Public Health, Welfare and Labor Committee - Senate and House
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0:00
Thank you.
Thank you.
Thank you.
Thank you.
Thank you.
Representative Jeff Wardlaw
Unverified
5:00
we'll go ahead and get started we'll start first things first uh senator wallace if you would lead us in prayer if everyone would stand oh lord thank
Senator Dave Wallace
Unverified
5:29
you for this day thank you for our friends and colleagues who have gathered
here together. Give us the strength and the knowledge that we may rule the state of Arkansas in thy will. Lord, please watch over our military. Watch over our loved ones. In Jesus' name, amen. Amen. Thank you, Senator. Members, I have
Representative Jeff Wardlaw
Unverified
5:55
a motion to approve the minutes. You're approving minutes from august 6th september 10th and september 11th got a motion have a second i have
Representative Glenn Barnes
Unverified
6:04
a second all those in favor say aye all opposed eyes have it we'll move on to item c uh overview of hiring procedures at the human development centers uh if we could get director breeze to the table members i'm gonna let them present we'll ask them questions and then we have a number of witnesses in the crowd signed
Representative Jeff Wardlaw
Unverified
6:29
up. So we'll go through those one by one.
Representative Glenn Barnes
Unverified
6:42
Ms. Weatherton and Ms. Breeze if you guys would introduce yourself for
Chair
Unverified
6:49
the record and you're recognized to start. Thank you. Jennifer Brze, director of the Developmental Disabilities Division at
Speaker 49
6:56
DHS. Good morning. I'm Melissa Weatherton. I'm the Director for Medicaid Specialty Populations.
Chair
Unverified
7:05
I'm not sure we prepared an exact presentation but we can definitely speak to the hiring process right now if
If that is what the committee would like to hear. So we, with the implementation of the new pay plan, we have had to become more aware of our number of budgeted positions that we have in our budget. And we have started, I would say, we just haven't had this issue before, which is a great issue to have with the implementation of the pay plan. definitely seen the number of applications and people wanting to come work for us increase and
so that's been very positive but with that increase we've had to slow down a little bit and make sure that what we're advertising and hiring is not going over that number we when a position is vacated today we have to wait for that vacated position to clear our system And then our staff creates a new requisition in AR Careers, which then goes to our HR committee, which reviews those weekly for approval.
Once approved, that position then goes back to the hiring manager at the Human Developmental Center for them to approve, and that creates the job posting that is then posted on AR Careers. And then I will take questions. Representative Ladyman, you're recognized. Thank you, Mr.
Representative Jack Ladyman
Unverified
8:46
Chairman. Thank you all for being here. You know, I felt like we needed to have this discussion because there are a lot of people that have called members of this committee
about what's going on at the HDCs. So my question, you talked about, well, let me ask you this. What is the difference between budgeted positions and unbudgeted positions? I mean can you what's the difference there and what changed so before
Chair
Unverified
9:14
my understanding is that with the unbudgeted positions we were still able to put people there but that was more of to keep the process moving a lot quicker
we were still had we always had that number of total positions and budgeted but with the unbudgeted positions we were able I think to more quickly advertise and get those positions in our system that we use to manage those. With the implementation of the pay plan, we had to pause and make sure that all of our people in those unbudgeted positions were put under a budgeted position. So it's very weedy, but it has to do with our system
and how we manage those positions.
Speaker 60
10:01
And we had to stop using those unbudgeted positions in our
Representative Jack Ladyman
Unverified
10:07
system. Okay. So what I'm hearing is that if someone leaves a position and the process that you just described takes a lot longer and so they can't fill that position as quickly and it might be a position that's like a direct care position that needs to be filled right away almost like an emergency and that that's causing a problem in them in the HDCs covering the necessary positions
at the site. So how long does that process
Senator Missy Irvin
Unverified
10:44
take that you just described? So it
Chair
Unverified
10:47
takes anywhere around five business days from the team's feedback to for a vacated position to clear out from the system and then as soon as that is clear in our system the HR staff is able to create a new requisition and then those new requisitions go to our weekly HR meeting and so that happens normally on Tuesdays and then the team looks at like I think agency-wide so it's not just DDS
they're looking at all positions and then those positions that are approved are approved within 24 hours and then that goes back to the recruiting manager at the hdc and then they're able to approve that for posting almost immediately okay but if you've got
Representative Jack Ladyman
Unverified
11:32
direct care people in the home and they can't fill that position for five days and they don't have these extra people that they used to have that that's a problem so are there any positions like direct care that are
exempt from this process where a a site superintendent in an emergency situation could could hire someone to be a direct care worker at a house is there
Chair
Unverified
12:00
an exemption for that there's not an exemption but we do have several nursing contracts that the hdcs are still able to use which would include our cnas our direct care positions and so the superintendents can utilize one of several contracts if we need someone out there ASAP.
Representative Jack Ladyman
Unverified
12:20
Mr. Chairman, one more and then I'll let someone else talk. But is it true that at the Boonville facility that the work center is shut down due to lack of staff? I do believe that
Chair
Unverified
12:31
we've had to shift some of those staff that were doing training into direct care to fill some needs while we're hiring. Do you know what kind of issues that's caused
Representative Jack Ladyman
Unverified
12:40
with the clients at Boonville? I do not directly, no. Okay. Well, I think that's something that we really need to look into.
Mr. Chairman, I'll get on later. Thank
Representative Lee Johnson
Unverified
13:03
you. Yeah, you're welcome. Thank you. Representative Johnson, you're recognized. Thank you, Mr. Chairman. So I'm hearing some things that I don't understand. So you're saying there are unbudgeted positions and budgeted positions, and you're trying to now have to convert the unbudgeted positions to budgeted positions. Yes. Help me understand why you would have unbudgeted positions anyway.
I thought that all positions would probably be a part of the budgeted process, and if we have unbudgeted, like, is
there more now unbudgeted? How does that work, I guess is my
Speaker 82
13:35
first question. So this is, I mean, this is not new to this year. So in our appropriations for each one
Speaker 84
13:41
of the divisions, there are authorized positions for each one of our divisions. And I don't
Representative Lee Johnson
Unverified
13:48
mean to interrupt, but now I'm here in a third term. I know. So is authorized budgeted or is authorized both budgeted and unbudgeted?
Speaker 87
13:56
Both budgeted and unbudgeted. So we have an authorized position number in
Speaker 84
14:02
each one of our divisions that then each year goes in. And based on the budget, we budget out of that total number what
Speaker 89
14:11
our salary line item can afford. So there is a series of budgeted positions, and then there's a pool of unbudgeted positions. That
Representative Lee Johnson
Unverified
14:21
decision as to what's budgeted and not budgeted, is that made within the agency, or is that made as a legislative decision?
I mean, I understand we control the budget, we control how much money we put in the space, But I would think that, I don't know, I guess I'm just trying to understand again the idea of budgeted versus unbudgeted and how that decision is made to divide these authorized positions into some centers have budgeted and unbudgeted. Again, is that an executive decision that's made or is that a legislative decision?
Speaker 90
14:54
I mean, it's solely based on the amount
Representative Lee Johnson
Unverified
14:57
of money we receive. So do you have a delta between the different facilities? So do some facilities have a certain number of unbudgeted, big air quotes?
versus how are you deciding facility to facility what the proportion of budgeted to unbudgeted is? How are you deciding how to allocate that finite resource of the money from space
Speaker 84
15:19
to space? Absolutely. So in the DDS budget, DDS as a whole gets RSA funding from you guys in our appropriation. And so there is no such thing really as a Conway HGC position or a Boonville position. They're DDS positions.
So, for example, out of our budgeted positions that we have this year, we only have 100 people that work at DDS Central, right, running the waivers and running all of the programs, and the rest of our staff are out in the facility. So year over year, we've made a conscious decision to continue to do less people in central office and shift more people to the human development centers because that
Representative Lee Johnson
Unverified
16:08
have an idea of how many unfilled i mean how many unfilled authorized positions you have i guess that's the question i would really ask per facility so not per facility but
Speaker 97
16:20
i can give you the the dds numbers i mean you can you can maybe staff can
Representative Lee Johnson
Unverified
16:25
get that to me i'll step out i know that there's other questions but I do think like I'm going to want to ask more questions about this to understand it better because I don't really understand now how we're I don't have a visual as
to how many unbudgeted positions are out there and then how are you changing your allocation of funding your funding's finite how are you changing that allocation now to decide you're going to do some unbudgeted to budgeted we set that in we set that in PBAS each year oh
Speaker 84
16:52
that's a big word You're going to have to help me with that one. And I wish I knew what it stood for, and I should. Tell me
Representative Lee Johnson
Unverified
17:00
what it is. I don't know. Acronyms, y'all know, people out there that know me, the acronyms are my thing. Like, I'm going to ask if I
Speaker 84
17:06
don't know what it is. So it's the portal that we go in and enter all of our budgets across.
Representative Lee Johnson
Unverified
17:11
Okay. What's it called again? PBAS. Anybody? No idea. I'm open to members
Speaker 84
17:21
to help explain. There's people who have been here longer than me. Okay, go ahead. We'll look that up later. So in that system, before the new state fiscal year begins, we go in based on the budget and we enter the number of positions that the budget will afford.
Speaker 87
17:39
So in the DDS appropriation, for example, in 2026, we have 2,490 authorized positions.
We have 1,965 budgeted. so and that that's for all of dds that's not
Representative Lee Johnson
Unverified
17:53
broken down by facility that's any position this doesn't really have anything specific to do with the hdcs they're just part of your budgeted sorry authorized positions and and we don't micromanage how you decide which ones to fill which ones not to fill that's right you
Speaker 84
18:10
know and um what we have done and what we are doing right now is we have
around a hundred staff that are outside of the HDC's running
Representative Lee Johnson
Unverified
18:23
all the rest of the DD programs okay I'll get back in the
Senator Missy Irvin
Unverified
18:30
queue and let other people ask some questions some members will contact fiscal division to come and answer your questions from BLR the personnel committee analyst should should know all that information and details for you we've requested them to come over so
Representative Jeff Wardlaw
Unverified
18:47
they should be here in a few minutes with that representative Bentley thank you
Representative Mary Bentley
Unverified
18:53
chairman right here you know our hopes and the legislature was that when we did that pay plan that we would decrease the number of contract nurses in these facilities that our patients would have more stability and have a long-term staff so I'm concerned that we don't see that playing out can you tell me what the percentage is right now contract nursing nurses staff CNA whatever in our htc facilities thank you
Chair
Unverified
19:15
i we don't have a percentage but i can tell you that
we have been able to successfully hire some more rns and lpns so about five additional rns and then a handful of lpns we compared this quarter contract spend to this time last year and we're about ten thousand dollars less in contract spend for this quarter than we were last year we still have 24 vacant lpn positions that are posted and 11 vacant rn positions that are posted and one aprn
Representative Mary Bentley
Unverified
19:50
position that is posted and those are those specifically for the htcs or those across the board they are so contrary
to things we hear out in the media we're still in desperate need of lpns in the state of arkansas would you agree with that i would
Speaker 54
20:05
agree and we have seen an increase in applications it's just we we still need more um director breeze how
Representative Mary Bentley
Unverified
20:11
long have you been in this position that you're in now just not recognizing one year and four months one year four months okay have you in that time how long have you been out to each one of our hdcs and
toured them and visit with the staff out there i have so i'm just i'm concerned what we're hearing about in boonville with the um bootech shutting down because it is a huge as i've heard now the ones in my district it's such a happy place for them to go and have meaningful input each day and to really agree add great value to their lives it concerns me that shut down do we know when we'll be able to open up the votech to get that up and running to
Chair
Unverified
20:46
help those clients there to enjoy their daily lives again hopefully soon we have had over 30 positions approved in the last couple of weeks
and so we are seeing it the process become a lot smoother now that we've cleared up the budgeted versus unbudgeted and then
Speaker 55
21:00
getting requisitions things are just happening faster now one more follow-up so that
Representative Mary Bentley
Unverified
21:05
soon maybe 30 days 60 days just give us a I just don't
Speaker 55
21:10
know because the training process and the onboarding process does take a while which is
Chair
Unverified
21:15
so important for our staff they're taking care of our individuals and so phase class can last anywhere for two weeks and then to do the additional CNA training that can take another 30 days and so
it can be a six to eight week process to get someone fully trained and onboarded to start taking care of
Representative Jeff Wardlaw
Unverified
21:37
folks. Okay thank you. So you guys are overseen
Representative Glenn Barnes
Unverified
21:40
by the Office of Long-Term Care correct? We are. So they can write you the same tags they write any nursing home or hospital in the state correct? Yes sir. So under your current staffing levels do you meet the
Representative Jeff Wardlaw
Unverified
21:54
requirements of long-term care off of the residents that you have in your facilities today as far as i'm aware we do
Chair
Unverified
22:03
and we that's what we strive for every shift is to make sure we're fully staffed to meet ratios
Representative Jeff Wardlaw
Unverified
22:10
so that would answer the question earlier about boomville that's the reason you closed that particular section down is because you
Chair
Unverified
22:16
didn't meet that staffing level correct i'm certain that that was part of the reasons is we needed to shift staff to make sure we
Representative Ryan A. Rose
Unverified
22:27
maintain ratios representative rose you recognize thank you mr chairman over here on
your right thank you a couple of questions i want to go back to a little bit of a discussion we had earlier with regards to the boonville
center and some other things that you had said so you'd been asked about staffing and being able to to hire people and there was some kind of an answer that was yes we're able to hire people yes we have enough staff to do these things and to cover when I think it was move maybe some nursing and staffing around when a vacancy takes place that's that I was trying to get back to where we were that you felt competent in we can move people we can fill these vacancies
but then just a couple moments later we were in discussion about the Boonville Center and it was Well, we had to shut down the vocational training facility to shift staff to fill vacancies. So to me, it sounds like those were two conflicting answers. Yes, we have enough staff to move in a vacancy, but, oh, we had to close down this training program to shift staff.
I kept hearing the word shift, shift. So can you kind of, can you reconcile those two things for me? You have enough staff to fill vacancies, but then you
have to shut something down to
Chair
Unverified
23:58
fill vacancies, which sounds like you don't have enough staff. So I think that it's two things. So to maintain our staff-to-client ratios, we did have to move some staff that were doing the trainings to
Speaker 55
24:11
make sure that we're meeting those client-care ratios
while we are still advertising and trying to hire folks and get them on board? I
Speaker 84
24:23
would add that I think the shift from no longer being able to put people in unbudgeted positions, and we had around 100 people in unbudgeted positions this summer. And so when we were given the directive to quit using unbudgeted positions,
um we had to pause because we had to then move those individuals into the same types of grades into budgeted positions and from what i can tell looking back at the time frames and talking to staff that took around three weeks and when you're not bringing hiring people for three weeks right because we're just moving people that we already had to a different position and hiring was paused and we're bringing in anywhere from about 20 to 25 people every week
is what we've been approving, we got behind. And so what we've been seeing the last, I would say, three weeks is we're back in business and those requests are coming through and we are approving them in totality as they come through each week. But to have that
Speaker 104
25:38
kind of three-week kind of pause on hiring was hurtful. so would it
Representative Ryan A. Rose
Unverified
25:46
be correct i'm making sure i'm understanding your testimony correctly
would it be correct to say that you feel like
presently you have the staff to fill vacancies but it was during the summer that presented an issue where you got behind and that's why the shift took place and had to close the the vocational program at the boonville facility for example that was a problem at at a moment during the summer that is not a problem now is that what you're saying because you don't you don't have this this pause that took place
Speaker 84
26:23
i would not i would not solely place on just that one issue i think there's been a couple of things that have occurred
Representative Ryan A. Rose
Unverified
26:33
um so is there still a a present issue then what i'm trying to figure out is earlier you said you had enough staff to fill the vacancies that was that was said that hey we've got enough staff to fill these vacancies but then we're closing down programs to fill vacancies which says to me we don't have enough staff so I'm still trying to figure out because
Speaker 84
26:56
those two answers conflict with one another so I think it's the word vacancy here that and I'm sorry I don't if I made this more confusing so we have we have vacant positions right now that we are advertising and we have more vacant positions that we need to be advertising right we have not hit our budgeted position cap so I would not say right now like we're staffed
to capacity because you're right if we were staffed to capacity we wouldn't be closing down um were units all right what i'm saying is we i think with over the summer with a couple of different systematic changes we lost some ground for a couple of weeks where we would normally have been bringing in 20 30 people each week and now
Speaker 141
27:47
we're now we're playing catch-up uh along this same vein and
Representative Ryan A. Rose
Unverified
27:54
then i'll hop out after this i don't want to dominate the conversation
you you were answering a couple of questions that representative bentley had asked and i've got small kids and teenagers and so i'm very comfortable using broad terms that can mean a wide answer like yes we'll do that sometime or we'll get together soon and so i i kind of want to go back to you use the terminology of yes we're going to have that resolved soon but then when pressed
it was well onboarding takes a while this could be six to eight weeks i'm curious if you could qualify the timeline still because when you say soon like representative bentley i'm like 30 days 60 days 90 days i heard well these all these people haven't been hired it's going to take at least two months to train them that doesn't sound soon so I'm
just curious can you give us a ballpark of what soon looks like
Speaker 84
29:02
we can go back and look and see how many positions we have been approving
week over week since we fixed the unbudgeted versus budgeted situation but you're right from And the moment we bring a staff member in the door, I would say it is six weeks until they hit the floor because of the
Representative Ryan A. Rose
Unverified
29:22
training. Would it, and I'll jump out after this, would it be more appropriate at this time to say it's undetermined when that vocational program will be back up and running in Boonville?
Speaker 84
29:37
We're not sure when. I would have to go back and see five weeks ago how many people we onboarded at Boonville and where they are in the
Representative Ryan A. Rose
Unverified
29:48
training. So uncertain at this time. I think that's fair. Moving towards it, but not sure. I think that's
Representative Jeff Wardlaw
Unverified
30:01
fair. Okay, thank you. So before I come to Representative Johnson, who is next in the queue, the Bureau is here to testify.
Representative Glenn Barnes
Unverified
30:07
I would say the Bureau is not prepared to testify on the exact numbers at DHS because they didn't know they were going to testify. So I think that's important for members to know as you're asking these questions. So don't get frustrated if Tony don't know the exact numbers of each human development center or DHS in
Representative Jeff Wardlaw
Unverified
30:25
general. So with that, I'm going to go to Representative Johnson. Sure. So does
Representative Lee Johnson
Unverified
30:31
staff want to come and try to answer the questions?
Tony Robinson, Bureau of Legislative Research. Thank you, Tony, for coming. Yes, sir. Imprompt to you to try to help educate us. No worries. So, I guess what I'm trying to get around to, it sounds like that they have authorized positions. Yes, sir. For DDS, but that's not necessarily broken down into authorized positions specifically for the hdcs no sir
Speaker 152
31:10
in dds the way i'm going to break down just the process real quick yeah please
Speaker 150
31:16
that'd be great so during regular session the general assembly establishes an appropriation bill okay and they give an agency like dhs and dds may have its own individual appropriation bill appropriated positions that's their total authorized number of positions that they can use within that following the legislative session the agencies go through an aop annual operation process during that time they take the money or the funding that is given to them and they
determine how many positions that they can utilize of their total at any given time so that sets apart your budgeted from your unbudgeted. And that amount of funding that's concurrent with the
Representative Lee Johnson
Unverified
32:00
appropriation bill is that through RSA or is that through the separate funding bill that we do now in conjunction with RSA? I think it's going to be in conjunction with. So it's not the RSA necessarily that describes that funding it's the the new process we kind of have in place where we pass a funding bill that connects the RSA? And I don't want to
Speaker 150
32:23
get out of my bounds because I'm a
personnel guy i'm not a i'm not a budget fiscal guy so i think it's going to be in conjunction of both because for the positions whatever you fund them they have to be able to pay for those positions so they can utilize any of the positions they have within the context of the amount of money that you're giving them if i'm making sense you are now once they set that once the aop is set and you have a group of unbudgeted positions and a group of budgeted positions they can utilize
some of those unbudgeted positions if they turn around and unused some of the positions that have been budgeted so they can kind of mix and match as they need to at times but that's a process that the agencies have to go through with dfna and dtss to make that happen so there is a there's a path that they have to follow and each agency is going to be a little bit different in dhs i'm quite sure because of their size is going to be an even bigger
Representative Lee Johnson
Unverified
33:28
path. Okay, I think I understand that. So after the session, each agency has some sort of planning.
What did you call it again? Yes, sir. Annual operations plan. Yeah, and in that process, they have the discretion in conjunction with the F&A and other people within the executive branch to decide how they're going to utilize the money they have for the positions authorized, and in that process, they determined that some of the jobs are unbudgeted, i.e., we're not going to fill those. Correct. We're not going to pay for those. That's correct. Because we don't have the money to pay for those unbudgeted positions. That's correct. And in this process this year, the decision was made to create unbudgeted positions at the HTCs.
Speaker 150
34:10
Yes, sir. And that's going to be every agency always that has unbudgeted positions. Right, but is it always at
Representative Lee Johnson
Unverified
34:16
the HTC? Okay. So always every year we decide some of the people that are working at the HCC, we're just going to lay them off? Because if they're unbudgeted, how are you going
Speaker 150
34:28
to pay for it? An unbudgeted position just means that there is no cost to the state at the time for an unbudgeted position. If a position has been budgeted, whether or not it's filled, okay, if a position is budgeted, you're going to pay insurance on that position, okay?
So that's number one. you don't pay retirement on a position until the position is actually filled. On an unbudgeted position, you're not paying insurance or retirement, okay? Now, if they switch and use an unbudgeted position, it is my understanding that once they fill that position, they will then begin paying insurance and retirement on that position to EBD, okay? So, but it's the starting point. That unbudgeted and budgeted, it's a starting point at the AOP process. then as they move throughout the year they can undo they can take a position that was budgeted
Speaker 164
35:20
unbudgeted and then take an unbudgeted position and budget it so somehow
Representative Lee Johnson
Unverified
35:26
i think i may have followed that uh we can have a discussion offline i don't mean to take up committee time educating us on
Representative Glenn Barnes
Unverified
35:33
things that hold on though i think i can add something to that so madam director you're not filling any unbudgeted positions right now correct that's correct you're not even touching that that's correct you don't even close to filling your budget positions correct
Representative Lee Johnson
Unverified
35:51
that's correct so i won't make that clear that does bring up another question like do you have people working currently the hcc that are
Speaker 60
36:02
working in unbudgeted positions that was part of the pause this summer is we move those
Representative Lee Johnson
Unverified
36:07
a hundred around people that were current that were working after your aop that were working at htc's that that you made the financial decision to have those positions that were budgeted before become unbudgeted and then you had to move these actual hold on hold on hold on representative
Representative Glenn Barnes
Unverified
36:22
i think that's where you're missing out yeah
quit using the word unbudgeted they're not even touching unbudgeted positions they're not filling all of their budgeting positions and they're using money from budgeted positions to fill the gap for the new pay
Speaker 84
36:48
plan correct so so we have always been able to utilize both unbudgeted and budgeted positions so i think i
mentioned earlier our budgeted position number is 1965 okay as long as we did not go over 1965 bodies regardless of what type of position we put you in we could move people back and forth all right they got paid i mean this unbudgeted versus budget is something we do in pbass right to make the to hit our budget so as long as we stayed within budget and we stayed within the budgeted amount of people we were fine we could put them in unbudgeted or budgeted so it gave us
some flexibility to churn faster so to be clear
Representative Lee Johnson
Unverified
37:33
though you had people in unbudgeted they were being paid yeah
that was the impression i got they just weren't now to your point you had actual people not just open positions that were unbudgeted they just weren't getting insurance and oh they were
Speaker 90
37:49
getting everything so it's just like kind of a um it's just a designation that we do
Representative Lee Johnson
Unverified
37:54
in our own planning system it does it does there are people who are working for dhs who are unbudgeted there were but right but that but they're we're fixing that because
we're having a movement these are actual people not
Speaker 84
38:10
just openings yes so regardless of whether we had you in an unbudgeted position or a budgeted position for our planning purposes did not affect anything about their benefits or their pay. We were just able to put people in open positions as long as we didn't exceed our budgeted cap amount. Now they have, this summer, they said, please stop doing that. Just put people in budgeted positions. So you have a position with a position number on it. And so, you know, I have to put you in that CNA position with that
position number that's budgeted in our system I can't put you in another CNA position over here even though we haven't hit our cap and we're still under the 1965 I can't put you in one of the unbudgeted I have to put you in a budgeted and because we had to pause and clean that up this summer because that was a shift in how we've always done this it was about a three-week lag where I had to move 100 people into budgeted CNA positions or housekeeping positions or whatever they do for us at the HTCs.
We had to take the time to pause so we weren't accidentally hiring new people into the positions we were trying to move these people into. And that caused, it's caused a delay in the amount of people we were hiring each week. I think I understand. Thank you.
Representative Jack Ladyman
Unverified
39:40
Representative Lederman. Thank you, Mr. Chair. Well, this is getting very confusing to me. I don't know about everybody
else. But, yeah, Jennifer, I knew you had been here a while,
but you and I shared a stage at Jonesboro. I didn't think it had been a year, but maybe it has. But maybe one of you all can answer this question. So you have 24 LPN and 11 RN positions not filled. And I know you said you didn't have the exact numbers, maybe you do, but where these are, but are most of those in, like, Arkadelphia and Conway, or do you know? I don't know, but
Representative Jack Ladyman
Unverified
40:21
Okay, if you would. The work center being closed down at Boonville bothers me a lot. Jennifer, when you were in Jonesboro, I don't know whether you had time to tour the work center there or not, but if you did, you probably saw how those people really enjoy working. You know, I worked in factories. I wish I had some of these people working in the factories I worked in because they like to work. I agree. And they don't, you know, they work every day.
To them, you know, these are people, we're here talking about things. Let's talk about those people in those homes. They're in this home with, I don't know, 10, 12 other people. They have no parents, no family there. They eat their meals, and they sit in the shared room and watch Gunsmoke, you know, and then they're able to go to classes and other things. But if they're not able to do work, which to them is one of the most important, maybe the most important thing they do in the whole day,
And these people in Boomville have not been able to do that. That's been taken away from them. And in some cases, these are mentally five-year-olds that are in a 60-year-old body. And when that happens, they get upset. I'm sure they do. But it's so important to them. So I don't understand when you say you've got budget positions not filled, yet we shut down a work center. I don't understand how that can happen.
Why do we not take some of those positions that are not filled
Chair
Unverified
42:05
and fill them and put them in a work center? We are definitely working to get that done. And I agree 100%, Representative Ladyman, how important it is to keep folks active and
Speaker 54
42:15
to give them purpose. And that training and those employment activities are so important. I think that's one
Representative Jack Ladyman
Unverified
42:22
of the best things we can do for these people. to give them value and worth.
So what can we do as a legislature to help this situation? I mean, what can we do to help you make this work better? Because it needs to work better. Do you have any suggestions? I'd like to
answer that. We passed a bill this past session that started an LPN school. Representative Bentley and I were the sponsors of that bill.
We have to have more people in
Senator Missy Irvin
Unverified
43:02
the pipeline. We have to have more people that they can hire that are trained to do this job. And that is something that
Representative Jack Ladyman
Unverified
43:12
we have responded to. They worked with us, long-term care, the Office of Long-Term Care, worked with long-term care industry who are here in the audience with us today and we started they the industry started new lpn schools and we were able to sponsor that legislation so
representative ladyman i that is a really great thing that this legislature has done uh in the process of trying to get that started but i have a question when you're when let me finish my question
if you don't madam chair that's not exactly what i was talking about what i'm talking about are the people that supervise these folks in the working center the people that cook their meals make their beds wash their clothes sweep the floor i mean these are really good dedicated people and and that's the people we're talking about here not the nurses
you know we're talking about the the people that are direct care and i don't know whether i can but At the end of this, I may make a motion to exempt those folks from this whole process. Because if they're cooking meals for 16 people and they leave and you don't have anybody, then they don't eat. You know, their beds are not made. Their clothes are not washed. The floor is not swept. They don't get baths at night. We're not talking about nurses or doctors or physical therapists here.
We're talking about the dedicated people that work in these houses to take care of these people. Is there anything we can do to
Speaker 195
44:49
help that situation? I understand the distinction you're making on this, and I understand. But every week we're approving what the HDCs are requesting to be hired. and so um i am you know we and we have other budgeted vacant positions available
Speaker 84
45:11
that can be pushed forward to us to request to advertise and hire so we're not we're not holding up what is being asked of us at each one of the facilities except for i am holding um we're holding a psychologist um position because i don't i'm not going to run it for the seventh tom right because we we've got no applicants so back to what senator urban was talking about we can put positions out there for some of these aprns and psychologists and nurses but doesn't
mean they're going to apply it doesn't mean we're going to hire them um i will say to you i think the cna is a little different that's easier more people are wanting that job but we are we're approving every single position request that's coming through every week tip for advertisement.
Representative Jack Ladyman
Unverified
46:01
So it sounds like it's a timing issue that we need to really look at and try to try to fix. Okay since I've got the mic I want to ask one quick
question. Can I get a timeline on the construction at Jonesboro? I know that it's gone out to bid or the bid package is being prepared. I need a new timeline on when we're going to have a groundbreaking we sent that um
Speaker 52
46:27
we sent that to laurie yesterday and she's got that for
Representative Jeff Wardlaw
Unverified
46:34
you today okay thank you you're welcome senator
Speaker 199
46:38
love your recognition thank you mr chair so i i i'm trying to
Senator Fredrick J. Love
Unverified
46:43
put this puzzle all together um we're talking about short uh um staff shortages we're talking about what we're doing
I heard the number of 24, 24, 11, and 1 as far as nursing. But let me go back so
I can understand something. You are approving positions that the HDCs are asking to actually be filled, and then they are actually doing the filling themselves. And
so, in essence, if the positions are not being filled, it's because of the HDCs that are not filling the positions as far as hiring.
I'm just talking about hiring. You're looking at me. I'm wanting
you to help me understand this process. I
Speaker 84
47:34
think one of the key other changes that occurred over
Speaker 195
47:37
the summer that is affecting this is, as Director Brzee mentioned at the beginning, we've always had a budget at DD. We've always had a budgeted position cap that we were staying with under, okay? But we didn't have enough applicants to even worry about it, right, that we were ever going to exceed it or meet it or get anywhere close to it.
and so when the pay plan went into effect we were swarmed with applicants so then we had to start looking at it more carefully so back then before the summer we did continuous advertisement those things were on the um on our website um they were always open right the positions were always open people could apply anytime and so we had i think 50 or 60 people apply um right after the pay plan went into effect and we thought oh goodness we can't leave these positions up continuously
advertised because we won't be like we're going to hit that budgeted number really quickly and so now the process has changed where they are having to request as somebody vacates um um so that also is playing into this so i think it was just several different um system changes at the same time um has caused this to drastically slow down um starting july and august
um that we are now um back and have a process going and are approving them as they come in each week but it doesn't but if you're if you're not hiring um because just say we lose 14 people across the hdcs each week right they're either terminated or they don't show back up um so we're always 14 people quitting 16 people coming in the door right i mean that's just how they've always operated our turn y'all know this our turnover rates are really high um and so it's just constant
churn of quitting and hiring and so when we had all those system changes happen over the summer people were still quitting but we weren't bringing in the same we weren't bringing in the amount of people that were leaving and so now we're back on track and so now we're able to approve every week but it's going to take a minute to
Senator Fredrick J. Love
Unverified
50:08
build it back up okay so in your assessment because i heard you say it takes
six to eight weeks to get people kind of put in and in your assessment I guess when will we reach
that I mean well number one have you done an assessment just to say hey you know within the next six months we will be where we need to be because one thing is this this churn that's going on have you all assessed that as to why we have just so much churn
Speaker 125
50:45
and we have the we heart program so I think the team recognized several years ago that you know there was a big
turn and so we've been implementing several what we call pillars to address the retention and retainment of employees and that's a report we send into the legislators I think every November December
Representative Jeff Wardlaw
Unverified
51:10
okay so members if we could silence the cell phones it's a little bit rude
Senator Fredrick J. Love
Unverified
51:18
to have those ringing every five minutes thank you mr. chair so here's
the question I have have we
done an assessment on that you said yes but number two is have we done an assessment on when we feel like we're going to have enough staff to kind of we're
Speaker 125
51:39
stabilized I do think that we'll hit our budgeted number within the next six months for sure if not
Senator Fredrick J. Love
Unverified
51:45
sooner and that means that there will not be any more contract nurses or you still have the contract nurses
Speaker 125
51:52
and the staff I think our need for contracted nurses should continue to go down but as I think we've
shared before that has been those positions have been harder
Speaker 195
52:02
to fill and it's not just on the on the on-call contracts center lab it's not just for LPNs and RNs it's also CNAs so I think we'll keep those contracts in place so if we have CNAs not showing up and we're trying to get coverage we'll have
Senator Fredrick J. Love
Unverified
52:19
to utilize those on-call contracts okay I guess the utilization of the on-call contracts is not really my issue is that we we up the pay plan so that we could actually hire nurses or cnas or whatever and then if we're utilizing the same amount of money
and we're utilizing it for the budget positions then we actually didn't save any money we're spending more
Speaker 90
52:43
money it is our intention to um as we continue to hire lpns rns and cnas that we will see a
Speaker 195
52:49
drastic decrease of those contracts and so that's what we're watching it's just i don't think it's been of Tom so like what I'm director Brzee said like right now we're only seeing $10,000 less use than we were at same time last year but as we continue to hire and we're watching it that should go down as well as our
overtime spend should be going
Speaker 220
53:11
down okay all right thank you thank you
Representative Jack Ladyman
Unverified
53:16
mr. chair so I know because of our federal regulations that dictate a lot of what we do let me
Senator Missy Irvin
Unverified
53:24
how much of this has played into this because i know if you have a fire you know and the fire firemen need to go tend to the fire it leaves limited people maintaining the fire station so with that scenario you i understand or correct me if i'm wrong did how much was that
a factor where we had to move people quickly because we had we had to make sure that we were meeting those those very important ratios and so it left us lean in other reasons or in other areas service programs things like that where we didn't have that strict regulation is that am i understanding that correctly or can you elaborate on that I'm specifically speaking about some the
work programs and things like that understanding that there's one area that's highly regulated and dictated where another program at program area may not be is that and am I understanding that correctly yeah I think so we and that's
Chair
Unverified
54:32
what our superintendents are so great about is doing that assessment of what staff is required to meet our federal regs but then there's also the complexity of our individual members and so we have some members that
need one-to-one staffing some members that don't need such a high level of staffing and so they have to take all of that into account not only our federal regulations but then what are just the individual needs of each person and is that a daily assessment oh yes okay people's level could change on a day like Like someone could be having a behavior and needs more staffing for a short time period until they get more stable,
Speaker 55
55:12
and then they can go back to less staffing.
Senator Missy Irvin
Unverified
55:16
Okay, so in that communication is with you on a daily basis with your superintendents?
The superintendents and the house staff for sure, and the nursing
Representative Jack Ladyman
Unverified
55:24
staff. Okay, and so a lot of that also played into this when we ran into this pause and hiring and the shift of all that, it just kind of snowballed. It was like a snowball effect. I just needed to also understand that, but I think it's also very important that we understand we've got to make sure we're meeting critical need as soon as possible and that we are reflective in that decision-making process at that superintendent level and also with the agency level,
Senator Missy Irvin
Unverified
55:55
and that is assessed daily and is communicated back. Okay, thank you.
Senator Mark Johnson
Unverified
56:05
Senator Johnson. Thank you, Mr. Chairman. I appreciate you letting me ask a question as a non-member of the committee. Madam Director, I appreciate the questions that my colleagues have already asked because many of them were the ones that I was here to learn about. But I guess I want to kind of sew this all up to say today, do you see any need that the General Assembly needs to work, whether by regulation or some other kind of temporary funding or some waiver of some of the processes in training that we need to do to put you in the position where you need to be?
I'm very knowledgeable of Conway's situation. I grew up there. I knew people who lived there, and many of them in those days actually worked in jobs in the city. I don't think you do it the same way anymore. But is there anything that short term and maybe even going into fiscal session that we need to consider and get the ball rolling to help you all solve this? At first, I just thought it was a workforce problem, and we all know that sometimes it's just a shortage of people.
But is there something we can do collectively as a legislature to make sure that these people who are some of our most vulnerable are not left without the care they need? I'll defer to my boss. Okay.
Speaker 227
57:32
All right. Thank you for that question. We are
Speaker 195
57:37
focused on hiring each week. and i'll be i'll be frank we we need to hire you know we need to bring 200 more staff on board statewide at the five hdcs yes ma'am it will still be within our budgeted um number and so that's our
focus um is to continue to hire as quickly as we can um to deploy 200 additional staff across the five hdcs and stay within our budgeted number of 1965 and stay within
Speaker 84
58:09
our salaries and we can do it We've just got to move more each week more people
Speaker 231
58:14
more hiring phrases each week Okay, well that that's then
Senator Mark Johnson
Unverified
58:21
I trust you you will get back with us if that situation changes and we need to do something here
With the generals and especially going into fiscal session, which is the time we'll be starting budget hearings before very long Thank you. Thank you, mr.
Speaker 236
58:40
Chairman Representative Richardson. Thank you, Mr. Chair. Based on what you
Representative R. Scott Richardson
Unverified
58:43
just said, I'm right here. Hi. The 200 positions that you have left to fill, what's the dollar amount attached to that? Do you know off the top what those positions equate to in salary?
Speaker 97
58:59
No, but I can get that for you. Thank you. Because it's mostly CNAs, and their salary just got raised.
Representative R. Scott Richardson
Unverified
59:03
Okay. What is that? Tell me that. Do you know where it got raised
Representative Glenn Barnes
Unverified
59:13
to? Do you know the CNAs? I do not, but I can get that for you. Thank you. representative lady man uh yeah i'm not ready for that so you were next in the queue and i'm sorry just
Representative Ryan A. Rose
Unverified
59:26
get back in representative rose yes sir thank you mr chairman are there similar to the
vocational program at the boonville center are there other programs similar to that or just other programs attached to the work that you guys oversee that have had to be either closed or temporarily postponed due to the system changes from this summer not that i'm aware of at this time
Speaker 55
59:52
but we can definitely check into that each one of
Speaker 243
59:57
our hdcs um has its own type of work program so
Speaker 84
1:00:02
like what representative lady was talking about they have a really cool greenhouse recycling center at Jonesboro called Greenworks and then each one of our HCCs they make the clients there make items that they sell at the Blue Umbrella that we opened about I was five six years ago and that's at the base of the DHS building it's a really cool store if you haven't ever been there and all of the money goes back to the clients that make goods so they we're still clients from the agencies are still
sending products the blue umbrella um but we will definitely check to see if they're not going as frequently or if they've had to um stop one temporarily and we can
Representative Ryan A. Rose
Unverified
1:00:44
get that for you so are there protocols that dictate when to close that because i heard somebody ask earlier if it was pertaining to ratio and i think your response was that that was one aspect of how that decision was made but are there other kind of protocols in place that when xyz happens then we're going to
close these facilities because xyz no sir i think
Speaker 84
1:01:10
a good example so if there's eight if there's eight men clients living in a house and depending on
Speaker 195
1:01:16
what their supervision level is one could be one-on-one one could be two-on-one because it's all based on behaviors and needs and and so so what if that eight bed house for those men in order to meet the ratios of those particular clients need four staff and one person wants to go
Speaker 84
1:01:38
to the work program and but one staff can't leave
right to walk that one or two people to the work program because
Representative Ryan A. Rose
Unverified
1:01:48
we won't be beating ratios in the house i follow
that um so i would i'm glad to hear that there are no others to your knowledge um that have had to close and so i'd like to request i want to give you the time to be able to to kind of source this information one can you confirm that no other programs have had to be closed due to uh staff shortages or vacancies and then secondly i think you can answer this now
just to be clear it is your intent to restaff that boonville program and it is your intent to reopen and that you are in the middle of that correct yes sir and so the second question that i want to give you time to answer as well can you get us an answer back on an estimated time for that to uh now that you are restaffing it get some timelines but the actual estimated time for that to reopen as well. Yes, sir. All right. Thank you. Thank you, Mr. Chair.
Representative Lee Johnson
Unverified
1:02:53
Representative Johnson. Yeah, and I think I understand. I just want to restate it
to make sure I'm clear. So you're telling us that there are 200 vacant positions that are budgeted that need to be filled at the HDCs. You've currently created these budgeted positions now. They're within your 1960 and you're telling me that we have ample applicants for those positions these are non-licensed positions I'm assuming the workforce issue is I mean not equally divided right you're telling us that we have lots of applicants because the pay plan's working which
is great but I'm assuming that's in the non-licensed positions not in the RN LPN positions is that correct that's correct okay so and you're telling me you have the budgeted money so to to fill those positions so is the rate limiting step really just procedural at this point and not workforce or dollars is that correct
i'm checking my math really quick yeah hang on math
Speaker 97
1:03:55
is really hard because i'm doing it over
Speaker 84
1:04:00
here on the paper i'm going to go back on that 200. i think it's probably more about
Representative Lee Johnson
Unverified
1:04:09
150. okay but conceptually you have you have some open positions yeah the rate limiting step to filling those open positions is not applicants and it's not you don't have the money you're not going to have to go to some other places where and rearrange the deck chairs and lay people off to hire these people somewhere else within dds you've got the money you've got the workforce there it's truly just
working through the procedure that has been introduced with the new pay plan yes but
Speaker 84
1:04:38
i will double check that um i will say that when somebody that's not an hdc employee at dds um leaves we're not back filling it um we're focusing all of our efforts on the on filling I
Representative Lee Johnson
Unverified
1:04:50
would just echo what Senator Johnson said you know if like it sounds like it's a good problem we've created it sounds like we have historically had unbudgeted positions because we just didn't have anybody applying so why would we change that because we've never had anybody apply
it sounds like the pay plan is working which is great we're getting the applicants but I would think that we've historically budgeted the same as you've historically planned for non-budgeted positions right as a legislative body we've given you enough money that you historically needed based on the rate at which you could fill the job so it's hard for me to envision that we haven't shortchanged you a little not out of any ill will or intent but just because maybe we as a legislative body underestimated the number of jobs the pay plan was going to was going to bring in
right and so if there is a need to adjust the budget to try to meet the demand that the pay plan is created appropriately right then you know i would encourage that to be brought out in the in the in the budget hearings so that we can make that accommodation because i think everybody here wants to try to take care of this
population of people thank you thank you so wait a minute that's that's
Representative Glenn Barnes
Unverified
1:06:03
not what you just said right so if you had enough money and you had plenty of budget
then why are you not filling that position back at dds and why are you taking that position dollars and putting it towards the facility because
Representative Jeff Wardlaw
Unverified
1:06:16
that's what I heard you just say. And am I missing something? We
Speaker 86
1:06:24
still have to stay within our budget. True, but
Representative Glenn Barnes
Unverified
1:06:28
you don't have enough budget right now to fill every budgeted position you have in the HDCs, correct? I would
Speaker 195
1:06:37
have to go back and talk to the CFO and double-check that.
Representative Glenn Barnes
Unverified
1:06:41
Okay, but you just answered his question and said that if somebody left DDS, you would use that position to fill a position in the human development centers or in the facilities. Is that not what you
Speaker 146
1:06:55
just told him? Yeah, and that is true. And that's how – it's tight. We're really
Representative Jeff Wardlaw
Unverified
1:07:01
watching it. There ain't enough money. So saying that is an incorrect statement, And leading legislators to believe we
Representative Glenn Barnes
Unverified
1:07:09
put enough money there is not the way this needs to leave.
It needs more money to fill those budgeted positions. And I can't go to bed tonight knowing that we didn't tell the true story. And I just can't do it. I'm sorry. And if we're taking a position from the department and filling the positions over at HDCs, it's a budget problem. And I'm not trying to put you in a bad position, but it's true. It's a budget problem. So saying that we had enough
Representative Jeff Wardlaw
Unverified
1:07:40
money is not an accurate statement. And using the questions to say that, this is not correct.
Representative Glenn Barnes
Unverified
1:07:46
Yes, because the pay plan, we do have more applicants. But having more applicants but not having more
positions we can fill, it
Senator Fredrick J. Love
Unverified
1:08:07
doesn't matter. So, Representative Love, you recognize. Thank you, Mr. Chair. And I was
actually on the same line as Representative Wardlaw. So I want to ask you this. So you said, just for clarification, that this summer you were actually transitioning people to budgeted positions.
So are you completely done with that so there's no more unbudgeted positions that you have?
We are. We're caught up now. Okay, so all
Speaker 84
1:08:41
your positions are budgeted. That's right. No, no, no, no, no. Sorry. So, again, we get authorized positions, and then we go in to PBAS, which Tony kindly told me what it meant on this piece of paper, planning, budgeting, and administrative system. We go in every single year, and we budget and unbudget based on the money
Speaker 195
1:09:04
that we're awarded for each division. So there's still unbudgeted positions in that system,
Speaker 89
1:09:09
and there's budgeted positions in that system. We're only utilizing the budgeted side. Okay. How do we pay for the unbudgeted positions? I'm so sorry.
Senator Fredrick J. Love
Unverified
1:09:25
pay for the unbudgeted positions? We do
Speaker 195
1:09:27
not. When we unbudget, then we do not have to pay the insurance or the fringe on those positions.
Speaker 262
1:09:34
they're they're just kind of on hold in the
Senator Fredrick J. Love
Unverified
1:09:40
system so we I guess I'm not asking my question correctly so you have people
that are in budgeted positions unbudgeted positions you have people are that are in unbudgeted positions not right now okay so you don't have any more unbudgeted positions no sir all of of them are in budgeted positions yes great now you said
there was 150 or so positions that need
to be filled
Speaker 84
1:10:15
budgeted positions correct and we have 1,726 staff at the HDCs and we have around 101 non-HDC staff running the waivers and pass and programs
and all those programs so we have hold 102 so right now we have 1,828 budgeted positions filled and we can go up to 1965
Senator Fredrick J. Love
Unverified
1:10:55
completing that to 1965 you will have enough funding but is that enough do you have enough is that going to meet your
capacity you're in need I guess so when you feel all those positions is
that gonna meet your capacity do you do
Speaker 195
1:11:25
you get what I'm asking I think we will still
Representative Jack Ladyman
Unverified
1:11:32
have to utilize some of them I think we'll still be utilizing the contracts so define the 1965 is not just HDC correct it's DDS it's DDS Okay. So 1965 is all employees at DDS. So, so they have, that is your authorized number that
you have to stay within 1965. So you're trying to shift people to hire at HTCs and not hire at DDS because you're trying to maintain that cap of 1965, but also you're trying to maintain the budgeted amount of money that you have to pay all those people under the new pay plan yes and so it it's do you see what i'm saying i didn't mean to interrupt you i just wanted to make sure that
Senator Missy Irvin
Unverified
1:12:23
we were clear about 1965 isn't just at hdc yeah but that's fine
Senator Fredrick J. Love
Unverified
1:12:28
and but that but that's that that's where my question was leading will
you have the capacity as an agency as an hdc's will you have the capacity that you need to actually under this pay plan under this 1965 number does that capacity meet what you need I mean I think it's gonna
Speaker 97
1:12:55
substantially help and I think we can reevaluate when we hit
Speaker 84
1:12:59
that and and several of y'all have offered you know to have further discussions about this which I appreciate but I think if we can get
Representative Glenn Barnes
Unverified
1:13:16
reevaluate okay all right thank you members just remember we still have two members of the public they want to testify on this
subject representative Barnes you're recognized thank you chair considering y'all your turnover rate
that you're having is that the first question is that normal has that been normal that you have this turnover rate is this normal for you all it is unfortunately okay are you all putting it in the systems in place I'm able to find a way
Speaker 82
1:13:49
to retain people and keep them longer so actually several years ago
Speaker 84
1:13:54
you guys at the General Assembly passed a bill that mandated that we do a
a 360 degree review on the HTCs to determine if we could pinpoint what exactly was going on that was causing the turnover, right? Is it more than pay, right? Because we were hearing a lot of it has to do with your direct supervisor. So we had a contractor come in and do a full evaluation, And they, at the end of it, set up this retention recruitment campaign called WeHeart. And so the five HCCs have been utilizing this recruitment retention platform, I would say, for the last two years.
And that's what Director Brise was saying. We send a report to you guys, I think quarterly, on how that is going annually. Thank you. The turnover is high, but, I mean, this is kind of hard to believe. Before we put WeHeart in, it was higher. So I think with the campaign, it's a big employee recognition campaign, and the staff really like it. So I'm hopeful that with the recognition campaign that we have been utilizing
Speaker 87
1:15:15
plus the increase in pay, thanks to the pay plan, that we will see those numbers go down. Great. do we have access to
Senator Missy Irvin
Unverified
1:15:30
that plan we can get it for you if you would i'd like to see it okay thank you all right thank you also if you're a legislator have you uh
Representative Jack Ladyman
Unverified
1:15:41
you could raise your hand if you've ever been to the blue umbrella raise your hand or if you've bought gifts from the blue umbrella good so it's a wonderful place um are we're going to go to our witnesses
yes representative ladyman you're recognized thank you
madam chair uh representative barnes that's a good question you ask and this program that they're talking about uh you can go to an hdc and i would i would recommend that some of y'all go there and and tour and there's a form that you can fill out this is just common sense in the business industry and one of the things that that they've implemented a few years ago is, you know, you can fill out a sheet of paper and comment on how good a person is doing their job at the HTC. They get recognition. They have employee of the
month, those kind of things. It's a really good program, but if you're around an HTC and want to go in there
and see it and fill out a form, I would recommend it. Thank you for that. Okay, we're going to move. Thank you, ladies. Katrina Robertson. It's Katrina Robertson. If you'll come up. And Terry Johnson, I think, do you want to do individually or come together? I'll let you
choose. Okay. Whatever you would like. If you'll just both want to come up at the same time, that'll be fine um and then if you'll just state your names please uh and who you're with or who you're representing um then we'll let you guys proceed so we have katrina robertson and terry johnson i have you both listed as parents and then i'll let you describe the organization that you have uh listed here thank you
Representative Jeff Wardlaw
Unverified
1:17:30
one one second uh dhs department don't run off i do have a
Katrina Robertson
Unverified
1:17:34
question for you guys when the witnesses are done my name is katrina robertson i'm mom to noah he's 22 years old and he's been a resident at the boonville human development center for three and a half years now i'm also president of the ffc off our friends and family of care facility residents for the boonville chapter terry here's the president for the the state and we just work to advocate for the needs of the profoundly disabled i can tell you that boonville human
development center has been a godsend to noah and our family life-giving in every sense of the word some of the most dedicated and compassionate passionate people that i've ever met work there and I'm here today because I'm deeply concerned about the staffing and hiring challenges all of the HDCs are facing but you've heard Boonville mentioned many times. I'm going to deviate just slightly from and I and my testimony is short but I'm deviate slightly and because I
just I have to say that I was just making me crazy that we've beat a dead horse for over an hour talking about all this confusing budgeted unbudgeted authorized and didn't break it down to the simple terms and that if you raise salaries but don't raise the budget you can't pay your employees I mean it's really I mean we're making something confusing that is not confusing you know
the HTC budgets have been flat for I don't want to give a number of years but I want to say a decade so we had a we are trying to pay the same number of people a higher amount of pay based on last year's budget um anyway that's I I don't I don't know why that has not been addressed more specifically now so Noah he's got a he's intellectually disabled he functions at
about a three to four year old level but he's very very verbal and he keeps up with all gossip on the hill as we affectionately call Boonville and he calls me with the latest gossip all the time and he called two weeks ago and he said mama I don't have a job anymore and I said what do you mean you don't have a job he says I I don't have a job and I I said well um I know there's I said well why do you not have a job and he says they don't have workers for us and there's been several
times where you know you have multiple employees call in there's sicknesses that go around and they've got to kind of rearrange daily schedules and I said well I bet you'll go to work next week he says no no there's no more work mama I I must stay in my room and watch tv and sometimes go play games but I need more of my word searches he can do word searches all day um so obviously I was concerned so I reached out to an administrator who confirmed that the vocational and training areas had been closed indefinitely so staff could be reassigned to the direct care roles
and it was due to the ongoing difficulty and delays in filling the open positions. You know many of y'all have know that I'm a strong advocate for HDCs not just on the state level but on the federal level. In two weeks I'll be back in Washington D.C. meeting with all of our federal delegates. As I stated, Noah's job, his job at Boonville is making rugs. I was in DC in May and I had brought all six of our delegates a rug as a gift. Senator Tom Cotton loved the rug so much
that he had his legislative assistant reach out to me here recently and he, she said, Cotton would like to purchase 55 of your largest rugs in red and green that he wants to gift to the other senators to showcase work done by a 14C program. However, when I tried to coordinate the order last week, I learned that the vocational program's closure meant there was no way to fulfill this order. The staff member I spoke with was thrilled about this request, of course, but disheartened
to explain that the only way to fill it would be just to use rugs that are in stocks. She wouldn't be able to accommodate the specific request um but she uh she also shared um the even more what exasperated the the problem is that many of those workers who had been transitioned to other areas have since left boonville human development center because of their frustration with the
situation which created an even more severe problem i will speak um i will make the statement that you know the statement was made that all requested positions are being approved that is not what i hear i'm not going to speak as far as names and statements and numbers of requests versus what's approved because it would be hearsay really who you would need to speak with are the people requesting positions and how that's working um you know friends this situation's dire um
our cnas and direct care workers absolutely deserved this pay raise um but overall budgets must increase to sustain those pay raises and to have proper support and staffing levels and the question was asked are we meeting licensure requirements that really i don't think has ever been um anything they've even gotten close to but as already has been addressed are these individuals require much more care than um the the bare minimum many of them one-on-one
you know this vulnerable population they depend on us and we can't allow them to go without appropriate staff um or the ability to have uh things like a job that make
Speaker 279
1:24:06
them make them proud i'm terry johnson i'm the president of our parent guardian
Speaker 281
1:24:12
advocacy group for the state of arkansas and katrina covered a lot of the of the main items but in my position as the president i get
the most unbelievable phone calls and texts all the time from parents who say my kid you know needs more staff in there you know there's nobody there they didn't pack his bag correctly when I came to to pick him up to really more serious things that I don't even want to go into here but I got an outrageously serious call this week but it's these houses that we're talking about here where my son lives uh where her son lives can't go without staff people uh my friend back
here has a hotel he likened it the other day he said you know when my house cleaner on the fourth floor of my hotel uh quits it's not like i can close down the fourth floor i have to get somebody in there no matter what I have to do I have to get somebody in there to clean that floor well when staff people leave a house and you're under license requirements and so forth you have to have somebody qualified and with the patients to deal with the folks that are in there because
nobody could possibly love their son more than me but he got to the point where I couldn't handle him on a regular basis, but the HDC has been a miracle. They handle him very, very well. He loves it there. He calls it his college. I would do anything for those HDCs, and I also say I would do almost anything for the two ladies that spoke up here earlier. Both of them have helped me in past years with outrageous problems, so I have nothing against them, but I must say
I have the feeling, no proof, not under testimony here, but I bet they are under some restrictions that we could not possibly imagine. Because if you really talk to these people, if you talk to the caseworkers and the staff people and the superintendents at these places, that's where you get the real story. And I'm going to get in huge trouble for saying this, but this is just the way that I have to do it.
If you all wanted to get the absolute bona fide true answers to everything that you're asking, because I'm an MBA and I had a hard time following all of the budgeted and unbudgeted stuff that we had. I couldn't follow. But if you ever want the true answers, call in the five superintendents that run these five centers and have them in a position where they don't have to worry about their job. They are petrified to talk about how bad the problems really are because they're scared for their job.
And I think that is wrong. They should be able to, and again, it's not their, they're doing their job, you know. They are doing what they're being told to do. But here, you guys have the link to people even above where they're reporting to, and that's what I'm getting at. If these handicapped folks that are citizens of this state, there's not that many, we're talking 850 or so, that's a very small percentage, you know, of the population.
They need the help. They need the budget. Talk to these superintendents. Let them tell you this is how we've tried to make, you know, lemons, lemonade out of lemons for a long time. Their budgets have been flat, like Katrina said. They do need more money, but everybody's been trained, God, don't ask for more money. Don't ever ask for more money. Well, but when this new hiring policy came and said, well, we're going to give you the raid, you can now hire these nurses that are going to work for hospitals and other places
because it's more competitive. Well, now they've got a lot of applicants. Yeah, man, now you've raised the price, I think $11 an hour to $18 or something. They got a lot, but then there's no money to pay them with. And if they do come in, they have to go through a five-week approval process and then, I mean, a training process. And then the approvals, unlike what they seem to indicate, the approvals are not coming. People are on vacation. Well, we'll get to you in a couple weeks.
I go back to my buddy with the hotel. When you have staff people leave these house and you've got 15, 20 high-risk individuals in there, You can't sit there and say, well, we'll just, you know, all y'all go home. When we get the right staff, you can come back. We've got to have somebody right then to take that place. That's an emergency situation. We have to have that. I don't know anything about when she said the 200 people or the 150.
I don't know what that means. But if you ask the five superintendents, they wouldn't have any clue what that means because they're sitting there waiting on resources to come, and they're not coming. And it's a problem. And it's finally gotten to the problem where they didn't even care if they risked their job. They said, we've got to get some help. So if you all are advocating for us, please go down there to Little Rock and tell the powers that be that somebody needs. I mean, we've always lived on the very lowest of budget, and we still will if we have to.
But we've gone beyond that now. Now we've gotten to where it might jeopardize the license requirements of some of these homes and some of the things that have to happen. Even these superintendents have licenses that are at risk if they allow stuff like this to happen. So God bless. I mean, those five superintendents have wings on them. They're the most wonderful people in the world, and so are these two ladies back here. They're trying to do something that's almost impossible. but if you really want real answers then ask those five people and they would probably they
wouldn't give you a wish list of everything under the sun they would just give you a wish list of just enough to get by what I need to have and they you could get straight answers there I don't know if that will ever happen but that's where all the answers lie so forgive me if I went off and I probably was not allowed to even say that but please ask them because they they they have it you're thank
Representative Jack Ladyman
Unverified
1:31:00
you for your testimony you're allowed to say whatever you want to say you you are a citizen of the state of arkansas and you're before the arkansas legislature
you have a right to say whatever you want to say under the constitution of the united
Speaker 281
1:31:16
states my heart is with those five superintendents we understand because if they weren't taking care of my son, I wouldn't have a life. My family wouldn't have a life. They are doing an impossible job. Just walk into one of those places one time. You have to be half angel to work there. It's a tough job. And when one or two leave because they can't take it anymore or don't have the money, we have to get them replaced. And so they are wonderful people. These are wonderful people.
this is a hard job we're trying to do the answer comes from above way above me probably way above them this comes from the people that y'all work with I guess and how important is it how these HDCs and the folks that are in there is that where we need to put our money maybe we need to put it in a highway instead or maybe we need to do something else I don't know that's up to the people a lot smarter than me but I hope that we will see the importance of these 850 people in these hdcs and god bless y'all for letting parents like us come in front of you and and talk talk
openly absolutely we'll do anything we can to help our group we're unpaid we're volunteers we've been doing this for about since since uh 2012 or yeah 2011 or something like that um and we're we're here to to help in any way we can appreciate you thank you resident lady you have something for the witnesses yeah i'd like to
Representative Jeff Wardlaw
Unverified
1:32:47
ask them a question if that's okay you're welcome to am i on here
Representative Jack Ladyman
Unverified
1:32:52
yeah thank you mr chairman uh terry good to see you hadn't
seen you in a while talk to you see you uh thank you for being here katrina carol thank you for being here you're not at the table but appreciate you being here um yeah terry carol's watching virtually okay uh terry just want to let you know family day was saturday in jonesboro i had lunch with your son uh he ate his barbecue didn't drop any of it he was good he did a great
Representative Jack Ladyman
Unverified
1:33:24
years i know you couldn't be there but he did good um but you talk about
the superintendents and i think you're absolutely right and uh mr chairman i would like to recommend that we have the superintendents at our next meeting and talk to them most people know i'm a boots on the ground guy and i want to know what's going on boots on the ground and i think it would be a good idea to talk to those folks and also uh i talked to one superintendent i won't say which one but uh that superintendent got called in and had to work on third shift in a house because somebody quit
Speaker 281
1:34:01
yeah i mean when you've got the highest the staff can't go to classes
because they have to go man the house now, and several have been working 18-hour days. But when you have the highest-paid
Representative Jack Ladyman
Unverified
1:34:13
person at that site working third shift, whatever needs to be done in a house, there's something wrong. So, Mr. Chairman, I have a motion at the proper time, and, again, thank you all for being here. Thank you. Seeing
Representative Glenn Barnes
Unverified
1:34:29
no further questions, thank you for your testimony. Can I get the DHS personnel back to the table, please?
So one quick question before we move on in the agenda. Can you walk me through the DDS RSA amounts from 2017 to today? And you don't have to go through every one of them, but just kind of highlight it. From where I'm at and I've looked into the RSA amounts, you were short before the pay plan and before we even came into this year if i'm correct and
Representative Jeff Wardlaw
Unverified
1:35:28
i just want to hear it from y'all's mouth where the
Speaker 84
1:35:39
today i'm happy to go through that i have actually have it with me okay so for dds the division Again, it's not broken down by HTCs, but as you could hear, that's where most of our money goes. So for 2017, our DDS RSA amount was $65,870,969.
Speaker 84
1:36:15
$21,000. So in 21, the DDSRSA amount was $67,782,000. And last year, in 2025, it was $65,603,057. And in 2026, it's the same, $65,603,057.
Representative Glenn Barnes
Unverified
1:36:42
so what you're telling me is is in 2017 we were at 68 million and change i'm not even going to try to say that big number but we're basically three million dollars less today than we were almost 10
Speaker 84
1:37:02
years ago nine years ago if you want to be technical no sir i'm sorry so in 2017 it was sixty five eight seven zero non six non so it's only about what 270 270,000 we received 270,000
Speaker 87
1:37:16
more in 17 than than 26 that's crazy and so when it went
Representative Glenn Barnes
Unverified
1:37:26
up to 67 million that was just through covid yes sir was that due to any federal programs that enhanced your funding or was that just due to filling gaps on staffing um you guys filled gaps on
Speaker 84
1:37:40
staffing because everything was costing so much money thank you all right
Representative Glenn Barnes
Unverified
1:37:47
seeing no questions from committee members thank you for that info
Representative Jeremy Wooldridge
Unverified
1:37:50
oh hold on representative Woolridge thank you mr. chair and that kind of made me think of a question. So when that COVID bump took your budget up to 67, what, what changes took place, um, that we then had to try to either cut or did we, are we trying to maintain those? Was there expanded positions? What happened
Speaker 84
1:38:14
with that additional funding? We just had to so heavily move towards contracts, um, at that time. And then of course we were getting all of the, um, the required, um,
PPE um to try to keep people healthy um so there was it was just a lot of added expenses back then that um I think the General Assembly recognized and knew that we needed more um state general revenue to meet those needs back
Representative Jeremy Wooldridge
Unverified
1:38:40
then okay I guess I didn't ask my question well I'm sorry so did we address one-time fixes with the
bump in COVID funds or did we increase pay or do things were going to be a residual reoccurring expense
Speaker 84
1:38:55
so i will say over probably the last 10 years we
have implemented two pretty extensive pay plans at the hdcs that many of y'all probably remember where we um the last one being we actually require now cnas and we set up cna schools so that we We could pay people more. So, yeah, we have been year over year. We've been very successful of using the money that we've been given. We've started a CNA school. We opened a store. We've been building on our campuses.
We have absorbed at DDS. We were able to absorb merit increases, right, year over year, um, and, um, and pay, uh, pay increases for the CNAs and LPNs on our own accord within our own budget. Um, I just
Speaker 87
1:39:46
think we've gotten to the point now where, um, we can't, we can't absorb
Speaker 303
1:39:53
everything. Understood. Anymore. Okay. Thank you for your time. Thank you.
Representative Jack Ladyman
Unverified
1:39:58
Of that, um, of your total, uh, funding, is it state general revenue or federal funding mix? The numbers, um, Senator
Speaker 84
1:40:09
urban i just went through was just the sgr that's in the dd um bless you that y'all give us during budget hearings each year so that's just the state general revenue um there's a there's a very high federal match at the human development centers because of the the nature of the work um the other thing that's occurring right now is because our state is doing really well our federal match rate is dropping
Speaker 87
1:40:36
so um we um we went down two percent and um in october so and every percentage
Representative Jack Ladyman
Unverified
1:40:42
so i just think that members of this committee need to understand it's always about a decision and i think that mr johnson adequately described it we have decisions that are being made and so with state general revenue it's critically important that we understand that state general revenue has actually decreased since 2017 for dds budget okay state general revenue and the match of the federal match has because the state of arkansas has done better economically
our f map has changed and every one per every percentage change equates to 90 million dollar hit to state general revenue. Okay. So that's $90 million more in state general revenue that we have to put up, pay our portion increases by 90 million at current existing service. That's not adding
anything new. That's just price of groceries have gone up. We're still buying milk, but the price of grocers have gone up, basically. So I say all that because Medicaid and DHS, DDS, the funding is critical for us to understand it in the perspective of everything else that is coming our way. So when a program that is being federally funded by 100% because of COVID loses federal money, you have to understand what you're asking of everybody else
when you're asking for state general revenue now to fill the gap of a
Senator Missy Irvin
Unverified
1:42:36
federal deficit of federal funding the people that suffer are these people you got winners and losers not by our own choosing okay but federal money has gone away because of covid money federal money went away so we as a legislature have to make a decision about who's going to be the winners and who's going to
be losers so when you lose federal funding for programs that are very good programs you always have to have the perspective as a legislator to understand well the state general revenue for this dds agency has remained not just flat but actually decreased so now we're way behind the And I'm sorry I'm on a soapbox, but I am very passionate about public health in the state of Arkansas. I'm passionate about everything else, too.
But at one point, at some point, you as a legislator, me as well, we all have to look at this as a perspective and understand our funding and understand state general revenue versus federal revenue and where we're going to actually backfill. And if we do backfill a completely 100% federal program with new state GR and we're already behind in this area, more suffering takes place for these people.
These people may win, but these people are going to lose. It's a decision, and I just think it's very, very important that we understand the mechanisms of budgeting and state money and federal money. The federal match for this program particularly is what? What's the percentage? So we put in
this amount of money. What is the current federal money for this particular DDS? 69.23, federal.
Representative Jack Ladyman
Unverified
1:44:35
Okay, so 69.23% is paid for by federal funding. Okay, and so I just. And that's going to 67 or it's at 69. It was at 71 and now it's gone down to 69. Okay. Thank you. Thanks Senator. See enough other questions. Representative
Representative Jeff Wardlaw
Unverified
1:45:01
Ladyman. I'm going to hear your motion.
Representative Jack Ladyman
Unverified
1:45:06
I'm not saying I'm taking it yet, but go ahead. Thank you, Mr. Chairman. Well, it's been a good discussion. And I have to say, because we're getting less federal money, it means that our economy is doing better and we're paying our own way. I don't think that's a bad thing. I think it's good that we are able to take care of our own people and not take people from money from California. But anyway, that's another subject. Mr. Chairman, I believe with all this discussion that there's an issue here that we need to make a motion.
to correct I believe there's a timing issue with these direct care individuals and I think if we can speed that process up even a little bit it will help these HDCs so here's my motion I move to exempt direct care vacant positions at the human development centers from the new hiring procedure that's my motion getting a
Representative Glenn Barnes
Unverified
1:46:21
answer from legal and then I'll come
back to you okay thank you
Senator Missy Irvin
Unverified
1:46:29
members yeah quit so as we're asking for more information on his motion if if I'd like to know yes or no if this public joint Public Health Committee has the authority
Representative Jack Ladyman
Unverified
1:46:42
to to do that if we do not does that authority exist at another committee level
Senator Missy Irvin
Unverified
1:46:49
perhaps through ALC or budget is that okay okay thank you
Representative Glenn Barnes
Unverified
1:46:56
represent layman we're gonna move on through the agenda while we're waiting hear back from legal but we'll come back to your question so i'm going to table it at the moment without objection and as we get that determination from legal we'll come back and take
Representative Jeff Wardlaw
Unverified
1:47:10
it up so with that we'll recognize oh you're at the table you guys are good so we'll go ahead and recognize you all for the substance abuse and mental health rule
Representative Glenn Barnes
Unverified
1:47:27
If you would have the new team members introduce themselves for the record. Yes,
Speaker 310
1:47:44
sir Good morning, martina smith director for the division of provider services and quality assurance Paula stone director of the
Senator Missy Irvin
Unverified
1:47:52
office of substance abuse and mental health dhs
Speaker 243
1:47:57
And Melissa Wetherton, Director for Medicaid Specialty Populations. Okay, thank you.
Speaker 84
1:48:19
So we are here on this topic. So Act 636, which was an act that was passed in this last legislative session.
that made several changes to psychiatric residential treatment facilities. And it, at the time, that bill had an emergency clause on it. So the three of us went and ran a set of emergency rules that went into effect on June 20th. And what we have before you today is the permanent rules that we are seeking to put in place to regulate psychiatric residential treatment facilities which are called PRTFs so we have
Ms. Martina Smith as she introduced herself she is over our division that does all licensure certification and our office of long-term care and then of course Ms. Stone is our behavioral health commissioner for the state of Arkansas she's over the office of subsidies and mental health so out of both of these divisions came a manual so we have a office of long-term care licensure manual for prtfs that will be regulated underneath miss smith's oltc unit and then we have the
corresponding medicaid manual that sets out what we think is the standard of care that should be provided that falls under miss stone's unit so that's why we're all three up here today i'll hit on some high notes um we feel like we have made some good changes we actually got two public comments back that um we were happy to see were pretty pretty complimentary like they're not happy with everything but you know we agree this is a good start we also responded back that we had
committed to um putting these rules in place for six months and then reevaluating if we need to do stuff differently and so that's what we responded to on the public comments so we appreciate that feedback um we also just to note we got really good feedback from blr on things that we had missed um and so we were able to go in and make some of those changes too so we appreciate that i think the high notes are prior to this law um the psychiatric residential treatment facilities
were being licensed by a board um and it was called the board's called child welfare agency review board and at that time um that board this was the only program that was paid for by medicaid that they were licensing so they are primarily they do our foster care um homes our adoption homes um but prtf previously was being licensed by this board and so now they are licensed as a long-term care facility just like a human development center ICF just like a nursing home
highly regulated required to have an administrator we change the age of admission previously you could go to a PRTF if you were five we it's now raised to 10 so there's no new admissions after age 10 we put restrictions in place that you cannot share a bedroom if you're outside of a three-year age range um and so that is now in here we banned any type of seclusion we have banned
any type of mechanical restraint um and we are requiring monthly reports so we can see what's going on um we are requiring a psychotropic drug um report each month um discharge reporting each month we want reports on out-of-state children each month and then any type of restraint we're getting restraint reports on a monthly basis the PR there the PRTF providers have been very engaged with us over the last several months on this work and we
might not have always agreed but we collaborated and it has been a I think a very good working relationship and we look forward to you guys approving these rules and let us know if you have any questions see you
Representative Jeff Wardlaw
Unverified
1:52:37
no questions without objection they stand reviewed committee the other item on the agenda was pulled by the department seeing no other business we stand adjourned
Agenda
A. Call to Order
B. Consideration to Approve the August 6, 2025, July 10, 2025, and July 11, 2025, Meeting Minutes [Exhibits B1-B3]
C. Overview of Hiring Procedures at Human Development Centers
D. DHS, Office of Substance Abuse and Mental Health, Review of Rule, Psychiatric Residential Treatment Facility Services for Under Age 21 [Exhibit D]
E. DHS, Division of Medical Services, Review of Rule, Urgent Care Clinics [Exhibit E] − Elizabeth Pitman, Director, Division of Medical Services, DHS
F. Other Business
G. Adjournment
Documents
Speakers
Speaker 3
Speaker 10
Speaker 17
Speaker 20
Representative Jeff Wardlaw
Unverified
Senator Dave Wallace
Unverified
Representative Glenn Barnes
Unverified
Chair
Unverified
Speaker 49
Representative Jack Ladyman
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Speaker 60
Senator Missy Irvin
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Representative Lee Johnson
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Representative Mary Bentley
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Representative Ryan A. Rose
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Senator Fredrick J. Love
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Speaker 173
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Senator Mark Johnson
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Representative R. Scott Richardson
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Katrina Robertson
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Representative Jeremy Wooldridge
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