Task Force on Autism
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- October 6, 2026
Senator Justin Boyd
Unverified
0:30
Good afternoon, everyone. Thank you for being here at the Arkansas Legislative Task Force on Autism. I'm going to hand it over to Representative Innit very briefly here. Good
Representative Denise Jones Ennett
Unverified
0:56
afternoon, everybody. I would like to take this time to do a moment of silence for Senator Uvalde Lindsey.
I do know that he passed a couple months ago, but we met before that happened, and Senator Lindsey was very integral in getting this group together, so if we can just take a moment right now to recognize
Senator Justin Boyd
Unverified
1:29
him. Thank you. okay thank you all right so the next thing on the order of agenda is the consideration of a motion
to approve the june 17th 2025 meeting minutes so does everyone had a chance to look over
those do i have a motion for approval motion okay i gotta have a motion
Senator Justin Boyd
Unverified
1:55
i have a second okay i have a second over here so all in favor say aye any opposed okay meeting minutes are approved the next thing c is here for your information
it's uh you know general session legislative overview from 2025 so that's again primarily there for your information next we're going to have a presentation on development disability services Jennifer Braze okay do you want to present from there go to go to the table yeah probably better to go to the table and once you're at the table if you will remind everyone who you are and who you
you represent and you can get started after
Speaker 17
3:02
that okay good afternoon everybody I'm Jennifer Brzee I am the current director of the division of developmental disability services at DHS and per our last conversation we've developed a short presentation on overall what services we do provide at our division as well as focusing on some autism specific services also wanted to mention from
feedback that we got at the last task force meeting i handed out a little um little card that we developed in response to a lot of feedback that everyone was sharing about how pcps and schools in particular a lot of times didn't have direction on where to go with our services and so i would love any feedback that you all have on this handout flyer that we have presented today if you do please email me we'd love to start planning to distribute these and
would also throwing out love ideas on best ways to distribute these to schools and pcp offices we're also exploring a lot of avenues on our side too but if you have a particular contact or idea please share so one thing about our division accessing dd services i think that is really cool is that we have one road in so we have an online referral intake form or a phone number both of
these will get you to individuals who know all about our idd services from our home and community community-based services to our waivers to our ICF levels of care. And so it's just a really cool process. You can fill out a short, brief online form, and that gets you to our intake and referral specialist. Or you can leave us a phone number, give us a call, leave us your phone number, and we'll call you back very shortly. And same process. So we have a whole team of people that really handhold families and individuals through the system, which I'll note can be
somewhat complex especially when it comes to the many different services that we provide also we have a connection to the access arkansas so medicaid as a whole has a very cool online platform now that you can apply for medicaid online you can also check ces waiver services on that portal and that will also connect you to our team and then as always we encourage all of individuals to attempt to apply for SSI it's just a great federal program that
a lot of our population qualifies for this just quickly sharing we have a strategic plan that we develop every year it is online and posted right now this high level indicates the different projects and all the really cool things that our divisions working on this year and I can go back to anything if anyone has any questions but wanted to get to the to meet of the services and so this This is high-level bullet points about the services that our division either provides or oversees for DHS.
The number one and biggest thing that we do is the CES waiver, and so that's our home and community-based waiver. Everyone in CES waiver goes into a pass, so once someone qualifies for the CES waiver, they get an independent assessment, and then they go into a pass. I'm going to talk a little bit more about that qualifying eligibility, but it is individuals with intellectual developmental disabilities and they have to meet or need a certain level of care to qualify for this waiver. Our second waiver is the autism waiver, which I think Karen's going to
speak a lot more about with partners. Again, this is a home and community-based waiver. It provides intensive in-home services to children under the age of eight, but you have to qualify for it by five years old to receive the full maximum benefit of three years of services and then children's special services so this is a really cool program it's part of a title five grant that we get under the department of health it allows us to provide care coordination statewide through
our in case managers to kids that have chronic medical and intellectual and developmental disabilities so children not only don't only have to have intellectual developmental disabilities we can also provide services for children with complex and chronic medical conditions like diabetes, asthma. This is a really cool program. It allows us to pay for some equipment and provide services. Our care coordinators do a great job of connecting families to other programs in their
communities as well as services and Medicaid programs that they might qualify for. We can follow children all the way through the age of 21. We also focus strongly on transition from pediatric systems to adult systems, and it's really, it's been super helpful for a lot of those families to help them transition from all their pediatric specialists to their adult specialists. We also, we oversee as subject matter expert the regulations around early intervention
day treatment and adult day treatment so early intervention day treatment is a clinic-based intensive clinic that you your kid they go to they get intensive ot pt speech rehabilitative and nursing services again you do have to qualify with a delay but it doesn't have to be something chronic so we serve a lot of kids who who just for many reasons have delays in the beginning and these intensive wraparound services really help them catch up but also to children who have those
really more complex things going on you can attend early intervention day treatment up to the age 21 but I think a lot of our early intervention day treatment centers really focus on that zero to six year old range and then adult day treatment another clinic-based day program for adults with intellectual and developmental disabilities this has been a great service throughout the state that really supports adults with training activities, employment activities. It's also another avenue that adults can receive PT, OT, and speech habilitative services.
And then, of course, applied behavior analysis. I think everyone's been hearing a lot about this lately. We actually have a stakeholder work group that we formed at DHS where we're working through some updates to the Medicaid manual itself. Again, this is relatively newish to the state of Arkansas. We really started seeing it grow in around 2019. The state has gone from just a very few BCBAs to a lot right now, and so it's been a really great treatment for children with autism diagnosis. And then we help consult PT, OT, and speech therapy regulations, especially around
habilitative services so those services that are in the early intervention day treatment setting and other
Speaker 18
10:03
settings can be clinic based and really focusing on kids then
Speaker 17
10:09
intermediate care facilities so these are our residential 24 7 365 day care facilities the state our division has five state run intermediate care facilities which we call human developmental centers we have around if you We put private ICFs and the state-run ICFs we take care of a little over as around 1,200
Speaker 18
10:31
individuals throughout the state with pretty complex intellectual and developmental disabilities and for one reason or another haven't been able to live in the home and community independently.
Speaker 17
10:43
and then while not directly over it we also help consult with personal care so this
Speaker 18
10:50
is another really unique service that helps a lot of our families and individuals with intellectual and developmental disabilities especially when they are maybe on the wait
Speaker 17
11:01
list or they're qualifying for the waiver these services help bring people into their homes when assist them with activities of daily living such as bathing dressing personal hygiene and then of course wanted to add counseling and crisis services while not our division isn't directly over that
such an important service as our individuals with intellectual and developmental disabilities continue to have behavioral health needs just as much as the rest of the population autism spectrum disorder so this was also new for me because i was in grad school a very long time ago, when you did have to learn how to break these different diagnoses out, such as autistic disorder, Asperger's, childhood degenerative disorder. So I think they did a really good thing around 2013 in the Diagnostic and Statistical Manual.
They combined all of these after recognizing that there was a need, that people weren't always using the same criteria. Individuals that had these symptoms were being given a variety of different diagnoses, just depending on which practitioner you were seeing. And so condensing all of these different diagnoses just into autism spectrum disorder really helped improve consistency and accuracy in diagnosis.
It's still, there's no magic test to prove autism, so it's not even a genetic test. There's no black and white, this is, you have autism or you don't. It really does take comprehensive assessments and behavior, like watching interviews with the parents and guardians. It takes observation. And so you need a lot of information and material to really make an autism spectrum disorder. So just sharing that under our current statute, you need to have two different qualified professionals to say and confirm that you have an autism spectrum disorder.
And that can be a physician, it can be a psychologist, or a speech-language pathologist. And having those two different professions agree really also helps support and confirm the diagnosis.
Speaker 18
13:23
And so the fast-growing and most popular thing right now for treating
Speaker 17
13:29
autism symptoms can be applied behavior analysis, or what everyone now refers to mostly as ABA therapy.
I put a short description of what ABA here is, but it really is intensive treatment centered around decreasing or getting rid of a disruptive behavior. And so these are generally the course of treatment is prescribed and developed by a BCBA, and that's a person with a master's degree that has that additional certification in licensure. BCBAs can be a wide range of professionals from psychologists to I know several OTs that have
attained their BCBA license and then BCBAs usually work with paraprofessionals to actually implement the treatment plan that they developed and this can range anywhere from a few hours a week to 40 hours a week in some intensive cases. Just going back to the fact we did we just published a new provider manual that went live in January and as all things it wasn't perfect but it was
a great step towards the future and we are working with our stakeholder group to make that even better. Right now ABA services are only available from individuals from 18 months to 21 years old and you have to have that autism-specific disorder. For Medicaid, all ABA services are prior
Speaker 18
14:59
authorized. If you're in a pass, that can vary depending on which pass you're in. And then I offered some additional information on the community employment support waiver.
This, again, is our biggest waiver at any point during the year. We can have 8,233 individuals on the waiver. You have to have a categorically qualifying developmental disability or other condition. The disability also must be present before the age of 22. And not only do you have to have a diagnosis, you have to show basically that substantial functional limitations in three or more major life areas. And so part of our qualifying process is our psychology team really looks at the diagnosis.
Do you have documentation that it happened before the age of 22? and then how is that impacting your life and what ways is that prohibiting you from doing the things that you want to do in your life. And then the disability and deficits are expected to continue indefinitely. And then just a little bit more about how that process works. A member, a family applies. We get a lot of documentation and information from that family. There's requirements for testing and assessments and a lot of stuff.
And then our psychology team really looks at that and determines that you've met all these criteria under this actually state statute. And then once you've gotten that, we give you what's called your 704, and then that 704 says that you are now eligible for this waiver. And then this is just more informational about, again, not only do you have to have a diagnosis,
but you have to show that you have substantial functional limitation, at least three of the
Speaker 17
17:04
six major life areas. And then just really high overview, once and if you're approved for the CES waiver, we send you for a referral to Optum, who does our independent
Speaker 18
17:14
assessments. opt-in comes out and schedules an assessment with the family or the member they do it's about
Speaker 17
17:21
a two to three hour process when you get your first assessment and then if you score a tier two or
tier three then you are automatically enrolled in a pass and then that past care coordinator will start reaching out within 15 days even if you are not fully in the ces waiver yet as long as you qualify for Medicaid, this
Speaker 18
17:45
still happens. This process still happens. So just sharing in a note that not everyone that applies for the CES
Speaker 17
17:54
waiver and goes to the wait list automatically goes into a pass because you have to meet those Medicaid financial eligibility requirements. Once you get
a CES waiver slot, it's a higher level. It's a higher percentage of the federal poverty level. And so
Speaker 18
18:10
individuals are more able to qualify for Medicaid at that time once they have a
Speaker 17
18:20
slot. And then just a little bit more about the PASS side. It went live in 2019. Again, it includes members who are on the CES waiver and wait list. There are four PASSes currently operating in Arkansas,
and this allows members to access those home and community-based services under our 1915I, which is historically a lot of our behavioral health paraprofessional services, and our 19C waivers, which is our IDD services. And then as of 818, there were 46,781 people in the past. And then
Speaker 18
19:00
this graph just highlights and shares, and this is a mixture of people on the waiver
and the wait list and what that distribution looks like per each pass. And then
Speaker 17
19:17
that is my contact information. So I'll stop there and see if anyone has any
Senator Justin Boyd
Unverified
19:24
questions. Are there any questions? And just a reminder, if you aren't familiar with this room, you need to hit the button and that will light up your microphone and let us know that you have a question.
okay seeing no questions oh sorry representative in it thank you mr. chair
Representative Denise Jones Ennett
Unverified
19:43
I have a question I have you remember this summer with that I don't want to say debacle but the with the rule about the daycares in the ABA therapists in that work group that you're working on can you just briefly explain what that was so the
Speaker 29
20:02
audience would know are you talking about the
Representative Denise Jones Ennett
Unverified
20:05
Hope Bridge situation I believe so. The one, like if you have a facility and you can't have the kid.
Yes. They hurt a child there for a certain amount
Speaker 17
20:17
of time. Can you explain that briefly? I sure can. This came up after there was a parent, a concerned parent. Something had happened. They went to the Department of Education to try and report this something. and the Department of Education realized that they had never heard of this facility, and so they had reached out to us, we did some digging, and we found out the individuals were registered with Medicaid as ABA, BCBA therapists.
So currently today, Medicaid does not license or register an ABA clinic per se. we register and we certify therapists, so individuals that provide that service. As we worked with the Department of Education, and they actually went out and did some on-site audits, what they discovered is that the group of ABA therapists were doing clinic-based services, which appeared to be housing kids, unrelated kids, for several hours a day, five days a week.
And so at that time, they realized they were probably not in
Speaker 18
21:28
compliance with the child care licensing rules. And so they started asking them and exploring with them how to become compliant with child care licensing. Then, working with the Department
Speaker 17
21:40
of Education, we realized that there might be other ABA clinics throughout the state that were unfamiliar with the child care licensing rule. And so in collaboration with the Department of Education, we reached out to several facilities throughout the state, you know, just to provide some education.
The Department of Education was very, you know, they were great, and they offered to educate folks and help
Speaker 18
22:04
them through the child care licensing process. I believe after that conversation and talking through some of the requirements for child care licensing, and again, this is not child care licensing, and I'm not Department of Education. So let me preface that. It's not what you're doing. It's how you're doing something. So anytime you're keeping
Speaker 17
22:26
children in a facility without their parents for multiple hours a day, unrelated, you could fall into child care licensing requirements.
Speaker 18
22:34
And so I think after they explored what it would take for them to become in compliance with child care licensing, they made the decision what it looks like from what they published not to do business here. representative ladyman thank
Representative Jack Ladyman
Unverified
22:59
you mr. chairman i'm not part of this group but i appreciate you let me ask the question uh no just a question jennifer for you uh on one slide back i believe where the map is
the arkansas map and it shows the passes at the bottom what's the significance of those colors on the arkansas map is there a number or it is that's the population distribution
Speaker 17
23:19
so the darker counties definitely have more people who qualify for the waiver and weightless than the lighter color so what kind of magnitude are we talking between a bright blue and
Representative Jack Ladyman
Unverified
23:29
a very very light blue i mean is it thousands or hundreds yeah i would have to
Speaker 17
23:38
i would have to dig into that so the total
population of waitlist waiver and prefacing also that I pulled this a
Speaker 18
23:44
couple of months ago when we originally did this presentation and so at the time I pulled it
Speaker 17
23:51
there were a little over 9,000 individuals throughout the state on the waiver and waitlist in the past system of care. Okay,
Senator Justin Boyd
Unverified
24:05
thank you. okay any any more questions seeing none thank you for your presentation thank you
okay up next we have Karen Burnett Director Partners of Inclusive Communities University of Arkansas if you want to come to the table miss Brennan Burnett and
if you'll introduce yourself tell us who you represent and
Speaker 54
24:45
you mr. chair I'm Karen Burnett I'm the
Speaker 56
24:48
executive director at the University of Arkansas partners we are the state's University Center for excellence and developmental disabilities education research and service thank you and I'm here to do this presentation because this is a DDS waiver like CES but partners has been the state's designated vendor for operation of that waiver since it began so that's my role is as that designated vendor and interestingly enough this waiver began as a result of
activity from this task force. There was an early intervention committee at the very beginning in 2008 or so when we started and that committee came forth with a recommendation that said that Arkansas really needed to do some intensive early intervention for children with autism diagnoses. That was what was evidence-based and so that was what the committee recommended. So what happened was there was a tobacco tax that you probably remember in 2009 and
that's what brought some funding to DHS to begin this waiver so it was approved it was a 1915 C waiver home community paste waiver that was approved by the the feds October the 1st of 2011 with services to begin January of 2012. I think Representative Annett knows the person who had the very first application submitted because her husband delivered
it to me by hand on a Saturday. The waiver was the start date and it was a first come first serve sort of a thing with only 100 slots so he was going to make sure he was in there and it was i knew he would be there so i was at the office on that saturday and sure enough he showed up bright and early with an application for the first child so initially we had 100 slots statewide the way the statute was written we had to just we had to phase those in 10 children a month
which was good because we were just getting started we have dds has expanded the number of slots twice now so at this point in time we have a current maximum child point in time number of 180 children statewide it's a different design than some of the other programs you might hear about this one is an intensive in-home intervention program so all the services are delivered in the
child's home and in natural community settings so if so parents are present while the services are being provided our teams provide their services typically late afternoon evening and weekends because that's when the parents are present most of our children are in some sort of a day program somewhere we have a few that have a parent that doesn't work but for the most part both parents work and the child is somewhere during the day so our team fills in in the afternoons, evenings, and weekends. You're eligible if you're between the ages of 18 months
up to the eighth birthday, but you have to get a slot in the program and begin before they turn five. The maximum service length is three years, and we use a multidisciplinary team. This is not strictly an ABA therapy kind of program, and we did that intentionally. When we started this program, we only had about 20 BCBAs in the entire state of Arkansas. So we knew that we wouldn't be able to operate the program if we had developed it as an ABA program. So we have used always
master's level speech pathologists, psychologists, special educators, some BCBAs. And that demographic has changed over the years because we thought it would be a you build it and they will come. And this was the first funding source that actually paid for ABA. And so we have seen that expand tremendously in the state since this started our team at partners is responsible for developing and main we developed a secure database that manages all the data for the program case notes number of children the demographics of
the children the progress that they make and I'll show you how we track that a little bit later we are responsible for recruiting training and monitoring monitoring provider agencies that deliver these services we manage the application process the eligibility determination and the waiting list for this program and then we make sure that everything that the state's supposed to do to stay in compliance with the waiver application is done all of those things reported to dds to jennifer and her staff we have waiver services that are
provided by a group of community-based disability providers, those non-profit organizations that deliver the services for CES waiver. Also, a number of those have signed on to this program. Those particular agencies hire the staff that form the team that go into the homes. So we have an interventionist that is a master's level person that's responsible for doing the evaluation on the child, developing the treatment plan. That's someone with a master's degree in
they could be a BCBA or they could have a master's degree in one of those other fields that I mentioned. This is a three-tiered system different than the way the ABA program is offered where we have a lead therapist that is a bachelor's level credentialed person that delivers weekly services and oversight and then we have a line therapist that is paraprofessional level that delivers the bulk of the hours. We also have a service in this waiver that makes it a little bit different that is a quality assurance of the treatment fidelity. And this service is, we call it our clinical
services specialists. They are people who are board certified behavior analysts at the doctoral level and are employees of the University of Arkansas in a different area than where Partners is located so we have a three separation if you will of of how this works with our staff at partners developing the plans and working with the families to get those in place the provider agencies hire those staff that form the teams that go in and then we have that third party if
there's an issue with the treatment if a child's not making progress if something seems to not be working well, then we have somebody independent of the group who developed the plan and are offering the treatment to go in and take a look at it. We wanted to make sure that we didn't have children being dismissed from therapy because it wasn't going well. And sometimes this has been a really nice piece because it has allowed those doctoral level BCBAs to help build the skills of all of our other teams. So there's
Speaker 61
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been a lot of cross-pollination or multidisciplinary learning
that's happened because of the way these teams were
Speaker 56
32:02
formed the unique characteristics and the part i absolutely love about this program is that it's all natural environments it's the child's home it's if the family says my husband and i take turns going to church because somebody has to stay home with the child then our line therapist can go to church to the sunday school class with that child which make great places for children to build social interaction because it's the same group of kids that are there every Sunday and there's consistency and typically it's a small
group. If they say we have an older child that plays ball and we can't go to the ballpark because this little one can't deal with that sort of setting then our team can go to the ballpark. If they can't grocery shop, those functional activities that we all take for granted every day that sometimes are a real struggle for a family with a young child with autism, they can be supported by our teams in those actual environments. So that's my favorite part about it. The atypical hours are different. Our teams work afternoons, evenings,
and weekends. And when we first tell parents that's when we'll come in, they look so shocked. It's like they really can't even believe that you're really going to come on a Saturday or a Sunday. How does that work? Parents are present. They are an active team member built into the team. So they're present when the activity is going on, which means they learn the same skills in terms of how to engage with their child as those therapists are using. And what that means is that the child gets the therapy all the time, even whether the team's there or not. There's the separation of the administration and the service delivery
and the treatment review. Our team members can all bill Medicaid simultaneously. If they're all in the home because they're all trying to provide training, then they need to be there at the same time, and they all have a different job in that. and so it's not a double dipping sort of a situation and we check we track child outcomes in the program as well as service utilization so we've received about 4500 applications from the beginning of the program to september the 26th when we cut this data off because we prepared it
for the first date of this meeting we've applicant have applications from all 75 counties in the state and somebody in missouri and tennessee even tried to get in but we just you know explained them pretty quickly that they weren't going to get into an arkansas medicaid program obviously the counties with the largest numbers are those counties with the largest population distribution and you can see from this graph how the applications have changed over the years that we've had the service it you know it was a little slow getting started it took us a long time to be
able to build those relationships out in all of those very rural communities for a long time we weren't getting start getting applications from children who lived in the delta and now we're getting applications from everywhere this just shows the distribution of the numbers across those counties we have children that are living in in camping trailers we have kids living with grandparents or a lot of grandparents raising children all kinds of situations but wherever the child is living is where we provide the services.
The difference between male and female is about what you'd expect with the gender differential that we see in autism all the time. Lots more boys than girls. We have a number of girls, but again, way more boys. This just shows you the distribution based on ethnicity, and this one shows that we're pretty close to what the demographics of the state looks like in terms of who's been in the program total number of children served for a particular fiscal year the last fiscal year shows that we
we pretty well stay at our total number that we can serve at any point in time our active number and our pending number pending are those kids that we've processed but they're in one of the locations in the DHS eligibility, usually waiting for a medical review team. And those two numbers added together pretty much all the time equal our 180 point-in-time slots.
When we started the program, we weren't seeing a lot of children diagnosed at age 2. Again, this starts at 18 months. But what we have seen is some shift in that. Most of our kids are still in that three to five range, but we do see some children at 18 months and at two years that are beginning to have the diagnosis earlier now, which is exactly what we'd want to see happen. The earlier, the better. And at this point in time with this particular program, if that diagnosis is not made, the child's not eligible for the program.
So before, when Jennifer talked about the change in the DSM where we went from PDD and autism and Asperger's to autism spectrum disorder, there were a lot of situations where children had been tested and they thought it was an autism spectrum disorder, but nobody wanted to call that diagnosis. So there were young children sitting everywhere with a pervasive developmental disorder diagnosis that didn't make them eligible for anything. And at this point, that sort of made that change because they knew that
Speaker 61
37:20
families were not going to be able to access services unless they went ahead and said what they really thought it was.
Speaker 56
37:29
So we have a lot of children who are sitting on a waiting list for us right now. We have kids that will probably age out before they get in because they have to get into a slot before they turn five. This shows our current provider listing, and you can see independent case management there has the longest red line, and Josh Wilson is in the back here. Josh is the CEO of ICM. They have by far been our largest provider the whole time we've done it,
and they are a countless advocate for home-based services so they've been great about going out into these very rural communities and providing those services for children so thank you to ICM and all of the other people that are listed on here it was a voluntary situation for the DD providers anyone who wanted to come in could we've had some additional ones other than these who worked with us for a while and then dropped out because they didn't have enough children that
were choosing them this is all based on a parent's choice we give them the list of who serves their particular county and the names and contact information for people in those organizations and then the parent can call and make a decision about who they would like to have to deliver the services for their child we do at partners we do a lot of chart reviews and we do a lot of contacting members of the team every month we reach out we rotate whether we're calling the
parent or whether we're calling one of the members of the of the treatment team but we reach out to somebody every month and say how's it going what's going on is there anything you need help with can we do anything to support you differently we complete all of our home visits are made in person we we shifted to virtual during covid for a bit but it's just not the same so our people go in the home because we want to see the backdrop we want to meet the families we want to know something about the situation we always meet
the family and the child before they come in as we develop those those plans for folks we use an ables which is an assessment the assessment of basic language and learning skills is what that stands for we do a number of different assessments but this is the one that we use to gauge child progress because it's sensitive enough to really measure skill change in children. We pulled a data pool here of 318 children who had received the full service
and had multiple ABLEs assessments, and what it showed was that the average initial ABLE score was about 182 objectives, and the final one showed 749. Per child, if we looked at total number of skills acquired it ranged anywhere from 51 to 1,347 with an average of 567. So every child in this program has made progress. Some of them made dramatic progress. You know you've heard people
say probably if you've known one child with autism you've known one child with autism and that's really the truth because they're all so vastly different and that variation I think plays out even in terms of the outcomes of progress but they all make progress and one of the things we really love about using the ables is this is the visual that we've had someone program into our database so if you look at this the very bottom of each of those columns each of those columns is a skill area the very bottom that's sort of a dark burgundy color is the baseline of what the child
could do when they came into the program we require that ables to be re-administered every three months and every time you see a color change those are the new skills the child had the next time and the next time and the next time so it gives you an instant visual of how much progress and this is just a child we pulled out of the database to show how much difference it's made it's a really nice visual to share with families because you can at a glance see how much change
there's been across the various modalities that we look at that's another set of the and the ones that are at the beginning of that are reading and math which are academic skills that we don't even target in a in a Medicaid program but you still see increases even as you know just almost a an aside to the things we've worked on. So it makes it nice to be able to show to families, look how much difference this has made. And we continue the very same assessment across all three years of the
services. We tell our interventionists that they can use any other kind of assessment they want to use if clinically they think they need something else, but everybody's required to use this one as a base so that we have a comparison ability. So we're very, very pleased. I mean, it's been a life-changing program for children the other thing that we didn't anticipate when we started but is a really nice outcome of the program is the change in the workforce it's it's been life-changing for
the people working in the program as well and this shows you that first bar shows you someone that nine people who went from the interventionist level which is the the master's level to the clinical services specialist. So they went back, got more training, were then qualified to act in that different role. Line therapists, paraprofessional to interventionists, that's parapro to master's level. Lead therapists to interventionists, that's bachelors to masters.
And you can see the largest group at the end, 203 people were line therapists to lead. So across the board what we've seen is people that were working in the program at one of those levels as a team member was so moved by what they saw happen in the child's life and for the family that they went back to school and got additional credentialing so that they could come back in the program and work at a different level so we didn't really expect to see this sort of thing happen but this
program has served children all over the state and it has built it has created jobs all over the state each child served in this program has at least three people that are working there probably four so those are jobs that weren't there initially and they're people now that have gotten additional educational credentialing to be able to have a different job and they're they're more readily able to even support their families these are we also do satisfaction surveys we do
an anonymous survey that we leave with every family when our team goes in to visit them and they mail those back they've been we look at how satisfied they are with with our staff at partners and with the rest of the program and pretty consistently everybody is very very pleased the families become very attached to the team members because when you're in the home anywhere from 20 to 25 hours a week with their child you're almost become like family these are just you know some of the comments that people have made we've had
parents who english is their second language who've written us letters in spanish that we'd have to have translated before we knew what they said but every one of them has been incredibly positive periodically we'll do this kind of a story and certainly we have permission to share evelyn's story but we'll share these that are just comments written by the parent what the parent said about the program and what it had done for the child and it shows the age and what county and how many objectives that particular child and eight team members which is talking about jobs
created in garland county for this child so when when this mom says without the arkansas autism partnership autism waiver i'm not sure where evelyn would be but that isn't something we as parents have to be concerned about now that's a pretty powerful statement from a mom because you know we moms worry about everything they have
Speaker 54
45:49
to do with our children um at this point um and these numbers are a little bit different um right now instead we have 440
Speaker 56
45:57
families who are actively working to complete an application and we're guessing that probably about 106 of those will not be able to get in before they age out which means turn five we have 122 on our waiting list with completed packets and probably about 23 of those won't be able to get a slot before they come in we turn our slots relatively quickly because it's a three-year max service limit. The idea is get in there as intensively as you can for a short period of time
and then hopefully you don't have to continue to do that later because there's been so much change that's made. So we've never had a waiting list this long before. Our waiting list right now is about six months long so if somebody comes in and they're a young four-year-old we're probably going to get them before they turn five but we just had one this week that turns five in January and that child's not going to get in and those are the hardest calls for our staff to make to those parents to say I'm so sorry but I had to take you off the waiting list and I don't have a slot for
you that's not something we ever want to have to say but it's the reality of where we are right now and here are our contact information Renee Holmes is right here she is an RN who is the day-to-day manager for this program she's also a parent of a child on the spectrum and she is awesome. Any questions anyone has?
Speaker 71
47:36
Rachel. Okay. My question is if you have a child that say is in preschool and they do receive ABA therapy while they're at school, do they still qualify to have the services at home so they can do
Speaker 56
47:51
both. Typically the preschools are usually it's an EIDT where they're getting the ABA will tell them they have to choose.
Speaker 74
48:14
Susie. Tell me what happens when they turn eight and is there a transition plan for them because some may not be ready some have made a lot of good progress but then they're in public school how do you all navigate that
Speaker 56
48:32
yes there is a transition we start our transitions several months before the child ages out we involve the title five people we talk to families about where they are and you know where they may need to be
we outline for them all the other services are available in the state so typically there's not school district people involved in the transition conference but we're preparing them for all of those kinds of steps and sometimes our interventionists and the people that have worked with the child in that local area will go to iep conferences with kids representative Dalby thank you mr. chair thank
Representative Carol Dalby
Unverified
49:15
you for letting me ask a question I'm not a member
of this task group but I've been
sitting out in the audience with someone from Texarkana who facility has autistic children who do a fantastic job and I've been listening to everything and this is kind of outside of my wheelhouse can you tell me on the individuals that are working in this program what type of training do they get is it a continuing education training do they have to have a certain level of college I miss
Speaker 56
49:51
that yes the um the
interventionist level which is a top tier for us has to have a master's degree in some health care related field and they have to have experience with children with autism and they have to have training that's specific to autism and it there's a total amount of hours and we don't specify exactly what you have to have but we do specify that they can only have a certain number of those hours that are like introduction to autism kind of things so there has to be someone that's got a pretty good history and their degree is specific to understanding this disorder the lead therapist
is a batch has to have a bachelor's degree plus training and experience that all the levels require training and experience and then the line therapist is the same way they have to have a theirs is 80 hours of training and then if we can do a provisional if we're in a rural area and we can't find anybody to allow them to get some of that experience as work experience but each of the levels requires a certain sort of degree and also experience with children with autism and training thank
Representative Carol Dalby
Unverified
51:02
you may have a follow-up mr. chair yes ma'am uh in and in that regard because um i'm i'm from southwest arkansas and so it some of that can be ruled even though i live in texarkana and that's not rule um and this is a you know a program for the university of arkansas and i'm a proud graduate of the university of arkansas but how many of our post our colleges and universities
how many offer this type of degree or offer this type of training and can they get started like are we partnering with our community colleges that the university has partnerships with i'm i'm just curious because it that and i'm i'm grateful i am thrilled to death that it requires that type of educational component and everything, but are there the people and are there the programs to get there?
Speaker 56
52:01
There are two programs in the state of Arkansas
that offer the credentialing for the master's level board-certified behavior analyst for people to be prepared to sit for that national exam for those national boards. One is the University of Arkansas Fayetteville. The other one is Ouachita Baptist University. Well, that's good. I have an undergraduate
Representative Carol Dalby
Unverified
52:21
from Ouachita and a nurse doctor from the University of Arkansas, so it works out well. Thank you. Thank you, Mr. Chair, for allowing me to ask questions. Senator
Speaker 56
52:32
Lindsey called, when he was chairing this task force, called representatives from all of the four-year colleges together
and tried to lean on people to begin offering that program, and we didn't get any takers. and I guess it's a small number of students and you know it just wasn't something that people were maybe didn't have faculty with that background to be able to do it I'm not sure what but we've got two and we didn't have two when we started so
Speaker 82
52:57
two is better than zero thank you okay co-chair in
Representative Denise Jones Ennett
Unverified
53:02
it thank you Mr. Chair thank you Ms. Barnett for being here we go way back as you said earlier
This program is wonderful. When our son
was that age, was it three? Yeah. You all came and helped us out tremendously. So I can't sing enough praises to you all. I do have a question. So is 250, is that the max that you all can take at any given time? 180. 180, okay. It's the max. Okay, 180. Point in time. Okay, 180. So you stated your current need right here.
So how do we make this list smaller? What do we need to do? Do you need an increase in budget or kind of walk me through? I
Speaker 92
53:55
think it's a slot increase, and the state's done that twice. It would be a revision submitted
Speaker 56
54:02
to CMS to say, you know, we'd like to add X number more slots to
Representative Denise Jones Ennett
Unverified
54:08
this program. Is that an arduous task?
Speaker 61
54:10
You know, your DHS people could tell you more,
but I'd say any time you're doing anything with CMS, it's a little bit of an arduous task. They like to
Speaker 56
54:20
play cat and mouse back and forth. That's my experience with those applications. Now, if it's purely just an increase in slots, I don't think it usually is as much of a big deal as if you're changing programmatic pieces. And I don't know what it would be like now if there's not very many people working in D.C. It might be a very slow process. I don't know. I don't know if we've had anything modified recently. Jennifer or Melissa could probably answer that better than I could.
Speaker 96
54:51
Melissa Weatherton, DHS, thank you for the question. What Karen is not saying very kindly is it's not as simple as just adding additional slots. It takes state general revenue to pull down the federal match
Speaker 98
55:04
to pay for the additional slots. I have a follow-up. So
Representative Denise Jones Ennett
Unverified
55:11
what's your budget to run this program a year? We'll have to pull that for you. Okay. And what's the match?
Speaker 96
55:23
So it's a direct service, and then it's a sheet. We also pay Karen to administrate it, so it's a 50-50 for administrative purposes, And then it's our regular FMAP, which starting in October is 69.23 FED.
Senator Justin Boyd
Unverified
55:45
Thank you. You're welcome. Okay. Any other questions? Cigna, thank you very much for your presentation. We're going to move to overview of Arkansas rehabilitation services.
So if those involved in that presentation would come to the table. If you'll introduce yourselves and remind us with whom you are presenting or for whom you are presenting, then you can begin, okay?
Speaker 107
56:30
yeah there we go good afternoon I'm Amy Lamb I'm the associate commissioner for access and accommodations it's a division of Arkansas Rehabilitation Services mr. Joe Baxter our can can your friend introduce herself
Senator Justin Boyd
Unverified
56:46
as well and then yes sorry I'm Dana Byram deputy director
Speaker 106
56:50
of special programs perfect now y'all can begin okay mr.
Speaker 107
56:55
Joseph Baxter our commissioner sends us apologies for not being able to be here both he director Cody waits they were pulled into a
meeting with the Secretary of Commerce so they are regrettably not available to be here today thank you for taking the time for let us to give you a little overview about what we do and the services that we provide I will give you kind of a brief overview and then Dana's going to give you some specifics about field operations and I'll come back behind and and give some information about access and accommodations you're gonna do my there we go so ARS operates on a 60 million dollar budget the current caseload as a Friday was 11,869
cases and we have 288 to excuse me 228 field staff who are working diligently across the state to provide those services 90% of our budget is really geared toward helping individuals with disabling conditions get into the workforce you know the goal be it training be it education be it job placement is to really saturate that workforce with individuals with disabling conditions we have about 10 percent that are a slighter amount
that's there for independent living services maybe we need some modifications to the home to be able to get around and do some things like that but the real focus is workforce saturation organizational chart we are under the department of commerce under workforce connections to the left yes those are our shared services with commerce folks it's going to be more it hr legal
fiscal folks like that communications that are working for the whole department to the right you're going to have more operational entities that includes field services access and accommodations we will spell that out just a little bit more Dana's going to give you some information more about the
Representative Hope Duke
Unverified
59:07
field operational side okay good afternoon so Arkansas Rehabilitation Services
serves individuals with a wide range of disabilities we have physical
disabilities including mobility sensory and chronic conditions we have cognitive and learning disabilities like intellectual traumatic brain injury developmental specific learning disabilities and then we have mental and health mental and behavioral conditions including like PTSD schizophrenia anxiety depression and then but any condition that's substantially impedes substantially yeah creates an impediment to employment and those clients that can
show a need or benefit from VR services are the individuals that we serve individuals that receive SSI and SSDI are presumed eligible for services as long as their goal is employment so this is just a picture of our field map we have 11 regions 19 field offices and we cover all 75 counties and it's color coordinated so you can see how those counties are divided up it also has the managers names the regions the contact information so if anybody needs that map we can also send it to you but how you apply is you can go to any one of those
19 field offices you can you can go to the field offices in person you can call email we'll get you the application but we do have a new application process and and so this is showing you a flyer that has our website so you can apply online but it also has a qr code and that made it easier for people to access because we have seen an influx in the last year just with referrals because the accessibility was so much better so we take pride in our certified vocational rehabilitation counselors because they all hold
a master's degree they have went through a supervised clinical experience they've passed their crc exam and completed it which is a very difficult test and i never want to let that lapse ever they have the knowledge of federal and state regulations ethical standards and best practices and each year they do continuing education and professional development so in order for an individual to be eligible for Arkansas rehab services they have to have
a documented physical or mental impairment have a substantial impediment to employment they have to show a need or that they can benefit from VR services and then a lot of the individuals might need multiple VR services so they might need training education accommodations just more extensive services and then we've already said the SSI
but actually let me go back how do I go back okay so we
have 60 days to actually find you eligible for services it doesn't usually take
60 days but we allow that just because sometimes it's more difficult to get medical or psychological records but we do have with that new application process we are doing VR now which is a new program that we're doing and this has increased the rate of services to get them in get services started faster and with that statistically has shown that is increase the communication between our clients and our counselors and the training is completed and they actually get a job faster because we are we are
just communicating with them more intensely and moving through the program faster so don't ever say i didn't say vr now because that's huge um so once the 60 days is done it is time to do an individualized plan for employment we have 90 days to complete this however we don't just jump in there and start writing up a plan we do a lot of pre-planning we do career assessments um skills assessments we utilize onet jan the job accommodation network and we use the
career index which is a really good tool for labor market information and it shows if they pick a career it also shows related careers so we can look at what the preparation is for those careers and what it would take to get what they're what they're wanting to do and so what we do is we prepare we work with their family support the schools the WIOA partners which include adult education and workforce and once we get all that planning done then we're ready to sit down and do the plan and once we do the plan we start writing down goals
and objectives and start dates and end dates and we definitely want to put the dates down of all the services because we get that credential attainment for our performance measures and so we can submit that to the rehab rehabilitation service administration so some of the other services that we offer counseling and guidance so our I'm gonna let Amy talk about the diagnostic but counseling and guidance our counselors use their judgment and experience to provide all that information that we just talked about so the clients can make a
responsible and informed decision that's realistic and feasible and post secondary we do have a lot of good connections and partnerships with colleges and vocational trainings I'm short and long term pre-employment transition services so we are in 189 high schools our counselors go in there and work with pre-employment and provide pre-employment transition services to students with disabilities 14 and up and so our main five core services our job
development counseling on career post-secondary work-based learning work-based readiness and self-advocacy and so we also do a youth leadership forum which is a week-long camp in at Henderson University in the summer and And we have done two CTE camps, and we're expanding that each year. But we just did two CTE camps in Bentonville and Rogers, and that is career technical. And hold on, I'm going to show you. I wrote it down. I had everything memorized except that.
Hold on. But that career technical gives the students a hands-on experience for some of the careers that they're interested in. so we've got construction auto mechanics robotics nursing welding and hvac and we had 26 students go to the ylf camp and cte camps are for 14 and up just a brief overview of the on the job training it's a work-based training experience under the wioa youth program that increases employment
engagement implements sector strategies which is letting us know what what businesses jobs and trainings are growing in the area and what is leaving the area so we can better when we talk to our partnerships our industry partnerships and we're building that we're doing informational interviews with them about what their unmet need are we can discuss the labor market info the sector strategies and decide how we can work together to match our clients with their unmet needs
okay so arkansas career development center so acdc is a training program that we have in hot springs and a lot of our students with disabilities utilize acdc because they have a virtual program because a lot of our students struggle with passing the permit test and so they have a virtual training to help those students pass the permit the driver's permit test they also have long-term and short-term training programs including culinary forklift retail welding and some more short terms
our transition special projects we have tep camp that is similar to the youth leadership forum camp it's a week-long camp at conway and and then we have the project search which is a nine month internship we have 10 sites across the state for project search and what it is is during that internship let's say it's at some of them are at hospitals they're going to go from department of department learning hands-on skills building interpersonal relationships communication phone etiquette hygiene
when and when not to use a cell phone resume building applications employ employer engagement how to talk to employers and then at the end of the nine months they're going to do a reverse job fair usually they do a reverse job fair and bring the employers in so the employers can talk to them about you know their their current skills their resume their applications and then once they and then they get a job at the nine months it's been a really successful program and we have been ranked 4th out of 10 nationwide for Project SEARCH.
Speaker 107
1:08:07
Program Planning Development Evaluation, it's the section that manages agency policy, federal reporting, and also houses our quality assurance team. Business Services works at the commerce level to educate businesses about agency services and help find connections for job placements for our participants in the community all right so access and accommodations i get super excited about this because this is kind of my wheelhouse um it it has the programs that provide assessment assistive technology
and direct support to the vocational rehabilitation clients the counselors and the employers with the goal of promoting successful integration into the workforce there's eight programs four of Those directly work in conjunction with VR for our – you can be a community member and access those. I'm going to talk about those fairly quickly so that I don't keep you here all day. So the Governor's Commission on People with Disabilities was established in Act by Act 9-11 in 1985 to promote the interests of our Kansans with disabilities.
right now primarily we advise and assist the governor in developing policies designed to address those needs the cool things that we get to do is we get to give scholarships to folks with disabling conditions and those directly come from funds from those very naughty people who park in handicap spots so if you shameless plug if you know people for law enforcement tell them that paperwork is worth it because half of those monies come over to the Commission and we get to pass out scholarships. This last year, we gave out 19 $1,000 scholarships
to individuals and students with disabled conditions. The other portions of those monies that we get to do are the billboards that remind you, don't do that. So it is really social awareness. So I say that in jest, but I'm not kidding. The more tickets they give, the more money we give, the more people we get to help. So it's a fun spin on that. And I say that because my husband is a retired law enforcement agent, And he was like, okay, that didn't bother me so much. That extra paperwork is not so bad. TAP, T-A-P, Telecommunications Access Program, was established in 1995 to serve Arkansans
who are deaf, hard of hearing, deafblind, or speech impaired to provide them with the telecommunication services so they can stay connected. It's not necessarily about work with TAP. It's about being involved in your community with your family, being that basic ability to just communicate and be connected. I say they have the bells and the whistles because they have all the fun things that they can do we have staff that will visit with individuals who provide an application and really hone in on what what are their level of difficulties what have you tried what didn't work and we have a showroom demo
room in the Commerce Building if people are local they come sometimes we have our staff they're all over they may be at your church potluck they may be at anything across the state they go and they love to show off this technology because just think about somebody you know that just
Speaker 123
1:11:20
can't communicate I mean it totally changes your life to be able to
Speaker 107
1:11:30
can independent increasing capabilities access now so that is the Arkansas statewide assistive technology program it's a hundred percent federally funded
receives no state contributions so it is another fantastic fantastic resource to receive assistive technology couple of programs the monies from the program purchase assistive technology so they're going to have new bells and whistles too so if you have a loved one or somebody that you work with that may need we had recently somebody who came and borrowed the hearing oh the Clearview glasses they were hearing impaired but with the glasses they had full-on I mean
what is the closed captioning as the conversation was happening so I mean imagine how fantastic it would be you know you're hearing impaired you're talking to somebody one-on-one you don't necessarily need an interpreter you don't need somebody to write it down it does take good connectivity though so sometimes in the rural areas it's not necessarily a great option but that's just one example of the kind of technology that they keep on hand that you can borrow I know that they have bed shakers for people who are hard of hearing they can't get up you know it has a very loud alarm but it also has a
little disc you slip it under the pillow and it shakes and it wakes up again the bells and whistles second part of the program is the reuse program so let's say you have a family member who required in-house care had a bed had all the extra things and unfortunately they pass away sometimes families are left with what do I do with that I can will take that they will refurbish it ensure that it's good quality and then provide it at no cost to other Arkansans who may need that it they really get amazing things in and it's a fantastic program
they're all over the state we have a primary location here on South University but they partner with other schools in certain areas so they'll have speech technology things for OT groups they'll have occupational therapy things so please check them out it's really just a fantastic way to ensure that people get the assistive technology they need AFP alternative finance program I get super excited about this one too because assistive technology is super expensive I don't know if you've ever looked at hearing aids right now or
four thousand dollars okay minimum four thousand to six thousand so if you have an individual maybe they've tried to come through rehab services but they don't meet criteria for paid services the alternative finance program is a fantastic option they're going to it's a loan let me say that up front it's a loan so you put forth an application and if you are approved they will provide you lower interest longer term rates so you can pay for those things if the
current let's say current interest rate is seven percent AFP is going to offer you at three point five percent because we know historically disabling folks with disabling conditions have a lower income threshold and then sometimes they have a higher debt to income ratio just because of that so you're looking at anything from hearing aids to vehicle modifications sometimes folks want a second motorized wheelchair insurance is only going to pay for one so this is an option that can help people get the assistive technology they need to be successful for programs that directly incorporate VR services I'm going to go
out of at a turn out of this just a little bit we're going to start with psych services we're going to slip 80 at work we'll come back to that so we have psychological examiners who travel the state we provide screening assessments so we're looking for strengths and weaknesses areas of interest and need to get the information back to the VR counselor so they can help their individual make that best informed choice what's good for you you know what what are you interested in and does it match if you're interested in nursing but your math is second grade we may need to have that conversation because
that's information the VR folks need to know to help and guide them towards success we also have a learning evaluation center that gives more comprehensive assessments GED anybody who wants accommodations with a GED GED requires a comprehensive assessment so we're able to provide that because they want to know their current abilities not looking at older testing and trying to see kind of how it is it similar to our screening they want that current updated information for GED for RN for praxis for things like that and
again the purpose of all of that is to gather just as much information so that the VR counselor can help them we're looking at academic stuff we're going to look at their work history we're going to look at mental health issues you know anything that may affect their ability to be successful in their training or education because again all that's going back to work we want to infuse the workforce with individuals that have the capabilities that our folks have we have medical services so we have a MD and an advanced practicing APRN that's
right now right now they do a lot of medical consultations we're looking over those records again looking for strengths and weaknesses what areas do they need assistance in how can we infuse support so that they'll promote success in education or training and then conversely on the job AT at work okay that provides the direct supports we have occupational therapists and And they go to schools, they go to workplace, they go to homes, they'll do those assessments
and look and see what accommodations do you need to be able to do that job or to be successful in that environment. They provide consultation services.
Speaker 123
1:17:27
They're looking to determine what assistive technology have you used,
Speaker 107
1:17:32
does it still work, do we need what additional services might benefit you again with a goal of promoting success it's really fantastic I know I say that a lot but I think it is really fantastic because there's there they're really one-on-one they're
geared they're going we have people like the OTs that go to the school and like okay is your dorm room ergonomically appropriate is your work site ergonomically appropriate what do you need because it's not sometimes whether are folks can be successful it's like do they have the right supports in order to promote that success stay at work return to work um this program really assists employers with accommodating the needs of their employees who may have a disabling condition or maybe have
been injured and they're looking to come back sometimes that's very daunting for employers because it's like, okay, what does ADA say I have to do? Well, I know I need to provide accommodations. I wouldn't know an ergonomic keyboard from another one, but an OT would, you know, because they're not one-size-fits-all. So we have the OTs are able to go out and do those workplace assessments. We have a manager who coordinates with that HR manager to determine to make sure that they're aware of what their responsibilities are
and how do you bridge that gap
Speaker 122
1:18:59
Because the return of investment of bringing back an employee who's been disabled rather than starting
Speaker 107
1:19:06
over, it's clear. You just really want to support and keep those employees that are very, very valuable to your agency. The focus is always on the client being able to successfully complete those job tasks. They may have to do it differently now, but if they can do it differently and still meet the needs of the employer, it's a win-win for everybody.
That kind of seems fairly daunting. There's a quick video we have that kind of shows exactly how that process works, and we will let you see that and then take any questions you may have. Why do you do that? It's
Speaker 130
1:19:45
embedded. Oh. Somebody just hit, oh, great, hold on. There
Speaker 134
1:19:59
we go. Many of us take for granted the idea that we'll work steadily until retirement.
Employment not only provides financial stability. Many of us take for granted the idea that we'll work steadily
Speaker 107
1:20:37
and all right so technical difficulties though at our at the ARS website you can link to this
under stay at work return to work I use it as a good visual because it is daunting for employers because they don't know what to do and this really walks through and gives you the perspective of the employer with this specific individual there was an injury and they were able to remote work at the time they became able to remote work they decided I want another job so they applied for another job when they went in the new the new company was familiar with them but not of her in a wheelchair so when she came in from onboarding they're like oh okay I didn't
know that what what do we do now so it really the OTs really helped walk through how you make that transition came back to work and at some point she decided I want to drive so she got through AT at work we got driving lessons she got a modified vehicle so it's not just as simple as like oh we're going to help you once and we're done we have a lot of people who have a lot of steps and we support them all the way through. Again, thank you for letting us be here and share our passion and our opportunities.
We hope that you'll have, if you have questions, let us know. If I know, we'll know. If not,
Speaker 129
1:21:55
we'll direct you otherwise. Yes, ma'am. Are there
Representative Denise Jones Ennett
Unverified
1:21:59
any questions from the committee or from the task force? Yes, Mr. Adams. Yes, Mr. Adams. uh jeff
Speaker 139
1:22:11
adams arkansas department of education i just want to thank you for the work that you guys are doing um we work really hard at the department to try to make sure that students
with disabilities including our students with autism have meaningful transition plans for post-secondary outcomes. I'm curious if there are any strategic partnerships or initiatives that you have to prepare business and industry to speak to the value of what individuals with autism can bring to our workforce. I'll start first.
Representative Hope Duke
Unverified
1:22:51
Well, I know for me, I talk a lot with our WIOA partners. we owe a board members because we have a lot of business and industry that come to those board meetings as well as we partner with our adult ed workforce and and and being in the high schools and talking with the teachers and just trying to educate not only the teachers in the schools but educate the parents and provide information to their the family that is taking care of the kids
because at school they're all about it and they know, but when they get home, their parents don't know anything that they're talking about. And so there's such a huge disconnect, and we're really striving to train everybody and teach everybody because we want them to go from pre-ETS program to our adult VR program. So the minute they get out of high school, we just want them to completely transfer from one to another to stay with us all the way through for a successful outcome. So we are implementing that, but it is a struggle.
because, well, it just is. It's just a struggle. But we are trying.
Speaker 122
1:24:01
From the access and accommodation side, our business relations team, I think that I mentioned
Speaker 107
1:24:06
earlier, we're really pairing with them so that they have, forgive me for this, a good elevator speech, okay, a good, short, brief understanding of exactly what we can do to help with that, especially if there is somebody who's been laid off or has had an injury and they need to come back to work.
So we're trying to increase that knowledge there so that we have people, when they're going out and talking to businesses, they're
Representative Denise Jones Ennett
Unverified
1:24:32
promoting that for us. I have a couple of questions, but in interest of time, I'm just going to ask a couple, and I can get with you offline. Thank you for the presentation. Did I hear you mention that you're only in 189 high schools? And if so, what's the impediment there? why aren't you in more high schools we
Representative Hope Duke
Unverified
1:24:53
are currently in 189 schools but we are adding 10
schools per year so we are trying to increase it I think a lot of that has to do with a lot of schools don't know which program they want we have several different programs we have a wolf wind vendor I mean they might not have a vendor in their area to use so then they would be responsible the school would be responsible and so they would need to have a personnel that's going to maintain all the paperwork to do the wolf and win we also have the star program and we only have a couple years left of the star program it was a 9.9 million dollar grant to help those communities
that are more rural and to help let the kids uh find jobs out in the community that's too hard but but i think really we're adding trying to add 10 per year but i think it's just like i said a lot of schools are skeptical still we're still trying to get schools uh to to be involved but they have to have the personnel to want to to engage in the program that might be it
Representative Denise Jones Ennett
Unverified
1:25:50
and in your department are you fully staffed in your department uh
Representative Hope Duke
Unverified
1:25:54
no we are not fully staffed now there are regions that are
fully staffed um but there are regions across the state some of them that still need pre-eds counselors and VR counselors and is is
Representative Denise Jones Ennett
Unverified
1:26:04
it pay or what's the disconnect there is it the do you want to go with them? I think
Speaker 107
1:26:15
probably to some degree prior to this new pay plan it was pay. I think we've seen an uptick when you say about a really qualified applicants that are that are coming in so I really think that at some point we're going to see that in a very positive trend and be able
to attract quality people in all those areas. Sometimes the the geographical region just makes it hard I have one
Representative Denise Jones Ennett
Unverified
1:26:37
more question um so when you're trying to place these people in jobs are y'all working with the state any are you just doing like outside like private businesses have y'all thought about you know having that inside like internal state agencies to hire people that go through the
Speaker 107
1:27:07
but I know that our business services they operate out of our VR offices so we're very in touch with the vendors that are very
Speaker 123
1:27:16
favorable they're open to working with ARS clients but as far as a specific state vendor yeah
Speaker 153
1:27:24
and I would say that we do participate with other state agencies
Representative Hope Duke
Unverified
1:27:29
especially at career fairs job fairs um college days you know those other state
agencies are there with booths as well we
Speaker 154
1:27:37
try to communicate with them as well for
Representative Denise Jones Ennett
Unverified
1:27:40
for employment purposes okay all right any other questions from the task force all right thank you for your presentation thank you next we have a presentation from Perimeter Behavioral Hospital of West Memphis. If you could come and recognize yourself, we can get started. Thank you.
Erica Fox
Unverified
1:28:20
Good afternoon. My name is Erica Fox. I'm Vice President for
Representative Hope Duke
Unverified
1:28:39
Perimeter Health Care. Natalie Bland, Director of Business Development for Perimeter Health Care of West Memphis. And
Representative Denise Jones Ennett
Unverified
1:28:45
I'm Renee Smith. I'm the CEO at West Memphis.
Erica Fox
Unverified
1:28:50
just a little bit about West Memphis we are an inpatient psychiatric hospital we also have a line of residential treatment for youth our inpatient facility is specific for males and females we start at age six and we go up to 17 and then we have a residential program for females ages six to 17 as well but today we really just want to make some awareness to all of you here in this room and thank you for slotting us here at the late end of the day. Just a little bit about a
new program that we have developed at West Memphis. A lot of people talked about data today and data for us drives decisions and one thing we recognized when we were getting referrals from all over the state for the youth retreat for the inpatient psych arena is that there were kids that we were deflecting because they had some neurodivergent behaviors and we just felt that we were saying know to these kids and we developed a program with a lot of help from our sister facilities we have seven different facilities across the state that work with kids and five residential
programs three of which are here in
Speaker 165
1:30:02
arkansas so one thing that i do want to piggyback
Representative Hope Duke
Unverified
1:30:06
on what erica said is that of course inpatient is not the first line of defense and it's not what we always want but we want it to be an option so there are times when a youth may need that extra service and so we are treating kids who are in a crisis and that need a short-term up to 14-day stay to help with the symptoms that they have going on
at that time. So it's a youth that is in danger of themselves or others and it gives us a safe place to treat them. So we wanted to offer something that for a child who may be neurodivergent or under that umbrella of care a safer place to be. And so we developed the program so that we have implemented a sensory room. We have sensory carts. We do a smaller staff-to-patient ratio. We are looking at what we can do, another tool in the tool belt,
um if we do say to offer something to these kids to be able to um to be able to benefit and have a more enjoyable stay or to take something home with them that they
Representative Denise Jones Ennett
Unverified
1:31:21
can use so um one of the things we also offer is our staff is trained they are we have a phd um dr cheyenne anthony who is a phd lpc and she's a human service practitioner her clinical focus is in autism and she trains our
Speaker 167
1:31:37
staff extensively as well so we have a lot of trained licensed personnel to
Speaker 164
1:31:43
work with these children as well so the youth that we're looking at are ones specifically for levels one and two they
Erica Fox
Unverified
1:31:51
don't have to have a formal diagnosis but we would like to encourage them to have some sort of an assessment so when they're coming to us we have the documentation we have their history again sensory processing disorders attention deficit disorders and then anyone that can really benefit from our program so
Representative Hope Duke
Unverified
1:32:12
right now we're focusing on youth ages 12 to 17
we in our facility we take as erica said earlier as young as six and so we are divided out on our different we have a unit one unit two based off of age so even though this particular program is designed for ages 12 to 17 we can take someone who is younger who can benefit from our sensory room because the sensory room is not actually on the unit it's off of the unit and then plus our sensory carts that we can move around but the actual unit is designed for ages 12 to 17 at the moment we are I kind of kind of touched on some of these earlier but back to the higher staff patient
ratios we want to be able to meet the needs as they come along sometimes they also come with some extra issues that may need more one-on-one staff so we can be able to provide that as well we do personalized intervention plans so it's not just one you know you come in and everybody gets the same thing so we want to meet that child where they are and what they need so we develop the personalized plans for that as well we have teachers on staff in school on our at our
facility as well so they will go at least two hours a day to school each day while they are there as well they meet with the psychiatrist they meet with nurses we have a gym and we have extra extracurricular activities that they get to participate in as well and we accept all insurance in terms of
Speaker 164
1:33:43
some of the modalities that we use we have TBRI trust-based relational intervention we
Erica Fox
Unverified
1:33:48
do CBT and we also do some ABA I know that was the topic today we would love to
actually employ ABA therapists and our staff. However, they are not licensed and Medicaid does not pay for that service, but we do contract with ABA therapists upon discharge. In addition to TBRR, we do Cheyenne,
Speaker 170
1:34:11
Dr. Anthony, that was mentioned earlier, she does training on understanding autism and the neurodiverse brain, the sensory system and interventions, social communication and emotional learning, problem solving and emotional regulation, and
Speaker 172
1:34:29
program implementation sensory environment design. So a few things that make our program a
Erica Fox
Unverified
1:34:39
little unique, I know we've talked a
little bit about this, but just scheduling design to assist with transition needs and mitigate overstimulation. We have an indoor gym, outdoor recreation space, a sensory room. In addition to the sensory room, we also have carts, so if the child can't come off the unit, we will bring the carts actually to them. So they have that opportunity to engage with some of the sensory items that we have for them. Again, our staff is trained under Dr. Anthony's supervision. We have a dietician on staff, so we ensure that if there's a special diet,
we can meet those needs. And in terms of also the education, we do have special education teachers on staff as well just a
Speaker 165
1:35:31
in our carts and sure so we do have a few exclusionary criteria we're looking
Representative Hope Duke
Unverified
1:35:38
at primarily level one and two when it comes to the autism we will do it case
by case so if there is someone on the level three and it's something that we feel like that we can accommodate we will look into that but we're primarily looking at level one in level two we I'm also so we are not part of a med search hospital we are a freestanding psych hospital so when it comes to medical issues or medical concerns we look at that as a case-by-case basis as well so if there are a few things that we cannot accept at the facility just because we do not have the staff that would be able to accommodate those
things and so we such as some diabetes now insulin dependent diabetes is fine but there are some levels that we are unable to take the cardiovascular issues requiring requiring ongoing oversight management and the PSEA as well how about that short and sweet the one thing just just
Erica Fox
Unverified
1:36:38
to kind of reiterate everything that we've talked about you know Natalie hit it on the head when she said, that we're really just trying to support the neurodivergent and the ASD diagnosis of
these youth. We're not going to fix that part of their behavior, but we want to supplement that when there is a behavioral crisis. And we have met with a lot of the payers. We've met with other providers. And it really seems that there is a need for this specialized program. We're not that far down the road from y'all. We're less than two hours. And I learned in this industry a very long time, if you've got the great treatment, you've got the staff behind it, people will come to you. And I know in speaking with Lori Graham from Children's, she said that there's a lot of these youth that end up in the ER.
And that's the very last place we want these youth is to stay in these ERs for 13 and 14 hours because there's no place for them to get the treatment that they need. So, again, our goal really is just to educate you on our program. we're thriving and just to connect with some of these great individuals in this room that we haven't had the opportunity to meet before just so we can share these services miss Karen is she still here does she book she booked we'll track her down I really just feel like there's going to be some youth that that we can that we really can help co-treat with the providers here in Little Rock
Speaker 71
1:37:57
questions I'm a school counselor and so this interests me just because I do have kids assessed more often than I'd like to but mobile assessments is that something that you guys provide okay yes so we
Representative Hope Duke
Unverified
1:38:20
have two mobile assessors on staff so we and we had we brought some folders today to with some of our
information so we'll make sure and give anyone who would like that and we give you phone numbers
Erica Fox
Unverified
1:38:33
yeah we have a main foot we have a main phone number it's 24 7 we're an emergency room for crisis for psych so we don't we don't we don't close open all
Speaker 40
1:38:46
the time do you all have speech language or occupational therapists on staff we
Speaker 185
1:38:57
don't hi I'm Sheila Smith I'm with the Department of
Education and I just what steps do you take
Speaker 20
1:39:03
to successfully transition those schools are those students back into the school setting so our education director
Representative Denise Jones Ennett
Unverified
1:39:10
that's a process that she oversees again we do have special education teachers in the classroom and so we collaborate with the schools to keep those kids on track and then we easily transition them back into the classroom so we stay in constant communication
with the schools I have a question so what's the typical length of a stay for a student so
our goal is 10 to 14 days
Speaker 167
1:39:37
again as Natalie said it's individualized it can be less it can be 7 to 10 days just based on what
Representative Denise Jones Ennett
Unverified
1:39:44
the child needs another question and you might already said this so do you go into the schools or they send the child do you go to the schools and they send the child to your facility or is they just come to your facility so we could do the assessment
Erica Fox
Unverified
1:39:57
in the school with a family member present or a guardian present but the treatment takes place in the facility any other questions
Representative Denise Jones Ennett
Unverified
1:40:10
all right thank you for your presentation thank you all right task force
we had a very long committee meeting today but we had some very good information shared with us um so we're looking at january for our next meeting so please um look at your emails for that before we adjourn I want to recognize Miss Varner who came in from Texarkana I asked her to come and I hope you could come back for some more
meetings and give us some input if you see fit anything else from the task force before we adjourn all right we stand adjourned You
Agenda
A. Call to Order
B. Consideration of a Motion to Approve June 17, 2025, Meeting Minutes [Exhibit B]
C. 2025 General Session Legislative Overview [Exhibits C1-C5]
D. Presentation on Developmental Disability Services [Exhibit D]
E. Presentation of Autism Waiver Outcome Data [Exhibit E]
F. Overview of Arkansas Rehabilitation Services (ARS) [Exhibit F]
G. Presentation on Perimeter Behavioral Hospital of West Memphis [Exhibits G1-G3]
H. Other Business
I. Adjournment
Documents
Speakers
Senator Justin Boyd
Unverified
Representative Denise Jones Ennett
Unverified
Speaker 14
Speaker 17
Speaker 18
Speaker 29
Representative Jack Ladyman
Unverified
Speaker 52
Speaker 54
Speaker 56
Speaker 61
Speaker 71
Speaker 74
Representative Carol Dalby
Unverified
Speaker 82
Speaker 92
Speaker 96
Speaker 98
Speaker 107
Speaker 106
Representative Hope Duke
Unverified
Speaker 123
Speaker 122
Speaker 130
Speaker 134
Speaker 129
Speaker 139
Speaker 153
Speaker 154
Erica Fox
Unverified
Speaker 165
Speaker 167
Speaker 164
Speaker 170
Speaker 172
Speaker 173
Speaker 40
Speaker 185
Speaker 20