Public Health, Welfare and Labor Committee- House

For the Division of the regime were working on it they turned it down elements or warm if anybody wants to I don't know what's wrong taken over jackets we take over jackets right there's no there's no rules yeah well I I make a motion if it was take off the jacket we pass that and say you and everybody in my jacket you know you know represent okay now I'm not opposed to that. It's always say make yourself comfortable I think you all know we have a full agenda today you know we've been relatively light on these meetings this will be one of those days we're here for for a good period time we'll work through as many of these bills we can we've got several on special order and then we'll take it bills on the active agenda without objection we're gonna be taking some of these out order just to accommodate some of the members there sponsoring bills in that have to be another committees and other meetings have other obligations also take into account some of the people that showed up to testify today and we have some people in the audience of travel to be here we're grateful to have you here look forward to hearing from you and we'll get to everyone as quick as we can for by just be patient so with that said representive eleven are you here you're recognized me like come see the tables it to here house bill twelve sixty six. You state your name then you're recognized present your bill. Gates. Mr with your permission I would like to ask Maddie Johnson. And Jason Chrysler two former students at Cabot high school to join me at the table for some compelling testimony as we move through this absolutely they just that come to the table and introduce themselves the committee center and for the record thanks. Chasing Crumpler Hendrix College. Ninety Johnson university of Arkansas Fayetteville. I'd have a representative eleven you're recognized proceeding in order you like thank you Mr chair. Members. Suicide is a serious public health problem amongst all age groups. I would almost imagine that everyone of you has had some type of suicide situation back in your districts that hit close to your home. However most use it enacts an enormous toll due to the significant years of potential life lost. Over the last two years suicide was the second leading cause of death amongst ages sixteen to twenty one. Teenage suicidal ideation attempt and completion are certainly on the rise across our great state. In Arkansas every five point three days on average a young person is lost to this silent epidemic by taking their own life. According to the US behavioral risk factor surveillance system almost twenty percent of high school students seriously considered attempting suicide with ten percent actually carrying out that attempt. The cost of suicide in the United States is consistently running close to nine hundred and twenty five billion dollars in medical costs lost productivity and the value of statistical life. However used suicide is preventable. Suicide rates for at risk youth can be substantially reduced by us simply doing two things number one. Knowing the signs and educating. Four out of five. Every suicide attempt is preceded by warning signs. And I can say with all confidence in knowing with working with governor Sanders secretary leave the new secretary of education. Mental health awareness amongst our school age kids and the prevention of that amongst our school age kids is a top priority. Secondly and maybe most importantly is improving access to mental health resources. Suicide crisis intervention support groups and effective outpatient clinical care. Arkansas youth currently ranked two percent higher suicidal tendencies as compared to the national average in the categories of feeling helpless and sadness for a period of two weeks or greater. When asked the question have you seriously considered suicide in the past twelve months I made a plan to commit suicide in the past twelve months our teams are two percent higher than the national average shockingly Arkansas youth ranks four percent higher when compared to the national average when asked the question have you attempted suicide in the last twelve months. Members this bill is very narrow this very specific specific to a critical need. In general what this bill do will do will provide outpatient crisis intervention services for suicide prevention chemical addiction or dependency sexual physical or emotional abuse of our teens beginning at the age of sixteen. By doing this we're giving you an opportunity for one of our very valuable in upcoming teams in one of the most crucial moments of their life to get help. No longer will they have to make an appointment with their PCP if you try to get a physical lately health check up it could take days. All referral. And then waiting for additional time to get an appointment with an interventionist. When teams hit that spot that dark spot that moment. Of do I do this or do I not. The first three hours of intervention are the most critical three hours to prevent a life ending tragedy. Not days of bureaucratic red tape. As the bill states a parent or legal guardian who is not consented is not obligated to compensate for the outpatient crisis intervention services by the minor. Currently Medicaid eligible children are already provided this benefit without age verification for ten visits. This bill allows the same services for those teens FOR six visits. When they're sixteen up and not Medicaid eligible. Mr chairman this time with your permission I'd like to committee to hear from these two young adults who have lived these issues and their own personal lives thank you representative minutes yes we have here from both of them in any order we were once go first thank you so much. Thank you Mr chairman and representative eleven for allowing us to speak today I thought that it would best begin this conversation to kind of give the history of how we got to today this is been three years in the work so we began our conversation at a young emerging leadership conference in the state where we met with fellow students across the state to discuss very serious matters and one of which was suicide and we discovered that our experience at our high school the issue was very permanent it. It. I was very serious us and had an impact us personally. And so from that conference we decided to head back and during our senior year we take an AP government course and part of that curriculum is to be A mental health and suicide of students across the state we don't know what that meant exactly at first so we decided to seek additional resources in the industry and the mental health area of the state and so ninety eight you'll kind of give us an insight on the. First of all thank you Mr chairman members of the committee a representative eleven the ability to be heard today Allegis inside one of our first steps after that initial a peak of project was to reach out to some of the mental health professionals we have in Cabot Arkansas with other from and we spoke to one who is a clinical social worker who mentioned that she really would like to see the counseling side of counseling centers in schools focus more on therapy so we spoke again to a counselor at our high school he testified that she would really like to see the age requirement be lowered from eighteen what is a seems to be an out to somewhere around a teenage age that she would deal with so that she didn't have to spend hours on the phone like with the bureaucratic red tape just a moment. so tied thirty was asking people that could you put your Mike look closer Caleb and thank you so much. so like I mentioned we spoke to that kind of high school counselor who said that she would really like to see this age requirement lowered because it really goes to that bureaucratic red tape that representative Evans mentioned she said that she would have students coming to our office in crisis and have to spend hours on the phone just going through the motions for the age requirement and like representative Evans mentioned all those hours are crucial and a student cannot wait and so this would really expedite the process and save students in the process and if I may add this bill gets is in line with other states that those around us are and are across the country on this is not a new thing dropping the age of consent for example Alabama just a step away is that fourteen agent the age of fourteen and the state of Texas at the age of sixteen currently there's also states that are as low as thirteen out in Florida so this is nothing new and we think it's times that we get our state up to where everyone else is across the country some ninety. And really enclosing an addition with the very compelling statistics that represent eleven mentioned about suicidal ideation and suicide attempts in our state according to the Arkansas center for health improvements from the year two thousand to the year two thousand eighteen Arkansas in general saw rise by forty one percent in suicide and the pandemic of course twenty twenty on has really exacerbated that and so we it is our hope and we see this bill as a way to really I can not that very troubling trend. Thank you Maddie and and Jason. they're the reason that I'm here today. They have spent the better part of the last three years as they mention researching. Assessing data networking nationally and advocating for change in this law and quite frankly I know that is this is very personal to them they don't want to lose another friend they certainly don't want to lose another one of their classmates just like they did in high school. Mister chair we have to answer any questions this time Committee do have any questions from the committee. President will ditch recognized for a question. You Mr thank you representive eleven I wanted to just clarifies so looking at the statute it lists the reasons for treatment without the consent of an adult for sixteen year old teen suicide prevention chemical addiction dependency sexual physical or emotional abuse. Are they are those the only things we're going to going to allow them to to be treated for yes without consent that is correct the bill is is very tight on that we want to be very specific that that was the only things I agree with that now and appreciate that were we're making sure we're doing our due diligence their follow up Mr. I also want to point out that it talks about not notifying the legal guardian unless there is and I'm trying to look at the word. let's see unless there's a compelling need for disclosure so is that going to be defined somewhere in rules hours this is gonna be a judgment call of providers moving across the board because as a provider in my opinion obviously suicidal ideation or homicidal ideation drug dependency or sexual physical emotional abuse like those are probably things that a guardian should know about so we have somewhere to clearly define them absolutely is is no this is part of the whole mental health package that that the mental health workforce group had spent months on we know that none of these bills are quick fix we just know that they are building blocks and we fully expect that is we've talked providers both large and small independent practices we know that there's gonna be a lot of rule making that will follow this absolutely I appreciate your efforts on this thank you both for coming to testify and definitely moving in the right direction thank you Mr president Gonzales you're recognized for a question. I thank Mr Resent eleven I appreciate what you're trying to do but I don't see in the bill how it cuts through any red tape from it looks to me like it's just like it's mostly about just not notifying the parent and you'd mentioned things like prior also cut through all that so I where does that come in house bill fix fix at a shop Presearch ask that questions if you go so I'm as I mentioned in the first part of the testimony currently any child if their Medicaid eligible can. Seek the services. The first ten visits are gonna be paid through Medicaid and there is no age verification. Question of the day of the of the red tape came into private pay so when a child is not a Medicaid eligible child then as the law currently states in regard to this a minor cannot bind a debt and so we had to then sat down with the Arkansas insurance commission with a Director McLean and with both ran who is our chief legal counsel if you go to the very back page section two states a health benefit plan shall not exclude coverage for outpatient mental health on the basis the enrollee is and is under the age of minority in the state that was a big a big key to this was that we need to be able to get private insurance. To pay for this for the visits and as it states in the bill under this would be six visits or as Medicaid is ten that insurance would cover the cost of those treatments. If those treatments took place. First. Intervention sessions I guess is a but it still doesn't take care of the problem of the prior off the. Prior authorization you still they they you to that still have to go through. Your you'd mentioned going through their family practice physician or whatever to get. The initial rumor right so currently now if if they're not Medicaid eligible let's just say hypothetically student at a school they find themselves in that dark place they just don't know where to turn they go to their accounts or they go their coach they go to an SRO or whoever they say I'm in a bad place ninety help. They're gonna be walked that counselors office and depending upon if they are Medicaid eligible that counts or is going to be able as Maddie it stated if they're not Medicaid eligible the and that counts for has got to go through all the steps of trying to get a get a point with the PCP to get a referral to get with interventions what this would do because now private insurance would cover those first six visits is it would eliminate those process those processes and allow the school counselor SRO whoever to be able to get that student help with whomever maybe the school may contract with you over the state's providing to help get that student that that within the first three hours that crisis intervention. So is the is the student expected to carry their insurance card and and have that ready for billing purposes how they. No because as the bill states that the there would not be That there would not be an obligation on the parent and so the provide with the providers of told us is is that we want to get that student off that ledge at that moment in the is the bill states. If that provider feels like Hey this is something that we're gonna need to follow back up on at that point they can reach out to the parents say here's a situation that we have we need to get we need to get some additional US services available to your child that's when that that binding agreement would take place in the insurance could be provided. Okay all right thank you are there any other questions from the committee. Represent Bentley you're recognized for a question. Thank you represent eleven can we I see no definition of mental health professional there so what type of thing that would come through in rules. Any other questions from committee. Represent Gramley you're recognized for a question. first off I really appreciate your being here today I teacher's grading in in in Fort Smith and I I I really can't count the number of students of the in there in that place and I sat with them and got them the counselor and try to get them to the place I need to be so I just really appreciate you you you doing the sort because I do think it's important I and I think it could save lives at I guess gently how do women sixteen I mean we have heard other states are doing lower I mean so certainly we S. BLR to put a chart together do the research and we looked at every state in the nation as I think Jason mentioned there are states that have gone to thirteen some to fourteen we're currently at eighteen so we just felt like that was a good kind of conservative Leding spot in the fact that in their experiences in the research they've done the council's they've talked to around the state that seems to be that fifteen one of the sixteen year raised or just a whole lot going on in their lives at that time and we just we felt like that was a good landing spot. Any other questions from the committee. Same manner as everyone signed up to speak for against the bill. Representatives you closed your bill. Yes Mister I'm I'm close tonight I'm just can't think committee and for just allowing us to to spend this time but the students share their stories that they have lived very personally through their own personal situations and through classmates and I would appreciate a good vote. A representative is closer bill was supposed committee we have a motion to pass all those in favor any discussion on the motion. All those in favor say aye. Those. Graduations represent eleven you passed your bill thank you Mr chairman for lying to special order of business today welcome thank you. Resent hawk are you a hero ready to present your bill. You're recognized come to the table and present house bill eleven eighty one. Thank you Mr chairman thank you committee members may I bring up a special testimony absolutely can someone to the table as you come in I did for the cells I understand you have a letter or passing out as well yes Sir from the American counseling association you'll be receiving that. SO however you'd like to come to the table there was an account for Hall. If you could just entity shall for the committee state your name and who you're with. My name's Chris hall and I'm representative hockey. Doctor hall is the director of graduate counseling at John Brown University and lives in silence springs which is in my district and is an expert on what will be speaking of today so I really appreciate him coming down to share with you his expertise and knowledge. We all are seeking best healthcare opportunities for the welfare of all our Kansans I really appreciate this committee being so diligent on the public health welfare and labor in Arkansas. We all seek knowledge understanding and wisdom to make the best decisions on every bill before us. Data from the National Alliance on mental health shows five hundred thousand our Kansans suffer mental health condition at a nine hundred and forty five thousand DO not receive or have access to healthcare. With mental health care one point four million our Kansans living communities without enough mental health care providers to meet needs. We just heard testimony of an increasing need for our young people. You will hear these just statistics represent real lives often in crisis Arkansas is ranked forty fourth in the nation and mental health. Today we want to share knowledge and experience from the counseling profession in order to make critical human need for mental health in Arkansas. Doctor hall has agreed to come today he is the predecessor or doctor holes predecessor Dr John Carmack has served on the Arkansas counseling licensing board for many years and also served as its chairman. So doctor hall comes with a lot of experience either it to this profession now but also his predecessor so at this time I would like doctor hall to give you his testimony. After all you're recognized to present to the committee. Thank you Mr chairman thank you committee members and thank you representative hawk for this opportunity to address the importance of house bill eleven eighty one as mentioned I'm the chair of the department of graduate counseling John Brown University we have counseling program locations here in Little Rock as well as in silence springs. Skews me I'm a licensed professional counselor in Arkansas and I've held a professional counseling license for over twenty years in four different states from two thousand fifteen to two thousand twenty I served on the board of directors for the council for accreditation of counseling and related educational part of programs or K. crap it's the national accrediting body for counseling programs in the United States I was the cake crap board chair in two thousand nineteen and two thousand twenty one serious conversations began with national counseling associations about licensure reciprocity and counseling compact's. As noted in your previous discussions on bill eleven eighty one the counseling compact brings with it a great Shares in the state of Arkansas. Data from the National Alliance on mental illness indicates that roughly half a million our Kansans suffer from a mental health condition about a hundred and forty five thousand Kansans do not receive or have access to the mental health treatment they need Furthermore nami reports that one point four million our Kansans living communities where there are simply not enough mental health counselors to meet client demand. According to two thousand twenty two data for mental health America and the U. S. census bureau household poll survey Arkansas ranks forty fourth in best states for mental health care this ranking was based on five factors prevalence of mental illness in each state access to mental health counseling in that state the number of people who actually receive counseling in that state the number of people who needed counseling but didn't get it in the state and mental illness map mental illness and health insurance coverage data again Arkansas ranks forty fourth I don't think we're calling the hogs for forty fourth out of fiftieth. As members of this esteemed committee have already heard the counseling compact will allow licensed professional counselors in Arkansas privilege to treat clients in person and via telehealth in member states currently if a client initiates care with an LPC in Arkansas and then travels out of state or relocates temporarily for any reason the Arkansas LPC must seek special approval from the licensing licensing board in the state where the client has traveled in order to provide care to that client this is a major barrier to the continuity of care for many our cans and clients house bill eleven eighty one changes that the counseling compact also expedites the licensure process for qualified professionals moving into the state of Arkansas as well as Arkansas L. PC's who moved to member states currently the Arkansas board of examiners and counseling in marriage and family therapy has educational requirements for licensure that go beyond the national curriculum standards established by K. crap this means that almost every licensed counselor moving into Arkansas must complete additional course work in order to be eligible for an Arkansas license regardless of whether they've graduated from a nationally accredited program or how long they've held and unencumbered counseling licensed in another state. For example when my family and I move to Arkansas in two thousand seventeen I was required to complete three additional credits of master's level course work in order to be eligible for an Arkansas counseling license despite already having a PhD in counselor education and having held and unencumbered license for fifteen years and three other states if we want to provide our Kansans better access to mental health services let's start by making Arkansas a more attractive place for experienced and qualified L. PC's to common practice house bill eleven eighty one does that. A number of committee members raised concerns with this compact that I would like to allay. The concern was raised about practitioners getting licensed in less restrictive read less restrictive states and coming to Arkansas to practice I think that's a valid concern however only states who currently have licensure requirements laid out in the compact will be allowed to participate in the compact meaning all member states in the compact must have an LPC designation that requires the completion of a sixty semester hour degree in counseling and passing and nationally recognized exam. These licensure requirements are actually based on national standards educational standards for counting programs are set by Kate crap and requires sixty credit degree in counseling that covers eight curricular domains this includes practicum an internship experiences where students must complete a minimum of seven hundred clinical hours across three semesters. National exam requirements are set by the national board for certified counselors the most widely used exam the national counseling exam is required in forty two states including Arkansas. Secondly outside of the licensure requirements indicated in this compact there tends to be very little deviation between state licensure requirements to the extent that some would be considered vastly inferior to those in Arkansas well states may vary in the number and type of post graduate clinical hours needed to meet LPC requirements most states thirty one to be exact require the completion of three thousand clinical hours post grad including Arkansas the compact does not have a specific post grad clinical our requirement for members member states thus allowing states flexibility and maintaining their current clinical our standards. Thirdly Arkansas's current path to licensure could actually be considered unyielding the restrictive based on its educational quite requirements of seven credit hours of course work above and beyond the national standards I would actually argue that the concern should not be whether droves of on qualified counselors will soon flood into Arkansas rather why so many qualified counselors do not or cannot. The concerns raised at this bill restricts the evolution of curriculum by outlining eight curricular domains again this compact simply reflects the current national curriculum standards set by K. crap the compact does not require specific courses or even credit hours only that coursework covers the eight curricular domains established by K. crap for nationally accredited programs as mentioned earlier the Arkansas board of examiners and counseling currently requires seven specific credit hours that fall outside of these eight K. crypto means including three credits of coursework and abnormal psychology three credits of course work in marriage and family therapy and one credit of course work and technology assisted counseling. These additional educational requirements specific to Arkansas guarantee that almost every licensed professional coming into Arkansas from another state will need to complete additional coursework beyond their conferred degree just to obtain a license to practice in our state even when that degree was earned at a K. crop accredited program. The question was raised about whether out of state PC's can practice telehealth in Arkansas and the simple answer is no. The Arkansas board of examiners and counseling regulates telehealth counseling for Arkansas residents so providing in state telehealth counseling requires an Arkansas licensed and an established client counselor relationship typically initiated in person prior to telehealth services being rendered each state is similar limiting telehealth counseling for state residents to licensed professional counselors in that state this definitely causes accessibility and continuity of care issues for college students traveling medical professionals military personnel and their families and other transient our Kansans who wish to maintain their Arkansas therapist when residing or traveling out of state. A few concerns are raised about the purpose rulemaking and prosecuting power of the counseling compact commission. The commission's purpose is to oversee and carry out the compact including establishing and maintaining a data system code of ethics bylaws rules Budget and financial records to be clear the commission oversees the compact not the practice of counseling in member states the compact is not a waiver of sovereign immunity the commission may not create rules that affect any state sovereignty over the scope of counseling practice in that state as confirmed by the council of state governments the counseling commission is not a super regulatory agency that cannot take unilateral action against the practitioner and it cannot dictate policies to member states. Well the compact provides that the commission may undergo legal proceedings this does not alter the member state licensure boards legal abilities or protections that might be associated with a legal proceeding. A simple majority of members state legislators may veto a rule of the Commission if the commission issues a rule that exceeds its authority under the compact this rule shall be void and have no force or effect member states may repeal their membership in the compact at any time and member states may amend the compact at any time finally and most importantly Arkansas has set a precedent enjoining similar compact's with equivalent provisions for interstate commissions including the Interstate Commission for juveniles the Interstate Commission for adult offender supervision the nurse licensure compact the physical therapy compact and the psychological interference fictional compact to support these contacts will not supporting the counseling compact would simply be inexplicable accounts in compact is an opportunity for lawmakers to support the practice of professional counseling in Arkansas and the thousands of our Kansans suffering without the mental health care they deserve it's an opportunity to make a statement that forty fourth place is not good enough I would simply ask that as you consider this compact you keep the mental health needs of our Kansans in mind as the greater good I fully support and strongly support house bill eleven eighty one and hope you will as well thank you thank you for that testimony doctor hall. Three questions from the committee for doctor hall or review talk. Receive Wardlaw you're recognized for a question. Thank you Mr. Dr hope right Paul H. U. L. L. okay thank you everyone thank you but you're that I'm it is a country accent a butcher names very easily if you follow me over to page eighteen U. you head on the only problem I have with the bill and that's the rulemaking authority to go over to page eighteen line twenty six it's as if the majority of the legislature. When you read that it's it's saying that we would have to be in session to. B. against a rule that is imposed by the compact. My only issue with that is is we can actually take up and there's amendment in the constitution will re approve or disapprove rules today that are. Get state law against federal law against constitution or go against Legislative intent that one is is the key on the and if they would take an amendment there I have the same conversation with another sponsored another bill to include Legislative Council that would allow us to review those rules instantly so as we meet monthly throughout the two year term that would leave most of my concerns with the bill And I can tell you are met with number Senate members on the other end of the other bills in the Senate at the moment and they have the exact same concerns as well so if that wording could change from legislature to Legislative Council then in Arkansas we would build review those rules on a monthly basis I think everything would be alleviated that point and that's very small change but it doesn't change the meaning of the compact or change anything just changing the way we review of the rule making process. Thank you is that something you think they're amenable to. Yes Sir I think that was something that we would very much think is a very helpful thing for Arkansas to maintain its continuity of care. So are you willing to amend that in yes Sir. Okay so we're going to I brought I brought a copy of ACT three thirteen which was passed in twenty nineteen with the interstate physical therapy licensure compact in Arkansas it's been in effect now for years and there's not been any issues with that and the language is very similar if not exactly word for word with the this commission compact which is an interstate compact commission as well but I think you bring up a good issue that technically for Arkansas were not in session but every two years and we would need the ability to make those changes on a regular on going basis through our our. deemed. Body to do that which is the Arkansas Legislative Council. So Mr last question you're recognized if you're willing to amend that in I'm I'm serious I think I'm fine with the bill at that point completely but are you going to do that now in the Senate in the floor you pull it down to get a member for next week I mean how are you going to vote for this process. Mister chair I would ask your advice I think you know as as a representative you have several options for trying to mend the bill certainly this precedence for committing to amending on the Senate side and following through with that have you here on public record they're also waste amended on the floor or you could put down those are three options he's presented its really entirely up to you how you approach that well I will to know your comment yes Sir. A. L. C. acts as the General Assembly when we're not in session despite the bill saying the of the legislature and I don't have the bill in front of me but A. L. C. acts as the General Assembly were not in session so I think most people would interpret it and some of centers I've talked as well have said that they don't see an issue with this because A. O. C. acts as the General Assembly when we're not in session so I don't think there needs to be changed and that's what the bill that she references that we had four years ago my understanding is not sales the but as the Arkansas General Assembly not once again ALC axes the General Assembly we're not in session I appreciate appreciate that comment but at this point we're asking questions happy to have discussion. At the right which is certainly happy to hear that comment but at the same time when I want to stay to the point of the question at hand and I think it's entirely up to represent talk how we proceed I would like to go ahead and proceed with the with a motion from the committee to go ahead and do pass and make any amendments on the Senate side Senator Justin Boyd is the US Senate sponsor he is also an agreement with the bill is written so I said yes I hear commitment from you to make an amendment on the Senate side yes Sir are there any other questions from committee represent Gonzales you're recognized for a question Mr I know it'll just get with you on this you came to me and we talked about it discussed in this and I failed to get back to the earlier foot on page. Page sixteen starting on line five that whole section three is what really concerns me on this and and that this may be standard practice across all of these compacts and I'm fully supportive compact's out I like the idea of I want to support this one but that part gives me concern that the Commission may levy and collect an annual assessment from each member state and a most of our boards and commissions are are cash funded their self another funded through license fees and things like that you know the state doesn't but in general revenue and to me this is saying that that this commission can levy whatever kind of annual assessment and it doesn't even outlined with that is it just a joke and come up with that assessment let me that on the state and that will impact our general revenue. So if you refer to the letter that was received from the American counseling association on your desk it says that states may if they so choose they can levy a fee for a member of a licensed professional counselor in a member state that would want to have a privilege to practice in Arkansas Arkansas would have the ability to charge a nominal fee or any fee that we would deem necessary to cover the cost of them practicing in Arkansas the fees that are part of the national database and the Commission ours set as you see on this letter from the American counselors Association or nominal to our member of the licensing board representing Arkansas going to an annual meeting that is held as a voting member so that would be part of the rules as to whether Arkansas counseling licensing board would want to an act a fee on any qualified licensed professional counselor in a member state that would want the privilege to practice in Arkansas and again these are individuals have to come before the licensing board or petition the licensing board for the privilege to practice in Arkansas and that would be something they could say as a member state they are are on the national database that the verification is instant and someone doctor whole if you have any other things to add on that the fee yeah my understanding is the commission would keep maintain a database and that way if there is any kind of issue with that practitioner in another state they would alert member states of that and so again I think the fees are for maintaining a database and and like a representative Haak said there'd be a fee to join or have privilege as a counselor to to practice in a member state that's that's pretty typical for for us already has licensed counselors we would have to go through the full licensure process in another state and pay hundreds of dollars just to apply for for licensure so I think a nominal fee is is is. Member state has the right to set that fee if they so choose yeah of a completely understand I mean we we do that with almost every license that I know of the state now we we have a fee for for that license what I'm saying is that. The licensee pays that fee and and here's ask and it. Permission for the commission to levy a fee on the state not not the licensee I realize that we can turn around and and. But whatever free if you want to on that license but. I would be more comfortable with that if the said the commission can can charge a fee to the licensee to be a member of the compact. That to me that's a better way of funding it and not saying you can. And I think that is the mechanism by which we would turn around and pay whatever fee we would charge for a. licensed to practice here in Arkansas that could be remitted from. To pay for the actual membership to but we have to be a member state in order to participate in the compact the and like I said maybe this is all all come back to is there someone from the health department they can answer that on on the other compact's is standard practice I would do these are on here from the health department can fatally set question Mr Gilmore you here. Some question per se to being are always just say see the table station. Matt Gilmore department health so that is in the question basically how would the Commission recoup any expenses due to the or how the board prohibited fees or expenses due to the Joint comp is that correct. No so let me just read section three The Commission may levy on and collect an annual assessment from each member state or impose fees are on other parties to cover the cost of the operations activities operations and activities of the Commission and its staff which must be a total amount sufficient to cover the annual budget as approved by the commission so is it standard practice of these compacts can basically tax the state of I think what I've seen with and the people as mentioned earlier physical therapy what they typically do I think it's passed that fee on to and they do charge a fee they pass that fee on the licensee and then that's kind of just of a pass through they they collected and then the board will pay the compact an annual base or something like that. Okay so it is standard practice I think it is my understanding yes or thank you thank you. In order to recognized for a question thank you Mr chair so I have some of the same concerns obviously with the compact approach so my understanding is reciprocity is currently available to councils in Arkansas they just petition the board for that correct and it did come a licensed LPC here in Arkansas. If you're coming from another state to practice in Arkansas you can you can apply. By endorsement. Essentially. It's a different licensure process that that would require you to meet the Arkansas requirements right so how does the compact change that process eight explain to us the compact so the compact just makes that an easier process for our sins it would basically it would basically say because you're part of a the compact and in a member state we already know your educational requirements meet the standard and you pass a national exam so you by pass those sections of the application okay so. If I am for instance a mental health provider and I live in a neighboring state that is a member of the compact I am being coming registered with the compact. In their monitoring me moving forward correct so so for all use my wife and I as an example my wife's an LPC I'm an LPC we moved here from Colorado Colorado is a member of the compact currently if we moved here and we we applied as a member to practice in Colorado we would have a much easier pathway to licensure we would have been recognized our education and our exam would have been recognized my wife had to do five extra credits and I had to do three extra credits before we could even start practicing in the state we would we would have been able to come in our education would have been approved we would have had a license to practice almost immediately so why did you have to do extra work in Arkansas because we are part of the compact the compact is didn't exist and Arkansas requires like a side additional credit hours above and beyond national standards that in most other states but those requirements don't exist so by joining the compact we are reducing our standard of current standard your your meeting the national standards you're not going above it but it reduces the Arkansas standard currently which is kind of the point that we talked about earlier it does take some things out of the hands of the state I think that you can look at it two ways yes but that's an accurate statement the it would be accurate that those seven credit hours that. That Arkansas now requires by the national standard would no longer be required okay so. Back back I think that does speak to the point that I think that some other members have tried to say that that it does reduce the standard of what we're currently doing in Arkansas but I have a follow up questions that the committee you're recognized for a follow up thank you also telehealth in Arkansas so this this is to ease access for telehealth in Arkansas correct what you mean by the contacts we're trying to broaden the the telehealth provider provided by the state takes away barriers for for telehealth yeah right so under current regulation from the Department a telehealth provider has to establish an in person relationship so if you're living in Colorado and you're now member the compact you've got to fight Arkansas established relationship and then you can provide telehealth services. no because in Colorado the licensing laws are different so that would only be for a Arkansas license holder if if established accounting relationship within our cans and client and that client left the state and went to a member state the Arkansas cancer could continue to provide care right fielder edge I think I've heard at least one follow up question there seven the it I understand that I will catch up for the moment are the any of the members have any other questions represent will make you're recognized for a question thank you Mr is there any evidence of these seven extra hours you guys are just talking about have have led to better outcomes for Arkansas patients versus other states. So my answer We have to law schools in Arkansas the University of Arkansas and UALR if they have a nationally accredited law degree they can practice law in Arkansas it would be like requiring them to take seven additional hours in Arkansas above and beyond their law degree which is a nationally recognized accredited law school to practice their law degree in Arkansas that's what we are The national exam to become a licensed professional counselor now we're asking them to take additional professional hours to practice their nationally recognized degree so if we have that same standard equivalent we would be asking lawyers to before they could practice their law degree that they received from a nationally accredited school here in Arkansas we would be asking them to take extra hours in order to practice their degree you're recognized for follow up thank you I'm trying to help the. You didn't answer my question is there any evidence that you're aware of that extra seven hours yes our professional can answer. there is not the national counseling exam covers the eight curricular standards that K. crap endorses for hi counseling programs and so those three additional areas are not covered in any national accounts and Sam's to practice. President hawking this is back to the comment about the amendment I'm being told by staff that if you wanted to try to amend that here in the committee we could have an amendment over here recognizing that would only satisfy it sounds like representative for my mom Wardlaw concerns that if you want to try to meet your committee we could do that today we might want to pause were rat for a moment to get the minute here again that's apparently that's entirely up to you but I am told that some option if you want to try to get him in that today and settle that issue thank you I would like to do that okay are you willing to pause for a moment we can get a minute over here yes Sir okay thank you we'll keep you here in the room and the you have more questions from the committee on this bill and work discussion on the amendment at that time so we'll pause let you step down will have the next person come to the table here bill thank you for your patience. Represent separate you here. You're recognized to present house bill one three three four thirteen thirty four thank you. I understand you have an amendment your bill as well. Members were pass at the minute her bill will hear the amendment first. You just give us the time for that to be passed down. Mister chair I also have to witnesses with me is it okay if they come up absolutely and. Richey Shepherd you're recognized to present the amendment to house bill thirteen thirty four okay. Thank you. This is an amendment to the bill there were a few amendments that were made the first amendment was may was we added a representative to the bill which was representative Matt Duffield the next amendment we made was after after speaking with the local health department we removed the language of our local health department from the bill and the last amendment that was made was to in regards to the final end of the bill and a hundred dollars so those are the amendments that were made to feel members of the questions on the amendment. I have a motion on the minute do pass the discussion on the motion. I'll close favor passing the amendment to house bill thirteen thirty four police say aye. All those opposed graduation pastor Amendment members were passing a letter that I understand support for the bill a few to read and as we're passing out reserve Shepherd you're recognized president house bill thirteen thirty four thank you Mr chair it's great to see you out this morning colleagues I I of course to me Shepherd I represent District seventy nine but I still I'm here before you this morning in my official role as a representative but also a mom here at the table I have with me my son on jury in addition to I have a me with the Arkansas calls in all fifty of colitis foundation about four years ago my life changed in our world was rocked which is why I decided to run for office my son was diagnosed with Crohn's did not know what calls was or anything about Crohn's the impact that it has had on my family I decided I shared with my son that I would run for the highest office in the land to fight for him as weather as well as other our cans is with chronic health problems so my son and I were talking one day in addition we did some research twenty other states have a a law out this call to alleys law and what that law does is it allows people with Crohn's ulcerative colitis or any other type of IBD issues to have access to a restroom so this particular bill is basically asking for basic human kindness in regards to allowing someone to use the restroom that has stomach problems since I began talking to the bill in addition to my son I've had a lady to reach out to me that was nine months pregnant and she also has Crohn's and she wanted to or a business that was an employee only rest of business to use the rest. Room and the only shared with her did she could use the restroom if she paid and I ask her how did she have to pay and the way in which she had to pay was to purchase something so it really wasn't about the restroom it was about getting money at individuals so this bill is to simply asking if the person has some type of IBD is your stomach problems if a business owner will please allow them to use the restroom if I can have a moment I would like to allow my son to say a few things if that's okay and then I would also like a me to speak if that's okay. Yes that'll be fine please identify yourself for record can. Thank you my name's Andre thank you chairman thank you mom for having me as it. as an individual with Crohn's disease I personally believe access to restrooms is a crucial aspect that impacts my daily life and those with similar conditions that the absence of readily available restrooms places constraints on on our daily lives impacting how we interact with peers family and friends in managing unexpected events in public settings It's already hard enough to express and articulate the daily challenges that we go through to people who don't understand what's going on and I just support my mother in this bill which could be a positive step in the right direction in fighting this battle. I thank you my short and sweet thank you. Well. My name is Amy Carroll and I am the community manager for Arkansas for the Crohn's and colitis foundation and like represented Shepherd I start working for the foundation and and twenty seventeen after my husband who has Crohn's disease and I have four children who have three of them have Crohn's disease and I decided to do is to step up and do something to find a cure and also to advocate for other people with IBD the Crohn's and colitis foundation is a nonprofit volunteer fueled our organization dedicated to finding cures for five Crohn's disease and ulcerative colitis and improving the lives of children and adults affected by these diseases Crohn's disease and ulcerative colitis are incurable autoimmune diseases collectively known as inflammatory bowel disease or IBD. Both diseases cause inflammation of the gastrointestinal tract and are characterized by abdominal pain diarrhea and frequent bowel movements one in a hundred Americans have this disease. People living with IBD often suffer from debilitating urgency to use the restroom immediately or risk having an embarrassing accident did this causes many IBD patients to worry about whether they will have access if they go out in public. Unfortunately not all public establishments have public restrooms available and they're been incidents in which I. B. patients have been denied access to employee only restrooms the first restroom access act known as alleys law or the Crohn's and colitis fairness act passed in two thousand and five making Illinois the first state permit public asset access to restrooms since then nineteen other states have passed legislation these laws seek to ensure that people with certain medical conditions have access to employee only restrooms when public ones are not available. These laws seek to ensure that people I'm sorry that for years the foundation has provided our members with the physical I can't wait card to help explain the businesses why they are urgently requesting access to a private restroom we now have we can't wait acts out of the office patient and any really anybody with IBD or anybody that has the app a simple way to locate publicly accessible restrooms and help identify sympathetic instead establishments in partnership with our other with other non profits the foundation is calling on stakeholders in the public and private sectors to recognize the issue of restroom access as a basic human need and permit public access to respite restrooms wherever possible specifically the state based model legislation ensures access for persons with certain medical conditions including Crohn's disease ulcerative colitis as well as those with Austin means when the establishment has three or more employee employees currently working and only when the employee only restroom is located is in a location that is both safe to the patient and not an obvious security risks for the retail establishment. Thank you. Per se that testimony it represents Shepherd giving thing more at before we take questions from the committee no Sir committee members are there any questions. Seeing no questions or anyone else a representative Alan you're recognized for a question. anyone sentence for speak for against this bill. This more thank you for bringing this to our attention and it was the will of the committee. Motion by a motion to pass representative Allan discussion on the motion. Represent Ladyman you're recognized. Thank you Mr chairman resented Shepherd thank you for bringing this bill I've got two very close friends that have the same disease and I never thought about this particular instance until now what they face so I think that's very good bill thank you for bringing thank you Mister Ladyman. The comments from committee. What at sea no further comments on this page comment yes Sir president Donald yes discussion still Sir So I'm honestly I'm torn on this like a I think it's a it's a great idea but ultimately where I land on it is we're we're interfering on private property rights by the. Telling these store owners what they have to do yeah we're we're legislating what should be just common decency and. Yeah I just don't know that we should be interfering with with private property rights like that so unfortunately is better than a two I'm gonna have to vote against this. Any other discussion. See note for the representative Richardson you're recognized for comment thank you very much Mister Speaker that I'm sorry Mr so I I'd like to add a little bit on represented Gonzalez just said at the end think this bill is a lot like what we do for eighty at a Merican disability act and things of that nature what we require restaurants or other public facilities to have certain accommodations sought I think this is a very good bill I'll be voting for it just because I think it's the same as us doing this for other purposes these are not things they can control and it is human decency and to do so thank you appreciate those comments seeing no. Have a comment from the vice chair Richey Miller. Thank you Mr chairman of to the point of representative Richardson I. I feel like I'm in a unique position to speak about that Not all restaurants and public places have accessibility are accessible restrooms and so forth obviously it's lot handier and and maybe I choose to do business with those who do more so that I don't do those who do not however. You know I I I don't feel like it's I'm a little bit like just Senator in our. There does gave you a motion sorry Anyway representative Gonzalez. I appreciate and and represent Shepherd I appreciate the the spirit behind this but at the same time of. I feel like I've made a commitment to. My constituents to not interfere on private property rights and and. I think no matter how hard we try we're never gonna be able to legislate morality and decency so with that being a mother will be of no. Any other discussion on the motion. Represent Womack I would just like to say I sincerely appreciate of the. The thoughtfulness that goes and everybody the votes on these bills and also if for me personally this is one of those bills that I think is a great idea but I have trouble. Justify making a law that makes sense especially considering the sponsors gone out of their way to make accommodations to not be too forceful own private you know it I had the as some of these guys questions earlier is like were you were you how are you feeling this bill because this is a. My best friend growing up had that exact situation so I I understand that I've been there with them. in those situations A I think I'm gonna have to vote no but I think you did an absolutely wonderful job present this bill in drafting the bill and taking all these things in the consideration of eyes I just want to say how much I appreciate you guys because I know you know how hard work and all the decisions we have to make and especially when you have a bill Anderson at the end of the table that you you truly care about and you've done the work and and it may not they may around I have a feeling it's bill's going to pass out here but I just wanted to say how much public that I guess I appreciate the work that went into this and but unfortunately I think I'm gonna have to be an oath to present Alan represent recognized for comment. Thank you Mr chairman and thank you my colleagues for bringing this bill just wanna share on trust or We will the bus leave in the cancer treatment centers of America. And we had a gentleman on the bus that had to go to the restroom right away and you know hi bill some of you when you're taking chemotherapy and radiation. And we stopped at this convenience store. And he gets off the van goes into the convenience store and I said we don't have a public restroom but we have a private Christian. But it is not open to the public. So the driver went inside. And pleaded with them to let this gentleman use the bathroom so confused about from on self is headed to apple. So the since the manager came and said Hey look we will make an exception to the rule. So they made an exception by men this term and use the restroom having not been able to go to the restroom. He could not have called its flight because he had to go to the restroom right away so for that reason and the reason is that you have indicated I'm going to vote yes for this bill because there is a need for it and I know we don't want to France on on citizens rights but we do it every day every time we pass a bill appeal we we practically doing it. So I'm going to vote yes what because I think it's a good bill is much needed if you never been in a situation like that before what we all have had some help along the way. To get here and one of my best friends always with him if you see a turtle on a fence. Maybe get the balancing somebody putting their. So for that reason I will support to be. Per se the healthy discussion on the motion I think that's a good good work for the process moving forward is there any other comments on the bill. On the motion distributing Bentley. I'll be very brief or from my colleagues that are not wanting to vote for this bill concerned about I would look at page two and they don't above and be on their way to make sure that we're not being too hard on private business owners given and a way for them to make a way out I just think they have done extremely good job make it as easy as possible for those a private business so I'm going to vote for the bill thank you for your efforts to make that possible president Pilkington give comments yeah I just I'm gonna be voting for it hi I understand the comments by so my colleagues but you know I just remind people that when you're twenty to do business with the public there certain rules and rags you're willing to accommodate two and and and and represent a balance point you know a lot of companies have private bathrooms but they they wanna make exceptions but they can't do it because when shall I want you have to do bunch and this actually gives some kind of an out to cancel keep their bathrooms private without force them to say we love that Catherine's like well he's he's gonna sit special condition and we've got a way to verify this which I appreciate which was put into the bill as well so so I'll be voting yes I don't think it's a. I think it's a bad bill the more discussion on the motion. Seeing none all those in favor say aye. All those opposed the ayes have it congratulations represent Shepherd pastor bill thank you colleagues as amended yes pass as amended represent hawk do you know if you have an amendment prepared yeah if you like to come to the table and if we can get the amendment passed out. President talk you're recognized to present the amendment to your bill that's the amendment to house bill. Thank you Mr eight one. The Amendment before you is Onald met amendment number one to House Bill eleven eighty one on page eighteen line twenty eight we have sent to the ward compact comma or the Arkansas Legislative Council rejects a rule in order to be able to best initiate all any of that for Arkansas the committee members have any questions on the amendment. We had a motion on the amendment. He said you have a question or comment comment yeah your motion and a motion on the Revenue sketched on the motion there's a poking you have a comment or discussion on the motion yeah I do I committee I want to make something something clear I was working on faulty information that I received from B. O. R. we we we talked it out we corrected it so I want to say that this is this is needed and also I think we're going to have to do some cleanup language in some of these previous contacts that we pass that we didn't catch this before that have been around for the last couple years so get ready for some clean up bills but I just want to clarify that were good I'm good with this amendment I think we're all in agreement so thank you. Thirty eight if you any other discussion on the motion motion is amendment to house bill thirteen thirty four all those in favor say aye. Post house bill eleven eighty ones yes our applicants and Novartis will count that vote I got too many they give me too many papers appear to look at we're gonna get there yes so at this is the amended house bill eleven eighty one and then amend it is passed now it are there any questions to the bill as amended house bill eleven anyone any questions for committee review what you're recognized for a question thank you Mr chair and I'm not going to continue to beat a dead horse that's not my intent with this but what I do want to make sure that we're crystal clear on is their current regulatory process is set in place by the counseling board in Arkansas currently it is above the national standard with the additional seven hours and the way that we implement telehealth Sir services by joining the compact we reduce our Arkansas standard to the compact correct we we make it equal to the national standards so if I may take a moment to explain a little further how this actually works itself out students are not coming to get their to their licensed professional counseling degree from our accredited schools because we do require additional hours to get a license here in Arkansas licensed professional counselors that have not been practicing more than three years I understand from Mr Gilmour that the board passed a rule that if a councillor has a license for three years they may practice here in Arkansas and be eligible without the additional seven hours so the board has already approved that for anyone with a license for three years but if we wanted a person to come in requirement that they have in addition to national standards so again I would argue with the technical technicality of your question are we lowering our standards in Arkansas and I would say we are not lowering our standards to practice as a licensed professional counselor okay. That's all I'm concerned with thank you any other questions from committee. See no other questions anyone else here to speak for an your question review see see no other questions you would hear that wishes at this time speak for against the bill. C. nine we have a motion do pass as amended to discussion on the motion. Seeing none all those in favor say aye. Opposed graduations are the House pastor bill thank you. Members next on the agenda is house bill one one one five representing Maddox you here to present the bill. Absolutely. If you could but you state your name for the committee. My name is Tanya Boyd St I'm sorry my name is Tanya Boyd St University of Arkansas rich mountain and just for disclosure I'm also a member of the C. tech Committee with the Department. Per person Matix District eighty six. President Maddox recognized present your bill thank you Mr chair. Committee this is a very simple bill this bill just provides another pathway for a person to Size therapist can become a master massage therapist if they complete a hundred twenty five continuing education hours so all this bill does is allow an alternate path where a person who is a licensed and registered massage therapist make can become a master massage therapist if they receive three hundred plus hours at an accredited university that is certified in this field that is all this does we did work with the department of health on this bill they have no objection to it we did visit with private industry and there's no known opposition. In fact on my witness to speak at the St Louis you're recognized to speak to the committee thank you for hearing us today this bill will bring into alignment an education. Pathway for students who are currently in the technical program for massage therapy they can also acquired an associate's degree that can further their education those hours that are have already been approved by the Department higher education can then transfer on to further their education with another degree as they stand without it then that's as far as they can go now as far as satisfying the master massage therapy hours they will be receiving more clock hours than what is already required to have that but they'll also be receiving educational classes through their desired degree plan and I just think that it is a win win situation as far as those students who choose to come to massage therapy through the college system and it unlike. Mister Reddick said It is just a nother pathway it does not distort in any way what is already in place for those who choose to do it a different way it basically is only going to affect those students who want to further the education within the college system. Thank you for those comments in this presentation to may have any questions for either the witness a representative Maddox. Seeing no questions. Representation close for your bill yes Mister chairman close from a bill similar here speak for against the bill now we have a motion. The motion to pass any discussion on the motion. All those in favor say aye. Those. Seeing the ayes have it represent Maddox depression bill graduations thank you for being here today thank you thank you committee thank you Mr chair. President Pilkington are you prepared to present house bill one zero zero six. President penny you're recognized to present your bill thank you chairman today present to you house bill ten oh six an act to amend law regarding plan that requires employers to provide paid maternity leave and other purposes once I start with how this idea came to be if you already if you will recall during the summer the Dobbs decision was released overturning roe V. Wade in Arkansas stricter law went into effect as well as other laws all across the country. Many corporate national corporations decided that this was a good time to express and virtue signal their support for abortion by helping their employees circumvent laws in those states by transporting and other states to receive an abortion Some of which were even operate here in Arkansas and so what was interesting is I remember having a conversation with of with a few women who said it's interesting these companies who are using this section and Kavanagh's decision about not being able enter commerce to to allow them to pay for an abortion but yet these companies will pay for paid family leave which show their priority was not really about women and helping them even though that's what their press releases said they said they really believe in choice they would of given women both choices to keep their baby and have paid family leave or not and so out of that Barker C. this bill the idea came and I wanted to be able to offer a choice for these women's it's obviously here in Arkansas in this pro life saying the nation we cannot stop these companies from sending women into illinois' and other other states to receive this we can though force them to give the option of paid family leave and so that's what this bill is about if you look on page two the really the crux of it is line for a covered employer may cover that covers abortion or travel expenses related to abortion for employees shall provide twelve weeks of paid maternity leave to eligible employees are employed in Arkansas and so on the twelve weeks that was we look I went around and looked at the averages for eleven other states that offer paid family leave and the and the average is about the thirteen point five to twelve so I want to that's also in line with the paid family leave that's offered that's offered in the learns Act which that y'all just saw yesterday so just trying to kind of a coca he said number across the state so with that I'm I'm happy to take any questions but one last thing I'll say is there member there is a senator from New York Senate been diagrammed it should states with abortion bans and state of paid family leave is amended agreement nothing the middle and the point was to kind of show that we don't care about women this and that and they want. Us to be on the other side and I think sometimes it's better to be in the middle that been diagram we're teklife from womb to tomb but that we also provide this I think is a good step forward I don't know of any known opposition I've talked to a large companies here in Arkansas that concerns of this none of them are against this bill they're neutral on it and with that as forget the. The questions really represent Wardlaw you're recognized for a question thank you Mr is there any companies you know of an Arkansas that our practice in this practice that we're trying to prevent there are few that offer their employees to go across state lines to get abortions I I know of three large ones by the time I had but out of good manners and I don't feel the need to name them I understand it does three haven't reached out to you in opposition though no they're not reach out to me in opposition actually I I reached out to all of them to discuss the bill to talk about it and and they're they're neutral on its because because I added some language to make it fit more like FMLA which they already have to offer because they're large corporations and so they were they're okay with that because also a lot of them also already we're offering paid family leave our our we're planning to expand their payment paid family leave already. Thank you for any other questions from the committee. Sing ninety was signed up to speak for or against the bill. Represent pecuniary clothes for your bill I'll close my bill thank you and I make a motion to pass any discussion on the motion. Seeing none All those in favor say aye. Opposed. Graduations represent Pilkington you've passed your bill. Representative Ladyman are you prepared to present your bill. He per. Are you prepared to present your bill. Thank you welcome to recognize the table present house bill one zero seven six. President Ladyman you're recognized to present your bill. Thank you Mr chairman. H. B. ten seventy six Is a bill that was brought to me by the department of health what this bill does it makes technical corrections to the septic tank cleaner proper law. this bill simply clarifies the language that one vehicle is included with the annual permit fee there's some confusion about that so the bill clarifies that. It clarifies that an owner is charged for each septic tank pumper vehicle. there's no increase in the license fee. Current law has been confusing to the industry and has been misinterpreted a number of times this bill clarifies that a license. That a licensee is an individual and that that that the vehicles have a permit so the licenses for the individual permits for the vehicles it clarifies that this bill clarifies if a business chooses they can employ more than one Lysons cleaner. Regardless of the number of trucks that they have. so it clarifies that they can have more even though they don't they may only have one truck but they have to licensees. this changes necessary to eliminate confusion and encourage compliance in the industry. there are approximately two hundred licensed septic tank cleaners in Arkansas. the business generally has a may have from one to ten trucks most of them have one or two. I'd be happy to take any questions any questions from members. Seeing no questions US Senate speak for or against the bill. Sing NO one you just close your bill representative lemon. yeah percentages closer's believe more make a motion make a motion to pass I have a motion to pass during discussion on the motion. Seeing none all those in favor say aye. Posed. Congratulations you pass your bill thank you responding here at one point she was here when the president Senator Sutherland says we're pass over house bill thirteen fifty seven I'm not prepared run that today Senate bill forty two. Represent Vaught no see and I think. Receive Eubanks is wanting to rest Senator Flippo as but he's not here representing the group has asked that we. All down for the moment House Bill thirteen sixty so I think that gets us to. Resent Burke are you here and ready to present I think that's the next one house Senate bill one three eight. Rick represent. Review Burke you're recognized to present your bill we're ready and it looks like you have some folks from part health Canada they can just introduce themselves to the committee and then when you're ready you're you're recognized president. Thank you Mr chairman and members of the committee I'm Rebecca Burke's District eleven and I have a couple of guests with me. Matt Gilmore partner health. Large to general counsel for the department of health. So the bill before you Senate bill one thirty eight is a simple technical clean up bill designed to eliminate a conflict in the code that exists right now it removes a provision saying that abortion clinics shall be licensed by the department of health abortion is illegal in Arkansas so the Department of Health does not need to license abortion clinics we are leaving in the code all the remaining reporting requirements inspection requirements and other requirements that exist we're simply striking that one provision that says that Department of Health would license abortion clinics we work to the department of health on this and and I have considered many many other alternatives but simply striking this one line out of the code is the best way to clear up this conflict we've also got run this through the attorney general's office and the attorney general's office has agreed that the simple clean up is the easiest way to do it. Any questions from the committee. Seeing the data represent Gonzales you're recognized for a question thing Mr adjusters what will leave all the other language and therefore not if if the clinics don't exist and. Yeah. Matt Gilmore partner help represent Gonzales I think that's just there just in case I think the the medical board has extensive rules and regs around and then also the department helps reporting requirements and Regulations are all there I think that's just a good. Back up I mean things just you know changed a few months back in which would be careful and you can just write this and not you know nothing else at this time. President Bentley do you have a question you're recognized thank you chairman thank you all for being here so I'm here a little bit concerned about folks that want to make sure that we are striking down the all the work this committee has done over the years to make sure we put restrictions in place for abortion clinics so eight years from now we may not be here we have a different governors and other some concerns there so if you guys can help address some of those concerns format that would I think I appreciate that. Again I'm I let miss you time as well. I think this up I think this legislature I think the governor you know understands all that I think just to be on the safe side and to be careful not mess with anything I think the simplest way is to strike the licensure at this point just so we don't have United to unintended consequences. Any other quote any other questions you're coming ahead yes l'arche general counsel for the department of health this section is been reviewed extensively by all the litigators that handle these types of matters in federal and state court AG's office is is fine with this language there's consensus from all the litigators that handle this type of legislation as you know Dobbs abrogated a lot of the current code but this part of the code that needed to be removed and and and and and review and you know getting thoughtful consideration to all the sections of the code in Arkansas that have been amended over the past few years I felt like this was the easiest at technical corrections to just take care of the licensure portion and not affect the rest of the code. You're recognized for follow. So just a quick follow up so in the I'm percent future or somebody you know if it overturned and we have to put in you know. Portion claims are allowed to get I'm going to repeat do all that we pass as far as all of the laws were put in place to limit you know to make sure there do all report required I was referred I'm talking about reporting requirements all the things that we put in place well for one abortion does occur in a hospital that so those reporting they still gonna be done and we're not going to redo all those bills we pass to make that happen correct okay thank you I appreciate the time chairman. Any other questions from committee. Signature was sent up to speak against the bill. You're recognized can speak thank you to state your name for the committee. Thank you chairman thanks committee lukoil a family council. You're recognized. As many of you know we are a family council is against this bills I've texted you will keep my comments brief. winner standards no reason the license abortion clinics in Arkansas because abortion is illegal in Arkansas the problems this bill deletes language from a forty year old. A life all that is tied to several abortion restrictions spread out across state code that could have unintended consequences in the future our office is identified between fifteen and nineteen different sections of code dealing with abortion but this one change could affect it's difficult to know what the unintended consequences of that could be we believe this bill can be amended to fix our concerns and address of washing clinic licensing without unintentionally affecting other abortion restrictions in Arkansas we would simply ask lawmakers to work with us to do that and with that I'll take any questions. The questions from the committee. Represent Wilder's recognized for a question I guess my thank you Mr my only question the rule in what way does this impact. Your confinement that can you expand your can expand on your concerns so our concern and by the way we would support the bill one hundred percent if the bill were amended and I do have language and I've provided to represent Berks as well test your answer your question represent Wooldridge. Our concern only is if abortion is ever expanded in the future I don't know that any of us kannst sit here today and say it's never going to be expanded in the future the close to fifty years for road to be reversed and for the dollars decision to be handed down so that that is our concern when if abortion is ever expanding in Arkansas there's a number of ways that could happen that's probably not gonna be any time this year. I can't tell you when it's going to be but Joe Biden has alluded to a federal legislation authorizing some sort of right to abortion in his state of the union speech if the Supreme Court ever found some sort of case that made it to the record to some sort of right to abortion if our state Supreme Court ever came to that point I was survey literally within the last two months myself via text message my phone about how I felt about a amendment here in Arkansas to establish right to reproductive freedom birth control abortion and so on so I can't tell you what the future holds our concern is only if abortion is ever expanding in Arkansas we would like for these provisions to spring into force immediately that's why we've prepared a trigger amendment of sorts. Represent Gonzales to you you have a question the lady when you're recognized for a question of thank you Mr chairman I have a question for the apartment Hearing the discussion had thought if if something like. That happened like was just suggestion and and report abortion did could be done in Arkansas and we were not in session. would they be able to open a clinic if this bill passed would they be able to open a clinic. In Arkansas without a license if we were in interim. I don't want to speculate too much I think the concern about A trigger is we don't know what kind of decision make I'm down in the future if we put something in the law now not knowing what that may be. It may not fit the knee that so I think I think we're. I hate to say that's what we be guessing to see what the fix might be but as far as if you know a facility could open in the state I think with all our reporting requirements I think we could still have some oversight over that. Thank you. There is anyone else have a question results you're recognized for a question they were shared salute this this bill doesn't do anything if we pass this bill and it goes into effect today it doesn't do anything that you all object to you're worried about what might come in the future is that the correct. Correct RepresentativeHouse for only concerned about if abortions expanded in the future so it's a good bill for today and would also be concerned if abortion is expanded in the future you know I don't see that one hundred percent pro life voting record will will continue to have that but you know we can't predict things come down in the future we always deal with those as they as they present themselves as as they come forward I don't see why this should be any different from what I understand it would take a reconvening of the legislature so obviously I'm not the health department but we are operating under the fact that would take a reconvening the legislature special a call from the governor the extension of some sort of session for this to be put back in place I I would love it if I'm wrong on that and something could be done or also under the impression that a lot of those other laws that are tied to this foundational piece of pro life laws that that some of this information would not be collected So we would like to see this trigger provision or aware of any good reason why we can't and this is the first I'm hearing from the start Gilmore about. The I want to quote him but I think you said it it may not fit to may not Taylor at the time depending on any expansion of abortion I can't tell you what that expansion will be all thank anyone can right now but we we see it being safe we see no issue with that we would support the bill to stricter Amendment were adopted one hundred percent. The questions from committee. See ninety new incentives speak for you would like to speak for the bill. Motion. Admission do pass anyone any discussion on the motion. All those in favor say aye. All those opposed. The motion at your bills pass catchers Review barks of thank you Committee yes representative Bader you here and ready to present a Senate bill forty two. If it's okay Mister chair all have Mr Gilmore said with me absolutely. Thank you. So this bill is just remit it removes unnecessary requirements for the full time employment under supervision and for those seeking additional training and specializations this bill will greatly reduce requirements for licenses and eliminate unnecessary obstacles to those who wish to gain new professional skills and competencies the board believes this proposal offers substantial red tape reduction and removes unnecessary barriers to last entry of the board is not aware of anyone that's in opposition to the bill. If you have any questions representantes. See new questions anyone signed up to speak for against the bill see no one review body close for the bill close and I ask for a good vote. Any. Your motion to passing discussion on the motion. Seeing none all those in favor say aye opposed congradulations review body pastor bill Review banks your ear to present Senate bill one thirty two. Thank you Mr chairman you're recognized Back to health. This is Senator Flippo as bill it just changes to forty five days to thirty days it just allow allows licensee a little more time. Soon any questions represent Eubanks review Wardlaw you're recognized for a question. I'm a little lost it seems like health departments but a lot more laws on the books I'm just wondering are we getting big government here are we lowering government what we doing here now we're actually making it easier for our constituents and we're gonna make it that much easier while we're not repentant. Why don't you run your own bill and we can do that. Any more questions representive Eubanks. I see no further questions was sentencing for against the bill. C. nine was motion do pass have a motion to pass all those of favor say aye opposed no. Your address you pass your bill. Senator you here I'm I think technically there tell me at the come down there at least set with you for a moment I'm gonna if you're if you if you the Committee as a monomer go down there Senator Irvin let her help me present Senate bill fifty seven. Ninety. Represent Johnson you're recognized thank you Mr chairman this is Senate bill fifty seven vying to make some changes in how we set medical board fees and I'm gonna let Senator Irvin speak to the bill and I'm sure should be happy to answer questions on. Thank you as terror terror representative Miller grace be with you guys senator Missy Irvin tester twenty four appreciate working with the health department state medical board on this legislation they have money and they want to be able to reduce fees which is a great thing and this bill allows them the flexibility to do that and and it it also sets it to where it cannot go above what is currently in statute and so just lets them give a little bit of relief out there to the people that their licensing. Thank you very much are there any questions richer Wardlaw. Here we go again. Note all services this is this is maintained a three year run an average that the other bills are targeting. I don't think it would interfere with the representative I think this just gives the board the flexibility to reduce by rule which they never have have that's always been set statutes that should interfere with I think I'm perfectly fine with the bills do as will make sure stay in a streamlined of what we've been what we've that are in town yes Sir yes thank you. represent out. The you just fixed it. thank you Mr chairman thank you of some of the for bringing this bill any time we can be reduced to burns of fees for taxpayers in the state of Arkansas that's a good bill someone to know I appreciate what you do thank you so much. Thank you have the other bills that would be happy to answer. The same. And actually it's important you want to make sure that we recruit the best retain the best and and the good may by the state medical board. A representative dollars your question. Okay any other questions. If I signed up to speak for against the bill. Sam Nunn was well committee. Oh eight I'll close the I'll make a motion to pass I thought you were you make a motion to pet all right all favor say aye. Imposed. All right thank you for the government thank you. Members with I think I said twelve o'clock so if we could just set around the creation discussion for another fifteen minutes I don't appeal to you I see no more business for the committee's meetings during.