Public Health, Welfare and Labor Committee - Senate

Testimony to two minutes all right that's that's a proper motion. You for your per person all right with this promotion of so a second all those in favor say aye hi all those opposed alright ladies and gentleman we are going to take up house bill fifteen eighty nine and Senator Ballinger is going to present that bill. And senator when you get to the end of the table and get settled you are ready. You are ready to be recognized and we are ready to hear your your bill. Thank you madam chair and I'm going to be as brief as possible but also to try to answer any questions that and the bill that I have is actually really fairly simple build if you get past the the definition section you go to go to what's the the first page and a half is just basically let's leave intent definitions section section starts the bottom page two and if you look down on. Thank definitions continue if you actually look on page four of the top of page four is the is the meat of the bill what it basically does is that prohibits the state or taxpayers from contracting with an abortion provider in the state there are some exceptions to that like the you know you A. M. S. no hospitals which is what I'm most of the hospitals are providing abortions but basically your the state is not a contract with abortion provider for state services. And I'm happy to answer any questions. All right listen to men you have heard the bill any questions from the committee. All right seeing none. Is anyone in the audience wanted. Want to speak for or against the bill and I believe Karen of music you are signed up to speak can remember please you only have two minutes. Please tell us who you are and where you're from. And by the way ladies and gentleman we sit to minutes and Mr price is going to be a keeping time so there you go we're ready go ahead Mrs music. Thank you my name is Karen music and I'm representing the Arkansas abortion support network. This seems like a simple bill. The state of Arkansas has already said no money for abortions so no money is being used for abortions but there are some individuals that the state is in control of periodically. Like prisoners. Or juveniles. Maybe a ten year old pregnant child. The intent of this law is to force your state paid professionals to ignore the assistance. It could be provided to a ten year old pregnant child that is what this bill is about. You're trying to force your religious beliefs of personhood you believe a sperm and an egg meeting is a person with all the rights of my ten year old. Most people do not. I do not believe IT ten year old's pregnancy is necessarily guyed or change. The state of Arkansas does not have the right to force a ten year old child to carry a pregnancy to term. That's not a job god is giving you or me. And I hope for the caring professionals that will assist a family in need because ten year olds. Sometimes get pregnant in the state of Arkansas and this bill would prohibit anyone from helping them. All right thank you so much. Up missed music has been spoken against is there anyone that wants to speak for all right seeing none. Ladies and gentleman what is the pleasure of the Committee. I have a motion and I have a second all those in favor say aye all those opposed congratulations you have passed your bill thank you Committee all right next on the agenda is Senate bill five thirty in Senator Wallace is going to present the bill. And for the gentleman that is with you if he would to. A state state his name and where he's from you'll be recognized to speak. Thank you madam chair Dave Wallace state senator district twenty two and I am with. My name is Brian blades I'm an attorney with Friday Eldredge and Clark in Little Rock. All right thank you senator you're recognized. Thank you ma'am. This will calm bill is about leveling the playing field. When an employee is injured on the job the employer or the insurance company is obligated to cover all the medical bills and compensate the injured worker for all loss which is. Arkansas law requires our employers to have workers comp insurance coverage. In the injured worker is compensated with Garcia whether the employer had any fault in injury or not. Not quite often the injured employee will bring a claim against a third party. Claiming that that third the third party was negligent and that often is true. That claim six recover lost wages and medical bills all of which have already been paid for by the workers comp insurance or the employer. The Arkansas law already currently provides employer a subrogation writing any against the such recovery. However unfortunately the Arkansas courts have consistently made the employer subrogation rights subject to the make whole doctor. Under this doctrine if the employee is not made whole by the third party recovery there's no right of subrogation at all. In the courts apply this even though there's absolutely no language in the current bill that calls for that. Arkansas is only one of six states that applies the made whole doctor. The remaining forty four states allow an employer the unconditional right to recover some portion of the third party recovery. Now to make matters worse the Arkansas court of appeals recently issued an opinion that actually execs extracts the punishment on employer if the employer does claim and go to court to seek these damages and if the employer loses. The employer has to pay for the. Employee's attorney's fees as well. And with that I want yes Mr guided yeah we to speak up and add to my of my testimony. Thank you for this opportunity. I have represented employers in the state for over thirty years with regard to work related injuries and previously with the nineteen ninety three ACT subrogation was provided eleven nine fourteen it was subsequently taken away by the courts of this state that prohibited the ability for an employer or carrier or selfinsured group to be able to recover for the damages that they have to pay workers comp this bill will not change the benefits that injured workers in the state of Arkansas received with regard to their workers comp cases this bill would allow though of up to one half of the ability to be able to recover from the tort features that basically calls the injury in this case their number of industries that are affected significantly by this particular inability to be able to recover those involving transportation those involving nursing homes or have travelling nurses that go to different places construction many of those in manufacturing are also ones that you are prohibited at least now from being able to recover and I have handled made hold hearings before various courts federal courts state courts administrative tribunals in an attempt to show that an injured worker was made whole and it's impossible that is such an amorphous term that was created by the courts that it's difficult if not impossible to be able to do that. so I would ask that basically you restore the rights for the employers in the state of Arkansas to be able to recover up to one half potentially of whatever for cover and we're not taking money away I mean what you see injured workers in making their claims against third parties is there using the damages that have already been paid by the employer the workers comp carrier or self insured groups the medical benefits of already been paid they make a claim for that in the third party case their time off work has already been paid they're making a claim for that in the third party case there permanency of their injuries have already been paid they're making a claim for that in their third party place and potentially future wage loss has already been a consideration in these claims and that's already been paid by the employer the workers comp case so really what we're asking is that you restore the ability to be able to make those recoveries and prevent a double recovery you've created of the courts have created the legislature gave us this right but the courts have created basically two classes of injured workers you have one that has an injury that occurs at the work place and you have one that has an injury that occurs at the work place but unfortunately was called by somebody else and when they have that right to go against a third party the employer common carrier selfinsured should have a right to be able to collect at least a portion of that in any employer in this state that has to provide workers comp benefits should have that ability because it'll affect everyone of them delete or get a premium re fund potentially in some cases of self insured or it affects their direct bottom line if their employer that is self insured in these kinds of cases that that goes back because all of those damages affect those individuals it affects their mods with regard. To insurance premiums because they have to carry that the end for three quarters of of insurance premiums whatever that determination is made and so giving them the ability to re Cooper to recover at least a portion of that would give them and assist with their ability to be able to to provide future employment and would affect each one of their bottom lines so based on that I'm asking that you basically restore Intel the courts that this is an absolutely because that's the language that we didn't have in the first legislation that wasn't there and that's what the courts used to say well yeah you have a right to separate cation but we're going to take it away from you and less that you can prove they're made whole and so based on that we believe that ask that you support this bill okay let me ask you a question so for those that to relate people so you have a business person and to. Let's say he has a lot of trucks on his property that he uses in his business and somebody from another company brings a load of whatever and that person then injures one of his employees that's what we're talking about today is it not that's exactly right in most cases that deal with transportation it would be a car wreck case if you're a truck driver in your driving down the road and somebody calls you to have an accident which injures your driver your employee this gives them the ability to make a claim against that third party but it gives the employer are right to collect up to half of what they pay the injured worker the injured driver in that case so with the injured party not be first with all of this well and and I'll be honest with the way the bill is written they do if they don't collect the nobody collection they would get at admin at at least half and ended as an example I hadn't made whole hearing in federal court in Little Rock and in that particular case the comp Kerrier it paid medical an indemnity benefits over a hundred and twenty five thousand dollars in workers comp benefits that they were required to pay. The injured worker brought a claim against the third party that basically calls their injury and they were willing to settle the case for six hundred thousand dollars so I thought there's a million dollars in coverage that the toward fees or had that gives us four hundred thousand dollars to be able to go against and try to re collector or read get reimbursed for what we paid the chords in that case the injured worker said well my claims worth one point four or one point five million dollars and I decided I'd settle for this and so you entered our skis but you employer you comp carrier cannot come back and collect that additional amount even though they're essentially saying they're made whole because they agreed to settle for six hundred thousand dollars. With the state of the law now in the most recent case that came out the young blood case that liberty mutual was trying to have a made whole hearing and essentially do what I said you know let's let's prove whether or not they're made whole in that case the court of appeals went so far as to say liberty even though you're using the right we gave you under eleven nine four tend to try to have this hearing to see who's made a whole we're not we're going to penalize you and say and say you owe the Attorney speed for the claimant for even exercising a right that you were given by the statute see so we're trying to restore that by this bill all right thank you other questions all right Senator Hammer you're recognized for a question thank you I'm sorry your an attorney or judge or an attorney you're an attorney okay what what kind of attorney are you I represent importers in workers compensation cases okay So if there's a there's an accident and a third party comes in and how much does workman's comp pay of the injured employee's salary why they're drawing compensation workers comp. Under the statute they get sixty six in two thirds up to a maximum that's what the statute allows of their salary while they're off work and then at that point once they're determined to have reached maximum medical improvement they get up to eight a an impairment rating which is that of the doctor's German there at maximum medical improvement and then they start getting permanent benefits okay. And say there's the third party settlement because that in my mind trying to absorb all this yes that's a whole lot of what this bill is all about is who gets what on the third party settlement is that is that accurate that a violation yes Sir does the employee who got hurt. it's only gotten sixty six percent of their salary why on workman's comp claim ever get the balance up to the hundred percent that they would have been making had they not been insured under the third party settlement sure they make that claim in the third party case I mean they make a claim that I was paid fifteen dollars an hour I work forty hours a week that's my salary and that's what I missed now what happens is that employer that paid the sixty six and two thirds at this point doesn't get to be able to receive anything for the benefits they pay so in essence the injured worker is making a claim for a hundred percent while he's already been reimbursed for at least up to two thirds of what he was earning at the time the same thing with the medical benefits we pay the medical benefits for all of the treatment of the injuries rehabilitation everything that goes into that particular injury and then he turned around despite the fact that he's already been paid for everything and makes a claim for a hundred percent of the medical as damages in the third party case the same thing with the permanency issue he's paid or gets an impairment rating from his doctor he's paid that impairment rating in the worker's compensation case he then turns around and says in the third party case I've got an impairment I can't work I can't do anything as a part of that but he's already been paid benefits by the workers comp carrier or the employer for that permanency he can also make a claim in certain injuries for wage loss if he claims I used to be a construction worker did heavy labor now I can't do heavy labor the doctor says I can only do said Terry work so he's paid benefits under the workers compensation act because his ability to earn wages for that injury because of that injury then he his pay whatever wage loss is determined by the commission he turned around and then makes a claim. I am in the third party case that I used to be able to do this job I can't do this job now because you're injured party RCB that your the party that causes accident created this particular problem and so now he's making the same claim for what he's already been reimbursed for workers comp and so what we're asking is even though eleven nine four ten when it was first promulgated in nineteen ninety three even though that allows for two thirds we're only asking for half up to half in this case depending on what he recovers but that would only be if he got or she got the full two thirds to make up for what they have lost while injured up to the determination whether it's going to be permanent or able to return to work yes Sir okay I mean we're we're not asking for anything that he hasn't been able to make a claim for in the third party case thank and and again this does not change or affect his ability to receive workers comp benefits thank you all right thank you Senator Flippo did you have a question or any other questions from the committee. All right so we are going to start with the those. that are for and we have believe we have three against and three four. Okay. All right the remember ladies and gentleman. Each person that goes to the table to speak for or against has two minutes Mr price is going to turn me in when that buzzer goes off you will know that your time is over all right the. Let's start with the I believe Mr way do you have you were down here for so we're going to go to the next person can't eighty. If you would come and tell us your name. Are you from and you're speaking for. Can't eighty I work for Wayne Smith trucking in Malta. And I appreciate the Senator Wallace and the opportunity to be here today and I think I've got a perfect example that will help you understand what we are going for. Of. I will support SP five thirty because we believe it it'll it'll improve subrogation law in Arkansas increased fares since nineteen ninety three wakes me trucking has been a part of this self insured fund or a group of trucking companies all over the state we we really concentrate on the safety of our employees keeper workers comp costs day on and as a group we have but we stay out of the market and try to. keep our prices down for workers comp insurers to a minimum. This allows us to board market fluctuations. But one of the things that was spoken of earlier is when we have a accident the driver was not at fault. That loss carries with us for the next three periods it keeps our premium tax we had a driver the January of seventeen was traveling south on interstate forty nine round Springdale. Vehicle pulled in front of any kind of all for a quick he hit the brakes to avoid it tractor trailer hit him in the rear end we paid all of this vision of medical calls therapy every size while he was off but right now we don't have a way is selfish Fund to recover those losses add this would give us one benefit and for larger testimony the the employee only get sixty six percent of his wife while he's off even though we pay that we've agreed that that employee should still have an opportunity to recover his lost wages but we would appreciate very much a away recover in our offices all right thank you your time is up. All right the the next person for is care and we can. He would come up miss mckinny are you here. All right all right. What we're waiting for her we will go to against and that would be Allen Hughes Mr Hughes if you would come up and tell us who you are and where you're from and to. Madam chair. Allen use Arkansas Ithiel CO. Up we've been up this table several times my years twenty six years of it talk about worker's comp worker's. We have a system in place we got a ministry of law judges hand on this now when you talk about somebody getting workers comp they only get two thirds of their pay weekly benefits paid starting out they still got a third recover when you turn around talk about people getting hurt or hurt what about those that are hurt they can't go back to work when you start open dorm taken money from them this is not what the intention worker's comp the ones that workers comp laws back in the past. We've got a system in place in its handling quiet while. Why do you want to turn around why can't the companies go so that third party if the worker consumed why can't they so and get their money back from nam why take it from the back of the workers because you're talking about people a lot of these people you're not they might have a farm I working Payton twenty years they had guys had chicken farms everything they also had run knows they don't get to recover this to that and the people I represent they're making eighty ninety thousand dollars you're working overtime. When you start talking about taking money from workers our top paid workers to come out short all right thank you very much. All right we're going back to for. Mr Hughes was against in care and the candy if you would come to the table and tell us who you are and where you're from and we have I don't know if you heard that we have two minutes per person within the company thank you we are thank you my name is Keren accounting I'm an attorney here in Little Rock I am representing the Arkansas selfinsured association today Mr that she is just mentioned that why can't the company said that's what we're asking you to allow us to do we the statute as written and Mr Wade said that it was given by the legislature in nineteen ninety three it was actually part of the original workers compensation act passed by the people of the State of Arkansas in nineteen forty eight. Subrogation the right of that work workers comp carrier the with the employer to recover from the third party has been. An instrumental part of workers comp until the courts took that away in the early nineteen nineties of. We. There is a third party at fault the statute says we ought to be able to either recover part of the settlement or go against that third third party Mr way gave you an example of where they tried to go against the third party and the courts even said well even though that part that pleinement accepted last plan policy limits you still can't go against that third party and get the difference plan policy limits on what the climate collected and ended up charging Mr way the attorney's fees for the injured worker to to tell him he can't do that up I had a case. Just last fall of man injured his ankle serious injury we paid multiple surgeries over a hundred and sixty thousand dollars in medical benefits and lost wages for this man he settled with the at fault party in the the other driver for five hundred thousand dollars what right now we couldn't collect anything what we're asking is the ability to collect up to one half of what that claim it got one half of five hundred is two hundred and fifty we would only get one sixty because that's all we paid the claim it gets all the rest and that's been the claimant and his attorney we're not asking to get more than what we pay now. And with our and with regard to. Settlement. See if we have it shall two minutes yes you have X. extended your two minutes all right I do see a question would you take a question yes Sir yes senator Hammer thank you have chair. Somewhere in the language I read about absolute lean how does that relate to what you do representing who you represent and where does that put the injured employee in line to get. What what they should get to the gym for his first period the injured employee gets their money first then any land that comes out and there's lands for child support things of that nature this is saying that workers comp is an absolutely in which means it it will come after the claim it gets his money so if if it's a fair split and we play an exact example five hundred thousand dollars we paid two hundred and fifty thousand dollars the claim it the injured worker gets his first one half R. lane is the first lane on the second one half so in anywhere wait this bill as written would you get more than what they are Loihi should be getting to be made whole hundred percent of what they would have had and lost wages we would never get more than one half of what that somebody is and may hold is such a nebulous term that we don't know what that means okay what's don't know what that means thank you all right I don't see any other questions thank you so much for it we're going to the next against of miss mckinny was speaking for the next against is Robert Grice. He did I pronounce it wrong G. R. I. C. E.. Okay if you come forward. All right state your names for the record please. Robert Bryce latoya Christ. All right you're recognized. We're here basically to speak against this bill speaking from a personal experience. The worst skews me is your microphone you'd see a little green button yes ma'am it to okay and not want to pull it closer to you please. Can you hear me now mmhm okay we're here to speak against this bill on a personal experience. the workers comp does say that they will pay sixty six percent of a lost wages I know for a fact that my husband was in his rack about two years ago we lost more than half of his wages. Not only did we have to figure out how to continue to support our family. But we then had to deal with the emotional strain of dealing with a workers comp case manager that goes to every appointment with you the only thing that they cared about was when he was going back to work. So they could stop paying medical bills. He is permanently disabled. If you take a half. Of any settlement from any victim all you're doing is can continuing to victimize the victim. His record was not his fault his injuries are not his fault. He should not have to continue to pay we have five children. As a nurse I had to watch him struggle I continue to have to watch him struggle. Along with having to support him as his wife. The doctors appointments along with raising our children and still working a full time schedule. It's enough to drive anyone crazy. All this bill would do is make that worse. The recovery process is enough. Then simply trying to go about their daily life and adjust to whatever new normal that they have. Is enough. Taking more money out of their pocket is it's not fair okay thank you so much that's the two minutes. If you wanted to say something I'm going to allow you as well Mr quickies okay. and I'm putting you down for two minutes okay I've been a pest control business for twenty seven years. This is really your burgers deal with this every day I heard and all you have nothing but disrespect Mormons. I was both have medical transportation they sent Kenyans cab service to pick me up in a wheelchair. I wish day I feel very victimized by workmen's comp I still take a hit every day. Are to go back to work so I'm home all the time it is very hard on me I heard twenty four seven and I don't feel any care or respect from workman's comp I think it should be for the employee. to help because I know there's other ones is the worst case is that many. I can support my family anymore like I used to in this whole or. And nobody understands it. So I really I noticed that this bill does not pass. Okay all right thank you I didn't see any questions for you so you are dismissed thank you so much. All right we have one more for against and that is Meredith more. Thank you state your name and where you're from police. Thank you madam chair yes skews me I'm Meredith more a plaintiff's lawyer in Little Rock and I handle the third party settlements in these types of cases so I represent people just like the grasses that have been injured by an actual wrongdoer while they were on the job and I just want to make something very clear this bill affects those circumstances where there's not enough coverage to go around okay so when there's enough money on the table for everybody to get paid I want to tell you how it works in real practice we pay workers comp every single time there is a lien that I'm responsible for and I have to pay so how we handle that is just us girls the legal counsel on both sides get together and decides what is fair for both sides on this issue. If we can't agree then we go to court I will tell you in the years that I've been doing this now. I haven't had to go to court on the issue we're always able to work it out if we do have to go to court if my firm has to go to court then there is a judicial process and it catches any unfairness there is you're going to go in front of an administrative judge that's appointed by the Arkansas governor if you don't like that decision you can appeal to the commission if you don't like that decision you goes up to the Arkansas court of appeals and even the Supreme Court so there are safety nets in place to make sure that it is fair on both sides this bill puts the actual injured worker second in line and that's just not how it should be right now worker's comp gets paid a hundred percent of what they have paid out but second to the actual injured party and in these scenarios we're not talking about a bump on the head we're talking about horrible horrific injuries we're talking about truck drivers that have been hit by drunk drivers that can no longer walk anymore and in those situations they're entitled to additional compensation to make sure that they're made whole hi thanks and I'll take questions all right Senator Hammer you're recognized for a question. Okay so it's your interpretation the way the bill is written that if there's a settlement on a third party. That the attorney is going to be first in line to collect for the employee is going to be first in line to collect. No attorney should be first in line I'll just make that clarification but if you're talking about the attorney for workers compensation is that who you're referring to well I guess I'm asking workers compensation attorney or third party attorney I understand the way that the bill the way that the law works right now prior to the bill is that workers compensation can collect a hundred percent of what they have paid out okay if for some reason it's determined that the injured party has not been made whole then in that scenario you look at the injured party first make them whole and then pay out to the workers compensation insurance company the way this bill works right now is turns that turns that on its head and puts the insurance company first. And split evenly with the employee. I wouldn't say that the sports anything evenly Sir because you're comparing somebody's lifelong injuries and well being and livelihood to medical bills. Thank you. A just for clarification are you saying that. Of this bill. Who does this bill put first this bill puts workers compensation first and I will tell you in my practice worker's compensation at the end of a settlement of personal injury settlements or third party settlement I have to pay workers compensation back from my client settlement the made whole doctrine right now which is been in effect since the nineties puts the injured party first to make sure that they are made whole they're put back as close to a position of as possible as they were before the incident before you're paying back the workers compensation insurance company now I will tell you that more times than not I am paying workers compensation more than what my client gets in their pocket at the end of a settlement. Even with the made whole doctrine in place where do the attorneys coming in on the payments. The attorneys come in as it is all lumped into one it is all one settlement to the injured party who has to pay their lawyer to maneuver through this mess out of there said on out of there settlement. So the only. Entity. In this bill is first. Two in this before the date in other words give me of the steps this bill. Takes the injured worker who should be referred to the line and puts them second all right to the insurance company and then in that settlement they pay they're turning they pay their talents and we reduce our free all the time because we have to make sure that workers compensation is paid for their services as well okay thank you senator Sullivan I believe you have a question thank you madam chair this is are considered and the workers comp the fact that premiums are being paid in the settlement. Well. As far as the premiums go I'll tell you I'm also the wife of an emergency room doctor who brings up insurance premiums to me on a regular basis and I will tell you that we are that every single year we are in the bottom three for the lowest premiums in the state of Arkansas for workers compensation and so and I think your question I will say as far as how this bill affects that. You know it doesn't it's not going to this is not going to affect those insurance premiums and we don't really have to worry about it because we never have to worry about insurance premiums in Arkansas thank you for everybody I have a follow up messages we just heard testimony and I'm sure I didn't sorry I didn't get that stuff like that testify that I think she was walking out she said that hi NO one can define made whole give any idea if we keep talking about may hold she said there's no definition to it or nobody knows what that means yeah I think I know why she says that don't justify what she said about asking yeah do you understand what made whole means legally legally made whole is simple it should mean that a person is put back together. In this state that they were prior to being hurt okay so you know what it means the reason why it gets complicated is because there's not enough money in all of these situations that we're here for today there's not enough money to ever do that for you clearly understand what made whole means. I do as much as I can given okay what a process the senses thank you ma'am thank you any other questions from the committee seeing none thank you so very much thank you madam chair. All right ladies and gentleman we have heard those against and we have heard those for. So the senator if you are ready to close for your bill. Thank you madam chair. You know I'm I would like to make a couple statements one as a business owner I can tell you that any time when you have a workers comp policy if there's claims against that workers comp policy. You will you will see an increase in your bill next year I've seen that over and over and over. The person that really gets paid first and all this. The first person this will be the trial lawyers. Cold hard facts. This bill does two things. It reasserts. The employee's right to intervene in place a lien on in that process it's. It reduces a portion from two thirds to one half. And despite the clear language. The law currently has to allow for employers to recover the cost. The Courts in Arkansas have consistently ruled against him. Liberally applying the whole maple Dr. What forty four other states. Don't do it this way. This section tends to clarify the intent of the language to allow employees the opportunity to recoup expenses when a third party settlement is obtained. But also. This is them out from two thirds or one half. In members with that I am closed. All right ladies and gentleman you've heard an explanation of the bill you've heard those for and against and the senator has closed what is the will of the committee. Pass what a motion to pass second all those in favor say aye hi all those opposed. All right of I think. What three yes yes. No. Okay all right we have a motion for roll call so we only need one hand. And the so Mr price call the roll. Senator Hester. Senator Wallace all right. Senator Davis. Senator Hammer. No hi hi. Sorry. Senator Solomon. Senator Gilmore. Senator Flippo. Share what's on. Yes. All right ladies and gentleman of. Let me get the official I think we've all been counting here so if the. All right to there are six sons the motion passed the bill pass is congratulations. Alright ladies and gentlemen let's go on down to House Bill Fortino too and who is running that for you're running that for a. A representative. Barker. All right which please state your name for the record please Senator Blake Johnson district twenty. Members this bill can may I proceed. Yes you may members this bill updates are Martian inducing drugs safety act in two thousand fifteen most of that bill went back to the it is. FTA and those have been those protocols have been loosened and this bill outlines requirements for dispensing abortion inducing drugs it clarifies that an abortionist must physically examined the woman in person before dispensing abortion drugs and to it clarifies the abortion abortion inducing drugs may not be provided by mail or delivery service due to a Supreme Court ruling it requires the abortion is to be able to handle emergency transfer of a woman who experiences abortion complications and have a signed agreement with an associate physician whose credential to handle abortion complications what as well thank you members per person give a. Right any questions from the committee. All right seeing none. Of this anyone want to speak for or against I believe the head to to speak against any of. Any for a. For this bill okay all right of the first one to speak against is Jessica lord. And I don't know if you heard that you have two minutes. Can pleads please state your name and. Who you're with where you from thank you madam chair and committee my name is Jessica Lloyd and I represent myself all right this bill would ban medication abortion prescribe through telemedicine or delivered through the mail however exports experts excuse me support exactly the opposite approach the American college of obstetricians and gynecologists supports policies that would increase access to reproductive health services including the use of telemedicine for medication abortion. An expert panel convened by the national academies of sciences engineering and medicine in twenty eighteen concluded that requiring medication abortion be provided at a particular type of facility or the physical presence of health care providers yields no improvement in safety or quality of care. And keep in mind medication abortion is safe the rate of significant adverse reactions is higher for over the counter Tylenol that it is for medication abortion also if concerning this bill is the requirement for third in person follow up appointment the FDA guidelines for dispensing medication abortion say this follow up can be done over the phone. Requiring patients who live long distances from the nearest clinic to commute unnecessarily let alone for three appointments now is an undue burden to abortion access in a time when telemedicine and mail order pharmacy are safe and effective ways to extend healthcare to underserved communities I urge you to vote no on this bill thank you all right I don't see any questions from the committee so thank you very much next is Caroline. Morgan. K. if you would come up and tell us who you are and. Where you're from who you represent. Hi chairman Bledsoe my name is Caroline Morgan I live here in Little Rock I'm not going to repeat the points that my friend Jessica just made earlier but please note my objections and I'd like to yield my time to the trans kids their families and their supporters who waiting in the next room I'm sorry ma'am but you can't do that because you're speaking on this bill we will take care of that market gesture hello okay all right thank you thank you. Seeing no questions of heavy clothes for your bill senator thank you members of a January twenty twenty one Supreme Court ruled. These drugs cannot be dispense no matter who thanks that it's a better way to do it and there are complications through that through that process and this is a very serious the thing and to have have those in it without a setting that is proper proper for the for the woman in the protections of that of that woman in that time so I appreciate a good vote all right thank you ladies and gentleman. you've heard the discussion you've heard those that are against and you have heard the closing of the senator what is your decision on this on this bill. Okay I have a motion all right. have a motion and a second all those in favor say aye. All those opposed congratulations you passed your bill right looking on down the calendar we have a House bill fifteen fifteen is there someone here okay you of Senator Hester you're gonna run that bill. All righty. You are recognized. Thank you members and I'm just gonna talk mostly about the about the policy here we've got three passes in the state of Arkansas and I think they're all doing a great job they're serving our community well they're serving our duty community very well and I think if you guys remember a few years ago we're having tremendous amount of constituent issues which as far as me have dwindled down drastically and I think that's a that's that's a testimony to all three of our passes student doing a great job but I think just as a matter of policy it's a concern for us that we would have anyone company owning more than one pass or provider owning members or for providers having membership or ownership of more than one pass because the goal is competition to keep to keep you know costs down and quality of care of I'd be happy to answer any questions and questions from the committee. All right seeing none. Of a six we have one person signed up to speak against it in that so Mr Derek Smith if you can come forward and tell us. Who you are and where you're from who you represent we appreciate. Thank you madam chair of the committee my name is Derek Smith I'm a lawyer with the Mr Williams the litigation would your law firm here in Little Rock where I practice insurance regulatory law and represent clients in their interactions with insurance departments throughout the country my comments today or on behalf of anthem Inc I did not speak on behalf of any particular path past anthem protest has participated in the past program since its inception as a minority owner of summit community care in March of twenty twenty at them completed a national acquisition of beacon health options at the time the largest independently held behavioral health organization in the country serving more than thirty six million people across all fifty states throughout this transit through this transaction anthem indirectly acquired beacon sixteen point six seven percent interest in power healthcare solutions another pass which serves approximately nineteen thousand Arkansans I was a member of the team that represented in this transaction that was reviewed by the Arkansas insurance department. Anthems minority interest in summit community care was known before the insurance department's public hearing on the transaction and acknowledge in Athens testimony during those proceedings anthem also testified that it did not have the ability or intent to materially change the operations of empower or summoned as a result of the transaction nor any plans to change the services provided by those entities no one objected to or testified against anthem's application and the insurance department approved the transaction September of twenty nineteen. We appreciate senator Hester's comments that the transaction is not result of the change of services provided to to to to the state but we still oppose house bill fifteen fifteen simply because it changes the rules of the past program mystery threatens disruption for past members and providers and sixtyforce asked them to choose between two legally acquired equity interests with no evidence to suggest that issue exists in the market today is sensually forces my client into a fire sale. Now. It inevitable consequence of this bill is a fundamental restructuring of at least one pass currently sorry interrupt the past two two minutes thank you so much. All right is anyone else on speak for against all right seen none. ladies and gentleman you've heard. The about the bill do you want to close Senator. I will I I would say that all right I agree and I appreciate Mr smis comments this this allows for two years for liquidation of that position and and again I think this is just a matter about competition I think they're all good actors and all them what they should but I think a matter of policy we don't want to see the same people having more than one of these passes and I would I'll close I make a motion to pass all right per the motion I have a second all those in favor say aye all those opposed congratulations you've passed your bill. The next bill on the agenda is house bill eleven forty one. Is there someone here to run that for for us okay. For representative vault. All right with them pass over that bill. All right the representative Lundstrum your next. Ladies and gentleman just as we get started on this bill. I would ask that you remember you only have those in the audience you only have two minutes to speak and if there is any disruption if there is when a close if if I want to ask you to close if there's any delay in that we're going to have to ask you to leave the committee room. So with that of. Representative or you do want to. It's something you need before you get started yes madam chairman I have to experts that are here to stay mapping them up the table yes please student please have them identify themselves for the record yes thank you. I believe there are some people in the holding room that may want to speak for or against so I'm not sure but you might check. All right are you ready a representative you may I have your of guest introduce themselves for the record and then we'll get started thank you senator Bledsoe and if I could have my guess to dismiss themselves and also you have their resumes in front of you okay. I believe with passing those sale. my name is Charles Lewis hi am a psychiatrist general psychiatrist in Arkansas practicing in the delta region of in public sector psychiatry. My name is Roger high as a junior MD I'm a child and adolescent psychiatrist trained at U. M. S. and the children's hospital here in Little Rock I've been practicing psychiatry for nearly thirty years currently in West Memphis and Jackson Tennessee thank you for being here today all right of representative you're ready or are Senator Clark whichever one. I'm going to a deferred to represent of Lundstrum all right Sir the you're recognized. Thank you house bill fifteen seventy prohibit sex change operations on children. This protects children in Arkansas from sex change operations as well as chemical operations are set chemical procedures the World Health Organization the United Nations population fund United Nations children's fund. And many other organizations universally recognized the general mutilation on children of surgically and chemically is wrong. A profound psychiatrist Dr Christopher Gillberg stated this is possibly one of the world's greatest scandals of medical history. These are children under eighteen. We are simply asking that they be protected. I'd like to yield most of my time to these two gentleman that have driven here and given their time today I would like to sit just have some things put in your mind first there are no standards of care for this this is about protecting minors this does allow for counseling this is a very tightly crafted Bill. And medicine the motto is first do no harm. My hope is that children would get to be eighteen many of you I would hazard to guess did things under eighteen that probably shouldn't have done to make decisions that probably shouldn't have been made. My hope is that people get to be eighteen and can make adult decisions we have outlawed or banned many things from eighteen year olds such as alcohol tattoos drugs smoking going to a casino renting an apartment purchasing cigarettes buying a lottery ticket even changing your name. Why would we ever even considering allowing a sex change from minor. This does still allow counseling and with that I would open it up to these wonderful folks that are here today all right either one of the disks decide who wants to go first. Thank you madam chair members of the committee. For allowing me to come here today in support of this bill I'm no lawyer but the scientific basis of the bill is as represented one percent is very tight it's a very good bill. I'd like to start out with a little history We've been here before. Transgender movement that we face right now is. Not new. There was a gender clinic at UAMS the University of Arkansas in the nineteen seventies. This. Corresponded to the same time that the most preeminent American research and treatment program for transsexuals was open to Johns Hopkins University School of medicine in the late nineteen sixties. Being a research institution. They're criteria for admitting people into their program was very rigorous they were subjected to medical psychological psychiatric social evaluations to make sure that this is what they wanted they were given cross hormone treatments and then they were given the the sex change surgery. Also being a research operations they follow these people for years doing follow up evaluation or psychiatric and medical status. And those people have to agree to do that before they would even let them in the program. At the end of approximately ten to eleven years programs closed. And the reason the program was closed was reiterated by Dr Paul McCue who was the department chair Johns Hopkins and the department of psychiatry for several decades. He said looking at the data of outcomes after surgery. Even though the patient said immediately after surgery they were satisfied their lives later on did not mimic this they had no change in their level of medical morbidity psychiatric morbidity. They're suicide rates were the same and their dissatisfaction in substance abuse histories were all the same after the surgery as before the surgery the ethics committee at Hopkins decided that since we are offering no improvement to these people we should close the service because we're asking these people to undergo. Severe severely serious changes in their anatomy. And cost and they're not allowed to they're not having any benefit from that so that close the American side of of this productive type of intervention in Europe that continued. In Sweden especially they were very rigorous about gathering data and keeping up with these people and they published in twenty eleven. A thirty year follow up study. Racking three hundred twenty four patients from nineteen seventy three to two thousand and three similar things at the Hopkins people looked at what was the outcome how did they do medically psychiatrically. And they found some shocking things. The medical morbidity and mortality the death of all calls is happened at a higher rate with those who had the surgery. Most strikingly the suicide rate in the people having completed the transgender surgery was nearly twenty times higher than the general population. The explanations for this are are being debated but the data is clear. So the seriousness of this you you probably noticed I haven't mentioned any data in children or minors that's because there's not much and what data there is or from small studies that are poorly designed. They don't have proper control groups they don't have blinding. And many of the studies are funded by the industry that manufactures the drugs used for puberty blocking and. And cross sex hormones hormones skews me. The It's also important to consider the fact that these drugs that are being used in the studies. Do not have FDA indications for this use. In in minors. My primary concern is about the brain development being affected by puberty blockers and cross sex hormones we simply don't have data on that. And it's. It would be naive to think that those chemicals in the brain don't have an effect we know now that hormones are you used in the brain as neurotransmitters. If some of those hormones are blocked while a child or teenager's brain is maturing which takes place all the way up to age twenty five we have no idea what this does to their brains we have no don't data to fall back on it is a psychiatrist that's my primary concern along with all the other medical issues. We also don't have any long term even short term studies on the all of surgical procedures and minors for a gender transition and so I just want to ask you to support this good bill for the protection of the children of Arkansas and I yield to my colleague Dr Hyatt. Thank you Dr Lewis madam chair members of the committee and. It's my privilege to address you and support this House Bill fifteen seventy hi as mentioned to did my training here in in Little Rock and now have nearly thirty years experience working with children and teenagers and psychiatric field I'd like to point out that Prior to about two thousand fifteen I only encountered just a very handful of young kids who who identified as transgender but that over the course of the past five years I've seen those numbers grow exponentially which is borne out by literature I have personally worked first hand with dozens of children and teenagers who are dealing with gender identity concerns I'd like to point out that that gender dysphoria does not occur in a vacuum that this is a condition that occurs in the context of severe psychiatric pathology depression anxiety and neglect and abuse often suicidality very frequently and has just been my practice to address the underlying psychiatric conditions the anxiety and depression the issues underlying into To sit sit back and wait I guess you'd say to have watch full waiting for these children to to declare themselves ultimately as trans gender or to desist and to I gender identity that is consistent with their genetic make up the literature is clear on the systems rates as. All the all the studies I've looked at it from a low of eighty percent to up to upwards of ninety seven percent of children who are left and to their own devices in childhood will desist by the time the turn it H. nineteen and it should be pointed out that the suicide rate amongst a trans gender identified individuals while about nineteen times higher than the general population does not improve after hormone a hormone interventions or even some surgical procedures the only thing that improves the so suicidal outcome for these kids is to assistance and the more the interventions are are taken undertaken to encouraged to trans gender identity the less likely they are to desist and consequently the more likely they are to kill themselves so I urge you to please advocate for the best interest of the children and teenagers in Arkansas and support House Bill fifteen seventy. All right of gentleman when when the chair said that you would have that others would have two minutes I didn't mean for the two of you so can anything I would love for you to go and it's so interesting but if you have anything to add please do but I do have a question tell me you said something about it something about eighteen and if you're in the brain development and all of that So. What can okay either one of you just tell me about the brain developing and the lack of development maybe I should say taking all these chemicals handy how do you know tell me tell me about how you know that it it does something negative to the brain. Well that that's. As I said earlier there's there's no there's no real data on this these are these are kind of fear radicalized D. is based on what we know about. What what little we know I I don't want to come across as a lot of times medical people come across like we know more than we really know the brain is the most complicated organ in the body we know less about it than any other organ systems. We do know some things. We know from neuroimaging studies kids teenagers young adults that brain functioning develops over time you're not born with the same brain that you wind up with with when you're thirty. There are more neurons being form there are more connections between neurons being formed and all of these things depend we think on cycles of neurotransmitters being applied at the appropriate times some of those neurotransmitters or hormones. We know that there's a lot of estrogen in the brain of of males and females more for more female born females but some in males that uses a neuro transmitter if you use. Huberty blocking agents in the middle of this maturation process. You will shut down the production of one or the other of the of the sex hormones. It seems logical that that could have profound effects on cognitive functioning later in life. But again we don't have longitudinal studies like to have in the adults that they have that in the adults but we don't have that in children and adolescents and taxed my biggest worry is we're we're doing something we don't get a do over on if this goes bad you can't go back and fix this. Thank you. Sir did you have anything you want to add well I I would like to add that in addition to the physical and physiological impact that the hormones whether it be purely blockers or cross sex hormones intervene interventions in addition to that physical impact there's and a psychological and mental impact that can't be ignored and many I would say most of the young people who I've dealt with who identified gender dysphoria as as of a primary concern become hyper focused on the issue to the point that that the productive work in on the depression the anxiety in the the abuse victimization and so forth is is that adversely impacted okay thank you any questions from the committee. All right of I'm going to ask you do you have any papers that are published on this. I'm sorry that we've published or that we've red red or I will publish to was the reason I'm asking that is this is the first time we have had something to go on you know we so many times we think that could that possibly be good. And yes we've reviewed literature Dr though yes and I can if given an email address I can for those to members of the committee that we in trying to deal and looking at the the representative look on Lundstrum could give my email address set out to and I could get it to Mr pricing he could forward that to the members of the committee all right of any other questions. Okay we've reached the point where we ask the audience to speak for or against thank you Sir thank you very much thank you. We have thirteen people that are here to speak against and I'm just gonna start down the road. Justin solo are you here in the audience. All right of Billy mac bride. Thank. Okay could of. Sir would you ask if it's the telephone that it's time to speak for against and if they would come in and take a seat okay. All right. Are you a Justin Sullivan. All right since we're waiting on the others wanted to come to the table and I don't know if you heard this or but two minutes that's right. Just right there in that chair up right there in the microphone next first microphone you can fund. All right tell us who you are and where you're from my name is lance live our I'm a citizen of North Little Rock and here speaking representing myself all right you're recognized in we're starting the cloth all right thank you we've heard a number of things that I'm not going to speak on the medical because on a medical professional but I can tell you my own experiences. I can tell you that similar bills and court cases have an amicable amicus briefs and others written against by fifty civil rights organizations and other one by thirteen medical organizations that these are not good in fact some of the things that they discover in there he spoke about suicide when you're not allowed to be around to be who you are suicide is much more likely to happen we speak about the fact that we seen more than lately we've also seen more autism diagnoses and why we've also seen more of other types of diagnoses having more now doesn't mean that somehow there's some kind of influence that you have to do it means finally you're being accepted. And we're trying to find ways to help you. I'm gonna tell you about my nephew my niece may. I had a chance to hear from her. That she was my needs now. I had an opportunity either listen to the little bits of pieces in my mind that said what's going on she just doesn't like to dress like a guy or something of that type instead I actually went to an expert who had actually treated hundreds of people. And he helped me figure out the differences in the ideas get close to find out how to understand. I'll take any questions from anyone okay thank you of questions from the committee right seeing none thank you so very much. All right number because some of these names out again I guess everyone that wanted to speak. Against the bill is coming in from the committee so Amendment I'm sorry from the holding room Justin Sarlo. Billing next Bryant. Cash Ashley. Chris a T.. Okay if you would come for when I called okay that you have to sit right there please Sir. And state your name and where you're from and you only have two minutes yes ma'am all right of my name is cash actually from Little Rock Arkansas I was born and raised here House attended college here I am the currently the head chef redo no brick oven and barroom on South Main street I am also transmission I have a feeling that there's very little I can say to change the minds of those here that need changing so I'm gonna say most of my energy for me in my community however I did feel compelled to go on the record. Say that I very strongly oppose this bill it not only creates many problems including further marginalizing and are already marginalized population but pretends to fix a problem that doesn't even actually exist if this bill passes people will die I wish deeply that this war hyperbole transduce aren't being experimented upon in receiving scientifically backed trans competent care. Those of you to support this bill are the ones experimenting with the lives of young trans people by testing whether or not they can survive the onslaught of horrors through which you are subjecting them had I received trans affirming care and or trans continuities I may not have tried to take my own life when I did I tried to kill myself once when I was fifteen and once again when I was seventeen. The world is already a hostile place towards trans people especially trans youth. Please don't actively choose to. Additionally in still violence by creating barriers to care which is what this will do transferrable we've been here we will always be here and you cannot erase us. Please stop trying please vote no on house bill fifteen seventy thank you for your time all right thank you questions from the committee seeing none no one wants to hear from a trans person well I think there are some others that are here to got it speak thank you Mr Ashley thank you wish it to be in here all right the next one is Chris Ateeq effect pronounce that correctly who come forward please Sir. Tell us the your name again and and also where you're from my name is Chris attic and I'm here from Little Rock Arkansas and I'm speaking for the fathers of all the trans job gender children in Arkansas who have to work or take care of their families today ninety first be directly to Arkansas's transgender youth with a lot of real father you are loved no matter what happens here today you're logged we will prevail against this hatred stay alive no matter what. Quick trigger alert this testimony contains distressing material involving transue aside. I'd like to read to the bridge words Ashley Harrell young lady born in nineteen eighty nine died in two thousand fifteen she wrote these are going to be my final words I can't stand to live another days on committing suicide I am transgender that means that even though I was born a male body I am and have always been female I've known I was female for as far back as I can remember this caused me to become severely depressed from a very young age because I was told that people like me who are freaks and abominations that we are sick in the head of the society hates us this made me hate who I was I tried so hard to be just like everyone else. This isn't something you can change. It wasn't until I was twenty that I found out I wasn't alone I had hoped that I would finally be able to live as I am in love who I am I finally came out as transgender begin trends just transitioning for the first time in my life I was genuinely happy despite this huge change I never got over the depression everywhere I turn I see the hate that society has for us I've already been poisoned by a society that didn't understand us and even worse didn't want to even try I saw the pain caused to people like me and going through the same or myself it's just become too much for me to take anymore you need to know that I'm not just another face of someone you never met I was alive I had a family and friends that I love very much I love being around those that I love I love listening to music and singing a lot going out to eat with friends and enjoying good food I was a real person transport everywhere you may never know who you're hurting until it's too late. Stop persecuting my kid stop hating my kid stop bullying my kid the state is not lawful long in my family's medical decisions and it does not define my children's identity please vote against this bill thank you thank you so much all right the court any. For your senate. Hi there I'm Courtney Frierson a social worker with thirteen years experience providing therapy to transgender community in Little Rock. There is no surgeon in Arkansas performing surgeries or experiments on children. This bill is unnecessary because it aims stop to stop something that does not actually happen. They're already criteria in place for the standards of care for the medical treatment of trans youth and organization is overseen care for trans people for forty two years. The world professional association for transgender Health W. passed standards of care for children are moderate and cautious. They advise adolescents to slowly move through fully reversible steps partially reversible steps and wait until eighteen for permanent steps such as secretary once again there's no legitimate medical professional in Arkansas and gauging and experimentation and it is offensive to call it that. Let physicians do their jobs informed by accurate medical research backed by forty two years of W. past experience you can reference your email for the medical research that I email to all of you. They're trans children in Arkansas and this bill will not erase them it would create suffering barriers to care stigmatize them and embolden police. In my therapy room right now I'm hearing that sadly my trans clients feel deflated and this bill and the others in this legislature confirms their lifelong experience of being targeted and hated for their gender expression. To deny someone access to treatment to pursue their authentic agenda is to deny their existence. Trying to extinguish gender expression is akin to conversion therapy to extinguish sexuality. Repaired of therapies are condemned as ineffectual in harmful by many medical and mental health organizations and they've been outlawed in twenty two states. Legislating discrimination is on brand for Arkansas but it's ugly and bad for business it has a chilling effect on research it harms our Kansans the Bill pass a rep team sorry state sanctioned violence against trans people pleasing them thank you so much all right the next one is doctor Natalie Burr. Good afternoon. My name is Dr Natalie bernama general pediatrician here in Little Rock I'm here today representing the Arkansas chapter of the American academy of pediatrics which represents over four hundred thirty the attractions in our state and I'm here to ask you to oppose house bill fifteen seventy this bill would cause harm to the health and well being of youth with gender diversity or gender dysphoria in our state first we do thank you for your concern for the use of Arkansas and we recognize that this bill does touch on a sensitive topic even amongst our chapter members as pediatricians we walk alongside our patients and families in navigating the health concerns that arise from birth to adulthood as a pediatrician I'm one of the first people to hold the baby after it's born share the joy and excitement of watching children learn to talk walk starts school and celebrate high school graduation we also share in the heartbreak of chronic illness disappointments and loss but sometimes come along with growing up we as pediatricians are not just professionally invested we're truly dedicating our lives to keeping children healthy and safe and this is why I feel that alongside parents we are most qualified to determine the best course of care for our patients this bill would penalize us for simply following best medical practices to provider even referred for appropriate effective care that is based in science and evidence not irresponsible experimentation this bill harms in already vulnerable group of patients and it would cause immediate and irreversible harm to children already getting treatment in our state removing access to gender affirming care could increase suicide rates for a group of children already at high risk. We oppose this bill because it undermines our patient physician relationship limits our ability to refer youth with consenting parents to care supported by medical experts to the transgender youth of Arkansas although this bill unfortunately reinforces the discrimination and hurtful messaging you so often get in society please note that many pediatricians and the A. P. stand with you and against this legislation thank you very much thank you we have some questions at least one of all right senator Sullivan you're recognized for a question thank you know you have four hundred some members was there a survey taken of those members are for sure select board that made that decision to oppose this so my understanding I'm not on the executive board for the AP Arkansas chapter but for stances like this they do have a board meeting for it the advocacy board would have been one that voted on this but on controversial issues that aren't really covered in our blueprint then they would have the executive board vote which is a board. At eleven members but you might wanna confirm that with our executive director and so the board voted to take our stance on this okay fee on that executive board you have a member who is a former you have a two members from UAMS one from children's hospital do you know if there are if they are voting in those entities indoors the pediatric association's position I would not be the person to answer that you have to follow up with our executive director okay thank you thank you manager all right Senator Hester. Thank you for being here in your testimony do you think if parents had a child so that a boy they wish for and I wish it was a girl that at a year older two years old they could have a start these blockers or have a physical change for the child you think that would be appropriate. Well I don't know do you think it four years old that would be appropriate I think that that's a decision made and joining with parents and the wishes of a child which is where gender affirming care comes in referral to specialist so four year old should have say on if they're a lawyer girl. I think that yes I think that a four year old you can listen to what a four year old says okay but it but one year older two year old how do you think I think that one and two year old developmentally generally do not have an understanding of what gender is at all. Okay so I think that will develop think that's my point you agree that there is an age that the that's not appropriate. I also agree that there's an age is not appropriate we're just now depending on what age is appropriate so you're somewhere around four and I'm somewhere around eighteen. But we agreed we have the same belief that there is an age of its appropriate and not appropriate for the decision to be made. No I think that a decision is made over time with input from family and professionals I do not think there's a line in the sand when a child's gender identity is determined and it's for ever that I think that that is something that needs to be discussed with appropriate professionals and not decided on by policy makers are legislators. But at one or two years old that decision should not be made on behalf of that child. Correct. So again we agree on that thank you. All right to talk to Byrd did you tell me again do you practice in Little Rock is it what are to the general pediatrician in private practice a city all right of. Any other questions productive for all right seeing none thank you so very much. All right Jennifer Steele. She okay. We set the clock again steel. I'm. Can you hear me yes okay introduce yourself please for the record my name is Jennifer Steele on the Little Rock resident a wife and a mother lifelong native I had a whole spiel I was going to do I'm going to go ahead and skip to what I think is the most important part okay One of my sons is transgender. And what you guys are not seeing and not trying to see is how difficult it is for a person who is transgender before that right knowledge and believed and supported. My son was a beautiful happy one year old and he was at that time presenting as a girl I had no idea he was happy he was chubby he was fine he was smart he had everything going for him as he grew up he said I can't wear dresses anymore mom. What it's like okay fine we'll just go with that and I don't wanna wear girls clothes anymore mama okay I don't like the hoochie girl clothes from target either and then he aged out and he said he hit puberty. Did spiral down black. Depressed withdrawn suicidal yeah and cutting on himself just did a quick cure pretty did it there's no happiness with becoming a girl none I had no idea what to do I had no idea what it was. I got therapy with him I got hit with the whole family I did everything a mama would do no clues still spiraled one day he came home and he said get it mama I know what I am unless he's. What it means and he's in. What you're missing is the joy that that we had on his face it was like. It was like having god in the room with me to tell me listen to your child he said mom I'm transgender it means I'm really avoid and. I had never even heard the word no idea this was quite a while back this was already in a moment are you are missing it and I'm sorry you're missing out on knowing all these people and supporting them because thank you for this bill kids are going to die and it's when you all. Thank you so much all right to we have Joanne a grant that. Microphone on. There if that's much better thank you. So my name is Joanna Brandt I'm an Arkansas resident small business owner in the river valley I'm here on behalf of my son Dylan and the other transgender youth and parents that could not be here with us today I thank you for your time and attention I'm speaking how to those of you that may have already decided before you got here to support this bill or are on the fence those of you that oppose this bill like we deal I thank you from the bottom of our hearts. I have parented Dylan for fifteen and a half years I've had to make tough decisions over the years always thinking first of his safety and well being the seat decision to seek gender affirming medical care was no different and I did not make the choice flippantly I supported him from the moment he came to me and told me he was transgender even so after many conversations with my son I sought the advice and expertise of medical professionals the idea of consult to law makers actually never occurred to me. I also search my soul is his mother who loves him dearly as to what I thought was in his best interest today after two years of therapy with both a local therapist and with the gender spectrum clinic and seven months on gender affirming cross hormones delegates happy kind thoughtful confident and hopeful for his future and his outside now matches the way he feels on the inside. I understand that you will think that you're doing the right thing I understand that you believe you are preventing harm but just because you believe it does not make it so. By supporting this bill you're telling me that you don't trust me as a parent to make the right decisions for my child you were telling me that you who had no knowledge of me prior to today and I've never met my son so how you know better than we do what he needs where will you be when you find out you're wrong. I'm here asking you to allow medical professionals parents and patients to make these decisions and you can all go back to the work of important issues that affect the majority of our Kansans I also if you've never had the pleasure of meeting a brave transgender child to take the time to do your due diligence meet my thank you talked with him before you make a decision that will thank you back to him thank you very much thank you. We had cancer in Stanborough. Introduce yourself for the record please. Yes ma'am and thank you for allowing me to speak to you today my name is Dr and Catherine sambo and I come today as a mother as in our cans and and is a physician provider for pediatric and adolescent transgender and gender diverse stations I would like to emphatically expressed my opposition to this bill I know that we are all present today because we care deeply for the children of Arkansas and what I would challenge you to think about is whether this bill advances these goals and my answer to this challenge is a resounding no I am gravely concerned that this bill does nothing to advance the care but we know is an already significantly underserved population with often insurmountable barriers which exist fifteen in the care and support they need and it is important to recognize the transgender and gender diverse youth these innumerable disparities including an equitable laws and policies like the one for you today societal discrimination and unequal access to quality healthcare that they deserve. So what we know is that trans and gender nonconforming use are aware of the differences in their agenda at a young age but there's often a significant lapse of time prior to any disclosure there's an increased rate of depression anxiety self harm eating disorders and most significantly suicide compared to their situation peers and this is not because they are trans but instead a multi factorial and because of this is tied at the living and we know that part of these factors and that our lack of access to healthcare providers like myself with expertise in caring for transgender and gender diverse you've played a large role and so I would close with this transgender and gender diverse youth deserve every bit of respect dignity and care there says gender peers are afforded and their parents and caregivers deserve the same amount of autonomy to choose what is right for their child is the parent of cisgender children and I cannot emphasize enough the enormity of damage this bill because you've heard it today the in individuals who come before me and so I will come back to my challenge to you does this bill advance the care of children Arkansas I would encourage you to dig deep and really think about that answer in relation to the mountain of data which I am happy to provide you as well with that supports the very real very positive and potentially lifesaving care I gender affirmative care model can provide thank you so much thank you let me ask a question please you said the are you a medical doctor yes ma'am all right and you have to practice here in Little yes ma'am all right that's all I need thank you so much right next on the list is Christensen rule. Can we to introduce yourself please for the record my name is Kirsten so all and I'm a licensed clinical social worker and in the State of Arkansas and I've worked with over two hundred kids in the last few years who identify as transgender can. I'm also like to say just in response to a question that you asked earlier Senator Senator Davis ord Hester I guess I just wonder if it take you into your eighteen to understand your gender identity as male because I kind of wonder if that was true. Transgendered Jean and adults are the most informed population I've ever worked with the teens I work with are excited to come to clinic and they've already done a lot of research for years. However no matter how well informed they are something that you might know is that teens don't get to decide if they start cross sex hormones under eighteen. Not even their parents get to decide it is a team approach. For the teams that I know it's at least a six month collaborative process to evaluate if medical intervention would be beneficial before they start medicines they have a psychological evaluation by a mental health professionals they need to nurses doctors social workers and chaplains. To help them understand the process and support and. In that initial visit they have a mental health screen for depression suicide risk. If they're not in therapy they're given supports ticket therapist that understands gender identity. Within six months they also meet with the psychologist who uses five to six research based tools to help them really understand their gender identity and their goals and hopes for the future. They also evaluate mental stability as well and if they need more supports their I'm given different suggestions on how to work towards mental stability. I'm sorry okay to add a ton okay thank any questions for me yes do you is anyone have a question okay Senator Hammer thank you measure your a licensed social workers that correct I am in your seizure training from where. Are you asking where I went to graduate school yes ma'am I went to graduate school at the university of Arkansas Fayetteville okay and what were you taught and and I guess one of the things I always wondered about. At what point do you as a social worker. Determine that you are not either equipped for what you are quick within the real way of training stops being a a approach from a mental health approach. To where it becomes a medical need as discussed today what's what's the line where you use my focus is on mental health and then also I'm in graduate schools and to ask focused on gender and sexual minorities studies as well as mental health my focus is on mental on mental health and I have the medical staff that is able to answer all medical questions okay all right thank you you're welcome thank you for asking all right we have of Senator Hester for questions. Yes ma'am I think I'd like to ask you the same question is it appropriate parents of a one day old child to start. Process of changing their sex. That is such a very interesting question and I'm not sure how it applies and I couldn't go back to the other Senator that just ask me questions and then I'll stick in my mental health thank you instead of a medical question thank you so much for that. I think I think you agree as I do that there's a day that you don't think it's appropriate I don't think I agree with you on very much thank you. Right next on the list we have Larry Tara Todd Bergman and I believe it says Reverend so you. We have a pastor coming. And if you would please the. Let us know for the record hate your name and where you're from please. Thank you manager. My name is Genevieve Bergman okay my legal name is on record okay let me interrupt you I read what's on this list Zacks all right and nine AM an ordained elder with United Methodist Church can I served as a pastor for twenty three years. I serve mostly churches that were rule rural conservative. And very opinionated about a lot of things. One of the things that they were very opinionated about. Was LGBTQ issues. I spent twenty three years talking with them about what the Bible says. Regarding people. Who are not like them. Trying to open eyes to say that there is a certain way to treat people who are not like them. Listed in the Bible. After twenty three years I had to stop being a pastor. Because those good rural conservative Christians broke my spirit. The most hateful venomous vile comments about people who were different we're coming from leaders in the church. People who are stakeholders in their community. People who had a majority of likeness over others. Finally. When I came out as a transgender woman. Those good Christian people violated the church law of the United Methodist Church remove me from my position. Would not allow me to clean my office out unless the church was empty. Then began to isolate me for the next two and a half months and would not associate with me in anyway what so ever displaying none of the Christian charity that they professed their Bible declared or. The Bill. It's a point of order you need to be speaking on the bill please yes ma'am I'm getting there okay well I think you've got to you're at a time so I'm very sorry your it's you have had two minutes in of five seconds okay I'm glad to answer any questions all right and do you have any questions. Okay thank you so much I appreciate you being here all right of the next one on the list is. C.. Stacey brine. Please introduce yourself for the record yes good afternoon my name is Stacie o'brien I'm here today because Arkansas's trans community should not have to bear the burden of justifying their existence I'm here to tell trans children that we are Kansans love you and welcome you and our communities I'm here to tell the sponsors and the tiny number of supporters of this bill that we are cans and see you for who you are. Your mouse may say love but your words and actions clearly say hate your mail say do no harm you do not heed to the clear medical advice of people who actually took that oath including over sixty thousand pediatricians eight thousand child psychiatrists a hundred and twenty thousand social workers and over seven million youth serving professionals your mail say give them time to normalize your actions seek to alcohol completely reversible puberty blocking hormones whose only purpose is to give gender non conforming adolescents time to make thoughtful decisions you put forward the false claim that eighty percent of transgender children desist with no intervention but you either ignore or did not bother to learn that number comes from a single discredited study of gender nonconforming children. You shrink insane horror and experimentation yet seek to enshrine into law on non consensual sex assignment surgery for infants walked out willing treatment that has been and safe practice for thirty years we are kids and see very clearly that your true goal is eugenics your true goal is to erase trans people from existence you will fail. In the meantime you will be remembered by our Kansans as the ones responsible for wasting millions of taxpayer dollars and for causing irreparable harm to our most vulnerable citizens missing Ryan thank you thank you very much. It needs to is willow Bashir's. Please identify yourself for the record. Okay hi I'm a little first years I am the founder of the young trans women's project and I am an organizer at the center for artistic revolution first off I just want to say that I'm an out and proud trans women and no one and whatever her name no one from the family council and none of these doctors with real medical bases are going to tell me I'm not a one man let me just get that out of the way I read a whole speeds for ya but calendar really guided by facts and evidence based practice so I really just want to say that bottom line this bill is hurting kids I have been on hormone stance I was thirteen years old I have been on estradiol progesterone and spironolactone I have never had any negative side effects from them Sorry this is very emotional and that you know as it is sitting here and telling you all the bad things that happen to me of the trans women sitting here laying out my time and I just wanna tell you how happy and being like transitioning and living in my truth is made me. without that I probably wouldn't be here. I love my life I am confident in myself and this is the best decision for me I have a loving family my mom is very supportive and I'm surrounded by people who left and. You are not at a time if you want to do so okay I'm going okay the. Yeah so we're we're listening so I think bottom line healthcare is a human right food is beyond me the any legislator with legalizes committing health care especially for children Arkansas fares for the bill frame as if it isn't nearly elective procedures that will be restricted however with the ambiguous language youth in this bill they can unite training center and other LGBTQ people any procedure that is deemed to lack the F. further more medical doctors and other providers who aren't into criminology or women's health really provide minor's hormone replacement therapy it is a specialized thing and you don't just go to any doctor for it it's difficult as is finding in Arkansas provider who offers adult competent hormone replacement therapy it's much more difficult to find it for children K.. Sorry you are at it and they have thank you very much for your testimony. I think we have for the use of. Make sure I have this right okay of moto hunter. Please introduce yourself for the record. My name is M. D. hunter and first I want to start off with saying that Senator Hester at the age of three my family knew I was gay I knew nothing about this so it's not too crazy to think that someone could be born the wrong gender. I'm a gay black male and I'll local track artist who's Allen for the trans community I first wanna start up about this two six of this bill starting with the very first one cited from the APA. It is not cited from the APA's actually cited from wikipedia which actually printed out and we should not be basing our children's health of wikipedia statistics. I'm also going to announce that the AP actually finds long term mental health benefits from a gender affirming care so this bill basing these facts off of these things are completely incorrect. Because the timing going to skip down to the very end because they have some people who are the doctors who actually can speak about this transmitter to an adult or some of the most powerful and brave individuals I can think of lastly I would like to acknowledge the disrespect of the trans community have experience doing the committees leading up to this. In general have been disrespected by the time limit to the people you represent representatives are supposed to represent the people and we have been met with representative from house leaving during opposing testimonies gossiping and calls disregarding the huge number of people opposing the bill and on their cell phones. Jett and. Just. Votes out this is about it's not a parent how to raise their kids thank you. Some may be had signed up twice so if I call your name in you've already spoken you just to say pass all right to listen to this Elizabeth the Barker. Good afternoon my name is Elizabeth Vargas I'm so glad to be here to address all and I hope that I have everyone's attention. Would you mind removing your mask we I'm sorry that we can it's harder to hear. There you go okay I also had a lot of prepared remarks but the speakers before me have been so amazingly Elifritz educated concise and have given the way more information than I could ever during this bill is. This bill is maddening. I'm actually I'm just mad as hell I've been on spend for days since I found out you can ask my husband how few hours I have slept the last several days as I've read and read and read more research that is completely contradictory of the way this bill as written. I'd like to add that on the grand mother of a transgender child. He's eighteen. You would like to leave. He's thank you need is wonderful kid who's autistic he's very mildly affected with autism and for a while we thought his quietness was because of autism when he was fifteen he came out and the whole family has remarked only god is like this a light came on and the child he's totally different and he is awesome and I love him so much I thank god that it eighteen he is out of the reaches of a bill like this that would tell parents and guardians how to make decisions for their medical care. Thanks to. All right appreciate your time the year all right to. Michelle Hutchinson I believe you are it's Dr Michelle Hutchinson. Hi I'm very short so I try to raise as chair. All right what size. Well. You may not be able see me you'll be able to hear me good so yes I'm I'm doctor Michelle Hutchinson MD PhD I represent myself and almost two hundred children that I have treated here in Little Rock for transgender would you do you work at a hospital I do I I work at a local children's hospital yes and I'm a staff there so I had no prepared remarks I just want to speak from the heart for these kids who really are the bravest brightest type a high achieving amazing children I mean I just can't go on enough about them and they're just amazing kids okay and they know who they are and they know who they are from a very young age There are ma'am multiple publish standards of care for the treatment of these children there are multiple guidelines for the treatment of these children the American academy of pediatrics the American psychiatric association the pediatric endocrine society the endocrine society not to mention dozens of European pediatric and adult published guidelines many many many published guidelines and we follow those guidelines to the letter because we care about these children and we want to keep them alive and healthy not just in childhood but after eighteen as well excuse me for interrupting you but yes if you would not look at the sponsor well I have a sister to me when they say things that are untrue and I want to correct the record so I apologize will not do that again or thank you so we need to correct the record because the folks that spoke before got an awful lot of time to tell you a lot of inaccuracies for instance they put they picked cherry picked articles that were in some cases fifty and sixty years old that have been miss proven and and and and to talk to multiple times there is a little mountain of literature about how the care of transgender children keeps them all alive okay so the last thing that I want to leave with you And guys this is not hyperbole I I I'm doing everything I can to maintain my sanity here we've already had multiple children just after this bill passed the house these kids heard about it I've had multiple kids in our emergency room because of an attempted suicide just in the last week of multiple I've had multiple children you know how many phone calls I've had to fill field in the last week of children calling me saying Dr Hutchison if this happens I'm going to kill myself multiple so I guarantee you if this bill passes children would die and I will call you guys every single time one does. Thank you for your. To take the question I'm done would you take a question of course of course with senator Hammer pleasure. Thank venture a statement was made a while ago and I just like to ask you and your medical or in your in your transition a tree and. the statement was made can be born the wrong gender can you speak to that please because I'm having trouble understanding how you can be were born born the wrong gender while I'm going to tell you if anybody anybody who says they completely understand trans gender would be lying we don't completely understand it Sir all I can tell you is that after having done this for three years I know it's the truth I have I can tell you I'm publishing a paper right now the children seem to know their gender either before the time they can speak or by the time of puberty it's a very clear bimodal distribution it's very fascinating actually so to speak to you doctor has to a representative Hester center sorry senator I'm a little nervous. Children do know usually to look young age who they are do we try to change the gender of a one year old or a four year old that's absurd of course not we wait until that child approaches puberty because multiple studies show that by the time of puberty a child will know who they are and they will certainly be old enough to vocalize it by that time no decisions are made for these children in the act in a vacuum we're working with their families and multiple healthcare professionals one last piece of data I want to leave you with Sir is by the time these children come to my clinic on average they've known about their transgender status for at least eight years and some of them up to thirteen fourteen years of managing living with that for so long before you got somebody to help you all right thank you any other questions sing none thank you thank you for your testimony I. The last one that his son to is Justin sorry love. He okay. We missed you at the beginning. Yes ma'am I'm sorry I just got it so right that's all right. My name is Justin sorry along I was born in state presence in nineteen fifty five under the name sandy case are low and the gender female. When I was eight years old Senator I told my parents that got it made a big mistake. To be fair to my parents C. eleven nineteen sixty three. The reaction was to send me to ballet lessons and put me in more dresses. I tried very hard to conform to who I wasn't. But by the age of twenty two. I couldn't take it anymore I can't describe to you the paying attention to a person goes to having to live in the wrong body. At twenty two I stepped in front of a dump truck just hoping to god what is that all. Luckily he failed. I basically got married had two children. And when they were grown they came to me one day and said and I've never said anything to anyone else in St they said mom if you want to transition we fully support you. So at the age of fifty five I came out. And I discovered that god didn't make a mistake god will be the way I am so that I can understand and help them to these kids. Thank you thank you. Alright ladies and gentleman you have heard to. The discussion and you pass questions we had lots of testimony and the. What is the will of the committee. Yes please do I'm so sorry for that I got so interested in the discussion of the thing up for the please close Senator mean representative. Thank you colleagues and thank you for your patience I want to address just one of two things and then I'll close quickly because we I think we all know where we've how we feel. but these kids do matter these kids are important. Every child in Arkansas deserves to get to eighteen to make adult decisions. And I want to emphasize that counseling is not being touched by this bill because counseling is critically important we all need good advice and good wise counsel. They are marginalized and they're not being denied care because they matter. And they are loved. I. I'm not gonna argue with any side of this issue I didn't say that the kids in Arkansas should never have this type of procedure done to them until they're old enough to make those decisions and with that I would ask for a good five. All right ladies and gentleman he per the closing as well as all the other Information of to have a motion. I have a motion to pass I have a second all those in favor say aye. All those opposed. Your bill passes. Right all right thank you madam chair thank you Committee yes going on to the fifteen forty eight. and I believe senator Hammer senator Hammer I believe you have are going to run fifteen forty eight all right. When you get settled we are ready. Thank you madam chair Kim Hammer state senator district thirty three. You're recognized. Thank you thank my chair this bill relates to personal care services as a reminder to the Committee personal care services are non skilled service that help our cans and stay in their homes like to thank all those that help work with this bill specially DHS native language that satisfies both DHS and the home care industry bills intended to accomplish two things for personal care services first is intended to address the difference in payment rates between personal care attendant care respite care services and the services are essentially the same in other words person comes into the home to provide non skilled assistance to the client currently the services are paid at a different rate even though they are sensually the same service this bill will bring the payment rate into parity with personal care rate and it's important the DHS is been working on this is partly our choices waiver and this bill simply would codify this process the second thing it does is it would protect the industry gets potential change in the minimum wage by triggering a rate review study only if a new minimum wage is higher than existing Arkansas minimum wage DHS provided language on the timing of the rate review and we have inserted language that would back to rate retroactive but only to the extent allowed by federal law minimum wage section is important for this industry because of the ongoing discussion in Washington about potential changes in federal minimum wage and Madam in closing out final comment the bill brings parity to personal care tend to care respite care rates and provides a mechanism for new rate review if and only the minimum wage goes above the current Arkansas minimum wage we work with DHS sign language incorporator language make the bill acceptable to them and I would appreciate a good vote. The. Motions from the Committee. All right seeing none does anyone want to speak for or against the bill. In one spot to speak on the bill. Okay we do have someone that would like to speak for an absolute Mattingly is he in the okay if you would come and introduce yourself for the record please. Monitor Miller manning Lambert president of C. C. O. Caroline can imprison sorry can you we think your messages while you're speaking thank you okay start again Public manning lamb CEO of caroling and I'm the president of the Arkansas association of area agencies on aging and the Senator Hammer graciously said everything I had to say so we just won't under support of this bill thank you committee for all right in the meantime just a minute any questions from the committee right sing none thank you so very much all right to there's no one that is signed up to speak against you are you close for your bill I just like it had not from DHS agreeable with that so that's all that with that I was looking for that. All right thank you of the education major I'd make a motion to pass appropriate time thank you all right I have a motion to pass I have a second all those in favor say aye. All those opposed you have passed your bill thank you manager members committee alright ladies and gentleman we're going to House Bill thirteen seventy three. All right madam chairwoman senator Bledsoe you're recognized to present house bill thirteen seventy three right is Jamie cook in the okay good I am so glad please come and join me if you don't mind Mister chair absolutely. And Jamie feel just introduce yourself and tell us here with for the record when you get there. Good evening I'm Jamie cook I'm secretary for Arkansas department of public safety right welcome. You are recognized for C. all right thank you so much of. Members if you would just take your bill in luck on page one of line twenty eight to thirty six this is just the legislative intent and of it mentions that if CPR begins before rival and the emergence of the rival of the emergency medical services personnel a person in cardiac arrest has a two to three times higher likely lose likelihood of surviving and that's what this is about today it is. About a just requiring that nine one one operators who give pre arrival medical instructions to be trained in giving CPR instructions over the phone. Of the training would be added to the required training of nine one one operators and of it the training cost range from free online trainings and and I do have a fiscal impact statement that says that there are so many free online training parts to to all of this that there is no revenue impact now there are some that do costs but there are several that are free of assuming that the training the free training will be utilized that should not be much of a fiscal impact and like I said and and mainly it there is no physical impact and then this would not increase liability for agencies or the nine one one operator in fact the inverse is more likely to be true the policy is fairly new but it's been enacted in eight states including Alabama and West Virginia and similar legislation would be introduced this year in almost every state and I would like to as Jamie to add to what I've said. Thank you senator I really don't have much to add that was a great overview of the bill we do have some free online training opportunities of for our dispatchers that would need this and we also are going to plan on expanding that to the unlock our learning management system that we already have an existence is freed all dispatchers in Arkansas. All right and be glad to answer any questions or any questions about it members. Right saying none senator Bledsoe you're right to close your bill. I'm closed but welfare because anybody here to speak for or against. All right now you're recognized the closer here I am close in a move do pass all right members or got a motion do pass on the second second by Senator Gilmore all in favor. Post graduation I'm showing your bill passes thank you. All right ladies and gentleman we're going down the of the agenda in the this is yes Sir you're running that furry of K. a. It is Senate bill two ninety six. This. Right. All right I'm chairman asked Jonathan Jones with DHS to join me all right if you would introduce yourself for the record. My name is Jonathan Jones with the Department I think it's not turned owner measureable closer little closer maybe Jonathan Jones with the Department of Human Services right thank you all right the members of this bill for Senator Stubblefield in so. A little bit of background with that working long term care and so you know what the city says is that you can't you know video taper resident put that on the internet without a signed consent form it does you know does not touch anything dealing with the an abused or neglected obligation or you know any medical reasons doing that you know more or less like a social you can't be taking pictures FOR do videos without a consent form signed by the it a resident or if they're at the past dated by their guardians property. All right you have anything you'd like to add another was covered very well it just adds language to already existing Arkansas Code that already prohibits photographs this just adds. Language that addresses Video and media and posting to social media all right thank you any questions from the committee. All right seeing none does anyone want to speak for or against. All right. What is it what is the pleasure of are you are you I'm I'm close I'm trying to do pass what is the pleasure of the Committee to passes I have a second all those in favor say aye five all those opposed congratulations you have passed your bill. We are going to Passover Senate bill four six eight. And then house bill twelve forty six is there You are I can't see. I would have a seat introduce yourself for the record and you are recognized. Thank you madam chair representative Lee Johnson District seventy five. K. you're recognized thank you and I'd like to recognize Senator Wallace as well he's co sponsoring this bill with you and if it's okay with him I would proceed with presenting the bill so this is a good bill committee this is one that was worked on diligently by a whole lot of parties it does two things in general one as expenses go for pharmacists to allow them to treat a certain acute conditions as can be tested for within their pharmacy on clear way of testing specifically influences strap that allows the treatment of these conditions under protocols outlined between the pharmacy and the medical board at that we statewide protocols covering all the treatment for all the pharmacist additionally for pharmacists it expands them it took to allow them to ride over the counter prescriptions so as it stands right now if you have if you have an insurance that would cover and over the counter medication say for instance a good example of the glucose strips that we use for testing sure verifies a position currently write a prescription for insulin but I forget if I forget to write a prescription for your glucose strips those are things you can buy over the counter you don't really need a prescription in order for your insurance company pay for them that require a prescription so if I forget that currently the pharmacist has to stop what they're doing call me I have to okay the prescription this just put your removes that barrier and allows the pharmacist to write a prescription for over the counter medicines which a person could buy on their own already additionally of the pharmacist it allows same class drug substitution so we have that right now The difference is that the default right now is as a physician in less I specifically mark substitution is okay the pharmacist can't make a substitution we're gonna flip that to make it where the default is the pharmacist can substitute same class medications of same or lesser cost to the patient without and in less specifically as stated by the physician that they can't this isn't this is also important bear to remove oftentimes I you know to exist in a right of first. Caption for certain Class medication like histamine blocker for risk for gastric reflux other multiple different types they all essentially do the same thing in but but once persons district insurance committee make everyone top and not another a current under current state if I forget to mark that box is a physician the pharmacist has to stop their flow like to start my flow we have to can we have to confer and and really that's just to bury that doesn't necessarily have to exist so on the physician fried expense physician dispensing to include acute care medications so right now physician dispensing in Arkansas is allowed if your play if you apply to the medical board can show an assessee with the exception of three things there's an exempt list that includes nor can of topical ointments and and contraceptives what we're doing is we're adding to that exempt list to include acute thank you for calling to care medicines which are medicine stream factions it's off limits were medicines cough medicines nausea medicines antihistamines and additionally what we're calling maintenance medicines for the first thirty day treatment so this would be medicines treat blood pressure diabetes high cholesterol again this is removal for berries care so if you come into the doctor's office just like under this if this law passes you can go to the pharmacy they can test you for flu dispensed the flu medicine there under protocol you would be able to go to the doctor's office they could test you for flu and just like the pharmacist they can go to the back and dispense the flea medicine to use their by removing that extra step on on either case the for the position I have to do that and to the same rules and regulations a pharmacist so you you're not gonna be under the same standards and regulations from that standpoint this is language and that was agreed to by the pharmacists association's of is supported by the pharmacy association and also support by the medical society and I'd be happy to try to answer any questions all right any questions for. Any questions all right seeing none of does anyone want to speak for or against the bill. Seeing none. Have to close for your bill I am close from the edge of. All right Sir Senator manager I just like to say when I first realize of the sponsor this bill at the very start of the session I thought it would actually be one of the toughest bills I had in purposes Johnson Dr Lee Johnson right here has done a magnificent job of pulling people together and meeting somewhere in the middle and I just want to applaud him for doing this I think so I agree with you wholeheartedly the only thing that to and and don't don't let this offend people the only thing I ask is that he joined us in the Senate we needing a lot happened before then members. All right of ladies and gentleman do I have a motion. All right I have a second all those in favor say aye. All those opposed congratulations you passed your bill thank you so that committee representative. All right the. Yes representative Holcomb you have waited so long. Thank you. If I hadn't I didn't see you over there so if I had noticed that you were sitting over there I probably would have led to come first so I apologize well I district opportunity to be here K. R. are you ready for me to proceed yes and if you would introduce yourself for the record please Mike Holcomb a house representative for district ten K. and thank you madam chair committee members I don't know how this bill guardian in your committee I think they were just trying place put it actually what this bill does it's it's a bill that I worked AT Q. and a County judges association known and actually what it does is it so it's to be in vehicle vehicle racing it requires any one that wants to open a a racing facility to petition the county judge the county judge will look at the petition feces is to deserving of Serra place where he thanks would to not be a nuisance to the community here then call a public hearing after the public hearing if he decides to issue a permit he the it in the permit it will it will show the the days are going to be open hours are going to be open what kind of racing facility it's going to be also they'll carry liability insurance that's it in short and also the the race tracks are now in operation that summer grandfather D. and they were grandfathered employer made a law but there are some that A. B. Q. permitted they will remain as they are this loan repayment. but only if pertain to new facilities and this section this takes back local control the local communities I'd be glad to answer any questions all right questions from the committee of senator Hammer thank you measure I'm I'm trying to find in the bill is this is this for ATVs or assist poor Lecter traction what used you know like out there to thirty well this would be for mileage or for drag racing oval tracks mud tracks that I thank this committee would go. So let's say a facilities out there operating not permitted now that is like a I mean they do racing but they they're they do like the the the Four wheel racing and all those other kind of racing's if they're not permitted now they'll have to go which is fine them will be fine with that I just want to know if that's going to capture those I don't think this this this is vehicles basically I think what we're talking about I I had no thought of that when when are when I run the bill so leave it up to them to decide I guess the county judge okay all right thank you can all right the D. takes some more questions. Okay all right go right ahead yes there were a Page one right there the first day of reckoning answers the questions as automobiles. Motor vehicle. Automobiles and trucks that are modified for racing so I that thank you senator. All right any other questions seeing none of these anyone want to speak for or against this bill. All right seen none of him to close for your bill close red chair and I would appreciate a yes vote thank you all right what's the will of the committee have a do pass in the second all those in favor say aye all those opposed congratulations you have passed your bill thank you I think she. All right the last one is a House bill fifteen seventy two and representative Lundstrum. Of sorry it's not the last one for. Okay go ahead if you don't mind and get settled in. Say your name for the record and you're recognized. Thank you colleagues. This bill is a straightforward bill it actually. Does not take away abortion but it does allow for consent for chemical abortion and the seventy two hour waiting period it's that straightforward. It fixed it stands with current law but it does allow women to have more information when she makes a decision about a chemical abortion and with that I'll entertain any questions right any questions from the committee. Okay is anyone I do have one person that is up signed up to speak against anyone want to speak for. All right miss music I believe you or send you are Jessica Jessica Lloyd please come forward can you speak against just state your name and where you're from for the record please madam chair again my name is Jessica Lloyd I just represent myself as a concerned citizen of Arkansas for the sake of time it's been a long day I will not repeat all of my comments from earlier a lot of them from that bill to apply this to and I want to remind you that medication abortion is overwhelmingly safe I think this bill really specifically is looking to add a lot of reporting requirements that are going to be very unwieldy and burdensome on the clinic and I just I would like my objection to that noted to please vote no on this bill thank you all right thank you so much all right to be heard the testimony but had heard the questions do you would you like to close for your bill. I know everybody's tired so I will disclose without appreciate a good vote all right to have a motion and a motion to have a second. All those in favor say aye all this suppose congratulations you have passed your thank you colleagues and thank you for your time thank you for the very last one. Of Senate bill five six two three five six three Senator Flippo. Michael you will join me a parent is really tough questions okay I got I got I got it members agreed upon bill there is no known opposition a this is brought to me by the American mystery Association and what this does is going to regulate plastics. As manufacturing and not as solid waste and so I'm for lotus notes here because this is some in depth stuff but ensures that post used recoverable plastics that are converted to plastic and for chemical feedstocks for other viable products be advanced recycling which is defined in this bill are classified as raw materials and not miss classified as solid waste is going to be a burgeoning industry in the future there's currently nine states that have passed similar legislation eight and sister bill just pass the Oklahoma Senate last week I believe and so what this is going to do is it's going to help us cut down on plastics in our landfills and help us create jobs we move forward and get better use of our plastic products with that Mr that we're pay would be happy to entertain any questions all right any questions from the committee. All right seeing none does anyone in the audience want to speak for the bill against the bill. Right seeing none are you closed. Okay the senators oppose first bill do I have a motion motion do pass do I have a second all those in favor say aye all those opposed congratulations you have passed your bill ladies and gentleman the meeting is adjourned.