Senate Convenes

Senate will now be called order there any requests for leave at this time. Senator Flippo you're recognized. Senator Teague. Madam secretary please call the roll. Boyd Brandt Caldwell Chesterfield Clark Kroll Davis these dismaying Dotson English Flippo flowers Gilmore Hammer Hester Hickey Hill Irvine Blake Johnson Mark Johnson King on leave Leding Love McCaig Murdock Payton Penzo Petty rice Stubblefield Sullivan Tucker Wallace. Thank you and everyone in the chamber would now the galleries please rise for a prayer led by Senator John Payton followed by the pledge allegiance. Thank you madam president colleagues that's very. Our father in heaven lord we recognize your sovereignty over the affairs of men. What I praise you for the opportunity to bring our petitions before you in prayer. Orders are fake as our state faces a couple of days of uncertain whether. What I pray that you just have mercy on us in order that the storm B. as minimal as possible portrays to watch over our colleagues and fellow citizens in or just help keep them safe and safe travels and keep the power on. What I pray that you'd be with us in this chamber today as we conduct people's business lord give us wisdom. In order to give us the ability to so do our passions and. Deal with one another and the differences correctly. What I pray that you'll bless the great state of Arkansas what are for you to bless our nation or help us to guide it in the good path lord forgive us we failed you in Jesus name amen. Under. It will. Justice for all. Ladies and gentlemen the gallery's welcome to your Arkansas state Senate it is our expectation that each of you exercise properly govern yourselves. Wardingly during today's proceedings without objection the rules will be suspended and Senate Spencer the reading of the Journal morning hour has now begun are there any announcements for introductions at this time. Senator Tucker. Thank you madam president to to announcements the first is please join me in welcoming today's doctor of the day Dr to Risso Wyrick she works in pediatrics at UAMS and also should mention that she's the daughter of Little Rock city director BJ Wyrick and former senator Phil why Rick so welcome back the the child of a former member and of course our nurse of the day sure Bernard please join me in welcoming Dr wire. Second announcmenet I will not jumping ahead of anything but today's the first day of the session and I can honestly say that I wish Senator Larry Teague was here. Because we we need to sing a song if I'm not mistaken to our new members Senator jim teddy's birthday yesterday so I'm like Senator Teague I'm gonna step away from the microphone and We're going to have. Senator you're recognized. Thank you members of the public health committee we're going to meet jointly tomorrow afternoon the house and the Senate but all members are invited to attend these are informational meetings that we're going to have presentations on different topics one of those of a keep mental health and in the State of Arkansas is tomorrow afternoon moving forward we will we will have different topics and these are for presentations and for information about public health and where we're at on different issues in Arkansas so those will be on Tuesday afternoons at three o'clock and big mac Hey it'll be a joint public health committee with house and Senate but all members are invited to attend again for informational purposes only no business on legislation will be conducted during those meetings thank you. I think Senator Irvin Senator Hester you're recognized members I'm getting asked a lot of questions about whether and what our expectations of over the next couple of days and I'll tell you where we're at but in close talks with Speaker Shepherd and I think this is where we're at tomorrow what we're all here right once everybody gets here the goal will be for us to work all week but we will be looking at after the storm hits if staff can get here not enough staff can't get here and then we'll probably just not have session and then the next concern would be if we feel like a storm is coming in that will prevent you from getting home in a day or two at that point we would would make a decision based on it members are gonna be able to get home whether we would have to re evaluate revalue it where we're at but like I say it is certainly a moving moving target thank Senator Hester Senator flowers you have a question. Yes I'm with the Senator Hester all of us don't stay up here. I hold back and forth to work every day. And I guess I'll have to take leave. Because. I'm not driving. The whole issue with respect that everybody is not outside the fifty miles into the per diem physicians to Hey the state. I don't. About that no I did think about that I had that conversation earlier today with the Senator Ricky Hill as well but there are so a lot of members that are you know and do not get do not have the privilege of getting to go home at night and are going to be sitting here in a hotel or an apartment that want to work if it's possible at all so we'll take what's the first of all the safety of all members but what's best for the for the whole body recognizing that no matter what we do not work for all thirty five members. Not always privilege to go home and then have to come back up here. Early in the morning and stayed eight. That. But what. Any other questions Senator Hester on this. Thank you senator Senator Hill you're recognized. Insurance and Commerce will meet tomorrow for here are we doing pictures right before we start so please try to get there a little early so we take pictures. Any other announcements. Rules committee will meet upon adjournment. Three oh nine. Thank you. Any other announcements. If not madam secretary items at the desk yes we are committee on engrossed bills to whom was referred Senate bill seven by Senator Teague compare the engrossed copy with the original find same correctly engrossed Judiciary Committee on engrossed bills to whom was referred Senate bill eight by Senator king compare the engrossed copy with the original find same correctly engrossed street isheri Committee on engrossed bills to whom was referred Senate bill fifty seven by Senator Irvin compare the engrossed copy with the original find same correctly engrossed public health committee on grass Bills to whom was referred Senate bill sixty seven by Senator Irvin compare the engrossed copy with the original find same correctly engrossed Joint Budget Committee on west Bills to whom was referred Senate bill one twenty two by. Senator king compare the engrossed copy with the original find same correctly engrossed Insurance and Commerce. Where your committee on Judiciary to whom was referred Senate bill fifty nine by Senator Chesterville recommend to pass as amended number one calendar. Committee on Judiciary to whom was referred house bill eleven twenty five by representative Evans recommend due pass counted. Senate resolution three by Senator Dotson to proclaim February twenty four twenty twenty three as a CNA Tuesday in Arkansas Senate resolution three calendar Senate concurrent resolution four by Senator crawl to recognize Emerson elementary school as a twenty twenty two exemplary high school performing national Blue Ribbon school Senate concurrent resolution for calendar Senate bill one ninety one by Senator Hammer to mandate coverage for use a recurring as of an occupation to treat certain pediatric disorders caused by infections and plan of merger to Senate bill one eighty one Insurance and Commerce center one eighty two by Senator Solomon to amend the law concerning public recording and deletion of electronic data Senate bill one eighty two Judiciary. Thank you madam secretary's any other announcements center needs did you have. In a moment all right. All right for the business. For the morning hour of storage center. Thank you madam chair I've got a motion to suspend the rules to to withdraw Senate bill sixty six for purposes of amendment my own bill my amendment. Are there any questions. Senator on this. All those in favor of the motion to withdraw please signify by saying aye. Imposed. I should pass. Thank you I also have a and a motion to to move the Senate bill six six for second reading for purpose of amendment. Any questions for the senator on this. All those in favor of the motion please signify by saying aye. Amendment one to Senate bill sixty six. My bill my amendment I appreciate a good vote. All those in favor the amendment signify by saying aye. Any opposed. Amendment passed. Senator gross. There's no further business in the morning hour of the morning hour has expired now start the business agenda Madam Secretary. Please read. Senate concurrent resolution three by Senator love. Designating the Barbie of cardio. Past the awareness day to educate people about active on a cardio. Okay Senator live you're recognized. Thank you Mr president Collins I do bring to the Senate Senate concurrent resolution three on hyper trophy cardiomyopathy basically what that is is is is more is term eight CM so this is called HCM for the purposes of this bill what is a chronic cardiovascular disease involving that thickening of heart muscles. And could potentially lead to debilitating symptoms and serious complications including heart failure atrial fibrillation stroke and in rare cases sudden death. ACM is is most common is the most common inheritable heart disease and can and can affect anyone about seven hundred thousand people in America are living with H. CM however only eighty five percent of them may remake are maybe on diagnosed and so therefore that is why we are wanting to build awareness of HCM in them in this while we are trying to designate this day and it's the fourth Wednesday of of in February as HCM date with that I will take any questions. Thank you senator lives anyone have any questions for Senator love. The nine I appreciate a good vote. Anyone wish to speak for against saying none all those in favor. Four Senate resolution three. Please signify by saying aye. Any opposed. Senate passed. I don't. Transmitted to the house. Senate bill sixty eight by Senator Johnson to amend the law that requires Holocaust education and to establish Holocaust education week in the public schools of the State of Arkansas. Senator Johnson you're recognized thank you madam chair members Senate bill sixty eight does one very simple thing it doesn't Eads the last full week of January as Holocaust education week in the state of Arkansas instructing the state board of education to notify all districts in the state that is the week designated out of the year for Holocaust education. We're happy try to answer any questions. Anyone have any questions for Senator Dotson. I appreciate a good vote. Anyone wish to speak for or against. Any objection to rowing the boat. See non committee secretary please for the love. VOL eight Bryant Caldwell Chesterfield Clark cruel Davis dis dismaying Johnson English Flippo flowers Gilmore Hammer Hester Hickey Hill Irvine Blake Johnson Mark Johnson King Leding Love McKee Murdock Payton Penzo Petty rice system Stubblefield Sullivan Tucker Wallace. Any senator who is not voted wishes to vote or anyone wish to change his or her vote. C. nine. Madam secretary cast a ballot. But thirty four E. A. zero nine. Bill has passed. Transmit to the House. Boyd you're recognized for S. B. seventy four Senate bill seventy four by Senator void to amend the authority of a certain under the Arkansas health care decisions at. I don't President of fellow senators many individuals one up in hospitals in lack capacity to make healthcare decisions on their own this can be either temporary or permanent and most do not have a power of attorney or other legal decision maker so this legislation here today does not apply to someone who has a power who has a known power of attorney or someone else who who is eighteen you know clear cut known legal decision making so in two thousand seventeen Senator Irvin ran the Arkansas health care decision act which did two things first the person with cat the capacity or the principal may appoint a circuit to make healthcare decisions for them that are consistent with their wishes or a fund known in their best interest second if a person lacks capacity that act also allows the supervising healthcare provider to appoint a health care center good on behalf of the principal. A majority of individuals admitted to hospitals are eligible for and apply for public benefits primarily Medicaid after Medicare benefits benefits are exhausted absent a Medicaid application their stay will not be covered in ads of financial bear the burden to providers and it also couldn't prohibit them keep them from transferring from one level of care to another so one the one of the things that was described as we had someone in a hospital a hundred seventy plus days who couldn't make a decision and there was no guardian to make the decision for them so they were just stock and you really don't want to be stuck in a place you you don't need to be and then all the time racking up you know Bills so if individuals in a hospital lack capacity to make their own health care decisions they also lack the ability to obtain financial information and documentation required to accompany a Medicaid application the proposed addition to this act would allow the duly appointed health care Sir again and again that a person would be appointed by the the supervising healthcare provider the attending physician generally speaking as well as access the financial information documentation to the principles of only sufficient to accompany an application for benefits this story is limited to the right of access only in terminates if the principal gains capacity so if the principal the person in the hospital has that capacity or for power of attorney is discovered then this this would go away this does not create any additional Medicaid criteria eligibility it simply allows an individual that is already eligible to have assistance in accessing those benefits. Thank you senator Lloyd questions I see centre Chesterfield. Thank you. And I mean within about. I guess what's of concern to me is on page one. Where is the line that the lines twenty five a surrogate me applied for public benefits such as Medicare and Medicaid principal subject any federal restrictions etcetera I don't have access to information regarding the principles income assets banking and financial records to the application what is troubling is once this information is a sorry sorry who is to prevent you from using this in a manner that would. Make that individual in tomorrow. Because we had guardians appointed that take advantage of senior citizens about all this is from personal experience. Grandsons to all the money. So how do we keep that from happening because I'll close people with this kind of stuff maybe you can swaging maybe or maybe not but when you start letting folks. What is going to accept the responsibility if they ask them with the money. Okay so so senator Chesterfield that's a great question so first of all the bill is very explicit that it limits it only to access to the information they have no ability to access accounts and withdraw money or do anything else second of all you have people who were trying to find a balance these are people who are stuck in a healthcare setting that have no one to take care of them they are stopped there and it is an absolute injustice to have people who can't have a secretary who need a surgery because they it's it's not an emergency surgery but it still nonetheless arguably needed surgery so there's not ability to pay for it so what it does is it only allows a circuit as appointed by the healthcare provider this was a well crafted bill in two thousand seventeen this was just something that you know has been discovered since then that that we need to do that so you know I think that the it some point you have to have some faith so. All Greenwood why we're trying to do. I don't have as much as you do because I like this is a different. Once you get my information you can use it anywhere you want to. Paychex Mehta. I spent my money so I'm just I'm just wondering is this the person that grants that service going to be responsible for making sure that. The that the person on the the person without the ability to make a decision they've got to be held harmless and their money be given back to them in case we wanted to a bad actor. Senator you could go to the doctor and then they could do do other things and we have well and you could. What we have in place and you can sue somebody else as well thank you yes. Senator flowers you're recognized. The board. For the same reasons that senator Chesterfield stated I'm wondering how. What would be liable. For an application. That In later. Can be. Fraudulent. Or. That. May have information and then I'm concerned about joint bank accounts. The access to financial information. Of that principle. Might include someone else said to add the relative. Maybe. The child. This is concerning. The liability. For making an application that is determined to be false. Later after benefits and you say public benefits such as Medicare and Medicaid. What about income. Hi the whole range of things. I don't understand we have a sodium is easy enough for healthcare provider. If someone is in a hospital or in a medical situation. Apartment of Human Services has the authority under our law. To serve as a custodian. Determine even by court order either so designate someone that the Department of Human Services to be the custodian. Our goal. Thank you for your. FOR guardianships Arkansas. This. You scary opens up a lot of possibilities and then you say. The authority under this. Subdivision of this section still. When revoke the principal vice principle who no longer decision over capacity. Well they don't have the. The. intelligently I don't get. But. I'd like to hear Your so so let me if that was a question center let me try to answer that so if you're the principal if you're the person who's in the health care facility your or and you are now able to make decisions you have that capacity again then you can revoke it you can say you no longer can apply for benefits for me so again this also is limited only for. Requesting the benefits and let me say maybe I should have said it this is this Arkansas is not the front runner on this this is being done this is patterned after legislation Florida I have not heard and read that this guy's following in Florida I don't think this guy's gonna fall here and so again I just say we're balancing. Risks yes any time we are giving someone any access to financial information that needs to be done. With very cautiously but these are people who are in a situation who have no guardian they don't have family friend someone who is there to take care of them the process to go through the guardianship. Through the state through DHS is a long process this allows the process for one aspect to get to get started so it's it's very limited to in a very specific setting where the attending healthcare the attending physician is appointing a circuit so they're not just saying Hey person off the street come in here and and and do this so. Senator love. Thank you Mr president. Senator board I do share the concerns the sponsor of the calling of the here's what I wanted to ask because any committee. Our state hospital I believe was at the table when you present the bill. More than likely who is from the service area for. For a person that is the capacity more than likely a hospital or healthcare facility. Personnel these are not just people randomly selected off the street this is a case worker someone who we would normally trust with other health care information that probably if there is any healthcare any financial data available they already would have access to it in the patient's chart this is not anything groundbreaking this is healthcare and you know I I appreciate the questions and I appreciate everyone's concerned but again there's a reason we're here there are people who are being harmed because they can't go from one level of care to another they're just stock because they don't have access to benefits to which they would likely to be. Have access to so that said I'm a step out of the well. Wish to speak for or against what I'm saying. Additional questions. F. five allow the I understand there's a little more flexibility in the Senate and then the reason that the House. Sorry. Question. To determine if you should decide all who determines if somebody's going to be a circuit the attending physician okay so here's the thing let's just say I'm going to the hospital. Do I have to say. Do I have to say that that I want someone to help me. This is just determined by the help so let's take a step back these are incapacitated individuals these are people who have no one there to advocate on their behalf and they are just there okay one more. I have they've been declared incompetent by the courts is that what you're telling me or as far as who's made that is somebody this is someone on a ventilator that is on medications you know this is someone who doesn't have the the mental capacity so that that's why this is health care there's an attending physician who is looking at the entire patient in saying for whatever reason they're incapacitated there on able to make these decisions yeah the patient is unable to make the decision for him or herself but a court is not required correct this is being done solely by the attending physician. At this moment in time I mean that but we're not the Clarion incompetency we're we're declaring someone who doesn't have the capacity to make a decision like this thank you. Senator Tucker. Thank you madam president. I'm for upon centers Chesterfield concern and I apologize if you. Directed if you answer this And I missed it but the the last line of the bill which is amended and says a circuit shall meet all federal requirements to act as an authorized representative including confidentiality provisions. And I'm just curious what that means what the federal provisions are on confidentiality thought about putting that language of this bill that that's my question. This is a an amendment that came from DHS they've worked with me on this process they felt like this is adequate language so no I'm not willing to make that amendment because they were locked in we got to wait two years to come back and there's really no reason that the federal requirements are what they are so. Senator Breanne your question. The one wish to speak for or against. Senator Chesterfield you're recognized. To speak against. Thank you madam chair and again let me apologize to senator board for not raising my concerns because everybody's life experiences are different and I don't have the level of confidence and folks that perhaps I should and allowing them access to people's bank accounts. To be able to make decisions about him even though we put some guardrails in place people associate now you write a check. If somebody could just white wash your check. Any me select what you want to pay. We're living in a world where people are not honest. Even if they're appointed by people who very well may be honest. And so while I understand and I think we need to have something in place for this I don't think it has to be quite as expansive. As what the senator is saying if he has the most to do that's fine but I would be remiss if I did not say on behalf of seniors like myself please be careful with us. Please understand that people take advantage of us and they knew do mean things to us because they can't because they can't and when people get control of your money they get control of your information they can do whatever they want to because we've already on able to make our own decisions and what we are able to make our own decisions we have no control over how people going to treat us. Mine is not opposition for the sake of opposition but it presents a different perspective for most of you here. Because you're not at that stage you know like what this might happen to you and you might be taken advantage of I would just ask you to remember that as you vote if you vote is yes I know what. But I what we're trepidation about giving all of that information to someone and that individual in that bill has no liability. Who's gonna be responsible if you rip me off all my money. You don't say that in the bill. Every person ought to have the right to have some freedom if this is gonna happen that I'm not be able to get my money back should we have a bad apple in this group so that's my concern and perhaps is not yours but I would be remiss if I did not at least year as one of those in the fourth quarter of life thank you. Easy to ask questions thank you Sir no question. Thank. Anyone wish to speak or sorry center Brian you have a question for Senator Chesterfield yes. The president a question as as a member with aging parents. And starting develop myself in this process And I know on our financial advisors always that there's there's ways to get the system to pay out a little differently if you start to shield assets of the members of my question to the senator Boyd and maybe you know this is one of a survey of the sign for healthcare decisions. It is I assume that that circuit has some healthcare background but will concur with the doctor you know this bill the circuit would have a financial background I do not know it does not say so in the bill it also does not say so in the bill that even if we appoint someone to do it. That there are ways that if someone is on toward in their action that we can recoup the fund having taking care of my mother for a long period of time and having taking care of my son who lost everything because our grandson took everything. Everything I guess that's why it's more personal for me. Senator Clark you're recognized to speak for. Thank you governor thank you colleagues. I want to say I appreciate Senator Boyd bringing this bill I know that there is a big problem out there that people are not aware of of folks who don't law times don't have family they don't have anybody in there they're in a place where somebody needs to make decisions and there's no one to do it and someone needs to be appointed and for that reason and my confidence in center Boyd will be voting yes of I do however think that Senator Chesterfield has raised some valid questions that I hope or being addressed or will be addressed as we move forward thank you. Anyone else wish to speak in opposition. Senator you're recognized center John Payton recognized to speak for. Thank you madam president our colleagues. I understand the concerns of we do know that fraud and thereafter ramp it and a lot of people take advantage of the elderly or the infirm but I've been sitting there reading the bill didn't have a dog in this fight the end of the first paragraph in the languages it's being added says to the extent required to make an application. Our this is not talking about managing somebody's financial. stuff is talking about this circuit having access to their financial information to fill out applications to qualify them for this for these programs and then the last line of the bill that was already mentioned the circuit shall meet all federal requirements to act as an authorized representative including confidential shall the provisions obviously within Medicare and Medicaid there are federal provisions as to who has the authority to make these decisions and and while I have similar concerns with those that have been voiced about. How very good it is in our society for people to take advantage of anti fraud and steal from the from the unhealthy and infirm I don't think this bills dealing with that at all I think it's just giving somebody the authority to find out. If a patient qualifies and make application I appreciate a good vote. Anyone else wish to speak for or against. Senator Irvin you're recognized to speak for St nine ask to speak against thank you I appreciate the concerns that I understand those working with the palette of care physicians particularly in a lot of our large hospitals and a lot of our indigent care that they've seen. They are in a difficult situation trying to get these patients to a place where they can get better care and appropriate treatment that's all that senator Boyd is trying to do is make sure that they are able to apply for the benefits if they do not have them many many times we see the and doctors offices all the time we are trying constantly to work with family members next of kin and those things do occur but there are protections in the law under what represent as senator Payton just discuss that gives us protections on those guard rails if it is something beyond making application I am very cognisant of this issue like I said working with those palette of Kerr physicians in our hospitals and making sure that these folks are able to get taken care of as best they can. And most of the time as a case worker a lot of times your case workers that are on staff at our hospitals I'm not sure if they have financial background but they do have a very good knowledge of your Medicaid and Medicare system and how those obligations need to occur in order to get them to the right stage generally speaking of these are indigent care folks they're probably not gonna have a Medicare advantage plan or any other type of additional plans I understand exactly what you're talking about but generally speaking if they're on straight Medicaid that's probably going to be the best scenario for these people which is going to be a different case scenario for for folks that may have certain levels of income but I hear your concerns but generally put in the straight Medicaid's probably the best approach center and I believe that Senator Clark dancing around have questions sure I'll try to answer the best I can under Clark you're recognized. Thank you. Of center room you're more familiar with this but I am and the I'm very much on board with what you said and what the circuit board is trying to do what Senator Chesterfield brought up though was unintended consequence do you think that we've handled all the unintended consequences of I with the I think what the language that was amended by DHS yes that DHS gave him that very last sentence about that I do believe me they they you know they do have adult protective services and many times a lot of the cases that are brought to the front of adult protective services are actually to try to step in and when there is a family member like what senator Chesterfield had talked about when it was a grandson that is trying to take their money away from them so we do have adult protective services act that to operate in that space to try to help protect our elderly from being taken advantage of thank you so we do have those guardrails in place. Senator Rapert. Tell me the the process like the time line from my time in a person needs something and they're not they're not getting the finances they need for for the system was signed service. Well I think that would just depend upon and the state of the health care for that patient I mean that would just have to be. It would have to be dependent and as you know dependent on their state of health care at that moment but also what at what is available to them as far as resources to pay for their bill because that is very scripted by whatever they're payer is only have so many days that they can stay in like a swing that situation or a regular bed situation you only have a certain number of days before you have to get moved to a different level of care facility I think that's what center board is trying to address is that if there's a patient that can't they're stuck in the system then that's also a financial burden for the hospital to because nobody's going to be paying that bill basically so it you know it's just a it's a very bad difficult situation I think for for both but there is so I can't give you a time frame because it would depend on the capacity of that patient where they're at and and they may want to stay in that may want to watch this and see if this patient can then gain capacity you know it that's just going to be at that time frame then there's some people that are going to stay on a ventilator for months and then come out of it but I don't have a time frame I don't think it's addressed in the bill. Senator Chesterfield you're recognized thank you. Yeah I agree with what you're doing yes ma'am I think you need to understand that I'm not disagreeable the second understands I just need to know who was the liability should someone come along and do something on four is that the agency has already. I'm asking the person just stuck with someone was taken on the asset who is responsible for making sure that I guess I guess I just need to know let me. I would assume that a prosecuting attorney could that could be turned over to prosecution tourney if they are using that information outside of just applying for an application for public benefits that not should be legal and I think that the laws specifically written to narrow of that scope that's why I'm supporting the bill. Senator Hammer you're recognized thank you measures Senator Irvin if you want to just kind of. Answered for this maybe the sponsor can finish it up but two things one a lot of the information that is going to be of concern outside of maybe the personal bank accounts cetera the hospitals are going to be in possession of all the information I have is that correct well. I mean neither income not the level of income or income but a lot of a lot of the information that things could be date of ours yes I mean personal information yes but not not level of income but that would have to be known in order to apply for Medicaid benefits then the second and assets okay and the second thing on that then is that it would be the facilities personnel that would be at the information so would there be a there would therefore be civil liability criminal charges that could be charges against individuals would do that and is there a fiduciary responsibility on the part a hospital if their staff person for the facility is the one that is that handling that information and if you don't answer that maybe the sponsor could but when it comes to close I'll deferred but and I would have to look at the federal HIPAA laws but federal hippa laws would apply not miss in in certain areas of the US but I would differ okay thank you. Senator flowers. I'd like to know. It becomes law. What is obligated to turn over at. The banking records. Account. Of that principle. Even though that is not only account this is what. Senator void. Your eyes are no further questions you're recognized close and perhaps you can address questions from senator Hammond St Senator flowers thank you madam president I appreciate the the a lively debate on this this bill I certainly would have liked to have had some of this before hand what I can say is DHS has had an opportunity to review the bill they have actually provided input the amendment that was made the second amendment was actually an amendment from DHS there is a guardianship process through DHS but it is something that takes time this is a very time limited narrow window when there is no so this is a person who is incapacitated unable to make a decision for him or herself they're in a healthcare setting overseen by an attending physician and they you know are potentially racking up hospital bills and just as importantly unable to transition from one stage of care to the other because they don't have a payment source and so they're just the patient is stock so this is not this is not a huge number of our Kansans but the the audience is wall small is very important and it's a disservice I would not be here if I thought it were a great place to just hang out in a hospital it's not you should be able to to move forward so Out of him again I I do appreciate the the concerns but we're we're striking a balance between you know a a small risk of someone taking financial information someone who's a case worker generally someone who is working in a healthcare setting who is already probably been background checked has access to all your health care who has acces your healthcare information and likely some of the financial information though probably not the income and less that just happens to be in the the chart so and again I wouldn't want to reiterate this is modeled after Florida so we're not the first state to to do this and with that said I'm a leave the well and I really would appreciate a good vote thank you. Thank you senator center has closed committee secretary please call the roll. Boyd. Right. Right. Caldwell. Caldwell. Chesterfield. Clark. Pro. Kroll. Davis. Davis. These. DISMANG. Dotson yeah English. Flippo. Flowers. Gilmore. Gilmore. Hammer. Hester. Hickey. Hello. Irvine. Blake Johnson. Mark Johnson. King. Only Leding. Leding. Love. Love. The key. Murdock. Murdock. Page Penzo. Penzo. Petty. Rice. Staffan. Stubblefield. Sullivan. Tucker. Wallace. Any senators who did not vote wish to vote. I see Senator Davis presents the center but no more present to see Senator Kroll yea I see Senator Leding president. Penzo president. Any other centers wish to vote or change but. Center left president. Seven nine nine secretary cast a ballot. But at twenty three a four Nays two not voting five present. It passes adopted rather passes and transmit to the House. Senator Dismang you're recognized Amendment one Senate bill thirty one. Members this is a amendment from joint budget committee moves a hundred thousand dollars in preparation for the professional fees on to the operating expenses line item provide for scholarships and educational programs and this is for the Department health licensing and there's been a regulation boards take any questions. Anyone have any questions for Senator Dismang. Anyone would speak for against. All those in favor. Please signify by saying aye aye aye. Any of those. S. the thirty one with emergency clause. Is amended. The amendment is adopted can be worse. Amendment one Senate bill seventy five. All right members this is an amendment by rule who was it by I was a state representative members three of my with their and it increases the GME funding from forty R. four hundred thousand dollars to ten million dollars and it is a preparation only. Any questions for Senator Dismang. Senator flowers you're recognized. What do you mean graduate medical education so doctors. Four four four hundred thousand fifteen million dollars million within the station there may or may not be some funds may be made available and again it's just a preparation only and it was from that was probably look with me but it was Lee Johnson is the sponsor in the house. So. This is in anticipation of federal funding well it may be our state may be part of what we have in surplus is really it's not known at this point but it is now that we need to have additional doctors in the state and so the hope is that we're able to have this increase increase preparation are able to find the funds to do it but again if the money's not there this preparation to stay there empty. Any other questions. Anyone wish to speak for against. Not all those in favor. Please signify by saying aye. Any opposed. The amendment is adopted centers. There any further business. Senator Dismang some members we've been moving fairly quickly in joint budget there's not a ton to do special language is set to meet on Wednesday if we have inclement weather problems special language require a lot of outside people to come into with agencies and just to make everything easier for this week not knowing what's coming I don't see any real reason they're gonna have joint budget this week and then special language I believe unless a senator Gilmore says otherwise will also be canceled so again I don't think we have anything to pressing we've been pretty diligent work so far. Thank you senator any other announcements. Senator Penzo. The northwest Arkansas chamber nine out of has been cancelled for this evening I will probably reschedule sometime in February that was the all the tumor converses of the northwest Arkansas and we'll reschedule for another date in February thank you. Any other announcements. It's not. We stand in the Senate has adjourned sent it to the clearing of the best until. January thirty first two thousand twenty three one o'clock.