welcome to come up and state your name and your bill and you're welcome we can. Representative Cameron Cooper District fifty seven thank you committee for your time have a good non controversial bill here this may be one of the shortest bills you seen this session if you will look at it with me house bill seventeen thirty one very short just strikes out the number ten changed it to twelve let me tell you what this does really quick. the idea for this bill came from constituents back home and road but in White County they provide an essential service to the community they provide an in home day care the nearest towns to road but we're other daycare services can be found or Conway thirty four miles west Beebe twenty five miles south Searcy twenty two miles to the east and he were springs fourteen miles to the north so for a single parent working in one of the business and road but it's not feasible for them to drive these other towns to receive day care services so daycare availability in their local community is essential and we see the same issue playing out all across the state not typically we think of licensing for daycare services we think of DHS under DHS in home daycares to provide services for sixteen children however in addition to that Department of Health also requires a retail food establishment license this is the same license at a restaurant has to have for day care wants to provide services for more than ten children. So if a daycare wants to provide services for more than ten kids they have to acquired tool licensure DHS licensure and our restaurant food establishment license from the department of health meeting the requirements for that food establishment license can be difficult and expensive requires retrofitting of a home and many in home daycares are prevented from being able to expand their services so this bill simply does one thing it amends number of children from ten to twelve so the day care providing services for twelve or for your children is exempt from that retail food establishment license modifying this regulation makes it easier for day care centers to expand their services provide more opportunity for working parents in their communities a provide services for two more children potentially helping up to two additional families it's up to both the department of health and the provisions services on this bill and they didn't have any issues with it it passed the house ninety eight to zero and I hope that you'll give me a good vote. Members anyone have any questions Senator of. Motion to part time okay. Members any other questions. Anyone here to speak for against the bill. Seven nine senator you're welcome our representative you're welcome to close for your bill closed. Which will committee you have to do pass seven second all in favor say aye. All opposed. You pass the bill congratulations. House Bill house bill eleven seventy three anyone here to run that. No one House Bill sixteen forty six. If you would please both introduce yourselves Senate minority leader sales thank you Mr chairman. State representative Richard McGrew District eighty five. And you may proceed. The. Thank you chairman comedia bring you house bill sixteen forty six it's really very simple bill but a very important one all it does is said that when public money is concerned it's only on public money that. In the bid process that the engineer allow three be expecting three separate Leding agency nothing has to change in the. In the design the only thing that have to changes when the. Right now. Some engineers are limited to one leading agency so it allows no competition at all. So all this does is require and at that point when they're putting the design out to put a note that they allow the three beats back from three separate lighting agencies just that simple and it allows could top competition an example of this was there's a job beating currently over House Franklin high school that only group allowed one Be at when they heard about this be it they let another laddie if you beat it so it's creating competition when public money taxpayer money is being paid it's being a good steward with the taxpayer's money I took this bill to the architects association they knew what was going on they approved it and they support this bill. And that's all I have. We do have someone here from the architects association. Okay members having questions Senator love. Thank you thank you Mr so representing the crew are you saying that. When they put the project out for bid that they're only taking one B.. It's C. yes it's or not there is there nobody being no the project you have to understand the process this is the world I come from so when the engineers designing so you said thank you it's a school building when the engineers designing the light fixtures in the lay out okay he lays that out on the drawing any puts on the drawing a picture schedule details what fixtures picture a B. and C. is Hey he uses a catalog number that may go with a specific brand and leading agencies there several in the State of Arkansas they represent a wide variety of the brands of lighting fixtures so when that Latinx fixture schedule is put on the drawing the other agencies even if it's not their schedule the other agencies have the ability to look at that catalog number and know what laughter Committee as what's happening now is the engineers in conjunction with those leading agencies are not accept they're not and they're saying we're not accepting an or equal. we're only accepting that particular brand. And they're by limiting the others not lead not letting the other ones prices this is before it gets to the contractors as before so that price is giving to the leading distributors to supply houses. And then the supply houses give it out to the contractors are bidding a job. In this case. The school has a project in the engineer the electrical engineer is. Putting together his specs right so. If it's what the school chooses. Then. Well I just I'm trying to figure out what the issue is. If it is this is a product the school chooses then what's the what's the problem. What limitations plenty to you this way okay your design in the House okay you're designing it and that in you say you know I'm putting this project out for bid and you go by your shingles and wood anywhere you want to be even though you can buy these live pictures from any hardware store Hasm. I'm going to say you can only back from love hardware store even though they're pressed a lot higher you can only buy from them but this is doing is saying you have to allow the other suppliers to be able to put out prizes for this project and it's the same qualities sign and has a lame but is it the same product right this does not say you have to take lowest prices did not say you have to cut quality it's equal for equal you know it's a PPO you've been a lot of schools get to before live picture the sealant it looks on you make set to perform live picture Williams makes several brands make it it's a pretty standard for the industry so it's saying that you let those other people price said what's happening now they're saying only let down yet or only Williams can press that we're not only anybody else press it. So they're fixing the press gacan at the prices and cost to the taxpayers a lot of extra money back killing the competition. All right thank you. Members any other questions. Thing And we Havanese one signed up to speak for against the bill. Systematics. The. Yes are you Mister Maddox yes okay. Yes. If you would introduce yourself and you may you're speaking against the bill correct that's correct against the. My name is Josh. My name is Joshua Maddox I represent a line agency. Speaking against the bill okay I prepared a few statements just I'd like to read and then I'm available for any questions you might have. thank you committee for allowing me to speak my name's Johnson Maddox as I've already said I represent allied an agency which is essentially the entity that this bill is going Speaking of. first what devise a committee there are existing laws currently in the state of Arkansas related to product specifications and procurement. From the Department transformation Sir services division of real and authority minimum standards and criteria effective October twenty twenty two there are four options for specifications first being a general perform specification so this would be a specification that describes a product's characteristics like size wait what is consumption optical distribution this case which would deal with lighting and this type of specification is open to all agencies not everyone all agencies bids provided they meet the specification standard. There's a second nonproprietary specification listing at least three different manufacturers a model numbers this is commonly practiced biological engineers within our industry now. There's a third nonproprietary specification that list to manufactures and the statement for equal in this case the engineer may only be able to identify to manufactures but is not limiting in any way the bid list only to those two. If an equal product is submitted for a bit it must be approved this is a very broad and very competitive strategy as it does not limit the number of agencies that can answer the best. Lastly how will state that there is in narrow circumstances an allowance for proprietary bits but this only deals on special occasions circumstances like space limitations. Compatibility with existing systems reading campus standards would require this in this case the bids or typically owner furnished. The items on first. A second law department finance administration state of Arkansas procurement laws and rules dated March sixteenth twenty twenty requires maximum practice civil competition. All specifications shall be drafted to assure the maximum practice will competition for the state's actual requirement and this is stated. That that is a quote. So in my opinion this bill is redundant and potentially will conflict with previously stated loss. It might in law house bill sixteen forty six will result in less competition in the State of Arkansas as it stands today there are no less than eight independent land agencies all of which depending on project specifics currently have the opportunity to be at all state county or school district projects on the previously stated loss the narrowness of this bill will limit the competition to only three only three we currently have eight. I have personally been a part of allied industry for over thirty years I've never in my thirty plus years in a state county or local school district project for competition was not allowed. I day pursue that and build work in the spirit of competition and this is important my competitors also day pursued and bid on the same work in the spirit of competition. In conclusion while I wholeheartedly appreciate representative groups passion on the subject I ask the committee to recognize the laws currently exist in these laws provide for broader competition that house bill sixteen forty six will allow for. The end result will be more harm than good in my opinion. I'm available for any questions. Thank you are there yes Senate senator love you're recognized questions thank you ma'am sure so Thank you in the room you for the example that I gave representative McGrew so from your from your standpoint. Explain to me what what actually is going on in this process he stating you know what you're what you said so just respond to that yes so Mr group states that he has the architects approval for this bill which that that could be debatable as well but wait doesn't understand or doesn't represent here's the engineer which is the entity that is targeted so the engineers are in fact the ones the the professionals as I was saying there there licensed professional engineers are the ones tasked with the responsibility to write the specifications. So when is the right to specification he is he is assembling all sorts of information how many watts per square foot campus building required how many lumens how much how much light levels do I have to have so as a whole host of requirements that he may or she may go through to determine the. The lighting fixtures and there could be literally hundreds. A different line items of fixtures for any given project so there's a lot of nuances to going to the design and then as it relates to bids. I have five percent of all the few projects only a couple few that may St this is the only thing we can have and I'll specifically say that may be the University of Arkansas campus standard for outdoor lighting that may be the the university for Smith they also have a campus center for outdoor learning other than that I'm not personally aware of any state local municipal project that would say you can only provide this so in my opinion that's a mis characterization. Any other questions from members of the committee. All right C. nine anyone else here to speak for against this bill Mike Holcomb at. Okay if you will come to the end of the table and and. Try not to repeat whatever was already set and bring new information for that would be fabulous for because of time issues. my name is Mike Holcomb representing AG say and car power corporation of which I'm president of car power corporation. Just to state that I support for Josh would say it is a hundred percent accurate high Hey of you have a list of several architectural firms in engineering firms who are opposed to this I know the I a has come out of for it but there are met there are several members of a who are not for this Cromwell Steve. A problem well architects W. E. R. R. P. P. Y. A. M. R. Polk Stanley modus call for prime engineers H. P. engineers crafting toll and any yes in engineers have all been asked about it and they have stated they are opposed to it there are many electrical contractors that I spoke to that are opposed to it some of which are some of the major contractors in the state one would be on Blevins electric Thompson electric car power corporation and Thompson electric and. Cambridge electric. So there is opposition to it okay. Thank you senator live you're recognized for a question all right so let me issued session this one. The. Representative Michael is trying to address an issue. Would you say the issue did not exist. I would say the issue does not exist because I firmly. What. No you talked the the issue in my opinion does not exist. The plans that come out there is nothing indicated all in or on the plans that says this is the only light fixture package that will be approved nothing is ever say at except if you're if you're adding on to an existing project where there's an existing fixture that has to be matched say site lighting or or any kind of specialty lighting this is what the owner of the project has chose. The in my opinion this is what he's entitled to purchase. All right thank you Sir. Are there any other questions from members of the committee. All right thank you so much thank you. The night okay and you're recognized to close for your bill. Thank you madam chairman. I will respectfully disagree I met we keep which electric is one of the bigger contractors in Arkansas about this bill personal friend of mine we should at the table with a at and representatives from the When the organization is part of. And he added looking by city you tell me this don't exist at this and I said no I agree with you admits it's crooked in its corrupt. But this is going to hurt it works and I said Hey I want to explain to me if you can give me something. That shows me how this would make it worse I'll pull it down or I'll change it but I don't see anything please show me and I gave him my cell phone number this was last Friday if you come up with something over the weekend I think what they did do is gather the troops against me and whether this passage or not this is a real issue I've been part of a project revealed Maddox did limit the competition to raise the price up it easiest it's happening today it is getting worse and all they see is is asking for a simple three be expected and so you have to be limited to three you can take more. It's a very simple bill this section we do the right thing with taxpayer money. And I'm close from a bill. Thank you. All right what is the pleasure of the Committee. Motion to pass is there a second. I don't see a second unfortunately it died for lack of a second thank you. Senator Flippo. Think about chair Senator Scott Flippo district twenty three About house bill sixty one the center Bryant ran earlier and manager going to make a motion to expunge the vote by which that failed. And I'm not sure the rules are so I just need to do that okay you don't need to do that okay the managers re run it okay so we just or the explanation from senator Bryant on on this it all is this is that state agency or government from the ministry an enacting or enforcing guaranteed income program I take any questions but bill projected vote okay are there any questions from the members of the committee on this bill this is house bill sixteen eighty one we're revisiting that okay any questions all right C. nine you're close to what my bill okay in your I make a motion to pass motion to pass and second all those in favor say aye. And opposed okay Is happened. House Bill sixteen eighty one passes. Okay Representive Aldrich let's do the one we haven't heard yet. As I'm trying to get all these out much as we can. Which one are you doing. Okay. Which one are you doing eleven seventy three okay two eleven seventy three thank you madam chair there there are for representive eleven yes ma'am thank you madam chair members of the committee thank you for allowing me to come down here in this bill for you this is a totally of agreed upon bill basically repeals that prohibition on LP licensors to try to meet the need for testing in school systems there was some debate on independent status and what that would look like but the bill has been amended the independent status and sets at the end of twenty four so there won't be any new people is that independently licensed in twenty four allowing the current independent license be grandfathered in so nothing changes there L. P.'s agree psychologists agree so with that I'd take any questions. Okay are there any questions from the members of this committee on this bill. Any any questions. All right C. nine anyone here to speak for or against eleven seventy three. Okay C. nine oh eight your clothes for your bill yes ma'am what is the pleasure of the Committee motion to pass second. Is there a second. Second all those in favor say aye. And oppose ayes have it congratulations you've passed your bill thank you madam chair thank you members of the committee okay. Represent Wilder's feel come back to the end of the table. House Bill fourteen forty six. What as so just state your name for the record we're gonna go right back to the top house bill fourteen forty six now that Jeremy Wilder's District one. Okay go ahead thank you madam chair members of the committee thank you for the opportunity to bring this bill back to you be real clear with what this bill does so P. R. T. S. of this I can't psychiatric residential treatment facilities I am a licensed mental health therapist I'm an LCSW been in the field for about sixteen years and just want to bring your perspective on this bill I know the committees heard it once I know they're gonna be some folks here that are going to testify against and I'll let you guys here that a make the decision that you think is the most appropriate by the what you to understand the importance of this bill and the importance of what I perceive the state of Arkansas being intellectually consistent when we talk about treatment for a mental health patients and we talk about the severity of mental health in the crisis that we face our nation I think that it's fair to say that we want to make sure that outpatient services reflect the in patient services and vice versa so currently an outpatient services a client comes to me I'm a therapist and I'm providing that service they're gonna get their P. two to four times a month typically and we're gonna try to manage the system those symptoms because we want people to be in their homes we want children to remain in their homes we want residential care to be a last resort because if you think about residential care and you think about the requirement of what it takes to meet that threshold these children are suicidal or homicidal and they're being placed in a day treatment hospital away from their families at a cost of somewhere at a minimum of around three hundred eighty to three hundred ninety dollars a day for three to five to seven days depending on the severity of symptoms outpatient symptoms are managed reimbursement is typically around ninety dollars an hour and again you're gonna get four hours of therapy a month roughly forty five hours of therapy month so a month's worth of therapy is about the price of a day of residential care and in Arkansas I believe that both services are wonderful services alchemy and the folks that are here to speak up on the bill for the services that they provide. What I think this bill is important but I think that we need to think about. Is the level of regulation for outpatient versus the the level of regulation for inpatient currently to be a behavioral health outpatient facility of hate behavior health agency in the state of Arkansas you have to be Jaco or car certified just like a hospital you also have to have DHS quality of care oversight to make sure the services that you're providing our quality services for these kids are coming to seek services that is what this bill request of you for P. R. T. F.'s so would also addresses some other issues that are important for the state of Arkansas currently out of state kids are being placed in our P. R. T. S. in our hospitals by their parents if their parents do not come to pick the children up they become a ward of the state of Arkansas that cost the state of Arkansas not only for child care they go on to our foster system DHS deals with those children so there is a substantial costs there this bill changes that to say that these children are going to be placed in our PR TS are our hospitals by their state by Medicaid in their state or their state provider that way when they're discharged from services here they will be given back to their state if the parents if you refuse to fail to can get those children so I think that that is a substantial change that's a that's a good change for the state of Arkansas and then when you dress the quality of care and other issues that this bill addresses I believe it's a good bill and be happy to answer any questions. Thank you are there any questions from members of the committee senator Sullivan you're recognized for a question to you and I've talked several times yes Sir senator position and the work you put in on this at this point go on record as I just have concerns that the supervisors of this program I have been trying to bring some of these problems in for years and the problems that you're dressing are not new at all and they failed to do that and I don't know that divisional legislation changes that but I appreciate the hard work you put in on it and I will see what happens sure Senator I appreciate that if I had an opportunity to answer that question I guess I would do it In a way to say if outpatient services regulations are here in patient services should be here or greater because these patients are more severe currently they're here because they share that join date that Dzeko certification they're coming and they're checking the facility there checking doors are checking exit signs I've been to several of those but there are Bob I agree there are maybe some quality of care metrics associated with Jaco have an additional layer of quality control DHS is our current person to provide that service and whether DHS is the right fit or not I don't think I can speak to that DHS is all we have and as a state we entrust them to make these decisions so I think that that from an intellectually consistent standpoint is where it has to fall the regulation should be the same currently there's no quality oversight for by DHS and I believe that there should be. Thank you other any other questions from members of the committee. Right C. nine thank you so much. Mr might Mitchell and we've heard from you before but we want to bring you up here and state your name for the record and you can speak against the bill. Thank you madam chair Mike Mitchell on behalf of pinnacle point hospital Nothing has changed in this bill since it failed not once but twice before in this committee and the reason it's failed is because it would impose on an undefeated set of second regulations on hospitals we don't have a problem with the regulations a PR T. apps but when you read the bill it also covers hospitals and that's our that's our objection to it up hospitals are already regulated by the health department this would put a second layer of unneeded regulations by a second agency on hospitals it It is baffling to me why this bill was not amended to aim at BRTS that's what the problem was that generated this bill there's been no problem with hospital care and yet at hospitals are are included in this bill and that is our proposition on behalf of pinnacle **** but on the other hospitals thank you so much are there any questions from the members of the committee. Right and just for clarification purposes the bill did not failed twice and at one point it got one a motion and then and it died for lack of a second and that is equivalent for us passing over the bill so technically it did not failed twice so thank you Sir yes all right any other questions for members of the committee art scene and you're recognized close for the bill thank you madam chair thank you members the committee and I would I would speak to that briefly to say that. The location of the service should matter PR TS are independent outside a hospital providing the same services that pinnacle point and other hospital setting services are providing so when you talk about quality of care quality of care should match the the children across the board that are seeking the services being located inside of a hospital being located inside of an independent facility should not matter we're looking at we're looking at quality of care for the services provided and again these clients are the most critical of our state and the most expensive service that's being provided of our state so I think an additional layer of just someone looking at it and saying Hey we wanna make sure that a quality services being provided here for what we're offering is not too much to ask I've also reached out to the hospital association they're not here speak against that they're neutral because it has been stated in the bills and it will be done and regulation that when there is a discrepancy Jaco or the accrediting agency will supersede the quality regulation by DHS so that will be part of the rules just like it is for outpatient behavioral health so I with that I'd again take any questions but I'm close from a bill thank you madam chair thank you members of the committee thank you representable dredged what's left of the committee. All right no motion. Sorry thank you. Okay and members I know we go in at noon so is there anything that we need to run right now Senator void. Yes. I mean I know that representive Cooper's bill is super simple and. He's already run is okay sorry I was out of the room at. Senator void go ahead yes. You have what I sent you. Senate senator Justin Boyd run in house bill sixteen sixty seven this is a very simple bill it it goes back to a bill that we passed earlier in twenty twenty three that's now ACT one ninety eight regarding road residential assisted living and what it does is it just causes a report to be provided to the legislature so the legislature can have some over site as well. All rights are there any questions from committee members of the committee. Is there anyone here to speak for or against this bill. C. nine your beacon because for your bill closed I'd appreciate a good vote and make a motion to pass motion to pass their second second all those in favor say aye hi and oppose ayes have it house bill sixteen sixty seven passes. Senator void if you'll stay down there and run. House Bill. Seventeen thirty four four I think seventeen seventy eight as a companion bill to my Senate bill. Seventeen thirty four real quick. Almost. Thank you senator Justin Boyd District twenty seven this is an act to amend the patient right to know act and it provides some intent of the General Assembly and then just Updated prohibited conduct if the healthcare provider who is reflected in his or her practice provides written notice healthcare provider's new practice location or contact information via certified mail to this C. chief executive or administrative officer. Happy to try to answer any questions. Are there any questions from the members of the committee C. nine anyone here to speak for against this bill C. nine you're recognized close the Bill. Close was the pleasure of the Committee make a motion to pass motion to pass second all those in favor say aye opposed ayes have it house bill seventeen thirty four passes Senator Penzo we're gonna go to House Bill seventeen eighty six. I'm not gonna take that motion. Clint Penzo district thirty one house bill seventeen eighty six pretty simple bill just says that the any any abortions that are done to save the life of the mother must take place in a hospital emergency room That's that's the bill. I. Any questions of members on the committee. C. nine. Anyone here to speak for against this bill. C. nine you're recognized close for the bill closing as for good vote all right second all those in favor say aye. And opposed. Is have it resolutions you passed your bill thank you Committee. do you want to. About this other Pilkington bill my house bill seventeen seventy eight. Is a companion bill. To the Senate bill that we've already passed on graduate medical education residency expansion board I don't know if we need to pass that or not but. Okay. Just take a chair from there okay here. This. The past. Okay. An. I'll just go down. This Is Senator Missy Irvin district twenty four house bill seventeen seventy eight This bill is a companion bill to the Senate bill we've already passed to amend the composition of the graduate medical education ex presidency expansion board to include the definitions for So that. Change the definitions for the medical school institution so that all for now As schools would be able to be qualified for this. Members anyone have any questions. Just re works the appointments. Say no questions is anyone here to speak for against the bill. Seven nine Senator you're welcome to close for your bill I'm closed I make a motion to pass I have a second all in favor say aye. Opposed graduations your pastor bill. Members of the to have conversation right here so give us just a minute and we'll move forward. Representable ridge. So members it because this bill welcome back to fourteen forty six because this bill did not get a motion it's as if we passed over it so it technically has not been killed twice. We've heard it a million times but I'm going to go straight to Senator Solomon he asked me to do this and difference by vice chair Senator Solomon state your name for the record and you're recognized for Dan Sullivan district twenty. Jeremy Wooldridge representative district one members we have heard this bill multiple times and I'm just now understanding what we're trying to do so I'm going to speak in favor of the bill right now I just talk with with DHS. And asking DHS promulgate rules that increase the quality of care. And car about the issues that happen with maybe pentacle are others so a pentacle has a special situation DHS can write the rule to carve that out so there's no conflict right now there are no rules that govern quality of care only Jaco I've dealt with Jaco and all those other groups and although they are there they do a lot of good things and they provide a lot of things and from all confident in them there are things that they don't do and this would give DHS oversight to write those rules right now no one in state government and DHS department health none of those groups have the authority to write the rules. so I'm speaking for the bill I hope will consider that because I think it's a good thing for DHS to step up and write those rules and we will probably get those so we'll be able to make sure they have those carve outs to do what we want so given all that I'd be glad to answer any questions. Thank you Sir are there any questions for Senator Solomon center live you're recognized yes I don't know if it's questions that even this is just perplexing the million the reason why. So nobody has been doing the quality of care checks at all just nobody. All these hospitals no one has done quality care checks is this entire world I mean the the. J. code us the national certification I'm familiar with check on but right now we don't have the no one has the authority of the state are you with or do they have is to make sure you're being certified by Jaco. And if and that's a good thing but there are other. Quality issues that we need to occur and I think there always are because Jaco only math does certain things and if we as a state want to require different higher standard then we there's no agency that has the authority to do that and we need to give that agency the authority to do that under our legislative oversight. Thank you. Thank you thank you for that information any other questions from the members of the committee C. nine your clothes time clothes and make a motion to pass motion to pass second of all those in favor say aye. And opposed ayes have it. Fourteen forty six passes thank as amended I'm sorry it's a do pass as amended thank you the only other bill and we have senator Boyd is quickly going to do house bill seventeen thirty two I promise senator Patty this is a companion bill to the Senate bill that we've already heard. Okay a year immediate consideration senator Justin Boyd district twenty seven I'm running house bill seventeen thirty two for Senator Petty we've already heard this in essence twice this is the whole seller bill there was some opposition raised by HTA but we passed it out of here overwhelmingly and passed it off the Senate floor overwhelming only in the Senate version and so that's really all I have to say you have a question okay thank you so much anyone here to speak for against this bill any questions for members of the committee scene nine motion to pass second all those in favor say aye hi and oppose ayes have it congratulations house bill seventeen forty two passes and I think we're going to be done we may come back if their bills I think there are some bills still to be read across the desk I know that Mr divine house one so we will come back for a very brief meeting for some of the other bills with that we are adjourned.