Public Health, Welfare and Labor Committee- House

Soon the needy and exactly and there's some some folks concerned about the weather and I think that's a reasonable concern and so I will send people home this afternoon and will pick up that topic potentially tomorrow we're gonna go ahead and schedule the room for tomorrow afternoon pending weather again you know how Arkansas whether is it may be sending seventy tomorrow who night so we'll have the room reserved I think DHS will be available to come in present if for some reason that doesn't work out tomorrow we'll we'll find another time to have that information presented so any questions on scheduling yes that represent road. Do you have a time in mind three thirty is Research yes same time right now is what we these schedules are in the same room the a meeting room the big mac a little marker big mac so all right the representative Ladyman are you prepared to a president Bill great you're recognized you have to. President Ladyman you're recognized to present your bill. Thank you Mr chairman. have mad here you want in their lives if you would intercept for the committee thanks Matt Matt Gilmore department health. The committee this bill was brought to me by the Department health it's basically a cleanup bill. India motion. right to close and I would make do pass motion I have a motion to pass all those of others favor say aye. The opposed graduations representative let me pass the bill if you don't mind coming up to the chair I recognize representative Ladyman with no objections to chair the committee will present some bills thanks. Sorry. Is that the best. Okay. A representative Johnson you're running bill number eleven twenty seven is that correct yes Sir. the numbers there's an amendment coming around to this bill. The bill meant to look over the amendment. The representative Johnson you're recognized to present HB eleven twenty seven thank you Mr chairman at the minute you have before you does three things wanted at Senator Irvin as a co sponsor the second is it reduces the fee required by the department of health for this licensure from a thousand dollars to five hundred dollars making it more affordable for our rural hospitals it as an emergency clause which I think is important because this is I think we all know our rural hospitals are struggling this if this bill is enacted this is gonna give them an opportunity to improve some they're finding at through to how they billing collections so I think support for us to go and get this bill on the books as quick as we can and I'll be happy to take any questions about the amendment. members any questions about the amendment will be voting on the amendment first. Seeing no questions. I have a motion to adopt the amendment. All favor signify by saying aye. All opposed nay. Motion carries you're recognized to present your bill as amended thank you Mr chairman so you committee members in two two thousand twenty CMS which is the center for medical services which runs Medicare federally they started looking at a new designation status for our rural hospitals so currently. The only dismissed as is available for some of these rural hospitals critical access hospital that allows the hospitals or designated critical access to bill at a little bit higher level for Medicaid Medicare services for inpatient services so if they're treating a patient in the hospital for inpatient services they get a little extra reimbursement their critical access. Because of how medicines involved we've changed to some degree how we deliver care in rural areas medicines become more specialized and because of that more patients are being sent from our rural hospitals to urban centers and there are fewer and fewer patients who were able to keep and take appropriate care of them and some of these rural hospitals because they just don't have the specialists there to keep them in in house is so CMS recognize that and start looking at this new designation they call a rule emergency hospital designation this allows qualifying hospitals to shift their focus from in inpatient care to outpatient care outpatient care would include observation admission so if you put somebody in the in your hospital for a diagnosis like chest pain you're planning on only keep in there twenty four hours just observe them that still counts as billing for outpatient services this is the hospitals that would like to apply for this designation federally need a pathway here our state ten able that certification what this bill does is it just creates that pathway so that the hospitals in Arkansas that would like to look at changing from a critical access hospital to this near rule emergency hospital designation would have the ability to do that our state so it's really just enabling legislation and I'd be happy to answer any questions if anyone has any questions about the rumors hospital designation or this bill in particular. The representative Bentley you're recognized for a question. Thank you representative John summer here's some good things from hospitals in my district can you give us a real brief summary since I just walked in the room what are some of the benefits you think that will help us hospital's medical staff yeah I think the biggest admits it benefit is revenue so the way this is proposed as those those folks those hospitals that decide to apply for this designation if they meet meet the conditions of precipitation they're gonna be able to build a hundred five percent of Medicare for their outpatient services and again most hello some of these hospitals not ever this is not gonna make sense for every role hospital in Arkansas some hospitals can we continue to be critical access because they take care of more patients in the hospital and receive that right now hundred one percent of Medicare for the services some hospitals have gone to model service with their transfer most the patients in the majority the care that they deliver is from the emergency department already indoor as these observation missions that we anticipate to be less than forty eight hours state for those hospitals there now if the properties designation gonna go from a hundred percent two hundred five percent reimbursement for the Medicare population which is a pretty significant season significant portion of the population is hospitals has a it really is for some of our hospitals can be a lifeline that allows them to get better credit for the kind of service they're already delivering. Any other questions from committee representative Gonzalez you're recognized. Thank you Mr. The does this bill prevent any new hospitals from opening up it appears you have to be licensed already before it gets to be license to apply for the designation but you get open a new hospital and then the new hospital once license could apply for the designation so the process would be if you wanted an open a new hospital you have to get a certificate of need which is the current process to get a new hospital in Arkansas with the Department of the issue that you would do the steps for licensure and became a licensed hospital you could then apply for this designation and that's part of the condition of participation the federal level two is you have to be an established licensed hospital but it doesn't prevent any new hospitals from opening and once they're open if they qualify they would be able to apply for the status. Okay so tell me if I'm if I'm reading this wrong on page three starting. On line twenty six a healthcare facility shall be eligible to apply for a role mercy also license if the facility on or before December twenty seventh twenty twenty one is a and then it list everything out so you had to be in existence already. Is that not with the same. No one reading that I have the same questions are read it let me read that again. Is this good question representative I need that I need to look at that closer with some of the folks of the hospital association that help me craft this legislation my understanding is it would be the way we intended route I don't think there's anything that would prevent a new hospital opening up to to met the criteria from applying for real hospital emergency hospital designation that that's a question that typically I would turn around and ask my hospital association fellows to come to the table and dressed but I don't think there would be here today because of the weather okay. I'm happy to hold this if you want me to to get an answer I can I can I make suggestions representative Gonzalez would it be alright if you talk to his people if there's amendment needed they could do it on Senate sign come back to us or would you prefer a call and I would I would commit to that I mean if there if if you're we drafted this legislation based on federal rules and so we neared what we're doing if there is some sort of issue with this that I'm misunderstanding I suspect is a suspect is a federal issue that we can't change at the state level if it's something we've done in a quirky way I would argue that even if for some reason there's some stipulation that won't allow any new hospitals to apply for this designation is still critically important for the current hospitals that are seeking this to have that pathway and I'd hate to see the process slow down for this particular issue that I'm I'm certain I'd be happy to work with an address if it's able to be address on the Senate side well I I just know there's been a lot of a rule hospitals close because of funding issues and if we're going to give them an opportunity for increased funding or give the existing ones that you know maybe there's an opportunity for for new hospitals to open back up if they have the same opportunity for for the additional funding so yeah I agree a hundred percent represent Gonzalez what's your preference he's agreed to do either one which would you prefer at the matter to make your bill spot would rather try to run it to committee Allen except I've been get a lot of calls from the real hospitals eager to try to apply for this designation and you know I'll commit to you to find out the answer the questions and make sure we're meeting on the Senate side to accommodate that if we can if you unless or some federal reason why we can't okay Russia's thank you. A representative Schultz you're recognized for a question. Thank you Mr I was just one if you had a feel for like a ballpark number how many rule hospitals is not to apply for this reminding that's a great question I think if my sense is there eight to ten hospital that are interested in this presently your I. think you get to we have the statute in place it's gonna be hard to know for sure because there is some after this right to me some of these hospitals have to look at they're giving up one enhanced reimbursement for services for a different kind of enhanced reimbursement that bit of the piece of those hospitals are out there that have shown interest I think it's less than ten. Mmhm road direct you're recognized for a question. Dismissed this section Gonzales was talking to you about what what section was yes Page three line twenty twenty nine I think is where that was. Thank you to get a twenty six line twenty six on page three. Any other questions from committee. Seeing none is there anyone here in the audience who like this week against the bill. For the bill. C. ninety rate close we build up some answers from a bill and I make a motion to pass. Okay we have a motion do pass as amended and as amended yes you discussion on the motion. I'll just say I like this bill and our law schools really need help I think this will help them so I think I like it so any other discussion. motion is to pass the bill as amended all in favor signify by saying aye. All opposed nay. Motion carries congratulations bills passed thank you represent six chair Mister chairman. Which bill would you prefer to run all this which everyone's next be found me I'm not Askin Mr Gilmour come to the table in case their complicated questions twelve fifty that'd be great thank you. So would please introduce yourself and who you represent. Matt Gilmore partner health. Charles Manson. Charles Thompson Department health representative you're recognized president Bill thank you Mr chairman so representative you don't know the prescription monitoring program we put in place some years ago was designed to try to curb opioid abuse and part of the requirement is that to you know have providers who are prescribing of opioids have them to have have have. To make them take the time when prescribing opioids to console this database to make sure that the people that prescribing these opioids to our already feeling lots of prescriptions right and there's a committee that's been appointed to oversee the prescription monitoring program this bill it does three things one is it adds to members that committee it adds an obstetrician gynecologist we're seeing more and more if it's born having withdrawal symptoms so this is become The Oprah crisis become more more of an issue for our doctors and physicians that are delivering babies and so adding an obstetrician gynecologist to this committee makes a lot of sense additionally we're adding a person from the partnership for after reading this act with the word there From the opioid recovery partnership in this is destiny from the Department houses just giving some more experience on the committee to discuss some of the issues that come up from time to time so we're adding those two members additionally were given access to the program to a medical to the medical examiner state medical examiner and you know this comes up sometimes in criminal cases where there's questions as to the cause of death in this would allow the medical examiner to get access to look at prescription records in prescribing patterns of the patient who's passed away so they can have more information when investigating those cases which I think is appropriate and then additionally allows for metallic or mortality review process so that if you're if we are looking for this re looking into a a case this allows the health department to lead that process through a more encompassing group of people that might include providers pharmacists in in in gathering that information and I'd be happy to try and answer any questions on these bills and have a couple gentleman here who can answer questions better than me if there are questions be happy to fill those. Any questions from committee. Yes seeing none. is there anyone here who would like to speak against the bill. For the bill. Seeing none are you ready to close for your bill representative yes some clothes from a bill and I make a motion to pass committee The motion is do pass the discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay motion carries graduation bills passed thank you. so do you are you prepared to run HB twelve fifty one I am Mr. You're recognized so committee members this bill is a pretty straightforward bill currently required to do background checks criminal background checks on people applying to do EMS services there's been some. Question is our ability to do this background checks on people come from out of state and access and see whether they've had a criminal background states other than Arkansas this just clarifying that statue to them to make sure that the Department health has the ability to do these criminal background checks in states other than Arkansas which I thinks important fair issue. We have to take any questions. Any questions from committee. Seeing none anyone here in the audience who would like to speak against the bill. For the bill. Seeing none you a close for your bill I'm close from a bill and make a motion to pass Committee motion is do pass for the bill a discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay motion carries congratulations representing your bill is passed. Some. Members I think next up on the agenda is Senate bill fifty eight I don't actually represent Bentley you were here earlier in the room would you like to present that House Bill let me fifty five that was first imagine you're recognized as president house bill of fifty five. I did you have an amendment for the bill okay members of the passing out amendment to that bill. Physician colleagues if you remember this is a bill we passed out of committee to help small rule child cares not to have to comply with commercial upgrades electrically or one fire hazard so this bill would pull back because representative Mayberry I'm announced to me as happens sometimes with our college she was also working on the very same bill and she had worked on some agreed upon language with the farmers across the state some bring this mad at her as a co sponsor Senate co sponsor senator Breanne Davis and also to bring that agreed upon language they have farmers across the state so I think make the bill even better at a combined was represented Mayberry had worked on so that's the amendment so that I would make a moment amendment to a. Pass the. Amendment to house bill eleven fifty five members with any questions on the amendment. Wardlaw you're recognized for a question. I don't understand to a. Prohibiting the operation of two or more childcare facilities immediate adjacent residence if if I have a child care agency and I got five kids how can I control my neighbor having five kids will. That was discussing some of the head may head duplex and they were operating more than six five children in the child care center trying to prevent somebody from abusing this what we're trying to do not just a residential home I'm not trying to jubilant but this this language here is not. Is not saying that that is a duplex is saying adjacent so in a neighborhood that would prevent me from going in the business of my neighbor has one. The state case by case basis. Committee it's not clear. Again this is angry following want them to make sure that one person was not the opening up a large child care facility in trying to abuse the residential thank you agreed upon here's relative because I'm not agreeing okay well I'm just trying to it was trying to make sure the sum would not abuse what we're passing here to have a large Tucker and I get that I just think that needs to be clear to prevent me and my neighbor from running into an instance where we neither one of us could go into business after the other. I can't run around the neighborhood and see what they're doing so I can see what I'm going to do where the bill is focusing on making sure that the farmers income and add extra restrictions on which to build us up and I'm just not full agreement with two a. Okay we'll we have we have a motion on the minute you want to take a vote on that amendment representative yeah I want a motion on the amendment sure would you make a motion to pass on the amendment said motion do pass on the amendment with any other questions. All the favor say aye. All those opposed say nay. Does have it. I will give you time to work on the amendment has find out thank your senate make sure it's clarified appreciate thank you. The representative would you prepared to present Senate bill five eight. Thank you Mr chairman colleagues get morning the US Senate bill fifty eight is a department bill and it basically does two things it allows massage therapy programs to do background checks before students or apprentices work with members of the public it does not raise any fees and it allows them to work after graduation while they study for licensure exam for a six month period which they're currently not allowed to do with that the department of health and I will answer any questions you have I have a motion of prep time members there any questions represent Wooldridge representative you're recognized thank you chairman lay representative Waldridge can you give me the definition of direct supervision within a massage setting I will yield to the department for that. The station for the committee and then be happy to answer any questions. Thank you chair thank you members Charles Thompson attorney Arkansas Department health representative we don't there's the is direct supervision we would state that would be line of when our minds with the line of sight that is not it's not defined in the code because it's in multiple places and and and the code now and it's not strictly defined so we would define it as at least line of sight or an immediate vicinity to ensure that somebody's not alone with with a member of the public in various states of undress prior to look for licensure. Follow up recognized. So unpack that a little more for me so when you say line aside or directly there so are we having a stock to print as used in the minister emphasized we're also having a master massage therapist in the room at the exact same time while they're giving them massage are they're just allowed to be in the same building that the eyes on him I mean most massage settings you have a close to door because it say there the patients in various stages of undress and so my question is if we're doing a program because we don't have enough massage therapists out there for you you're required to massage therapist being the exact same room at the same time we're doing is limiting our labor force so you can work on this yes representive well you know what they're doing schools what they're doing to pressure programs are very different we don't have also very different they are different in the fact that we don't have jurisdiction over these principal grants those are administered by the department of labor so whatever they're doing did you mention to a principal Graham specifically whatever the department of labor the US department of labor requires for direct supervision we would follow follow their guidelines the schools are a little bit different the schools are generally the the bigger the rooms they're generally and in larger rooms so that a so that a a teacher instructor can see see what's going on and make sure that there's you make sure that everybody's doing a quick techniques nobody's getting hurt so for an apprenticeship program might have to plan to the department of labor because they actually minister that department health has no jurisdiction over that under there and learning. Okay. Are there any other questions for represent Waldridge. Anyone here to speak against the bill for the bill. Residuals you're recognized close your bill make a motion if you time thank you Mr chairman I'm closed and make a motion to pass the motion to pass all those in favor say aye hi all this personnel no the eyes have it receive water to pass your bill thank you Mr thank you Committee. Members I think that concludes the P. the business we have today I don't think there's anyone else here prepared to run any bills this mission will cancel meeting this afternoon and everybody just stay tuned and we'll let you know as soon as we can if we're gonna be able to have the meeting tomorrow afternoon. Thank you appreciate it meeting adjourned.