Public Health Welfare and Labor Committee-Senate and House
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Speaker 2
0:16
continued to rise through targeted marketing and flavored products and Arkansas44% of high school seniors have tried vapinglavovos like fruit and candy apparently directly to young people while social media makes vaping seems normal aping among Arkansas students and now more than double traditional cigarettes is used we must act to protect young people from these influence
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0:50
Good afternoon. my name is xana Torres vaping does not only affect the user vape aerosol contains nico nicotine heavy metals and harmful chemicals In
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1:08
Arkansas over 10% of adults vape increasing exposure and published spaces children and family should not be exposed to the subs and
public clean air should be protected for everyone.
Speaker 8
1:26
Vaping is disrupting our schools students are using devices and bathrooms and classrooms affecting learning environments in Arkansas7% of sixth graders and 22% of eighth graders have already tried vaping schools are spending time and resources addressing this issue this is both a public health and education concern. aping harms your brain primarily
through high concentration nicotine which alters the brain chemistry disrupts development especially under age 25 in impulse control while risk of anxiety and depression and mood disorders. a dictionary wooing nicotine and vapes changes the brain chemistry creating a reallance on nicotine for pleasure Do name release which leads to addiction innerability and restlessness but not vaping.
nicotine increases dominate a chemical messenger that uses users feel awarded creating a dependency where the brain requires nicotine to feel normal aping can heighten stress and trigger separate mood disorders and users often experience brain fog reduced concentration and impaired mem Many students feel pressured to try
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2:49
and do and try it and some become addicted quickly. This is
not just data. this is our everyday experience we are asking for your help to protect students like us thank you we respectfully recommend prohibiting vaping in all public indoor spaces aligning vape laws with smokefree laws and increasing prevention efforts Arkansas has made progress in tobacco control. now we must include vaping. We urge you to take action to protect public health
Speaker 12
3:27
Vaping is impacting the health and future of Arkansas's youth. We respectfully urge you to support legislation that prohibits vaping in public places thank you for your time and leadership. in closing in closing
Speaker 15
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and I just wanted to take the time out to thank thank you all again for giving us time to bring this very important concern to you it is whenever and hit your button sorry go ahead we just want to
hear you talking to gymnasiums full of kids and I have a loud voice but yes this is a very important concern and we are so happy to be here today and let me just take a mention that today is april 1st but today is actually take down tobacco day so we're here to fight for our community in Arkansas for better laws to help protect our future our and our communities we receive a lot of calls and complaints from people who are not able to enjoy movie theaters or public places
because there are people who are vaping and and most people seem to think that vaping is harmless or less harm harmful as normal tobacco smoking but research and studies found out that vapes actually contain 2,3 and up to4 times just depending on the brand of tobacco or vape e cigarette that you're using it has 2,34 times as much nicotine as one pack of cigarettes for
example one vape pod has40 grams of nicotine in it one pack of cigarettes has 2 g of nicotine in it and some of them can vary up to 80 and 90 gms so which is which is the reason why people are becoming more addicted to vapes at a higher rate because they're getting introduced to more nicotine at once and you know it's concerning when I get called to an elementary school because of fourth graders having problems with vaping and I have to offer cessation materials counseling and other
resources that bewell Arkansas offers through the Arkansas department of Health so we just thank you so much for listening to our concerns today and thank you guys Project Prevent we did it thank you Thank you guys takes a lot
of courage to sit at that table he, before you guys
leave I just again want to say our we are so
grateful to you. It took a lot of courage for you to come and speak to us. You did an outstanding job articulating your position and advocating for your your cause. so we you know thank you for that and we hope that you continue to be successful and we hope to see you back if there's legislation you'll have to testify for it in the public healthal committee s during the session. so
make sure you're prepared to do that as well if that if the legislation that you're working
hard on continues but don't stop here, talk to your neighbors, talk to your communities get a lot of people on board and start building support for the legislation that you want to see passed by this general assembly. OK? right challenges on let's do it p re s ent ative Bartchultz chairman you had a request yeah I'd just like to take a moment to recognize
Speaker 28
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our friends from leadership Batesville who were in the room. Members if you would help me feel welcome make them feel welcome.
thank youpresentative with that we'll move on to the overview of the rural health transformationgrame. Secretary
Hudson and Bradner I'm guessing the secretary was scared
you couldn't handle it so he came to help you
Speaker 35
7:39
ru e afternoon mis Chairman Jimhudson secretary DFfa and you know number one rule in public speaking is don't follow cute kids so I'm
Speaker 36
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I'm violating my number one rule now good
Speaker 38
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afternoon committee. My name is Brad Nny. I'm the director for the rural health transformationgra and
Speaker 39
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I report up to Jim Hudson at the department of finance anddministration. So I'm recognized miss mis
Chair
Unverified
8:10
Chairman first I wanna thank you and don't think Senator Irvin we've had lots of conversations about this program and we thought
it'd be a great idea for us to come over and just spend a little bit of time making sure that you have all the information you need to have about this new and and very very important program that we'll be launching here in Arkansas the rural health transformationgra I'm gonna s kind of really set the stages for a few minutes I'm gonna turn over Brad he's he's got the details he is running the program out of DFA and he's he's doing an exceptional job just a little bit of history this this came about through the one big
beautiful bill last summer a program that was set up you know the roughly50 billion dollars to be allocated amongst the states to have programs focused on improving rural health throughout the country but you know especially here in Arkansas for our concerns and you know we went through a process of soliciting some feedback from stakeholders here in the state we wrote a plan submitted it to Cms in Washington DC and then we got our notice of award of about $209 million for our first year
of operation and if we were to maintain those amounts through all five years of the program that mean we'd get about a billion dollars40 million billion dollars40 million over those five years my my goal is for us to actually do better over time this is a formulad driven project so based on how well we do in our first year of operation will determine how well we get funded in the 2nd year and3rd year and fourth year and5th year. so we want to excel coming out of the gate do a really good job because I'd love for us to get more money next year
one of the things that I'm particularly sensitive to from your perspective is just thinking about what this program is and what this program isn't for those of us who've been around for a little bit we remember all the funding rounds that we did withARS act money and with ArRpa money and I think it's fair to say there was just at times as frustration about the process and maybe at times not enough transparency in the process and how do we get access to the money and I think different stakeholders you know felt like maybe they didn't have an
opportunity to kind of get get in there and get access to the money it is really very very important to the governor it's important to me personally that we have a transparent process and by transparent we're going to tell you we're going to tell stakeholders are all throughout the state what money we're getting ready to release what that money is for and how you access the money right and and the important thing that as I'm talking to hospitals and talking to you know clinics and
physician groups is to draw a distinction you know before we're dealing with arpa money andazac money, the conversation was something like this we have x amount in financial need how much money can you give us and that's a very legitimate conversation but that's not what this program is this program has very stringent requirements from the federal government as to what we can do and what we can't do and one of the things that we can't do is just provide working capital needs to the to the
hospitals and to the clinics and to the physicians we've got to be very targeted in how we approach releasing the money and I would say that it's more focused on the overall health of our kansans than it is being pointed at particular institutions now we help the health of ourkansans by making sure institutions are giving them what they need to have better health so it is a partnership but really the focus is what can we do to move the needle in terms of the quality of health outcomes in the state
of Arkansas and this is really is one of those opportunities that is once in generation we may have to have a conversation at some point about you know the funds are tight. I'm just not expecting that's gonna be the case I really don't I think the the question is can we spend the money fast enough and can we spend it wisely enough that's really what I'm dialed in on. So Brad that's his number one job we talk about it all the time don't let us do anything stupid we don't need to do anything stupid let's make sure that we're moving the money out the door and we're really
getting it to those things that they needed and so big picture I'm just give you a couple of things to think about from from your perspective as you're talking to members of your community one if you if you look at our plan I encourage you if you've not read our plan please read it you can find that at dfa.arkansas.gov we'll make sure a link goes to staff and they can send it to you it's over 100 pages so they probably won't print it out just read it online but we're up front with what we're gonna fund what our priorities are but there's a tagline that we have there that introduces that plan and the
tagline is Arkansas healthy connected, local. those three words are more than marketing they really set the stage for what we're trying to do the focus is on health you know we want to be able to say at the end of the next this next five years that the efforts we put into this program led to better health outcomes in Arkansas for example, we we struggle mightily in Arkansas with chronic diseases what are some specific initiatives that we can do to help with chronic
disease management. for example, helping people monitor their blood glucose levels, monitor the blood their blood pressure if they have congestive heart failure the things they need to be able to do to be able to address that. those are example s of things we need to do. how can we leverage technology to be able to help rural Arkansas. the next thing is connected and and really that's one of the big emphasis that we have right now our healthcare economy is very fragmented. there are lots of pockets of isolation what we have to do is figure out ways to better collaborate
across regions, OK? so that you know we have multiple counties that are partnering together in order to be able to solve healthcare crisis that we're having to face in our state so we'll be funding initiatives that really will encourage collaboration where you can have hospitals that maintain their autonomy but they're also partnering with other institutions and getting some of the benefits of being part of maybe of a larger system without actually formally joining a larger system those are the things that we're gonna be talking about doing and then
finally local I'm not a healthcare policy expert. you know I live in the finance area the governor asked thefa to take a lead on this because we can run the program pretty efficiently. I don't need to take an admin share on this program so we'll be able to do that and maximize the amount of money that's going out the door but I'm very very concerned that the governor was exceptionally concerned about us trying to impose solutions on local Arkansans we don't have the
answers you have the answers your constituents have the answers they have the most at stake so we want whatever we come up with and what we're funding to be let those be locally driven initiatives we've got the money we'll vet it we'll make sure it makes sense it meets the Cms guidelines and then release the money and then let people go do what they're best at doing treating patients and improving healthcare in Arkansas. So with that I'm gonna turn it over to Brad and I'll be sticking around
Speaker 46
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as well if you have any questions for me after he's done. thank you secretary.
Speaker 38
15:28
so just piggyback piggybacking off of what the secretary just talked about you know we are extremely
Speaker 39
15:38
focused on local solutions kind of a ground roots grassroots approach to healthcare in that vein I'm just getting off of a couple of weeks ago a tin city road show around the state where we did a little deeper dive into the rural health transformation program then what I'm gonna do
today today's more of a 15,000 ft level but the at the end of my slide deck there is a URL for an Arkansas RHTp website and we'll have the more detailed slide deck there available so if a constituent in your district reaches out and would like a little more information they can you can certainly refer them to that link but also I'm I'm taking I think the secretary just alluded to this I'm taking meetings daily from hospitals from
community providers from faithbased groups from vendors anyone that is in the healthcare space to to visit with them about their ideas about where they see themselves fitting into the state's RHTp program and providing them a little back and forth technical assistance so so I encourage you if if you have folks reach out to you along those lines you know feel free to connect those people to me I'm happy to have those conversations so RHTp as as the secretary
Speaker 38
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alluded to and and I've got a again a 15,000 footle kind of a slide deck that I'll go
Speaker 39
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through Jim's a much better public speaker than I am I really prefer more of a back and forth with questions so I'll go through about 10 slides here fairly quickly I've been living and breathing this program nonstop the last about three months now so if I gloss over something if you have questions with permission of the chairs I'll certainly entertain those at
the end but thank you so as the secretary alluded to the rural health transformation programme first came into being with an act of Congress last summer with HR one more commonly known as the one big beautiful Bill Act as he mentioned it was it is a50 billion dollars set aside across five years for all50 states to look at improvements to access workforce prevention and sa sustainability
in healthcare um50 billion across five years that's $10 billion per year and each state was required by CmS to submit an application and by submitting an application each state was able to access half of that award money the other half of the award money was a competitive process where Arkansas competed with all50 states and then based off of how
excited and impressed Cms was with our plan they adjusted our award accordingly so as the secretary mentioned we received about $209 million which puts us in about the top 13 of the money that all 50 states have received so Cms is excited about Arkansas's plan they have high expectations for us and we're excited as well but as the secretary alluded to I'm not a clinician you know my
entire career has been healthcare adjacent but I'm certainly not in rural Arkansas providing services we need this we need you to bring ideas to us. back in october our governor put forth a portal asking for ideas around rural health transformation we received a lot of great ideas some of those were turnkey projects they were shovel ready and that's wonderful some of them were more think
tank type ideas that still need a little bit of work to become an actionable plan and so what we've decided to do is those proposals back inoctober we helped those formulate how we built out our plan and submitted it to the fed to the feds but we're treating that as an RFI and so what we anticipate doing and I have a a slide on this and we'll get into it is we will issue a series of notice of funding opportunities no foes will we seek
shovel readyad ideas from applicants for each of our four initiatives I'm about to talk through and when we get those applications in again this isn't a a situation where money's a scarcity this isn't a competitive grant process we're looking for ideas that provide us with a solid plan a program narrative a budget and help show us where it fits into our four initiatives we want to get to a yes when we receive an application
so there will be a lot of back and forth that I provide and that our team provides with applicants to help get to that point so let me get a little bit more into our vision. let me get into our four initiatives and we'll talk a little bit more about timing So Arkansas's vision for rural health as Jim said it it can really be summed up as healthy connected and local. I think that's a wonderful tagline I think that is the spirit of the plan
but we're looking to redesign rural healthcare again not just about facility stabilization but really about prevention connectivity and long term sustainability we are trying to tie the dollars we used to RHTp to the broader goals of healthier children, stronger families, workforce participation and local economic resilience. we're asking folks that end up applying to be partners with
us in this program to think of this not as a one time grant not not like ArRpa, not likeARs but as a multiyear transformation opportunity five years with RhTp but then the goal of sustainability post five years for true transformation in Arkansas healthcare. So Cms set
Speaker 38
22:07
forth some very specific goals that they wanted to see with rural health transformation and Congress
also with the language of hr one had similar requirements so Arkansas came up with four key
Speaker 39
22:23
initiatives those initiatives very closely mirror what's required of us at the federal level but also lets us put more of a local Arkansas spin on the way we deliver healthcare. within each of these four initiatives that we'll talk just a little bit about there are69 sub initiatives and so the way I lead off every conversation I have with a
perspective applicant is exactly what Jim just alluded to have you read our plan? we encourage folks to go out and take a look at it see which
Speaker 38
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of these initiatives speaks to you that you think you can be transformative in and then have a conversation with me about about that
Speaker 39
23:04
idea the first initiative were I I'm gonna try not to read the slide deck to you guys. I've I've sat through plenty of presentations where I'm read to and that's just miserable so we'll we'll try to ad lib just a
little bit the first initiative is our heart initiative and this is really about prevention and community health this is really focusing on children families and chronic disease prevention. within the heart initiative which has a lot of the make America healthalthy again type language we're looking at ways that we can help people get access to healthier foods we're looking at nutrition healthier nutrition options for kids that's our grow kids initiative
within that same initiative we're looking at schoolbased clinics schoolbased education that heart initiative has a farm initiative which is looking at how we can help Arkansas as an agricultural state how can we help bring fresh produce into Arkansans lives and help them learn how to cook it. helping Arkansans do things that we've forgotten how to do like how do you grow a garden in your own backyard with produce that is suitable to being grown in Arkansas and
provides healthy options for you and your family where we have a move initiative which is about getting folks in rural parts of the state more active active healthier lifestyles we have a faith initiative which we're really excited about which is about engaging our local faith leaders and places of worship as touchpoints for rural health in many communities there may
not even be a clinic or a doctor's office but there's a place of worship and when I show up into a small town and I'm wearing a suit like this it's that old adage I'm here from the government and I'm here to help but the pastor the deacon at the church is a trusted member of the community folks already reach out and interact with them and oftentimes they know what a family's needs are in the healthcare space much quicker than any of us ever would so very excited about that
a couple of other initiatives in there again we we've got quite a bit to go through but this is really school-based health chronic disease, food is medicine and valuebased the packed initiative is really more of our hospital and clinic provider facing initiative this is really around addressing access gaps in rural Arkansas. it's around care coordination and it's around again financial sustainability
Speaker 38
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this sub initiative includes mobile units using telehealth and
Speaker 39
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technology to help bridge the gap for folks in rural Arkansas moving towards clinically integrated networks and regional collaboration for our hospitals helping them with economies of scale by partnering with other hospitals helping them figure out what service lines make the most sense for one hospital that might make better sense for another hospital helping them
align how they operate we have workforce alignment we'll address transportation issues in this initiative and then again shared services and hospital stabilization is within that initiative the rise initiative as you can see is really our workforce facing initiative we're doing a lot of work there around establishing a training pipeline for
healthcarere related fields in rural Arkansas we envision starting in the K through 1el level we do a
Speaker 38
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really good job in the state of introducing kids to autobody and welding when they're in high school but I I think we could
Speaker 39
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do a better job of exposing folks in rural communities to the health professions that are available to them because I think we all know that homegrown talent folks that have roots in a community if they go off to school and they get a healthcare related education
they're more likely to come back home to the community that they know so we're very high on on that idea and finally the thrive initiative is really our technology facing peace around telehealth remote patient monitoring electronic medical record upgrades and and really
Speaker 38
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digital infrastructure as a whole. So rural health transformation dollars there are some allowable uses of money and
there's some unallowable uses of money. Again, I'm not going to read to you the slide deck, but I think the key unallowable uses of money that I wanted to highlight in Secretary Hudson I think
Speaker 39
28:19
already could did a good job of covering this is we we can't pay down debt or just cover operating losses this isn't one time money we're looking at transformation in healthcare long term sustainability nor can we cover routine facility maintenance or capital replacement and we can't
supplant existing funding I think one of the big disappointments for folks as HR one was working through in the rural health transformation programme was being developed at the national level was a sort of a last minute decision was made to clarify the states that we cannot use this money for new construction and I know I've had a lot of conversations with clinics and hospitals and and they're very
Speaker 38
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disappointed in that but I didn't want to point that out as as an issue
one thing that we can do in happy again to do some technical assistance with whomever would like to have it because we can do some targeted renovations so if a hospital or a clinic maybe has
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unused space that with a little bit of money and a little bit of sprucing up could then be used for clinic space we can certainly help with that so
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who's eligible to receive a sub grant through this program well it's it's pretty much anybody that you can think of that is healthcare related
it's it's not just the hospitals or the health systems it's it's your clinics
Speaker 39
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it's FQHc's it's your RHCs it's your EMS providers pharmacist university partners dental clinics you know this list is not meant to be exhaustive it's just illustrative but what we are asking of our sub of sub recipients go out and read our plan we will be asking for alignment with our strategy
Cms has made it very clear to us that now that our plan has been filed and finalized with them we can't alter the plan so the for initiatives with our69 sub initiatives are what Arkansas gets to work on over the next five years we're asking for a regional collaboration across all providers the more partners in application has included helps us get a better idea of how collaborative it is and I think the
greater chance of success and the more innovative an idea might be we'll be asking for helping with data sharing and with performance reporting because as you can imagine this is a federal program administered by Cms we have a lot of reporting that we have to turn around to the feds again a willingness to redesign care models back in my packed initiative we talked about I briefly talked about clinically integrated networks clinically integrated networks are are a wonderful platform
to help with back in support and to help with economies of scale but I think more importantly than that Cms views them as a wonderful platform for hospitals to use as a base to look at different ways to deliver care in different payment methodologies moving more towards valuebased care away from fee for service and prospective payment systems and again I think I've said it5 or6 times already but we're we're seeking a commitment to long term sustainability for healthcare in Arkansas
Speaker 38
31:49
so let's let's talk about program timelines here momentarily. yes sir
Speaker 53
31:56
thank you yeah I'm I am throwing a lot at
Speaker 38
32:01
you guys I hope you're hope you're thinking of your questions so the highle programme timeline there is on the screen you'll notice that spending for
Speaker 39
32:10
budget period one we are already in budget period one that began on December31st of 2025.
this is a five year program but we receive5 separate tranches of money and that money is tied to the federal fiscal year so the $209 million that Arkansas has to spend in year one must be spent by the end of the next federal fiscal year so by October of2027 that is a very very quick turnaround for Arkansas it's a very quick turnaround that we're
asking of our sub recipients but unfortunately that is those timelines are set in the legislation at the federal
Speaker 38
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level and they cannot skip to this slide along with the budget dollars having to be spent by October of next year
Speaker 39
33:10
we must obligate all dollars by October30th of this year obligating dollars means we have to tell Cms whom are
subgrant recipients are and how much money they're going to receive so as you can see this is a very quick moving program for year one with a very quick turnaround which is why we are are here presenting this is why I'm meeting with folks on a daily basis to hear their ideas and to start help helping them come along so that when we get to the notice of funding opportunity process in May and June of this year we'll have many shovel ready projects ready to go
Chair
Unverified
33:56
OK I think that's that's enough before we start taking some questions just real quickly appropriation wise we will have an appropriation request before the general assembly in fiscal session for500 million dollars that will roughly represent about half of what we anticipate the funding to be it's more than the 10 or9 because we'll be crossing federal fiscal years and so inFy27 will have two different awards we're trying to fund so we need the500 million that'll come to you then really
stress what what Brad said if there's anything that I'm worried about right now you know we've gotten approval with our overall plan but CmS still has some technical questions we're working through we don't have the money yet I hope to have the money in hand sometime in april really hope we have it in April. so we can really hit the ground running. so we're gonna have roughly6 months to obligate $209 million without making stupid decisions, without being wasteful, actually
moving the needle and that concerns me and believe you me I'm I'm talking about that with the team not only Brad but we also have an outsourced administrator BdO a formerly known as Horn they've got a whole team of Arkansans and and other folks who are backing us up the application process for the money is going to be completely online it'll be digital it'll be easy to apply and you'll be very clear on kind of how things are moving in terms of what your application is so we wanted to
make it administratively easy for the applicants to be able to access the funds and with that Mr chairman we're happy to take
any questions I think my senate chair has the first questions. thank you hed he does know me.
So I think just a couple of different things and I've I've expressed this but I just kind of wanted to say it publicly when we talk about rural Arkansas I I hope and I just want to say this on record that we are sensitive to the
people that are already on the grounds providing rural healthcare so that we're not just dismantling what they have been doing they are they are filling the space right now so you know I just want to be sensitive to that sometimes when we have enacted policies at the state level we have not been sensitive to that we have not collaborated with them because they're working within the system they have it's not their fault but they're there actually getting it done and making it
happen so you know I think it's really important when we say redesign that we're sensitive to the fact that we're not redesigning it because what you're doing is wrong or bad and we appreciate that you're here doing this and we need more of it so we need to replicate what they' re doing so I just want to say that because I think being sensitive to the existing infrastructure is really really going to be critical and and I think when you say local, I think that's what you mean is that correct yes ma'am it is let me give you a specific example
Chair
Unverified
36:59
of how we're sensitive to the point you're making so I I've heard you know from numerous people who are pitching opportunities for you know a mobile imaging OK? and in obviously there are some deserts on on imaging in Arkansas but what we don't want to do is fund some imaging initiatives where you have outside providers come in and cannibalize a patient base right so we want to make sure that whatever we're doing is augmenting and complementing the
healthcare infrastructure that is there and not supplanting it that's that's a big concern and then also just to ensure that you know if we're going to make an investment on something like a mobile imaging unit that we're approaching that on a regional basis so that we have adequate utilization of that technology and it's not setting idle for an extended period of time that we're moving it around to where it's needed so it is fully utilized you know over a month or over over a few weeks yeah and I think the same is true with school-based clinics
you know you can cannibalize your existing provide patient base and then your providers go out of business that are sitting there you know and so I think that's the same idea. so just kind of thinking outside of the box I'm hopeful that nonprofits will hear this because I I want I would love with physical activity and children for like an Arkansas soccer association to get involved or something to that to where there could be some more innovation and I there's there's one that I've
actually been texting to me the most transformative thing that we could do in changing a culture when it comes to food is building greenhouses and gardens on every single campus of a public school like if you think about that that to me would be the best use of this money because then you're teaching these kids and then they're gonna go home and they're going to teach how many how many of you have baked a recipe that your kindergartner
brought home because they baked it in their classroom and they loved it and then they bring their little paper home and we have to do the same thing at home. That would be incredibly transformative in my opinion where you could then have like build out an agra curriculum of gardening of you know, I mean that's that exudes the culture that I live in in Mountain View everybody's got a garden and there's tons of fresh produce but that's not everywhere and kids don't know
how to do it unless they're in that kind of a community or they're with a family member that just knows how to do it and I just think you know, building and teaching that level. I mean it just it fits into stem it fits into biology microbiology you i molecular bi ology I mean all of that is encompassed into food science and nutrition to me that would be your best bang for your buck and really transforming under that heart initiative. that's
just my takeaway but that and and we've I've
Speaker 39
40:05
had the opportunity to visit with a provider that's already here in Arkansas that's doing that in a couple of school districts the only reason they haven't been able to expand so far as they didn't have the seed money well we can help with that
you've got the seed money let's do it. you've got the seed money you can pull the resources and and we could do that on a trans I mean that would be transformative. I mean that would you know you can build in literacy curriculum into that
whole idea too of teaching those kids and if it's open to the public, you're reaching0 to5,0 to6, not just elementary school kids so and you're teaching the parents and you're teaching grandparents or whomever to come and be a part of that to me that fits so perfectly and I don't know if any other state that would like if we set a goal for that as a state how awesome and cool would that be? OK, sorry and real quickly on the
Chair
Unverified
40:59
on the nonprofits so you know Cms you know was impressed and and
view viewed our application as a differentiator and that we were leveraging the faith community they didn't see any other states that were doing that and so you know that's one of the things that we're really going to put a lot of emphasis to. We do want to have kind of a a community non p ro fi t faith community roadshow where we go out around the state and we connect with them directly and just kind of tell the story of what is possible this money and then generate the ideas like farmers' markets you know we can provide we we can't buy food but what we can do is provide the
infrastructure money to get those things established additional money to kind of maybe help with the cooperative extension services they're already there75 different counties to be able to leverage them yes ma'am to let them be a platform yeah our extension services have got
to be leveraged and we've got to figure out to and my last question though is on your programme timeline so it looks to me that and you're going to focus on thrive first. is that correct? And then packed rice and heart is going to be the
kind of the second phase of of the way that you're I mean as quickly as I mean it's it's one month and then the next month but you're gonna is that
Speaker 39
42:16
correct is that how we're leading off with with thrive which is the big technology piece because we think technology is a good platform upon which to build the other initiatives but all
Speaker 82
42:23
four should be launched in live by June
Chair
Unverified
42:26
yes you just may be varying amounts of money you may be heavier on Thrive this year you may see like rise be more next year because rise in graduate medical education all those folks are
already matched you know for their programs for this year so we just need to do preparatory work this year do you want to really talk about EMS very quickly because that's a very important platform you know some of this money will be able to be used to you know, purchase vehicles kit out those vehicles so that they we can have a good fresh ambulance corps in roe Arkansas and to be able to make sure we have all the equipment there that we need to have awesome thank you thank you Mr Chair. Representative Grammlich you recognize
Speaker 86
43:08
thank you very much. brad I'm glad you're here I'm glad you're the guy doing this job I think you know this this is good to have someone like you in this position even if you're not the best public speaker. thank you. I guess
a couple of questions just really broadly like I guess first off you know this is rural. so like who who is rural like like I apologize like you know I'm Fort Smith it's
one of the largest cities in Arkansas. do people or organizations inortsmouth have a chance to apply no that's that's a great question
Speaker 39
43:38
so the technically the definition of rural is the herrsa definition with some additional metrics that CmS set but that doesn't matter Cms came back and they clarified Arkansas can determine what is rural so if a healthcare provider is in littlettleRock or in Fortsmith or in a rural setting urban setting but we can show they serve and connect to rural people they're eligible to receive dollars. so like so like we've got obviously we
Speaker 86
44:10
have hospitals in Fortsmith we service people south of us40,50,60 miles east of us40,50,60 miles because they live in rural environments we should be able to apply for grants you guys are serving great conversations with your hospitals already and then guess so when do our applications open is that today or later this
Speaker 90
44:27
so end of this month early May is when we expect to see the first
Speaker 39
44:32
thrive application go live but we'd like to have all four live by the month of June. So basically assu we're gonna have
Speaker 86
44:40
we need we're gonna hopefully have
money in hand in april and we're gonna start as soon as we can start throwing in
Speaker 90
44:48
at projects that that y'all you all approve so the so this is a Cms funded project so as
Speaker 39
44:55
soon as the money is available to us what we're envisioning is this will be a reimbursementba program so as your folks are out there performing work invoicing us we draw the money down from Cms and reimburse them no no more
than I think a30 dayy turnaround is what we're looking at
Speaker 86
45:15
and then I guess there's two more questions so for us in fortsmouth specifically we're having some some healthcare challenges right now could some of that money be be used to open for new services in some of our hospitals yes I think
Speaker 90
45:29
you know the details there always matter but those conversations are
Speaker 39
45:34
important to be having right now and and be honest we're starting to have those conversations now OK and
Speaker 86
45:43
then I guess finally you know we we have a lot of new medical medical schools opening up across the state but we have a limited number of residencies are we could that be used to open up more residencies so our Arkansas medical school graduates can and will stay inkansas and not only can it it will be used for a new graduate new residency slots in the state
Speaker 73
46:01
no doubt about that yeah thank you all very much and the great thing about you know starting the new
Chair
Unverified
46:10
slots is we can we can provide the seed
capital to get them going and then once they're established then they have to be able to be self sustaining by just being able to
bill for the services that are being provided. Representative Woolridge you recognize.
Representative Jeremy Wooldridge
Unverified
46:24
Thank you Mr chairir. you know, I know it's a Cms program so they're setting a lot of the guidelines and the
rules by which you're operating if I understand correctly the state can have a more stringent rule, just not a more broad rule is that right I don't think that's that's not
Chair
Unverified
46:38
how I would frame it up. we've got to operate consistent with what we've given Cms as our plan
that's so the plan really is you know what we're having to stick to so did
Representative Jeremy Wooldridge
Unverified
46:49
Cms set what's not allowable for expenditures or did we set that so my question is and I I you you said earlier there's no capital improvement necessarily for rural hospital is that right? No I said there was no working capital,
Chair
Unverified
47:03
no working capital so if somebody needs funds just to kind of you know be able to keep the doors open not eligible rad's point was we there's no money to be allocated to expand the footprint
or to build a new building but within the existing footprint we can allocate money to repurpose space to you know take space that was maybe you know, closed down Ob ward and and turn it into something else. we could potentially idle space decommission it and provide money for that it could be that you have an HVacC that is out
Speaker 73
47:36
of date and they need to update the the HAC we could provide money for
Representative Jeremy Wooldridge
Unverified
47:42
that so not a ground up build per se but we can repurpose space
but senator Irvin to her point and I agree with a lot of what she was saying you were talking about you use the example of farmers market you can't purchase the food but you could build the farmer's market building potentially the infrastructure infrastructure infrastructure around it so not the facility by which they operate but what would that infrastructure look like if we were trying to expand that into rural parts of the state because I've had had two communities they're talking about implementing the farmers market so what would be an example of an allowable cost there I would say you know just talk to us
Chair
Unverified
48:14
have a dialogue with us about what you're
thinking about and then you know we'll we'll tell you whether or not it's workable. I can imagine things like trailers, you know that are temporary stalls booths things like that it just couldn't be a permanent fixture that's a new construction and
Representative Jeremy Wooldridge
Unverified
48:30
then last question Mr chairir if you don't mind the application process do you have a committee that vets these applications how does that work? Is that only DFA internally is that local healthcare providers that are part of a committee who vets that so that the committee will consist of
Chair
Unverified
48:48
myself, Secretary Janet mann, you know with the DHS her name Mall, Secretary of Health Kay Chandler who is the surgeon general and Doctor Ted Brown who is the head of the estaterime lab those were that was the committee that did the work in putting the plan together ok thank you sir but I'd also say that you know we're having maximum dialogue with all the clinical stakeholders and so we we want feedback on you know what what's working and what's not working in the program
Representative Mary Bentley
Unverified
49:23
Represented Bentley who recognized thank you chairman. again was getting back to healthy food with senator Irwin I just been proud to support our farmer school program so do thearmer school folks need to coordinate with the regional people to get funds for that so how would that I'm just trying to curious what that step would be because I know that getting seed money for some of these schools would be great it'd be a good thing to get a school garden going. so do they need to connect with the local regional people as part of the application process or trying to
Speaker 38
49:56
get that that step figured out I think I think them connecting to to the regional would would make
Speaker 39
50:03
sense for me because what we would like to see is is you know big bold projects so the more more partners the bigger swath of the state that we're able to impact and and selfishly only me having to look at one application would be the preference I'm happy to visit with folks and help make those connections in fact during
the application process if we see an applic couple of applications come in and they are complimentary and it looks like well maybe there's a potential partnership there and those folks haven't talked yet and it's apparent they haven't talked we'll work even at that point to make those connections and say have you considered pulling your resources and your ask and being more impactful with it OK great I have one
Representative Mary Bentley
Unverified
50:49
other constituent in Conway in the farmer there called Healthy flavors and they've got FDA grant where they're working with seven schools here in Arkansas
right now just getting food that's the kids like to eat right they're working on recipes
Speaker 117
51:01
to eat so it's a great project so I'll get them to connect with you guys've met with a couple of yeah we got some
Representative Mary Bentley
Unverified
51:07
great things moving forward I'm excited because this is really can help with diabetes and health and so many things for generations so thank you all for this work it's great Representative innnett you can't touch your button
after I turn it on or you're
Representative Denise Jones Ennett
Unverified
51:32
going to turn it off thank you Mrir. I have a couple of questions my district is here in LittleRock and have parts of lasky County so I want to touch on whatpresentativeremlich mentioned so my district is like LittleRock and so I sit on several boards. I have our house there's wolf Street Jerichoway there's several organizations here that are in that space they don't
necessarily touch rule Pulaski countunty so how does that work? They normally just touch people in the greater LittleRock area. how does that work if they want to apply for something like this would like to have a conversation with them I mean I I
Speaker 38
52:13
know maybe at maybe at first appearance they don't think they're impacting
Speaker 39
52:19
rural parts of the state but it's worth a conversation to see if that's actually true or not I would be I would be surprised if if we couldn't figure out that
Speaker 38
52:30
they do impact healthcare in rural parts of the state
Representative Denise Jones Ennett
Unverified
52:34
and also there's Saint French sorry Saint Francis house here in littlettleRock is is for VA people or people there associated with the VA does that will that kind of fall in line with this initiative so mean it really depends on what what is the the mission of that nonprofit Saint Francis house is a
Speaker 73
52:52
it's a great institution they they do an awful lot of help a lot a lot of good in the community
Chair
Unverified
53:02
I'm not sure how much that's actually healthcare you know that's getting delivered same thing you know our house I'm'mm personal supporter of our house I love it it's fantastic but we really need to be make sure that we're staying in the healthcare space on this and the nutrition space so to to Brad's point just because the facility is not located quote in rural Arkansas doesn't mean it's not impacting rural Arkansas or it's not impacted by a rural Arkansas's healthcare struggles and so go ahead and be a part of a larger group where
you're making an application and then we'll tell you whether or not you know you're eligible for for being funded don't don't necessarily
Representative Denise Jones Ennett
Unverified
53:40
remove yourself from from the front end and I have another question so I do represent rural pulaski County as well and so I have a lot of farms, small farms in Pulasaski County southeast area so with this something like this help that area as well if they producing produce it could now we again we can't buy
Chair
Unverified
54:01
food that's prohibited by Cms but as
as as we opened up with what I would encourage is you tell all your nonprofits read the plan and ask the question is there something that I'm doing now or that I want to do that aligns with this plan because I think what we what we won't be able to do is just say you know can we give you money? well not necessarily depends on whether or not what you propose to do aligns with one of the initiatives69 initiatives it's a pretty long list surely they can find something in there that they can they can say yeah we'll be a part of that
Representative Denise Jones Ennett
Unverified
54:36
all right thank you yes ma'am you have oh I'm sorry do you have contact information Mr Nnye? get that
Representative Jack Ladyman
Unverified
54:48
to you thank you Representative ladyman you recognize Thank you Mr chairir. this kind of connects to what uhpresentative Gimmmwick in it has just said because Jonesboro's similar to that but in Jonesboro the NnyIT program there at ASU they have a a mobile van and they go out to the they try to serve the whole delta all the way down south
so I I suppose them trying to expand that program would be eligible is that correct yes sir
Chair
Unverified
55:15
so good great question expansion of existing programs it's allowable what we can't do is you know supplant existing funding so what they're currently spending they have to continue to spend but they want to add additional vans to reach more locations that's something we could possibly fund. OK, Stint Bernard's has the same thing they have remote
Representative Jack Ladyman
Unverified
55:37
rural Arkansas and one of the problems
at ASsu of course they're using their students I think Fort Smith may be similar to this I don't know whether they have a van or not but but if they do they'd fall in the same category but they use their their their senior students to go to these remote areas through this van so it's also a training and they get to these rural communities I sit here and wonder why we couldn't do that at other universities Fortsmith is an example I'm sure if they're not doing it they probably could with their school but
a program to connect like the the ASU to another university in southern Arkansas as an extension of their program or train them in
a program is that something that could work? Yeah I I mean we need to have
Chair
Unverified
56:26
more coordination and collaboration across the whole healthcare system. there's no doubt about that that is something that the systems the teaching hospitals need to resolve and we're conveners you know we're bringing them together and we're asking them to do that
so what what we don't want to do is just have a conversation with NnyIT just have a conversation withuaMs just have a conversation with Fort Smith because we're gonna be incredibly inefficient if we do it that way so let's figure out how we can allocate resources in a way across the whole system that comprehensively solves the problem and
Speaker 45
57:01
doesn't waste money one of the other issues that
Representative Jack Ladyman
Unverified
57:05
ASsu has told me they have this van is huge has a lot of equipment on it but it's limited
on the test that it can run but they need a a brick and mortar building to do that. I don't know how you do that in rural community but maybe if there's a building there that they could renew that the city or county would the city of your county might apply to turn that into a
Speaker 39
57:33
part time clinic or something so we can't can't pour concrete can't add to existing footprint Cms has said you know case by case basis that targeted renovations are allowed so if a community
purchased unused space and wanted to try to use RHTp dollars to refurbish that as a clinic that's a possible use of funds again details matter we would need to see the application have some back and forth but that's a possibility and I think if you had that set up on the same day
Representative Jack Ladyman
Unverified
58:00
Tuesday wednesday every week and they're there it'd be almost like a regular clinic but it'll be a two day clinic or something like that and the faith
Speaker 82
58:08
initiative engaging places of worship you know I've started having conversations with folks about doing like a
Speaker 39
58:15
community health Sunday once a quarter where a mobile clinic can come down to a place of worship and can do some of the screenings and and connect folks to healthcare like we're talking about I mean it's it's a great way of thinking through it
Representative Jack Ladyman
Unverified
58:28
one more question Mr Chairman for Mike. you know we know what the problem is what we we don't we can't identify the problem. We know we're bad. we know we're fortyninth we just went to a meeting and that that was brought up. Arkansas's fortyninth what are you guys doing? Well we're getting money that donet throwing money at it don't help if you don't have a
good plan. So do we really know where the problem is that by county I mean I don't think in Craighead we have a problem. have we identified what makes us number50. you know what are what are the problems and where are they at is that something we've done or could that be something we want to do again
Speaker 76
59:08
I'll go back to what I said earlier we're not the healthcare policy
Chair
Unverified
59:12
experts there are plenty around here so I I don't want to speak to that. I would I would say this though
I think we got the problem in all75 counties. I think we have needs in all75 counties they may be the same level of needs but we have needs all75 counties and so I think we ought to approach it from from that perspective you know one of the things I believe in research, I believe in studies those are good things to do but that's not what this programs about you know we're looking for turnkey shovel readyady initiatives that make an impact immediately and so I think you know to the extent that we know there are some
things like management of chronic diseases and helping people to be able to check their blood sugar on a regular basis you know those things will make a huge difference encouraging people to walk 20 minutes a day would make a profound difference in the health outcomes for our Kansans I know I've had to start doing it myself all right thank you Representative Henley
thank you Mr Chair. thank you for being here
Speaker 142
1:00:15
guys. you know my my district has two rural
Representative Dolly Henley
Unverified
1:00:22
hospitals in both certainly need help but I do have a few questions for you and Mr.hudson this 1 may be for you directly. the the horn group who is now the BdO group so did did you had'd you come across those guys to to help with this process I mean did they did they like bid on the job or something they did we had
Chair
Unverified
1:00:46
competitive procurement for the administrator of the of the program they helped us just on a sole source to write you know
the application but in terms of being the administrator of the grant program that was competitive competitively procured and came over here for
Representative Dolly Henley
Unverified
1:01:02
review. I have some personal experience
when they were the horn group with the ESg program used to be operated from DHS and now it's through the Arkansas development of finance authority that nobody seems to know who they are I'm sure you do So they were just very very
slow in the ESg grants applications from a year ago two years ago absolutely when they took over from when DHS ran that program so I'm not aware that they're running the ESG program at ADfa. I know for a fact sir I'm
Speaker 73
1:01:37
just not aware of it pagan I'm aware of pagan yes she's my contact
Representative Dolly Henley
Unverified
1:01:48
with theSG it's been very very slow, very very slow. so the last deal was there's problems with the governor's office trying to sign contracts
but now I think all that took care of I just I'm just concerned about that I would like some acknowledgement that that that's really going to be ok and that they're going to turn around those applications those reimbursements quickly enough for the hospitals to operate30 days is what you said
Speaker 55
1:02:16
earlier, right ok yes ma'am. well they know the conversations with me the speed of execution is absolutely expected their contract is a deliverablebas contract
Representative Dolly Henley
Unverified
1:02:28
so they don't get paid unless they accomplish the result. and
they're paid by the state not by this grant program right? No they're paid by the grant program so my second question is Mr Chair is the applications that are due at the end of this month. so you you're both aware of the severity of of of my hospital situation and hope. you know they they submitted an application back when you asked them to the state ask everybody to submit those applications early on let's find out what's out there they came back you all
admitted that you came back with some very good ideas. You know y'all had that paperwork. So I'm wondering why it's taken so long except that the fact we don't have the money in the bank, what's taken so long? I mean the this is april 1 so now we're gonna go the whole month before you can accept those applications so you know Representative
Chair
Unverified
1:03:20
Henley it's not a correct statement to say that we solicited applications last fall we did not what we had was a portal
where we solicited ideas you know for how the money could be used but we were very clear that was not an application that the applications are gonna be solicited all at the same time it's not correct that the applications are due at the end of the month we haven't even opened up the portal yet for accepting applications that will start hopefully you know in the early May we cannot control the timetable in which the federal government releases the money to us that's that's the pacing item on this and I'm very familiar with with
their case down there and as I said before you know working capital needs as genuine as they are as significant as they are they're beyond our control in terms of can we spend money on that now if there are other things like HacCc that could potentially we could spend money on that can free up working capital use for other things we might be able to do that and so believe you me if they submit an application I'll be looking at it as soon as possible. all right thank you do have
Speaker 73
1:04:26
another one mental health facilities right did you talk
Representative Dolly Henley
Unverified
1:04:33
about mental health and how how funds can be used for them? no
Speaker 39
1:04:38
ma'am again I try to do a 1015 1000 ft level today umhaal health is absolutely a need in Arkansas and I'm I'm visiting with and talking with folks in that space I would love to see applications in that space I think the the heart initiative even though it's called the heartart initiative really is around early intervention and prevention. I think there's a lot of opportunity a lot of white space in our plan
we we do reference behavioral health in our online plan if you if you go out and look at it two or three times but there's there's not a lot of detail because again we're not the experts but we do want to get feedback from the experts and and they've had some good conversations with a few folks around behavioral health and
Representative Dolly Henley
Unverified
1:05:25
I'm excited to see where those go. My last question
Mr Chair our hospitals because of our dire situation in in southwest Arkansas including Camden
Magnolia Hope Nashville all of us down there. they have been collaborating and they have been meeting and and I think they're doing some great work. Can hospitals spend dollars together like that the CmS allow that how how how can how do you say that really working in this process? One hospital will take the lead on supplies or whatever they're gonna purchase
Speaker 39
1:06:07
that's where the clinically integrated network comes into place it's a separate legal entity it's got to meet several FTC requirements to get around some federal laws that prevent or or limit hospitals and their abilities to work together but the CIN development and the development grants that we'll offer are really a good vehicle for hospitals to come together and and work together and and Representative Henley to your point we're keenly aware of the situation with your
hospitals in fact I'm coming down next Friday for another meeting to visit with them and we'll we'll do everything we can. thank you very much thank you Mr Chair. madam chair
just quickly, I appreciate the GmE conversation, I think it's important that you know there's a there's a lot of us that have worked on this issue for a very long time in the policy space so that work is continuing with myself and others with Jimmy and all the stakeholders and the medical schools in the state we don't want to leave anybody out.
we want to make sure that we've got a really good comprehensive plan. so I just that was representative ladyman's line of questioning but I think that's really really a huge opportunity and so we're working on that and I appreciate you all allowing me to and others that have been working on that policy for a very long time to collaborate on that on the move one expanding access to fitness trails modular fitness equipment and recreation but that also includes like development of programs utilizing existing
fitness trails, right? OK and then all right because I think that sometimes is a key whereas you may have a a walking trail you may have this but you don't have a lot of level of coordination or community outreach or whatever so I just wanted to ask that quick question about that one and this is where the association of counties and misipal
Speaker 73
1:08:01
league can be engaged as well you know we can't build new trails but you know can we
Chair
Unverified
1:08:10
develop programs to more you know effectively utilize the infrastructure that's already there
Well exactly and also like the recreational programs you know for kids sports but also those are adult sports too you know adult softball whatever getting people out and moving and off their phones. its should be something that we should I hope we're talking to those association of counties, county government, city government because a lot of times you know they have the ability to really apply for these
things more so than an individual but they could be teamed up with an individual and utilize the city or the county as the vehicle by which you apply I think might be a good idea. so I hope we're having those good conversations with them. Thanks. Representative Wwooldridge Thank you Mr chairir. we were
Representative Jeremy Wooldridge
Unverified
1:09:03
talking a while ago about the plan and you've referenced the plan several times I know that that's been a collaborative effort over a long
period of time trying to develop what that plan looks like but as you lay that plan over the top of applications and and the reason I was asking a while ago who who is making a decision on who gets accepted, who gets funded how how does that translate into laying that plan or laying those applications over the top of the plan to make sure that we're connecting those dots to make a picture of what we want healthcare to look like in Arkansas and especially rural healthcare. I mean this isn't obviously like a first come first serve program so the
criteria that ' s been set I guess this committee is going to take every application they're gonna break that down and they're going to somehow look at this plan broadly across the state is there anything you can share with us kind of maybe a 15,000 ft view of what you see that plan to be what do you want rural healthcare to look like in Arkansas at the end of this window of time. So again I think that the plan that has been prepared is our plan
Chair
Unverified
1:10:12
and and finish we're not the healthcare policy experts you know we're here to execute the plan that we put together so I don't think it's up to us to say here's what rural healthcare needs to look like it's what rural Arkansas is going to say they want their preferred future to look like and if they can give us the ideas that they have that they'd like to see funded as indicated before I don't think it's gonna be a question of not having enough money. I don't think it's gonna be a a first come first serve, you know, sort of sort of a deal
either we'll have a notice of funding opportunity that will be a public document be opening date and the closing date we'll take all those different applications together for that particular nofo opportunity and make sure eligibility is being met and then I largely expect that we'll fund all those that are eligible if we don't have enough money for a particular initiative then we'll make reductions to make sure that we fund what we can fund OK who put the plan together I guess is what I'm trying to understand
Representative Jeremy Wooldridge
Unverified
1:11:08
yeah it's what I indicated earlier a group of people who are doing the
Chair
Unverified
1:11:14
review, they were the primary authors but this is the governor's plan you know she's the one who had the final say on what goes into it and then we also solicited feedback you know from legislative leaders as well and then submitted to Cms and we had to receive significant feedback and still are from CmS too all right thank you thank you guys thank you for presentation thank
Speaker 58
1:11:37
you with that we'll move on to DHS and I
think we have Miss Mary Franklin andelizabeth Pitman with us today.
you guys would introduce yourselves for the record and you're recognized to
Speaker 168
1:12:06
Good afternoon I'm Mary Franklin, director of the division of county operations for department of humanman Services
Speaker 169
1:12:12
andelizabeth pittman director for division of medicalical Services. this afternoon
Speaker 170
1:12:16
what we have to present to you is a rule that impacts Medicaid and CIP it is we are bringing this rule as part of compliance with consolidated appropriations Act
of 2023 and it relates to coverage for eligible incarcerated youth. the coverage of that will be provided to these youth include care coordination services targeted case management services including referrals to care and services available in the geographic region of that juvenile's residence the juveniles who are going to be eligible for these services include incarcerated individuals in any medicaid or CIP category that are 19 to20
and if they are in the foster care the former foster care category they are eligible from 18 to26 years of age. the length of the coverage that these incarcerated youth will be eligible for is thirtyday period before release in 30 day period after release and the other updates in the eligibility manual were grammar spelling formatting standardization type updates also want to mention that juveniles who have active medicaid coverage when they
become incarcerated and when we say that we mean fully adjudicated. they've been sentenced we do not close their coverage, their case isn't closed but the coverage is suspended for 12 months so that if they are released and the household still has active medicaid coverage we can add the kid back to the case without them having to reapply if it's beyond 1el months then they would have to reapply but initially we just suspend the coverage there was a public hearing held on this and it was
on January7th of 2026 and we received no public comments and I'm going to pass it over to director Pittman to talk about the provider manual and state plan changes good afternoon as Miss Franklin, our
Speaker 171
1:14:19
director Franklin indicated the service is covered include targeted case management which we've added to our state plan as a service for this population it will be provided by a provider type that we're also adding and that is the targeted case managers for
incarcerated juveniles we're working with some communitybased organizations now to begin providing that service for these youth and we're working with organizations that already serve this population but the provider type is open to any organizations that would like to be so do so and can meet the requirements. and it also includes coverage while the juvenile is still incarcerated of screening services so that they are able to receive the appropriate services when they leave the carceral setting so they're screened for health and mental health diagnoses and issues so that we ensure that they have
the appropriate services when they leave. most children that are involved in this program will go into pass upon exit as most of them will meet the tier two or tier three criteria. However we will have some fee for service providers in place for those children that do not meet that. and we're happy to take any questions are there
any questions members of the committee all right seeing none this rule is reviewed. Thank you. Without objection
did we now have the health department we have Nathaniel owe and Matt Gilmore. I'm just wondering to coordinate
with the other earlier presentation do you have anything from tobacco prevention today?
Matt Gilmore
Unverified
1:16:10
Mr Chair Matt Gilmore I didn't come prepared to speak on that issue. I'm happy to if you would like the contract renew Which
which contract the tobacco prevention or smoking prevention are you it's ok
Speaker 176
1:16:27
matt you can go ahead and there's there's several contracts you can present
Matt Gilmore
Unverified
1:16:32
the rule at handgain, Matt Gilmore department of healthalth I've got Nathaniel let him introduce himself NathanielRowe, director of
Speaker 179
1:16:40
the speech pathology and auudiology licensing boardard. he'll give a quick overview won't take any questions y'all have. yeah so we're here with our proposed rule changes the take into account act517 at and 966 of2025. that expands the scope of practice of audiology
slightly and also to change our renewal deadline from June30th each year to October31st. I think that's a quick overview we had
Matt Gilmore
Unverified
1:17:28
one one comment and we've addressed that but happy to take any questions y'all have. seeing no questions from the committee without objection I'm
pausing for that objection this roll will be reviewed. thank you guys thank you thank you
Unknown speaker
1:17:49
seeing no other business for the committee today we stand adjourned
Agenda
A. Call to Order
B. Consideration to Approve the March 6, 2026, Meeting Minutes [Exhibit B]
C. Presentation by Breathe Free Arkansas [Exhibits C1-C2]
D. Overview of the Rural Health Transformation Program (RHTP) [Exhibit D]
E. Department of Human Services (DHS), Division of County Operations & Division of Medical Services, Review of Rule, Health Care Coverage for Incarcerated Eligible Individuals [Exhibit E]
F. Arkansas Department of Health (ADH), Arkansas Board of Examiners in Speech-Language Pathology and Audiology (ABESPA), Review of Rule, Arkansas Board of Examiners in Speech-Language Pathology and Audiology Rules [Exhibit F]
G. Other Business
H. Adjournment
Documents
Speakers
Speaker 2
Speaker 4
Speaker 5
Speaker 8
Speaker 9
Speaker 12
Speaker 15
Representative Jeff Wardlaw Chair
Unverified
Senator Missy Irvin Chair
Unverified
Speaker 28
Speaker 35
Speaker 36
Speaker 38
Speaker 39
Chair
Unverified
Speaker 46
Speaker 53
Speaker 82
Speaker 86
Speaker 90
Speaker 73
Representative Jeremy Wooldridge
Unverified
Representative Mary Bentley
Unverified
Speaker 117
Representative Denise Jones Ennett
Unverified
Representative Jack Ladyman
Unverified
Speaker 133
Speaker 45
Speaker 76
Speaker 142
Representative Dolly Henley
Unverified
Speaker 55
Speaker 58
Speaker 168
Speaker 169
Speaker 170
Speaker 171
Matt Gilmore
Unverified
Speaker 176
Speaker 179