Public Health, Welfare and Labor Committee - Senate

The first one. Okay all right senator eads believe you're up a house bill twelve sixty one. When you're settled the you are recognized to start your presentation and I believe we have Becky Keogh with this cabinet secretary department of energy and environment but would you mind introducing yourself for the record please ma'am. Thank you my name my name is Becky Keogh I am cabinet secretary for the department of energy and environment as well as service director of the division of environmental quality in that department thank you senator Reid's thank you madam chair committee this is a house bill twelve sixty one that Concerned with the the dredging feel permitting process that has been under the purview of the A core of engineers and and Secretary keels and explain how this process is going to change what this bill is about. Thank you committee this is an important piece of legislation we believe that further advances of the state's role in administering important regulatory actions that affect not only the protection of our environment but also protect those investments that are made our state allow investment to be made in infrastructure of that section for for the clean water act is a program is as explained it is currently implemented by the US army corps of engineers at the district level therefore districts Senate across Arkansas so an entity that's getting permits across the state would normally have to seek permits potentially from various districts not just a single district we believe in Arkansas at least it's been the will this legislature that one federal programs are available to be the same to the state level of the state has supported that to provide more local input and more. The practical and realistic a rule making that works for Arkansas Arkansas has taken leadership in that capacity and and assumed all available delegated programs the corps and EPA indicated that this program was intended to be delegated has not been in the past decade and would like to see that move forward so Arkansas's putting forth the first step which is the enabling legislation so that's what this bill is really just the very first step on how we would go about setting up a program in Arkansas are working back with the Commission PCA Commission to and per stake holders to establish what type of rulemakings are appropriate and permitting language obviously bringing that all back to this body for your review and and support before anything goes further so thank you so much to the committee but I think it would it's a great opportunity for Arkansas to continue your great leadership and and providing certainty to those regulate the that we regulate and the Public but expects that regulation to be protective. All right thank you do you have any other comments Senate just be happy to take any questions all right any questions from the committee all right to senator Sullivan you're recognized for a question. Thank you manager so just what are we going to dredge and fill. Well the actual of dredging operations are generally done either by counties or cities are done by agriculture these or where they're of actually working in and around what would be considered a federally regulated water way and so that this is just authorizing those temporary activities that may affect water quality on a very temporary basis or you know. About the damage is give me the exact hearted hard example direction feel operation well I know that we need to developments you might. Have to read. If the yellow movie might have drainage ditches that have to be re directed or something like that so that would require authorization or stream crossing might require a wetland determination and a recreation of that well and so is the process okay great thank you thank you manager all right any other questions from the committee. All right seeing none does anyone in the audience want to speak for the bill or against the bill. I think we had this. No I don't have a list so I guess. Of the women go on in the have you close for your bill I am both appreciate a good vote all right puts the pleasure of the Committee do pass a second all those in favor say aye on those suppose congratulations you have passed your bill thank you madam chair of the committee all right going on down the agenda. The Senate bill nineteen is there anyone here to run that bill for Senator Clark. All right we will go on down to senator Gardner Senate bill eighty six. I think we have some amendments correct and then we have something to say no ma'am we shouldn't have any amendments no amendments okay something to let's one these members I did something on this thing. Which. But I'm sure but with your permission unless after joint L. rod with the presence of a eighty eight in court where of the revelations with them to be up here with me as well all right and if you would just introduce yourself for the record. Appreciated. My name is Corey we're on the governmental affairs chair for Arkansas athletic trainers association. Okay. Jonathan all right on the president for the Arkansas athletic trainers association all right thank you welcome to our committee all right senator garner you're recognized to present your bill thank you madam chair members committee SP eighty six is a very simple bill as far as we change and make that we made to the athletic Arkansas athletic trainers Act you can see all the rule changes the addition of activities related to a porn Forsman military or rescue services to require annual physical training the only real change is the section be which could see in the bill. We limited those three categories for these reasons first that carries our first responders and military is already similar to what our current a teacher doing throughout the state. If you look at the vast majority train our law enforcement military does it's physical exercising running ruck March carrying equipment physical fitness it's all very similar to the activities that you're athletic trainers do every single day throughout the state. One for if you look at there's a tactical athlete oracle describes kind of what it is to be a tactical athlete which is what our military is call on our current soldiers to serve and help those skills or similar to a high school athlete or college athlete or athletic trainers work on. For calling the with the activities though is the treatment and injuries that they would either prescriber have to deal with. Sgt rolled ankles hurt knees things like that things are athletic trainers do every single day in order to do. Next the first military builds these changes to help them they're asking for it is no coincidence that two sponsors myself in general Representative Barry Allen the house in have extensive time the National Guard. That's why you see the letter support moneys you're looking mail folder you seen from law enforcement you see from the military the Arkansas National Guard association and others who were asking for this change because they will be able to utilize the athletic trainers similar to help this is been done before. In fact any better example look behind me I haven't people from the military law enforcement and fire services here. Both support this bill and to testify why they needed if that is needed by the committee. Next we seen our first responders military get this similar treatment other states and even at the federal government there's a study out there that shows the benefit of athletic trainers on our airforce training academy that actually the Federal government allowed athletic trainers to go when they're in to treat the soldiers going to basic training and guess what they found out the results were excellent allow for better training allow for more training and for them to heal quicker to get back other states have adopted this it has been a success in those states Arkansas is when the states that don't and that's what we're trying to change. Finally and most importantly our eighties what this. It's important because we all have eighties in our district there there every single day treatment our students. They're out there make sure they're safe in our districts every single day. Only thing they're asking for is the ability to treat more people with the training they have in a safe and effective manner like to do to every single student. I'll close in like this. If it's good enough for our children every single day I think it's good enough for an old right like me to get work now I ask that we ask the same courtesy we do for our children that we allow to be done and with that better chairman at my guess have anything that I would as they be allowed to speak all right of you want to add something is this your time for speaking for the bill or would you rather just wait until we call for those after questions. Right to that the questions okay I can kind of base their testimony based off that if it's questions from the committee. Any questions from the committee. All right seeing none then we will call for of those to speak for and against and so. The two of you are welcome to speak for the bill but let's make it says Singh Klay and the and you know within a reasonable amount of time and those who what we used to go for and against but since the since the two of you are sitting up there Let's do this let's let you do the two four and then I'll call for the two against and then we'll go through the rest up about that all right. One of you which one would like to go first. Thank you senator garner madam chair members of the committee for taking time here about eighty six. like I said before pointing Johnson all right of an athletic trainer president of our association also have unique background in that I'm an emergency medical technician also spent thirteen years in the Arkansas National Guard deployed once so I'm able to to speak to this bill from not only perspective of an athletic trainer but somebody who would have been like to enable to benefit from the services when I served. So basically this bill would just change the current statute to include military public servants to become tactical athletes this is not a new term it's a term that we all we already see and physical therapy community armed forces during conditioning community and there's some concerns that this is a scope of practice built the bottom line is is that it's not the case we are not asking to do anything different we're not asking for any new skills to be able to perform any new procedures we're simply asking to be able to do the things that we are trying to do to care for others who get hurt while they're physically active. So we've also included some language in the bill that further delineate that so not only are athletic trainers gonna be remaining in the scope of what they're trained to do but athletic trainers are also going to be restricted to who we can military law enforcement public service. But we're rescue service but we're also narrowing it down to those that have a complete an annual fitness for physical fitness requirements we already have something similar to that in our current statue that we to be considered an athlete in Arkansas you have to have an annual physical exam so this is something very similar to that we are a seat in the federal government the active duty component see the value in it we would like to see our National Guard soldiers receive the same expert care that the federal government has already invested in eighties are already in the community we already provide safe care every day to athletes. In the schools colleges professional athletes and we would like the opportunity to provide that same care in those same communities to more people. All finished with this ultimately the bill is not about making life better for athletic trainers is not about expanding our scope of practice the bill is about making the job safer for warfighters in public service these are heroes that train and serve to protect this and they to serve someone to protect them I think military law enforcement rescue personnel are very much athletes and they very much deserve an athletic trainer that's what I ask for you to vote yes for Senate bill eighty six all right just a second of Senator hammer did you want to ask a question all right would you take a question Sir sure. Afternoon the big push back we're getting is the fact that people think that you're going to go out and open clinics and cut the PT's out from their business model would you dress a question. Thank you for your question center hammer of the with the the addition to the language with the annual physical fitness evaluation we added that based on the concerns the PT had when we met with them to you know differentiate between athletes and those that are active in those that aren't we also have some legislation that that is that is going to come before you that it shows that we athletic trainer can't open up a clinic we we can't practice on our own independently without the supervision direct supervision of a physician so that promise will be false with there's there's nowhere in the statute that would allow us to open our own clinic and act independently and and treat those outside of our scope okay follow up manager yes so give me the the difference between a player gets hurt on Friday night football let us get this the test let's get the tennis player okay we'll give them some credit so they get hurt on the on the tennis court athletic trainers there and goes and see it sees the of the sports athletes the next day that person goes to see the doctor what is it that the PT. Could do or what is it that you could do that the PT couldn't do so that there's a firewall between the two the all in that situation. What I think that's a great example one thing is that athletic trainers are gonna employee strategies by being able to participate that would hopefully prevent these injuries and make the job safer but one thing that this would do is it you know so if it was that a tactical athlete got injured similar to if it was a tennis player they got injured they would see us we would evaluate them anything that we felt like was outside our scope we would certainly make an immediate referral to a physician just like we would with one of our normal athlete and then you know it would all depend on the model that was set up but more than likely that patient if they were injured and they needed physical therapy then more than likely that patient would still be referred to a physical therapist. Thank. Right yes the senator Sullivan. Thank you thank you for the question that I have would work are we getting the cart before the horse here we don't have a model set up but we're setting up a program without a model and I'm I'm always concerned about this oversight because that every time we we do a scope of practice issue we talk about oversight the oversight goes from you know in one venue from once a week with extensive oversight to all the signed the paperwork once a year so I'm I'm concerned that although this sounds really good and have a lot of value the program that follows would really be what drives this in my opinion so could you address that please. Under the current model of as senator hammer alluded to with that athletic trainers working in the community and and working under the direction of a physician this same set up what would work the same way and again if we're talking about you know consumer protection this bill is going to act similar in on this statute of this going to acceller to what we already have now and there hasn't been any data that shown that no athlete or been injured because of care they're receiving from athletic trainers and so the same weight same would go for a National Board our men and women in uniform that are training every day we would still deliver care under the direction of our physician whether they're with us or not they still you know direct us and what you know care we can deliver under our scope. Follow up manager so this is been being done and member of other states I would presume then there is data to show that your program doesn't just keep status quo but it actually improves. And you have that data. Yes Sir I do have that data okay thank you. All right of. I'm sorry I don't know if I didn't write down your name or you Cory on the set Cory where okay if you would you like to speak for the bill of. Yes well speaking for the bill all right. Are you what if anything you want to add there's nothing else like to add that have not been addressed all right thank you all right then if you wouldn't mind sitting in the audience and we're going to start calling up funders we have for the boe rinsho that would like. To see everyone come together least okay all right so wind chill and Bradley Phillips you're going to be together and and making statements against the bill you're speaking against the bill. You're recognized state your names for the record please Whitaker mask off please. My name is Bradley Phillips and I am the lobbyist for the Arkansas physical therapy association as well as we have been at which is a physical therapy association full of PT's that on their own clinics and Mr Bower installers with me today he's our legislative chair for the Arkansas physical therapy since you're recognized. Thank you. College as. So furnished a ratio of I'm sorry madam chair thank you for recognizing us to speak in thank you committee for hearing us today myself and Mr rinsho have been involved in the legislative affairs in the physical therapy industry for fifteen years now we're not always enjoyed the healthy relationship with the athletic trainers however little over a year ago I received a phone call from Terry been them stating that he would be taking over that account and I'm happy to say that we've enjoyed a wonderful relationship with them since then Terry I have had several productive discussions about trying our hardest to steer clients toward a compromise I appreciate and respect here you Jonathan and Corey for their hard work they've demonstrated on these two bills one of these compromises is a bill that you'll hear later today that is house bill house bill twelve fifty nine Terry been amended me to drafts at the end of last year the first bill is a bill that puts athletic trainers in a clinical setting we have always been opposed to athletic trainers in a clinical setting and I guess I would best. Give you an analogy of ambulance are EMT workers we are not looking for new ways to put them in a clinic the they're already adequate people who treat and clinics so those people are are trying to deal and emergent settings just like we feel an athletic trainer is trying to be court side or ring side or field side whenever an athlete an athlete has an injury we were able to compromise on house bill twelve fifty nine Dr Israel from Arkansas children's hospital was wanting to employ athletic trainers in his clinic we did not see how an athletic trainer belonged in a clinic but we were able to craft house bill twelve fifty nine which will allow athletic trainers to practice in a clinic under the on site supervision of a physician. This is a huge win for them it It with twelve fifty nine The you'll hear later and agreed to bill that we know is going to pass that puts them in a clinic which is something huge that they did not have last year however we just simply couldn region are a agreement with the bill that we brought before you today We simply can't agree to changing Arkansas code to define something as something that it is not they're simply not educated to treat Pete the population that is added to the scope in this bill we support athletic trainers there any portent link in the chain of injury injury and rehabilitation however where they fit into the chain as determined by their education PT's complete three years of undergrad followed by three years and PT school followed by one year residency. All graduates of a PT program I have graduated with a doctorate in Arkansas since two thousand nine when the state shifted to a doctoral level programs program currently according to an athletic trainer employed by one of our physical therapist as well as information from the national association of athletic trainer for the trainers two year and a half of undergraduate pre prerequisites after acceptance into the eighty program the student completes two a half years of training The New York qualified to sit for an exam there's quite a difference in education ATV's are educated to be present court side or on the sidelines of the sanctioned event to perform triage asset assess injury and stabilize the patient well we understand that athletic trainers are making a push to become masters level programs we called the bore the athletic training board last year and asked how many applicators that master master's degree Nancy from the board stated that she did not have the information but she had a stack of the twelve most recent applicants she looked through there and there were none with master's degree. Now it is true that the entire state will transition to a athletic training master's degree program that that will be in twenty twenty six that's still a long time away Arkansas state and you're very both offer master's degree programs that are in good standing you see a has a master's program but it is on probation because less than seventy percent of the students passed their exam. You say you is a bachelors level program but is also on probation for past lace Pratt past rates less than seventy percent we recommend that these two schools offering eighty degrees bring up their programs and wait until all schools are masters level programs before we give athletic trainers a new population of patients to treat with respect to our men and women in military this bill will do nothing for them the department of defense has jurisdiction over all military bases the military is currently using epilators leading training trainers and both training and battle as a matter of fact tricare the health insurance given to all service members does not even mention athletic training in its manual. They're just over a over three hundred that but trainers in the state we've all been football games and you've seen the athletic trainers on the sidelines you don't have to be a if you don't have daughters yourself you may not know that those athletic trainers are nowhere to be found for any of our female athletic events only thirty eight percent of Arkansas high schools have access to an athletic trainer. This is not the fault of athletic trainers it's because there's not adequate education dollars to pay for it we don't solve this problem by giving them the population they are qualified to treat and have our police and fire departments pay for it with another public fund. Senate bill eighty six would simply define the term athlete to include non athletes and that's dangerous if a seventeen year old healthy athlete walks off the field with the pain in their left arm the athletic trainer on the sideline is educated to examine the joints ligaments bones muscles and tendons of that healthy athlete this bill would that military police and fire to the bill so let's take sergeant Smith the camp Robinson he's got a history of cardiac problems and the replacement is at heart attack before any set angioplasty sergeant Smith comes off the treadmill at the base in complaints to the athletic trainer these got a pain in his left arm as we all know that can be a host of other problems the joint or ligament that's not a boogeyman story that's a real life problems we had a young and healthy tennis player in their forties with the pain in their left calf come into one of our clinics Less than an hour that patient was in the hospital with a blood clot. Trainer does not have the education level to recognize something like that the athletic trainer has had six sufficient training with a bachelor's degree and six month course to deal with the significant changes with that come with a population other than young healthy athletes. One question that we always ask ourselves in that we passed the athletic trainers is what problem is this trying to fix House Bill bill twelve fifty nine the athletic trainers wanted to work in a clinical setting as athletic trainers not physicians extenders we've visited with doctor Johnson we've visited with the athletic trainers and they said here's what we want to do that we cannot so house bill twelve fifty nine we are allowing the bill will allow them to practice in a clinical setting under the direct supervision of a physician. All right I'm sorry I we fix the problem with house bill fifty nine they have yet to tell us who needs athletic trainers and why they have been denied athletic trainers we've established that the military is free to all right but it trainers and does not reimburse for services I have talked with the police chiefs association and they have not asked for this and they're not supporting announcing Roger Smith here so we might hear something from the fires Association we this appears to be an attempt to grab population because in ways they resemble the population that they're educated to treat I have great respect for the folks in the police fire and service industry that have signed up to speak we would like to apart from these people when we ask that trainer's to please tell us how our men and women and service are not receiving the care that they need from athletic trainers this will be the first time today that we've heard these concerns are you hearing Mister Phillips I don't mean to interrupt but we have lots of people on the list and so if you could just take one more minute to kind of work then I'm going to go to a Mr renshon to see if he has any comment descent all right thank you We we asked if they could tell us where they're not asking getting athletic training in the military police and fire and they could not bring anything to our attention to help fix that problem now. One of the things that we have done in the past year is we have started the allied health care professionals coalition with O. T.'s PT speech hearing athletic trainers and Collaros that would have been the perfect place to begin the discussion of what can we allow athletic trainers to do that we are not already doing and we genuinely do believe that there are niches for actually athletic trainers we just have to make sure that the primary function of taking care of our students is not lost in one last point madam chair I hate to discuss hypotheticals what we're facing a very real scenario today if both house bill twelve fifty nine and Senate bill eighty six pass you will have athletic trainers treating all of these populations in the clinical setting under the on site supervision of a physician they have expanded training rooms with this bill this will expand training rooms into military bases police departments and fire departments the language on the initial draft of house bill twelve eighty nine they asked that the physician be readily available not on site so if they remove the physician on site requirement then we will have police we are training rooms and our police stations fire department a military bases that are now clinics we want to work with the athletic trainer Sturch spoke expand their scope and profession we've already proven this commitment in working with them on house bill twelve fifty nine we want for this to population to receive care if they're needing care we just don't think redefining athlete to include them as the best way to provide care and thank Peter Mr Renshaw. Thank you. Thank you manager committee members a appreciate the I'll try to be as short as I can my name is Lauren Shaw past present Arkansas physical therapy association current legislative chair I'm a physical therapist and athletic trainer so I feel like I bring a unique perspective to to this a specific issue owner of physical therapy clinics that provide sports medicine in north Yorkshire would Jacksonville hot springs village I pursued an education sports medicine since I was an undergraduate receive education and training to become an athlete trainer in order to cover sports medicine for athletes on the field record I received my graduate level degree and and physical therapy to perform clinical we have to all populations including athletes in short I. want to PT school to be to buy a PT in an eighty Education to be an eighty I perform diagnosis and treatment of patients in a clinical rehab setting as a P. T. I'm on the sidelines of performing merchant care triage and the preventive care as an athletic trainer the Arkansas physical therapy association opposes SB eighty six as written we want to work with or athletic trainers and come up with comprehensive comprehensive path forward that everyone can support the bill is too broad in my opinion it is a piecemeal approach to a complex solution that we like to collaborate with the athletic trainers on in the same spirit as some of our National Association members on both sides of done in an effort to work together to improve health care we support and believe in athletic training most of the trains MPT seven excellent working relationship in the process of getting injured athletes back to competition we need more eighties practicing where most of them indigent themselves when they decided to go into the athletic training working with athletes on the field or court or court and helping them safely prepare for competition prevent injury and properly returned competition. By contrast PT's have been educated and trained at the clinical doctorate level for an entry into the profession with a focus on clinical rehab of all populations S. B. A. six would simply redefined the term athlete to include these three subsets of our poppy of the population who are not traditionally athletes which may lead individuals being treated in a clinical setting by professional is not the most appropriate care care giver and or being treated in a facility is not regulated or inspected as outpatient physical facilities are currently. I was asked by legislator several years ago I've been working with this for over seven years been a PT ATC coming up on twenty. I was asked by legislators person several years ago asking are the PT's against eighties And school setting and I was like absolutely not we need to work hand in hand there are currently approximately three hundred eighties on the roster license eighties in our state we have approximately two hundred seventy school districts in our state servicing a half million students this is where we need them. We need more eighties working with the student athletes in Arkansas we need to work together to find resources that will help our student athletes using public funds that will take eighties out of the traditional setting we have a shortage eighties it not make does not make sense to me maybe there's a proper path to utilize eighties And nontraditional athletic environments I recognize that but I do not believe this B. eighty six as the proper approach approach when we could work together through a coalition that Bradley mention that has been formed and we're both a part of arbitrarily adding three steps of the Palm Beach of subsets of the population who are performing activities related to. Those subsets and calling them athletes is not proper we need to work together to come up with the compact not comprehensive solution as far as settings PT's do not own clinical rehab but this is our sole focus of our education at a graduate level this should be who the public expects to perform clinical we have. At ATC do not own emergent care on the sidelines in such places as like the NFL or high school sidelined they don't own that but this is the focus of their education and what we should think of as the position as a person that should be on the sidelines if an athlete is injured as far as military firefighters and police as a close here What issue is there that is not being serviced already I would love to collaborate with all of those industries of people within that industry I'd love to answer any questions they have if possible I believe our professional associations have made some strides in working together I have a lot more work to do I believe we can come to a place where both professions can support each other collaborate in value to others place in the health care system I welcome the opportunity continue discussions with eighty so association letter sent to the Senate we have worked with the eighty leadership currently as mentioned on else H. B. twelve fifty nine and have come to a copy of compromise on language and other bills that is not happened to date with this particular bill I'm asking you to vote against SB eighty six Arkansas physical therapy association pledges to continue working with eighties And with the coalition to find solutions to solve problems so we can resolve our differences and get to the business of working together to make Arkansas healthier SP eighty six is not the solution and possibly cause more issues with unintended consequences thank you for your time all right thank you any questions for these two all right to Senator Hester. are there any other states that you're aware of that allow enforcement military or rescue services that for eighties to work with them. That work as an athletic trainer yes for what's being here do any other states allow that I'm not aware of that okay next you guys test to find that this would not affect this bill would not affect military so if I remove law enforcement and rescue services should be given this bill because it says military and you sit and effective anyway would you be okay with that. So much but to some it was this Bradley says testimony says it decided twice that this does not this will not affect the military because the department of defense already allows it so that being the case if we remove law enforcement rescue services would you be okay with the bill Senator Hester I I think we'd be okay with the solution that did something other than define them as athletes if there were another way to work out language that would define what they did for the military but we've just taken the term athlete and we're letting them into that and that is what we disagree with if they would like to do something with those military individuals we'd like to know what they like to do and help them work towards that gives you said twice this bill doesn't affect the military now you're saying that does it would do nothing for them so then they would they would offer no help to the military. So then you would have a problem leaving that in there I would assume all right I got a letter here from the From Chris Bolling's enable special warfare operator he is the head of sports medicine director for the navy seals and he's saying this is a good thing in the navy seals do this can you explain the navy seals while the wrong. So I would need to see the content of the letter but what I'm asking for is clinical re happen and the bill allows for clinical re have. I recognize fully I'm very well aware of what athletic trainer can and can't do. So that setting are they working with them individually on site overseeing triage emergent care other things that are traditionally athletic training. I can't specifically say I can say that he's. I will give you a copy this letter but he is specifically read SB eighty six and says this is a good thing for Arkansas a good thing for the military and so anyway it just seems to me if the navy seals are doing that they're not they're not putting their people at risk I would think they're not and the last question is I'm not being disparaging or cause I understand if they get into you get into very technical rehab things but like when when when athletic trainer is working with the fire department the police department military they're they're routinely taping ankles talking to people about heatstroke prepared to see when I got falls out immediately how to address heat stroke these types of things that they should be there on a daily basis to help do our physical therapist looking to be at the police station in the fire station on a daily basis talking about heat strokes and warning people as it is at a job you're wanting are they waiting in line to do that job. No we're we're not wanting that job and I recognize that that is a fine thing for athletic trainers to do not recognize that this bill expands beyond that to a clinical rehab setting is what I believe that which does not address that I would love to collaborate with firefighters police officers military the athletic trainers and come to a solution there would you give me and this my last question would you give me an example of something in a clinical rehab setting that you believe that this would give athletic trainers the ability to do that you don't think they should be doing. Sure anything it say for example you know you have a secretary that works in the fire station front desk that and how they're performing related task to rescue. You know is that is that person now an athlete I believe they would be recognized as an athlete so anything medically related this in a clinical setting. From a rehab perspective is now game total knee you get a training you know the property concerns anything done treating treating all kinds of different issues related their typical in a clinical rehab center so yes I believe that's not the the education of an athletic trainer I do recognize that they have some education exactly what you said heatstroke concussion things like that. Thank you all right Senator hammer you're recognized for a question thank members here I'm trying to understand from the from the way the bill is written how would the athlete athletic trainer be allowed to do any more than what they are and will you just turn me though no this is not but their level of training their scope of training how would they be able to do anything more. Then what they're able to do now if these three categories are grouped in. Yeah so this this bill allows them to be classified as an athlete so anything that falls underneath their scope as an athlete and they recognize that they can do all forms All Things re have so currently the way the scope is read there is no supervision and a clinical set the setting except by physical therapist which is off site five now that things could change in that language we we don't know which you know it's going to happen with that so yes that it would grant it would grossly expand to a new population that wasn't really intended to and this is the one that example I just gave it's it's gonna have unintended because it's not really narrowly defined it's broadly defined anything related to someone who relates to being a firefighter relates to law enforcement anything related to that may be able to do one quick follow manager yes. Yes what about through the action that will take as a committee. I was just going to ensure how's this going to change how insurance companies or try Kerr or any of the. Payers are actually going to treat this based on how this bill goes. Correct. My understanding is currently try Kerr does not recognize athletic trainers and that does not reimburse I think this is a first step down that road and the and other things as well other insurance companies as well they this it's obvious that they want to do clinical re have they want to agreement to be reimbursed for rehab services and this will be a step in that direction. The Alaska insurance companies for that and and read and try to go down that path but with this bill actually allow them to collect for services I mean what this bill does would not allow them to collect for services as you would be able to collect as a P. T. correct. No it does not recognize that so actually under the insurance policy that's what with that recognize that would not have anything to do with this bill now okay thank you Mr all right any other questions. All right seeing none thank you gentlemen. now we're going to the rest of the people who would like to speak for and Brian Donovan is first if you would come forward please. And for the rest of you who are going to speak for the bill if you would please listen to Mr Donovan and not repeat what he says please all right you are recognized much of it you might to identify yourself for the record thank you madam chair and members my name is Brandon on Sarcee fire department fire chief in the I've been in the fire service for twenty five years of saying the development to where old school fire has change into new school were real progressive now and and I think not nothing here today is just to let you know that we are the fireman we have today are athletes the job performances that they do and I can give you many examples if you would like but I was just I'm here for the bill I think it would be good it gives us an option to where we're on they can bring them in house they can be on house with us to help us instruct the gas improper either proper tech techniques and also if there are any stranger anything minor that they can take care of parking at least lead us and direct us in the past we need to go where there be go to a physical therapist whether it be go to a position I thank data they got a level of professionalism and also education that they can direct us and help us to Make the best for our firefighters and that looks I'm speaking for myself with the CDS there see I have not. Spoken with other like or professional firefighters and back that that I am speaking on behalf of the fire department at the for myself in the fireman the source our department so I'm open for any questions that you would have for me that that you need to know what type of things we do that will be considered athletic I guess all right any questions Mr done Donovan. All right single questions thank you so very much for your testimony thank you to we're going to Jonathan L. Rohlik. I've already spoken all right of Terry do wit. If you would come to the table and introduce yourself for the record please Sir. Thank you Matt and the members of the committee my name is Terry with. I'm a a educator a professor of kinesiology washed a Baptist university and I teach athletic training right now in a grad program there's a few of pieces information I was given a while ago I think that needs to be clarified. There are no undergraduate athletic training programs. In Arkansas. In America this was the year in two thousand twenty all people sitting for the national exam to be an athletic trainer have to graduate from accredited master's program we have three in the state of Arkansas Arkansas state has one you see a has one and so this University of Arkansas. So all programs are master's degree programs. And then just one other thing that I want to make sure I point out and under the current quote is here from the National Guard association to speak but at military installations all surrounding Arkansas employee athletic trainers to work with their service members we're not doing anything new no compensation no new competition do clinical skills that we don't already do on our athletes and that's already been will stated so I won't repeat that but as a as a veteran. As a thirty two year of service member who wore the uniform and as an educator. And as an athletic trainer I would ask that you support this bill and vote for thank you right to her any questions from the committee. All right seeing none thank you so very much next on the list is of. Cody Walker. A pass pass and didn't. Did we just call on Terry to wit. Okay. All right is there anyone else in the audience okay yes Sir. Please come forward and identify yourself for the record madam chairman currently card Damon Clark I'm with national guards thank you thank you I'm with the National Guard association Arkansas on a I know you guys have heard a lot about this so I'm going to in in the interested brevity just correct a couple things or maybe created earlier is Terry said if I sent in Arkansas national guardsmen for sale for basic training and he's injured in that training in athletic training at Fort Sill he'll be treated by an athletic trainer we put into a program that will help address whatever's injury was and it will quickly get him back into training that does not happen at camp problems and because camp problems and is not a federal military installation it is an Arkansas National Guard installation owned by the military department of Arkansas also the policies of the department of defense and referred to earlier. Are not applied we we have to practice their under the Arkansas state law this happens at camp Robinson it also applies at fort Chaffee which is a former active duty base but is currently leased by the state of Arkansas with a military department and also it being airforce base at Fort Smith which is our National Guard installation under a lease from the airport commission there and all anyone operating at those bases has to operate under the practice of of Arkansas state law and that's why Arkansas is different from us a military athlete that would attend training it one of the active duty installations that surround us other than that madam chairman I'm open for questions I appreciate you giving me your time all right questions from the committee. All right seeing none thank you so much thank you. All right we come to the list from against and those who want to speak for senator garner are you ready to close for your bill yes ma'am I understand like I told my witness is behind me that your almost time while they're gonna bring up this story. Grants the was a fifteen year old ball player in Benton high school. He was out there practicing on the ball field would also and he collapsed. As coaches ran up to him the check going. The seat was wrong what they mean I couldn't find a pulse. It had a massive. Issue does dropped him on his knees and dropping down on the verge of death. But athletic training T. J. white. Showed up. And to TJ's actions not only did he say that boy's life. He's made a miraculous recovery for the injuries we have still has a few issues but they said weeks later he was back at home with his family. Shall we trust them every single day to take care of our most vulnerable population are children that you send to school to run out there and play sports and wrestling everything else these physical activities that can be damaging and we look and we say take care of a make sure they survive. Make sure they have all these underlying health issues you know about increase your there every single day we do that every single day in the state of Arkansas. And the only thing we're asking the only thing is not that they don't do anything different doesn't change or scope of practice this bill doesn't do anything with the clinical setting that's a separate bill. Only thing that we change is a concealed little bit more of our population has similar athletic skills. Like I said earlier if you'll trust that fifteen year old kid in the hands of someone like TJ public to trust somebody like me in the same hands madam chair and close thank you all right thank you so much ladies and gentleman of the committee you have heard the bill presented you've heard for from those that are against it you've heard from those who are for it and you've heard the closing by the sponsor what is the will of the committee. The motion to pass do I have a second second all those in favor say aye. All those opposed say no. I'm sorry senator garner you have a failed to have a. Bill to bill. All right thank you so much all right to ladies and gentleman the next item on the agenda. Is anyone running for the Senate bill twenty two fort Senator Irvin all right are you wanting her okay if you go to the end of the table please. I believe you have an amendment. Spaz the Amendment was look at it for just a few minutes and then we'll take a motion to adopt. I am sure what you're looking have Roger Smith come to the table for a second time yes they will head in introduce yourself while we're looking at the amendment please check your spam member state senator district thirty three member remove my mask manager please do thank you. I'm Roger Smith I represent the orthotic and prosthetic providers in the state of Arkansas. K. just when you're ready I'll explain the amendment all right give us just a minute to look it over. All right you are recognized Mister Smith to explain the amendment thank you madam chair I appreciate that the orthopedic and prosthetic providers the state of Arkansas established licensure probably about a decade ago we're one A modification of their practice act it covers two areas let me start with the easiest area for research to help excuse me I'm sorry we didn't adopt the amendment Let's do that do I have a motion to adopt the amendment all right I have a second all those in favor say aye. All right The Amendment is adopting excuse me for interrupting it that's all right. The practice act in Arkansas covers two areas one of those is for an assistant. A prosthetic or orthotic assistant is just that in order to become an assistant it takes three years of on the job training they have to be under the supervision of a licensed to fortis prostitution and before they can get a permanent assistance license they have to be endorsed by whoever has train them. We're adding to that and opportunity to do that program in two years. At the recommendation of Representative Johnson we've added language to says if you'll take some college courses in the area of Human anatomy physiology and medical technology or terminology rather we can shorten that period to two years so we we don't want to require that they have the college because it makes it hard to hire people and once they get in the business that looks like something they'd like to stick with them they can shorten their training period by a full year. In addition to that the more important piece to us is that today there is a master's level program that trains you in both disciplines orthodontics prosthetics at the same time and when you complete that program it does require an eighteen month residency separately if the discipline you you in the past that you've taken is just or thought ex you then have to do a twelve month residency if you do prosthetics that takes another twelve months so the masters level program allows that to be completed in eighteen months and the other thing the bill does is during that residency period it allows that graduate to continue to work as an assistant so to speak he would do the same duties as assistant would while he is preparing for his board exams in Arkansas once they've completed their residency and they've passed their boards they can become a permanent licensed artist prostitutes. And I dare you to say orthodontists are prostitutes. All right any questions be happy to answer any questions from the committee. K. seeing none. Do I have anyone in the audience would like to speak for the bill or against the bill. Seeing none of what did you close for your bill. I don't think I'd be read anything to venture out clothes make a motion to pass I have a motion passed. As amended so we have a motion do pass as amended we have a second all those in favor say aye. All those opposed you have passed your bill. Thank you very much thank you for your curtesy K.. Senator hammer would you of a lamb Representative Lee Johnson who is not on the committee to go next because you you are okay of Representative Johnson if you come to the table and identify yourself for the record. We will be hearing your bill house bill twelve fifty nine thank you madam chair Representative Lee Johnson district seventy five and I do have an amendment adding center here is because right we have the co sponsored and do I have a motion to adopt the mid motion a second all those in favor say aye all those opposed okay we have adopted the amendment and you can explain the bill as amended thank you madam chair committee members present you give me this opportunity present this bill this is a good bill that's been a negotiated compromise between the athletic trainers and physical therapists in the state of Arkansas to understand what this bill does you have to understand current law so current law says in the state of Arkansas physician may supervise an athletic trainer in a non clinical setting but not in a clinical setting a with this bill does that change the law to allow a physician to expand that that supervision into a clinical setting as well it does so on a level playing field with the physical therapist and there's no opposition that I know of to this bill all right ladies and gentlemen do you have questions for represented Johnson. All right seeing none and to have anyone in the audience that would like to speak for the bill against the bill. Seeing none of have you close for your bill I'm close for a bill manager at the right puts the pleasure of the Committee have a do pass I have a second all those in favor say aye all those opposed congratulations you have thank you so much thank your committee members present thank you. All right the next on the agenda is Senate bill three eighty seven are you ready to do that one. Miniature Medicaid and you M. S. are working on an amendment on that that will make it easier we get here with that if we just pass over all right we'll pass over that one point about Senate bill three seventy nine. Okay the end of the table. When you're settled we're ready to hear your bill. Read thank members here I can hear state senator running Senate bill three seventy nine of no doubt this last year's been unusual year that's understatement out of it I think it's been a good learning experience for everybody one of the things that we've learned is that through the process and this is not a criticism I wanna make sure to state this clearly on the front end this bill is not intended to attack nor is it intended to call criticism to anybody that's been involved in the process for last year I would be legislative branch with the governor the one however I do think that is prepared and it has a provide a platform for us to evaluate our emergency a declaration process here in the state and to make sure that we as legislators have a seat at the table whenever it comes to things like we've dealt with this past year hopefully will never repeat this that we have this last year however the reality is that we may this bill is crafted and is intended to a look to the future and should up something like what we've dealt with this past year in the pandemic ever repeat itself god forbid it would but at least we is legislators would be position to where we could have a seat at the table earlier than later and that's the intent of helpless bills written what I'd like to do madam chair is just go through and just verbalize section by section of what it does and unless you want to go we way deep in the weeds will take the high road okay and then I've got a comment when I get done it may help members first of all six one is just the legislative intent one thing that we did was we did have debate I consulted with the several attorneys outside even our bureau a to determine that what we wanna do is not make sure that we don't do anything that is unconstitutional so section one is just simply identifying the intent of what the legislation is intended to do which is give us appropriate checks and balances as a legislative branch with the executive branch in the times of declared emergency when you get to section. Two of section two actually with regards to the executive orders or with the ability the administrative branch now to issue a proclamation as an executive order it doesn't it doesn't really alter that with the exception that does bring into play a process whereby if it's an emergency is declared by the governor outside of a public health emergency we would have a seat at the table when you get down the line twenty two three twenty four you find that this is the this section that talks about how that we will deal with it if it's not a public health emergency when you get to lines twenty five through twenty eight Uh state wide state disaster emergency related to public health and that's one thing that is being created new that if there is a state of emergency that is statewide that is declared it needs to be declared if it's gonna be a public health emergency so we can have the things that are in this bill inserted to give us a seat at the table when you get down to lines when you get those lines twenty nine through thirty three this is actually a piece of legislation is actually available now it just clarifies and bring a little bit better understanding this is what I refer to is to kill switch which says that we as a legislative branch that in time that we exercise the the way in which is laid out this bill we have the ability of a concurrent resolution to come in and terminate any emergency whether it's a emergency declared for public health purposes or any other emergency this is the leverage that we have is the ministry to branch to exercise power to terminate any emergency when you get to the bottom line to go over to a page three you find that it explains the the methodology which that should happen it can be done by the protein can be done by the Speaker house but also a gateway to the fact that if you have maybe a pro tem or Speaker of the house does not want to call us in for the purpose it does give weight to the membership. Eighty one in the house for eighteen in the Senate can submit a letter and we can be called into a for the purposes of terminating emergency it goes on and says. That we have the ability to that if we do come in answer concurrent resolution a vote not to renew the worksheet or terminate it's kind of a term of art in which way you want to use it and the governor should choose to be to that that we have the ability of your simple majority to override that veto and this is really all pattern come after what we do now just put into the situation of dealing with an emergency you get over to page four talks about declared being declared for public health emergency then if you drop down a little bit further it's all related public health one of the things that's in there is the debate of and again I want to make sure the members know and I wanna make sure that the administrative branch knows that this is not a bill of criticism but this is a bill of just taking where we are now and what if we had to repeat this in the future so what we did we set a minimum threshold what constitutes a statewide a declaration emergency by setting in nineteen counties are twenty five percent at that time we use a legislative branch would be called in to deal with the statewide declaration emergency for public health purposes yeah once we get to that threshold it kind of becomes I think incumbent upon the legislative branch to get involved and so if if that threshold meets and I'll give the example we're thing about we think about the flood that was coming down the river we're thinking about the ice storms we're thinking about a tornado outbreak were effectual large number of of counties personally believe that's where we need to insert ourselves into the discussion to make sure that all the states is represented you go on down that it deals with the reemphasize and the veto of policy again Slip on over to section three. Section three and we did not see that here in Arkansas thank god we have a governor that didn't do this and I don't think he ever would but in section three it simply states that the governor cannot permit us from assembling at the X. at the seat of government you know have seen situations around the country were governors did prohibit legislators from having access to the seat of government so we answer this just as a precautionary thing make sure that we would be prohibited from being able to come in when you get down to section for. This is dealing exclusively for thanks exclude this is dealing with executive orders themselves and the process for dealing with them yes just slip on through the bill and you get over to and and by the way the executive order the public health declaration of emergency once it's declared within eight days we would have to come in as a legislative branch to vote to terminate the emergency and if we voted not to terminate emergency it would be allowed to go on so the burden is upon us and one of the comments that was made by one of the legislators is that the governor has to make tough choices we should have to make tough choices to so it's position from that angle that section for deals with how to treat the executive orders which would be brought before the age A. L. C. for consideration I'm not sure we got eight or nine now but it would be brought before a LC for debate for consideration and then when you get over two it also deals with the of the board of health the you know the governor can issue statewide directors but the board of health can to this deals with the process of bringing of the decisions of the board of health as far as directives before us for consideration so that we can take them selectively one of the things that leadership on the other end wanted was to make sure that they could do what's referred to in the legal field I guess is log rolling so each one of the directors in each one of the executive orders would be considered individually one on one and the processes are put in place so that we can have a discussion that if within like one we would be able to take them out systematically or discuss them systematically to be determined when you get over two of. That when your section six. now on the the one thing I would point out is that on the directives that come out related to the public health emergency the directives that come out either from the health partner from the governor related to the public health state what declared emergency those would be put before ALC every thirty days and we pretty well took the ALC rules as they are written and applied it to the setting because that's what most people are accustomed to so we wanted to merit with that in section six and section seven section six deals with the public health directives but it also deals with the executive orders one of the things that we're dealing with and this is just real time is we're dealing with what we know is a temporary situation but we need to address it a lot of this is going to be in place moving forward so once the current state of emergency declarations go away and we're we're done and moving on it allows it puts into place a method for dealing with it but at the same time we got to deal with what we're doing now and so one of the things when you get over to section seven it deals with the directives of the Department help they would be submitted before subject matter committee which would be public health joint house and Senate and so those would all have a chance to come before this committee and I do want to just advisor to make the committee where the reality is that this passes and I believe will but hopefully it will it passes we is a public health committee will have to take up the sanction look at them individually unless something happens that this goes way March thirty first then all the separate language just goes way that's what's not codified that's watch temporary case the current one goes away when you slip on over then two eight it's a severability clause which just says you know most shall know if this is determined to be unconstitutional goes away we did have some pretty heavy debate on this does that kind of contributed to the conversation about putting in here the. Whole emergency the whole emergency powers we just felt that was given the what we've dealt with those of state the last year we thought that was just really a heavy lift number one we don't think the environment which support that we don't think it's going to be exercise we hope it's not so that's why we just limited to this piece of legislation only one other thing I want to bring into consideration is on page fourteen lines eight nine which is consistent with all the other sections we've delegated to Legislative Council that the rules can be adopted because one of the things that the leadership on the Senate side brought out is what if it's a nuclear. Situation what if we can't get here the emergency would be allowed to continue until such time that we can assemble a majority of the legislature here we delegated that to the Legislative Council in order to develop those rules so we can address that wouldn't micromanage it in the bill and then the emergency clause is there simply because that's what we're dealing with and it's an emergency and would like to get this in place as soon as possible madam chair that is the somewhere between ten thousand and hundred thousand foot view I'll be glad to answer any questions all right Committee of you have any questions okay US senator Sullivan. You work closely with the executive branch are they on record as a confirming this bill are in support of their own record of supporting. The official position of the administrative branch that I have through text messages this number one I want to say this. Some people have made the statement and I'm just put it out there this is the governor's bill I don't agree with that statement but I think also the legislative branch we have a responsibility to work with the administrative branch and bring good policy and to work with them because we're all in this together this is not the governor's bill but we did work very closely with the ministry branch to make sure the official position is that this bill comes across his desk he will sign it in the form that it is presented today. All right any other questions. All right seeing none of does anyone in the audience want to speak for or against this bill. All right seeing none. heavy clothes for your bill so would you like to close a manager I just think this would be good for the future generation of administrative branch and legislative branch and with that I'm prepared make a motion to pass at the appropriate time I think this is the appropriate motion to pass I have a second. All those in favor say aye. All those opposed. All right you have passed your bill thank you measure thank members committee. I'm prepared to do. Three seventy eight if the chair okay one three seventy eight and then we're going to have the we're going to. Here's another one that is not on the agenda but we will have you know will suspend the rules in and adopted the go ahead if this is a fairly quick when is it not it is so quick you brought a all right go right ahead this is the financial component that deals with the emergency situation I'll be very schools specific and this is modeled after the example of what happened when the one point two billion dollars came down and we had a special session eccentric cetera what this bill does is set in place how those on and and the key phrase in this is this unanticipated discretionary federal funds are work with Adam in order to get this language in the mystery branch along with represented Gazaway not I need to give a shout out to him because he's been critical in this process I wanna give a shout out Representative Gazaway but we worked with the Adam and the administrative branch this is to capture that money similar to what you would experience with one point two billion it will not interfere with your tornado money your federal you know you federal money that comes down to counties to help clean up with ice storms and flooding and all that kind of stuff this is just to capture that on anticipated discretionary fund and basically what it does is before gets spent is gonna come before us is legislative branch but they will have to submit the plan with how the money's going to be spent that way we have that discussion before the fact instead of after the fact and that's the essence of the bill manager all right ladies and gentlemen you have questions. All right seeing no questions. Of this anyone the audience want to speak for or against this bill. All right seeing no one to speak for or against you're going to close for your bill manner share I will close the bill make a motion do pass appropriate time all right this is the appropriate time thank you ladies and gentleman you have heard the bill explained in there are no there are no people here would like to speak for or against it and we have a motion so we have a second all those in favor say aye. All those opposed congratulations you have spent you have passed your bill. Now we're going to suspend the rules for Senate before House Bill thirteen fifty one. And this is represented wings bill and of Senator Scott Flippo is going to present the bill all right let's of the I need a motion to suspend the rules okay I have a motion to have a second all those in favor say aye. All those opposed all right the the rules been suspended and you are recognized to present to House Bill thirteen fifty one thank you madam chair and thank you members I hope this is a non controversial bill the others no known known known objections to it came off the house floor would ninety three votes I believe and so what house bill thirteen fifty one does is it is intended to limit the harmful effects of poly floral kill commonly referred to as P. P. A. S. P. F. A. S. and what it uses with the harmful effect for firefighters in the environment eliminates its use and training purposes so it can't be used in any training purposes PP E. F. A. S. is a chemical is put into phones and what these phones are used to is present liquid fire supposedly fires at four refineries airports gas stations so not like a house fire or anything like that firefighters association fire chiefs association are supportive of it this is already been done by the department of defense and it doesn't expand its use it only if it only you know restrictions used to real life situations and with that I'd be happy to take any questions alright ladies and gentleman do you have any questions. All right seeing no questions do we have anyone that would like to speak for the bill or against the bill. All right seeing none of. Any clothes for your bill I'm sure I'll close my bill on a motion to pass the preparatory all right to. Ladies and gentleman do I have a second I have a second all those in favor say aye all those opposed congratulations you have passed your bill ladies and gentleman that can collude agenda I don't see any other business so we are adjourned.