Public Health, Welfare and Labor- House & Senate

Share sees a quorum. Members a. I would go ahead is seeded we're gonna get started we've got a fairly long agenda today hopefully won't go too long of before we get started like to recognize Carly Cooper is our new administrative assistant. Over here. for the house and Senate public health committee. K. still is been promoted to assistant to the administrator. So Carly will be working with us in the future the next meeting of public health the main public health committee will be December the sixth at ten o'clock in mac a. If we need to have the subcommittees meets they'll meet at one o'clock in other venues other meeting rooms. So with that and I ask my co chair Senator you have any comments. Thank you Mr chair we're glad to see you and we feel like we're going to have a very interesting meeting today thank you. Thank you. Okay first item on the agenda is the consideration to approve the September seventh minutes the motion. I have a motion. All right I have a motion and a second secretary I have a second over here I have a motion and a second all in favor signify by saying aye. All opposed nay. Motion carries. K. next item on the agenda that would be item D.. Review president Biden's executive order one four oh four three regarding requiring COVID nineteen vaccination for federal employees. As referred by the Joint Budget Committee percent two ACT six await. And we have a deal fair here legal counsel for bill are to explain this to us and what our duties are under this act. You would please introduce yourself for the record. Thank you Mr chair Jill Thayer of Legislative Research I'm I was asked to come and give you a brief overview of this the subcommittee or these committees duties under would you for Michael to close review can yes there I'm just gonna go into the public health committees duties under Act six oh eight M. as you know the Joint Budget Committee referred to you by president Biden's executive order regarding COVID nineteen vaccines for federal employees at its meeting on September thirtieth under Act six oh eight and. That then prompted the house and Senate public health committees to meet jointly to consider that executive order and under the act you have to responsibilities wine and eat at the act states that you may decide that you want to referred the executive order to the attorney general's office for consideration they would review it and give you an opinion as to the constitutionality of the executive order and other items if you decide to do that it would be a vote of this these committees to refer at AM if you do referred them once you receive that opinion back from the attorney general's office you would meet again to hear that and then your duty under the access that you shall make a recommendation as to action that you would you recommend to either the Legislative Council if you are in the interim or if you are in a special session or the fiscal session when you take this up again it would go back to the Joint Budget Committee and your recommendation should include whether or not state resources or personnel are being required by the executive order and whether you feel there's any further action that needs to be taken by the state in order to preserve your rights and third litigation and so that's that's all that is required of you under Act six oh eight I'll take any questions so if our committee. Did not want to recommend anything we still would have to send that to the council or budget yes there under the act it says shall recommend but your recommendation could be that no further action is needed by the state okay thank you. A wrecker US senator garner you you're recognized for a question. Thank Mister Moore statement of I'm the one who sent a letter to joint budget during the session do this this kind of shows you House sometimes our time lines get. Extended to appointed some things may be moot so the reality was whenever I drafted this letter it was right after the exact words came down and as of today there has not been another executive order for the hundred employees or older are over which I think is more the crux of the issue so as far as the federal employees themselves I I don't know how much authority we have but I'm drafted a new leather letter for federal contractors because that issue does seem very apart at this time we had the Attorney General filed a lawsuit last Friday as seen as unconstitutional we've had changes in the body ministration since that executive order on what that actually look like and since that's more of a permanent issue I think if proper we needed to that budget due to having to December six meetings so that's my take on it obviously just body can take any action that it wants to I think the issue of this particular executive order it is a lot less part and then some of the other ones that may be coming down the pipeline so thank you miss for indoor minister. All right is there any Comments from the committee any other questions. Any motions any actions. Seeing none thank you for your I'm sorry. Representative Bentley you're recognized thank you chairman in this this discussion committees and you asked us of I know reading of remarks from our Attorney General but she does not she's against these executive orders and so it might behoove us to get a review from her for us to have this prepared for me again I was just a I thought that might be good to get an opinion official opinion for this committee from the Attorney General to so we're. Maybe step ahead. I just thought so. So representative Bentley are you making a motion I make a motion that we send this to the Attorney General to get an official review for us to have maybe just due diligence ahead of time before we need to come back and hear some discussion on this okay. I also make that motion to sent to the Attorney General for her I have a motion and a second to request an opinion from the Attorney General on this subject. Any discussion on the motion. Seeing none all in favor signify by saying aye. Those opposed nay. You guys have a motion carried so we will request that opinion thank you. Okay I'm moving on to. Item II. Discussion of the U. S. supreme court's decision in the PCM Association case. So if you all would come forward. From September. Yeah this is committee this is a carryover from September when we. Then get the cover this. So if you would please introduce yourself for the record. Good afternoon chairs members of the committee my name is Brad nine the legislative director with the attorney general's office. Hello I'm CNN Holly on deputy Attorney General for public protection. You're recognized. Thank you Mr chair I'm I'm afraid I'm here mostly as window dressing today miss Holly on is certainly our expert and speak with the staff I had of today's meeting I believe our understanding of the agenda item is to discuss steps forward in relation to Review of of pending complaints that received by our office before the PCMA decision came down so with your indulgence I would lie from his holy on just kind of talk through that process with you. Yes and through that process we have a number of complaints that were submitted by pharmacist that were on hold during the time and everything during the pendency at that Rutledge action into now we are working through those and processing then we have hired an outside consultant who was actually at the the lady at the Arkansas insurance department he did that very thing and says she retired from the Arkansas insurance department is now on board with the AG's office as an independent contractor and is working with us to process all of this pharmacy complaints that are being submitted to the different PDM it does take a lot of time and resources because of the way that the pharmacist had submitted their data it wasn't necessarily all uniform that we are working through all this issues communicating with that the PM's who have thus far being have been cooperative with our office so we expect some results as soon as a month from now and hopefully sooner and those will just take some time to work through each each one of them. Happy to answer any questions about the process or any other details that you might point out. We do have a question a couple questions Senator Teague you're recognized. The. Okay. I think I don't see him over the. Senator garner did you have a question. Yes Sir if if or when when when appropriate times you're recognized thank you so. The crux of the case wasn't just really about PBMs and the ability of Arkansas to kind of just the rates on that debt for broader implications own kind of states rights to set pharmacy rates across the board I can you can a dive into that more in kind of what the the case said what kind of our our powers that we have moved for versus some of the older court decisions. And senator garner I've I appreciate that question I'm afraid I would have to defer to our solicitor general's office that actually argued the case to really get into the inner workings of what the case actually stood for and and I apologize if we misunderstood the agenda item today we are really prepared just to talk about how that claims processing process will look going forward but we are happy to get answers back to you or to have the appropriate people at the table the next meeting. If that was the scope of this agenda item apologize I just thought we're generally talking about the court case and what we as legislators to do for by understand that's not the scope of. All right thank you senator. Senator Teague did you have a question. Push your button again you don't have one. Okay thank you. It was earlier. Somebody's messing with the over there I guess. Are there any other questions from committee. Seeing none. Thank you very much for your comments. Thank you. Okay item if on the agenda COVID nineteen guidance about the monoclonal antibodies. The bill would come forward. Please introduce yourself for the record. What I've known having Patel deputy state health officer. Good afternoon Casey Cochran the director for programs. Hi Greg brown the director for the officer preparedness an emergency response up before I recognize you all to present I was at a meeting earlier were you presented something similar to this and you all had a really good hand out we don't have that today is that available somewhere on a web page. Or. Which you know which window you're referring to make sure you I think it showed were the treatment was available there was a man up I believe. This one right here yes and I can get a copy of that to you Sir could you send that to absolute pricing will send out there by absolutely thank you okay you're you're recognized to present. Thank you with us to provide an update as to how this program is going on so I would like to stated that since we last met as the number of cases have gone down so has the demand for the product but we still have adequate uptake in this state number of flowers eighty as bad this is available Mr brown is going to give an update on that later on we have expanded access and we are making every effort we have enough quantity throughout the state with all the request being fulfilled as much as they want they could are dead and we can provide them those resources so there is no shortage of this that is still optic we are now trying to educate more and more you know we are having more outbreaks and and long term care facilities in the prison system you know because of flight you know of any community so we are trying to provide them and educate these facilities for update on monoclonal antibodies so long term care facilities rather that having large outbreaks we contact them educate them and provide them with supplies to get us in history to that along with the staff so the uptake has been good I am the service could I have just ask you questions about the process so are they able at the long term care facilities to actually dispensed the antibodies yes they can you know they can either requested from the health department all of which of our facilities guiding them yet by they have a provided you know usually a medical data to an authorized it and uh nurse practitioner dad can administrate you know it can either be given as the IV infusion audit a subcutaneous injection so that a lot of options to to get them they don't have to be more note from the nursing home or long term care facility to go to the hospital that was the case previously but now things have improved and and more people are comfortable with this street man being provided. In the House thank you I apologize for interrupting you go ahead so I ask that as of now everything looks good in all we are more worried about the media months hopefully you know we'll have more boost does and other things so that this program can continue to provide the services as needed so we have no issues the chart age or anything as of now update an understanding of the medication is the a good I'm on the prowl why does so we make every effort to ship to any provided we had a provider of with a twenty clinics or the state in rural areas he missed the deadline to order from the federal government but the state health department provided them antibody dissolutions are to be shipped to all is clinics in it'll Arkansas. Sir just a quick update on kind of where we are so currently there are three monoclonal antibodies that are available for and allocation to the state we got all three of them we have two that are strictly foreign fusion only and then we have one is strictly for injections just give me a sense of of the drop off I think since the last time we were here about a month ago or a little more than a month ago the utilization across the street is dropped about sixty two percent we were at one point giving about twenty six hundred doses a week this last week we gave nine hundred and ninety it's just there's the demand is not its highs it was in most all of the locations are moving to the injection last week we had no facilities order the infusion civil because it just takes longer to get from that takes little more logistics of the of the company or the organization to do that so most all of it is injection base now the third one is infusion and we only have one hospital where that third monoclonal antibody this week we had no facility since the beginning of our allocations that have gone without if they've ordered the received we've been able to manage the inventory within the state as Dr deal said a lot of the excess inventory we go ahead and request as an agency and we keep in our refrigerators here and so if there is a shortage or somebody that doesn't have it we can get it out to him within a day so we we we think that we've managed this inventory well within the practice in the process that we have. Now we don't see the demand increasing and you know obviously you know we don't know what the future holds but certainly in the in the near term allocations continue to be a decreased up to this point we've received we've pushed out to pharmacies and hospitals and clinics almost sixty thousand doses so far of all three that's not the actual utilization because there are still some facilities that have someone hand but of that sixty thousand doses most of that has been used so we've been very proactive in pushing the sat across the state and if if a hospital or clinic wants or pharmacy we can make sure that they get it. So for the benefit of the committee members that might not a minute counsel when when you all described as program the injection it's not just a simple injection it's and can you describe the process. So all three represent the that have been authorized right now that any city are to be IV infusion so what happens is a positive new diagnosed positive patient outcomes and data given infusion that runs till late on that assessed and it runs through basically about an audit Dixon are to run through the infusion so it's IV infusion that given that and then data monitor for a few minutes to make sure that okay and then sent out that so that required a place where you know everyone gets an IV and so on and so forth but with does subcutaneous one with the Regeneron which can be given as a subcutaneous injection they usually give it in your belly which has some fact that so you can do it in four different places Saudi can also give it on the site if there is enough five so you can give that in four different places and it's a much easier process you know you don't have to wait one not the injection can be given that in a few seconds so you know you don't have to read that but they still have to be observed and all that but logistically it's a much easier process to do so so that's the reason we have a more update because hospitals or clinics or facilities can do it faster and you know read more people sold that's why that product is more a all the products are good it works against all the AT and sole that's not an issue it's just that the process is much easier with that particular product and they need people need to get this treatment within forty eight hours of being infected is a non not nothing like that in on basically they say five days but we're giving people up to ten days off the positivity on you know it's just that the the medication is is kind of and to stand ready simple layman's terms is preformed antibodies so you have the white as that in the body multiplying and all that what ninety body you know the one of the ninety body does is basically a blockade from entering your sentence so it it reduces the symptoms that. Use the same entities on and so forth. Okay all right we do have some questions of are you all done with your presentation. The. We have we have nothing further to add okay we have a few questions. A representative Bentley you're recognized for a question. Thank you chairman right here thank you for being here today you know since we last met we've had over sixteen hundred or cans that are passed away so it's going very important to us as we continue to get early treatment very much so that so I appreciate the work that you've done there I want to ask you if you've considered Dr Patil if we allow pharmacists and others to prescribed this new mark drug them I don't how to pronounce it mall you prepared The New I Mark medication also average affirmation of business and I don't realize to public push as much as we can early treatment keeper Kansas from dying I think we have failed miserably at early treatment keeping or Kansas from dying so do we have any any interest moving forward to allow pharmacists to be able to die to prescribe the same so we can get even more early treatment keep Arkansans from dying so I I think the drug has not yet been approved the mug Drug you are you going to once that's approved I think the process is as usual of with the monoclonal antibodies and vaccines they're going to ship it out to us and then the meat we plan to ship it out to in a way it is provided as well but it requested whatever based on that scope of practice they they could do that so if if this falls under the book of you off it is practitioners they could do that but I'm not sure what what the pharmacy Board ruled and I'll them to prescribe to Seoul this is a basically a drug it's like I'm delighted that I'm just like you have time you so it falls under that category and I'm not sure I don't know if pharmacists are allowed to prescribe that. The chairman on when their medications that you added it to was able to make an so again it's not recommended by you that have to be able to identify organizations for using COVID but I do know that provide as I prescribing it it's left up to the discretion of the individual provider to do so I don't think there's any shortage of that the that. Okay so quick follow up yes you're recognized to clarify so I guess I was under the illusion that when it came to the monocle antibodies that we that you all pastor allowed pharmacists to prescribe what was the. The. Protocolo wanted to allow pharmacists to prescribe the monopole antibodies what body did that I'm just curious what the process. My understanding is I don't think the pharmacists that hello to. Prescribed developer dispense it in that pharmacy pharmacies okay that clarify that for me thank you chairman. So just a follow up to that and we have processes in place for people that do not have a primary care physician to be connected to a provider if they are requesting monoclonal antibody treatment so that population is covered as well as those that have a primary care provider to get the order for the treatment. Thank you. Senator Solomon you're recognized for a question. Thank you Mr chair home over the other way folks over here. Should we offer any incentives for people to take the monoclonal antibodies like if you get sick and you come in immediately you get two hundred Bucks or something. Like we did the shots. So there's no incentives for the monoclonal antibody treatment only for vaccinations do you see a a given the success we're having with it would be a good idea in your opinion to start offering incentives maybe a day off our other things you can come in and get that and get better. Well it would rather people get vaccinated say will probably stick with the incentives for the vaccination but by the time they get there they the accident they might be vaccinated still be sick. So the monoclonal will help and I would see not let that go so do we what is certain age limit for giving that to chill two kids can you give can kids take the. knows that it said just to to a Lenovo as of now to open a vote and Mister chair just one last follow up there if you don't mind yeah you're recognized so we have we list see these numbers every day in the hospital how many people we have to we have a success rate of how many people are in the hospital have taken this treatment and then been discharged. I would like to clarify a couple of points monoclonal antibodies I'm not supposed to be given in the inpatient setting that supposed to be given in the outpatient setting they cannot be given to someone who's in the hospital because of corporate so they have to be given and hold patients at a the studies done on this antibodies in the latest mobile Act forty short that people who garden this you know we're not ready civilly and advocate at the right time it prevented them from being hospitalized and dying so that's what the study is that based on we have not done that detailed analysis of data to see you know how many did not lined up but from my expediency dis we know that most of the people you know I'm talking about ninety percent ninety five plus and talking with hospital executives and others of the people who guard guards that did not come to the hospital. So would it be to our advantage to check him out of the hospital given the treatment put him back in. Be a part in that does sometimes when that in the hospital that those sixty eight a date they actually are disqualified from that process and once they started letting oxygen once they're second bottom because I met you know they cannot get get those medications it is actually proved not to be efficient and that recognition all right thank you Mr. Senator garner you're recognized for a question. I thank Mr in September the Joe Biden ministration essentially nationalize our supply of the treatment and I know that time that roughly seven southern states took up about seven percent of that treatment and initially I read a few reports the bill it was kind of hard to actually track down that so no shortages affected Arkansas and our ability to do it it seems like now that just to the natural course of the cover nineteen virus will require less of those but as we learn to the delta very there may be additional variants what are we doing to combat the kind of nationalization of this very much the treatment by the bottom ministration to make sure that if we do need another flare up the state of Arkansas will be on the forefront to make sure we get this vital in the treatment. So I would just like to clarify even then we had a splitting cases between you know July August does my you know we never had a shortage of medications it was it was the access to it you know how many places will be able to meet the people had easy access to a that was the main issue rather than actual shortage of medications yes the southern state I took up my most of the supplies because we had the most cases we had the date that such much earlier than the rest of the nation so we took up most of the supplies I am as I'm numbers came up and other states started having them so we immediately did not have any shortage of medications and with three drugs now available in the market a monoclonal antibodies and anti white of that's been approved hopefully be approved soon I do not anticipate a fee that we may have any shortages and as I said earlier all these monoclonal antibodies as of now work against all meetings were there to be also be calendar the that activated so it's effective against everything so R. as of now we have it ready optimistic that we should not have any shortages a thing the federal government has taken over the supply of all of them want to pull nineteen bodies and if needed that able to supply as much as possible and I let Mr brown expand that further having one of the other things that we anticipate and and this is an unique I mean that that you know the our our federal partners have. Done this for test kits and supplies and just about everything that we have received at this point is they've they've maintained the allocation as the as the federal government limit allocations to the state based on different parameters I think how we position ourselves for the following going forward is for example let's say today we're allocated twelve hundred doses for the for the state let's say we only have six hundred Facilities that are requesting six hundred doses we take the remaining we put it at the health department we don't just turn it back to AmerisourceBergen or partners we hold on to those in case that we have those surges in the coming months the challenge is that most that's that's a very very short expiration time by the time we get it may expiring January or may expire in February and so what we don't want to do is in in this is this is the fine balances we don't want to hold so much that we take it away from another state that needs that and so we're we we manage that were inventory very very carefully and we work with our regional partners as well if they have a shortage we have so we're going to make sure they get it we just don't want to have drugs expiring on the shelf we don't have to but we also have to also consider what happens in December if we have another search and we don't get the allocation of we want we have seven states so we have we have a I've got a group of folks that really work hard to logistically try to manage that it is not easy but what I think we've got to this point we've been very very successful okay well just one thing I've defined a news report said Arkansas Memorial Hospital Creedon said that they did not have a do not supply and that was a new report in September that time rain so saying that blankly that there was no supply thanks ms little bit misleading but back to the original point The variance could come in any different way in and there could be another surge both in those who've already had the virus before and we require this kind treatment so it's it's incumbent on the state to continue to pressure the federal government to make sure we have our supply move forward whether we hopefully continue down this downward trend which seems to be happening or if we have another service of thank you. Representive clown you're recognized for a question. Thank you Mister you Thomas seat eighty year did you I thank you gave rep resented cloud my mind representive cloud you're my going to it yes thank you Mr chair thank you panel for being here a doctor Patil just questions about the efficacy of the sub Q. versus the IV infusion would you compare and contrast that for us and then let us know is that antidote Ole facts that you're going to give us or what kind of numbers do you have there thank you so in recent weeks and months most of the does this that's been given a sub subcutaneous NO and these were done studies done in on this no actually related data that was done because this was a committee does implode because IV infusion but they date of web based on the pharmacological studies in all the drug is absolved and hope based on that date referred subcutaneous and from what we have heard is you know again it is as effective as that again we can come to know if it does not affect the route as seen as boating hospitalizations so we have not seen so with that evidence be viewed that and this is not only Arkansas but and it's a nationwide that the bloody of the lasing sub you just because of the logistical easing that with which this can be done so I it is I I believe it is as affect you as as as as the fusion thank you. Senator Hammer you're recognized for a question. Thank you Mr would you explain to me again the rationale of why somebody that's in the hospital for COVID cannot get the antibody treatment. So you know the the medications are approved based on studies that they have been done so what the studies done on the local ninety bodies was. If David given to certain that lots of people. What did they do what what did they prevent so what the study short laws if the monoclonal antibodies that given to the people who made these criteria they would not be admitted to the hospital or die from that so those studies were based on that what they also found out was people who guard Dante bodies in the hospital. Did not benefit because already Davis all sick with the amount of white as in the body so high you did not benefit that group of population so that is why it is not a commended I want to have to add a caveat that say for example a person is admitted to the hospital for a stroll or for a heart attack if they go with a different diagnosis unrelated and then double up COVID because you know some family member or relative gave them covid they can get the monocle ninety body because that admitting diagnosis was not that and and that's how you know people some people in the hospital have have received that but the clinical indication is not fight me to people once person admitted to the hospital to have oxygen requirement to have other issues so once that happens it is not recommend once a person starts needing oxygen and identified I mean does does that one of the ninety bodies not indicate and these indications I know that by if the act upon approval followed Mr yes you're recognized in in that report that you're referring to. Was that a plug did that apply to everybody up to the point of being put on the respirator or I guess I'm trying to distinguish if the if the person is at home on O. two and they're taking the medicines at home but they're in the hospital and I know to and taken maybe the same kind of medicines and they're not on the on the ventilator there have made so far there on the ventilator how does the research distinguish between those two groups of people if there are situations are identical whether they're in the home setting or whether they're in the hospital setting. I honestly do not have access to that sort of the dates in on this is a general order of you off of the studies that were coming to that we have studied but I do not have that sort of the day if someone's already in oxygen actually if someone's already in oxygen that excludes them from from getting the medication but I can I can get back database that is in need of further data from the companies that are available and I senator cause Dr Senator Hammer all right thank you Sir. All right seeing no further questions. Thank you for your presentation. Okay Committee will move on to item the G. update on the Arkansas breast milk bank. Bill would come forward. In the committee there's a handout coming around. The bill would please introduce yourself for the record. Left their phone. Hi my name is Tanya Johnson and I am the director of nutrition services at UAMS. My name is Dr misty for money I am in the in the tala Justin pediatrician and the director of breast feeding medicine at UAMS in Arkansas children's hospital. In my name is Elizabeth cam I'm also a pediatrician and neonatologist and I'm the assistant director breast feeding medicine a UAMS in Arkansas children's hospital. You are recognized to make a presentation. Thank you very much for having us. On a first date that as we have gone through the process of developing the plan for a Arkansas state state medical. Breastmilk hospital in accordance with act two fifty five which was the Arkansas breast milk bank fund that was supported by representative Pilkington and Senator Davis and was passed in both the house and the Senate with no opposition but we have generated support around the state we have partnered with some of the other regional milk banks in Oklahoma and Texas to take over their depot sites that are already in existence here in Arkansas and we have spoken with our level two three and four nurseries around the state including their icy use to discuss using our products and assisting mothers with donating back into our state Milbank once it is developed. For those who we have not yet presented to about what a donor milk bank ads for Arkansas's mothers and babies. I'd like to start with that explaining what donor milk is donor milk is milk human milk that mothers of usually term infants donate to a human milk bank that goes through a process called pasteurization that eliminates any infectious particles in the mailbox to make it safe for our preterm and second vulnerable infants in the icy use we use it most commonly for sick babies are admitted to the neonatal care units around the state it helps reduce risk of premature death and severe morbidities for those infants and help some get safe nutrition without having any of the the confounding factors that can occur with exposure to the bovine based formula products. it is helping moms who are pumping and trying to express their breast milk for their babies to meet their goals of being able to feed their infants only human milk I'm so we feel like it helps mothers meet meet that goal and that need because most of our mothers feel very passionately about being able to feed their babies only breast milk and it provides safe feedings until mom's milk supply improve so that we can feed her her baby her milk. There is a state wide benefit to using a donor human milk bank and having one that is regionally in Arkansas Doraville currently is used in all of our regional nurseries levels two three and four nurseries and then it'll intensive care units it is currently obtained from many other states so we obtain milk from the North Texas milk bank sometimes from Oklahoma Illinois and I think right now Michigan. so we have to go to different states around the country in order to get on the adequate donor milk supply for the hospitals around our state. Right now we spend over a million dollars every year paying out paying money out of state to obtain some of this donor milk for babies and. I would like to add that I receive notification at last week that donor milk was going to be going up in price so where we currently pay for fifty an ounce we're going to be paying upwards of six dollars per ounce at a coming in December. Currently we also have a lot of mothers in Arkansas who have healthy babies who have excessive milk supplies to pump their breast milk and would like to help benefit other infants and they contact us about donating their breast milk and we have to refer them to milk banks that are outside of the state in order to donate that milk each state that has a donor milk bank processes it's milk and prioritizes its own states needs above anybody else's so if they don't have enough milk for their own state they certainly are not sending it to Arkansas which is why sometimes we have to look around at other states to find milk for our babies. One of the most important things that we need to recognize about why donor milk in Arkansas is important to keep in Arkansas is because our genetics and our population help us define what happens to our babies and our babies are helped by their own mothers genetic codes and regional genetic variations will impact the milk that is being provided to the babies both and how they develop in and how their immune systems continue to develop. We are hoping that by supporting a donor milk bank we will also help support breast feeding mothers around the state so we have to have pumping mothers expressing milk to be able to support having a donor milk bank here in Arkansas and Alice's of that mother's milk for her preterm infant will help us to optimize that baby's growth and nutrition and we can then tailor our nutrition programs within the nurseries and Nick used to help our babies grow healthier safer and stronger. Through the milk bank we are also going to be able to offer some innovative breast milk research which is very much needed within our country we will help partner with the Arkansas children's nutrition center we already have some alliances developed there will be able to do research on the composition or what's actually in the breast milk and some research on what medications on the effect of the medications and drugs mothers may take on what happens to the breast milk. We can also help determine some of the impacts of different maternal characteristics health characteristics regional variations and how moms live in what it does to the breast milk and interestingly for me investigate things like the microbiome or how what we eat and how we live in the environment we live in affects our breast milk in our nutrition and growth and development later on. So. Why is breast milk so important why do I advocate for it so strongly well your mother's die after they breast feed or when they breast feed. Like Tatian helps reverse some of the very harmful metabolic changes that occur during pregnancy pregnancy is a state that is intended to help grow another human there are a lot of metabolic changes that increase mom's lipid levels and her sugar levels in her blood in order to help grow into human body. If she doesn't breast feed following pregnancy those changes don't reversed they state that increases her risk of things like having diabetes and other metabolic complications having a heart attack early in life having coronary artery disease are sclerosis of the arteries and having strokes. Not breast feeding not lactating following pregnancy increases the mom's risk of death from heart disease almost three times and other mothers risk. Lactation following pregnancy also changes how a mom's hormones work and the stimulus to develop some Yeutter and cancer some female reproductive cancers things like breast cancer if mom breast feeds the risk can be reduced as much as twenty six percent ovarian cancer risk is reduced anywhere from twenty four to thirty seven percent and uterine cancer risk is reduced by eleven percent. Death from cancer heart attacks stroke and diabetes are some of the top leading causes of death in women under age sixty five in our state black women have substantially higher rates of deaths from these causes lactating after pregnancy or breast feeding for even thirteen months total in her lifetime following pregnancy can reduce a black woman's risk of dying from stroke by as much as fifty six percent and that is more than any medication or exercise and dietary changes are going to allow. Breastmilk for children's is the sole source of nutrition that reduces the risk of things like sudden infant death. Childhood cancers like leukemias and lymphomas. Hospitalization from New for pneumonia and gastrointestinal problems chronic inflammatory bowel diseases and increase in risk of sick visits for things like asthma and allergies and ear infections and other viral illnesses. This is just recently published that in the lancet regional papers a big collaboration with the CDC including three point two million and funds over the year two thousand seventeen all across the nation looked at ever breast feeding rates and the rates of risk of death. And for all babies for mom to ever be able to breast feed reduce the risk of death in the first year of life by forty percent some some specific risk of death reductions or death from infection was reduced by nineteen percent death from sudden unexpected infant death by fifteen percent and death from something called necrotizing enterocolitis which is a devastating illness in preterm infants that I deal with. By thirty three percent. So breast feeding saves lives it saves money if every infants and mothers die out in the United States breastfed. Or at least a ninety percent of them breast fed for the first six months of life over nine hundred lives in the United States alone would be saved many more worldwide. There be thirteen billion dollars in health care savings across the United States and the and it'll healthcare dollars for the birth hospitalization. And there would be seventeen billion dollars in healthcare dollars related to women's health expenses that are created by not breast feeding and lactating following pregnancy. Almost five thousand fewer cases of breast breast cancer would occur if more women were able to breast feed and supported many impure cases of high blood pressure and almost fourteen thousand fewer cases of heart attack in overall this means that we have a healthier workforce and a healthier society. How does the milk bank help well it keeps Arkansas's donated milk in Arkansas means of those genetic variations in those munificence I've said I spoke of earlier stay in Arkansas with Arkansas as babies and we get to prioritize our baby's getting our Arkansas mother's milk. We get support from hospitals and from the legislature to correct an imperative to help mothers breastfeed and create a public health priority that this is important for not just the health of our infants but for the health of our mothers and our work force in society in general. We also get to create a statewide support of lactation team so we can have a team of specialists who can call mothers follow up through telemedicine visits and help others when they are able to come into the lactation center to help them with breast feeding issues something that is lacking in our state. We will have some specialized services available including this medically fragile Care and one of the things that we would like to do is develop a very specialized set of products that are targeted to our very sickest of an offense. We would be the only center in the southern USA and the second Senator that exist that can do this in the United States if we are approved. These patients need a US spouse's Barbara sorry specialized product delivery things like higher calories higher protein content higher fat and sometimes no fat very specific needs for very specific patients even preterm milk and we will be able to deliver this. We hope to be able to in addition to allowing or providing milk for all of our inpatient centers including nurseries in NYC use all around the state to be able to have human milk allocation centers so when a baby who needs human milk but is not hospitalized in that moment. Needs it they can get it from anywhere in the state this would include high risk in sick infants who are now past their initial hospitalization but still in need of extra help infants who are bereaved father mother died shortly after delivery and the family would dearly like to be able to provide human milk we would be able to help them with that and in instances like adoption where a mom can't provide her own milk to her baby. We would like to have drop off depots spread all around the state so that moms can come and deliver milk drop off milk within thirty minutes of anywhere in the state and then can be brought to us at no charge to her. And then again we will have the lactation support by in person or by telemedicine and we hope to eventually have an on site store so that we can have lactation supplies and specialty products for moms who need it and the human milk allocation center as well as walk in an appointment based lactation visits and a donation drop off site. One of the more important things to us that we would like to be able to offer something called the bereavement center support so when moms lose their babies early. Sometimes donating their mail because the thing that they can do that helps our baby's memory live on and helps them feel like they have a sense of closure and the ability to provide care for another infant even though their infants is no longer with us that donation helps some families cope with the grief of losing their child. Honoring this donation in the life the family lost will help them give closure and peace and we would like to establish a memorial in our lactation center and our milk bank to be able to honor those gifts to our center. We would also like to be able to offer educational opportunities to the community through partnerships at Arkansas children's and UAMS to have research participants help with research product project within the milk bank and to have teaching tors and lactation education for both our students including grade schools and high schools all of our medical students in pharmacy and nursing students who are here within the state as well as community organizations to help emphasizes public health priority. I'm going to let Tonya Johnson talk about our business plan. At so we have some identified space which was the old red cross building which is now known as the main road building initial cost to renovate this space for the milk bank would be around one point two million dollars but it is about forty three hundred square feet of existing space where we have the old red cross freezers and refrigeration system that is in there it would just need to be renovated to be ready to use it's also got existing laboratory space that we just need to be updated to be food great one thing about this space is that once we do get the renovations done we wouldn't have to you know worry about leasing buildings finding a spot or paying a monthly rent so this would be a one time expense to do the renovations and then that space would be for the milk bank for the future and then also our space it also has emergency generators that are already in place so if there were ever a power outage we wouldn't lose supplies and that's very important also the initial equipment to start up a milk bank would be around three hundred forty thousand dollars and that is not including you know the the one point two covers the cost of the freezers but the US three hundred forty thousand is for like the sterilization equipment the computer software that would be able to do the new trend analysis and the equipment to be able to sterilise pastor as he's still in process the milk and then to be able to do the specific compounding so that we can do this specialized formulas for individual needs if we did need a low fat no fat or high calorie high protein upright at and typically the. Licensure from what I've looked at other milk banks it's about software packages fifty thousand in and around five thousand dollar annual that we we need to keep that software going and most places that we have visited the other milk banks around two hundred thousand dollars in your annual supplies for the labor pool given our current rates of pay around three hundred forty thousand dollars so the initial investment for year one would be about almost one point six million dollars but the pay back period on that would be three years at the end of that three year period we would have generated revenue through the milk sales to offset that initial expense. So right now we purchase around one point three million dollars of milk at out of state and as I said earlier that's on our current price of four dollars and fifty cents per ounce I just got an email from Michigan that they're going to be raising their price to six dollars per ounce in taxes raising their stuff five dollars and fifty cents per ounce so by next year you know that amount is going to go up almost one and a half percent so the estimated amount of milk that we would be able to process based on our state size is around three hundred thousand ants ounces annually and so that would generate around one point three five million annually so the revenue off of that would be around six hundred eighty one thousand dollars annually based on our labor cost at and if we itemize out what we're doing over the next three years within five three to five years we should be able to have a self sustaining milk bank here in the state. Pardon me some of the benefits that we talked about is that we will be able to provide a full nutritional analysis on every product that we send out we can offer specialized calorie and nutrient content to individual Nick using nurseries when they request it we will be able to ship frozen direct to the facility and have overnight availability to any facility that requires a product. In summary we are very excited about this opportunity to help support breast feeding women in Arkansas and to help improve the health of both mothers and babies through this endeavor our donor milk from Arkansas's mother directly benefits Arkansas's tiniest residents and in Arkansas milk bank helps keep our revenue in Arkansas we can help also use this not paying bank to help provide education to providers learners and to communities. One of my favorite quotes is that breastfeeding is nutritionally immunologically neurologically and chronologically economically and ecologically superior to formula. Thank you for your time and support were open for any questions. Thank you for that presentation we do have some questions the Senator Solomon you're recognized for a question. Thank you Mr wisdom over here yeah I understand the the cost projections were based upon models from other states on other facilities forget that you made some claims earlier about savings nationally and okay some numbers one is that done through a blind study are those done through modeling. Those are done through modeling and. Thank you. Representive cloud you're recognized for a question. Thank you Mr chair thank you ladies for being here yes also have a question about the money since the milk is donated. Is that the price incurred that a potentially as soon to be six dollars an ounce is that covered by the mothers of the infants who need that milk and then kind of a corollary to that is the things like weight programs and and Medicaid do they cover the. I am currently what we're looking at as far as the cost is most hospitals paid the costs for the milk for those I have for their nurseries individuals you can purchase that so most of the buildings that we have visited so the cost would be offset by other area hospitals or in hospitals around the state purchasing the milk from the Arkansas milk bank and then having like an outpatient area kind of like if you want to get it you know a drug out patient you would prefer you know purchase this outpatient so that would be were some of the revenue would be coming in and then also you know there are those things like with bereavement and different things that those would be looked at on a situation where that might be a donation from the milk back to that you know particular baby if the mom passed away and said there's a look you know we look at all kinds of things like that when we're developing our model. Follow up. Yes you're recognized so help me understand then if the cost is incurred by the hospitals somebody's got to pay the bills so that's that's what I'm wondering where's where's this potentially six dollars an ounce come from. That comes from the hospital's paying I mean that's what we current like at UAMS Arkansas children's hospital I K. Michigan right now six dollars an ounce for every ounce of milk that comes into UAMS we pay taxes five dollars and fifty cents an ounce for every ounce of milk that comes into Arkansas children's hospital or UAMS so that money is already being spent so the hospitals within instead of purchasing that from an out of state hospital milk bank would be purchasing that from an in state hospital and some of those costs to our hospitals would be reduced because we wouldn't have the access shipping costs so now when I'm paying for milk overnighted from another state we would be able to get that milk directly without having to you know charge the additional overnight you know fees because it's not coming from such a far distance so that's a lot of the reasons why the we're seeing an increase in the milk prices is because of the increase in shipping prices so we would be able to really save our state hospitals money by having this here because we wouldn't be incurring all those out of state shipping fees I understand all that I'm wondering where that initial pot of money that you pay six dollars an ounce is that just part of UAMS overhead and in the system so that it's yes it's like anything else that we budget for I've had nutrition services so that four dollars a day I would spend to feed you breakfast is the same you know I spend that six dollars an ounce for that baby it's part of our overall budget so we do budget for that thank you. Represent the mental you're recognized for a question. Thank you chairman so ladies can tell us where you're at right now we do have the funds to move forward to you coming here looking for funds I guess we're all kind of wondering where I'm all about is a hundred percent on board with this and getting C. ark Arkansas better at breast feeding so we're we at what can we do to help someone we need the funds. To my knowledge it has not been funded yet although the bill was passed to create the fund I do not believe that there is any money in the fund so that we can proceed right I've been part of the budget correct one we we've got all of the basis down we've got space identified we've got equipment identified we've And being able to do what we have to you know pay some membership fees and do that to be able to move forward with starting our milk bank here in Arkansas. Thank you. Yes Senator Hammer you're recognized for a question. Thank you Mr the. Is the the the up milk from the mothers in state is it totally on a donation basis or do you purchase from the mother's all mail that we receive is donated no from band a certified mail banks purchase any milk from his **** a blood donation so the milk is donated and then we you know we incur the cost of all the testing to processing the sterilization and pasteurization and and that is the fees that is passed on to the area hospitals. And then the one point two nine two million that you pay out annually. Two out of state milk banks. Do you. Is all of what they receive also donated as well or to any of the state you purchase from pay the mothers all of our milk is in band a certified so it is all donated milk so we do not purchase any of milk that has been I guess paid for okay and the the we'll software the licensure what is it what is that specifically for what is it that you have to have that for and this software that is what we would use to do the new trend analysis on the mill so that we could determine the fat content the protein content carbohydrate content and then you also have to be able to track that milk based on the food and drug administration guidelines we would be basically considered a food manufacturing company and so we would need to track where that milk came from how we process yet dates at ten make sure everything was safe and effective and then monitor be able to track when we ship that milk out to what hospital and then they could even go down the track to see what you know baby receive that milk so it's a it's a huge fight if you were you know when they do recalls on lettuce for Sam and let that's that whole tracking process is they would do we would be able to track that milk if there were ever any need if there was a baby they got sick and they were like Hey we need to know who do you know what the lot numbers were where this bill came from then everything can be tracked back so the tracking process as well as a new trend analysis okay software okay then the five questions would be the sustainability of the program as I'm looking at the numbers and the proposal is based on your ability to sell milk is that correct that's a portion of the savings savings by not having to purchase is a portion of it but how much of your system. And ability is dependent upon your ability to sell to other states who currently are doing it now currently we would not start out selling to other states our goal is just to support the needs of Arkansas babies and hospitals I'm then after we met the needs of the hospitals we would be able to then hopefully be able to do that outpatient sales for ours in state residents and then you know be able to move forward any of kind of bereavement plans for in state residents our goal is if we had a state milk bank if there are other states that maybe didn't have a milk bank that we could help if we ever had an abundance we would sell to but our primary goal is to serve Arkansas. And all the reimbursement is gonna be to insurance or for the for the for the cost of the hospital pay or the outpatient is that all going to be billed out to the insurance companies for them to be able to afford to buy it or what's their funding stream that they're going to be paying for the milk thank you Mr. If you're asking for the hospitals they're already paying for it so it would go through their current funding streams of either Medicaid or insurance payers it's usually covered at least in Arkansas UAMS Senate Arkansas children's it's part of our departmental funding so we don't bill it out as individual donor milk to each baby we cover it as a unit wide expense and we feel like the benefits are so great for our babies and this is the standard of care to provide human milk as an exclusive form of diet or infants that it is something that we are going to do regardless and most nephews and nurseries feel that way about it I just wonder why they would pay for the funding of that if it's going to be a savings to them where they would have to be paying the insurance companies why why would the hospitals and the others that are having to pay for it now step up and help provide the funding to you. I don't know the answer to that specifically but they would be paying us for the milk so there would be some degree of cost savings for the hospital within that itself seems to me like they would step up on it thank you. And I support what you do and I do thank you. Thank you a next we don't we have the representative Payton ready for questions. Thank you madam chair I'm over here to your left so you've done a great job laying out the start up costs to your and I guess you've identified a great location where a lot of that would be mitigated thank you you mentioned earlier the satellite locations for drop off and things and I'm not seeing any of that in your start up cost so my question is when you're estimating the benefits and the pay back on this three hundred thousand ounces per year. Is that this to achieve that three hundred thousand ounces are you going to need the satellites or not because I don't see the satellites in your startup motorized this the satellite areas that we're talking about those are like volunteer donation spot so we would work with other hospitals around the state health departments and set up what they would call depots where that the mom could just drop that milk off and we would have like a dedicated freezer so we really are having in light really invest in satellite locations it would be like that you know that we would partner with those other facilities that are already established a lot of the states that we've talked to they have their police departments fire houses you know a lot of different organizations Act as their depot is there drop off location and then that milk is then careered over to the milk banks okay thank you thank you madam chair thank you but seeing no other questions we appreciate you coming today and thank you so much for this power point. All right of we're going to item and each and we are looking forward to hearing Arkansas research alliance Gerry Adams and Brian barn house if you come forward please. You would please introduce yourself for the record. Push button there at there you try again good afternoon my name's Gerry Adams I'm present the Arkansas research alliance. Good afternoon Breitbart House CEO for ARE. Right you're recognized for presentation slides come up You know that we send our point. One just make sure. It's. There are. And we provided a presentation hopefully that was distributed and the slides along with thank three articles two or three artists we have the Arkansas money in politics magazine. if it hasn't been distributed we can see that it is yeah yeah members there's a copy of the hand out in here thank you so they have that. Okay thank you for this invitation of this opportunity of what I'd like to do is go through a couple brief introductions then talk about what we're framing into this pretty as expeditiously but again my name's Gerry Adams I am a native our cans and raised in Saint Louis all their own return to this state in nineteen seventy three to help start axiom corporation or twenty people at action when I started there were over seven thousand when I retired in two thousand seven and had the great honor of the of the current in the last two governors appointment of Blue Ribbon commissions committees governor Huckabee on higher education governor baby on healthcare and governor Hutchison on data science and data analytics I start in the Arkansas research alliance and April of two thousand eight and we're now in our fourteenth year right. Thank you Jerry and thank you all of you for giving us this opportunity present or work to really appreciate it I'm lucky enough to be an adopted our cans and I got here twelve years ago a native of St Louis I was raised in Houston with the school in southern California worked in LA in the private sector now moved to DC for work my wife and I relocated from DC to Arkansas what we just couldn't get here fast enough. I've spent my career in economic development in DC for the international city county management association helping communities around the country with military base closures and re use And here in Arkansas for the Arkansas Economic Development Commission doing foreign direct investment and trade work then moved on to pursue an opportunity in regional economic development Southeast Arkansas worked in pine bluff for the economic development alliance for Jefferson County there are a lot of alliances here in Arkansas and so I joined a R. A. in twenty sixteen to venture into this world of innovation based economic development. And so what I'd like to do is cover five things today or what we like to do is on who are we. Second what we do three how do we do it and for why we feel it's important to the state and provide a few examples and then if there's time for some questions would be happy to answer those prime so before we jump into the who what and how here's a sample of questions that are important Arkansas that are being addressed by the A. R. A. academy members first how to grow bone to replace damage from wartime industry how to understand childhood brain development and the effects from childhood trauma how to sustain or increase rice yields with higher night time temperatures. How to increase the safety and efficiency of high speed conveyor systems for Amazon and FedEx and lastly how to improve and grow stronger catfish industry in Arkansas. So who are who are we you want to click me. Or right now we're a public private partnership came out of the visioning of accelerate Arkansas exonerate arsenal may not be a household word but it was a nonprofit active in twenty two thousand to two thousand probably twelve that was responsible for most of the knowledge economy visioning of the State and it produced a strategic plan in two thousand seven which from which A. R. A. involved areas focused on twenty first century economic development for the state through the lens of university research like you we care a lot about the future of Arkansas and the future of Arkansas is really focused on talent focus collaboration and results A. R. A. is committed to increase the economic committed competitiveness of Arkansas by understanding where we have research competencies and focus resources to recruit retain and recognize strategic research talent to grow the state's innovation and discovery. From the beginning we've had a very strong board of trustees but shall address a little bit later and I as I mentioned we are in our fourteen year of operation. So. So our work with this talented researchers really to elevate their collaboration and focus them on results results such as research productivity bigger awards and connecting them to relevant industries in the state and the ideas that ARE focus is the strategic research leaders to accelerate their impact on the economic future of our state our nation and we do this in partnership with the states five main research universities represent over ninety percent of the federal research dollars that flow into the state and as you can see are you of a UAMS Arkansas state university UA little rock and you APB. We also manage a strategic collaboration with the US food and drug administration's national center for toxicological research this is the state's largest federal labs and we do this through a twice renewed five year MOU between the governor and the commissioner for the FDA. Along with that there's a companion partnership intermediary agreement between A. R. A. and and CTR and what I said is a large federal live it has six hundred employees a hundred and fifty PH dis and over a million square feet of space under roof their campus in Jefferson County produces the tools and technology needed by regulators and product reviewers at the FDA headquarters in Maryland and we treat them like our sixth research university. Click okay. Hello border trustees have been kind of foundational for areas since the beginning when I started this I go around and talk to people is that you're at I don't really understand what you're saying you but you've got one hell of the board of trustees say that again so they've been helpful but right now we have five chancellors and eighteen corporate leaders five chances of the five universities that Brian discussed recently we welcome Chris barber's the CEO St Bernards healthcare and Curtis Barnett who is the current president president CEO of could cross the she'll of shop to always been on our board from the beginning and step down this past year as well. But overall we've had a total of fifty six members of the A. or board of trustees since beginning nineteen chancellors these five institutions and forty five corporate leaders who invested their time money and and and us today these leaders like you all are focused on the future of Arkansas. So how do we do it well A. R. A. has involved to operate six programs and we're not the same organization we started as in two thousand eight we've matured but we're staying in our lane on talent and we really gonna portfolio of programs and services that have high impact we started with the scholars as a recruitment program in tool for the chancellor's to incentivize strategic research leaders to come to their universities from out of state the scholars award takes the form of a five hundred thousand dollar grant paid in one third installments over three years. And twenty fourteen we supplemented that by introducing a retention program and started recognizing fellows it's another tool in the hands of the chancellor's to retain and recognize key research leaders already resident on their campus and it takes the form of a seventy five thousand dollar grant payable one third installments over three years and then our history we've had a total of forty scholars and fellows with retirement and transfer sometimes folks just get picked off we're currently at thirty two which we've assembled into the area category. And we bring together once a year so they can meet each other and learn about their science and research projects and over the years this academy has really grown into a true community of research leaders so imagine now when a potential scholar candidate sees that there's a ready made peer group that they can tap into and how they can help jumpstart their work in their career Arkansas it's a pretty powerful enticement. In twenty nineteen we hit on a way to grow the research of these academy members and launched the impact grant program as a pilot and it's proven to be enormously successful I will share the results of that in a minute but through an R. F. P. we made up we made awards of up to seventy five thousand dollars with matches from each of the campuses for short twelve month research projects that enabled academy members to do one of three or more things first it would better position them to compete for future extramural funding and gather data that would allow them to go after larger research grants to it would give opportunities to explore industry engagement or commercialization by conducting commercially oriented proof of concept or prototype development or data generation specifically requested by prospective investors or industry licensees. Third the impact wrench also allow them to pursue scholarly advancement and accelerate the discovery process especially those that are high risk high reward as we get into a moment this program is paying off. Most recently we started developing the core facilities exchange. Now the course was exchange is a public facing online platform that shows research instrumentation and the accompanying services available at university labs across the state and AT and C. T. R. this resource is intended to create awareness about the presents the capabilities and availability of high value research equipment in the state and it can help facilitate access to that instrumentation those who may not have it it could lead to the revision several benefits emerging out of this for instance more new collaborations more competitive grant proposals reducing redundancy and very expensive capital expenditures increasing utilization of some of this equipment and ultimately incentivizing a thriving well networked research enterprise a plate we plan to go live with it in the first quarter of next year. The final program we hope you'll find interesting is a communications campaign called Arkansas voices for research it's a one two punch where in one month ARE works with an individual academy member to spread the word about their work in two ways first we curate an article in Arkansas money in politics the legend showcase their research and how it's impacting society the economy and the world we live in the column is called discovery economics and we hope you look forward. Then we organize a one hour webinar form to share a deep dive on the technical aspects of their sites and trust me it's intended for scientific audience the web in our series is called project scope and we'd be happy to invite you to attend these are programs as they stand today but we have even bigger ideas in the pipeline and we can't wait to share more when the time's right. So the next thing is why is what we do important to the state clearly recruiting and retaining research town is a twenty first century competitive advantage for Arkansas it's a critical ingredient in the knowledge economy and retention drives continuity and success increasing collaboration between the institutions and the researchers is also priority area gathers the top research leader in the state in the state and we help connect the dots between institutions between researchers and between corporate Arkansas supporting more port organizations especially in C. T. R. I'm not sure if all of you know offense ET are haven't had a chance to visit it's really overwhelming but I considered one of the most under valued assets this state has Arkansas our effort with our partnership in our intermediate green met with them is really focused on maximizing their input in Arkansas one of the great values that is involved is the Arkansas bio informatics consortium which is now going to have its eighth conferences coming year and we bring together about two hundred fifty researchers across the state for that conversation. I came out directly from an city are. Right. We understand the importance of quantifying impact one of one way to do that is through grant activity and we want to be very transparent here and that we're not taking credit or responsibility for all of the federal grant activity of our academy members but we wanna give you a sense of the productivity of these talented researchers to back in twenty twenty no like you. I'm sorry but there's a question but we want to give you a sense of their grant activity back in twenty twenty we had twenty six members of the academy they were responsible for a hundred and twenty three active federal grants which amounted to approximately seventy four million dollars coming to and circulating in the state's economy and we mention the impact grant program. Well the impact grant program has been a boon to the pilot round invested one million dollars across fifteen research projects and even given the pandemic slow down they've return thirteen million dollars in federal follow on funding plus the investigators report that they have another thirty six million dollars and their proposal pipelines because of their impact rates this program was so successful we launched round two earlier this year and we can't wait for the results the entity the N. C. T. R. partnership has also produced two research contracts worth more than five million dollars and we'll touch on one of those near the end time committing. Well let's meet the Arkansas research alliance Academy there are these are the faces of our active area academy members over the lifetime of a R. eighty thirty nine total academy members have been identified eleven scholars and twenty eight fellows currently there are thirty two in our canton nine scholars and and twenty three fellows remember the scholars are recruited the fellows are recognized that already on these campuses we've had some attrition attrition some retirements a few of men and moved out of state will highlight a few examples of how these people are changing the future of Arkansas but one though is that everyone of these have been nominated by their active chancellor so these have been purified at an institutional level that these are the strategic research later recommended by each campus. So let me just comment on a couple here arch Miller all right how skinny marks Meltzer from UAMS and Alex Berenson you at Little Rock Alex Pearce is a nano material engineer and marks Meltzer is Anna might by crow microbial researcher at UAMS Alex has been really and supported by DOD he's able to groan about grow about two minutes two centimeters of bone and what remarks mostly focus is to make sure that anti bacterial when it's replaced and so there are Alex to a company he's developed on the shores is developing and manufacturing capability of this and west will rock and he's currently has I think it's in the eight to nine million dollar deal the grant and so you should see a significant economic to impact out of new shores probably within the next two years. My comment now on Rebecca Lachman who is in the in the aquaculture division of the U. A. T. B.. I because I believe is our only PhD program there but she's focused on improving the performance in the production of of catfish and other fish and Arkansas primarily looking at dietary iron supplements but in their very a nationally and internationally known researcher. This is doctor Alan Mantooth he's in a are a fellow at the university of Arkansas and he is he and his team designed the tools the circuits that controls and the cyber security software for advanced power electronics and the primary applications for advanced power electronics are everywhere from outer space to planes trains automobiles heavy equipment including power grid modernization really power electronics are everywhere the slide here is showing how his group is addressing an industry need for companies like caterpillar that are relying more and more on clean energy electrical systems and what that means is basically going for fully electrified vehicle but but more electronics equals more heat more heat equals more weight for the cooling systems so Allen's team is designing a special inverter system to electrify the vehicle without additional equipment needed to cool it that's pretty powerful work it was also just announced that Allen's group won an eighteen million dollar National Science Foundation grant to build and operate a national silicon carbide research and fabrication facility and hot on the heels of that was another five million dollar grant from the army that will go toward equipment and at that fabrication facility and this is interesting overall his contributions to the state's economy due to his collaborative research aye aye has been estimated over one billion dollars and is group has built a top five program around advanced power electronics in the US and a top ten program in the state in the nation. Excuse me in the world. This is our heli of Lawrence she's a biochemist and ARE fellow at Arkansas state university and her work is helping rice farmers prevent lower yields from higher night time temperatures and the stresses are looming challenge in the industry because every degree increase in temperature equates to a ten percent loss in yield. Every degree increase in temperature equates to a ten percent loss in yield which in the six hundred million dollar rice industry in Arkansas would mean a sixty million dollar a year lost that's important work for our state. If there is time I would like to touch on one of the NCT our contracts. So long cancer is a problem that is literally killing our country killing our state it's found in two hundred fifteen thousand Americans every year and in Arkansas the death rates are higher than the national average one of the FDA research contracts mentioned earlier is tackling this problem the project has to do with finding an alternative to the invasive procedure that currently exists to diagnose lung cancer in the first place essentially you crack open someone's chest and take a sample of tissue. Instead researchers across all six a or a member institutions partnered and used three million dollars in FTA funding to demonstrate how that painful and risky procedure could be replaced with what amounts to a blood draw or liquid biopsy with better results they're showing that liquid biopsies more accurately diagnosed the cancer and lead to more precise and effective treatments and that's the value of research and the power of collaboration that ARE sees for the future of our state. So relatively quickly you all been deputized as now knowledge of along the Arkansas research alliance we've tried to share with your who we are and what we do how we do it. Why it's important to Arkansas and shared a few examples well we appreciate your time and will be open for any questions you may have. Thank you for your presentation we do have a question here Senator Solomon you're recognized for crest thank you if I'm looking at your hand out here for Arkansas state. And it says that your climate changes increase in Arkansas not time dems my point five degrees and never worried about threatened to our world to food supply our production yet when I look at this little research on that and right shields in Arkansas seem to be going up year over year over year so my question would be when one applies to be a part of your group how do you vet are make sure that the the validity of what the study is how do you go about that well let me go through the process of how people get into the category there's an internal process each of our five actually six including NCT ours And the nomination comes to the chancellor we vet that externally with other groups to confirm that the credentialing is valid we don't go in caps to every part of the research the the progress of a price and this state is positive but if you look at the night time temperatures there's a thing called chalk is coming in in the grading the the the rice and I'm not a I'm not an agronomist there's been a recent discussion with Arkansas state and a large producer of rice about what they can do to counteract this creeping nighttime temperature so I'm I'll leave it to them to talk about it but we do validate their credibility externally before their passed by our board in terms of entering the academy cooperation I've already called a mass for a meeting with the research team that's my area held a number or as a job coming and sharing what you're doing research is critically important thank you. Senator Hammer you're recognized for a question. Thank you Mr whenever research is done by the institute and say it is something that results and profitability or do you does the center profit any. Of what the now the I. P. is traditionally on by the the institution and the institution it goes Eads licensing agreements on that and that all all of that's within the purview of the institution A. R. A.'s sources of funding or two we get we got about five hundred and thirty five thousand from our board dues and right now about a million three through the commerce department on an annual basis and we're at five oh one C. three non profit and do not take a position in any of the I. P. through our academy to start curiosity do you how do you know when. Money is earned off of the investment off of the project do you know where that money goes back to when it goes back to the of higher ed institution is going to well there it's I think it's formula driven center I think it is a win either the licensing agreement is negotiated with an external organization and or the IP is commercialized I think there are specific guidelines by the systems either they as you system and are you a system about how that money is distributed back I don't have that on hand but you could check with each of the systems office because I think that's formulated clean your oven okay all right thank you. All right seeing no more questions thank you very much for your presentation thank you again or interest. Thank me the next item on the agenda is II report of the Arkansas minority health commission. would come forward. Everybody else has one. Members you have a handout for these presentations will. please introduce yourself for the record. Good afternoon my name is S. T. Frazier and term director for the Arkansas minority health commission. Good afternoon my name is Beatrice Mondragon and I am the program manager grants coordinator at Arkansas minority health commission. You're recognized. Thank you it is an esteem honor and privilege to present to you our fiscal year twenty twenty one information regarding the operations The minority outreach and accomplishments of the A. M. H. C.. Again miss Mondragon is accompanying me and she is the grants coordinator for the A. M. H. C. in which he is responsible for the commission's outreach programs and sponsorship activities. So on your hand out beginning with page two of the document that was presented to you will see the vision the mission and goals of the A. M. H. C.. Our continued vision is that the minority that minority our Kansans an undeserved communities of color have equal opportunity and access to health health care and preventive Wealthcare. As it relates to our mission we seek to assure all minority our Kansans have equitable access to preventive healthcare and to seek ways to promote health and prevent diseases and conditions that are prevalent among minority populations. Our goal is to bridge the gap in the health status of the minority population and that of the majority population in Arkansas as it relates to health disparities promoting programs awareness services educational materials and partnerships are some of the ways we are working to address and focus on the disparities among these communities according to the twenty twenty United States Census the population in Arkansas is three hundred thirty one million. Race and ethnicity minorities make up thirty eight point four percent of the total population of Arkansas. With blacks twelve point four percent Hispanic eighteen point seven Asian six percent American Indian and Alaska native along one point one percent native Hawaiian and other Pacific islanders make up point two percent. As a historical overview of the MHC it was established through ACT nine twelve of nineteen ninety one which was initiated by then senator bill well in with the combined efforts of the eighty H. B. B. N. eighty H. director Dr Jocelyn elders and of course the Arkansas legislative black caucus. Additionally at three fifty eight charge the AMA to see with the developing implementing maintaining and disseminating a comprehensive survey of racial and ethnic minority disparities and health and health care. The compilation of the report is every five years with the last report completed in fiscal year twenty nineteen the act also requires the commission to report annually to the governor legacy legislative leadership and the house and Senate committees on public health welfare and labor with a summary of the work done to decrease health disparities in minority populations ACT five seventy four of two thousand nine modified the governance structure for the commission to expand and clarify its duties. On page three. The agency's guiding principles are over arching or strategic. And those strategic goals are listed there before you. One of the Commission strategic goals is to increase the number of minority our Kansans obtaining screenings for diseases and conditions that disproportionately impact minorities such as diabetes cholesterol high blood pressure prostate cancer tobacco and etcetera. To include HIV testing and now covert nineteen testing investigation. In addition the A. M. H. C. is meeting people where they are covering each corner of the state through the deployment of our mobile health unit. Page four indicates our funding for fiscal year twenty one. We had general revenue of two hundred nineteen thousand one hundred and one dollars in which we had three salaries paid from this fine the treasury account we are able to utilize twenty five thousand nine hundred forty nine dollars. As it relates to tobacco settlement funds operations one million ninety two thousand three hundred forty three dollars and this is geared towards salaries travel professional services advertisement and other reoccurring monthly expenses. As far as minority outreach is concerned. Five hundred fifty eight thousand five hundred fifty four dollars. Is used to include our grants and aid scholarship mobile health unit maintenance and upkeep our screenings HESTAN supplies and equipment. Going to page five. On page five please see the agencies or an organizational structure. In fiscal year twenty twenty one the Arkansas minority health commission had a staff of seven. For reporting purposes. Sure Rhonda Love served as the director agency's director and resigned July twenty twenty one. A fiscal year twenty twenty two. On July twenty six I was appointed interim director a new health program specialist was hired and we are currently in the process of hiring a registered nurse for the agency. Pages six through seven. The Arkansas minority health commission currently has twelve commissioners that were either appointed by the governor's office house of representatives or Senate. And they are listed there before you on pages six through seven. So are reporting. Pages eight through nineteen. The following pages in the agency's report that was provided to you indicate the work we've done from July twenty twenty through June twenty twenty one. The agency's five year strategic plan is what guides us to working towards decreasing health disparities that exist among Arkansas minorities. One of our over arching goals is to increase the number of minority our Kansans obtaining screenings for diseases that disproportionately impact minorities to accomplish this goal we provided screenings or access to screening for hypertension stroke and other this order that disproportionately impact minorities what will also provide the services that any citizen regardless of racial or ethnic group. We deployed and utilized the mobile health unit. The mobile health unit has continued his partnership with the Arkansas bank is collaboration with partner statewide and was awarded cares funds to be able to continue serving our Kansas safely. The mobile health unit offerts preventive screenings and health education as well as allows an opportunity for coordination of care through the mobile health unit coordinator as a result of our mobile health unit efforts twenty seven counties were served and two thousand four hundred eighteen screenings provided. Referrals and additional services were given to approximately seven hundred forty nine participants however due to the cold at nineteen pandemic the mobile health unit did not provide screenings until October twenty twenty. The A. M. H. C. value our partnerships. The A. M. H. C. and the Arkansas Human development corporation Hispanic initiative focused on preventive health screenings and health education activities to increase public awareness and screening rates especially among Arkansas's Hispanic and Latin American populations the project collaborated with community based organizations such as. A. R. care connect care UALR mid south eighty eight U. A. P. B.. DHS UAMS based network amongst others. As a result of the end of this initiative one thousand two hundred sixty nine our cans from fourteen counties were provided one thousand two hundred and forty eight screenings. In fiscal year twenty twenty one through the mobile health unit sponsorships partnerships and collaborations the AMA to see documented ten thousand four hundred thirty one health screenings. And the map on page ten indicates where our mobile health unit has visited in the areas where sponsorships were giving. Our next over arching goal is to increase the number of minority our Kansans who receive education regarding diseases that this poor disproportionately impact minority. To accomplish this goal we increased awareness of hypertension stroke and other disorders that disproportionately impact minorities through our publications and fact sheets in addition to radio and television. And of course social media. We have our program let's chat broadcast the AMH the has the let's check broadcast which is a casual interview between A. M. H. C. we're of the AMA sees grant coordinator and a community partner who provides education on monthly health topics such as breast cancer Alzheimer's disease prostate cancer and diabetes. It is broadcasted live once a month allowing community viewers to ask questions that can be addressed in real time the purpose of let's check broadcast is to fill in the educational gap that resulted from the covid nineteen pandemic and to incorporate a conversational piece to a platform that is already in place Facebook as a result of let's check we have received two thousand seven hundred sixty three views in addition to region five thousand five hundred and thirty three I can't since. We have our bridge magazine. The brick bridge magazine uppermost awareness of minority health and health equity work that is taking place not only by the MHC but throughout the state. Educational information is provided to address and prevent diseases and conditions that are prevalent among minority populations in Arkansas in addition the publication supports the achievement of a Macy's goal to eliminate health disparities improve the health and well being of all our Kansans increased adversity and inclusion in the public health workforce and foster I'm going. Communication and collaboration with our partners and the public. R. Colbert nineteen webpage and resources in an effort to address the COVID nineteen pandemic that A. M. H. C. added a web page to its website to provide information about what COVID nineteen yes I was previous. How constituents can protect themselves it also includes a list of links to resources for further research including testing sites in Arkansas and COVID nineteen information provided by the CDC. The AMA cease COVID nineteen webpage received nine thousand five hundred and fourteen page views from July twenty twenty two June twenty twenty one. Our means of awareness also included radio and television we have the axe the doctor radio show. Of which is in a MHC produce radio show on K. I. PR power ninety two the heirs the third Tuesday of each month from seven AM to nine AM in partnership with the Arkansas medical dental and pharmaceutical association the show's format included discussions of topics provided by health professionals such as COVID nineteen and is the effect on minority communities and their mental health children's mental health hypertension women's health breast cancer lung cancer healthy eating adverse childhood experiences colorectal cancer and more. Listeners are able to call in and ask questions with medical professionals providing answers to their health questions or concerns currently ninety two has an audience size of seventy thousand across the state of Arkansas the show received an average of forty downloads emails and calls per month within the week prior to and following the show. Then we have the thirty minutes of exercise childhood obesity diabetes healthy eating stroke immense help. These are ongoing communication strategies focus on ethical activity diabetes cholesterol and hypertension that encouraged listeners to have a conversation there help with their health professionals. Two thousand eight hundred and seventy four health communication messages ran on six radio and nine television stations. Then we have our tobacco quit smoking lung cancer and tobacco plea H.. This is ongoing as well and the strategies focus on the effects of tobacco use on an individual's health their family and finances there were nine hundred twenty eight communication messages aired on six radio and nine television station. And then we have the heart American heart association. With reports that heart disease is the number one cause of death for women in the United States the go red for women campaign encourages women to increase awareness of cardiovascular disease consequently the AMA C. were and two hundred seventy two heart disease awareness ads which are brand over US six radios and nine TV stations. COVID nineteen awareness and prevention advertisements ran throughout the fiscal year to encourage healthy behaviors of mask wearing washing hands and social distancing to slow the spread of the virus we also aired advertisements emphasizing the facts and myths of Colbert nineteen and encouraging people to get vaccinated. Three thousand seven hundred and forty two communication messages aired on six radio and nine television stations. Our chronic disease awareness efforts were also visible on television regarding tobacco use in terms of heart disease and stroke with our thirty minutes a day in mobile health unit advertisements indigestion nutrition as a component of our southern any price and ace program are cooking with love commercial spot rand five hundred thirty nine times on nine television stations and focused on reduced sodium healthy eating and a balanced diet. And not to mention that A. M. H. C. added the over the top streaming two is media tools to help reach corners of the state that are radio and television partners can that in an effort to help further spread messages of prevention and education about diseases that are prevalent among minority populations this tool allows the agency to share fifteen to thirty minute commercials to television and media streaming devices such as Amazon fire stick. Commercial topics include stroke COVID nineteen men's health breast cancer minority mental health breast feeding stroke awareness and more the MHC told more than one point one million streaming impressions this that of this fiscal year. We have our social media tools which include Facebook and Twitter we had information on heart disease and stroke as pertains to causes signs symptoms and treatment as a result of our radio television print and over the top awareness twelve thousand one hundred and forty three health promotion commercials that focused on tobacco heart disease stroke nutrition disease prevention health education and COVID nineteen were documented. Through over the top streaming more than one million related commercials were documented. Another goal in fiscal year twenty one was the establishment of a collaborative network of stakeholders to address workforce diversity and education of healthcare professionals in fiscal two year twenty one the AMA si director joined a statewide stakeholder advisory board focus on establishing and growing the profession of community health workers through cares finding the AMA C. collaborated with tri county ruled health network which is based in Helena to train and contract out twenty two community health workers with their efforts we were able to reach the county they residing in as well as surrounding counties to educate and disburse educational material to communities they also travel with the mobile health unit to engage with community members and to encourage them to participate in the perfect inventive screenings in addition to COVID nineteen testing and vaccine. The next over arching strategy strategic goals set forth by the AMA si is the establishment of a network of coordination and collaboration with other agencies and organizations addressing the help of minority populations as a result we collaborate with health care providers and community groups that provide screening and health fairs and or clinics providing the services. Through our care is finding the coronavirus eight relief and economic security act established a corona virus relief fund to provide ready for funding to address on porcine financial needs and risk created by the covid nineteen public health emergency. We had our partnership with the legacy initiatives community health fair in partnership with the lofting clinic and the queen Arkansas in which a total of two hundred and ninety screenings were provided to two hundred ninety one attendees representing six counties screenings included blood pressure glucose cholesterol thyroid white blood cell count weight BMI prostate and colon the cities counties were live Little River severe Howard poke him state am a curtain in Oklahoma. They did the foundation of Little Rock storks nest project this starts next project is a collaboration with the Arkansas minority health commission and to say that the foundation of Little Rock to provide access to interventions supplies and health education to improve birth outcomes for minority mothers the store X. ness project provides incentives for expectant mothers to obtain early and regular prenatal care interventions include education opportunities for pregnant women to help them make informed decisions relating to parenting nutrition and health. Due to the pandemic to store excess project Health classes virtually the collaboration with the MHC provides support for maternal and infant mortality training interventions for thirty seven graduates in Pulaski County additionally twelve of the members and workers receipt HIPAA training. Then we have a partnership of faith based partnership with the H. street missionary Baptist church in which they held a health fair as well and with a total of a hundred and thirteen attended representing Pulaski County. Two hundred and ninety screenings were provided to the attendees ample the flu and pneumonia vaccines were also made available. And then we have the MAC's COVID nineteen mask and sanitizer out reach in may of twenty twenty the AMA C. launched a state wide mask and sanitizer distribution intervention to provide resources in education to reduce the spread of COVID nineteen this effort continued in over into the new year fiscal year twenty two. The A. M. eight C. provided eighteen thousand five hundred and thirty six mass an eighteen thousand five hundred eighty three hand sanitizers which were distributed in thirty four counties that were served. Thank you have them listed there on your page. So. Our next goal that was established a constituency of individuals community based organizations and communities committed to the mission and goals of the A. M. H. C. as a result of this collaboration local communities addressed health and health disparities at a grassroots level. To identify critical deficiencies that negatively impact the health of the minority populations with a focus on education and prevention we had our partnership with the Arkansas cancer coalition. In which a on March ninth twenty twenty one their summit was held and the purpose was to provide continuing education to ACC coalition members and partnering organizations and increase attendees knowledge of cancer and tobacco control statistics transcended best practices for our Kansans. There were a total of one thousand seventy nine screenings provided to one hundred and forty eight attendees representing twenty seven counties. And then we had our partnership with the Arkansas Martin Martin Luther king junior commission a division of the Arkansas department of education along with this community partners and stakeholders. They hosted a health related event in January and February of twenty twenty one as a result a total of one thousand one hundred forty four screenings were provided to twelve hundred participants impacting four counties in these counties that were affected were Pulaski Jefferson Kato pairs and Louisiana and Tarrant in Texas. And lastly our next goal was FOR African advocacy. We serve as an advocate for policy that will promote the health the minority are cancer. In which we identified existing laws policies and regulations related to improving the health of minorities we had the advocacy for Charice binding. In which cares funding has been extended until December twenty twenty one with the effort to increase fascination continued effort to increase vaccination rates and outreach. And we also had our aim eight C. six by any might nor T. health summit the M. A. C. six biennial mind their minority health summit was hosted on October sixteenth twenty twenty the summit included a COVID nineteen panel discussion and a keynote presentation from TV personality judge Glenda Hatchett. Judge Hatchett share her personal story of maternal mortality and the health disparities faced by Mike Norton's. So what's next on the horizon for the inmates see this fiscal year. We will continue to implement implement program goals objectives and pilot projects that align with new focus areas diabetes homicide maternal mortality prostate cancer tobacco and mental health. The mobile health unit. We'll continue. Going out to each corner of the State. Providing screenings. Not only screenings but COVID nineteen testing and resignation the mobile health unit will be in a partnership with the Arkansas food bank statewide the Arkansas foodbank has agreed to allow the HMAC to part the mobile health unit on their gated lot overnight for security and then this initiative will also provide an Avenue to double our preventive screenings by reaching people where they are with a screening clinic on wheels. And then we have our much highly anticipated camp I can nutrition and fitness camp increasing reach and access from Phillips County to each current congregational District. Also. We will collaborate with state and private institutions of higher learning. We will have our state of minority health. In addition we will have our biennial summit in twenty twenty two we plan to host the thirtieth anniversary in which we just had on October fourteenth. And at this celebration we had we it was a virtual celebration in which we did celebrate our thirtieth anniversary with the panel of past a MHC directors along with Dr Joycelyn elders to detail the history of the agency past and current health disparities in the projects and programs each director implement. And with all that being said this concludes my report. Thank you for that report. I don't see any questions when you do the screenings How do you do you connect them with facilities there locally I mean how does that work. For any abnormal screening we do if they have a PCP we do refer them to contact their PCP and follow up with them and if they don't have a PCP we do find a low income clinic for them to be able to go and follow up with those abnormal readings. Okay thank you very much and I'm sorry I would like to add one more thing not only do we just refer them out but we do have a follow up process where we reach back out to them in three months for any I'm not for anyone that was with abnormal screenings we do reach out to them three months after in the end from their initial visit then nine months out after and then at the year mark. Okay thank you very much for your report. Thank you. Okay of next item on the agenda is item J. report of the vision screenings by Arkansas public and charter schools. Would please come forward. Please introduce yourself for the record. Good afternoon Mr chairman committee I'm sorry about Donald the state school nurse consultant with the Division of elementary and secondary education this is the annual summary report for vision screenings in school age children on table one that was provided just want to give you a quick overview of grades pre K. through twelfth grade that are screened for vision screenings and the mandatory grades are pre K. kindergarten first second fourth six the night but there are other screenings done when there's a transfer student or there's any observed abnormalities or complications maybe in the classroom. of that referrred were a little over twenty four thousand I have that received an exam then we're seventy seven hundred and five and then confirmed abnormal are needed treatment and where lands were sixty seven hundred and then we added to Datapoints this year in which we did virtual students with no screening they were offered a to come on site for to do offsite even for some type of screening if wanted but as a virtual since they were virtual students then if they did not and they were documented in our data system as a virtual student and then we also have a data point in which the parent refused to screening to those on site student to I just did not want a screening to be provided by the school nurse and of course this is a basic screening provided by the school nurses so. And if you have any questions. So are the numbers screenings I mean is that increasing or the look at that year over year so this is down a little bit yes the screenings but of course we have virtual option here southern it's about average I will say that over the last fifteen years of this that those that are referred stays around the same anywhere from ten to twelve percent and those that follow up and I are about anywhere from thirty five to forty percent and it is down a little bit this year thirty two percent received and then of course those that do get referred and are seen and have a problem or difficulty anywhere from eighty five to ninety percent are confirmed to have difficulty. Or any treatment or lands or some. Top of follow up. All right any questions from committee. Seeing none thank you thank you. Okay item K. Department of Human Services we have a rule to review. I thank Mr Marxuach tomorrow you Miss services Elizabeth and Division of Medical Services you may proceed. The first rule we have for you today is the extension of benefits and and telemedicine for behavioral health the extension of benefits for acute crisis units. Or a crisis stabilization unit systematically they've gotten ands ninety six hours per mission work allowing them to get access to and six hours of the R. six encounters and then an extension of benefits this is something we put in place during covid and this is creating an as a permanent rule additionally the telemedicine for obi AJ Services counseling and group therapy also put in place during covid and this is just making it part of a permanent role. Right any questions from committee. Seeing none without objection this rule stands as reviewed. You're recognized to do item ill this is the second role before you today regarding long acting reversible contraceptives or larks I these have historically been covered by Medicaid they needed and an update to their pricing methodology so we are now pricing them by the wholesale acquisition cost and clarifying that we do cover all of the like devices. Any questions from committee. Seeing none. Without objection this rule stands as review thank you thank you thank you members. Okay moving on to item AM the department of health. Have to rules to be reviewed if you all would come forward. Please lose yourself for the record. Thank you Mr chair members of the committee on Larson I'm general counsel with the department of health. I'm Jamie typing the PDMP administrator you're recognized to present a IBM thank you Mr chair we're here to present first the rules pertaining to the prescription drug monitoring program this rule was approved by a board of health in our July meeting we had a public hearing in October and we receive no public comments we do have authority to implement the rules through our at title twenty and also to implement Act sixty two of twenty twenty one and Mr bin is here to answer any questions if there are any. Sir if you would please introduce yourself for the record. Sorry Sir chairman Charles Thompson twenty eighty age okay we're talking about item M. on the agenda there. All right with this section and everything else I'm. Sorry Charlie even yours of rules regarding medical medical ionizing radiation it's pursuant to Arkansas Legislative act and requirements to Nuclear Regulatory Commission and I'd be happy to answer questions on that. Okay now we're talking about item M. here so any questions from committee. On item M. on the agenda. Seeing none without objection this rule stands as review. You're recognized to a president item in I'm sorry terminated and I thought I thought you said item and as in Nancy I'm I apologize like I said this is the rule regarding the rules regarding ionizing radiation we had one public comment from a chiropractor and Texarkana that we answer this question so that he was satisfied regarding regarding the rule and I have to take any questions. All right any questions from committee. Yes senator Bledsoe you're recognized thank you Mr chairman I was wondering if the. Mr. Bevell could come of this well please. Please introduce yourself and who you represent for the record. Yes ma'am yes Sir I'm Bernie bevel I'm with Arkansas department health and radiation control section chaser. I just wondered about of. Why this rule was necessary. And what you just explain it for ma'am thank you the rule that we sent through the legislature actor two sixty eight quest to. To clean up some of those older legislation so that we would be compatible with US nickel regulatory commission. Also what we've also use this opportunity to adopt some regulations of cleanup regulations to be compatible also within U. S. Nuclear Regulatory Commission all right thank you so much Senate had not been updated for a number of years that correct yes Sir that's correct okay. Thank you so much and chairs if I may add you may you'll see a second round coming through it's over a thousand pages these rules so we had to do it and parts so to become overwhelming so this will be this will be the first time you'll see you'll see another state coming through your senate about a month thank you so much any other questions. C. nine without objection this rule stands as review thank you for your comments. Okay committee saying no further items on the agenda. We are turned.