Insurance & Commerce - Senate

Would you like to start with this be six six sixty six. Thank you Mister senator Tyler the sister thirty five. All right thank you members this is that a concurring of Senate bill sixty six is pass the Senate and passed the house with with amendments I think it might be wise to make a motion to batch all three of the amendments they are minor I'm happy to go through each one of those today though amendment one it has to do with the thirty three a third percentage make sure we worked on that language make sure it was clear in the bill amendment to. Grab that here amendment to that has a semi colons change from an axe Michael in order to to just an axe Michael and and a lot of these types of changes we put through working with bill aren't working with AG's office to make sure things were strengthened in the terminology in the flow of the bill later you'll see there where we at we change things from may be harmful to is harmful to be consistent with the messaging in the clear intent of the bill. Let's see here. You'll see continued throughout the bill their own amendment to of maybe harmful change to is harmful material. In in a minute three is we continue that that train of thought works with the members of the House side of of what would be clearly instated for the legislative intent talk about the definition of of commercial entity third party vendor you'll see some minor word changes there they're online Page three line thirty a sexual act and any it's up to us with of a sexual act and any without the semi colon so very minor changes appreciate a concurrence vote today have answering questions. Any questions for the senator. Seeing none. No one here to signed up to speak for or against amendments. With the will of committee. I have a motion to do pass to concur house amendments one two and three. And a second centreboard. All those in favor say aye opposed say sign centre your amended bill has passed thank you chairman and alone to SP three ninety six center duties just stay there and. Start up on that one all right wonderful I can invite my friend. Doctor Kevin matters today to join us. Please enter yourself for the record. That's matters I'm a medical physician I'm an emergency medicine physician at UAMS I'm on the thirty and happy to be here. The data center these if the bill thank you members this is Senate bill three ninety six the social media safety act. This bill is about the protection of children and the dangers of social media. The father of three kids under thirteen this is very important to me with the growing in that technology advancements and the ability to have internet devices always ready at your hands on your wrists in your pocket a tablet in your in your lap it's very similar in and a little bit Quinn said and all that today it's coming on the heels of the concurrent to Senate bill sixty six where we are trying to protect our children from harmful material online and that's what this bill aims to do with the focus on social media social media as continue to to grow it's it's very similar to the technology advancements in in which I tell my kids that they can be used for good or they can use for for for for evil and they can be used to control an arm off like a sword and so we as a body need to come along and protect our children from the statistics that were seen from the harmful damages of youth and exposure in our time being spent on social media Senate bill three ninety six aims to help with that three simple age verification process to where parents. Would be involved guardians would be involved with confirming that their children their use are allowed to be on social media that there where they're on social media and if a parent wants to allow that they have the full ability to do that we are seeing growing statistics troubling statistics a third of all sexual crimes are initiated on on the internet tied back to exposure from an incidents on social media one third or C. N. N. at kids are spending an hour or more a day on screens on internet devices and they were just a year ago. They're being exposed they are spending time online there they are being drawn and marketed to social media sites we need to make sure that we have the correct parameters to to make sure it's eight eight helpful environment empowering parents does that that's what this bill aims to do it aims to involve the parents more to let them know what their children are doing online that's the goal this simple simple age verification process through a third party from from these websites from the social media sites we have the intent you'll see throughout the bill is that this is only for new accounts we're not richer actually going back and asking for all counts to be to be age verified before any new create accounts in the State of Arkansas that they would be age verified to where a parent is giving consent for a student to be for a young person to be online in the social media sites. That the statistics again are are staggering I can't wait for you to hear from our friend our expert here Dr matters but I can say that depression and anxiety the suicidal thoughts that are increasing because of of damages being done with our young minds on social media is appalling we have we we have allowed an atmosphere where students or kids or young people are going on to social media sites without their parents knowledge without their guardians knowledge and unfortunately they're being preyed on by groomers by bad actors they're being advertised to on things that should be it should be it exposed to in this is the first step that we need to take to remedy that I can tell you we're not the only ones praise the lord Utah just passed this similar bill in this last about a week ago there's three or four other states that have this in further legislation today I believe this is the correct step it's it's a it's a needed step to make sure we can protect our children I can take the culture of the road in front of us and it's happening online we've got to make sure that we take measures into or to hand to fix what we're doing so that I want to introduce you to Dr Kevin matters any our doctor here and I'll let her tell her story her background yes. First thank you so much as senator eats senator dis representative Eubanks at governor centers for having me today I just I feel so passionate about this issue and so I'm so honored to have the chance to talk about it like I said before I'm I'm an emergency medicine physician at UAMS I'm also a medical toxicologist I did my training in Dallas Texas and you know I saw the years and years of consoles I have from the emergency room from children's hospitals from the poison center and both North Texas and then here now in Arkansas where I work as well every single shift I see young people with suicidality either with attends a with the other mental health issues I can't stress enough how how big of a problem this is and as a mom of three kids I mean I'm absolutely worried that this is gonna just continue to grow and worse and we all know that covid the pandemic did not help these statistics we're spending way more time online than we ever have before but I think my main point that I want to make your is that what I know about it diction the disease of addiction is that we do have permanent changes in our brain whenever we have the disease of addiction and that can either be from gambling or from illicit drugs of abuse or anything and social media is no exception people young people with very vulnerable growing brains can become addicted to social media very easily because of that reward center in that instant gratification of posting and looking for lights and looking for positive feedback from that so the more we pose the more we get addicted especially our young people and so this bill I think what it would do it would be to add a layer of protection and just involve the parents and make sure that parents even if they already know that their children are on social media it could at least heightened awareness that maybe this is a bigger issue than they realize maybe there's more going on than they realized and I think it can. DO nothing but good to allow the parents to realize this is a big issue that they may need to take caution and to provide that verification for their children if they so wish and it'll let the families figure that out if that's something they want to do or not if not at a child would be able to wait until they are eighteen where their brain is much more formed and they're less likely to the damaging effect that happens as a teenager than what we're seeing now but again that reward pathway of the instant you know gratification of social media is not to be understated as a real disease and it is something that we see in the medical community we see on in our eyes of the brain we see on imaging and we know that it's real and so we know social media can causes just like other forms of addiction and I think this bill will will heighten awareness in that area and hopefully prevent some of the damaging things that we're seeing with social media. The doctor. This is important you know we we have we have the ability is that today to draw a line in the sand and say we're going to take it so we're going to take a stand you going to stand up and empower parents today that's what we're trying to do it I can tell you when working on the language on the focus on this. We are trying to make the most impact possible you can see our definition of social media sites it does target the largest sites out there and because we know that that's where the most impact will be. happy to take any questions but I'm excited that we have the ability to to take a stand for our children today thanks so much if you would K. kind of relate which companies this is going to affect parts kind of gonna go through that sure so in the bill it outlines any company with a hundred million dollars in revenue more so any company that falls under that description would be impacted okay could you name some of ours happy to say I know Facebook would be involved I know we've been reached out to many other companies such as such as tictoc Snapchat roadblocks other other companies in that nature have asked questions about their involvement in relation to this bill. And the. The. On that line of questions Senator are all of those a part of the are the affected by this is will those to toxins others sure anybody who would have more than a hundred million dollars in revenue per year would be impacted so today as of their current valuations and and sells would would make those companies following to stir sticks so the instagrams and all those everybody okay yes so if I for major yes so as it relates to The oversight of so basically what this does is it makes. Someone under eighteen have to have parental permission to utilize Facebook at those type size that your name. How will sold the let me know about the verification how do you verify the third party entity all members going to verifying that is okay because we know people of eighteen can input information themselves I've heard in some other states with this is going on that that verification process is. Is being exploited by youngsters that either don't have parents in the home or do it themselves so how do you deal with that yes Sir so the process will be a third party verifier that that the social media site would would contract with they would verify the age identification and then they would dump that date at that point they would be able to give consent for a new profile to be created at that at that point it's that is the verification as a gateway for an account to be created or a profile to be created on the sites in the state of Arkansas and so as someone could do that under eighteen could do that themselves it today they can this this would create a. A process where you have to show identification in order to not have access to be able to answer not Accipitridae profile you have to show it identification yes so under load like a blow to drivers usage identification yes Sir okay ID yes. Thank you and it's just for the initial creation of the profile. Shall I want you to spend it'll be spent about on that to see if you come from a split family. Hello how do you does this third party no which one of the parents has the authority to sign them up. Yes Sir so we we have outlined for at the a parental consent right and the ability today is to have right now an adult who is over eighteen to be able to give that consent we do recognize that it won't always be easy to to tell who is a parent who is not a parent we know there's there's gonna be struggles there I can tell you we've met with somebody's large sites and ask them about their current a I'd social media the algorithm systems they themselves have the ability in their family centers in their parents documentation to where they can actually act as parents to control settings so we know the technology admitted that exist we know that the leaders in this space have the ability to use a I Systems tendo with or at least believe that there is a parent involved it so we're going to ask them to share that type of technology in this process. Centreboard. Just to clarify did you say roadblocks is one of the companies that is. Thank you by this they reached out with questions I assume that would mean that their their dollar figures might be in the realm of concern. Correct okay thank you. Any other questions Senator. Seeing none we do have some. Sign up here to speak to speak against the bill we have a Dustin Wright. Right please enter several record yes Sir. Mr chairman members of the committee thank you for allowing me to be here today my name is Dustin Brighton I'm here today representing net choice which is a trade association made up of social media companies as well as internet commerce companies IT companies. You know I'm like the rest of the world that the US has the first amendment we value free speech and parental rights so much that unlike other countries we highly resist government control. Think about it the state rightly recognizes that kids shouldn't be forced into the public school monopoly similarly parents shouldn't be forced to comply with a law meant to protect their kids even if they disagree with the man's parents. I didn't unlike governments know best that that is the promise we work on we applaud senator duties for taking on this task we certainly agree that these issues need to be observed. Furthermore if I could go on the bill violates the first amendment just as Supreme Court justice the late Anton Scalia Antonin Scalia struck down California's ban on minors by buying violent video games without express parental consent in brown versus entertainment merchants association this isn't a parent's rights bill it's just as justice Scalia said about California a government knows better bill. The bill doesn't ban minors from accessing social media it merely puts bands on them from doing so without parental consent the Supreme Court has already said that access to constitutional speech cannot be conditioned on prior parental consent plus it interferes with decision making within families parents are more than capable of setting rules of the road for social media usage day as opposed to government entities know how to resolve those matters all those parents may not know what tools are available to best handle those matters we should have a public awareness campaign as opposed to heavy government intervention that also harms adults finally this bill actually requires the collection of more data even though it says the businesses should not retain it even if businesses do not retain the specific data inputs surely they will generate logs and other records however this can make comply with the law how else can they prove they reasonably verify a user's H. despite the bill explicitly forbidding the retention of personal information the bill is either internally contradictory or impossible with which to comply either way it is not fair to businesses who will face expensive litigation especially with the private right of action that's contained therein or to users who will face roadblocks to viewing constitutional speech it also puts their data at risk massive data breaches of Congress's healthcare systems medical records earlier in March would serve as an example again I applaud senator dis we appreciate him working with us he is definitely taken time to talk to us about some of these concerns and we certainly hope to continue that dialogue as we try to protect our children but at the same time making sure that that businesses are exposed to litigation that don't even allow that is contradictory and in nature and doesn't allow. How them at to protect themselves or be able legally to take a stand. Okay Sir. Richard Wright asked few questions for you appear on out with the. Senator Murdock. Thank you so as it relates to protecting our minors we have some situations obviously where the parental the the home the structure may not be adequate for and have the at what that would parity talk to me a little bit about how you would address those situations because honestly I've seen the negative effects of some of these platforms and I've seen it personally and in in my community even up to be quite honest and I'm very concerned with that we protect the Old State sometime are too young when you have people accessing this at ages five six seven I had no who should be there but when they're not there. So this was Center diss addressing I'm sure and that's very very important because we grow culture then at that age may start getting access to this by the time you get to the age of eighteen it's too late we've lost a how do you address that protection well again I I do not know the specific safeguards for each company that's a member of that choice but I can tell you they develop safeguards as well too with regard to making sure that children are protected however I don't know too many companies that would be able to verify if somebody is seven years old as opposed to eight etcetera now as senator use mention there's a third party that might be able to assist with that but I would also say children are very innovative maybe not a seven year old but teen teenagers absolutely will learn how to circumvent that even if it is a third party I mean for instance one thing that comes to mind is those of us that have children which thank god minor young adults now and out of high school they they absolutely will that obtain fake ID's to buy liquor beer etcetera that happens a lot and I'm sure this would not be any different so I would say that the companies realize there's an issue they are developing their own safeguards but it is very difficult to to verify what the ages is what the age of a person is with accuracy and dive I think that that is they would tell you they themselves don't want to call cause harm to children and they're still working on this and again we're still working with senator duties on this legislation. Thank you. Six point. Thank you Mr chair so you know I appreciate the parents know best in the government knows better bill that those are things that resound with me and it gives me you know the I.. Look inside and go really now with but some things came up and where maybe the government does no better we've decided so how would you reconcile this with say smoking or rated R. movies or other places where society in general except that maybe the government does know best and let's get can you kind of speak to that thank you sure obviously those examples that you mention are valid I would say that these companies they they agree with you on that that at times maybe there do need to be standards but I would also point out like with regard to movies the MPA a set those standards and came to the government with those standards as far as the rating system when it comes to movies that I think that situation would be better here to work with industry maybe mandate they set standards where they have input into the process and come up with something that might work at the same point in time not expose them because the bill at this time we would say is a bit confusing I don't think that even really know how to guard themselves legally at this point if this bill were to stay in its current form. Any other questions Senator Johnson. Thank you Mr chairman of Mr Brighton first of all thank you for your testimony yes Sir enlightening and while my tendency is to support the bill I I want to go back to your comments about to a justice Schooley is. Pinyin is California case Can use. Real down just a little bit more to summarize what it what his opinion stated in that case it had applies to Senate bill three ninety six yes Sir the bill this bill doesn't have. The Supreme Court has already said that bill such as this provide access to constitutional speech they cannot be conditioned on prior parental consent it interferes with families parents are more than capable of setting rules of the road for social media usage. They again I as I said they not the government I know how to traverse the terrain so to speak to be sure parents may not know what tools are available we should have a public awareness campaign as I suggested not not at having to worry about whether or not they're going to lose millions maybe billions when it comes to liability so again hi scholia the premise of his argument as I understand it and I I am not an attorney how admit that but it's it's on the premise that parents as opposed to government should be making these decisions. Well I can certainly go along with that broad. This statement I believe the same thing however I'm also sensitive to something Senator Murdock and chairman mentioned of a broken homes and and communities where let's just say the parents are as new as especially technologically up to speed as the kids are and I I worry about that I'm. I'm grateful that I got through this with my two kids mention years but I will save my. One of my candid children told me once about buying beer she was under agency the fellow in the store just said just hold your lock hold a card up so the camera can see that card and you know the words it doesn't have to be a driver's license and I'm not going to check it but the point is you know these kids are smart and they can game the system and the ones that probably need the most protection are probably the ones that are more capable of doing it of. I realized with all the wonderful technologies we have now and I'm not going to check GPT to find an answer how to figure all this out but. He he would think that somebody could come up with the way not that it's a hundred percent foolproof nothing yes but that we could to do this and are you telling me are telling this committee that your clients your socio Haitian members of your association don't have any reasonable reasonably successful process where this could be verified. I don't know of anything specifically I do know that the companies have taken these issues to heart they definitely know there is a concern there certainly sending people like me and committees all over the nation to talk about this these topics they know there's an an issue they are working on those as a speak they would rather work with government then have to try to comply with something that's confusing because obviously out of the appreciate as a business owner or a company that's publicly traded they they don't want to open themselves to unnecessarily high unnecessary liability while they're working on these very issues. Thank you Sir thanks for your. Okay I know we've covered this but I just want to cover it one more time to make sure I'm fully so it requires on the verification of age and you have to be eighteen or older but there is still the ability to access the platforms if you have parental consent is that your understanding of of the bill as well I would have to get back to you on that because I'm not sure what the specific companies are doing on that front I would say right now of course they they ask the questions how old you are but again it's hard to verify if somebody is is saying and I mean I'd I'd give you the example of in some states it's legal to ship liquor or something like that into the State and these companies to put up on our websites a pop up window or something that says to the this site you must be eighteen I'm sorry twenty one or older please please check the box and that check the box the course a ten year old can do that if they're sitting there at the at the computer so I I don't disagree with you that it's hard to up to verify the age I do know the companies are working on those technologies and at I know this if they were here today that would tell you that. Any other questions for Mr Wrighton. Thank you for your testimony Sir thank you for allowing me to be here yes Sir. There is there anyone else here to speak for or against the bill and in the audience. Seeing none. Senator days I do have a couple questions you for you before you go into the to your closing yes Sir. Who is going to enforce the S. and. What what's what's the enforcement mechanism Sir Senate bill you'll see a fine structure there is there's I would I would simplifies it is kind of two lines of thought there there's the AG's office is involved with the fine structure and there's also a civil litigation so private private cause of action that's involved and so to be litigated in courts and I mean is going to is only going to be a policeman out here overseeing this enforcement area. No Sir it would be it would be cases brought through from the AG's office okay and. The other question I have for you look looking at the bill here under account holder and he said this is for new accounts but if you read that it says account holder means an individual who has all or create an account or profile yes Sir so that to me I would read that as existing accounts as well as to I would point you to page five means here. From this section here it's really good to read into tally. let's see here. This section here. Where does call new new account holders so Page five starting at start at fourteen it talks about the retail age verification and parental consent but you'll see if you move down to two line twenty two if the account holder is a minor the subcommittee company shall confirm that a minor has consent under subsection a of this section to become a new account holder at this time in Arkansas in Arkansas user opens account so there's there's a if you read that that section in its entirety it outlines eight the a new user moving forward is the legislative focus on this on this bill. Thank you Sir any other questions for sent relief. Sam Nunn center these you're pretty close thank you again committee I I know this is a. This is a serious issue I can tell you the reason I was elected I I'm I've never run for an office and okay my life until the C. here as Senate district thirty five Senator. It was from conversations door to door from regular parents who sent me here. For regular common sense issues like this we have an issue we have a problem let's find reasons us find solutions this is a reasonable solution to a serious problem that we're seeing. I'm afraid even this is ten six we have the day our backlog meaning there's more ramifications we don't even know about yet if we don't intervene here. It is not a first amendment issue on address some of the paid for lobbyist testimony here. We have it is not a first amendment issue all right we have the best lawyers from the governor's office from the AG's office every viewed our our language here if you do not want to partake with the content with posting with setting up for an account you don't have to any sites right you have all the freedom in the world you want to. We just want to put safeguards in so our our children are protected. I also will say this. There is a questions and comments about how do you how do you confirm age verification if you to dump the data first off it's very important to dump the data we don't want to give any more. Private information of these types of companies they already have so much info on us out there that's why we require a third party. To be involved with this and I can say I have personally interviewed with the largest third party age identifier in the country. A company that is involved with eighty percent of all of the driver's license in the country a company that also is involved with TSA precheck with global entry age identification ID. The software and they have validated that it is possible to age identify to dump the data and to show a record proving that they have identified without concealing data they could show blogs of services provided they can show geo tag of within a state border it's a the technology advanced everything else you hear out there is about a fear of profits being taken away. That's what you're hearing that's what you're hearing from this industry a fear that they could no longer pray on a bench of consumers that they are bringing up and bringing through their system so they can advertise to so they can compel to so they can have more users in at the end of a more profits. Today we have to take a stand we have to say you can still have access to this material it's good if there is a lot of good with social media but has to be done in the right way it's the same thing we do with rates reasonable age verification if you are purchased cigarettes if you want to gamble you must be a of age right we we say it's allowed within the right context and so that's what I wanna make sure that that is clear today and so I would I would ask that we we not listen to the the issues that are we guys we can't stop it also which into this bill we're not gonna stop all issues online. Not gonna do it kids are going to find ways to get on the things here and there we're not gonna stop all sites that doesn't mean this isn't a good bill we're taking a good good direction we're taking the right steps it's like saying people are gonna speed anyway why have a speed limit that's not the right approach either we do the right thing And we can do that today I'll close appreciate a good vote thank you. Thank thank you senator these. So what is the will of committee. I have a motion to pass Senator Penzo was second by Senator Johnson. Okay just a yes. So I plan to support this bill I think it's moving in the right direction but there were a couple questions that did come up that may be will be addressed it it some point in this process about age verification you know what happens if you're eighty years old and you you know don't drive anymore you know so there are some practical concerns that I I hope that the Senate sponsor will work on the next chamber to rectify thank you. Thank you Sir Boyd. Okay so what is the will of committee all in favor say aye. saving sign asset as senator bills passed thank you anything Mr. H. B. fifteen fifty eight is anyone here run that bill. Saying none of the. Okay we'll give up okay did just just want to know H. B. twelve seventy one S. B. one nineteen SP one twenty two SP one thirty seven SP one forty three this B. one eighty one. The four run thirsty those are all single bill Siegel will be here thirty to talk about the financial impact so all those will run thirty. And so. The. Okay we'll we'll skip over that for right now we'll we'll move that down. The representative Alan. Senator Wallace. H. B. eleven twenty one. This. And Senators you do have a handout on your desk for the biomarker testing. Please enter your for your senate bill. Good morning Sir senator Dave Wallace District nineteen. House bill eleven twenty one is that concerning biomarker testing for early detection and management for cancer diagnosis and for other purposes. The governor's office is neutral on this. The passing house ninety eight zip. This bill will save lives. There's no physical impact on the state of Arkansas government. Biomarkers are characteristic that is objectively measured as an indicator of normal biological process. With biomarker testing patients can receive the specific treatment best suited to combat this specific disease. The growing use of biomarkers. This targeted precision medicine which can help save lives by early detection and can better inform treatment plans options and reduce unnecessary treatments. Members nineteen states are running this legislation this year. Four states Arizona lose in Illinois Rhode Island have already passed this bill C.. This. There are more the thirty national state and local health organizations that support by market legislation including you A. M. S.. Members with that I'll stand by for your questions. Any questions Senator Johnson. Thank you Mr chairman senator Wallace and representative Alan thank you for bringing this bill I I have a small technical questions of. We hear words like biomarker and we're not exactly sure what that would be up but I guess I wanted to ask is what we talk about a PSA test that's a prostate specific antigen is an example of a biomarker It is okay so that's and there are other things I'm sure that could fall in that category but that's one that most of us man the defendant's testimony about so I just wanna make sure that I was not missing something on that and obviously I'm supportive honored by being a co sponsor but I just wanted to clarify in my mind exactly what we were doing before we did it but you Sir I appreciate you senator Wallace and my friend representative balance I've been praying for your health for so long it's just a regular part of my day and god bless you for for fighting not just for your own health or that of others thank you so much thank you Mr thank you for your practice. Any other any other questions. See non represented Ballinger anything you like to add. Template please RT for several record. I'm state representative Fred Allen District seventy seven I think Senator Wallace is said off about the bill and I appreciate you all vote is crucial to support. Thank you Sir and seeing no one signed up to speak for against the bill is there anyone in the audience of we have one in the audience. In please let us know if you're for or against the so we'll have that for the record when you tell us who you are. Good morning everyone my name is Max Greenwood and I'm with Arkansas Blue Cross I am not against the bill biomarkers provide a vital tool to our oncologist in determining the right treatment for people who are diagnosed with cancer my concern with the bill deals with the broad language of the bill because the bill ventures into diagnosis and screening which biomarkers are not safe for using for. The American cancer society's own website says for people with certain types of cancer biomarker testing is done routinely to help guide treatment decisions not screening and not diagnoses. Arkansas Blue Cross and blue shield paid more than thirty one million dollars last year in claims for both for biomarker testing it's obviously a a concept we support. Neither the federal preventative services guidance the national comprehensive cancer network or the American society of clinical oncologist recommended that biomarkers to be used as a tool for screening or diagnosing cancer these are the experts. As written this bill would force insurers to pay for tasks that are deemed investigational and experimental and would not only lead to huge increases in cost but more importantly dangerous false negative test results that could encourage folks to skip safe and proven types of testing like Colin Oscar bees like PSA screenings like mammograms like PSA and low dose CT for lung cancer. Even though no one. After many many conversations not one person has been able to identify a single biomarker test that is bends deems safe and effective that is not currently covered already by insurance there is a very simple way to fix this bill and to make it a very good bill. First of all the title of the bill could be changed to say. Concerning coverage for biomarker testing. For management of cancer take the word out early detection and take the word diagnosis out. The same thing with the subtitle and then finally on page four section twenty three seventy nine twenty four oh two the Bill talks about concerning coverage for biomarker testing from early detection and management of cancer diagnosis and in this section you will see that it says that the healthcare plan shall pay for bio marker testing for diagnosis. That needs to go we pay for it for treatment we want on colleges to have the tools to make sure people are getting the right chemotherapy the right radiation all of those things are what biomarkers are for. I know the sponsors have said there's no cost impact on this bill I would respectfully disagree our estimate shows that our costs would increase at a minimum of nearly twenty million dollars because of the broad language of the bill we believe this would encompass a a test called a multi cancer early detection cat test which is informally called a grail test. There are no limits on the frequency of these tests in the bill it is not supported by the cancer society or the comprehensive care network. But we believe this bill would force us to pay for that test. We also believe that that one test alone could add fifty million dollars to costs. Medicaid asked that they be excluded from this bill because according to them it would have created a sizable cost impact for their members and for their program our home is also excluded for this very same reason. In other states this bill has passed but the people who are supporting and pushing it are not oncologists. They are labs who stand to profit from these types of bills. Personally I don't believe this bill is necessary I believe this bill would put the health of our members in jeopardy and add to the increasing costs of health insurance for a for the working our Kansans that pay for their own insurance and the small employers that are struggling to continue providing insurance for their employees. I would ask that you vote no on this bill or at least consider my suggested language changes to make the bill safer for Kansans receiving these tests thank you and I appreciate your time. Thank you any questions. Yes. Go ahead Senator Clark thank you chair thanks have you had the opportunity to confer with the bill's sponsors on this is very detailed and what was the response to those concerns that you mention those things that you of the response and and correct me if I'm inaccurate but the response was that the American cancer society didn't want those changes may. I think those changes are reasonable. and I think those changes will make it a better bill and will protect people from having tests done that would potentially give them false results and you know as I said the oncology community is not here because we pay for biomarker testing and we want to continue all right mmhm. Great thank representative Alan would you like to respond to that as well. Yes I appreciate of my friend Max coming down here saying that she's not against the bill but spoke against. About what one of the things that I would like to say is that we have tried dialogue with Blue Cross on several occasions and we can come to an agreement this bill came out of the house nine eight zero maxim Blue Cross was in the bill and the bill is in the room we ran the bill. And no one came down to the table to oppose the bill now here we are today fourteen ballot member shall have what have you will see it we're trying to get something done for patients this is not about me I assure you that I'm out I have my battle with council and I'm still ballots cast I made a commitment to myself in to counsel patients that as long as I'm here on the face of the earth I'm good do everything within my power to make sure that cancer patients get the best treatment the best tested in this bill is designed to do those things we can sit here all day long speculated talk about what the bill does. The thing that she's talking about those things I think that the bill but do I want us to focus in on the four corners of the document of the bill if we read that it will tell you this bill will do three things. They will save lives. They will save money. It would give patients treatment options I just attended a funeral this weekend well maybe that from. She was my ex mother in law she said to me. She said I appreciate you're fighting for calcified for counsel patients the council patients don't have a voice the only voice that they have this is my voice invoices thank you all and this bill is designed at. To help cancer patients. Thank you representative Alan Senator Dismang. In really my questions on the cost of me was this bill recently not having look at languages originally filed to exclude our home in Medicaid. What what happened was when I filed the bill Medicaid was in in the bill of mark white's of came to me and he said that the governor wanted to remove Medicaid from the bill because she have a mobile mechanism that she was going use to pay for. I'm I guess my my room. I have an email from whites. What to a biscuit Mr white okay we'll let him image that questions okay Senator Dismang. I like the people speak for themselves. Thank you Sir Clark what perfume Services so you have the the original version the bill does not explicitly call Medicaid is amended to add Medicaid they always will present Allen about was to pull Medicaid out for the time being because we are engaged in an in depth copy to review the Medicaid program is as many things as we can their potentially or new costs for Medicaid we will look at those as a group and so we can make some decisions emerge recommend recommendations back to you all about with the changes that makes sense as a whole and so it's not it's not saying no to this all together but rather let us look at this as part of a comprehensive review of the program. Yeah and that's kind of my I mean it. So we we we don't know if there's a cost or we just haven't had a chance to study there's a cost do we believe that there would be a cost we had a fiscal impact and give me just a moment I can pull it up for ours. Spiegel record while he's pulling up senator Johnson you have a question for anyone else. What's in. C. and then. I thank you that was. Thank you. Well and and so what we're what we're waiting on that and maybe just questions for the. Sponsors you can decide on taker but it's time waiting and it. My question because it sounds like to be honestly cross and even kind of your response are very much in line talking about the treatment of cancer you can say you want to work on the diagnosis of tanking answer whatever may be which I think most of our language change bill would treatment which is kind of what you've been talking about to you know I'm concerned about the cost of think we probably excluded from Medicaid for a reason because we knew there was going to be cost and you know I would hate to ignore that being passed on to everyone else it's in a you know and health insurance plan so Mike my question would be is it mean is that language that you all would be willing to entertain or some version of that language. We just because I think if I'm hearing things right is the external experimental forces that that the questioning its the the portions that are being used for to diagnose that maybe haven't been proven out it's it's those are the things that. Is of concern. The senator what we would not okay we had a meeting over here about five minutes before okay this all started a member of the representative of the manager of the American cancer society. Said no he would not want to change that language that okay that he's happy and believes that the language we have best fits his initial that the national Cancer Institute agrees with the language of this bill okay so we've gone to the experts is anyone here from American cancer society. Mr if I can so that the cost we predict for Medicaid was approximately twenty two million with about six million that state share that due to caution you my my sense was that there are a number those procedures that we do not pay for the private insurance does pay for so I don't want to say that I don't say that is a cost you can necessarily extrapolate directly private insurance. Senator John. Thank you Mr chairman Mr why I just want to. Get you reiterate what I think you said what you said was that Medicaid my paper Medicaid may not pay for this and you all need to kind of drill down during a review to determine if and when it does is that a summation of what you just said that's correct for this bill as well as for a number of other bills this session we're gonna come back recommendations and say we think these are the ones with the best use for Medicaid doc I can live with that so you're okay with the language the way it is right now yes Sir we have no objection to this bill thank you Mr thank you Mr. Any other questions. This state so so whatever you all look first look at all make sure I understood what your cost and it is so was the diagnosis and was that all included inclusive at that time what is that what you were looking at or do you know because that was a look that sounds like a a lot of contention here is this and I was wondering if that if that was inclusive within within your cost numbers or if you know I do not know what I Senator finance folks about that good thank you Sir. Thank you seeing no other questions anyone here to speak for against the bill. Seeing none. Injured you're pretty close. Members. I'm a businessman you all are mostly all ours will. I understand Blue Cross and understand their position they have to worry about profit loss. Again I to that we had a meeting right there five Mister FOR this. Committee started. I told you would American cancers too said I've told you what the national Cancer Institute said this bill will save lives. And with that I'm closed. Thank you so what's the with the committee. motion do pass by Senator Johnson. Seconda Senator Irvin. All in favor same sign say aye aye opposed same sign. Five seven send your bills passed thank you all. Thank you Sir. Representative leading. We're going to you for SP four forty three. Senator Leding please introduce yourself for the record and you're free to present your bill. Thank you Mr chair Mr question members a committee senator Greg Leding from paid bill. Of this legislation would work on which began last year with established the Arkansas office of employment first the employment first advisory committee and the Arkansas first business partner program within the department of commerce we talked a lot about the importance and value of work here in the legislature how job is key to achieving self fulfillment and self sufficiency that's true for all of us including our Kansans with disabilities so Arkansas appointed first served as a hiring strategy for state by helping employers and our kids with disabilities connect to be clear all persons with disabilities pursuing employment under this legislation must meet minimum job requirements among the tools that would create our web portal to help employers looking for candidates and Arkansas king for jobs find one another I would increase work based learning experiences for students with disabilities and increased ICP student participation and work readiness and career readiness certification programs the legislation directly aligns with our current administration's workforce related policies and would reduce demand on public funds and publicly funded resources and couldn't fact potentially through employing just five hundred Arkansans with disabilities save the state more than thirty two million dollars just a few quick facts for turn it over to my friends and we have a lot of people here today to speak in support of the legislation more than sixty percent of employers surveyed indicated that hiring people with disabilities increase the pool of candidates eighty percent of employers survey describing police with intellectual and developmental disabilities as dependable engaged and well integrated with coworkers and a two thousand seven Walgreens opened up a distribution center for more than thirty percent of the eight hundred employees lived with some kind of disability and the company reported to the center was twenty percent more efficient than comparable facilities without workers with disabilities so we value the work we value work and promote self sufficiency in this bill champions both for our fellow Arkansans living with disabilities so with that Mister chair alternative against. Thank you senator please please have them there do some social record okay thank you senator Leding and thank you chair and vice chair and committee my name is Pamela all right across. Good morning everyone my name is Christine bill community liaison thank you in please proceed. So S. you have heard from Senator Leding giving you an overview of employment first I do want to define what that definition looks like for us as a initiative so what employment first is is where we're looking for the general workforce where it should be a preferred option for individuals with disabilities receiving from public funding systems to be able to work alongside individuals without disabilities and earned regular pay. So one of the things we want to talk about here today is just telling you why it's important. And so S. Senator Leding had also mentioned that it does reduce the demand for public funding but also as an example right now we have a hundred and eighty eighteen year olds that are going to age out of D. C. F. S. however there is no way for them to go they have been I'm prepared what was that policy the employment policy offices wanting to do is be able to streamline how are we going to do business so that we can clear disease but type these type of gaps so part of this gap is that we're wanted to make sure that the of the collaborating organizations that are already in place that we continue with those partnerships but we help to strengthen and help them to enhance what they cannot do so everyone is being able to increase the referral base for all agencies that are focused on employment secondly we want to be able to increase the visibility of individuals who have a desire shared desire to go to work and to be a part of their own self economic system one is that they are able to lobby for them sales and employment this is not a charity this is part of them trying to be a part of the work force which also coincides with what our governor is right now her platform and her legacy is leading toward work force and how we getting people to work so one of the things that is so visible right now that would help this whole initiative that she had started is that we have under employed individuals with disabilities so why not reach out and give them the proper training and preparedness and closed them and where we are right now in the state of Arkansas lacking employment employees so that would be another one as an example. So the other thing that we want to make sure is the the purpose of those creating this office is to create a more streamlined collaborations between agencies that means that we looking at the vitality of the work level increase in efficiency I think our governor when I was listening to her not too long ago when she talked about her workforce initiative she also talked about how she streamlined me from office to office but also less office but more efficiency and what we're doing and that's what this office creates and will be doing we're about the policy and about the data collecting and being able to look at the gaps that many of the agencies already have that we can come in and help them to fill those gaps with the viable workforce that has not been that's actually been overlooked. So a lot we've heard a lot of chatter and people are sent that's one Arkansas rehabilitation services does and of course we love our partners that are in the community we enjoy working with them I'm actually a provider with them for over twenty three years working and putting individuals with disabilities to work so one of the things that we want to talk about on those differences with the other agencies is that uh employment first focus on policy as whole as opposed to services. The employment offices also is based with the intimate relationship what I mean by that is that we're able to have a larger reach the and where are other agencies may not for example we do have agencies that have a small engaged the unit but they are only putting the individuals with disabilities that are their clients what we're trying to do is make sure that we cover the whole state of Arkansas for individuals that are disabled with the desire to go to work and here's another copy art we still have that group from eighteen to twenty five that graduated from high school but just went straight home who's working with that group who's reaching out to that group so that's another under and unemployed population. The other thing is that the employment office we'll have that specialize RES to increase business relationships so when I initially was talking to you about the specifics of other agencies having engagement units with the employer but we are trying to also have the engagement where we going to partner with the vital partnership that we will be able to expand our reach so the employment first office was specialized in interest the business relations that will allow us to reach smaller and mid sized businesses not just large business we need to be able to compensate all of them. The other thing that makes the employment office you need is to meet the W. that we do meet the W. I'll a standards of serving all persons with disabilities. The employment first office can focus on more specialized compact city to build employment relationships faster because we are not focused on a variety of services employment first is strictly a policy office so what I mean by that is we will be strictly focused on policy streamlining how we're doing business to capture all ages all disability individuals but also we're looking at the collaborative efforts with our other vital partners throughout the state of Arkansas. So employment first will be able to engage with our working age individuals veterans with service connected disabilities and intellectual disability developmental disability another name is added the D. that population along with the passes helping them to reconstruct personal service plants with employment being at a proper authority this will allow employment to be part of their treatment plan and that's where we want to move to we have to be able to move the needle to in order to engage our persons that are on the star of the unemployed a successful employment first office would increase of the organization's referral retention you asked me how so by increasing employment businesses and relationships and networks and include increasing shared services increase in the number of people being served creates an increased need for training as well as the need for services. So at this time I would like to win over to my counterpart who would talk just a little bit about some of the statements that could occur. Hi recognizable but soft spoken so let me know if it's difficult to hear me as former staff I think it's a bit more nerve wracking to be on this end of the table I'm very thankful to be here speaking on behalf and in support of persons with disabilities there's several states. My name is Kristen bell thank you senator there are several states that are currently utilizing employment sars employment first as a hiring strategy so it's not that what we're doing is innovative it's just proven fact. Particular states are Florida Mississippi Kentucky Colorado and we have been working closely with these offices to formulate ways to streamline data they've they've currently found research and software from the university of Indiana University that helps and allows a streamlining of data to allow the agencies to better communicate between each other. In Florida when they were allowed to institute institute policies to find employment services this on increase in available employment coaches paid internships and in one year they saw an increase of two hundred and six persons who were able to. Achieve competitive employment that was twenty three secured internships in one year. In two thousand thirteen two thousand fourteen fifty six percent of students with disabilities upon graduation one point and pull it enrolled in post secondary education. I recognize the. Per leg sense to want to open a new office but as a legislation states would be a small office in office consisting of three people and not only is it a hiring strategy but it's an investment in our state Senator Leding spoke to earlier they're currently four thousand seven hundred eighty eight people that are utilizing public funds and fund it services according to DHS records. For each person that sixty five thousand dollars a year to find those services if we can simply by gray five hundred of those people to utilize employment as a priority master option we could say thirty two point five million dollars. That's an easy number to achieve that's a simple investment. We're simply asking you to invest in Arkansas I understand that the office the reluctance in opening the office is because it's a new it's a new space and it's a service provider of saying how we're providing a unique service that does not representative please City it's important that we open the Arkansas employment first office. He what. With that being said one of the things we want to shine a light on is that when I spoke earlier about a hundred eighteen U. eighteen of age aging out one of the things that we want to focus on is that the uniqueness of this population can almost be certain that they are have a considerable number of diagnoses with a disability of some sort but by us putting individuals back into with disabilities into the workforce we would actually help them live longer they will be have better quality of life reduction again all public. Public funding we were reduce costs and residential and psychological services and then we will also have the opportunity to work with the individuals that continue with their final fours and IP's we definitely want to look at from this office standpoint that the rates are telling us that we can start at age fourteen introduction but we're looking at a bigger picture as well as when we spoke with Mike Rogers they we want to do career tracking and we want to be a part of that team and that's where we can actually help solve some of the issues that our governor had mentioned and what Mike Rogers who's heading up the workforce cabinet had mentioned earlier so we just ask that you would take this under consideration and please know that the employment office is not anything to the tier any other organization or agency we are honestly wanted to work in collaboration with our existing partners so that we can help Arkansas streamline and bring our numbers up under the employment for disability but also the numbers for the employment for the workforce overall. And that in mind. Thank you for your testimony we've got some questions for you all your senate like when you three would present yes member benedictions okay Senator Hickey. Well just just just first I heard what you said also see in the bill Wirtz is encouraging encourage competitive employment as a preferred option. It is. I mean I guess in my mind is that what we really want to do what we want to encourage equal opportunity I mean I I don't know why I'm. I just I just throw that out there because it just kind of runs up of a river runs of a red flag for me but it just the the wording of that I think we always say well we want to provide equal opportunities for everyone I don't know about this preferred are preferred thing. And I'm just going to be honest I appreciate you trying to explain it but I don't fully understand this whole bill It is so. Who is paying. Employment first for the work that they're going to be done for the work that they're going to be doing word of those funds come from. There is a companion bill an appropriation of five hundred thousand dollars. Okay that's filed with the state yes Sir. Okay that's already been done that appropriation is already are they are they bills already been ran and budget does refer to the personal subcommittee this morning to schedule at this time to be here tomorrow okay all right and. As far as the benefits of of being in Arkansas. To to do that are there any benefits to being one of those businesses are there federal funds are available or something that if you if that if you become one of those businesses that you receive additional funds or subsidies or I just wanna make sure I'm following the exactly everything that we're doing here so yes senator one of the things right now that we are that we would be tapping into is work opportunity tax tax for the employer where they're hiring individual with disabilities and the and they are afforded the opportunity to apply when they file their taxes to receive some type of income coming back to them okay and does the language is required for that to happen does that say that they have to have a preferred option you know that or is it just come up with with that no Sir the preferred option was language that we used asked to state that if you were as an example graduating from high school we will light for your treatment plant to say why don't we try employment first and we recognize that employment first is not the only resources out here but if you take the opportunity to do employment first and it does not work then we have other entities that are existing that they can be I can apply for so it's still a win win and we just wanted to make sure that we can take the individuals that have the opportunity to come off of any type of Medicaid services public housing services that they can literally invest in them sales and be a part of the if the medical system so that's what this is about is not to force individuals or not to take away but to also make sure we can streamline how we can come out of state are. State those type of funding dollars. Continue Mr yes. What you said I don't disagree with course yes I'd rather have a mental within you know sitting at home yes from what you said and from what I'm seeing in the bill may be I'm just missed reading that wrong was on page three line seven. Courage competitive employment as a preferred option for individual with the disability receiving publicly funded benefits so I mean. So it's not your intent that if you have two individuals that are sitting next to each other. That have the same qualifications of one eleven this disabled. That they would be the preferred option for the employment hole No okay so let's back up thank you that's why I'm reading it that way. And thank you for pointing that out no again let's make sure that let me make sure that we're clear this is not for charity this is about them become in part of the work force they will go through the same mechanism as everyone else if their accommodations they have to be met of course that employer would be able to do that and be able to assist them with that but they will go they're not asking for any spins we're not asking for any special treatment if the job has a requirement of A. B. C. and D. they go through a B. C. and D. and if they are qualified then they meet the minimum qualifications to be interview for that particular position the word preferred that we're using here it's only because we prefer you to try employment first. Okay I like what you're saying there I just I read it somewhat different with right language I don't I don't like the languages to be but I I like what you're saying but yes what I'm reading. So and the other the only other thing is it's a little odd to me because on the last page you know what we have the. And I don't know if you all are going to be considered a political subdivision or what or what you're going to be considered but you know we actually have the the pro tem of the Senate and the Speaker of the house that they're the supposed to be the ones that review your rules you know normally all that would always come through our subcommittee of A. L. C. Legislative Council what exactly for sure and then you know even goes as far as to say that that they're going to review the development of your logo I just. That seems a little that seems a little less mission that is outside of the box and saying little to me that's just that's just a little different. It is Senator and those are things that can be amended after this past. And we can make those changes and actually have a conversation with you on that concerned of the language. Senator Dismang. Personally before I vote yes I'm going to probably to be amended out Senator Leding of these well versed in how to do that okay our conversation here I certainly we would have the time to get this done again I'm I'm not for sure we couldn't do that in the preferred option a little bit better and definitely the stuff on the on the E. and yes I almost think that we would been Senator Dismang I think was involved in that he might can speak to it I'm not I'm not for sure that is not a requirement that it wouldn't come before you'll see I'm just is not exact I'm not a hundred percent sure about how you're structured if that's going to be the case or not that's something we probably need to get with our. Legal people yes I. Senate my. Senator Leding just a little bit curious on the language in it because it's very very specific and very please very little room for rule making in Maine all the way to thank you said we specified that the logo is going to get designed here and how it's going to get the design and he's going to prove the design of the logo I mean one of my concerns is looking at the bill I'm not opposing through to what we're doing by any means and actually very supportive but you have a board of twenty one people like when when people can get anything done I mean it it's just that's just the reality in my opinion in in that type of environment I I don't I'm not sure why some of its in there I think what we're trying to say is we want to be able to it in general all we're doing is saying we want to be able to designate places of business as being proactive in support of of of those with disabilities and by the way here's a place to go apply you know this is the database whatever reason we're going through a whole lot to be achieved but I think it's a pretty simple task in the bill just so my per question really is like why some of these written so stringent is there something I'm missing or could not a lot of this been figured out through a rule promulgation or a at the development or of an understanding of. You know what we're doing go ahead. Thank you but I'll put my guess speak to some of that but I think it's going to be as clear as possible so that we were presenting a very clear and concrete idea to the committee I do agree twenty one people can sometimes be tough to get things done but there are thirty five members of the Senate I feel like we get stuff done every day at also point out that those positions are unpaid so we're not creating twenty one paid positions but Joe like to address the specificity yeah. The Amendment. Thank you for the question regarding the advisory board and the number of members we felt it was important to include as many experts in the field of employment and disability services that way we can have the best best practices and ideas brought to the table for a policy office. The to Senate is nine six okay center Johnson. Thank you Mr chairman and I appreciate Senator Dismang Senator Hickey because they helped and ask some of the questions I had I want to get a little bit further US Senator Leding you're somewhat familiar with the issues relating to the plant board and what the Supreme Court did about saying that you can't let all these groups appoint people I'm I'm drawing that analogy only to compare the this it seems awful lot of people and it's a lot of positions and yet you mentioned they are unpaid but I presume that they would get per diem and mileage or mileage of to attend these meetings and then even the they issued Senator Dismang brought about the logo that makes me jump up and thank gosh that means our program we hire an ad agency I'm figured out where the money's going now and and again I. I'm very much in favor of the concept we want to do something proactive to help people with disabilities work that is laudable and wonderful thing and I'm grateful for my friends I know then the disability community what they do on the other hand always worry this time the session of the infamous low bill that don't do nothing and I'm just trying to weed through it and see. It's almost like it's it's a statement of Legislative findings and maybe resolution or something as opposed to you know a bill that does something and and put something as Senator Hickey incentives might might very clear into the statute that we usually do by rule or some other kind of More flexible tool so it am I missing something that I should know I will certainly be all yours if I am missing something that. I recognize your reluctance with the number of members of this board but each organization that's represented on this board brings a unique knowledge base we have Arkansas rehabilitation services we have the division of services for the blind. A number of these it's really difficult to rule out workforce services with this being a work force effort it will be difficult to rule out workforce services office especially with that being where we want to be hal's the governor's council on developmental disabilities Arkansas transit association transportation for persons with disabilities as a problem it has serious concerns that affects not only their ability to move around to navigate their surroundings but also to to maintain employment and to. To to make it to the place of employment. Yes ma'am if I can interrupt you of course I understand the The the the end of the potential people from that representing those disciplines in an entity's I'm just going to get it you're putting us in the statute and its that's a little troubling to me not those organizations and and if you say among others the representatives could include and then name all these it again it's it's just the. It seems an awful lot of of chiseled in stone law for something that she should in my opinion be a little bit more more stiff little bit simpler and a little more where it could be dealt with in rulemaking process as opposed to statute that's really only question I had thank you Mr chairman. Thank you any other questions. Hey I guess it's kind of up to you do you want to go down try to simplify some or you want to proceed or what it is kind of a in your court based on my esteemed colleagues feedback it does sound like a pared down version of this legislation would stand a better chance today so will likely pull the bill down with I know the committee is busy but we did have a number of people who showed up today to speak in support of legislation committee's permission would still like to go through that process and at least a few of them share their thoughts I would agree with you understand that if you will aid me in the list keeping it keeping going nothing repetitive and in kind of limiting in some. Yes you should. The just just to make sure and thanks I don't want I mean if you're going to do this I want to get rise purchases were so late in the session so so you will look at the preferred option. The point that centre Johnson brought up I thought was a good one with the appointments because you know if per diem is going to be there and you know if taxpayer dollars are available if that you know is approved you know there's the appropriation or however that's done I think that was a good point we need to make sure that that records labor able to appoint those or that has to be done by some legislative function the executive branch or whatever whatever that may be so what we I think we need to do that. Of course of continuing with the the parties. With sales the we need to check with our legal people to to see exactly how that needs to be done how you all are structured whether you're some type of political subdivision that those rules have to be Obligated to do them remove that stuff with the Speaker in the pro ten then I will be reviewing your logo. And that other stuff. So miss anything just so that no thank you cover the whole bill. Yes yes wait a certain Senator Leding I'm is really going to throw this out to the ever in the room including the chair but has the is department commerce representative in the room today do we have someone from commerce that I believe so. Could could get this gentleman to kind of give us their perspective on it Mr chairman yes thank you before we move on that day Leary's Senator Hickey was or anything else that you wanted on that the. What could you awful early no I don't think so the. I think of course I can go back and review the tape to make sure there were anything else it here but I don't I don't know anything. Thank you Sir. Please enter several record sure Tucker bracken's department of commerce all the concerns we had with the bill have been addressed by the committee and we voice some of those the sponsors yesterday as well and so we're willing to work with them to address each of the things on your list senator Hickey so willing to do that thank you Mr thanks for that introduction okay thank you enough Senator Leding if you would the we have I think it's fifteen signed up to speak for the bill so would if you would help us facilitate that and greatly appreciated and and keep us on some check we if I don't wanna thirty one shortly that will tell us to be here and speak. Thank you what we're going to start in order deals a state in the in force we're gonna start with the area treat she in all these will be far. Relating how long how long would you like for each person to speak. Understanding the committees rather busy just a couple minutes apiece that's fine. Sixty seconds thank you Sir. Please enter yourself a record here. I'm. If that Sir Mr commitment by a I'm very honored as a person with a disability to be here to speak on behalf of the bill. But as I stated motive you know who I am opposed to this bill stability and I'm fortunate I've been employed on non not all night but I know you said bill several individuals that disabilities are not what and I believe that this is a motion. Moses mmhm most read said Page suggests I should put an appointment in one minute privileges but each state that diverse thing. The the it is sitting and for the roll is **** global password though it. The two percent of American public budgets but dates working age are getting pool and what seventy or seventy six percent that the individuals with disabilities room or what. Boyd does Marty gap between the two numbers. And I said we made of wood burning need to close a gap this is a good bill thank you thank you mystery. Next we have a means a. Kramer. The. And please enter yourself for the record. Good morning my name is one state Kramer I'm an employee of dislike Rights Arkansas an Arkansas after the association of people supporting employment first president I'm here to speak about the points of employment first and compare them claimant for people displaced in the communities I have worked in the field to display services for over four years how much of that time has been felt helping people with disabilities gain competitive employment Arkansas I've been stable since birth and needed assistance with getting and maintaining employment growing up I knew I'd go to college and then into the workforce estimate would be easy by no idea at the time how difficult be for me and how difficult about that for disabilities despite the challenges faced employment so important to me and point as may be able to buy an electric supplement in it's not being part of a conversation everyone is being asked what they at do you allowed me to expand my network and start saving for my future and incredibly employed has meant I've been able to contribute to businesses both big and small Arkansas I can disabilities want to work to get them all the tools and resources they need to make that happen thank you for your time. Thank you and we look in going to college what is it that you're going to college I finished college student to appear on the card we're going I finished college and twenty twenty one with my masters in counseling from you Larry great well congratulations thank you. Next we have a more George if you're signed up to speak you don't want to just let it wave us by that office not no big deal. And please RT so for the record thank you Mr chairman members committee my name is mark George and I'm the parent of a twenty five year old daughter with down syndrome. Prior to the pandemic she was employed in a competitive and integrated position since the pandemic when she got laid off she's not been able to do. Be employed again. So for that reason I wholeheartedly support this bill. The one thing about the bill that I really like is the finding section and this goes to your comment sir about. The concept of the bill. These findings. Our true at least in the soon to represent a. Major change that the state needs to make and how it views. The knees and services to individuals with disabilities. It reflects a real world view reality. When the no to individuals or confronted by unique barriers and disincentives to employment and they are. And what is changed over the last fifty years is individuals with disabilities. Arsene is are now being seen as people have hopes and dreams. And are capable. Not in capable of doing things and that's a that's a huge change and we need is a state to adopt that view point of how we provide. Assistance is services to people with. Individuals ill. Okay. Achieving integrated competitive employment is an arduous. Journey. But this bill leasing a finding section establishes a destination so. Even as we make whatever changes the bill I have to be made I really hope to. This legislature this state of Arkansas will adopt the findings of this bill is a guideline for all for future approaches to how we deal with the services needs of individuals with disabilities it's a beautifully written bill. And Irish's Health is passage thank you thank you Sir. Lisa Kramer. I pass. Angela Davis. I will be happy to speak when the bill is re introduced if that would save time okay that that be fine thank you. Randall Morgan. My name is Brenda Morgan. A work of art Davis. And. A. A supported because I'm a disabled woman myself on the autism spectrum FADD and I have generalized anxiety disorder. And the. The. The legislation. Please. Thank you thank you very much. Very good job. Jennifer Lewis. And Jennifer if you would would you please tell us what city you're from for Senator Hickey when you should definitely yes I plan to do so I appreciate all of your time say and I'll try to be brief but I did drive three hours to get here today as a constituent of Senator Hickey in Texarkana and I will try to get through this as quickly as possible my name is Jennifer Lewis and I'm the executive director Texarkana resources for the disabled a nonprofit in Texarkana Arkansas to help individuals with disabilities gained independence or training employment and housing support I'm here today in support of SB four four three and hope you'll vote to support it as well I started working at Texarkana resources seven years ago when I relocated to Arkansas from Washington DC. I was disheartened when I first came to this state by the lack of employment and resources to gain employment to those with disabilities Arkansas. Texarkana resources has a sheltered workshop we had one since nineteen sixty eight. And this is a man that I learned about the historical option for people with disabilities when I was in my grad program at George Washington University I didn't realize they were still so prevalent until I moved here. I was shocked by the low numbers of those with disabilities employed in Texarkana when I first moved there this is because I believe that all people with disabilities can work in full community integrated employment if provided the appropriate support. Arkansas ranks forty six nation for employing people with disabilities I still have that is the transportation infrastructure in smaller cities and rural towns like Texarkana and outscoring communities did not have sufficient transportation options to provide individuals with disabilities transportation to and from work our local trucks buses do not even on the weekends employers like education on the benefits of hiring those with disabilities and still fall victim to a long term disability mess of hiring those with developmental disabilities in our workplace this state provides employers such as our community providers such as ours. Insufficient support and funding. Then I can go on and on about that. We are one of the only providers left elected to actively provide employment for services of the Arkansas rehabilitation and talk for ten Arkansas. The program has not sustained. That program in our agency the last seven years I ran in the red we continue to have that program because it is imported I'm fine or is I write grants that we are small I do it all because I value the importance of community integrated employment we talked about options today I don't know fourteen seats to go away because quite frankly that's one of the only options in Texarkana for people right now I have fifty five people that come to my program every day and if we were to get rid of that will go to the house but there are other options and there are two gentlemen that are going to speak briefly and I'll let them talk about that that. When provided the support encouragement to gain employment they did. But never talk to them about that as an option before and so I started it Texarkana resources. That's ridiculous. We talked about transition she said you know they just go to the house I have worked and worked to try to get Arkansas to work within your transition programs I started a transition program in Washington DC for projects are working with George Washington University no one listened to me so you know what I did I want to run across the state line and started working with Texas we've been working with Texas high schools for three years now and when they graduate they have a plan and we get them work. Arkansas. Policies we need to re think of what we're doing for people with disabilities in this community. There are so many people disabilities in Texarkana Senator Hickey a ton I urge you to come out and visit us whenever you want I see you across the street artist talks are Canada were right across the street come see what we're doing and help people with disabilities are community. Thank you very much for that and appreciate your passion. To the point of personal Yes yes service please. miss Laurie tragen with the bank's associations as a group and we a committee I want to recognize before they have to go Senator Leding skews me the emerging leaders section of the Arkansas bankers association I like to recognize them could you please raise your hand. All right welcome. I know that was was growing a little late and we want to recognize you in between thank you appreciate that Sir thank you for dropping by and appreciating the whole there's something you'll gained out of the estate. Next we have the. Ron say. Okay okay. My name is Ron state I'm a person with autism I have a girlfriend and my own guard and I have an apartment in market Cooper tire test can Arkansas poster was in this all this way however however for many years I had a guardian who do not want me working at a thank you committee appointments. Who did not want me to live on my own and who did not want me to have a girlfriend this is a barrier to employment many of us with disabilities space but no one wants to talk about many parents will talk to you today about how they want their adult child to be able to work but that is not everyone's story I did not want to live on my SSI check I want to work and be able to live my own life to make money my journey to committee employment was a difficult one the first thing I had to do was to fights to regain my guardianship I successfully did that on may twenty four twenty twenty one after a year long battle just a month later I was employed at Cooper tire and rubber company with the help of tests can resource for seven years per year I was participating and they're sheltered workshop program whites it there but want a job in the community I'm glad to its can resource supported me and whatever employment option I want for myself this is working to keep retired for the past two years I haven't called in sick to work once I have earned enough money to move out of my community living group home to a train apartment and then from a train apartments your committee apartment with my best friend as my roommate as I learned to schedule transportation to and from work on my own transportation costs me a good portion of my check since I worked on weekends and our chat system does not run on the we cancer tests can become more financially independent and working on seven up for a car learn job all of these things would never be possible if I did not have a job in the committee last year I got a raise on Cooper tire since I am so. Such a hard worker I work in the heat and the cold sore and plaster rubber and Belling cardboard my supervisor Gary is impressed by how hard I work before just before choice and I started working there they always employed young kids out of high school that did not stay long we have how to retire and they have helped us I am so happy to have a job in the community I hope you will support this bill to help other individuals with autism let me for better opportunities in Arkansas to gain employment thank you thank you Sir. Foregrounding. Okay. All. Tell what time it. I am in my time up there and to pop up okay bye bye. And approved by the follow Ralph two out for its provide that for them to that file. And by December my client at the two five we have a medical and the okay my fat and filed with the and my family in route to a total of all time. We we talked about I just want to hold a little bit translate for for trade trade made a face many barriers to community inclement because of his disabilities is alive you know difficulties with communication and not being able to read how many people mark Detroit off Tory was attending our. Children workshop program for twenty years and nobody ever really talked to him about community integrated employment true with an extremely hard worker and I told her you can get a job in the community you know right he's very scared and I had a knock on a lot of doors which is why I appreciate this legislation and having some employer incentives are having a list of places I can go in Texarkana where I know they want to slam the door in my face because they don't appreciate a hiring people with disabilities at forty seven years old I got his first job and it should have been much sooner he's working at Cooper tire for three years never missed a day they have great retention rates wrong got hired because of Troy because Jerry called me up and said man I got you something was great do you have another do you have another and we do and we'll send them because they want to work and they can work and. It's just been great and we mystery how you know around in our day program but he's off to bigger and better things. Thank you thank you very much for. Christian Christian bale. The okay. To the. John Brandenburger. I make a brief. Good morning John Bremer I'm with community bakery and the reason I'm here today I'm a big supporter of not only the bill but the program we see it in action every day also attend Pulaski tech you just trying to. While my culinary skill sets and I have come across so many amazing folks at that at that facility that now several of them work with us and our from the three D. program and and folks with disabilities and autism we have several folks and from someone who is an entrepreneur and and runs a I consider a pretty important brand in the city that's been around seventy five years I don't have the exact data but it's pretty close all my folks said that work with us at the bakery that either have autism or on the spectrum or through the treaty program their attendance rate is like ten times greater. Ten. And the rest of my staff and I have sixty eight employees many of which have been there twenty plus years and I hear entrepreneurs all over the city crying about they can't find people you don't know where to look I do and send me more I take these two gentleman tomorrow if I could thank you. Thank you Sir. A Derrick Parker. Derek's not here nation McCain. Designate them either in Johnny Baldwin. Is there anyone else here to speak for against. Saying ninety central banks. Thank you sincerely appreciate the committee's time whether got different people today with committees Mitchell put the bill down and see if we can make some changes. Thank you Sir thank you. This is. The sixty four fifty four Senator Gilmore said Ricky all right. Please enter your cell phone records certain key. Thank you Mr chairman. Medications state Senate six. Senate bill four fifty four. Referred senate bill for. So what this bill seeks to do is codify the existing interruptible service policy the benefits large scale energy consumers and utilities bill. Currently the rate structures only outlined by way of an order from the public service commission in nineteen ninety eight in its order the public service commission recognized that offering interruptible service to large customers benefits every stakeholder involved in the present provision of reliable and affordable electricity throughout the state of Arkansas. Putting this policy in the code simply solidifies how interruptible service customers will be charged for service and gives those customers long term insurance. Of consistency on the rate structure. This bill does not change anything from the net metering bill that was passed recently. And if you look at sections a and B. on the last page even clarifies the grandfathered in interruptible service customers from the net the net metering bill and I'll be happy to answer any questions I believe this this language was agreed upon with energy in the co ops and everybody involved. Any questions for the senator said Johnson. Can anyone here to speak for against the bill. Seeing no one these center you closed closed at your present a good vote we have a motion by Senator Johnson second by Senator Penzo all those in favor say aye. Opposed same sign scent your bill is passed thank you. And I'm going to go next to present my two bills and turn it over to the Senate senator Murdock. Senate bill four twenty seven and four fifty six thank you for. For twenty seven first. Senator hill you're recognized to present Senate bill four twenty seven. Thank you Mr Senate bill forty Ricky Hill district a eleven this is Senate bill four twenty seven this is a a simple bill all this bill does is. Makes the special being vehicles which are motorcycle all terrain vehicles utility scooters go carts and low speed vehicles the same as the RP a bill that we currently held may make some near each other basically what this does allow you have a special event that you're putting on that you can go outside the county you're in and to took the parliamentary and if you do not have anyone that'll that wants to come into effect in other prime example this let's say that would be the big boat classic with a bring bring inventors over the school to pull man from From local areas now they can go to adjoining counties to try to find a vendor for for particular items. That I'll take take any questions. Any questions from committee. Seeing none is there anyone here to speak for against. See no one Senator hill which led to close for you I'm closer. Okay close was willing to committee. Got a motion to pass second motion to pass by Senator Johnson second by Senator boy was that a second centreboard second centreboard. All in favor please signify by a. Hi. Those opposed. Congratulates you pass your bill. Thank you Sir Clark but first time I heard a. Okay. Six of Senate bill four fifty six you're recognized to present that yes this is Senate bill four four fifty six basically it just says that to a a state funded medical school cannot use taxpayer dollars to pay an ideal athletes so basically saying that not saying that they can't pay them just saying they cannot use taxpayer dollars to support them. Okay the questions from the committee centreboard okay so Senator Hielscher Mr so like if they had private funds they could still use private funds they just couldn't take taxpayer dollars that is correct they still be it will still be able to do that okay so if in their current commercials they were using private funds they would be able to continue setting that is correct and this is clarifies that we're not using not using taxpayer dollars okay thank you. Any other questions from committee. Senator Hickey at. I don't I don't read it that way okay so may I let me let me let me little bit farther okay that is going to be corrected we're talking yeah I was going to go to correct that on the House the. Cool in any any as he or he can verify that we've had that discussion. So there's going to be an amendment there will be an amendment on the verified that you invest can. Dissipate but they just can't you state that that is taxpayer skews me taxpayer dollars that is correct okay. Any comments questions from committee that. Senate Johnson. Thank you Mr chairman senator hill hi and lot of concerned when I saw this happening and I've expressed it to Mister Davis and he was forthcoming with the information I appreciate that but a. The supreme court's for basically rule that these and I health thing is a. Basically it you can't stop account person from from working or selling their a major whatever I I've except that although I'm don't think the NCAA and the others of regulated in it as well as they could have for the benefit of of everybody not just a few I think the quarterback for Alabama is making over a million dollars a year now which. Sure is a lot of imagers rolling over in their grave on that but. Is is your bill. Just an attempt to try to put some kind of rains on this as opposed to really trying to get get it under control I'm after I'm not remind idea as far as getting our Trel up I think the the courts have already made that decision my my main point of this is do not use taxpayer dollars to pay athletes. We're going to do that when he have given your money at a general revenue to do it. So it would be a line item they need to that's right yes five hundred dollars I don't have any other questions thank you Mr. NO questions from committee. Seeing none do we have anyone in the audience to speak for or against. Okay sent offense Davis and you okay. Okay all right of your clothes for your bill senator I'm closer with the will of the committee. Hi motion do pass a centreboard second by Senator Johnson all in favor signify by proper sign. All those opposed no. Your bill is passed congratulations. What hello no excuse me your bill is fail. Let me look at this again called on second that let me start off City on all in favor. Signify by saying aye. Those opposed. Congratulations you Bill pass. That will close. centre Penzo. Thank you Mr chair of two people I'd like to bring to the table with me. Yes Sir thank you. If you would please their dishes up a record. Thank you Mr chairman Casey Castleberry here on behalf of the Arkansas hold a service station. Matt McClure president of the Arkansas home based services association. In the lives thank you member first. Okay I have a Amendment just standing representative Johnson. Thank you will of committee. The motion to adopt the seconded by Senator Johnson all those in favor say aye opposed same sign center please present your bill as amended thank you Sir Senate bill four sixty eight is a Medicaid transparency bill and I will let the Mr Castleberry Devin two thank you senator I have a handout about his or. Yeah there. Thank you. Thank you senator Penzo. Mr chairman Senators appreciate the opportunity to address on this bill this. This bill as center Penzo described is really a transparency bill pertained Medicaid payments by the state it simply requires all personal care service providers to provide documentation to DHS to show that they're paying their health care workers Fike a unemployment taxes or unemployment insurance workers compensation and health insurance on behalf of those workers Hey did you a letter from December twenty nineteen from Millman eighty to the Director department Human Services. And this letter sets out the methodology used to determine the rates that are the state Arkansas pays to home care providers for those workers. I've highlighted some language on the second page because I think it's it's most important part of this letter for purposes of this bill the language on the second page makes clear that when determining this rate Milliman took into account all mandatory Arkansas in federal benefits including unemployment insurance and social security as well as any employer costs associated with health insurance so when Milman came up with the rate they assumed that the healthcare providers are paying their workers these these benefits along with the hourly wage. So what this bill requires is that in order to get that rate was determined by Millman and adopted by DHS you have to show that you're providing your workers with those benefits if you if you do show that your provide those benefits no further action is necessary if you don't then you have to show a DHS what sort of benefit and compensation plan that you are providing to your workers it's simply a way to show the state how the Medicaid dollars are being spent to provide home care services I think it's important to note that this bill does not compelled or prohibit any business model whatever business model is being used today by healthcare providers home health providers excuse me. Can continue to be used a simple places a reporting requirement on all home health providers including those members of our association to make sure the state dollars are being spent the way that they were soon to be spent when the rate was set so appreciation the opportunity to address you very briefly on this bill and would would ask for a vote in favor happy to answer any questions and Mr McClure as well as here to answer any any questions that you may have. Mr colors and things like to say. No Sir I'm just here to answer industry specific questions. Do we have any any questions. Senator Hickey so. The only make sure I fully understand this so basically what you're saying is is if somebody cannot operate the ten ninety nine. You're or you're wanting them to provide evidence. So. Could they provide evidence that. That they were under the federal insurance contribution act if they were headed to ninety nine. Senate I think that's very good question our position is that this bill does not prohibit using ten ninety nine workers. But they have to provide evidence but it doesn't say if you don't provide evidence you can't to receive any payment from DHS it's simple if you don't provide evidence that you're paying those benefits then you have to show DHS what you are paying because what we kind of run into the situation where. Where the of providers who've used independent contractors have take the position what we do that because we pay a higher rate to our workers and what this bill does is simply requires them to come show that and make sure that the state of Arkansas is it just subsidizing additional profits to those providers. Almost could turn it the other way it almost seems like to me that the you know by requiring by requiring this or take it out it could be more cost to the state. because I'm sorry what you said about Millman intimate if they made a mistake in the their calculations but not figured that that's that's on the contractor that we hired but it almost seems like to but from my standpoint I mean owns or smaller businesses if I if I want to provide our get contract labor out there as long as I do the for the the federal guidelines where they're not using their their tools and things of that nature then that's why out I don't guess I really understand what you're doing I remember a couple years in public health the John not try this a couple years ago when Public Health it was it was run public health company a couple years ago it's a separate us as a similar bill but to the issue but but but not exactly the same concept. Was there anything under the federal guidelines out there I mean since their providing this money that that disallows somebody. To be a ten ninety nine employee or not It level even worker it's it's it's our position that if you're if you comply with the federal guidelines there promulgated by CMS that the required by Medicaid and you have that in the amount of oversight that is required by the federal guidelines that's mutually exclusive from being able to operate as a ten ninety nine but but they've taken the position that those agencies the federal agencies have have bless their business model if that's the case so be it but I think what this bill really does separate apart from that is make sure the state is getting what it pays for and and it's not simply put more money in the pocket of the provider is not provide those benefits to the employer employees or workers. Thank you Sir I want can I go going on to the extent that morning so or what I don't wanna be filling in ward five are you trying to say maybe that there's some competitors out here billing the state for those benefits and not offering them to their. Employees I think that's exactly what's happening Senator is they are being paid to write. That was determined with the assumption that they're paying their workers these benefits ficus unemployment insurance workers compensation insurance and health insurance when they're not a in fact paying those benefits to their workers and and that's that's what we would like to create transparency to see that that's happening so DHS can deal with it appropriately thank you thank you senator Murdock. The follow up on that so you make an assumption that they're not somebody is making a motion what what what what discovery do you have to to prove that. I would departmental clear if I could Senator okay discovery at. Hi there yes there's been testimony by providers that they do not provide those hence why they use the ten ninety nine model. And it has so would presented to me is that they do pay more but you saying they've testified that they're not paying no that's not what I'm saying I'm saying that they don't pay those benefits and I think what this bill does is it allows them to demonstrate that they are paying more. So if you look at it Senator it is just from the perspective of it makes it transparent like we're actually asking for more regulation on us that we also put that out there and give that information to DHS wouldn't be more prudent for the regulatory arm which would be our is DHS or some other entity to be putting this is asking for this rather the in a in the industry another portion of the industry the appearance is that it's one. Question trying to dictate to another portion of business model if you will that eliminates a model possibly to be exposing them to something versus just a. Good transparent the transparency is the cover for something else that's what it appears in the room it in and for me is always the best way to tell me the truth on what you're trying to do what is in the round to get to something yes Sir and and I agree with that wholeheartedly I think that's what this does is it makes it transparent or that is occurring where right now there is no transparency with it because the rate is the rate even though the rate was set based on those parameters. There are some providers better pain that and some that are not and all this bill does is says. We're going to demonstrate that to DHS how were expending those funds and I think from that perspective you know the fiscal responsibility of the state would be like we want to know you know what I mean how these funds that are being generated by Medicaid how they're being spent and I would suggest to you that probably the entity which in this case is DHS that there are overseeing these funds being expended for us are obviously there okay because they have not brought this to the fore for us to consider in the manner that you are it generally doesn't come from where it's coming from. But if you ask the question thank you and we do have some DHS here and if you want to call them out in in center Murdock out I'd like to point out that it's a it's or reimbursement rate and that reimbursement rate was based on paying out certain you know benefits and so it's not. I think the key word is reimbursement so they're being reimbursed for expenses that are if there is a different model they're being reimbursed for expenses that are not incurring way all so here's to two ways it goes W. two has certain expenses that that you have to employee into nine I have a different one but what I what I'm what I'm told is that the independent contractor being paid at a higher rate so if this state rate is forty dollars and is using the number. The independent contractors may be getting and doing it in a different way but still it's forty dollars it may be through a higher rate for the provider as well as in the end it you know those taxpayers to have to pay dollars we different contractors still pay tax pay taxes on their income so it's not like we're missing that is how its utilized and we should be okay with that flexibility arses and we're both the construction so I understand ten ninety nine W. two and the benefits of both I just think when we're dealing with you know taxpayer money and it's you know reimbursing for things that are being spent I think that's where the importance of bringing transparency to to what is being paid out think it's very important and this out my last that is that's why I want to the point usually the the the regulating authorities did look it is something being done properly is generally the agency or IRS or someone else is not usually in this fall but I appreciate as. Service my. And and I really from my questions for DHS because I wanna make sure I understand how the reimbursement works how it's calculated and have applies to the. Against two different models gonna mark Senator Hickey you have a question first well if you could be the center Murdock Senator Dismang heading down the same road and maybe we can do it here my question was going to be along the same lines I assume that whenever this was done that there was an RFP or RFQ that was used to procure those services and I guess the thing is is may be Mister white can answer that was there any limiting factors within that the contract for lack of a better word that the send out my rescue has to say and since that's where action yes so that's why I want I'd like to see if you got mine. And so I'm just trying to understand how we kind of established reimbursement rates and how that works and and and so much tell you what I think. Is. We compile all information from all the providers out there we we kind of have it what we think that their cost are and then everybody gets paid back the same reimbursement rate so I mean all all entities are paid to save same reimbursement rate is that fair yes Sir Clark what are means services you are correct for for personal care for doctors fees for part of the majority of the fees we pay that's exactly what it is we we paid we we figure standard rate based on what we think it should cost that individual provide that service and what they do with those funds on the back and we do not look at that's not true for like nursing homes hospitals mothers in this case yes Sir that's correct all right so and so but it's all based on information that you've collected and so if you want entities operating as contract labor which I mean typically. Image it also varies it I guess it depends what they're paying and so when you all did your analysis I mean it is that which all saw that there was a higher contract labor reimbursement payment being made that was in lieu of all these other taxes and so are you know the employer taxes and that sort of thing what we saw with that we saw a lot of variation not just between these two sides to tops providers but between all the providers I mean there's there wide variations in terms of the hourly rates they pay the tops benefits they provide what they pay for those benefits and so we just we look at that trial of the entire universe based on the based on the information we receive back and this come up with what is a fair average that will account for most folks there's no R. F. P. R. if Q. or whatever maybe it read the reimbursement rate just reimbursement rate it's based on collected data that that's out there for that I'm. I'm I'm understanding it and so whenever. You're gonna reset rates again. At some point we expect to right and when you reset rates. Are you what what information you gonna be requesting so what from these ten ninety nine folks or for the W. two folks I mean it is this already information you're going to be gathering. If it would do a lot with the previous time which I think we would yes Sir what what we will use the last time we we use a very extensive survey we sent providers and ask them to break down what are the costs you incurred in the last year for your Medicaid clients to Westwood you paper salary what you pay for benefits what is pay for your office expenses we try to itemize all those things and then as we average we're trying to check against so standards so for example with other set rates for faca no and so we we try to check that and see is that accounted for in what's being reported back to us just to make sure that we're not going off on some out liars as we come up with some numbers new furnace cut to the chase I think it's that there are certain entities that don't feel like they're able to utilize a contract labor approach and they're entity it either I don't I don't have many are operating with a contract labor approach B. do you mind touching on when you're pretty well aware I think of how in these folks work why wire centers these able to capitalize on using ten ninety nines and seven cities are only able to the W. twos my my sense is the majority of our personal care providers do pay on an employee basis for the ten ninety nine in terms of our rules in our requirements we do not distinguish we allow our rules speak to both employees and contractors so we allow that either way for us that's ultimately a quick as a tax question to the R. S. the US farmer labor they have certain criteria rules they established determine if someone is truly an employee or they are true to ninety nine contractor that's not our our bailiwick so we do we just don't look at them not into you get to the calculations and making sure that everyone is paid you know the flat rate all entities are paid the same regardless what the model is regardless what their hourly cost is or whatever it may be yes Sir they're all pay the same rate okay and I'm probably have a couple questions later than not like Senator Hickey. And you answered the or if they are to question appreciate that so I mean it's almost a million I wanna make sure that I understand so we're not requiring the the entities are operating under under W. twos to provide their employees the same rate so in other words if they play an employee ten dollars an hour that's okay are they play an employer eleven dollars an hour. That's okay also is that correct yes it's just like so from my standpoint it's almost to me like with this same mentality of we're going to go down this road and and and try to provide that type of consistency there would be a new need to be a consistency with what you are paying an hourly rate because if we're just talking for trying to go as far as saying we're worried about the whatever so security is the seven four seven eight percent my apologize for not remembering that on the employer side then you know it then I should be worried about whether or not you're paying in your employer dollar more or a dollar less so I I do struggle with this I appreciate you answering questions. Thank you any any other questions for Mister white or the. The sponsor. And and and so my question would be then what why would no one else move to the ten ninety nine model if that makes sense then why why is only a minute. Is it because we think it's noncompliance of federal law kind of what brought me through the kind of why there's this difference. Senate you hit the nail on the head we don't believe that you can operate ten nine I'm modeling and comply with federal law the the the CMS requirements require all kinds of oversight of of these workers to make sure that they're showing up making sure that their their tracks their location every fifteen minutes and and and can confirms that the person who's receiving the services actually you know provide the services that the state is paying for and so given that level of oversight by our clients don't believe that that's consistent with a ten ninety nine model for federal regulation constraints. Senate Murdoch. Right to that same point but the other side of the pool there is so many of entities that exist for a long time or using a ten ninety nine model and again you make an assertion for me industry stand four point oh a particular part of the industry a W. two side and the agency the regulators have not concurred with your conclusion so let's be clear when you say that you don't think they can obviously they have because it's continue to exist and the only thing that this bill is asking us to do the legislature it is determined that they can't exist anymore almost where you asking us to report DO is a reporting what you just made a statement that you didn't think may of followed all the guidelines possibly used and I think that that's just. Probably not true based upon the existence of both methods see what we have going and we have the B. two we have two ninety nine that is in we can co exist like that people choose their business models so I just don't think that's the point not the we need to be involved in outside of of what we call the if mark right DHS or an agency it is involved and let us know of some issues then we get involved but of I think that the two ninety nine when they can do it well. I appreciate your point center I guess our our position with respect to this bill just to be clear is it does not it does not say you can't operate as a ten ninety nine the reason we don't believe we can operate ten nine nine model is because a federal law which is not going to be affected by by this bill we're simply asking I believe Senator Clark you mentioned earlier that that your understanding that these ten ninety nine operators are paying their workers higher rate all this bill does is ask them to show us that if they come in show that that may justify what they're with with a my only point to that is that why do we need to show that to you because DHSS to terminate rate and from a from a methodology and they're going to pay that forty dollars per anyway so now asking you can't like Senator Hickey just mention get into the how you do your business is not. This is your business with you P. M. ten dollars eleven dollars hours that B. two or whatever they do as long as they take care of that the constituents of they're serving an agency and an A. R. S. and other agencies don't feel like they're doing in an improper manner. Thank you senator thank you senator Johnson. I'll be brief Mister chairman I have just. Serpens are you mention your business you use ten nine nine you use contractors I've did that for thirty five years I was actually sitting here calculating and until I. In nineteen eighty three I left the employ state government last time I got a W. too until I became a center so I just don't see those I see this is a solution to a problem that doesn't exist but could you tell me where I what I'm missing here. Like you said the when it comes to construction let's say I've got a a roofing crew that a subcontract out they don't check in with me every fifteen minutes they can do the job when they can come to the job and then I pay and when they're done with the job you know when it's when it's some of my employees I know where they're at every minute they're on the job site and what they're doing so there's there there's that component you know the when it comes to the the dollars I mean that you pay an employee that's that's the free market you can you can paying ten you paying ten if you have to pay a living to get you know police you Pamela so this this is in my view completely different in it I mean I hate to use the word fraud but that's kind of what what this appears to me if if if the reimbursement rate is calculated on you know paying out certain benefits and you're getting reimbursed for benefits that you're not paying I see that is a huge huge issue. If I could follow up. I like Mr white follow up on that first yes thank you. The on the fraud pizza so. It if that's the case you want to address. Well I'll just say as as I said earlier I think historically for these types of response personal care begin what we paid to doctors and other providers like that we to store a we do not look behind that to see how they are spending what we pay them on those cost at the end of the day I think we think this is a question of are these providers in compliance with federal tax and labor law and that's most of them that were qualified or have jurisdiction to address thank you for that Sir. That pretty well answered I just it's a little bit strong we start talking about fraud but Mr quite we. We just went through a pandemic and I think we had a few nurses moving around and getting ten ninety nine to that not happen during the pandemic yes Sir do you think we have been able to solve our nursing situation without that option I think that would be very difficult it's All I Want to thank you Sir thank you Mister chairman Senator Hickey. I'm not normally the law thank. It's a first for anything. The Bill. Any other questions. Seeing none we have the. Peter presenting sentence over yes okay we have to do speak against. Lawrence Williams. Please RT for several record. my name is Lawrence Williams mechanical in home care in northwest Arkansas. And then when you introduce yourself. I'm Sonya bowling and I'm from all care home care and Jones for Arkansas okay so we'll get both the same time the part I have a handout you'll give that out now or will it staff pick it up from you. Thanks are you State Farm Mister chairman senators I appreciate the opportunity to address you today in opposition to Senate bill four sixty eight this bill is another attempt by national home care companies to eliminate the independent contractor business model for personal care services provided by Arkansas Medicaid providers the empower independent contractors active twenty nineteen providing an exemption for independent contractors for realtors insurance brokers car salesman farm workers construction workers and personal care workers in many more there are over twenty of them have this exemption. This bill again is another attempt to get rid of that exemption for personal care workers for their personal care worker chooses to use the independent contractors model or employee model we all follow the same guidelines that Arkansas Medicaid has established for our clients. This bill would give the Department of Human Services oversight and how we set up our business and how we choose to pay our care givers Arkansas Medicaid does not. Need to decide how we pay our caregivers they just need to make sure that we're following the guidelines and the clients for taking care of this bill would greatly reduce small home care providers in the state and greatly affect the number of care givers available to take care of the people that need it most our Medicaid clients we currently have a shortage of care givers as it is and our call our care givers like the flexibility of the independent contractor business model in July twenty nineteen a rate study was completed concerning the reimbursement for Medicaid providers. That study it was mandated to be done every four years the study in twenty nineteen allowed for a one point four percent one time increase in reimbursement to providers at the time and twenty nineteen inflation was one point seven percent today inflation is at six point four percent. The rate study was completed and implemented four years ago pre coded the workforce of today is not the workforce of four years ago there's great difficulties in all areas of the economy to find good workers cost for some consumer goods foods everything else of going up and the cost for care givers going up as well. Instead of eliminating the the ten ninety nine contractor from this business model we need to focus on giving more reimbursement so we can pay our care givers more. Senate bill four sixty eight is another to have a large national home care agencies to change the way small home care businesses operate in Arkansas and reduce competition the Arkansas Medicaid personal care provider manual section two point two thirteen point three mandates the client has freedom to choose their provider if this bill passes Medicaid clients will lose that freedom of choice. One of the other things that they alluded to is they feel that this is not a ten ninety nine business and they feel that they have to be W. two. Well I received an email from Bobby Kelly certified franchise executive at home helpers which is a national companies. And I ask you soliciting me to get my get my agency to convert over to a home helpers so I ask you some questions and he responded back our care givers are all W. two employees most are part time employees considering our hiring practices and retention programs but we never do ten ninety nine the national companies do not allow the ten ninety nine and that's why they don't do it and they even state right here they're part time employees and they try to do that the way they Hiram. Simply so they don't have to pay the extra benefits that Senator Penzo was talking about again I encourage everyone to vote against Senate bill forty sixty eight. Senate my. Thank you in just a couple quick questions make sure I understand because I've been I mean construction but I wouldn't dare you know my hourly folks will never work in but it'd be too because if I if I did I don't care what state law says or whatever says the feds are gonna REDETERMINED that for me and I'll be paying back and so my question is what what I don't know if it has ever been challenged I mean so I think the insinuation is that the ten ninety nine and the you know the model is is probably inconsistent with federal law regarding contract labor in employees as that has been challenged on a I can address that for her just the back four years ago I went through both federal and state labor board on its both of which I came through with flying colors I do things by the book one hundred percent I have to go through stringent rules and regulations proving that I did that and I'm fine so to say that we don't is just a. Imagination they're just gather guessing because I've gone through it and I can prove it so on and so it's never been there's not some case out or or what if there's never been a ruling against a on Health Organization ninety nine. Okay and it's sort when you said you went through it you went through the fat it was a federal federal labor board audit and a state labor board on it thank you. Thank you any other questions. Seeing none thank you very much. Yes so I wanna make sure that up specific did did they look into your ten ninety nine is that specifically what they were looking at whatever they did the audit yes it was thank you. Thank you very much. Senator Penzo really a question for him. Saying nine you're pretty close okay we'll let. Guests were closed just as for good vote. Thank you what's the will of committee. Motion to pass. Twelve second segment senator Boyd all those in favor say aye. Postings and Do that again all those in favor say aye I. Opposing signed no no Senate. Centreboard. Thank you Mr Speaker chair if the committee will oblige me I'd appreciate it if not we'll just for go it but if I can make a motion to adopt to add me as the Senate sponsored house bill fifteen fifty eight. Do we do that real quick no Sir we can't do that okay then that's good we'll just a figure it out Senator Justin Boyd district twenty seven house bill fifteen fifty eight this is a bill that expands access to medications for detoxification and treatment of withdrawal and it really is pretty as simple as it is. We have a handout a party once passed out what is it it's a handout sure. But the important thing is there's no fiscal impact unless there's somebody here that I don't know of the speak against it there's no known opposition. And that's really. What I have to present. Any questions. I have a motion do pass I have a second right here all in favor say aye hi those same sign your bill password Jr.