Joint Budget Committee - Pre-Fiscal Session Budget Hearings

Okay we'll get started back cold Joint Budget backed order. The first item on the agenda The Department of Health is Hamilton. You're recognized thank you Mr chairman good afternoon members my name's builder Hamilton with the fiscal division of the bureau we're going to start on page 73 and 74 the budget this is for the health department. They develop policies and plans and enforce regulations for environmental and health protection they have a variety of funding sources it consist of federal funds general revenue some third party reimbursements and sent it back settlement funds the operations budget that we're gonna go over today includes the administration shared services which includes the office of the secretary and the trauma system and tobacco prevention and cessation programs they have a 2300 full time positions and their overall budget is approximately 488000000 which has not changed for about fiscal 22 to fiscal 23. On pages 74 and 75 you'll see the department a House paying shared services account. This was appropriation put in place by transformation is used to pay the secretary department a hell salary and personal services matching. On page 75 you'll see the appropriation summary the executive recommendation for 23 is essentially the same as it was for authorized a fiscal year 22 at $275000. On page 77 you'll see that they have some contracts that were awarded to minority owned businesses that were over 50000 there are 5 contracts listed which is an improvement over last year which only had one contract listed. On page 78 you'll see 10 appropriations this is their department appropriation summary we'll go through each of those very briefly there are not a lot of changes most of the changes are minimal and they consist of changes related to salary and personal services matching adjustments first appropriation is on page 79 goes through page 80 S. FOR EM ****. This is for certification processing expenses of the emergency medical technicians covers your instructors personnel software in their programs it's also funded with visa consist of the certification renewal fees you'll see on page 80 that the recommended appropriation level for 2023 is the same as authorized for 2020 to $60000. I'm page 81 is they're paying account this is their large operations appropriation and covers to central offices in their 92 local health units it also covers the medical marijuana section the kidney disease program and their breast and cervical cancer control programs this is a variety of funding sources that you'll see on page 83 overall however they would like a continuation of their recommended appropriation amount of 360 8000000 that was authorized in 2022 the only anomaly in their budget is for the inspections diseases testing expenses you'll see a line item all with the bottom and it has actual expenditures that are slightly over what the recommended appropriation level is but that's just because they received a transfer from a miscellaneous federal grants program. DO not expecting a large amount in a 2023. Page 84 we're going to the nuclear planning grants appropriation this is a special revenue appropriation and this provides for the 5 counties that receive money there or close proximity to nuclear one. So this is going to cover $325000 recommended in 23. AS in authorized 22 that they expand for the 5 counties that are surrounding nuclear ones so we're talking Conway for the residents of Russellville pope y'all's login and Johnson each one of these entities receives about $65000 annually so they can. Provide for operations maintenance of the system testing response in any person now. Page 86 is a trauma system this is a general revenue funded appropriation. A right now it covers all of the comprehensive entities that are in the trauma care system is fully integrated with hospitals medical services providers and emergency rooms. There are 62 there are listed on the state's website. They're requesting that their appropriation level of 26.1000000. He continued into fiscal year 2023 this is approximately what was authorized in 2022. Page 88 you've got your tobacco prevention and cessation programs this is funded with trust funds from the master settlement agreement. This covers all the program components that are approved by the board of health. From initiated act one. On page 89. You'll see there appropriation summary and request is continue their appropriation level into 2023 of 14.6000000 which is essentially what was authorized in 2022. On page 90 we've got our health building and local grant trust appropriation which is posted which funded skews me with trust funds. This says it is for construction and improvement to the state health buildings but really there's the fund balances have not been high enough for that so they've essentially been using them for any sort of improvements or renovations to the local health units funded from local fees at the health units and moneys that are transferred from the state board of health laboratory revenue fund. Page 91 shows you that the request that they were asking for fiscal year 2023 B. 1.9000000 which is the same as what was authorized in fiscal year 2022. Page 92 is their next appropriations the cash appropriation for wick. Provides for the issuance of vouchers that are redeemable for for the specific foods at local grocery stores. All these funds come from the US department of agriculture and they're held in a cash fund. Any benefits get transferred to vendors and reapers re rebates reimbursements from contracted formula companies you'll see on page. Sorry 93. That the requested appropriation levels about 75.8000000. Even though the expenditures are only about 33.3000000 if you look at the funding sources they actually receive 33.7000000 so they are spending everything that they get this is an appropriation that is contingent on available funding. Page 940 appropriation that is new to the agency it's the full independent practicing credentialing committee committee this was implemented by ACT 769 of 2021 sponsored by Senator Hammer this is a cash in treasury appropriation appropriation has not yet been set up for this appropriation but the committee has been formed my understanding is they are meeting there are some activities going on some rules and regulations are being promulgated an 88 staff is providing support and resources so they're still in the process of getting this appropriation and I believe that the appropriation amount is going to stay the same 350000 for 23 as it was authorized in 2022. Expropriations on page 96 this is a special revenue and funding for the appropriation comes from special revenues. And essentially these are for people who plead guilty or are found guilty for providing services to deaf persons but these persons are not licensed or for entities to provide services to deaf persons and employing people who are not licensed so that's where the funding comes from and it pays for the advisory board expenses you'll see there appropriation summary on page 97 approximately $4800 was spent. The appropriation level is going to be requested at 10000 which is exactly what was authorized in fiscal year 22. This is the last appropriation on page 98. And this is a cash insurer procreation provides for expenses of a COVID 19 media campaign now this this was an appropriation that was approved by a LC back in 28 was approved for a bright 1.3000000 for the public health emergency response communication campaign but as you can see on page 99 almost all of the funds have been expended says appropriation is not going to be requested for fiscal year 23 so there is no recommendation for that and that's the conclusion of my presentation Mr. Thank you miss Hamilton. First off is a representative Springer is your question for staff or the agency. You're good okay. A representative would need your question for staff or the agency. Okay you're recognized. Thank you Mr chairman of. Page. 78 of them to. On the actual expenditures 300 65 360 8000000. Budgeted 586. And then when we give them a recommendation issues or recommendation a legislature 3 360 8000000 360 9000000 but the agency owner requested to 280 3000001 why is that. I'm sorry did you say pay 72737578 I'm sorry 78 he said 78 the first time thank. Okay I'm sorry what what was your question now that I'm on the right page 78 the 7 a 34 P. the second item on the page yes what is there a difference between the 368000000 in 293000000. The agency requests verses the recommendation and then we spent 368000300 so well 68000000. What's the difference okay that that would be an agency or GFA question because the agency doesn't necessarily always get with the executive recommendation is so why they requested that 282.9000000 I can't answer that okay thank you Mr chairman Wallis and engines wait to staff retail department come to reserve Cavenaugh for you. Stafford apartment. R. as anybody else have questions for Mr Hamilton. I will bring up the Department. Hello. Thank you. If you all identify yourselves if you have an opening statement you can make it or we just go right into questions but please identify yourselves for the record. What. Forgive me can you hear me now. Thank you representative thank you very much sentimental I am the secretary of health and director the health department. Casey Carter and I am a deputy director for the department of health. Joe Thompson chief financial officer for the department of health thank you all for being here do you have an opening statement removal straight questions that we would go straight to questions representative all right representative Cavenaugh off you're recognized. Thank you Mr chair I'm over here to your right. I'm going to start my first question is going to be dealing with our page number 87 on the trauma. Our system and just for my record if you can remind me on here where we say try my system expenses that's the biggest expense that is in that area what what is actually covered in that expense. Thank you so in that trauma section and those expenses at let me just flip to those review can speak to the might between the Mike in your mask I can't understand I'm sorry is that better yes thank you thanks thank you for your question so things that are covered in those trauma expenses are the grants to the trauma partners and a general operating expenses if you have more detailed at an explanation that you would like then we can ask Greg brown that's here today to come at what if you could just send out to me when it talks about the grant to how much of this is actually made up of grants and who the grants went to and then what the rest of the expenses are. So we can do so and then I have some other questions you want me to get back in the queue Mister chair how many more yet. 3 we have land make a quick okay. My other question is dealing with Page 89 which is tobacco prevention and cessation programs. On the professional fees on their. What is that paid for. Again. Let me just look at this professional fees we have on this budget line and. That's a variety of. Programs and services that are offered we also have a a contract person at UAMS for scientist position that's paid out of that money as well as children's hospital get some funding effort various programs they support. We used to have a number where they could call to help them quit the quit line yes ma'am be well is adding relating in here anywhere yes ma'am where is that included. M. it's part of the expenses I have associated with that line and that covers things like staff the nicotine replacement therapies as the educational materials things of that nature. If my memory serves me correctly we did away with paying an outside company to handle that I think there was at 1.a company and. Was it St Louis Missouri or somewhere in that area that was actually staffing the help line and actually doing it I thought we have brought that in house and that was covering more than just stop. The smoking there other things that they were trying to handle with that is that correct are we doing that now are we still paying an outside source. Let me referred to as Christy sellers or generate pickle on that question specifically they can give you much more detail thank you. You come to the table. Identify yourself. Because the sellers and Senator actor for that. Mask off I'm over on the right hand and sellers with the Department and with the center for health advancement so we did have an outside entity that did that we did bring it all in house. I can't reporter the question was I'm sorry okay and it covers more than just smoking yes so we also do referrals for diabetes and hypertension programming. That's what I thought Mr I'll get back in the queue. Thank representative. Senator Hammer you're recognized thank you Mr the the first question is going to be on the. Trauma center a trauma system expenses if I'm if I'm reading this right you. Did you spend more than you had budgeted or were you right on target trying to understand the numbers. What paid you own I'm on page 8787 yes Sir. You were going to bring up as code Greg brown please come up and offer explanation of a. I feel identify yourself in a open Mike right there. Yes Sir Greg brown director for preparedness are crumbs System instructions to me systems are. Remind me again other questions please repeat your question percent amateur over here too far left yes Sir good afternoon. On the trauma system expenses the actual in 21 was 17000000 your propose a budget in 22 for less than what you actually spent 21 I'm just curious as to what you anticipate is that covered related that the expenses are going down can you just give in explaining you know there been some are certainly unique challenges over the last couple years of the pharmacist and I think a lot of it. Has has caused us to hospitals not maybe to spend as much on the collar program does it have to focus on other areas such as clothing and other things we've never spent over others to our budget we've always had a little carry forward every year the most most of the expenses that you see in that that decreases we've I think we've had 3 full time positions empty for the last year trying to fill those again probably directly COVID related for those as well so it has some challenges in both staffing and some of our EMS services I've certainly had some challenges as well and not spend a lot of their funding to. And to the EMS question it's a subject you just brought up what are we doing in the pandemic as it ties into the budget for the EMS system are are we doing anything more than we were doing or budgetary wise none of the trauma funding are dark the statute is very clear that has to be spent on trauma related activities so I did that from the funding you know they can certainly spend it on things that they normally would which can include staffing but again the sub grants that we offer or not is robust enough to probably supported me in my service anyway shows anywhere in the budget that we are helping EMS or. Specifically that that you know of no Sir not out of the not out of trouble but it for sure and then last question is on the independent of practice attended a couple of the rule meetings do you guys have an update for where they are as far as when that rules going to get before us. Or we talk off line if you if you don't know real quick I don't know and I will talk online with you okay I just like there were the department is parts of the rules for that so we get it going I will have every bill thank you Mr thank you senator. Of the representative would you're recognized. Thank you Mr chairman my my question is back on page 78. But it also. Ties in with page 83 and that's. 2. Expenses of 360 5000000 budgeted 597. 368 was authorized by the agency's own requesting 292 and Mister Henderson pointed out to me on page 83. Testing disease infectious disease testing expenses your actual expenses and 2021 were 140 8000000 your budget at 352 you authorize 90. But you're only asking for 16000000 here we are going wild on test what. One of the reduction. Miss Thompson road recyclers. Yes Sir the the discrepancy in the numbers is due to the the funding being federal funds and on page 78. The discrepancy is that when we receive our federal funds we generally ask for increased appropriation to the federal through MSG request so where are we are authorized as budget is a set amount we have that that on from page 83 that infectious diseases testing expenses we were given 90000000 to add to that amount so it in essence the reason why the numbers office because much of this is being expended through a sub fund and 34 P. where we get. A an abundance of funds I mean hundreds of thousands of dollars and I'm but actually $0 in an area so this budget report that I have here so does this federal funds of 98000000 you're saying 90 of that went to testing is not considered and that this of the 90000008 years the 90000000 that I'm referencing is in addition to our a normal federal funds is all cover related expenses so really was throwing these numbers off of the hundreds of millions of dollars we've got a federal funds. Where is the where is that shall is shown in that line items are on page 78 on that 57 I mean that. The budgeted 597000121. The majority of those funds are federal COVID release 0 yes I. Your budgeting hundred 7 8000000 this time yes Sir in a little funds yes okay thank you Mr chairman. All right senator Johnson. You're recognized. Thank you Mr chairman of doctor where I've got a couple questions the first one is about to. On the page 83 you have under health operations paid you have a a personal service matches or salaries of 93.2000000 personal service master 32 and then we got and we have professional fees of 1010 0 890 6000 100 $62 could you can flesh that out a little bit and tell me what that actually covers is that include personnel or is it the I think a professional fees is like if I'm. I'm not a doctor obviously but our doctor had it registered with the state medical board and pay my licensing fees is that what that is or is that of consultancy or something on that order. I will not miss that time to give you a greater detail okay Sir to make sure I understand your question you're asking the difference in our profession of personal services matching in a professional fee simple I I know what personal service. I was just going down the list to compare comparison to the number could you tell me what the professional fees on page 83 what what is does that entail Sir entails professional services contracts I mean we have various contracts across the whole department so what we do is we take this appropriation we are outside consult yes okay do you have a. A number anywhere anywhere how many there are. I can get it for you okay I'm not gonna worry about small ones could you give me a list of those it either companies or individuals that for that line item that are over $100000 yes okay great and I have one other quick question I could Mr chairman on page 89. Under it as well make sure I'm seeing this correctly. We're spending or we're requesting. 14.6 almost 14.$7000000 for. Tobacco cessation I realize there's a couple of things up there in this but this is been. As you describe a few moments ago moved in the house of. What in the world within $14000000 other than handing out T. such churches and balloons and say please don't smoke or are maybe put some PSAs that I just I really I'm I'm not supporting tobacco I'm against the back of my mother died of lung cancer but I want to know that we're doing it we're it actually does some good if you could just kind of give me a quick synopsis of what that's actually going for I appreciate thank you. Mr Cochran will give the answer. Thank you. So those plans also cover at in support different programs as well as the B. well hotline in educating and supporting people that are trying to a stop nicotine products so part of that at funding goes to children's hospital part of it goes to teen programs and initiatives it pay staff healthy active Arkansas initiatives are also included in that finding at so there's a variety of things that are going on at surrounding being active and being healthy besides just the focus on at nicotine. So it it's not all tobacco cessation or something and it's I mean when you you mention these expenditures I might be fine with them but that doesn't really tell me exactly what they are is it possible for you to to maybe send me something with more detail absolutely of of that and since it is a whole lot of money I just want to see and I I go back to the original when the settlement was made many years ago I kept thinking that you know we could could rebuild every school in the state and take care of the different lists of people that needs but special help just on the money we're spending saying please don't smoke and I again I'm not saying don't say please don't smoke I'm just I'm I'm starting to drill down on the efficacy of this particular approach to things so I appreciate if you would send that will provide that information to you okay thank you thank you Mr thank you senator. All right we're going to go to. Representive 11 you and had a question yet. Hey Mister doctor Marshall to follow up on something thank understood Senator Hammer question that the department is not done anything for EMS through the pandemic is is that what you stated me not anything federal funds are provided nothing is going towards EMS through your department health that is correct Sir okay and the reason for that is. Well we we don't oversee the EMS itself that is a DHS issue we are we have met with them and heard their concerns but we're not directly involved in that. Thank you. Second wave. Representative Cavenaugh off you're recognized. Thank you Mr chair I'm going to go down to page number 91 which is the health building and local health grant trust information you're asking for 1.95 it shows that the most that you've ever spent thank you is black 1.5. But you're only giving out wide 328000 is what you gave out the last time how come we're not do using more of that granted the bail ability. Mr Johnson what will enter a it is very from year to year depending on if all the funds are expended they're issued out as projects and if there's something that affects the the building of a project at a local unit then the funds may may not be expended during the fiscal year so we need the we're asking for authority to carry forward so in the event that the project is carried out in another year that it that will have the appropriation and with COVID that is affected a lot of the building projects will your your high spending actually came in year 2011 so you're you're you're been trending down in your spending for your health care units but the real thing is if I'm reading this correctly is you have a fund ballot access you have a fund balance and it shows in be like 14.$5000000 is that correct. Of what page are you on male 91. Okay. The fund balance I'm. Excess appropriation funding if you'll notice to go all the way over and it's gonna have a 14.5000000 mmhm. You have a fine balance of 14.5000000 yes we do what are you doing with that money. Thank you one answer that okay. John Adams deputy director so we have to sources of funds that come into this account 1 is $600000 a year specific for local health unit upgrades in rebuilding and so those can fluctuate those projects some take time state 2 and 3 years so we may have 1 year that has a lot of expenses and then the next year not as much the other funding source that comes into this account is from battle records fees and that funding previously was paying for public health lab but we got that note paid off early and we got permission to the legislature to continue to put that money in this account with the hopes that we could build a new or remodeled our current main office on Markham so that money is building up a balance in anticipation of hopefully at some point being able to rebuild or remodel our current main office on Markham. When do you hope to have enough money to do that well it we're in the planning stage we've had a study conducted we met with the governor's office on this and so we are progressing forward but I think it would be 3 to 4 years from now before we would actually start construction but that's the time line we're on because you're really not spending much money or historical span on the other ones I mean it it's low so you're not really even spend anywhere near the 1.9 but this excess just keeps doing it so you're not even spend in the 600000 that should be going out to your local units yes that's the amount that's replenished for the local health units the other amount is set aside for the potential of building a new state office so if you don't use the money that set aside sorry Mr for the local health units does that get put into this excess funding also no ma'am you know the we have a subcommittee of the board of health that reviews proposals from county still of the local health units are actually owned by counties and they apply for a grant from this committee to apply for these funds and so those grants are awarded it's usually not enough to build the facility that sale so they have to find other funding and so sometimes it takes a while to obtain and these projects can occur over you know. 2 to 3 years before they actually are completed so a lot of the money is assigned out but it's not always spent immediately. Okay I I guess I'm confused because your actual spend last year was just 328000 and twenty eight thousand and you're saying that you have 600000 that is already that's false to be going to the counties to the local ones but you're not spending that. And I don't see where you have stored please spend it yes ma'am I don't have that historical trends for country and is in 2011 was our high speed in which is 1.5 dander 376 then there's no spin and then there's 900 there's 800 there's 200 400 700 500 and then there's 50 8000 so I mean there's not showing where you're really spending that and I'm just curious where that money's going. Well it stays in this account this is the only you know purpose that money can be used for I can definitely we can look into this further and provide you some information on the details if you can let me know how much is in that. Fund balance that goes to the local units yes ma'am thank you. And member for a bit of clarification I can that money has to be solicited by the county itself so it it's not money that we that we would appropriate directly is from the county itself so they we we we way for those requests. All right we've got to the representative Fortner you have been asked questions yet. Thank you Mr Speaker that this is the information questions for me on that tobacco cessation that money. Could it are you restricted on how it can be spent does it have to be of literature or can it be of going into the schools like at 1.used to take a dummy or a mannequin and show what the lungs look like I believe there was a device that you could sucked through and simulate what your lung capacity would be with children it could that still be done or to buy playground equipment or things that actually would benefit the younger people because that's where it's going to affect. Hi my name is Jake pickle and I'm the admin for the center for the advancement and yes Sir we're still doing those types of things we said grant out money in the communities and they go in and do some school education and your example dummies is something that we've done in the past the long kits and things like that we've done that we used to do a lot of that at health events of course recently that has not been going on quite as much because of covid but we still work we have coalitions in the school with project prevent we have commit 19 members that are with in those schools they go in and do education in schools there is some limits on what we can do because of course we're. Trying to prevent tobacco's people starting to smoke and people quitting smoking so we do limit our money to specifically to read that research. Follow with. A. What I have seen in my local school districts. When there is a program presented it's more just bring the kids and and just talk. And may be given a leaflet and that's not affect. The items that you mentioned that. Are available I think if they're going to come do it they should make their time worthwhile make to the school's time worthwhile and bring those. Props so the children can actually experience something because his attorney often 5 minutes if you're not animated so that that's my request thank you absolutely thank you. Thank you Sir okay Senator Hammer we're back with you. Although. Right now thank you Mr I just want one thing everyone qualifies something you made the statement while ago about DHS but actually you guys are the regulators of the ammo system correct I wanna make sure that's clear that is correct we are the record so when it comes to DHS's involvement that would be Medicaid reimbursement such as that is that correct I remember seeing that that is correct okay on on our page 78 of our binder it's to the subject of fees under funding sources. And what. When you'll find it let me know because we on the same page. Yes Sir please okay set to 45 of fees. Is that all fees incorporated into one number or is that a what what are those fees comprised of. Mr Johnson will address that to. We have several fees within the apartment and I'm not sure who asked the question yes Sir and and I can get you a list of all the things that go in there I mean along for you know plumbing licenses for different permits is just as of several I mean you I don't even know the full number your number and a list of all the fees that go into the air but not art but here's my question and in in the 2021 actual is right at 20 5000000 but in the budget it's showing 14000000 that's about a $10000000 differential can you expand on the difference between those 2 numbers because if I read it right it looks like you're projecting $10000000 less in fees that that are in the budget my looking at that wrong no Sir you are looking at this right and I actually ask our budget analyst about this for clarification the actual the amount that we brought in and so we anticipate at a minimum ringing in the 14000000 but yes we've exceeded at that minimum amount histamine historically so the the budget announcmenet is an expectation versus what actually comes and we cannot really predict what actually comes in so the actual number the 20 5000000 is that what you actually brought in in the 2021 cycle yes Sir. What I guess and what what what is accounting for losing $10000000 in fees if you're adjusting the budget number in 22 down to 14000000. But Sir the budgeted amount is just is not there's not a we're losing that's just what we anticipate that's not what we brought in so it's just an anticipated announcmenet that we have exceeded the anticipation R. X. expected amount of doing that we exceeded that amount on the fiscal year let me ask questions different way why don't you put in your budget the nearly $25000000 instead leaving it up 14. What was or what we're request is for 19000000 so we have actually increased about 5000000 but it's just you know. I can work with the programs and ask for more details but you know. I'll I'll give more details before this just say my first thought about this but at it if we were to anticipate more in budget more don't bring those fees and that could be a problem with the agency so as it is now we're I see we are $10000000 under budget and we could be closer to that but it would be in our best interest not to over budget. Okay I understand that but it would appear that it it's it's almost like your preparation is right at 20000000. Realistically you know you brought in 25 if you don't think that number's going to go down and you're leaving a 14 that's going to create a surplus I'm just wondering House accounted for or where's that money go to if you're coming in over budget where's it where do we find that money in the budget it would be in our fund balance. And what is your current fund balance for all funding sources here is listed as of 4. The actual for the 2020 to 2021 was 37.7000000 is that indirect way to put money to your fund balance by doing the numbers the way it is on the budget is not our intent it does it is it it may actually end up being that indirectly but that's not our intention to just to pay at our our fund balance but it it does it does both within Africa me toward overall balance okay a thanks for lighted to mission that just seems like an indirect way to pad your bottom line by. No fence adjusting the numbers playing with them whatever term you want to use to where it's going to create money that's going to go to your surplus balance I don't know why we do that verses either going into lowering fees to the people they're paying it in order to make it a true reflection we talk more thank you Mr all right. Representative will assist. You're right Mr. This switch secretary of our own talk about personnel a little that's when your favorite subjects well first of all I want to commend your department for what you'll do is for my colleagues information on the and and D. 5 that we're going to look at perhaps Tomar they have a pager to have positions that they surrendered and I want to commend you for your response to 2 so that new act regarding those vacant positions of over 2 years my question is 11 of 1 of the medical board has 41 positions budgeted are authorized. They had 19 that were public and at the end of the year and then they have 9 that have been vacant for over 2 years can you dress senator do we need to have someone from the medical board. Mr Adams was a don Adams deputy director unfortunately I can not directly address that Matt Gilmore was not able to be here today I know that a lot of our boards and commissions like our department is the trouble feeling position as of late and we're constantly evaluating when a position becomes vacant whether or not we need to fill that or not is the need still there still some positions that we you know that calm vacant we intensely do not refill if we don't feel like we need them but beyond that I would have to get with the medical board to get get the details and we can do those instructions to ensure got 20 of 50 percent of what's budgeted very good then and then 50 percent of those are haven't been filled and let me let me emphasize one of this is so important. You have 89 positions that are vacant over 2 years at the present time. This state you say 38 a of the total 2300 you have or not budget there budget so I took half of them 19 would leave you with 70 positions 70 positions provide a cost EBD or we have to pay we pay $420000 a year. Hello 7 employees that are is not feel it's not a position it's Phil the other thing is. And I made this very clear each and every time I'm not after your money in the agency I'm after was utilization of the funds. Yeah in total the B. D. and the salaries for those 70 people would run 3.$6000000000 and that's in one of the agency and again thank you for what you did but you know how that is thank you so of thank you for what you did yesterday we're going to forward today but I just encourage you to look at those positions thank you thank you Mr chairman. All right of representative. Ringer you have an ask questions you. You're recognized. Hello. Thank you Mr chairman good afternoon I just want to follow back up on senator Helms question of that almost $25000000 in fees that were collected do you know for those fees mainly come from do you can you tell us that the majority of what what of the collections maybe that'll help you. Budget. For future reference if you can identify specifically for you the majority of those fees were collected the total to 25 minutes. Yes ma'am I can I can give you some examples are I can't provide a comprehensive list from memory but we have environmental programs at the health department like or safe drinking water program our food inspection program our plumbing program and those programs levy fees to the licensees and other fees to people like opening up a new restaurant we have plan review fees those sort of things we have health facility permitting agencies that charge fees to hospitals for their certification and inspections so we have a variety of programs in the health department that do licensure state do inspections and certifications and these programs are supported by those fees. So maybe that'll help you in the future to the terminal for the majority come from since you're able to take away those in that way yes ma'am thank you. All righty. Reserve can often get other questions yes thank you Mr chair this questions dealing with page 93 the wick program. The wick program you're asking for a. And the appropriation of 75.$83000000 but last us being with only 33000000. Your Highness B. and was back in 2012 for 69000000 and that has been trending down every year since then. Why. Just. Yes ma'am a couple of points there right now are we case load is at historic lows so we can range anywhere from I've seen it is high and 90000 active a case load per month and right now it's around 50000 now that case load in week trans of closely with the economy so as a county goes up this is a national trend not just in Arkansas our caseloads are caseloads are down which means our food expenses are also now the other issue with that we could instrument is we get rebates so we have to have appropriation to spend the money initially to buy the food packages of the food instruments but then we get rebates and we spend that money again so we have to have double appropriations in order to spend both the original money and then also the reason. So that's why you see a difference between the appropriations in the amount of funding we have okay we'll your rebates are only 18000000 and you spent 33000000 that's a far cry from your procreation quest of 7.8000035.8000000 yes ma'am are are expenses in that program or historic lows because our our caseloads are extort blows. Thank you and well they've been trending down. At the top they just been trending down every year since 2011 no ma'am over the past decade our case load has slowly decreased and that what do you really need that a 75.$8000000 then appropriation if if we say that we're trending down historically for 10 years we can definitely look at that I will say that it can change very quickly if we go into a recession or something happens to the economy our case load can bounce up really really high very quick or inflation hits double digits. Yes you know different different different economic factors can really affect our case load and affect the spending on that account. On your 93 if you'll look it shows that your budget you actually had excess funding of 5.$8000000. In the budget your actual haddock I guess for that year you had excess funding of almost a 0.$5000000. Yes ma'am let me catch up with you I'm sorry. Page again 93. Could you could you repeat your comment I'm apologize down there on the excess funding you'll see that you had a fine balance of $455000 for 21 the budget showed a 5.8000000 in the course it disappears because residents such big but when there's that how much excess funding do you have there is not a 5.8. I'm not order for that to Joe when we may need to bring we've got with program staff here as well see if Joe can answer that question. So your question is how much funding do we have for which now my question is how much excess funding do you have it shows 5.8000000 well 5.8 is how much that we I'm if I'm correct and and to regulate can assist you with this is that that's almost that that we we've budgeted for that year 400 and and 55000 and so it's actually not as is not a deficit is over even though it's an accounting you when you see that it looks like it's under this that's how much more than we budgeted that we expect that they we actually needed for that this one no that's incorrect when this parentheses here that's an extra funding that you have welcome Senator it in excess is over is not a deficit so what are you doing with that extra funds is what I'm asking I would have to detect the program to know exactly but we we have it available for any of which related expenses okay I'd like to know what your fund balance is okay and what you doing with that money will go okay thank you will. Good. And I may be wrong and it's all federally funded correct yes that is correct so there's in there's going to be an audit on that fund on that balance per federal regulations and so that's going to be made it's all going to be very tidy and what they can and cannot do with those dollars at least that's mine and I'm just guessing going on I'm Letona you are correct okay so this isn't some of the state funded and we can you know shift around something else man is gonna be with related and that's what it is and if it's not then the that's come in say everybody's in trouble so thank you. All right to. Senator Dodson you're recognized. Archosauria I feel like you've already left. Thank you Mr chair. Home. At my questions on page 83. The your agency request on a couple of these things operating expenses line item. And. Professional fees. Transcend aid and think maybe infectious disease or touched on but the. Is is less than what the executive recommendation is on these what's the discrepancy there was the exact recommending more than what you're agencies requesting. On those line items. Could you repeat those items so your operating expenses I believe you're asking your agency request a 76.7000000 but the exact rack is 79.8 so $3000000 difference there roughly and professional fees line item. The 1.$4000000 difference you're you're requesting 12000000 exact reckons 13.5. I believe it's the grants and aid line item you're requesting 15000000 exacts recommending 21.8 so 6.1000000 roughly difference and infectious disease line item down there. That 16000000 you're requesting but executives asking for 90000000. What why is why is there a large discrepancy there and. Should we approve the the agency request your request or why is the exact wanting more. Sir I'll tell you honestly that that as far as the executive recommendation may have to get some input from of the FAA or the bureau because. I the only of those I did you ask about the only one that I know for sure without double checking with the FAA or with but within another source is that for the infectious diseases testing expenses as I explained earlier is part of the federal fund right so we have been up for the first time we were at last year we were appropriated that 90000000 so that's why this a larger amount to any of federal funds that we have the we know that we're going to use wanted to the FOR 23 rather than get MSG for those funds will put that in that area so that kind of keeps us from having to come over and request additional corporation as far as the discrepancies from the agency request an executive recommendation I would have to defer to the F. need to make sure I gave the correct answer DEFA available to. Or know the answer to that question. I thank I think you can handle that okay. Read. Thank you Mr chairman. The agency request column listed in the 2223. Call that is less that we're talking about like for example the last commitment item the infectious disease testing expense where they've only requested 15.9 that request is from. Last regular session hearings and it has not been changed so in other words the legislative recommendation reflects that first column right before it reflects what is actually in their bill with the legislative recommended and so the executive recommendation at the far Colomiers that so in other words we're looking at an old agency requests that hasn't been revised so you're saying. The agency request for this particular fiscal year. Is the agency request from fall budget hearing instrument over yes Sir because we we looked at both years and now is our chance to update this year in the in the regular session currently is that I just was unaware that agencies don't annually request specific amount they they didn't have any changes therefore DFA just put their regional request in there they they were happy with legislative record exact correct would be my assumption okay. All right thank you. We're getting down to 2 more field hold of a representative. Johnny Reid. Thank you Mr chairman Dr Meryl I've got something here I think that will will help you are on page 90 thank you Sir. You figured it out Page 91. Where it mentions excess appropriation really that's that's just future building. Remodeling. And if you could take that input that into 2 different places and call it a limiting Building construction phone. And you have one for local and one from the central office it looks like to me that's a good way of doing business because really drop what you're doing here instead of saying we need $150000000 you're taking advantage of the time that that that we're going through now what money is pretty good shape when you get to a year that you know you got to do this work in your novel having money if you don't put it back so basically if you could put those into 2 brackets man I think it's a great way of doing business thank you Sir we will take that advice. Senator hammer you the last question. Thank you I'm back on the feet thing again the the fees are moved to year. Sir plush account. And are those fees designated to any particular cause to where they can't be spent for anything else once removed into that account. Yes Sir you're exactly right the only fees collected for a certain purpose can be expanded for that purpose we do not intermingle funds okay and given the number of fees that you are collecting. How do you differentiate the how much. Of of that total amount. Is reserved for that and and what purpose whatever come up that you would say okay plumbers we need to come in and take your $50000 of that surplus funds okay I'll have to taking the the specifics of how we would expended because I will be more problematic question based on what maybe could come up in a program but as for from a financial perspective for the fees you have separate codes in a down to call centers G. AL general ledger code to to track all the expenses that come in and how we store them you know account for them in our banking system are there all mutually exclusive so there's no into me intermingling of just like a dump for lack of a better way to explain we don't just don't in all the one account each one is separate so we have a way to track every expense the receding office as it comes in and how it's recorded in our banking. All right because. What what I would like is a historical reflection because best I mean we haven't raised fees are allowed fees to be raised. On any of these fees that are represented in this category to 45 is that correct or can you right off top ahead remember if we've allowed any fee increases I am aware of some feet X. of some changes in fee some free I'm not aware of increases but I do know some decreases from 2 fiscal years ago over again our work with our programmatic staff to give you specifics on that from my bit my vantage point I distracted to make sure that we would you know see would bring an end that we keep it recorded up properly but I can get you historical information on any fee changes that we've had at the department okay I'd like to get that historical look back as far as the the usage of those fees because and I'll just give you a heads up where I'm going with this if what you give me indicates that we can come in the next legislative opportunity I would rather give that 5000000 or in my way of looking at 10000000 because you raised it up to nearly 20000000 you collected 24 your previous budget was 14 I'd rather go in their return that 5 or $10000000 back to the people that are paying the fees then see it go to your bottom line and less you can give me good cause as to why we should do that. Yes Sir will work on that and give you a response okay thank you and and will work together to make that happen because we return that money thank you. All right members that's all the questions of doctor Moreau you you and your staff is excused we thank you for your time and come before this committee today. All right members. Of seeing no other questions we need a motion to exempt executive director on the department of health I have a motion and a second is there any discussion. Yes Sir. This is just to send the bill for that they be draft aired for the fiscal session be drafted you just heard my conversation about the fee will have an opportunity to amend any bill once we come back here in the fiscal session okay good thank you all right. All right any other questions or debate. All in favor say aye any opposed. Health department is approved members appreciate a good work we will be back in here to 9:00 tomorrow morning with the department of education we are adjourned.