Public Health, Welfare and Labor Committee- House

Will be added to the consent agenda. So members will go back up to the top of the agenda and start over again. representative Johnson's not here yet but I think that H. B.. Ten sixty three you want to pass over. So. What was it. Okay. All right evidently that H. B. ten sixty three was recalled to the Senate today. so we're gonna go to the consent I think we got one or two items on the consent agenda that we want to run. The first item. On the consent agenda is S. B. sixty five representative back you're recognized to present the bill. I guess someone. Okay thank you. The. Senate bill sixty five has to do with it changing our plans as far as you for changing plan concerning the carbon dioxide emissions from like a coal fire plant or something of that nature so that's what this is This agrees this bill deals with basically what the bill is saying is that there will be an initial report prepared that report will will go to the public service commission also got Economic Development Commission has to determine what the effects of the regulations on saw would be. would be and then it goes out for public comments and after that point then it would go to a L. C. and that's really the biggest change in this is going to go out I'll see for us to kind of get a little review at the at that point it would be transmitted to the governor and then eventually make its way up to the use of the environmental US environmental to me to make sure that that thing was approved there were no one spoke against the bill on the Senate side and I appreciate a good vote. Our questions I guess. All right any questions from committee. Seeing none. I don't believe we have anyone signed up to speak against the bill. So is there anyone in the audience that would like to speak against the bill. For the bill. Seeing none you a close for your bill. Of close would appreciate a do pass with Wildman centreboard have a motion of do pass by representative Boyd any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries congratulations representative your bill has passed thank you. Okay all right we'll we'll go back up to the top of the agenda yeah. First item on the regular agenda. Is H. B. seventeen oh eight by representative Eads are you prepared to run your bill. Thank you Mr chairman with your permission of god of a constituent here that would help me present this bill yes out of time on having come up and there is an amendment is that right yes entities yes okay members there's an amendment come around. So we'll give the committee a few minutes to look at the amendment. Seventy away. A representative you want to go ahead and present your amendment yes this amendment just strikes out Section. Three now yes section three in its entirety section three anti we're removing the occupational therapist entirely from this bill it's all The Amendment us. I have a motion representive Eubanks to adopt the amendment any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay moshing carries your amendment has been adopted you're recognized to present your bill as amended or thank you members I know you've got a a long schedule so I try to be as brief as I can but this is a topic that I think is important It's a it's a topic that deals with a disorder known as reactive attachment disorder reactive attachment disorder is a rare but serious condition in which an infant or young child fails to establish healthy attachments with parents or caregivers this disorder may develop if the child's basic needs for comfort affection and nurturing aren't met and loving caring stable attachments with others are not established. To tell the an expected for a child to become attached to his primary care givers those he looks to for nurturing soothing a child with reactive attachment disorder has been subject to extreme neglect or abuse and fails to establish the expected bond with its primary care givers resulting in irritability sadness fearfulness and difficulty interacting with others with other adults or peers a child diagnosed with what is called rad rarely seek to response to comfort when distress shows limited positive effect and has unexplained episodes of your ability sadness or fear from this when in contact with this character is or her care givers. with treatment children with rad may develop more stable and healthy relationships with caregivers and others these treatments include psychological counseling parent or care giver counseling and education learning positive child and caregiver interaction care giver interactions in creating a stable nurturing environment without treatment. Rad can continue on for years and can have extreme lifelong consequences research suggests that some children and teenagers with rad may develop callous unemotional traits that include serious behavior problems and cruelty toward people and ask for animals. So the prevention committee for rad is is first recognizing the problem with the attachment and getting help as soon as possible this is essential to preventing this disorder but may not always be possible to prevent rad I think we must take steps in that direction by learning about it in recognizing the disorder by those that frequently come in contact with the children. And while there many groups that could be identified as needing a specific rad training we have to start somewhere. So today these groups are DHS case workers adoptive parents foster parents psychologists and psychological examiners. So briefly what the bill does it will require DHS case worker involved with the adoption of a child or involved with the foster child to complete at least three hours of training with rad annually. A prospective adoptive parent will have to complete three hours of training before the final decree of adoption is entered. Third a foster parent will complete three hours of training annually and in order to obtain a psychologist or psychological examiner license they would need to be required to complete three hours of initial training psychologist and psychological examiners will also have to complete three hours of training in order to renew their licenses. That is in essence what the bill does And I've got a constituent here from my home town and servicing and Christine Walker and if you allow she can give you some background on rad and and how it's affected her life personally. If you would introduce yourself and who you're here to represent yes my name is Christine Walker and after fostering adopting and being a child advocate through that just representing yourself for an organization yes Sir just myself you may proceed yes I know that you'll have a long day and we have several people that are going to testify so we are each going to try to keep our testimony three to five minutes I'm going to tell you a short story and you're going to possibly perceive it as having nothing to do with this but I promise you it will circle back in and fit right into what we're about to talk about. And one day Albert Einstein was on his way to a science convention for speech on the way there he tells the driver that looks a little bit like him I'm sick of all these conferences I always say the same things over and over the driver agrees you're right as the driver I attended all of them and even though I don't know anything about science I could give the conference in your place that's a great idea since Einstein let's switch places then so they switch places and Einstein goes and to pretend he's a driver in the crowd and his driver gets on stage and in the crowd there is one scientist one scientist who wants to impress everybody anything so very difficult difficult questions asked Einstein. So he he thinks that Einstein won't be able to respond to and he interrupt the conference any poses difficult questions the whole room goes silent holding their breath waiting for the response the driver looks at him dead and I and says Sir your question so easy that I'm going to let my driver respond to it. So even though reactive attachment disorder might seem a little confusing and something that it's kind of hard to wrap your mind around I can look back on seventeen years of experience with casa foster parenting and adoption and I look back and there's so many of the children that I have no doubts have one one in particular I just got off the phone with this morning she's now twenty three years old she's very independence and is doing well she had probably the worst abuse one of the two worst abuse cases I had ever seen when she came into my care I refused to take or the first time they called me and they told me the extremely of her sexual and physical abuse the abandonment she had inquired and I I I turn the call down the said that's way above what I can help a child with they ended up putting her in a shelter in three days later they called me and they said her dad just committed suicide after his confession and that child I'd I'd told them I would take her at that point and she was in my home for four and a half months her relatives from Washington and ended up getting custody and I have both of their permission to share this testimony in fact I have a a two page letter from the antiphonal one would like to read it that child when I took her to the psychiatrist was given medication the only place we know to do to go to get her counseling was just a you know families in downtown in the the counselor look to me and she said I have no idea what to do with this and I said I don't either I had so far the the best thing we've done is go you know on a horseback ride at a ranch and you know I've tried to just take your mind off of everything but this is some pretty heavy stuff she was heavily medicated after meeting with the psychiatrist for five minutes. And never given any diagnosis except for PTSD when she went out of state to I therapist where they are are trained for rads quite often in that area she received that diagnosis or it was we able to get her the help she needed and as an adult she will now tell you I know I have rad I'll probably always have rad but I couldn't deal with the rad because I was given the help I needed so I I look back on the countless children that I have met over seventeen years and I think how many of them instead of being heavily medicated or give and talk therapy could have gotten really good therapy that really could help them with this you know I just I just feel there so many children suffering I had a talk with my my doctor the other day who's a good friend of mine and and I said you know I have to speak tomorrow and I'm not really sure exactly what I'm going to say I'm just going to try to not get is a motion as I could get when I think of these children in their lives that I said you know it's it's being talked about by eight different people that this is a rare disorder and most of the definitions of it will tell you that it's a rare disorder. But it's rare in in the fact that in the general population but my eye doctor friend told me she said I'm not a doctor and there's certain diagnosis is that are rare in the world I'm an eye doctor so this is where people come to get help and then my world they're very common so I think it's like that with foster and adopted children they all have a huge loss they all have great just abandonment issues and and yes there is PTSD and lots of other things but if we continue to miss diagnosed Brad they are not going to get the help they need and I promise you that when when the parents step up and ask and the people in charge and don't understand what the disorder is then they just keep getting the wrong kind of help and and we're basically providing a pipeline to prison because if they don't get the help they need they are going to self destruct sooner or later and that's that is on our society not them so you know I I think that asking for the professionals that are already in place that already have to get C. E. credits to simply take the hours that they already have to go and get for a continuing education to just simply include three hours for reactive attachment disorder and some people will say that three hours is a lot I don't think it is when it is such a mis understood problems in Arkansas if we were allowed to bring in zoom testimony I have been in touch with therapist and and experts in Utah and Colorado and California and Georgia and there's a lot of other states that are not to get out of the park and they understand how serious and how different this particular disorder that is but we have a lack of understanding in Arkansas there are a few really good places you. We're going to hear testimony today from someone from youth homes and I highly respect her and her knowledge but I also think that it's it's very rare that this disorder is diagnosed and it should be diagnosed a lot more in the foster and adoptive system and these children would be able to get the help they needed if we could do that and I will not go into my personal testimony of one of my adopted children but I will tell you that it is it's not hard to get help for them it's impossible and we we won't go there this is not going to turn into something personal but I don't want my child to almost eighteen now and he has not gotten the help he needed to the full extent he needed it but there's thousands of children behind him that could if you make the right decision today. I'm going to turn it over to the next parent what women is there any questions are as to how this works I have a question how many other states have adopted a similar program is training if we adopt to this law it is you're going to be rock stars because there's people across the country watching this there is an organization called Brad advocate that that is is very involved in this and they are definitely in touch with parents begging for help across the nation and everyone of those children is adopted and these parents love them fiercely and they want them to get the help that they need that was not my specific question how many states none none that I know of Sir okay thank you representative board you're recognized for a question. thank you Mr chair is this is really for representative Vives I'd do you have any idea how many state employees were would be required to have this training and and I'm making assumptions we would the state would be paying for that just what that is great I don't have that number but I think you're gonna hear from DHS that will probably have some update on that. Resented Payton you're recognized for a question. You Mr my question is where does the training come from nothing in the bill seems to designate whether it's training in diagnosis or treatment I would assume both or either yeah but who offers the training and and. Forty gets injured I believe Christine can probably answer that and yes I never present a problem without a solution rat advocates has a training program and like I said that's a nationwide program I also reached out to White River academy and the founder of star guides wilderness is two weeks away from having a training program for one separate for teachers foster adoptive parents and and and state employees and the curriculum should be done in about two weeks and that one will be certified there's also norm turn bill there's there's quite a few options on this and also use homes in Little Rock they have an excellent pair program and I believe that they are working on a curriculum also. Thank you in and maybe if I could follow up yes you're recognized who does the certification you said somebody's one of them's going be certified who certifies that I am not a psychologist you'll have to refer to the driver. Thank you Mr president Ferguson you're recognized for a question yeah and that that was also my concern about the does where is the training where is the the certified the CMA's your credit going to come from is it going to be from the American academy of child and adolescent psychology their clinical standards or I mean it's not it's at is it going to be some nationally recognized treatment and. Not just like somebody in Arkansas thank and that this is what we are today. I believe that there is some really good training modalities out there that are being worked on and I can't tell you if they're going to be accredited through those places I just know that we have a really big problem and we need to start somewhere and I think that if we are all willing to be educated in it then we can help these children if we refuse to be educated in and we call it other disorders they will continue to get the wrong kind of therapy. Yes maybe as the are the is the Arkansas psychological association here anybody from there I. No no use of a I guess that would be my questions for them about what CMA they accept and if they're training already involves you know diagnosing and treating this are we adding an additional. Barton to something they already feel like its they're doing I. Well I most certainly would not want to see this be a burden on anyone but if it can help the children I think that's the most important thing. Representatives do you know what the cost is of this and who would pay that cost or aye these funds come increased talking about the adoptive parents the foster parents well the DA three hours of training for a lot of people that could be a lot of money yeah and who's who's well paying for that and how much is it my assumption would be that the foster parents and adoptive parents would be something they pay for out of their pocket if you talk about DHS that would be something that comes in my mind out of their state funds about three billion dollars. And I do know that rat advocates will do a zoom training for three hours for around three hundred dollars so the training that's already out there is. It's it's pretty simple. Okay do we have someone DHS that could talk about the cost. The answer yes you would come to the table thank you for your comments thank you. Yes can you answer my question Sir good afternoon I'm Mr Martin I'm the Director of the Division of Children and Family Services thing at this point we don't have a specific costs we did as looking at this bill closely and do have some concerns why we do recognize that rad is a very rare but serious condition that does face some of our foster children as we looked at this bill and reach out to our expert partners around that and state to just trying to find a training and we struggle to find and evidence based training that would be easily implemented for our staff so I do not have a specific costs but as to the number of staff we have approximately eleven hundred and fifty M. as individuals who work for children and family services who would have to be trained annually and then as far as foster parents not only do we have foster parents but also our providers have foster parents such as TFC providers CDS providers private lessons placement agency and specialized private lessons agencies to the cost would impact us as well as our providers somewhere around three thousand foster parents in this state that would be required to have annual training and three hours specific to rad in addition to the other trainings that they are required so I apologize to the chair I don't have a specific cost yet but we have been reviewing this bill and I'm trying to understand the impact that it will have on the Division but we do have some other concerns around this bill if you'd like to for me to speak on this at a later time. Did you signed up to speak on the bill I did. Okay well we'll let you go ahead and speak on the bill at this point well I can't do that I'm sorry we'll do that later on thank you. The answer other questions. Representative Boyd. Okay. Thank you Mr chair so I just want to clarify you know obviously cost is a concern and the more we understand that that is the more informed decision would make I guess the other question I have is is there anything any reason that we would require state law to do this is this something you could do by I guess my concern is if we say three hours and we figure out that we could really do it into or maybe we need for you know we're we're micromanaging at St loss under this could you give me some feedback on that thank you represent Boyd I don't think that and I did not actually prepared talking points that cost is our main concern because we do train staff and we do train foster parents we do have concern about finding an appropriate evidence based training but we do have a budget for training cost is not my biggest concerns I don't want that to be the take away we do not we are not legislatively mandated for certain type like every single thing that we train foster and adoptive parents and we are more than more than willing to work with representive ease to and make sure that rat is included as a part of the training we do have concerns about it being three hours mandated annually because rat is just one diagnosis and many other diagnosis that our children face and to highlight that diagnosis we feel like people will be happier vigilant and possibly end up over diagnosing rat and missing some of the other things that really are more significant for the children which is complex trauma PTSD and other other trauma related mental health issues. Representative Bentley you're recognized for a question. Thank you not sure if the if this is for representative bees and I but I know this is a serious issue I have had Spokesman payment of a doctor this is a very serious issue I think it's something I'm really proud that brought this legislation forced the thing in the long run we'll save ourselves a lot of headache and heartache and I these kids are just a. This is an extreme problem and I have two members of my family that adopt and both of them have into some kids and they haven't had had training serious training these kids or some serious issues and I think this is a great bill I think which are actually being ahead of the game and doing really prevent or so some heartache in the long run so I guess I'm for it I can't and I just think of give me some reasons why we should do when I know that these kids are a serious issue depends on our I don't want to integrate details but I know some serious details I think this is an excellent bill just because I've been or I have never mind people from the top of both and I do have had kids that had to do with this and this is more problem that we want to be unfortunately in Arkansas so give me some thoughts on why we shouldn't do it I guess mission well again we're not I'm not opposed to the bill we have some concerns about the three hours mandated training specific to rad and what the experts tell us I think we have you might hear from other experts is the online is that this is a rare diagnosis a very serious and I agree with you that our foster parents and our staff the training does need to include reactive attachment disorder as part of that training but it also needs to be presented and that way and hear all the different things that our children face complex trauma which you know all Children who enter enter foster here they not only have the trauma of what happened before they enter foster care but then the trauma of foster care and so we just think that there should be a at when we've been working on this at the division I revamping our training with our foster parents and with our staff to be more trauma focus to include other diagnoses and not have three hours mandated annually on specific to rad we would hope that the representative would work with us and make sure that rat is in our training but for foster and adoptive parents as well as our staff but not the three hours mandated annually. Thank you. Representative Gonzalez you're recognized for a question. I thank Mr you mentioned a couple times that I think once he said this is a very rare condition will and seven it's rare another time so can you tell me how many what percentage of kids in the foster care system have this at any given time however he said right so we we do not have a and a data backed based system that tracks exactly how many of our kids sorry how many of our kids actually have rad in working with the experts across I'm not a clinician I will fully admit that and in talking with the clinicians that we work with commonly we have been told that it is frequently misdiagnosed and so our kids are diagnosed with rad and many times it is comma or another diagnosis but yes I fully admit that we have kids in foster care that have rad but it is still rare and it is one of many disorders that are kids face when it comes to mental health issues. So you don't have any idea what percentage that might be just no I would be guessing and I don't even yes okay thank you. When you're recognized for a question. Thank you Mr chair I'm of actually to change my question sense you've given a couple of answers but is it it sounds like the follow up a little bit on what representative board was saying is that does is legislation needed or is this something that can be incorporated within your current training that you do with each new foster family and then also of I'm just curious this would be for all current fall so would be kind of grandfathered in not just the new families but everybody would have to go through this is that your understanding of this bill the Bill Murray not only requires her new foster families it requires for on going foster families in any events that states that if a foster parent was out of compliance that they could not take it they could not take placement of a child until they were compliant so if they were two days over their annual compliance for their three hours mandatory we would not be able to place a child in their home until they got that three hours and read training which is concerning to us by a specially when we need foster parents we would we would want some flexibility to say Hey you're behind but let me take this child and let's work with you to get the training but this this law if our this bill if passed would not give us the flexibility to do that and to the first part of your question absolutely we would work with vestments Walker and represent Eads to make sure that ride was incorporated both in New training as well as our staff training which we have offered and there are numerous things in our training materials that we train because it's best practice and we want our foster parents and staff in a that is not legislatively mandated thank you. Representing Pilkington you're recognized thank you Mr chairman how many hours of current training to your employees have to do. So I'm gonna have to ask my assistant director of of training come up I I did bring the hours for foster parents so for foster parents is thirty hours ongoing and then fifteen hours of continuing and and then Kristen Harper is my assistant director he's over training and she can give you the specific hours or. Yes which one order. For the. The Bill. We ask for a specific questions but. Well then we have specific questions of your you are on the list to speak on the bill so I'll recognized representative Payton is concerned here if you want to go back in representative eaves did you have other comments before we had people to speak for or against the bill. I'll close okay. All right. All right so we're gonna go back to the list and Members we have done I get my questions answered no you don't not yet you will later on. We're out of order here we have five people's signed up to speak for the bill three against into on the bill so. A representative Pilkington she will come back to the table in the order that we have. So now I want to ask one of the people that is signed up to speak against the bill. And that is the Ron brown. There is. I've got a deer run in a Derry could you both. Okay. Okay if you if you would introduce yourself. Yes taking time to hear from me my name is Dr Derek brown I'm the executive director for Arkansas Baptist children's homes and family ministries we are a private license placement provider and a specialized placement provider for foster care for DCFS I'm also a clinician as a licensed professional counselor and instructor graduate counseling for several years through various universities I am very adamant for training our foster families but I am against this bill and I would like to tell you why I'm against the bill in its for diagnostic reasons I'm against this bill I believe everything that's been said in terms of our our families need support our kids need proper training and and counseling that meets our needs I agree with all of those things but the diagnosis of rad most of the time in Arkansas is actually a misdiagnosis I can explain why that's the case if you guys give me a minute so attachment occurs on a continuum the concept of attachment theory was developed by John Bowlby in the nineteen fifties it's been added to sense but is this idea that kids who grow up in a typical environment will develop a secure attachment. But then that continued on roles from there in that kids to I have what's called an attachment injury which may be something based on you know parent drug use or it could be something as simple as parent hospitalization something that calls pro long distance or maybe intense conflict between a parent a child creates what's considered in secure attachment. A very severe form of insecure tax means actually considered disorganized attachment all of those things occur before we get to a diagnosis of reactive attachment disorder and so what happens often in Arkansas because of the language reactive attachment disorder is more common people see attachment injuries or they see disorganized attachment or they see anxious or avoidant insecure attachment and they think reactive attachment disorder the the description the descriptions of those in securitized mints even disorganized attachment which is a severe thing but it it falls better under posttraumatic stress disorder. And so the problem if we pass this bill is that we're actually perpetuating a misdiagnosis and and I would argue that by perpetuating that misdiagnosis were not getting kids the help that they actually do need and we're adding a burden to by the way foster parents or volunteers are not professionals these guys are people have careers just like you and me and if we if we are in Arkansas and we're not foster parents we have a job to support me quit foster parents that's all of our jobs and if we passes bill to actually add a burden to the volunteers who by the way a year ago we were asking questions are they going to quit. The people who now are counting on their the foster kids going to school being able to go to their jobs. They now their situation changes significant enough that we have to ask or these volunteers going to stop doing what they do and if they did what in the world what our state do. That problem hasn't change we have to make sure that we are considering the people who are volunteers and and what more inspirational group through this last year then the foster parents who didn't quit. Let's support and encourage them let's make sure they have the training that they need but this isn't it and so let me go back to just the content of attachment I'll wrap up with this and so it at the very bottom of that continuum is a kid who is considered detached. That kid actually qualifies for the diagnosis of reactive attachment disorder if you study the disorder the kids who are considered detached are the kids who grow up without physical contact in orphanages that don't exist in Arkansas. There is a diagnosis of red in Arkansas I'm not denying its existence but most of the time it's existence is when a parent is severely severely mentally ill and lacks the capacity for any emotional connection with the child and pro longed environmental distress in that way will produce rad but here's the kicker in this is another reason why I'm against this bill the treatment for rad is no different than the treatment for PTSD this is why you don't see any evidence based programs and clearing houses for reactive attachment disorder because reactive attachment disorder is a form of severe trauma it's a form of complex trauma all of our clinicians are trained to deal with complex trauma the treatment is no different they need emotionally available care givers they need emotion regulation skills and they need a felt safe safety in their environment. We can produce those things with the training that were already doing and we can produce those things by focusing our efforts on supporting the volunteers who are doing this day in and day out and so if you pass any legislation make lighten the burden ease a burden on the volunteers who are doing this during the most stressful time in all of our histories don't add to the burden please thank you. Any questions. Seeing thank you for your comment thank you okay to speak for for the bill. Dore Jean the call for and I probably miss that name up but you would please introduce yourself and who you represent. You actually did pretty well thank you you're recognized my name's Georgian Bakkavor I became a foster parent in two thousand eleven adopted about seven years ago five children and I'm representing myself because I'm on the front lines every day with kids the mother of eight wonderful children all of them suffer some level of trauma. Some of them I gave birth to some of them I've had since they were infants some of them I got when they were little kids or preschoolers. But. All of them suffered trauma some of them suffer trauma because of things that they're care givers did or did not do when they were young and some of them suffer trauma because of the children that I brought into our home and the things that went on in our home because the kids have trauma. To my children suffer symptoms of reactive attachment disorder. The difference between the children who suffer trauma and those with rad is profound. Burst of anger anxiety and extreme emotion are common around home we run a fairly tight schedule we discussed changes in advance if we're gonna go to a restaurant we make sure that we look at the menu before hand and talk about what we're gonna order because you want to take a kids to a restaurant and have no idea what you're going to order that's a lot of change in a lot of chaos and they will have meltdowns where they're skewed plan everything before hand and make sure that expectations are clear and we reinforce these things on a regular basis so that our kids have an atmosphere of love and safety and they feel like they have some control. The extensive training that I received before becoming a foster parent and continually throughout being a foster parents and adoptive parents is why I know what to do with trauma they taught me what to do with trauma it's why I know and can deal with the kids that I have that have autism that have ADHD that have trauma disorders But unfortunately for the child suffering with rad these things often that the very things that I do to make my kids feel safe or the things that make those children push me away. their outburst unforeseen often violent remorseless an unexplainable. When asked what caused an outburst when I asked one of my kids what I often hear is I don't know I don't know why I did that and I believe them they don't know they didn't plan it beforehand they didn't think about the consequences beforehand they have no idea why they did that. They're always sorry that you're upset they're always sorry that they're in trouble but they are not sorry for the effect of what happened to the other people they just don't want to be mad at them. But. Okay so my brothers pleading because I had him over the head with that board. I don't really care that is bleeding I just care that I'm gonna be in trouble. That's the difference between my kids that are suffering with rad issues and my kids that have just normal trauma it's a huge difference All of my children now sleep with their doors locked to protect them when they can't be on the lookout they look for outbursts they look for signals they look for what is going to cause one or two of them to be violence. But will sleep with the door locked because you can't be on the lookout all the time and you don't know what's going to happen in the middle of the night. Most of my kids around at my house damaged. And we knew that we expected that we I also came into adoption believing that although the state had really good intentions that it's a big problem and they can't be in my home every day and they can't follow through every day I have to know how to handle my kids and their issues. I'm. We were told that there will be issues that would arise and that if it ever became a problem that we couldn't handle it that you can terminate your adoption and they specifically said was please don't re home your children I said re home our children what does that even mean because I wasn't aware of the fact that when a child becomes extraordinarily difficult they begin looking on the internet for a place to put them because there's there's no place there's no treatment there's no help and so they train re home them and they often end up in sex traffickers home so what they told us was don't do that please please bring them back to us and we can terminate the adoption. That's not something I ever want to do I love my kids I love my kids broken I love my kids whole I don't want my kids to go somewhere but if we had known beforehand that they had some of these issues it's not that we wouldn't adopted. It's that we would have been able to be better prepared just like we were prepared for trauma and if there's more done to teach people about it then there's more treatments available and we know where to go and right now. Every day I wonder what my family still be intact. I believe is one of my kids in prison some day. I don't know where we'd go into the future is scary. My two kids that have problems are thirteen and nine with the thirteen year old didn't have problems until puberty. I thought that her behavior was odd. But it became violent when she hit puberty and I'm terrified. What my nine year old will do hit thirteen homes before it came to me at three years old thirteen homes in a year and a half not because DHS what any moved almost everyone of them was parents asking him to be moved because he was so very damaged I still would have taken it I love him to speak with. But we need help. And I don't know what happens if we don't get it. Thank you. Thank you for your comments any questions. Thank you. Okay to speak against the bill Cindy Coleman. Please include your seven who represent. My name is Cindy Coleman and I represent Methodist family health or nonprofit organization in state of Arkansas that provides behavioral health services to children we also work with DCFS we have group homes where we place of foster children in care for them long term as well as residential treatment centers and hospitals some. I'm here you know to speak the bill as it's written we're opposed to I think specifically with regards to the continuing education requirements for psychologist in license psychological examiners One the the continuing education many of those professionals do not specialize or treat this population so you would be requiring those professionals to receive training in an area that they are not specialized when it comes to diagnosis and treatment of reactive attachment trauma it is a specialized training that is a lot more than three hours in terms of commitment and so clinicians that are trained or not You know are gonna have extensive training and certification in any of those modalities I am a licensed clinical social worker the outpatient ministration with Methodist family health so I don't currently treat. And children any longer but I I did so that's that's our primary concern with the bill I I absolutely we support any additional training this is a serious issue and additional training can absolutely benefit foster parents and DCFS case workers which we work with cigna you know consistently but it is I think the training curriculums that are in place or where those changes can be made probably to improve. The training in this area so that's really all the comments that I had any questions. Thank you for your comments. Okay to speak for the bill. Kristi Austin. Please introduce yourself and who you represent. My name is Christy Austin and I'm representing myself as an adoptive parent. my husband and I adopted a son back in two thousand ten he was nine years old at the time. At eight he received a diagnosis from UAMS of reactive attachment disorder I can tell you between the ages of four and nine when we adopted him he was inpatient and residential treatment facilities including the ones that are mentioned here today more than twenty times. Between the ages of four and nine. I won't go into everything that we have dealt with as an adoptive parent but I will tell you how many times we've had probably ten therapists in the time including the residential placements we've had as it with him as our son. And I will tell you how many times countless times we have heard I really thought he was making progress I mean I flat out told one therapist he's playing you he's been in therapy since he was four he knows all the answers to give you he's very charming he's not the route that you see on TV where they murder animals and set houses on fire although he has heard our animals and set the house on fire with his biological mother. he's very charming very engaging very sneaky very manipulative and he's twenty years old now. And my husband and I have lived under incredible stress because of the therapist that did not believe what we told them about his condition. Including the ones in residential treatment. My husband attempted suicide in January of last year in large part due to the stress of living with him. We're not asking for a whole lot we're asking for therapists who believe us. We're asking for support the most support I have ever felt was in a group of parents who raise these kids at a camp we paid for out of our own pocket. Or with the therapist in Tennessee that we paid for out of our own pocket and the generosity of our church. We are asking for education. That's what we're asking for because I am a of family support partner through DCFS. Trained to work with the of. An office in Searcy who does mental health care I see these parents I see parents with kids who have attachment issues and their grounding they're exhausted they're just like we were. And I'd love to tell you that our son has been a success case but it's not true we are still he's twenty years old he's still in our home he still has an alarm on his store because we don't feel safe going to bed at night knowing that he's up under and we don't know what he's doing. It's a heavy heavy burden and when you go for help and no one believes what you're telling them. Because they're not educated. It leaves you feeling very lonely and very helpless. I understand that there may be problems with the bill I understand that there are a lot of things to work out but this is a very important incident my son is going to end up in jail or he's going to have told his therapist he's gonna end up turning tricks on on the side of the road because sexual issues a part of his issues and he has no remorse. No conscience he sees no problem with that at all. So I would just ask you to consider this very seriously please for the families that are raising children who have attachment issues and the worst part of it being rad. I appreciate it thank you any questions. Thank you for your comments. A. We don't have anyone else signed up to speak against the bill. we do have two more people to speak for the bill and then I think three people to speak on the bill so Brenda Shaffer. You would introduce yourself and who you represent. my name is Brenda Scheffler IT was asked to come here by Christine Walker to talk about reactive attachment disorder I am a licensed clinical social worker I have worked with Probably hundreds over the years of hundreds of children and families that have dealt with attachment issues primarily teenagers primarily in a residential treatment center so I've seen many many kids with this attachment trauma I was also a therapeutic foster parent for seven years I adopted two boys one with significant attachment issues it was a long time ago by and this is now thirty one but so I've seen from the professional side in the personal side just to let you know and I was asked to talk about that because of what I've experienced primarily as a therapist working with teenagers and what I've seen is maybe a little bit different than what some other people of St rather than I've seen it being over diagnosed I've seen it be on recognized under diagnosed and not adequately treated until kids are like teenagers and that is tragic because of it have been recognized and treated at a younger age the prognosis is so much better than waiting until they're teenagers to try to address attachment issues the other problem with that is for years families have gone through tremendous stress when is not adequately diagnosed and treated just like some of the parents have spoken because they don't feel like they're listened to or supported or heard or getting what they need in terms of taking care of their children so the families have gone through years of trauma themselves at the hands of their children often times by the time they're adolescents parents are burnt out they're hopeless helpless feeling adequate and so I'm in strong support of better education and training so that people can understand this so that can people can get their needs met more appropriately I don't agree that the treatment for a touch. Issues is the same as PTSD attachment trauma is different than complex trauma and PTSD in that old kids that have attachment trauma DO have complex trauma but this trauma occurs at a very early age in life this trauma occurs between the time of conception to around age three well if you can imagine from occurring at that age you don't have the verbal skills you don't have the clogged to memory to go back and address that so it's a much different way of looking at attachment trauma than it is maybe some other traumas and so the focus is more on of treatment that addresses the core issues prior to language prior to cognitive memory and in the parent child relationship. So. I don't know if anybody has any questions but I'm just want to say that of the parents that have worked with almost every child I've worked with has been adopted most of them to the DHS system not all of them some or private jet options summer foreign adoptions many of those parents didn't have a good understanding of attachment issues by the time their kids with teenagers some of the parents had a very good understanding and good training but sadly to say most of those got that good education and training when they were living out of the state of Arkansas. Representative Ferguson you're recognized for a question I guess I guess after hearing several people testified the only health care people that I see in the bill or psychologist and I don't see social workers or counselors in the bill at all so I mean I. I'm just here to talk about attachments not necessarily the bill itself because I'm honestly probably would have done that differently yeah and I guess just listen the presentation it seems like maybe the wrong people are included in the bill but thank you. Thank you for your comments right. Some I have a question. Okay thank you okay. Mike Rohde. Please introduce yourself and who you represent. Good afternoon everyone I'm Mike Rohde I represent myself. in early twenty seventeen my wife and I adopted a fourteen year old boy who had been in the states care for many years. We were given a notebook filled with information about his past but there were prolonged gaps we were told that he had problems and that it could be difficult but we expected that given the circumstances we were not informed of any specific diagnoses or known disabilities we were told that he struggled at school but that he'd been doing better recently. My wife and I've felt called by god to adopt the specific child based on a series of events in our lives when we completed the required training through the call. Early in the six month pre adoption trial period we discovered that he was illiterate he could not read or write even though he had recently completed the seventh grade we enrolled him at access academy to providing the best opportunity to improve his learning deficiencies his maturity level was roughly one half his age or less which we learned was not uncommon with children who experienced severe trauma early in their lives. Our relentless attempts to make him feel loved safe secure cared for and appreciated by us and our extended family were met with rejection throughout our entire experience this rejection manifested itself through disrespect disobedience deceit disdain and or anger. He saw any authority figure as the enemy even when this person had his best interests at heart and was coming to him. Whenever it appeared that we were making progress it turned out to be an illusion his reactions to our attempts to guide him were quite common with attachment disorders as we would soon learn. In twenty eighteen out of sheer desperation my wife and I enrolled in a class offered by our church entitled empowered to connect which was based largely on the work done by the late Dr Karyn Purvis and her colleagues at TCU. During this class almost two years into our adoption journey we learned for the first time about attachment disorders and the devastating impact they have on a child from a hard place. Through our studies we began to connect the dots and better understand our son's behaviors as stemming from an attachment disorder. Understanding attachment disorders and the related behavior help this process our experiences however our son's behavior did not improve despite our efforts to more effectively deal with the challenge and the efforts of his therapist to help in process and he'll. His destructive behaviors were too deeply rooted after so many years of hurt. So after roughly four years of pouring our hearts and souls into this young man and seeing virtually no measurably sustain behavioral progress we along with this therapist reach the difficult conclusion they would likely be best for all concerned if he were reunited with his extended family. When the notes to him many of his extended family members had been searching for him for several years we hope that by re attaching with relatives he might be in a better position to heal the wounds of his early childhood and begin moving forward so on a bright Sunday afternoon he was reunited with several aunts uncles and cousins in a joyful hopeful heartfelt reunion. However the joy and hope we're far too short lived roughly one month later he was looking for a new home having lost his chance to living here with an aunt and uncle due to his destructive behavior and his lack of respect for them he has since continued to bounce between family members and other acquaintances. My wife and I fought hard for a different result. We did not step into this journey lightly or give up because it was hard we put our lives in our own interest to the side to answer recalling we persevered and kept searching for opportunities that would help him heal and move forward. Through it all he never respected us you never like this you never appreciated us. For the opportunities that we gave them and perhaps most importantly he never trusted us as a result we have virtually no chance to helping heal. Despite everyone's best intentions and our tireless efforts we all collectively failed to reach and really help this young boy who is now a young man we cannot know how different things might have been had we and others over the years better understood the difficulties and challenges brought upon by attachment disorders. Each one of us undoubtedly would have been better equipped to providing that help you so desperately needed and still needs to this day. At nineteen years of age with no high school diploma and lacking many of life's basic skills this unfortunate young man remains in a hard place he trusts no one and he respects no one. These kids in our society need and deserve better outcomes we should all strive to do better. The work and sacrifice by each person who chooses to be in this field is to be admired and greatly appreciated. Everyone believes they can make a difference and they can. The battles in this field are incredibly difficult to fight. We should do everything we can to provide the proper tools to those who need them so that they are better equipped to help these children heal and thrive. Thank you for your time today. Thank you for your comments. A committee we only have we have three other people signed up to speak on the bill. So. I would ask. President Wardlaw you're recognized I make a motion to call the question. I have a motion call the question not debatable. All in favor signify by saying aye All opposed nay. Motion carries. What you what your motion I make a motion do pass I have a motion do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Finos haven't. Representative bills failed. Okay next item on the agenda is HB fifteen fifty three representative Brian. Z. in the room. Thank you. Over in judiciary I believe. Okay representive Penzo H. B. seventeen fifty seven are you ready presenter bill. Okay. I have a sure. Mr may I have us recent. Dean join me at the table yes thank you as members there's a handout coming around to. If you would please introduce yourself and who you represent. Thank you Mr chair injuries dean with family council. You're recognized thank you Mr. House bill seventeen fifty seven requires any health care professional who has a scope of practice to prescribe oral contraceptives to verbally explain any possible health complications or adverse reactions as printed by the USDA and have a patient sign an informed consent. informed consent form. This is the same language that was in The pharmacy of. bill. The the you want to present something. Yes. Okay. As representative Penzo said this is the act to require certain informed consent when prescribing or administering oral contraceptives this has very similar Langer language to the the bill that representative Pilkington actually had passed earlier this year and what it does is it requires the physicians or other health care professionals who have scope of practice to prescribe oral contraceptives to explain to the patients the possible effects including the death of an unborn child and the possible health complications or adverse reactions that are printed in the US FDA insert the FDA insert has multiple sections and pages outlining the warnings precautions contra indications adverse reactions side effects and drug interactions of the mechanism of action for for for oral contraceptives is to lower the risk of becoming pregnant Powermat primarily by suppressing ovulation number to changing the cervical mucus making it thicker ten had inhibit sperm penetration and lastly changing the lining of the uterus that reduces the likelihood of plant in plantation this last action is what can cause the death of an unborn child. Women who believe life begins at conception should be informed of this action. Of oral contraceptives so that they can make the best informed decision. On whether to use this form of birth control or reconsider their options by having this conversation with their position they can discuss other options during the time of the appointment. just a few things to to say one thing and it it has the same languages ACT ACT four zero eight Currently. The product label the FDA insert. that has all of the information the adverse indications and all of that after speaking with. A few of the pharmacist I was informed that they are no longer included in the patient's package the when the patient gets their oral contraceptives because they come in a multipack. There's only a few in the multipack which are not enough for each patient to get their insert so what is done now is that a portion of the answer is printed and added on and stapled on to the prescription not every patient is given the sponsor. Some of the warnings that the FDA label has that when we ought to be kept or made and aware of our of strokes cardiovascular events blood clots liver disease a regular you're in legal headaches and the list goes on their eve even been lawsuits that have been brought over the deaths that are associated with oral contraceptives and most of them had to do with blood clots and with that. I conclude my presentation but if you have any questions. Hello this representative Alan you're recognized for a question. Thank thank you Mr chairman it's my understanding that I used to work in pharmaceutical sales I worked for Abbott laboratories for three years and My daughter currently works as a pharmaceutical sales and I know that each time a doctor writes a prescription or you get a prescription from the pharmacy they tell you the country the cases side effects and all of that is that not correct. That is not my understanding okay so have you ever been to the pharmacy and got a prescription. And they did not ask to be that explain to you the side effects yes on several occasions because they asked do you want to consultation. But they also follow up don't they also include in your medication built tax it to and I know I went to the I'm I'm I take the pharmacy all the time because of all alarm medication in their taxes to give education if you don't want it they still taxes and bill while you an opportunity to take it home and read it yourself if you if you refuse a consultation so my point is is there a need for this bill and I appreciate what what you doing represent Penzo but my question and I'm your heart is in the right place we'll I mean I don't know how the question can't go to both of us but do it often and I don't know if you if you can answer well I mean I I've had the same experience at pharmacies before were there like you're familiar with this drug or do you need us to consult you mean that's generally thing in yes there now they do have a a previous version on it some pharmacies have a Q. R. codes so you can go home and maybe get your phone pop it out but a I remember back in the day used to have these things igen folded NO oh yeah looks like Annapolis you know in in in its in mouse print you look at it and it's got all this chemistry you know all these big hurdles to all all my my whole goal with this is just to make. Provide the opportunity for women to be better informed on what the drug does I mean I'm not I'm not trying to inhibit of prevent you know access to birth control I want the woman to choose which birth control is best for her not because because I've talked to women before that said if I had any idea that the the third phase of birth control was to prevent a fertilized egg which I believe is a living organism from implanting. And to be just released To me I mean this is for a woman not to know that and have been on birth control for years that is that is horrible to think that they may have had you know because the book birth of an unborn child without having any knowledge of it I just want to I just want to know that okay well I appreciate what you're doing but but I think what with siris wells. Was doing a may not try which to me meant was trying to do it but she was paying the doom and gloom pitcher. And that's not all that's not always. The case when when you get a prescription because when we she said of pharmacy the doctor don't explain to you what the drug deals and and that's not correct but by the I've I appreciate to the your clarification I really thank you so much thank you. Share a written report do you have an answer because that may I respond to that yes ma'am okay as I stated in my as I was speaking before. I said they do not receive that what he describes as the fold out paper anymore they receive a refund abbreviated faction of that full that paper that's what I said. And that's the truth. So I with that painting of doom and gloom picture of anything I was just explaining what the situation is today let me respond Rivera representative Allen we get other people in here that we responded and if you don't know that I did not say that I see it it appear it. So that's the difference okay representative Gonzalez you're recognized for a question. Thank you Mr I hear you describe the building what you you think it does but what I read the bill I don't think it does that if you could help me understand because it says one initiating therapy and administering or dispensing so to me it this is it doesn't it doesn't cover to somebody's just. Prescribing the medication they have to be initiating. And administering or dispensing oral contraceptive before mission lies amid an initiating therapy what would when do you think that might begin it but it says and administering or dispensing. So if they're not the ones administering or dispensing than this none of this is going to apply to them. You. The second part would apply the. Jett follow up questions Senator Gonzalez. If. Resented Payton you have a question. Thank you Mr and Misting was when you were talking about side effects and things like that sounded like you were saying that. If you wanted to you could use contraceptives to have a chemical abortion is that the case. No that's not what I'm saying okay so an overdose wouldn't be. Causing that I don't have that type of I'm not a I'm not a doctor I don't know okay if the. Well thank you. President Ferguson you're recognized. Yep list this was to say what this really is the anti contraceptive Bill but I just but the FDA he said including the death of an unborn child that's not in the FDA The that's not in the that's not a part of what the FDA puts that in there of. Concerns of oral contraceptives and that's a very radical view I mean you may think that but most people would think preventing ovulation and preventing implantation or not the death of an unborn child but that's not part of the FDA guidelines I don't I don't believe it's a radical interpretation of what what it does when it says the mechanism of action the the. It can cause intermedio changes that reduce the likelihood of implantation so if it's reducing the likelihood of implantation of a fertilized. IG. Senate you have an embryo that's been prevented from implanting I don't I don't think that's a radical interpretation of of preventing. Live from that place she implied that was part of the FDA of mornings and it's not that's not part of what the FDA puts out so the FDA the the the sheet that's in the prescription who would that come from. What a concern the FDA but it doesn't. Ism of action provided by the FDA states that I don't I don't think that's a stretch. Well it doesn't include that warning and I think most people consider determination pregnancy when it's after implantation but. That it's possible your definition. Sun I'm sorry may I respond to Monday one I never said that I never said terminates pregnancy there's a reason why we didn't use that language because pregnancy is after implantation. Because of the death of an unborn child. According to. Several places in the Arkansas code. And I just name a few. While the Arkansas Code does not and discussing the bill or while the Arkansas Code does not have a definition section that applies to the entire Arkansas code there are several sections within the Arkansas Code they have a similar statement that life begins at conception fertilization. The pain capable unborn child protection act. Fertilization means the fusion of humans for some spermatozoon with the human over. at amendment sixty eight to protect the life of every unborn child from conception until birth to the extent permitted by the federal constitution Arkansas human life protection act five dash sixty one dash three oh one contain simple language to your below statement. Fetal death live birth in the vital statistics area. Under the criminal law definitions five dash one dash one oh two five dash two six one five an unborn child is considered a person and as defined as the offspring of human beings from conception until birth that in the Arkansas code and that's just a few places my point was it is not in the FDA warnings. Representive Eubanks you're recognized. Mr chairman I move into debate. The motion I have a motion to end debate. Non debatable. The motion is to end debate which requires two thirds majority. Is non debatable on obviously All in favor of ending debate signify by saying aye. All opposed nay. By seven debaters in the. Representative you're ready to close for your bill. Sure sure I would like to say this is not in an. Attempt to limit access to birth control as a someone mentioned this is to empower women to make the right decisions to give them the information that they need to make the decisions that might impact their moral ethical religious beliefs just informed consent not trying to limit access just what women to make the right choices and be aware of consequences of what they're doing. and with that I'll be closed for the bill and ask for a good vote. The motion. make a motion to pass. I have a motion do pass in discussion on the motion. Representative glad you're recognized. Thank you Mr thank thank you the representative Penzo one sorry I didn't get your name thank you you said in your last testimony that lap again to the implementation and then yes you did and then you get a lot of so I think you just misspoke but I just wanted to clarify that it at conception that's what I meant Ladyman yes in order for ordered we're in discussion on the motion may okay fair. Yes all data okay the FDA insert has multiple sections and pages outlining the warnings precautions X. cetera. The FDA has multiple pages on every drug and not a pharmacologist and and I'm not to have one of these the pharmacist here but if. They have to. Go through every FDA contra indication. On medications is going to take an awful long time the Bill says possible side effects. Possible side effects as far reaching and I think that you if you don't give the woman really the knowledge. Of. You know the mechanism of oral contraceptives is to prevent ovulation. Third point there are different types of oral contraceptives you mention the uterine lining and all that and and that's for many pills and progestogen only pills that's a whole different conversation so the this bill is so wide when it just says oral contraceptives. so let's some of my thoughts thank you. Any other discussion. Representative Bentley you're recognized represent Penzo I appreciate I did reach out to my local pharmacist where we're here on me before I thank you for talking about it but all of them are handing out everyone they make sure everyone of their clients are given the information that we've asked him to give so and the and the FDA handout so I feel like my pharmacists are following through and the doctors are so I appreciate. the heart of this but I think what we are competition and women are given the right fax anyway they are in my district a major before so I will be voting no on this. The representative Boyd you're recognized. Thank you Mr chair and I I just want a second that I mean I don't know if either you've ever been to calm a pharmacy of alma but I'm a little Disappointed that you would assume that that pharmacy doesn't hand the FDA required product information to the patients and further more. This issue about there's not enough is just not a true statement in my opinion thank. Any further discussion. Seeing none representative welcome when we're doing a pharmacist a lot. This was already in the pharmacy bill this is this is about physician that I think the people against confused and I just wanna make that clarification for the committee. Language like this is it was already past and this licenses were physicians this this doesn't have to deal pharmacist. Masih discussion. Yes you're on the committee that The same language. Specific to pharmacist was voted on by this body eighty eight vote. So I just want you all think about that when you vote on this is amended same thing this just addresses it here we are. Passing the Buck bend of the pharmacist to have this discussion with the patient once the doctors already prescribe it. And didn't have the discussion that the pharmacist now has to have and now the the patients going to be like why did my doctor tell me this. So I mean if the pharmacists want that responsibility to have drug that they've got a later explained that it does something the patient may not want I think I think it probably needs to start back at the beginning when the patient is prescribed the medication. Thank you representative gray you're recognized. No thank you I'm just I'm getting I thank more upset by the minute I'll start out by saying family councils upset with me right now and so what I'm about to say that this has nothing to do with. The other issues that we have going on but I feel like this I have voted on every single and I'm gonna get upset every single pro life bill this session and this is another pro life bill in my opinion where you are trying to block access to birth control. That stops. You would enter upon discussion. I'm going to be next okay thank you. And I feel like this is misleading I don't think it's you represented Penzo at all with me okay we'll get there but I would like to say that every birth control packet that I've gone for the last ten years has both the abbreviated and the full insert the comes with all the warnings and it. And so to say that that's not being handed out as an over generality is wrong and. And I'm just I'm very frustrated with this I'm probably over the top on it but I will definitely be voting no thank you. President Penzo you're recognized I do I want to explain the committee this is not the family council and I was hesitant to even I was trying to decide whether I wanted trees come up with this is something that I a approach them with way earlier in the session that's kinda how I believe the language ended up in Pilkington's Bill so if this is directed towards a family council this this is this has nothing to do with trying to block access to. Two. Sir has distracted by a conversation. If if. I just don't want anybody think that the family council brought this forward this something I brought to the family council told them that I wanted to do and they helped me you know connect a few dots so um. You know if just I just don't want to be directed at them because this they had nothing to do with that I approach them with something that I feel passionate about so thank you for let me make a comment on that. Any other discussion. Yeah just one quick thing so those brought to my attention so does look at the bill I was look at the policy brief but there does seem to be some Maroney's information on this policy brief those brought to my attention about About what foresters either multi packs and so I just wanted that to be clear that I I think there's some inconsistencies here so just to the point clarification for everybody. Any other discussion. President Payton. I hate it that your bill is wrapped up in the road this information that family councils started but now this will be the first pro life vote up missed for family council. But. It's all in interpretation thank you. But may have may I the request that a this bill this bill down yes you may thank you thank you. Representative Alan. Representative Alan. Are you ready to rep to. Without objection. I'm allow representative Alan to run H. B. fifteen twenty. Passover seventeen sixty four because he has some work on that it run the H. B. fifteen twenty which is on the agenda further down. No objection represent round you're recognized to present HB fifteen twenty. Thank you Mr chairman and members I ran a speed fifteen twenty last week and one of the concerns what I have for my colleagues that wanted me to make an amendment to the bill and at the we're qualifications I did what they asked me to do so I ask for a favor vote on this bill. Yeah. So you thanks for your presentation. Yes any questions from committee. Seeing anyone here to speak against the bill. For the bill. Seeing none even close for you will close get a motion motion do pass as amended. Any discussion on the motion represent Dotson rent you're recognized. Thank you Mr chair I think the amendments been engrossed in the bill so it it it doesn't have to be as amended okay thing but I want to say thank you representative Allen for working with us to get this language in there and I think it's good bill thank you. All right any discussion on the motion. Motion on the floor to pass all favor signify by saying aye. All opposed nay. Yes Is have it congratulations your bill is passed. President Penzo your back up H. B. seventeen thirty five. H. B. seventeen thirty five Committee. thank you Mr if I could have a guest come down or Maria right yes thank you. I'm going to get started I think she's in the room and okay I just ever join me when she gets here. Hello this is. Please if you would introduce yourself and who you represent. A good afternoon my name is media right I am the founder executive director for Arkansas United. You're recognized to present the bill okay House Bill. Seventeen thirty five seventy thirty five yep get my paperwork mixed up here else bill seventeen thirty five requires occupational professional licensing entities under title seventeen to grant licenses to individuals who fill all requirements to practice in Arkansas and hold a federal form seven six six work permit some of the. Careers that are under title seventeen are in the healthcare field construction real estate industry and I'll go ahead and let you say a few words no thank you so much of representative Penzo of Mister chair madam vice chair and us to members of the public health committee as I said my name is made a have my non nonprofit operates immigrant resource centers across Arkansas and now we're we're going into our tenth year serving the state of Arkansas we are an organization that brought to the attention of the state legislature back in two thousand nineteen as challenges for our deferred action for childhood arrivals or daca students as regards to licensure here in the states as well as educational opportunities and you all of responded and we thank you for responding in two thousand nineteen with giving us I'd data nurses as well as the opportunity for an in state tuition equity bill that has helped thousands in our state and I could not be more excited to share that the doctors nurses that you all supported became our front line nurses during the COVID crisis and we're able to help especially as you all are aware of the search that we experience in the summer and so many of our immigrants were directly impacted and our nurses were able to support our community and helped turn around those statistics that in turn help the help of everyone it in turn you all have supported us said this session with data teachers and enabling of those same documented individuals to have the opportunity teaching profession and we're excited to share if if you all I did not have a chance to file the Senate this week update Platt past that as well that the teachers and now we're just awaiting the signature of our steam govern. to turn that into law so a couple months ago as we started out of the conversation this session of members of our youth committee have the opportunity to meet with a state representative Penzo as you all know he has been a leader for our immigrant community and spring Dale and especially the Marshallese and as you know I had filed a bills both last session in that session with opportunities at that would also look at licensure for the Marshallese us so at that time we approached at a state representative Penzo about the possibility of also making of the same corrections out for our documented and other students and individuals who are and work permits and that we are very excited today that H. B. at seventeen thirty five is the fruition of those conversations in the leadership of representative Penzo I'd to give us this opportunity and so we respectfully I Mister chair don't want to assume your responsibility in anyways but let you know which individuals we have speak for the bill today and who registered online and if we could respectfully us addressed out Mister chair an order in which they speak because I think it helps lay out the story that they're here to tell about other Professional licensure areas and how are our documented I hope and aspire to be able to go to work and get licenses in those areas so the first person that we like to respectfully suggest to speak I would be I Jake Walker who is from and you CA and the Arkansas research center he has data specifically on the needs in various licensure areas the shortages just like we experience with nurses and teachers and how they would support and economic impact the positive economic impact that you all could expect from H. B. seventeen thirty five if you give us a positive vote today and then following him we have three individuals who would be directly impacted by this bill hi dear Lou nine who aspires to be a civil engineer Louise at they have the ward who inspires to be a home inspector and Jose by my as buyers to be an anesthesiologist all of them are from little rock and all of them I have data and then and it respectfully out because we know that you all have a long day ahead of you already had a long day and and while I do want to get out here to descend time we did have Carla Palma signed up she was a beneficiary of doctors nurses and can speak to the success of that bill if there's questions but if you all don't have questions then we would have that rather us prioritize you all's time with the three individuals that would be directly impacted by the bills today and then I finally want to offer I'm available to any questions up from this at is deemed committee in addition to the roll up and that I I played Arkansas United I I recently I was chair of the state board of education up for which I was able to launch a national ICT E. study that looked at workforce issues and so glad to speak to any of that if there's questions about otherwise I with stats at Mister chair again not that not wanting to take your job from you but I I take what. Walker is prepared to speak next if you agree Mr we have a couple questions yes Sir representive Eubanks you're recognized. Thank you Mr the representative Penzo said this bill would just extend to other doctors individuals at that have met licensure requirements for other occupations professions to receive the same benefits as sex is that correct that is that is correct as long as they meet all the requirements from whatever licensing entities there and they hold the work permit then they would be able to obtain a license I thank you thank you. Representative Gonzalez you're recognized. Thank you Mr even numbered Gonzales I'm still not expert on immigration so. Looking out this form seven six five or seven six six says that they're they're basically identical these look like temporary work permits that do have expiration dates on on so if if these work permits expire does the license expired along with that are or how we how's that gonna work. it is so if it their work permit expires and if the federal government doesn't renew it and they're they're not able to work the licensure doesn't supersede the work permits. But at this time data that there is confirmation the administration amongst its its first efforts the current administration did commit to an extension of the daca program and as you know right now there's actually a bipartisan bill in Congress to turn data into a formal a formal law what happens with that in the time line of that is impossible to stay which is where and in the interim of these you with some of them are experiencing limitations in at even applying to higher education because higher education institutions don't want to accept them if they know they can't get licensed rates out of fairness to them and then obviously they're they're limited in their ability to work immediately. Hello Mister yes you have one follow okay thank you so reading through this again there's also an availability of nonimmigrant work visa that allows you work for specific employer so why would that not be a better path than. The doing what what we're proposing here in this bill. I'm not sure if I understand your question Mister representative. So there is a non immigrant visa that authorizes you to work for specific employer that it lists several different options there of that different type of these of H. one B. L. one B. O. or P. these so there's there's other options out there already but thank you I think I can answer that now that that actually you're speaking to so the bill speaks to anyone with a work permit those are other examples in addition to a data of of work permits that would be available but the employer themselves can't can't confer those those specific again at immigration I would handle those issues so this is just out licensure this isn't the actual immigration process but again of the the governments and and to work if you have a work permit you have to present that to your employer so that they would not be able to get the licensure does not in any way replace the work permits. Representative Payton you're recognized. Thank you Mr neither one All My can answer this but it's my understanding that this is a defined group that was established a few years back and the it's deferred action in order not act deport number we've deferred that but the group is not being added to at this point I mean it would take further action at the federal level to create a second group is that correct. it It anything related to immigration would require action by the federal government so in that sense yes that that's correct I will say that I'd in January they did allow for new applicants to the daca program that had ceased a couple years back and so it was just renewals so now individuals that still meet all the qualifications can apply for the first time to data so in that sense the data pool is growing but but in terms of anything again immigration related this this law does not supersede its they they have to comply and and and meet with all the requirements with the federal government to get paperwork they have to show that paperwork to their employer that's what keeps them active here this is the separate issue of what they can be employed in and then their pathways in that employment and and then that's where the licensure opportunities coming and like we said some higher education institutions actually or even technical schools will limit those pathways to are individuals because they can't end up with a license I will say as well that states surrounding us in Arkansas do do allow the licensure and administer I Walker cool Speaker to second will speak a little bit too how Arkansas's laws differ from other state laws related to licensure and why I'm so this is our hope and aspiration to keep the youth that we trains that grew up here in Arkansas and not having them go to these other states they want to stay here and they wanted to the potential here so for us this is a work force issue and an economic development issue and again does not in any way supersede the immigration process thank you thank you Mr. Okay saying no more questions we do have five people signed up to speak for the bill. So the first person is Jacob Walker. Please introduce yourself and who you represent. Thank you Mr chair in Misco Germany I'm doctor Jekyll Walker with the Arkansas research center at the university of central Arkansas on the project director for education and workforce development. I was recently contacted by Arkansas United help provide some of the data picture for what the current situation with immigration in Arkansas is. particularly you want to things this isn't going to only be impacting daca students this will impact other Immigrants they come in for educational purposes as well that are to traditional processes so want to start out by explaining some of the demographics than looking at the work force economic impacts and the education skews me just isn't represented the bank did you have a motion. I would like to make a motion it represented Penzo agrees I know that they've been people come here to that want to testify but I I think that from what I'm gathering from the committee that this is gonna pass but and like I said I know you have people coming that have come here and and. I want to leave it up to you I'll call the question maybe maybe limit debate to. Or two minutes well it S.. People are leaving. I mean if that's what the committee wants to do I mean I make a motion to call the question. Okay the motion that's about motion collection ways pass as well. Not debatable so. The vote is on the call the question call question all in favor signify by saying aye. All opposed nay. Motion carries. In your motion is to pass I have a motion to do pass in discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay motion carries graduation your bill is passed thank you can I would like to say thank you to all of you that came and drove that long way to be here sorry we could not hear you speak. This is the best part. Thank you all. Thank you. Penzo you got one more here. A. B. fourteen fifty nine we can make this quick as well House Bill House Bill fourteen fifty nine just ensures that all health care providers are reimbursed for behavioral health services and you want and with that. You don't have any questions that has for good vote. Are there any questions for. Senate emergency and you're recognized sorry it is not being reimbursed now I guess what it is. However let it said in licensed professional counselors and licensed marriage and family therapists. The under the. Federally qualified health centers were being reimbursed for those two categories of our health care providers okay thank you H. fees have any concerns that you know of mmhm not that I'm aware of no. The fifteenth there's no no no opposition this never. Does nobody signed up to speak against the bill for the bill. Any other questions. Seeing none anyone who speak against the bill. For the bill. Seeing none ready close for bill clothes make a motion to pass a motion do pass any discussion on the motion seeing none all in favor signify by saying aye. Those opposed nay motion carries a graduation bills passed thank you committee should read these two first. Each of. Representive Eubanks do you have a question. Well I see we have two members here that have been waiting patiently is there any way we can go to their bills yes we can thank you let's find them here Only the ones quick. Fuhrman. Representative eleven which bill are you here on. That was at the bottom. Okay we're going to H. B. sixteen sixty seven. This represents permit you're going to present it for him is that correct Sir. Okay you're recognized to present HB sixteen sixty seven. Thank you Mr chairman committees Keith Brooks representative district thirty one as I said earlier in the day I'll be presenting this on behalf of representative Tony Furman he is still in the hospital with his wife and appears to be there somebody could be longer today so here I'm sure is watching online to to see the festivities if you please the I think they're just kind of hanging out represent Bentley so please committee of may have Joe for bath with the foundation for government accountability to join us as well you would representatives yourself and who you represent yes Sir absolutely my name's Joe Horvath I'm with the opportunity solutions project actually headed in the wrong business card. Because my flight was at five it was dark so I grabbed the wrong ones. And may proceed HB sixteen sixty seven is relatively simple bill does repeal any licenses all the current license to stay in place what it does is it allows licensed professionals to moved Arkansas more easily from other states if someone has a is currently in Arkansas resident and holds a license that is in good standing from another state pager fees Arkansas recognize the licenses and allow them to work here there are several states eight to this point that have passed similar legislation with Mississippi just being most recent one within the last couple weeks so it's it's a simplicity bill good for small businesses from the standpoint of limiting regulation and with that we'll be glad to take any questions. Any questions from committee. The first you're recognized exactly what licenses are in. Does this cover a missus medical and dental license or. What what license are included in this I'll be glad to let Joe answer these questions the so the occupational licenses that are managed by DWS the list of three hundred would apply to anything that's not currently it would not affect so basically in short all of them but it would not be it would not affect any current interstate compacts that Arkansas is involved with. So this this would include medical license and dental license a nursing license and all licensing I think nurses have an interstate compact so they wouldn't be affected but yes so to give a bit of background when Arizona to this a couple years ago that was actually one of the explicit reasons they did so as to increase access to healthcare in the state by allowing individuals with health backgrounds to come in and practice and just to save you know they've they've had a year under the belt they passed a two years ago that had a full year of implementation it had twenty four hundred individuals from varying backgrounds including medical elect to to get license this way moved to Arizona and haven't had any issues so far. I mean I know that our medical and dental boards aren't and they they they don't have interstate compact so. You're saying they would. Tell me exactly how that would work I mean now they'll accept licenses from other states I just have to. You know of plying pay the fees with that still apply yes. Yeah we have that this are this they would they pay their fees so if an individual is licensed in the state for a year. That still pay the fees if their license is in good standing not standing criminal or civil complaints or no professional issues so would be just the same yeah but I mean each state has different licensing requirements you know especially medicine I mean they're different requirements for different states and die required direct verification I mean there's. It's a lot more involved in. You're saying that we have to accept that license even if the requirements are different yes because they remember the licensing boards are still gonna have the same kind of oversight authority on any of these occupations that they would otherwise so doesn't feel any licensed the licensing boards oversight authority is going to remain in place the same as it ever was this is just initially accepting the level practice that an individual moves in with. Presumes the acceptance of the license and then they're just in the same pool with everybody else treated the same as everybody else from that point moving forward. Yeah I think there a lot of provisions that would want to accept to a license from another state without looking at their own licensing requirements but. Representative when you're recognized for a question thank you Mr chair so I wanted to kind of ask a little bit of follow up on but we were just talking about so how do we handle the issue of someone who is coming from a state that perhaps has just different standards then what Arkansas is something like in construction we got to deal with by more stir in the air maybe in the western part of the United States that have to deal with that very much I wouldn't have that type of training or understanding that I hear you correctly that if they if they came to Arkansas they would then be under the law the current licensing boards they would have to get up to our speed we would just recognize their license how do we how do we handle the possibly having people who might operate incorrectly from coming here and I and being able to operate immediately. you're you're asking about certain you know geographical regional differences between when to similarly that's just one example but yes well yeah well how do we handle different standards. You know I've I've when we're talking about. Abuse example from my own background my own my own of work product so you know when I was sixteen I worked in an auto shop for years and whether I was in Connecticut or Texas when I threw open ninety seven Subaru up on the left it was a ninety seven super no matter what state I was in and more often than not the subject matter there's going to be far more if you imagine a sort of an diagram they're gonna be far more overlap than there will be a discrepancy I think any sufficiently committed productive and and professional individual is going to make sure to close that gap because they they have all the incentive in the world to serve their consumers right so if it's going to be an impediment to them getting customers doing business properly I think will be properly incentivized to to close any of those kind of gaps that may come up good thank you Sir thank. Any other questions from committee. Okay we have a three people to speak for and forced to speak against this bill. Yes representative Miller you're recognized I like it make a motion to limit debate to four minutes per Speaker please four minutes for Speaker including questions including questions okay. so we will start out with someone to speak against the bill first one I have is bill Rochelle. He's in Northwest Arkansas. If you don't mind a lot of great road over okay that's fine Greg Crowe. Please introduce yourself and who you represent thank. Thank you Mr chairman names regardless of I and my capacity today is as the chairman of the Oleg Committee which is occupational licensing advisory committee that is created four years ago for the first two years we and we're bonding the red tape reduction committee working group sorry and then over the last year or the whole so to we've been working with the same commercial losses sustainability group so that's my that's my capacity today that I'm because the finance my objection to the bill Oleg's objection to the bill which is made up of of hold over fifty people who are from different occupations is in two thousand nineteen after almost two years of study between legislators members of the public and industry representatives the red tape reduction working group working with the occupational licensing advisory group which is made a payment of legislators introduced and passed thanks for twenty six and ten eleven which address these very oceans of that address the address not only issue of you've got a license another state but also if you're coming from a state that doesn't have licensing and dealt with those issues the the the. This bill would undo a whole lot of that work the agency is required to pass regulations agencies did they were all all the regulations were approved by the legislature they the biggest difference between this bill and what was done two years ago is not the substantially similar as mentioned by representative Ferguson sometimes you got one state whose standards are way down here and other ones are up here there can be substantial differences here's Beck does create what some people call a race to the bottom where you just find the lowest license in any particular thing a license there then you can come back here. Even a bigger concern to me is our squad a few things and current Arkansas law that everybody else has to do with this bill would allow you to for example a criminal background law the oldest notified a few minutes ago it's it says yeah so you've got a second degree murder conviction you cannot get a license in Arkansas right now period and now what profession put into this bill we're not allowed to look at that you do that they have a license in Tennessee and Tennessee didn't care about that you got a license in here the the sorry they don't allow any kind of local to. Local testing as far as this is no testing whatsoever sometimes says things I'm just not necessary absolutely sometimes it is if you got depressed when you have differences and and skill sets or differences in law of a whole lot of agencies will have a a what I call business in law test or some or jurisprudence test because the laws and and Tennessee are not the same as laws Arkansas for a given profession frankly you're not doing any favors when you've when they're not having to become familiar with those situations the same cemex point trying to hurry because I've got four minutes the the applicant does not meet any Arkansas requirements could simply obtained a license in another state income back that that's that's very disconcerting and we're trying to wrap up quickly as I can does allow up sorry. Hello this is a critical point there are lots of things in the the other aren't necessarily on your ability to be a surgeon or your ability to be a real estate agent or utility or whatever that are in place such as maybe have to pay into a claim for. Maybe you have to keep insurance yet he workers comp insurance this bill doesn't let you do those things if they have a license in New Jersey by example probably but if you have not is in Jersey and I come here we can't make them have the same workers comp that everybody else has to happen we can't make them have the pay the claim fund you can make them have insurance if they are not everybody has those of cross the board all kinds of things that you the board that today that the again I think this with this problem was addressed absolutely and nineteen we felt like it was a lot of work went into working a compromise and work or everything cover everybody's interest was vetted and we came to a very good solution that has worked extremely well might affect the the I think we did better than Arizona yeah because there's our credit her but they did not that hot we did a better so um we feel like what we did in in nineteen what's great when no one's upset with it and is working perfectly let's not mess that up please. Any questions. Representative Wayne recognized. You said something that I had not considered and that's the criminal background could you elaborate on that please yes Sir this bill does not provide any kind of revision for the criminal background law in this what comes later and I'm and if I'm not mistaken I don't think it's as when read without regard to any other law you have to follow the through this way so if a guy comes from currently a person with great conviction cannot get a license in Arkansas any profession period end of sentence and if they come over from Tennessee with the right conviction maybe Tennessee didn't care Arkansas doesn't didn't do a background check on all right with the law doesn't require a background check they get to come here with that rid conviction your time is up thank you. My. To go a representative Miller you're recognized. Thank you. hi. What time is it. What about click here actually at eight five o'clock in the area of. I don't know what I was B. and figure to. Of the server hello that you just protection on this but. So we know of a lot of I will use the example of a medical. Malpractice. And let's say somebody is involved in a medical malpractice lawsuit and. Nevada maybe they do weird stuff out there and and this guy was like you know what screw it I'm going Arkansas. And you know go to work for little bit follows lawsuits going on is this bill going to make that possible as I understand it yes they can lessen the bottom boarded taken action against the person all right let's say no boards taken action did yes Sir they could come here and set up shop that's my understanding the bill yes thank you. Thank you Sir. All right to speak for the bill. Speak for the bill yes. Yes. Allen Campbell Campbell. Who's Allen Campbell here. The main room back there. The. Okay is Joe home built. Home with. These sellers would have little raffle. Alexander going on the node. I'm here. Thank. My back there okay. Okay we have three more people to speak against the bill. Bill Rochelle. Is. He's not here okay. Mike Holcomb okay. Please introduce yourself and who you represent. Of my name is Mike Holcomb here on behalf of a G. C. A. B. C. and car power corporation which is a company now. You may proceed. Four minutes yes Sir thank you. Of what why I'm against and in one of the organizations I'm presenting or against it I'll specifically address an issue an electric shins license the state of Arkansas has made. Great strides and has for many many years of training even like traditions we have a excellent program and if this bill was to pass. Other states don't have the requirements that we do in our great state. It is a big concern for me at from a safety standpoint if you allow somebody to come in who's got a license from some other state that that you don't have to take a test you don't have to go through the apprenticeship program you know things of that nature you are jeopardizing the safety of the public I don't think anybody here who would want to have somebody who's not qualified to do any kind of electrical work in your house nor would you like to have an unqualified electricians in a healthcare environment. nor would you want to have of an unqualified or me back up under qualified person do you work in a school or an airport it's in my opinion it's a matter of public safety and again we as a state we have done very well we train our he looked rations very well I would put it up against any training in any state in the country. And without. President Gonzalez did you have a question or motion. The question. Okay I guess my my good deal Chuck Clark of us as members selected. I know I walked in late on this I had to go file following amendment over the house but In you may not be the. A person to ask this to we we passed a bill very similar to this earlier in the session dealing with military members and and their spouses allowed on that license reciprocity I don't remember any organisation elektrische in this contractor anybody coming to speak against that the do you believe that they have more qualifications by serving in the military or be in the spouse of a military member to to perform these well it licensing services yes I do because I thank our government trains whether you're in the army or whatever that they are working in life safety situations airports airbases whatever so yes I think they are very qualified. Okay. Thank you. Okay seeing no further questions thank you for your comments and thank you Mr chairman may I answer the previous question. Yes okay represent Miller you had asked questions about the crazy people in Nevada and how that may. What's that. Million none none none none it's a beautiful state just referencing your your question so on page three of the legislation couple specifics no unresolved disciplinary action imposed by any other occupation licensing entity if any juror if another state is taking disciplinary action against the person has not been resolved does not have a complaint allegation or investigation pending before another occupational license entity in another state their place on I'm professional conduct if they have any complaint allegation investigation pending all that is dealt with in that still within the legislation so I don't think that that specific situation that that person would would qualify under the statute. Yes you may. well I appreciate that representative Brooks but what my concern is is that sometimes you have situations where in the medical field where you have a a a doctor or or somebody who has. Given enough calls for a family to perhaps to him or be pressing charges we're may be the medical board due to political connections or whatever I mean I think you know there's no there's no board or commission anywhere that's not of immune from that and let's say that they haven't taken any action they haven't suspended his license or whatever I mean and in the legislation that you just read off. Does that prevent him from coming over here if the board has not let's say if he just has a case pending in court perhaps a a civil lawsuit but now but no action taken by the board. I've been yeah I'm reading back to the city of Joe will be a lot more familiar represent from it but according to Page three line twenty seven if an applicant has any complaint allegation or investigation pending. So sounds like that's a Fairly specific of understand your question. I think the bill okay yes thank you thank you Sir representative when you're recognized for a question. Okay see no further questions we have one more person to speak against the bill send the Estes. Please reduce yourself and who you represent. Thank you my name is Cindy Estes and I'm the executive director of the national electrical contractors association Arkansas chapter. Thank you for allowing me to speak here today I want to first just echo the things that Greg and Mike stated of course representing the electricians and electrical contractors safety is of the utmost importance to us so that is appears. The president ever present on our minds and but in addition to that as Greggs stated The occupational licensing review subcommittee that was charged with conducting the comprehensive review of all occupational licenses has put an in depth review of the occupational licensing and has is in the best position to actually evaluate the occupational requirements on a case by case basis and they put a lot of time into that. But. I would just like you to think about the fact that before changing any rule or law a law made lawmakers should always ask why the current rule or law exist in its present form and what is the necessity to change that will it change with the change help will it hurt is it necessary. the intent of occupational licensure is to safeguard public health and safety protect consumers by guaranteeing minimum educational requirements and industry oversight and support career development and pathways for licensed workers and enhance professionalism for licensed workers. So bearing that in mind. My problem with this bill is that when you read it as written. It kind of doesn't make sense really when you read just the first three paragraphs it says occupational licensing. It says the General Assembly finds that occupational licensing protects current practitioners and disproportionately burdens entrepreneurs unemployed workers and low income individuals here trying to enter profession occupation. Well occupational licensing the press purpose of it is to protect safeguard the public health and safety. So the fact that it's your you would be finding by passing this bill that the licensing protects current practitioners and disproportionately burdens entrepreneurs and unemployed workers I just disagree with that just on the outset in that first paragraph because we have these high standards and spend strict requirements for a reason. Because of safety being one reason but. You know. It's it's it's we should be touting our high standards we shouldn't be trying to reduce them. With. By reducing them it will devalue our licenses here you know our electricians have worked very hard to over the years as Mike Holcomb was saying to to get these high standards. And and then all of the professions as representative Ferguson was saying that in the healthcare field I'm a lawyer in the legal field we should that will actually make our economy stronger is if we tell our has standards and seek people who are qualified to come here not see people who are trying to escape the high standards and strict standards that we have. Any questions representantes no question. All right seeing no questions thank you for your comments represent Dotson you're recognized. I make a motion to end debate. I make a motion to end debate. In the bank the most intimate non debatable. All in favor signify by saying aye All opposed nay. Motion carries the betas ended motion to pass I have a motion do pass representative Dotson any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Those having your bill has failed representative thank you Mr thank you. Okay committee I I said five o'clock we would be out here but I was talking the mountain time so we got another hour we have a couple of people that have been here for a long time someone try to let them go and will probably go until six central time. A representative and you're recognized to present seventeen seventy six. You're recognized thank you Mr chair committee members nursing homes that participate in Medicare and Medicaid programs are subject to strict staffing standards are established by federal and state law those standards are enforced by DHS and CMS or representative just minutes a committee admitting we got too many people talking. Okay hold on just a minute representatives yes you're recognized represent Wardlaw. Mister is my understanding from the rules since we suspended or rules to hear these bills this morning we have to without objection here on this afternoon. So are or make a motion to is to first keep the rules suspended to hear on so all make the motion to spend rules to hear this. You are correct and this was one of those bills cracked yes Sir I think I have to make the motion but thank you for you can that so I would ask that we suspend the rules so that we can hear HB seventeen seventy six and discussion on the motion. Sing none all in favor signify by saying aye. All opposed nay. Motion carries. Representive eleven you're recognized to present seventeen seventy six thank you Mr chair and thank you for that for procedure members I was saying nursing homes that participate in Medicare Medicaid are subject to very strict staffing standards by federal and state law the standards are enforced by DHS about CMS surveyors that make very frequent unannounced visits to modify and that compliance I foresee current state standards have been in place for thirty plus years without any modifications the purpose of this bill simply to update those standards bring them into line where the federal standards are today so that the Regulations are consistent what this will do is it is it allows the use of modern staffing practice permitted by federal regulations to recognize a full range of professions that are available for the skill needs of Beverly nursing patients across our state I'll be happy to try to answer the questions. Any questions from committee. Seeing none anywhere speak. You were speak against the bill. For the bill. Seeing none your clothes yes I'm close and create a motion to pass representative Bentley you're recognized. I have a motion do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay motion carries graduation your bill is passe Committee. Okay we're gonna run one small bill here representative Bentley. You're recognized I wanna make a motion to suspend the rules and here H. B. seventeen eighty aids cash on the motion. Seeing none all in favor signify by saying aye. All opposed nay moshing carries you're recognized to present your bill we do have an amendment to this bill real brief moment it just delete section three out of the bill so when you guys get up make a motion to a. Except the amendment to the amendment gave me a few minutes look at it. Seven eight eight three seventeen eighty the company is the bill that represent evidences had. All right Committee motion on the floor is to. Except the amendment and discussion on that. Seeing none all in favor signify by saying aye. All opposed nay mosting carries your amendments been adopted you're recognized to present the bill as amended thank you colleagues we've had rules in place for quite awhile to have medication assistance that worked like you have a certified nurse nurses say that works in a nursing home and the next step but would be medication medication assistant we've had rules in place to because it did not have the rules that represent eleven just past we didn't have the funding available to users that really have not been utilizing the state like we would like them to so this is really just an additional to that to say we have rules in place to train these medication assistance and also to allow for training for LPNs in a consortium of nursing homes that come together just like our into trained in the hospital that's pretty much it not shall take any questions anybody has. On the bill. Any questions from committee. Seeing none anywhere speak against the bill. For the bill. Six hundred close for your bill I'll close for the bill and I make a motion to pass as amended as amended thank you motion is do pass as amended any discussion on the motion. Seeing none all in favor signify by saying aye All opposed nay Motian carries because there's no bill is passed thank you committee I appreciate it representative Brian your last on the list. So you are recognized we gotta go back up the gym the committee we passed over this earlier H. B. fifteen fifty three correct yes Mr you're recognized if if I might have Mr Cody wait with Arkansas or for Office skills development join me. Please introduce yourself and who you represent. Thank you Mr president committee county weights Director office skills development department commerce. Thank you committee members we we have already heard this bill once if you can remember this is the apprenticeship program that we that we are the I am seeking to adopt in this state underneath the Department labors guidelines and standards UPS FOR couple amendments one representative Payton to add that the date to the code of federal regulation to ensure that we don't find ourselves to federal statute and then representative gray concerns with permissive language maybe to be in the shell in the may what I found in my research is it is most agencies can do this already they they just they choose not to and then when I spoke with the Department of Health to kind of maybe blanket cover them it was their member Lois to broad and I start to exclude other entities that currently do this program and then several of the programs that they oversee do into this program so they wouldn't have a concern in the sense of the program because they feel like they already fit the guidelines of what the bill seeks to do this morning I talked to to UAMS and they felt the same way like no we we kind of already do that so I couldn't satisfy your full concerns but. Mr way was here last time and I he is the expert on with Arkansas does in the area of apprenticeship programs and I feel like he can better explain how this bill is good for Arkansas. the representative yes so as as the representative mentioned I was here last time and listen to some of the debates in the comments that were made around Richard friendship and and just really want to make some comments about what we've been doing in Arkansas as well as kind of provide some insight into what we're seeing nationally as well you know since twenty fifteen obviously we've been working you know collectively under the that the time Department courage cation skills all in the division of workforce services to expand apprenticeships since that time we've increased our active number the premises from around three thousand close to seven thousand today increase the number of programs offerings that we have from around eighty to well over a hundred twenty at this point time and are graduating hundreds of the premises by the month when you look at the growth that we've been seeing it's really and what you would call nontraditional occupations around state and manufacturing healthcare IT just to name a couple just to point out a few you know obviously when you look at manufacturing spaces a couple years ago while those may not be licensed occupations those review as as a principal occupation while I can just tell you there's a number of companies and and many of your districts are leveraging registered pressure to train industrial industrial technicians machine operators machinists whatever the case may be as well as in the I. T. space albeit cybersecurity analyst data analysts web developers so forth and so on as we continue to try to expand a partnership in Arkansas you know we're always trying to figure out how we can expand other into other occupations whether they're licensed occupations like electricity and plumbers who make up a majority of the oppresses you having the state today or whether that be other licensed occupations or nonlicensed occupations the state of Alabama who we look at and partner with in a lot of different ways from a workforce development perspective not just in a partnerships did it pass the bill similar to this back in twenty nineteen that was called eliminating the legal barriers to appreciate backed in which they basically when a step further that said something along the lines of any individual who goes through a partnership program for a license occupation passes those exams is is able to receive that license. Bill the similar to this bill to me does a similar piece step in that respect occupations whether it's you know we heard from the cosmetology and barber group I believe that last last meeting states like Louisiana Virginia Washington California Arizona have a principal occupations within the cosmetology space we talk about healthcare we have a registered graduate a part or a nursing registered nurse graduate apprenticeship program in partnership with lane county Memorial and National Park Medical Center here in the state of Arkansas currently we have a number of C. N. A. occupations and obviously we're looking at LPNs and things that nature has an opportunity the state of Washington is actually working with through their state board of nursing right now to allow for petitions to be done through the like LPN pathway as well so whether it's surveyors cosmetologists Boilermakers all these occupations I think the testimony previously mentioned thirteen hundred fourteen hundred plus occupations are principal under department of labor to me this bill doesn't necessarily make a workaround for licensing and just as the ability for individuals to learn while they earn away agents support their families and so on those are some comments I want to make around the bill and I'll be happy to answer any questions. Any questions from committee. Representative Ferguson you're recognized I yeah I guess I'm just I'm sorry I'm just trying to figure out what all professions you would not have to go to school to do so you're saying and our end would not have to attend class. Currently right now under the department of labor standards or is not a registered appreciate program for registered nurses to set orients no LPNs licensed practical nurses CNA's there is a graduate register to print seven Arsene program so what the hospitals found in Arkansas is that over sixty plus percent of registered graduate registered nurse graduates were Leaving their hospitals within the first year employment so Wesley memorial did and national park Medical Center did was part of a true on healthcare established a one year apprenticeship program to help mentor and guide the students along with the the on the job training as well as the related technical instruction piece that goes along to it as a way to reduce that turnover and stability within the hospitals themselves I guess what other healthcare professions would you not have to go to school today I think I mean at the core right I mean do you have to got some sort of related technical instruction under twenty nine CFR part twenty nine and thirty of the federal regulation around a partnership and so you know most of these pathways Willard's an LPN your start up to be part of the two year college university to go through that training see and I can be done in a little bit different factions because it's a certified occupation as not as great of a in in educational requirement as much as an LPN or in foreign would be and like I said as far as a registered nurse those that doesn't exist right now under under federal regulation as approved by twenty nine CFR and section within that so I I hope I answered your question I'm not sure if I did. The representative ray you're recognized for a question. Thank you Mr chair. So I'm trying to figure out a way to vote for this like I'm not sure I hated appreciate you amending that effective date in there because I do think it really did need that and so on page four and this is back to the second part you address to me about the shall language so like on page four just want to is is all licensing entities are required and. As required under this act shall promulgate rules necessary to implement this act I think my question is. Are we forcing all licensing entities to have apprenticeship programs if they're in the federal registry of programs because I don't want to force like the bar where the license the cosmetology to have an apprenticeship program if that board does not want to. Sure if I may representative I appreciate question you know I think what you have to realize is perhaps it does I'm not a specifically sure about this section of the bill where it says shall or may but even if a border licensing entity had this language in there that allowed for the petition to be done unless an employer in the state of Arkansas wants to leverage that then it's not gonna happen right because you have to have employers that was up to the table so whether it's a hospital healthcare provider of a barber shop or or a spa or salon if someone doesn't want to leverage that mall they feel like it's not good for them then it's not gonna be done because it has to be employer driven we can't set it up with that employs or it's not a partnership program okay that does so if the employers want it then it'll happen if they don't want it then you know it's not gonna happen that helps me thank you resented Allen you're recognized. What what happens thank you Mr what happens if a Person and try to force an employer to doing it well if they say well this is currently the law. So you have to do it so. My question the of how can an employee of not be boxed in with this. Yeah they can choose not to do it I mean it's simple as that so an employer this doesn't require an employer to use in a partnership model what this does in my opinion and correct me if I'm wrong it allows the flexibility for an employer to say you know I want to have in the premises working alongside my and you know the terminology the Department labor uses journeymen worker my skilled worker who's going to mentor that individual for a period of not less than one year right so and appreciate but it's for us to be no less than one year two thousand hours of on the job training and a hundred forty four hours of related technical instruction it does not require an employer to do that employer has the choice is whether or not they want to leverage a partnership for their for their business if they do then great if they don't then they don't have to do it they could see the status quo remains. Okay saying no more questions. we do have. One two three four six we have eight people signed up to speak against this bill. Representative Bentley you're recognized. It was a long day there are six including questions. I have a motion limit debate to two minutes per person including questions and discussion on the motion. Thank. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries it away okay thank you members committee two minutes Andrea Wilson. Andrea Wilson. For several of them yeah is is there anyone in a waiting room. I was going down the list here Paul Wilson. Here's a look. Please introduce yourself and who you represent. Hi my name is Paul Wilson I'm injury Wilson's husband I should go get our kids and we are from the salon professional academy And we're in against this bill for only one specific reason and it's not because of protection as a. The reason why we're against this bill is because in the bill that representative pride is fit in there he's put an exemption for. Licensure as resulting from a four year program. The only difference between our school you see a any other four year institution we don't have sports teams we don't have dorms but we have all of the other requirements that a four year university has but I mean requirements I mean the administrative oversight accreditation we have those so if this bill passes what's going to happen is that you're going to have two sets of standards for cosmetologists barbers anybody that falls under that blanket of professions so. If this past you would have students going through the apprentice program in a salon in there they would not get the same standard of training that all the fifty thousand cosmetologists and barbers that have it all the sixty four other schools in Arkansas have. So we're going to have a. Mismatch of standards of professional centers across the state. Which is really what the whole purpose of the reciprocity across the bill in this bill and to some extent so I've met with representative Brian a few times on this and I've been trying to get him to amend the bill to simply say incentive for your institutions all post secondary institutions that would cover barbers Cosmo's estheticians you name it but would also cover. Architects and professional engineers for example myself before I joined the Air Force I have a master's degree in electrical engineering and I will AM or was not anymore a licensed professional engineer in the state of Missouri. So I would suggest for with on both sides of this that the bill be amended to simply change that language to say all post secondary institutions as opposed to four years your time is up thank you that's all I have to say thank you for your comment. Okay we'll wait is strong. Please introduce yourself and who you represent. What strong. Wait Strawn Arthur's beauty college Jacksonville Fort Smith Jonesboro Conway. This bill is a in my opinion and other attempt to do regulate. A license. That I've earned. I do not understand fully why we're constantly attacked of my people like. What I'm sitting here in front of not all of you but some. you know one thing that I learned through the. Here's a issue and I said this in one other meeting. I know a lot about business I'm a businessman. Okay. And when I try to talk about business I try to talk about business that I understand I got this little quote from miss Curtis Mr Chris as you know a lot about business on but you don't know nothing about my business. Wade went and got his license and now I know about my business and her business I'm asking you all to. Pull us out as Paul said because we are postsecondary were educated we're not out here just combing hair and and you know rolling terms it's very technical and if any of y'all would like for me to give you a theory lecture on any choice of the area that you are in question on call me. I'm in all those campuses all the time not be more than happy to sit down smile at you and give you my very best information ploy and teach you. The importance of what we do. We need to be licensed and we need to have oversight for under the department of health for that reason. And we want to stay there we want to stay the way we are set up without people looking into for lack of a better word are paying the drawer. In trying to pull things out of it that you don't fully understand. Thank you times of thank you for your comments. When Middleton. Thank you I'm going middle Salem campus president for Arkansas College barbering Arkansas beauty school in Arkansas technical school I am against this bill for several reasons one being and I also have a letter here from the barber board that they could not be here and they wanted to be known that we had an apprenticeship program with a barber Board it has to be removed because of one reason that school areas in rural areas there was no one to be able to bring an apprenticeship for the students these students were coming to Little Rock doing whatever training they needed to and going back to the rural areas and if there was one or two barbers in that place they were not willing to have the apprenticeship because they saw it as a threat to them that the few clients that were there they would take those clients from them if they did the apprenticeships and the people got license so rex Bailey who is the head of the bar report wanted you all to know that he does not approve of this and we do not want this and from the school standpoint I need to and make you aware that right now as the lights as an accredited institution we cannot discriminate against any student that comes into our school we have to look at them individually we have to make sure that we are following federal guidelines if we bring this apprenticeship program and we cannot guarantee that an employer will not be under those same standards the last thing I want to point out is this bill will allow them to have some classroom training however because they are not eligible for federal funding anymore who is going to pay for that classroom training if you're paying them as they go they're more likely going to have to take the wages that they're earning in order to pay for whatever training the bill will allow them to have so that is my concern I am against the bill do you have any questions. Questions representative Alan. Just come in this bill from the on the sincerely thank you for us start now with us early this morning and I you and do what it it was dinner time unfortunately we're not serving them in the day your time is up thank you so much thank you for your comments. Shelley plant. Please enter seventy represent. My name is Shelly Platt I'm a salon owner and have been for quite some time I'm speaking against this bill. I. I do not feel that an apprenticeship in the cosmetology industry is appropriate. The school's job is to educate and make a skilled worker which can come to me and I can help that worker thrive in a salon atmosphere or in out in the employment field so. Our problem is is it being in a salon. We don't have the infrastructure nor do we have the business model to take on an apprenticeship we don't have the income to take on an apprenticeship expressly during the new year we've had at our industries service based so those of printers that are coming to us and we're having to train we are having to create myself speaking from behind my chair I'm having to create a second income by working twice as hard in order to pay someone that I'm teaching. To give them a salary as well so it makes it very it's very strained on my business model my income and myself personally to hire an IT M. and apprentice now I am for a viable solution to help transition and educated worker into an employment situation and if that could be if something come up that way it would be wonderful. We do have a question yes the representan Allen you're recognized. A motion to end debate. All right thank you for your comments have a motion to end debate. All in favor signify by saying aye. All opposed nay. Motion carries representing the UAE to close for your bill. Thank you Mr just just to address a few concerns this this program is is voluntary to the to the outside to the citizen it takes a willing employee a willing employer and willing school system to be able to meet these guidelines this does not affect our current licensing the licensing board will promulgate the rules and Smith and Dale C. for approval And if if it affects someone scholarship if if I have a choice between a partnership or a scholarship and I lose my scholarship I do them partnership then you know I should have that choice and scholarship would be the way to go maybe the partnership program isn't the right way. several states have also adopted that we have. We're not throwing these licensing boards the rules of the Office skills development is set up for this purpose they want nothing more than to expand this program will expand this program we opened our door to more federal aid to help create more jobs and more lives in this program and with that Mister chair I am closed. All right was will committee. I have a motion do pass any discussion on the motion represent Bentley I know we're all tired but we want to say if they don't want to be involved they don't have to be involved nobody's forcing anyone to do this are really that the testimony was irrelevant I have to say but no one's forcing anybody to do this as a great opportunity for students to get get training what earn money a lot of students can't afford to work and earn money go to school and a great opportunity for our candidates to get jobs of my goodness at a who would I would vote for this thank you. Any other discussion. Seeing none all in favor signify by saying aye. All opposed nay No seven. Local. Roll call. Representative Wardlaw. RIP center Eubanks. Representative from McGee. Representative Dotson yes. Representive Miller. Representive Miller. Representive Payton yes. Representative Bentley. Representative grade. Representive gray. Representative Gonzalez yes. Representative Boyd yeah. Representive Allen no. Representive Coleman. Representative Coleman. Representative Pilkington. Representive Pilkington. Representative wing. Representative Penzo. Representative pens a. Absented Parry. Now. Representative Davis. Representative Davis. President of clown yes. Vice chair Ferguson. Sure Ladyman yes. President of your bills failed thank you can make a members don't levy at levy at that one more bill here I'm told to take thirty seconds. H. B. eighteen thirty six represent Wardlaw is that the right one. You're recognized it's going to need that motion Mr yes make a motion to suspend the rules and here H. B. eighteen thirty six a discussion on the motion. Sing none all in favor signify by saying aye. All opposed nay. Motion carries you're recognized so this is a companion bill to this morning I reference to it this morning and it would be this afternoon it takes that twenty five thousand dollar fine up to twenty five thousand dollars fine down to up to five thousand dollar fine for a violation and all ADQ so it's a reduction by twenty thousand dollars in a fun with that I'd be happy to take any questions any questions. Seeing none anywhere speak against the bill. For the bill. Are you close. Representative very close for the bill. I'm close I make a motion to pass motions do pass. All in favor is there any discussion on the motion all in favor signify by saying aye. All opposed nay moshing carries some resolution your bill is passed. Well I didn't get mine but telling thank you members for staying late again you know you've done something I didn't think you could do you work harder today than you did last time and I want to thank the staff when we came back they had a new agenda for so they did a great job thank you.