Public Health, Welfare and Labor Committee - Senate

Are excited to have everybody with us in attendance and we'll just quickly we're going to do an organizational meeting but we're also going to meet a lot of the agencies and personnel that we're gonna be dealing with throughout the session and throughout your tenure here on this committee with a few presentations so let me first just introduced the people of the committee and I am Senator Missy Irvin I represent district twenty four which is Stone County Searcy County Van Buren County and portions of Cleburne County Faulkner County and Newton County and I've been in the Senate since twenty ten I have served on public health welfare this committee for ever and shared it for two years and then whatever interrogation for two years and now I'm back to public health to tear this so I'm very excited to be back into this world so just grateful to be the chair of the committee and I want to introduce our vice chair senator Dan Sullivan and I'll let each of you make your introductions. Thank you madam chair yes senator Dan Sullivan I have three terms in the house this is my second term in the Senate and my second term on public health glad to be here and look forward to working with you thank you all. Hi folks Dave Wallace my third time on public health. I have Mister Kennedy Poinsett county cricket county. I read it and I'm glad to be here again thank you. Clint Penzo I represent Springdale Johnson twenty ten MM springs up in Northwest Arkansas spent two terms on the public health and in the house and the. Glad to be on public health and the Senate now. More than Fredrick Love First term in the Senate and I'll tell you this this is this is a a trip for you all you know it's it's funny because the in the House everybody's around the table now I have to turn on the facts so this is a of course is my first term on the Senate but I've been in the public health on the House him for several terms so I'm glad to be back on public health I represent only Pulaski County but it seems like a good call from any other county so I just represent you all thank you. Justin Boyd I was state rep for four terms I was fortunate to be a public health all all for those terms very excited to be able to be on public health here here in the Senate my district is Fort Fort Smith more less. Right. The Senate district twenty eight S. R. six years now six years in the Senate I've been out for years so I'm still confused from a new member returning member or what but anyway represent all of Carroll County all the Madison County the biggest part of Boone biggest part of Newton and talk party Johnson Franklin County and I served on public health from two thousand and two thousand twelve. Right thank you and we do have Senator Flippo who's not with us but everybody knows Senator Flippo so. but we'll let him introduce himself when he arrives I want to introduce our staff with the bureau of legislative research which we are so grateful to have we have Kate steal his our committee analyst at Donna Johnson who is our administrative assistant Jessica Biel is our attorney as many of you know and Cassie hal is also an attorney that we work with sometimes we also work with Alex Stevens and others and we have missed until there as well with us today shall be presenting on a on a procedure that we've adopted and if you will review the Senate rules for our committee if there any questions that if you will just review those those rules that are in your folder. if you have any questions. We will proceed to review and adopt those Are there any questions. Senator Boyd. As you know I'm the to Senate yes but one of my committees transportation I made a motion to change the rule to work the rest substance not a non substantive change like there was an extra the or something that that could be made I don't know if that's a good idea for the for this committee or not but I just throw that out to see if anybody else thought it was. G. A. R. are you making a motion to adopt the rules unless there's I would make that motion and then if somebody likes it okay and second it is there a second. I'm sorry. Okay. So so on the part that says we can't have verbal changes to the bills the end transportation the way I understood we change or modify the rule so if it were not a substantive change it we're just like a Scribner's error or just something that it was a clerical error whatever we could make those changes verbally. I was there any discussion about so you're you're just making a change to the to the rules and with that change of if it's a verbal we can make a verbal amendment if it's not a substantive change but as like a grammatical error or a drafting error basically that's that's what your motion is as their discussion. As a second option yes this is that not already accounted for. Those kind of changes in our current rule. No I mean just verbal amendments are not permitted at all by our rules so if you want to make that as a verbal amendment change I mean if you want to make that a change to these rules then you would vote for Senator boys motion. And again it would only be changes that were drafting errors or grammatical errors or a number in issue number you might could become substantial but okay and there's a second okay with that all those in favor say aye. And opposed ayes have it okay those rules are adopted without one change. Okay it. So just a little bit of housekeeping before we make some introductions and get charge into and just to make sure you leave your folders in the room after each meeting we are meeting here on Wednesdays at ten AM we will move through our work as at I would I would just say aye aye efficiently as possible if and you know if there are and the way I will handle legislation just so that everyone's clear is that we will try to work through our agenda with items that are non controversial if I'm a piece of legislation is controversial I will work without sponsor to order a special order of business is very important to me that we have the ability for the public to weigh in on the legislation and so we will work as effectively as possible with the sponsors of the legislation I would ask you as members of this committee to help me in that process if there are sponsors of bills that you have questions about or or you yourself would ask and request that a bill be held and treated in a different manner such as a special order of business than just communicate that to me and I'll be happy to oblige you and so you know we have a lot of issues that we deal with in this public health committee they're very serious that touch a lot of people and there's a lot of folks that want to weigh in on that and so my job is just to steer as the navigate us through that so that the public has the ability to be fully engage on those issues just a couple different things if you're presenting and have an amendment please let the staff know before the meeting so if you have an amendment that needs to be presented to the committee if you'll just reach out to miss Steele in this chase and then they will at this let them know before the meeting a bill resolution that has been called up for consideration will be moved to the bottom of the agenda if the sponsors not present and and able to present if a bill or resolution has been called up for. In three times it will automatically be dropped to the deferred list unless that sponsored the notifies the staff or me as a chair and then we will that request to move that bill up to the regular agenda and off the deferred list will come and we will move that to an active agenda but it must be made by two thirty PM two days prior to the scheduled committee meeting okay and there are special rules for health legislation just as a reminder that any legislation that specifically changes the scope of practice of medical professions and Special introduction deadlines require that much must be introduced in the first fifteen days of the session and no action can be taken for fifteen days after introduction so because of our extended recess of Martin Luther king day I believe that date no that doesn't apply to scope that does not apply discover practice so it's fifteen days of the session is when it has to be introduced and then we have to wait we will hear from is there about this portion as well later about and bills that would impose a new or increased cost obligation for health benefit plans and and she will she will talk about that and then finally you know I would just ask that if you're presenting before this committee and we as members of that committee at this committee you know it is our obligation to to conduct ourselves in a very professional manner so we just ask you know we will we will be addressing you using your professional titles and and your surnames and I just think that's appropriate for committee and I know we we intend to to treat everyone with that level of professional respect and with that I'm going to move to agency introductions so first and we have the Arkansas department of health and so if you will come to the table and members you have a handout from the Arkansas department of health. And I'll let them introduce themselves for the record and then I give us a little just a brief rundown of who they are what they deal with and who the people that we will be interacting with our. Thank you madam chair members of the committee member name Mallory interim secretary of health. Matt Gilmore department health. Thank you so at the Department we have five major divisions main divisions that we refer to as center so I'm gonna go through the centers and just give a little bit about what they do of course there's a lot more than what we could get through and just a short time so the far center that I'll talk about is health advancement they have our chronic disease programs they have family health tobacco cessation nutrition and oral health so of course our week program is under under that Senator. In the centre for health protection we have some licensing and regulatory Roles there we do health facility licensing we do radiation control licensing we also have our medical marijuana program in the centre for health protection we also had injury prevention which has our suicide call line in our prescription drug monitoring program we also have infectious disease and immunizations in that in that center the third center would be the center for health practice and we have that's where our registries most of a registry sit lock or trauma registry our cancer registry in our hospital discharge registry that also houses our epidemiology branch and are vital records which of course is you know responsible for ensuring birth certificates and death certificates the next one is the public health lab we do a lot of testing in our in our public health lab we do not want screening we do some prenatal care we do sexually transmitted infections T. B. immunizations I'm sorry I'm. That's not right okay so in our public health lab we do do born screening to be sexually transmitted infections rabies flute months of measles and food and drinking water and then our local public health branch which I was trying to combine the two is by far our largest branch we have a local health unit in every county in the state some counties a few counties we could have to and then Pulaski County we have a few more than that they are responsible. for prenatal care they do sexually transmitted infections treatment testing we do immunizations there the fluoride varnish and we also do with it in that in local public health we work in partnership with and the. The county the county used data on the buildings in that we are we house our services in those counties so they do building upkeep maintenance and then we do we provide the services in those buildings I mean the staff. and then we are last one then I'll talk about is not a Senator but during transformation we got twenty three boards and commissions which of course is a big part of the agency now and that's what Mr Gilmore heads up so with that that's that's a broad overview of what we do with the Department and I had key staff here key leadership staff and the staff that you'll be seeing a lot during the session if if you'll allow me to introduce them okay so the first step would be Dr Jennifer Delahaye if you all if they'll stand so you can just see there see who they are thank you welcome yes stand that we can see. We have done Adams who's our deputy director of administration. Casey Cochran who's our deputy director programs. Laura hsu who is our chief counsel. And Chuck Thompson who is also one of our attorneys and you will see that you see them a lot over here along with our chief of legislative affairs Matt Mr Gilmour yeah and so that's my presentation for today wonderful thank you appreciate that very much other any questions from members of the committee. Any comments questions okay thank you so much for the retail being here thank you for the work you've done for our state and we look for to continue working with you guys. Thank you okay next up we have department of the Arkansas department of Human Services. I'll let you Secretary Putnam and introduce yourself for the record to and your team and yes good morning Kristi Putnam secretary department of Human Services and I would like to introduce members of the team that we have here this morning we've got mark white is our chief of staff. Janet Mann is deputy for health and also state Medicaid director or other deputy mission Martin is pulling duty over in the just Judiciary Committee so she's not with us right now we do have some other members of the team that I'm gonna go ahead let Janet man introduced their part of Most the part of an emergency has a couple of those that will introduce as well thank you good morning and Elizabeth and is he or she is the director for medical services and I see Melissa whether ten he was the Director and. I apologize if anyone else is here I haven't called you names I think that is all for from Medicaid today. A little idea of a force for most means the potus Committee either I'll be in here or McDonald is service or deputy chief legislative affairs and so to us we work to cover this committee also know many of you know Jeff Williams who's with DHS he's going to be helping us out the session as well he is covering insurance and commerce force this morning correct. Wonderful. Thank. And so we at as you know DHS is a very large agency and I appreciate everyone's patience the team it's been amazing there's a lot to learn we were asked specifically this morning to go over Medicaid and to really give an overview of that as that is primarily you know what this this committee will focus on among other things but there's a lot of Medicaid work to be done and so with that we do have an overview of the Medicaid program for you this morning correct. Well I think we want to start by making clear the differences between Medicare and Medicaid lawyer might set right to use sorry our mice is not pick up very well thank you biology's a matter chair. We always want to clarify the differences between Medicare and Medicaid because that's I know when I first got to DHS it took me a good six months to sort out those differences and to keep that in mind and so we know for those who are in the state today that that gives point confusion with Medicare of course is a federal program is run by the federal government it's paid for through per Medicare taxes they're charged on individuals which they then used our coverage through Medicare mostly serves individuals who are older who are individuals who have disabilities and been found the same about so security ministration Medicaid on the other hand is covers some of the same individuals but also covers individuals based on their income as well and when Medicaid we have a variety of eligibility categories tied to income some of them tied to the amount of resources that individual may have and they can speak eligibility for the program through those things can I can I can the biggest differences Medicaid serves approximately half a million children in the state of Arkansas said that's at large category that Medicare does not cover yes. And so Medicare courses Payton told by the federal government Medicaid is partnership on average the feds pay about seventy six percent of our Medicaid program in the state pays the remainder of that amount and there are differences from state to state and Medicare I'm sorry excuse Medicaid sensed it was Medicare is more consistent nationally and then to to overlap so want to mention FOR Medicare Medicaid one is as a kind of suggested earlier we do have beneficiaries who have both Medicare and Medicaid and so we coordinate with Medicare on what services we pay for services Medicare pays for and certainly that is does create some confusion at times when someone is having an issue getting someone paid we've had folks who call their legislator they call us only to find out it's actually Medicare issue the other important overlap is around rates that there are limits on what we can pay to providers and those limits are tied to what Medicare pays for similar services and so you'll see that come up in rate discussions particularly also policy there's other comments on the Medicare Medicaid. At yes. So every state has to submit a state Medicaid a Medicaid state plan to the federal centers for Medicare and Medicaid services CMS that outlines how Medicaid will operate if state officials do wanna make changes there is some flexibility for the Medicaid program but you have to submit state plan amendment or waiver request and that was my introduction to Medicaid when I was in Kentucky is working on the sectional in fifteen waiver for that for transformation in that state couple differences a state plan amendment is a formal plan to change how the Medicaid services or operations function in a state does not have a cost or budget requirement it's typically a ninety day process so it's a it's a little quicker than a waiver process but CMS Kansas spends that time clock to request more information the changes permanent to that Medicaid state plan how the operations are for the Medicaid program in the state. Separate from that a waiver request is a formal request to waive certain Medicaid requirements in your state does require the change to be cost neutral or budget neutral cost effective sorry cost effective a budget neutral if the request is approved in the state receives that official waiver it is time limited the states can request to renew them those requests can be approved or denied but it does it does offer some flexibility in how the Medicaid program is operated in this in the state. One point all mention on that some of you may remember from past discussions this last year we talked about the to the least the missile go to reviewing requests that we send in either state plan amendment or waiver amendments and I do want to reiterate that that in the current administration we've seen significantly longer let wait times for approval of state plan minutes in a waiver amendments and so I miss that because I know we have several things that are pending right now that we thought would be approved sooner and they've continued because CMS raises questions the reason of the setting questions so I saw that out there is that we we do our best try predict or at least give us and when we may hear back from CMS on any given item but we are seeing longer times for that this last couple of years link the negotiation process. So on the next page and Page four is just a brief summary of the make up of the Medicaid program it's not just one program there's over thirty different programs within the Medicaid program and we are currently serving over one point one million our Kansans and say we separated it to look at it so you can see the broad break down with our kids a and B. which is all of our children at two nineteen and twenty one our home which is our expansion category parent Kate caretaker the SSI Medicaid category which mark briefly mentioned with Medicare and Medicaid newborns which we like to give them their own category because we hope that they're all born healthy and if not that we can be there to help them get through that first year and help the parents Medicare Medicare savings programs is one of those programs we work with the duels as we call them that have Medicare and Medicaid. And then we have several DDS waiver autism and have for a and then they are arches are choices waiver and living choices waiver and then adoption and foster care. And on the next page we did a summary briefly to say you would know who's working in Arkansas we have a number of enrolled in active providers which is a hundred and one over a hundred and one thousand and then forty nine thousand of those providers actively build us in fiscal year twenty two and we have eighty five different types of Medicaid providers and with those different types of Medicaid providers comes provider enrollment which is different levels of enrollment and registration so we can track who is serving and what their billing. So there's third General eligibility requirements for Medicaid there are their basic income limits based on a percentage of the federal poverty level or FPL and number of people in the household also called house of composition and this ranges from less than twenty percent of FPL in up to two hundred fifty percent of appeal depending on what category Medicaid they're applying for or qualified for the limits are higher for children pregnant women and long term services and supports clients and their lower for other adults in Medicaid DHS does REDETERMINED eligibility each year that has been different under the public health emergency and and we'll go a little bit into that to briefly but typically clients are required to report changes in their circumstances which is income household composition it's that are within ten days and that redetermination does happen annually of clients of LTSS have to meet asset limited edition income limits and they also have to meet an institutional level of care to qualify for LCS us. Leding see on the next page we gave you a chart showing some of the current income levels for some of those different FPL levels but I do want to emphasize that there are many different thresholds depending on the eligibility category that you're talking about and that's because just over the years Congress will see a situation they see a gap in eligibility or they want to address particular problems of the past a law that means that we now have this patchwork of a dozen or more different eligibility categories that all have different standards for eligibility not to mention earlier some tight just income some tied to both income and resources some that take your medical or functional capacity into account so we do have some guys that we can certainly provide you all that give some details but each of the specific programs if you're interested in that we always like to come back to for Medicaid expansion that's the most common one right now no is under thirty eight percent of the federal poverty level. I'll talk a little bit about the public health emergency so with the omnibus bill that passed in December. And they D. coupled the end of the public health emergency and the funding that was given to Medicaid with the an additional six point two percent F. map in addition to that it set a date of April first of twenty twenty three to begin the unwinding so we have internally already begun in county operations which may Franklin is the division director in working across the whole agency cooperatively to get ready for the unwinding everyone will be REDETERMINED in the next six months is the goal and we are starting to send out those packets to you may hear from constituents that have questions and those packets will be beginning to be mailed in early February the first weekend in February and we like to give ninety day notices for all eligibility except for long term supports we give a hundred twenty days we want to give that additional reminders not just the one reminder that additional time to be able to work with them to do get the paperwork and to get re qualified so. That's going to be a lot of work that we're going to REDETERMINED the entire population in the next six months starting in February and you'll see the first people coming off of the rolls on April first of twenty twenty three. And so you will get calls from constituents ought to go and let you know that you're going to hear from them it may start earlier than that as they start to get some the initial notices that we send folks telling them it's finally here we are finally getting ready to remove you if you don't know show us that you're eligible C. magazine because the about that particularly after those those closures could go out in people's go to the doctor and five oh my my my Medicaid that eligibility is no longer active they will be calling you and social encourage you when you when you get those certainly you can wrap that present a constituent staff you're also welcome Director ride through our our staff we have course No committee to work with a Morgan Donald on constituent services issue we also shall be well to is an office she is handling the day to day constituent what's on the session let us know if you could give us that information and we'll give you the information on that case help you respond and make sure that that individuals situation is addressed and then if there's a problem or a mistake that we've resolved it so just wanna jump in here that's really important information for not only us but all of our colleagues as well in the Senate so if you'll just give me a little bit of a time line and a break down that I can share with our members of the Senate and then contacts because you know they're gonna they're gonna get calls and then they're going to call us because we're members of a public health. But generally works but that's very important permission I was one of the primary things that I wanted us to discuss today was this public health emergency and how it's going to be and wanting and you know what what's in front of this agency in particular in REDETERMINED in the entire population within six months so we have questions represent I'm I'm sorry Senator live my apologies. Thank you madam chair I think it's hard for people to give me that promotion. The The first thing I want is a definitely surprised is is it I usually call or McDonnell and so she's been awesome so um this I will say. secondly is besides yes you're going to be re assessing people that is that the largest challenge that we were going to find with with kind of the ending of the public health. It is I think it's the volume of reader termination we want to retirement and the entire population which is one point one million and and growing and so we want to do that is going to be it's going to be a challenge I just be be honest and it's going to be consuming I guess the next question I have in mind that this might not be a problem might be but do you all have the the capacity to do that. We are looking at different ways to handle the search and I know a few days it is day five man if I could ask for a little bit of grace I actually like to bring the Franklin back who's been in the weeds and several of the other team members that have been working on this that can answer all the detailed questions for you but yes we we've been anticipating Sarge and we're trying to anticipate what to do with additional staffing or different options instead of that just one one detail is because we have a hard deseo staff division County operations to handle eligibility and we've been working to get them ready for that we also we already have contracts and vendors in place to provide that additional surge capacity so that as we see that workload increase we can instantly transfer that over and continue that work and keep up with it. And during the the public health emergency. During a public health emergency operations continued so there were continual process things going on so it nothing stopped during the PhD and the I think the backlog of applications was down to about a thousand is what we heard yesterday so the application processing is relatively current right now and and as a chief of staff and Debbie said we are looking at other options for additional staffing it is a concern with we spoke of immediately as soon as we came in thank you thank you mention. Thank you senator Penzo did you have a question. Okay Senator Solomon you had a question you answer to any of the other questions from members of the committee okay proceed. At the next page really and goes into a little more depth about how we have been operating is as normal as possible without with the extension of the PhD without eliminating anyone's services and so um this is just some talking points on what we will be going through and doing I don't know. Well and and I just of course we we discuss in there about know why someone would have been removed up to this point is a very limited set of reasons why someone will be left on so we do have a significant of people who are on the rules now that either we know are eligible for we've reached out to the we've asked them to provide us the information to show that their eligible and they have not given that to us and so and that's and that's the good the big mystery at this point is we just we have no way of knowing of these for her ninety eight thousand clients how many of these are truly no longer eligible and how many no they couldn't be removed and so they just have not responded to this state and so that's that's the challenge and that's the unknown we're going to work for in the coming months. And I just want to be real and put it out there that you know there will be people who are determined ineligible who truly are still eligible so there will be those instances of you know our due diligence our responsibilities to make sure that we go through and that we have free determined properly but when someone brings information back in yeah that's where things can be reinstated and we will make sure to get you all the time line as well as contact information who to reach out to and since some talking points around what to expect so you can have that to share with your constituents that is great that's great yep and if I may add one additional point selflessly course we we want to help you with your constituent issues but also it helps us because there's certainly been times where you legislators brought us an issue from one constituent and we didn't dug into it and discovered there is a systemic issue that was affecting a dozen constituents or under constituents and so that helps us as an early warning if you can get those to us we have set up other mechanisms to try to get that early warning as well but I switch owners in the dollar part of that and we eighty the when you get that to us that helps us and helps your constituents great thank you thank you so much are there any other additional questions from members of the committee. The thank you are so excited to have you from Kentucky and from Mississippi and back thank you and that we're glad to have you with us secretary Putnam and your whole team thank you so much thank you very much all right. All rights next agency that we are going to be working with is the Arkansas department of energy and environments. Secretary Corey can introduce himself and his folks thank you. Welcome. So my name is Shane Cory I am the secretary for the department of energy and environment to happen to live in district twenty four. But yes I know that and we're going to try our best to limit any controversy a legislation at least that we're proposing. But in say others would propose. That being said so the first question I get a lot of times is. How do you do both energy and environment part those kind of natural in conflict with each other and and the answer is really know because I think in order to have a sound energy policy we have taken consideration our environmental impacts and also we need a sensible environment a policy to allow us to utilize and maximize our power in energy resources in the state that being said we do have at the Department energy environment we kinda have to section so I have both the Larry mingle he's our chief administrator of energy and Caleb Osborne recently appointed to the D. Q. director position and he's our chief and minister of the environment so we do kind of have to different paths to different tracks there and I let them introduce themselves and if they want to say anything else but most of you know administrator being he's been the only gas commission director for quite a long time the state Caleb's background recently just coming to us from parks heritage and tourism but had a DQ background as well as as well as some energy background resources we have Michael Gruppe many of you know him he's kind of our contact here at the capitol if you all need anything feel free to reach out to me or him directly he can coordinate and the biggest thing that we have in in terms of constituents Mrs which side does it go to right because a lot of people think of energy and environment is just the queue and that's not the case it's the he was probably seventy five percent of it in terms of number of people but we also have you know the liquefied petroleum gas board the oil and gas commission the Arkansas Geological Survey obviously the police patrol the college commission they're all housed under now this department of energy and environment. So that being said I do have a brochure that were working on finalizing that will kind of have a breakdown of what all the individual agencies within the department do who to contact to contact for for your constituents or and we should have that to you within the next week or so we're just trying to make a lot of changes and update that to reflect all the changes that we need in the near future so we have a few other people here that just quickly introduce we have an injury Hopkins she works on the energy side she is our associate administrator of angle of energy she works directly with Larry Bingle and then we have Bailey Taylor many to you might have known her for working with some of the D. Q. issues we've had the past few months but Bailey is the associate administrator for environmental works directly with Caleb. So I guess with that I'll ask either clear your cable to feel have anything you want to add. No I just pull the make of the. Well here it's okay they're very wonky tower about that minus two if it makes you feel better call repairs already. one thing it's that you'll be interested to keep in mind is it the oil and gas commission legislation if we were to have any which we do this session that goes to the ag Committee. Even though a part of the any which most of the legislation we come to this committee. I'm not sure where the energy office legislation would go on but that would probably go to the a committee no come to this committee because it's part of the queue so this committee would be dealing with several different things in energy because only because it's related to any in the queue. as far as. Having the two The issues dealt with in the same department we were able to take advantage of the Hughes environmental aspects as well as the ball gets commission and aspects. For example we have joined jurisdiction over environmental issues or else bills and things of that nature before there was two agencies each dealt independently with those issues sometimes there was some conflict now the or in the same energy were able to bring those together we have one set of rules from any of those events there's no conflict makes it easier for the regulated community to deal with those not having to deal with different state agencies sometimes in conflict with the resolutions so it's been able to work some of those things that we continue to work on those. All right is the secretary said Caleb Osborne on the new chief administrator for the environment Lazio will think of it as the DQ director I can answer to that as well so um wanted to. To echo will echo the the comments from from sectarian from director being a. But I think there is tremendous opportunity for us to work together and having at the environmental and energy site in house in my past time with the Q. I had worked as a with the environment oversee the water quality section any work quote a work closely with Director Bingle and his team on some issues as he said it's much easier when it is all part of the same organization in two separate agencies so we look forward to continuing to do that I will also borrow from what our friends a DHS had mentioned earlier you committee I will probably hear some questions or concerns about various things that come up my sexual or my job we will oversee water quality issues air quality issues solid waste hazardous waste and a variety of other program so please reach out to me let us know how we can help we want to help you all have the answers to take back to your constituents and help resolve those challenges and we look forward to where we go through this session and beyond thank you. Like I said we will have a brochure that time with your indulgence will get to that next week or so that that contact information and thank you thank you I think it's so important they're such an intersection between your agency plus the Department of act plus the department of health because of a lot of the water issues that we deal with and you know the licensing issues and so there's a lot of cross agency work that happens and a lot of those areas that Mr Osborn just discussed briefly and so I think it's is a very important for the members of this committee to understand how all of you kind of work in your own and your own offices and agencies but also how you work across the agency lines and a very important manner to deal with some of these issues particularly and the solid waste issues the septic tanks and all all of that water quality issues so just appreciate it out as understanding that a little bit better I think is very important as members of the committee helps us kind of help you work along policy lines so that we can just be more efficient as we're addressing those issues in the state. Any other questions do you have any questions members of the committee. The all right thank you so much for being here. Thank you really for to working with you and the final as the so we have Arkansas division of workforce services. Thank you madam chair good morning senators jim Hudson chief of staff for the department of commerce my boss is secretary commerce secretary Hugh McDonald it could be our days actually traveling out of state in the coming development trips or wishing him good luck on on that trip and then the doctor Childress assure shoulders heads of division she's a traveling Mountain Home today so she couldn't be here all that court enters herself. Good morning can you hear me yes Courtney trailer on the deputy director of internal operations of the division of workforce services great to have a yeah and justice you know what you know in terms of Department commerce were spread amongst three different to the Committee so again here obviously pretty to have yes our insurance and commerce as well Rossow imac and Economic Development Dr Childress will be here you know most times when you have something before you pertaining Division and she can be here all be here and obviously there's a need to have a secretary McDonnell here he'll be here as well and we can get you a contact list for body in division two thanks for a great well we're glad to have you thank you so much for being here and then the other agency we might have some interaction with the Secretary Bassett and and his work and so anyway just thank you for the introduction other any questions from members of the committee. Thank you thank you for being here will look for to working with you thank you and then add finally at last at last but not least until there with our bare of Legislative Research she is going to address our committee about a new process and procedure and that we've adopted three legislation. Thank you madam chair Jill Thayer bureau of legislative research is Senator Irvin asked me to be here just to give you all an overview of some new procedures that have been put in place this session regarding and bills that will affect health benefit plans for entities of the state and during your fiscal session last year ACT one twelve was passed and that imposed a fifteen day bill filing deadline on these types of bills and it also requires a fiscal impact statement be produced for any bill that will impact and it either the EBT program or other health benefit plans for entities of the state so as we determine now that's going to be EBT and some of the institutions of higher ad that have their own self funded insurance plans. And the Legislative Council during this past fall and instituted some procedures and adopted them for how the fiscal impact statements will be prepared and they identified primarily the to public health committees and this insurance and commerce committees as the one so most likely receive these types of bills and so far that has been the case they also hired the Siegel group to be the actuary that will perform these fiscal impact statement for the General Assembly. And just to go over with you how this process is going to work and Siegel began working for us they have a contract with the bureau that started last August they began monitoring the bills and with that pre filing that started on November fifteenth they are watching for any bills that they feel will have a an impact on the cost obligations of these health benefit plans Siegel notifies me now this session is began every day of any that have been filed and referred to one of those four committees that they feel will require a fiscal impact statement the process then is that I contacted the chair of the committee to which the bill has been referred that chair will reach out to the sponsor of the bill to find out if they plan to proceed with the bill in committee and if the sponsor says that they will the chair is letting me know and I'll throw as Siegel to proceed with the fiscal impact statement. And the process then is that it's my understanding and this committees Senator Irvin has indicated that she would like to wait until the fifteenth day filing deadline has passed and then and beyond having Siegel lab produce those fiscal impact statements and. To do these fiscal impact statement Siegel has to have access to the data for those plans so I've been working with sad Nick fuller with the Department of higher ed he's coordinating and getting data use agreements and with all of that And institutions of higher ed and the bureau is entering those and then also we are working to get in and and you data use agreement in place with EBT we have not accomplished that yet with the change of the administration and the new secretary of our transformation shared services they're looking at it and so we're hoping to have that by the end of this week. M. Siegel will reach out to me and let me know with what their data request is and I'll communicate that to all these entities. So just so you're aware there is a slight time frame issue there which is why Senator Irvin has has said she'd like to wait just a little bit to take these up and we've been told it could be five to ten business days to receive that data from the institutions and then Siegel will begin their analysis and. Under the rules that are going through right now the joint rules this information is in there and then ACT one twelve and requires that the insurance and commerce committees adopt these procedures the Senate to insurance and commerce committee did that yesterday so any bill that requires this type of fiscal impact statement as identified as such cannot be taken aback in a committee until you have that fiscal impact once you do then you can go through your normal process and if there is a bill that a member or a committee feels might require a fiscal impact statement but wasn't identified by Siegel at you can make that request you can let me know and and then if it is a Senate bill and a Senate committee at the president pro tem of the Senate would just need to authorize Siegel to do that work I'd be happy to answer any questions Senator Solomon you're recognized for a question. So as you mentioned there's a big concern over the data the data will drive that impact so and you mention you get the data from higher read and from the EBT so how does a heck figure into this and we have a lot of requirements that a. Collects these database and they hold the databases. Your tell me what their engagement is defending. At this point nine we're going directly to the plans and their providers is there the holders of this primary data. Again I'm I'm just trying to feel my way through this we have. A heck it's embedded in the law in several places that we have the different agencies. I have to report their data to a hacked may collect all that in their database yes the database separate from the database that that that the colleges have a are they not Then I cross over and what they have I'm sure that they do they do have to report it to their and are in no use that we've entered with institutions of higher at that will allow us to pull that data directly from the provider so it's more up to date it's up to the the moment that is requested so and if you don't know the answer to this you don't have to respond but may not what we need a heck. That is a totally separate issue from and I don't have that answer thank you are there any other questions Senator Boyd. Thank you so I'm just curious is this the first time that we've ever hired a private company to help with fiscal impacts or is this something like we routinely do no Sir we have utilized it to give a good example that joint retirement committee has an actuary that only works for that committee and we've been contracting with that actuary for at least fifteen years possibly longer and so it is something that we have done and I think the retirement committee is a good example of how that's that process happens. Yeah I would say it's modeled after that and when we when we work through this through executive subcommittee of ale C. we kind of modeled it after what happens in retirement every retirement bill has to have a fiscal impact statement and they're perform spot outside third party actuarial company the fiscal impact statements in the Education Committee I believe are done. Those are at in terms of economist Dr Silva right so that is done internally and now from time to time I do think it's also appropriate if we have legislation that we have a fiscal impact to medicate and so that also would be something that I would requests or any member could request that as well what's the fiscal impact of this legislation to the Medicaid program that's not necessarily an statute but that is something that we I as chair can can request as well we have requested that in the past. Senator love fifty of questions or just clarification so so we're no longer a question impact statements from like DF and at least get a from D. F. and they were requested from the actual. Well just on these on his chest on this type of legislation it's just legislation that would. and impact any health benefit plans through EBT or through our institutes of higher at okay thank you the reason why with the scissors because we did pass an insulin a piece of legislation that dealt with and someone and we didn't have an impact statements really at that time and we had to end up repealing that legislation I think it was you know that I think there was good intentions of what was trying to happen we just didn't have a fully realized. That's why I can. I think that's what precipitated this change okay all right thank you yes Sir any other questions. All right thank you so much miss their appreciate that we will work to diligently through that process okay and as we wrap up we have some familiar faces in the crowd so I will just start over here right here you yes come on stand up and just introduce yourself for the members of the committee on my. number. We're glad to have you Mr Anderson. Williams. The house in session with. Thank you. Arkansas. You'll probably see us and. Thank you others. He also. Okay glad to have a Mr ****. The tax. Thank you. Thank you Mr Williams. Bills. Thank you. Thank you. A little. Thank you. Being. Thank you. Thank you. Grants or Arkansas State University systems can. Thank you. The Arkansas. Thank you Mr Altman. The Arkansas. Grades thank you. Great great well we're glad to have everybody and then I will have some other side that will come in and I just appreciate everyone being here are there any other questions from the members of the committee any other business that needs to come before this committee all right we are organized and we are ready to work we'll start hearing legislation next week and look forward to working and serving with all of you were adjourned.