Arkansas Legislative Council (ALC)

Members will drive you see we're going to start in. Representative Fortner. Ready you're recognized for the morning prayer. Let's pray heavenly father I thank you for this beautiful day I thank you for the state we live in for our health. For the ability to do the work you put before so I ask you lord that you will help us today to remember that we represent the people of Arkansas and all that we do. And that we will behave in a manner that you'll be proud of us we ask this in your name amen. I am. Thank you representive. Its members would need a motion to approve last month's meeting minutes our motion have second all those in favor say aye. Oppose ayes have it with that we'll move on to the revenue report in the Senate. If you would introduce yourself a committee and you're recognized oversee. Ellie Stennett BLR. I'm here to. Members of you would to scare conversations out of the room you have the respective representing person thank you. I'm presenting the October revenue report we are four months into this fiscal year compared to the same time last year gross general revenues are up one percent net general revenues are up one point two percent and not available for distribution is up two percent. We are fifteen point eight million dollars above the forecast. In that graph does reflect the forecast revision from October of this year. Gross receipts taxes are up nine point four percent total income taxes are down four point two percent that concludes my report. Any questions on revenue for members. C. nine thank you for your support thank you. That will move on to the read. Executive subcommittee report of recognized co chair rice. Thank you Mr I have four Committee reports exactly subcommittee met November night and heard from the Siegel group regarding its final recommendation for the employee health benefit study subcommittee voted to move forward with recommendations for consideration in the final report at its November eighteenth meeting. Subcommittee also met on November tenth and reviewed proposals submitted in response to the RFP regarding state budgeting and revenue forecasting consulting services. On November eighteenth so getting subcommittee met again that which was yesterday and heard a presentation of the final report for the employee health benefit study or representative Jeff Wardlaw and responses from Jake bleeding B. D. a Director own recommendations in addition to the subcommittees approved approved an amendment to the bureau's contract for outside legal services with Dover Dixon Horne and made a determination to hold until December any action on its revenue consultant or if the and then today we met again at eight thirty and reviewed and approved an emergency rule by EDC regarding the funding on Arkansas rule can connect broadband grant awards after the presentation on the employee health benefits by representative Wardlaw I will move adoption of for this report after that in a copy of this report is in your package represent Wardlaw you're recognized president. Thank you Mr chair we thought that instead of just adopted a report from the executive subcommittee we would offer the full report to the full council this morning so you guys had a full idea of what we have done this summer and you might get a little bit place in going through this report sorry Mr so just give a little background members. Back last September EVD issued a I guess it was in August but September is when the legislature was told about it they issued an order to end pharmacy benefits for retired state employees and they were able to stop the Medicare advantage plan market to fulfill those pharmacy benefits as you're aware the legislatures are fit we were able to stop that and we're to reinstate those benefits but the result of that was to look at the plan and find savings to be able to fund the program and its full potential so it to begin the session March fifteenth we release an RFP through Legislative Council and may twenty first we hired single group. We are secretly gave him six months to give us a report and that full report is what office in a present you guys was our findings there's really two major findings and report those to findings have around pharmacy and retirees so when you look at that report and you go through we'll start with plan designs and contributions when you look at our plan designs we had one major difference we offered the ASP plan it's the state employee's plan a little bit richer benefit plan that we get our teachers so we felt we felt like that was unfair so we want to equalize those plan designs to make sure we're offering the same benefits start teachers that we offered our state employees that change in that recommendation were actually cost the system four million dollars When you look at the medical. When we reviewed of Arkansas Blue Cross blue shield and their benefits and their contract with the state we look at our market numbers we look at our fees we look their discounts they're actually doing a really good job when you compare that across the United States to other states so really want a whole lot of changes there one of the things they asked us to do was to to look at total cost of care approach resident discount and fees right now we put all of our inferences and discount fees they want to put it across and start looking at total cost of care so this bill will go into the pharmacy side pharmacy side it gets it gets a little confusing complicated when you look at the pharmacy benefits and you look at the R. F. P. we put ours be every so often for a PBM as an evil acronym but you have to have them but when you look at that the national average on rebates is about twenty five to thirty percent when you look at Arkansas we were only get together in in about eleven to fifteen percent and we are maybe D. yesterday one of the things that they marked out with the reason our rebates are so low is because we're just we we push heavy generics and when you push the generics the rebate side is is really small there so they admit though that the market has changed since twenty eighteen and they think the rebate business is a little bit higher even on the generic side so they're they're. They're okay with putting out a new RFP it's it's all in how you write that are as P. so we heard from our pharmacy association during the last six months in a real concern that we would push towards a bigger larger PBM that would push mail order pharmacy. Well we looked at Alabama how then was kind of similar to us and how they put their R. P. out on pharmacy Alabama put an incentive in there are three for retail local pharmacist we plan on doing the exact same thing here that way we incentivize our local hometown pharmacist and make sure that our independence have a fair shake at supplying to our hundred sixty one thousand employees and teachers so when I make that clear that this is in no way or form to get away from our local hometown pharmacist that was the pharmacy side and I'm kind of going through this and yesterday we took questions on the set but I just want to go through the whole thing and I'll take some questions at the end. We got down to the savings on that piece looks like it's about twenty five to fifty million and that follows that same twenty five percent to thirty five percent rebate so there's there's a huge difference there but it all bases on that R. F. P. and what level rebate you're able to to get so we look at the Medicare Medicare retired coverage population. So instead of cutting our pharmacy benefits offer cutting our retirees often telling to go shop the market what we want to do what recommendation say do is we'll put our F. P. out to have a Medicare advantage plan for the retiree system that's an E. B. D. Medicare advantage plan so the benefits and that is the federal government Medicare will pay the premium of that Medicare advantage plans so that's where the incentive lies in moving people to an advantage plan so we're able to take advantage of that person's Medicare we're able to take advantage of that savings to our system at that point so what we would do is we would all roll all of our Medicare age the retirees into the system. We would allow for an opt out so these people were in a intense medical situation such as cancer our our such as any other diagnoses that require certain medications we wouldn't want to change their insurance so we are allowing that opt out there so they can stay on the plan their own the waiter formula Aries all match everything stays the same we don't to disrupt anybody's life but we absolutely want to gather all the savings for system for the longevity as possible. So we would do an auto opt out there we would set the plans where the benefits was B. as equal as possible that way the Medicare advantage plan would offer almost the same benefits as the EBD non retiree system would offer. We look at that and we look at the savings is about thirty four to forty one million is what would be gathered by doing a Medicare advantage plan through EBT. So pretty pretty large savings there as well you get into the clinical side. and you look through there and we had a lot of discussion during the session about wellness plans lot a lot of discussion early online discussion last fall and is you know there were some cuts in the wellness plan last fall under some cuts this spring what a consultant says about the wellness plans instead of going to a self service wellness plan we are to go to our results based that we we actually look at what we're getting and we're able to incentivize our members off of what we're seeing and what we're getting there and so instead of running through like cattle it is looking at him and catch and one percent we'll be looking at and trying to catch fifteen to twenty percent of future problems so we'll look at that will roll out a comprehensive diabetes management plan one the biggest cost our plan is diabetes when the biggest. Arguments in this legislature for the last twelve years has been whether we want to keep the dive the berry after surgery program what we learned in the last six months there testimony from a lot of good doctors in the state was that you can actually cure diabetes and upwards of sixty percent I think was the lowest number of cure rate bye bye but performing bariatric surgery there's two different types of bariatric surgery and there's two different results from those very attributes surgeries one has a higher cure rate than the other but you're still care and sixty percent yes I said the number sixty percent of your diabetes at that point we do not want to dis incentivize secure and sixty percent of our diabetes so we want to reinstate bariatric surgeries want to reinstate it without a cap on diabetic patients we want to make sure that we're opening that up to gather up as many of those cure rates as we can grab and and that's one of their recommendations and by putting in a comprehensive diabetic Plan reinstate a bariatric surgeries on on certain diagnoses and looking at a result based Wellness plan you're looking at about ten to fourteen million dollars in savings in that in that category so is you can see we've well paid for that four million dollars equalizing those benefits out and making sure that our teachers have the great benefits in our state employees have have seen so we move on Senator reserve and in funding strategy is where things get a little confusing this whole thing's a little confusing Vaught away but they came in and they gave us a target range for reserve funding we had always been told the number around twenty percent on reserve funding in the past Arkansas this came in and they said twelve to sixteen percent whatever's a few of us members is been playing with a B. D. for number years hello nervous that seems low when you is when you're in state these recommendations your liabilities go down there for your reserve funding shouldn't be as hot so that twelve to sixteen percent not as bad as it as it sounded what we can't hear rain so we need a target so we we set our target at fourteen percent in the recommendations and what we're doing is we're going to set some triggers up if that funding in a reserve funding it's twelve percent use the premiums go up you'll see state contributions go up into we reach back to that fourteen percent. If that thing hits sixteen percent you will see declines in premiums and declines in state contributions so we put triggers on both sides so that people can enjoy the the decrease but they can also have to do entered the increase in order to keep that reserve funding to where it would have to be for the longevity of the program. So we'll come back to funding again in a second So I've lost my. Pager all right so we're going over to the other. And we get into and I'm following along in your reporting your attachment bodily we get into other and we. We've got a lot of trouble in the past with legislation popping up and I'm using insulin legislation for example no fun intended on any member well we pass legislation sometimes it feels good but we don't understand the impact it has to our systems. so what we want to do is ensure a rule a joint rule between house and Senate that would sit that would be similar to our retirement rules of in a retirement committee if you propose legislation let's go through an actual word against theirs actuary the member and the body is aware of the impact of that legislation to the system. So that's all we're doing here is we're put a rule in place so any legislation any any legislation revenue a pharmacy any legislation has to do with benefits any of those pieces of legislation have to go through an actuary and obviously the council would have to hire an actuary for the bureau to use just like we we we do that already for retirement we're doing it now for tax so we would do it for EVD and that actuary would bill to give you a sound recommendation of what that legislation would impact the system. So where we found out insulin was going to impact is about eight million dollars a year we would know that on the front end therefore we would be able to take those votes and now in some of those we may adopt but we bill take that voting good conscious and know what it hit before we actually passed that legislation so I think that's one of the biggest pieces of this price to make sure that we're prudent and now we know what we're voting on and we know how what we're voting on is going to affect our system so we're not sitting here again for money are making changes because of some legislation that we passed in the last session so when you look at the results of the study. It's it's about a seventy million dollar conservative figure that we're willing to say of overall savings to take all those ranges you take the averages we're looking at about a seventy million dollar year savings to the system. So one the biggest things we found to get to that was the way we fund the public school employees and this is another one of the others we fund a public school employees right now basically on elective bases we send them a hundred sixty one dollars and a matrix and we ask them to send that back to the B. D. for every member that elects to be a process by navy day. What is your where we fund and and represent within your really aware of this but we fund state employees to Positions budgeted positions therefore we have a book of open positions that pay the B. D. and we pay that on every position where that position was filled or not. So what we what we've done and what we studied since day one of the study is how can we mimic something similar to that on a teacher side when you look at a public school system they don't really have a lot of open positions nor we push them to have any open positions but they have a lot of positions that don't take the insurance but yet the state is still paying for that insurance but we're paying it to the school district will be able to get that money back and make sure that goes the EBT. We also subsidized to the tune of an average of about fifty five million dollars a year on the public school fund to that same entity. So what we want to do is take that average funding that we give them out Public School Fund. Take that one sixty one add those numbers together so you're looking at about seventy five million plus fifty five million so you have round full numbers here and one divide that out by L. eligible employees at the state level at the school level so you take the matrix and you would take it on five hundred students and divide that out I don't have to explain that and we've all been beaten head over what the matrix is and then we would move that to what we call categorical funding and and moving it to the word categorical funding means it goes straight to DVD. So it will not ever go to school districts it will not be elective it will go straight DVD so you ask yourself what will that do well when you do that you apply a medical CPI to that annually which is about five percent average has been as high as eight percent in the past but it's about five percent average. And you're able to use some of that in adequacy not all some but you're able to apply that percentage therefore every year the funding would go up the same amount as the cost of health care every year so you're not set you're looking at a five year average in a big deficit out there you look at a five year average in your fund is funded you're able to come in your budget for the state and you already know what you have to pay EBD. works very well it sounds very simple it's not it the writing this bill is is one the most complicated things that they've ever been part of but that's probably one the biggest pieces of this pa because that's where our biggest deficit is annually is Public School Fund in number one reason it's our biggest deficit is we don't fund. We fund it when we have to and we don't money in it every time we have to so the whole point in this was to try to fix this stuff to where we not dumping money in when we have to we're dumping money and now going for when it's catastrophic event. That's the point so if that Mr chairman I'd be happy to take any questions from membership. And members for go to questions me give you a little perspective. this affects every county in the state so whether you're interested in it or not and we had some good input from members coming to the many hours that the executive committee is put in this it's affected everybody putting bandaids doing nothing is not an option you got in the red in a few years and this the proposals that we're taking our are not just pine discuss proposals they are they are things that are working in other states in their fact based hello thank bill are for all the work that they've done on this it's it's been a very big deal so with that built referred questions Senator Hammer you're recognized. Thank you Mr represent Wardlaw one thing I'd like to see included in any legislation that's going to be initiated to do this is a regular report that would be brought back to us so that we can track the projected savings and see it actually occurring as things are implemented put in there because right now I know we're deal with projected savings but would rather tract that on a regular schedule bases and get to the end of the year two and find out they didn't meet projections is that possible or is that in the plan in there so if you go to page three I think in your report number two and I'm sorry but I try to hit every single thing we went there and I I I can't do it I'm not efficient enough but number two is ongoing legislative oversight for administration of the plans and what we plan on doing and chairman rice can back me up on this because he actually asked for this is more oversight in the beginning so we can see exactly what's going on and how this stuff is affecting and then as we go and feel more comfortable with the V. D. management of plan we will go to basically a twice a year report or even a once at by our our annual report of two Legislative Council. That is included and there is a comprehensive have your reporting on the front in plan that will come out of that are thank you thank you for the question I'm sorry I did not mention or thank you. Represent major recognized thank you Mr chairman thank you for all the work you've done on this is definitely been a heavy left I have a I have a question to follow up on the my question is you mentioned about the guard rails being put up and if the phone goes blown above certain percent those adjustments to the premiums would they take place on a month by month basis so what the funding is short this month so this month we are premium goes up just for that month or is this a year over year so can you kind of delve into that a little bit and and if that's it if it is a month by month case do a create an opportunity you know everyone take care of your health and there's an opportunity for savings potentially it's it's not a month on month consecutive rolling your average lawyer okay they set the premium plan prices once a year which are okay and then then my follow up that obviously this seems like this is gonna take legislation have you talked to the governor about including this in the special session or something we're going to wait until twenty twenty three to implement it's a good question and also forgot to talk about the governing board I'm looking to Senator Hickey because I know I'm in trouble but once again I can't go through everything all once but there is a a book of legislation that legislation is going to take time to draft we've already started drafting some of it we've already started reviewing some of those drafts The PSC funding bill has already been sent back twice and we met with department of ed and EBT just this week and we send it back again with a lot more changes so it's going to it we're hoping that by December counsel with the president most of the legislation to the council itself and I want to have all the legislation presented to council itself before we go to a session because I think it's important that we go into this as a team we go into this is this is what we're doing and that is why this is how and make sure the public's involved and we get all the comment from the state employees association the the teachers association we will make sure everybody understands what we're going and how we're going to get there because there's gonna be a lot of triggers in this funding going forward one the biggest problems and I talk about the board hearing this answer will be ex problems in previous boards I didn't act okay so when when the plans needed increased they would just come to us for lump sum cash out of rainy day or wherever we pulled it from in their was no acting what we want to do in this legislation is actually have those triggers as you alluded to those guard rails in those triggers would would force the board to it to act so that they're not coming here and asking for those Arkansans and less as I said earlier there is a catastrophic event so we want to make sure that this thing works and works for itself and manages within the funds that **** so that's kinda the purposes here's a set up guardrails but to set up incentive plans and investments for the future that allows it to be able to manage within those guardrails so we want to set up a board of directors and we promised in the wells of the House and Senate they would have representation from the affected groups we want to make sure that this board of directors has educated folks on it that I understand insurance that I understand healthcare that are stand pharmacy and and that those people are incentivized to actually work and to take votes that will ensure the. Plans longevity and ensure the plans are there to to ensure that our state employees have a recruitment tool that folks want to be part of this program or plan sounds like going about this right away based on what you're you're saying is there's probably spring or summer at the earliest before we could actually have us any kind of session to enact this I think the hope is that we an act this whole new plan and we have a capital in place meaning that we have the reserves funded the plan funded in full by by the start of calendar year twenty three so hopefully by the fiscal session we're ready to start looking at legislation from here as far as making that legislation law and in an act and the governing board and all so hopefully by the January council we've presented all the bills and by the time we roll into the fiscal session we're ready to start looking at actual activity thank you thanks to our representative Deffenbaugh you're recognized. Thank you Mr chairperson Godfrey thank you representative for the for your work on this and for leaving us and I have gotten a couple questions about the auto enroll into Medicare advantage or Medicare advantage I understand and that the purpose there and the advantage of thought I'm wondering if you can tell me and just the mechanism for the opt out how folks will know that they have the opportunity to opt out and then and just in your estimate how many folks you have I'm kind of anticipated will make that choice to opt opt out and if it's more or less than you are assuming in these numbers how it may impact the overall stating that we have a lot more folks who choose to opt out of the Medicare advantage so I don't want this come across wrong but I'm very blunt person and I I say things the way it is but last fall it was it was not done correctly there was no education done to the membership there was a letter sent said you're leaving the plan on this date and good luck basically. We do not want to do that and that's one of the key points to making sure that this goes right is it there has to be some education asked and the word communication was used a lot yesterday in the final report that has to be a lot of. Communication education to the membership and especially that age group over. When this is going to happen and how it will work and how that opt out will will play out when the consultants look at other states and and I will get to them in a second because I'm let them chime in on this it seems like on autumn road the only way to go because that insurers most of the members stay there. Of you're gonna have a few members are gonna be high in medical needs as I said earlier and they're going to stay at the planned I have we also have to talk about illness and and I forgot to mention that I mentioned yesterday is some type of requirement period that they had to participate in the program before they get to retirement what we see in the plan is when people don't need us they're not on our plan so we're not gather not premium but I want to get to the retirement age they need us so they they enroll and we're paying for and that's when their cost or the highest so what you want to see in some other states have done is I've got a five year requirement Aegyptus pay five years if you want to grab the retirement benefits when you retire so in this we've got to put some kind of of call back that you participated when you're healthy and and and I hate to say it that way but it's just the fact so I think that's part of it as well but I can't tell you how much I appreciate a single group we stayed here one night during the session really late and we are presentations from three awesome companies across the U. S. of who want to be Arkansas tent and we deliberated in in the conference room over here and and we were all nervous walked out that converts room is executive committee over whether we were going to pick the right person or not but I can tell you today and we haven't seen any savings at some say in this early but I think we picked the right people Matkin and Patrick and and that group have have done an unbelievable job Nick with the pharmacy of. They've done an unbelievable job going through everything in a quick manner the date of these guys have went through is is fast But I'll let them talk about the averages in the numbers because I don't know him to quote him to you but it it will work if you educate the membership and you let him know that they're not losing a benefit there actually gaining some benefits thank you and that was my bigger concern more than the numbers is that the education and communication pieces there because that is a significant change from any of those retirees thank you thank you Mr can if you would can you address that. With the will thank you talked your bones that that we what we put in place and we're recommending is that the Medicare advantage with prescription drug plan That too was that were for the teacher's side yes the plan we're actually looking to reinstate a pharmacy benefit that the the big decisions so so savings from the Medicaid managed medical side will offset the cost an arm he said on the future is basically well what about that first part of that and and and get what the individual market because of the group planned so you guys control but as I of that plan so the the mental load of clothes your current plan as you can probably be a little more enhanced than your current benefits with Medicare group plan usually and supplemental benefits. You're in a you know transportation and meals things like that that in the. Each of those we just. Every year just the fault and into the and a plan that's all it's really doing that in one day and then what so it's not really it's just that I've engages sign in that plan and actually a lot of the state allowed them to to reverse that in a letter to after the call one one if there they didn't realize in that plan and they want to go back they can still switch and go back section of the records of people do it as. The thing is share so the the retiree contribution roughly about half of that the contribution rate is and then this for the state says and the member states and little bit better and better benefits they can access virtually any Medicare provider nationwide not a close network at all then the other states with all actually that eighty five percent that that state plan. Yeah you can you can you I wrote back up from the microphone a little bit or pull back its sentence got some blowback Senate. Yeah. That's a lot better that's a lot okay only one okay so. To repeat but in general the function is that just throw your basically allowing the retiree of the. At to the the Medicare advantage program and then they have the option to start whatever they want and then also the there's usually a couple months after the end of the year they can reverse it back they want to do that as well yes we have got up to eighty percent of that and the other kids that they get and you know the. Pharmacy benefits without the pay that part D. drug cost that they're paying but on the other side me again it's enough for a lower contribution the way it is and there's nothing to talk about winners losers the real numbers is it optional planets next of what your current plan thank you one of the other one. One of the big big pluses here and and I don't think I mentioned it was the teachers lost their pharmacy benefits in two thousand seven the same way state employees almost lost theirs last year and what what we found and moving to the advantage Medicare advantage plans we're gonna be able to instill those benefits back to the teachers so they're going to get those pharmacy benefits back. And and we're still having and enjoying that almost forty one million dollars in savings so that's that's at almost zero cost to the state to be able to put those benefits back. Yes. Our numbers are conservative though actually get better numbers and procurement these are very conservative thinking but we dig in the market you know people what they are comfortable giving us but I know when a procurement or be a lower rate than that one competitive and it is best in class of like cross the country state of our committee either replacements or or options and they're they're gonna very high satisfaction rate with members of the I'm happy to answer any other questions you might have about earlier earlier discussion but any other questions that you do you do it. Okay sent Senator Teague you're recognized for a question. Thank you Mr chairman. Mr chairman you you may not be aware about term limited next year and I had heard that. And the it seems to me as we move forward that. Things tend to be trying to put more power into the what I would call the management of the house and Senate and and make it harder to get things done and and I'm for safeguards in this and that but the flip side of that is. We all be able to access we ought to all be present bills you are I'll be of do things well I had to jump through a whole bunch of hoops I understand why we do it for rules I mean for a. Retirement of and I'm not criticizing by not person I'm just saying that I get concerned when we begin to do this These kind of things that appear to me to make it harder to get things done understand represent Wardlaw position and and I'm not criticizing him or centre hooky Hickey our of Senate chair representative Shepherd I just I just wanted to say that I worry about as we as we tighten things down the. Of that at some point we're gonna wish we had I appreciate your let me speak Sir. Thank you representative back you're recognized. Thank you Mr chair of my question has to do with your talk about lives from the funny down to the category will. As far as a mattress is concerned at being on the Education Committee. We learned that you know the the personnel numbers in the matrix don't match the actual personnel numbers and district so my question is is how we're going to account for that within this server are does move into the categories category of funding take care that. It we we think that we're able to address the language in the categorical funding to address that but that has been a concern yes Sir because one thing you find is a schools that have three hundred fifty students and are looking at a five hundred student matrix that those averages in those employee recommendations are actually higher than what's present in the school so yes there there's going to be some address to that in the language of the of the legislation and and it's being taken into account. Thank you the last one I have is represented with. Thank you Mr chairman Wardlaw alone I won't come in you know it is an and rule report and job and proposal which will come forward with it is something that we needed to address as you and I have discussed for fifteen twenty years maybe even longer thank you all know the good job I only have two questions what will we continue to have the six thousand dollars charge per employee like it is now five hundred a month will that still be and this program is that how we're going to fund it from the contributions signed we're we're not changing the state contribution sign at all the only change on contributions would be to the school system because we want to make sure that we're funding adequately okay so we'll so we'll we'll funded positions vacant or filled either way we're we're not changing the stage that okay the other question I have the school districts also make a contribution to that I understand you correctly that they'll no longer be the case no Sir no Sir and I want to clarify that and I probably didn't and I did yesterday I spent a lot of time on it yesterday okay we do not want to de incentivize school districts that fund above and beyond the amount so a lot there are some school districts and and I'll explain this really well but there are some school districts in the state that pay more on the premium so that they can have a recruitment tool. So we send seventy five million dollars to the schools a year through the matrix we receive a hundred six are hundred eight million a number changes about two million a year under six hundred eight million back that difference there that that. Thirty billion thirty two million dollar difference is. The school district's contribution for recruitment and we're we're actually working on some language to put in the bill that would still incentivize them to use that money for their purposes but what we're hoping is that what we're talking about doing what we're proposing causes a smoothing effect on premiums for the employees teachers so small districts that are able to do that actually don't see those huge increases in premiums per year they'll see a more smooth increase we're hoping is less than five percent. Well that's great that that that that's the that's the that's that's our target I guess is what we need to put it well that's what needed to be done to avoid the big jumps in increases in and so I appreciate it again I want to thank you and and all involved in the consulting the last thing we want is our teachers to get a raise and that raise go all the insurance we have our teachers get a raise won't get a raise and in order to do that we've got to fix the way we fund insurance and. Robin found here's we give you know ten years ago we went through this and and continue every time they get a pay increase the end up with contribution increasing they'd lose it so I'm glad in again I appreciate you thank you Mr chairman thank you Senator Rapert you're recognized. Thank you Mr chair up and thanks for all the work obviously you lost a little bit of sleep I think over this I would be I just I want to clarify about the what's happening with the matrix and the of the funding that's going to go to public education so the money right now that's going to the matrix for health insurance is not going to be disturbed. Is it the money with the money the funding right now that if we work with the matrix right now the money that we put into the matrix to fund adequacy that is undisturbed. It is underserved in a moment but don't proposal is is to pull that out of the matrix input into categorical funding which still gets counted in adequacy categorical and matrix recounted their and then instead of sending that to the school districts in a straight the meeting. In. And I night I had gone there benefits to their bench the benefit and so I assume the discussion with the department of education and with lawyers and whatnot that's going to be okay as for as the meeting and the requirements by the courts just as long as we're getting it funded in an adequate fashion thing that's our number one rule that we're about yeah is that we do not affect that yeah yeah the and that's that's that's good to know but I just wasn't really clear about this is gonna be a new pool of money or whatever the case may be all right thank you so is it going to be a large feet to meet and we have to make sure that we do not affect adequacy and make sure we still meet adequacy brought forward and what we found is that we need to act as a through the percentages we put in if you take the last twelve years I've been here two two point one or two point two percent in the highest we are put in when you look at that on the medic on the medical CPI in history medical CPI averages five percent we've never adequately funded insurance when we've met adequacy through that two percent because we're nowhere near that five percent admit your other Dennis couple of those years it's been as high as eight percent so we've been paid in basically. A fourth of it we should be paying all of it so by moving into this categorical we're able to apply a different percentage to that portion and still count that in our adequacy numbers I know this was mentioned but I'm not sure I understood how would would work are if we have an answer yet so for the school districts have been depending on that insurance money to fund their districts because it is a finding of matrix Not a spending matrix. How have you talked about making up for se Warren school district that has not been putting all of that insurance money I'm to insurance what happened to say hire an assistant principal show a lot of members here want to tell you they represent rural district. But I represent three school districts that are in the three fifty range okay. That use that very money for other purposes right they have to. I met with doctor Tracy Tucker the superintendent hermitage where where I grew up where I still live today I've met with Brian Cornish superintendent worn and I've talked with the other two superintendents Hampton Fordyce on this very subject because this something's bother me all summer because and and representive Eubanks B. and a a long time member of of Education Committee he's sponsor him too because he represents small districts. When I met with them and I showed him what we think will happen with those premiums and asked moved in effect in the ability for them to recruit teachers the small districts now inability for them to actually offer affordable health care where before they were offered healthcare but it wasn't affordable okay we we can all get ourselves but it wasn't affordable because they were looking at ten at eighteen percent increases at one hit because the deficits. When I when I went through all that and I showed him what we think the grass will look like everyone said we'll give up to one sixty one to do that because we can't get a teacher to come to our small districts today And we sure can't get him we show what are benefit package cost but if we can show that these increases are gonna be mild in general over a time period and this cost is going to come morning round because one thing that are often mentioned it today we don't put enough money in from the state side so what you're seeing is planets we're gonna put more money in for state side we should slow down the premium side a lot. So it's going to make our program a lot more attractive for recruitment for the small schools which means the bill to put a teacher in every classroom instead of a map program person and I mean I'll be saying Matt program right but someone is not under certified so they're they're not mad about this I think there will be some somewhere in the state that are mad but minor like this this is going to help us on a long term and they're willing to invest early on for a long term plan that helps them in recruiting teachers and did you talk to have you heard from school districts of different sizes I mean I know I understand the issue with the smallest three fifty I talked to everyone in my district and we have to talk to doctor Hernandez at a small level not at a high level we've we're deep conversations with department of education I like that conversation then we will be on going absolutely this section I will come out past we're good we're gonna we're gonna have a lot of conversations right because I'm I'm with you know birth to the banks and others on this you know how we wrestle with it just seems to make so much sense you are to use it for what it says but that's not the way the major work matrix works so it's a good thing that is on the principle that should be easy it's practicality this really loosely isn't hot yeah all right thank you so much yes ma'am. just for you're recognized. Thank you thank you Mr chairman thank you representative Wardlaw for the work of you and the group that have come together for this my question is very simple I've heard what is going to happen to teachers I've heard what's going to happen state employees I have not heard what's going to happen education support professionals are cafeteria workers all of these folks are you considering them as a part of the teaching group are they've because Transportation Fund something's. Rather than all things and you have the bus drivers who will we have a huge shortage because he lost the benefits of of coming in now school districts don't have people to transport so what we do tell our education support professionals as far as health insurance is concerned we're not we're not changing the eligibility of those people to the program at all so does that are eligible program today will get eligible for program tomorrow okay thank you we had went back and if my memory serves me right we did make an eligible for bus drivers back on the program after we took him off and twenty thirteen and there's no push here to take him back off or to change that at all so we I think when I say that you're here I should say PSE I was trying to stay away from St acronyms but because it is confusing so I was saying teachers to identify the school grade okay so it it is inclusive when I say that to all the school group all right thank you and what do you want us to do today what is our role we just got a doctor's report today we'll see legislation in the future he's a motion in order now Mr. the borders cleared I will take your motion I move that we adopt this report. Adamo motion the richer Wardlaw in motion is being because of the whole executive yes please ma'am. The executive Rick that is that is the four reports that gave them a second second all favor I hi both thank you members again that that's important it's going to affect all of you so we appreciate your time. Thank you membership for all that long report. with that I represent I was recognized Senator Hickey. Thank you Mr a recognized for point of a personal privilege you're recognized yes members there's been some discussion and I want to bring this up because of the importance of it right now to give you a second or two to think about it but there's been some discussion today that we're not going to allow the supplemental and my assumption on that is is that we prefer not to deal with some of the items to drone on their. We have you a mess here today and other entities we've been in discussion with them all week. You all pass that state law which requires them to come before us on that. Any kind of lends itself that if we don't hear them and and don't passes supplemental that possibly that you could be okay with whatever would transpire from there so we have to take that take that into account also. You can not make an informed decision until we hear all this testimony today with the discussion it is transpired this week. And there will be a motion at the end which you know that you would not know about Lissette supplemental is allowed to be heard so I hope you all consider that today we have business to do and I hope we can get passes so that we can continue continuo thank you. Thank you senator. So with that I'd entertain a motion to Spencer rules to hear supplemental calendar. I have a motion the second all those in favor say aye. All opposed. Is have it is with that we'll move on to something supplemental calendar. So the first item of business on supplemental calendar is a request for approval to establish a code baxeen policy submitted pursuant to ACT nine seventy seven of the twenty twenty one regular session. So with that I would recognize Dr cam Patterson chancellor of UAMS. Dr Patterson if you would introduce yourself a committee and you're recognized to proceed. Yes Sir represent Wardlaw Senator Rice and members the Legislative Council my name is campaign or some of the chancellor of the university of Arkansas from. Just get real close to you it's hard to hear those Mike speak up this is this better okay my name is Ken Patterson on the chancellor of the university of Arkansas for medical sciences I am here today to respectfully request approval from the A. L. C. under section B. three of ACT nine seventy seven of twenty twenty one for you M. S. two add COVID nineteen to the list of required vaccines for our employees with reasonable medical and religious exemptions in accordance with the centers for Medicare Medicaid services in a final rule requiring COVID nineteen vaccination for healthcare facilities it is critical for you I must be in full compliance by the January fourth twenty twenty two deadline to prevent an interruption in our programs in all three of our mission areas the Legislative Council and the GA have been incredibly supportive of our mission at a U. M. us and it's something that I am personally very thankful for the this act this decision this request to maintain our ability to continue caring for Medicare and Medicaid patients from all four corners of our state and for training positions of medical professionals and partnering with rural hospitals and providers is essential for healthcare here in the state of Arkansas I thank you for your consideration and continued support of the statewide mission of U. M. us. Thank you a dog person if we would take questions. You senator Gardner your first in the queue thank you Mr chairman look confused about this because I will be clear the way I'm interpreting the law as passed if this legislative balloting made a ruling on this we would actually be correct no legal action let me explain what happened Act nine seven seven which doctor camp Patterson reference was passed by this body. Owned zero four twenty eight twenty twenty one it had the exemption for a L. C. to be able to actually hear this hello I passed. Past two days later became law act one zero three zero it is specifically removed the A. L. C. exemption. Typically in our law the law that was passed last rules if you look at this section of code which a representative day is the exact same reference of the cold so this action by a whole season a legal action underneath the law there's no exemptions within that law to allow a L. C. to over rule of law. And if we do this I think this body if we were to allow this exemption would be putting out there to the public that we traded in legal action so I don't understand how this body is able to circle let the law the way I understand it the law passed said this vaccine for employment cannot happen for any reason. Not if I'll see approves that are otherwise so I like the staff or others to discuss that before we go down this road because this body could be taking a very dangerous action by saying we're approving something we don't have the authority to. So if this notion her noticed brought to the committee on the stand five minute recess. After the great attorneys at the bureau have conspired and looked Act nine seventy seven ACT ten thirty. Well for codified by the co Division commission without revision to either act. ACT ten thirty did not amend the language of ACT nine seven seven and the acts were not in direct conflict we will proceed with the hearing from the entities on on their ACT nine seven seven request with that all moved to senator Hammer for the next question. Thank you Mr just two of. Give me back in the thinking pattern what what is it you here asking for day. I'm here asking for you M. S. to be a able to add Code vaccination to the list of required vaccines for our employees with religious and medical exemptions available to our employees as well. And if you're not granted that permission what happens it according to the final rule of CMS on January fourth if we're not in compliance with the final rule UAMS will lose about six hundred million dollars a year in reimbursement for clinical services from CMS for Medicaid and Medicare services that we provide to our Kansans and we will also lose a hundred million dollars in federal con contracts is basically for our entire research mission so if we are found in noncompliance that will mean that we are not able to provide services for Medicare or Medicaid funded our Kansans it will mean that our residency programs which are funded by CMS will cease to exist that wills impact significant portion of our workforce that will also alter the future of our healthcare provider so as to the doctors and nurses were going to be taking care of us in the future in addition we will lose a number of our programs that are certified independent on CMS that would include a renal transplant program or Nikki program which is almost entirely Medicaid based on it will require us to shut down our level one trauma center we have the only level one trauma center in the state of Arkansas it will mean that we will also impact our ability to staff the VA where we have a significant number of our faculty who practice their as well as Arkansas children's hospital where we provide all the faculty and our educational programs will probably go away because they are all cross subsidized by clinical services and are not is not this. Actually under litigation at the federal level was just is just not one of the lawsuits has been filed by the Attorney General to stop this there are a lawsuits that have been filed you know that three three different final rules for OSHA and for healthcare providers hospitals the OSHA rules have been state there's not been a stay on on this rule. It is not better for their number okay I will let you get back in thank you we have a lot of members on the queue and all I will have to spread the love. You Senator Stubblefield you're recognized for a question thank you Mr chairman the question of do you believe that the vaccine mandates circumvent the HIPAA laws. I'm sorry do I believe a certain believe that vaccine mandates circumvent our HIPAA laws no I do not you're not. Yeah you've you've given us the worst case scenario here your opening statements but in reality you have no certainty or surely that any of this will ever take place and yet. In two months ago sixty days two months ago we allocated six million dollars for you and you know what that six million dollars was given to you for. I don't recall its staffing should be it was it was given to you for staffing shortages. So you were given that money for staffing shortages why would you want to impose further hardships. On people who refused to take an experimental vaccine. After they want to see two years of of living hell. In the middle of war in the middle of one of the worst inflation periods that we have in this country over thirty years. And send them home right before the hot right after the holidays. We don't know for sure if they'll if we're going to lose any Medicaid America Medicare funding at all. Why would you want to do that I don't want to do that are team members Teague U. M. S. our our health care heroes I'm I'm extremely proud of the work that our team members have done there are some members of our team who have differences of opinion about the vaccine I respect that very much and I hope that first of all I have I hope the there is released from the final rule the but as as a steward of the resources of healthcare in the state of Arkansas I have to be prepared for that worst case scenario I will say that I'm I'm we we have had vaccine mandates in place at UAMS for a long time we have them for flu and for for other vaccines we have I I I think a very broad a religious exemption that many of our team members choose to take advantage of and in the time that I have been at U. M. S. the to my knowledge no one who is requested a religious exemption for a vaccine has been denied such an exemption so I hope very much that we preserve our team members that we maintain a hundred percent of our U. S. employees because I'm proud of what they do and I want them to remain part of our team we can't do our work without them. Duck duck one more senator committee chairman I'm more let you have your question but I want to say something first or from the chairman's G. we're watching the board and we have numerous members to ask questions so to make a very prudent that we acknowledge the voting members of council today so to make sure you understand the definition of what I just said the voting members means the members all members and the alternates that will be voting today so we will only be recognized in members that will have a vote today at the current moment because of the board so I don't want to hurt anybody's feelings but I want to know we've got to make sure the folks that have to have a vote today get their questions answered so they can make a prudent vote Senator you're recognized finish your questions or doctor question you your familiar with with the fact from a CMS that over one hundred million Americans have had covid. And it got no for it is big number yes Sir do you believe in natural community there is some national immunity that is compared by by cover nineteen affection sure did you just receive a of raising your salary. the I I did receive a current contract extension that included rates yes Sir just recently yes Sir. All have Mr. Senator Hill you're recognized. Thank you Mr chairman. Doctor Phil over here. You just gave us the sky was falling scenario. How long can you operate without the federal money. We we have about sixty days I and of Cashin on hand. Okay well it sounds to me like if this mandate goes into place and you lose those employees that you're referring to possibly is certainly like those services you're referring to the shut down anyway. If if we lose CMS funding what we would have to pare down what we do to only those clinical services that that generate revenues to cover the cover the cost so there are plenty of services like high risk B. I I mention solid organ transplant our level one trauma center all that will go a our educational programs require clinical revenues to sustain themselves they they they don't generate enough revenues to cover their costs so they will go away and and I research programs or all federally funded so those those go away. Well sometimes in business we have to tighten up and operate and run yes Sir. Represent Dotson you're recognized for a question. Thank you Mr chair Thirty percent you're right in the back row So. If if this I guess do you know Evan idea of how much of your staff is currently unvaccinated and if this goes into effect or if this passes what percentage of your staff to anticipate firing if if you are able to mandate backs and actions for COVID nineteen. Great question I don't know the exact number I know that we get you and us have vaccinated eighty two percent of our employees of the remaining eighteen percent and that number is going up because of our employees are continuing to elect to get vaccinated but the remaining eighteen percent what we don't know because we haven't asked is how many of them had been vaccinated somewhere else my my rough feeling is that at least half of them had been vaccinated somewhere else besides you M. as a sort we're starting from of a pretty good place so if you lose ten percent or nine or ten percent of your workforce how many people is that. so we have about a depending on how you count about twelve thousand. Lawyers if you look across the country and and even across Arkansas in hospitals that have required COVID nineteen vaccines of about zero point five percent of the employees I choose not to get vaccinated I think our because we have a much broader religious exemption then is available in most other than is available in most other parts of the country I think our number can be even lower than that. And I hope it is I can't you know My hope thank you Mr zero. Senator Clark you're recognized for a question thank you Mr. Of. Changed for of it isn't it true that you're already in violation of Agnon seventy seven. I I I don't know the weather we technically are we we we have notified our employees that there's the January fifth deadline and I wish that we had had the opportunity to spend more time with you before we did that the reason why we were so tardy in coming to the A. L. C. is that we had anticipated getting the final rule from CMS on October first and we didn't get it I I think until November the seventh. And since our employees need to be getting their first dose of the vaccine by December the fifth time was really of the essence I've talked to Senator Hickey and Speaker shall. Let them know that I apologize for the timing that's been part of our conversations this week and we will our hope is that we'll be able to abide both by the wishes of the Legislative Council and see about us and making sure that our employees are are are safe and they were able to operate. The So you have it already told your employees that there was a vaccine and. We have informed our employees that that the CMS final rule requires us to have a vaccine mandate in order to be comply with with are to be in accordance with CMS regulations and that they would be voluntarily terminated if they weren't vaccinated eight according to the CMS regulations that that is the case yes. So what let me go down time one that I have. Late July I believe but certainly early August I begin to get phone calls from and emails from UAMS employees most to to know each other of saying that they were concerned that there will be vaccine mandates at UAMS and that you. Of were saying that you wanted boxing mandates a UAMS and that you were trying to find a way around ACT nine seventy seven of. The I have never said that. Just I'm just telling you yes Sir numerous employees who didn't know each other. Of the. Monday. Receive a newsletter that says that you all have vaccine mandates Tuesday Senator Garner I bring it up. In a meeting here. Of because something from UAMS came up and I asked what would be the the brought venue to bring up the fact that your breaking the law of and as a result of that we invited you to be here and then we got a request of that of. That we. I make an exception under recognised sent me some. Other than what you say that you were not looking to. The to the vaccine mandates back in August those arrested is there anything wrong with the rest of my time on. I I would I would argue with that I I know that we worked on the letter to the this body over the weekend I'm not sure when it actually have a I would have thought it would have been before Tuesday but if the drive to see the arrive Tuesday. Mr could I ask when the Little Rock. I would acid you get back in the queue like I asked senator Hammer let me move there's a board. Well this is a question for staff. staff here yes. I'm sorry your asking when we received the letter requesting we receive that Wednesday night. Thank you. Which I would say Senator I'll add to that because there has been some statements this morning that we have manipulated agenda. The reason for the supplemental agendas because that rob after the six day notice so the chairs do not have the right to manipulate that agenda so as you see you A. B. B. has a request on the supplemental as well and those are added to the supplemental when they come in past that six day notice and that's reason we hold that threshold higher than the other well I haven't said anything like that Mr I'm aware but I would say that we should consider that as we consider two thirds vote to to do anything or not without which we reach that threshold. President makes you're recognized for a question language German I'm right here in front of you. Thank you for being here this morning so my my question and concern around this is and you said your testimony and I just ask that you reiterated. Is a lot of the employees have concerns because they've heard and there's been all sorts of reports about people who have requested exemptions for medical reasons or for religious beliefs that those have been denied across the board that employers are being strong armed into accepting this mandated or course. Or being forced to leave because these you know we're we're there are paid places that are just not accepting those religious exemptions so would you testify here in public in front of this committee in front of the employees that are here that if this mandate is put into place that you will honor those religious exemptions that they bring forth absolutely and if I can explain our process so that everybody understands that we we have an existing committee that reviews religious exemption requests for our vaccines of that process I think works very well It you and us there are two ways that an employee can request a religious exemption the employee can get a letter from my past or other religious leader stipulating to the need for a religious exemption or the employee can write a letter themselves under oath stating that they are requesting a religious exemption I take that those matters very seriously as god fearing or Kansan I I know that deeply held beliefs need to be respected and as I mentioned before at least in time that I have been at UAMS we have never denied a religious exemption and there's no reason for that to change just because we're now adding COVID nineteen or work hoping to add COVID nineteen to list of vaccines that are required all also let the committee know that if our vaccine religious exemption committee elects to deny a religious exemption request and again that's never happened but if they do I have confirmed with the committee members. That they don't have the final rule on that and that that will then go straight straight to me for adjudication okay because the I think is you and I both agree right of conscience is one of our most fundamental right here in this country wanna make sure that that is that is protected my my and so with that being sad I should never none of us up here if this passes should ever hear from constituents that says UAMS tonight are religious exemption there's no reason for that for that to be the case of you know if something strange happened with the request I'll make sure that this body knows about it okay my my follow up is if this is denied how will CMS know if there's compliance is that something you self report or is that something that they come down and all your files how is the CMS determine whether you're and compliance with their rules on this I I at I'm hi if I'm not exactly correct all I ask my religious council to I'm on my religious because. I probably needs religious council right now. lastly legal counsel to correct me but I I believe we take a test to it and and that we're subject to audit all right thank you thank you Mr. What a lighten up the mood we need. Well we'll go to Senator Ballinger. Thank you Mr the I know we keep referencing the final rule but is actually an interim final emergency rule correct that's correct yes so the notice period is out right now. Yes so the final rule could actually be something altogether different correct it could be yes Sir so my issue is not that we're dealing with this but I don't think anybody here wants us to to at least at this point four go Medicaid Medicare money we're not in a position that will be able to handle it without hurting our people. But what we're looking at is we have a a rule that's an animal that is just now in the notice period that is being litigated by twenty five states that are that's seven. And we've just had success on social factors has withdrawn and decide not to you know force right. So what we're doing is we're violating state law or or at least with the with the people of Arkansas they don't want the state of Arkansas farm people expressly when we're in healthcare shortages because they don't want to take a backseat because they have a difference of opinion. And there are opportunities for us to deal with this later if you know the rule in the be an up hill and the final rule when it comes out is something that we can't comply with consistent with state law. We can have a LC needed just a matter of few days. And to me it seems like you're really pushing this and I I you know I I don't want to be a jerk but it feels like you're doing this because you want to do this because you want to implement the vaccine you want to fire people who aren't willing to get the vaccine rather than it and if not then the pull down change your policy and wait until you have to do it do you understand where that how it could be said. If we have another outburst will clear the room. We do not tolerate outburst in the room. Senator you can per se thank you do you see how it could be perceived that way I I I hope it's not perceived that way and I want this body to know that we did not come before this body requesting an exemption until the CMS rule was in place we like I thank I guess we could have I'm not sure what the reception would have been but our reason for being here is to maintain the fiscal integrity of the U. M. us and I hope that we do that with a hundred percent of our current team members on board it in fact because other hospitals all the other hospitals in in central Arkansas have implemented a vaccine mandate of maybe some of the people who choose not to work those hospitals will come to you M. S. and take advantage of our religious exemption that will have more and better healthcare workers you'll have us that would be my hope. So. In light of some of the questions Senator Ballinger asked I had asked the attorney general's office to be present to give an update on some of those terms that you brought up that may not be as familiar to the rest of the committee such as final rule and the notice to rule and where the lawsuit status is if the membership would like we can go ahead and have that update or we can hold that update to after testimony UAMS I just wanna make that clear that we do have them here to address some of these definitions and some of these of terms. Bring on up so if turning General's office would come on to the table we'll go ahead and get that update and talk through some of those terms. And are not person if you would just stay present at the table please. Yeah. I know you want to leave. Mister nine Mr Boeing if you would introduce yourself for the record and you're recognized to give. The best update you can. Thank you good morning Mister chair good morning members of the committee my name is Brian I'm the legislative director for the Arkansas Attorney General. Good morning members my name is Brian bell and I'm the chief of staff for the attorney general's office. I I will start probably to give you all the best overview of where we are currently and are pending litigation on both the OSHA rule as well as the CMS role we have been successful thus far and challenging the as shown regulation mandating back vaccines there is a permanent injunction or that has been entered in the fifth circuit. Monday of this week because multiple jurisdictions filed and went to a lottery system which is standard practice in the federal court system and has been assigned to the sixth circuit no action or no movement really has has occurred in the sixth circuit since it's been assigned by the injunctive relief issue by the fifth circuit. Vacating that the OSHA role is still in place. For the CMS role. It is a bit different and will not move quite as quickly as the OSHA challenge dead. Briefing schedules have been expedited however and final briefings from all parties involved should be concluded by November the twenty third and based on communications from the court we anticipate a ruling hopefully the week of November the twenty night on our request to enjoin the CMS role. There is never a guarantee that it will happen that quickly but signaling from the Court indicates that they understand the importance of making a decision prior to the implementation date that has been listed Senator Ballinger was correct that this is an interim propose propose interim final rule in the event that we are not successful new ticket there are other jurisdictions that are hearing similar cases and there may be an injunction granted and a different jurisdiction. I think everyone that has filed challenges to the CMS role it is my understanding that they have asked for if the injunction is granted that it would be a nationwide injunction granted but there is never a guarantee that that that those will be granted. With that I've just given you a lot of information so I'm happy to answer any questions you all might have. Members here's what I'm gonna do I'm all clear the board. And I'm all allow members to have questions for the attorney general's office to light up on the board. So that I can tell the difference between the questions. So if you want if you have a question for Attorney General's office please enter button now. Representative Payton you're recognized for a question for the attorney general's office thank you Mr chair so I know there's a do a huge difference between the OSHA rule and the CMS role. But at least one federal judge his. Saul the potential. Of a problem with the OSHA rule. And so therefore you he implemented a stay until he can determine whether it violates constitutional rights but it's about constitutional rights isn't. So representative Payton I'm I'm a try to address your question if I'm off base I'll be happy to correct me a you know there is a distinction to be drawn between the the OSHA rule that we have received the injunction in in the fifth circuit and the CMS role the CMS rule is a little more complicated because there is a precedent in the court's longstanding precedent. That federal dollars going to states the feds can attach conditions are strings receiving that money this the states back to so far there are up for the point of time what I would like you to weigh in on. Is if this is about a person's individual rights. To take a vaccine or not take a vaccine. And whether they can be forced to buy their employer if that's what it's about does the fact that they would work for a car lot versus the fact that they work for university or hospital change their constitutional rights. So as a representative there there is a there is a distinction and and I think the last time I I dress Committee on this topic I I talked a little bit about it you know we're talking the difference between a a state actor in UAMS versus a private employer the private employer is is a different animal it's a more of a contract between the employee and the employer for for employment a state actor is. A potentially a whenever they input enforce a a mandate or any condition of employment you know there could be an argument that it is a a state action being taken but there is also Supreme Court precedent dating back to nineteen oh five decision dealing with the small pox vaccination that seems to suggest that. That sort of mandate it is proper release the court has held in the past and and that is part of what we're addressing our litigation currently. Thank you thank you Mr. Members I would also remind everyone that there is litigation pending an announcmenet information that can be given is limited and therefore to turn jobs offices not avoiding your questions and not void and answer your questions they are taking care of their jobs at hand with that senator Hammer you're recognized for a question for the attorney general's office thank you Mr. It goes before the judge and I think you're estimating maybe November twenty ninth to determine whether it's going to put a stay on it what kind of state that's going to be let's say he does that and the clock starts ticking at that point all the other litigation works out and then he comes back or she comes back and says or they come back and say you know what we were going to let it we're gonna let the mandate state and. In the meantime the clock is ticking as far as what the original order said that people have to get their shot by how does that play out as far as would they extend that time frame to get us further into the first next year or how is that even addressed in the lawsuit if at all. So Senator that would require probably a bit too much speculation on our part we can't really be certain what the feds would do on the in the OSHA of pulmonary injunction with the fifth circuit once that was granted the. The fed through OSHA actually took the step to back off of pursuing the rule and tell litigation could come to fruition until they could get a final answer from the courts I imagine if a PI a a pulmonary injunction is granted on the CMS issue that the federal government would probably take the same approach As far as extending timelines for having your employees vaccinated I'm not sure what would happen it would seem logical that if the deadlines keep moving to the right because the courts they would also have to give us more time to comply but again it's it's speculation I'm not certain. And refresh my memory. In the in the lawsuit or in the mandated requirement that's being challenged did allow for testing or for submission that you have antigen in your system or what was that even in the lawsuit I don't remember so senator on the CMS mandate it's my understanding that there is not currently an option for antigen testing or weekly testing in the interim role so straight up and down mandate on the vaccine that that is my understanding at this time yes are thank you thank Mr. Senator flowers you're recognized for a question. Thank you Mr. I wanted some clarification when you're talking about this the OSHA case. And the fact that the there's a permanent injunction of by the fifth circuit that's because it's been transferred to the sixth circuit is it not and consolidated with the other cases. And you as you said they back down for the litigation to to continue in the sixth circuit. Is that your understanding. So I make sure I understand your question so procedurally us. The cases have been consolidated to the sixth circuit but no one has lifted the stay or the injunctive relief that was granted by the fifth circuit so that still stands as of Tuesday right but that doesn't mean that the outcome. May be that there is a reversal of that permanent injunction against the rule that that I think is a fair assessment there is never any guarantee just clarification went when you're in the court system the sixth circuit could agree with the fifth or they could not so I but but as it stands today the OSHA regulation has been stayed by the fifth circuit they've pulled down their implementation and hi at this stage I. Thank you we're in a wait and see approach as to what the what the sixth circuit us. I ask the question because I'm concerned that people start using the term victory and and nothing has been finally resolved. Would you agree I Depending on your viewpoint of the position but I would say that the fifth circuit. Was a victory for for the fifth circuit. Senator Mark Johnson. Thank you Mr a German. Are you where the twenty twelve Supreme Court decision that CMS could not withhold funds run state for not adopting Medicaid expansion under the affordable Care Act and does that have application to the situations. Senator it has been a number of years since I've looked at that decision I. You unfortunately I think is distinguishable Medicaid expansion was and an optional program verses what CMS is arguing now that the mandate is a condition of participation so I'm afraid an inmate without going back to the opinion refreshing my memory I I think there would be a distinction between the two. I don't want to. Get you too far the ways because as may have some day if your brief before the but I have a question going to ask doctor someone ask you first and this is not disrespectful to him at all it's just enquiring. Is doctor Patterson state employee. He could stipulate to it but not if you want so I don't if there is a follow up that clarifies what I'm asking is. At. I have not not trying to avoid your question but I don't I'm not certain and I think that. I am yes Sir he so you do stipulate you are state employee a. So as a state employee doctor person would have qualified immunity in his actions official actions is that correct Mr roller. That's a fair assessment yes okay yeah that's a munity of somebody follows the law if you're a police officer and you do something that's outside the law then you're qualified immunity is comes into question at that point is that not correct I think that there's several factors that could raise any state official beyond protections afforded either and and any immunities situation that that you all enjoy where we enjoy state employees okay but again you're you're enjoy that protection when you're following the law in essence is that correct in essence yes Sir okay thank you very much for that thank you Mr. President of hot you're recognized for a question. Thank you Mr chairman my question for the attorney general's office is should not the constitutionality of the rules be determined before the deadlines are set and if so what the attorney general's office recommended delaying action until a final rule by the federal government. So it in the general rule making process rules or or promulgated put out for public comment either through the emergency or normal process and it would be the duty for someone to challenge those roles which is what is taking place right now there is a challenge to a proposed rule that we feel is unconstitutional if you're asking us. Whether or not the agency should be here asking. For permission today in the event of. It is hard for us to speculate outcomes of cases and I think that I and I don't want to speak for those that are here today to talk to you all. From what I've seen it seems that they're asking for a plan of action in the event that we are unsuccessful and litigation. and I may be misunderstanding what they have said unto you all but it seems to be that's what they're here to talk to all about today. there is no guarantee when litigation will resolve itself or how quickly there have been deadlines assessed by the federal government and we are hopeful a that we're successful on challenges if not we are hopeful that the federal government will extend the deadlines that they've set out thus far so it's very hard for us to answer that question directly I'm not trying to avoid your question but there are too many factors at play for us to say. Have them come back in a month we may not know by then and we deadlines may have come and gone or deadlines may be extended in as we sat in the OSHA rule implementation they have extended those deadlines and if memory serves me correct to on the federal contractor mandate deadlines of it have been extended in that case too so it it's very difficult for us to answer that question. I guess my follow up would be like should deadlines be more important than constitutionality of rights of our Kansans. At I'm a. I want to be clear and we are challenging the constitutionality of the US and and when you're asking that question the question and we would have to defer to the agency's really to answer that question and members once again I remind you that we are in litigation and the answer is that we given will be very limited and it will be very limited in scope to make sure that our litigation is as successful as possible so as to be really careful what are questions to make sure we don't put our Attorney General an awkward position. Senator Ballinger you're recognized. Thank you Mr at it if if this doesn't pass today this request so you technically you know they will be complying with all if they would have waited to issue the mandate clearly until they came and asked the LC then they'd be in compliance with this law act nine seven seven the question about the additional law may be a different question but we're we're moving on past that but it if this if we do not give approval today for them to issue the vaccine mandate what the general recommend that an agency of the state not move forward in violation of of ACT nine seventy seven or act to know thirty for that matter. In till we either see the final rule or we see what the situation is with litigation would you would you recommend them to not move forward in violation of state law. This recording is on play appear. as so at. I don't know that it is really are. Within our purview. As the attorneys to recommend one way or the other I think that that that the responsibility or the decision making at that point would be on those that are receiving the Medicaid dollars. To have to make the decision of do we lose funding or do we have an issue with our what with nine seven seven or any other act again is you all heard us. We as attorneys can advise all day long but it does not mean that any of our clients have to take our advice Recognizing to that the university system has their own counsel. and many of the state agencies that you'll hear from today I have their own in house counsel to which may. Be advising those entities and I don't want to speak for the university of Arkansas system and systems attorneys or any of my fellow attorneys and other state agencies that's that's probably a question better served for them. Senator Irvin you're recognized for a question. Thank you Mr chair during the promulgation of this rules that were challenging that the Arkansas the Attorney General is challenging and the time of public comment has any legislature weighed in on with the resolution has been passed. And during public comment of the rules and would that be any with that be an acceptable public comments would be a resolution from a legislative body. With that being acceptable public comment so senator I'm unaware if anyone from Arkansas has made a public comment to the feds for regarding these proposed rules the rules are are fairly clear that any interested person can make a public comment during the public comment period whether that be individually by interested parties or by a resolution of this body I think either would suffice. Right and so the question I guess to the chair No member of this legislative body has put forward a resolution. to make a public comment on the constitutionality of these rules we don't I mean we could have right any member of this legislative body could write a resolution presented before this legislative body as a resolution for us to vote on and to pass as public comment to be submitted to the to the to the federal CMS of the public comment of those rules that's correct right. So we as a legislative body could actually take that action separate and apart from your lawsuits that's correct right. Yes Sir that is correct okay thank you. Thank you senator. Representative Ladyman you're recognized. Thank you Mr chairman. my question kind of is what represented Hawke's talked about if we're talking deadlines versus constitutionality. What a what if a government agency implements a rule that is determined and and puts it in place puts a date land puts it in place and is determined to be unconstitutional by a court at a later date. What penalties I mean what happens what responsibility does that government agency or that department have because they've implemented they've falsely implemented unconstitutional act by putting a deadline in and I I think we're seeing this being done a number of times so what's your response that. What representative Ladyman similarly to how the rule making process works here in Arkansas that you're very familiar with. If an. Government body an agency goes to the proper rule making process the rule is presumed to be a proper rule Intel it is challenged so if a rule were to go into a place and a there is a deadline looming and the deadline passes and is subsequently that rule is is challenged ending to be unconstitutional it's very difficult for there to be any redress at that point which is the whole purpose of us filing suit and seeking a preliminary injunction the point of a preliminary injunction is to stay a rule pending that challenge arguing that if the challenge is not excuse me if the action is not state until a ruling is made that there may be irreparable harm to a party so that's that's exactly what we're pursuing to the court system. So there's no repercussions for an agency that implements something they may even though was unconstitutional because the so the the time that it takes to go through the legal representative representative there are I mean there's some some copy odds out there I mean if if an action was. I think deem to alternately to be considered ultra vires which means. You know it was completely outside of their authority and they should have known better than yes there there could potentially be some repercussions but it starts to get a little speculative for us it it's very hard to answer your question to be perfectly honest. Thank you and if I could follow up very briefly one of the reasons that I gave that and that I talked about the hope of. Having a decision the week of the twenty ninth of November as I think the judge and not and again I'm speculating but I think the judge understands the urgency of making a decision on the request because of the pending deadlines that are coming from these federal agencies so. If we are successful then there's deadlines would be pushed and soul finally here. If we are not. That means the judge has decided to leave the rule in place and would. Create the I think the the conflict that we are here to to debate that you all are asking about today. Sure Dismang you're recognized for a question thank you Mr chairman it may be a little bit for you M. S. and and the all too so what I've tried to do was last night was spent some time in a reading that federal mandate and how was applied and really but I kind of hone in on was this. Religious exemption which then references back somewhat to the EEOC and how they define religion which religion is by EOC it's not about religion it's about a sincerely held belief of act that that's at its core in a way that I read it it's the believe one person like it doesn't have to be even a congregation but it's a it's a believe about your life and death and philosophy for instance. And so what I'm what I'm trying to understand is that's a huge hole in in a way for an exemption to take place it in nine putting that correctly from the AG's office opinion I mean is that is that pretty fair I mean even if you believe if you do not believe you have a belief. That you don't take the vaccine should have to take the vaccine to be an employee. I mean that that's what the rule says. My in my missing anything it is a fairly broad exemption okay event and you're not because you're not incorrect okay in in so in one thing out so indeed to the leader of the question for UAMS means a word like preparing. We what we are asking us to do what we're trying to decide for today is is like it you know do we play the game of chicken what happens when one side loses you know how does how does is going to work. I mean with my reading of the exemptions I mean I assume you want all of your employees are not willing to take the vaccine because they have a sincerely held belief have something on file so that the court case rules in favor of the federal government that does remain to be employed you know they stay on as employees or you a mess can continue to operate because we've met whatever this is because again if it's sincerely held belief not religious not from your pastor not from your whatever your exempt the best that I can read and I think you met in which relating to an we don't we don't. You can't deny these I don't see how you can and I wanted some way if I'm missing something on that Senator Dismang that's the way that you M. S. interprets this and and just to put this in personal terms I'm practicing Roman Catholic pope says the vaccine is okay but if I as as haven't deeply felt personal I believe that there's a reason not to take the back saying that the our committee would accept that as a religious exemption you know we're we're clearly in in between a rock and a hard place and you know we have you know of you know at least I think we can all agree at least some risk of losing. We are roughly half of you know the revenue that the we use to keep our our ship afloat well I mean in that same time we we we are deeply want to be respectful of the jet G. A. the A. L. C. and the bylaws of the of the state and. We value our employees our team members regardless of how they feel about the vaccine and the people cheer for being for the vaccine or against vaccine that doesn't change how important they are for you M. us so we're trying to navigate all three of those issues at the same time at me because the if men and again I would I would just say. Or my understanding is amended if you believe so strongly that you're willing to quit your job that's a pretty sincerely held belief again at number appreciated just wanna make sure I understood and one thing. You know I'm not how we move forward I mean if there is if there is one that is not granted. For instance if we don't allow it again this isn't we call on religious because Jensen's exemptions that's not if you read the way that it's written what it truly is but if those are not granted could we be notified as in Nailsea Committee if any of those are denied by any employee that seeks a exemption based on their you know sincerely held belief I will what will surely name right but I mean just a I will assure you that if anyone applies for religious exemption and and that religious exemptions tonight then I'll notify represent Wardlaw said Senator Rice Senator Hickey and speak Speaker Shepherd personally that that is the case okay thank you. And we will make sure that notification goes to the full committee thank you for that. Representative gene you're recognized for a question. Thank you thank you Mr chairman a doctor Patterson I'm well aware of. I will get in Parramatta around twelve thousand employees at UAMS that correct yes Sir it kind of depends on how you count with you including part time or full time a yes eighteen twenty percent have not been vaccinated. At the at the most we have not when you M. S. is not vaccinated eighteen percent of our employees but many of them don't live in central Arkansas we have employees working seventy three out of seventy five counties across the state so you know I'm willing to send a substantial portion of that eighteen percent has been vaccinated we had no reason to collect that information on them inside this twenty twenty percent eighty percent probability two thousand employees of how many is that included the religious exemptions or is that outside the ridge six and no because we've not we've never at we have not asked for religious exemption and until the I'm CMS guidance came along so this is total that's not been vaccinated and is not deal with the root religious exemptions yet I'm sorry I didn't understand that this is the truth around two thousand have not been vaccinated the work for you a M. S. and and we have not this is not a number inside the reserve religious exemptions. Right is it's is less than two thousand students so somewhere south of two thousand and M. we have not had any requirement for vaccination so there's been no reason for our employees to ask for religious essential nobody's asked for one year well we we now have a believe as of this morning hundred eleven requests okay and your testimony was nobody you amis's ever been denied religious exemptions on a vaccine I can only speak for the for the time that I've been on March okay has anybody ever been denied a medical exemption aye ayes suspect that that's the case but I don't know for sure okay thank you. Permission representative Lowery you're recognized for a question thank you Mr chair. Dr Patterson your testimony will was a you just clarified that under your watch as far as you know. There have not been any denial of religious exemptions but that is that testimony is not specific to this particular vaccine committee your you just told us a hundred eleven request but those are requests that are pending correct. Yes a hundred eleven requests are are or pending we're we're going to judicata as quickly as possible and yes you're correct that what what I'm referring to are people of requested religious exemptions for other vaccines like influences that we require we've not required COVID nineteen so there's been no reason for us to to ask employees to but seek a religious exemption okay so you really have no evidentiary information to tell to share with us of whether the covid a request the religious exemption for the code test would be granted as it's been done previously I I think we have a very good reason to to state that that's the case because our policy is not gonna be any different for COVID nineteen then than it is for any other vaccines that we require okay just one last follow up under the previous religious exemptions that have been allowed to have any of those in have those been on hold on representive. These questions are allowed dot person to answer questions while ago it was the same question AG's office these questions should be primary for the AG's office considered I understand since this is just one quick follow up I'll come back to you when we come back to doctor Patterson all right questions for the AG's office I think I'm all. Senator Clark you're recognized. Yes of thank you Mr. If I may I have two questions for ages office but if I could ask the chancellor if he consulted with the AG's office before making this decision. That's a proper question. I'm I'd prefer to the the university council about whether there's been any conversations with the AG's office. then I'll go to. The two gentleman from the AG's office you know of any. conversations with UAMS. Of before they made this request. I know that we have spoken with you university lawyers about. Our challenge is to. CMS and OSHA regulations but as to the specific. Your specific questions Senator I'm not positive I'd like to get back to you I'm not saying no they didn't no one of university system lawyers did not call our Solicitor General I just don't know but I'm happy to follow up and and get that information for you so you you wouldn't know if that offered any assistance. My inclination is to say no but again I I don't want to I'd I'd like to check with some of our staff to make sure that they're were phone calls made the most important question. A real us were one of many states involved but would I be wrong. To assume that an exemption for the state's major hospital. Of those not exactly help our case. So. The exemption that they're requesting is created by the statute that you all have passed and I I'm not sure of any other state that sits in a similar situation. As Arkansas there may be other states that have similar bills that have passed but I don't think that there are I don't think that this will have a major impact on the case pending because at at issue. Really is the constitutionality of the role that CMS is passed and I don't think this will have a significant impact on the arguments that we're making in the eighth circuit or that other states are making and and there's jurisdictions. If we grant exemption there's really no need for the case. I'm sorry I didn't hear your if we grant the exemption there's really no need for the case I think that and now I I think that there still is a need for the case again we're we're talking about the mandate and the constitutionality of the mandate which would still be addition still challenged. What what they're asking for I don't think moved out of the arguments that we have made in our pleadings. Thank you thank you Mr. Senator Hammer you're recognized for a question thank you Mr to the AG. If you get the state. Would that prevent Medicaid from withholding funds to you M. S. as long as the state is in place. Yes senator would. I have a question to the chair please when when I can. Question to the chair please yes. I'd like to know what the what what the deadline date is for the first vaccine that has to be. When once you got to be done by and I don't know that you answers that are not want to come back to you with questions. Is that your question for mayor such questions for them well maybe one doctor Patterson I understand you're trying to keep order I just wanted to make I want to a state is a December fifth is the it's also a different server fifth is listed in the guidance and is the drop dead date for the first shot okay that is that is concrete okay then if we expect that the judge would rule on November twenty ninth as far as a state. And we're gonna be back in here the first of the week then if we were to not grant what the chancellor's asking for today and the judge puts a stay on it as the AG thanks that they will Medicaid funding will not be threatened. Then we can come back in the event the judge does not put the stay on it and still have time what what first of the week or we come back in your own I'm I'm well we had to come back in just to the chair I'm just saying that if you M. S. is gotten ahead of the game a little bit for you know everything and and we're gonna be back up here is legislative body or we could be back up here I think could be would be the proper language if we could be back up here and I think this would drive the necessity to be back up here we could take it up once we see how the judge actually rules. M. that that is that a possibility I will be very careful out say this but I think that could be addressed. Here after we hear from the three entities on the agenda so I think they're say thing there's a motion that could address some of your concerns coming forward very good thank you thank you. So with that. Senator Ballinger you're recognized. Thank you Mr at I want to admit to have follow up last month and got a cue to quickly my my concern here is clearly you all realize the general is the is the chief attorney for the state of Arkansas right if you guys spend a lot of your time defending the laws frankly that we pass. It to me it seems like not an option to say it's that you have no opinion about whether or not an agency of the state follows state law to say that they have to make a decision about well the potential Medicaid funding or or following state law it. Please tell me that's not the general's position that agencies have a choice of deciding whether follow state law or not. At I will go back and and I think one thing to you that will help clarifier I think get to what you're asking in the event that we are not successful and the CMS challenge. The rule becomes a role. Which would then preempt or potentially pre and any state law M. for a right of action that we are talking about here a state employee or somebody impact it would have to bring a case against a state entity state actor or someone that would then. Raise a very different issue. What we ever tell. It is a speculative question that is very difficult for us to answer. Because there you there we would also have a federal rule that would be in conflict with the sample let me just put just so we don't go down this path too far at first off let me just say this that and I don't you know you know I love you guys we work together a bunch of things together great guys this is not your in your area you're not involved in this this is different than the ocean roll those roles that you got to do this right this is you got to do this or you lose money so that's actually not a conflict laws question here at all there's a there's no question of supremacy clause thank you get comply with state law and the you just lose federal funding which states and that's a big problem none of us want but that's not really what my question was me go back to make it clear what the question is if now they're working through the process of of ACT nine seventy seven if this body says no we're not going to grant you the authorization to its issue the vaccine they would clearly be moving forward if they move forward and say no we're going to mandate the vaccine it would be in direct opposition to state law. And would the general say I don't want any agency of any state I would recommend they not violate state law. Senator Ballinger yeah I appreciate the questions I do I don't think that there is going to be a time that the Attorney General whatever advice and agency to clearly violate a state law I think we're gonna be in a position that if we go forward and ACT nine seventy seven causes problems that there will be some statutory challenges to that act and so we need to be very careful how we answer questions because I do foresee that there will be litigation around the statute so please don't think we're trying to Dodge your questions and please understand that no the attorney general's position would not be for someone to deliver early of Wade following a state statute thank you. Some members I'm I'm look for. So motions from you guys but I have. Non members non voters left in the queue. Senator Chester I'm sorry and so you know thank you Mr chair we for from the AG's office we've heard from doctor Patterson I think we need to move the case with what it is this body is going to do because we can continue to talk and talk and talk but what. What is the chair's Opinion as to what we should do should we move to a vote on what. On what we should be doing should be grant this or not is that the next step I can you know next year. Because we debated and debated. Is a motion in order to grant the exemption I know it's gonna fail I just need to know what is in order. All so we're gonna go back to doctor Patterson is that was Nicks that would be next and then I would. I would think it be prudent for the body to hear from the other entities involved okay and then just wanna take motions certain thank you and we're regardless of whether we take a delay motion or not today I would think it's better to hear testimony from all entities involved to know what we're up against if we end up taking the delay motion all right thank you so much Mister chair for you clarity. Representative Payton you're recognized thank you Mr chair we back to questions for doctor Patterson yet Not yet. Let me back in the queue them thank you Sir. Sir you're more at I have you and senator garner in the queue I will recognize you for very brief questions Senator any general. Thank you Mr for indulgence and is Senator Dismang this proof is deep intellect already asked the question that I was going to so by way of follow up to the attorney general's office I know some institutions healthcare institutions that have been perhaps more burdensome than necessary based on the CMS rule what would be your interpretation if you can answer this of what UAMS is doing or they following as closely as possible the the CMS rule or they perhaps being an unintentional error or intentionally burdensome. Senator Gilmore I appreciate the question of. With the motion for the preliminary injunction pending with that potential decision coming down the twenty ninth. I honestly would have to say I think UAMS is being prudent I think they're working under the assumption that the deadline that has been set by the federal government will go forward for December the fifth and so they are here making a request of this body under act nine seventy seven. Thank you for the response. Senator Garner you're recognized for a question for the attorney general's office thank you Mr my appreciate bill to speak to all non voting member because of the seniority system set up in the Senate let's go back to a couple things on a correct Mister Brad first you said that the. National F. F. NF I be referred still best case dealing with Medicaid expansion that was optional that's actually not true the law first passed that it was mandated every state take that money or risk losing all their Medicaid funding. And the court stepped in and actually said that you would be optional for state if you start not to you will not lose all your Medicaid funding which is I think very appropriate for we find ourselves today with the federal government is threatening us to take our Medicaid Medicare money if we don't follow that we all know that Medicaid expansion debate happen here in Arkansas but I wanted this CMS rule itself CMS rules typically go through a process where it's put out there there's public comments and the nasty side on where that rule be an act or not that's not what happened this case they are an emergency rule order which means there was no public comments before this put in place and that CMS basically made a rule or unilaterally and now after that rules in effect they are actually discussions going on you can comment on that so this is my question go to Senator Dismang and centered Gilmore point I actually give you a missile strike on this. You can't determine what the religious exemptions or. Underneath CMS is rules here's what it says Senate is made discussed the recently held belief that's what they put on the website CMS believes that exemptions could be appropriate in certain limited circumstances but no exemption should be provided to any staff for whom is it lead not legally required so even if you a mess puts in a religious exemption CMS can come over the top of them and say no that exemption doesn't meet our standards if you needed and I'll close this case of how this happened look at what happened to our military members and federal employees their religious exemption or be in the not across the board group of navy seals brave people who serve in military like me or about to be kicked out of the military because they're religious exemptions work did not so is it true that CMS could actually overruled anything that UAMS put in place or any other hospital for that matter and say that their religious exemptions do not meet the CMS rules at the time and that they could still be found in violation of this law. All this rule I should say. Senator first of all I I would up thank you for that clarification as I mentioned to Senator Ballenger it's been sometime since I've read that decision as to your point about CMS overriding exemption I've. I can't speculate as to that I I cannot think and and I may not know but I cannot think of a time when when CMS has come in and would have overridden such an exemption I would think that I potentially the equal employment opportunity commission the EOC might be a check on that power but center I can't be certain. Yes Sir because of the federal level with federal employees is happen extensively where they've denied those exemptions so we're having this debate whether we can accommodate you AMS allow the release exemptions what I'm saying is I don't trust a drag on federal government not to commit over top and deny all those exemptions because you've been in the not exemption here stand up real quick raise your hand. Senator senator let's stay in order. We're not we're not doing that Representative gene recognized you. Our. I will propose a motion if the chair will hear. I'll hear your motion I'm not saying I'll take your money all right. So if we do have a few some litigation is going to be determined possibly next the twenty ninth. Of. I would make a motion that we postponed the vote after the litigation that could be a lot clearer for members to vote of. Well we can still have testimony today. And with the the possibility of having a special session the week of the fifth of December that week. And then of course we do have another opportunity at a call especial Cole of Legislative Council at any time that will be my motion that we propel postponed the vote until after we have the legal of clearance on the twenty ninth of help the members with their vote okay so. I didn't take a motion yet. I would ask for an amendment from the chair. We we have to abide by the rules of council and since this is such a sensitive issue and it would take two thirds vote to spend those rules I would say that with that you put a date in there because we have to have six days prior notice for any special called meeting. So if you can. How does a chair what what date with the two chairmen. Give me give me thirty seconds. Representative Jane you can amend your motion to relieve the notice to twenty four hour notice and then we can set a date in future in which we have to turn all right. I'll make a motion to route to what we amended to a twenty four hour notice of the Legislative Council hired as proper motion I have a second from Senator Hester all those in favor of the motion say aye. All opposed. Is have it there for the council will have twenty four hour notice I will proceed with testimony as stated by the representative so that we would understand the the places in which all agencies are at Senator said I mean representive seperti recognized. Thank you Mr chairman just I guess The point I'm not sure it's a point of personal privilege or just to make a clarification for the benefit of of those that have made this request. Given that we have taken this this action to potentially come back at a later date the deadlines by CMS are still in place and so I think it's important that you a M. S. DHS anybody else is potentially it affected by that that they continue to have dialogue with their employees to let them know what those parameters are because. My point being that even even if some action is taken at a later date practically it could be too late as to the requirements CMS has irrespective of what we do and so I just want to make that point that it's important that our state agencies are communicating with their employees again we've not approved a mandate but they need to be communicating what the realities of the CMS of the interim rule and what those states that have been push down from the federal government what they are so I think that's important for people to keep in mind. I second that. Senator Hickey of recognize you for the same way on senator thanks for okay we'll come back to you. Okay so members I still have one two three four five six and the Q. are these questions directly for the Attorney General. Please on like your microphone if your questions are not for the Attorney General. Okay so see in that the board is clear I'm going to excuse the Attorney General's from the table thank you guys for your update and Preciado sure proponents to this issue. Thank you Mr chairman thank you members of the committee thank you thank you so now I will take questions again for doctor Patterson. I will only take questions from voting members if we have time I will come back to nonvoting members at the end as we did with the Attorney General. With that representative Lowery will lead us awful questions for doctor Patterson thank you Mr chair and I'll get back to the question I would ask you doctor Patterson on your your knowledge of because of previous religious objections that have been approved have those been unconditional exemptions or have there been accommodations for instance you know we've been hearing reports of some agencies or entities around the country that the exemption is that you can take six to six months of unpaid leave as part of the accommodation for your religious exemption has that ever been applied to previous religious exemptions UAMS I can't say for sure but I I I I'm ninety nine percent sure the answer to that is no okay if you can in this would be my follow up if your committee that here's these say these one hundred and eleven requests for exemptions if they were to recommend an accommodation that says that you can receive the exemption but you'll be taking six months. Leave without pay. Would you ratify or would you veto that type of recommendation hi I can't think of a circumstance in which that would come up I will want to understand what the issues were But the that's not something that I can envision happening for religious exemption because religious you know as somebody has deeply held beliefs I and I can envision saying well maybe that would change in six months somehow okay well thank you for your clarification on the record thank you Mr chair. Senator Elliot you're recognized for a question. Thank you Mr chair Dr Patterson before you made this decision could you just give me a snapshot of the considerations that you made knowing this is going to be a decision that was going to be controversial most yes ma'am The last thing that I want to do is to be here right. we we Chose not. To seek an exemption prior to the CMS rule that was promulgated even though many hospitals across Arkansas as you know hi had implemented there are their own requirements for vaccination we had hoped that we we get guidance from CMS on October first which is what was initially promised that would have given us all much longer to have a good conversation about this issue when the CMS guidance did appear a week or so ago when we were forced to scramble and our team work over the weekend to to try to figure out the appropriate steps to take so that we could begin the machinery of. to vaccinate our team members if we needed to which is a lot of work the logistics of that how we were going to collect exempt exemption applications how we're going to have a committee which is used to handling one or two religious exemption requests a month to suddenly have troops to handle hundreds and hundreds in a short period of time so it it it's been you know kind of a whirlwind of of trying to navigate waters in which there doesn't seem to be this a particularly safe passage for you M. us and is put all the star team members thank you my leadership team in in a difficult circumstances and I think that the debate we're having here is a fair debate to try to adjudicate what is the best pathway for so that we don't put three million our Kansans at risk from healthcare perspective so that we don't get crosswise with state law and so that we don't get crosswise with our major funder of our enterprise. I'm I'm thinking there was probably no way to avoid what you described earlier as between a rock and a hard place and just the very fact I'm not suggesting that the fact that ninety four percent of the funding from UAMS come from sources other than the other than the state ninety four percent with the huge amount of that no from the federal government and I'm not saying that whole amount is wrapped up in this but the bottom line as as the head of the institution and we have our positions when you have to make a decision that's what we hired you to do to make a decision that we have to decide what we're going to do so I'm just I'm just wondering if in good conscience you could ever make a decision that you consider it not being in the interest of making sure this hospital continues to it's to do the job but it's doing notwithstanding we don't mean that to be a statement to dismiss anybody who is valued at U. M. S.. Could you ever entertain your do you think. Make a decision where the three million people in Arkansas I'm not put at risk. You you would hope that you that that somebody like me would never be put in in into that position and you know if. The choice is. That. We have to have a vaccine mandate to be in compliance of verses we are in a situation in which we will probably would lose two thirds of our employees we probably could only keep a third of our employees on board the U. M. a surprise. You know that's not just devastating to our team members although it is it it would be very distinct people who lost their job that's not only devastate health care and and in the state that that we would. The a shot at the economy of the state of Arkansas so you know god please never let me have to make that kind of decision right thank you Mr chairman thank you doctor Patterson. Thank you senator. Senator Teague you're recognized. Thank you Mr chairman. Dr. Think I read somewhere that If you lost your funding. Through. Of not doing what the feds want you to do. that it would Would that kill Medicare. Coverage for. Elderly are I guess for anybody really but I worry special about the elderly the disabled what would that. Jeopardize their coverage yes yes Sir it would mean that everybody in the state of Arkansas for everybody in the state of Arkansas who had a Medicare or Medicaid card their Medicaid or Medicare card would not work you want us. I would not work at UAMS would not work in the hospital I. If we're the only hospital that is out of compliance so mean that it would not work at U. M. S. okay so those services that we provide that nobody else provides would no longer be available to them unless they were willing to pay out of pocket. I had a call yesterday from a doctor's in my district who said Teague are you gonna vote to. take the funding away from you a mess. And I said. I said heck no I'm not going to vote to take the funding away from you a message because there's issues besides the issue of mandate I mean I think the real issue is you take. What I would call the last the last choice for a lot of people which is to go to UAMS. Get covered as as expensively as a cat and so and I said no I'm not going to vote for that so anyway You have any thoughts on is is there a way around that is there a way of roll avoiding the what would happen immediately help me understand how that would all have. If if CMS decides to both withhold our Medicare Medicaid funding as well as preclude you enough for participating in government contracts that has all the consequences that we talked about today but I would also Senate take respectfully remind you that you M. S. teaches our trains seventy percent of the healthcare providers in the state of Arkansas so if our ability to train residents medical students nursing students at cetera it is it is precluded because we're no longer able to participate in the Medicare Medicaid that's going to have impact on our kids and their kids. So I I think I voted for every mandate block blocking your or whatever during the session but at some point you gotta take a stand for those who can't stand for themselves so I may have spoken against that Mister chairman thank you. Senator Johnson you're recognized for a question. Thank you Mr chairman. A doctor Patterson I have a copy of a letter from Lady twenty your boys and this is a letter from her doctor and I want to read it leave the name out of course and I just want you to speculate on your response you may have already responded but I just want to speculate the letter says has her name it's as to whom it may concern she has a documented. Corgi Oppel a I hope I said that right. That requires the use of anti anticoagulant medications because of the blood clotting risk associated with COVID vaccines is recommended that she not take the vaccine respectfully submitted this person's primary care physician is that something to be in the best of your knowledge you would approve that medical exemption if our our committee that reviewed exemptions so that that was an unacceptable exemption I would agree with them if they said that that was not an exceptional exemption I would have a serious conversation with the committee because that sounds exactly like the type of medical exemption that we should be granted so you have a committee that reviews instances such as this and at least your personal opinions that's one they should grant this state I put it in it M. in my opinion us and I know a fair amount about quite a lot that the and I know that the the issues with with blood clotting related to vaccines or it's incredibly rare but in an individual like that it should be a concern and I personally yes I personally would grant that exception and I and I would personally quiz the a committee or or an individual who went cross was against that opinion okay thank you Dr Prashant thank you Mr. Representative Deffenbaugh of which is represented Godfrey you're recognized for a question thank you Mr chair thank you doctor Patterson my first question I was hoping to get to before we meet the motion to delay because I was wondering if there are any implications I'm to S. delaying until after that litigation is further resolved I think it would depend on on how long the delay is animal and what actually constitutes I think conceptually we're we're fine with that that the challenge that we have is how many people can we actually get vaccinated and kind in a short period of time that that would be you know one issue that is you know a practical issue that they would have to deal with the second question that I would ask is. Even if we delayed would we have permission to continue to collect exemption requests because My hope would be. We still be able to do that even if ultimately we decided not to implement a manager so that we give our employees the opportunity to express their concerns I wanna make sure that they would have the opportunity to do that and I I think that's worth clarification on if we need to do that as a party but I understand your concern there my second question is about you know there's there's been some conversation with some framing that you're with state agencies or state entities that are in violation of state law but what you're doing today is in compliance with the law which is to come before a LC and ask for this exemption you've talked a lot about how this is not a decision we made lightly and you who wish you were in this position yet we do have this provision to where you can come and say these are the circumstances they seem inevitable they seem dire they seem very I'm worth coming to make that the request even though it is a challenge for you and so I'm just wondering if you could speak a little bit to you you have the opportunity previously because of this provision in the law to come before us and ask for an exemption but you had not previously until now until we see how high the stakes are how significant the consequences could be for your institution for our candidates who are receiving very vital health care from you a mass if you could just talk to why now you said I am going to access this provision in the law to where I can come to a LC as permitted by the law it is where that at this point because the consequences are so dire correct first of all I'm I'm I'm grateful for the invitation to to be before the committee today and I thank you all very much we did have the opportunity to to make the same request before and we elected not to we wanted to be respectful of of the state long wanted to be respectful of the opinion of the legislature you know I I I hope that you know even if we did not communicate as well as we could have over the weekend that everybody understands the. The we were very grateful for the work the legislature and especially with the legislature's done for you I must but we do not feel that we had grounds. To come before this group to make this request until CMS put the. Put you M. S. in position being an existential crisis. Representative Payton you're recognized. Thank you Mr chair so doctor Patterson I've. He per she ate the rock and a hard place by myself there all the time of. You're coming before this committee and asking for relief for an exemption or or something and I understand that. Can I have a copy of the letter or whatever that you sent to CMS asking for relief for asking from to postpone the deadline what kind of correspondence if you had with CMS of requesting that they. He's on their side of the issue. I'm not aware that we had any conversation with CMS and I I doubt that that would be fruitful conversation which is why we have elected to do that they've got their bluff in on your to the point that you don't even ask. I'm sorry Kunj said again so they've got the bluff in on you to the point that you don't even ask you just assume it's a no so you don't ask well it if if you're recommending that we do that I'm I'm happy to do that. I would recommend you do that especially in light of the what we voted on a minute ago that delays it for another week or so I would definitely recommend that you allow CMS to fully understand the position you're in and fully understand the law that we passed and how that they're requirements would force you to break state law. Or they're rule I'm out I would think that you lay that out for CMS I'd appreciate if you would thank you I will do that I'll make a commitment and I'll give you a copy of the letter thank you. Senator Hammer you're recognized and members I will remind you of we have a. Still the number of people in the queue that are nonvoting members I'm going to recognize a few of them after senator Hammer and then we'll move on to the next presenter so I'm going to stop the queue at this time and then move forward he. Thank you Mr you're already on the thank you senator bound thank you doctor patient do you have a policy that is specifically written that clearly defines what allows for religious exemption from the code faxing shot do you have a a policy written in place we don't have a an explicit policy we we have the practices that we follow that that I describe to you if you're more comfortable that we reduce that to a policy I think we probably can't okay. It is your testimony today that you've turned down no one that is filed for religious exemption I checked with with the our last chancellor for human resources Danielle Lombard since this morning okay she confirmed that all right you're you've got a letter or memo out there I think that says November twenty fourth is the cut off to submit a religious exemption maybe this was to senator Elliots questions while ago by my math you got a couple thousand that you're going to have to give religious exemption to if they all choose to apply otherwise they're not going to be employed with you. Why would you just not do a blanket statement or how are you going to handle it massive overload between now and the twenty fourth unless you're just your date that you're gonna allow for that well if if the day gets adjusted for this committee want them will have flexibility to adjust that date and I'm sure that we would the reason why we we chose that date is just to the point that you made Senator Hammer okay if there is a large number weeding and not the time to adjudicate that before the what is our drop dead date which is December fifth our I would I would encourage you to adjust that date or cure clearly communicate that because you've set the stage is set for failure based on the number of applications you may get and limited time you've got to do it and do adequacy to end of the you know individual you look at them I would leave that to your discretion to make that call but I would encourage it the last thing I want to write a letter CMS Pat to up tag off of representative Payton we have a state law that's going to take effect January fourteenth is specifically used CMS guidelines to allow for testing and for antigen I'd like you to write a letter CMS and ask if they would give allowance for that to be considered there's a state law that's going to be in effect unfortunately not chill January fourteenth and already I'm getting text messages or private and I commend you I do commend you because their private hospitals institutions out there that is open gate it's open season on other employees at least you're trying I will commend you but I want to write that letter sent me a copy of the police and ask them to allow that into your policy Sir I am Hammer I'm I'm happy to do that and I'll get some more information from you off flush out the issue thank you thank Mr. Senator Ballinger you're recognized for a question. Thank you Mr at. Would you be willing to communicate with your your employees and let them know that I I do understand the need to continue to collect the realistic religion to exemptions but to let them know that you intend on follow following state law that if if this if you don't get approval when we meet again with they'll see that you won't be issuing the mandate or or that it currently there's not a mandate in place even if you continue collecting those exemptions. So if I'm understanding correctly I I think there's two different issues one is what what if the CMS mandate stays in place and and and we're not granted the ability to to move forward and and and that's circumstance you know then the issue becomes you know the contingencies for how how we divestitures of our staff the I think this second issue that you raise I think it's easier to address if the CMS guidance if the CMS rule is state or overturned we will withdraw our request. It It yet and I'm sorry Sullivan I did kind of have to questions there that was March let me limit narrowed down to one like in the in the intern right now you have a bunch of employees that are worried about getting fire trying to make that that choice well also right now it you you don't have approval from this body to issue a mandate that you kind of consistent with the with the speaker's comments your people should be communicated with they should know that there's still potential for for no this body approving it and that there be a mandates but they should also know that currently there is no mandate for them to to get the vaccination and would you communicate that absolutely you know I I think we're getting new information today from you and we will or going to make sure that we communicate where things currently stand with our employees and and that will depend on what happens today thank you. Members I stated earlier that we were at the end of the queue it's been a few more addy and I'm sticking to my statement that we were at the end of the queue so I'm recognized in the nonvoting members at this time and will be moving on to the next presenter. Senator Garner you're recognized thank you I would look AT ACT ten thirty as well which specifically prohibits a state agency for getting documentation about COVID nineteen vaccine so even if this body approves the L. C. request next week less law changes you be a violation of state law to take those documentation for people if they choose not to give it to you such once know that understood we're discussing a lot of money I get it me my personal take is there's zero percent chance Joe Biden's going to actually fall through take billions of dollars out of multiple state's economy for Medicaid or Medicare I think this is a life and I think it's a block from beginning as a personal take. Let's talk about the people. I look to do some your tweets dot Patterson you speak highly of your staff and employee team UAMS talk about how much you appreciate them and but you we should have time to store them. What do you say that these people. Who worked at a pandemic. Who've Mr lives going out there. Who did this for months and months. The dozens if not hundreds of them to a certain date if approved by us you will fire. Your senate home their families with no future if you think this is hypothetical just take some my phone calls I've had people call me crying had people call me cousin I had people call me just a motion about this because they're forced to make a decision what do you say. To those people who you appreciate. And for months has been called heroes. Thank you gonna send him home and cut their job that what do you say to them the that's not what I want to do that we want them to remain members of team you and us and we want to do everything that we can to to make sure that that Senate that's true why don't you wait to the last possible nano second before you have to put that in the fire why do you put out a letter what do you put out of email asking that they be vaccinated before you come this body because you did how come you go to the let don't wait till last possible second to do this why are you trying to force it on before the end. We're we're. Trying to it is I said before we you know we are in between a rock and a hard place there's an amount of time that's needed to get people vaccinated to collect religious exemptions and really we felt that this weekend was the last possible minute so I think we waited until the last possible thank. President Lundstrum you're the last question for this president. Thank you Sir. I'm. The email that you sent to the U. M. S. team. Was very direct in in the second paragraph or actually in the first paragraph you should failure to comply may result in fines and loss of CMS funding which in the case of UAMS is more than six million a year loss of this money would force us to close programs and all our mission areas this is a very difficult situation for us everyone of our US you A. M. S. team members regardless of stance on vaccination is important your valued however non compliance with CMS role will result in the loss of sixty percent of our total funding this would affect our ability to provide unique parent patient care programs trying tomorrow's healthcare professionals and search for cures in our laboratories the result would be devastating to health care in our state consequently we're asking for help in compliance with CMS rules this requires all of employees to receive one dose of the Fizer maternal or Johnson and Johnson vaccines by December the fifth. If receiving these two doses you don't want to talk about January fourth. That's a pretty. Forceful email and emotional email plea to folks that have or have been working on the front lines and they are well aware of the impact of covered in their choosing not to why would you not in that email also say. We're going to be issuing a blanket. I'm sorry to hear the last one why would you not in that email say we're gonna be issuing a blanket statement be reassuring to these employees who are heroes. The I I I feel like we did try to be compassionate term ploys and to tell them that that they were valued and will continue to reiterate that you did say they were valued but you didn't offer much of a life line you did say a little bit about exemptions here but these this is some. Emotional blackmail is what it looks like them it's just hard it's hard to listen to that I know you don't mean that that way but it comes across I so I'm just wondering I'm hoping the next email the chill offer more information on exemptions. the follow up on my car from my question is with Mister Payton said when you send that letter to CMS would you also send it to both our senators and our for congressman so that they're aware of your plea for help yes ma'am thank you I appreciate that. Per person I can't thank you enough for your job and the job that you're doing thank you for your testimony today. And we do appreciate the position that you're in in a position that our federal government and our executive has put us in at this time so thank you thank you thank you very much I appreciate the opportunity to respond to address the committee. With that I'll call Ford secretary Cindy Gillespie for DHS. You guys would introduce yourself for the record and you're recognized to present your request to council thank you very much Mr chairman syndicalists be I'm the secretary of the department of Human Services. A more quiet a director and chief of staff for DHS. Hi good morning Melissa stone and division director for developmental disability services act DHS thank you for you will pull your much close to you thank you thank you I'm here today a speaking for DHS really on behalf of the facilities that we operate which include the human development centers that Director stone overseas unfortunately rector Health is out of town today he oversees the health center and the State Hospital those facilities actually if the CMS rule ends up coming into place those facilities will be under that rule not DHS itself those facilities so we are I have requested that you allow us to take the first step of putting in place a policy by December fifth of which is what. That current interim final rule says so we would begin to take that first step and I think part of what we have been trying to convey is we are navigating this as slowly and carefully as we can we are working with the attorney general's office on their lawsuit and Also filing public comments with CMS expressing our very real concerns about what will happen if this is put in effect and also in discussions with CMS on some of the practical issues around it in other words we're tackling it everywhere we can but we also wanted to come before you in order to begin taking that first step should it be necessary having listened to the previous of testimony and questions. Just so you're aware we are decision to come forward at this time was because Council is meeting this week we've been a very regular touch with the attorney general's office about the lawsuit providing information as two of the health and safety issues that we're concerned about so that they have those for part of their case and we basically realized this was going to be the last A. L. C. before that December fifth deadline so that's why we sent in our request in order to make sure we had come before you properly. We'll be happy to take any questions. Would you briefly. Describe of the special. Basically and patient care that. That there are options are are not available to do something. Sure the facilities the DHS runs. Our facilities if that exists because it is the patients the clients those facilities it is very hard for another entity that would be a private sector entity to provide that care we operate with a very unique clientele the human development centers there are five of them around the state they serve our clients who are developmentally disabled and then developmentally disabled to an institutional level of care these individuals required twenty four hour care and we try very hard to operate those centers in a way that they receive good care but also that those are their homes and a place for them and their families to left. The Arkansas Health Center is the state's nursing home which we operate the individuals that are there are in many cases for a list of the frail they are in many cases public guardian's they do not have family they do not have income and these Arkansas State Hospital is states it's the state psychiatric hospital. The preponderance of the individuals that are at that hospital have been court ordered their for forensic treatment or they have failed forensic treatment and are there either undergoing restoration or they have failed restoration and they are there as we continue to try to treat them The bottom line is the individuals we serve there really is nowhere else for them to go and dial that's how the state has a setup and and we serve them in that way Because I know the subject of money will come up we for those facilities that we operate we receive roughly a hundred and twenty right under a hundred twenty five million dollars in federal monies for those facilities they are substantially paid for through the federal federal dollars. Sir Clark you're recognized. Thank you Mr. Of. When we receive the request from UAMS until was not when did we receive the request from DHS. Should have been Wednesday night as well as the not was one was sent over so you all coordinated with UAMS. No we did not coordinate our. What I did I didn't let me make sure you do it within a quartet with that we we we heard third hand they they worse your request but we did not or day with the. Of. Has anyone visited with the by the administration I didn't ask your M. S. this because six hundred million sixty percent are operating budget us and it was sixty percent of patients of has anybody asked the bod administration. Where. Of what they would suggest that we will do with these folks we want these facilities as a my district I'm very familiar with it what we're gonna do with these folks The I'm used to negotiating and I'm used to pit people want to avoid so. What are their thoughts what if they're going to cut the money off what were they going to. I'm assuming they still care about going back to M. S. the elderly the poor I'm assuming they care about the disabled in the of the criminally. Insane except for two. Yes Sir I We have a band our reaction to it I think has been very similar to yours in the sense of that is why we immediately began working with the attorney general's office to file a lawsuit to make those same kind of points that taking this action in this state We have across our facilities right now roughly sixty seven percent of our employees are vaccinated right this is why you you don't see me go before the press very often but this is why I did want to join the governor that day to make it clear that for us it is a health and safety issue if we lose anymore staffing we are down staffing we are making those points as vehemently as we can we're making in our comments to them and in our ongoing discussions with them along with other state about how would you implement this we are raising all kinds of practical issues through that forum so I hope you're not asking me to defend the by the administration. No I just I was wonder if there's been conversations and I hope that I won't appear more callous than they are of the that would appear but they don't seem to care of you know and I know that they're flying people all over the country of the perhaps of the perhaps we should get buses ready to go to Delaware thank you. President makes you're recognized right my question is on the exemptions religious and medical exemptions died you have policies in place for that and can you go over that I don't have any employees requested those how does that process work so forth okay I'll start this and then let mark is the legal person here actually provide the more substantive answer. We we do not have a policy in place at all around COVID nineteen vaccines right so part of what we're really requesting from you today is for us to be able to. What a policy in place by December fifth as it raise required which means we will have to develop this but with that said I will let mark talk in general about how these work sure and it. What a CMS is done in their rule is they've tied this to EEOC guidance around religious exemptions and difficult for me at all that one thing the EOC says the of trade every application on a case by case basis I historically I don't know that we've received any privileged exempt her quest for a vaccination requirement if so it's been very rare and there's been handled as they've come up with this situation now we recognize that we need to have a policy at the release to establish a procedure so that is in the works now all right thank you Sir. Representative Greg nice thank you Mr chair and a state I guess the question just almost you would to a Speaker Shepherd said earlier my biggest concern is because I mean hospital administration and you know Trent Garner I think he was off the rails when he said this early but he would say you should wait to the last nano second but being in administration I understand that like on the case of UAMS they were talking twelve twelve hundred employees at minimum up to twenty four hundred employees and if you wait to the last nano second December fourth you know even at noon you got to the backs make twelve hundred people or approved exemptions in what happened day so I guess my question to you would be. You know how many employees are we looking at you know if if we don't give you permission at some point in the near future to start at least eight let the staff know what's coming and have a policy around exemptions are you going to be able to process everything in the days notice before that December fifth deadline. I think mark has our actual numbers written down over here so I'm going to have him give you those numbers sure and we I think we're a slightly better position than you I miss may have been in that we had the incentive that was paid for employees throughout state government for vaccination a couple months ago is less helped us keep better records at this point across all our facilities we have sixty three point seven percent of the employees are vaccinated I have seven numbers on the facilities if anyone's interested but that's the overall number across those facilities that you know what number we're talking about like actual number of employees so if I'm looking to say I need to vaccinate a hundred people in one day is that even feasibly possible it's right now the number is nine hundred sixty three okay it is to follow up like how much lead time do you need to either vaccinate or look at exemptions for that number of people. We I meet in typical instead of vaccination clinics it has taken some time to set that up because you have to make raisins with the pharmacy providers actually delivering the vaccines you have to arrange to have the nurses there or the staff to deliver it there's the paperwork associated with this that is not a quick process but what takes even more time is that religious exemption process because you have to take every single one on a case by case basis that is going to be an and time intensive process depending on how many of the employees submit that request so that that is a process that it will. I hesitated for projected time because it just depends on how many do it but I would say only for anyone request it's something that if our current attorney could handle note that may look at it in thirty minutes have an answer they met spend for five hours on that one request and it's just it's going to vary from request a request or thank you Mister chair I would just like to reiterate that when a L. C. meets again that we do leave enough time between when we meet to look at this you know if it's not state and the actual of the live data the fifth thank you. That opens up. Point that I should should have made earlier. A lot of the places where L. C. actually has an exemption and were able to take a ruling it allows joint budget to take those same rulings under this act nine seven nine seven seven it does not allow for joint budget to take up the ruling so if in fact we're in a special session. we would not be able to meet so in that case we would try to schedule this meeting as early as possible once court hearing has taken place on the twenty nine so that's why we ask for the twenty four hour notice verses of a a set time. Senator Hickey I saw you light up. Yes Sir in your second right and just to let everyone know the governor's office has been notified of that fact because of the importance of that could have some bearing on the special session so of course as totally it is called but the that has they have been made aware of that point thank you Sir thank you. Thank you representative for point out Committee needed to be aware of the notices. Senator Hammer you're recognized thanks for sharing your here asking only for exemptions for the facilities that you run correct. It would be for those ditches implore As who are in health care facilities and so would not be the rest of our staff like our staff or county offices would not apply to them okay so help me through a help me understand of situation I'm getting text messages that providers that yet Medicaid dollars have sent out notices to their employees at their terminated on Jan on December fourth and they're receiving Medicaid dollars the way the law is written does that extend down to those private providers that are a hundred percent depended upon Medicaid funding to administer services on your behalf like community dividers or like counselors where where's the cut point it is tied to the way CMS is this is what Mr not I was referring to from the AG's office the way CMS did this rule dated this rule tied to certain provider types a certain group of provider types. And that group of her provider types Medicaid and Medicare providers this becomes a condition of participation for those providers in the programs so the nursing homes are included which is why ours is there the hospitals are included intermediate care facilities which is wire HTC's are included there is an and there's a long list of those we'd be happy to get you but it does include community health centers which is one that you just referenced it does not include assisted living facilities they are not included in this list so market you may remember a few of the other categories I will one one question one we got a lot of questions about to make clear on hold health. it does apply to home health agencies providing skilled nursing care in the home it does not apply to personal care agencies they're providing the hands on assistance to individuals with their ADL's and it does not apply to a doctor's office. But if we tell you know today or we do you like we just did you a M. S. and postpone the saying. And we tell you we tell you know that does that reach down into those provider groups to tell them that they can't tell their employees or they can't terminate employees it because not that that's Medicaid dollars that's the worst minute pause directly to those to those private providers regardless of what we do or say all right of Adams your Medicaid funding goes away they go away to yes okay thank you. Senator Chesterfield. Thank you Mister chair I do have a question because I'm I'm looking at the community centers behavioral centers such as but whatever the children's colonies call today. There is no natural immunity for those individuals is there. Senator you know I'm a lawyer not a doctor but. Let me just make myself more clear. Coming in contact solely with each other. Most of the time. The the virus would be introduced by an external force. That's my concern. My concern is people are supposed to be giving care. Can bring into these facilities inadvertently. A virus that could possibly kill these kids were already having their systems compromised. I think that's the reason for the rule. my great concern is because I stopped going to my dentist because people were vaccinated they were in my mouth and one in my mouth. Maybe there are others who don't care about that. But when you become a senior citizen you even more careful about where you go and what you do. Because you want to be safe to and you anticipate that those what serving you who are in medicine we want you to be safe. And that's a concern for some of us who have not spoken on this issue at all. That is my concern. It's my concern for those individuals will medically fragile is my concern for those who are who are seniors. That's my concern that we would care enough about them to do everything we could. To protect them. And that includes getting a vaccine. Thank you. Representative back you're recognized. Thank you Mr thank you Mr chair. My question is we've heard a lot about religious exemptions today and the processing of them and thank you reference the thirty minutes it could be four hours. To go through the house. So my question is is. What would you be looking for if I if I gave you on set okay I don't want to do my religion says my my religious beliefs as I do not want to be vaccinated so what would you find in that statement that didn't. That would say no you don't get it. There are two steps in the EOC process digital but you look at number one is it a religious objection to what's being proposed number two is the sincerely held religious beliefs now that's that is a very gray area of how you determine that but there's some there there really simple no if you are members of a church that has longstanding established Dr and that your members may not accept vaccinations thank me really straightforward and that status by this the church you're in and it's you've held that for a long time you act consistently in accordance with that that's a simple one. More difficult is when someone says is against my religion. But they're not a member of an organized religious organization they're describing their beliefs and there's not an indication of how recent that is there is there are no clear. Rules or guardrails in terms of what is or is not acceptable it's one of those were unfortunately large just have to look at it make a judgment call. Follow. You're recognized yeah it's it's just it's it's seems odd to me though and I. Is is that now we're trying to determine what my believes. My religious beliefs are or of really we're putting of church. Over the state's rule right because if this church says you don't these people don't have to get vaccinated and all the everything we talked about today with all the state laws and stuff so. That's fine say it's I thought I find it odd that we're we're in that situation I'm I'm not I'm I'm not pushing this issue either way but just seems to me like. If you're gonna use a religious exemption it's nothing more than a person saying. This is like you would give all those out but but anyway I I just find it hard to. I'd be curious to see what a lawyer would spend four hours determining whether or not I really believe that it back by my religion my personal relations I don't get vaccinated I don't see where he's gonna get a or that individual getting the data from that would support our or deny that action it's it can be difficult the bill is it was difficult question before now we're looking other situations now they're trying to apply to the code vaccination interest yes to very difficult and big US issue to deal with thank you. Sir Clark you're recognized. Yes We considered. That maybe if we hold the line. That and and stop and they do actually of. All through and stop the money. Of that the the. The main ministration has showed some compassion if they falter and stop the money that the people that are injured. Of the don't get treatment except for that maybe later they'll come back through and I am hundred for fifty thousand dollars and perhaps we can tax that. No no Sir we have to wait I think we have been looking at this side of it from the a client side is that we're we're navigating from multiple sides as we try to. Hopefully. Be successful in the lawsuit or if not CMS modifying these rules. Our concern has been. Being able to safely staff the facilities so we can serve the residents if we. Where to be unable to staff those and the residents of these facilities some have a home to go to some do not have a home to go to and I think. Later on down the road them getting money would would not matter with the types of individuals we're serving for them it is we believe a life and death situation that we be able to serve many of them in the facilities that we have. Sure this is and it's a shame shame that this administration doesn't seem to know that thank. Senator Johnson you're recognized. Thank you Mr chairman and I'll be brief and I don't really expect complete answer mark Did you hear of Senator Dismang description to doctor Patterson regarding the religious exemption and the fact that. The basically you don't have to show your membership card in a particular denomination to be given the benefit of the doubt of what your personal feelings and and philosophy as our did you hear that I did okay and it seems that what you stated a moment ago is that DHS is kind of taking a little bit more extreme view of how to measure that it. I guess I should ask you what am I hearing that correctly and do you recognize that the first amendment specifically talks about. But not just of this act prohibiting an establishment of religion but prohibiting the government from up prohibiting the free exercise free exercise means what's in my heart in my head could you respond to that please sure it is understood Senator Dismang was addressing how broad the exemption potentially is for employees and I I'm I'm not an expert in that area so I certainly don't want to Go against that I think where I was coming from was for the procedural side of it of how we as an agency have to address those request and this is in this new to us as I said earlier we have rarely if ever receive religious exemption request is just not some that we've commonly dealt with it so we're trying to fill our way through this and see what is going to take but in in looking at what the EOC at outlines for how employers are supposed to look at this issue that's why I'm going down from working with analysis of what we what are tourney's will have to do to evaluate this request I would hope that you have attorneys that recognized that the first amendment tends to be very broadly construed by all the cores absolutely thank you Sir thank you Mister. Members we still have one more presenter on this topic it is their questions left in a queue that are specific to DHS and their implementation request. President Ladyman you're recognized. Thank you Mr chairman. I'm asking some hard questions. How many people. Maybe you can answer this but how many people do you have or employees or residents of your facilities who are currently in the hospital with COVID nineteen. We can give us one second we can pull that up we keep a running report on it. He comes out every other day. What you're looking that up mark how many people. Have you do you have in your facilities who have died with COVID nineteen. You want to do the agencies J. is not here so. No it's not we've had two employees at Asher passed away one Senator Ladyman you know I lost our superintendent at Johns press the former good friend yes another. First Lady when what what I can access here is number code cases I can't tell you these are the hospital but as of now we have one active case and the patient and. Six active cases and staff in the course that's very low point we've had much higher numbers for now but fortunately we're in a a low point statewide and that's our numbers and load the sport so if if you lose these employees that are not vaccinated that many employees and I know you're that way down already I mean. Would you anticipate more issues. The tower these the you said life or death and I I agree with you slapper that if some of these people cannot get the care they need so would you anticipate more people would die without care then the people that have died with COVID. I know it's a difficult question and but I feel like I need to ask that question and I and I. Completely understand and respect very much respect the question Are you know I have to start with this because it is our goal and it is. I mean if this were to come into full fruition our goal is still for us to maintain all of our staff. As well as continue hiring and add back the staff we've lost so that we can be fully staffed at our facilities and I start with that simply because the the folks who have worked through the past twenty months of this pandemic have really done an amazing job and they have worked brutal hours and are so that's that's our very real goal we also simultaneously as we're doing all the different things we're doing we are trying to think through. What's so for us for us is an impossible situation to think through as to how we will maintain staffing and health and safety across our facilities if we lose more staff and continually staff so we are looking at every option we can look at because we if we are running the facility we have to maintain health and safety in the facility we can't have residence in a facility where we cannot maintain the ratios and the services and that's why I referenced how hard it would be if we are not able to staff because we would have to start figuring out. I don't want to go down that road but we can't have people in the facility if we cannot maintain safety. It's does that. Answer your question. Yes it does and I I can't believe we've got the ministration that would put these people in this situation. In these life and death situations but one more question Mister chairman is a so are you asking us to develop a policy are you asking us the the right to mandate the vaccine. We're asking you. To let us take the first steps under that CMS rule if there is not an injunction you know prior to December fifth that would stop at which if there is we plan to stop but we're asking you to let us go ahead and move to put in place the policy because right now we don't even have a policy in place that would allow employees to be to be able to a pot and apply for religious exemption we have to do a policy that would say that we would be enacting this type of a vaccination requirement according to the CMS rules. And put in place steps for them to be able to exempt themselves from it it is also why as we're moving towards doing that we are trying very hard to get answers from CMS around some of the some of the questions that naturally arise Employees would need to be counseled right around vaccines employees would need to be counseled to address their concerns and questions how much of that has to take place how should that take place how much of that takes place before there would be any potential action how long would employee have to be unvaccinated before there would be any potential action I mean we're pushing CMS for a lot of those NIT picky questions that you need to know. That they don't have answers completely for us so I agree I appreciate your answer just one more thing so in your if you believe that you would have to come before this body again before you mandated vaccines that correct. Not I I would say no Sir I would say that our our thought was for your great permission with understanding of we're taking this very slow methodical process and the first it would be to adopt a dog policy and the terms of when we actually implement I think it's going to depend on the outcome of the litigation also the outcome of if we can make it additional guidance from CMS and also frankly just once we can see for CMS how much room we have to maneuver thank you. Representative Haak you're recognized members I will remind you again the Q. seems to multiply. We still have one more presenter and we're not taking a vote at this time so I and we still have our full AOC agenda to go and it is one PM so once again I remind you I will take all your questions what we what we are we are really getting into some long hours here. Representive you're recognized thank you Mr chairman thank you all for the work you do and please thank your employees for us and thank you for taking care of those special citizens in Arkansas Director blessed be your saying you're coming from a position of protecting your clients and I really respect that I think you also respect that we are in a position of protecting those clients constitutional rights as well. As well as your employees as well as all our Kansans and those are the really hard questions we're trying to determine what this we work hard to find a solution to those mandates that we saw coming and felt like one solution to that was to allow. Those who would like to get a vaccine would be able to do so and that would fulfill those requirements. As well as those that have antibodies through an antibody FDA approved Arkansas patented produce manufactured antibody test was another option or weekly testing so my question is without law in place with those options are we going to be back here six months from now or. In the next year. St all antibodies our own from my vaccine that I had back in may I no longer have antibodies I need to get re Max unaided how long do you think that these actions that we're going to require of all people mandated without exception how long will that last and we will we be back here when they're antibodies have Expired. I'm not a medical professional to answer your question right what I can tell you is that among the public comment the comments that we are giving to CMS Because we're we're going to address a lot in our comments to CMS about how they should modify this rule if they do not completely taken down is that testing should be an option antigen should be in a there should be other ways and not just a flat you must have the vaccine so I for whatever that is worth we are we are trying to in addition to expressing our health and safety concerns expressed a desire to have more flexibility in the way that we comply. Thank you I really appreciate that. The see no further questions we thank you for your job in sorry for the position federal government as but you. Thank Mister thank you members with that of we'll call up Secretary Nate Todd. Or his representatives. If you guys would introduce yourself for the record and you're recognized to state your request. It. Secretary Todd since his regrets he already had a previously scheduled engagement that he could not change. My name is Erica Ingram on the Arkansas department veteran affairs chief of staff. You're running a pulley the finance manager for Arkansas Department of Veterans Affairs. Mr chairman we come before the board today requesting the ability to begin work on a draft policy I concerning the COVID mandate just in case we needed our our requested not come over to Wednesday evening because it came out of a meeting that we had on Tuesday with our council because we do not have in house counsel our counsel is someone in the AG's office so I in the midst of that discussion it was determined that we to ship request the ability to draft the policies DHS. Any questions for the Veterans Affairs agency. C. N. nine we appreciate you and please From from what I've heard today in committee please look at your policy on religious exemptions and please look to see if you need to produce a policy that is isolated to COVID nineteen vaccinations. And we would Mr chairman we already have and I just for the group but also like to add that we do currently have nineteen people nineteen refusals I we have had a quite a bit of success in our North Little Rock of people who have chosen to get the vaccine they're currently at ninety five point five percent and in the Fayetteville home is seventy percent so we would be able to process those exemptions in a timely fashion. That's it thank you thank you members the other item on the supplemental agenda will be taken up in the review subcommittee report so with that we'll move on to report that would go to the ministry to rule Senator sample you're recognized for that report. Thank you Mr sure that managed thirty administrative rules subcommittee met on Wednesday November the seventeenth the script subcommittee adopted reports of the executive subcommittee concerning its approval of emergency rooms subcommittee reviewed and filed a quarterly reports that were submitted by the department of corrections and parole board subcommittee received an agency of Derek update on delinquent rulemaking under ACT five seventeen of two thousand nineteen and file written updates pursuant to act five ninety five of two thousand and twenty one. All rules were reviewed and approved on like to note that the eighty D. C. broadband roll that was reviewed and approved by the administrative rules subcommittee does not conflict with the emergency room that was reviewed and approved by the executive committee this morning and Mister I move for adoption of this report proper motion drive second I have a second any discussion on the motion seeing none all those in favor say aye All opposed us have it motion passed I move too fast earlier so we'll come back us Senator Irvin I think you have a motion. I do thank you Mister chair I move suspension of the rules to consider an interim resolution of the Legislative Council they're passing out this resolution right now and this is really based on the testimony DHS also provided for public comment so that we may have the opportunity to submit public comment on the CMS rule interim final rule because of the hardships that is placing on our health care workers and facilities and that type based on the testimony that we heard today so I would may suspension of the rules to consider an interim resolution and that's being passed out right now as proper motion I do have a second that is non debatable all those in favor say aye hi All opposed us have it if you would. Of move your way down to the table to present your resolution to the full council. Absolutely thank you Mr AS one was going to vote against the resolution I would like for my opposition to be a part of the record that goes to wherever this is going to be sent is that possible when when the motion is made for adoption if it's made for adoption we would take your point at that point and make sure that is placed in the record thank you so much yes ma'am. Thank you Mr chair what before you have you have before you today is an enormous solution that basically just states and and testimony that we have heard today from the attorney general's office this supports the action by the Arkansas Attorney General and this is a resolution stating that we as Legislative Council support that action taken by the Arkansas Attorney General to oppose the rule the interim final rule and then it also supports the testimony given by Secretary Cholesky at DHS that this is because this rule is causing a hardship on our health care facilities and our healthcare workers and and then this resolution be entered into that public comment to be taken consideration as they are finalizing this interim final rule and with that I would take any questions. And I will move adoption of this interim resolution with the understanding that it will be formally filed and numbers prior to being submitted to CMS as a public comment on the interim final rule. Before I take a motion for adoption or take questions on resolutions are sent representative hop you're recognized for a question resolution. I was just looking out the it says it and the lawsuit in a federal court in Missouri with that be the eighth circuit court of appeals do we need to specify that is the eighth circuit. I had the the attorney general's office and tourney's Health in the drafting of this resolution. It says I felt that that paragraph was they were comfortable with that paragraph. And and stated that I could state that they are supportive of this resolution. Any other questions for the resolution itself. Okay see no further questions for resolution Senator Irvin I'll take your motion at this time I move adoption of the interment Lucien with the understanding that it will be formally filed and numbers prior to being submitted to CMS as a public comment on the interim final rule has proper motion I do have a second presenter English. All of I will take discussion from center Chesterfield and others thank you Mr chair of. However the outcome of the motion is I would ask that my name be placed in the record as being in opposition and that anyone else feels the same way. that there's be recorded as well. That's proper will be noted in the records Senator Elliot you're recognized. Mr I just is that the same request and con and my comment is that you know we constantly have the Attorney General one lawsuit after another after another intervening and I just think it's just at a point it's just become a political stunt. And I'm just I am. I just think this is time we can spend doing something else thank you. So noted center representative Ladyman you're recognized thank you Mr chairman I don't believe this is a political stunt I believe what we're trying to do here is save lives. We're trying to protect the constitution I would ask that my name go into support of this resolution thank you Mr. So not a representative Whitaker you're recognized thank you Mister chair I would like to record reflect that I am in opposition to this resolution. Members members. We. We'll take a vote. There is a proper roll call motion made this time will will honor to. So I'm not gonna take any more request to show how you're going to vote would take that as we go. Is there any more discussion on the resolution for the vote Senator Clark. I want to of thank you of. Senator Irvin for bringing the resolution of all thank the Attorney General for the work that they've done. If there's any political stunts are not sure whether it was the president who promised that there wouldn't be any vaccine mandates when he was a candidate or when he issued the after he was president thank you. So seeing no further discussion all those in favor say aye. All opposed. No the ayes have it. I ask three hands. So start to roll call. Senator Hammer. Senator hammer and has no alternative. Senator Pitsch. Senator Pitsch Senator Pitsch has no alternate center Johnson Mark Johnson. You Senator Mark Johnson is aye Senator Bob solder Ballinger. Senator Ballinger is an I. Senator Hill. Senator Hill isn't by Senator Davis. Senator Davis. Senator Wallace. Her alternate is Senator Leding who is first alternate for Senator Eads. Senator Wallace. Senator Wallace has is not hear us. Senator Leding. Senator Leding. Senator Blake Johnson. Senator Blake Johnson is an ice Senator Flippo. Senator Flippo is an I Senator Hester. Senator Hester is not here Senator Hickey. Senator Hickey is an on a Senator Stubblefield. Senator Stubblefield as an ice Senator Hendren. Senator Hendren is not here Senator Ingram. Senator Ingram is not here Senator Clark. Senator Clark is an ice Senator English. Senator English as an on Senator Caldwell. Your call is an online Senator sample. Senator sample is an I. Senator Dismang. Senator Dismang is an I Senator flowers. Senator flowers is not here Senator Rapert. Senator Rapert is not here center Chesterfield. Senator Teague. Senator Teague is not here Senator Elliot. Senator Bledsoe. Senator Irvin. Senator Rice as an I.. That having passed the Senate I'm going to go to the House now. Yes representative ray. Represent raise not here representing McCullough. Representa Collison NO represent Garner. The garners a no representative Cavenaugh. Representative Cavenaugh is not here representative Vaught. Representative speaks. I'm sorry represent bodies and I represent speaks. Representative speaks is not here representative fight Lanny Fite. Represent Lanny Fite is an I. representative Ferguson Kenneth Ferguson. Represent Kenneth Ferguson is not here representative back. Represent back as an I. representative gray. Represent graze and I represent Ladyman. Represent Ladyman is an I representive McNair. Represent McNair is not here but he signed in. A representative evens. Representatives's ninety here represent Payton. Represent Payton is an I. represent Deborah Ferguson. Representative Marsha Davis. First alternate represent marsh Davis second alternate representative Nicks. No voting for representative for David Deborah Ferguson or her alternate represent Hillman. Represent Hillman is an on a representative would occur. Represent Whitaker is a No representative Charlene Fite. First alternate representative Haak. Represent park is in on a representative Bragg. Represent Bragg is an I. representative Womack. Representative Womack has no alternate representative Josh Miller. First alternate representative wing. Second alternate representative wouldn't. President Lowery. Representive Lowery. Representative Cozart. First alternate representative Richmond. Not here represent fielding. Representative Eubanks. Reserve Eubanks nonvoting representative Deffenbaugh. Representative from buzz not here representative Godfrey. Representan Godfrey's NO representative Shepherd. Represent Shepherd is an I. representative Murdock. Representative Murdock is not here representative hollow well first alternate. Represent Hollowell is not here representative met McElroy is second alternate. Represent McElroy is not here representative gene. Representing is not here representive Meeks. Represent mixes and I represent Dotson. Represent Dotson is not here represent Wardlaw. Represent Wardlaw is and I. If. With that we'll move on to the rest of the reports were down to the gamefish Reports Senator Ricky Hill. A scope. You're recognized. Thank you Mr chair. The game patients likely subcommittee met Wednesday November the tenth twenty twenty one the subcommittee received a report Arkansas state police regarding the use of it maneuvers low profile vehicles and state police salaries in the Arkansas game and fish commission provided updates for the ongoing conservation projects. With that I move for adoption as proper proper motion I do have second any discussion on the motion. Seeing on all those in favor say aye ayes have it. Of report as reviewed. Hi read subcommittee representative David Whitaker. You are recognized thank you Mr chair the LC higher education subcommittee met Monday November fifteenth twenty twenty one the subcommittee heard testimony from Dr Chuck Welch of the Arkansas state university system regarding the activities and initiatives of the system and higher education during the pandemic and afterwards. I move adoption of the report has proper motion to do have second any discussion on the motion. Seeing none all those in favor say aye opposed ayes have it Ford is adopted with that we'll move on Senator sample for marijuana oversight. You are recognized thank you Mr M. medical marijuana oversight committee met Tuesday November sixteenth twenty twenty one the subcommittee received a report from the alcohol beverage control regarding medical marijuana sales and dispensary licensing and heard testimony from professionals within the medical marijuana industry and with that I moved for adoption of the report as proper motion I have a second any discussion on that motion seeing none all those in favor say aye. Oppose ayes have it with that we'll move on Senator P. report sent Senator Jonathan Dismang and I think you'll have to that's correct you're recognized that's my understanding of the beer subcommittee met on Tuesday November November sixteenth as noted in the report subcommittee receive reports for you for a request and approved the following items for his temporary preparation increases cares preparation increases reallocated resources for DHS appropriation transfer American rescue plan appropriation correct request one A. R. P. requests from the department of commerce for nearly one hundred twenty five million in preparation for rule broadband members of the subcommittee have questions about rule broadband program at this time I move pulling from the report and see twenty six the commerce A. R. P. request raw band to be voted separately after discussion moved for adoption the rest report. That's proper motion do I have a second I have a second all those in favor say aye I got. If we. Okay. All supposed. Is have report is adopted Senator Dismang you are recognized to make your second motion all right members we have a revised broadband hand out at your desk there there are representatives here today from the Department anyway massive provided technical guidance to the Department to answer any questions so I'll open it up for questions of someone else this time. No. President of Ladyman you have a question for you Senator Dismang a for the department I have a question for the department all right I see income. Mr Hudson if you would introduce yourself record representive you're recognized ask questions you Sir jim Hudson deputy director ATC. Yes correct that's not my question is about the the three projects that were removed what was the challenge I'm interested in the Craighead county the to rake in county yes represent Ladyman you know we began to receive some communications from folks in cricket council that there may be some potential overlap in the footprint that to Ritter was proposing with some existing work that was getting done there so also we don't wanna double spend on this so we thought it would be best for all three of these that we just tap the brakes and give the the parties who were expressing concern opportunity more fully explain what their concerns were let us take those into account and if we agree with them that we will move forward with it but if we don't believe there's basis to it then we would bring it hopefully to the chairs for approval at a later date. A how does that negatively or doesn't negatively affect the project being done or being delayed their. Well it you know he will create a delay from compared the ones that they hope they get approved today but we're not dragging this process out hopefully we can look at this so the next you know couple weeks or so and get a better handle on what the concerns are so I would hope that would have resolution to it by no later than early December. Thank you. I see no further questions. Senator when you have a question yes just I appreciate that because I'm an I want to make sure consistent with making sure if that's going to be the case you know as projects are considered and so we've had that discussion about some of the projects that were funded in this round and you had stated to me it was because of that cross over so just so long as we're very consistent you know with all projects across the state and that you don't want to. Cross over or. Layer them on top of each other or or however you want to state that I just wanna make sure we're consistent yes ma'am in in just with real quick bills into the chair just explain what I shared this morning the executive subcommittee with represent Dotson which is a conversation peers well we know we have work to do to tone up the challenge process so that there's a lot of clarity about how one can challenge a potential grant to be awarded and so we're gonna work on revising or preparing a rule that specifies how one goes about challenging so people really clear about the steps are that would be good I think because I want to make sure you know those projects are getting cut just one company may be we like one company more than we like another company we just need to make sure that we have a consistent policy and that all of them are treated equally so yes ma'am we we wanna recommendations to withstand scrutiny thank you. It's represented what you're recognized. You say you're going to change of the way these are challenged I mean how is that done now I mean all these others get approved and you pick out the story and the reason I'm asking the question is because there is a shortage of contractors to do this work. And Health they need to be able to be approved so they can move on these communities can move all of these counties so what what has the process been and will send these three or pool that yes Sir the the process is is that we review these on the front end before you make a recommendation for a ward and we rule out whether or not there's any overlap in this case we have individuals coming forward some ice fees maybe competitors members of the community same there indeed is an overlap and the reason that can happen is that the the ground is changing awful lot out there because our people putting in fiber all the time and so just out of an abundance of caution but not a long period of time we want to make sure we get a chance to go and look at it look at their concerns make sure there's no basis to it so we can move forward on these grants we just rather do that than to be in a rush and it turns out that maybe we should move forward on something when we did. One more follow up have these contracts been let early notice of an approved they now have been approved yet we're making a recommendation to so you the on the okay thank you Mr chairman thank you Mr. Senator Dismang you're recognized. Are we ready for motion. Okay I move approval of the hundred thirteen million seven and forty one thousand seven forty nine dollars and sixty cents an A. R. P. appropriations apartment commerce for a broadband as highlighted. In the green on the department's handout. Thank. C. notification all those in favor say aye opposed us have it thank you for your before thank you for testimony that will move on to review one more I also moved that we allow the chairs Legislative Council approve the three contest projects highlighted in yellow on the handout totaling eleven million twenty four thousand three hundred ninety one dollars and eighty eight cents after further review has taken place. As proper motion and a second any discussion on the motion. C. notification all those in favor say aye. Opposed us have it with that will move now to the review subcommittee representative Bragg you're recognized thank you Mr if you subcommittee met on Tuesday interviewed methods of finances question or grants and services contracts and method of finance for you in mass was held for additional information the whole is not been released in the item will remain on hold in the review subcommittee there's a contract for review on the supplemental agenda for you a P. B. to hire security guards services for upcoming events on campus it was not available for review at the meeting earlier this week but is needed by the agency prior to the December meeting date I move adoption of the review report is presented and review of the U. APP contract. I have a motion and second. Any discussion on the motion. C. none all those in favor say aye. All opposed us haven't. In representative Bragg did did you include the UAMS I mean you A. B. B. on the supplemental in your motion. Okay sorry thank you. So that will move to the of personnel subcommittee representative Hillman you're recognized Mr chairman of personnel committee met on November seventeenth the committee reviewed and approved the request and reports listed in items one through eighteen on this report Adam nineteen was a discussion only with no action required I move for the adoption of this report. Thank you has proper motion the second all any discussion on the motion seeing none all those in favor say aye. All closed eyes have it with that we'll move on to the occupational highway subcommittee and I'd be Senator Blake Johnson. Thank you chairman of the the how the commission commission review an advisory committee met on Wednesday November seventeenth subcommittee reviewed the following items efficiency study rule report and annual expenditures and revenues report progress our construction project and the in the end and Action reporting on interstate forty Hernando desoto bridge and move for an adoption. As proper motion I have a second. All those in favor say aye. All opposed us have it with that we'll move on to the occupational license committee be Senator Clark. Thank you Mr. The occupational lossing review could subcommittee met Thursday November eighteen three reports on occupational occupational authorizations from then that's resources division the Arkansas department of agriculture Arkansas State Board of athletic training in the elevator safety division of the Arkansas department of labor licensing I would. That we accept the report. I have a motion and a second all right to any discussion and motions in none all those in favor say aye. Oppose ayes have it motion is adopted with that members will move on to aids there's only one item under age that needs a motion that is one the Arkansas Economic Development Commission division of real services that is a of grants block grant cycle so I have a motion and a second all those in favor to approve. All opposed no ayes have it so we go move on down the agenda to a new business. Under new business there was a letter submitted to council in pursuant to ACT six oh eight of twenty twenty one by Senator Trent Garner that motion we'll I will need a motion to refer to that letter to the public health house and Senate committees so move I have a motion and a second all those in favor say aye of all oppose ayes have it that motion has passed that will be referred to the public health. Senate and house public health committee so would I will move on number two Major General Penn. A general view would you and your staff introduce yourself for the record and you're recognized to give your report. Good afternoon Sir and thank you again for the opportunity to appear here today for the act with the teen report my name is Major General Kindall pen of the agile General of the Arkansas National Guard the disgusting or chief of staff or military. Thank you. Thank you. So I'm very privileged to lead one of the finest organizations I think in state government I'd like to just run down real quickly and thanks at the chance that maybe I'm being a little done with the last time I was before this committee on a first off with how the organization is organized so the US military department of Arkansas and the Arkansas National Guard or often use the terms are used interchangeably in fact when you look into state code there to legally distinct and separate organizations of the Arkansas National Guard is composed of eighty seven hundred uniformed members including sixty seven hundred army two thousand there is a federally funded trained equipped paid and administered organization is concerned is considered the organized militia of Arkansas in who a they also serve as a part of the reserve components of the army and the airforce the army is stationed at two installations here in the state for chat or for Chevy in camp Robinson as well as fifty four armory scattered around the state many of them in your communities. The error has one wing at Little Rock Air Force Base in one wing at ebbing Air Force base in Fort Smith the military department on the other hand is composed of one hundred and twenty state employees paid from your state appropriation and about three hundred and thirty state employees aid from federal appropriations the purpose of the military departments to support the National Guard by turning federal dollars into state manpower goods and services. The R. and then I as the adjutant general I act as both the commanding general for the Arkansas National Guard as well as the US secretary for the department of the military so I wanted to give you a quick feel for what the National Guard has been doing for the last two years armados always ready always there and quite frankly I think we've lived up to it in spades. In March of but March eleventh of two thousand twenty Arkansas has first COVID presumptive case in Jefferson County on the fourteenth the National Guard mobilized or first twenty guardsmen to assist the department of health with its emergency operations center in a call center on March the nineteenth six guardsmen from the what any not wing will call the state duty at UAMS on March the twentieth two army guard doctors were a requested and provided to the department of health demand aches up positions call center to provide providers around the state with information about the coronavirus March twenty third we mobilized for guardsmen from the thirty not to handle incoming shipments of personal protective equipment they handle over fifty six million pieces a PP before the mission ended on March the twenty eight ten civil engineers recalled and these are civil engineers with who are those skills to their so they and employment were called to duty from the army and air guard to support the army corps of engineers as an example dental sites to establish emergency facilities to care for overwhelmed hospitals that could run out of bed space we didn't need the did if we didn't get the virus under control on April the first the governor ordered for me medical planners for logistics planners seven logistics and communications planners and three inch information analyst support to support the department of health plan for future operations and build out those alternative care facilities if needed on the may the twentieth we mobilized five guardsmen to support grounds maintenance at the Arkansas state veterans cemetery after their crews were exposed COVID net going to quarantine on June fifteenth we sent twenty guardsmen to assist apartment filled with case management in on the fourteenth of July the governor of the fourteen medics to help staff a facility for COVID nineteen patients from around the state. On November the sixteenth the governor called up to thirty guardsmen to assist department help with COVID nineteen case management. In addition to that wall all of that was going on we still ended up falling over two million gallons of water to Carthage wants will collapse all over two million gallons of water to the fifty six community in north northern Arkansas mobilized five hundred guardsmen to support the Arkansas state police during the civil unrest during the summer of two thousand one or two thousand and then responded to the Joint Jonesborough donate for NATO with cots and turned over one hundred and forty one acres of land to the Arkansas state veterans cemetery to expand the cemetery grounds. Twenty twenty was of a very busy as I said twenty twenty one didn't slow down. We mobilize five hundred guardsmen from the one forty second field artillery brigade in the northwest corner of the state to go to Washington DC to protect the capital. End up February of twenty twenty one we have a cold spells y'all might remember and we ended up with a hundred guardsmen alpha trolling the highways to help rescue stranded motorists as well as to drive analisis for ambulance services you couldn't navigate the snow and ice in March of twenty one we also mobilized more than a dozen minutes medics to administer COVID nineteen vaccinations statewide with four different mobile strike teams in July the governing authorized in order to thirteen mechanics the state active duty to help the Texas National Guard with the border crisis we provided eight soldiers and airmen supporting department help with vaccination planning and distribution support during all that we still mobilize guardsmen to defend the nation our guards armored protection detachment spent a year at fort Meade Maryland protecting the nation's sovereign for structure one eighty eight when continuous operations in the US Central Command area of responsibility of flying Connext recognitions the one I did not airlift wing continued its C. one thirty age aircrew training mission the one forty second field artillery brigade sent soldiers to Europe or to participate in an exercise in the brigade headquarters and headquarters battery has since deployed and are now operating in the US Central Command area of responsibility the thirty ninth after brigade conducted a large scale joint readiness training center operates the exercise of poor Polk Louisiana and then lastly we'll talk about the future that's coming up for the Arkansas National Guard you may have all heard but the C. one thirty wing the one eighty not counted Walker for space has been selected to field the C. one thirty J. the newest model and they will continue training guardsmen and what we intend in the and are aiming to train active duty airman as well on the C. one thirty J.. And for our our friends up in Portsmouth one eighty not wings been selected to provide host facilities for for military sales training for the F. thirty five as well as the Singapore Air Force F. sixteen school bringing in somewhere between what we think is gonna be seven hundred billion and a billion dollars a year of economic impact in the region Mr chairman thank you so much that concludes my report. I just want to say The representative twelve years and I never ran into a crisis like Carter Chad and we ran into that crisis I don't know if people understand when you have a whole city that has no water that is a crisis and I went up there and we were able to start Hall of water with fire departments the first two days and I personally held and hold water these guys showed up ASAP with a holder grade of trucks and tanks and and went to work and I personally went by there every morning and every afternoon. All the food I helped him get diesel whatever they needed but these guys are unbelievable folks and I don't know that we know what we have over there are what they do for us as a whole but they stayed at Carthage for almost a year why that well was being drilled in a hard water every day prompted into that water tank so that city had water just like there was no interruption I can't tell you from the bottom my heart how much that means to me and my voters in my district that you guys were there thank you. Senator Rice you're recognized for a question statement thank you just just a quick one and again Major General thank you for your reporting for your service up are you seeing any we. You sit here all day thank you for your patience We're seeing some people retire allow out or leave some of my earlier than they planned on it with what we discussed here today by nation mandates and all is this anything that that is. A volume do you have a number that is expected to that we need to know about. Yes Sir and so when I talk about the Arkansas Army National Guard and I as mentioned that is administered federally I have to break that down further to say that the army guard is administered according to army rules and regulations and the guard according to the Air Force rules regulations but taken as a whole we've been up providing COVID nineteen vaccinations sense a. The. Since September I believe and so those are are required by the Secretary of defense order and to date we have had three hundred and forty five absolute refused. Out of the. The roll out of what is roughly seventy seven hundred folks who are eligible to take the shot. You. Thank you for that report Senator Irvin you're recognized thank you chair I just have to reflect and I have a second the comments made by representative for the law because you did the exact same thing by hauling water to my community in stone county of fifty six and that's hard to get to those are at it's a mountainous area in that community was just so Just distraught by the fact that they ran out of water and how you all just came to the rescue and and I just again I want to say exactly echo the sentiments that represent Wardlaw stated for his district it was the same for my district in the middle of a pandemic fifty six runs out of water and had no way of getting water everybody was panicking and carry all came to the rescue immediately with the trucks that you brought and hauled water for so long and I just have to echo it was just amazing and so from the bottom of my heart and for what you did for my constituents in stone county and fifty six I am so grateful to you and to everybody that helped us I mean you came running and for the people my rule community it just meant the world to the world for my whole entire county and we just really just want to thank you from the bottom heart for what you did for us thank you. Senator Blake Johnson you're recognized. Major General I have had similar circumstances and we created a fund where these reading is centers and and your armories are AG. And there's federal funds that that you can capture if you have the the build up and and we created a fund where you could carry over. Into that so you can apply for those federal grants I can't remember the specific time line on those federal grants but could you tell me if if you had funding that you can carry over in the last year and and the time line because I can't remember yes Sir and so the way you military construction and major modernization repair works for most of our facilities and that kind of clarify so that's all of the state facilities which includes the armories out in the communities as well as other facilities on campus events and those all require a state match before we can apply for federal funds to repair those facility or to put repair those facilities and so. We're fortunate in that last from last year we have about eight hundred thousand dollars in carryover money that we're going to apply a largely towards of the debt the deficit we built up in the in our maintenance but not right now we are about eighteen million dollars of repairs behind in all of the facilities that we have in the state and so you know as we. As we look forward into the future could we use more money to help bring down that backlog of maintenance at absolutely no camp problem or as a mention of state facilities federal facilities like up for Chappie ebbing Air Force base and Little Rock Air Force base they don't require a state match so we're we get federal funds yeah and every year to repair facilities we can only use as much of it towards armories out of the local communities as we have a state match to apply and so as often as not we run out of state match in into the end up spending I wouldn't call it gold the gold plated facilities on those installations but at we spend federal funds on those installations at greater rates than we would if we had a state match to apply outwards arm remains yes Sir just a on that same note so I just want to let you know that according to my facilities engineer here thank you two days ago we've just got contracts on Walnut Ridge so hopefully we'll be seeing some improvements on that are good deal I appreciate that but. This is the facilities it's in our community. They can get funding from the big facilities. But in our budget. If these guys can get a million dollars. How many years cycle is are are those funding so for major construction like to build a brand new armory the the National Guard bureau budgets to provide every state a new armory about on about an eight to ten year cycle and so normally that's about a I think it's a twenty five percent match for that which is usually around five to seven million dollars that we need to have up front to be able to compete for those so if we started this process. It would take thirty years to update those because of the cycles. If if in in that time frame are am I wrong if we were if we were to have those match funds ever eight years or so. Yes Sir just to clarify so if we were using only brand new construction to replace armories that currently exist thirty years would probably be an optimistic assessment however we also can use the state mines or the state funds to upgrade the facilities that currently exist and keep them are usable for a much longer period of time. I appreciate the help from the members and and leadership and help in the general help help our local communities with these armories and I appreciate gels work thank you for your. Representative Ladyman. Thank you Mr well I just want to add thank you for what you all did in Jonesborough I mean that was a horrendous events I drove around in the wind and rain trains were blown over every plane at the airport was piled up in a pile not a single person died only five people went to the hospital you guys helped out with that was a big part of that and I just appreciate what you do some people haven't recovered yet it's been two years I mean the main mall in the fifth largest city in Arkansas was blown away at five PM on a Saturday afternoon nobody was killed and the response was great you were part of that thank you very much. Senator Chesterfield you're recognized. Thank you so much Mister chair and I normally move for whatever but I am moved you just say thank you. Thank you for helping us as we faced one of the greatest pandemics in the history of this country. Without your help in the State of Arkansas stepping in wherever you were needed I'm not sure what we would be as a state and so I want to say thank you for that because. COVID nineteen is a cool thing. And it is treated this state cooling because we've lost over a thousand lives and without your help. In role helping us rolling out some response I don't know where we would be so I want to say thank you for that and to also protecting our nation's capital. I appreciate it. Thank you so very much thank you ma'am and I'm very again very honored to lead great young men and women out there across the state and as a preventive COVID you know we we operated we've got a lot of things but we operated as a whole of government approach and so if you look at the response from all of the Arkansas state government agencies I mean all of them did yeoman's work. Members of you would join me in a standing ovation I want to make sure they understand our appreciation. I just want you know general Barry is upset because in the days he said there we didn't do that. But thank you guys and thank you for what you do thanks we appreciate it. With that we'll have secretary of state your. You if you would introduce yourself record you're recognized good afternoon Amy Fetzer secretary of the Department of transformation and shared services. Our department while we may not be saving lives we are the operations of state government we have six divisions the Building Authority geographic information since systems information systems procurement of personnel employee benefits and we also manage the state surplus. Our focus is we were created in July of twenty nineteen has been outstanding service upgrading legacy systems and finding efficiencies some of our projects over the last couple years our What we have branded a our careers which is a new HR management system A. R. by which is our E. procurement system that's being implemented currently my Arkansas internship program which is a statewide internship program that goes across all fifteen departments. Our data center modernization is taking place now and we are strengthening our cybersecurity and fell over daters data through that system we also have what we call a R. data which is an analytics division within D. I. S. that supports and collaborates with other departments to four case studies and to help the citizens of the State. Also this year GIS got to participate in redistricting and the maps for that. You have the report in front of you and I'm happy to take any of your questions. We do have some questions I would say that we look forward to having your cooperation as we go through the final steps of the EBT transformation in thank you and thank you department for the information and the ability to get to where we are today. Senator Ladyman you're recognized thank you Mr secretary of venture you have difficult job over the past couple years in the you don't moving all these different pieces together and creating a apartment and you know a lot of the savings that we thought we would have came because of your department but do you feel like we're were you thought we would be as far as improvements savings and that sort of thing are we on track with the plans are we behind what what's what's your opinion of that. I believe we've made great stat strides since you live twenty nineteen when ACT ninety and became effective of course you know the pandemic has slowed down a lot of things that we hope to accomplish but we're still going full force and I feel like we're gonna realize even more savings before the end of this administration. Senator just feel you're recognized yes thank you Mr secretary Thatcher you mention a number of programs including my internship program what are you doing to make people aware of the programs are are they on TV on the on radio what are we doing to make sure that young people know. Or even some not so young who want to engage in a interpretatio how we getting that word out. We currently we don't have an apprenticeship program so we are targeting those that are at least age eighteen or through their college years so the way we have done it so far as we have things up on our website many of the departments have chosen on their website to link it to theirs as well and we're reaching out to colleges to let them know and some high schools if they have some seniors that are eighteen already that want to enter into the program we prefer them to have at least one semester of college before they come into it though it will I guess my concern is with the broadband constraints under which we operate in this state. Are there other any mechanisms that you are willing to use because are we getting them out to all councillors and if so is it high school counselors only are we getting them out to how we distributing them to the colleges and universities I just need a little bit more specificity and if you want to share with me online that's fine but if we're having programs and we're kitchen the devil hiring people in the state if we're going to have internship programs would have to do a better job of making sure people from everywhere know what and not just those who have access to broadband thank you Mr. Senator Irvin you're recognized thank you senator tester I just wanted to also express my and thanks to you when we were able to consolidate all of the catastrophic fines in order to provide a maternity leave for the state employees which I was so excited about being able to do yes I was just the I thought the beginning of all the different kinds of innovations that we could do under your office and under your leadership you've continued that so really just you know that was such a huge move for state employees to consolidate those catastrophic leave plans and then come to continue down that path of what else can we do to create some efficiencies so even so great and understanding that and you know maintaining that and moving this forward on that path of where we can also find some of those innovations so I look for to working with you and just wanted to tell you thank you because we do appreciate you very very much I do at least thank you. Thank you see no further questions thank you for your four members C. and no other business on the agenda we stand adjourned thank you for your insurance.