Senate Convenes

All right members will call the meeting to order Secretary please call the roll Ballinger Beckham Bledsoe Caldwell Chesterfield Clark Davis Dismang Eads Elliott English Flippo flowers Garner Gilmore Hammer Hendren Hester Hickey Hill Ingram Irvin Blake Johnson Mark Johnson Leding Pitsch Rapert Rice sample Stubblefield Sturch Sullivan Teague Tucker Wallace. All right members if everyone would please rise include everyone in the gallery center financial leaders in prayer today in the way Jennifer. Thank you Mr president please join me as we approach the lord in prayer. Heavenly father as we prepared to study the important issues in front of this assembly help us feel your presence as we contemplate the decisions we must make give us guidance and counsel in our hearts in our minds for this strength we pray amen. I put. Of the. in. One. In. This is Ross. It out for you started. Senator Hammer. You're recognized. Thank you Mr president like care do sir doctor of the day Dr James Hahn from North Little Rock in also order Sherri Bernard with regards to Dr James Hahn which there is right there you may remember we ran a piece of legislation last time called al hunt Bill this is is that if you remember so we're glad to have a doctor hunting audience today. Senator Hendren. Thank you Mr president I've got a visitor I think probably is from further away than anybody else is going to have today this is a young man I got to know who's got his masters at university of Arkansas road if thesis on a project called the canopy project about settling refugees in programs to help refugees get settled in our country. That turned into the real program and now he works at that program but he's from Afghanistan from Cabool he reached out to me about a copy shop to get into Afghanistan the nine lives in Fayetteville he's in the he's in the gallery merry girl Batesville she running back Arkansas so would you welcome Khalid I'm a Daizee appear in the east gallery. Senator you're recognized. Thank you Mr president I have with me today my mom and my dad and my two brothers Bob and John at there so if you would just help me welcome them thank you for that. Senator Elliot you're recognized. Thank you all right members as some of you who indicated that you wanted to be a part of the cost cuts the arts caucus and on the arts caucus bill need to see me today or tomorrow because we need to get it ready for filing and there will be a press conference on Thursday to roll it out and you should have gotten a or will get an invitation from the R. Kansas for the arts it will be at noon in the rotunda so see me if you want to sign up to be of a co sponsored and I think you do. Thank you senator Elliots. Senator Flippo. Four days later presenter Gilmore. Anyone else. Any other announcements. Some like you know thirty every centering. Centering a recognized. Thank you I was just visiting with the Senator Solomon of I found out this morning that senator Jean robot that serves from nineteen ninety seven to two thousand passed away Sunday night is we know that's Johnny robux a brother in law Tommy robux brother I'd like to ask you to keep the robot family in your prayers. Thank you Senator Ingram anyone else. Are there any items to read across the desk. Yes Sir will your committee on emerald Bills to whom was referred Senate bill thirty one by Senator English Senate bill six by Senator Irvin Senate bill sixty three by Senator Irvin Senate bill one O. one by Senator Irvin compared the enrolled copies with the original and find them correctly enrolled and it to twelve thirty were delivered to the governor for his approval. Where your committee on engrossed bills to whom was referred Senate bill two thirty one by Senator Johnson compare the engrossed copy with the original find same correctly engrossed retirement Committee on engrossed bills to whom was referred senate to thirty two by Senator letting compare the engrossed copy with the original find same correctly engrossed retirement where your committee on verse Bills to whom was referred senate bill three thirty nine by Senator English compared the engrossed copy with the original find same correctly engrossed city county local Committee on engrossed bills to whom was referred senate bill three four by Senator Ballinger compare the engrossed copy with the original find same correctly engrossed state agency Committee Committee on engrossed bills to whom was referred senate three forty six by Senator Rapert compared the engrossed copy with the original. Engrossed Judiciary. Committee on engrossed bills to whom was referred Senate bill three eighty seven by Senator Hammer compare the engrossed copy with the original find same correctly engrossed public health. Committee on engrossed bills to whom was referred Senate bill three eighty nine by Senator Ballenger the engrossed copy with the original find same correctly engrossed Education. Committee on engrossed bills to whom was referred senate bill four eighty nine by Senator Davis compared the engrossed copy with the original find same correctly engrossed insurance and Commerce Committee on engrossed bills to whom was referred house bill ten sixty three by Senator Talkington compare the engrossed copy with the original find same correctly engrossed public health Committee on engrossed bills to whom was referred house bill ten sixty nine by representative Pilkington compare the engrossed copy with the original find same correctly engrossed. Ten sixty. Sixty four. We are committee on engrossed bills to whom was referred house bill eleven fourteen by representative Wardlaw compare the engrossed copy with the original find same correctly engrossed Judiciary. Committee on engrossed opportunity on the upper right to whom was referred Senate bill one three one three by Senator Irvin recommend due pass counted. Committee on engrossed to whom was referred Senate bill. Four eight four eighteen by Senator Dismang of recommend due pass counted Committee on Iran to whom was referred senate bill four nineteen by Senator Dismang recommend due pass counted Committee on that ground whom was referred house bill thirteen fifteen by representative Bob recommend due pass counted Committee on act right to whom was referred house bill thirteen fifty three by representative hall recommend due pass counted Committee on a grant of whom was referred house bill fourteen seventy one by representative Hillman recommend due pass counted. Committee on city county local to whom was referred senate bill four fifty four by Senator Johnson recommend due pass counted Committee on city county to whom was referred Senate bill forty two six by Senator Stubblefield recommend due pass counted Committee on joint budget to whom was referred Senate bill one fifty six by joint budget recommend due pass counted. Senate bill five O. three by Senator Irvin. To establish a scholarship appeals committee within the Division of higher education senate five oh three education center five oh four by Senator Irvin to amend provisions of the code concerning sex violation finding aid to create the teacher's salary causation Fund and clear an emergency senate for Education symbol five O. five by Senator Bledsoe to mandate to cover prescription of an opioid and. Antagonised under certain conditions and to amend the how like how axon Act access act Senate bill five oh five overkill zero five a six by Senator Tucker to amend the law concerning members of all public facilities board Senate bill five or six city county local. Okay members are there any other announcements. We start the business agenda. Senate bill. Sir you're recognized. is sorely. Senate resolution eleven. Thank you Mr ladies and gentlemen of the Senate. This is women's history month and this proclamation is to proclaim women's history month in Arkansas. And I can't read the totality of it but it says where is the purpose of women's history month is to recognize the importance of women in history and to increase awareness of women's involvement in history whereas out the history of the United States whether in the home the workplace the school the courts or during wartime women have fought for themselves their families and all people of the United States. It resolved by the Senate of the ninety third General Assembly the end of the state of Arkansas the Senate proclaim March twenty twenty one as women's history month in Arkansas and recognize the importance of women in the history of the United States I appreciate a good vote. Every bird resolutions all in favor say aye. The proposed amendment is adopted. Senator English. Senate concurrent resolution nine by Senator English to pine March seven through thirteen twenty twenty one AS americorps so weak in Arkansas centering that you're recognized thank you where and service to others is a hallmark of the American character and throughout our history citizens have stepped up to meet our challenges by volunteering in their communities and whereas americorps provides opportunities for nearly seventy five thousand Americans each year to serve their country through an intensive commitment to service and nonprofit schools public agencies community and faith based groups across the country and whereas americorps in reaches the lives of its members building habits that create engage citizens who are active participants in civic matters affecting their communities long after their service services are completed and whereas americorps members encourage collaboration and partnerships leveraging millions of volunteers and service and acquiring the support of business partners to increase the effectiveness of their IT initiatives and whereas the twenty nineteen twenty twenty annual state report reflects that in Arkansas more than three thousand three hundred americorps members of the areas. ages and backgrounds help to meet local needs it more than three hundred locations in the state by tutoring or mentoring children and youth restoring the environment increasing increasing food security and responding to disasters whereas in exchange for their service americorps members develop valuable work skills earn money for continuing education and strengthen the lives of their families their communities and the state as a whole and whereas since americorps was founded in nineteen ninety three more than ten thousand residents in Arkansas have served approximately sixteen million hours through americorps and have received higher education and loan reimbursement from the Segal americorps education award totaling more than thirty million dollars and whereas americorps week is an opportunity to recognize the dedication and commitment of the more than one million Americans who have chosen to serve their country through americorps and their community partners and to encourage more Americans to follow in their footsteps now therefore be it resolved by the Senate of the ninety third General Assembly the state of Arkansas the house of representatives concurring therein at the state Senate bank americorps members for their service and proclaimed the week of March seventh through thirty twenty one as americorps week in Arkansas. Member center in which is a presented at city or learn all in favor say aye. Many of those. It is carried you would transfer to the House. Senator Ballinger. Senate bill sixty five by Senator Ballinger to amend the Arkansas law regarding state and pension plans for fossil fuel fired electric generating units. You're you're recognized Sir thank you my bill my amendment. Take any questions an amendment. All favor say aye. The opposed sending grossing. Senator Garner. You're recognized for its B. one sixty one I'm sorry the Senate bill one sixty one. By bill my many. Any questions all favor say aye. You pose we sending grossly. Senator Irvin. You're recognized for an amendment to SB three fifty four Amendment one Senate bill three fifty four. You're recognized thank you my bill my amendment as cosponsors three questions. All in favor say aye. Pepose better carry presenting grossing. Okay next we have a we're gonna skip over SP five is anybody presenting that. Principal over that next will be Senator Ballinger. SB three forty one Senate bill thirty forty one by Senator Ballinger to amend the law concerning public employees and prohibit a like the bargain the. You're recognized. Thank you for that this bill I mean it is said that basically title says it all I we have basically it is prohibiting state agencies schools hi read to engage in collective bargaining I think that currently there's no collective bargaining agreements with with anyone I think given the The Little Rock schools is not engaged with the collective bargaining agreement right now but it prohibited in the port in the future it also prohibits them state employees from from striking in state employees from obstructing the operation it this is basically just a policy choice you know we as the representatives of the people are the employers the people really are the employers of state employees we've got a lot of great state employees to do a lot of great things the bill specifically makes it clear that they have the ability to form their own associations but from a policy decision we're not going to recognize collective bargaining going to bargain individually within the parameters of the frames that we put forth and we're going to going to negotiate an prohibit them from from striking you have to answer any questions that anyone having questions for us Senator Ballenger Senator Hendren you're recognized. Thank you Mr president so I think you've heard this concern that I've had a couple people reach out to me that. Again philosophically I don't disagree but I understand that there's some federal dollars that are put at risk for razorback transit. Like a million dollars a year and that it would take an amendment to fix that yes Sir with respect transit they are looking into it and and reaching out to the the federation seeks to verify and I what I've told and you've a is that will amended on the house and to completely take razorback transit out if they can't if we can't get clarification that it doesn't that wouldn't apply when hinder their ability because they're willing to to engage in collective bargaining for prohibited by law with that violated if the answer is yes that will mean them out to take care of it the intent is not to not to jeopardize federal funds and I've already committed to that with the U. they if we can't figure that out. And I appreciate that we pass bills a lot was saying we're going to amended or fix it on the other side normally that's for small changes our technical corrections or thank you we're talking about really putting that in jeopardy that transmits organization in jeopardy if the answer turns out to be yeah we're gonna lose those federal dollars if this is passed as is so I guess what I'm saying is we're going to continue to do this which I don't really understand we've got over a month the session Senate bill down there to fix I just would like to hear commitment that you're going to make sure that federal funding is not subject yeah absolutely and and from the very beginning this bill filed for three weeks this issue was only popped up the last few days and originally the concern was other mass transit but they have already been amended out of this bill and visited with folks in in DC and they agree that there are no longer covered that difference of razorback transit is that they are actually the pulleys of the of the universe of Arkansas so they probably would be covered the question whether jeopardize federal funds is not clear but I agree not to run it into we is amended to make sure that it's clear the other issue which was a cause I've also heard that there was some concern about other mass transit is being affected as well but you have got confirmation that the they are not in jeopardy of federal funding yeah I had a long conversation with their association with with their union in the and their counsel the yesterday on the way in and they agreed with the taking out the cities and the counties would would make aware they're no longer covered so but if that were the case of a work come up what we'll do another amendment. What will probably do just amend regional transit out all together make it clear but they agree that right now it's as it is in fact yeah in in in in theory I agree with the concept I just don't want to lose funding so any amendment to put on there I would ask clarifying that unless federal funding is subject to the loss or something right right I think I think that that's at least when it comes to the the regional transit I'd agree to do that. Senate. Senator Elliot jumping Act. Senator Ballinger many of us long before I was ever legislature worked on this state being a right to work state and I appreciate ballot or your bill and I've read a special on page two collective bargaining. Statements in their. Was there Extra precautions made because sometimes when you're trying to go and add something to a right to work state you end up messing up and causing non right to work for that. Can you assure the body that we are not messing with the right to work in anything in this bill I couldn't find that it did but I kinda want your opinion yeah I know what we are not one thing I'd also want to say is we are also not uniformly prohibiting collective bargaining if the private industry and private employees want to form a union private industry wants to engage in collective bargaining they can do that we're not having that what we're doing is from the state level we're not we're not doing it but yes there's nothing in here that the modifies makes a change to our right to work state. Senator Elliot. Posted. Yes I do Senator Ballinger you saying that this is a matter of a policy decision but you didn't say why so help me with understanding why you think this is necessary. Sure well okay so the very nature of a public employee as they work for the citizens of the state directly so they they're they're vested with the responsibility of a public trust and so if you are a school teacher your vested with the responsibility to educate kids then if you are to two strikes the you are actually working against that because it's not you're not striking against some private employer not striking against Walmart instructing it to the Tyson foods your tracking it's a very citizens of the State of Arkansas so there's a great FDR quote that goes right along this this lines where where when you're talking about a individual who is obstructing the operation of government they are they are running afoul very much directly of the of the the trust that was put into that individual so it's not a matter of like in the private sector we work with private individuals the very nature of you working for government means and you have the obligation to redress the person just like every other citizen does now it's a little harder because you know you have to have get a collective body but but that's what you do is you get people who are like we want our teachers to be paid for and so they go out in the the pressure you're there legislators and you know we're part of the body that has in the last few years given a couple different pay raises to teachers because their with their valuable to us not because of any union or anything else because the the public citizens of the State of Arkansas wanted to see it happen and so therefore we responded to it so that's the difference between like a private sector union or collective bargaining in from a public sector standpoint and and I did there are some people who disagree but I agree with that the art of this weird where it's not a which I don't have that the online things and silly but in this case he was he was right where it is the very nature of an Indian frankly that was widespread both parties agree to clear up to the nineteen sixties when when public sector unions really kind of blossom before the. That is they just didn't exist because the the difference in public and private sector so why did you then exempt police officers and firefighters who are public service folks what a difference and the answer to that is that's a policy decision that should be made on the local level so this is an example kind of answer to your question from yesterday. This. Thank you. In any other questions. I'm. Anyone or speak for against the bill senator Chesterfield your speak against the bill. You're recognized center. Thank you Mr chairman. As I usually say I know when the train is rolling and I'm about to get rolled over by the Bills however. Public sector employees should have the right to have a voice in their working conditions in the benefits all of that they're adults just like people in the private sector and to say that we know best for you. And whether we care about what you say and what you do just doesn't matter. When you take away the right to bargain collectively you are taking away the rights of individuals who are adults who have concerns want to sit down at the table across the table from other adults and say these are our concerns we would ask that you would give merit to our concerns now there's no mechanism really to sit across the table from anybody and discuss what adults deal best of them. Because it just doesn't matter. It just doesn't matter you work for the public you accept anything we give you too bad to say that if it is not appreciated too bad to say that because you don't deserve as an adult a voice. In your own employment this state is better right to work state for a very long time which is translated into being all right to be poor the most of the workers in this state I would appreciate and no. A center Chesterfield is spoke against the bill the normal speed for it. Senator Elliot you want to speak against it. You're recognized center of it. Thank you. Want to speak up for the police officers and the firefighters what a wonderful thing that you honor them enough and appreciate them enough. That you will extend them the good graces of being treated like professionals and being able to join a union if they so choose. I can't think of anybody who's more of a public employee then the firefighters and the police officers and I don't want you to take that away from them they deserve it. But how do you square. You leave out everybody else. How is that even possible that you get to that conclusion simply as a matter of policy rather than a map of that a matter of the I'm picking sides. So this state as of right to work state has been to how it it's even been touted in terms of economic development come to Arkansas we're right to work state and you have to know that's code for. You know we're not going to pay people the same thing we're gonna they're gonna pay and some other State for people make more money. I as a teacher except for my very first year teaching I was a union member all my life. In my work life outside here. It helped make me a better teacher. It helps make me a better advocate for my students because I had a voice. You know we were treated like little girls and boys. We were treated like professionals and why we would be proud of a right to work state where it is designed not to give people a voice is just beyond me. How do we be better. Without including people and in a way that they choose to have their voices heard this is how you get better. We hold ourselves down and romanticize this policy it does not help us. Senator Ballinger. I would really ask you. Please don't in shrine into the law a bill that is just purpose. Discriminatory. I'm glad the other two groups in there. The rest of us are just as good just as important so I ask you not to do this. This is a bad idea thank you. Thank you senator Elliots anybody for speak for against Senator Ballinger you closed is closed ma'am secretary please call the roll. Ballinger. Thank. Bledsoe. Bledsoe. Caldwell. Caldwell. Chesterfield. Clark. Davis. DISMANG. He. Elliott. English. Flippo. Flowers. No hours you know. Garner yes Gilmore. Hammer. Hendren. Hendren. Hester. Hickey. Hickey. Hello. Ingram. Ingram. Irvine. Blake Johnson. Mark Johnson. Leding. Page. Rapert. Hi. Rice. Sample. Sample. Stubblefield. Sturch. Sullivan. T.. Tucker. Wallace. Is anyone wish to change their vote he is that. Senator Caldwell is that Senator Ingram is no. Anyone else anybody else. Please cast a ballot. By a vote of twenty four days six days three nonvoting one president. The bill is passed please transmit to the House. S. B. three that. Before that senator Hammer do you have a announcements will take the fall for this. Thank you Mr chair could do this earlier because our guest was down at the house being here to stay in the house I'd like for you to recognize if you would please stand Laurie Arnold who is the executive director for the greater Arkansas chapter red cross all of y'all have a folder that has a red cross pin on it as a gift as a token to express your support and if you would would you all please welcome or are we ran the resolution earlier and she's here today to be recognized with Joe recognized please. Thank you Mr president. Thank you senator Hammer. SP three ninety seven three ninety seven by Senator Irvin to create that higher education consumer data. Senator Irvin you're recognized thank you Mr president members of the committee this is just a great government bill I think that creates them a consumer guide for higher education this is important because of the policy direction that we're moving in to bring career coaching programs all throughout the state of Arkansas and starting that early so that students and their families can have a good discussion with all the information available to them about what career path they want to go down where they want to go to school what type of degree they want to get and then they know at the end of that what the return on their investments going to be into higher education so this is a consumer guide this directs the and the higher ed coordinating board to create this and then is it issues listed on websites of all the institutions as well as department of higher at and then a copy is given to a prospective student that goes into higher education so I'll answer any questions and I appreciate a good vote is there any questions Senator Chesterfield. Thank you Mister senator Irving is this information not already available on the website. So in some cases perhaps and some institutions but not everywhere and so this provides a consistency across all of our two year and four year institutions and that in private I'm sorry both public and private and just public yes this public no this is I believe it's public and private thank you. Any other questions. Anyone would speak for the bill against the bill center you close yes. Any objection role in the vote. Zero. Ballinger Beckham Bledsoe Caldwell Chesterfield Clark Davis Dismang Eads Elliott English Flippo flowers Garner Gilmore hammer Hendren Hester Hickey Hill Ingram Irvin Blake Johnson Mark Johnson Leding Pitsch Rapert Rice sample Stubblefield Sturch Sullivan Teague Tucker Wallace. You wish to change their vote. I was present. Senator flowers president. Senator Chesterfield is present anyone else. Anyone else. Please cast a ballot. By a vote of thirty two U. A. zero nine eight to present the bill is passed please transmit to the House. Thanks to be S. B. fourteen simmer for ten by Senator Irvin to amend title twenty three of Arkansas code to ensure the stability of the insurance market in Arkansas educate the Arkansas Health an opportunity for me active twenty twenty one the Arkansas Health an opportunity for me program. Senator Rapert you're recognized. Thank you Mr president and members of the of the sentence and for over about a year and I along with representative Michelle gray and work groups of other legislators have worked on for about a year and a half with DHS secretary Gillespie and the DHS team and so there's lots of fingerprints of legislators on this piece of legislation so I would be remiss if I didn't recognize them and thank them for all of their efforts and said today we collectively presents Arkansas health and opportunities for me also known as our home I believe the best policy that we can develop as a legislature for the state of Arkansas is achieved by being intentional and accountable and this was the goal in mind as we undertake this massive collaborative efforts are home health in opportunities for me is not a one size fits all approach it is intentionally designed to make a difference in the lives of our Kansans in order to improve their health their life circumstances and to continue to build a strong healthcare infrastructure that's vital to our overall economy not only is our home is designed to provide health care coverage but it also is designed to address longstanding health issues in our state through the live three sixty homes on your desk I will refer to this but on your desk there are specifics about this life three sixty homes in this that you have the life three sixty homes are focused on incorporating all of the resources and opportunities needed for our citizens to seek care at the right time and to manage health issues and diseases these homes also provide an additional source of funding for the participating hospitals the maternal life three sixty home is intentionally designed to improve maternal and infant health outcomes. Arkansas sadly ranks forty ninth in the nation in maternal and infant outcomes this is unacceptable and we have to do better over sixty percent of the enrollees and the current Medicaid program are women we know from claims data that less than sixty percent of the pregnant women and Medicaid use prenatal services in their first trimester that's critically important for the development of that baby in the womb that women have good health care and prenatal care and that first trimester twenty one thousand babies are born under Medicaid annually of those ten thousand required neonatal services seventeen hundred were low birthrate weights and approximately twenty one hundred babies required as stay in the neonatal intensive care units not only does this cost more than a hundred and forty four million dollars annually to our state these babies are born into the world with complicated health problems that will affect them for the rest of their lives maternal homes which are anchored by our participating birthing hospitals will work with expecting mothers and two years after birth on an intentional efforts to improve their health outcomes in their baby's early development. Over forty percent of our Kansans live in rural Arkansas study after study has shown an increase in mortality rates as well as an increase in illnesses such as cardiovascular diseases diabetes substance abuse issues obesity and mental illnesses royal rule life three sixty homes are intentionally designed around these known facts anchored by participating critical access hospitals the rule homes will connect citizens to the resources they need and help improve their health and circumstances this is a robust rule health initiative that is long overdue for our state. Currently there are nearly fifteen thousand veterans that are enrolled in Arkansas works over seventeen thousand who were formerly incarcerated about twenty five hundred you were in D. Y. S. custody and another twenty two hundred who were in foster care the success like three sixty homes are intentionally designed to provide the citizens with the needs they are facing from mental illnesses this substance abuse disorders disabilities behavioral health and other illnesses we have successfully built a crisis stabilization units in Arkansas but we don't have to build new ones when we can use open beds in our participating critical access hospitals to meet this needs it is marks and if and and and it's intentional to use our existing healthcare infrastructure to partner with us to solve our state's problems and that is exactly what the life three sixty homes are designed to do. Government programs and policy must also be accountable with the ability to measure our successes we are accountable to the taxpayers of the state of Arkansas to create and implement effective and efficient policy we must constantly assess our programs and adjust courses as needed we must always ask is this working does this make sense are we utilizing our resources to the best of our ability in both health policy and and financial policy this legislation creates an accountability and oversight committee for these purposes to help define goals and measure successes Furthermore if things are not going as they should be there's another level of accountability that comes before Arkansas Legislative Council and or the executive subcommittee and to improve to make immediate improvements are home uses the same financial structure of partnering with Arkansas insurance companies to purchase qualified health plans this increases the physician and hospital rates from twenty five to sixty five percent about the current traditional program this in itself opens the door for increased access for Medicaid patients and that is critically critically important especially in rural Arkansas where the percentage of Medicaid patients is higher Furthermore using insurance plans has proven to successfully stabilize premiums for all health insurance products in the private market place Arkansas ranks sixth in the nation for the lowest premiums this financial policy that put it was put in place seven years ago is working and it has worked in its and we have the data to prove it finally Arkansas negotiated with the federal government seven years ago a one hundred now ninety ten split with the premium tax that actually comes out to about ninety two eight this successfully brought. Liens of federal dollars into our health care infrastructure which is self help save our critical access hospitals from closing on page eight of this handout you'll see the map of where there has been over fifty seven rule hospital closures and the surrounding states with Arkansas being an island where only one of our rural hospitals has closed. During this emergency health crisis we saw first hand how important our entire healthcare infrastructure it was our state hospitals increased I see you back capacity by nineteen percent to meet the needs of our covid I see you patients we did this by utilizing all of the beds in our rule and critical access hospitals that was incredibly important in ventilators and personnel in an ICU beds that were open to to care and help save lives during cove it and it's because we had this program in place and that we had rule hospital infrastructure in place it was also eye opening to me and to many to see nurses lab technicians doctors and hospital employees laid off revealing that the margins and the majority of our rural hospitals are razor thin we cannot afford to veer off course and pursue alternate pass by utilizing these qualified health plans Arkansas will leverage and bring in an additional six to seven hundred million dollars annually a federal dollars totaling approximately three billion dollars more than what we would have done over the next five years these dollars are essential to keeping our rural hospitals open the total for the total economic impact of this program over the next five years is nine point seven six billion dollars to the state of Arkansas and our health care infrastructure. I believe this really truly is the most responsible and pragmatic policy approach we can take it is intentionally designed to serve our Kansans to be good stewards of our taxpayers money and to be accountable for the outcomes we desire to make our state a better place for our citizens and with that I've given an over you view of this legislation this legislation is a framework to give to DHS from this they will create the waiver that will go before the federal government and be negotiated at CMS they will come back through rules and regulations as a promulgation before this would be implemented hopefully by January one of twenty twenty two I'm happy to answer questions members anyone have any questions Senator Solomon. You're recognized. Thank you Mr president not truly appreciate the good work you've done in the hours you put in on at. Have a look at the book I see a lot of goals mentioned and a lot of data this many people here this many people wondering why if we're going to hold people accountable why don't we have something specific in the law that demonstrates accountability we're going to make it ten percent improvement here going to make a five percent improvement here in this specific population and you made the comment earlier that we have the data to prove our systems are working and the data that I've seen is that we're still forty seven forty eight. So I don't expect to address that however I do I would like to see some more specific outcomes in the bill and not rely on DHS to promulgate rules that are flexible could you comment on that please yes thank you for the questions Senator Solomon and there are and there are there are about thirty health outcomes that we are going to incorporate that are part of what is existing in federal and the federal and in the federal guidelines and so we're going to incorporate that but I will say to you The accountability and oversight. All members will get a little bit better in here and you know what echoes because of the glass so if we could please just law keep it down. Thank you again for the question and so the accountability and oversight committee Senator Solomon will really tract along side DHS when we're implementing this and that accountability and oversight committee will also help determine and advise on those health outcomes and those metrics that we sat in the ability to measure against those and those this let this is the legislative and executive branch group of. Advisory panel. If it tracks along the same way and the same time we can set those outcomes and then we can measure them out of the program is being implemented and developed so the reason why it's not put into the bill specifically is because we need to have that accountability and oversight committee working along side DHS to insure that we are in agreement with what those health count outcomes are and what they should be and those targets that we need to met and then warm how we're measuring this and so this this legislation set that up but it is an ongoing partnership with the legislature and that's the way we read the bill further more we are relying on the qualified health plans to help us set those targets and to meet those targets and if they do not partner with us to help drive outcomes so that we can measure our successes we have built in this legislation that there will be financial penalties that will come into play on the insurance and partners so I think that's another piece of making sure that we're all heading in the right direction and that we're actually getting our money for what we're paying for right I think it's really important the financial policy for many is really just very very important to the overall economy of our state for for members like me I want to make sure we're actually changing things right I want to see health outcomes improve our citizens and and you for your questions about the data and the information your rights I stated we're forty nine and maternal and infant health outcomes we have to do better we can do better and we have to do better and we can utilize what's already worked in other states and reading those ideas to this program and that's exactly what that maternal life three sixty home is designed to do as well as the success live three sixty home and the rules six that the rule life three sixty homes so yes we need to move the needle and said that's. This legislation the healthcare policy portion of this is designed to do short follow up with program yes Sir I guess we have we've talked about this we did see that differently I'd like to see if we have whatever the number is. Four thousand or some four thousand four hundred and in foster care I'd like to see something in the bill that we have a target goal of a ten percent reduction otherwise what those targets are my experience is different than yours mine is that we don't reach our targets and we go to the contrary flexible and it is moving targets thank you Mr president thank you senator thank you. Other questions Senator. We will speak for the bill. Senator Tucker. Can I speak for the bill Senator Garner you won't be recognized next speak against. Thank you Mr chairman policies those little climbs again on my seat there first of all I just want to start by thanking Senator Irvin and representative gray who have the utmost respect for for all the work the all put into this bill you can see in the legislation how much work that you all have put into it and how much work DHS has as well and I want to express my gratitude for that Actually the life three sixty homes I think there's a lot of really really good work done and some really aspirational goals for our state and I'm excited about the only thing that makes me a little bit uneasy is the dual system between the qualified health plans and the fee for service and and what makes me uneasy about it is that I'm not totally convinced that the population of people that this is designed to serve will recognize a qualified health plan as an incident over the fee for service and I'm also concerned about. The turn going back and forth I've had a lot of conversations with the H. S. about this and and I think they've you know convinced me mostly that it'll be implemented well and I the reason I want to come sort of express this concern from the wells because this is as legislators are opportunity to do that Senator Irvin put it this is really a framework that were handing to DHS and that's right there's really no other way to do it whether you're for or against the work requirement. I think a lot of people can agree that the way that it was administered was problematic because we had working people who would show up and learn that they had lost their coverage when they showed up at the doctor's office or their pharmacist and some people even lost their jobs even because they couldn't get the medications they needed in order to work because they hadn't gone through the bureaucracy the right way and so my concern here is about you know creating a bureaucracy that could end up being a burden on people that are really working and and and doing the right thing And so there's a lot of aspirational goals in here that I think are wonderful and I applaud and and so what I'm what I'm saying is my hope is that when the department implements this legislation if it passes and becomes law is that we don't create that same sort of burden and that we're doing a better job of communicating to the people who are served by this program which is among the most important in our state has to offer that we really have boots on the ground to to really help people have healthier outcomes and economic independence which I think is what our goals are and with my yes vote my my I'm expressing that that's what I'm counting on the department to deliver so with that I'll be voting for the bill thank you. Senator Rapert you're speaking for the bill is that correct. By senator garner you're recognized. I think this president I'm here to speak against this bill because this is nothing more is slick rebranding of the same tire expensive program should got law not long ago get rid of long ago. With the Arkansas whole program really is about this about slapping paint on a program to make give us political cover. We like to run those that say now for small government less taxes less government interference less government health care when it comes to it more private staying with rubber meets the road we get this version of it. This conservative piece of legislation when the private option first pass that you had a democratic governor and with a majority of Democrats in the General Assembly and some Republicans who supported. But I wouldn't hear for that fight I really know what happened. Then we got the second re brand the Arkansas Works program the county didn't work. And here we are again. The third rebranding as the server program. This guy we're doing put lipstick on this pig and recorded a few twenty. I will tell you. We keep supporting this kind of program on beyond that slop in that look in that he. Feces. Senator you're so wrong this innovative program it leads the nation worse innovative doing these private plans. This amazing Modelo. Two state ever adopted. New Hampshire and Isle of. What happened. They got rid of the. Because they didn't work in fact in New Hampshire this year after they got rid of this. The private insurance premiums went down. Right we're gonna lose so much more money so they could. What you do is you to the traditional Medicaid expansion fee for service I'm so happy we got this book here. If you look on it. It shows that we will spend three billion dollars more. In federally money with this program over traditional fee for service get it in the morning it's federal money our taxpayers are paying into either way. But as. I don't know the concern of the option on the bill. We spend three billion dollars more here's a key point the more we spend in federal money is more we spend state money. Yeah. DHS in their own number safe we switch to a traditional fee for service we will save one hundred million dollars per year then this program. Thank you. We take care the most needing in Arkansas and we could fix Medicaid reimbursement rates we could take people off the waiting list and still have money left over we could two thousand dollar raises to our teachers we could turn around and fully fund. And with state money. What. Two traditional fee for service. Sounds like a win win to me. Take care the most needing to get away from this program have money left over. But let's talk about this point what's actually in this bill you know they conducted the study one time. Concentration. They had people in black shirts and people in white shorts and a past a basketball back and forth and asked people to care how many times that ball hit the groom did you. Did you. What. Is that study people had an amazing ability to count that to concentrate that even I had did the black team get it more than the white shirted team and back and forth. A minute long video halfway through that video. A gorilla's comes out a man dressed in a gorilla suit he walks into frame he sister for few seconds and then walks out the door. Those people who are concentrating so hard on the count to do do. When asked about the role. Said what really. Interesting part isn't. Right now we're in the middle of the session all got eight thousand things going on do you. This bill was introduced last Monday you will run it is quick to do every time you hear about this bill you hear about the veterans and the the pregnant women and all the people is going to serve did you. But forget about that basketball gas. Look at the guerrillas but that is all. What's in this bill one of the flaws in this bill this bill expands in X. stands the program able bodied adults that have employer sponsored insurance they would actually be adding more able bodied adults than we did before Page fifteen line sixteen says it we will actually be able to offer these able bodied adults after they leave the obamacare subsidies for all spend millions of dollars taxpayer dollars I don't really know teen courts more people to join up to this taxpayer subsidy program to get more people dependent on it. The cost saving measures there is no skin in the game there's no cost saving measures. What we did before. This doesn't do anything that will actually address those real substantial you think the bottom ministration it's going to support a waiver has real conservative reforms. What is work requirements take again it was good for let's do it again real asset test right premium sixty day lock out for people who commit fraud eliminating retroactive eligibility enrollment cap for free. What those ideas in this bill. Ministration support those rule for. She were doing that soon around real meaningful reforms to this Medicaid expansion private option in order to make sure we continue the Medicaid expansion private option re branded as Arkansas home. In closing we do more we need to move on from this failed experiment experiment and I adult real changes that will help the most needy while saving the taxpayers millions. Let's get away from this P. again not stick lipstick on it let's move to real health care reform thank you senator is voting against the bill does anyone will speak for the bill. Senator Hendren. Senator Hendren recognized to speak for the bill. Well I was here during the private option and I just want to give a little historical context here because I think it's important particularly for new members to understand there was a time when not my position was not too much different than senator garner us but I want to tell you what's changed between between then and today. The fact was we were faced with a hard decision when obamacare Medicaid expansion whatever you wanna call it. Was made an option to the states. In Arkansas was it a place where we had a governor from the Democratic Party in a newly elected Republican majority and the idea that we would come together and find a way to do that in that environment. Was pretty of remote. And I will tell you that I was on the other side of that argument the people who won that argument and and deserve credit for why we're here today Senator Dismang Senator Sanders Senate representing Burris former Speaker Carter. People who work across the aisle and with the democratic governor to say look. We've got to do what's best for Arkansas and sometimes that means not posturing and and and throwing up things that aren't really relevant in the real world and here's why I say that because I sent. Ten years ago when that when that debate occurred. Smee and a few other members in this chamber on the opposite side of the. And it was a two year program with the private option with the sense that and then we had to figure out what we're gonna do what we are going to ten continued or not. And as you all know we create we created a healthcare reform task force to figure out what is the best solution for Arkansas moving forward and from that came Arkansas Works. And I will tell you one of the things I'll not forget is to and at the first or second meeting of our task force the CEO of the hospital in my hometown came to testify and was very clear. This hospital will be closed if Medicaid expansion goes away it's a critical access hospitals Senator miss talk about. Graham it's not a big ten that's one of our biggest employers and I will tell you in this pandemic we're not for that hospital we would have been in a way with testing with vaccinations with treating COVID patients and it's not just grab you seen the map all over the state of Arkansas it was clear is we studied is that hospitals are open because of what we did not you asked why is that. Here's the deal is we look at the as we look at the dollars and I'm an engineer and my position changed and this is one of those times as a politician I'll be something pretty rare and say I was wrong Senator Dismang Senator Sanders were right and what was best for the state of Arkansas and here's what. When we hired John Stevens to come down here and do an analysis of this. It wasn't even close over the five year period of the waiver that we were looking at. If we had not continued Medicaid expansion Arkansas health care would have lost five billion with the billion dollars money that would not go to our hospitals would not go to our providers in people who would not have insurance if we found a way to make it work over that same thing same five year period. There would be six billion dollars with the B. coming into Arkansas. So I had to ask myself am I willing to do an eleven billion dollar hit and close down hospitals all over Arkansas. Because at a ninety ten split at the worst case. Because I don't like obamacare. I am glad the Arkansas found the path forward it stabilized the commercial insurance market it kept our hospitals open I appreciate those who worked in this session to find a path forward. It's the real solution that we need we want to continue the idea that we would go back to see for service we look at that. It was the most corrupt system the testimony that we had providers bringing in one kid in charge of the state for twenty routinely. Another conservative principle is that we let private we think private industry does things pretty much a lot times better than the government does we have found that to be the case with the Arkansas Works are our homes and private option model so I commend those in urban centers Dismang and does it have worked on this program over the years pass and it would be a tragedy for us to discontinue a program so vital in this time so I hope to vote for the bill. Senator Hendren a spokesman for the bill does anyone will speak against the bill. You will speak for the bill. Are you closing or you want to close. Yes ma'am. You're recognized thank you another story about what happened seven years ago was when we were when they were writing the legislation I actually got on the phone with president George bush's CMS director who now works for the state of Arkansas bush forty three guess what he works for DHS I was on the phone with him and I said we're about to pass this bill look at it what is the need in it what was important for that bill and the private option and I amended that bill on that day and included my name as a co sponsor on the bill with senator Dismang was for us to utilize a section eleven fifteen waiver what is this section eleven fifteen waiver it's a section within the affordable Care Act which allows the state of Arkansas and every other state in the state in the country to seek a waiver saying we don't want to do it the way you're saying we want to do it our way and that section eleven fifteen waiver why is it important it requires budget neutrality why is that important because seven years ago we were on a growth trend in the traditional fee for service Medicaid program at the seven point two percent growth rate annually we could not sustain that we were depleting the Medicare trust fund completely and taking half of the surplus immediately to plug the hole for Medicaid we were funding a Medicaid program on one time funding that was irresponsible I was there this program helps correct the correct this ship because it lowered the growth in spending in the Medicaid program because we had a budget neutrality cap yes this is conservative legislation yes this is conservative fiscal policy yes it works and yes it has brought me billions of dollars into our health care infrastructure why would you advocate for a program that pays our providers and our hospitals twenty five to sixty five percent. Why would you advocate for program that pays them less. You don't do it in education policy you didn't do it whenever we got one point two five billion dollars for COVID relief from the federal government I didn't hear a single. Voice that said give that one point two five billion dollars back to the federal government we don't need it thank you very much no we had to use that does little dollars for important to our health care infrastructure. We advocate by using state general revenue as effectively and as efficiently as possible to leverage the federal dollars that we send to the federal government to come back to the state of Arkansas. We do it everywhere why are you advocating for it to be done differently in health care why would you advocate to go back to a fee for service program which was bright with corruption. Why would you do that is our providers and hospitals less money why would you advocate for a program that will close critical access rule hospitals in Mountain View Arkansas Clinton Arkansas rabbit Arkansas Dardanelle magnolia Salem calico rock. I don't know why you would do that this is down financial policy it has been proven to be so for the past seven years those dollars are critical to keeping our health care infrastructure open this is not. Any this is not just the same old thing with something slapped on it and I'll tell you why it's not I live this rule medicine for the past twenty something years with my husband he began a rule residency program for you in the **** do you know that these ideas are incorporated into his practice. He does he does he will write a prescription and say you need to go take that free exercise program that they're offering at the extension office because if you exercise and if you eat right guess what you don't have to pay for diabetes medication you're going to save yourself money if you exercise and if you eat right and you're not going to have to spend money on diabetic medication you're not going to have to have that and it works we're talking about here that's real stuff those are the things that we need to help these populations with and so I am thrilled about this because it is aggressive it is innovative it is creative but it's going to take all of us working in the same direction I again want to just close by saying thank you senator Bledsoe Senator Dismang Senator Hendren all those folks that have had their theme some prints on here representative Ladyman representive great so many others that we've met with I want to just thank you this was a collaborative effort and I would just appreciate a good vote for our state and for our rural hospitals in our hospitals across the state of Arkansas. Thank you senator madam secretary please call the roll. Ballinger. Ballinger. Beckham. Beckham. Bledsoe. Caldwell. Chesterfield. Chesterfield. Clark. Clark. Davis. Davis. DISMANG. Eighty. Elliott. English. Flippo. Flowers. Flowers. Garner. Gilmore. Hammer. Hendren. Hester. Hickey. Thank you. Hello. Hello. Ingram. Irvine. Blake Johnson. Mark Johnson. Mark Johnson. Leding. Page. Rapert. Right. Rice. Sample. Sample. Stubblefield. Stubblefield. Sturch. Sullivan. T.. Tucker. Wallace. Okay members anyone wish to vote or change their vote Hickey aye aye aye. Chesterfield is I. Rapert aye aye. Senator Ballinger is that. Senator Mark Johnson is president. Senator Hill aye aye senator Baker was present. Senator Breanne Davis is hi. Senator Stubblefield as president. Well as. What did you say senator flowers. Senator flowers is a. Anyone else. Well. By a vote of twenty six days three days one non voting in for present the bill is passed please transmit to the House. Okay members any is there any announcements before we move the House bills. Okay we'll move to the House bills. Senator Breanne Davis. House bill ten sixty one by representative may bring Senator Davis to create the no patience left behind let alone act concerning visitation rights of patients and to declare an emergency. Senator Davis you're recognized ma'am thank you Mr president. This bill is the no patient left alone bill. It's been worked on for months I think most of you are familiar with that. We know all know that so much has changed in the last year in society and and just what life looks like today and and we have had. Thousands of people across the state sitting alone in a hospital bed sitting alone in nursing home facilities unable to see loved ones unable to have a patient advocate there for them in order to ensure that they are receiving the care that they need and that they deserve and this bill addresses that to ensure that if you know numbers rise again and and we go back in to mandates with COVID or if there's something in the future that we don't know about yet that we protects. That health care of people across our state that they're able to have somebody there with them and this bill has and been worked on to make sure that. It doesn't give false hope so we worked really hard to make sure that. Whatever we did it didn't it met with federal guidelines say that you know in nursing homes specifically that people didn't think walking to show up at the nursing home to see my family member whenever I want we try to be realistic and make sure that what we're doing was correct it wasn't giving false hope to people said we worked with DHS and the healthcare association the hospital association department of health the list goes on and there is no opposition to this bill everyone is good and I'm happy to take any questions at this time. Soon having questions for Senator Davis Senator Teague you're recognized. Thank you president of a seat Miller before I just didn't think about I think the language is the patient has to ask for this so in case you for the patient pain ask or what's the situation on that. So. I there are two or three different places where the patient has passed well so if the patient can't talk for that mark Is that where it came to you know do a lot. Do they get how do they request somebody come in. So patients are thank you it is in several different spots throughout here and addresses I think nursing homes and hospitals a little differently and but. You see where there is an option maybe there I don't know. Trying to like I've got some spots highlighted that they are allowed to designate at least three so I think if you have that in order before. You know they may need to be admitted or and to the hospital or if they're in a nursing home they can have three people listed. With one coming in at a time it wouldn't be all three could come in whenever that. Thank you Mr president yes sorry I don't have the answers totally but I understand what you're saying but they do have a list of three that they can have in. Thank you senator Centerville. You're recognized. Senator Davis how we handle the situation was I in a nursing home or a hospital where they have a roommate in the in a roommate does not want anyone else in the room size the other patient. It does address that in here and so they can meet in a different place and or maybe the patient to a different place to receive care to have someone to visit so the nursing homes a little easier to do that and simply because they have common areas so if you know the roommate doesn't want anyone in the room then they can't meet somewhere else within the facility but there are ways to address that in here. Senate bill your follow. To address the situation if that patient goes and meets with the family and they get sick then that other roommate has been exposed. Well if there because the their remake out sick. The nature quarantine they follow protocol I mean the truth is we have and health care workers that for a year they don't live at the facilities of the hospitals and you have seen people in society put pictures on Facebook and Instagram at baby showers in church and weddings and hanging out in ball games and they show up to work on Monday at that facility so people have you know you can argue that they've been bringing some people of brought COVID into the facilities and so I just I don't know why we would say they're such a risk there that workers can come in that family can't and watch their loved ones people are just deteriorating and people have died not because they contracted covid but because they were isolated and felt the effects of carbon so they would just follow protocol. Thank you. Any other questions. He will speak for the bill. Senator Rapert you're recognized before the bill. Thank you Mr president I want to thank representative Mayberry and Senator Davis for bringing the bill. And. I just want to speak up because my family went through this with my grandfather. And I've gotten many emails many messages about the issue. And I can remember. The staff holding the phone in my grandfather's year. He couldn't speak. And they would let us go in. And visit with him. He was there for probably six months to just like Senator Davis center answer questions. At some point something happening co would got loose in that nursing home and said this man your own grandmother was in that same nursing home we talk about it. And I'm just really. Ashamed. Of what's happened over the last year and some of the situations to put stress on families that we now know probably wasn't necessary you could been a burden and could allow the dignity of certain people. I was actually just down the hospital COVID few weeks myself when I finally got the call at the end. That he was done. In a let me speak to him. And so I just want to say I'm proud to to vote for this bill I wish I'd been involved earlier on put my name on it because it's important. And I pray that if we ever under another situation like we've had this past year. That we remember the humanity and dignity of people at a time when they need to be with their loved ones I'm proud to support bill thank you. Senator Rapert is voting for the bill does anyone will speak against it. You will speak against the bill. Senator Ballinger you're recognized speak for the bill. Thank you Mr president I just want to resort on it to answer Senator Teague questions if you have somebody who is in some sort of assisted living nursing home then if they don't have their capacities they've either been to declaring capacities that somebody was a guardian appointed or they have a durable power of attorney before they go in but either way they there's a lot of really important decisions make so usually they'll find some way to have somebody to make those decisions on the B. acts as the mechanism this case was with the individual is acting directly as power of attorney or in the name to somebody else so whoever that person is would have that the choice but at least as bills right now it's up to so that's kind of what what. Senator Ballinger is broken for the bill Senator Clark. It's going to speak for the bill. You're recognized Sir. I have a similar bill of similar in that it's the same subject and only two pages long. And of of held off on it and joined in with the Senator Davis and represented by Perry who when a lot more in depth. No our families policy our extended families policies like many extended families if one of ours is in the hospital somebody's there with the. And our extended family includes doctors and nurse practitioners and nurses and EMTs and they all feel the same way. that if you're there somebody needs to be with you. We almost lost my dad last February right before all of this and we were grateful that we had in home. before all this here and I got lots of phone calls and I'm sure you did and there was not much that I could do to help people. I did have one. Of. The lady that I went to high school with that was a nurse at UAMS. And it took us three days to get a local hospital to allow her to come in state not to come and go to come and state of. And the caregiver and advocate for her mother. But it really came home in November. We thought that had a blood clot in his leg and so we had to go to the hospital. In for three days. somebody was within my son my nephew my sister. Of twenty four hours a day and doctors and nurses tacitly agreed. that somebody needed to be with the. His M. G. has a hard time committee make communicating. He doesn't like it when I say so but sometimes is a little confused. But on Saturday morning. My sister called. And. She had stepped out of the room for a moment was when the nurse came in. The shift. Of and when she came back in. My dad gave her a pill that he had kept under his tall because it. Should be in his chart that because of in G.. He can't swallow all very well they can't swallow a pill I have to you have to grind it up and he could have aspirated and dot. In my sister very nicely. Said something. In a couple minutes there was a security guard there to escort her out tell her that their policy was it no family could be there. And they called me and I was on Speaker phone I told her not to leave. I told Michael Bartoli Tucker out if they had to and I would be on my way. I got the and I stood in the lobby for two hours. I have power of attorney. I told them I had power of attorney. They said you can't visit I said I'm not here to visit I'm here to get him. Two hours while on Speaker phone I called the governor's office I called the hospital association I called the sheriff's department they had a security guard come stand beside me I didn't raise my voice I didn't curse but I said I came to get my dad. I'm going to get my dad I have power of attorney. You can't visit him I don't want to visit him. I came to get help. Well we have a policy. If you visit with the the that if you talk to the ministry between Monday and Friday. That we can set up something special said he won't be here Monday. We're not waiting till Monday we're not leaving him by himself also tell you that I don't would trying to criticize anybody we also know because we were with with him around the clock. They were short handed because of coal which wasn't their fault. And if we had not had people there to help care for him he would have been in trouble. But finally because of my persistence they would got an administrator who came and they told them the story and he said I don't see one Mr Clark can't go back to see is that. And I said I don't either. And so. Within a couple days I was riding a bill certainly not. I go to all the work that they want to but I want to tell you. Everyone's not as persistent as me. Not everybody could come get Thursday at a lot of people have to stay. To be there and this is not as we had these discussions behind the same everybody would keep saying visitors and I said this is not about visitors this is about a patient advocate is what this is about more than anything and lots of people need an advocate when they're in the system and I don't blame anybody for anything that happened the first two months of covert of lot of uncertainty but we now know that people still need a patient advocate you knew without me telling you that this was a good bill but I want to hear my personal experience. And I'm sorry for all the people. Who lost his. Other things happen that don't that either think that they wouldn't have or don't know or just know they were there. And I hope it never happens again. Senator Clark is working for the bill you will speak against the bill. Senator Hammer you're recognized before the bill. You're recognized thank you Mr president. To a detailed I I will give the details of personal stories other than to say on a personal level have experience what it's like to lose a loved one in nursing home but also to tell you what it's like to be a pastor who's been with church members who have been separated from their loved ones and the inconsistency I think in the policy is what has driven a lot of confusion but a lot of frustration so the one thing I appreciate about the legislation is that as a legislator it allows us to establish some boundaries since the policies that will be not necessarily in the books as much as it will be in the law and I think that will give us some weight moving forward for hopefully what will never happen again but if it does at least we have the weight of the law Preciado. Anybody else. Senator Davis if you want to close. Yes thank you. And like I said there's tens of thousands of stores across the state we all know someone that's been impacted in some way due to the restrictions in hospitals and nursing homes and I think this is a good bill and I hope that you all agree and and I'm close for a bill. Thank you senator three Jeff objection rolling the vote on the role of a Ballinger Beckham Bledsoe Caldwell Chesterfield Clark Davis Dismang Eads Elliott English Flippo flowers Garner Gilmore hammer Hendren Hester Hickey Hill Ingram Irvin Blake Johnson Mark Johnson Leding Pitsch Rapert Rice sample Stubblefield Sturch Sullivan Teague Tucker Wallace you will wish to change their vote. Please K.. Well. Senator flowers did you say no. The president Senator flowers is present. Anyone else. Okay well. By a vote of thirty three a zero nays and one present the bill was adopted. The Bill pass an emergency clauses adopted. Please return to the House. House bill eleven thirteen. In thirteen representative Dotson and Senator English to amend the commissioner of state lands urban him homestead act permits the development of schools on land donated by the commissioner of state lands the land is not being utilized as a homestead and player in the merchant city you're recognized centering thank you this bill basically is gives a community organization that receives donated land from the land commissioner to be able to transfer the donated parcel to recipient they can use the property for development of a public school traditional or charter school. Three questions Senator English. Anyone else before the bill against the bill. Senator bill if you want to speak against the bill you're recognized. Members I think the thing that's really important about this bill is I know I take a real chance of coming down here speak against this bill and have what I say misconstrued I get that. Because this sounds like a really really good idea. And in some ways it is. But what bothers me is what I know. Can be and likely will be the inevitable outcome. In my district. Right here in Little Rock it could be anywhere. This land according to the bill the donated parcel of land is in a sense this tract. What the poverty rate higher than the average poverty rate in the state of Arkansas. And it could be misconstrued to say well don't you you don't want housing for people with higher than the poverty rate yeah I do. The best policy would not packed them all in one place. Because you know what happens we have had this experiment before. When you take people higher than poverty rate and you build housing for only the people who are a higher than poverty rate who can live there in the in these homes. And I don't think that's good policy for us and the way we are going to be a part of that because they can do it right now. But the way we're going to be a part of that is to sweeten the pie by building a school there. I think it's policymakers we ought to be on the side of having more mixed income housing not packing people into an area where you do not want next to your home or even next to your community. But. You can do that right now. We don't have to enable that by saying we're going to build a school there or the school district and build a school there. It was in the committee it was made clear. That with this bill the intent is to in southwest little rock to build one of these areas and then we could put a school there well I know the little rock school district is not building more schools. They're twenty one charter district it's trying to schools our twenty one already in the little rock school district. But what's behind this bill. Is the bill of this community where we packed the people into that community are going the way subscribe on the bill and then a charter school is going to be built there. We are charter rising are traditional public schools into nothingness almost we don't have to enable that that's why I'm against the bill if you're confused about it I'm sorry about that but. Everything is not what it appears to be. That's the only reason I'm speaking against the bill. Everybody ought to have housing so do not characterize this as I am against people of low income have been houses but they are to have the right not to all be packed into a place like this and then we in a public. Senator Elliot is spoken against the bill does anyone will speak for the bill. It will speak against the bill. Senator English. So just to clarify the property that has been given or donated by the land commissioner to the Committee has been sitting there could be sitting there for three five years and nobody's ever used primaries goal was to build housing but no housing appears so this would give them an opportunity for a. Munity. To transfer that property instead of being used for housing which no housing is appeared to be able to use be used for a school. Thank you. Secretary please call the roll. Ballinger. Ballinger. That. Bledsoe. Let. Caldwell. Caldwell. Chesterfield. Clark. Davis. Hi DISMANG. DISMANG. Aids. Elliott. English. English. Flippo. Flippo. Flowers will. Garner. Gilmore. Hammer. Hendren. Hester. Hickey. Hickey. Hello. Health. Ingram. Ingram. Irvine. Blake Johnson. Mark Johnson. Leding. Page. Rapert Rice. Sample. Sample. Stubblefield. Sturch. Sullivan. Teague. T.. Tucker. Tucker. Wallace. Soon wish to vote or change their vote yes no. Dismang is our. Senator Ingram is no. Anyone else. Please cast a ballot. By a vote of twenty four yeas seven days. The bill is passed please return to the House. Okay room house bill eleven seventy five. House bill eleven seventy five a representative board Senator Ballinger to amend the Canada filing requirements for positions on school boards and local boards of community colleges. Senator Ballinger recognized. He was president that this is just a clean up ledges clean a bill a couple years ago we moved the the election for school board to the general or the primary this cleaned up some language they're they're at one time was a thirty dollar fee for filing with the local community college that is taken out and then this just treats school board members like any other unopposed candidates so I'd be happy to answer any questions but it's pretty straightforward anyone have any questions for Senator Ballinger. It will speak for the bill against the bill any objection rolling the vote of the rope of Ballinger Beckham Bledsoe Caldwell Chesterfield Clark Davis Dismang Eads Elliott English Flippo flowers Garner Gilmore hammer Hendren Hester Hickey Hill Ingram Irvin Blake Johnson Mark Johnson Leding Pitsch Rapert Rice sample Stubblefield Sturch Sullivan Teague Tucker Wallace. J. U. one wish to vote or change their vote. Please cast a ballot thirty four U. A. zero nineties the bill is passed be returned to the house. House bill eleven seventy six eleven seventy six by representative Johnson Senator Davis to ensure that reimbursement in the Arkansas Medicaid program for certain behavioral and mental health services provider provided by telemedicine continues after the public health emergency and it's clear emergency. Senator Davis you're recognized thank you Mr president and this about this bill just allows for certain behavioral and mental health services that have been allowed to be a telemedicine during that pandemic that during the public health emergency to continue while ensuring that Medicaid reimburses and that reimbursement rates have been negotiated with DHS and there's no known opposition to this bill. Okay any questions. The one was for the bill against the bill. The objection rolling the vote. Please roll Ballinger Beckham Bledsoe Caldwell Chesterfield Clark Davis Dismang Eads Elliott English Flippo flowers Garner Gilmore hammer Hendren Hester Hickey Hill Ingram Irvin Blake Johnson Mark Johnson Leding Pitsch Rapert Rice sample Stubblefield Sturch Sullivan Teague Tucker Wallace you wish to change their vote. Flowers president Senator flowers is present. Anyone else. Okay by a vote of the please cast a ballot. By a vote of thirty three a zero Nays one present the bill is passed Emergency Clause was adopted please return to the House. House bill twelve fifteen twelve fifteen by representative Bentley and Senator Hammer to grant full practice authority to certified nurse midwives. Senator Hammer you're recognized. Thank you Mr president you have a handout that was on your desktop from the March of dimes that gives a lot of vital information is to the necessity of this piece of legislation along with some important documentation Arkansas has the third highest infant mortality rate in states where this type of legislation has passed they've seen decreases in the Syrian birth preterm birth stillbirths birth trauma severe blood loss newborns with low birth rate and newborn admissions to the neo intensive care unit currently there are an estimated ten to thirty individuals who would qualify for the full practice authority for the certified nurse midwives this legislation goes through so it gives you an idea of the impact of the numbers that we're talking about in the state you heard testimony earlier today in this chamber about the need to help with the infant mortality rate in the state of Arkansas I believe this will complement what we passed earlier I'll be glad to answer any questions you would have any questions Senator Hammer. Senator Elliot. Thank you. So. These. Winds in this case will be able to prescribe drugs I think it says second the third second third schedule I don't remember but you I'm not looking at it what does that mean like what kind of drugs are they able to prescribe. There is specified in the language they would only be able to prescribe schedules three through five that's on page three line two which are not the opioid chin up what we would refer to as the hard drugs yeah I I I read that three to five I just don't know what's in three through five but on this bill tells me what's not in it but do you have any idea what is. Now I don't I'm sorry how she came here to answer that but I know it's not involving the drugs that we are having such a hard time with but I can say this is only these are only to drugs at their they would be allowed to up to their scope of practice to be able to do so. And They can also diagnose they are they have not nonstate authority to win this bill right and it is that is that regulated in any way or yes ma'am thank you for the question on page two lines thirty through thirty five it to it talks about as used in this section full practice authority means the authority healthcare professionals to it lists several things but if you go back to lines three through seven that are mentioned on page two it gives a a pretty much defined list of what they're able to do as far as what's allowed under their scope of practice. Well I guess maybe I didn't get to pick it up when I read it I I it was not clear to me What if there are certain things that they can diagnose it they have general diagnostic authority to diagnose whatever only an attorney only in the maternity area so they're not gonna be able like go up and open up a a practice that would compete against a general practitioner it's limited just simply to to their scope of work with regards to the delivery of babies so they would have the same authority as an MD what happens is that what you're saying about. A general practitioner in the I would have that same kind of diagnostic authority I don't think they would have the same kind of diagnostic Thor T. as an empty because they are not they are not licensed to go outside of the scope of practice it would simply focus toward what is associated with the maternity needs okay all right thank you thank you. Senate bill. You're recognized. Thank you Mr chair thank you senator Hammer for taking my my case my brother was delivered by a midwife but some of the things in here give me great angst so let me share them with you congrats. They are fine on line twenty eight on page one you delete have an agreement with a consulting position if providing intrapartum care. Can you give the total total practices already. Two eighty four practice certified meat one why would you eliminate the consulting with the the certified position. I thank because they are going to be given their full practice authority as they are licensed and capable to be able to do it doesn't mean that they wouldn't have relationships with physicians but this is simply eliminating the full practice authority requirements so they would still. I want to have good relationships in fact if you go over to Page three lines ten through thirteen it talks about they would not be able to be able to deliver in the home unless they were in let's say were identified or they were they were certified nurse midwives shall identify a licensed physician or facility or both with which an arrangement has been made for referral and consultation in the event of a medical complex complication so they wouldn't be able to deliver in the home unless they had that but this is simply giving them that full practice authority Page five of that same pages certified nurse midwife with full practice authority is not subject to the collaborative practice agreement requirement if providing prescriptions and medications I'm back to that why would they not have to do this in collaboration with the position. Well because they are only to be able to practice and perform their duties up to what their scope of practice says that they're able to do. I guess I'm confused because I just don't understand what their scope of practice you and if you could just tell me some of the drugs within their scope of practice you would give me less angst okay well maybe I can answer that question by going back over to page two. Thirty three thirty five. And also three to seven those pretty well described what are within their abilities to do under their scope of practice line three through seven and lines thirty through thirty six they can that and that's another thing that they can diagnose medical conditions. And as a full practice as a fully certified Why you're able now to diagnose medical conditions in order and interpret diagnostic test. Under their Kerr for professional practice yes this is just removing that collapse this is all just about removing that collaborative arrangement thank you thank you. Any other questions Senator. You're recognized thank you just quickly on page two lines six and seven on the treatment of male partners for sexually transmitted infections is not in their within their current what they can do to day before the bill passes that and that's something that they can currently do is and is this just included because of the way your restructuring Mr the statute. I believe that the correct answer they're not being given the authority to do any more than what they currently can do okay it's just removing the collaborative arrangement agreement okay thank you thank you. Any other questions. It will speak for the bill you want to speak against the bill. Are there any objections drawing the vote and I closed I'm sorry center yes or you can close thank you. On the handout that you have a just want to draw a couple items to your attention in the first paragraph it says an Arkansas more than a hundred five thousand women fifteen to forty four years old live in maternity care desert with thirty seven Arkansas seventy five counties having very limited or no access to maternity care services at all given the conversation earlier today I think this is a critical component to what we're trying to do and that is to address the needs of those of many of which are on the Medicaid rolls that are in a position to look to deliver babies I would think it is to our best advantage is a state to make sure that all the babies are blessed to be born in Arkansas are blessed to have the best access to care possible I would also draw your attention if you would to the bottom left hand corner of the handout that is being given to you and about those that are referenced as being supportive and that are also encouraging us to pass this bill and so with that I would just ask for a favorable vote and say thank you. Any objections role in the vote. Federal. Ballinger Beckham Bledsoe Caldwell Chesterfield Clark Davis Dismang Eads Elliott English Flippo flowers Garner Gilmore hammer Hendren Hester Hickey Hill Ingram Irvin Blake Johnson Mark Johnson Leding Pitsch Rapert Rice sample Stubblefield Sturch Sullivan Teague Tucker Wallace we wish to vote or change their vote. I was no Senator flowers is no anyone else Senator Elliot is no. Senator Bledsoe is present. Senator Chesterfield is present. Anyone else. Please cast a ballot. By a vote of twenty nine yeas to nays three present the bill is passed please return to the House house bill thirteen thirty one. Thirteen thirty one by representative Milligan to amend various municipal statutes for consistency. Senator Wallace you're recognized. Thank you. Mr president. Members this bill simply makes it easier for our second class cities to manage their vacancies. in the past we've had different statues will combine those were eliminated to statues for elected marshal recorders and treasures emerging those with existing Mayer vacancies and what that does is it would now we have a vacancy and a treasurer or recorder we can either have a special election. The entire town vote or the city council can determine who it is. The second part of that. uses a mechanism for incorporated town to fill a vacancy for elected Marshall in the past if we had a vacancy there we didn't have a mechanism to fill it. the last part is it but to me the most important. Having come out of a town the board we I was on city council with second class the use of mayor. Able to establish a quorum nine a pass he could he could he could decide a. A draws so he could always vote this allows you to be counted as a quorum a lot of times the small towns it's hard to feel court once the court of city council. And with that available for questions it would have a questions for senator Wallace. It will speak for the bill against the bill. Are you closing your post closing your role in the vote. Three zero. Ballinger Beckham Bledsoe Caldwell Chesterfield Clark Davis Dismang Eads Elliott English Flippo flowers Garner Gilmore hammer Hendren Hester Hickey Hill Ingram Irvin Blake Johnson Mark Johnson Leding Pitsch Rapert Rice sample Stubblefield Sturch Sullivan Teague Tucker Wallace the one wish to vote or change their vote. Please cast a ballot. By a vote of thirty forty eight zero may. The bill is passed please return to the House members we have just a few items to be read across this Madam Secretary when you Committee on engrossed bills to whom was referred Senate bill sixty five by Senator Ballenger the engrossed copy with the original find same correctly engrossed counted Committee on engrossed bills to whom was referred senate one sixty one by Senator garner compare the engrossed copy with the original find same correctly engrossed counted Committee on engrossed bills to whom was referred senate bill three fifty four by Senator Irvin compared the engrossed copy with the original find same correctly engrossed calendar Senate resolution thirteen by senator garner recognized install fund for his charitable contributions to the Arkansas Arkansas small small business committee Senate resolution thirteen calendar Senate bill five O. seven by Senator Garner to amend certain provisions of initiated act of nineteen forty eight and a clarify the treatment of durable medical equipment and the workers compensation law Senate bill five oh seven. Public health center five oh eight by Senator Leding temen the number of official holidays of the state and to make election day an official holiday Senate bill five oh eight. State aid center five oh nine by Senator Leding temen election all into amend the law regarding work hours on election days Senate bill five online stayed eight simple five ten by Senator Leding to prohibit conversion therapy for minors in the five ten Public Health. They're in their assessment Senterfitt you're recognized. Members insurance and commerce in room one seventy one ten minutes upon adjournment we have a full agenda today. Any other now. Anything else come for the body. Okay the Senate will stand adjourned until one o'clock