ALC-Occupational Licensing Review Subcommittee
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- October 6, 2026
Senator Alan Clark
Unverified
3:00
Let's call this meeting to order,
and I've asked Representative Richmond to start us off in prayer and then representative ladyman to lead us in pledge.
Senator Alan Clark
Unverified
5:07
you.
be, I will be relying heavily on my co-chair, Representative Kavanaugh, and on Maddie, because I am not only new to co-chairing this committee, I am new to this committee, so I'll be relying on their experience. Yes, y'all can come forward.
Speaker 15
5:56
Mr. Gilmore, I'm assuming this is Ms. Emory that's with you. That would be correct,
Senator Alan Clark
Unverified
6:10
sir. Okay, the review of report from an occupational authorization entity, Arkansas State Medical Board, Arkansas Department of Health. That's Exhibit B. Would you all like to proceed? Thank you, Mr. Chair. Matt Gilmore, Department of Health.
Speaker 21
6:26
Hello, I'm Amy Embry, I'm the Director of the
Speaker 22
6:32
State Medical Board. Thank you for the opportunity. Ms. Emry's got a few things she'd like to mention and then we'll take any
Speaker 25
6:42
questions y'all might have. Okay, as I said, I'm the Director of the State Medical Board and I was just going to give you some numbers of how many licensees we have at the moment, how many have
Speaker 27
6:54
increased over the past year. Right now, we currently have 19,396 active licensees.
Of those, 12,184 are physicians. And of those 12,184 physicians, 7,313 are located within the state. Of all the licensees that we issue, of course, we license physicians, physician assistants, OTs and OTAs, which are occupational therapist aides or assistants. We license respiratory therapists, radiology assistants, license genetic counselors, and we register surgical techs.
They are not required to get a license just to register with the state. Over the past year, everything has increased in every category except for licensed genetic counselors and the respiratory assistants. The licensed genetic counselors, that is simply because that was a new license in calendar year 20. That's when we had a surge and it has just decreased, which is natural, under a new license. And that's what I have, unless
Representative Frances Cavenaugh
Unverified
8:03
Okay. Representative Cavanaugh. Yes. Can you just give me, for all of the licenses, can you give me how much they have in reserve? If they have a reserve, a carry forward on their balance. And then can you break down their revenue into licensures and what they are or their
fees or penalties or whatever so I can get a breakdown of what their revenue are for each one of the different types of license? She may have, excuse me, Matt
Matt Gilmore
Unverified
8:41
Gilmore. She may have a few of those numbers with you today, but we might can just, if it's okay, provide that. Yes, if you could, that would be great. It is
Speaker 35
8:49
available in ACES. I can get those reports. That's not a problem. Thank you so much. If you just give it to the committee and Maddie can send it out. Yes, thank you. Thank you.
Senator Dan Sullivan
Unverified
9:04
Senator Sullivan. Thank you, Mr. Chair. I know you all expedited your processes I think two or three years ago and I have not had one complaint from anybody about the slowness in your office and getting those expedited licenses through just wanted to compliment you on that that's really been a great thing for our state and our consumers and our people to have more licensed professionals in our state and you've done a
really good job, and I appreciate it. Thank
Speaker 44
9:52
you. Thank you, Mr. Chair. Senator Garner. Thank you. So some of these positions have an annual renewal
Senator Trent Garner
Unverified
9:59
fee of 65 to 100 dollars what's the justification for that amount of money for both the initial
application fee for say like genetic counselor or for the ots the radiation technologists and what is that money used for per year and to pay for that fee We'll try to break this down.
Speaker 25
10:24
Your question had several questions in it. I'll try to break it down as best as I can. Any fees that come in, we are a cash agency, so we are only funded by the licensure fees,
renewal fees, or any other fees that the board issues. We do not have any general revenue whatsoever. Any money that comes in pays for all operations of the board as
Speaker 47
10:46
well as the salaries and benefits of its employees okay so similar
Senator Trent Garner
Unverified
10:52
to what you asked before so you you're funded via licensure correct how many positions do you have what's your expenditures on that what's that position what's that look like as a board itself we
Speaker 25
11:07
are authorized for 41 positions right now i only have
24 positions filled i try only to fill positions that are absolutely necessary i would have to i did not bring my Appropriation Act with me to say exactly how much we have for salaries. Okay, and do you hold, like, what the
Senator Trent Garner
Unverified
11:22
latest question was asked earlier, maybe I'm re-asking it, but do you hold a reserve of money based on that, or do you typically use the revenue to pay for expenses and then pass the savings back on to the people? We do have a fund balance, yes. We
Speaker 56
11:36
do have a fund balance. Do you have a general number of that?
Speaker 25
11:42
I do. Can I generally have it? Right now, I would say we
Speaker 50
11:50
are in an outside bank. The board just voted to move the funds from an outside bank to the state treasury, and I
Matt Gilmore
Unverified
11:59
would say it's between $8 million and $9 million. One thing I'll add as transformation is moving forward, Senator. We're identifying efficiencies. Some of the duties that Ms. Emory and her staff used to take on were able to do that.
So, you know, I think the plan has been moving forward to use those funds to reduce fees going forward and draw down that fund balance over time. So that's kind of what we're doing with other boards, and I think we'll look at that with the medical board as time goes on. That's kind of been the method we're using right now.
Speaker 60
12:30
Okay. Sounds like a good plan. I mean, I'd like
Senator Trent Garner
Unverified
12:36
to know what's the reason to have an $8 to $9 million sitting in an account If there's a legitimate reason for it, I get it,
and you've got to make sure you have rainy day expenses, but that seems extensive for 24 positions, especially whenever that money could be returned back to the people through lower filing fees and renewal fees. Thank you. That's
Speaker 52
12:52
been our way to move forward on that and try to
Matt Gilmore
Unverified
12:55
reduce that, and some of the boards are doing that, the medical board, and we would discuss that with them as well. Thank you. Thank you. Thank you, Mr. Chair.
Senator Greg Leding
Unverified
13:18
With regard to the genetic counselors, you mentioned that it's natural to sort of contract in the second year the license being available, but are we talking like a couple percentage points or is there any sign that the decline might continue?
Speaker 25
13:30
I do have the numbers just to give you an example and we're only in the second year. So one thing we were surprised about the genetic counselors is the number of telemedicine genetic counselors we had. That's the majority of them that we have. So let me get that number here for you.
Speaker 27
13:56
I think it's the very last one. In 2020, we licensed 157. In 2021, we're at
102. So it's not a drastic decline, but it's still a decline. Just for
Senator Greg Leding
Unverified
14:04
clarification, so we license 102 in addition to 157 or we're down to 102 total? Correct. That's just for the year.
Representative Frances Cavenaugh
Unverified
14:15
Okay. Thank you. Representative Kavanaugh. Thank you. I noticed that you were asked, do you provide for automatic licensure for active military? Every one of these say no. Can you explain why you don't do that? We have
Speaker 25
14:27
an expedited process in place, but it also has to do with the criminal background
check, that we need a federal criminal background check. However, every single one of our applications, the first question at the top is, are you active military, veteran, spouse? And if they check that box, they are put to the top of the heap.
Representative Frances Cavenaugh
Unverified
14:45
Do you have an idea how quickly that they get processed?
Speaker 27
14:49
Every application is different. The majority of the applications depend on the applicant getting the information to us. However, and it changes from month to month, just depending on how many come in, but I would say right now the average at the last board meeting, it was between 22 and 26 days.
Senator Alan Clark
Unverified
15:04
to receive a license thank you the following up
on I'm not sure understood the answer to Center Leading's question the there was 152 and then 102 had 150 aren't how did that relate did we did we have
less licensees or no that was the applications that came
Speaker 27
15:33
in that we licensed so in 2020 we did license so
we had that many more correct that's in addition to just the number that we licensed from one year to the next
Speaker 81
15:46
went down slightly and this is not a new license it was
Senator Alan Clark
Unverified
15:50
introduced in 2020 so it is a new license okay was there a
Speaker 27
15:55
problem that we were curing with this license this was not introduced by the board it was introduced by the legislature so we received the act saying that you needed to license this. From what I understand, there was a need in the state for licensed genetic counselors.
Therefore, a bill was introduced and enacted and assigned to the board to license. Okay, but your
Senator Alan Clark
Unverified
16:12
position again is? I'm the director of the
state medical board. Okay, you're the director of the state medical board. Were you all aware of problems that we had that required us to enact legislation to create genetic counseling? No. I did not have that
Speaker 81
16:32
information if it existed. I did not have that information.
Senator Alan Clark
Unverified
16:34
So you at the medical board were not aware of a problem that we were fixing?
And I very well may have voted for this. I'm just, you know, lots of things come through, but you were not aware of a problem, because that's one of the reasons that this committee exists. You're not aware of a problem that we were fixing? No, I was not. Okay, we just created a new license. It seemed to be
Matt Gilmore
Unverified
16:59
a good idea. If I may, Senator, or Mr. Chair, I think that was something that Senator Letting brought to the board, so he may, I'm not trying to put him
Speaker 26
17:06
on the spot, but he may have something he wants to add to the situation.
Senator Greg Leding
Unverified
17:11
Let me hit his... Central lighting. Thank you, Mr. Chair. And you did vote for it. All 35 members of the Senate voted for it, and I think it was unanimous in the House. The story was in October of 2017 or 2018, before the 2019 session, a young woman working as genetic counselor in Rogers came to us to talk to us about the need for licensure in the state. And so I went and spent a day with her in her office and got to see firsthand sort of the power of the work they do,
and we decided we would try to
Speaker 66
17:47
create that license. Okay, but the need... So, well, for her case was that it was, this is a very important service that can
Senator Greg Leding
Unverified
17:55
help people learn if they are genetically predisposed to perhaps develop a certain kind of cancer. But because there was no license here in Arkansas, insurance companies wouldn't necessarily cover the service. So it was just out of reach for a lot of Arkansans. So by creating the license,
Speaker 74
18:11
then insurance companies were more likely to cover the service.
Senator Alan Clark
Unverified
18:15
Okay, so that it was about insurance coverage? Yes. Okay, all right, that's a suitable answer. All right, thank you, Senator.
Speaker 90
18:29
Representative Payton. Thank you, Mr. Chair. I don't want to make you nervous about the fund balance and everything, but that's good information for us to have going into the budget process. knowing that you have eight or nine million that has accumulated not knowing the time frame that it took for that to accumulate is that's an important piece of the puzzle so do you have
any knowledge with you or information on how much surplus there is per year that has created that eight or nine million in fund balance i do not have that with me
Speaker 27
19:02
but on the aces reports i would be able to figure that. If
Speaker 90
19:05
you could send it to us, I'd appreciate that, because, you know, if you're gaining $500,000 a year, then there's not as much slack there as if you're gaining $5 million a year, you know. I understand.
Speaker 89
19:17
Thank you. Thank you, Mr. Chair. Yes,
Maddie, if y'all could gather that information for us.
Senator Cecile Bledsoe
Unverified
19:47
Senator Bledsoe. I'll try it again, push it again, there you go. Thank you Mr. Chair, just to give you an example of how that helps.
We have women who have breast cancer and trying and they have daughters and they just want to know uh the propensity of the disease in relationship to their their young daughters and so you know that can be helpful especially if uh the tests prove that it is apparent that they are susceptible to that within their own families so just in in support of what we're
Senator Alan Clark
Unverified
20:31
trying to do today. Thank you, Senator Bledsoe. And yes, and I wasn't disparaging genetic counselors. I was just asking about the need for a license. And let me follow up on that. I was in the business, we may get representative, COVID's already involved here. I was in the business of installing flooring for most of my life before I needed a license to do so. And I can't see that it's done anything to change the business. Also now, because I bid commercial jobs, had to get
a commercial license, and I am now a commercial contractor. I don't know, and I'll tell everybody here, I don't know the first thing about commercial contracting, but I got the license, buddy, so I can go out legally and bid commercial jobs and do commercial jobs. So, I think there's a lot of questions here we should be asking. That's why the committee exists. Why is a license necessary?
It's not that the job's not important, but is a license necessary, and what does it actually accomplish? Representative Ladyman.
Representative Jack Ladyman
Unverified
21:46
Thank you, Mr. Chair. You gave us some numbers on the number of individuals that were licensed. you know we we hear or I hear I guess everybody does we've got a shortage of doctors within the state so is that number of licensed physicians and I know there's different categories you may
not be able to give us a number but is that growing I mean are we having more this year than last year you got to
Speaker 27
22:19
one I can say now this is just on physicians either the numbers I have for physicians in 2020 I'll give you an example of course that's when the pandemic hit our license our excuse me our number of license issued went up 20 percent the number of telemed licenses that went up was 54 percent and then this year and for example in 2020 there
were 1,109 physicians licensed and right now we're at 1,165 so it went up slightly however there was a huge jump from 19 to 20 so the physicians are increasing everything is increasing except for the two that I said that there was a slight decline or have remained the same so we are seeing more people whether they are physically located in the state we are licensing more people across the board so we you don't know you
Representative Jack Ladyman
Unverified
23:06
you don't know where that growth is more out of state or in state you can't really can you tell that I
Speaker 27
23:13
I could dig deeper into the numbers. That's not a problem. I did say earlier, though, that of the 12,184 physicians that are licensed by the board, 7,313 of those are within the state, meaning they are physically in the state. The remaining are, they could be in Missouri and they practice telemedicine. They could be in California. They could be in
Representative Jack Ladyman
Unverified
23:37
Alaska. Practice telemedicine. Well, I know during the pandemic, we passed legislation to lysine border doctors, so I'm just curious.
I think other people might be interested to know the growth in out-of-state positions versus in-state. I
Speaker 27
23:52
could get that information. That's not a
Senator Alan Clark
Unverified
23:54
problem. You can send that to the chair. Yes, we will gather that information for the committee also. Thank
Representative Frances Cavenaugh
Unverified
24:05
you. Representative Kavanaugh. Thank you, Mr. Chair.
My question deals with the radiologist assistants and the radiology practitioner assistant. There's only nine in the whole state. So what is this licensure? And if
Speaker 106
24:17
there's only nine, I mean, do we need it? I mean, it's such a small number
Speaker 27
24:27
for the whole state. That is a very fair question, a very good question. So what I had
Speaker 25
24:32
to do is I had to speak to a staff member who had institutional knowledge on this. This particular license, this is basically a radiologist assistant, is the equivalent of a PA to a physician. This is an RA to a radiologist. UAMS does have a program in which they can receive
Speaker 27
24:48
their degree to practice this and it is in the statute that we are required to license them. They cannot practice as a radiology assistant without a license. now that whether the need exists I can say we have never received any complaints on radiology assistance and as long as there is a program at the schools teaching this there is going to be a need for a license this used to be years ago and I do mean years ago it used to be licensed at the Department of Health
Speaker 25
25:18
under the radiology section there and there was an issue with one
radiology assistant and then legislation shortly thereafter moved them to the Medical Board and that's how they ended up at the Medical Board. Do
Representative Frances Cavenaugh
Unverified
25:28
you know how many of these are actually new licensures or they just old licensures has been out there for a while? They're old. They're old so we're not really having any new ones
coming into the system? No. Okay thank you so
Speaker 96
25:46
much. Do you anticipate any new ones coming into the system?
Speaker 25
25:50
I would need to contact UAMS to see how many they
have in their program that really it really depends on the
Speaker 27
25:55
schools that have this program and how many graduates they're expecting so I would have to
Senator Alan Clark
Unverified
26:05
reach out to them did I also see on the genetic counselor that there was no specific education required which I'm
good with by the way I just know I I believe
Speaker 28
26:18
there was some education required. Let me get back to that. I want to
Senator Alan Clark
Unverified
26:22
see. Sometimes I miss something when I'm reading that much technical,
but it appeared that you had to just pass the test. You
Speaker 69
26:32
had to have earned a master's degree from a genetic counseling training program that's accredited by an accrediting board, and that's under
Speaker 115
26:39
1795-1106, so they are required to have at least a master's degree. Senator Gilmour.
Senator Ben Gilmore
Unverified
27:01
Thank you, Mr. Chair. Just had a quick question. I wanted to ask about Act 725, I believe it was, the bill that waived certain fees for certain individuals. I wanted to know how that was being implemented with the board because obviously I see fee schedules on here, but
I didn't see anything relating to Act 725. We are in the
Speaker 25
27:24
process of promulgating new rules, and there is going to be no rule that lists all of our fees,
and at the bottom it does have that waiver. So that will be going through the promulgation process. So if
Senator Ben Gilmore
Unverified
27:38
we do come across an applicant, that will be taken care of. Great, because obviously the hope is to
help folks who might find that burdensome to pay that coming out of college or whatever, might help
Senator Alan Clark
Unverified
28:01
increase more people getting that license. But thank you. Appreciate it. Do we ever have a problem, the occupational therapist assistant?
Speaker 25
28:08
Anyone ever get unlicensed? We work on a complaint basis. we do have some complaints against
Speaker 27
28:16
the OTAs how our complaint process works is that obviously we received the complaint it is then sent to the licensee for a chance to respond and then the complaint and the response is presented to the board every single complaint received in our office is reviewed by the board and my my standard answer for that is even if it's something as simple as I didn't like the color on the walls in the waiting room or your care or lack of
of care caused the death of my child. The board sees every single complaint so once they review a complaint in this instance if it's on an OTA if there is a concern they may say we want to see this licensee at the next board meeting so that they can explain the situation and because an OTA requires supervision the board may also
Speaker 81
28:59
require the supervising OT to attend with them.
Senator Alan Clark
Unverified
29:10
Could you explain to me and the committee, mostly to me, more about the physician's assistant and the license and what that person does?
Speaker 81
29:29
A physician assistant is in a doctor's office. Your
Speaker 25
29:33
physician probably has a physician assistant. Some do. Some do not. In this past legislative session, it was passed that a PA is going to be added to the board,
so it will be 12 physicians, two non-physician members, and now one PA. They are required to be licensed just as anybody else. They have a delegation agreement with their supervising physician of what they can and cannot do. Also,
Speaker 27
30:01
in this past session, legislation was passed that increased their prescribing duties in controlled
Senator Alan Clark
Unverified
30:13
substances. And we have over 12,000 licensed MDs in the state.
Speaker 125
30:24
For MDs, we have 11,256, for osteopathic doctors, which are
Speaker 27
30:29
called DOs, we have 928, for a total of 12 184 but they're all physicians
Senator Alan Clark
Unverified
30:47
and respiratory therapist would I be wrong to
assume that that would have been a very busy profession during the pandemic
Speaker 25
30:59
You are correct. It was very busy. With the respiratory therapist, they have to complete their education and take an examination to receive a license. However, during the pandemic, there is a stipulation in the law
Speaker 27
31:12
that allows for me, the executive director, to issue a temporary license after the education has been completed prior to the exam in an emergency situation such as COVID. And that is what we did with the graduating classes of the programs here in Arkansas. We asked them to complete their application and to submit a letter from their program director
Speaker 81
31:33
to let us know that they are safe to practice prior to
Senator Alan Clark
Unverified
31:37
examination. And can you give us an idea of how many
Speaker 53
31:48
of those there were? There were 65. Let's see. I have two separate dates here. hold on just a moment.
Speaker 69
31:55
During the first executive order, there were several executive orders. During the first one, there were 65. During the second one, there were 29. So we had close between 90
Senator Alan Clark
Unverified
32:06
and 100. I'm known for being critical, but my compliments to you
and the governor and everyone involved for moving aside the bureaucracy on that and other things to do the right
thing. The, um, anyone else have
any questions? Seeing none, we're to, uh, y'all have any other remarks? We're C, other business? Or do we have a, this committee seems to have a set
schedule when we meet, so when do we meet next? I'm sorry.
Okay, the next meeting of this committee will be January 27th, which will be after the budget hearings, because we were looking to see if there was a conflict. So, the next meeting will be January 27th. Again, is there any other business?
Hearing none, we are adjourned. Merry Christmas.
Agenda
A. Call to Order
B. Review of Report from an Occupational Authorization Entity: Arkansas State Medical Board, Arkansas Department of Health (ADH) [Exhibit B]
C. Other Business
D. Adjournment
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — ALC - OCCUPATIONAL LICENSING REVIEW SUBCOMMITTEE, Dec 16, 2021 | Agenda | 1 | Official source ↗ |
| Exhibit B - Arkansas State Medical Board | Exhibit | 15 | Official source ↗ |
Speakers
Senator Alan Clark
Unverified
Speaker 9
Speaker 15
Speaker 21
Speaker 22
Speaker 25
Speaker 27
Speaker 28
Representative Frances Cavenaugh
Unverified
Matt Gilmore
Unverified
Speaker 35
Senator Dan Sullivan
Unverified
Speaker 44
Senator Trent Garner
Unverified
Speaker 47
Speaker 56
Speaker 50
Speaker 60
Speaker 52
Senator Greg Leding
Unverified
Speaker 81
Speaker 26
Speaker 66
Speaker 74
Speaker 90
Speaker 89
Senator Cecile Bledsoe
Unverified
Representative Jack Ladyman
Unverified
Speaker 106
Speaker 96
Speaker 69
Speaker 115
Senator Ben Gilmore
Unverified
Speaker 125
Speaker 53