Public Health, Welfare and Labor Committee - Senate

Thank you madam chair my name is Jim Dotson state Representative members the committee I bring before you House Bill eleven sixteen which is called or better known as Simon's law. And it's my pleasure to bring this to you OR my honor rather As as you will see this this is a law that when I first found out about it It was as well as things like why isn't this the law already Simons this law is in a nutshell the requirement that a a provider for a hospital doctor or whoever it is has to get the consent of a parent or legal guardian before putting a do not resuscitate order in on a minor and so that that's kind of it in that shall two can I go back the reasons called Simon's laws in twenty ten a young boy and newborn was name Simon. I was born and had some medical conditions and. As he was getting ready to go in for heart surgery. he had some you started to have some medical issues and the medical staff and personnel were not coming to the aid of his parents and they had watches his as their baby helplessly died in our arms Because unbeknownst to them the condition that he had was had a secret fertility the the hospital had a secret futility policy on it and they put a do not resuscitate right resuscitate order in on him without their parents his parents knowledge and so that began a process in this is in Missouri this was in Missouri this is not Arkansas that begin a process whereby they began to try to get the law changed to make sure that this never happened anybody else again and so far Simon's laws passed in several states most recently in Missouri after several years where they got us on the books and that's when I first became aware of it I found out about it in twenty nineteen the summer twenty nineteen when it passed to Missouri and like do we have this in Arkansas find out we don't and drafted this language since then I've worked with the various stakeholders in Arkansas were unaware of any situation in Arkansas that that this is ever been a problem and we're just trying to make sure that it never becomes a problem for any any Arkansas family in the future there's no known opposition that at this past Out of public health in the House ninety six to zero in the House floor and is before you today and it's my pleasure to give you guys the opportunity to weigh in on the more happy to answer any questions. All right Committee it's time to ask questions Senator hammer you're recognized for a question the committee I just need some clarification understanding something Page two line seventeen in nineteen. The. This section doesn't apply a I probably get to married to pregnant and the other but with regard to those children that are in custody at the patient corrections or the Department of Human Services. With this. Main. Who would have that control of the children are in control of those two agencies. And what it means that the division would be making the decision or no decision at all could be made or should they be given. Automatically covered. That they cannot be considered do not resuscitate. If they're in the care of these two. So. I think if I understand your question correctly The reason that that section is in there is if they're not in the custody of a parent or legal guardian this doesn't apply to them if they're in the custody of DHS at DHS would be the ones responsible not the parent or legal guardian to for making those decisions okay but are we going to give direction to or we can give direction to. Are we gonna require the Division of correction and the Department of Human Services tell. To make sure that children in their care are going to be given lifesaving. Manner what if the Division said no we don't want to do that. What what authority do we have to make the Division do that. That is that is a question I haven't contemplated prior to now so I don't know the answer to that one off the top of my head and I would just hate for child get the custody of either one of these agencies and we got good agencies now of. But I'd be afraid that may be an employee of one of the two divisions would just say well there it's my decision because they're they're in the custody of the state and no we're not going to give them life saving treatment I think we do have some. Do these things if it. So if you look under item Jean. It is set to specifically set out in the section of minor has all rights granted to a minor and the Arkansas health care decisions act and it points to that section of the code that's already in there That was something that we would specifically put in this bill or that the the hospital association actually requested we put in this bill so that because we I guess we haven't statute already on the books that kind of governs those decisions so It would points to that if it's something in here was not specifically covered. That makes sense yeah thank you thank measure all right any other questions. All right seeing none does anyone in the audience want to speak for the bill or against the bill. All right seeing none are you close for your bill I'm closed all right of ladies and gentleman of what is the pleasure of the Committee all right do pass from Senator Hester second from Senator Davis all those in favor say aye all those opposed you have passed your bill thank you Miss madam chair and members of the committee. All right going on down the agenda we have representatives in content Pilkington. If you come to the table please Sir. Introduce yourself and then when you're ready. Would like to hear your bill. Thank you madam chairwoman and don't worry about between my name it's not the first day. The unnamed it's often hard to remember my first name so at. I understand. Okay I have my guess from UAMS come up introduced themselves thirty percent alongside yes. If you would introduce yourselves hi my name is Tanya Johnson and I'm the director of nutrition services at UAMS and oversee our current middle class all right. My name is misty for money and one of the positions in the in a tall adjusted Arkansas children's and UAMS and I'm the director of breast feeding medicine of both institutions can. I am also one of the staff neonatologist that both you and mass and Arkansas children's hospital and I am the assistant director of breast feeding medicine it both institutions of. You are a physician are you not all right thank you all right Representative Pilkington thank you so much Today everything to a bill to establish a breast milk bank at UAMS I'm sure many of you probably remember at last session we passed legislation to create rules to establish a breast milk bank and hoping doing that was having the depart Health is that with these rules we would have someone step for what you're create a breast milk bank in Arkansas and UAMS is one of those institutions that stepped up and and wanted to to be a partner in this and so by doing that we wanted to create legislation that would allow them to create this bank and to create the fund now. A point of clarification to this bill has no funding attached to it so you're not so with this vote is just merely on allowing the creation of the funding creation of the bank itself no funding in general So would you may ask why are we doing this what is the role of the state to do this well. We already import mail from other states it's something that we desperately need right now with hospitals it's been over eight hundred thousand dollars a year that we're sending of Arkansas dollars two out of state and up because of that we have terrible outcomes when it comes if an attorney health and we have hospitals that would like to expand their their breast milk delivery to mothers but because of this shortage but not having a bank of the state or not allowed to do that so our hope is to keep state dollars here in Arkansas there numerous benefits to having a bank in the states we see that their breast milk that we've been able to reduce the amount of sids and a long term health of. The disparities by having breast milk thanks in state so we're hoping to have that in Arkansas you know we're one of the worst states when it comes into mortality and we're trying all we can to prevent it. The quick I did not present today so this is all from memory but I have one of the best teams in the state of Arkansas with me today who I think and also kind of shed some light on how important this is and how the bank will actually function because I think that's kinda where somebody else questions might be is is how does that function so when it turned over to them to kinda To Make sense out of my ramblings. All right who would like to go first. And if you and if someone says what you were going to say it of you might. Decide what you want to speak or not so the. If you don't mind just be. The sink and to the point all right thank you and you're recognized yes ma'am thank you madam chair again I'm doctor for money and one of the neonatologist and one of my specialties is breast feeding medicine and nutrition for infants and neonates we use donor milk which is what this breast milk bank would be providing to hospitals and nurseries around our state as a medical need it helps prevent some very critical illnesses that can be life threatening and are premature infants particularly something called necrotizing enterocolitis is a life threatening condition of the intestines that involves infection and inflammation at the very least involves a long period of antibiotics and not being fed and IV nutrition and at the worst can result in the baby's death and if they do survive that long term medical costs that extend not through hundreds of thousands of dollars within that hospitalization but throughout their life so for premature babies in particular. You can't get mom's own milk which is always our preference donor milk is a lifesaving therapy having a breast milk bank in Arkansas will help support breast feeding mothers by including on the in the within the state and emphasis on the importance of breast feeding and telling people across the state healthcare providers and families that breast milk is important for the health of our mothers and babies around the state. And it will give us the means by which we can then start to promote breast feeding more in the regions where breastfeeding is lacking and eventually hopefully not necessarily need the donor milk because we've got the milk from the mothers but having that donor milk for those instances where we do need it and be able to promote the health of our infants. All right. UP next someone else like to to speak. If not I'll open up for questions that go right ahead. Well I'm I'm good you are you okay. We don't want to keep you from speaking because I have some questions this is a kind of a new thing for me and to. The. Can someone just run this through this if we have a milk bank here it it takes the milk from the mothers of the babies who are in distress is that right what what what does that tell us a little bit more about it this state probably tell you a little bit more but what from my understanding what I work with that you a mess in our neck you is that we have babies moms who can't produce milk or who may not be able to feed their infants so then we purchase milk from other mothers who may have donated added at a milk bank and another state and then we take that milk and give to those infants and so our main challenge is a state is finding adequate supply of milk from other states because states primarily their concern is their own state so they take care of their own first and then we purchase where we can when they have excess of need and a lot of times we have moms who are willing to donate milk in state but we don't have an adequate resource for an easy way for them to donate and so there for their milk is going down the drain they're throwing it away because they can't easily donated and that some life saving you know milk that we're disposing at a city of Dr Kim do you have anything you would like to add. Just as a point of clarification the milk typically comes from others that have delivered healthy term newborns and that have an adequate milk supply for their own child and make excess milk that they would then like to donate to a bank and they are not paid for this milk so this is not for profit on and as Tony was saying that there are lots of moms across the state and that to sit down at their milk but the milk donation process is is not convenient and by having a bill bank in Arkansas we would again as Dr Ramani said continue to promote increase breast feeding rates in Arkansas which benefits the entire state as a whole but also allow the mothers of our state when they're considering donation of their milk assuring them that thought medical stay in Arkansas to benefit the care and the health of the infants in this state. Thank you any questions from the committee all right of center to hammer thank you measure could you just state your case about the delivery process is it going to be at UAMS in little rock and children's or how are you gonna handle collecting from all corners of the state and be able to know that it's it's a. Okay once he gets to where we're gonna be stored that's an excellent question thank you senator hammer we will have depots or drop off spots spread out around the state so that women from all corners of the state will be able to easily donate their breast milk it will go to a central location House by UAMS for pasteurization a process that make sure that any viruses or bacteria or harmful substances that might be in the milk are taking care of so that the infant Senate spent two or them not harmed by that there's an extensive testing process that is probably more stringent than even donating blood to make sure that mom is healthy and that the milk is safe before it goes out to the babies once it is then pasteurized imposing it will then be shipped to the hospitals around the state that would like it so as having an automatic bank here in Arkansas will be able to prioritize our hospitals to make sure that they have the breast milk in the the donor breast milk that they need to keep their babies healthy. You know right now how much you spend buying milk from out I heard thousands but I mean idea UAMS so we spent around fifteen ten to fifteen thousand per month depending upon our senses but state wide when you count children's Northwest Arkansas campuses Jones borrows things like that it's roughly eight hundred thousand dollars a year that we spent a. Mainly in North Texas Michigan we get it from all of where we can get it you feel it's going to be revenue neutral as far as or will it be a actually create a savings and it should create a savings in my at thought processes right comes to that okay thank you Mr are any of the questions. All right of. Does anyone want to speak for the bill. Does anyone want to speak against the bill. All right sent a Representative hated you close for your bill that's like that that it passed unanimously out of the House committee and units on the house floor and I hope I get a unanimous thank. Okay what's the pleasure of the Committee I have a do pass second all those in favor say aye all those opposed congratulations you have passed your bill and ladies we thank you so much for being here thank you for having us. All right next on their agenda is Senate bill two ninety five then that is Senator Flippo. All right when you're ready Senate rates okay and we might have for. Sure yes yes ma'am I will go to great first name is Scott one of which the last one so let him introduce himself manager Scott Center Reno hi Scott center in Ohio willing to Scott thank you madam chair and thank you members so Senate bill two ninety five is that's exactly what the title says is to promote integrity in our welfare programs and to amend the Medicare Medicaid eligibility system so currently the state and DHS is already doing a lot of things in this bill and what you are seeking to do which is to codify what they are currently doing however there are some some some some some changes and reforms that we have put in here and I want to walk through that with members and so if you look on. Page one starting on line thirty four what that is is it's a dot data cross check in food stamps and require the department to cross check and state data sets to verify eligibility for benefits and that does include lottery winnings death records employment records and out of state EBT transactions. And then moving down. If you go to the bottom of page three starting on line twenty nine. The the second reform in there is going to be the reporting requirement and requires food stamp recipients to report any changes in circumstances like income residency and that's got to be within ten days of the department can re verify the eligibility. And then on page four starting on the one twenty five as the third major reform in here and that's not required data cross checks in Medicaid and that requires the department to cross check state data sets the verify eligibility including lottery winnings death records employment records and out of state EBT transactions department must also it out independently verify all federal exchange applicants. Going down to Page six starting on line sixteen. Fort reform is going to be to mitigate the damage from the federal Medicaid restrictions and several federal legislation that's kinda hand cuffs Arkansas Medicaid program is a lot not allowed us to roll anybody even if they are in eligible and so what this statute does is it just kind of heard section skews me does is it says the up once those handcuffs come off it's going to require a full audit of our Medicaid rolls to. one think it's come off and activate remedies in the mean time it's just to keep up with the eligibility check ins. And so that wouldn't be applicable until the federal laws change. And then down on page seven story on line nineteen. Reform hospital presumptive eligibility in Medicaid so today's hospital practices presumptive eligibility for Medicaid coverage opens Arkansas up to millions of dollars in waste and fraud this bill would require department to seek federal approval to return to pre obamacare every practices and limit this process to children and pregnant women it also creates a three strikes you're out system to enhance perfect cation. That's it. And so I'm gonna ask The other Scott if he's got anything that he'd like to add to that sure thank you madam chair and thank you senator just by way of introduction of Scott Center Reno I'm visiting fellow at the opportunity solutions project before that I was an assistant Attorney General in Louisiana it's great to be back in Arkansas even though you know I'm an outsider here I've never felt like one and I really appreciate your warm welcome I'll be very brief for this for the sake of of clarity and just add some color here as a senator said I'm more interested in answering your questions as they come up if you have any I I of course want to urge this committee to support this comprehensive welfare program integrity bill all reforms all all major forms of the as the senators outlined will help Arkansas with its present budget situation which obviously I don't need to tell you all about but really at the end of the day this is less about budgets and more about the people is about making sure that benefits are going to the truly needy which is more important now than ever obviously the safety net. Is critical for those families and they can only be strengthened fiscally fairly morally if its benefits to reserve for folks are actually eligible so just to highlight a couple things as a senator said one of the main features of this bill is regular thorough periodic cross checks that's exactly what it sounds like it means the department's will talk to each other and and it seems that they're doing some of this now which is great but just make sure that the departments are talking to one another to make sure that folks getting benefits are getting the right benefits and that they're actually eligible for that and you know obviously in the real world when people especially able bodied adults they move they get married they get jobs they get races they die things change in life and it makes sense to check eligibility more than just once a year or at most twice a year so that that's one of the things that this bill really focuses on. as the senator said it changes the standard default from simplified reporting to change reporting in a nutshell that basically means that everyone on food stamps will be required to report a change in circumstances within ten days if it's over a hundred dollars rather than putting the the onus on the beneficiary to know what that the eligibility guidelines are to know exactly what a hundred thirty percent of the federal poverty level is in any given year and it changes from year to year and it puts that that on this a little bit more on the department to be able to sort through the new data as it's presented to them Senator also mention the the mitigation in this bill with the maintenance of effort handcuffs and they were they truly are handcuffs this bill obviously doesn't take those and E. handcuffs off Arkansas just like every other state that accepts the boost in Medicaid funding is has its hands tied behind its back right now until the public health emergency is is rescinded but this will help to get all out of the hole that that you'll be in on the Medicaid front and last but not least is the senator said it It tackles hospital presumptive eligibility which frankly X. excuse my blunt language it's not the sexiest name for a concept hospital presumptive eligibility but it really is a pretty big deal millions of dollars of waste if not outright fraud occurs through this loophole and just to put it simply may be oversimplifying it this is when if I show up at a hospital in Arkansas anywhere in the state the hospital if I answer just a couple questions about income and say that I'm under the income threshold the hospital consigned me up for Medicaid I then get whatever coverage and services the hospital provides and the state is on the hook to pay for whatever cost sine Kerr even hundreds of thousands of dollars whether or not I end up actually being eligible for Medicaid the state is in no way under under federal law to claw that money back so you can imagine the incentives that are lined up for hospitals to do that job well so. This this will require the department to seek a waiver to limit that practice back to its original narrow goal of just pregnant women and children which is the status quo before Obama era regulations just that narrow population but even if that waiver doesn't end up getting granted by the feds this bill will implement a three strikes you're out provision to encourage hospitals to get these determinations right in the first place with that I'll stop yeah bring your in and make sure that I leave some time to answer any questions that you all might may have all right of. Senator Flippo one notice that you have an impact statement would you explain that sure if you want to look in your your folders there We got a different a impact statement so there's there's there's no revenue impact and I think the the biggest thing is going to be just the time and effort this can be required to be some education for some Department of for some of our state departments and certainly I think some some educating some members of the attacks community Also that I'll be happy to answer any questions that any members I have on that I know I think we've got mark white back here he's gonna. I'm sorry you said what you have mark why I think he signed up to speak on this so he might have talked a little bit of this autumn just be happy answer any questions that members have. All right let's see Senate today this and then we're going to Senator hammer. You're recognized. A madam chair M. I. see the ward's essential winning several times throughout the bill and is that to find anywhere and how do we do with those words against the estate show winnings. So Page five line ten it also says it goes off. Page two line twenty three and twenty four so Senator it's it's not defined in this bill typically what that means under federal law in in related statute is about three thousand dollars okay but it's not defined here but there's in other words there's some discretion baked in on that front for the department. More than likely they they use the three thousand dollar threshold based on other law but that's a question for them okay thank you and follow up please yes and I'm curious and. I understand the goal is to you as reduce fraud waste and abuse in government of course that's something that I'm certainly prevented at various and if we know what that looks like an Arkansas do we have any estimates of what we think and maybe even based on national and averages of what that fraud may look like in Arkansas right now sure so. Not great but that's true everywhere right now is the short answer so the Medicaid improper payments rate I'll just take that one because that's the biggest in your budget and and in the waste factor In Medicaid in twenty nineteen the improper payment rate at least for the cycle that was under review was about fifteen percent if I'm not mistaken this year or twenty twenty I should say it went above twenty percent that's related but not exclusively the result of the and we handcuffs that we keep referencing that really if I can kind of go off script a little bit that's basically fraud by design frankly it's written into policy it but you cannot remove folks who are ineligible and so that's just written into the code that you will make those improper payments basically and there's nothing you can do about it on the food stamp front Arkansas's improper payment rate is actually not bad at least before code that's the latest data we have it's it's a little bit less than the national average which is to say a little bit less than five percent but still lower than a lot of states are still higher than a lot of states I should say and there's still plenty to be done but that's a credit to the department for doing to the extent they're doing these things that that are covered in this bill that's great like I said it's probably why they're in better shape than a lot of states but there's obviously still work that can be done. All right Senator hammer you're recognized for a question. Thank you measure on page seven I try to get my mind around. On line thirty two. A decision making presumption presumptive eligibility determination a hospital shall. Do we do that they do we do that in Arkansas and the how does that play out as far as holding the roof the hospitals. Accountable if they don't is that the three strikes in outers or would help me understand that yes senator so Arkansas does have hospital presumptive eligibility right now to answer your first question how that plays out is the hospital kind of the example I used to somebody goes into a hospital and answers a couple questions about income the hospital makes that determination so to break it down just one level deeper the Department decides which hospitals are qualified health entities they decide which hospitals can make those determinations and so that's the leverage that this bill uses it says okay so hospitals in order to be a qualified health entity to enroll someone presumptively into Medicaid without doing any kind of paper check of immigration status income level without doing any paper verification of the person's eligibility we're gonna make sure that you are within this regime of the three strikes you're out provision as you said senator so this is that that's the the three strikes you're out provision as part of this bill the status quo does not have any kind of sanctions that you can you can ask the department they may have more information about whatever sections they use now my understanding is that it's it's a pretty light sanctions regime if there is any and I know that they cannot get any money back when that's obviously the big ticket items so by going to the hospital after a car accident or you know you name it and I get a hundred fifty thousand dollars worth of services I can say I have an income of five thousand dollars the hospital signs me up for Medicaid the state is then on the hook for a hundred fifty thousand dollars medical care and if I was a millionaire and had you know a million dollars of income every year. Too bad so sorry the state's long hook because that initial presumptive eligibility determination was made that lasts for the duration of the visit and the St still on the hook the answer questions under it did not follow up after this. So on the three strikes and out that's against the hospital correct yes it is yes senator it it would basically premises their status as a qualified health entity on that regime okay and on that three striking out is that like per patient or if they got a thousand patients and they do it three of a thousand then they're out or is it like Joe Smith comes in at three times a do it on Joe Schmidt's which one is it that's a good question senator the latter so it is not it's not limited to one patient is limited to all patients. Okay so the three strikes and you're out. On. One patient on all patients all patients this is how how did you come up with the threshold of three. Three strikes. Simple that's it's just what everybody else does with your kids that kind of thing about this more more specifically what I mean other than it being that the rules of baseball senator inside it where this comes from specifically is what mane did they use a three strikes you're out system and they found that it worked in terms of reducing the or increasing the incentives to get the determinations correct so what we try to do is see what works in other states and help states find the solutions and the seem to work in Maine when they use the system and that's the one thing that you can do without approval from the federal government limiting this practice in general which is obviously the first choice of this bill is to get this waived so that this only applies to pregnant women and children where if you're able bodied adult you can't just you there has to be some kind of verification of income before they're they're enrolled in the Medicaid but short of approval that kind of a waiver if you're stuck with the current regime and this applies to everyone then what we found in the main experience is that this worked in terms of increasing incentives are thank you thank members or any other questions from the committee. All right senator Davis. And I'm curious if we have an estimate and on how many people are regularly winning like three thousand dollars and I I guess a year and a lot I'm just trying to get a feel for how many people this may impact in the program and if the threshold is three thousand then how many do we anticipate maybe we need a lottery person here for that now they're not you guys are sharing data I understand I'm kind of curious that would impact how many that would impact Senator that's a good question I don't have a specific number for Arkansas I can tell you that Michigan use this the state across checks and pulled more than you might expect I don't have a specific number from me but more than a thousand folks that were pulled off of off of food stamps in Michigan and I think Medicaid as well due to lottery winnings but it's it's more than you might think it's not just one or two people as as I think you probably know senator. All right any other questions. Seeing none. Does anyone in the audience want to speak for the bill. Does anyone want to speak against the bill and we have for mark flight from DHS that wants to speak on the bill so we'll. Let him come and then we'll go back to for and against. Into tissues for the record please. Thank you manager mark what was part of your services first also say I certainly appreciate your vote on this bill we had a good meeting with him we do have some concerns about some of the language we think there's pricing changes that need to be ready to make sure that the bill does accomplish the goals and intent but Senator Flippo as a graciously agreed to work with on that so I expectation is that we will probably have an amendment on the house side bus will be up front with me about that that that we're working with them and we appreciated cooperation and it will work to improve this make sure this is a good bill I do it how do we correct the record record on one thing respectfully we do not currently do hospital presumptive eligibility it is required under federal federal regulations however we've had system is systems issues and obstacles that have kept us from implement implementing that we work to see miss over the years and they've been okay with that and so now that may change down the line particular this administration believes at this point we do not we do not use percent of eligibility for hospitals and have the answering questions any questions for him all right to senator Sullivan. Thank you manager and while back we had some problems with verifying eligibility across state that we would send information Informatik a patients who receiving benefits in other states and Arkansas we had ten twelve fifteen thousand people that we fail to verify is that in any way impact for here we are we checking this same population for a check amend state over checking them out of state to we are doing state checks and so we don't have ten thousand people were missing anymore. I don't believe I don't believe so okay I mean we had a glitch a few years ago right of a reckless check it out. Yes that's the notice to Paris matching and we we are doing that okay thank you thank you manager. Any other questions. All right of thank you so much for coming to the table and helping us. With this all right the so we have no others that want to speak on the bill are of Scott cintura to know you have really spoken for the bill come on back and and I believe your testimony was speaking for the bill. A. So ladies and gentleman madam chair back and just you just very quickly address Mr Weitzman's comments I want to thank mark and I enjoyed our meeting yesterday and you know the whole point of this is not to to create on you know you know impossible burdens for DHS to add to that that to go along with us to implement this night deal that we actually want to move the needle and tighten up the verification to make sure that we're conserving our our our our resources for the truly needy and for those that are eligible and so we certainly have given mark and you know my word that I will work with him and others and if we have to amend some things in the house and you know to make sure that this a Bible process that is workable for them that we are going to do that I want to assure you enough my other members here today that that's going to happen okay is that your closing six minutes that's all right. Right ladies and gentleman you've heard to the bill you have heard those for and against you and one speaking on the bill and you've heard the closing of what is the pleasure of the Committee. I've got a motion the second all those in favor say aye. I'm sorry go ahead I apologize madam chair but just full disclosure my brother one of my brothers is a lobbyist who has several clients and has worked I know on this bill so I just wanted to disclose that under advice from Steve cook also have a letter on file to describe that as well but I believe in more integrity and more accountability so I will be voting for this bill all right thank you thank you. All right to. We have a motion we have a second all those in favor for this bill say aye. All those against congratulations you have passed your bill. When the member's. All right. The next bill on the agenda is Senate bill three oh one and it has a fiscal impact statement as well and the city of senator Sullivan when you are settled and ready to present your bill. we're ready. Thank you madam chair and committee I want to kind of go through the bill with you so that we know what it does and what it doesn't do in the words are very familiar to all of us and I don't tire of hearing them is that we hold these truths to be self evident that all men are created equal there were endowed by our creator with certain inalienable rights life liberty the pursuit of happiness you all heard those many times in the Arkansas motto of the people rule and this bill is really about the separation of powers that one branch has the authority to make the law and one branch has the power to execute the law a unique philosophy the government of men. And you also are familiar with the statement freedom is only one generation away from extinction Act extinction. Our state government is going to punish or fine or otherwise infringe on those principles of life liberty and the pursuit of happiness as our declaration says governments were instituted to do that it should be by the consent of the governed through their Representative form of government. Here we passed a bill just a few weeks ago Senator hammer at the bill that said we couldn't find a business far couldn't customers who violated rule we passed that this is kind of a add on to that are partner builder that if senator hammer would allow that what this bill does it makes a statement that elected representatives have their voice heard that we will actively protect our citizens as individuals their businesses and their groups from authoritarian rule. They know that we've got their back. What this bill doesn't do it doesn't determine the value of a directive so all those directives that came under the emergency this doesn't determine each one of their values. After the governor's opening address to the house in the Senate he offered an open door policy and Representative Gonzalez and I took him up on the offer that we met. We had already filed several bills and I've got to back up their of the directive that needed to be extended so we anticipated that And a group so we agreed that the director for necessary again This doesn't talk about how what the value of those are. We are for our full assistance in passing away of legislation and several of those bills are working their way through the legislature now. Let me walk you through the bill. I'll try to do it quickly and if they have some time for questions but Page one line thirty five. Of the health directors or orders failed to provide alternative compliance opportunity for business yeah there are a lot of states that have these directives that offered alternatives in compliance and other things they could do this bill did not offer any of those any such alternative compliance. On Page two line one it talks about arbitrary fines only to be to restaurants or personal care businesses you know the when you look at the list of who got find. It's only our small businesses and restaurants you don't see our big box stores you don't see them walking through the legislature here finding any of us although none of you would do that I'm sure but they don't find us you don't see those people on there I want to ask Department of Health very pointedly this appears to be targeted and it's on video they said no it's not targeted that's just how it works out. You look at the finds it is targeted. You know when we look at the I have and have a paper that I got from department of health on the rationale for why we at eleven o'clock closings we had a study of Wisconsin on there that says if you live to a certain distance within a bar from the bar you're more likely to get colder than you are if you're not they use modeling the U. Switzerland. They're very selective in what states they the model you can go on the CDC website all fifty states and you can pull up six at a time and compare their trends from the beginning of Covin the the data that I think March eleventh you can look at those transfer market March eleventh every day until now and in Arkansas we rate we do well but you can look at the states that are more open in Arkansas who do just as well and I think the department of health was very selective in which stage they follow. On page two. Lime three it talks about the negative effect on businesses I think if you drive through your community you've seen that. Page two line thirteen it deals with any subsequent emergency orders so this order ends in a subsequent one comes up which will probably happen in a few days this would still apply. in line thirty three if we continue to collect any fines in any way it allows far things that have been a five violations anyway so for restaurants people are washing their hands and taking those regular precautions it allows those fines to be collected. does this hinder the executive branch their ability to enforce the law yes. Without legislative participation it does. Does it hinder going forward yes without legislative participation are there solutions and compromise possible yes when were involved. Yes I thank someone asked me if the this would handcuff the executive branch and I say yes but they have the handcuffs they put him on they have the key in that can take him off. Just think about the decisions that you've not been a part of you've not been a part of the vaccine decisions you're not been a part of setting thresholds and big benchmarks for opportunities to changer in the emergency order you've not been a part of defining essential businesses you've not been a part of the educational process and how we impact our schools you've not been a part of the business impact you've not been a part of religious freedom. You've not been a part of determining what is reliable evidence to support the directives you're not been a part of reliable outcomes to make their judgments. Colleague this is a statement that your vote on your constitutional obligation to fulfill the consent of the governed. You know the last thing I mentioned this earlier today the administration knew when they did the executive order that it within one day and all these things that have happened since then you were coming up in a real scrambled out of passed different laws that we're going to be heard it's going to be difficult they've known for a while that was going to happen they haven't prepared this is our chance to say we want to be a part of what goes on thank you and I'll answer any questions. All right ladies and gentleman do you have questions for senator Sullivan. Any questions. All right of this anyone see I do have a list here we do have some people that want to speak against but does anyone want to speak for the bill. All right of we have for the. I'm many mispronounce your name that looks like a door Lee Chandler. yes come forward please send of state your name for the record please. Chairman committee my name is Doorly Chandler I'm the director of the alcoholic beverage control and I am here today to speak against the refunding of the funds that have been assessed. At this point as everyone knows because the nineteen start impacting the Arkansas in March the March the declarations were put in place and the department of health issued directives towards businesses. The alcoholic beverage control. The license permit locations became a focus of the environment is different and I B. C. permitted location And that for other commercial businesses you have close proximity removal of mass to eat and drink a generally speaking louder and projecting so that you can be heard over music and other events going on within some of these permit locations. The sole intent was to protect the health and safety of employees and patrons and others with the potential exposure and to try and keep the state functioning without a complete closure. So in March we started receiving complaints when the directives commonplace from members of society that local entities runoff complying with these regulations. And so we would I for those complaints the director of enforcement agents would go out and they would to complete inspections if the agents witnessed an entity that was not following the Department health guidance they would issue a report that would get forwarded to administration. And we would evaluated about July July first of July is when the husband nineteen inspections became for systematic for ABC's and Forsman division. Since the law one ABC enforcement has reported made from the director that they've conducted over six thousand checks two hundred and fifty of those reported have been reported and forwarded it to administration for us to adjudicate in some form less than five percent has been forwarded to us of those checks. And I think it's important to share with you these numbers that since March of twenty twenty one this all began two hundred fifty seven reports were Ford and total. Administration issue thirty three written warnings to permit holders there's two hundred twenty four potential monetary penalties remaining consisting of a hundred ninety one different locations. Sixty eight had paid bonds to date sixty nine are still pending review by my attorney staff attorneys seventy two offers have been issued with no response to date and fifteen or set for hearings. Where did these reports from an met from enforcement. For not one criteria but for there's not one overriding controlling criteria that multiple we compare the facts in the report to the Department health guidance is that were issued the number of times there's been a violation for specific permitted location and prior issuance of a warning to those. So I'm sitting here asking you all to consider not refunding the fines because of the message that is being sent. Majority of your constituents complied with the guidances and criteria from the department of health less than five percent were referred to ministration to review. The bonds issued resulted in from behavior within the control of the permittee less than five permitted locations that ripple report for Ford to administration indicated exclusive patron noncompliance and that but that behavior was invited by the permittee three their signs indicating that they do not require facemask or when they're doing IT checks make sure someone was twenty one entering that club they told them not to worry about wearing face masks. Or they opened up the dance floors to allow patrons to dance. Establishments that disagree with the offers of settlements that we have issued have the ability to come before a director's hearing there's no honors unfair burden. Thank you requested directors hearing they do not have to be represented by counsel they don't have to pay a fee to have an appeal we haven't set up right now I have them set up as a go to meeting so that the the permit holders do not have to take Kerr that expense to travel to little rock for this hearing. And to date fifteen permittee's have hearings less than ten percent have requested hearings just this week we had a hearing in From the six hundred dollar fine down to a written warning. These are valid lawful directives that are undertaken in good faith to protect the health and welfare of the citizens of Arkansas and in an attempt to keep from a complete in Kenya tenuous shut down refunding these funds ignores the rule of law and integrates not only the agents of spent day and not working but the ninety five percent of the constituents that sacrificed income in an effort to comply with the court with the criteria set out by the department of health. Everyone as we know has an opinion regarding the efficacy of the guidance in the criteria just as people do about whether they should be prohibited from smoking in public or being fined for not wearing a seat belt this is about a larger picture if you all like to immunize the funds you're setting a precedent that if you don't like the rules contrary to the hard work you all put in place to create these roles they don't have to be followed. Responding to route rewards the non compliant behavior and for other purposes those that have complied. And for these reasons that I think that the funds should not be refunded. All right have you finished with your remarks are does anyone want would you the. Would you be willing to answer questions yes ma'am all right does anyone have a question all right I have first ahead Senator hammer and then we're going to Senator Flippo you're recognized senator Hanson. The center for promaster same question last but I just want to point out we didn't have any involvement in making the rules you made that statement you do understand with legislative branch had no involvement. In making the rules correct okay. VOL a manager yes thank you. Of the fines. That we are talking about are those are all related to covert nineteen directives issued either by. Well by the health department you didn't issue a directive yourself under your agency they were all issued under the department of health and you are forcing them is that correct that is correct and I'm sorry go ahead they are you're referencing the two hundred and fifty seven that have been forwarded to Administration are what are those all were you referring to the the dollar figures contained in the financial impact statement of the dollar figure that's contained in the impact statement that would be refunded to the businesses are all of is all of that related to fines that were issued to businesses that were associated with the health department guidelines that you're there to enforce yes Sir. Okay thank you all right Senator Flippo you're recognized thank you madam chair for the future reference if you could put me in front of Senator hammer and the very best I do get in the queue so to my questions for me that would. Remember. this Taylor first of all I appreciate you being here with us today and I think Senator hammers that right that we had no involvement with the rules and that's part of problem that we're going through right now you know personally have a problem with the government that expects more from its people than it does from itself and I've watched some of our state agencies including the department of health I have some pretty big blunders along the way. I don't know of any may find your mechanism that we patent place to hold you know you know that's been allies in the people working in state government for mistakes that they're making everybody's trying to get through this. Mmhm and you know one of the things that Senator had hammered I decided about before he felt this bill and I'm gonna ask you. Were there any chain restaurants or or or you know you know you. Establishments that had a national presence for a multistate present that you will find during this Last year yes Sir fifteen percent of that two hundred and fifty seven that we find have issued offers not all of them have been fully adjudicated but the two hundred fifty seven approximately fifteen percent are chains whether it's a dollar general or one of the well known restaurant chains we have to have those funds before us. Does not seem like a overall small percentage considering the large presence that these larger change happened in the state I mean dollar general Gee Gee whiz we got those popping up all over north central Arkansas. It does appear to be a small percentage of that and I do not have the percent of times that we've visited back when you review the when I review the reports that are coming in for they have director of enforcement I see that those agents are going out there what we're saying is there is a little bit larger of compliance with some of the change depending on that time. All right but I'm sure I'm good at it but questions all right thank you and seeing no other questions thank you so much for your testimony all right to the then we have Laura issue with the Arkansas department of health and Matt gill may more with the Arkansas department of health you both could come up and sit and missus you would like to have the first thank you madam chair entity would you introduce yourself for the record certainly thank you madam chair members of the committee Larson I'm general counsel for the department of health and we appreciate the opportunity to talk with you today about this bill we also appreciate senator Solomon visiting with us about it prior to the committee meeting today we did want to clarify a few of the Statements that are inside the bill as it's written throughout the public health emergency of the Department health received thousands of complaints about lack of compliance with health directives through its call centre and emails and we continue to receive calls from concerned citizens every day the department provides due process prior to issuance of any civil penalty during the public health emergency multiple attempts to encourage voluntary compliance have been made with thousands of permitted facilities and retail facilities across the state with success for the majority of our efforts only after complaints of multiple violations and refusal have six food establishments been set an order and only five have consented to one violation for a two hundred fifty dollars that civil penalty that equates to less than point zero nine percent of all of the public health emergency compliance assessments conducted after a warning the Department of Health also issued sixty seven fifty dollar civil penalties to cosmetology establishments for non compliance out of four thousand three hundred ten licensed alliance which is only point zero two percent of all of the salons across the state. Unfortunately we we do have to point out that they're incorrect searches assertions in this bill including that the department of health has been unfair or arbitrary in its enforcement and essentially that there's no rational basis or data to support the directed. This is not a simple return of civil penalties because the bill is based on mistaken statements the true future fiscal impact is more than returning legitimately collected civil penalties admission of wrongdoing sets up the state of Arkansas to be sued in federal court for violation of civil rights this bill if enacted subject the state to future litigation in the claims commission in federal court from various entities for enforcement of legitimate health directives more importantly it diminishes the ability to use established procedures to protect others and have a public health emergency it removes the deterrent effect of consequences for not following the directives which may result in further spread of the virus and that would conclude by statements and I'll pass it to all right the Mr Gilmour. Thank you Matt Gilmore partner health state senator sold as well as talking to us and within the Arkansas earns I don't want to repeat the same things have been said but I'll just say we haven't targeted businesses of certain types and kinds we operate off of the plane based process and we take each one I'm serious we do work with them I know we work with some you know multiple times to six times trying to you know educate and provide some kind of direction and show them you know. What will work with public health and so I just wanna make that clear we have this is something that we you know it's not been you know fun for any of us and I know it's it's been a challenge for you all your constituents but I think it's important that we get the consistency here and moving forward of the set up of a precedent for other rules that we have to enforce just want to state that thank you all right of senator hammer your question thank measure of all these funds that were that were wage or levied against individuals. What did we did these results because your agent actually walked into the stable shipment and actually caught somebody violating one of the health department rules. It varies but most were complaint driven which inspired are in an environment health thanks to go out and reach out to the retail establishment were to the restaurants themselves often times they would observe this in person and it knows the restaurant was fined and less they were observations by the health inspector or by the ABC enforcement officers and this was only after multiple attempts to achieve voluntary compliance sometimes three four five six times follows manager yes would would you encountered a situation where you often and use all the customer in violation of the health department directive. Why did you not find the individual instead of finding the business. Thank the whole purpose of our directives is to encourage voluntary compliance that we would respectfully ask people to put their masks over their nose or to put their mask on the whole enforcement mechanism of the department of health is always to encourage and education first and to encourage people to comply first. Thank members all right any of the okay Senator Hester. Yeah I think I think what we're seeing here in and I believe the Department health ABC probably has treated people very fair and and done your job the frustration is not at you the frustration is that the executive branch gave us zero input on what was happening to our constituents and and I I don't think we should against input the first thirty sixty ninety days but at some point six months nine months and. There was plenty of time to reach out to the legislature and so the votes that you're about to experience I don't think it's reflection upon the the work that you guys have done is the frustration that we had that no one but thank you. All right any other questions. All right the discussion all right. Chair and just I wanted to comment on what you guys said with mad people calling and complaining still and something that I've experienced personally but I know many business centers of experienced is people M. hiding out taking pictures of them people just coming in to you hair salons and that don't go there but they're just taking pictures of what's going on in there and see him and like there are and citizens who have essentially terrorized business owners and people working trying to put food on the table during this pandemic that are cutting hair or serving food or you know at the farmers market I had people hiding behind bushes are farmers market taking pictures of people walking around outside and and not understand the context of someone you know remove their mask for a minute you get a drink or two and be able to hear you know talk to someone so they could hear and and they have no idea the context of what's actually going on but then they're turning around calling the health department complaining and so I think to it's fair to say that well yes you may you know likely do get a lot of calls a lot of those calls are people that I think are harassing people in our communities and that to follow guidelines in a way that they feel are appropriate and without knowing the circumstances of what's actually going on and that's not right or fair to people who are just trying to you know feed their kids and keep their homes so I just wanted to point that out thank you all right any other of discussion. All right thank you so much we appreciate your testimony thank you. And the. Senator hit of. Sullivan we're going to help you go back to the end of the table and you are ready to close. Thank you not be quick with that I've had a great relationship to the Department of Health would agree they've gone above and beyond in many ways to keep our people safe in the the comments were all trying to do that and as senator Hester said this is about representing our people yeah there's a little bit of misdirection here I don't think it's intentional but it's not about us on willing to have regulatory issues we're certainly support of a regulatory and mentoring and monitoring and fines absolutely we do that but again this is about the consent of the governed and we talk about what precedent this is kind of set this is going to undermine the most important foundational principle that our government is founded on that's the consent of the governed and what it will do is cause governors in the future and leaders in the future to reconsider when they do emergency orders bringing the legislature in at some point of course the first ninety days and and maybe even beyond those decisions needed to be done by an executive but at some point we've got to participate in our people are want to hear that thank you and I'll be closed madam chair all right ladies and gentleman. You've heard the discussion of the bill the of for and against and also discussion and the closing what is your pleasure C. we have a a do pass of the second all those in favor say aye. All those opposed no. All right congratulations you have placed your bill. Ladies and gentlemen if there's no other business and I don't think so yes that's right excuse me you're right on the the agenda it says god sent. And The New that he had already coming down so there you go in its house bill eleven eighteen. Thank you madam chair members of the committee and this bill all it does is allow for and direct sales online for cottage food so our current state law allows for direct sales only limited venues thank County Fair farmers markets and or from someone's house and the cottage food is what the FDA has categorized as a non potentially hazardous foods so and some of you guys have talking in front of you something like that brownies we have a pretty limited list in Arkansas as to what a cottage food actually is and our current laws restrict cottage food operators in a way that's really unnecessary and for protecting public health and safety of those in our state and and those restrictions actually stretch far beyond this bill and this bill also if we legalize the ability for people to ship their cottage speeds across the state and and in the states that have a similar laws and it'll provide opportunity for entrepreneurship for people that have the talent or skill and the grit determination and work ethic to build a business from the ground that from scratch and and this allows them the opportunity I think to get a following and from across the state or other states before they decide to maybe invest in a commercial kitchen or something where and if they're selling to restaurants or grocery stores they have to have a commercial license and and that's a pretty big left based on the M. requirements from the department of health on what that looks like so This allows them an opportunity to really add bill the following in the face for their business and be able to reach people far and wide and that is all I have and I'm happy to take questions. All right ladies and gentleman do you have questions for senator Davis. Well I have one two steady curiosity you know during the coded the requirements and all that at a meeting what is a cottage in industry do when. That is upon them input yeah and so many of them I mean you could set amount on your front porch at people pick up and a lot of communities have an online farmers market and and actually a lot of the physical Mike and in person farmers markets and several across the state started on and started online and continue that way or did drive three and so communities kind of worked out what time works best for them but yeah in in that county we had in person farmers markets and but we have certain guidelines that we had to abide by and and that that's where people could sell their goods all right now it's a good answer all right any other questions. All right seeing none does anyone want to speak for the bill or against the bill. All right seeing none of any discussion. Okay would you like to close for your bill I am class ask forget that please all right we have then a motion we have a second all right all those in favor say aye. All those opposed congratulations you have passed your bill thank you now ladies and gentlemen I don't see any new business or any old business and we are returned.