ALC-PEER

With that charities a quorum. Sorry. Thank you we're gonna go ahead kick things off of got several approval items and we'll start with the section be. Thank you Mr section beer the various temporary appropriation requests the first item the one is a letter from the department of finance initiation revenue Services Division and this requested increase appropriation by one point five million it is being thirty would allow the department to replace ten year old machines use for mailing license renewals child support and tax correspondence and other revenue services responsible mailings the letter says Division mills ten million items each year. Nicks I don't be to the letter from the from a tobacco control this is requests increase preparation by seventy five thousand according to the letter the new spending thirty will be used to purchase equipment that is necessary to perform duties safely and effectively our analysts reach out the agency and learned that they would like to purchase Arkansas wireless information network radios and those or to replace to replace areas they're no longer serviceable. Next item is B. three it's a letter from the department public safety division of Arkansas State Police and this is requested increase preparation by seven hundred forty thousand you Senator to be used to purchase computer aided dispatch system and the next item B. four is also a letter from the division of state police this is for one point four million and any spending three be used to obtain an upgraded mapping system for tactical an air patrol aircraft. Sure those roller coaster based in preparation. Want to backtrack just for second members you've got a supplemental agenda on your desk and we need a motion to suspend the rules and that to the agenda we've got a motion we've got a second all those in favor signify by saying aye All opposed motion carries okay thank you members of the school and kick things off with with any questions we're going to these in order so if you've got a question I mean you're in the queue right now right now we're gonna focus on the one with questions on B. one. Senator Ingram I have a question on B. two Sir B. two all right any questions on B. one. All right seeing none. The motion to approve. About a motion to get a second all those in favor signify by saying aye All opposed motion carries might be to Senator Ingram to glad it your Mike again. You're recognized for a question I've got a question for staff regarding this seventy five thousand is only for radios correct. I'm sorry thank you I see a lot of head nod that hearing officer or they've gone to sleep yet or not it's just that the answer to that is to seventy five thousand is only for radios okay thank you. Okay members to wearing a questions on B. two. All right seeing none. Your motion got a motion to approve a got a second all those in favor signify by saying aye those opposed motion carries on it be three. The questions on B. three. All right seeing none in a motion of got a motion to approve the got a second all those in favor signify by saying aye those opposed motion carries and then be for. Seeing no questions about a motion to approve of got a second all those in favor signify by saying aye those opposed motion carries arm kicked things off with this section C.. Thank you Mr chair section C. of the American rescue plan a request according to the cover letter by the CFO the first several questions by agencies this been awards that made directly to them from a federal entity the last request is for reallocation for award may by the state A. R. P. steering committee but has been pulled from aid from the agent of agency requests but then it was added back after yesterday's steering committee Emergency mean having a four thirty so that will be only if the millage in the plus two more requests one from the private health one for you M. S. INR both related so these require prior approval by L. C. the first request is on page three the packet this is C. one. This is for or you or its request to spend one million seventy five thousand the R. P. funds for the committee's information this grant is not from education stabilisation fund at the U. S. department education like most of the other university request we seen over the past year education the education stabilisation funds are used to make emergency grants to students and help institutions respond to the pandemic whoever's like H. back upgrades this grant for you learn is from the US small business administration in these funds be used for a community navigator pilot program to ensure small business owners have access to technical assistance in business advisory services next item is on page six. This is for you CA it's request to spend six point four million and the funds be used to make emergency grants students next item is on page nine this is C. three for Black River technical college and this is for one million eighty eight thousand and the funds be used to make direct grants to students to reimburse the college for COVID nineteen related operating expenses and to suppress COVID spread into do I reach for financial aid a full breakdown of of of these expenses are shown on the college's letter in the next page. Next item is C. for on page twelve this is for Arkansas tech university it's a request to reallocate previously awarded appropriation according to the letter the in this request is for software to assist with COVID related medical records however the contract P. would fall outside of the grant timeline university would like to re purpose a hundred seven three thousand these funds to make purchases that would support distance learning and remote work he also request repurpose one point one seven million in funds originally allow for faculty stipends to use instead for training and support for hybrid or online at high flicks course delivery next item is on page fifteen this is C. five both C. five and C. six oh for a department of Veterans Affairs C. five is requests for eight hundred twenty seven thousand as for the state veterans home state bill C. six is to spend one point one million the state veterans home in North Little Rock and for both of these funds to be used to support facilities ensure care for veterans during the pandemic break out the cost to a transit van for resident transport nursing equipment vital sign machines and more the next request B. C. seven that's on page nineteen. C. sevens for Arkansas development finance authority it's a request for one point eight million the funds to be used for administration and planning costs for the home A. R. P. program to serve the homeless and those at risk of homelessness next item is on page twenty three. This is the request from economic development that was pulled by aids your quest of course now it's on the stability in its last the committee go to that supplemental agenda and the first requests on this ability to general be on page five. So it is a Belgian Ellen page five is a one it's an A. R. P. requests for the department of health it's for four point seven million from an award by the steering committee that was made yesterday an emergency meeting of four thirty the funds to be granted out to UAMS to increase hospital bed capacity for COPD patients and the corresponding question you M. S. is on page nine. This is a to a page on its request has been that same four point seven million and these refunds it passed through the Department hell to them to increase hospital bed capacity. Next item is on page twelve. This is eighty three the R. P. request for economic development commission it's request to reallocate previously awarded appropriation and spend a or P. funds or bribing consultant I spoke with the agency and they're a contract for this consulting came in lower than expected so they'd like to use these funds dexus funds repurpose them to send you emails for technical review and to spend some money on staff retention of costs and that's requests they have here today. All right thank you all right members we're gonna go through this again wanted time I think will prove by block but I I do want to go wanted time so if you've got a quote what I'm going to say see one I've got a question in light of your Mike if you're late right now you don't have a question on C. one if you would turn your Mike off. Okay all right so any questions on C. one. C. two. C. three. C. four C. three. The seat eighty seven. Senator Hammer you're recognized for a question I thank Mr I guess what actually my question is for the University of Arkansas is that let's see to. Central Arkansas see torrential. That's why I want to ask questions of please okay. You're recognized for a question the staffers of the University of let me go to staffers I guess if I'm I'm trying to catch up on the reading but this is one where there and use it for emergency assistance to students. Yes Sir. You know what the status of what defines an emergency that were given that money out for added to for that to the institution. You're recognized in squared. Please introduce yourself and recognizing question Jeremy Gillam university of central Arkansas. Senator hammer the does the definition that we're using in this is going to be like we have in the previous one so if students apply and they've got financial hardships we've got a formula in place with that we'll be able to enter implement you've got Pell grants status things like that'll be all into the question as well. Follow up Mr. So I'm I'm trying to. Get help wanted signs out everywhere what what's changed that it now is still an emergency given the fact that. That the direction we're trying to go is recovery and with the amount of jobs out there that can be gotten what it what is it that. As a federal government done something way of cutting out the Pell grants or what is it that drives the emergency will these be emergencies also I could you know family situations economic situations that the student may have at home is not necessarily driven by you know loss of Pell grant or anything like that if I implied that I apologize for that. This. Communication there but that would that's just part of our formula including how much dollars would be if they applied for that assistance a could be a situation where they need the laptop and we'd be able to use this these funds to assist in that as well so a lot of it's based on the personal students situation. Do you know how many are lined up to apply for right now I mean that you have at the number you did did you have a basis for determining how many students are. In a emergency status that they feel they need this money. I don't have that specific number on me today and I apologize for leaving that piece of paper at my office but the the the dollar amount was arrived at based on what the request we've had leading up to this as well as pretty predictive model based on the students that have inquired a moving forward as well all right thank you Mr thank you. Thank you see ninety. Mr miles for bawak River technical college not UCLA okay all right Get get to hear just second. Members we have any other questions on C. two. All right. C. three. Senator Garner you're recognized for a question thank you you killed your Mike there. Yes Sir is is this black Rep Roger make sure yes or yeah I'd I'd like to ask questions. Staffer of the institution of the institution so my understanding is maybe step clarifies that before this grant was used for medical records related COVID nineteen I've been there trying to re appropriated to a new fund is that correct The New a new spending reason. After defer that to the institution correct. This was the. We run the sound like we're technical college I am vice president of finance and administration. I Mark Meghan's burger president of Black River technical college. Yes yes Sir do you want me to ask my question again yes please so the requested to re classify prickly request expense categories and not requests for new funding the original purchase was for medical records software to assist with COVID nineteen met related medical records what what I I don't think that's Black River technical college's request I have missed the. I'm sorry I'm trying to it's. Okay I think you're right that's Arkansas tech my bad I'm sorry about that is. No it's all right. Your great. That's what we want to hear. All right we're gonna get a move on the to see for. Thank you for being here this morning glad to help and I'm going to hitch Michael more time Senator Garner you're recognized third time's the charm so can we please have some of an institution and I ask the question for the third or fourth time I can remember. Please to be prepared thank you. Laury Fiorello vice president of admin and finance Arkansas tech university. Yes ma'am over to your left over here hello yes ma'am. So I guess the question I have is the original grant was for medical records related to COVID nineteen issues what kind of information was the University trying to collect on COVID nineteen with students before the real allocation and was any money used for that purpose was this a. A punitive thing was is to help the students if they had this I don't stand I guess my question is why would the university collected data about COVID nineteen relate to the students is there some long term implication to it I'm trying figure it out. We have a health and wellness Facility that services just the students and we needed a medical records technology to help facilitate those medical transactions going forward so we utilize that system on a daily basis for example they come in and just get a standard medical check up it's it's like any doctor's office medical records type of software so we needed to add a module for COVID related tracking such as if I came in and got a vaccination but that time frame for that particular contract fell outside of this grant period so we could not use the grant funds for it okay the information collection was similar to a medical clinic that was on site that would individual within the internal structure of the medical clinic I could see if you've been vaccinated or had COVID it wasn't a larger university kind of system determines somebody had over that may expose anything like that no it was for standard medical use and to help the model to add was for COVID related issues but because if it's medical related is covered under HIPAA and we were not able to utilize that information in any other way other than service to students for their medical means understood as great to hear I know I've heard some reports about University of Arkansas actually having a system where students can report on each other if they've been exposed to COVID or somebody has been around somebody with COVID you could actually call in and snitch on their fellow classmates so I'll make sure there was some similar system in Arkansas tech sounds like it's not so it's going to clarify thank you ma'am thank you. All right thank you members we have any other questions for C. four. All right see none we're gonna move on and think free time this morning remove on the C. five any questions. C. six. And then C. seven. All right members we're gonna go ahead and I take a motion to approve item C. one three C. seven I've got a motion of got a second all those in favor signify by saying aye All opposed motion carries and then. Senator Irvin you're recognized for a question that we're gonna circle back for questions we've already approved this item but B. two. So if there's a somebody from the tobacco control board if you could get with me I'd like to get a list of the equipment that's going to be purchased under this seventy five thousand dollars if you don't mind if in a or that's really it I don't waste any of the committee's time but I'd like a list of that equipment thank you and I do have a question on hospital beds and cove it at that at the proper time under the supplemental agenda. With the Department health a one okay. All right members we're gonna go ahead and move on to questions on a one so Senator Irvin you're recognized. And I'm assuming we need someone from the department health and for yes. You could just recognize yourself for the committee and then Senator Irvin last question. Don Adams Arkansas department Health. Matt you know what from health. Thank you Mr chair thank you gentlemen for being here I wanted to have this conversation because it. It is increasingly difficult for us to transfer our patients from our rural hospitals to larger facilities we cannot find bets we cannot find that and I I know it's different from what's being reported when you actually live it and you're trying to transfer a patient out at three AM who has it who is in chronic heart failure and whose families have to make a decision because we can't find them of that anywhere in the state so you know I'm supportive of of this request however I want some assurances that the people in rural Arkansas have the opportunity to take advantage of this grants because at this point they're not able to receive any transfers and it's not just COVID patients it's people that are having heart attacks who are in incredible distress whether they have a ruptured appendix or they have into internal medicine issues or need a surgery pretty quickly we cannot find surgical ICU beds we cannot find that for our cardiac patients it is a huge problem for rule Arkansas and you know just on Sunday we had to work with a family who had to make a very hard decision about keeping their loved one there. And watch them not. Because we cannot find a bed to transfer our patients to so you know I'm elected to serve rule Arkansas and I've got to be their voice because it is incredibly difficult for these patients and their families to have to make a decision because we cannot treat them at a larger facility because nobody's accepting or transfers. Senator of and I'll try to address of the site can and we may have some individuals here from UAMS second speak specific to this proposal but we had added two hundred sixty five bids to date with this recent surge This Is an additional request for twenty seven we have systems in place for transferring patients all of these facilities or required to accept patients regardless of the geography of where they come from their other think triage factors that that go into the decision on whether or not they're going to accept a patient but it has nothing to do with geography so if we have specific examples where that was the case in which we would definitely want to investigate that but you know we're adding these beds as is quickly as we can to try to eliminate the the the the pressure that's on the hospital so that bids are available when patients need them. Follow up question. I know that we have perhaps beds available but we are shortage and staffing because of everybody being sick is not also complicating the issue. Yes staffing is the limitation the two hundred sixty five beds that we recently approved they are all available now most of them are full of the I think as of yesterday we had of the two sixty five thirty five bids that were still available of those two sixty five for transfer or for patient in a course you a mess is as sure does that as soon as this is approved they can stand those beds up through contract nurses through overtime those sorts of things they can staff these beds and have them available immediately once approved okay and I know this is not on the topic of the beds not grant before us and so I'll ask for latitude and you can get me this answer later but I'd like to know the status of the monoclonal antibody treatments and where those are distributed and how and how that's happening across the state at some point and if you could get that information to me that would be great it's not on topic of this contract or this request right now but I'd like to know where that's happening to make sure that that people all across the state have the opportunity for that treatment and where that's happening because I know we're getting limited reserves in limited quantities of that from the federal government which I think it's important that they are controlling treatments for people right now that's not correct but I would like to speak to an update on that if you don't mind thank you for the yes ma'am we can get that for you thank you thank you Senator Garner. Thank you service private question more for UAMS and department help I don't know if they said there was somebody available to speak out okay so me hold you off until so eighty two that's fine I'm assistant yes Sir whatever happens for you I do we have Senator hammer you on a one. You will be okay. Senator Hammer you're recognized thank you and alas this question if it's not you will put it down lie but when when it comes to evaluating the cost of the beds and which facility because I'm getting different information from different people so say with different hospitals that when it comes to the determination the amount that's assigned per bed like the forty five hundred coming up for discussion do you all have anything to do with that at all or is that just up for the institution when they present The request. The yes yes senator the institution submits a proposal for the to the health department for review that includes the price for the I. see you bids and then the prize for the medical search bids and so I mean there is an acceptable range and but the prices of the bears that we have looked at you know we've accepted those as proposed and submitted those to the opportunity so we have not asked them to change those obviously if one was out of line with the others this we would negotiate that with the hospital and then second question is there some discussion about nonprofits being able to receive funding and for profits being able to receive funny I'm in possession of some documentation that would show that there's no reason why there should be a discrepancy between for profit hospitals or nonprofit hospitals being able to access those funds can you speak to that as to what the reasoning is to wipe monies only being directed to want to as opposed to be made available to the other. Senator I may have to ask our CFO Joe Thompson come up if she can speak in more detail it is my understanding that the reimbursement from FEMA that we can receive to reimburse the state for these expenses for the hospitals need to be non profit but I know there's some there's been some back and forth on that in some research but that's the latest information that I have is that the hospital would need to be non profit for us to be able to seek FEMA reimbursement because to Senator range situation if more hospitals were made available to this funding we would have to be transporting patients as far I think this is something we need to have a relaunch discussion and I'll share this with you is from an attorney that has an opinion okay and I think we need to look at opening up the floodgates on that so that we can get better access across the state but yes Sir. House sure wants to handle the letter answer now yeah go ahead recognizes the. Good morning I'm Jill Thompson CFO for the department of health and I'll just come to support with deputy director Adams explained it primarily are consideration is been on FEMA reimbursement as far as the nonprofit and for for profit status of hospitals. We'll have an offline discussion may we get back from the Committee before Friday then Mr Senator hammer if I may I think that we simply discussed with Adam to they handle that theory and reimbursement with us so we can we can double check with Adam but I think that's kind of our understanding that based on what they told us we work with them well let's let's have offline discussion anime will bring back up for Friday's A. L. C. meeting okay thank you. Thank you got a letter and got some documentation from attorney may be best to give that to them for I will gather there where an understand kind of how to move forward all right senator garner thank you Mr chairman I think Senator Irvin kind of spark my memory on this because today I saw the FDA actually remove the emergency authorization for the modern Clark treatment and the state of Florida has put out a statement saying basically they have to shut down multiple sites because of this reversal of FDA rule so my question is. Due to that change in the federal policy is Arkansas the member receive these lifesaving treatments is there any change in the near horizon to our site so be able to do this bill would be limited supply because unless I'm misinterpreting the data from what the governor and health secretary of Florida said they are no longer able to operate their site because of this change in the rule at the FDA do you know anything about there's any discussion about that it's important health what's kind of the status of that. Senator garner I apologize this is a little out of my area I know we're on allocation from the federal government and we are restricted to what they provide us the on that we would have to get some of the medical staff available to answer that question with my understanding is it isn't that is restricted anymore even though that's did happen it is that the FDA has revoked the emergency order for the usage of certain treatments due to on the crime because of the original Treatment was more for the original delta L. the original variant yes my understanding is that right now we know the Arkansas is being overwhelmed by on the Krein well we would not be allowed to use this kind of treatment on patients in Arkansas because of this ruling by the FDA. I do understand that I think there's two types of the monoclonal antibody that worked well against the Omicron and the other types do not the course right now Omicron of the of the of the samples that were sequencing the last report I got a hundred percent of them on the ground so there are two types monoclonal antibodies that are effective against Omicron but the others are not it that's my understanding and I guess the skewed live outside this right the. BAM a low valance and into reject on region covert C. O. V. as the two that they ever both to our stories I just want to see if that is what we get that is that going to affect us I'm just kind of trying to spit ball here yes Sir what will follow back up we'll we'll get the right people on that get you that information thank you. I thank you Senator Irvin. Thank you for the follow up and. Primary reason is not a lot of your critical access hospitals in your rural hospitals have COVID wards so they cannot keep these patients so they are in a predicament okay so I'm not sure how many people are aware of that but that's why they have to transfer these patients out because they do not have a COVID ward and they don't have the money on gas you know to have a covered ward but I'd like to know that status because if we're increasing beds at UAMS that's great but we do need to look at then how do we create those beds in our existing infrastructure throughout the state of Arkansas so that these patients don't have to be transferred away from their loved ones how do we make that happen and we need to do that and we and we need to do and I thought we had already kind of done this so that we have that capability there so that we can use it when we needed it and when we saw on a price in cases or search and and now we were in a search and we don't have it so you know what do we do a year and a half ago or two years ago to make sure that we were ready for this because here we are and you know we don't have the ability to have treatment for these patients. So for Senator I think some of the issues with some smaller hospitals in your familiar with this they don't have the. The specialist they don't have the home and all just they don't have for code specifically I think that's what's on the larger hospitals can stand up these bids quickly an easier and provide those services the COVID patient might need and I think with the with the of current issues we're seeing with COVID with you know a lot of healthcare for individuals that are of care workers that are out and then I think the smaller hospitals struggle to keep those people year round anyway but I think with with the current cases were seen as healthcare workers are beings are getting sick so the hop larger hostels in the same issue but I think the the main issue is a smaller hospitals which are alluding to is they don't have a specialist in these COVID patients needs I'm I'm that thank you but I'm office back real quick because every doctor out here in the state of Arkansas had zero scientific research zero scientific studies when COVID hit and family practice doctors all across the state of Arkansas where the one saving lives in this state it wasn't a specialist sure okay everybody has excellent education and a lot of them graduated from UMass and these doctors that were out here in rural Arkansas who were not the specialist in the public knowledge as save lives every single day in their clinics and in their little bitty hospitals and so they have to have the tools to save their patients lives and they are the specialist and saving lives that's the only specials they need at this point and COVID does not have a silver bullet treatment we know that the federal government is restricting us on an actual life saving treatment that I know works and that is important to me okay it's awful and it's wrong but do not discredit these doctors who are trying their best to save their patients lives senator who could give that life trade treating decide life saving treatment there in rural Arkansas. They have the capabilities and they've done it they're the ones I have to get their pharmacology books out they had to study the science and they had to put together their COVID cocktails because there was no data there were no scientific studies to tell them what to do and it worked and they found out what works and they kept treating their patients and saving as many lives as they could with their knowledge their expertise and their education and their training so here we are with the new variants. And they've they're doing the exact same thing so you've got to give those doctors who are they're trying to help their patients survive the tools to survive in those hospitals whether there's a specialist they are not they are respiratory therapists there excellent nurses and their excellent doctors they may not be specialist that they know how to pick up the phone and call on and they know how to transfer into an ICU unit when available and when necessary we know how to do that but they gonna be able to at least care for that patient to get them to where they're a little bit healthier to with so they can wait for a bed even so that's my request and I think the smaller hospitals have to have some of this acknowledgement and some of these dollars have to be spent to help them because I'm not seeing it so I'll finish thank you Mr chair thank you. Senator Hammer. Thank you and if the chair will I have a question for you M. S. but let me ask them first first of all can I get a heat map of where all the beds are that we have funded in order to get them stood up and and see where they are distributed across state police. I think we can get you a listing of where the bills are one hospitals got what I think that's what you're yeah I'm just asking maybe for visual map that shows which hospitals have on which ones don't where the pockets are around the state and then and then the second thing is I'm sorry go ahead we'll see the great amount but I think we got a table we can probably get you pretty quick okay great second thing is what what is the limit is thirty five hundred per bed the least that you awarded money for what you mention range while ago what's the range. I think I've got it here. For the medical surge beds believe yes thirty five hundred would be the the lowest that I'm looking on the most recent proposal of the two hundred sixty five bids. The course the I. see you bets one processor partly or or higher than that. What what's the high number thirty five loners seventy five hundred. Do you guys do a cost analysis or auditing to determine why such a variance in cost per facility are you doing a follow up auditing to make sure that all that money is actually going for what is being asked for and what are they auditing procedures yes I'll let hi Joe Thompson address that further she'd like to thank you. Yes so there is a lot of those conducted through the department of finance and administration that throughout the believes the kaffir section that works with each every recipient of both the cares about our funds in there is there is audit process that we have to hear too so it happened after we've place the awarded the funds to the hospitals are that I could get to the criteria but I don't have that prepared this morning but I'd like to get that have that discussion because if if one can do it for thirty five hundred the other ones doing it for Senate five if I'm not misinterpreting your numbers for standard bet that's a really high range considering they all have overhead and they all are out there trying to get nurses. And and I'd I'd really like to know what's the discrepancy as to why it's such a wide range between facilities Senator Hammer if I could just clarify think a mis communicated or or they can clarify okay thirty five hundred is the lower on the med surge bed okay the seventy five hundred is the upper end on the I. see you bit so it's little apples and oranges yeah that be apples oranges so I don't see the cost comparison if you know what's the apple apple comparison and I'll follow up with you afterwards thank you they Mr all right thank you members with any other questions on a one. All right seeing no other questions he's probably good to go and take a vote if we can any a motion to approve a one. Got a motion I've got a second all those in favor signify by saying aye those opposed motion carries remove on a two night we had a couple folks with questions Senator Garner. We'll start with you. This is for the agency your staff should be for the University of Arkansas medical services okay mass. If you could just recognize yourself for the committee and senator garner you're recognized for a question thank you Sir. Morning Mr chairman Michael Carrick with UAMS. What can you give me a ballpark of how much additional funding you a message received during the last two years due to COVID nineteen both in additional Medicaid patients that can't be kicked off the road anymore so you have more people with coverage from the additional payments for COVID nineteen related payments from the direct payments from the federal government through numerous stimulus packages in the State of Arkansas through numerous mercy orders and other things else have given direct payment the UAMS to last two years. Senator off the top of my head no but I can get that information for you and I will commit to you to to get that to use this service possible okay let me ask a different way. What was your bottom line last year. As organization the relative lack we're going to read if you don't want a black how much to how much you'll have in savings give me a general ballpark of what your financial situation looks like Senator although I did not frankly come prepared to give a specific answer in regards to our financial performance last year I would be happy to get the people available they can answer those specific questions for you I'm not trying to be vague but the specifics of the numbers that you're asking I I don't have absolutely if I may make a come as chairman I'm not. Going to chastise you for that. But it's amazing to me that part of your letter says that unless you get this additional four million dollars that your organizational be under financial stress that they cannot afford. And I look at the last two years we have we have probably given if not tens of millions hundreds of millions of additional dollars to UAMS in organizations like that. When you come here and you can't tell me your basic financial information I don't ask you to break it down by you every single account import but just a generalized picture then you come to us for four million dollars additional money because you can't afford the bad stuff for the last two years the taxpayers have given you extensive money to have for this kind of situation. That is what concerns me as you said you all were in the red hundreds millions dollars okay I I make sense you said you were the plus hundreds million dollars okay that might make sense. But the fact will give you four million dollars in your letter you say it because you will be under financial distress unless you can do this especially with the decision on Friday of. Possibly fire nurses. Two additionally add stress to your financial situation I just think that's unconscionable that we're going to just give you this money on faith without seeing basic information about the financials of it can you all four to four million dollars without the taxpayer's giving you an additional four million dollars that's a basic question if you can open the best today if you can't do we got a decision to make. All right thank you have a seat sixty five. Thank you senator it's me over here Mr K. it is my understanding that the U. M. S. and children's get expedition of funding through Medicaid that are other hospitals that were granted extra funding to for staffing do not get so. Are you guys not gonna get sufficient Medicaid funding for these beds as you open up to cover for the for the knee that was my question I'm just looking at the number represented Bentley we when we accept patients we are unaware of what are payor mix will be specifically for the patients that are added with their a lot of variables when patients are admitted into the hospital whether it's by transfer or direct admission we don't know okay now we don't know payor mix for those that are referred to in hospital as that financial problem component of it is dealt with and then the appropriate parties are built specifically as to how much we're going to receive from Medicaid for these additional beds I can't tell you because I don't know how many of these patients will be Medicaid I don't know how many will be met their I don't know how much will be reimbursed by insurance or will be private pay or will not have the means to pay regardless of that mix we will do our best to take care of a you a much one quick follow up chairman that's okay in the past two years every had patience that you've not been reimbursed for. There have been patients that have come to UAMS that that we have that do not have a payor source yes ma'am so Medicaid and that has not covered for the duration there are some that have been referred to us and I'll get the specifics of that for you yes I think that that to me I appreciate it thank you ma'am. I thank you just to clarify I mean this is the center rooms talking a little bit earlier about how there's just not bed space is open up additional bed space there's a nursing shortage and a very high cost associated with travelling nurses and everything else that's happening in and out I think what this is supposed to do and I may be wrong is it's supposed to allow you all to utilize an additional bed space or those transfers can get be made and take some of the pressure off the look the rule hospitals or clinics or whatever it may be that these folks are trying to get attention or you know healthcare attention it in my missing anything on that as far as your corrects what this request is about our thank you senator Hammer. The thank you Mr of the twenty seven beds that you're opening up is that going to take out twenty seven beds that can be used forever other medical diagnosis is no sure. All right so you you have the. Facility space to be able to add the twenty seven beds yes Sir okay the. With regards to the insurance for services do you have the ability going back to when COVID started to be able to save patient XYZ we receive this much reimbursement on that patient or patient ABC we were not able to get a reimbursement because no pear sauce source. Specific to to cope with patients to cope with patients I would have to do some research but I believe we can gather that information okay okay it was offline at because that's one of your that's when your points in your letter is that you also retain the privilege to bill patients insurance I'd like to know how much off the private insurance that you've been able to retain and do you get paid additional of through payor sources if the patient is identified to be COVID or test positive. COVID in a hospital may be not admitted for covid Sir I. That's actual questions I'll be happy to get the specifics for you okay I'd like drill down to get that if you don't mind thank you. In just one more point of clarification in the in the based on that question I mean what this is going what they should do it you have a limited number that that you're able to staff at the hospital now and so if you're you know if you're at a different facility needing transferred for the services you a mess when there was a point last week or a week ago there were no beds available for those transfers whatsoever was my understanding that eleven of eleven many goes up and down but I mean it's been very restricted people be able to actually come in and gain services or get services at UAMS by opening up this additional bed space with additional staff you'll be able to relieve some of the stress that's on UAMS in those needed transfers that are occurring now by being able to utilize more staff and that sort of thing additional space in it so that it's not just for code this is for those folks that need additional services that you M. S. really can only provide in making sure that bed space stays open also and I'm missing anything on that that's correct yes Sir okay. All right Senator Hammer. Thank you share and and just so there's no misunderstandings I just wanna make sure. Those twenty seven beds aren't being taken away from any the current non COVID needs current this is adding twenty seven new beds that's correct it take care COVID patients specifically that may come out of Senator Irvin Jerry my area whatever this is gonna open up for thirty days which we is the intent that we hope that at the end of thirty days the numbers will turn down and you'll be able to shut those twenty seven beds down then the the. Request is for thirty days for twenty additional med surge what's referred to as much surge beds for covered specific and then seven additional ICU beds for forty five days all right last question you know what you're paying day now for travelling nurses what's the what's the going rate today you know I do not know what that rate is I'll be happy to get to thank you thank Mr I thank you members we have any other questions for a to seeing nine I do have a motion to approve I have a second all those in favor signify by saying aye All opposed motion carries thanks for your time I removed two eighty three. Any questions on a three. All right seeing no questions was will of committee. We got a motion to approve we're gonna second all those in favor signify by saying aye those opposed motion carries. All right that's the conclusion of our provided for in a move to the. All right you're recognized. Thank you Mr we have one right on the supplemental agenda that does require approval it's restrict your reserve transfer request it's the last two pages of the supplemental agenda. So this is the item being that agenda it's a request for a transfer for the university of Arkansas division of agriculture. This is the recommendation from the stage of state chief fiscal officer to transfer six million from the majority vote set aside account within the researchers are fun to the university division of agriculture university will use the funds for two initiatives five million will go to the north east rice research and extension center in Poinsett county and one million will go to in and out of water fell on wetlands conservation research. Members to any questions on a four. All right seeing none was will committee. We got a motion to approve got a second all those in favor signify by saying aye those opposed motion carries right now we're gonna move into the Review items thank you Mr chairman section D. now this is an appropriation or transfer request. this is a letter from the division of higher education special language in the divisions appropriation bill allows a transfer of funds and spending it already between financially programs to more adequately aligned with the number of eligible students request to transfer three point three million from the first four programs in the table and that'll go to the National Guard tuition waiver program P. O. W. E. M. I. A. K. I. a dependent scholarship program and law enforcement depended scholarship program or illness reach out to the Division of learn to the National Guard program has seen growth in this cycle it and both tuition and fees will be covered the peel W. depending program has also seen growth and is now allowing private schools to use scholarships were in the pass is only available public schools. In the reserve funds will cover all of the X. all these increases. All right thank you members really questions on the one. I see no Quincy no questions I'm the one is reviewed without objection. Thank you Michelle announce section II these are the cash fund appropriation increase request the first one is a letter from the from a racing commission this is requests increase appropriation by five hundred five thousand any spending thirty is needed due to increased costs from the extension of the horse racing season. Next item is a letter from if a disbursing officer this is for five hundred thousand the new spending thirty would allow the FNA to disperse a donation from the Office of Attorney General two women and children first for any family peace center. Sure those all their questions. Members for any questions on the one. The two. Any comments single questions or comments items in one and two are reviewed without objection. Thank you Mr chairman now section F. this is the budget classification transfers there's only one on the agenda it's for the Arkansas beef council this is requested transfer five thousand from conference and travel to operate expenses the transfer is needed to cover the additional travel of board members due to COVID cancellations in fiscal year twenty one I did speak with if they learned that the appropriation needs to be placed in operating expenses as opposed to confident travel because it travels for board members not staff and that is how the accounting guidelines instruct classifying these expenses. All right thank you members for me questions on F. one. Any comments or objections. I'm not saying no objections item F. one is approved. G. will. Section G. thank measurement section G. these are M. F. G. request miscellaneous federal grant appropriation quest the first item G. one is for DHS division of county operations this is request to establish one position and assistant deputy director and a grant from the U. S. department of treasury to administer the emergency rental assistance program this item is one hundred and fairly funded and the position would be reviewed for grading classification of tomorrow's personnel subcommittee meeting. Next item number two is the chess again division kind of operations this is four six hundred ninety four thousand we have a grant from USDA for the snap nutritional education program and this item is one percent fairly funded. Number three is again the chest Division coming operations this is for two point seven million they have another grant from USDA to continue administering the pandemic EBT program it's hundreds in fairly funded number four is the chess County operations again this is for two point four nine million they have a grant from the administration for children and families to address poverty at the committee level through the community services block grant and this is one percent fairly funded. Number five is the chess this is the division of aging adult and behavioral health of a request for eighteen thousand in appropriation this is from a grant for the administration for community living to pay for video and audio equipment for senior Medicare patrol projects this is a fairly funded. Number six is again division of aging adult and behavioral health this is for thirty six thousand they have a grant from community living to make a sub grant to the Arkansas state independent living council into print booklets and to do a virtual conference this is a hundred percent fairly funded. Next item number seven is for the Department health this is request for two point nine million appropriation to spend federal funds into established in positions they have a grant from the CDC to enhance workforce availability of a availability to implement data modernization efforts and these items one hundred and fairly funded. Next item is number eight this is the administrative office of the courts it's request for one million and they have a grant from the department of justice to improve outcomes for system involved youth by decreasing racial and ethnic disparities to the Arkansas juvenile justice racial and ethnic disparities reform initiative is items under severely funded. Share those all the end of your quest. All right members and we any questions on G. one. Two. Three. For. Five. Six. Seven. Right. Hi Senator Irvin you're recognized G. eight. Just a quick question on On this one. And how that's going to affect their somebody here from the ministry of Office of the Courts. Just a quick question you know we passed the juvenile justice reforms that we and how is this gonna work in combination with that effort that's really the only question I have is chair okay thank you if you could just go ahead and recognize yourself for the committee or whoever's going to answer the question any committee to restate that if you don't mind Sturch. Sorry go ahead. My name is Faye Shepherd I'm the juvenile justice specialist for the administrative office of the courts this actually Senator Irvin just continues that okay what the work that was started in the juvenile justice reform right starting back I think in twenty fourteen and going on this just continues that work to look at better ways to do all kinds of things and and juvenile justice okay so it this is going to working in conjunction with the the legislation that I passed where we're going to be able to provide that assessment tool and okay and implement that and and okay and go through that and help support our juvenile judges in our juvenile courts that's right All Saints greater thank you appreciate it thank you Mr. I thank you members any other questions and comments I see seeing none we've got a motion to review all the items in a section G. we've got a second all those in favor signify by saying aye those opposed motion carries a. You Mr chairman section age these are the performance and pay plan hold account transfer request there are three quest for people appropriation totaling three hundred twenty six thousand the dietetics licensing board requires I'm sorry your request twenty five hundred due to PTO and sick leave payouts for a retiring employee the claims commission quest twenty three thousand two to performance increases in salary Justin's and the if any revenue services division request three hundred thousand due to increased utilization of extra help positions. I thank you members of any questions on H. one. Two. Four three. All right seeing none there any comments and objections seeing none of the items H. one through three are reviewed I. Thank you Mr the next section Is overtime appropriation could increase request there's only one on the agenda it's for the Revenue Services Division for two hundred fifteen thousand and this is to pay for proved over time. I thank you members of any questions on I. one. Seeing none I've got a motion for review is second all those in favor signify by saying aye All opposed motion carries all right and move this on to the reports. Thank you Mr the first report in J. is the item approve an emergency basis this is for the department of health. On January eleventh ails him Pierre L. C. impair cheers approved fifty million in a R. P. appropriation for the Department health three emergency action department requests the emergency spending authority to send funds to nine hospital systems to secure an additional two hundred sixty five ice you in medical hospital beds request knows the problem will submit proof of A. R. P. of A. R. P. expenses to FEMA for future in person. You questions on the report. Seeing none. Mr run section K. now this is the in C. I. legislative report ACT one eighty one of nineteen created the UAMS national Cancer Institute designation trust fund to pursue a national designation for the Winthrop Rockefeller Cancer Institute the act also requires the main reporting on the fund that shows the fund balance list of administrative costs paid from this fun total revenue in a detailed description of the steps taken toward achieving national Cancer Institute designated cancer center status the first four pages or provide an overview shows the value of NCI designation process to obtain designation expected time line and how COVID nineteen has impacted those activities. One page five is a map that shows states with the designated center there are seventy one centers in thirty six states Arkansas Louisiana Mississippi are the only states in south south center the next page page six shows roll back to this nation you in UAMS is currently in the bill stage Page seven shows future income expenses. Pages eight through ten show expense pregnant shows expense breakdown. Page eleven shows the trust fund balance. Beginning balance for the reporting period on June first with seventeen million the fund received twenty six million and transfers and eight hundred and forty eight thousand from the cigarette papers tax the fund had five billion expenses for the period that leaves a fund balance of thirty eight point three seven million. Ages twelve to thirteen show the progress toward achieving national Cancer Institute designation. Page fourteen shows a U. M. as cancer navigators the next pages fifteen or sixteen shall recruitments. Page seventeen shows cancer research grant activity. I am sure that's report. All right thank you I do think we're going to get an update on NCIS so can go ahead and come forward. For that thank you are gonna make some comments. Thank you for being here this morning just I recognize yourself the committee in you're welcome FOR C.. Michael beer. I am the vice chancellor UAMS and director of Winthrop P. Rockefeller Cancer Institute thank you very much Mr chairman for having and giving me the opportunity to give you an update summary the report was exceedingly accurate I think objectively we've made a substantial step forward to going to designation despite the code pandemic our first most urgent issue when I arrived here now about two years ago was to rebuild the research base. the can't natural constitute is very clear you have to have ten million dollars. Of cancer research dollars in order to even qualify to apply of course since is national Cancer Institute you can imagine they have a secret formula to calculate that we calculated right now that we're in nineteen million they calculate us at nine point five so we're still below that ten million cut off but this year we will be going above it I can guarantee that partly because of the generous support from the state we've been able to hire eighteen of what I would call the best number right is young researchers and they themselves have brought in about five million dollars many of them are actively applying for grants right now so the good news is from the research standpoint the land base standpoint we are all essentially almost where we need to be we're shifting our attention to two other major components which to certain extent keep me up at night worrying about it because it's someone time dependent the first is clinical trials we have completely re organized or clinical trials structures to the clinical trial office is now sitting in the Cancer Institute used to be in the cancer service line I honestly don't know why it was there but it was an on will be and and essentially we could not grow it is down the Cancer Institute with higher twenty two additional staff members we're almost up to a hundred patient accruals that all sounds fine but again the NCI has a secret formula axes once the secret it's transparent we need what ten percent of our new patient volume on trial we have about three thousand new patients per year that means we need three hundred accruals or at a hundred so we need to triple that so we're working overtime put some of that just takes time so I reassure you that it's our top priority. The third element I will point out is that about eight years ago the national Cancer Institute decided to create something called C. O. U. community outreach engagement they no longer simply required us to do cutting edge research with cancer dollars they wanted to know that the cancer center was engaging its catchment area. Our catchment areas the entire state of Arkansas. it's a big state so this means that we need to create a statewide navigator program we're lucky enough that parliament L. fish was willing to become our socio director for COE she hit the ground running we now have an it's in your read it's in the report we now have a statewide navigator program these navigators will will reach out to all areas of the state including many the rural areas and help patients get the right screening get the rate cancer prevention and ultimately god forbid they get diagnosed with cancer these navigators will help them find the right treatment that may not be in Little Rock in U. M. S. it as long as there's good quality care they can go locally and I have to point out that in math represent Ferguson and really had this idea long before it became popular thank you. so that's the highlights I'm happy to answer any other questions please no if you look at that dollars it's a little unusual in that we've only spent five million but we have committed about forty eight million meaning that these people come into the labs they have a package extends over five years and spend it because not been five years but this is standard for recruitment so. With that I'll stop thank you thank you excited about the things that you're doing we do have a question senator garner yes survived his own out and J. I'm sorry I missed that I was doing something else we've been go back it's not a question shall. Same here. No it again thank you for your presentation this morning and and members be able to serve you be sure to circle up if you have any questions about the progression again excited about what you're doing thank you thank you. All right. We can circle back up. To J. one. So Mr I don't know the best way to handle this because obviously this is approved this is for port it was done by four members of the General Assembly pursuant to rule sixteen but this has some questions in general about it I guess and commoner to I just trying to figure out what's the best Avenue to discuss this issue. Are you want to questions for staff who proved did what what direction you want to go in. I guess my question is it would be I don't know if this proper form and to the members who approved it did you get some basic questions answered so I I just look through it I noticed a few things about this emergency thing that we didn't come to rail C. ASP per allowed by the rules but I noticed that Conway regional health system with one of the ones received a large bonus money. And I would love that have the opportunity to talk to their CEO about a letter they sent a few months ago. A condescending letter to please people requesting a religious exemption for Kobe nineteen vaccine with a compared to multiple other things used for fuel cell research now the CEO had to backtrack on that and say that actually they didn't actually mean that to be condescending air again like it was done but I imagine the CEO would into similar letters for say a Muslim related person and things may have swine related research or other things so my question is different from you I am asking you a mess right now is under state law they can't fire people. Multiple these hospitals have COVID nineteen vaccination policies. Where they fired. Under the free market system that I know you. Expels Senator Dismang multiple nurses I've heard from some of these people been fired. But now this legislative body have given tens of millions of dollars to them for the specific purpose. Of hiring new nurses because of staffing shortages. I guess my question is. If these people are truly a free market system if this is what they're supposed to do there can hire and fire we live under that system and these people fire nurses under that free market system why are they getting massive government bailouts now from the taxpayer dollars of the people they fired. To phone their replacements. Because we can spend our want to but that's exactly what we're doing because per the letter specifically mentions staffing shortages as the reason they need these tens of millions of dollars by the way none of these hospitals in south central Arkansas but I guess we don't have the same needs everybody else and some of the rule areas are not covered as well so I guess it's just I'd love to have that discussion with the CEO understand by the rules that the automated decision because we're an emergency still but I just would like to have some clarification about the thought process for us once again in this free market system bailing out with taxpayer dollars these hospitals. Well I mean in I guess so in some ways and I'll answer it lease from my perspective I might my perspectives there was a need for beds because the surge of armor on in India granted over crown is not been asked Italy thankfully I but there are still a number of folks that have a good time cells and critical situation from it my understanding is that these institutions have the bed space available which is the big thing And needed the ability just to staff at this point you know I've talked my local local hospital and I would urge you to do the same about what their policies are in back on the regard to the free market. The by demonstration put in what I think to be a very faulted a policy but unfortunately it's stood the test of a court decision at this point. And I think what's critical for us is to have those conversations with our local health care folks to see how they plan on implementing. I can say that if you I mean me personally if you read the way that the religious exemption is is made out it's really a strongly held belief is what the qualifier is for that and it's my understanding that most of these institutions are are reading it exactly the same way. but but again I think that's an instant institution by institution basis anyway anyway that's the the basis for my decision on approval can I ask a follow up where you can any specific financial information of these institutions see what their bottom line was I mean at similar to you a mess for you given like basic bank statements to say you know their hundred million dollars in a black where they where they deprive the money to do it I guess that's my question to you is if these needs are available and they can't fund the staffing shortages. Then that makes sense if you were given that information I'd love to see it and make that into your calculations I know my local hospital I would imagine that a lot of them are doing very well financially because of the extensive amount of government money they've received and my understanding is this is to staff up additional beds why can't they use the money they already have the staff up. If if there honey million dollars I mean just this type that say there's a hundred million dollars in the bank account for hospital X.. And they receive this money in their free market they can fire people why don't they provide a free market service and have those beds available and hire additional staff income other bottom line that's what Walmart McDonald's everybody else is having to do for him to up their wages they have to do all these market things a lot of those people especially small businesses are receiving for five million dollar chunks every other month to do basic services I guess that's my question. Again my understanding this was to add additional beds because these institutions have the bed space available but did not have the staffing this is to add additional staffing to take care of the surge that was occurring so that was not a minute someone when your loved ones got sick whatever it may be that there was a space for them to go to. and so I think it's a bit of a different situation but again I appreciate your question thank you Mr for the endorsement for sixty six. Thank you Mr chair It seems to me like this is a lot of money to go through an emergency process likened this of held off until and gone through a regular process like peer Well minute again eight I'm no health care expert but it's my understanding that we anticipate that this surge is going to peak sometime in the next two weeks and in there is quite a bit of time needed to be able to staff up because there is a nursing shortage shortage and that's what you're paying for and so we could have delayed until this Friday and then they would have probably never have the opportunity to open up the additional beds to meet the additional demand as the peak started fall that that's my understanding so were my rationale would it be possible for this committee to receive an accounting of all the funds that have been expended to date from this report from these these bills to see if they actually have used the money in that emergency time frame like they screamed I think that that the you know we've we've done something similar in the past and I I do think department health or someone could probably answer questions but not all not all the time or those funds fully utilized and they can speak to that more directly than I can if someone's here still I know that we are circling back to something. Okay. But if this is you know it just just say the additional bed space ends up not being needed than those funds aren't spent if if I remember correctly this is a after the fact pay out to these institutions not a before the hand before the fact. Yes Sir you're correct this is all costs reimbursement after the but not compared to what they're not occupied and time span this proposed the money will be returned to the committee so how I guess what is the time frame my dad did I miss that. There are we just talking about the one word for you M. S.. We circle back in we're talking about the the Emergency. The Carillion dollars went to the various hospitals you're the don Adams department help the two hundred sixty five beds of already been. Approved or were approved on emergency basis skews me course they're already available now and being used that was approved on January tenth so we did take several weeks or in fact as of yesterday I think we had the last B. it's coming online so it did take a few weeks to get all of those two sixty five an online but it's my understanding that they are now available. in the bill to surge we added a total of two hundred fifty four beds and then with the approval of the U. M. S. so far we've approved two hundred ninety two in this search so far. So I'm not talking about the Delta necessarily the I think that was close to a hundred and twenty four million somewhere in there that we approved hospitals anyway but. This this roughly fifty million I. The just the process that was requested as an emergency so that we it by pressing by pass the legislative committees that needed to sign off on it that's the concern that I have because it's a large amount of money that it was such an emergency that we needed to have that those capacity that those beds up so quickly I just want to see an accounting of. If it was January tenth if they were approved when did they come online and when was this money expended this fifty million dollars that had to be done before this Friday representative Dotson we are put in place is also memorandum of agreement so after we we're approved for the appropriation we make sure that we put in safeguards to to tie back to their proposed letter and then also that they would have to report to us every week the number B. as that are occupied and you know that are being field and then after that after they have actually had patients in the bay and there will submit invoices to us respect our first invoices by the fifteenth of February so everything is on a you know we're going to make sure that they're the cost accounting before we expend any funds so so none of this fifty million has been expended that's correct none of it has been expanded as of today. I guess it wasn't that much of an emergency thank you. They're they're paid in rears are. Since the days after the services are performed are they paid. It in so that's the reason the funds haven't been expended now if you want them to go out and spend the funds prior to providing services by all means. But I think if you listen to what she just said I'm not sure that your final comment is you're hopping off the Mike. Was accurate or appropriate. This was approved on the eleventh we're at the twenty fifth we're approaching the peak of the Makran correct me now all reports point to that. If we do would waited until next week to staff up these better make them available where the funding available or let the institutions know that it was available we would have missed the peak. When it was needed. If you have any other questions. Thank you seed eighty seven. Thank you Mr the. At what point time will you determine the unused funds or is your way to even know that. At this point we won't know we requested that invoicing be submitted on the fifteenth day after services six fifteen day of the month after services have been rendered so we won't know until you know we have different conference summer R. thirty day summer forty five days but until after the dates of good that they propose to expel states have expired then we'll know if there's any unused funds okay I'm going back to the first batch of money I'm thinking back to the first batch of money that we awarded based on what you just said should we already have report of unused money from the first batch money we gave back up I don't see like two three months ago yes I have that I can I can send it to you and I can tell you just what out of committing all the numbers to memory that was a very small amount I think that I know there was one hospital that because they did not our staff is quickly as it had planned and could meet the time frames that they did not Bills for not using the bed so with the small amount but I can get their report to you right to that point in the discussion just heard previous the money that was requested is all gone there's not like a pot sitting out there of unused money. Based on your recollection at this time yes so that money will be returned to return back to the steering committee would not remain with the Department health all right and one last question because the hospitals are pricing in it different when you when you get those invoices do you do a cost analysis between the hospitals to determine why one hospitals able to do an ICU bed for four thousand and another one feels like they've got to four seventy five hundred do you do you do any cost analysis of comparison once you get those invoices and to see why the difference in pricing sorry at this point I have not you know of just you know as I have not now that that I know the department has heard from your concerns this morning we'll go back and take that into consideration and and see what we can do to address that but at this point so no I have not I just process the invoices to pay for the services rendered okay I'm on want that so what discussion thank you thank you Mr. Senator Garner thank you question real quick staff how long do what's the notification okay what's the notification requirements for an ALC meetings is two days before and you can have a meeting. Six days yes so within sixty days you can have a meeting frail seat any time as long as the chairman chair person call for that I just check on that clarification per department health do we have any idea. How many nurses were fired from these hospitals and health care professionals far from the hospitals do the COVID nineteen vaccine mandate. Senator Garner I think that's come up before we've tried to see how we could track that and we don't have a way to do that you know as far as where they work and that sort of thing we don't track we have the nursing board they're not able to track and see where your nurse may moving from job to job I got I got a lot of sympathy for you I mean that's hard to quantify I mean. If we had like the CEOs of the hospitals in front of us who directly do that RCS owes who do the hiring decisions we could probably ask them to get a number for how many people they fired and that just clarification the reason specifically stated in the letter is because of staffing issues as a reason to need this money Mike request back to work in my correct about that request I think so but as a kind of mention to Senator Irvin I think part of the issues we're seeing all these health care workers are currently working are getting sick I noticed in the paper of the reports that you know some some hospitals are down two or three hundred employees so it's not just you know vaccine related individuals it's it's it's individuals are getting sick with all across built or so forth that's fair enough and they have to hire its traveling nurses that expended rate as well so both of the fired and the people are sick enough. So and if we could on that have been there was a state issued on me about on implementing a mandate correct on the bottom bottom mandate so. I mean is that so I guess they would be in the individual institutions that have their own mandate in place would have been the ones that were doing that firing or whatever it may be related to backseat vaccinations but not tied to the mandate is that right I think there was some that were doing it before a new come in and then there be some other state entities I have to work and so I think what senator garner who would like to see and maybe you could reach out to the hospital association is winced institutions were moving forward with a vaccine mandate you know prior to this most recent Supreme Court ruling. court ruling rather seat sixty five. Thank you chairman I appreciate your indulgence just one quick question to clarify for me this money that we're giving the fifty million and the form into you and Mrs that above and beyond what they were received and payment from Medicaid for those patients and from insurances is above and beyond the money that they were receiving payment from those patients that would normally get I'm just trying to get clarification thank you in some cases it will be above it is In my discussions with the hospital it was explained to me is that the rate that they have going to us are not in many cases sufficient to cover the full amount of services that will go into treating at like an ICU patient for coverage I'm sorry can you speak to them I have a hard time hearing I apologize I'm sorry I thought it was okay thank you you're welcome but no I I actually asked that question last week about you know if there's going to be in addition to the Medicaid or Medicare reimbursement and the explanation I was given from hospitals is that in many cases the rate that they gave to us is not going does not cover the full amount of services that will go into amount or call so we're going to services for patients in a COVID I see you be it so it will very it just depends on the nature of what services are needed for that patient so there isn't a good of a set yes or no in some cases it will be less than the Medicaid rate in some cases it will be more. But they will still receive the Medicaid on top of this is what I'm trying to clarify yes ma'am I'm not a date the the hospitals we will bill for the patients they can deal either private insurance or or Medicaid they will way they will be all those patients their pricing structure is based on how much this is going to cost them how much they feel like they'll get reimbursed there's a certain amount of uninsured that they may also have to occur so their pricing structure is not cost based it's what the difference between what they'll get reimbursed and what it will cost them that's how they and that's why there's some difference between prices because there's a different mix of private insurance a public insurance uninsured and those sort of things that can change the price that they are requesting from the health department thank you for that clarification appreciate. Thank you Senator Ingram. Mr Gilmore when you do that research on those nurses that have been fired would you also do research on how many nurses and doctors have retired or quit from burnt out because of people that have not been vaccinated people that don't wear a mask I would appreciate those numbers to compare with the work our people are doing that are burned out is well as find out about the ones that have been fired thank. All right thank you not seeing no other questions were going to move on to the quarterly reports that we're we are. Centerman you're recognized question for staff and I'm sorry this is on a three long time ago but in my understanding that there was money that was not spent by the consultant that was turned back to the Arkansas department of economics at Arkansas Economic. My and the department of commerce my understanding is the contract for the Broadway consultant came in lower than what was expected okay how much sorry I believe is four million right out of the total amount will I don't want to speak too much because I have very limited knowledge on this okay the but I know that it came in under what was anticipated and so they had some excess funds they are already paying you EMS for technical revised through cares funding yep a of requested through this proposal to repurpose that money to use a R. P. money to do that technical reviews oppose using cares money so that was the main thrust of it but need to get the more detail afterwards the agency so I just just wanted to put a pen and that and knows that the kind the contract came in under and I think that's great because we don't see that very often so I just wanted to make that point and I appreciate the clarification and I appreciate the people of doing that and and the fact that it came in under what we expected thank you. Thank you. Amy sharing section L. now these are the quarterly reports we typically do quarterly reports on the second month of the quarter but because as he was pushed back a week and because we'll be going to a session February a majority of the court the parts were available to report this month in order on the agenda we're only missing L. one for DHS and L. for property if in a so start with L. two this is the Office of Attorney General cash settlement fund this report shows quarterly cash account activity therefore details six settlements and show the initials bounce of the cash funds on the first page cash receipts intercept and disbursements from the next pages and it transaction detail reports on the final pages next item is L. three this is for the state police it this report shows asset forfeiture expenditures for each quarter of the fiscal year the first page of the partials eighty thousand expenditures for the second quarter out of the TPC zero one hundred fund that's for federal asset forfeitures and on the second page it shows two engine forty two thousand expenditures at the same quarter this is out of the TPC easier two hundred that is a state asset forfeitures Again L. four and five the federal grant application order ports will be reported a later date to remove into L. six this is the eighty you staff report on Bellavista hazardous waste removal and this report is required by special language that the agency or C. twenty million an additional preparation and the ability to receive a ten million in love a two million dollar loan from the budget stabilization trust fund to remediate the underground fireside Bellavista. Into the report total expenses incurred by the state today are one point three million no expenses were made in the last quarter all expenses of in paid out of the hazardous substance remedial trust fund and a loan from the budget stabilization trust fund was not required will not be required the Bill Evans the property owners association soon ownership over the project completed fire suppression in June twenty nineteen and is currently working restoration plans report states the agency is actively investigating potentially responsible parties who could be held liable to say for the cost of the remedial recovery actions at the site. Sure those are all the quarterly reports members to any questions on the reports. All right seeing none section in. Thank you Mr Gramm monthly reports the first report is for the Arkansas tourism economic development administration grant report last month peer proved in their pure quest for the tourism division to support travel tourism outdoor recreation sectors through planning marketing and media visitor engagement workforce training a condition of approving that request was for the department to come back to the Committee and report on the efforts made towards that project in one instance divisions report according to the report the division is currently completing a plan and budget form to the end of the month in February they'll begin on the activities outlined in the form there's a project here a project here to include with report in accordance with there's a break out of the budget by pro activity with brand development paid media being the largest outlay at one point four five million each activity then has a section to go over details as a timeline under transformational development planning an outside consultant will be hired and representatives from each region will create a plan that reinforces the state's tourism and economic development of vision in this plan will be guided by concepts outlined in the six full points to follow it the next pages go over brain development paid media marketing promotional items outdoor recreation visitor engagement and workforce training. The next report M. two is the income and distribution report for us surplus funds and this shows sources of unobligated funds in the in the distributions from the rainy day restrict reserve long term reserve in long term reserve fund as of the end of December the rainy day fund shows five point four million distributions in a balance of eleven point one million there should reserve Fund shows one hundred nine point four million distributions and overall balance of ninety three point six seven that will be less six million if LC approved on Friday their shooters or transfer that was made that was approved today the long term reserve balances one point two billion. The next item in three the budget stabilization trust fund report and this shows cash flow loans throughout the fiscal year as of the end of December there are sixteen point four six billion in outstanding loans the cash balance is a hundred seventy five million enforce the back of settlement report it gives a summary of income fund balances investments actual payments to the state and on the back page or all expenses a fiscal year. M. fives is the Central Services Fund report and it shows the fund balance in this residence as well as dentures of each agency supported by the fund. M. six is the American recovery plan report the first two pages report show requests that were approved by the A. R. P. steering committee that the state has discretion in awarding cord to report the steering committee has approved six hundred seventy seven point three million requests and the remaining balance of appropriation is nine hundred twenty two point six seven million on the third page begins attachment a this report of a a RP funds that were sent directly to state agencies from various federal and federal entities according to this report one point three six billion in appropriations been awarded for these funds and the last four pages are tested B. that's reported the R. P. funds that were sent directly to institutions of higher education according this report two hundred eighty three point three million appropriations been awarded the remaining balance for preparation for the state agency's entities and institutions from the direct federal awards is two point nine billion. I thank you members will be questions on the reports all right seeing none is there any other business seat forty one. Thank you I had a question on M. one please. If you could just go ahead recognize yourself for the committee and you're welcome proceed with questions. Travis number with a director tourism with the Department of Parks here to toward the. All of Leslie Fisk and chief of legislative affairs for parks heritage and tourism okay thank you my biggest question is on the brand development and paid media is that of something that comes down from the federal government for those passers fines or is it something this state in the regions make up themselves it's something that would that would internally within the state we will we will be able to make those decisions and primarily I'd like to do use this if possible creating new brand assets that could be utilized across all our regions and our other this advertising promotion commissions as well kind of unifying our brand with them as well okay. Follow up please. I would just I was just wondering is there a way to follow that process so that we can see before it becomes the face of Arkansas what it's going to look like. eat yes we we present all our stuff through the S. PRTC skews me up commission and we we we invite any attendance to that and we can also present process along the way for any new creative as we go. And somehow could there be a way to where you could send that to me could I be on that list yes thank you. Yeah we can spend those make sure you're invited to the the commission meetings any of them obviously but the ones that are much benefits for this okay thank you absolutely. Thank you members of any have any other questions I see no thank you all for your time this morning with that let's see other questions any of the reports I don't see any other business if you don't mind please grab your trash on the way out today and thank you for your time this morning we're Jr.