Public Health, Welfare and Labor Committee- House

Members we've got to bills to look at that will be an amendments coming for the second bill. So will be a after the dress that amendment first we get them to HB nineteen seventy seven. I want to thank you Emily for being here this morning to help us out and filled in for Phil appreciate you doing that. So if there's anyone here in the audience that wishes to speak for or against the bills there's a sign up sheet up front so if you would go ahead and sign up on that. In the first bill we're going to list we're going to hear is H. B. nineteen seventy four by representative rye. Representative right you're recognized to present your bill. Mr chairman I need to identify Sir yeah go ahead and identify yourself representative John have district number fifty four. All right you're recognized okay thank you Sir basically on here this this morning pulled out a bill but I want to explain a little bit about what we were trying to do with the S.. Rain court is actually been hearing in the last months situations dealing with COVID masking in all other situations I was trying to get this bill through actually before yesterday's. Decision by the Supreme Court. they had a ruling on the mask and basically what I was trying to do was set this up in a way where if we had an emergency this bill strictly deals with an emergency within the state within our schools. And this was handed down in a way that in the bottom line of the situation with the COVID situation at that is within a school it would rate to six point five percent level of before actually an emergency was declared. But in the tail end of the situation of of Of the masking and all that sort of stuff we want to make sure that the mother and dad are the guardian. For actually in charge of anything that happened to their children and can make a decision concerning concerning any kind of masking are not to use masking. President recognized you quick question of the six point four did you say six point five yes six point five percent of positivity. So any school at six one five percent then they have to implement certain requirements right Sir it would have to rate to six point five percent rate of COVID which would include the teachers of the students and administration and all of the other people that are actually involved in the school bus the question is how do you arrive at that number was at the given to you by the agency or something because reason I ask that question some schools are using ten percent using ten now so what were boarded the six point five percent six point five percent actually we there was a bill that was introduced by representative may very of about a month ago maybe a little bit longer when we were in session and that was actually around two percent and I move the percentage up to six point five actually sure this is we've been working on this for about three months I'm thinking that your ten percent right that you're speaking of is probably closer to ride now but that's. Basically we're we we should I just knew some schools that use ten percent I guess that was their board and decided that but yes the bill would receive anything further discussion well well represented placement basically that that's what we were trying to do is cut it off that the Supreme Court made yesterday and had a ruling on the S. and. They jumped eight they were ahead of us just a little bit as far is there ruling up against our legislation and that's what we were trying to do I was hoping I could get this and maybe three four days ago but he didn't fall that way so. Since they have made their ruling I think district probably up I'm a music tuition but I would say that in special session that will be here in about a month we need additional work on the is because the parents in our state we feel like we need to have control of their children instead of the bureaucracy. Yes. Yes represented more you're recognized. Thank you Mr so representative Ron we we passed a mask mandate ban earlier and that's I think that's what you're referring to right courts have been holding that up and in that band we told the government they couldn't have amassed mandate right that's understanding so so basically right now the courts have a son hold that this body can't tell the government what to do says your bill also tell the government what they can't do. You know I think you're right okay it's it's a situation where we came out with something I felt was right in the session. But the court absolutely didn't go with us on what we have so I feel like that was a bad thing. Right yes Sir. Thank you Sir you're very welcome. But the court action was just rude a ruling on the state of that. Bill correct yes Sir representative placement in and actually the the things that the court is doing is not being done in a complete form and there's just statements that are coming through from you know wait to wait a month to month so actually they haven't finished yet there's still two or three points within this particular legislation that will be used later on down the line but overall I think if we went forward with this is is probably going to contain some stuff that the court system actually is is over and honest with okay yes Sir all right so you want pull your bill down to the answers make pull bill but I appreciate you guys and we do need to get the same straight because we do feel like our parents statewide should have control of their own children. All right thank you represent the right thank you Sir. All right committee the the next bill is H. B. nineteen seventy seven. Representative Brian the representative Bryant if you would come the table Committee there is an amendment that's coming around to. H. B. nineteen seventy seven. So representative Brian if you would go ahead and do it yourself for the record representative Brian District ninety six. Give us just a couple minutes to get these past Okay representative right you're recognized to present your amendment. Thank you Mr chair committee what you have in front of you and amending page to where we delete lines thirty four thirty six original language to the bill in nineteen seventy seven. It gave some languages that. We shall funding for the testing shall be paid for by the employee's healthcare. That gave a little bit concerned for officer healthcare providers saying what are you telling us you mandated us to make that a provision so what we did to do it to change that is we we put the cost of the testing shall be covered through any state or federal funding made available including the they are funds if the employees health plan does not cover it that gave them the healthcare insurance providers a little bit of. You know that we're not mandating them to do it we're saying if they don't do it then we can use our funds or state funds. So the way it was originally written it would have been might be considered as a mandate. For the insurance companies that's that's the way they're council thought. All right any questions from committee. Seeing none what's will of committee. I have a motion do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Is have it members adopted you're recognized to present your bill as amended. Thank you Mr chair this bill house bill nineteen seventy seven we already discussed pretty good detail it matches house bill nineteen seventy two except with amendments the amendments if you'll turn your attention to. Page two lines twenty one through twenty four there is a language of nineteen seventy two said that it would be on an annual basis. And that it would also be a healthcare provider using a serological test and then it gave us more finite definitions antibody tests are T. cell tests and talking to positions member member positions and other other bodies we decided that it proof of immunity to agent approves from unity would broaden what that meant for what kind of test that uses a position we also turn it into two times a year because one time of year was just too too long so we did it will twice a year but not to exceed every six months that way an employer can't say test month test on January test on March and then not be able to require the test throughout the rest of the year so just you know twice per year did not to exceed every six months and then we got rid of their logical test that way just healthcare provider needs to be the one that performs this procedure. And then the last change we did is we took out the originally section three which was the unemployment insurance benefits and in talking Department com commerce at length we feel that there is plenty Appanoose for them to seek benefits in the event that they are dismissed due to this bill or other other instances of the code backs. All right any questions from committee representative board you're recognized. Thank you Mr I just wanted to clarify Page two lines twenty one through twenty four is this some attempt to just drive more business to healthcare providers or is this because we. Blake there's a better standard or or a more consistent standard with healthcare providers did it and what they might receive somewhere I think the original language the business community was concerned that if we can just go do what they wanted to go to Walgreens and say I have this and get online and send a test in so this language you know not only basically. Puts it into a twice a year pattern but also make sure that it is from a licensed health care they're the ones telling the business yes this employee. Is good to go per our standards. Representive Allen you're recognized for a question. Thank thank you Mr chairman I just need to know what is the fiscal impact Do we have one. I I did not get one we I probably don't know how many employers are going to participate in this So I'm sure the oven a understanding is they have no impact bottom line is whatever state or federal funding we put in this will be at our discussions so when the to me when the kitties empty. Is is empty and then the employer employee will have to figure out there you know what the next steps are. President Wardlaw you're recognized for a question. two points I think DF and a is here with some documentation on what they think that cost would look like my first my question is on on page two same same questions Representative Boyd asked We looked at the data from last year the health department reported ninety days was your immunity from the time you are off quarantine to time you are back into the quarantine rules and all the documentation in this paragraph you're saying. Did they don't have to do this or not to exceed once every six months so you're basically saying a hundred eighty days what's on TV data do you have or what specialist do you have in your corner to says that a hundred eighty days is adequate and how do we know we're not sending people out for next or ninety days to expose or spread the virus. I don't I do not have anybody here to ensure that it is just an arbitrary number you came up with well just just the did you know if you read article after article he read in I. H. documentation the knights would say I believe you know it could last you up to eight months nine months so yes the twice a year. Seems reasonable as far as you know what your committee could last at the proper time Mr we have health department comes able to comment on that paragraph. Yeah there becomes the table they're going to speak on the bills thank. Senate Danzig you're recognized for a question. Thank you Mr chair Representative Brian I I didn't see this before but I'm comparing this with your previous bill nineteen seventy two in that section you pointed out with the on page two line twenty one through twenty four were you said proof of immunity. And I hate your previous bill you said the antibodies are T. cell response or or things like that I'm wondering how you. How you prove immunity from a virus I mean I understand it's a really broad term without. Without saying something like such as. The presence of antibodies are T. cell or or something else or you know have listing a criteria that can be used for proof of it to prove the immunity that makes sense it does it doesn't we discuss that and the consensus was if you if you just left it broad with proof of immunity you can capture all the tests with previously mentioned that any new additional tests that may be available in the future okay so the positions we talk to separate from unity in their world covers a very broad array there there's been a a term that I've I've heard repeatedly over the last several years that it or inserted into bills lawyers like to put in there at that without limitation so if if you added those back into it that said without limitation I mean these things without limitation anything else I don't know how that would work you have to talk to one of the drafters on that but as far as a suggestion on thank you thanks. Any other questions from committee. Seeing none. representative pain you're recognized for a question. Thank you Mr. So I guess my question based on the last couple about the proof of immunity your other bill is still scheduled on the House floor do you intend to pull that bill down or if this one passes yeah I believe the language in this bill alters the more agreed upon it's it's a better cleaner bill under the run this thing run the one previous to pass I'm not gonna I'm not going to run one previously passed I'm working with this one with the language that agreed upon by multiple members of the house in the Senate to to make its way through the system okay well if I could follow up yes I recognize that language we've been discussing here for a minute on line twenty one of proof of immunity. it's been proven that after the vaccine some people still get the virus and it's been proven that. Even after having a case of covid. The people can be re infected so I don't know that unity to COVID nineteen exist anywhere that's been proven yet. So I just seems like a very broad term for the courts to jump on. Did not give you concern it did but I I'm gonna rely on the medical community that we discussed other members other doctors that are among the membership to say that that's to then that that covers anything they want to do. To to certify that they feel that I'm forty is it is quote has some immunity maybe equal to or better than the vaccine you know at that point of testing okay thank you Mr. Senate board you're recognized. I'm just trying here to to think through what what this could. Can I ask questions see see how it responds I'm still working on formulation so back to one twenty one Page two proof of immunity so when we have the practice of medicine practice pharmacy practice of nursing practice of podiatry the healthcare professions there's an art and a science and so sometimes you you make a decision based on the best information available and it's not always one hundred percent certain but yet you would say you know you have a. No this diagnosis that diagnosis committee so do you expect this proof of immunity would mean you're one hundred percent risk free because I've been the vaccines are the best ninety five percent you know but we would say your mute because you had the you're fully immunized is that what you mean by proof of immunity. I think the in car conversation was if if you're the treating physician. And you have a a normal patient that you see on an annual basis for the routine checkups or they came because they have with you know with all its code a code and then three weeks later they show up and say or they came to them and said Hey I've I've had you know I've think I've got code in the state well yes you do and so they get quarantine they take their and whatever treatment options are available to them through player no well then that that position. It's certify that employees immunity for this window is because that position talking to the ones I talked to said that will tell me that you have proof of immunity for you know at least up to six months. You know maybe eight maybe nine months but you know the employer would say that this is good for six months if I choose to ask you to test again I can in this in the following six months. Representative Greg you're recognized for a question thank you Mr chair as kind of want to clarify to that I worked with Josh on this language and the intent wasn't to confuse things the intent was because someone that test positive if they there's no reason for them to go back and get the antibody test a month later because they tested positive so the intent was to broaden it a little bit of some kind of broaden that a little bit while reducing the time frame I don't know if this body things that we need to adjust the language that I think that's appropriate but they that's what the intent was. I'm not really question do you agree represent. Any other questions a representative Payton you're recognized. Thank you Mr chair would you be willing to explore other language that would more perfectly Define your intent. I'm open to any options to get this moving you know my my my concern is you know as the time crunch were in as a body but you know we do have good legislation and weight but I don't know of waiting is an option. Well I know we have a time frame but you have another bill that's already passed this hurdle. So. If some of us prefer that bill might be hesitant to replace it unless we get language right. Yes thank you thank you Mr. The other questions. Seeing none. We have a. Six people signed up to speak on the bill. And two against the bill. I'm sorry just one against the bill. Okay so jim Hudson. You would go the on the table and please introduce yourself and who you represent. Thank you Mr chairman jim Hudson Arkansas Department commerce one is real quickly and I got the real pressed on time I do wanna thank represent Bryant for reaching out of members as well just to hear the concerns from the employer community and and I appreciate that some of those concerns getting reflected in the current version of the bill just want to just make sure that within that were clear you know we're having to the employer community as we talk to them they will comply with state law and federal law the choice right but expected special expected federal law you look at the OSHA standard and the incredibly tough Hammer that that is those employers are covered by the ocean standard those employers you're separately covered by a president binds Executive Order lane federal contracts and my folks I'm sure here from hospital association speak about you know those things are applicable to hospitals and health care settings you know despite this bill ever some version of that passes those employers are going to have to comply with those laws the states have no choice and this will make sure we're we're clear about that that the concerns that we're hearing from the employer community do appreciate that the unemployment language got you have got change there and in terms this issue of of testing you know the employers were not medical experts you know in business we're looking the milk medical experts to tell us for the protocols me to follow and so we need clarity we don't ambiguity about that we understand what that is and in terms of the the the cost for that to the extent that funding is not available from the state is not funding available but our government building comes back to the employers and if that's a significant expense then you that could certainly be a hindrance to business in Arkansas so. It I came to get more specific than that others what I'm hearing this morning and as I listened to the debate at this concerns are kind of popping off in my head about that so we'll continue to monitor legislation as we see things will give you feedback as as Rabal to absorb and with that I'm happy to take any questions. Excuse me. talking about OSHA you brought that up in your Comments there is there any organism organized opposition in the business community. to OSHA rules it might come down due to this mandate because the should department I used to be a special government employee for ocean yes they would have to prove that this is a workplace hazard and it would have to refer to the rule. And that is there any organize organize opposition or maybe opposition to this in the business community yes Sir there is you know they're already sending at this point I'd say it's queries to OSHA saying you know how you can address this I can address that for example you know hundred employees is is the threshold was at a hundred employees at a location is at a hundred ploys for the employer across various locations is it's things like that there's this testing opt out for the OSHA standard that is by the way not applicable to the federal contractor standard there is no testing opt out federal contractors you have to get backstage and so but it for the OSHA standard on on the testing opt out what is that protocol going to be and and you know better than I based on your experience that social love to grind into the details and so I suspect they will tell us exactly what they want to answer your question yes business interest business community chamber across the the nation they're reaching out to a motion to register their concerns I believe OSHA has already crossed the threshold of declaring COVID nineteen a workplace hazard I'm not concurring in that determination but I believe they have already done so and so it's going to be subject to future litigation. Well my concern about that if if they can declare COVID a workplace hazard then why can't I declare the flu the workplace hazard because it has the same effect in manufacturing I mean it's just under operation. Yes Sir I did not hear defend defend ocean but you know I believe they have already reached the determination about then it's gonna require I think actions by the court to either overturned or firm thank you questions from the committee. Representative Bentley you're recognized. Thank you chairman would you agree that there are a number of what ifs with these ocean rules that right well and if the entire thing in court. I totally agree with that so I think it's hard for this body would you agree is hard for this body to make rulings based on what it's when we're very containing some concerns of my constituents that want want some Smith what I would say a very simple things to make sure that workplaces. Of safe we know the antibodies we sent when I see or read numerous reports of these antibodies are just as well more effective than the vaccine so you know as an employer I'm scratch quick question just think that we are we as I want you so would you agree that we as legislators listening to our constituents that are very concerned have legitimate concerns about this vaccine that we can't really just be basing things on what it's when we know there are we've heard from the Attorney General and others other trying jobs across the nation they're going to battle these OSHA rules. Head on and put incorrect and delay them yes ma'am I don't think I can current can concurring your statement I do agree that you know this body has to listen to his constituents constituency which includes the business community as well we know as a matter of certainty that oceans no promulgated standard if there's not question if that's going to happen it is going to happen likely sometime the next six weeks or so and so in the absence of a court of competent jurisdiction enjoining enforcement they're gonna have to apply the standard to the work place and live with it until that gets sorted out in the courts. Any other questions from committee. Oh I'm sorry representative Wardlaw you're recognized. Mr Hudson where where is OSHA regulated that. Federal level it's it's a it's a function of the US department of labor so not not any law or any bill that would pass from this body would be able to regulate OSHA regulations at any level no service from the quality now state's constitution relegates that authority strictly to the president United States interpreting statutes passed by the United States Congress thank you for my morning civics lesson. But Mr Hudson on the same subject. States that have taken over enforcement of the OSHA regulations do have some affect on how that those laws are enforced is that not correct that's correct Arkansas is not one of the states unfortunately we're not. The other a question the representative Boyd recognized. Would you agree this bill regulates a market and regulating markets is one of the per views of this body thank you. In the sense of regulating the employment relationship and the labor market is that your point representive it does and that is one of the the purpose of this body is to regulate that yes Sir. Okay seeing no more questions thank you for your comments thank you committee thank you Mr chairman. Paul Anthony you're recognized. The come the end of the table the research that I pronounce it correctly. Please introduce yourself for the record the represent thank you Mr chairman all of him Fortner finance administration thank you Sir My role here today is to give you some information about the funding level that we currently have with you it's just a cost of this could be. We currently have a billion forty million dollars is allocated to the state of Arkansas. Two hundred and fifty four million of that is currently available. Another US seven hundred eighty six million will not be available until July of next year. Have some hand out there for your staff could pass these around. They're on the side of the. it right here. What we did. Is a simple calculation can I take a look at those for him amount please go ahead Sir. What we do is a simple calculation of the number of people that might be tested on a weekly basis at a cost of a hundred dollars per test. And Iran that the ninety five weeks that a remaining between now and July the thirty first of two thousand twenty three. if twenty five thousand people are tested on a weekly basis that will cost approximately two hundred and thirty seven million dollars over that time period. If we take that number up to a hundred thousand people. on a weekly basis during that time period the cost would be nine hundred and fifty million dollars which would be approximately approximate most of the remaining funds available through our. As you're aware there's a know been money that's been distributed there's other uses for that money that have been caught. Number two. Senate more you're recognized. Thank you Mr chair so you're if I understood your testimony correctly you're saying this could cost nine hundred fifty million dollars. It's all depended upon the number of people to take the weekly testing of but that number is of a is one of the ones that we calculated yes or so so could you help walk us through the specific math so that we understand and we can find the right balance of you know here's a range the you it sounds like you're saying this is the upper end but there's got to be in zero would be lower and if nobody did this right so can you help us with the mass so we can better understand what the implications might be. So we are Marner standing is is that the test the reimbursement rate is approximately a hundred dollars per test. This given. We started we started the calculation out with twenty five thousand pretty of persons per week being tested. And there's ninety five weeks between October the first and the end of July thirty first two thousand twenty three. So the calculation was that point would be two hundred and thirty seven million dollars if that was the number of people on a weekly basis. We have given graduated this by twenty five thousand of people per week to give you a feel for what that might be. And if the upper range that I gave you a bit point range of a hundred thousand people the cost would be nine hundred and fifty million dollars. I would so I stopped the calculation is a hundred and fifty thousand people and that cost would be one point four billion. Measure simply estimates or weekly basis. Jett following it you're recognized. Thank you Mr chair so. Well let me ask specifically I I do have the calculations in front of me and thank you for providing that the so that I can see it visually. What evidence do we have that they're even going to be twenty five thousand people who are going to need this the service where did you come up with the twenty five thousand is a starting point as opposed to five thousand or ten thousand or three or four or what have you could you help me understand that process we started with a number and I have no idea as to how many people would have to be tested and how much the how many will not be covered by insurance or other forms of a payment I simply gave your range of numbers for use calculation. Johnson you're recognized for a question. Thank you Mr chair I'm. I understand your math here I'm just curious about how you came up with a hundred dollars a test I believe what we're referring to is the antigen tests that are here and just did a quick search and I can get two tests. For fourteen dollars. so that seven dollars per test not a hundred dollars per test. Is this some. I wish we special government tests we should go to the heart of to the department of health years they're turning and they gave us that amount is a reimbursement rate for test administered so our our government is. Spending that much per test when you can get it on the open market for seven Bucks a test. I'm just blown away by the waist thank you. I had a question. Just make sure I'm reading this correctly the total cost of the program on the right hand column. If I look at the seventy five thousand which is in the middle of your chart. So now that is a three year cost is that correct because it goes from October twenty one two five twenty three so an annual basis between thirty four thousand. Well. Yes Sir. Thank you. President Penzo you're recognized for a question. I was curious what the of fiscal impact for the state of Arkansas would be if we were to lay off a hundred and fifty thousand people. I mean we're at the fiscal impact of what it would cause to test and it will be the fiscal impact and to the state. A federal government and just overall business community to lay off a hundred fifty thousand people sure I can answer the question. Thank you. Senate boy you're recognized. Thank you Mr chair for allow me another one so it is I'm looking at this I'm going You know that's a that's a lot of money we don't really know but again we're we're kind of doing a what if scenario right and so what if it were a hundred fifty thousand what if it were two hundred thousand and I think and will what would we do but is it correct that if costs started to really spiral out of control that our governor could call us into special session to address this. They're always Revenue Shishir. President Payton you're recognized. Thank you Mr I believe it's my understanding that the government is currently paying for the vaccination is that correct sorry I didn't hear you Sir does the government currently pay for the vaccination yes did you deduct anything for for the cost of the vaccination because what I'm of people that would not get vaccinate vaccinated. Those represented calculated with the testing with the okay thank you thank you Mr chair. Any further questions from committee. Seeing none thank you for your comments. Matt Gilmore. Lord shoot. Please introduce yourself and who you represent. Thank you Mr chair members of the committee on large you I'm general counsel for the department of health we apologize for having to be in two places at once so we're trying to cover all the bases and I believe that there were some questions earlier on house bill nineteen seventy seven expressed by representative Wardlaw and representative Payton on that page two in section beyond the proof of the immunity this may be it more of a battle of the experts type situation it seems that the sponsors talk with some doctors and we wanted to make sure that that you all were aware that the health department does recommend you know best practices and we're trying to make sure that that that you are aware when you're passing this type of legislation that not all tests are are created equal the tests need to be for specific you know for natural infection they need to be based on a non spike protein antibody titer Dr Romero's expressed concerns about not really knowing what a protective antibody is with the with the positive tighter there's no core let of immunity right now there's still a lack of information and and case studies regarding the level of protection with natural immunity get that gets up a person over time and so that there is a concern about the current language in there about the basis of two times in a year we had some recommended amendments that would add the proof of the positive tighter for the virus that causes COVID nineteen or its variants on the basis of at least every three months so and making sure that that was from a licensed healthcare provider so we would recommend that on the lines twenty one through twenty four and we just want to express our concerns on that thank you. The questions from committee. Seeing none thank you for your comments. I Mark Twain. If you would introduce yourself and who you represent. Thanks chairman mark white party and services person I'd spoken with the committee regarding the earlier iteration this bill the other day so don't want to retread bunch of ground there just a and emphasizing as I discuss of the day CMS is going to be issued a mandate for vaccination for all health care facilities that receive Medicare or Medicaid funding that means that for the seven facilities we operate which is the Arkansas Health Center the state hospital R. five human development centers we expect that at least two and all I could also to those facilities will be subject that mandate and in this bill for you you've you've been there been some changes made around the top of testing that's allowed which I think kind of illustrates the potential conflict here if CMS comes out with a mandate that says that testing is allowed but it with PCR testing SP every two weeks instead of twice a week instead of every week or if they don't provide for anybody testing or if they say the anybody testing cannot has to be every ninety days there's any conflict like that and that's going to put us in position where we cannot comply with the federal mandate and if that happens that does put or funding at risk and as as I mentioned we receive a total of a hundred and thirty million annually in federal funding for those seven facilities there present three thousand jobs and with a thousand clients who live in those facilities that we care for assessment we'll make sure the committee understands the possibility of that conflict there don't know for sure there will be conflict but there's the possibility it was make sure that you understand the the possible risk this represented there we have to entry questions. The representative Gonzalez you're recognized thank Mr. The so I've heard on multiple bills that have came through here since the time that I've been. Here that it puts our funding at risk this one puts our funding or as we passed many of them seems like have you ever had your funding cut. In the past we've been a work of work situations out when they're having situations where we've been for the lancers no right out yes Sir okay thank you. Any other questions from committee. The representative Pilkington you're recognized thank you Mr white I thank chairman do you have any draft language from the CMS memo they have not issued any dress yet so they issued bullet points anything like that no we at this point we're in the dark about what the specifics of their mandate will look like so it's just this phantom out there. It's I mean the president about as directed them to do so sob as with OSHA very intent every expectation they will be issuing a rule within the next I would guess next four to six weeks but as far as to the specifics of what that rule look like we just don't know at this point yes thanks. Any other questions. Presented Payton you're recognized. Thank you. Do you think that when CMS promulgates rules that they take into consideration existing state laws and how their rule may. be contradictory to existing state laws across the nation okay Sir that may certainly take a look at that and give that some consideration the same time you know discrepancy because federal law controls and so they will they may take thanks consideration are required to and there's no guarantee that they will. So the supremacy clause federal law rules except in the case of marijuana I would assume. I I'm not an expert on marijuana law so I can't speak to that okay thank you. Any other questions. Seeing none thank you for your comments thank you members. one person signed up to speak against the bill Joanne trip. You would please introduce yourself and who you represent. Good morning I'm Jedi entered on the executive vice president of the Arkansas hospital association I am against the bill as written I'd like to point out two things for you if you'll look at page two starting with line twelve. The word treatment there I'm a vaccine is not at treatment for cove it it's a prevention in order so that you don't get COVID people who are COVID positive and don't get vaccines so you might want to clarify that language to actually be the definition of an immunization if that's what you're really after for immunizations and vaccines to be something like a preparation that is used to stimulate the body's response against diseases that also helps you in defining who your employers are because the way it's written right now the only entity that's really required to treat patients who are also employees it's hospitals hospitals are required to treat everyone and all diseases so just if you get that language cleaned up for your real intent might help secondarily and the I know that I've spoken on another bill about this particular issue this the privacy clause does cause us great problems and while we agree with everyone here who's talked about OSHA standards and the Medicare conditions of participation the Medicare conditions of participation are the lifeblood of hospitals ability to be financially stable if we don't follow those Medicare conditions of participation Medicare and Medicaid absolutely will not reimburse us and for things that we do for folks over age sixty five who are covered by Medicare and for anyone who is covered by Medicaid and many of our hospitals that absolutely would financially cripple them not to mention lots of insurance contracts with us are based off of Medicare and Medicaid rates if for no longer participating in the Medicare Medicaid program because the feds say were not following enough of their regulations it puts us in a dramatic bind and finally on the Perspective of hospitals need all their tools in their arsenal to do what's best for their individual patients in their individual setting we actually want hospitals to have the opportunity to determine whether mandating with particular exemptions is appropriate for their individual facilities I don't think anyone's happy with the threat of the mandate from the federal level so we might ask for some language in this bill that would say your state law stands until those regulations come out at the federal level where you your state law would be preempted anyway so that it's very clear that your state law exists and is in place and is the law of the land until there is a conflict with federal regulations which I don't want to speak for DHS but it might actually solve part of his problem it it certainly would solve ours don't forget hospitals with more than a hundred employees which is pretty much every hospital in the state and don't have to comply with two federal standards at the same time we'll have the OSHA standards and the Medicare conditions of participation and where those two conflicts the federal government makes us take the most strict version for example if the ocean standards do not allow testing for us if it's either a mandate or not a mandate for a vaccination or not even if the if the Medicare conditions of participation say vaccine or nothing and OSHA says vaccine or testing and we have to go with the one that's the most strict which would be vaccine or nothing I'll be happy to answer any questions that you might have representative board you're recognized. Thank you Mr thank you Mr for being here today you bring up some valid points and any concerns and I appreciate that the I have two questions if yes allow me so number one is would you agree that the term vaccination is a Generally means it promotes active immunity in the term immunization would include both vaccination and it passive in a community which actually money clue treatment such as antibody treatment right but look at the language in that particular bill because it looks like you're talking about employee the employer is the employer who provides treatment to its employees if you take out that parenthetical the including vaccination or immunization you just read that sentence without that in there it looks like the only employer you're catching in your law is the employer that has to treat covid which is hospitals and then secondly again I hear you I understand you on your request about until federal law basically preempts this. I guess I'm I know you're here today representing health care association and you're not here to give us legal advice but I guess my question though is is. My understanding is is if if we do something contingent on federal law and less we put a specific date or something that courts have held that our law then was unconstitutional because it was we did it based on federal lawsuit if you have any comments that might guide us and that I would appreciate it yes I would offer an employer is exempt from complying with this section during any period of time that compliance with this section would result in a violation of regulations regulations or guidance issued by the United States occupational health and safety administration the centers for Medicare and Medicaid services or the centers for disease control and prevention. The representative Bentley you're recognized for a question. Thank you chairman thank you Jody and I know that you're looking at what's going on in New York and would you say that in Arkansas we're gonna have the same situation here food look all the sudden lose twenty percent of our staff of the hospitals fifteen to twenty percent that we would be in the jeopardy they are shutting down labor and delivery having to bring the National Guard so would you agree that if we have the same scenario here in Arkansas we could see some of the same things that they're staying there and we have been very concerned to across the board and and you know that you've been super helpful especially on some of the nursing things that we've done to try to maintain our own work force and and recruit others to take care of that and numbers of covert positive patients and frankly right now the numbers of really sick our Kansans who are not COVID positive but who for appropriately put off care for the healthcare system but maybe not appropriately put off care for their own individual health so our hospitals are still full not so much with COVID patients anymore those numbers are declining even though we still have way more than we'd like and so I absolutely agree with you that workforce is paramount and taking care of our people is paramount which is why and till these regulations come down from the federal government we like our individual hospitals to have the flexibility to determine what is best for the safety of their individual patients so we're constantly going to be afraid of that work for shortage that we have in Arkansas and we're constantly battling that we're battling it before because of it and we're going to keep battling it long after one quick follow up yes. Would you not agree that keeping as many of your well qualified employees working as possible would be the best thing for the patients that are in that hospital right now as long as those employees are promoting that best safety possible for those patients absolutely and my members would agree. One fast follow up since that was the remark you know there's and these intrusions where we're trying to be very conscious of our of to I we want cans and save but there's ample evidence out there to show the people that I've had COVID and have a good antibodies that we've seen from Israel that people that get COVID have their images or thirty seven times stronger than someone gets a vaccine so we're not I don't think we'll be records would you agree that we are really looking out for our Kansans and ours ours People that are working are working employees in the hospitals well we're not trying to be unsafe at all with those that are working with those nurses I know you quite well I know there's no way in the world you would want to create an unsafe environment I know everyone's trying to do the best they can with the resources we have which is why hospitals need the flexibility to mandate if they need to vaccine or other accommodations to make sure that their patients are the safest they can be. Resented Payton you're recognized. Thank you Mr chairman thank you Jody and let's look closer at that language that you're concerned about in section to a. And and the term treatment. If you look at it there it does not go without being defined this is an employer that requires treatment for an employer that is mandated to require treatment. And then it has a clause that says including without limitation vaccination or me or immunization so I mean they're defining treatment in this language without limitation so could include other things but it is specifically says vaccination or immunization. Is is what's being defined as treatment here treatments for COVID nineteen are monoclonal antibodies they're ventilators if you can't brief there dexamethasone and I'm not pronouncing that correctly that which is a steroid that helps your lungs expand and grow you have a physician here who knows way more about this than I do treatment for treatment and vaccination treatment for COVID is something once a person has covid vaccination is to prevent a person from getting code or prevent a person from getting those symptoms there are two different things in the medical field and again you have medical personnel here I I think with a little clarification we're not an argument if your point is to say that you want this to apply to immunizations and vaccinations that's totally fine you can leave your language including those things to make it very specific that that's your intention but the word treatment likely needs a better definition so that you're not also pulling in monoclonal antibodies et cetera other employees are not giving other employers are not giving monoclonal antibodies to their employees under that that's the whole point an employer that requires mmhm so do we have any employers that are that we think are going to require those other treatments that your name well we know because most of them can't right the way that sentence reads what that might mean is only an employee who can require only an employee who can require that treatment is covered in your law Walmart would not be well I would disagree with the. The reading of that sentence but I do understand your definition of treatment I just think through the it is clear in how it defines treatment here. For the requirements that which is the subject of the paragraph the mandates thank you thank you Mr. Seeing no further questions thank you for your comments thank you for having me and thank you for your work committee thank you a committee I'm gonna take a five minute recess and I'd like to meet with representatives gray Gonzalez and Brian over here. But just a few minutes sort of be on recess for five minutes. I'm all. Representative Gonzalez. You're recognized. Thank you Mr I'd like to make a motion to expunge the vote by which the amendments. She or H. two seventy two. Past. Go ahead. The. You may explain not explain The motion yes please so there is a this seems like there's consensus around making more making another amendment to to this bill and. Because of the way you this will be have to be engrossed into the bill before we can add any other amendments it would take a lot longer to do so if we expunge this vote explains this get this amendment all we can come back in hopefully in thirty forty five minutes with new amendments and add this back in with new language that we've the we've been talking about this morning. Well. The ballot motion it is debatable it requires two thirds majority of the membership which is fourteen any discussion on the motion. Seeing none. All in favor with. All in favor signify by saying aye All opposed nay. Motion carries. So the the vote on the amendment is expunged. Now committee what we're gonna do is we're going to recess until. Nine forty. And wait on the amendment so hopefully they'll be back to us by nine forty. So we're in recess until nine forty. All right Committee who would get your seats we're going to get back in session here. So the amendment you should have been trying to you. Representative Brian you're recognized to present your Amendment. Thank you Mr chair committee in the second representative gray you're recognized thank you just I guess a point clear did we expunge the original amendment yes we did okay thank you. You're recognized representative Brian. Thank you Mr chair committee and members of the of the public that gave great testimony good questions I think with this amendment will will address some of those and maybe some additional. concerns whether members. We have a we've approached. The issue of. Page two line twelve. Employer that requires is amended to require treatment as our members were an agreement testimony that maybe that's a little not narrowed yes to nearly define it may not be accurate so we trade change that to an employer that requires or is mandated to require a vaccination or immunization and then deleted including without limitation vaccination on lines thirteen and fourteen so that should clean up that language I wish I had a clean bill not just in the amendment should clean up that language and then down below that. The questions of just saying proof of immunity. We've actually added proof of immunity Or variants including without limitation presence of antibodies T. cell response or proof of a positive COVID nineteen ports variance test that way it's kind of including but without limitation as what test the physician should use so really that not only keeps the proven unity as some members thought would be broad enough to capture future but it also shows what test would be available. And in the the last change the original motion to amend this morning it was previously expunged still in there with this amendment but we've added B. which says in the event that the cost of testing in subdivision C. three a which is the R. or state funding is not available the cost of testing shall be covered by the employee that way the employee or is not bearing the costs in the event partner for state funds are not available. All right any questions from committee. Seeing none. Anyone here in the audience wish to speak for against the bill. Sorry. I'm sorry the amendment. Seeing none what will the committee. I have a motion to adopt the discussion on the motion. Seeing none all in favor signify by saying aye. Those opposed nay. Motion carries graduations amendments been adopted you're recognized to present your bill as amended. The. The bill is is now amended to what we previously discussed the there's no other no other changes that we've we've that was added to it. So I have sent all right any questions from the committee. Seeing none. anyone here in the audience were speak for or against the bill. Seeing none once will of committee. I have a motion. To pass a do pass as amended in discussion on the motion. Resented Eubanks recognized. Thank you Mr. Our thanks go represented Brian for amending this a little more it's. Closer to what I feel like I could I can deal with I believe that businesses do have the right to set certain policies and. that. Employees have to work under those policies and. Business is that you know have to make decisions that they think is in the best interest of their. Of that business. I also understand why people do not want to possibly take the vaccine and I thought that there ought to be other options available to them that were truly viable so I've I believe that if somebody has had the the has had covid and they show that they have antibodies that audit that ought to count. At the same time I felt that if an employee chose. Not to take the vaccine had not had code with that if there ought to be a testing option available but I also felt like that ought to be the responsibility the employee now I I know in your amendment you're stating that if the funds are depleted then that that does that responsibility falls on on the employee I just believe that it should have started that way because that's that's that's risk personal responsibility you're given you're given an employee of a viable option as to what their choices and they get to choose that they're not being forced to take the vaccine so We're closer to where I think it should be I wish that other language about the state funds available we're not in it so But I think we're close. But I don't think I can move forward as it is but the. Thank you for your efforts. Any other discussion. Representative Bentley you're recognized. I just wanna applaud you represent Brian for the hard work you've done this and everybody coming together it's good compromise it makes for good legislation so I'm very supportive were looking for individual liberty center have been our businesses that I think it's a great bill so just of full support how to present thank you for your hard work on that and all the others that worked with. Any other discussion. Seeing none motion on the floors do pass as amended all in favor signify by saying aye. Those opposed nay. Yeah ayes have it graduations your bill is passed. Thank you Committee no more business to be considered where German.