Public Health, Welfare and Labor Committee - Senate

Areas and so just a couple of different things right off the bat at welcome to the public health committee were glad to have you today this morning and. I think we do have some bills that we're going to try to move three orderly but let's see Senator Solomon you want to are you gonna move you you're recognized. Ballinger I'd like to move us Senate bill eighty two to the deferred list. And I a need to move. Senate bill three nineteen I believe to the deferred list. That's right. That's right and I believe Senate bill three twenty is being amended its members so we're gonna be passing over those bills today. All right. So just just if you're here for Senate bill eighty two that's moved to deferred or Senate bill three nineteen that's gonna be deferred Senate bill three twenty has member's own amendment being engrossed in it before I can run that so So that that's where we're at if and then so we'll just go head start at the top Senate bill eighty six senator Penzo you're recognized. And you have an amendment. Thank you madam chair Committee I have before you hear an amendment for Senate bill eighty six pretty much it gets all the substandard of language from the other bill and sets up but do not codified session it just creates a study so it the just passed the department of health to construct conduct a study regarding natural Pathak physicians kind of outlines what what we want in the study this is too complicated of a bill to be trying to work through this late in the session so what I'd like to do is just amend this bill create a study for the department of health and then come back in two years with some good data and Board to the medical society on this Scott Smith and he was very helpful and put this together so there's no opposition to submit the study that be happy to answer any questions if anybody has any. I just want to state that I really love I love centre Penzo story and think he has such good information to share and and I think it's so important for us to really encourage this area of healthcare in my opinion as it relates to your your diet so your you know you the different the different things that people have different allergies for that they may or may not know about and yeah I do I just want to share my appreciation to you for bringing this issue for and I think The Amendment and the study is a great idea because I think we need to encourage more healthcare providers to gain certification knowledge education into this field I had a and I'm just sharing this with you and I have a cousin who they had a child he was just a of a real and ball of energy I guess is the best way to say it in the teachers just kept saying you've got to put this child on medication you've got to put this child on medication and they did not want to put their child on medication and they started doing research and realize that he was very allergic to the dies that don number seven I believe is one but mainly dies are found like in ketchup and mustard and different types of dies and it would just cost them just it because behavioral problems and once they started to cut things out of his diet the child completely changed and it was pretty remarkable so that I just I appreciate you know your efforts on this I think we need to really understand this area of health care a lot more agree and if we're going to do we need to do right so I'm willing to wait another two years to make sure we have all the thanks everything lined up so so motion to adopt the amendments. Made in seconds all those in favor say aye. And oppose ayes have it and the president of the bill as amended to give a motion do pass as amended motion do pass as amended yeah and is there anyone here to speak for or against the bill. Scene nine. All those in favor say aye and opposed ayes have it Senate bill eighty six as amended is passed thank you Committee thank you. It's H. B. eleven eighty nine I know senator Hammer is working on this bill with representative Clowney they are not in the audit room yet but we will go ahead and just move down the line Senate bill three forty five. I was representative Connie coming in okay we'll go to House Bill Levin eighty nine. Okay. Yes we're getting. Finders okay house bill eleven eighty nine. All right if you'll to state your name for the record T. may proceed thank you madam chair and representative Nicole Clowney district twenty one and we have an amendment on the bill so I'm happy to let you all take a look at or explain it well it wasn't the committee on explaining amendment it looks little bit complicated at all it is is it removes all references to a national certifying board and just replaces that either with periods or with reference to the Arkansas Board. All right yes we have a motion to adopt the amendment so made in second all those in favor say aye. And opposed as have an amendment is adopted you may present the bill as amended thank you the transformation could ask an expert to come present with me and to answer questions thank you. If you'll just say your name for the record you're recognized my name is Elizabeth Laura. committee house bill eleven eighty nine deals with licensure for a field of folks come behavior analysts and behavior analysis is a practice that use to decrease challenging behaviors in children and adults it's used for people with a range of intellectual and developmental disabilities but is particularly successful in children who have autism. So this bill came about as a result of the behavioral health working group that we met over the summer and fall we heard about the need for licensure licensure for behavior analysts is important because it will allow for local oversight for ethical complaints for one it'll it'll allow for some consumer protections so as it stands currently there's an ethical complaint with somebody who is providing the service in the State of Arkansas that complaint has to be heard by national board I'm rather than a board of our Kansans I'm also as it stands now behavior analysts in our state don't have to pass a criminal background check and as I mentioned before the populations that they work with tend to be vulnerable populations I think we want that protection for I'm so this would solve that problem it's a growing field we fall in a little bit behind so all of our surrounding states offer a license this bill creates a new license under an existing board so this license would fall under the psychology board we've worked with them at length over the course of the last few months I had to come up with this I have version that you have in front of you today and so I guess at this point I will turn it over to doctor Laura here there any questions that you may have for her if there's anything she wants to provide in addition. The only thing I'll say in addition to what representative Connie has said is that in terms of the local ice control this is especially important in rural communities so our national certifying entity located in Denver Colorado may not understand the intricate nature of rural communities in the intimacy of community members in those areas so one of our ethical guidelines is not having dual relationships we know being in rural communities that often times we have multiple relationships with people just because it's an intermittent firemen's our teachers our neighbors our doctors maybe our cousins these relationships are sometimes unavoidable so it's a great example of why localized oversight of those ethical issues or potential ethical issues is super important in the state of Arkansas. Thank you. All right thank you so much and and I understand that this was a lot of the collaboration that occurred last year with the task force is that correct can you just highlight a little bit about representative Clowney the work that was done by this legislature kind of in an interim study approach right on mental health and and these types of issues so can you just kind of go through that and the collaboration that occurred yes thank you so um we first heard about this and that any behavioral health working group that we set up over the summer we met multiple times over the summer and fall from behavior analysts who were who were interested in pursuing licensure but more importantly heard from folks who work in in a broad range of professions work with children with autism and other intellectual and developmental disabilities about the services that this particular practice provides so we worked with the Department of Health the psychology board DHS DDS or in support of this I'm really want to see this get across the finish line so. Yeah and and I appreciate the fact that you're bringing back an Arkansas perspective for me I get really nervous about some of these license or Bills we have where we're kind of relinquishing our ability to provide criminal background checks and provide that oversight at the local level to just like what you reference and so I I think that for me is the strongest point of the bill and I I appreciate that efforts thank you are there any questions from members of the committee senator Sullivan you're recognized so we just and some of the license yours not recently had was a checklist and once you checked off you done all those things you can automatically got this licensure so it is just licensure subject to review as or how does that work. So I mean it is still they're still an application process there's a licensure fee there are the requirements that they're currently people that are practicing as behavior analysts in the state of Arkansas and they're meeting criteria that are set up by this national certifying board do standards will be the same standards that are adopted by the Arkansas board but you will have to show that Arkansas board in order to receive a licensee to pay a fee show them that you've met that criteria and receiver less okay Sir there's a criteria there once you meet all those criteria then you're certified yes the board doesn't have discretion to say no you're not you gonna do one more thing because we we actually shortened are linked in some of our licensing process and now we're trying to be very tactful and strategic about what your cheese so you you do those list of things and now you're receipt that certification correct that's correct yes okay can I just add I'm sorry senator but that presuming that you passed a criminal background check or a check that **** yeah that's part of the checklist and then this is licensed the purpose of the licenses to do what are you trying to allow consumers to know that that person is specifically licensed with this training has a purpose yes that's correct in this because of restrict other professionals in other. Degree from providing that same kind of service. So someone might have a social worker's degree or other behavioral health degree and this will not prevent those people from providing that same or similar service just because they don't have a license well they would be certified by our national board so they would also apply the eligible for a license I don't that don't apply so if you have a social worker or other behavioral health specialists or this is the services they're providing that the licensed people providing these that restricting others from doing the same thing not provided that they're practicing within the scope of practice links to their other license right okay. This one make sure we're not carving out a niche that will preclude other professionals who want to provide a very similar service but they don't have that license we're not precluding them from providing as long as it's within the scope of their license that's correct okay thank you thank you manager hi there any other questions from members of the committee. Senator Boyd you're recognized. All right thank you madam chair so I'm still trying to understand this issue of there's a a group of licensees out there who are worried this is going to make them have a second license and pay a second fee so. While it's not in this bill that it certainly I want understand what's going on you know before I I vote on. Sure and I can speak a little bit of that and I think alternative but and so it is true that there is we have heard from a social workers who are concerned that this will somehow limit their ability to practice just so that you are kind of understand the field and I know it's confusing in this is a relatively new field but this is it this is much different than what social worker this is sort of I mean maybe I'm freezing this wrong. But there are currently no social workers who are certified as behavior analysts it's it's a separate field and so if that were to ever arise if that instance whatever rise in order to hold themselves out as licensed behavior analyst they would have to get into an additional license an additional you know pay that additional fee we see that sometimes for instance your pharmacist if you also wanted to be a speech language pathologist you would have to get your speech language pathologist pathology license and pay that fee in addition it's not unheard of social workers in particular if they want to practice telemedicine have to get licensed in multiple states and pay multiple fees or certainly not looking to exclude anybody in fact this this legislation is meant to increase access to care the folks who who will be subject to paying this fee are the same people who are asking for this licensure to be implemented. Or other question the answer. So so kind of help differentiate I mean because if it's the ocean workers who are concerned. At what point are these intersecting that is bumping up in making them concerned verses this is a whole new thing so I mean so this of the the fact that they're concerned with sound like there's some kind of overlap and and where is that and what is the the line of distinction made there's clearly a lot of distinction between a nurse practitioner. And you know a physician assistant or a or a physician you know so what what is that line. I'm not aware of any areas in which our scope of practice overlap we certainly overlap with other scopes of practice teaching for one is the most common but I am the president of the Arkansas association for behavior analysis and I have not heard from anyone within our group that has opposed the idea of licensure or for the paying the fees for licensure to to receive a license but I'm not aware of to answer specific questions any overlapping scope of practice there. Any better okay any other questions for members of the committee. All right thank you see and none we do have some folks to speak on the bill let's see Brandon and Brent Greenlee. Greenlee okay if you want to come forward. You of test you're speaking against the firecracker okay. If you'll just come to the end of the table and state your name for the record and who you are with representing. Hi my name is Brandon Greenlee I am the director of policy and advocacy for bridging autism services a nonprofit notice Arkansas and I'm also here representing integrative learning consultants a awesome service provider notice Arkansas as well. Okay you may proceed. So the first thing that I would like to speak on his this point of background checks I believe that is actually a misnomer to say that behavior analysts do not receive the background check as the as it's being leveraged as like the sole reason to pass this bill any service provider that is credentialed with Medicaid and or serves a Medicaid patient must have a background check and that goes for all B. C. B. A.'s BCAAs and RB teases while I was a former beauty and I did have to undergo a background check and the child maltreatment check as well. Also many private insurance companies require a background check. Yes many private insurance companies require a background check or that the service provider organization has completed said background checks on its providers and most service provider organizations to require background checks on employees because they're working with these vulnerable populations in children as a whole also any services that are provided in a school preschool yeah AT T. center head start program or other type of institution require background checks and child maltreatment checks before providers enter such facilities next thing it would be the amendment that has been made on the removing of the national certification that national certifying entity within this bill so. Since it's being placed under the psychology board if that certifying entity is being removed and that we use the language to be very ambiguous for the psychology board to then create their own certifying entity or to provide what type of certifying entity may be appropriate if the so the field of applied behavior analysis in which is behavior analyst practice it is a derivative of psychology but it's distinctly different as shown by the national international professional boards independent behavior analysis journals and thirty six other states that have already licensed behavior analysts since two thousand nine. the US Surgeon General American medical association centers for disease control many other national organizations all agree and have endorsed a BA as a standalone treatment for children with autism and those with intellectual developmental disabilities so. You saying behavior analysts under psychology board is. Is how we limiting their scope of practice because now with this edition of the Amendment we can see that the language within the bill is starting to become very ambiguous and leads to psychologist possibly having oversight of the behavior analysts as a whole Two other quick points They would there is no mention of any type of committee that would possibly be formed for and behavior analysts I know that would have to go through making processes but. If the Arkansas psychology board word to be able to have this kind of oversight over an entire profession then and they were to allow a committee to be formed most likely allow representation for A. B. C. B. A. that also has a qualification as a psychologist and currently in the state of Arkansas there's only one known person with that certification so highly limits the entire scope of a behavior analyst within the state. lastly would be that the As we know there's a behavioral and mental health crisis in Arkansas and it's been stated many times over and over that there is I'm not enough providers across the state of Arkansas to serve our demands and so within this bill it is also very ambiguous and it has been left out that the behavior analysts Assistant behavior analyst which is a PC APA is that has a undergraduate degree they are not allowed to have a license within this however and the psychology social work and I believe the alcohol drug abuse counselors they allow the bachelor's level and degrees participants to hold such licenses and so by not allowing a the behavior analyst license board to allow the undergraduates to have such a license as well we're now limiting more providers that could be helping with such crisis so that I think yes. All right other questions of senator Boyden senator Sullivan. So. I missed it you speak against this bill yes okay so you're you're in opposition to it I do have one clarifying question from get back in real quick so as far as the background checks go though I mean would you agree that if you had one at a board you know when you got a license that that would just simplify things and not be in and provide consistency and assurance to the population that you are background checked yes I would agree with that but the overarching thing is that day be placing of the psychology board so and throughout the entire bill the language is pretty ambiguous so that possibly least oversight of the a behavior analyst by psychologist that's the I guess that's the primary issue of this this whole thing. Okay and Senator Solomon you're recognized for a question. Thank you we seem to be creating more more licenses and behavioral health and more more fees and more more specialties and I'm just very concerned that as we create more more specialties more more car about the consumer struggles with finding who does what for whom. What do you what do you what's your response to that comment. I mean. You don't have to have one of. I'm very new to this I mean I was only in R. B. T. for the past three years so I'm like just now kind of getting into what licensure isn't thank you and being so young I'm not entirely sure how to. And so that come as a whole okay that's fine thank you. So I just have a quick question I'll go to Senator love but just wondering if you're organizations let's see you're here for representing. Bridging autism services and integrated learning consultant yes both okay did either of those organizations participate in the year long meetings and that occurred no we just recently started at the end of twenty twenty two and down to twenty twenty three doctor Tiffin or the she I believe has Centerton a couple of emails with comments on this bill as well but. In previous years she was the CEO and was a founder of a awesome service clinic in northwest Arkansas as well and I don't believe she was consulted on the case as well okay I'm just not familiar with your organizations under and their lives lots of people that are involved in these organizations that you represent or Not at the moment seven yeah like I said we're very new we're just getting off the ground and getting started so okay gotcha so I mean I just wanted to know who you were speaking for you know if there was like a group of people or I'm mainly at this one individual then that started your organizations yes but we do have some clients that would be coming like I mean that we are taking in currently so I guess it would be on behalf of them protecting them as well okay all right thank you as Senator love you're recognized for questions. Thank you madam thank you madam chair I guess the first question I would have is the behavior of analysts are. I guess the. Their house in their house somewhere in other states where four of these boards usually House certain some of them have their own consolidated boards some of them are it within a behavioral health board specifically with behavior analysts someone have their own licensing board some of them are on and the psychology board but what has been happening with those that are on the psychology board for example in North Carolina and they just finished a ten year long battle with the same thing under this psychology board a psychologist had to sign off on their treatment plans delaying treatment down for services for a child with autism and. They just got that done within the last year okay so this is not this is not of a novel. Something novel that we're doing in Garson located out of the psychology yeah it's not novel but it's just too it would just be to ensure that either a committee or a on licensing board was formed not under the psychology board because of that the ambiguous language as in this bill that allows for a that could allow for a psychologist and the board to make rules to ten provide that oversight for behavior analyst. In the and then also do you have any behavior analysts to work for you yes we do so currently it with their I believe we have three currently because we are relatively new we don't have a large group okay in in in that question do they belong to the same I guess we had a previous person that is the president of behavior analysts I guess of Arkansas I'm just gonna say that. So do they belong to the organization as well I'm not sure that I personally do paid due because beat I was a student and I was thinking about pursuing a master's and applied behavior analysis and so I currently am a part of the Arkansas appear analysis board Association and to my knowledge there has been very little actual stakeholder involvement or allow me allowing us to be involved I believe there is only one meeting that has been held any others have I'm not aware of. Okay. And Senator love we have some folks from the board of health that could probably speak to this question that you're having if they could come up to the. Miller and Melissa from DHS if they're here can they come up. Your partner. All right let's go more thank you so much. So if you could just add there were some questions I think that Senator love had in regards to the board to make up and what the Arkansas law is and certifying process if you don't mind giving this response to his question sure I think when we talk to represent the Clowney. we thought it be a good fit for the psychology board it's it's one less board would be created one les Committee I think there are folks on the psychology board that have some experience around this and would have some expertise in helping get it set up you know we'll go through rule making process they'll be public input support that they can chime in on that when we go through that but I think it fits better under a current board to create a whole new board on licensure process. Because that was going to be my other questions in regards to the rules the rules and in making other wealthy rulemaking through office yes Sir. I think I think assess okay thank you Senator Solomon you're recognized. So historically it seems like every time we create a new license we create a new population to receive the service which increases our Medicaid cost so it has there been to your knowledge do you have any can you speak to that qualified if you want to recognize your name for the record and you may first answer Senator Solomon sat Melissa whether ten division director for development disabilities services so yes I completely agree with your train of thought that sometimes when you legitimize a program and that it doesn't encourage additional costs however we're already they're already seeing a huge increase in cost with a pie behavioral analysis we're gonna be bringing for the manual for you guys after the session ends to put some rules in place on how we regulate this differently. So. Was that a yes or no to the address it was a long ****. It was a yes but that increasing because we're we're already seeing it this is I don't anticipate having M. and oversight board to increase the cost we're going to have to do some things around our own rules to regulate ABA therapy who receives it how many hours incites maybe a misunderstanding so this new license is it going to create a new population that has previously not been served are just provide a service for the current population is not in a license we have a BA therapist we have many of them and enrolled as Medicaid provider serving thousands of Medicaid children right now through a BA therapy under a national license this is just giving them a state licensing process that's the question are thank you. Okay are there any other questions for folks at the end of the table Senator hammer at do you want to make comments now I know that you're the Senate sponsor of the bill and I know you're on Education Committee so we'll try to get your comments while you're here at the table thank you measure I would just wait and see this some sort be late but represent the county has kept me up to speed on it the two up Senator Solomon question do not think it's necessarily creating any new cost of medications might think having set three years worth of mental health caucus meetings of which this idea was born that what we're doing is we're trying to bring a very narrow target to the re certain population and one of the things that was just said I think that I rang true to us is that this creates an opportunity for the state to have more involvement with the people that live in the State instead have be depended on the National Board and I think that brings it closer to home to where you know our folks will be dealing with our folks of their issues or things that they want to express to be able to do it at the state level instead of you know at a national level that we may not have as much control so the way I would view this is we're gonna be able to meet the needs of the population utilizing folks who want this which is why it's being brought to us as they wanted not necessarily so we can drive up costs but so that they can better serve the public we're trying to take care of thank you all right thank you are there any questions for senator Hammer members of the committee all right C. nine and we'll get to we have one other person Arkansas council for behavioral health gill Landry. He'll come to the end of the table and state your name for the record. Thank you madam chair I am jewel lander NO I am the executive director of the Arkansas council for behavioral health and I'd do request the committee not to adopt the bill in its current form and I want to briefly explain why I ask that but first I want to make it clear that I am not sitting in this chair because of any a conceptual opposition to regulating a BA it is a growing field representative Clowney has worked diligently with us to try to work out our concerns and I want to thank her first off for the efforts that she made to to work for accommodation ideally we would like to see the ability for licensed therapists and licensed clinical social workers to be able to get the national certification some of them do have it and have their regulation happen through their existing boards with a letter of intent that includes behavioral analysis as part of their scope of practice ideally we'd like to see that happen and in the meetings that president of council thought the coordinated with us and with the payroll and and and Alice's folks the response we got to that proposal was yeah well that's a national certification and any time you have ethics complaints it's handled through national board and we would like to see a state based process for handing handling ethics complaints which totally makes sense so would seeing that that was the goal of the bill released what we were and what what was represented to us as the goal of the bill we will down our ask to simply this. That there be preamble language added to the bill that would make it clear that people who hold other licenses who are required to get this new license under a different board at least not have to pay the fee and the preamble language we ask for was simply this whereas it is the intent of this chapter to create a new licensure of behavioral analyst in Arkansas in order to expand the workforce and remove barriers to offer access to our Kansans in need of services it is our intention to be inclusive of all current providers without creating an additional expense to those licensed by other entities such as the social work licensing board of the board of examiners and counseling further it is our intention to create a common set of ethics for all practicing within the field the reason why I'm here today is that the information we have is that that proposed language as a preamble has been rejected and so it is I believe that people who are licensed by the social work licensing board or the board of examiners and counseling if they could have initial certification in behavioral analysts and want to practice a BA that they would have to get the second license and pay a second fee and perhaps even be under the supervision of as master's degreed folks under the supervision of a psychologist which isn't the case today and I'm particularly concerned about hearing the amendments to the bill that remove all references to the national certification I don't think that's probably a step in the right direction but I ask who is really a simple one for those people who are licensed otherwise if you gonna make them get the second license at least don't create an additional burden by making the pay a second fee when they're already paying for a licensed to practice in paper health as as it is so with that I would to concur of my remarks and entertain any questions thank you I have I have a question there are many professions that have national certifications that pay fees at the national certification fee and then R. as state law. Syncing fees many of them. So I'm I'm a I that's not unique. My response to that Senator Irvin is that in this day and age when we don't have enough practitioners and we have we're looking at trying to remove barriers to. Becoming licensed and certified in the field for example accounts and contacts contact bill we just passed. This seems to be erecting a new barrier which doesn't presently exist at a time when we're trying to address workforce shortages by removing barriers right I mean I think that was the whole point of the collaborative nature of the work group that happened all year last year was to actually increase access to behavioral health field since specialties ticket people um services so I guess I'm a little confused I mean I prefer just a state licensure and not the national certification to be quite Frank but I think it's not a choice that can be made so I just that's just mine my comments that that that that does occur I guess by choice but senator Boyd you're recognized for a question and then Senator Solomon did you have a question okay gotcha thank you thank you managers so I want to try to ask clarifying questions so I can wrap my mind around this so let's let's say that I'm a dentist and there's some kind of certification I need to do some kind of surgery in the jaw. Or I'm a physician who is a surgeon who needs the same certification but I would still only be licensed by the dental board of our dentist and only be licensed by the medical board if I were a physician is that what you're saying. It I think the question comes down to and I'm not qualified to answer this question is what degree of overlap is there between the practice of applied behavioral analysis and other methods of mental health therapy and it seems to me that there's enough overlap that that could be governed by other boards that are also also licensing people in the behavior health realm. Okay. If you're if failing that if you're gonna require the second license at least don't require a second fee. Okay so so what your contention is is here are the licensed and now you might have to have a second license from home other board right when you're already performing this scope of work because you have the national certification to do so right okay I think I understand thank you senator Hammer he wanted to respond to Senator void if that yes and the representative council can back me up on this or correct me to one there's not a fee in this bill that be promulgated through rule so if there's a question about the it will be handled through the rule making process so it's not like we're turning this thing out here with you know with with an unknown that's going to be handled in rules and so it could be adjust support and might be five dollars I don't know as we get into it will will you know take that on the rulemaking process I just want to get that disclaimer there please thanks for the. Conversations going on I thank you Senator Solomon you're recognized for a question anybody can answer this so it's the state license more restrictive less restrictive are the same as the federal we don't know at like Senator Hammer just said it's gonna be subject to rules promulgation and so and that includes the fees which is why we want the preamble language in there to guide the the rule making process all along in this area but whether or not they adopt the national standard as the standard or create an entirely new standardized I don't know that the bill addresses that Senator Irvin marathon yes that is actually in the bill that language is in the bill the requirements are the same as the national certifying board the reason that we've taken out any reference to the national certifying boards it's actually requirement under Arkansas law that you can't reference I national organization as having authority over in Arkansas but but the the the requirements for that national certification are exactly the requirements that required for this license if the historically my recollection is we rarely have more restrictive at the state level than we do nationally so I think the rules process forfeit that has been our historical position thank you. Thank you yes Senator Blake you're recognized for a question I just I'm I'm I think owner help clarify this in my own mind if not everybody else's so we're talking nationally that's not a license that's what is referred to as a certification what we're talking about is actual licensure which is a different legal standards and a certification correct. That's right the national certification is just a certification on a license okay. Are there any other questions from members of the committee. Right thank you so much for. Senator Hammer representative Clowney you're both recognized if you'd like to make comments for the closing the I'll just say and then the representative council have the line sure proposing and that is that this is just an attempt to provide a pathway forward for those that would like to do that but also would like to be held accountable to a set of standards that would be established here in Arkansas which having sat through all those public health caucus through all those mental health caucus meetings last year to your point awhile ago I think made Senator Irvin we're just trying to get more people out to help address the needs but we just want to bring accountability which I think is our duty as you know as a body is to protect the health of the public but make sure people that are out there doing it are being held accountable at the state level where we have some jurisdiction that would just be my comments and you'll to represent clients thank you. Thank you senator I'm I just think to close all just expand a little bit Senator Irvin and one more time on the fact that this is an extremely collaborative process amended that the association behavior analysts had for public meetings where they took input and then we have been working with all the stakeholders for for months and months the people who want this behavior analyst they are happy with it being placed under the psychology board they think that this will protect our Kansans and allow them to serve the populations that they want to serve in the best way so I'll close with that and I appreciate a good vote. Thank you so much what's the pleasure of the Committee. Motion to pass as amended is there a second. Thirty second. Sorry the bill dies for lack of a second Boetticher inquire if chair yes will have the opportunity to come back and run it again is that correct that's correct okay thank you. All right Senator Dismang. Thank you madam chair Senator Jonathan Dismang. Have an amendment. Please. I do other handing that out it's a very simple amendment all it does currently the bill states twelve thousand five hundred would be the cap this lowers that down to six thousand the the thought there is a couple things number one that's well below what the amount would be adjusted for for inflation that would actually closer to eight thousand not a little bit above and at the end of the day I was trying to make an argue make a number that would be hard to argue with so that's review see the six thousand there. Okay is there a motion to adopt the amendment motion to adopt the amendment second all those in favor say aye. As opposed amendment is adopted you may proceed with Senate bill three as six as amended the chair members have debated back and forth with myself of how to present this bill you know to the committee it's I don't believe that we're talking about a left or right issue and they need to do right issue I think that we have problems include if that have been created because of our adoption of that federal amount for our asset limitation and I'll just wanna roll through a couple of what I believe to be issues with where it stands right now I think first and foremost if someone wants to save we should be encouraging that we actually mandate that our kids in high school to go to a class to learn about financial responsibility the cornerstone of that class is saving we should be encouraging saving and if a poor person wants to save then we should be supportive of that I have an in with our capital two thousand two hundred fifty dollars as it stands right now in the state it creates all kinds of hurdles for folks that are wanting to improve their own position in life if you want to think about in the City of Little Rock you can't pay for your first and last month's rent with two thousand two hundred fifty dollars in a two to three bedroom house it's just not possible if you look at this list right here if you wanted to buy your child that's going to college a car you can't spend or he couldn't save more than two thousand two hundred fifty dollars to be able to buy that car and if you can find a car for two thousand and fifty dollars let me now. I have a it one other thing we just went through and pass learns here in the state. we're gonna give about seven thousand dollars in the future the family so they can attend private schools. Private schools don't cost seven thousand dollars the vast majority of those are well above that and and I think on average is about eleven thousand dollars we don't allow a poor family to save enough to make up the difference to send their kids to private schools if we want if they wanted to utilize the provisions in learns bill again I think we have a lot of issues in in that cap I think it's something that we raise I think six thousand dollars a reasonable amount again that is less than what it would be if it were just in for inflation and and one thing you have in front of you is the snap eligibility I've I've joked with some of the members what if we had a work requirement would you support it then ironically the answer's yes VOL even go beyond that out what if we did a work a registration requirement. Well I'll tell you we already have that in place this is already a very stringent program we're not talking about people that are sitting home doing absolutely nothing. We're talking about the working poor you have to be working to be able to qualify and maintain your snap benefits and again you can see all the other provisions that go along with this or not there's all kinds of you know limits in rules and you pass inside the snap program to make sure that people are trying to lift themselves up and now the one thing that I see on this sheet that is the out liar is the ability for that poor family to save. And we're hoping to be able to increase that I would argue six thousand dollars isn't enough but again I'm I'm hoping to get something that's palatable to the Committee with that I would be happy to take any questions. I have a quick question you may or may not know the answer but when was the site and how long ago I don't know actually went back last night was gonna research on some of that and I got stuck looking at other states in the fact that the vast majority or of a majority don't even have an asset limitation because it's not effective. Yeah I mean it is not effective to produce the outcome that we're hoping to achieve with helping people lift themselves up and out of poverty. And so again I'm not sure when that was set out like so that I'd have to go back and look and see but there may be some folks here that can answer that from DHS okay what will go ahead and proceed with questions and then if those that some DHS that could get that answer for us I would be great senator Boyden senator for Sullivan. Thank you madam chair. Just wanna make sure I'm crystal clear on what I'm voting on with says asset limit under the snap nutritional program shall be six thousand dollars now. Is that specifically like six thousand dollars in cash or is that total assets how how do you measure that six thousand dollars and that's part of the reason I brought this sheet for you to be able to look at and see there's different exclusions that's property essentially the cash being the predominant one special you're talking about working poor but if for instance you get an exception to have one vehicle in the entire house so that the men's there's six people living in that house sold in you know for a minute driving age you get limitation I have one unless they are able there there's other people in the household working going to and from school and then they get they get the privilege of owning a vehicle that's worth four thousand six hundred and fifty dollars and so again there's different different limitations even on those assets and you can kind of look through here it's even limitations what you're able to own a property and so on. But Bromley what we're talking about the six thousand would be what a family be able to save. Senator Solomon your aunt recognized for a question thank you talked several times about cars this is for you guys support senator Payton's use carb bill. Well every car that will qualify already you know to be able to be in step already qualifies for the exemption as a city place right now thank you. Any other questions for members of the committee all right DHS if you could come and answer my questions that would be great if you'll just state your name for the records. Thank you senator Clark quite portray Human Services with your question was how long we've had the asset limits in place. Based on the memory of those that I've talked to be there for some time Arkansas has historically followed the federal minimums around the access link as asset limits and so that's just what we did at least as far back as we can remember the legislation that's being amended this bill this was passed has been with the last couple of sessions weird restricted our ability to change that and so course that's what this bill is introduced to give us that flexibility federal law does allow for states to request exemptions and to do exactly what the bill is proposing it's just that's not something that we as a state have done at least not in living not in recent memory. So the federal and does a federal minimum ever change or is it just been set this amount for all these years I believe it's been set for this several hundred years so it is established I would just say a for grass Bills. So there's so. So what would be what would be. I guess where I'm trying to understand is if we don't have the flexibility and in the bill it says that the asset limit shall be automatically adjusted for inflation on a biennial basis so I guess what I'm getting to is when was the sets and if we were to adjusted because of inflation where would we and. Price that makes sense it does make sense I don't know the answer but offhand I can go back to our folks and have been to the research to see how far was the last time that that amount was changed but I don't have that today okay I just think that would be helpful information. And then what would be used if it's the CPI and you know what index will be use for inflation to get to that amount I just would like to know. Generally speaking we we do tend to use certain indexes when we do inflationary rises are cost of living rises and adjustments so I I just would be interested in that is that we will get that for you okay thank you are there any questions from members of the committee of Mister white all right C. nine. Let's see we have some folks here to speak for against this bill. Brian Burton. If you'll come for. Thank you. The server and if you'll just state your name for the record you're recognized. Turn your. All right thank you the three state your name for us and the year with yeah my name is Brian Burton I'm the CEO of the Arkansas foodbank thank you for being with us thank you for having me. I'm a native of Arkansas graduate Ouachita Baptist university in the southern Baptist theological seminary in Louisville Kentucky. past eleven years I have the privilege of running the largest food bank in Nevada and I came back to my home state in October to to leave the Arkansas foodbank. To testify in support of raising the asset limits because we did this in Nevada in two thousand and nine. three years ago this week COVID nineteen was declared a global pandemic. Three years ago today in fact the Las Vegas Strip shut down for the first time since the JFK assassination. That entire economy froze overnight I am unemployment went to thirty three percent forty million people start coming to Las Vegas for conferences and vacation. It put our entire state into a panic and a crisis. I was just like watching a horror movie our food bank of course had to have it overnight and and create twenty three satellite feeding stations many of you all might remember saying the long lines of cars three years ago all over the nation that were lined up with people needing food a lot of those images came from Las Vegas some of those car lines were four miles long. Half of those people had never asked for help before ever. Fortunately NO a decade before the bipartisan members of our state legislature had looked at these asset limits and realize how punitive it was not only to helping people that need temporary help to us to eat but also was fostering more poverty and so they they did away with all of the asset limits in about a so we had about eleven years now to see the impact of that. As you know snap is a number one anti hunger program in our country. I'm very proud of what the Arkansas foodbank does to provide meals to for thirty three people in thirty three counties across our service area. over two hundred thousand people a year that access that I'm very proud of the other food banks around the state that serve but I'm humbly aware that for every meal we provide snap provides twelve minerals so that program divorce what we do eighty percent of food insecurity in our country is met by some form of a federal nutrition program. And so we had some skeptics a decade ago and about a they were concerned about what will the snap polls explode after we remove the asset limits there were people concerned about the impact of that. And there's a strong libertarian culture in the west the federal government owns eighty percent of that state so there's a lot of people but not exactly love the government there. But it was very interesting to see folks step up and realize that. No this actually is sound policy not only for people in need but for the economy of our state. And as we look in subsequent years here's what's happened snap participation patterns were largely similar over time. In the M. and about a and Arkansas. With us. Just removing that asset limit. it resulted in a modest increase in benefits but most of those were the result of what you may remember the American recovery act so that was legislation in the wake of the recession. So we felt like it was not only a good anti hunger program but anti poverty is the gentleman said earlier we think about those folks that are five out many people trying to get out of those expensive weekly hotel motel rentals that they're having to live in. And bill the don't try to save up enough money to get into a cheaper apartment but then if they go over two thousand dollars then they can't eight they can't get the the food that they need because will be disqualified. One more example I think of here in Arkansas is how many elderly we have how many senior citizens. And many times they'll have a a small inheritance or they'll have a few acres of land and and they may be penalize from getting qualified for that and don't have a health experience or something crisis in their life and so they'll they'll you know they might be disqualified from getting us now so I to me I think it's a triple win for us here today number one I think those already on a journey out of poverty the working poor will be tossed overboard because they begin to build a modest asset commission secondly I think vulnerable seniors and people who experienced the death of a provider a health issue natural disaster or heaven forbid another pandemic won't be punished by the salvage value of what and few assets they have left and finally. I know many of you love the faith based charities and non profits in your own districts the the US of feel that crack conf and feed and serve people and make your communities more humane more livable they're going to going to really appreciate you lifting the asset limit because it's going to he's a little bit the over extended old client loads that they're having to serve right now and we've seen with food inflation the numbers of people on the uptick needing food assistance so I just submit to you that my experience and and about a and I think the data that we have from there. I think really alleviates a lot of these some of these concerns that I've five heard by some of the skeptics and once again the income requirements are not changing here we're gonna see actually a dependency on assistance and decrease and the snap in Romans will not sort I think it's a tremendous opportunity for us and I hope that we'll have the the confidence to to passes unanimously as a triple win for all the people of our state thank you very much. All right thank you so much are there any questions from the committee alright thank you so much for testimony. And a strong. The state your name for the record you may want to good morning out in a strong I'm with the Arkansas chapter of the American academy of pediatrics and I represent about four hundred fifty pediatricians here in Arkansas who care for kids in all corners of our state it on behalf of our men are member pediatricians I'm here to speak in support of the bill and you might ask why pediatricians are even engage in a conversation about food and security and I will tell you that this is one of the top issues around social and family needs that are pediatricians are dealing with when when they're focused on keeping their families at families and and their children healthy and so they're screening for many many of our members are screening for regularly for food insecurity as part of their well child visits in clinic and the data showing that the top needs are food and security as some family I mean some practices have even established a merchant see stable to shelf stable food pantries in their clinics to help families who don't have food to put on their table that evening they know how important this is to health care and to the overall health and well being of kids and we've actually had a grant focused on this over the past few years and have been going out and talking with clinics about how to implement screening for food insecurity and that the pediatricians do see that struggling families are disqualified from obtaining snap benefits only because of those asset limits and so that can be such a challenge for those families and I will go into all of the health benefits that come from the snap program but we know that access to healthy food equals healthy kids and and and Health happier and more stable families so I'll just say and wrap up with just saying that AS Arkansas kids live in the state in families where they are struggling to make ends meet and want to put healthy food on the tables Not being able to save up some money for emergencies can really set them back and we support S. B. im SP three of six to help make sure that families can do the responsible thing and save up funds to emergencies while also helping feed their kids thank you so much. Thank you appreciate you any questions from the strong. Okay thank you see no questions I appreciate it. there any questions from Maliseet is there anybody else here to speak for against the bill all right C. nine I just had one question actually presented its bank yeah I'm my family is a big Dave Ramsey we we'd like Dave Ramsey I read his books and I'm not sure if you're familiar with with what his practices are but if you are can you just describe I think he He he advocates for having an estate or savings account and I'm not sure if you're familiar with those types of practices but I just wanted to see if you're familiar with those I'm not sure what his exact areas because I I'm not the it's not some of that listen to but I but I will say again as far as you know. Financial literacy and when you're talking about wanting educate our kids I think the foundation is always been savings I mean it's not how much can you borrow or you know do I need to pay on a monthly high interest note to be able to afford my tires or whatever it may mean it is about saving and making purchases with those savings as opposed to putting yourself in debt I would argue that the way the current structure is we're actually creating the incentive for people to go into debt someone made the comment to me but when we were talking about the Freedom accounts of wealth the you know most schools have a payment plan in place yeah that's true but they also have a discount if you prepay. And so if we don't want people to be able to take advantage of those discounts I get it but I but I think that with these are the types of things that we should be incentivizing and and one of things I will say in regards your question I don't know if two percent of all those that are currently enrolled would ever take advantage of trying to save more than two thousand two hundred fifty dollars I don't know. I don't think it's going to be a very high number but I think we should applaud those that are willing to because again I think that's a true testament to their conviction. You know internally in that family to get themselves out of poverty they're making the right moves we should encourage those moods and not create barriers and cliffs that artificial nature that that that holding down. Thank you are there any other questions for members of the committee right you're recognized the close of yes I'd like to close in in one thing it would probably all our mailers a month everybody in the room but those it right ran on the Republican ticket probably put somewhere on your mailer a common sense conservative. Right that's what we like to say and we have individual conversations about this issue I think almost everyone of us go that doesn't make sense. This limit doesn't make sense. And so I'm asking is just to be common sense conservatives in the room as we cast the vote today met and and I would also say they're being conservative doesn't mean it should we should be devoid of compassion. And I think that's exactly what this issue is we should look for opportunities that help people lift themselves out of the situations that they're in. We we shouldn't discourage the working poor from saving and with that I'd appreciate appreciate a good vote thank you what is the pleasure of the Committee. motion do pass as amended their second second all those in favor say aye. And opposed I haven't congratulations you passed your bill as amended thank you very much. All right represented Mayberry I believe that's here. You have a hand out. Never mind. What bill are you here with us for a representative maybe. There's two. Your I believe that you are here for H. B. fifteen NO nine. Let's go to All right let's go ahead and go to House Bill fifteen oh nine. And then we'll come back to fit well let's to fifteen eighteen. Yes okay. Just fifteen eighteen. House Bill fifteen eighteen. Okay if you'll state your name for the record you may proceed yes state representative Julie Mayberry and I have a guest with me. David cook awesome Association thank you you may proceed. Members many of you may know that we've been meeting for the past two years for Alzheimer's disease and dementia Advisory Council that included a lot of people from the community various backgrounds all concerned about Alzheimer's disease and dementia and we put together a bunch of great ideas many of them already come through this committee we appreciate the support here is one more we have worked with the Arkansas health care association the Arkansas residential assisted living association and DHS on this bill I'm gonna let David cook from the Alzheimer's association explain a little bit more what specifically this bill does. as represent Mayberry of the set up one of the things that we looked at in the Advisory Council was the dementia trading standards across care settings and so we looked at the assisted living facilities we knew we didn't have those of record and statute wanna make sure that those who are providing care and assisted living communities were quick with the tools they need to interact with the unique needs of individuals with Alzheimer's and other forms of dementia because of this bill works to address that issue and masculinity we want to thank director Martina Smith from Division prior service and quality assurance for assistance and crafting this legislation and what this bill does is it requires three things first four hours of initial dementia training for all direct care staff assisted living facilities it also requires two hours of continuing education for those direct care staff in those facilities and a third lever that it pulls is it requires the state to update the rules and regulations that govern assisted living communities which is something that we need to do here for a long time so this bill come publishes those three things and I'm happy to take any questions if you have any. Okay I know you have in here on the training costs that are covered staff member is not required to bear any of the costs but who does pay for the training. Sure what we've heard from providers thank you for the question is that many providers already are doing this training we just want to capture those who are not but we are working with providers as we go through making process we're going to we provide access to free training that we have that the association will also work with them to implement that but these yes I do implement other training costly tried to actually minimize the impact on the system the living facilities by broadening who could actually deliver those training so staff that's in there can actually deliver some of that content as well to minimize the cost some providers because we know they all having issues with work forces well so we try to make it friendly to providers as well. Okay I'll Alzheimer's association isn't like the proprietor of CME continuing medication or that I mean education what I mean who who would be the the entity that would do that continuing medical medical education sure we have we actually do have something that they could access if they if the facility chooses to do that but but staff on site can deliver those continuing ed to meet those requirements there's some things that will clarify and the rules. Okay. Senator Solomon. Is a training concurrent part previous employment so when I come to work far do I have to get the four hours before I can start work is a concurrent with while I'm working out of the operating. Sure we had a provision in there that it's requires a training within the first ninety days so they can be actively working as a as a complete those training requirements within the first ninety days of their employment okay with the providers agree that the cost is minimal yes are you have that conversation with the yes Sir and they're okay with all the yes Sir overhead no opposition from providers we actually work with them at a time to make sure we had a good piece of legislation to present okay thank you. I just want to follow up and I don't mean to be appointed but I think I just want to ask the question I mean is this creating a new revenue stream for the Alzheimer's association no ma'am all of our training is is offered free of cost okay be accessory so I just want to yeah thank you that was I just wanted to be able to have a clear thank you. Any questions for members of the committee. Right C. nine is there anyone here to speak for or against this bill I don't see anybody signed up for its. All right you're recognized to close for your bill. I just appreciate a good vote all rights what is the pleasure of the Committee motion do pass as their second second all those in favor say aye. And oppose ayes have it congratulations you've passed house bill fifteen eighteen thank you thank you so much now we're gonna go to House Bill while you're at the table let's move to House Bill fifteen oh nine. I feel the state your name for the record sure state representative Julie Mayberry and I'm actually really glad that Breanne Davis is walked into the room right now we add it was this time last year I'm sorry three years ago that the state just kind of shut down from covid and we've learned a lot of things from that time period one of the things that I believe one of the worst things that happened during that time period is that patients were denied the right to have someone with them in the hospital a support person to help them navigate their medical situation Arkansas was the very first state to pass no patient left alone last year and we ensured that you could be with a loved one in a hospital setting and a healthcare clinic in a nursing home those are all beautiful things other states after we pass stars they pass there's we still had some little glitches to it because we were working from scratch so I've tried to work with a lot of different people on line on this bill one of the first things that I wanted to addresses even in may of twenty two I had a constituent come to me and asked why she was being told when her husband was going in to have a colonoscopy that she wasn't allowed to go into the building this is in may of twenty two okay. This is not even like major pandemic time and she was being told she wasn't allowed to go in yet when you have a colonoscopy you are required to have someone with you because you can't drive home after the colonoscopy because you've had Anastasia I looked into it the health department said because I did not specifically include outpatient facility but they were excluded so I wanted to make sure that outpatient facility was included in there we also wanted to just add a little bit more language to make it a little stronger for our Thirty that might be denied coming in especially when someone is expected not to make it we want to make it really clear that that clergy should be allowed to come in and then the other thing that I heard most often even after the hospital started opening up is that they would say it visiting hours someone had to go home so it's seven or eight o'clock at night they were saying sorry your support person who is allowed to be here must go home and if you've had a loved one in the hospital you know that a lot of times overnight is when things really start to go down hill and that's when they really need to there and I really didn't understand the idea if it was to protect you protect that patient from infection if for sending them home and telling them they have to go home they might be actually going home to other people who have been exposed to infection elsewhere and then the next morning that love one is coming back in the hospital and actually bringing that infection in and so with this new law it would guarantee that someone could actually spend the night with you in the hospital and wouldn't be kicked out again not a big party this is one person being able to spend the night those are the main changes that we've done in the bill we've worked with DHS we've worked with the health department we've worked with the hospital association there is no known opposition to this bill and I would appreciate it. Good vote thank you I've I have questions Senator Flippo Senator boy of Senator Flippo first. Thank you madam chair thank you represent member for putting this bill and I perhaps have overlooked it but is there an exemption in here for the proper corrections for it made that that's in the original bill but yes we we clarified I'd have to go back to the original bill but That's in the original bill before I haven't updated any of that with this so it doesn't need so that will it was Ryan twenty one. Say that again the original bill was a when was that runs and that was twenty one okay yeah so there's. You don't do that I don't know this honestly so there doesn't need to be an exemption placed in this one because Ragland I'm not touching that piece of it. Okay okay thank you. Senator Boyd you're recognized for a question. Okay I Senator Solomon. I'm glad to see a penalty clause in here so can you explain what that means peers at the penalty clause only comes from the federal agency we don't have any penalty. Locally for violators I'm on page six kind of starting at the line three can I ask DHS maybe come up because they asked me to kind of change some of that wording in there to meet their needs because I did have it worded a little little bit differently do you mind sure. Up for quite or even services resume ridge creek we did ask for an amendment just make clear there's some solution losses but part of Health others that are regulated by us constricta for long term care where we have the office long term care they go out and do the surveys they would be the ones who would be making those findings and issuing those penalties. So it would it again I if the our state office long term care the object this decision to get. Okay. I have I have one question and and and it's on page three when you talk about the lines twenty nine through thirty one and that prohibit a person with the right to be physically present under this subdivision section from staying overnight with patient. This becomes problematic in your I. see you units so there's no exemption for your I. see you and I and I I mean I was with my mother and in the hospital and an Arkansas Baptist hospital to did a great job of allowing clergy to come in I really appreciate all of this I've had constituents that you know I've been able to work with hospitals to get them in some very supportive of your bill I'm that is one exemption that I think needs to be included in this bill though well that we need to be really clear that if you're in an S. I. see you or and I see you are in need of natal neonatal ICU. You know there's no there's no place for you to spend the night we'll many of them do have places for you to stay the night and and there's always a waiting room that you could if for for whatever room reason the room is too small you can go spend the night and and another room but we do have been here to prevent disruption to the care of the patients it would right which would allow for them to have discretion in certain situations because every I see you is different there is no I. see you that's exactly the same around the state and so I think that that piece right there to prevent disruption for the care of the patients I have talked with you a mass I have talked with the hospital association about this and they have I understand this is Senator Missy Irvin okay reading your bill and having an issue with the fact that it states here from staying overnight with the patient and that would indicate that you would be they would require the have to then require that you have the head in in that I see you and that that can't I mean I've been in I. C. U. S. I. see you and there you know you have to be respectful of the other patients that are in that as I see you unit and there is no room for you as a family member to spend the night with the patient and as I see you it's just not it's it's actually not good for it's not good for anybody in that unit because they have to do things during the night time shift that they normally wouldn't do while there are visitors there sometimes they have to remove people and if there's a code it's and so for me personally I really think you need to look at including some language to where it's very clear that if it's a neck Q. as I see you that that. That would be exempt from this provision I I wanted to marry I think that it is already in there I think that they can use some discretion and on top of that you do have icy use that may not may not have a bed I don't see anywhere that you can sleep in that room but you can physically be there here here's a potential situation you have just been brought to the ER in the middle of the night it's midnight or whatever and that person is being brought to the I. see you at that moment you know they've done whatever they can in the in the ER and they're being broader it was right after surgery and they're being brought to the to the ICU I'm going to tell you that if it's my daughter. And you're telling me I can't go into that room to make sure that she's getting the proper care when we've just changed from an ER room into an icy you room and the communication because I've been there many times from what we just talked about in the ER to what we're talking about in the I. see you it doesn't always go well. You better believe I want to be in that I see you with her and I would be very upset of someone's telling me that I can't be there because my daughter can't talk and that patient can't speak for themselves and they need someone there to do the communicating for them. I thank you at. I don't argue with you I had a loved one as well that couldn't speak and who had to go to the S. I. see you and have was there for twenty days I understand the situation that you're referring to we've all we have many of us have lived through those same situations I'm just reading the language of the bill and that is a concern for me. So are there any other questions from members of the committee. St nine is there anyone here to speak for or against the bill. Three nine you're recognized to close for your bill. Members there's still a clause in here that would allow in certain situations and I see you to prevent the destruction of the care to the patient. But I want to lean on the side of caution that allows that person who cannot speak who does not feel well to allow someone to come in and advocate for them if you've been in that situation I promise you you're going to want to be in there with your loved one. And I appreciate a good vote. Thank you what's the pleasure of the Committee. Motion to pass as their second. There's no second I'm sorry the bill does not pass. Thank you. Senator Davis. Sarit centre Davis you're recognized what will you with fine thank you madam chair and house bill fifteen forty six. Nine if we go to you have three ninety two I kind of want to get Senate bills may first is that okay are you or do you not want to run that one is three ninety two is that the M. body art one yes I am not prepared to run that at this time what can on an amendment that I'd like to read that after spring break okay I just I just wanna make sure we can move our Senate bills down first okay yes house bill fifteen forty six yes I thank you yes no I appreciate that very much hope you had a chair Ortiz's and Brianne Davis state senator district twenty five. And this bill is a bill to protect forts fourteen sees fourteen C. allows for a special minimum wage certificate where employees are paid on production there is currently a national movement to do away with fourteen cities and fact fourteen other states have already voted to no longer allow them. So this bill protects our fourteen season our state as long as the federal government allows them. We need to protect individuals with intellectual and developmental disabilities by continuing to provide a work environment that allows them to work at their own pace and helping them to fill a basic human need that we all have a sense of community and belonging. With that I'm happy to answer any questions from the committee. All right thank you senator Boyd you're recognized for a question. Would you say that work might also be a basic human need in most circumstances absolutely yes senator void. All right any other questions from members of the committee. We have some folks here to speak for your bill. Miss Carissa Bryant. The person okay. Stephanie price. Okay come on down we're happy to have you. Sorry you're fine just if you'll state your name for the record get recognized to speak for this bill yes I am okay so what is your name ninety seven a price thank you Mister prime yes so I'm from being herein and so I'm here to speak in favor of fifteen forty seven me fifteen forty six sorry okay and so some people would get want to get rid of the fourteen seed which that would hinder in my work options so I am I work at ability to invent abilities unlimited in Fort Smith. And I have worked there for sixteen years. And I use thank you first I transition from high school and I had worked. And assembling products at first. But now I a supervise a four percent janitorial team. So when I say it late. Okay so. What I say is like. Everyone has you know a choice in life okay. And. For me and everyone like me. To take away that choice. Is like. Taking a. You know like say it all you know everybody in this room even in If you all had a choice and what you wanted to do you had a choice in being Senators you and you had a choice in. A place where you want to work so. Say you had that choice taken away from you and you couldn't. Work where you want to work. that's I just I get that's is my up up up up. Decision. So my question for me my hope for all of you is that you. The support everyone like me and everyone. As yourselves to support the this bill thank you. Thank you so much for appreciate you being here miss price any questions from members of the committee C. nine is there anyone here to anyone else here to speak for against this bill. Right C. nine you're recognized close for your bill right thank you I think Stephanie did a great job and closing for the bill and this is about choices and options and allowing people to choose an employment situation that best fits them and the way that they need to work and I know that our legislature strongly supports them are fourteen see workshops across our state and the work that they do and the folks who work there so thank you for your continued support ask for a good vote. Thank you miss price thank you so much for being with us and for your choices that you made and for giving us your testimony your life experience and what you're doing is so very important to us and your voice is so important and so we're just grateful that you came here today. Thank you. Motion to pass second all those in favor say aye. And it has congratulations you've passed house bill fifteen forty six. Thank you ninety five percent house bill one and as zero zero eight okay house bill one zero zero eight. Representative Pilkington you wanna come to the table as well. There is an amendment and it was just add me as the Senate sponsor okay is there a motion to adopt the amendment seconds all those in favor say aye. And and oppose ayes have it and it is adopted you may present house bill ten zero zero eight as amended. All right thank you members and pre and Davis state senator district twenty five say this bill is simply adding and CGM's as a pharmacy benefit so we're striking language from one section and putting it back into another section and just like I said solely for the purpose of allowing it to be a pharmacy benefit which means I'll be eligible for rebates which ultimately is cheaper for the state it still requires a prescription and the fiscal impact if you'll look as a savings of four point three million dollars and which is one point two million for the state happy to take any questions all right are there any questions from members of the committee. Senator boy I have a question I just wanna remind everybody I'm a pharmacist in the state of Arkansas the four of a. I'm married to a husband who writes many of these prescriptions I'm sure. anyone here to speak for or against this bill right C. nine you're recognized to close for your bill. I thank you members we M. are close this is about and having better outcomes better healthcare access for people across our state have diabetes and say this is just an important step in the right direction and also a fiscally conservative bill and mass forget that thank you all right thank you so much as a pleasure of the Committee motion to pass second as amended all those in favor say aye. And oppose ayes have it house bill ten zero zero eight as amended passes thank you so much all rights. Are there any other bills to come for a committee senator yes representive Pilkington and you have. Okay Senator Boyd you're recognized which bill do you want to run. Fifteen twenty. We have an amendments. Okay motion to adopt the amendment second all those in favor say aye opposed amendment is adopted you may present the bill as amended thank you madam chair this is really a pretty simple simple I'm sorry senate bill this bill simply raises the petroleum tank trust fund correction action payments from one and a half million to two million dollars this represents a thirty five percent increase but there hasn't been a change since the nineteen eighties when it was set and inflation has a sixty five percent increase this is not expected to have a negative impact on the trust fund balance and eighty Q. is neutral on this proposal. Okay. It's really that simple all right are there any questions from members of the committee. No questions is there anyone here to speak for or against this bill. Nobody is signed up all right you're recognized a close for the bill as amended closed and I would make a motion to do pass as amended okay motion do pass as amended as their second. Their second second all those in favor say aye. And opposed Is haven't house bill fifteen twenty as amended passes. And let's see representative Pilkington a house bill eleven OO to. Eleven a two. Okay. Yes. I have a hard time keeping track of what bill but never goes with so sorry thank you for your patience on that okay this is to create the universal newborn screening that yes ma'am thank you representative Aaron Pilkington District forty five today president you house bill eleven oh two which as the as the chairman describes great the universal newborn screening acts currently we follow lists for newborn screenings that match the federal government that lists is changing and so in the past we've always had to do is we had to include a new test if it gets added to the list is that were up to date this which is merely have as mere what the with the federal government says the tests for newborns there's no fiscal impact across is anymore money it is a ways in that way we're not always having to go and every two years and update these lists and statue we just got the number following No known opposition to the bill and that's essentially it. All right seen it are there any questions from the members of the committee. C. nine is there anyone here to speak for or against the bill saying nine you're recognized to close for your bill I'm close from a bill and that's for good vote thank you admitting motion do pass second all those in favor say aye opposed. At eyes have it and house bill eleven oh two passes thank you thank you committee house bill ten thirty five to require screening for depression of birth mothers at the time of birth yes thank you Jeremy this is another bill you know obviously we look at our our mortality rates for both infants and mothers after birth one of the things that we found is a good way to prevent that is by having depression screenings early on in the process most at actually almost all insurance companies already doing this we're just asking to make sure that they do it within the first six weeks which obviously come inside to the usually when they get get that first check up after after giving birth and so there's no fiscal impact of spoken to a few of the insurance companies they're not oppose this anything like that they think it's good policy and you know obviously we understand now the mental health so much more important part of the whole process and so with that I ask for a good vote as well all right thank you any questions from members of the committee anyone here to speak for against the bill C. ninety to close for your bill I am concerned bill Nasser good vote all right motion do pass seconds all those in favor say aye. And oppose ayes have it congratulations you pass house bill ten thirty five thank you Committee. This. Could I do zero zero seven yes but as far as gas thank you Ten zero zero seven to authorize pharmacists to dispense HIV pre exposure and post exposure prophylaxis saying that correctly this is a bill that Angelina of. Fite I didn't know a lot about but having known people who have had exposure to HIV this is some very amazing medicine that if taken either post exposure are pre exposure can actually reduce the chance of contracting HIV to upwards of ninety percent so essentially what we're doing though is it's already on the market worry Leding doctors for scrap it but we're disallowing pharmacists to dispense it as well you know big key factors if you have an exposure getting this medicine and you within the seventy two hour window is really important to reduce the number so we work with the medical society on this as well and so we we made sure they were go the language and so far as to support this Arkansas medical society supports is there's no no opposition I think we're all in agreement we we made sure that the pharmacist were not diagnose anything they just words simply dispensing which made the medical society happy with this bill so. Thank you are there any questions from members of the committee. Is there anyone here to speak for or against this bill. C. nine you've closed we want to because I'm I'm close right bill and I think this will help a lot of Arkansans okay and the pleasure of the Committee. Motion to pass second of all those in favor say aye. And oppose ayes have it congratulations to pass that bill thank you thank you that's it for me see also thank you can make you're welcome I do have one bill Senate bill four ten that I need to run is there anybody else so that needs to run a bill before me I try to make myself complex. Yes. C. R.. Okay I sure do. H. C. R. ten eleven. Do you want a copy of it Okay. I feel state your name for the record you're recognized state senator Justin Boyd district twenty seven so this is a house concurrent resolution it's already made it through the house it's over here for concurrence and so what it does is it encourages the food and drug administration the DA to Encourage support individual unit dose packaging and this is a good innovation that helps patients and in the long run and helps them keep track of how many doses they've if they've taken it does today for or not so that's really all it is is just the resolution and as a pharmacist I'm supportive of it. Okay are there any questions for Senator void. C. nine answer anyone here to speak for against this bill. The nine you're recognized to close. The motion to pass okay motion do pass as their second second all those in favor say aye. And opposed ayes have it H. C. R. tenant one one passes thank you all right Senator Solomon must build Senate bill for ten. Members I understand that we did have somebody here to speak for the bill but he had to leave and catch an airplane back and I did. I just want to jump in front of everybody else but so I'll let Mr Wallace and talk about his you within yourself first sorry. Senator Missy Irvin district twenty four. Somebody else that's right okay go to. Yes my name's Jimmy Wallace not representative or print statements in the surcharge and this is add to cart the border specifications that we haven't state today it just or it changes the date of an inspection so you had a inspection on may the first and you had some opportunities to share to border downturn the operation say up to six months after that you can do that and flexibility this bill you have to pay a chair for forty dollar fee get free of forty dollars for you whatever your initial inspection is is due and then if you. Apply for an expansion a phone inspection that year pay another forty dollar fee we've been in contact with the a lot of the industry that have both orders and there's no opposition to this at all so would appreciate a good vote on. Members anyone have any questions. Saying no questions in the committee is there anyone in the audience to speak for against the bill. Seven nine With the will of committee. Okay close Senator sorry no thank you so much I appreciate the individual that came in from Green Bay packaging company I believe to speak for the bill so I'd just trying to help these at different manufacturing and facilities accomplish what they need to do on the inspection of their boilers and I appreciate a good vote. I make a motion to pass second the second all in favor say aye aye opposed same sign thank you pass the bill. Thank you thank you. Senator Flippo could just gavel that's right out the door as he was leaving all right is there any other business to come before the committee C. nine we are adjourned thank you committee for your work today.