Public Health, Welfare and Labor Committee- House

Speak or maybe they'll be a lot of debate on that so because of that we want try to run all of those regular bills on the consent agenda those are bills that we can roll over and run next time and keep moving those on their their quick bills and normally they don't have people here to speak they may have one person so those will will roll over to the next consent agenda but that's what we don't do them first because the regular bills we want to try to run all of those because there are people here to speak on those bills so that's the way we do that if you have a bill that's that I haven't talked to you about or is not on the agenda then text me when you want to run that bill the number of it and we'll get it on a future agenda. All right that being said we we do have some changes on the agenda HB fifteen eighty four we're going to pass over that representative Meeks his wife has some surgery so he could not be here and H. B. fifteen forty seven representative Lundstrum is amending that bill and made they did not get that completed so we're going to move those two bills to next Tuesday. And the representative Womack I think you have an amendment coming is it now is it here okay. All right so we'll go back to top the men the agenda and you're recognized representative Womack to present HB fourteen sixty and there is an amendment yes Sir and I say that bill that we can have it momentarily this what this amendment does this tracks basically all the language in the bill in its new language that does the exact same thing this is language that we work with municipally with a. To my knowledge no opposition to this bill I think everything's great so I'll get a second to take a look at it and I would appreciate. Adult in a language. My committee will give a few minutes to look at the amendment. The committee more time look at the amendment. Okay if not representative talked about the amendment is or what's will the committee. I have a motion what from representative Lloyd to adopt the amendment in discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay moshing carries congratulations your amendment is been adopted you're recognized to present your bill as amended I thank you committee of this is a very very simple bill it's actually one paragraph that you have in front of you now this was born out of of some of our work from the occupational licensing sub committee of A. L. C. there were some for lack of better words threats made you know that if you guys take this section and then we'll just go cities and have them pass ordinances to kind of do in and around around the work of the legislature and we've not had a case of that in Arkansas yet to my knowledge but has happened in other states so basically we're just making sure that the state. Maintains its its right to work in occupational licensing in that cities can kind of go around this that's all this bill does and I'll be happy to answer any questions. Questions from committee. Strips in Ferguson you're recognized I'm sorry I'm just I'm not familiar with all the work that's been done on this in what cases would as CD want to have more stringent requirements what's an example I guess there in other states that have been. I guess issues where they used it as a cash cow basically said if you're going to do this you also have to be licensed in the city to do this and provides kind of double licensure. So if you're a licensed plumber say in this state then you don't have to have a city licenses that does that do to a city could not require you to have a CD plumbing license basically. Any other questions. Representive Allen you're recognized. Thank you Mr. Could the city require you to have a city business license yes Sir this does not address the okay so this is determined Johnson former. I would feel happier how will see the. Business license if if that business licensure is in place this this bill does not address that is just the address a double licensure okay thank you. Any other questions. Seeing none. there anyone here there's no one signed up to speak on this bill is or anyone in the audience to speak against the bill. For the bill. C. nine U. red clothes for your bill I think I am close I just want to make a note that there's no known opposition and I would appreciate a good vote. Was will the committee. Representative Payton made a motion do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay moshing carries a graduation your bill is passed thank you Mr chairman committee I appreciate it. Let the record show do pass as amended. Thank you representative Payton next item on the agenda is H. B. fourteen oh two representative Barker. He's got an amendment. And the committee there is an amendment coming around. Representative mark or do you wanna speak on your amendment what it is. Yes thank you Mr chair it's just add my seatmate representative cloud as a cosponsor. I have a motion representive Dotson to adopt the amendment in discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries your moments been adopted you're recognized to present your bill as amended. Thank you Mr chairman thank you Committee House Bill Fortino two is a bill to improve the existing abortion inducing drugs safety act of twenty fifteen the bill six to improve the safety protocols for women to whom these abortion inducing drugs are given does that in several ways and I'll address those ways briefly and then let can introduce himself C. five missed anything the first thing the bill does obviously is replaces and updates language to the existing act. The bill requires the emotion inducing drugs to be dispensed according to FDA protocols one of those And as listed in the bill important protocols is that cannot be delivered by mail courier or delivery service. The bill requires informed consent to ensure that the woman choosing to have these drugs it receives comprehensive information. The bill states that the administrating physician must physically examined the woman before. Dispensing prescribing administering these drugs physically examine her before administering but also to Verify that there is in fact an intrauterine pregnancy the bill requires this administering physician also to be able to handle the emergency transfer of a woman who's experiencing complications from this type of abortion or to have a signed agreement with an associate physician who is also credentialed to handle abortion complications and then finally the bill states that certain information in this process must be included in the woman's medical records and that's that's the gist of the bill. Did you have someone help you present yes if you would let him introduce himself please please introduce yourself and who you represent thank you. Hello I'm can you hang on the director of governmental affairs with Arkansas family council you're recognized thank you Mister chair well thank you for having me this is one of the great piece of legislation is passed in twenty fifteen but in the sciences has changed it to a protocols has changed administrations have changed and so this will keep us up to date with the ever changing protocol so FDA protocols have recently been loosened with the court case in in twenty sixteen and there's a potential war the actual particles may disappear with the new Biden and Harris Administration so we just don't want our laws tied to something that might be might be disappearing Another thing I think of this addresses to or it does address is the you know adverse effects when taking abortion inducing drugs and so we had a great legislature now graduation twenty fifteen that had the foresight to pass something like this because another state there's actually recently a New York times article that talked about abortion clinics Planned Parenthood using are you forty six now as a missed period Health sunset prescribing it as portion inducing drugs when we're coming in and said I missed my period and and the planned parenthood would acquiesce and say well here's the miss period pill instead of actually dispensing it as a abortion inducing drugs so we are you thankfully already had that had this to address that and this just makes it stronger make sure that that also does not happen here in the state of Arkansas and so with that like I said changing protocols and the new administration this will address our our law and make it stronger and be happy to answer any questions. Any questions from committee. Representative Ferguson you're recognized I would go back to what you said about it it can't be delivered by a mail delivery million. Right directly to the woman. It can be delayed to the clinic yes but not directly to the patient I thought you meant it couldn't even never done sorry okay to make that claim he could. Representive cloud recognized for a question. And any other questions from committee. Okay we do have one person signed up to speak against the bill. Karen music. I would go to the table manager so. My name is Karen music and I'm co founder of Arkansas abortion support network another day another abortion restriction here in Arkansas. I've been asked to speak by hundreds of our Kansans. Actually thousands of our Kansans. Another with these abortion restrictions already. The changes proposed in this current law would do nothing insert zero medical purpose and is meant only to make abortion more complex and inconvenient to provide. It has nothing to do with the safety of our Kansans. It's a light to even imply it's protecting women. Legal abortion is safer than a colonoscopy. Safer than having your wisdom teeth removed and many many times safer than delivering a child. The risk of dying from childbirth is fourteen times higher than the risk of dying from an abortion. And in many parts of this state that risk is even double that or more. Arkansas women want and need medical reproductive care like everyone else in the United States of America. Health of the work force here in Arkansas has a uterus. And a quarter of those will need access to abortion care at some point in their life. We already know your families and your friends are utilizing abortion care this only will make it harder for the poorest people in the state. And it feels to me like a Christian terrorism. It's clear you have not been listening to the women who have told you over and over again that they do not regret their abortion their lives are better because of an abortion. In to presume the majority of our Kansans think that ten year old child should be forced into birth is just outrageous that still is hard for me I pray the voters of the state will hold you to account for this hateful two thousand twenty one Arkansas Republican legislative agenda. Do you want business is here or not. You get to have a say in that in in this proposed law it says half of the work force bodies belong to the state of Arkansas. That's not true you can't have them please vote no on this punitive bill H. B. fourteen zero two. Thank you for your comments is there anyone here in the audience to speak for the bill. Against the bill. Seeing none are you ready close for you bill representative. Yes thank you Mr chair I just like to reiterate that this is a safety bill as with other. Procedures I think it's hard to argue that their safety in being fully informed and being fully examined and being fully prepared in case things do not go the way you want them to thank you. What will the committee doctor I mean representive clown I'm sorry you're recognized for motion. Thank you Mister motion to pass I have a motion I have a motion but do pass as amended by representative cloud the discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries in graduation your bill is passed thank you Mr chair thank you Committee. Okay we're gonna move on down to. S. B. three oh one. Who was going to present that bill lost my sheet here. It Gonzales representative Gonzalez are you ready to represent to present S. B. three oh one. Okay. All right of. Will move down to S. B. two eighty nine. representative Smith senator Hammer was he going to be here. Body was we can move on down and come back to you in when the. The report to the table now telling you said that. So. So representative Smith you're recognized to present S. B.. Two eighty nine probably gonna be recognized for a lot more after that comment Mister chair I'd like to have a. Stefanie Nichols come and sit at the end of the table and also Luke McCoy if he's in the room just to potentially ask questions if we're asked. If that's alright. If you would please introduce yourself and who you represent. I'm Stephanie Nichols I'm from Jones for Arkansas and I work for alliance defending freedom is legal counsel thank you represent Smith you're recognized thank you Mr chair Committee I want to thank you all for the. Input that you made on this bill there were. So many comments and some help that you provided in helping make this bill better as a matter of fact these amendments have been engrossed in the bill there are three pages of amendments and that we believe we've answered every. Concern every issue and so what you have in front of you on your screen or tablet is a much better bill than what we presented just a a short several days ago and so I don't. I don't think there's a need to go into a lot of reading and discussion on this from my part but I would just ask that you look through the bill. You probably have already done that and you will see that. These amendments have been engrossed and they're ready to be presented back to you for a good vote. Representive Eubanks you're recognized for a question. Thank you Mr chair representative Smith I was asked by a K. twelve education to ask if there was anything in this bill that might affect. Their operations with the regard of their school nurses I think I know the answer to that but I told him I'd ask the question and and see if there was any any way that this would interfere with anything that they do not thank you for the question representative you banks and there is nothing in this bill that would impact K. through twelve Nurses school nurses in any way and I'd like to deferred to make sure that my statement is accurate to Mrs Nichols. I I will say that it could theoretically you know have a small impact on a K. through twelve you would have to have something like let me give you an example that I've heard from one superintendent let's say that medication was being given to a student every day for gender transition for a minor neck your committee has voted to ban that and so has the house so that you know possibly a moot point anyway but if the nurse had a conscience objection to that there may need to be worked out some ability for her to step away temporarily or for the parent to administer that drugs so that day after day the nurse didn't have to be complicit in something that violated her conscience but other things that schools offer light therapy services there are absolutely no conscience cases in the United States based on somebody not wanting to perform speech therapy occupational therapy physical therapy those sort of things and Illinois and Mrs Mississippi that have brought conscience laws there are there's only a handful of cases that have come about in those states and none of them involve public schools so I'm very confident that this does not pose a threat to public schools and it also has institutional liability protections like if the public school nurse did have a conscience objection on a rare occasion the public school could not be held liable for that we think that's very important resented Allen you're recognized for a question. Thank you Mr chairman on page two two eight would you please help me better understand that. I'm sorry was that a question for me or for represented one of your okay are you talking about conscience means the religious is that the line that you're referring. Permit me. One twenty eight line twenty eight twenty eight okay on page two. Go have prepared to address that as so adverse action that's very important language because that doesn't mean that any accommodations you work out with your employees are necessarily adverse action you have to be put in the employee with a conscience objection in a worse position for it to be adverse action you're still free to work things out with that employee. That answer your question is invalid still a cloudy okay sound a little bit okay so for example one of the things in case law and conscience law is that you can work out an accommodation or transfer of an employee to other job duties but it does not need to be a worse position so for example let's say you have a nurse working the daytime see if if at all possible you don't need to transfer the nurse to the night time ship like a punishment adverse action is something that's kind of along the lines of a punishment so the simplest way to understand this is that you can't punish your employee for exercising conscience now you'll see that some of the amendments that have been added have been added to protect employer so that they can dive into what potential conscience objections an employee might have before they're hired then that employees is protected if they've disclose their conscience objections but and you later on try to force let's say for example and nurse is hired and she's working for L. B. G. Y. N. clinic in that clinic does not perform abortions then later on they decide to that's an example of where that and are should be covered under this law but if the nurse goes to work for Planned Parenthood she knows full well what she's getting herself into. It's it's a different situation. All right any other questions from committee. Representative Payton you're recognized. Thank you could you spend a few minutes and expound on the definition of conscience here yes okay so the definition of conscience has been narrowed and tight end up and it it honestly it was it was a good suggestion the philosophical part of the definition has been delayed it and it's left with religious moral and ethical and we have more case law in the United States that shows what that means and it's a more secure fitting for conscience and honestly I actually feel good about that change it's it's a tightening that up with some good suggestions from legislators and I have to say that I think the political process and this amendment process and listening to different voices worked as it should to tighten up the bill and make it still a good bill but something that medical institutions and others can be more confident about. Thank you. Right any other questions. Senate saying none we do have two people signed up to speak against the bill. Karen music. He would come to the table. Yeah thank you. Please introduce yourself and who you represent. Again my name is Karen music I read you could you put your mind a little closer so you better think this better. My name is Karen music it's easier than it looks of I represent Arkansas abortion support network we started doing clinic escorting at abortion clinics years ago I'm gonna tell you a short story about a woman who came into the clinic as she walked in she said I'm forty five years old I am too old to be going through this again I just got my last one off to college. I think that's the feeling most of us can identify with or many of us can. When she came out she had a long face and said I was not prepared for that. And of course I talked to her and she said there's no heartbeat. No heart beat nothing they can do they set me to my G. B. Y. N.. She had insurance she was able to go to her medical doctor. Imagine my surprise two days later when she showed back up. Because her medical doctor OBGYN refused to treat her because she told him she had considered an abortion. Where do you draw the line on the conscious of conscious consciousness of providers as opposed to the consciousness of patients. Where do the patients lie in this I would say this woman's life has value and it needs to be recognized as such she ended up paying for an abortion she didn't need that her insurance would have paid for. If her doctor had followed what her doctor does for every other patient that has not thought of having an abortion. Thank you for your comments. A Mike Hernandez if you would come to the table. To speak against the bill. Please introduce yourself and who you represent. Dr Martin and does so from the ministry to association I'll be honest definitely not my bailiwick coming here to the health department talk about education type stuff and so one of the reasons that they brought me here just overall some concerns we are have been in conversation with the sponsor as well as as the attorney here about the possibility of amending K. twelve out of this you know we have several concerns that it as it relates to counselors nurses you know any social workers working for the district and a number of districts which some of you may have those in your school districts that include a school based health center we're not real sure how this impacts you know based on our our review the there's things where you know kids come in and I have various issues for medical to mental to all kinds of things that they may want to discuss your be counseled on you know the pope people that are working for the districts are employed by the district and contracted and so we we're very concerned about what impact this would have as it relates to those things in may make districts you know not be able to deal with their employees directly because there isn't a lot of choice when it comes to come into public schools and a little bit about the timing of this when this bill would actually if it were to pass we would understand it go into effect come in the middle of the school contract your again mission school districts and and timing with this in so there wouldn't be at a timing where you know the the district would already be in contract to be working with that employee so there would be that opportunity to consciously object to the things that are in roles of their contract in addition to that You know being able to to do anything about that if a person chooses not to perform work based on a conscious decision at we appreciate the definition that was given but those are just our our concerns with this bill. Thank you thank you for your comments. Thirty one the audience who would like to speak for the bill. Against the bill. Seeing none are you ready close for your bill representative. I'm ready to close for the bill with the following statement when this bill was presented in Senate. Public health one of the comments that senator Hammer made. In his closing remarks and I'll share that with you right now is. When we talk about the rights of conscience. Fundamental. Decision making that we all value in our personal lives. If there's not a remedy. If there's no solution there's no remedy and this bill provides a solution. And a remedy to protecting the rights. Of Medical. Workers and so with that I would ask for a good vote. It was will the committee represent more up I have a do pass by representative Boyd. Any discussion on the motion. Seeing seeing none all in favor signify by saying aye. All opposed nay. Motion carries congratulations your bill is passed thank you Committee. Okay next on the agenda is H. C. R. one oh oh three year of sin Gonzalez. Okay. Okay of moving them to the S. B. three seventy eight that's senator Hammer and representative Gazaway. President of yes way here. All right. We're moving down the agenda pretty good today. All right we're gonna go to the consent agenda. And representative Hawks recommend asked if he could move his to the next meeting so the next item on the agenda is HB ten sixteen the represent of rye. You're recognized to present your bill. Thank you. Thank you thank you committee of the reason that I'm here with you today. Is a. I love children. And we've got a problem I'm not saying we're gonna fix it overnight and not trying to just wanna do the things that we can do To protect the children within swimming pool areas. This issue is very close to my heart and I would say I love children and this is about pool safety. I didn't know there shall I start working on the bill but as of June the sixteenth twenty twenty drowning is the second leading cause of unintentional injury and death of children in the state of Arkansas. data shows ninety eight percent cannot swim and fifty percent of the queue is over the age of fifteen also can't swim. Thousands more suffer moderate to severe injuries as a result of submission not excluding elderly persons. Those that are disabled rather than it be mentally or whether it be mentally or physically as well as handicapped persons I'd like to tell you about a child. This was the last one as far as I know in Poinsett County. the the child's name was Alex little boy little Spanish boy. Over Marjory but I didn't know what to the these folks come to ask me about it but actually this is the third one that occurred and It's a it's a pretty bad thing and what I would like to do. Is step one is a struggle cost very little to nothing I mean some cost a lot okay. We got children that are dying. And they're drowning and lot of times they don't have supervision I didn't know a lot about that. But This this little boy named Alex. He stumbled over to his neighbor's yard. A little brother was right there with him for years I will. And the. Hey washes rather that. Charles Thompson here with me As from the department fails to they're going to help us with that. Not gonna cost a whole lot and. What we're going to try to do basically. All the people that. FOR do swimming pools and sale from outside the border. And inside the border to anyone. All we're gonna do is repair manual. And in this manual it will tell you about the dangers of not having a fenced area. Analog it was not gonna make any one. DO anything. Just basically we're telling people. That there is an outlet in there is a danger. And I'd for I'd appreciate a good vote only if if there's something about this bill that someone's having a problem with all you gotta do is let me know I'm open minded. To change in anything. That will cut down on this problem. And I appreciate you. A committee any questions representive Allen you're recognized for a question thank you Mr chairman of represent Y. right how would you in for something like this you can't enforce free there's no law all right so this is just and right there's no law is British don't go beyond and enforcement this is mainly going to start out in a sport I know it'll never get a father then I'll education. We want to educate the people that are buying swimming pools of of the need for to be fair stand because France. It's easy for a child to walk into another yard and and dry on and no one even know what. But it is far as enforcement. You don't have any forfeit you can even across state for a and there's not even a permit system in the counties so you don't have to worry about counties in force in the Code you know and and cities do but I I didn't I didn't do it that way I thought the best thing to do is is taken to the committee but I'm not a problem that's out here. Let you know. And and let's do something I mean let's do something to inform the public of of situation because second cause of death in the State of Arkansas is drowning four children. Your representative right yeah I haven't come in really not a question but I thought and I believe in Jonesborough they have this law we do have to have offense is are there other city my question is are there certain cities in the state that have a law yes Sir yes Sir there is representative Jack and they can do that on their own but actually A representative Jack this is not what we're trying to do here I mean it be nice if everybody could have a offense around swimming pool there's people that don't and then you know that's that's okay I mean it's not against the law but what we're trying to representative Jack is is that people know because if you do have a chance in the bill in the house and you want to put in a swimming pool. It sure would be a great idea if you could put a fence up around it. Any other questions from committee. A representative Payton you're recognized. Thank you Mr chair of. Representive right the bottom of page two paragraphs C. starts with any person entering into an agreement. To install construct repair or remodel residential swimming pool shall give this notice so I'm in. There is yes enforcement one what happens if they don't there is that because it says shale their eligibility there is no felony to represent John you don't think they'll be a penalty coming in now so there's no penalty at all representative John this is just to let people know about the problems and we got a a Charles is is working on this for us it's not going to cost a lot but the main thing is is anyone that would like you say if they did remind I don't know if that would be because John within its situation but my main thing is it's just people putting in pools John to let people know the dangers. Fire follow is repair well but John how would you keep up with that there were a few kind of my point now I don't know how you would do but if you go on because there's no law okay I'm not trying to do a real low as far as a lawless concern not hello I'm trying to to to to make out with the issue Gassen girls is just something to let our people know that we have a problem and if they by swimming pool then they will. They'll get a package to show of the dangers of a pool safety. Representive Allen you're recognized thank you Mr chairman. I appreciate to bring this bill. But you keep saying that's not going to calls very much you keep saying it's not gonna cost very much is not so what calls will be associated with this bill the cost of per day for up for any of the material so who's going print. Right here this that the Department hail okay if you would come come for the table in addition self if you can answer RepresentativeHouse question. Charles Thompson attorney Arkansas Department health appreciate appreciate a chair representive Allen representative I came to us with his concerns about this the bill was was a lot different when we originally was originally presented to us we found a way to get it to a to a point where it got to the intent of what he wanted with a very very minimal cost so we would the idea was that we would present to some education materials on pool safety put on a website that anybody could just go and click in and print that off so we realize that that was a significantly W. to minimize costs to the Department but we got to represent right where he needed to be with his intent and so we as a department don't have a problem with the bill. It is a follow up. If is it possible that we could do some PSAs on the public service announcements or something. Representative we have haven't gotten that far but I think as part of represent rye was felt strongly that that maybe we get a group together to discuss these issues that that that the department would part and said we'd be willing to do it for discussion with stakeholders and industry professionals when it comes to poles and I think that could be something as part of that discussion okay but I think that was representive rise intent is to to get the ball rolling kind of have these discussions is is what how we understood it to be okay again thank you Mr chairman and and thank you with the Rafi of the. Representative Dustin you're recognized. Thank you Mr chair at I guess I'm trying to figure out why we need to a bill for this can you not in the department of health not already. Provide education or put something on your website without or get people together I mean not the danger seems to be obvious when the resolution kind of recover this maybe represent Dotson I that yes that that the answer the answer is yes again this is not the Department health bill this is represent bill Ryan he's very passionate about it we understand is passion we're about pool safety as well I mean public health and safety so you know but I think he is I thank you six all concerned he's that touches close to home and he felt that it's something that we needed to to and I'm I'm speaking for him but that's what expected status that it was something that needed to be needed to be taken seriously but to your point the Department health is all about education we can do things with educational so you can do everything within this bill without the bill actually being a law. From a department of health standpoint as to the educational portion yes okay thank you. President Payton did you just have a question or do you have something else. Okay. Representative Perry you're recognized for a question. Thank you Mr chairman. I understand the. The the reason behind actually have had our own we have a swimming pool we have a privacy fence in the separate fence around the pool so as to prevent this kind of illness kind of concerned but in your workgroup you may want to add someone from the insurance industry on that as well so thank you. Thank you representative Miller you're recognized for a question. Thank you Mr chair. Of and this is for for both you gentlemen of. Represent Johnny would you be happy with the Department just posting. Like. All safety tips and stuff for consumers on their website or whatever and and I mean the department seems. Willing to do that as of now is in my in my correct and what other centers represent Miller we're willing to do whatever whatever this body says or what represent brought to get his intent whatever this body says where we're able to do when it comes to the swimming pool safety educational component. Whatever it takes that we will do it. We need to amend a bill to make it right for you. No I'm just what I was thinking maybe we don't need to put it in the law and if they're willing to do it I I think you're doing a good thing they seem willing to do it if we could just save us from passing another law. What have you talked about that representing Miller. Okay thank you Mr representative gray you're recognized for a question thank you Mr chair and looking at the work group that's being established on page on the last page three it talks about to study the feasibility of adopting international swimming pool and spa code of the international code council so my question would be I guess the department of health is what swimming pools standards are we using currently. This could represent Greg currently we we do monitor public swimming pools and those are rules and rags rules we use terminals now I'm sorry no you no longer use regulation rules that come through a LC in this body approves so that is that is a it's based on science and and and state and standards usual industry standards but it's also approved by the Arkansas General Assembly to ALC. Okay follow up Mister chair yes you're recognized thank you and this that and I don't know anything about these international standards but would it be a large I mean it would this be a very large increase in governmental regulations if we were to do this do you know. Representative Brett I do know that the the international code when it comes to spawn pools is it is lengthy I can I can state that we have the department of health is not has not taking a position on the adoption of such a code that would be something to discuss but we have not taken a position on that but it is a lengthy code book to my understanding thank you. Representative Payton you're recognized for a question. Thank you Mr chairman this is probably the either or both of you. Do we have any data or studies that show the percentage of. Cool owners that may be I won't use the term ignorant but oblivious to pool safety. It all pool hazards do we have any studies or information that indicates a significant portion of pool owners are oblivious to the dangers. Eighty H. doesn't have anything as it pertains to to Arkansas representative Payton there is You know to as a point discussion we don't know how many private pools are and spas and hot tubs are in Arkansas right now because we don't currently regulate them so I can point you to to any any data but I'd be happy to go back to it with our experts and see if there are any from of other states that the male point us to. Okay thank you thank you Mr thank you representative Gonzalez you're recognized for a question they Mr. Do you know if this international swimming pool spa code applies to residential pulls her. Is it usually just public period the rest the the what is reference in the bill is as pertaining to two residential representative so and that is our stand again Arkansas Department health does not have regulatory authority of a residential currently so we just do the public pulls out of you know the the large public schools is what we handle. Thank you. All right any other questions. Of seeing none of us or anyone the audience to speak against the bill. For the bill. Seeing none representive you a close yes Sir and the only thing I can say is just to help me inform the public about the dangers of children that are grounded. Sure. What will the committee. To representative a don't have a motion thank you for your presentation. Okay we're gonna move on to. Next item on the agenda is HB fourteen thirty nine representative Pilkington was or somebody to present that for him. I don't see anyone. All right we'll move on then to HB sixteen twenty two representative gray you're recognized. Thank you Mr chair and just in the for expediency if I could I'd like to have Lloyd Warford with the Medicaid fraud control unit actually sit here with me and help present the bill. You would please include your self and who you represent. My name is Lloyd Warford I'm on the deputy Attorney General in charge of Medicaid fraud unit for the state of Arkansas thank you representive you're recognized if you would go ahead elegy presents a much better than I can. The chairperson this this bill affects the the authority investigative authority of of the Medicaid fraud control unit as it relates to the maltreatment statute. state or federal law both control what the Medicaid fraud unit has to do and right now those those two loss right to sync in two thousand twelve because of Congress passed a law that the Medicaid fraud control units were supposed to investigate abuse neglect and exploitation in board and care facilities and creative definition for board care facilities in two thousand twenty that passed a law that expanded further that we're supposed to investigate you prosecute cases of abuse neglect exploitation of any Medicaid recipient whose abuse neglect or exported into Medicaid setting. We've been doing that strictly under the internet generals general law enforcement of power and the authority of the office to to bring civil cases and to litigate. But I maltreatment statute has not been modified to adopt that new definition what this bill does is adopt the federal definition of boarding care facilities and expand the authority of of the Medicaid fraud control unit to investigate abuse neglect and exploitation in those settings. All right. Senate have anything to add no thank you. He. Okay we don't have anyone signed up to speak for or against the bill anyone in the audience to speak against this bill. For the bill sorry was there any questions from committee. You're recognized represent Gonzalez. The Mr do not already have the authority to investigate anybody that's accepting Medicaid funds can. The. We have the we. It's complicated I wish I could make a simple it's not we have a we have criminal authority we have we can investigate an incident in the same way that law enforcement does there are certain procedures and policies that apply to law enforcement are investigating cases there or administrative authorities under the maltreatment statute that allow us to vested gate cases very differently for example if we were to go to a facility where there was where they do not receive Medicaid funds in the maltreatment statute in the platform and we asked to see the residents and they refuse access we have to get a search warrant to get into that facility we can do that and we have done that if we go there under the maltreatment statutes of facility is covered by the military the statute they can't refer you fuse entry to us under the law so it it affects how we go about investigating the cases of the vast majority of facilities a state of Arkansas already receive Medicaid funds so it is not gonna be a change but due to a handful of facilities where they do not receive Medicaid funds in those cases it will affect how we can approach that facility even though it doesn't we're not entirely prohibited from investigating and now. Does that make sense. Follows yes you're recognized some. So if the facility except the funds then you have the ability to go in now but if they don't but they have a resident who is Medicaid this is what that's allowing you to do is if they have a resident in a facility doesn't accept met Medicaid. Funds we can the. It otherwise the the the rules and procedures and the authority that set out in the Medicaid in the maltreatment statute. To a facility that does not accept Medicaid funds yes and date let me explain this is well they are currently covered by that in the concurrently it can currently be investigated is just investigated by DHS rather than us. So let me finish with this last fall I imminent maybe this will help there are no new crimes committed by this there's no new type of maltreatment created by this there are no acts or conduct criminalize by this statute it's simply affects the Medicaid fraud unit's ability to investigate those those incidences and frankly in some cases we bring a little more to the table then then other people can I have nurses on my staff I have lawyers or nurses on staff I have license count professional counselors were also certified law enforcement officers I have accountants I have a financial analyst I have a CPA all of which can be used to investigate exploitation cases in abuse cases that are in those people are not there. For DHS or for local law enforcement so that's what we bring to the table when we come. Represent Wardlaw you're recognized for a question. President of Boyd you're recognized for a question. Thank you Mr just for clarity sake so this would allow you to investigate and bring the Attorney General staff on board to investigate but if it's a happening Craighead County then the prosecutor of Craighead County would still have to be involved in the process the prosecutor does it somehow allow the attorney general's office to be absolutely wrong thank you to the local prosecutor has complete control over anybody being prosecuted. Representative Johnson you're recognized. Thank you Mr thank you Mr chair So if I'm understanding you correctly this is opening up to where you can investigate independently of DHS being involved and having to investigate. We have overlapping jurisdictions now with with DHS of for all Medicaid funded facilities and we work with them closely in those in those investigations what this does is it is expands our our ability to investigate to facilities that don't have Medicaid funds that that do not have Medicaid funding. That but we already work with DHS they will DHS will still be involved. At. I don't so so that's all under the attorney general's office. Not sorry that I've I was thinking you were the Medicaid fraud. Is the Medicaid fraud division yes there it each state has to have a Medicaid fraud unit that has a law enforcement authority investigative authority throughout the state in in all but seven of the state's those those units are in the attorney general's office and that's where it is in Arkansas. It this is expanding it beyond Medicaid. Yes. That K. it. I think I'm more confused now but well. You know I I don't I don't create the Congress passes the laws were seventy five percent funded by by the federal government the federal government additionally from two thousand from nineteen seventy six until two thousand twelve we were restricted to only be able to investigate abuse neglect and exploitation in Medicaid funded facilities in two thousand a lot of uh in two thousand twelve the law federal law changed. and to the extent we had and we've have authority we have been investigating those cases but we have a limited ability to do so this would put all of the nurses all of the nursing facilities on the same footing without regard to where they get their funding. So now the Medicaid fraud unit will be investigating non Medicaid related institutions we have always investigated non Medicaid abuse neglect and exploitation cases you do not have to be a Medicaid recipient to be a victim in one of our cases. So we we've we have prosecuted cases investigated and prosecuted cases involving non Medicaid recipients in Medicaid funded facilities who abuse neglect or is supported in the non Medicaid funded facility since nineteen seventy six. C. H. R. victims do not have to be Medicaid recipients and never have been but the civil Jeez are authority to go into the facility. Was limited to Medicaid facilities. Okay thank you. It's it's complicated but essentially Arkansas head to standards of protection one set want one standard of protection for medicated Fund facilities in a lesser for for non Medicaid funded facilities in this makes them the same will be treated the same. The further questions from committee. Seeing none. I'll ask again is there anyone here to speak against the bill for the bill. Seeing none representive are you ready close for your bill yes thank you Mr chair I think you guys can saucy why I handed off and allowed it to be exploited by someone other than myself but I think I am completely understand what you're saying representative Dotson in the best I can understand it myself is this is something that the federal government has allowed the state to do under this division for the past ten years and so we're just essentially bringing our self up to code even though. Non Medicaid in Medicaid I do understand what you're the point you're making. Yep I'll close for the bill thank you Mister chair and I make a motion to pass. I have a motion to do pass a discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries resolution your bill is passed thank you Mr representative gray you're recognized to present HB sixteen twenty three. Thank you Mr chairman I would like to do the same thing I did on the last bill and ask Mr Lloyd Warford to sit at the table with me present the bill. A surgeon it is yourself again please my name's Lloyd Wofford and the deputy Attorney General charge the Medicaid fraud unit you're recognized this one's acting a lot easier to understand. Congress Congress has given the private citizens the right to bring a claim in federal court where people have defrauded the Medicaid system those claims are always some division of state and federal money the amount the percentage changes over time but it's roughly seventy thirty percent most of the time Congress is also given those individuals the authority to file a claim on behalf of the state of Arkansas in each of those cases for the thirty percent that Arkansas has has it's state in those claims of those lawsuits are sealed. The federal government does not share that information with us we are not involved in those lawsuits we have no ability to monitor those lawsuits. At some point we typically or sent a settlement offer. and with very little information we have to decide whether or not we're willing to take that settlement because of the process the federal government use we use is we are not permitted to speak to the relator we often are not allowed to see the the pleadings we have to make a decision on what this bill does is require any person who's going to follow claim under the federal law to give us notice of that. And then at that point also gives us the opportunity to intervene if we think that's in the best interest of the people state of Arkansas. If nothing else it will give us the information we need to know whether or not we're getting a good deal when the federal government settles on our behalf. Procedures for a minute. Any questions from committee. Seeing none we have no one signed up to speak for or against the bill anyone in the audience to speak against the bill. For the bill seeing none represented great clothes for your bill I'm close for my bill Mister chair make a motion to pass I have a motion do pass and discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries congratulations your bill is passed thank you Mr chair committee. Okay we moved into S. B. one forty three. The representative ray you're recognized to present the bill. Thank you Mr chair this one I think I can be myself so. This is what this has to do with essentially is a D. you are bored it has to do with product and label expansions new medications that are essentially approved by the FDA what we're asking here is that the Medicaid program automatically allow new drugs new medications that are approved by the FDA. To be considered I guess to be considered formulaire you upon approval and instead of right now what they're doing is saying if you've got a medication is approved by the FDA we have to wait until the day you are board meets and decides that the medications are clinically appropriate and they add them into the formula so that's taking like nine months to a year sometimes in order to get these break through and we've got some like cystic fibrosis I know is one of the things we talked about last session breakthrough medications but when we're having to wait nine months to a year it was affecting people's lives so essentially what we're saying is let's go ahead and approve these upon FDA approval and then the D. U. R. board can meet like they normally do and if they have a some clinical evidence to show that that medication should not be used OR not be paid for through the Medicaid program then they can discontinue its use so allowing it on the front end instead of the back end and then we're also setting up We find what we got it but it's called here. Have establishing the rare disease Advisory Council within the Department of Human Services have and that purpose the purpose of the council's provide expert clinical advice and input in writing to the committee to the Arkansas Medicaid drug utilization review board which is what I'm calling the D. you are bored when the board reviews a drug or treatment for a rare disease or condition and so what we were very specific in the membership that we put on this board to try and You know get a wide swath of people with rare diseases that that had a lot of expertise in the area of on this council so be glad to take any questions of the representative when you talk about rare disease I don't see it in your budget what what is a rare disease that defined in here or is that already find somewhere else. That I do not know. I don't know okay breed them looking and see if I get the answer for you here in a minute. Thank committee any questions. Something to section two yet rare disease or condition means any condition that affects less than two hundred thousand persons in the United States for more than two hundred thousand persons in the United States for which there is no reasonable expectation that the cost of developing or making available in the US a drug for the disease or condition will be recovered from sales in the United States of the drug. Thank you representive Coleman did you have a question. Thank you thank representative Payton did you have a question. Yes thank you Mr I got confused on the board. That so you're creating a commission or board that reviews the drugs or is there already one in existence and we're creating a another one that does something different so that there is a D. you are bored already in existence this would be an additional Advisory Council said was simply to provide is that the you are bored and they don't have a wide array of people on the board with expertise in rare diseases and so the purpose of this Advisory Council is essentially to you you have experts in each area select cystic fibrosis you know if there's someone on this board that has expertise in just that one thing they'd be able to this council will be able to advise the day you are bored on that particular medication and what its purposes all or and whether or not it should be approved essentially or not. If I get a follow up yes thank you so that answers that question the other question I have a concern I mean I understand this is done in the spirit of trying to get the medication to the person in need as fast as possible. But then we're going to the review later so once you've already. Had the drug on the street for some period of time. Are they going to be more hesitant in the review the to see the problems and say now we need take it away and then also because we we fast tracked it to use. Then there's not so much urgency to review it is quick so you all of my concerns are you know do we create a backlog and do we are. Because I'm not to want to route not to want to take one away they see a problem with actually I don't think so right now it's taken at least nine months to a year to even bring it is that there is no urgency right now so I don't. I don't see that is an issue into. What set it being allowed to be used the physicians that still going to have to follow what or what's clinically appropriate for the medications I don't know if that many I say I don't know of any. New label expansion label medications that have not been approved for the proper use by the D. you are bored eight they've just been stalling. For an extended period of time to added into their formulate products okay thank you Mr president Johnson you're recognized. Thank you Mr chair. I mean I I I applaud the effort to try to get these things fast track to to get it out there as soon as the FDA approves it. I'm not so excited about creating and thoroughly new board or council or whatever they're called is there have you thought about. Just having it. Fast tracked getting it out there after FDA approval automatically and then having the existing board go back and just do that review and allowing them to call on expertise as they needed if they need additional expertise and I think that would be an option so that currently so right now if we change the process that's what would happen but the expertise would be in the form of this Advisory Council my main goal with this is to get the medication into the hands of the patients sooner than what's currently done secondary for me is the Advisory Council and if that something that I'm getting some semi I see where this is going. I would be glad if that's the wishes of this committee to pull this down and look at possibly removing the Advisory Council K. and at least getting the meat of the bill and our intent thank. Okay. Is that your suggestion representative Johnson. My whole committee is nodding at me. So let's hear action that's what I will do I would like this real quick one more thing if I could a lot of other states in the in the US there they do allow this of the day you are bored but get the medications are automatically approved with FDA approval and then they go back and review them so I feel like we are kind of coming into line so. With that said I will to withdraw the bill for today amended and bring it back I think the committee agrees with your ear thank you representative thank you. Okay committee we're gonna go back up the agenda now we have some other folks that come in the room so we're gonna go back up and start at the top where we stopped so representative Gonzalez S. B. three oh one you're recognized. A committee we have an amendments gonna be coming around. Oriel one the member is not on three oh one okay there is no amendment on three one the bill would pass that and we'll get and we get that bill representative you're recognized to present SB three oh one thing Mr if you don't mind I'm a Senator Solomon come up here that's fine. Center if you would please introduce yourself. For the record. Thank you Mr chair Dan Sullivan. Thank you representative you're recognized to present the bill. Englischer Committee on of how like to present bills keep shortly I think Senator Solomon had more he wanted to say basically all this bill does is make the health department and the other state agencies the collected funds due to current of our stock violation to return those funds to the businesses most of these businesses suffered enough through The regulations with the that were placed on them from our government that we don't need to stack fines on top of that so Senator so when you have some matter and I just said that we are asked doctor Delahaye in committee if they would enforce some of these rules on big businesses and she said no that they would consider it but they were not and I never heard back from the same thing with some of the other electives that that were placed on our businesses on the eleven o'clock curfew they didn't have any evidence that that would work when I asked Barton got the evidence back in that it didn't work and the reason they gave among other things was modeling and yesterday and and. Dr Dallas are Dr Romero has said that they don't necessarily use modeling and to make decisions but they do. I went to a meeting are the governor had a meeting in Jonesborough the invitation for set out to community leaders and I didn't get an invitation when I called the governor's office they said they would consider that a letter and got an invitation to go with this what we're facing here we is representatives and elected representatives of the people we just want to voice this is never been about the directives representative Gonzalez and I were the first ones to go final the directives that the governor wanted in the bill to bake that bridge between the and of the emergency order where we went when the and it Agency rules quite frequently I think I've got a couple of. We're gonna be running later that kind of correct air you hear the agencies come up all the time and say no this is I'm running that for X. Y. Z. agency because we've made an error and that I think we just aired in doing these businesses also thank Secular branch enforces the law when the executive branch makes the law enforces the law at some point we have an obligation to correct that if you're going to come into my district and I hope you all see it this way if you're going to come into my district and you're going to find punish restrict enforce rules that I as a representative when I have a voice in that I understand the emergency act well and I think there certainly is a place for emergency action by the executive branch but at some point that ends and I know many of us contacted the governor's office and contacted the executive branch and asked to be a part of that and that was denied so I think you know as far as following the rule of law I wish they had done that and follow the the executive branch and follow the law and brought us in. All right any further questions. Resented Payton you're recognized thank you Mr chair so this just talked about the fines if if somebody was found in violation of the health department director for ABC board. That's still a violation just returning the fine right correct so as far as a rule of law is satisfied by whatever website they maintain that says this restaurant had so many violations those violations are still reflected on there yes okay my knowledge they are here we're just return the money and you don't I think there are this president also you know if you are rental property owner and your someone person dumpsters garbage on your rental property and the word of the government board of of the city where to find the the owner of the property they would be in violation of the law and they would take that. Give the money back and find the person adopt the trash so it's not unusual for our government to make an error and it's not unusual for us to repay the money thank you thank you Mr. Hi there any other questions committee. Seeing none we do have two people signed up to speak against the bill. Dorothy Chandler. Please come Board and introduce yourself and who you represent. Thank you for allowing me to speak my name is Doorly Chandler I am the director of alcoholic beverage control and I'm here today to speak against this bill and to explain to you how all ABC became involved in this in this matter as we all know COVID nineteen hit the state in March of twenty twenty of margin declaration was made and directives began to be imposed by the Arkansas department of health with the intent to protect the safety of employees and patrons and others with the with potential exposure and the focus became on the different commercial businesses that all calling beverage control permit locations became a focus because the environment is a little bit different for those commercial environment. And entities because of the on premise and the private club permits that we are provide them you're in close proximity the patrons are in close proximity they have to have removed their mask. For eating and drinking and generally speaking louder to be over heard to be heard over music and other noise within that facility from March to July one. My office would receive complaints of individuals not complying or entities not complying with those directives that were set out in the guidelines of the department of health. At that point in time we forwarded those to the director of enforcement of alcoholic beverage control enforcement and they would send agents to educate and investigate those complaints as the numbers rose there was a point in time when the Director of enforcement began to have systematic COVID nineteen checks going forward from July one. Since July first and the systematic checks were completed by enforcement they completed over five thousand eight hundred compliance checks and forwarded to my office two hundred and fifty seven violations. They forwarded less than five percent of their checks ninety five percent of your constituents and the governor's constituents never came to my office. Of the two hundred and fifty seven reports forwarded thirty three when written warnings were issued by my office there were two hundred twenty four potential monetary penalties of those sixty eight fonts have been paid sixty nine are still pending review seventy eight seventy two offers have been issued and fifteen were set for hearings. It's been stated that we arbitrarily and unfairly applied the finds that you stick to respond at this point we reviewed multiple have multiple criteria for those reports that we reviewed there was not one overriding criteria that we look that we looked at the. And compared the facts that the agents but no reports to the Department of Health guidances we looked at the number of times there was a violation for that entity and prior issuance of a warning and what guidance and instructions we had provided or enforcement had provided to assist in them following the guidance is. Why not require refund or why not refund at this point. I'm asking all to consider not refunding the fines because the message that it sends every action taken centered around the health safety and welfare of the citizens of Arkansas as it related to the emergency a vast majority of not just your constituents but the governor's constituents complied with the guidance and criteria from the department of health as I stated less than five percent were referred to administrative review for the education it was stated on the Senate floor that we're passing permittee's for action of the patrons. But I'd also but I'm here to testify that the fines issued resulted from behavior within the control of the permittee's. Less than five permitted locations that were reported to ABC Administration for violations were the result. Of a report that a patron had miss behavior or noncompliance and their behavior but that behavior was invited by the permittee three there signs indicating they do not require face masks or checking people's ID's as they entered the club and telling them not to worry about needing a mask or to opening up the dance floors to dancing. Refunding ignores the rule of law and it denigrates not only the agents and local law enforcement officers that sent reports to us. But also those that complied the ninety five percent that sacrificed income in an effort to comply with the criteria refunding rewards non compliant behavior and further punishes those that did comply these were valid lawful directives that were undertaken in good faith to protect the health and welfare of the citizens of Arkansas and in an attempt to keep from a complete and continuous shutdown of the State. Any establishment that disagreed with the offer of settlement that we've sent out headed in a redress there was no unfair burden placed upon that they could request a director's hearing there's no attorney necessary to contest the offer and ask for hearing we did them by got and are still doing that by go to so they don't have to travel to little rock as we did prior to covid so they don't have to appear in person fifteen permittee's. Have been set for hearing less than ten percent request a hearing and on more than one occasion the offer has been reduced to either a warning or the charges have been dismissed the violation is meant dismiss based upon the testimony of that permit permittee. Everyone has an opinion about the efficacy of the guy and the guidance and criteria is just as people do about whether they should be prohibited from smoking in public or being required to wear a seat belt and I understand that those the guidance is came from the executive branch not the legislative branch like my examples but they did come from an authoritative figure that were a lot of that was allowed at the time and this is about the larger picture if you all like to immunize the fines you're getting your setting a precedent that if you don't like the rules contrary to the hard work put into creating them then they do not have to be followed from for many years in private practice before trying to state government I can tell you that most individuals when they make the decision to violate a rule they don't set you skews me resume Wardlaw jet motion how do can we call the question most of the call to questions posed to call the question. The motion is non debatable. So all in favor of call the question signify by saying aye. All opposed nay. Motion carries question do motion to pass. I have a motion do pass by representative Wardlaw. A discussion on the motion. Seeing none. All in favor signify by saying aye. All opposed nay. The ayes have it motion carries. Resolutions representing your bill is passed. Okay we're gonna move down to H. C. R. one thousand one representative Gonzalez you're recognized to present your resolution. The HR one thousand three a House resume I do have an amendment on this. You do have an amendment yes. This. You already have the amendment passed out that amendments been passed down okay members passed out so The difficult for okay all the amendment does is updated so this this resolution was filed precession the Emergency has been renewed twice since then another thing that is so all it does is a updated to current emergency and add a list of co sponsors. I make a motion to adopt the amendment okay I have a motion to adopt the amendment in discussion on the motion. Seeing none all in favor signify by saying aye All opposed nay. Motion carries the amendments been adopted you're recognized to present the bill as amended they Mr a committee this concurrent resolution is what it takes to call for for the legislature to call for an end to the merger see many of you also through meeting with me the other day that and that Dr Romero spoke at that he said that he would never recommend calling an end to the emergency and talked about it being a a national emergency when I question them specifically about it being a state emergency he still did not speak anything to in my opinion directly about the state and state issues it was more the threat to the state from surrounding states in other states in the nation so at that point that's when I decided that if if we're not gonna get that from. From the executive branch that we're gonna have to do something ourselves so. This is. This one takes the. Committee any questions. President Ferguson you're recognized that I'm sorry this bill just allows us to determine the emergency it doesn't in the emergency. LOL as if this if this concurrent resolution passes the house and the Senate then the merger C. will immediately and. And so what what the financial impact bay and the impact I guess it would end all the emergency orders for telemedicine and all those kind of things yes everything done through the emergency directives would would come to an end as far as funding goes it wouldn't it would not necessarily stop federal funding There are some things that would have to change that but we can handle that stuff through the rules some of these some of them are to see executive orders you we've already put into law I just ran another one in Judiciary earlier that is business liability protection that will that I will make sure goes ahead of this but other things as you all know of of Random House for we've already passed and and they're they're in law I realized telemedicine has been delayed a little bit but I guess I'm just trying to understand the full fiscal and impact otherwise to all because there are a lot of emergency orders out there that'll be impacted. Senate boy you're recognized for a question. Thank you Mr chair representative Gonzalez I just wanna be very clear about what it does and doesn't do if we in the emergency is best you understand so for we and the emergency we being the legislature does it in the mask mandate yes. A representative Gonzalez some of the I'm the executive orders identified in here have ended aren't having today. some of the changes to guidelines for mandates. So the emergency is in it is just a guideline now on some of I'm not technology. No the the mandates in the guidelines aren't necessarily I mean they're a part of the emergency declaration we're still under a declared emergency okay. Any other questions committee. Rabson Wardlaw you're recognized. President of dollars I'd hate amassed more than anybody and I think and drink more water you coke's I don't have to wear one now than I ever have so I'm compliance. The fax or fax it in we're getting vaccines out slowly but surely were I think I heard on the news last night we're close to a million vaccines out things in eight hundred thousand range which is about a third of Arkansas you could you agree to that and I've not heard those recent what those numbers are out there and I guess we get to health department there to testify those numbers but. When we as we vaccinate more more of the population I think I'm in a whole lot more favor of Indian the emergency moving on to normal life. Until that point reaches I mean are you. Open at least to a time frame here if the F. department contest fight we have sixty six percent of people vaccinated by this date would that work are you just did cut off right now. I don't know that we have an option as a legislature to set a time in the future to do that the amount we have the option of of running the resolution to end it or not that's and but honestly it could be the governor could renew the emergency immediately or board anytime in the future so but this is this is the authority that we have this point there is another bill out there that's that would you know that would give us a little bit out of control saying that. Well and and I think representative gasoline senator Hammer have the bill that it puts it after the merge is filed you have so many days ago is the Legislative Council outside of session so the merger committee ended I mean to me that where we are and where we're headed we're seeing numbers getting better but we're not perfect yet and we still have a lot of people in hospitals to have a lot of people on ventilators we're still seeing risk I mean I guess I'm asking you are you open to pushing that builders so we can look at it at a time frame are looking to amend your bill to get to that time frame no I'll fully support that that piece of legislation I think that's great and you know it that particular bill inserts legislature into the process into the future which I think we need as well so absolutely I'll support that. Senate Bentley you're recognized. Representan Gonzales if we pass this resolution is a prevent anybody from or in a massive sum if someone can freely wear mask that used or masquerade when I was running people wearing masks if that used to correct that's correct thank you. RIP center wing you're recognized. Thank you Mr out representatives also just had a couple of questions one is does it address in this concurrent resolution if we declare the emergency is over to the governor just turn right around and clear another emergency yes he could okay and then the second thing the timing of this I was a little bit concerned just because of things like telemedicine we've got a couple of things that we still want to address while we're still still here in the legislative session is there a way for us to conduct. Perhaps the deal with this once we get all of our eyes and he's got it on our wish list of things well you know I like I said I'd filed this precession you know before we ever came in here started I had this file but I I realize that there were some other things in the works some of the things that needed to be done so now we're more than halfway through session and I'm just now not running this marking that from the very beginning of this emergency declaration was out the I one of the legislature involved I wanted us to have a voice and it we've been here long enough to. If those things were the important things to us we could have gotten them done and first one reason or another they're they're being held up at this point I think it's time to decide if we want to take action on ending this or not. Just like. My position all right any additional questions from committee represent Payton you're recognized. Thank you Mr so you said you filed this before the session. We're sixty days into the session you've been waiting patiently of. Are are you beginning to wonder if the some forces are trying to run out the clock and and maybe uses to speed the clock up for or a. However I'm just curious if you think it's important that this advanced one or two stages just to try to make sure we keep everybody honest on their intent with other bills yeah I I do think it's support that we have something out there that that's moving forward that at least yeah shows are people we're the we're standing up for the legislature and believe in the separation of our state so thank you and if I can have a follow up. Yes you're recognized so there thirty four hundred cases currently in Arkansas on the populations over three million that's less than one percent or about one percent of. Point one percent. The point one percent so. Do you think that's an emergency. I do not believe that it is at this point okay thank you thank you Mr. All right any other questions. Thanks saying none of we do have two people signed up to speak one informational. Or against I'm not sure but if you all would come to the table more quiet Lawrence you. Yeah both of you all come up and introduce yourselves and you represent and whoever wants to can go first. The restaurant or club or medium services March two and general counsel of the department of health. You're recognized. And market my god sure I'll go first. Thank you Mr chairman so I've said I'm informational on this resolution just want to make sure that Committee understands the context and so the possible consequences from resolution back on the pendant pandemic started we took a number of steps to try to make adjustments accommodations because the pandemic and the things that if required us to suspend or rules because there are things that otherwise the rules would have kept us from doing and that's one thing is that having the emergency in the executive order by the governor that's what allows allows agencies to suspend their rules to address that emergency and just give it a couple examples of things were doing so for example run telemedicine we've greatly expanded the use of telemedicine Medicaid so for example development just disable clients can now receive occupational therapy physical therapy speech therapy through telemedicine where is ordinarily under rules they could not but because we suspended those rules they can't they can't now all other forms telemedicine like behavioral health also paid for Kobe testing as well as paying for some treatments for covid and so those families that we mental accomplish thanks the authority which we've had under the emergency executive order now going forward we are in a process right now to do two things one the text of those things that still need to be in place temporarily and put them in place through an emergency rule which will come to the else exactly subcommittee for approval and there's other things that we've done we see that it works makes sense and will make those permanent and so those also we're looking at a mercy rule to get that going and then a permanent rule long term to put those things in place but as a process at this we're still in the middle that process and so our eyes would you be aware that if this resolution passes and the Emergency ends before those rules are in place a lot of those flexibilities are going to disappear there is going to be a gap there were those things. Are not available and so I to make sure that we is aware that in that context and that I'm happy to answer questions or or deferred issue for her presentation. Mr you're recognized. Thank you Mr chair members of the committee despite making significant strides in controlling the virus there still is uncertainty as you know that we are under a public health emergency that's been authorized by title twelve and title twenty under two twenty dash seven dash one oh nine and one ten and our rules pertaining to reportable disease that went through a committee committee would would would you hold it down low but we can't hear the presenter see thank you Mr as you all know that we are still under the public health emergency that was authorized by the law under title twenty and title twelve and our rules pertaining to provide reportable disease that was approved by the public health committee and A. L. C. rules and A. L. C. back in twenty eighteen and affective as of twenty nineteen so we are concerned about this resolution ending the public health emergency at this time there are new challenges that arise and constantly with the the variants that are in Arkansas already in a nearby states they will likely significantly increase the rate of new cases the national experts are warning that the national emergency is not over to the extent that Dr Romero mentioned the national emergency in his speaking engagements recently he was referring to the fact that he does consider other states information and the national emergency information when he is giving advice to the governor in accordance with his role as the secretary as any cabinet member gets advice to the governor the resolution ends the protection of the executive orders and there are several bills pending that affect the emergency that have not passed yet but implement the suspension of the rules in addition to the ones mentioned by Mister white for DHS EMS providers and hospitals have been given flexibility to respond to the immediate needs by using personnel to the maximum extent of licensure and in their facilities to reallocate resources these are important things that we need to have flexibility at this time during the public health emergency currently the pa. A health emergency will expire as of March thirty first unless it is renewed the face covering directives or the mass mandate will end on March thirty first but that's based on a scientific data and criteria that should be evaluated at that time if this resolution passes it takes away the flexibility to react quickly as of the Department health is constantly evaluating the information that we receive day we have lower case rates that have permitted easing of restrictions but we recommend that we proceed with caution we thank you for your time today. Senate Gonzalez you're recognized. A representative Johnson you're recognized. Thank you Mr chair mark I had. Question I guess really regards the rules the emergency rules that you talked about and the promulgation of permit rules the flexibility you're talking about particularly with regards to the telehealth or telemedicine and things like that I mean this this public emergency I believe. Was declared one year ago today are we are we had a year later about I think ready year yes how long does it take you to get an emergency rule together. We've been working for the last couple L. at least two months probably three months to put that identifies what needs to be kept working expire when a public health emergency and and what may be need to be in place for some temporary period but would eventually expire and started visions of organized in a file those putting those rules together and so they've been at work on that for the last you know it's over the last three months so you have some pretty good idea of what you're going to be asking for have you begun the emergency yes Sir I thought rule making process and the permanent yes Sir and I would expect that what we bring to you is going. It within a matter of if not days and we just few weeks at they were they were close I think you can do it within a couple of days If if you really tried we're we're pushing to get that done as quickly as we can okay. And. I'll I'll reserve any other questions get back in the queue. Representative Boyd you're recognized. Thank you Mr chair these these are for issue I just have a couple questions first of all on ask you the same question asked representative Gonzalez if we were if the legislature were to end that the emergency. What it in the mask mandate because I have other information that says the legislature ending the mask mandate is convoluted because it's because it's in a mix between an executive order and Department of Health orders and I just want to be clear does it in the mask mandate. That would and depend on the the the wording of the resolution and but from what the way were reading it would ends the public health emergency and so that would end the directives that are currently in effect but there is that the the mass mandate issued by the executive branch that would expire on March thirty first based on the scientific data. So I'm still asked I'm sorry I'm not clear on that answer if we have like let's pretend today is the final step of this resolution and it's gone through both chambers. If that ends the does that in the mask mate will. Mask mandate after this goes through both both chambers or does the health department still have control of that mask mandate. We would as listen to the legislature and address it at that time and would would likely remove the mask mandate according to the will of the legislature so it wouldn't necessarily remove it we would still have to depend on the department of health to remove their order even if we ended the Emergency corrected still currently in effect until March thirty first according to the executive branch the executive order and the Department of Health directed. Okay and then I have another question if you'll blood yes. Thank you for that answer I just I'm I understand better now so February of two thousand twenty I believe secretary Smith spoke to public health and he spoke about it that moment in time we're going to flatten the curve. And I'm just we've been going on a over a year now from that meeting. The curve seems to be dramatically going down I just wanna make sure. What in the view of the department of health is that is still the emergency why I mean I understand the rules I get that in and understate but I wanna understand make because it could go on forever I mean how what is the end look like how how flat do we have to make the curve. I think the problem with the public health emergency has been trying to predict the future and we can't predict the future people often ask for doctor Smith doctor Romero to look in their crystal ball things change on a daily basis when we were issuing the directives back in March and April in may of twenty twenty we were changing things on a daily basis it was looking at the data every hour every second and so we use our expertise at the department of health to help make those decisions and so it's a quick decision it's something that we have to evaluate on a daily if not hourly basis. Senate person you're recognized for a question. Thank you I'm not near is concerned about the mask is the unintended consequences let me just wanna be clear what they are you're saying Medicaid will no longer pay for because the testing is that the here you say that. That does my understanding that our ability to pay for the co tester right now we have rule suspensions in place to do that in order to continue paying for cobra testing would have to go back and amend or existing rules which as I said we're in the process of doing that we will have an emergency rule package to you all to accomplish that but is this just is not there yet and does that include treatment for covid to disclose some treatment and and wants to a comfort two is the use of monoclonal antibodies that's awesome that was it was envisioned in the remaining rules and so we had make a special combination for that what about the mess the question but what about the fiscal impact of pulling down federal dollars are some federal dollars dependent on us also having declared an emergency what. Tell me about those sure we're receiving additional federal match on Medicaid right now but that is that's tied to the federal emergency declaration so this the state of ours declaration should not have any bearing on the continuation of that funding. What about any of the other federal funding the. She had are there any other federal dollars dependent on us being. Cllr the Emergency I can get you that information and I will have to follow up with my and chief financial officer as far as all the code cares money it's my understanding that there are some tax implications for businesses but that businesses would have to speak to that. Okay thank you represented by Senator another question. Yes thank you Mr of this one's for you Laura. I was in a meeting a week or so ago with doctor amero and he had mentioned something about the criteria that the there's they were looking at for March thirty first two I guess advise on with regards to masks mandate and had mentioned what that criteria was in at that time he said that we were currently below that to where we're heading that direction. And when asked he had said that we were there for about three weeks at that time that was a week ago have we risen above that since then are we still there we now four weeks into that. Having met that criteria where March thirty first it's going to end. The criteria of which you speak is the seven day average of testing positivity remaining below ten percent if the average is seventy five hundred that are tested day and then also with the testing is below seventy five hundred average specimens daily then the number of hospitalized patients would be the indicator so that in that case that it would be fewer than seven hundred fifty hospitalized patients that would be the trigger and it's my understanding is that we are currently under that rate but again we would ask that we would proceed with caution and and be looking at that data on March thirty first so so it hasn't risen above that I mean it hasn't fallen below that I guess technically in the last week since he gave that update so we are now four weeks into having met that criteria I would I would hate is to speak to the the data as I don't have that with me currently at hand and it does change on a daily basis and I would hate to say something on the record that would be incorrect but I'm happy to follow up on that okay thank you. See the other questions but I am I have one I'm a little confused here on the executive orders. Of I guess about well on the on February twenty seventh the governor. Made the statement that he and then all the orders except the mass. So is that the governor's executive orders and is there a difference in the governor's executive orders and the Department of Health executive orders. My understanding is he did change some of the directives to guidance but the declaration of emergency is still in place as I understand that's what this resolution on does is it on does that declaration of emergency and that's what allows us the authority to suspend rules. To the creation of an emergency the mask requirement to mandate is still in effect what other things are still in effect. For us to to be those again as rules suspensions that we put in place around Medicaid arrest move or other areas to allow for these additional services and flexibility is that are needed for but due to the pandemic there there no directives in place if if I'm missing is plans telling someone to do something in a directive as opposed to we're allowing some things that were allowed before. So our restaurants are allowed to be open a hundred percent. But I cannot speak to that that would be within the purview of foreign health. Mister chair if I could address that and all of the directives that were in effect back in February I believe there were seventeen that we're still in a fact I move to guidances and so they now are are strong recommendations they're based on scientific data and medical consensys and so we strongly recommend that the folks follow ardor are guidelines that they are mere guidelines and not directives. Tore guidance isn't recommendations enforceable. No Sir. Thank you. Represent first direct I'm sorry I'm just trying to. Get this clear my head we can still have a declared emergency but get rid of the mass mandated other things with and still have a declared emergency and I write those things could be lifted. And still have a declared emergency so we keep things like the medical payments for covered in testing in places this is that right correct and some states have done that yes thank you. Any other questions. All right thank you for your comments. Okay representative are you ready to close for your resolution. Representive is closed Yep motion. Okay we have a motion of do pass as amended any discussion on the motion. Seeing none representative Wardlaw you're recognized don't be shy. Any further discussion. The representative when you're recognized I'm just it is some of the concerns I had I mean I'm all in favor of what we're trying to do here I'm just worried about the timing of it I don't want to leave some unfinished business that's important to what we need to do and I know that we've got a a bill that we sent out of here that is over the Senate that got changed up a bit and and that's something that I think important most of us this can kind of help me feel a little bit more comfortable with that and also with what the fact that we could do this and then the governor turned right around tomorrow and and undo all of this by declaring an emergency discount it tell me to help me through that. Okay. A one sure if we were if I was recognized for discussion on the motion to your concerns about the timing of it I think you heard him say that. The funding it is a if the funding is the issue I guess I need to know more about what your concern is on the timing if it's if it's a funding that's not. From my understanding that is not tied to us being under a declared state emergency it it it does have to do with some of these rule changes I've been able to suspend the rules but I would also say that they can bring the merger C. rules to us for our approval but. When as long as we remain under declared emergency the executive branch has. All the forty so if we remove the. The emergency that it puts us back in the control of it I don't see that we lose any any type of funding I guess it wouldn't funding as much but things like telemedicine that we haven't we haven't put that check mark yet on the things that we need to take care of the legislature and I didn't want to get this in front of that and then have us have some regrets later. If we pass this out of here today you have my word I'll hold it up until we at least here the telemedicine bill and decide whether we we want to pass or not that way the legislature will have a say and we can move on from there to do. Representa Miller you're recognized. Thank you Mr chair To me this. Comes down to the simple thing. For a year now. This stuff's been going on the first couple weeks were pretty crazy I know all the all we're getting calls like I was schools and trying to figure out what we're going to do and and you know whatever. I literally have not heard from one single constituent of mine. Say and. Hey please make sure we stay in a state of emergency and we have all these regulations and mandates and directives please I beg you Josh. All the governor asking to mandate some more stuff I'm not heard from one single person in my district saying that I have heard from many. Saying the exact opposite. And who were very frustrated. As I was what a turn around say. I'm as worthless is. Thanks or bore all. Because I mean we're in a state of emergency we were not even consulted. We've gone for a year of not even being consulted. Now I understand that we can pass this on air tomorrow and Monday there can be a new an issue. But but not I think it's time that we stick up and say Hey next time to consult this. So for that I'd ask for good vote on this. All right any other discussion. The person paying you're recognized just real quickly I'll remind everybody. It's been a year we could have a special session. It just seems that it's being drug on for ever so thank you. All right see no further questions. The motion is do pass as amended all in favor signify by saying aye. All opposed nay. Is haven't motion passed. Roll call. The third best vocal. The past two is amended I said motion passes and then three hands and I said real. Representative clown. Yes yes. Representative Davis. Representative Davis. Representative pairing. No. Representative Penzo yes yes. Representive wing yes yes. Representative Pilkington. Representive Pilkington. Representive Coleman no no. Representive Allen. Representative Alan. Representative Boyd. Yes no no. Representive Gonzalez. Representive great. Representative grade. Representative Bentley. Representative Payton. Representative Miller yes. Representative Johnson yes. Representive McGee no. Representive Eubanks. No. Representative Wardlaw. No. Seven no yes it was another okay. Vice chair Ferguson. No. Three. Six seven eight is not compassion just got a. Not voting yeah okay. Representive yeah the resolution is fail. Six. All right a committee we're gonna move on then we get two more bills that we really need to hear today Senate bill three seventy eight is represented Gazaway still here. The thank you ma'am. All. Zero okay. Representative yes where you're recognized to present this B. three seventy eight. Thank you Mr chairman what I would ask representative Dotson pointed out an issue to me the earlier today about this bill and how it may function given not given whether we adjourned OR whether and and and stay in session or whether or not we actually adjourned in the session because the redistricting issue that's kind of looming out there there's some question about whether will adjourn or whether we won't and whether we do or not if under this bill would affect whether or not issues related to the funding or considered by joint budget committee or whether they're considered by council and so I think what I'd like to do is hold off on that one until we have a more clear picture of of what's going to happen with with regard to adjournment and so if if with the chairs permission I'd like to set this one aside for the moment and that but only proceed with the SP three seventy nine okay are you saying whether we adjourn a recess is that what you mean that's the proper terminology I'm sorry okay we can do that so we'll move on to S. B. three seventy nine. Thank you Mr chairman. Colleagues this bill is in response to of what we've seen over the last year with regard to the emergency powers have been exercised by the governor and the extent of involvement that our current Emergency Services Act affords the legislature as many of you know after the emergency declaration was issued we in the legislature were consulted very little we did not have any real meaningful decision making during the emergency from the time that it was a declared by the governor many of you I'm sure like me receive calls from your constituents when certain weather was by executive order or directive of the Department of Health came down who wanted to know why is this happening why can I not operate my business why can I not cut here why can I not op opened my restaurant what are you guys doing down there and I'm sure many of you like me had to respond to your constituents that I didn't have anything to do with that I had no say in that issue here's the governor's office number call them. And that that was the position I found myself and I'm sure that many of you found yourself in. And that goes back to the Emergency Services Act of nineteen seventy three which that sets forth the powers of the governor and the powers of the legislature in the event of a disaster emergency and what we find is unfortunately the Emergency Services Act of nineteen seventy three gives the governor almost all alternate power during the states of disaster emergency. with very little if any for the legislature I ask the bureau of legislative research when Act start working on this issue back in the summer of twenty twenty what the legislative history was on the Emergency Services Act what may have occurred during the debate and why the legislature would have chosen to give away so much power to the governor not keep any for themselves and the bureau was able to find anything I asked of it they could even go back and look in the Arkansas Democrat Gazette to see if there's any reporting on the issue in any debate about why the legislature refused to give up that much power and authority and they couldn't find anything the end and that's still a mystery to me today. What we found ourselves the the situation that we found ourselves in was not unlike what every other legislature in the country found themselves down and that we had an old statute. That really hadn't been tested or dusted off since its initial passage then again this or was originally passed in nineteen seventy three and we've not had a reason to dust it off or use it and and I know that how limited we truly were with regard to the power of the legislature until this current pandemic and so what we've seen is that the legislature has no power in these emergency situations and what we seek to do with this bill is to empower the legislature when there is an emergency declaration by the governor giving the legislature the power to terminate giving the legislature power over executive orders giving the legislature power over determinations and directives issued by the department of health. And then there's temporary language at the end in a couple of sections that deal with the president emergency that were in and how we deal with executive orders and directives that are in place. At the time of the passage of this bill and so that's kind of a separate issue in the first section of the bill I'm gonna go through it a little more detail and I want to belabor the point I know it's all been a long day the committees I had a lot of uh tough issues today it's getting late in the day so I want to belabor things but I do want to cover it thoroughly enough for you feel like you understand what it does. And so what I would say is in the early parts of the bill we set forth a general framework for how these types of situations will work out in the future with regard to the involvement of the legislature and then at the end of the bill we have temporary language which addresses how we're going to deal with the present situation and so. One of the first things that you'll see in the bill in the first section of the bill if you're on page. two of the bill you'll see that. A state wide state of disaster emergency cannot continue for longer than sixty days unless renewed by the governor so long as Legislative Council does not deny the request for the renewal so it can't last any longer than sixty days if the governor wants to go beyond sixty days he'll have to request renewal from Legislative Council and legislative council will decide at that time whether to terminate or not but we're not going to let this thing continue for long periods of time before again the legislature gets involved what you also see and what's important in this section is that beginning on lines twenty nine on page two the legislature will have the authority to terminate a state of disaster emergency at any time. And so there a couple of distinctions in this bill that states a disaster emergency that I want to be clear about there's any state of disaster emergency whether it's what we would call a state wide state of disaster emergency which is defined in the bill as being nineteen counties or twenty five percent of the overall population the state of Arkansas that is a state wide state of disaster emergency then you just have any state of disaster emergency that the governor may declare and the point is if you have a governor who does something that's road and violates any standard of common sense the legislature has the ability at any time to come in and terminate that emergency whether that's a local emergency because of it something that happened in Jonesboro or whether that's a statewide stated disaster emergency. How do we terminate under this bill a governor's state of disaster emergency. And how we get there is it can be called by the Speaker of the house and the pro tem of the Senate or if fifty one members of the House request a meeting or and eighteen members of the Senate request a meeting then we can get to a meeting to terminate a state of disaster emergency whether that's a local state of disaster emergency or state what state of disaster emergency and we can do that at any time. And we do that by a committee of the whole of the House would meet at a committee of the whole to debate the the declaration of state of disaster emergency the Senate would meet as a committee of the whole to debate the US state of disaster emergency and if we passed a concurrent resolution that would go to the governor for his signature. The there were a bit different variations the bill I will tell you that had different types of resolutions that could be passed to terminate the state disaster emergency we ultimately went with concurrent resolution because there were some questions about if you didn't do it by concurrent resolution which is the type of resolution is recognized in the constitution so generally I mean the legislature can pass bills which become laws by the signature of the governor or we can pass concurrent resolutions which carry much more force than other types of resolutions. And so with the concurrent resolution if we pass that the house and Senate that it goes the governor for his signature and we ride into the bill that it would operate like the passage of any other bill if it goes to the governor and the governor won't sign it within five days we could we come back and vote again and that the that concurrent resolution terminates the emergency if the governor vetoes the concurrent resolution so to speak then same process after five days we come back we can override that veto and we can terminate the emergency and I want to keep in mind that can happen at any time okay and that's any emergency local or state wide and so that's the first section of the bill. The next section of the bill. Set forth the process when the governor declares a state wide state of disaster emergency. And so again we define state wide state of disaster emergency and we defined that is not affecting nineteen counties or more or twenty five percent of the overall population of the state of Arkansas according to the most recent census. If there's a state of disaster emergency effects that number of people then the governor has to declare it as a state wide state of disaster emergency. Upon the governor declaring a state wide state of disaster emergency this is important because this guarantees legislative involvement if there is a state wide state of disaster emergency the bill says that the legislature shall meet. Within eight days. To consider termination of the governor's declaration. And that process works the same way that we talked about that's a committee of the whole of the house to debate a resolution for termination If that passes it goes the governor of the governor won't sign it is the same process is that we discussed before at five days past we can override that and we can terminate the emergency. And that is a guarantee meeting and that was one of the things that we heard from the legislature wanted to make sure that if it's a statewide that the legislature is going to get a guaranteed meeting and a guaranteed voice at the outset one of the other things was we want to make it the whole House and the whole Senate because of the governor issues a statewide stated disaster emergency it affects everybody and it's at least at one point in this process everybody senator and representative ought to get a vote on whether or not it can it should be terminated and so that's why we set that out from the outset we do today days. Thereafter if the governor wants to renew the state of disaster emergency that goes to Legislative Council and the governor has to submit a letter to council stating that he desires at least ten days The prior to when the expiration date of the state what state of disaster emergency he has to submit a letter to council stating that he wishes to renew the emergency he has to state in that letter the rationale for why he wants to renew that emergency. And then Legislative Council will meet to determine whether or not to terminate the emergency or not Legislative Council have to be the entire Legislative Council Legislative Council can't designate or can't delegate that to a sub group of Legislative Council is going to be the whole Legislative Council that votes on those renewals. And again a renewal can't last longer. than sixty days. And if we're in a state of emergency there's a provision that the Legislative Council can adopt whatever rules may be necessary in order to perform its duties under this section. A section three says just get kinda interesting came up in the debate the governor should be able to prohibit members of the General Assembly from accessing city government if you have a this state is aster merges you have a governor at the time he wanted to can act as a tyrant and say there's no ingress or egress inside the Pulaski County and the legislature couldn't get here to perform its duties and I realize that's kind of of not you have to kind of think like a maniacal governor there is kind of an odd way to think someone brought it up and so we made sure to say that governor can't prohibit us from accessing the capital so that we can do our job. Section four we talk about executive orders if the governor issues executive orders those will go to council for review if he wishes to then renew an executive order again those will be renewed by council individually counsel can terminate the executive orders that the governor may issue. And. Let's see here. The governor does issue those they're effective immediately until it's is terminated by a majority vote of the Legislative Council and so that's how we deal with executive orders the same thing has to be a majority vote of the full council you can't delegate that to some some subcommittee of counsel section five deals with the board of health and what we say there is the board of health currently under the Emergency Services Act has tremendous power to really amazing when you look at what kind of power of the board of health has board of health has the power to quarantine every man woman and child in the state of Arkansas and so we needed to take some legislative oversight over that kind of just extraordinary executive power that's what you'll see in section five the board of health can adopt directives like we've seen in this instance if they do one thing that we thought was important to add they can't combine those directives in other words you know it's like we've seen and pieces of legislation around here where someone puts the poison pill and that in a big directed or in a in a bill they've they have a bill that's full of really great things that no one could ever vote against and they put that one thing in there that nobody's really for but they feel like they don't have a choice but to vote for we've specifically prohibit the board of health from being able to do that they cannot combine multiple subjects that were directed into a single directive they have to be individual again those. Directives under the emergency will become effective immediately because part of what we had to do was try to balance the needs and and there were conversations with the governor's office about this the flexibility of the governor's office to manage an emergency the flexibility of the board of health to respond to an emergency with appropriate legislative oversight so if the board of health issues a directive it's good that is good immediately for thirty days They will they will go to the executive subcommittee much like rules currently do and that happens very quickly for within the first four days for review bag by executive subcommittee and then they remain in effect unless the majority of the executive subcommittee terminate some. if that doesn't happen then they have to do like the governor they have to request of Legislative Council renewal they have to do just like the governor they have to submit a letter stating why they want to renew the directive and then council will consider termination of those directives if council chooses to do that same way we operate with a governor you can't delegate that has to be a full vote of the quorum. Of Legislative Council. And again that's what you see and section five that's taking control and some of the worry over the board of health and so I'm gonna try to speed this up where the temporary language and we can close the temporary language is how we deal with the current emergency that's in place if there is an effect on the effective date of this act should we pass it. A state of disaster emergency that follows the same procedures that we set out earlier in the bill so that means the full House in the full Senate within eight days after passage of this bill are going to vote on termination okay and if the governor seeks to renew then it'll have to be submitted to council thereafter if we don't terminated at that initial meeting same thing with the board of health If there directives in place of this actually operates a little differently if they're directives in place at the time that this bill passes those directives have to be submitted to the this this committee public health and public health can meet so it they're they're a lot there were lots of directives now that we know the governor has. And done away with sensually all those directives if there are directives in place then this committee meets with whatever subject other subject matter committee that might have some interest in the in that directed without be education transportation there were a number of them to consider than they would review and make recommendations to council and then council would vote on each of those whether to terminate those directives. and then if if they did not terminate on then the renewal process of submitting those every thirty days to counsel for renewal would work the same way there is an emergency clause on the bill if we pass it becomes effective immediately and with that I'm happy to answer any questions. What represent Gazaway just let me say that I know you've done a lot of work on this but many many many hours on this and Senator Hammer as well and then a good job on I know you met with many departments and individuals and I so appreciate your work on this committee any questions from committee. Your representive cloud recognized. Thank you Mr chair thank you representative Gazaway for all the hard work I can imagine just. Allow me to to kind of pick your brain just a little bit if you would you made the statement quote that we were consulted very little meaning we the legislature unquote and that you'd even reference the Arkansas Democrat Gazette to try to get some information so just let me read this quote from the Democrat Gazette Senshi representative from this week this from Dr Romero he said quote I wish state representatives and senators had really championed the use of mast and the use of mitigation there were people that didn't think of this as a major issue unquote. The opportunity to champion anything. So my question with with everything you been three do you see something in retrospect twenty twenty they say that we could have done as a legislator will legislature to help with the situation in spite of this quote. I think legally under the Emergency Services Act as it existed. No I don't think that we had all much ability to do anything the governor could have called us in to legislate it into an executive session he didn't. You know that would have been an opportunity for us to weigh in on some of these issues you know to hear them out and to take a vote the legislature doesn't have the ability to call itself into session and so without that ability you know I think it from a purely legal standpoint. We really didn't have a way to way and unless the governor would have called us and special session and course that didn't happen. Senate boy you're recognized. Thank you Mr chair I think I got a pretty quick question so what if this is like a major disaster that all right. Takes up the roads and so on and so forth and we can't all assemble in Little Rock not because the governor keeps us out but because of there's that much destruction how would how might it work then. I seem to recall that there is a provision I know that was discussed that. The the legislature can adopt rules to deal with those types of situations of course we have our house rules we have our Senate rules and we really need to be thinking along those lines if we don't already have those types of emergency provisions available in our and there are existing rules and course you can't bind a future legislature but we need to look at the rules that we have and if we ever find herself in that circumstance how we. How we can respond to whether that's remotely vote by proxy vote by there other ways but I think those things we to look at. You're recognized for follow the so just to clarify so those things we really should be thinking proactively and address in our house rules once this becomes law yes okay thank you. You know I think that's a really good question represent void because in some natural disasters like an earthquake Jerry up in our part of the state there might be instances where nobody can go into an area that could happen here to capital and what you're saying I think is a remedy for that that we should develop a rule in that case yes so that's a good question any other questions. saying none we have no one signed up to speak did you have a question response. And is there anyone here to speak against the bill. For the bill. Represent or read close I am thank you Mr chairman I do want to say I think I'll let this out of my initial remarks that this is not a criticism of a sergeants and So to speak and and the way that he's handled this emergency the governor had to make some very tough decisions I think what we all feel like as a legislature is we want to ensure that we're consulted and the current law the the current law as it exists does not. provide for that and the people the people's representatives deserve the opportunity to weigh in on these issues these issues have affected the entire state and the people's representatives and our senators the people's branch of government deserves to be involved in these issues and from the very outset and so that's what this bill seeks to do and with that I would appreciate a good vote. President Johnson recognized. Hello motion of do pass. The owing a committee at I think the discussion being good here but you know we we didn't know what to pandemic was none of us are old enough to see what I don't think anybody's over a hundred year but. It's been a hundred years since we had one in the we should learn from that process and I think that's what we're doing here and developing policies that can help us to the next one so I think it's a good policy so the motion is do pass any disk any further discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay Mostyn carries a great leasing your bill is passed thank you Mr chairman thank you Committee. I committee thank you. All right representative Boyd you're recognized. A representative board is going to present HB eleven thirty six. The correct represented more yes thank recognized I'm sorry Mister chair I've had people here for two days go right ahead you're recognized others an amendment to adopt that just if it addresses the concern that some of the self insured plans had so there is an amendment come around you wanna explain explain your men it just the resolve some of the concerns of the self insured plans had like the universities on the this particular bill motion on the amendment I'll make a motion to adopt the amendment I have a motion to adopt the amendment the discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries your men stop that you can represent your bill as amended so this is a a bill to require hepatitis C. during screening during pregnancy it's important to help make sure that the. We the it's important for healthcare to catch hepatitis C. early and it can be transmitted during pregnancy during during the pregnancy or delivery and so this book bill will mandate that of course if the mother says no I don't want the screen to she would still have that and they just have to documented in the chart so in essence that's what it does it's been out there while lots of people seen it there's no known opposition and I appreciate a good vote. Of any questions from committee. Represent Wardlaw you're recognized. He tells what the cost of the screens are. I can bring someone up to the health department but all of that is covered Medicaid agreed to pay for it the blue crosses agreed to cover it they health insurance the self insured serve worked it out but I will get somebody up here if you want that I'd like to have an answer. Please enter seventy represent park Hammer Baker I'm the family health corrections chief at the Arkansas department of health and we confirm committee and the cost is twenty dollars per test screen for Medicaid and about forty for private insurance. Okay what's the what's the cost of my seven fake cash. So somebody has no insurance. About ten ninety four percent I believe is that right are from or not by ninety four percent of the ladies having babies have coverage but it would be the same price I would yes thank process your doctor greenfield. You comported you want everyone in that works with us to tell. Please yes please include yourself and who you represent. Murdock will green feel with the Arkansas department of health about ninety four there were thirty seven thousand deliveries in the State about ninety four percent of these either covered by private insurance or Medicaid price that we have is based on what we've seen the preponderance of the payments have been for both players have been I don't have the exact number for an out of pocket costs for an individual because we based on what those where the where the payments mostly going for the deliveries in the State. How much Mr yes how much do we require on a pregnant person now to be screened for tested for. Choir tornado what what is those requirements so like now sure if you're we have a required testing for help for HIV hepatitis B. and syphilis all in the third trimester and this would be in addition to that what we've already done up in the rationale behind it largely is that for those individuals who have hepatitis C. about half of them are a symptomatic and the transmission can go from mother to baby in utero and when it is actually detected you may be facing a a. Portion of the advanced disease so if you were a factor in the cost of treatment after disease versus prevention when you factor out out of the number of pregnant women who actually may in fact have hepatitis C. the cost savings is about four million dollars if you were to actually prevent or treat those patients early as opposed to treating advanced disease. That in all hold represent version you're recognized. Again like how often are the images that the standard of care already are most people doing it already or is it she were currently it's it's recommended in the past what we have revised was to do testing based on risk and that is what the recommendations were in the past the CDC made changes in the recommendations back into the in twenty twenty to recommend a universal testing of all people and the ideas that intense nineteen eighty nine until nineteen eighty nine we didn't really know about hepatitis C. recorded ninety nine B. and since that time we now have affected treatment now that we have a disease that we can effectively treat and I think we can test for it the the the the scientist caught up and so the guidance from the governing bodies of the recommendation bodies a society paternal maternal fetal medicine and the American college of obstetricians and gynecologists have not said they mandated in it in a pan with the C. C. is made that recommendation so I would say they haven't quite caught up we are one of nine states that require certain testing of HIV hepatitis B. and syphilis and so we have been on the front edge of testing an advocate for pregnant women already and I think this would be another step in the right direction. I guess my question is how many women are actually not getting the test now is it ten percent or it is not part of the routine panel of tests that we do and and and and patients so I don't have the number in terms of how many we don't test for I can say of the thirty seven thousand roughly thirty seven thousand deliveries that we have about point five percent so that almost two hundred about a hundred ninety six I've had a pregnancy check box that showed that the moment fact that privacy okay thank you Revson Wardlaw you're recognized. So I guess I'm a believer in this point but what what what we rank in the U. S. mortality on babies being adverse maternal mortality we we or about in the bottom quartile we're like okay so we're the forefront we're one of nine states that require all these tests that you've named off how come we're not moving up and that breaking. So the I wanna make sure I'm understanding the question so the question we're not doing any better by requiring all these tests for this test that we required for a the others that I mentioned but that was only two years ago so this is that's relatively new. Okay thank you Mr. Any other questions represent Payton you're recognized. So is help CD I have close to the one on a CM advertised on TV this the this drugs it's really expensive. Treated occurs it yes so does this mean that if you catch it early you don't need that broker we just trying to identify a symptomatic we can sell more of that drove we are trying to identify those patients who have it so they can be properly treated because the cost of treatment while expensive is less expensive than the cost of treatment of severe disease. Thank you. Any other questions. Seeing none thank you all for your comments Anyone here to speak against the bill. For the bill. Seeing none you a closed. Yes Mr and I'm sorry that this was a little rushed I've had them here for the last two meetings and I didn't think it's fair that it's expensive to bring them here and and wait so I'm sorry if this was a little rushed this bill is about ultimately providing better care better health care for mom baby and ultimately saving the state money two thirds roughly the pregnancies are paid for by the state of Arkansas through Medicaid and if we catch it sooner rather than later it's a cost savings to the state so that said I'm I'm closed I appreciate a good vote and I I'm I could do pass motion thank you. Motion on floors do pass as amended. Any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Hi seven please. Graduation your bill is passed. A representative Miller you're recognized to present HB fourteen twenty seven. Thank you the Mister chair and committee and I'll try to be brief and thank you to the tens of people watching online as we do our jobs here late in the day of this bill is real simple of actually it Mister with your permission I'd like to invite bill Maher quiet with DHS yes up to the table with me if for no other reason I want to be documented and recorded VHS and myself are together on the bill in front of this committee so there's that anyway back in two thousand thirteen of we passed a bill I ran it requiring in home care givers paid by Medicaid to past drug test and background checks this bill tweaks a little bit with the background checks adds registry checks there's some new like abuse. I guess registries out there that would be helpful to DHS to make sure we have. All five people. That were pale Medicaid dollars take care people in their homes. Mr white wants to join me is welcome to. Hey here is mark quiet here on the hallway okay he may have left already well may the record show DHS left me. Okay. Anyway. I'll try to answer any questions you all got if you want to real quick and if you don't I would like that and we can go home. All right did you have any county please introduce yourself and who you represent. I'm Sarah Schmidt with DHS I served as the deputy director for the division a provider services and quality assurance. Did you make any comments or just answer questions stage questions if you've got any. All right the Committee is there any questions from the committee. Seeing none anybody here to speak against the bill for the bill. Are you ready close representative I'm closed I make a motion to pass have motion do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Congratulations your bill has passed Committee I want I say it a lot but presheaf your work